Investigations into the relationship between phospholipids and brain acetylcholine. The effect of a phospholipid mixture extracted from the bovine cerebral cortex and of pure phosphatidylserine (PS), phosphatidylethanolamine (PE) and phosphatidylcholine (PC) on ACh output from the cerebral cortex was investigated in rats anaesthetized with urethane. All the phospholipids were administered after sonication. ACh was determined by bioassay. The following results were obtained: after i.p. administration of 100 mg/kg of the phospholipid mixture a marked increase in ACh output I asting approximately 30 min was observed. The i.v. administration of PS caused a dose-dependent increase in ACh. At the dose of 150 mg/kg a 3-fold increase over the spontaneous ACh output was found. PE was less active than PS and PC showed no effect on ACh output. The possibility that PS and PE might increase ACh output through a mechanism facilitating Ca penetration is discussed.


Fine structure of the testis and epididymis of rats treated with cyproterone acetate. Adult male rats were administered the antiandrogen, cyproterone acetate, for 4, 8 or 12 weeks, and the histology and fine structure of the testis and several parts of the epididymis were studied. After treatment for 8 or 12 weeks, the testes of treated animals displayed a great reduction in the abundance of late spermatids. Necrotic cells, many of which were identified as cap-phase spermatids, were present in the seminiferous epithelium. Sertoli cells contained many large lipid droplets and lysosome-like structures with a content of cellular debris, including parts of spermatids. Leydig cells of treated rats were smaller than those of control animals at all the intervals studied. Sperm were absent from the lumen of the middle segment, or caput epididymidis, of severely affected specimens. In the terminal segment, or cauda epididymidis, the microscopic appearance varied in different regions. In the proximal part of the cauda epididymidis, the lumen was usually clear of sperm. The epithelium was tall and the light cells were very large and distended with many dense bodies resembling lysosomes. In contrast, in the distal part of the cauda epididymidis, the lumen was filled with sperm and debris, which appeared to be derived from germ cells. It is suggested that the light cells of the epididymal epithelium may have a role in clearing the lumen in the proximal part of the cauda epididymidis, in which they are particularly large and numerous. The results suggest that in the presence of cyproterone acetate, germ cells develop up to a cap-phase spermatids and then begin to undergo degeneration and death. This alteration may have an important role in the antifertility effect of the drug, but changes in the epididymis may contribute also.


Observations of the microcirculatory bed in rat mesocecum using differential interference constrast microscopy in vivo and electron microscopy. The microvascular bed of the rat mesocecum has been examined in vivo using differential interference (Nomarski) optics and subsequently by electron microscopy. The preferential channel, from terminal arteriole to collecting venule, has been examined. In the terminal arteriolar segment the endothelial layer is covered by a continuous layer of smooth muscle cells which, in turn, are surrounded by adventitia. In the metarteriolar segment the periendothelial cells still resemble smooth muscle cells but the tunica media is discontinuous. In the distal segment periendothelial cells are more scattered and have the appearance of pericytes. There appears to be a continuous transition of the periendothelial cell layer from terminal arteriole to distal segment. Nerve endings were seeen in both the terminal arteriolar and metarteriolar segments. During contraction smooth muscle cells, oriented circumferentially, shorten and thicken. Endothelial cells appear anchored by myoendothelial junctions. Endothelial cells have filaments which show increased banding during vasoconstriction, suggesting that such cells may contract. Capillary offshoots leave the preferential channel, usually at right angles. Smooth muscle cells are oriented to form a sphincter and there are many myoendothelial junctions at the branch point. Within a short distance the capillary branch loses its periendothelial coat.


Evaluation of a multitest microtechnique for yeast identification. A new, multitest, microtechnique system, API 20C (Analytab Products Inc. Clinical Yeast System), was evaluated by comparing it to the U.S. Center for Disease Control (CDC) standard techniques for the identification of yeast. Forty-four yeast strains isolated from clinical specimens were tested by fermentation and assimilation. Six fermentation carbohydrates and ten assimilation carbohydrates were compared. API results were read after incubation of 24 and 48 hours while the standard CDC system was read after 48 hours and 14 days when needed. One hundred per cent agreement in identification was found between the two systems in the strains studied. Growth in the presence of actidione was tested by the API strip only and gave unreliable results with nine per cent of the strains tested. The API 20 Clinical Yeast System provides a reliable and rapid approach to yeast identification enabling the clinical laboratory to completely identify a yeast organism in 48 hours instead of the usual four to 14 days. A cost comparison showed the API system to be significantly more economical than the conventional method of identification.


PSRO: current status of the professional standards review organization program. Since Public Law 92-603 was enacted in October 1972 considerable progress has been made in the establishment of Professional Standards Review Organizations (PSROs) for the purpose of determining the necessity, appropriateness, and quality of medical care provided beneficiaries of the major programs authorized in the Social Security Act. Sixty-five conditional PSROs are implementing review in acute care hospitals in their geographic area, and 55 planning groups are developing plans to qualify for conditional PSRO designation. The PSRO hospital review system is based on three interrelated review mechanisms. These are concurrent review, which includes admission certification, and continued stay review through discharge; medical care evaluation studies; and analysis of hospital, practitioner, and patient profiles. This article describes the review system in some detail and the potential opportunities the PSRO program offers to occupational therapists.


Twins with academic learning problems: antecedent characteristics. Developmental histories of 46 children experiencing academic difficulties, all of whom had participated since birth in a longitudinal study of twins, were compared with a matched control group of twins. Genetic influences on the liability for academic difficulties are suggested, since identical pairs were more likely than fraternal pairs to be concordant both for academic difficulties and for preschool behavioral characteristics specific to the index group.


Influence of pancuronium of potassium efflux produced by succinycholine. Serum potassium (K+) levels were measured after thiopental, succinylcholine, pancuronium, and pretreatment with pancuronium prior to succinylcholine, in 100 patients divided into 4 groups of 25 patients each. Significant increases in serum K+ were found after succinylcholine (1 mg/kg). Administration of pancuronium in small doses (20 mug/kg) prior to succinylcholine (1 mg/kg) was effective not only in complete prevention of serum K+ elevation but also produced consistent decrease in serum K+ concentration below control values. Both thiopental and pancuronium produced moderate fall in serum K+ levels. Our observations indicate that pretreatment with pancuronium may play a beneficial role in patients at risk from succinylcholine hyperkalemia.


Respiratory distress with left aortic arch, right descending aorta, and right ligamentum arteriosum: a case report. A 7-year-old girl manifested the rare anomaly of a ventricular septal defect (VSD) with left aortic arch, right descending aorta, and right ligamentum arteriosum. After open-heart surgery to correct the VSD, symptoms of tracheal obstruction on spontaneous breathing developed, due to tracheal compression by the right ligamentum arteriosum. The compressed segment of the trachea was found to be thin and unstable following division of the ligamentum. Positive-pressure breathing and continuous positive airway pressure breathing effectively splinted the patient's airway during the postoperative period, with recovery of the patient.


Influence of pancuronium or d-tubocurarine on circulatory responses during thiamylal-N2O-halothane anesthesia. Circulatory responses after thiamylal (4 mg/kg) and pancuronium (0.08 mg/kg, 20 patients) or d-tubocurarine (dTc, 0.5 mg/kg, 20 patients) followed by tracheal intubation and nitrous oxide-halothane administration were measured. Three minutes after thiamylal, the mean arterial pressure (MAP) and cardiac index (CI) decreased significantly only in patients receiving dTc. Heart rate (HR) was increased 12 bpm in both groups. The magnitude of reduction in MAP and CI was similar and the HR was not greatly different between groups after 5 minutes of N2O-halothane administration. MAP and CI were better maintained following thiamylal in patients receiving pancuronium as compared with dTc. However, circulatory responses during early anesthetic maintenance were not influenced by the choice of neuromuscular blocker.


Spinal anesthesia: bupivacaine versus tetracaine. The clinical effects of equal hyperbaric doses of bupivacaine HCl and tetracaine HCl were studied and compared in 99 adult men undergoing spinal anesthesia for similar surgical procedures. The spinal anesthetic agents were used in random order in various dosages. Comparisons were made of (1) amount of anesthetic agent used, (2) elapsed time for onset of analgesia, (3) elapsed time for obtaining maximum anesthesia, (4) cephalad dermatome level of anesthesia, (5) incidence of motor blockade, and (6) duration of anesthesia. Results with the 2 drugs in equal dose, volume, and specific gravity were almost identical. However, tetracaine provided a motor block in a significantly greater number of patients than did pubivacaine (100 versus 42%, rho less than 0.001) when both drugs were used at the 9.75-mg dose level.


Neuromuscular blocking effects of aminoglycoside antibiotics on fast- and slow-contracting muscles of the cat. The neuromuscular-blocking effects of neomycin, streptomycin, and gentamicin were examined in fast- and slow-twitch muscles of pentobarbital-anesthetized cats. These antibiotics were more effective in reducing indirectly stimulated contractions of the gastrocnemius muscle than of the ipsilateral soleus muscle in adult cats. Respiratory-depressant effects of these antibiotics were more closely associated temporally with effects on soleus than on gastrocnemius twitch. Neomycin was a more potent neuromuscular blocking agent in kittens greater than 7 weeks old than in kittens less than 6 weeks old. Calcium ions were more effective in antagonizing the effects of neomycin on gastrocnemius than on soleus twitch; however, neostigmine was more effective in antagonizing the effects of neomycin on soleus than on gastrocnemius twitch. These data indicate a difference in responsiveness of fast- and slow-twitch muscles (fast greater than slow) to the neuromuscular-blocking effects of aminoglycoside antibiotics, and suggest that this may be related to a difference in the predominance of pre- and postjunctional inhibitory actions of these agents in the 2 muscle types.


"Acupuncture anesthesia"--a clinical study. Forty-two patients who were to undergo plastic surgical procedures were asked whether they would accept acupuncture as a substitute for local anesthesia. Eight patients agreed to acupuncture; one of these had 2 operative procedures with acupuncture. Five of the 9 procedures were successful; the remaining 4 required conversion to local anesthesia. After interviewing the patients, we felt that the success of "acupuncture anesthesia" was largely dependent on patient motivation, and that a patient may experience pain during surgical procedures without any change in facial expression or vital signs. We concluded that "acupuncture anesthesia" is of little value in our patient population at present. Its results are unpredictable; therefore, we anticipate that patient acceptance will be small.


Perioperative awareness and recall.

Perioperative awareness and recall. This study was designed to introduce a relevant stimulus at successive time intervals during the entire anesthetic period, including the pre- and postanesthetic periods. Using galvanic skin responses, the authors were able to recognize a plane of light anesthesia and arousal, at which time it is considered that sensory input might be perceived. Presenting to the patient a stimulus of some relevance, but one not likely to be psychically traumatic, they investigated the correlation between the ability to maintain an attention span and to recall in the postoperative period. No recall was obtained during the intraoperative period, the first occurrence of recall being in the immediate postanesthetic period and the incidence of recall increasing with increasing time intervals after the end of anesthesia. The authors conclude, however, that since intraoperative awareness without recall is a possibility, care should be taken to avoid emotionally disturbing auditory stimuli throughout the anesthetic procedure.


Intraoperative awakening for early recognition of possible neurologic sequelae during Harrington-rod spinal fusion. To permit early recognition of possible cord trauma due to spinal fusion with Harrington-rod instrumentation, 42 patients were awakened introperatively for testing voluntary motor function of the limbs. N2O-O2-curare and morphine were used for anesthesia in all patients. In 5 patients, who refused IV induction, halothane was given for induction only. Only 1 patient had any complaint referrable to being awakened intraoperatively. The awakening caused no displacement of Harrington rods in any patient. No neurologic sequelae were found.


Post-thoracotomy intercostal block: comparison of its effects on pulmonary function with those of intramuscular meperidine. Study of 34 patients who had undergone thoracotomy revealed that the group given intercostal nerve block analgesia had a significantly smaller decline in vital capacity after operation than did the group given narcotic analgesia only. The postoperative increase in arterial CO2 tension of the nerve block group also was significantly smaller than that of the narcotic group. The study suggests that intercostal nerve block for post-thoracotomy analgesia offers some advantage in preserving effort-dependent pulmonary function when compared with postoperative narcotic analgesia.


Changes in blood chemistries following prolonged enflurane anesthesia. Blood chemistries revealed minimal or no injury to the kidney or liver in 12 young healthy male volunteers subject to 9.6 MAC hours of enflurane anesthesia without surgical stress. The results were similar to those previously obtained with halothane, isoflurane, fluroxene, and diethy ether.


Cardiovascular and respiratory effects of isoproterenol before and after artificial heart implantation. Quantitation of peripheral vascular versus direct cardiac effects of isoproterenol (0.002 mg/kg) was attempted in a new pharmacologic animal model, the unanesthetized calf, before and after replacement of its natural heart with a pneumatically driven artificial heart (AH). Isoproterenol significantly increased (rho less then 0.01) cardiac output and pulmonary shunt and decreased aortic blood pressure before and after AH replacment. Elevation of cardiac output and pulmonary shunt was greater (rho less than 0.05) and depression of aortic pressure less (rho less than 0.05) before AH replacement than after. Isoproterenol did not change pulmonary artery (PA) or right atrial (RA) blood pressures before AH implantation but did reduce (rho less than 0.05) PA diastolic and mean pressures and increase mean RA pressures after. Systemic vascular resistance was significantly (rho less than 0.01) reduced by isoproterenol before and after AH implantation. Heart rate, 02 uptake, respiratory rate, tidal volume, and minute volume were all markedly increased before AH implantation but unchanged after. These findings demonstrate that approximately half the increase in output and pulmonary shunt and all changes in 02 uptake and respiratory dynamics after administration of isoproterenol are related to cardiac effects of the drug. Our data also suggest that the unanesthetized bovine before and after AH replacement is a unique model for study of the differential pharmacology of drugs with respiratory, cardiac, and peripheral vascular effects.


Spinal anesthesia for lumbar disc surgery: review of 576 operations. Neurologic complications accompanying spinal anesthesia were examined in 576 lumbar disc operations on 507 patients. The single serious complication did not seem attributable to the choice of anesthetic method. Minor neurologic complications, with the exception of spinal headache, could be explained by surgical manipulation. The authors conclude that spinal anesthesia is safe for surgical operations on the laterally herniated lumbar disc.


A dosage nomogram for sodium nitroprusside-induced hypotension under anesthesia. Sodium nitroprusside (SNP) was used to produce deliberate hypotension in 30 selected patients, 9 to 78 years of age, for total hip replacement under halothane-N2O-O2 anesthesia. Hypotension was induced in the first 13 patients by infusing a 0.01% (100 mug/ml) solution of nitroprusside (NP) in 5% dextrose. Blood pressure was diminished to a level just producing a dry surgical field. Preliminary data demonstrated that the mean arterial blood pressure (MAP) achieving this condition was 65 torr (p less than 0.01) and that the minute dosage of NP (mug/min) required to consistently reduce MAP to 65 torr could not be predicted on the basis of body weight. However, the age/weight ratio (yr/kg) of each patient, plotted against the known minute dosage of NP given during anesthesia, produced a highly significant dose-response curve (p less than 0.001, r = -0.8226). The preliminary dose-response curve was examined in a double-blind study on an additional 17 patients. The curve derived from the prospective study did not differ from that of the preliminary study. In addition, the combined data from the retrospective and prospective studies (30 patients) gave a better statistical fit than did those from the preliminary study alone (p less than 0.001, r = -0.8939). The nomogram provides an additional margin of safety in the use of this potent, fast-acting drug. SNP has been found predictable and effective in reducing surgical blood loss in selected patients undergoing total hip replacement.


Serum neutralizing antibody after rabies postexposure prophylaxis. One hundred seventy-seven persons submitted specimens for serum neutralizing antibody titer detreminations 30 to 90 days after starting postexposure rabies prophylaxis. Ninety-two percent of those who received duck embryo vaccine alone developed adequate antibody titers. However, 23% of those who received equine antirabies serum plus duck embryo vaccine failed to develop an adequate antibody titer; one of these inadequate responders subsequently died of rabies. Factors that increased the risk of a poor antibody response included the receipt of steroids during the course of postexposure prophylaxis, and the use of more than 55 lu/kg of equine antirabies serum. Many persons receiving postexposure rabies prophylaxis fail to develop adequate humoral immunity and may have an increased risk of developing rabies. We suggest that persons receiving postexposure rabies prophylaxis should have serum neutralizing antibody determinations 30 to 40 days after starting treatment.


Effect of norleucine on mycelial fragmentation in Cephalosporium acremonium. DL-Norleucine, which is known to replace methionine for stimulation of cephalosporin C formation, also mimics methionine's effect on arthrospore formation. Thus, hyphal fragmentation, like antibiotic biosynthesis, is divorced from a sulfur donation role.


Treating acute heroin and methadone toxicity. Acute heroin and methadone overdose reactions are seen with increasing frequency in E.R.s servicing middle-class white suburbia. The authors give step-by-step procedures for the management of this life-threatening medical emergency.


[Scanning electron-microscopic findings in orthoergically damaged skin surfaces of hairless mice (author's transl)]. Mechanic-chemically defined irritation of the skin surface of hairless mice regularly leads to macroscopically sub-visible changes of the horny layer. Scanning electron-microscopic analysis reveals extended regular horny layer dehiscences, as well as deeper dehiscence or trench formations in the area of irritation, as compared to normal skin. The damaged horny layer sample, presented respectively, depends-to a degree-upon type, intensity and duration of irritation. Hairless mice proved to be best suited at test animals for informative studies concerning cutaneous resistance to stress.


Fatty change in the brain in perinatal and unexpected death. The presence of fat-laden cells in the cerebrospinal fluid is usually associated with a fatty change found particularly in the area of the tapetum in the postnatal infant. In a series of 307 child deaths the presence of fatty change in this area of the brain was age-related, decreased with age, and was rarely present over the age of 4 years. It was particularly common in stillborns and in children dying with respiratory distress, but was rare in children dying from acute surgical conditions or from acute infections. It was found in one-half of a series of 41 infants found unexpectedly dead and in whom no adequate cause of death was found. The most likely cause of this fatty change is thought to be chronic hypoxia.


The impact of national health insurance on the tasks and practice of psychiatry. Psychiatry, like all professions, is strongly affected by changes in societal expectations and economic forces. Changes in professional priorities and patterns of patient care will undoubtedly be brought about by national health insurance. Two major types of national health insurance have been proposed: comprehensive health insurance and catastrophic insurance. We do not anticipate major impact on psychiatric tasks from some form of catastrophic insurance. Comprehensive health insurance would shape and change psychiatric practice. An examination of psychiatric tasks provides a framework for anticipating alterations in practice. We identify four major task areas in psychiatry: (1) medical tasks, (2) reparative tasks, (3) social control tasks, and (4) humanistic tasks. These tasks would be differentially influenced. Psychiatry's medical tasks will be stressed, while funding for many reparative tasks may be limited. The care of the severely ill patient may be fragmented because of problems in integrating medical and rehabilitative services.


[Primary cardiac tumors in childhood: Three case reports in early infancy (author's transl)]. Three cases of primary cardiac tumors in early infancy are reported: 1) An intrapericardial teratoma which manifested as neonatal respiratory distress, cardiac enlargement and normal electrocardiogram. Diagnosis was not made during life. 2) A fibroma was diagnosed because of the presence of a greatly enlarged heart associated to ventricular tachycardia. Angiocardiography showed the tumor localized in left ventricle. Extirpation was attempted but resulted impossible. 3) A rhabdomyoma simulating severe pulmonic stenosis. Multiple tumors were detected by angiocardiography; only some of which could be extirpated. Histopathological examination was carried out on all the patients and a complete post-mortem examination on two of them. An extensive revision of the three types of tumors is described.


Herniation of the singular nerve into the round window niche. We report two cases of herniation of the singular nerve into the round window niche and one case of bony dehiscence without herniation between the round window niche and the posterior canal ampulla. It is believed that the middle ear and the inner ear are completely separate. However, in the temporal bone of a 10- to 15-week-old human fetus, a communication between the round window niche and the posterior canal ampulla is observed. Later, the mesenchymal tissue in the communication is replaced by cartilage from near the posterior canal ampulla. If the communication does not fill with cartilage, ossification is not able to begin behind the posterior canal crista. When there is bony dehiscence behind the crista, the singular nerve fibers are easily pressed out by ossified endosteal bone and herniated into the round window niche.


Sensorineural deafness and labyrinth damage due to lymphocytic choriomeningitis. Report of a case. Lymphocytic choriomeningitis (LCM) occurred in a hamster handler, produced a "flu"-like illness, and caused unilateral sensorineural deafness and labyrinth damage. Unilateral sensorineural deafness and labyrinth damage caused by LCM virus have not been previously described in the literature.


Systematic examination of the red eye.

Systematic examination of the red eye. The major causes of 'Red Eye' are discussed and the importance of accuracy of diagnosis to recognise and treat potentially sight affecting conditions stressed. Referral when necessary is important, and the article ends with a working list of reasons for referral.


Respiration-dependent efflux of magnesium ions from heart mitochondria. Energy-linked respiration causes a net movement of Mg2+ between rat heart mitochondria and the ambient medium. When the extramitochondrial concontration of Mg2+ is less that about 2.5 mM the net movement of Mg2+ constitutes an efflux, whereas a net influx of Mg2+ occurs when the external concentration of Mg2+ is greater than this. Both the efflux and the influx are induced to only a very small degree by externally added ATP. Evidence suggests that Pi may be required for the respiration-induced efflux of Mg2+.


General practitioner prescribing at first attendance for diseases. Prescriptions written during first attendances of patients in the second quarter of the Australian GP Morbidity and Prescribing Survey (April-June, 1973), have been recorded and the results analysed. In the quarter, April-June, 1973, 186 general practitioners recorded data on all patients in a random week. The total number of attendances was 30,713.


Mycotic aneurysms of the internal carotid artery. Case report. The authors report a case with two mycotic aneurysms in the cavernous portion of the internal carotid artery, presumably secondary to a transient bacteremia from pneumonia. The strikingly rapid development of the aneurysms was demonstrated by angiography. Painful total ophthalmoplegia and extophthalmos were the main clinical features.


Plasma cholesterol levels in rabbits fed low fat, low cholesterol diets: effects of dietary proteins, carbohydrates and fibre from different sources. Rabbits become hypercholesterolemic when transferred from commercial feed to a low fat, cholesterol-free semisynthetic diet. The role of different dietary components in mediating this effect was investigated by varying the composition of the semisynthetic diet and of the commerical feed. Addition of alfalfa to the semisynthetic diet prevented the normal hypercholesterolemic response, but other plant products, including several with high fibre content, were ineffective. Increasing the content of powdered cellulose appeared to enhance the response. A commercially formulated diet in which the alfalfa and soybean meal components were replaced by ground corn and oats did not produce a significant elevation of plasma cholesterol. Substitution of different sugars or starches for the dextrose in the semisynthetic diet gave variable results, but of those tested, only potato starch prevented the hypercholesterolemia. The type of protein used in the semisynthetic diet had a marked influence on the level of plasma cholesterol. Semisynthetic diets containing proteins from animal sources gave higher plasma cholesterol levels than those containing proteins from plant sources. Very low levels were obtained with a low choline semisynthetic diet containing soy protein isolate, and supplementation with choline and methionine only raised the level to that normally obtained with commercial feed. Replacement of the salt mixture in the semisynthetic diet by one specially recommended for rabbits made no significant difference to the hypercholesterolemic response. Prevention of coprophagy did not significantly affect plasma cholesterol levels in rabbits on either commerical or semisynthetic diets. Growth performance was generally better on commercial feed than on semisynthetic diets but there was no direct correlation between weight gain and level of plasma cholesterol in rabbits on the different semisynthetic diets.


Aldosterone, deoxycorticosterone and corticosterone differences between arteriosclerotic breeder vs nonarteriosclerotic virgin rats. The circulating levels of the major adrenal steroids, corticosterone (Cmpd. B), deoxycorticosterone (DOC), and aldosterone were compared in male and female, arteriosclerotic, breeder and non-arteriosclerotic virgin, Sprague--Dawley rats under resting conditions, i.e., quiescence, and after exposure to a mild stress, i.e., movement from one room to another just prior to autopsy. Under resting conditions, the arteriosclerotic animals had significantly greater circulating levels of Cmpd. B, DOC and aldosterone than the non-arteriosclerotic animals. Both the arteriosclerotic and non-arteriosclerotic animals were able to respond adequately to the mild stress stimulus. However, the female breeder rats which manifest the most severe aortic sclerosis, showed the greatest increase in Cmpd. B and aldosterone in response to the mild stress. Although no statistically significant differences could be found between female breeders with grossly visible aortic sclerosis of clear, minimal, moderate, or severe degree, it was apparent that adrenal steroid responsiveness becomes progressively compromised with increasing severity of arteriosclerosis, e.g., unusually high or low levels of Cmpd. B and aldosterone under both quiescent and mild stress conditions. It is suggested that there may be some connection between abnormal hypothalamic-pituitary-adrenal-gonadal function in repeatedly-bred and the pathogenesis of their naturally-occurring ateriosclerosis.


Booster vaccination with further live attenuated measles vaccine. Revaccination with live attenuated measles vaccine was evaluated in a large group of children to determine (1) if protective antibody to measles infection could be augmented and (2) after what interval will the revaccination yield optimal results. The rate of decline in measles hemagglutination-inhibition (HI) antibody was observed to be directly related to the time interval since the previous vaccination, and individuals with declining titers became increasingly responsive to revaccination with a maximal response approximately four to six years after previous vaccination. Six-month follow-up studies demonstrated sustained elevations in measles HI antibody titers. Measles-neutralizing antibody showed less tendency to sustain a titer increase with revaccination. The observations suggest that revaccination with live, further attenuated measles vaccine is safe and may augment immunity.


Botulism in Alaska, 1947 through 1974. Early detection of cases and investigation of outbreaks as a means of reducing mortality. Since 1947, there have been 21 outbreaks of botulism in Alaska, involving 46 people with 13 deaths (28% fatality). In the last six months of 1974, there were four outbreaks. With one exception to date, type E toxin was involved in all outbreaks for which laboratory confirmation has been obtained, and in all instances, Eskimo and Indian foods were the source. Clinical signs and symptoms of nausea and vomiting, dysphagia, diplopia, dilated pupils, and dry throat occurred with great frequency, forming a diagnostic pentad. We recommend that treatment include close medical supervision, supportive care, and the use of antitoxin, cathartics, and possibly, penicillin. The source of an outbreak must be determined to prevent further cases. Only prompt recognition, therapy and epidemiologic investigation can reduce the death toll from botulism.


Arrhythmias during acute pericarditis. A prospective study of 100 consecutive cases. One hundred consecutive patients were examined to ascertain the incidence of clinically significant arrhythmias during acute pericarditis. Only seven arrhythmias, all atrial, occurred, and these only in patients with heart disease. It appears that the vulnerability of the sinus node to being engulfed by subepicardial extension of the inflammatory process is insufficient by itself to provoke arrhythmias in the absence of disease of the myocardium, valves, or coronary arteries.


Serologic therapy of tetanus in the United States, 1965-1971. To study the influence of tetanus antitoxins on the outcome of human tatanus, we analyzed data on 545 cases reported to the Center for Disease Control from 1965 through 1971. Patients treated with antitoxin had a significantly lower case-fatality ratio than untreated patients, and the effect of serotherapy was not modified significantly by the age or race of the subjects. Antitoxin of equine origin and human tetanus immune globulin (TIG) were equally effective. The data on the effect of different doses of TIG suggest that 500 units may be as effective as the currently recommended therapeutic dose of 3,000 to 10,000 units. The importance of possible bias introduced by unmeasured factors such as quality of supportive therapy could not be determined, but confounding by 11 recorded potentially confounding factors was minimal.


Efficacy of selected diagnostic tests for sexually transmitted diseases. Direct urethral and cervical smears for gonorrhea in women are useful because of their high specificity. Male rectal smears are less efficacious. Direct tests for candidiasis and trichomoniasis are also specific, but less sensitive than generally thought. Most tests exhibit only moderate month-to-month variability. No association between infection with trichomonads and gonococci was demonstrated. The gonococcal tests all perform best under conditions of high prevalence, such as those that obtain in venereal disease clinics in the United States.


Problems with balloon-tipped stylet pacemaker catheters. Balloon-tipped stylet pacemaker catheters have two intraluminal stylet-related limitations that warrant extreme caution in their use. The first limitation involves manipulation of the stylet inside the catheter and appears to be a consequence of the angulation made by the catheter in the right atrium; the second limitation is a complication involving actual in vivo fracture of the stylet and is presumably related to tapering of the stylet at a point of stress in the right atrium. Although these pacemaker catheters have distinct advantages, the problem arising from their use cannot be ignored. Until modification can be made to resolve these problems, this catheter must be used with extreme caution.


Lymphogranuloma venereum. Outbreak in a university community. One aspect of the current epidemic of venereal diseases is the spread of lymphogranuloma venereum (LGV). Formerly confined to the lower echelons of society, it now affects more affluent classes as well. A cluster of four cases was seen in a small college town. Serial LGV complement fixation tests, the most valuable diagnostic tool, may reveal many more cases than reported previously. Early treatment is important. We recommend therapy for all persons sexually exposed to LGV who have any LGV complement fixation test anomaly, whether or not clinical signs develop.


Calcifediol in chronic renal insufficiency. Skeletal response. Quantitative histology of thin, nondecalcified sections was performed on sequential bone biopsy specimens from five patients undergoing long-term hemodialysis and treated with calcifediol (25-hydroxycholecalciferol) for periods of three to nine months. With increase of intestinal absorption of calcium and decline of circulating immunoreactive parathyroid hormone and alkaline phosphatase, the bones of each patient exhibited striking histological improvement. The group as a whole showed statistically significant decreases in osteoclast number and in the percentages of osteoid surface covered by active osteoblasts. Marrow fibrosis was either eliminated or strikingly decreased in each patient. Osteoid volume significantly declined in four of five patients. In patients with osteitis fibrosa as the predominant histological lesion, calcifediol therapy resulted in decreased calcification front activity. Increased activity was the result when osteomalacia predominated.


Psoriasis day care centers.

Psoriasis day care centers. With the rapidly mounting cost of medical care in hospitals, physicians must seek alternative forms of therapy for illnesses that could conceivably be treated by less confining methods. One appraoch to this problem is the Psoriasis Day Care Center, where psoriasis patients with extensive disease are treated during the day and allowed to return home at night. The advantages include reduced cost, accessibility for more patients, and superior therapeutic results. This day care center concept could be equally applicable to other diseases now routinely treated by complete hospitalization.


Measles and rubella eradication in Alaska. The Alaska Department of Health and Social Services has instituted a special surveillance program to investigate every suspected case of measles and rubella. Clinical and epidemiologic information is obtained, and serologic testing is performed to confirm all tentative diagnoses. In 1974, forty-one cases were investigated, and none were confirmed as measles or rubella. This record is attributed to high immunization levels and rapid epidemiologic follow-up of all suspected cases. We believe that this program can be easily instituted in other states, particularly those with a limited number of reported cases.


Subtotal colectomy for refractory pseudomembranous enterocolitis. Pseudomembranous enterocolitis resulting from therapy with antibiotics such as clindamycin and lincomycin hydrochloride monohydrate does not always respond to drug and vigorous medical support. We describe two seriously ill patients who recovered after subtotal colectomy with ileostomy.


Ambulatory surgery in a university setting. Establishment of an ambulatory anesthesia and surgery program in a university teaching hospital presents difficulties. A successful program of this nature, the "Day Op program," was begun at the North Carolina Memorial Hospital in December 1972. Through December 1974, of all surgery performed in our operating rooms, 2,590 cases, (17%) were Day Op cases. Various types of anesthesia were used, and a high percentage of endotracheal intubations were performed. The hospital admission rate was 1.54%. Many difficulties were encountered, and much satisfaction was obtained, in the management of the program. The Day Op room has proved to be a major part of the success of the program.


Electrical malfunction at endoscopy. Possible cause of arrhythmia and death. Gastroscopy-associated electrical shock occurred in two cases, with one death. An ACMI Wappler transformer-powered Hirschowitz flexible fiber-gastroscope was used. Ideally, endoscopes should not contain electrically conductive material or metals that might corrode. Electrical systems used at endoscopy should conform to the existing standards for "electrically sensitive patient" localtions, and should be subject to the routine maintenance procedure prescribed for equipment in such locations by the National Fire Protection Agency.


Side effects of diazoxide.

Side effects of diazoxide. Diazoxide given for hypertensive crises caused severe complications in two patients. Hypotension, anginal syndrome, cerebral ischemia, and right hemiplegia developed in one patient, and myocardial infarction in the other.


USAN assigned to radioactive pharmaceutical. The United States Adopted Names (USAN) applicable to radioactive pharmaceuticals are composed of the names of the basic compound serving as the carrier for the radioactivity, the symbol for the radioactive isotope, and the atomic weight (since several radioactive isotopes of a given element may be in use--see listing under iodine). The following listing of nonproprietary names (shown in boldface type) is arranged in alphabetical order according to the English name of the radioactive element. The isotopes of hydrogen are listed under their specific names, deuterium and tritium. Radioactive pharmaceuticals are often supplied by the manufacturers under a designation equivalent to the adopted nonproprietary name and are listed as such; specific trademarks are given in brackets when they exist. Basic information relative to these lists was given in the editorial that accompanied the first such listing.


Incomplete Reiter's syndrome: discriminating features and HL-A W27 in diagnosis. Reiter's syndrome (nonspecific urethritis, conjunctivitis, and arthritis) may present with arthritis alone. There are, however, other discriminating clinical features that contribute to diagnosis. Additionally, the presence of HL-A W27 provides a new diagnostic aid. Thirteen patients were studied and support the validity of the concept of incomplete Reiter's syndrome. Peripheral arthritis was the presenting complaint in all, and none had urethritis or conjunctivitis. The majority were young white men. The arthritis was oligoarticular and asymmetric with lower extremity involvement predominantly. Heel pain was a prominent symptom in 10, with periostitis of other sites in 5, and "sausage digits" in 8. Mucocutaneous lesions occurred in 1 and significant weight loss in 6. Only 2 had sacro-illiitis. Chronicity has characterized the course in 12. HL-A W27 was present in 12 of 13. Additional data suggest that Reiter's syndrome may be one of the most common forms of inflammatory arthritis in young men.


Recurrent hyperthyroidism after thyroidectomy. For 53 patients with toxic recurrent goiter (TRG), the interval between thyroidectomy and recurrent hyperthyroidism range from six months to 50 years (average, 12.4 +/- 11.9 years). Recurrent hyperthyroidism may occur in older patients for whom cardiac decompensation may be the initial manifestation. Reports on surgically treated hyperthyroid patients may underestimate the incidence of TRG unless follow-up is extended for many years.


Poststapedectomy otitis media and meningitis. A patient developed acute otitis media, labyrinthitis, and meningitis 16 months after a stapedectomy operation, and 14 similar cases have been collected from the literature. Poststapedectomy otitis media carries an increased risk of labyrinthitis and meningitis and requires prompt antibiotic therapy and regular observation until cured. Should labyrinthitis occur, with or without meningitis, fistula repair must be undertaken as soon as the infection is eliminated. All stapedectomy patients require regular supervision, and must report for urgent treatment if symptoms of otitis media or perilymph fistula occur. Stapedectomy techniques should not employ sharp bevelled prostheses, and autogenous tissue grafts are probably superior to an absorbable gelatin sponge in protecting the inner ear. Eustachian tube problems and recurring or chronic upper-respiratory tract infections can predispose to middle ear infection and are thus contraindications to stapedectomy.


Simultaneous high-pressure liquid-chromatographic determination of some anticonvulsants in serum. We describe procedures for simultaneously determining some anticonvulsants (phenobarbital, diphenylhydantoin, primidone, ethosuximide, methsuximide, carbamazepine) in serum by high-pressure liquid chromatography. The drugs, together with an internal standard, phenacetin, are adsorbed from serum onto charcoal and eluted from it with organic solvent. The eluate is analyzed isocratically on a reverse-phase column with a mobile phase consisting of acetonitrile/water (17/83 by volume). The eluted drugs are detected by their absorption at 195 nm, and quantities estimated from their peak areas as compared with those of extracted standards. Results are reproducible to about 6%. Sensitivities, for 0.5-ml serum samples, of 0.1 mg/liter for all the drugs analyzed except ethosuximide (0.5 mg/liter) are attained routinely. Correlation of results with gas chromatography was 0.912 for phenobarbital, 0.982 for diphenylhydantoin, 0.886 for primidone, and 0.966 for ethosuximide. Amobarbital and secobarbital interfere with the analysis; chlordiazepoxide, methaqualone, salicylate, diazepam, and oxazepam do not. Including extraction, analysis time for a single sample is 20 min.


Rapid estimation of carboxyhemoglobin level in fire fighters. The analysis of expired breath with a portable electrochemical cell after carbon monoxide exposure provides a practical field method for the rapid estimation of carboxyhemoglobin. A fire fighter can collect and analyze his own breath sample for CO, an operation that requires 1 1/2 minutes. This simple technique has the accuracy necessary to determine compliance with the regulations governing occupational exposure to CO.


Polyvinyl chloride toxicity in fires. Hydrogen chloride toxicity in fire fighters. Polyvinyl chloride, of all the plastic polymers, has been implicated primarily in causing the most serious problem in fire fighting today because it releases hydrogen chloride gas when burning. One hundred seventy fire fighters who experienced symptoms from its toxicity have been studied from 1970 to 1975. One died.


Paint-remover hazard.

Paint-remover hazard. The in-home use of paint removers containing methylene chloride results in the absorption of this solvent, which is metabolized to carbon monoxide. Exposure for two to three hours can result in the elevation of carboxyhemoglobin (COHb) to levels that stress the cardiovascular system. The metabolic formation of COHb continues following the paint-remover exposure, doubling the duration of the cardiovascular stress produced by a comparable COHb level after exposure to CO. Patients with diseased cardiovascular systems may not be able to tolerate this unexpected stress.


Medical school admissions, specialty selection, and distribution of physicians. This review of the University of Missouri-Columbia medical graduates, with similar data from two other studies, supports the thesis that hometown size and speciality choice are interrelated predictors of the community in which physicians practice. Physicians with nonmetropolitan backgrounds were two to three times as likely to select nonmetropolitan practice as physicians with urban backgrounds. Physicians entering family medicine were almost three times as likely to select nonmetropolitan practice as physicians in other primary-care specialities. Presence of both predictors (nonmetropolitan background and selection of family medicine) resulted in two thirds selecting nonmetropolitan practice. However, selection of family medicine by graduates with urban backgrounds or selection of other specialties by graduates with nonmetropolitan backgrounds did not appreciably increase the likelihood of nonmetropolitan practice. These data have implications for medical school admissions policy and curriculum.


Spinal epidural hematoma.

Spinal epidural hematoma. A diagnosis of acute, cervical, spontaneous spinal epidural hematoma was made in two patients by combining clinical signs and myelographic findings. If surgical decompression can be accomplished early, the results are favorable.


Hematin treatment of acute porphyria. Early remission of an almost fatal relapse. Intravenous infusions of hematin in a young woman with acute porphyria in profound relapse was followed within 48 hours by remission of symptoms and rapid recovery. From a state of severe central and peripheral nervous-system involvement, the patient recovered so completely that she was able to leave the hospital in less than a month, with only a residual weakness of her arms. Serial studies of serum and urinary levles of porphyrin precursors and serum level of hematin provided highly important information about the effect of hematin on acute porphyria.


Coombs-positive hemolytic uremic syndrome. Two children presenting typical clinical features of the hemolytic-uremic syndrome had a positive direct Coombs test that remained positive throughout the illness. It is probable that an upper respiratory tract infection precipitated an antigen-antibody reaction that caused the autoimmune hemolytic anemia and immune-complex glomerulonephritis.


Respiratory tract illness in meat wrappers. A questionnaire survey was done in 152 Houston supermarkets to assess the prevalence of respiratory tract symptoms in meat wrappers exposed to the thermal decomposition fumes of polyvinyl chloride (PVC) film wrap and in two supermarket control groups (checkers and meat cutters). Meat wrappers had increased respiratory tract symptoms; 12% of meat wrappers who smoked (vs 6% and 2% of controls) and 5% of meat wrappers who did not smoke (vs 0% and 0% of controls) had multiple respiratory tract symptoms. It is probable that a large number of meat wrappers have mild symptoms with some progressing to more severe respiratory impairment or clinical asthma.


Diabetes insipidus in hypoxemic encephalopathy. Diabetes insipidus developed in two patients who experienced severe hypoxemia as a consequence of drug-induced respiratory failure. Post-mortem examination revealed generalized cerebral edema, encephalomalacia, and a profound and diffuse loss of neurons. Hypoxemia-induced diabetes insipidus may indicate that the patient is suffering from severe brain damage.


Evidence for defective skeletal mineralization in low-birthweight infants: the absorption of calcium and fat. Using serial metabolic balance techniques, the absorption and retention of calcium and the absorption of fat have beem measured over the first 30 to 70 days of life in 11 preterm and 2 full-term light-for-dates infants. They were fed either full-cream cow's milk, half-skimmed cow's milk, the proprietary filled milk S.M.A., or breast milk. The values for calcium intake, absorption and retention were compared with the rate of accumulation of calcium by the fetus in utero, which was calculated from published data on the chemical composition of fetal bodies. Infants fed breast milk had an absolute dietary deficiency of calcium. Those fed other milks ingested sufficient but they did not absorb enough. Though calcium absorption increased with increasing postnatal age, intrauterine rates of calcium retention were never achieved on any of the milks. The average retention of calcium by preterm infants as a percentage of intrauterine accumulation was, for cow's milk 38%, for S.M.A. 27%, and for breast milk 17%. The full-term light-for- dates infants absorbed and retained more calcium than the preterm infants; it was on average 52% of the amount accumulated by the human fetus for an equivalent weight gain. The average absorption of fat by preterm infants was, from the cow's milk preparations 55%, from S.M.A. 61%, and from breast milk 84%. The light-for-dates infants absorbed on average 87% of the breast milk fat. There was no evidence that the amount of calcium absorbed was materially influenced by fat malabsorption. The principal determinants of the amount of calcium absorbed were the length of gestation and postnatal age of the infant.


Plasma and dietary phytosterols in children. Plasma phytosterol (plant sterol) levels were studied in 26 infants on various commercial formulas, in 36 infants on breast or cow's milk formulas, in 101 normal and 22 hypercholesterolemic children on a free diet, and in 32 hypercholesterolemic children on a low-cholesterol diet. Commercial formulas, poor in animal fats and enriched with vegetable oils, and low-cholesterol, phytosterol-rich diets generally elevated total plasma phytosterol levels in infants and hypercholesterolemic children from normal mean levels of 2 mg/100 ml to about 9 mg/100 ml. The implications of long-term three- to five-fold elevations of the plasma phytosterols (campesterol, stigmasterol, beta-sitosterol) in infancy and childhood are unknown. Watchful prospective analysis of plasma phytosterol levels may be useful, particularly in regards to otherwise unanticipated long-term effects of cholesterol-poor, phytosterol rich diets.


Antral-ethmoidal decompression in Graves' disease. Five-year experience. The orbital manifestations of Graves' disease frequently constitute the major and distressing portion of the morbidity in this poorly understood process. Patients with optic neuropathy, exposure keratopathy or disfiguring proptosis may be aided considerably by decompression to permit swollen orbital contents to move into the maxillary and ethmoid sinus cavities. Experience with 38 patients treated over a five-year period indicates that antral-ethmoidal decompression is a logical, successful form of therapy and generally free of serious complications. it may provide benefit earlier in the course of Graves' exophthalmopathy than has been accepted in the past.


Ehanced biliary thyroxine excretion in rats treated with pregnenolone-16alpha-carbonitrile. Normal rats were treated with pregnenolone- 16alpha - carbonitrile (PCN) 10 mg/100 g by stomach tube twice daily for 3 days. In these animals the biliary excretion of intravenously injected 125I-thyroxine (T4) was enhanced and the bile: plasma 125I ratio (B/P ratio) and the biliary clearance rate of plasma 125I-T4 was increased. Normal rats were treated with PCN for 3 days and homozygous Gunn rats for 13 days. In both groups PCN enhanced the bile flow and elevated the B/P ratios and the biliary clearance rate of plasma T4 following ip injection of 125I-T4 17 h previously. PCN-treatment had no effect on the fractions of biliary 125I present as T4-glucuronide, T4 and I- in either the normal or Gunn rats. Treatment with PCN for 10 days produced goitres in normal and Gunn rats and in normal rats elevated the serum TSH (bioassay) levels and the 17 h thyroid 131I uptake as well as the serum PB125I concentrations, without affecting stable PBI concentrations. These data indicated increased pituitary TSH release in response to increased peripheral metabolism of thyroid hormone; enhanced hormonal release from the thyroid kept pace with the accelerated peripheral loss.


Aldosterone secretion during high sodium cerebrospinal fluid perfusion of the brain ventricles. Conscious sheep with permanent indwelling cannulae in the lateral ventricles and the cisterna magna were Na depleted and then perfused for 9 h with an artificial CSF solution. There were 3 experimental groups: Group I (n=5) received perfusion with aritifical CSF containing NA 170 MEq./1, Group II (n=7) received perfusion with artificial CSF containing Na 145 mEq./1, Group III (n=7) received no perfusion. In Group I the blood aldosterone level fell from 26.4 +/- 7.4 to 8.6 +/- 2.3 ng/100 ml by 9 h after perfusion. There was no significant change in plasma [Na] or [K], blood angiotensin II or plasma renin concentration. Blood cortisol and corticosterone levels rose. There was also a fall in post-perfusion. Group III showed no significant change in blood aldosterone concentration. Multivariate statistical analysis showed that the fall in aldosterone levels during 170 mEq./l Na perfusion could not be accounted for by changes, either alone or together, of ACTH as evidenced by alteration in blood cortisol or corticosterone, or by change of plasma [Na], [K] or renin concentrations. This data supports the hypothesis of an additional factor which may be of CNS origin being involved in the control of aldosterone secretion.


The effect of intra-uterine contraceptive devices on the oestrogen-induced incorporation of [3H-5]uridine into RNA by the rat uterus. A length of copper or stainless steel wire or of silk thread suture was inserted as an intra-uterine device (IUD) for 3 days in the right uterine horn of ovariectomized virgin female rats. The left horn served as a control. The control rats were ovariectomized but had no IUD inserted. The in vitro incorporation of [3H-5]uridine into uterine RNA was significantly inhibited (P less than 0.005) in copper-bearing horns compared to control horns, while silk and steel devices had no inhibitory effect, thus indicating an effect of intra-uterine copper on oestradiol-induced uterine metabolism. The insertion of an intra-uterine device had no significant effect on uterine wet weight, DNA content or on the uptake of [3H-5]uridine into the nucleotide pool.


Body weight regulation in female rats following neonatal testosterone. Neonatal testosterone treatment of female rats led to an increase in body weight and skeletal growth and produced evidence of altered ovarian function over a 76 day period following treatment. Bilateral ovariectomy performed eleven weeks after neonatal treatment increased the rate of body weight gain of both testosterone propionate- and oil-treated groups, but no differences in the increased rates of weight gain were evident between groups over a five week post-ovex observation period. Subsequently, long-term oestrogen replacement therapy, via subcutaneous Silastic implants, produced equal reductions in the rates of body weight gain and somatic growth of both early testosterone- and oil-treated ovariectomized groups. In spite of the marked effects of these manipulations on body weight and skeletal growth, no significant differences were noted in the Lee Index of obesity between androgenized and the appropriate non-androgenized control rats at any interval of the experimental period. These results indicate that neither ovarian hormones nor an altered sensitivity to oestrogen of body weight regulatory mechanisms are important in the increased body weight that follows perinatal testosterone treatment. Additionally, the present data add support to previous work which has suggested that a general increase of somatic growth rather than "obesity" provides the major contribution to the elevated body weights of androgenized female rats.


Non-suppressible insulin-like activity and sulphaton activity in serum extracts of normal subjects, acromegalics and pituitary dwarfs. Non-suppressible insulin-like activity (NSILA) is a term used for a variety of substances in serum, excluding insulin, which promote glucose uptake of adipose tissue and diaphragm in vitro. NSILA-S is a peptide with a molecular weight of 7000 which is soluble in acid ethanol and which has been purified on a large scale from human serum. This study describes a simple chromatographic one step procedure by which NSILA-S can be extracted and quantitatively measured in individual sera. Using Sephadex G-75 equilibrated with 1 M acetic acid, NSILA-S was detected only in one peak containing small molecular peptides. NSILA-S obtained with this one step chromatographic procedure exerted all the effects of purified NSILA-S including sulphation activity on the rat cartilage. All chromatographic fractions with NSILA-S also had sulphation activity. Both, NSILA-S and sulphation activity were increased in acromegalics and decreased in pituitary dwarfs. It is suggested that one molecule in serum is responsible for both activities which are, at least in part, under the control of growth hormone.


Second antibody chemically linked to cellulose for the separation of bound and free hormone: an improvement over soluble second antibody in gonadotrophin radioimmunoassay. Coupling the second antibody to a solid pase (DASP) was found to be a definite improvement over the classical technique of soluble second antibody (DA) separation of bound and free hormone in the radioimmunoassays of gonadotrophins in plasma or in serum. The duration (2.5 to 7.5 min) and the pH (10.5 to 12.5) of the cyanogen bromide activation of microcristalline cellulose did not affect the coupling capacity or the immunoreactivity of the second antibody, nor did it augment aspecific adsorption of free gonadotrophin on the cellulose matrix. Precision of duplicates was comparable for both methods but the accuracy and the detection limit of the solid phase system were higher due to a better separation of bound and free hormone, to the lower blank value and to the absence of aspecific interference of protein concentration. Cost was lower since much less second antibody was needed in the solid phase system than in the soluble system and since the experimental procedures were simplified by the absence of prozoning effect and the solid nature of the cellulose matrix.


Application of a radioligand receptor assay for determination of luteinizing hormone in human serum. A sensitive, specific and economic radioligand receptor assay is described for measurement of LH in human serum (RRA-LH). By means of ethanol fractionation of (NH4)2SO4-precipitation serum can be prepared for LH-quantitation and tested in the RRA-LH without interference of a non-specific inhibiting substance present in untreated serum from various human sources. Treatment of serum with 8% ethanol separates non-specific inhibiting substances from LH, the latter remaining in the supernatant at this ethanol concentration. The criteria of specificity are examined. The results of experiments designed to produce evidence for or against specificity suggest specificity of the RRA-LH. Recoveries, as estimated by administration of [125I]hLH and unlabelled hLH to untreated serum samples are shown to be between 80 and 95% for the thanol fractionation procedure and between 65 and 75% for the (NH4)2SO4-precipitation method. The ethanol fractionation procedure is preferred for routine serum-LH determination because of its simplicity, speed and higher recoveries. Ethanol-treated sera from post-menopausal women show, on average, higher RRA-LH concentrations than ethanol-treated sera from young women. RRA-LH values are consistently higher than LH-values found by radioimmunoassay (RIA-LH). The LH-concentrations in sera from two menstrual cycles and from two LH-releasing hormone tests are measured by RRA-LH and RIA-LH. Similarities and discrepancies of the LH-profiles found by the two assay systems are described.


The interaction of growth hormone, somatomedin and oestrogen in patients with Turner's syndrome. Baseline somatomedin activity in seven of eight patients with Turner's syndrome was found to be within normal limits. Somatomedin activity readily suppressed with oestrogen administration. The overall mean serum somatomedin activity during oestrogen therapy (0.87 U/ml, SD 0.15) was significantly lower (P less than 0.005) than the mean of the control serum somatomedin activities (1.09 U/ml, SD 0.24). During oestrogen therapy, suggestive elevations of fasting growth hormone levels were noted in five of eight patients. The data indicate that oestrogenic suppression of serum somatomedin was not due to decreased growth hormone secretion and suggest the existence of a negative feedback link between somatomedin and growth hormone.


Infusions of hFSH and hLH in normal men. I. Kinetics of human follicle stimulating hormone. Serial serum assays of immunoreactive FSH before, during and after a 4 h intravenous infusion of human follicle stimulating hormone (hFSH) in five healthy men revealed two disappearance rate constants with corresponding mean half-lives of 2.9 and 50.6 h. The mean distribution spaces calculated for the fast and slow component were 4.36 1 and 75.9 1 respectively. The average value for the metabolic clearance rate was 17.2 ml/min and for the endogenous production rate 50.9 mU/min. Two of the subjects had human luteinizing hormone (hLH) added in the infusions without the FSH kinetics changing.


Infusions of hFSH and hLH in normal men. II. Serum testosterone response to infused hLH and hFSH. Standardized 4 h intravenous infusions of human follicle stimulating hormone (hFSH) and/or human luteinizing hormone (hLH) were given either separately or combined to 7 normal male volunteers. The infusions raised the serum gonadotrophin levels at least 10 (FSH) and 18 (LH) times above the basal ones. Serum testosterone (T) levels were measured serially before, during and after the infusions and, in 4 subjects, during a corresponding period of another normal day. During a normal or basal 24 h period fluctuations were seen and also a circadian rhythm with lower levels in the evening. The infusion of hFSH alone (3 subjects) did not alter the serum T levels. The infusion of hLH alone in 2 subjects raised serum T levels by 17% and 55% over those of the basal day. The combined FSH/LH infusion caused a significant rise (35-68%) in 4 subjects and greater rise in 2 of them than after infusion of the hLH alone. The serum T responses were gradual, reaching a maximum 7-8 h after the end of the infusion.


Effect of alpha-MSH on plasma levels of LH, FSH, progesterone and cortisol during the corpus luteum phase of the menstrual cycle. In healthy women (21-28 years) the influence of synthetic alpha-MSH upon the peripheral plasms levels of LH, FSH, progesterone and cortisol was determined during the corpus luteum phase of the menstrual cycle. As controls 3 women were given 6 intravenous infusions of 250 ml NaCl; 4 women received a total of 18 intravenous infusions of 5-20 mg alpha-MSH from 9.00 to 11.00 a.m. on the 5th and 7th hyperthermic day of the menstrual cycle. The blood levels of the hormones were usually followed for 24 h, and in two cases for 48 h. During and after the control as well as the experimental infusions with 5-20 mg alpha-MSH, no significant changes in the plasma concentrations of LH, FSH and progesterone were found. The cortisol concentrations, however, showed on the average a 2-fold increase over the initial values during the infusion of 5 mg and 10 mg alpha-MSH. During the control infusions they were not enhanced. One experiment was conducted with 20 mg alpha-MSH. The increase in the plasma cortisol levels following alpha-MSH administration generally seemed to be dose dependent, but statistically no significant differences regarding the increase in cortisol level could be detected between the 5 mg and 10 mg doses.


Iodothyronine content of human thyroid albumin. Stable thyroid hormones (T4 and T3)1) have been demonstrated in pure albumin isolated from normal human thyroid tissue iodinated in vivo. Five samples of albumin were separated from other thyroid proteins by acrylamide gel electrophoresis. After pronase hydrolysis, the content of Thyroid hormones was measured chemically (T4 + T3) as well as by competitive radioactive measurement (T4) and radioimmunoassay (T3). The purity of the albumin and validity of these measurements were confirmed by different techniques. The synthesis of thyroid hormones is not therefore a property unique to Tg and may occur in albumin. However the amount of iodothyronines in the albumin (average 0.004 residue per molecule) is much less than that found in Tg (0.5 residue per molecule). In the albumin as in Tg the number of hormone residues per molecule is proportional to the number of atoms of iodine. At an equivalent iodine concentration, the albumin seems capable of forming the thyroid hormones as well as Tg. The difference between these two proteins, in their capacity to synthesize thyroid hormones, seems to depend on their capacity for iodination. This difference of iodination does not seem to be linked with the number of tyrosyl residues, but might be related to the position of these residues.


Pre-operative localization of hyperfunctioning parathyroid tissue by parathyroid scintigraphy. In 22 patients who underwent surgery suspected of primary hyperparathyroidism, the surgical findings were compared with the results obtained by pre-operative parathyroid scanning and biochemical screening. Thirteen of 15 parathyroid adenomas were localized by pre-operative scanning, but in five of them a false positive focus was also described. The technique was less useful in primary hyperplasia. Comparable results were reported by other investigators. In both instances the best results were obtained in patients with high parathyroid activity as measured by plasma calcium, plasma alkaline phosphatase and tubular reabsorption of phosphorus (TRP). Parathyroid scintigraphy was especially helpful in the presence of ectopic adenomas and in patients who had undergone previous parathyroid surgery. Unfortunately, the possibility of false positive results makes it unreliable for the diagnosis of primary hyperparathyroidism.


Free cortisol in obesity; effect of fasting. Plasma and urinary corticosteroids were measured in 13 obese subjects before and after high and low protein diets, and after fasting. During isocaloric high and low protein diets, urinary 17-oxogenic steroids and to a lesser extent urinary free cortisol excretion rose and fell in parallel with protein intake. Plasma unbound cortisol levels were not much changed by high or low protein intake. However, during 7 to 11 days total fasting, there was a highly significant rise in plasma unbound cortisol at 24.00. A smaller rise occurred at 09.00. The overall effect was a considerable diminution of the day-night variation of plasma unbound coritsol levels during fasting, and a rise in prevailing unbound cortisol levels and urinary free cortisol excretion. In 3 subjects tested these changes were reversed immediately by glucose re-feeding.


In vitro modification of rat adrenal zona fasciculata/reticularis function by the zona glomerulosa. Following earlier findings, the possibility that the zona glomerulosa of the rat adrenal cortex may modify inner zone function was investigated. In a series of in vitro experiments designed to test this hypothesis it was found that: 1. Inner zone preparations gave significantly more steroid than either glomerulosa tissue incubated alone, or (for the first 40 min of a two hour incubation), an equivalent amount of whole adrenal tissue. Whole tissue yields were greater than glomerulosa alone only at the 120 min point. At no time did the whole tissue output approach the total anticipated by addition of separate inner zone and glomerulosa yields. 2. In 20 min incubations, inner zone steriod output generally could be depressed by the addition of a glomerulosa preincubation medium (PIM), or a steroid extract of a  glomerulosa PIM, or by the addition of 100 ng aldosterone. Inner zone PIM had less effect. 3. Higher concentrations of aldosterone gave increased inhibition of inner zone corticosteroid production. The results indicated that only a part of the total corticosterone output was aldosterone sensitive in this way. 4. More specific analysis of the steroids showed that yields of corticosterone from endogenous precursors were depressed by aldosterone, but deoxycorticosterone and 18-hydroxydeoxycorticosterone were not. In the same incubations the presence of aldosterone had no effect on the formation of these three products from [3H]pregnenolone. In total the results suggest that the presence of the glomerulosa may affect inner zone function by inhibiting the secretion of corticosterone formed from endogenous precursors. It is possible that aldosterone is the agent of this effect.


Plasma concentration of oestradiol-17beta in premature thelarche and in different types of sexual precocity. Plasma Oe2 concentration was measured by radioimmunoassay in patients with premature thelarche, with precocious puberty and in 29 normal controls. The mean plasma Oe2 was 1.5 pg/ml (0-7.2) in normal prepubertal girls, 23.8 +/- 17.8 (SD) in pubertal girls, 50.2 (+/- 19.4) in the follicular phase, and 94.2 (+/- 19.5) in the luteal phase of normal adult females. Ten girls with premature thelarche had a mean of 7.7 +/- 6.6 pg/ml. Three of them showed higher values than the other 7, suggesting that in these cases, elevated levels of plasma Oe2 might have played a role in the development of breast tissue. Ten untreated girls with idiopathic precocious sexual development had a mean of 51.6 +/- 42.9 pg/ml while 6 patients treated with 150 mg per week of medroxyprogesterone acetate had a mean of 11.4 +/- 2.5 pg/ml. Two patients with Down's syndrome, hypothyroidism and sexual precocity had plasma Oe2 of 144 and 31.5 which fell to 24.7 and 8 pg/ml, respectively, after thyroid replacement. One girl with a granulosa cell tumour had a basal value of 304 pg/ml and a concentration of 27 pg/ml after surgery.


Dissociation between LH-induced aerobic glycolysis and oocyte maturation in cultured Graafian follicles of the rat. Luteinizing hormone (NIH-LH-S18; 5 mug/ml) stimulated aerobic glycolysis in cultured Graafian follicles explanted from pro-oestrous rats before the preovulatory gonadotrophin surge: lactate accumulation in the medium was 70% above control levels during 6 h incubations. Iodoacetate (2.5 x 10(-5) M) prevented this effect, without impairing the ability of LH to induce resumption of oocytic meiosis. Enrichment of the medium with pyruvate (3.3 x 10(-4) M) or lactate (2.5 x 10(-2) M) did not in itself cause ovum maturation. The results do not support the hypothesis that termination of meiotic arrest by LH is due to stimulation of glycolytic activity in the follicle cells, resulting in increased availability of an energy source readily urilizable by the oocyte.


Bovine plasma oestrogens, progesterone and glucocorticoids during dexamethasone induced parturition. Plasma samples were collected from jugular, uterine and utero-ovarian veins during glucocorticoid induced parturition. Plasma oestrogens, corticosteroids and progesterone were determined by competitive protein binding methods. Corticosteroids and progesterone began to decline within 8 to 10 h following DXMS treatment. Corticoids were only temporarily suppressed, while progesterone fell to minimum levels and remained low through calving. At this stage of gestation (270 days) peripheral plasma progesterone was primarily of ovarian origin. Pre-treatment with HCG appeared to support progesterone production by the CL despite DXMS treatment in 2 of 6 cows. These 2 cows failed to calve within the expected 96 h after DXMS. Plasma oestrogens did not show significant increased until 24 h after DXMS treatment. Cows which responded to DXMS treatment (calved) had significantly higher oestrogen levels than those which did not respond. It was concluded that oestrogens probably play a permissive rather than an initiating role in parturition.


Effect of some synandrogens and antiandrogens on the conversion of testosterone to dihydrotestosterone in the cultured rat ventral prostate. The actions of prolactin, insulin and cortisol on the conversion of testosterone to dihydrotestosterone in the cultured rat ventral prostate were examined in conditions in thich they have been demonstrated to act synergistically with testosterone on the macromolecule synthesis of the prostate. On the other hand oestradiol, progesterone and cyproterone were tested similarly in conditions where they have been shown to be effective antiandrogens. The metabolism of testosterone to dihydrotestosterone was found to be extremely rapid and approximately 70% of the radioactive steroids in the tissue was dihydrotestosterone from 5 min onwards, but only insignificant amounts of dihydrotestosterone were found in the culture medium during the first hour. Physiological concentrations of the synandrogens did not alter the metabolism of testosterone or the accumulation of the steroids into the tissue. Oestradiol, progesterone and unlabelled testosterone in a 500-fold concentration markedly reduced th e conversion of tritiated testosterone to dihydrotestosterone while cyproterone and dihydrotestosterone had no effect. The possible role of other hormones in the alteration of testosterone metabolism in the target organs as the mechanism of synandrogenic or antiandrogenic action is discussed.


Plasma steroid and protein hormone concentrations in patients with prostatic carcinoma, before and during oestrogen therapy. Plasma testosterone, androstenedione, oestradiol-17beta, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were not significantly different in patients with prostatic cancer, with benign prostatic hyperplasia or in patients without prostatic disease. Plasma prolactin concentrations were significantly lower in the patients with benign disease than those with prostatic carcinoma. Endocrine therapy in the form of stilboestrol administration significantly decreased plasma levels of testosterone, oestradiol-17beta, FSH and LH within 7 days of the treatment. After 7 days therapy prolactin levels increased significantly in all patients studied. Changes in growth hormone concentrations were more varied in response to stilboestrol, being elevated in several patients and remaining unchanged in others. Treatment of a few prostatic carcinoma patients who were receiving stilboestrol therapy with CB154, an inhibitor of prolactin secretion, brought an immediate decrease in prolactin  levels which was was sustained. Plasma testosterone, androstenedione and growth hormone were unchanged in these patients but a significant decrease in plasma oestradiol-17beta was noted in two patients during CB154 administration.


Food allergy: the 10 common offenders.

Food allergy: the 10 common offenders. The 10 chief offenders among food allergens are cow's milk, chocolate and cola (the kola nut family), corn, eggs, the pea family (chiefly peanut, which is not a nut), citrus fruits, tomato, wheat and other small grains, cinnamon and artificial food colors. Food allergy results in a remarkable variety of clinical syndromes. Diagnois rests on an elimination and challenge process. Treatment is avoidance. Desensitization does not work.


Lactose malabsorption in Mexican-American children. Inability to absorb lactose due to low intestinal lactase is common in many population groups. This study is the first to compare lactose tolerance in 282 Mexican-American (MA) children and 51 Anglo-American (AA) children 2 to 14 years of age with the dietary intake of selected nutrients found in milk. A lactose tolerance test and a 24-hr dietary recall were obtained for each child. Gastrointestinal symptoms were carefully recorded for a 24-hr period following the lactose load. Overall prevalence of lactose malabsorption was 37% in MA children and 8% in AA children, and it increased with age. Number of symptoms occurring in lactose malabsorbers of both ethnic groups also increased with age. Mean protein intake exceeded Recommended Dietary Allowances at all ages for both ethnic groups. Mean consumption of vitamin A, calcium, and energy was below the Recommended Dietary Allowance for MA children. There were no differences in calories, nutrient, or milk intakes between lactose absorbers and malabsorbers, but AA children drank more milk than MA children. Fifteen percent of lactose-absorbing MA, 23% of malabsorbing MA, but no AA children reported having symptoms after drinking milk. There was a significantly greater incidence of lactose intolerance in MA as compared to AA children. This suggests that Mexican-Americans share in the high incidence of primary lactose intolerance characteristic of the majority of the orld's peoples.


An organotypic in vitro model system for studying pulmonary surfactant production by type II alveolar pneumonocytes. This report describes an in vitro model system in which monodisperse fetal rat lung cells reorganize to form alveolar-like structures when cultured on a gelatin sponge matrix. The alveolar-like structures are composed of cells that have morphologic characteristics like those of the type II alveolar pneumonocytes of intact lung. These morphologic characteristics include lightly stained nuclei, microvilli on the apical surface, and osmiophilic lamellar bodies in the cytoplasm. The presence of osmiophilic lamellar bodies and tubular myelin in the lumen of the alveolar-like structures suggests that the cells in these structures are producing pulmonary surfactant. The formation and long-term maintenance of these alveolar-like structures provide a unique in vitro model system for studies of the synthesis, storage, and secretion of pulmonary surfactant.


Disseminated pulmonary blastomycosis in an immunosuppressed patient. Diagnosis by fiberoptic bronchoscopy. A 73-year-old man with malignant lymphoma who was undergoing treatment with systemic chemotherapy presented with an acute, febrile illness associated with cough and sputum production. The patient developed bilateral, diffuse, pulmonary interstitial infiltrates with rapidly progressive respiratory insufficiency. The diagnosis was made by demonstrating Blastomyces dermatitidis in bronchial brush and transbronchial lung biopsy specimens obtained through fiberoptic bronchoscopy.


Immunoelectron microscopic and immunochemical demonstrations of serum proteins in the alveolar lining material of the rat lung. By means of antibodies labeled with horseradish peroxidase, autologous albumin and IgG were visualized in electron microscopy on the alveolar epithelial surface of the rat lung, as a continuous cell coat, as free granular deposits, or associated with tubular myelin figures. These 2 proteins were detected by immunochemistry in alveolar washing. After ultracentrifugation of alveolar washing, they were still found in the phospholipid-rich precipitate fraction by immunization of rabbits and by immunoelectron microscopy. Thus, albumin and IgG appeared as normal alveolar components in the rat lung; fibrinogen was not found under normal conditions.


Estimation of surfactant lecithin in amniotic fluid and prediction of respiratory distress syndrome. The quantitative and qualitative analyses of lecithin in the human amniotic fluid in relation to the antenatal prediction of developing respiratory distress syndrome were described. Surfactant lecithin (disaturated and/or dipalmitoyl lecithin) was estimated for the first time in 42 amniotic fluid specimens of 21-42 weeks gestation. Surfactant lecithin was present in considerable amounts in specimens obtained near or at term except in the ones associated with infants who subsequently developed respiratory distress syndrome. One infant developed typical respiratory distress syndrome despite the normal total lecithin concentration of amniotic fluid at birth. The fatty acid analysis, however, revealed that the surfactant lecithin concentration was extremely low, showing a great discrepancy between total lecithin and surfactant lecithin concentrations. Thus the estimation of disaturated and/or dipalmitoyl lecithin in the amniotic fluid seems to be the most precise sign of a potential risk of respiratory distress syndrome.


Thyrotoxicosis induced by iodine contamination of food--a common unrecognised condition? The incidence of thyrotoxicosis in northern Tasmania rose significantly in 1964, two years before an epidemic of iodine-induced thyrotoxicosis was precipitated by the addition of iodate to bread to prevent goitre. Each time older patients accounted for most of the increase. The 1964 increase was probably iodine-induced as the use of iodophor disinfectants on dairy farms, which causes iodine residues in milk, began in 1963 and a fall in the prevalence of goitre in young children suggested an increase in dietary iodine at about that time. A further small increase in thyrotoxicosis in 1971 may also have been iodine-induced as it followed an extension of the use of iodophors. Dietary iodine is rising substantially in many places because of high iodine levels in milk and the use of iodine compounds in automated bread making, and this may be causing unsuspected iodine-induced thyrotoxicosis. Dietary iodine should be monitored regularly and clinicans alerted to any rise. Contamination of common foods with iodine should be more strictly controlled.


Retinopathy of prematurity and retinal detachment. A group of 39 patients with retinopathy of prematurity or retrolental fibroplasia have been evaluated. Nine of these were prematures at the time of their examination and showed severe bilateral disease. One eye in each patient was treated with the other eye serving as a control using either Xenon photocoagulation or cryocoagulation. It will take many years to observe the effect of this form of therapy but initial changes suggest alterations in the amount of retinal traction and in the appearance of blood vessels at the posterior pole in some of the treated patients. Thirty older patients have been assessed and of these, 18 eyes developed retinal detachments. Of the 16 operated upon, 87% had successful scleral buckling surgery. Three additional patients had similar retinal findings to retrolental fibroplasia but no history of prematurity or oxygen therapy. These patients were not included in this study. Retinopathy of prematurity is much less common now that it was 2 decades ago, but still represents a significant cause of ocular morbidity and blindness.


Cell membrane sialoglycopeptides of corticoid-sensitive and -resistant lymphosarcoma P1798. Cells of corticoid-sensitive (CS) and corticoid-resistant (CR) lymphosarcoma P1798 were labeled in vivo with either [14C]- or [3H]fucose before and after treatment with 9-alpha-fluoroprednisolone (9-FP). Labeled glycopeptides, derived from isolated, Pronase-digested cell membranes of both tumors were separated by gel filtration on Bio-Gel P-10 by a double-label technique. Elution profiles of CS and CR fractions showed significant differences in early eluting material. Desialylation of glycopeptides by neuraminidase lowered the molecular weight of both CS and CR fractions, and altered 3H:14C ratios indicated that CS and CR sialoglycopeptides are different. 9-FP treatment for 7 hr increased the density of isolated P1798-CS and -CR cell membranes. All CS and CR glycopeptides from treated tumors eluted faster than did those of untreated preparations. Both CS and CR sialoglycopeptides were altered, although differences in CS and CR profiles persisted. Histochemical investigations indicated that negative charge, present on surfaces of untreated CS cells, is lost between 6 and 8 hr after exposure in vivo to 9-FP. CR cells had no or few anionic sites on their surfaces before and after steroid administration. We demonstrated that glycopeptides of both CS and CR tumors contain sialic acid, although only CS cells carry a surface-exposed negative charge that is lost after 9-FP treatment. Glucocorticoids alter both P1798-CS and -CR sialoglycopeptides, but the consistent differences between their chromatographic patterns suggest that steroid-induced changes in cell membranes of the two tumors are not identical. Cell death or survival of glucocorticoid-treated P1798 cells may, therefore, be influenced by specific structural characteristics involving cell surface sialoglycoproteins.


Structure of the nongranulated cells in the hypophyseal rostral pars distalis of cyclostomes and actinopterygians. The structure of the nongranulated cells in the sea lamprey adenohypophysis and similar cells of the rostral pars distalis in a number of actinopterygian fishes was examined with the aim of determining the role(s) of these cells in pituitary function. A number of possible roles are proposed for the nongranulated cells. In salmonids and Amia calva the cells may be involved in the active movement of material into or from the follicle lumina. The structure of the nongranulated cells in in vitro cultured and in in vivo transplanted trout rostral pars distalis also suggests a phagocytotic role for these cell. In teleosts with a non-follicular rostral pars distalis the nongranulated cells and in the subsequent dispersal of the hormone (and/or carrier substance) into the peripheral circulation.


Spectrophotometric studies on the binding with polynucleotides of 4,4'-diacetyldiphenylurea-bis(guanylhydrazone) and methylglyoxal-bis(guanylhydrazone). 4,4'-Diacetyldiphenylurea-bis(guanylhydrazone) (DDUG), an agent very effective against several animal leukemias and tumors, was found, spectrophotometrically, to interact in a biphasic manner with several natural, native and heat-denatured, and synthetic DNAs. The spectrum of DDUG was shifted towards the visible region with a hypochromic shift reaching a maximum hypochromicity at 316 mmu at a 1 : 1 molar ratio of DDUG to DNA nucleotide. Increasing molarity of DNA nucleotide resulted in a further shift towards the visible end, but with hyperchromicity rather than hypochromicity, and reaching its peak at 323 mmu. The interaction with yeast RNA was much weaker than that with DNA. 4,4'-Diacetyldiphenylurea (DDU) did not show any interaction with DNA; its monoguanylhydrazone (DDUM) showed only a hypochromic interaction. In contrast to DDUG, methylglyoxal-bis( guanylhydrazone (CH3-G), an aliphatic bisguanylhydrazone with antileukemic properties, showed only a hypochromic interaction with DNA at low ionic strength. Unlike DDUG, CH3-G was a very weak inhibitor of the DNA polymerase reaction. The hypochromic shift of the DDUG spectrum with DNA was abolished in the presence of 15 mM sodium citrate or 500 mM NaCl but not in the presence of 150 mM NaCl or 100 mM sodium acetate. The hyperchromic shift was abolished in the presence of 8 M urea. From the results obtained with different DNAs, RNA, synthetic polynucleotides and nucleotides, it appears that the total shift of the DDUG spectrum in the presence of intact DNA can not be ascribed to interaction with a single base although a greater shift occurred in the presence of G-C rich DNA.


Prolactin and delayed pseudopregnancy in the rat. In (RXU)F1 hybrid rats delayed pseudopregnancy was induced in three different ways: 1) by removal of all recent corporl lutea on day 2 of pseudopregnancy, 2) by removal of the in situ ovaries from ovarian graft-bearing animals on day 0 of pseudopregnancy, 3) by administration of 1 mg of ergocornine hydrogenmaleinate (ECO) on day 1 of pseudopregnancy. These procedures ended pseudopregnancy and in 50-60% of the animals a delayed pseudopregnancy with a duration of 6-15 days was observed after the experimental cycle. After sterile copulation two daily prolactin peaks were observed. Removal of the ovaries in situ (from ovarian graft-bearing animals) or of recently formed corpora lutea (from non-grafted animals) caused the disappearance of the prolactin peak at 19.00 h, without affecting the occurrence of the 03.00 h peak. The administration of ECO caused the disappearance of both prolactin peaks. Until the day of estrus prior to delayed pseudopregnancy there were no differences in prolactin concentrations at 03.00 or 19.00 h between animals which became delayed pseudopregnant and those which remained cyclic. In the latter animals the 03.00 h surges decreased slowly in the luteectomized and the ovariectomized animals and were no longer present 7-9 days after copulation. In animals becoming delayed pseudopregnant both prolactin peaks were present from day 0  of delayed pseudopregnancy onwards. Progesterone cencentrations during delayed pseudopregnancy were relatively low when delayed pseudopregnancy had a duration of 6-9 days. When delayed pseudopregnancy lasted 10 days or more normal progesterone values were found.


Effects of castration, testosterone, estradiol, and prolactin on specific prolactin-binding activity in ventral prostate of male rats. Lactoperoxidase-catalyzed 125I-labeled ovine prolactin (PRL) was found to bind specifically to particulate membrane fractions of rat ventral prostate. Unlabeled PRL readily displaced the labeled PRL, whereas ovine GH, LH, FSH, or TSH showed no such competition. Castration reduced the binding of 125I-labeled PRL to about 1/6 of that in intact rats, and injections of testosterone propionate (TP) increased PRL binding to values as great or greater than those in intact controls. Injections of TP into intact immature and mature rats also increased PRL binding. In vitro binding of labeled PRL was inhibited in prostatic tissue removed from intact immature rats 2 h after injecting unlabeled PRL, but not in ventral prostates from rats killed 26 or 74 h after injecting unlabeled prolactin. PRL injected together with TP in castrated rats produced no greater increase in prolactin binding than TP alone, while estrogen appeared to decrease PRL binding beyond that produced by castration alone.


Characteristic chromosomal abnormalities in biopsies and lymphoid-cell lines from patients with Burkitt and non-Burkitt lymphomas. The karyotypes of cells from 10 Burkitt lymphoma (BL) biopsies, eight cell lines established from BL and nine cell lines from non-BL sources were studied by chromosome banding techniques. With the exception of the BL-derived cell lines BJAB, GC-BJAB, Maku and U-8691 all biopsies and lines of Burkitt origin contained an extra band at the distal region of the long arm of one chromosome 14. An extra band on chromosome 14 was also found in cells of one non-BL biopsy, in cells from a lymphosarcoma-derived cell line and in a long-established cell line derived from the pleural exudate of a patient with Hodgkin's disease. A distal region at the long arm of one chromosome 8 was missing in all metaphase figures of good technical quality in the same material. The size, morphology and stain-ability of the missing region corresponded fairly well to the extra region at chromosome 14. We therefore suggest that the chromosome 14 marker represents a translocation between chromosomes 8 and 14,t (8q-; 14q+). The translocation was present neither in lymphocytes of the peripheral blood of five Burkitt patients nor in five lymphoblastoid cell lines of non-BL origin. Trisomy 7 was found in two of the 10 BL biopsies, in two BL-derived cell lines, in one non-BL biopsy, in two lymphosarcoma-derived cell lines and in one cell line derived from a patient with Hodgkin's disease.


Stabilizing mechanisms of the loaded and unloaded knee joint. Knee specimens were placed in an apparatus which imposed cyclic anterior-posterior or rotatory forces, with various compressive loads applied to the joint. Force-displacement graphs or torque-rotation graphs were automatically plotted, giving the laxity under various conditions. The ligaments, capsule, and menisci provided joint stability under no-load conditions. However, under compressive loads, the conformity of the condylar surfaces was an important factor in stabilizing the knee. The mechanism proposed was the uphill movement of the femur as the femur and the tibia were displaced or twisted relative to one another.


Comprehensive evaluation of fatty acids in foods. V. Unhydrogenated fats and oils. This paper summarizes representative values for the fatty acid composition of unprocessed vegetable fats, vegetable oils, and animal fats. The data for these unprocessed fats and oils are identical with those of the processed, but unhydrogenated fats and oils. Calculations to convert the fatty acid methyl ester data to grams fatty acid per 100 gm. food are discussed, and the converted data are presented in tabular form. Climatic and cultivar effects on the fatty acid composition of some of these oils are reviewed.


Plasma free amino acids of children consuming a diet with uneven distribution of protein relative to energy. Adequate N retention and growth have been demonstrated in children consuming diets in which the total daily protein is fed in a single meal, energy intake being spread over a 14 hour period. To elucidate how adequate protein nutriture continues when protein is not consumed in parallel to energy, plasma free amino acids were measured in 11 children fed a casein-modified cow's milk based diet providing all protein (6.4% of calories) in one feeding, while energy was evenly distributed among five feedings. Children were fed at 0800 hours, 1200 hours, 1500 hours (protein-containing meal), 1900 hours, and 2200 hours. Fasting plasma aminograms were determined in all 11 children. During a long-term growth study with the diet, six children had additional determinations 3 and 4 hours after the first feeding on the same day on which the fasting sample was obtained; samples prior to and 3 and 4 hours after the 1500 hour feeding were obtained on a different day. In a seventh child, all six samples were obtained on a single day. Fasting values for total amino acids (TAA), total essential amino acids (TEAA) and TEAA/TAA, Val, Ile and Pro were elevated in most cases, a pattern seen in children fed high protein diets. The 1100 hour and 1200 hour samples showed a marked decrease in TAA, TEAA and TEAA/TAA. A further drop at 1500 hour produced a pattern characteristic of protein deficiency. Following the protein containing meal, TAA increased 50-100%, TEAA 100-200%, with disproportionate increases in Leu, Ile, Val and Pro. The persistence of this pattern in some cases up to 17 hours suggested that EAA were available for protein synthesis when additional energy was subsequently consumed. An aminogram characteristic of protein deficiency was seen only 18-20 hours after the last protein intake.


Hepatitis B surface antigen and antibody in asymptomatic blood donors. Seventy-two volunteer blood donors who had hepatitis B surface antibody (anti-HBS) were studied and compared with 115 carriers of hepatitis B surface antigen (HBSAg). Anti-BHS-positive donors gave a history of greater possible exposure to hepatitis B virus, there was a lower male-female ratio, and they had a much lower frequency of abnormal hepatic function test results. Those who were positive by counterimmunoelectrophoresis (CIEP), which indicated a high titer of antibody (greater than 1:2,000 as measured by passive hemagglutination assay [PHA], also had an ethnic origin similar to that of the donor panel, ie, predominantly Canadian and northern European. The HBSAg carriers, on the other hand, had a high frequency of origin from Mediterranean and Far Eastern countries. Low-antibody-titer (positive PHA but negative CIEP) donors had ethnic origins that more closely approximated those of HBSAg carriers.