Effect of rapid temperature change on mean body temperature and gill ventilation in carp. Carp were transferred from 25 degrees C water to a calorimeter at 15 degrees C or from 15 degrees C water to a calorimeter at 25 degrees C. During cooling, dorsal muscle temperature (Tdm) and mean body temperature (Tb) were continuously monitored. During the first minutes Tb changed rapidly, while Tdm changed only slightly. In a 0.468-dg fish, Tdm decreased to two-thirds of the final value in 8.05 min, while Tb attained this value in 3.6 min. Tdm changed faster during heating than during cooling. Carp were also placed in a device where gill ventilation (VG) could be continuously monitored while rapid shifts in the temperature of the inspired water (TPINSP) AND/OR BODY SURFACE (Tbs) were effected. Changing Tinsp and Tbs both effected rate-sensitive changes in VG, although Tinsp was more effective. Decreases in Tinsp or Tbs produced decreases in VG; increases in Tinsp or Tbs had an opposite effect. The fish respiratory system is sensitive to the rate of change of external temperature. This sensitivity provides evidence for the existence of peripheral thermal input to the systems regulating respiration in teleost fish.


Sex and estrogens in protection against circulatory stress reactions. From Wistar rats, data are presented which indicate that inbred females a) have a greater ability to clear particulate matter from the blood stream than do males of the same strain; b) are significantly more resistant to two different forms of lethal circulatory stress (e.g., intestinal ischemia and whole-body trauma) than are males; and c) exhibit a greater resistance to undergo reticuloendothelial system (RES) phagocytic depression after both forms of lethal trauma than do males. Estradiol treatment of males, using either acute, massive (1 or 10 mg/kg) or multiple, low dose (10 or 100 mug/kg) regimens, confers trauma resistance on such animals. Such estradiol treated male rats exhibit hyperactive RES's. These estradiol-treated males, when subjected to either lethal ischemia or trauma, fail to demonstrate the early RES phagocytic depression seen in untreated controls. Untreated female as well as estradiol-treated male rats exhibit significantly higher arterial blood pressures post-trauma than do untreated male rats. Direct microscopic observation of rat mesenteries indicr whole-b0dy trauma, the untreated females as well as the estradiol-treated males exhibit significantly less dilatation of microscopic capacitance vessels (i.e., venules) than do untreated male rats. The data reported herein could be used to suggest that estrogenic hormones may play pivotal roles in a) the amelioration of an organism's reaction to systemic stress; and b) control of macrophage and peripheral vascular functions.


Osmoltye and tryptophan receptors controlling gastric emptying in the dog. The effect of three monosaccharides, three disaccharides, two dipeptides, combinations of tryptophan with two hexoses, one hexitol, and two amino acids ongastric emptying was studied in dogs to further define the samll intestinal receptors responsive to osmolytes and tryptophan. On a molar basis the disacchardies and dipeptides were almost twice as potent as their respective constituent monosaccharides or amino acids implying that the osmoreceptor is deep to the brush border disaccharidases and cytosol dipeptidases. Tryptophan probably acts by a mechanism different from the osmoreceptor since slowing of gastric emptying by tryptophan was inhibited by methionine which has no effect on a stimulant of the osmoreceptor mechanism. Lysine unlike methionine does not share the neutral amino acid transport pathway with tryptophan. Lysine did not change the inhibitory effect of tryptophan on gastric emptying. This imples that transport of tryptophan into the intestinal cell is necessary for its slowing effect. Glucose and galactose also inhibited the tryptophan effect whereas a nonabsorbed hexitor, mannitol, was without effect. Interference by the hexoses was also probably by competition with tryptophan for transport into the cell. These studies further indicate that the tryptophan receptor is different from the osmoreceptor.


Pathways regulating cardiovascular changes during volume loading in awake dogs. The role played by the cardiac sympathetic nerves and arterial baroreceptors in the cardiovascular responses to acute volume loading was studied in conscious dogs. In 15 normally innervated animals, mean arterial pressure rose 10 mmHg, heart rate increased 38 beats/min and cardiac output 1,696 ml/min, while peripheral resistance decreased 0.99 PRU. Neither bilateral baroreceptor denervation, dorsal root sections (T1-T5) or surgical interruption of the left ansa subclavia altered the above responses to acute volume loading. Bilateral section of the ansa subclavia (total cardiac sympathectomy) significantly reduced the heart rate response from 35 +/- 5 to 20 +/- 5 beats/min but did not alter other changes. A similar reduction in heart rate response was observed following selective section of the right ansa subclavia. Intravenous infusions of epinephrine augmented the heart rate response in both normally innervated and cardiac sympathectomized dogs. It is suggested that although the primary efferent pathway for the reflex trachycardia is via the vagus, responses are modulated by sympathetic neural activity. Additionally, the nervous system was not shown to play a measureable role in the observed peripheral resistance changes.


Lipoprotein lipase and uptake of chylomicron triglyceride by skeletal muscle of rats. Uptake of chylomicron triglyceride and lipoprotein lipase was studied in red and white skeletal muscles, heart, and adipose tissue of rats. Retention of triglyceride fatty acids 10 min after injection was 1.6%/g in heart and adipose tissue, 0.2-0.4%/g in red (soleus and diaphragm) muscles, and 0.1%/g in white (psoas minor) muscles of fed rats. Fasting (24 h) increased retention two- to fourfold in red skeletal muscles and heart, had no effect in white muscles, and decreased retention greater than 75% in adipose tissue. Lipoprotein lipase activity in fed rats was lowest in white muscles and in certain red (posterior belly of digastric and medial head of triceps brachii) musclws, intermediate in soleus and diaphragm muscles and adipose tissue, and highest in heart. Fasting doubled lipoprotein lipase activity in all red skeletal muscles and heart, had no effect in white muscles, and decreased activity 60% in adipose tissue. The findings indicate that triglyceride uptake is related to lipoprotein lipase activity in skeletal muscle and the changes in enzyme activity during fasting divert blood triglyceride to red skeletal muscles.


Duodenal and ileal adaptation to dietary calcium restriction: in vivo studies in the rat. Intestinal adaptation by the growing rat to a low-calcium diet was studied by in situ perfusion of duodenum and ileum in vivo. Rats were fed diets containing either 1.2 or 0.02% Ca for 17-24 days. To study plasma-to-lumen flux and net calcium absorption, rats were loaded parenterally with 45Ca and perfused intraluminally with 3.4 mM calcium. Calcium restriction caused net absorption in ileum to increase fourfold, in duodenum almost twofold. With calcium restriction, plasma-to-lumen flux decreased in duodenum but not in ileum and was small relative to absorption. However, net calcium secretion, when measured in a separate set of animals by intraluminal perfusion of NaCl, decreased in ileum but not in duodenum in response to calcium restriction. The magnitude of adaptation is greater in ileum than duodenum and is largely the result of increased lumen-to-plasma flux. The distal small intestine is probably crucial for calcium homeostasis in dietary calcium deficiency.


Renal gluconeogenesis and increased glucose utilization in shock. The roles of renal gluconeogenesis and glucose utilization in control, hemorrhaged, and endotoxin-injected animals were investigated using anesthetized, eviscerated, nonnephrectomized and nephrectomized dogs. Results demonstrate an increased glucose utilization in both hemorrhagic and endotoxic shock which was marked after endotoxin. Since blood glucose values dropped more in nephrectomized, hemorrhaged animals, in contrast to the nonnephrectomized, hemorrhaged dogs, the kidneys were assumed to perform a significant gluconeogenic role. The kidneys did not appear to perform gluconeogenesis in endotoxin shock since blood glucose levels were comparable in eviscerated, endotoxin-treated animals whether nephrectomized or not. To ascertain the tissue responsible for the increased glucose utilization in endotoxin shock, a study was performed with endotoxin added to blood in vitro (estimated LD100 concentration). The endotoxin-treated blood (n = 7) demonstrated an increased glucose utilization compared with saline controls (n = 7) (P less than or equal 0.02). Acclerated glucose utilization rates were comparable between the eviscerated, nephrectomized animals and in vitro experiments. These data suggest that excessive glucose demand by certain blood components may partially explain the lethal hypoglycemia of endotoxin shock.


Effect of fatty acids on renal ammoniagenesis in in vivo and in vitro studies. Intravenous or renal intra-arterial infusion of sodium octanoate results in a 60% decrease in renal ammoniagenesis in the acidotic dog. Mobilization of endogenous fatty acids by levarterenol infusion is accompanied by a 30% fall in renal ammoniagenesis which coincides with considerable increase in renal extraction of fatty acids. In both types of experiments, the renal extraction of glutamine falls in proportion with decreased ammoniagenesis. The effect of octanoate and levarterenol infusion cannot be explained by changes in acid-base equilibrium, renal hemodynamics, or the release of insulin. In vitro experiments using kidney cortical slices from acidotic dogs show that addition of sodium octanoate (0.05-10 mM) or sodium palmitate (0.1-2.5 mM) to the incubation medium induces a 35% decrease in both ammonia and glucose production when L-glutamine (1 mM) is used as the basic ammoniagenic and gluconeogenic substrate. Glutamine uptake decreases concomitantly, whereas tissue glutamate either rises or remains unchanged. The same results were observed when L-glutamate (5 mM) was used as substrate. Glycerol (5 mM) in the medium has no effect on ammoniagenesis, whereas gluconeogenesis increases by 81%. The present studies demonstrate that fatty acids may interfere with renal ammoniagenesis from glutamine during acidosis. The effect is probably related to substrate availability and competition. Fatty acids appear to inhibit ammoniagenesis in the mitochondria through a direct metabolic effect linked with their oxidation and not through modification of glutamine transport across the mitochondrial membrane.


Interstitial fluid oncotic pressures in rabbit subcutaneous tissue. Interstitial fluid oncotic pressures in rabbit subcutaneous tissues were measured by chronically implanted membrane osmometers. Pairs of osmometers were used, one using a membrane permeable and one impermeable to plasma proteins. Measurements from the small-pore membranes averaged 10.2 mmHg while pressures measured from the large-pore membrane osmometers averaged -1.2 mmHg, indicating that the measured pressures were osmotic rather than hydrostatic in nature. These values are in agreement with previously published values from this laboratory on oncotic pressures of excised rabbit skin and with a computer-simulation study of capillary fluid balance. The oncotic pressures described in this study are of the s-me general magnitude as those of lymph from most organs in the body.


Stimulation of rat lung metabolism with 2,4-dinitrophenol and phenazine methosulfate. Glucose metabolism was stimulated in isolated perfused rat lungs by perfusion with 2,4-dinitrophenol (DNP), an uncoupler of oxidative phosphorylation or phenazine methosulfate (PMS), an artificial hydrogen acceptor. Lungs were ventilated with 95% O2:5% CO2 and perfused with Krebs-Ringer bicarbonate buffer pH 7.4 containing 5.5 mM [U-14C, 5-3H]glucose for 100 min. In control lungs, 45% of total glucose 14C was recovered as perfusate lactate plus pyruvate (L+P) and 24% as 14CO2. Perfuson with 0.8 mM DNP resulted in a 102% increase in 14CO2 production and a 98% increase in L+P, associated with a fall in tissue ATP/ADP ratio and decreased incorporation of glucose carbons into lipids. Perfusion with 8 muM PMS resulted in a 116% increase in 14CO2 production but no change in L+P; the lactate-to-pyruvate ratio in the perfusate was reduced to 4 from a control value of 10, and tissue adenine nucleotide levels were unchanged. In all experiments, 3H was mainly recovered as 3H2O in the perfusate. These data demonstrate the pattern of response of the isolated lung preparation to uncoupling of oxidative phosphorylation and to alterations in cytoplasmic redox state. The results suggest that the isolated lung preparation is metabolically intact and suitable for study of metabolic control processes.


Energy expenditure for thermoregulation and locomotion in emperor penguins. During the antarctic winter emperor penguins (Aptenodytes forsteri) spend up to four mo fasting while they breed at rookeries 80 km or more from the sea, huddling close together in the cold. This breeding cycle makes exceptional demands on their energy reserves, and we therefore studied their thermoregulation and locomotion. Rates of metabolism were measured in five birds (mean body mass, 23.37 kg) at ambient temperatures ranging from 25 to -47 degrees C. Between 20 and -10 degrees C the metabolic rate (standard metabolic rate (SMR)) remained neraly constant, about 42.9 W. Below -10 degrees C metabolic rate increased lineraly with decreasing ambient temperature and at -47 degrees C it was 70% above the SMR. Mean thermal conductance below -10 degrees C was 1.57 W m-2 degrees C-1. Metabolic rate during treadmill walking increased linearly with increasing speed. Our data suggest that walking 200 km (from the sea to the rookery and back) requires less than 15% of the energy reserves of a breeding male emperor penguin initially weighing 35 kg. The high energy requirement for thermoregulation (about 85%) would, in the absence of huddling, probably exceed the total energy reserves.


Thermoregulation in fasting emperor penguins under natural conditions. Emperor penguins breed during the cold antarctic winter. The males incubate the single egg while fasting for up to 4 mo and losing some 20 kg of their body mass. Fasting captive birds under outdoor conditions lost from 0.145 to 0.434 kg day -1. Mean resting metabolic rate, 49.06 W for 24.8 kg body mass, is 7 and 27%, respectively, higher than predicted from general metabolic equations for birds. Minimal thermal conductance, 1.31 W m-2 degrees C-1, is within the range for other birds. The lower critical temperature is about -10 degrees C; this can be related to large body size (20-40 kg) and to body shape, giving a smaller relative surface area than for other birds. Rigidity of the feathers explains why winds of moderate speed (up to 5 m s-1) have little effect on heat loss. At very low temperatures the behavior of huddling close together is essential in reducing metabolic rate. Without this behavior, survival during the long fast (up to four mo) at winter temperatures would be impossible.


Effect of dorsal root section on the arrhythmias associated with coronary occlusion. In anesthetized vagotomized dogs and cats the circumflex and/or the anterior descending coronary artery were briefly occluded (5-90 s), and ectopic beats occurring during the occlusion and for 60 s following release were counted. When arrhythmias were regularly produced for a given occlusion, the dorsal roots from C8 to T5 were transected and the occlusions were repeated. Dorsal root section produced minor changes in heart rate and blood pressure. Dogs and cats did not differ in their responses. Dorsal root section was performed in eight animals and decreased the absolute number of ectopic beats by 63 +/- 19% compared to control values (P less than 0.05). In four animals the effect on ectopic beats produced by repeated occlusions without dorsal root section was investigated and found to be increased by 35 +/- 24% compared to contrl values. Most of the somatic afferents contained in the dorsal roots were damaged by the surgical preparation. Therefore, repeated occlusions and interruption of somatic afferents do not appear to have influenced our results. The arrhythmogenic interaction between the local effects of myocardial ischemia and the sympathetic activity, whose outlow contained in the ventral roots remained intact, was still possible after dorsal root section and this explains why ectopic beats were reduced but not almost suppressed as is usually the case after bilateral stellectomy. We conclude that dorsal root section reduces the number of ectopic beats associated with short-lasting coronary artery occlusions and that the most likely mechanism is the interruption of the cardiocardiac sympathetic reflex which depends upon afferent fibers running through the dorsal roots.


Stretch receptor model for renin release with evidence from perfused rat kidney. Control of renin release was studied in isolated rat kidneys perfused with Krebs-Henseleit solution containing albumin. Cumulative perfusate renin activity (PRA) as measured by radioimmunoassay was increased by low perfusion pressure and suppressed by high pressure. Renal vasoconstriction induced by infusion of phenylephrine or methoxamine increased PRA, whereas vasodilatation by papaverine suppressed renin activity. The increased renin activity induced by phenylephrine was blocked by high pressure or papaverine. Changing sodium concentration in the perfusion medium had no effect on basal renin release. A mathematical analysis for an intrarenal stretch receptor indicates that renin release is related to the elastic modulus, the internal and external hydrostatic pressures, and the internal and external radii. Calculations based on this model also indicate that renin release is most sensitive to changes in the ratio of the radii. It is proposed that basodilatation or high perfusion pressure may increase the stretch of the afferent arteriole and depolarize the granular cell membrane, whereas vasoconstriction or low pressure may decrease stretch and thus hyperpolarize the cell.


Effectiveness of the aldosterone-sodium and -potassium feedback control system. This study was conducted to determine the quantitative importance of the aldosterone feedback mechanism in controlling each one of three major factors that have often been associated with aldosterone, namely, extracellular fluid sodium concentration, extracellular fluid potassium concentration, and extracellular fluid volume. To do this, the ability of the body to control these three factors in the face of marked changes in daily sodium or potassium intake was studied under two conditions: 1) in the normal dog, and 2) in the dog in which the aldosterone feedback mechanism was prevented from functioning by removing the adrenal glands and then providing a continuous fixed level of supportive aldosterone and glucocorticoids during the low and high electrolyte intake periods. Under these conditions, removal of feedback control of aldosterone secretion decreased the effectiveness of plasma potassium control by nearly fivefold (39% vs. 8% change in plasma potassium concentration), fluid volume by sixfold (12% vs. 2% change in sodium space) and had no effect on control of plasma sodium concentration (2% change with and without feedback control of aldosterone secretion.)


Incidence and pathophysiological changes in chronic two-kidney hypertension in the dog. Unilateral renal artery plication in dogs reduced renal blood flow by 80% and produced a sustained elevation in arterial pressure whereas plasma renin activity increased for only 4 days. Sodium was retained for 3 days after plication, but this response is similar to that after a sham operation. Of seven dogs studied chronically, elevated arterial pressure was sustained for 27 days or longer in six animals. In three dogs hypertension continued for 2 mo before collateral vessels developed and arterial pressure fell; ligation of these collaterals restored hypertension. Arterial pressure was unaffected by an infusion of [1-sarcosine, 8-alanine] angiotensin II in chronic hypertensive dogs on a normal sodium intake. This angiotensin antagonist lowered arterial pressure after sodium depletion, but became ineffective following rapid sodium repletion. Chronic hypertensive dogs showed normal responses to deoxycorticosterone acetate. These findings suggest that the renin-angiotensin system is not critically involved in maintenace of chronic two-kidney renovascular hypertension in the dog. The data also show that the homeostatic role played by the renin-angiotensin system in the maintenance of arterial pressure remained intact in chronic hypertension.


Preglomerular resistance and glomerular perfusion in the rat and dog. Glomerular blood flow in the rat, measured with radioactive microspheres, averaged 233 +/- 59 nl/min per glomerulus, significantly less than the glomerular flow rate in the dog (568 +/- 115; P less than 0.005). The difference in glomerular blood flow rate could not be attributed to differences in mean or cortical flow rates, the fraction of acrdiac output received, cardiac output normalized to body weight, or the fractional distribution of blood flow or glomeruli from outer to inner cortex in the two species. The size of microspheres reaching the glomerulus, however, was significantly larger in the dog than in the rat (P less than 0.0005) suggesting that afferent arterioles were larger in the dog than rat. The difference in afferent resistance calculated from the size of microspheres delivered to the glomeruli was larger than the difference in glomerular blood flow. With a similar arterial pressure, a lower afferent resistance suggests a higher glomerular capillary pressure in the dog, consistent with a number of suggestions that filtration equilibrium is less likely in this species.


Uptake and release of hormones and metabolites by tissues of exercising leg in man. To examine release of insulin from tissues of the exercising llin, growth hormone, cortisol, and circulating metabolites were studied in five men before, during, and after exercise on a bicycle ergometer at 60% of their maximum work capacity. At rest, insulin, growth hormone, and cortisol were taken up by leg tissues. During exercise arterial plasma insulin concentration fell, but cortisol and growth hormone levels rose; there was net release of insulin into venous blood but little change in uptake of cortisol and growth hormone. Insulin release persisted after exercise for 15-30 min. During exercise arterial concentrations and uptake of glucose and free fatty acids (FFA) increased. Examination of the changes in hormones and metabolites failed to identify any single hormonal or metabolic factor causing the observed reversal of insulin uptake with exercise.


Changes in canine saliva ion concentration induced by increased intraluminal pressure. Hydrostatic pressure was applied to a cannula inserted into Wharton's duct of adult dogs anesthetized with pentobarbital and the effect of pressure on saliva flow rate and ionic composition of saliva was measured. Increasing the back pressure on a secreting gland resulted in a decrease in flow rate. Over the range of 0-100 mmHg back pressure the decrease in flow was proportional to the applied back pressure. The potassium concentration of saliva collected in the absence of back pressure and at raised pressure was similar even though back pressure reduced flow. In contrast, sodium concentration decreased when back pressure caused salivary flow rate to be reduced. However, when examined at the same flow rates the concentration of sodium is increased when back pressure is applied to the gland as compared to absence of back pressure. Under conditions of constant stimulation the total output of sodium and potassium into saliva decreases as back pressure is increased; but when equal flow rates are compared total sodium output increases in the presence of applied back pressure, whereas potassium output remains constant.


A reconsideration of the Kety and associates study of genetic factors in the transmission of schizophrenia. The author reviews a study by Kety and associates that reported a significantly greater prevalence of schizophrenic spectrum disorders among the biological relatives of schizophrenic adoptees than among those of nonschizophrenic adoptees. The  principal statistical analysis of the Kety study used an incorrect sample size (306 rather than 66) and failed to weight each index and control case (family) equally. This violation of the independence assumption would allow a few families to disproportionately influence the outcome. The author argues that proper statistical analysis applied separately to available categories indicates that significant differences between the index and control groups occurred mainly in the half-sibling category; this result violates the principle that genetic effects increase with greater consanguinity. She concludes that Kety and associates' study raises more questions than it answers regarding the role of genetic factors in schizophrenia.


Studies designed to disentangle genetic and environmental variables in schizophrenia: some epistemological questions and answers. The author addresses questions raised by Dr. Lorna S. Benjamin in the preceding paper. He quotes from the original studies to respond to questions regarding statistical logic, the relative prevalence of schizophrenia among half-siblings and parents of index adoptees, and the possible role of socioeconomic status as a confounding variable.


The legal implications of sexual activity between psychiatrist and patient. The author examines the legal and professional sanctions against sex between therapist and patient. The relevant literature of criminal law suggests that charges of rape or related sexual offenses against psychotherapists who exploit their patients are a remote possibility. Although sexual activity between therapist and patient may form the  basis of a malpractice claim, the existing case law is complicated, and the legal distinctions are not always consistent with good psychiatric practice. Professional associations lack the legal expertise and indemnification to act in these situations, but medical boards in some states have the power to revoke licenses. In the end, patients must depend on the decent moral character of their therapists.


The alcoholic physician: a survey.

The alcoholic physician: a survey. The authors conducted interviews with 98 recovered alcoholic physicians, all of whom had been entirely abstinent for a minimum of one calendar year. Psychiatry was the only specialty clearly overrepresented. A disproportionate number of subjects reported high standing in their medical school classes. Nearly half of the sample had experienced difficulty with drugs other than alcohol. While legal sanctions and admission to health care and correctional institutions were common among this group, relatively little formal response of a disciplinary nature from colleagues or medical organizations was reported.


Impact of a district branch Task Force on women. A questionnaire sent to all women psychiatrists and trainees in North Carolina as part of the development of a district branch Task Force on Women indicated that institutional sexism affects the careers of many of the respondents. Problems of family-professional role conflicts were especially pronounced in residents and faculty women. Survey findings have resulted in recommendations in the areas of education, communication, and increasing women's participation in task force and district branch activities. The authors feel that such task forces provide a much needed network of supportive relationships for women psychiatrists and raise the consciousness of the district branch regarding women's issues.


Importance of dopamine metabolism for clinical effects and side effects of neuroleptics. The authors studied the relation between human central dopamine (DA) metabolism and the clinical effects of neuroleptics. The neuroleptic-induced increase in central DA turnover (an indicator for the degree of DA receptor blocking) was found to be positively correlated with the therapeutic effect of neuroleptics and the development of hypokinetic-rigid symptoms. This supplies a direct argument in support of the contention that DA antagonism is related to the occurrence of clinical effects. The authors also found indications that neuroleptics of different chemical types do not significantly differ in their intrinsic ability to provoke hypokinetic-rigid symptoms, that development of these symptoms depends on the patient's individual susceptibility, and that individual susceptibility is based on relatively low DA turnover.


A dopaminergic mechanism in mania.

A dopaminergic mechanism in mania. The authors present a case study that explores the relationship of dopamine function and manic illness through the use of two drugs with relatively specific effects in stimulating and blocking dopamine receptors--piribedil (ET--495) and pimozide, respectively. Piribedil, as well as d-amphetamine, was associated with manic episodes, while pimozide had an antimanic effect. These observations suggest that dopaminergic mechanisms may be involved in the mediation of manic episodes in at least some patients.


Platelet monoamine oxidase activity in schizophrenia. The activity of platelet monoamine oxidase in 12 chronic schizophrenic patients was not significantly different from that in a matched group of normal individuals. The authors emphasize the importance of simultaneous processing of control and patient blood samples and the use of carefully controlled techniques, since relatively minor changes in procedure can markedly influence platelet yield and leucocyte contamination.


Treatment of requests for sex-change surgery with psychotherapy. The authors describe two patients whose requests for sex-change surgery represented crises in sexual identity and anxiety-masking symptoms. Brief psychotherapy enabled these patients to relinquish their belief in a surgical "cure". In evaluating such request, the psychiatrist should consider the patient's total personality rather than focusing on the genuineness of the perceived gender disorder. Whatever the final decision, the opportunity for continued psychotherapy should be provided.


Peer counseling in a general hospital.

Peer counseling in a general hospital. Self-help groups can aid an individual in coping with and adapting to catastrophic illness. The authors describe a therapeutic technique in which a member of a medical team serves as a catalyst in introducing a "veteran" patient to a newly disabled patient with the same disease or problem so that they can share feelings, experiences, and strategies. Two cases are presented in which patients who were severely depressed benefited from peer counseling. Short-term or "one-shot" encounters can be a valuable way to help some disabled patients deal with the anxiety and helplessness they feel in the acute states of serious disease or injury.


The psychiatric resident as an ex-officio community board member. The authors describe a program in which third-year psychiatric residents participate as ex-officio members on the boards of community service agencies. Experience as board members gives residents a broad understanding of issues related to the delivery of community mental health services and encourages them to continue community involvment after their training is completed.


The use 0f two-way TV in bringing mental health services to the inner city. The authors describe a cable TV link between a medical school and a child health station in East Harlem. Nurse associates and community health workers trained through television conferences with a child psychiatrist have the primary responsibility for patient care at the clinic. Patients and their mothers are evaluated by the child psychiatrist in TV consultations at which nurse associates, health workers, medical students, and child psychiatric fellows are present. Patients and mothers respond positively to the system, and a high percentage of the psychiatrist's treatment recommendations are accepted. The authors suggest that such TV links can increase mental health services to underserved inner-city children.


Sixteenth Emil A. Gutheil Memorial Conference. Factors influencing sexual behavior in our future society. The paper is concerned with some of the factors that will probably influence sexual behavior at the end of this century and in the beginning of the next. These include changes in family structure, marriage, male-female relationships, effects of large organizations on male-female role playing, mass increase in population, anticipated food shortages, and the effects of forced leisure.


Beyond sexual freedom: clinical fallout. This paper is a critical evaluation of the nature and meaning of various radical changes in sexual customs and behavior and their clinical consequences. The author contends that many of the revolutional changes demonstrate a complete and disastrous disregard of knowledge gained through painstaking psychodynamic and psychoanalytic investigations over the past 75 years.


Children who are victims of sexual assault and the psychology of offenders. Psychiatrists and others have too often discounted reports of sexual attacks upon children and ascribed the incident to fantasy. The author's experience in private psychoanalytic practice and in Philadelphia's rape victim clinics indicates that these assaults occur frequently. If the sexual attack is dealt with improperly or repressed it may cause serious psychologic problems for the victim as an adult.


Adolescent sexuality and societal change. Social changes have occurred so rapidly and in such magnitude as to invalidate previously effective coping mechanisms and to reduce the supporting factors in the social milieu. Concomitant with these changes has been an increase in adolescent sexual behavior. Psychoanalytic theory indicates that this behavior will warp or retard psychosexual maturity, but other authorities disagree with this stance. Present evidence does not allow a definitive statement, but indicates the need for more attention to those adolescents who escape psychic damage.


The psychodynamics of male prostitution. In a seventeen-month field study thirty-three male were interviewed and tentatively classified into four categories: call-boys, street prostitutes, bar hustlers, and kept boys. These classifications, though flexible, were deemed useful in exploring the homosexual psychodynamics involved. In addition, twenty frequenter of prostitutes (scores) were interviewed and the prostitute-customer relationship was analyzed and discussed.


Gossip and psychotherapy.

Gossip and psychotherapy. Gossip, a phenomenon as old as history itself, is reflected upon in terms of its need-fulfilling functions for persons and social groups. It is seen as one of the sources of knowledge about life that has potentials for wisdom, and its interpersonal and intrapsychic functions are shown to have similarities to many salient functions of psychotherapy.


Telepathy in psychoanalysis: an instance. A case is presented of a patient telepathically perceiving a stressful event in the analyst's life. Evidence for this is a dream of the patient that embodied a similar content and affect. It is hypothesized that the patient's telepathic ability derived from his self-effacing character trend, which determines an act of perception.


The stigma of seeing a psychiatrist.

The stigma of seeing a psychiatrist. Mental and physical illnesses are compared and contrasted and reasons for the stigma attached to seeing a psychiatrist are discussed. Psychiatrists appear to share in the responsibility for perpetuating such a stigma. VIP's and others are sometimes prevented from seeking competent help because of such attitudes, which fit into the systems theory model of mental illness. The validity of the medical model is re-emphasized.


Psychotherapy of borderline psychotic children. This presentation of excerpts from the literature synthesizes many suggestions by various therapists concerning the treatment methods of borderline psychotic children. The importance of providing a stable, auxiliary ego for the child to introject emerges clearly and is clinically demonstrated. Comments on the author's own experiences are included.


The mortality of Swedish and U.S. white males: a comparison of experience, 1969-1971. The life expectancy of males in the United States is lower than that of males in most of the developed countries and in some of the not-so-developed ones. U.S. females, by contrast, do much better in international ranking. This study compares the mortality of U.S. white males with that of Swedish males who have had the highest reported male life expectancies in the world since the early 1960s. Life expectancy at birth in 1969-71 was 67.9 for U.S. white males compared with 71.9 for Swedish males. Greater U.S. white male mortality is found at all ages from birth through ages 75-79. At the upper ages there is a reversal of the differential with U.S. white males having lower mortality than their Swedish counterparts. The greatest relative differentials between the two male populations is found at ages under 1, ages 20-24, and ages 50-59. At ages under 1 the greater U.S. white male mortality is accounted for mainly by higher death rates from infectious diseases, at ages 20-24 by higher rates from the external causes of death (specifically accidents and homicide), and at ages 50-59 from most of the major organic causes of death.


An analysis of physician visit data from a complex sample survey. A generalization of ordinary least squares methods is used in the analysis of physician visit data from a complex sample survey. The emphasis, in this paper, is on the valid substantive inferences to be drawn from an analysis of this type of data. The procedure is found to be useful in two ways. First, the resultion on a national basis. It is concluded that age is an imp-s of a comparative sampling study are reported. Second, the procedure is used to remove statistically non-significant variation from the data in order to generate fitted or smoothed estimates on which the substantive analyst may focus his attention. These fitted values are then examined for implications to physician service utilization on a national basis. It is concluded that age is an important variable while the effect of sex and race depends on age. Similarly, residence and income are important but the effect of education depends on the level of income.


Quality of care given to first time birth control patients at a free clinic. In an empirical study of the quality of care at a free clinic, criteria for optimal care for female first visits for birth control were established and 100 charts were reviewed, 50 in April 1974 and 50 in April 1975 with an interval in between of in-service training accompanied by new medical forms and procedures. An encouraging improvement in record keeping was observed. The authors feel it is important that free clinics concentrate on quality as well as quantity and accessibility of care.


Healing of deep venous thrombosis: venographic findings in a randomized study comparing streptokinase and heparin. Sequential ascending venographic studies were used to assess the healing of deep venous thrombosis in 50 patients randomly assigned to streptokinase or heparin therapy. Various degrees of thrombolysis and/or recanalization were demonstrated by venograms performed on the fourth and tenth days of treatment. Late follow-up studies (mean, 7 months after treatment) showed three basic patterns of resolution: (1) return to normal, (2) complete recanalization, and (3) incomplete recanalization and/or collateralization. Loss of valves or their function was associated with recanalization. The character, speed, and outcome of healing reflected the nature and extent of thrombosis, prior thrombotic disease in the extremity, and the type and timing of treatment. Streptokinase was highly effective and preferable to heparin in patients with deep vein thrombosis when therapy was begun within 4 days of onset of symptoms. In later stages of acute or recurrent deep vein thrombosis, the effectiveness of both drugs was significantly reduced.


Hemodynamic assessment of obstructive aortoiliac disease. Angiographic demonstration of obstructive aortoiliac disease is of paramount importance prior to surgery. Obstructive disease in the femoral popliteal system can only be surgically relieved if inflow is adequate. Severely stenotic lesions may be missed by angiography due to the oblique course of the iliac arteries and inability to obtain right angle views. Translumbar downstream catheterization of the abdominal aorta and puncture of both femoral arteries allows simultaneous pressure recordings. The injection of 30 mg of papaverine into the femoral artery assures maximal vasodilatation mimicking conditions under exercise. A minimal gradient at rest may become obvious following the injection of papaverine, indicating hemodynamically significant disease and warranting surgical correction. The technique has proved to be simple and valuable, and there have been no complications.


Effects of experimental hepatic artery embolization on hepatic function. The hepatic artery was embolized with Gelfoam in 12 dogs to evaluate the effect of embolization on hepatic function. Liver function studies, including SGPT, alkaline phosphatase, BSP test, and bilirubin, were done serially over a 6 week period following the embolization. Eleven of the 12 embolized dogs survived the 6 week experimental period. Hepatic artery embolization caused some liver damage; however, recovery occurred by 6 weeks. These results suggest a possible therapeutic role for hepatic artery embolization in patients with massive hepatic bleeding or hemobilia who are not surgical candidates and who would require hepatic lobectomy or dearterialization to control the bleeding.


Traumatic thenar ischemia.

Traumatic thenar ischemia. A case of posttraumatic digital ischemia involving the thenar portion of the hand is presented and the differential diagnosis of hand ischemia is discussed. The importance of obtaining an occupational history for assessment of possible hand trauma is emphasized. Angiography can confirm the diagnosis of posttraumatic arterial injury and will localize thrombosis or aneurysms for possible surgical repair.


Sacroiliitis in severe psoriasis.

Sacroiliitis in severe psoriasis. In 100 consecutive patients admitted to the hospital for control of severe psoriasis, 25 had radiologic changes characteristic of psoriatic arthritis. Twenty had erosions and mild sclerosis around the sacroiliac joint; in eight of these, asymptomatic sacroiliac changes were the sole manifestation of musculoskeletal disease. Twelve had vertebral syndesmophytes, 11 had terminal interphalangeal joint changes, and 10 had peripheral joint involvement.


Posttraumatic adhesive capsulitis of the ankle: arthrographic diagnosis. A disabling decrease in range of motion may be a sequelae of ankle trauma. This complication can result from secondary degenerative joint disease, osteochondrial fractures with loose bodies, or posttraumatic adhesive capsulitis. The latter entity is well recognized as a complication of shoulder injuries but is rarely described in other joints. Since adhesive capsulitis produces no specific plain film findings, the confirmation of this diagnosis depends on the usage of a contrast study. It is only recently that ankle arthrography has been utilized to differentiate between the various causes of a painful posttraumatic ankle. Once a diagnosis is established by arthrography, therapeutic efforts can be directed toward relieving the specific abnormality. Three cases of "frozen" ankles are presented. Two were the result of intracapsular fractures, while the third had previously sustained a severe injury of the soft tissue. The arthrographic findings included a decrease in the joint capacity, obliteration of the normal anterior and posterior recesses, and extravasation of contrast material along the needle track.


The infrapatellar synovail fold: a cause for confusion in the evaluation of the anterior cruciate ligament. The anterior cruciate ligament may be simulated by the normal infrapatellar synovial fold or ligamentum mucosum. With the aid of lateral tomography, the expected course and insertion of the structures can usually be differentiated. This distinction is important, since a torn anterior cruciate ligament can be overlooked and lead to a delay in appropriate therapy.


Determination of bone mineral content using CT scanning. The usefulness and accuracy of CT scanning in the determination of bone mineral content is studied. The radius in 31 patients of both sexes and varying ages was examined using both the Norland-Cameron bone mineral analyzer and the CT scanner. There was reasonably good correlation (r=.72). Ten cadaver bones were then examined with CT scanning and were sent to the laboratory for calcium determination. These results indicate excellent correlation (r=.97). It is concluded that CT scanning represents the only practical and accurate in vivo method of bone mineral content determination.


Sphenoethmoidal mucocele: radiographic diagnosis. Fourteen cases of mucocele of the sphenoid sinus are reviewed to assess differentiating radiographic features. Recognition is usually possible using detailed tomography in the frontal, lateral, and submentovertex projections. Two constant findings were opacification of the sinus (usually bilateral) and expansion and thinning of the sinus walls. Contiguous opacification of the ethmoid sinuses was present in most cases, and pansinusitis was frequent. Distinction from intrasellar lesions is based on the absence of sellar enlargement. Early and correct diagnosis is important to prevent permanent visual loss and to assure appropriate surgical approach.


The radiology of transsphenoidal hypophysectomy: a review of 100 cases. This report describing the radiology of transsphenoidal hypophysectomy based on a review of 100 consecutive surgical procedures. Preoperative laminographic evaluation of the sphenoid sinus is an important aid in planning the most direct surgical approach to the pituitary. It is also useful in defining the many anatomic structures that may be injured inadvertently at the time of surgery. Intraoperative radiography or fluoroscopy is helpful in identifying the sella floor and as an aid in preventing loss of orientation within a capacious sinus. Various changes occur within the sphenoid sinus following surgery, some transient and others persistent. The surgical defect is usually difficult to identify on routine roentgenograms but is clearly visible on lateral laminography. A persistent soft tissue mass within the sinus is usually a manifestation of fascia and fat placed as a seal within the sinus.


Air contrast colon examination in patients with colostomies. A readily feasible technique for producing an excellent air contrast examination of the colon in patients with colostomies is described. The technique employes no special equipment and is easily tolerated by patients. Indications for the examination include a symptomatic patient with a negative conventional enema or suspicious single column examination. The surprisingly high incidence of both benign and malignant coexisting colonic neoplasms is reviewed.


Radiographic manifestations of malignant histiocytosis. Twenty-six cases of histologically proven malignant histiocytosis are presented. Patient ages ranged from 20 months to 82 years, and a 10:3 male preponderance was seen. Clinical presentation is similar to that of malignant lymphoma and leukemia; histologic differentiation is required. The frequency of intrathoracic involvement at the time of presentation is similar to that of non-Hodgkin's lymphoma. Retroperitoneal lymph node invasion was readily seen on five of the eight lymphograms performed. Hepatosplenomegaly was a common finding, and three of the patients had evidence of bone involvement during the course of their illness. While there are no radiographic findings specific to malignant histiocytosis, the presence of hepatomegaly should suggest this possibility. The establishment of the correct diagnosis is important to guide choices in chemotherapy.


Neonatal diaphragmatic dysfunction.

Neonatal diaphragmatic dysfunction. Several unusual diaphragmatic problems in the neonate are presented and a new potential complication of the negative pressure respirator is illustrated. The association of bilateral diaphragmatic eventrations with chromosome anomalies is emphasized. In our experience the appearance of the chest on frontal and lateral views is usually so characteristic that no further evaluation is required. The relationship between several neuromuscular disorders and diaphragmatic dysfunction is discussed. A case of congenital myotonic dystrophy with unilateral eventration is illustrated.


Early diagnosis of necrotizing enterocolitis. This study demonstrates that the diagnosis of necrotizing enterocolitis can sometimes be made before the full-blown clinical and radiographic findings are manifest. Of 12 infants with films available prior to diagnosis of the disease, nine had early selective dilatation of small bowel and little or no air in the colon. Necrotizing enterocolitis should be foremost in the differential diagnosis when this finding is coupled with signs such as abdominal distention, acidosis, and diarrhea.


Correlation of renal images on bone scan and intravenous pyelogram. The reliability of renal images using the 99mTc-labeled bone-seeking radiopharmaceuticals was evaluated by comparing abnormal renal images on bone scan with IVP and, conversely, abnormal findings on IVP with renal images on bone scan. Several findings on the bone scan renal images were associated with abnormalities on IVP. However, some conditions may not be detected on the bone scan images which are demonstrated on IVP. Results suggest that an abnormality of the renal image on bone scan warrants further investigation while a normal renal image does not exclude renal pathology.


Angiographic documentation of systemic-portal venous shunting as a cause of a liver scan ""hot spot'' in superior vena caval obstruction. Four patients with superior vena caval obstruction were evaluated with contrast venography and radiocolloid liver scans to investigate systemic-portal venous shunting as a cause of a liver scan "hot spot". In two of the cases a hot spot due to systemic-portal venous shunting was documented by angiography. The venous anatomy and pathophysiology related to hot spot formation on the liver scan is discussed. To develop a liver scan hot spot it appears necessary to have considerable systemic-portal venous flow through anterior parietal and periumbilical venous channels.


Carcinoembryonic antigen (CEA) monitoring of radiation therapy for colorectal cancer. Serial CEA radioimmunoassays were performed on 16 patients receiving preoperative radiation therapy of rectal cancer or irradiation of recurrent or metastatic colorectal cancer. Radiation therapy of localized colorectal cancer reliably reduced previously elevated circulating CEA titers. Significant decrease of elevated CEA titers with accumulating doses of irradiation may indicate that the bulk of CEA-producing tumor is within the radiation treatment portal and assist in patient management decisions. The decrease of circulating CEA with preoperative radiation therapy was of short duration and may indicate that surgical resection should not be delayed more than 6-8 weeks after irradiation. Because of the high frequency of false positive and false negative results, CEA must be used only in conjunction with other clinical and laboratory parameters.


Radiation therapy in the management of primary breast cancer. Since 1960, six cancer centers in France have used radiotherapy alone (with or without tumorectomy) in the treatment of "operable" breast carcinomas. The technique at Hopital Henri Mondor (Creteil) includes a basic irradiation of 5,000 rad to the breast, 4,500 rad to the chest wall, and 4,500 rad to the axillary, supraclavicular, and internal mammary nodal areas. Boost doses of 1,500-2,500 rad to the axillary and internal mammary nodes are given with electrons. A boost dose of 4,000 rad is given to the primary tumor site in the breast by endocureitherapy. Results appear equivalent to those obtained with surgical techniques. Esthetic results are, on the whole, satisfactory. Definitive results will be reported several years hence.


Use of auxiliary collimating devices in the treatment for breast cancer with 60Co teletherapy units. I. Dosimetric considerations. The dosimetry of tangential field treatment for breast cancer using an auxiliary collimating device on 60Co teletherapy machines is reviewed. The position of the device with respect to the source axis has negligible effect on either the dose rate or the dose distribution. Measurements with thermoluminescent dosimeters in an anatomic phantom verify the accuracy of the method of correction of isodose distributions for sloping skin. Possible systematic errors in dosimetry are identified.


Use of axiliary collimating devices in the treatment for breast cancer with 60Co teletherapy units. II. Dose to the skin. Special auxiliary collimating devices are often used in radiation therapy for breast cancer in order to treat the chest wall with tangential 60Co fields. Some of these devices are manufactured with a permanently attached Lucite end plate which increases the skin dose due to electron contamination. The relative surface dose was measured on a 60Co irradiator utilizing the collimating device with and without the Lucite plate. A parallel plate extrapolation chamber was used. The surface dose was measured as a function of the distance from the end of the device, the position in the field, and the angle of incidence for typical chest wall fields. These results are used to compare the dose to the skin of the chest wall for several treatment regimes. The data indicate that if the Lucite end plate is permanently attached, the skin dose may be enhanced to the extent that the use of additional bolus may be neither necessary nor desirable.


Simplified method for standardization of roentgenographic image quality using penetration quality measurements. A simplified method for standardization of roentgenographic image quality is described. The method employs the concept of penetration quality (PQ) originally established for calibration of x-ray tube potential (kVp). In order to verify that the PQ measurement is useful for standardization of roentgenographic image quality in a clinical situation, a cadaver was selected for patient simulation. It has been shown that PQ may be utilized for roentgenographic technique specification in place of kVp. The validity of this standardization was evaluated subjectively by radiologists.


Computed tomography in progressive multifocal leukoencephalopathy. An area of decreased density found with computed tomography corresponded to confluent demyelinative lesions in the brain of a patient with progressive multifocal leukoencephalopathy. Failure of the CT scan to enhance with contrast material together with the clinical picture may enable clinicians to diagnose this subacutely progressive viral demyelinative brain disorder.


Bilateral subclavian steal syndrome.

Bilateral subclavian steal syndrome. Two cases of bilateral subclavian steal syndrome are presented, demonstrating complete occlusion at the origin of both subclavian arteries with distal reconstitution via reversal of blood flow through the vertebrobasilar system. Since unsuspected subclavian artery obstruction may present significant angiographic hazard, careful physical examination including blood pressures in both upper extremities and auscultation of the neck is necessary in order to avoid undesirable complications.


Scrotal "arteriocele" from iliac artery occlusion. A case is described in which a testicular artery, pulsatile and palpable in the scrotum, provided a major collateral for an obstructed iliac artery. The testicular artery was probably spared from occlusion because it originated from a renal artery. Following surgical relief of the iliac obstruction, the testicular artery reverted to normal caliber and was no longer palpable in the scrotum.


Displaced lateral surface of the liver (Hellmer's sign) secondary to an extraperitoneal fluid collection. In 1942, Bellmer (1) first described visualization of a medially displaced lateral liver edge on abdominal radiographs in patients with ascites. In Hellmer's original article and all cases subsequently reported, this appearance was described as being pathognomonic of intraperitoneal fluid. This paper reports the occurrence of Hellmer's sign in a patient with a large extraperitoneal fluid collection extending into the flank. Thus the differential diagnosis associated with a medially displaced lateral liver edge includes pathologic processes in both the intra- and extraperitoneal spaces.


Genitourinary involvement in chronic granulomatous disease of childhood. A second case of symptomatic renal involvement of chronic granulomatous disease of childhood is reported, and all previous cases of documented genitourinary lesions in this disease are reviewed. Although frequent infections of other organ systems are a well recognized part of chronic granulomatous disease, involvement of the urinary tract has been rarely reported. The nature of the few cases described suggests that extensive insidious destruction occurs before urinary tract involvement is clinically suspected.


Metaphyseal chondroblastoma of bone.

Metaphyseal chondroblastoma of bone. This report documents the ninth example of a chondroblastoma localized to the metaphysis of a long bone. The tumor appeared as a lytic lesion in the femoral neck of an 18-year-old boy and was associated with a periosteal reaction. When such neoplasms occur in an unusual location with associated periosteal reaction, chondroblastoma should be considered in the differential diagnosis.


Acupuncture needles: a "new" foreign body in the ear. With the recent popularity of acupuncture therapy and anesthesia in the United States, patients are having temporary needles placed in the external ear. These matallic radiopaque needles appear on routine skull and mastoid examinations. This article is written to familiarize radiologists with this ""new'' iatrogenic foreign body.


The cardiovascular effects of ketamine in man. The arterial hypertension of ketamine is prevented by verapamil, a calcium ion antagonist. This indicates that ketamine is a direct myocardial stimulant acting by increasing the availability of calcium across the cell membranes of the myocardial and the Purkinjé systems. The positive chronotropic action of ketamine is not reversed by verapamil. Both the chronotropic and the inotropic effects of ketamine are prevented by halothane which acts partly by increased vagal tone and partly by what appears to be a verapamil-like depression of calcium availability. Ketamine blocks the reflex sympathetic response of the peripheral blood vessels to surgical stimuli. The site of the block within the sympathetic reflex arc has not been identified. It is not at the alpha adrenoceptor level. The clinical implications of the findings have been discussed.


Althesin anaesthesia and a long induction-delivery interval at Caesarean section. A case is reported in which obstetric management resulted in 52 minutes elapsing between the induction of anaesthesia and delivery by Caesarean section. The mother was induced and maintained on Althesin and minimal methoxyflurane throughout this period without detriment to the neonate.


Unusual presentation of phaeochromocytoma. Management of anaesthesia and cardiovascular monitoring. A case is reported in which a patient with a history of high output left ventricular failure presented for exploratory laparotomy and removal of a highly vascular tumour which was intra-operatively discovered to be a phaeochromocytoma.


Pulmonary embolism. Prophylaxis diagnosis and treatment. The natural history diagnosis and immediate treatment of patients suffering from pulmonary embolism has been discussed. Anaesthetists should use their influence to bring about a high standard of prophylactic care against deep venous thrombosis and consequently of pulmonary embolism. They are likely to be involved in the resuscitation and treatment in intensive care units of those cases who suffer from major symptoms and massive emboli and some of them will rarely be involved in anaesthetising for pulmonary embolectomy aided by cardiopulmonary by-pass and, less rarely, for IVC ligation or plication and venous disobliteration. Anticoagulant drugs appear to limit the mortality of pulmonary embolism to 5%. The mortality of IVC ligation or plication varies in different reports from 2 to 50%; it should therefore be reserved for the special indications which have been discussed. There is also an incidence of recurrent pulmonary embolism after IVC ligation and plication and leg troubles from stasis in about 30% of cases. Streptokinase is usually indicated in the immediate treatment of major pulmonary emboli which cause shock and severe distress with an immediate threat to life. In hospitals having access to cardiopulmonary by-pass, pulmonary embolectomy has a small role to play in major emboli with cardiovascular collapse, if surgery can start within 2 hours and pulmonary angiography is available. Cardiopulmonary by-pass on its own may be life-saving in supporting the circulation while the clot fragments. If cardiac arrest occurs, external cardiac massage should be undertaken as it is sometimes successful and disseminates and fragments the clot in the pulmonary artery.


Anaesthesia in patients with phaeochromocytoma. The authors' technique of balanced neuroleptanaesthesia with droperidol, fentanyl, nitrous oxide, pancuronium and nitroprusside is outlined. It is suggested that this is the anaesthetic method of choice for the surgical removal of catecholamine secreting tumours since it is associated with good operating conditions and an uneventful post-operative period.


[Preoperative digitalization. Measurement of digoxin plasma levels (author's transl)]. In a study of 233 patients from the department of surgery and anesthesiology taking digoxin preparations 64, per cent exhibit digoxin levels in the therapeutic range (0.6--1.5 ng/ml), 19 per cent had subtoxic concentrations ranged from 1.6--2.0 ng/ml and 7 per cent were in the toxic range (greater than 2 ng/ml). In patients treated with digoxin before admission to hospital subtherapeutic levels were most frequent. An average loading dose of digoxin 1 mg or more on one day may result in subtoxic and toxic digoxin levels on the second day, in patients receiving less than 1 mg digoxin daily an increasing frequency of plasma digoxin concentrations of 1.5 ng/ml or higher values was present on the third day. Averaged plasma digoxin concentrations were correlated with daily maintenance dose. There was, however, a wide individual variation in digoxin plasma concentrations. A low incidence of toxic digoxin plasma levels was observed in patients receiving a daily oral maintenance dose of 0.375 mg digoxin (Lanicor). For prophylactic digitalization of patients with normal renal and thyroid function the following schedules or statistical guidlines are proposed: Lanicor (bioavailability 60%): oral loading dose of 0.75 mg over two days, and then daily oral maintenance dose of 0.375 mg; Novodigal (bioavailability 80%): oral loading dose of 0.6 mg over two days and then daily oral maintenance dose of 0.3 mg; Digoxin i.v.: intravenous loading dose of 0.5 (0.4) mg over two days and then 0.25 (0.2) mg daily intravenous maintenance dose. For any patient needing treatment with digitalis glycosides therapy must be individual and dynamic. The reasons for toxic concentrations were frequently attributed to wrong dosage.


[Cardiovascular changes caused by atropine in normo- and hypothermic methoxyflurane anaesthesia (author's transl)]. The authors examined in 25 patients, of which 15 were normo- and 10 in hypothermic, the cardiovascular effects of 1 mg atropine i.v. In normothermia the heart rate increased significantly from 100 to 110 beats/min after atropine. At the same time the stroke index and stroke work decreased significantly. The mean arterial pressure, the heart index, the left ventricular minute- and stroke work and the total peripheral resistance did not change. In two patients with an arteriovenous fistula and hypervolaemia, the atropine injection caused an increased of heart- and stroke index. Arrhythmias did not occur after atropine. In hypothermia on the other hand atropine was shown to have no effect on heart frequency and all other examined parameters. In one patient in which the P-R interval was shortened, the atropine injection was followed by an total atrio-ventricular block. The authors cannot recommend atropine therapy in cases of hypothermic bradycardia, because of its lack of effect on the heart rate in hypothermia.


[Central venous pressure and blood circulation in orthostatic by changes of the total blood volume in postoperative patients (author's transl)]. In 13 postoperative patients (1st to 9th day) of both sexes, aged 32 to 74, we studied whether an additional volume of 500 ml Haemaccel might demonstrate-as in earlier test series--a correlation between CVP measured in the horizontal position and changes of CVP and Pa measured at atrial level in a partly upright position (tilting angle 45 degrees and 60 degrees of the revolving bed). After volume administration (average: 8.13 ml/kg body weight) and raising of CVP in the horizontal by 3.42 cm H2O corresponding to an E'-value of 0.42 cm H2O/ml/kg body weight, we noticed a significant reduction of the decrease due to orthostasis as well of Pa at heart level as of the "shock index"; at the same time, however, the extent of the CVP decrease registered for all patients increased significantly regardless of tilting angle. Therefore, a correlation between the intravasal filling state and the reaction of orthostatic CVP and Pa may be assumed. In conclusion, the explanation for these results and the relation between the venous filling volume and some pathophysiological functions at the right heart are discussed.


[Serum concentrations of pancuronium in anuric patients (author's transl)]. After a single intravenous dose of 6 mg serum concentrations of pancuronium were measured in 6 anuric patients by means of the bromophenol blue colorimetric method at 1, 5, 45 min and 3 h. After 45 min and 3 h there was a retention of 1.7 and 4 times the control values respectively. The prolongation of pancuronium induced muscular paralysis which has been demonstrated by other authors now can definitely be related to elevated serum concentrations of the active drug. The termination of muscle relaxation in anuric patients is considered merely to be due to redistribution of the drug from the motor end plates to non specific structures. Prolonged neuromuscular blockade may occur in as much as the redistribution mechanism is overloaded by inadequate doses.


[Diagnosis of acute acquired defects of coagulation and their therapy (author's transl)]. Simple coagulation tests, easily performed in every laboratory allowing diagnosis and differential diagnosis of acute acquired defects of coagulation are reported. The therapeutic possibilities and their practice are presented.


Preoperative haemoglobin levels.

Preoperative haemoglobin levels. It is a common practice in many anaesthetic centres throughout the world to require a minimum preoperative haemoglobin level of 10g/100 ml of blood or more, but very few references are quoted by writers on this subject. A search of relevant medical literature has been made in an attempt to establish the origin and significance of the preoperative haemoglobin requirements recommended.


Metabolism of enflurane in man following a second exposure. A second administration of one half MAC enflurane for two hours one week following a previous identical exposure caused no increase in urinary inorganic Fluoride excretion (UFV). At this dosage of 1 MAC hour, which is equivalent to use as a supplement, UFV did not sub-anaesthetic doses of enflurane are administered at this time interval there appears to be no increased risk of nephrotoxicity. This study also provides strong support for the concept that drug metabolism is very reproducible within individuals but there is considerable variation between individuals. Since the subjects in this study were all of similar age, and drug free, the results are in keeping with recent twin studies which indicate that individual differences in drug metabolism are largely determined on a genetic basis.


The hypotensive effect of fresh lympholised plasma. The hypotensive effort of fresh, lypholised plasma, both during and after cardiopulmonary bypass is demonstrated. It is postulated that the mediator is bradykinin, or one of its precursors.


Post-operative respiratory function: a ventilation-perfusion study. Many studies have shown that after uncomplicated abdominal surgery arterial hypoxaemia frequently occurs because of regional underventilation in relation to perfusion. This paper produced evidence that shows a small increase in physiological dead space to tidal volume ratio following general anaesthesia for abdominal surgery. This increase is thought to be due to tachypnoea rather than alteration in pulmonary blood flow.


Use of an automated register in the administration of an operating theatre suite. Slight modification of established recording practices is frequently all that is necessary to enable a computer to be used as a powerful and flexible administrative tool. The organization of an automated data processing system in a hospital operating theatre suite is outlined and discussed.


Thrombus formation on indwelling venous cannulae in sheep : effects of time, size and materials. Three experiments were performed to measure thrombus formation on plastic cannulae inserted by cut-down into veins of sheep. On polyethylene tubing, considerable thrombus was present after one day and the amount increased in the subsequent 13 days. When different sized polyethylene tubings were tested, thrombus tended to form in relation to the surface area. Smaller tubings had smaller proportions of their lengths covered with thrombus. There were differences between types of plastics with one batch of polyvinylchloride tubing being virtually non-thrombogenic.


Measurement of thrombus formation on intravascular catheters. Relative thrombogenicities of several brands of intravascular catheters were measured in the saphenous and cephalic veins of sheep. Differences in thrombogenicity between brands of up to eleven fold were found. At least one brand contained an ingredient which was locally toxic to sheep and which caused phlebitis in cannulated vessels. The brands tested were made from six types of plastics. It is suggested that differences in manufacturing technique may be more important than the type of plastic in determining the thrombogenicity of catheters.


Bicarbonate requirements during hypothermic cardiopulmonary bypass: the relative effects of pulsatile flow. An analysis of 541 patients having total body perfusion under hypothermia (30 degrees-33 degrees C) showed that the use of pulsatile as against constant flow perfusion was not associated with a reduction in bicarbonate requirement, though the use of a vasodilator was. The implications of this are discussed.


Clinical evaluation of etidocaine in continuous caudal analgesia for pelvic floor repair and post-operative pain relief. A randomized double-blind trial compared 1-0% etidocaine and 1-5% lignocaine (both with 1/200,000 adrenaline), for caudal anaesthesia for pelvic floor repair. Etidocaine was highly effective for the surgical procedure, with rapid onset of action, adequate muscle relaxation and longer duration of action. Its use for post-operative analgesia may be hindered by the concomitant immobilization of the legs. The problem of tachyphylaxis with etidocaine needs further investigation.


Bronchospasm associated with enflurane exposure--three case reports. Three cases of severe bronchospasm occurring in known asthmatics following the administration of enflurance are described. Other commonly known causes of bronchospasm did not seem to be operative. Moderately high concentrations of halothane in the respired gases protected against the bronchospasm whereas a moderately high blood concentration did not. Although the authors have administered enflurane to other known asthmatics without producing bronchospasm, they feel it should be used with caution in such patients.


Intercostal block for post operative pain relief. Intercostal nerve blocks with 0-5 per cent bupivicaine were used for post operative pain relief in 100 patients having upper abdominal operations. The blocks were very effective in 86 patients and had an average duration of 11 hours. Two asymptomatic pneumothoraces occurred.


Head injury, spasticity, suxamethonium and hyperkalaemia. Cardiac arrest due to hyperkalaemia following suxamethonium in a patient with generalized spasticity due to head injury is reported and discussed.


A comparative study of intravenous anaesthesia with thiopental versus althesin in outpatient dental practice. Clinical effects of two intravenous anaesthetics--thiopental and althesin--were compared in a group of 160 outpatients. Each anaesthetic was used in 80 cases. The administration of these anaesthetics was preceded by an intravenous injection of fentanyl and atropine sulphate. Anaesthesia was carried out with the patient sitting in dental chair. The observations confirmed that this method of anaesthesia provides good conditions for carrying out minor dental operations and is safe for the patient, as evidenced by a negligible number of minor complications. A comparison of the results of clinical observations and gasometric determinations indicates that althesin is superior in outpatient practice to thiopental. This simple and easy technique of anaesthesia without the necessity of using expensive apparatus should be widely introduced in outpatient practice.


Effect of endotracheal anaesthesia on the activity of lysosomal enzymes in peripheral blood granulocytes. The purpose of this study was to assess the effect of endotracheal anaesthesia on the activity of lysosomal enzymes in peripheral blood granulocytes. The determinations were carried out before anaesthesia, after 1 hour of anaesthesia and 1 hour after awakening. The activity of lysosomal enzymes was assessed on the basis of the activity of marker-enzymes, i.e. acid phosphatase, acid protease and neutral protease. The lysosomal fraction was prepared by Choduker's method and the activity of lysosomal enzymes was calculated for 100 mug of protein. The obtained results showed a statistically not significant rise in the activity of these enzymes in the lysosomes during anaesthesia without a similar rise in the supernatant. The activity of marker enzymes in lysosomes rose to the initial values after the awakening of patients. Such rapid changes in the activity of lysosomal enzymes seem to depend mainly on the mobilization of the reserve pool of granulocytes from other sources than the peripheral blood and, to a lesser extent, on latency and stabilization of lysosomal membranes by anaesthetic agents used in correctly conducted anaesthesia.


Studies of blood clotting system during dissociative anaesthesia with ketamine. The effect of ketamine administered to 20 rabbits in a single dose and in fractionated doses on the blood clotting system was studied. The following blood clotting indices were determined: thrombelastography (TEG), plasma thrombin time, platelet count, euglobulin lysis time. No statistically significant differences were observed in the activity of clotting and fibrinolysis systems in the group of animals receiving a single dose of ketamine and in the group receiving fractionated doses. The obtained results suggest that ketamine as an agent used for dissociative anaesthesia can be administered safely in serious conditions associated with disturbances in the haemostasis system.


The effect of methoxyflurane on certain renal function parameters. In 43 patients the effect of low concentrations of methoxyflurane on the renal function was studied. The blood levels of urea, creatinine, uric acid, sodium and potassium, and specific weight of urine was determined. It was found that the anaesthetic technique used and methoxyflurane concentrations in the range of 0.2-0.5 vol% caused no abnormalities in renal function. It seems that methoxyflurane in low concentrations (0.2-0.5 vol%) is the best method of anaesthesia with this agent, with the simultaneous use of a nitrous oxide-oxygen mixture and controlled ventilation.


Plasminogen activators and urokinase inhibitors in the lungs of foetuses and newborns. The concentrations of plasminogen activators and urokinase inhibitors were determined in histological sections of 87 foetuses and newborns. It was found that urokinase inhibitors are a constant component of lung tissue in foetuses in the 2nd and 3rd trimesters of pregnancy and in newborns. With progressing maturation of foetuses the concentration of urokinase inhibitors diminishes and, as a rule, the concentration of inhibitors is scores of times higher than that of activators.


Anaesthesia for operation of traumatic heart tamponade. A case report. The authors report a case of myocardial stab wound followed by shock and symptoms of heart tamponade. Following a discussion on the haemodynamic aspects of this disease entity and description of the case the authors analize the most essential elements of general anaesthesia in such conditions.


A simple device designed to protect operating theatres against atmospheric pollution by volatile anaesthetics. The authors worked out and applied a new device of positive pressure valve encased in the rebreathing circuit and one-way Ruben's valve, as well as a modification of Rees's system making it possible to conduct excess gases containing anaesthetics outside the operating theatre. These devices and modifications are completely reliable owing to their simplicity and their construction is cheap. They effectively reduce the degree of atmospheric pollution in the operating theatre with anaesthetics used in inhalation anaesthesia. They may be applied to every type of apparatus used for general anaesthesia.


Assessment of acupuncture as a method of analgesia during operation. The authors evaluated the method of acupuncture used for analgesia in various types of minor and major surgical operations in patients not previously tested for determination of susceptibility for this method. The report is a preliminary communication. For major operations the patients received premedication and during the operation they received additional local or general analgesics. Out of 13 patients in various age groups 5 evaluated this analgesia as very good and in 3 cases the degree of analgesia obtained was not sufficient to perform the operation. The authors regard that acupuncture has found its main application principally in the treatment of chronic pain, while as a method of analgesia for surgical operations it has many disadvantages and requires further experiences. The authors observed also certain features of acupuncture analgesia not observed in conventional methods of nerve conduction blockade, which may contribute to the explanation of the mechanism of acupuncture.


Ketamine used for anaesthesia in children for pneumoencephalography. Ketamine was given together with premedication (droperidol + pethidine + atropine) for general anaesthesia in 36 children during pneumoencephalography. Most children (26) had epilepsy. No significant cardiovascular and respiratory disturbances were observed during and after anaesthesia. This proposed method of anaesthesia in children is sufficient for short-lasting diagnostic procedures, particularly for pneumoencephalography.


A case of malignant hyperthermia during epidural analgesia. Malignant hyperthermia syndrome developed during epidural analgesia in 25-year-old female to be operated on for haemorrhoidal varices. After premedication with diazepam and atropine epidural analgesia was started with lidocaine 300 mg and bupivacaine 50 mg. Signs and symptoms of malignant hyperthermia syndrome appeared 30 min. later, with muscle rigidity, hyperpyrexia 41.5degrees C, and loss of consciousness. Treatment alleviating the syndrome was applied as indicated in this complication. Full recovery was obtained.


The effect of dissociative anaesthesia with ketamine on the activity of lysosomal enzymes in peripheral blood granulocytes of guinea pigs. The effect of ketamine on the activity of lysosomal enzymes in peripheral blood granulocytes was studied in guinea pigs. Ketamine was given intramuscularly in one single dose, in divided doses and in long-term administration (repeatedly) for 14 days. The blood for determination was obtained from the heart, the lysosomes were prepared by the Chodirker's method determining the activity of marker enzymes: acid phosphatase, acid protease and neutral protease, in the obtained fractions. No statistically significant differences were found in the activity of lysosomal enzymes in the studied groups. The results obtained point out the usefulness of ketamine in severe conditions associated with significant catabolic changes in the organism.


Spirometric, gasometric and electrocardiographic studies in patients with extreme obesity prepared for surgical treatment. Spirometric, gasometric and electrocardiogarphic studies were carried out in 17 patients at rest, who were treated surgically for extreme obesity (overweight from 52 to 175 per cent in relation to the normal weight). The measurements were made before operation. It was found that the mean spirometric values were within the range of acceptable deviations from  the normal value. The residual volume showed a tendency towards decreasing, especially in young patients. The values of dynamic parameters indicated a tendency towards ventilatory changes of a restrictive type in both groups. Minute ventilation at rest increased proportionally to obesity. Decreased values of respiratory equivalent indicated a good economy of respiration in obese persons when at rest. The mean gasometric values in capillary blood at rest were also within the acceptable range of abnormalities. Electrocardiographic tracings taken at rest showed considerable changes in the group of more obese persons.


The influence of upper respiratory tract receptors stimulation on the respiration and heart action in rats. 1. Stimulation of the upper respiratory tract with water releases reflex respiratory arrest and very marked bradycardia due to conduction and impulse generation disturbances in the heart accompanied by ventricular hyperexcitability. 2. Asphyxia causes bradycardia as a result of an inhibition of sinus node and the development of vicarious rhythms with excessive ectopic ventricular excitability. The intensity and duration of bradycardia during asphyxia are less than during water stimulation of airways. 3. Urethane anaesthesia did not prevent the development of the above described changes appearing during stimulation of the upper airways while topical analgesia with lidocaine completely prevented their appearance. The observations seem to suggest that for safety, surgical treatment in the upper airways should be done under analgesia of the respiratory mucosa. 4. The mechanism of the development of these changes seems to depend mainly on nervous and humoral factors, although the influence of other factors cannot be excluded. 5. Reflex changes in the action of the heart caused by water stimulation of the upper airways may be one of important components of the complex physiopathological process leading to death in drowning persons.


Pathomorphology of lungs and heart in experimental prolonged hypoxia. The authors carried out morphological examinations of lungs and heart in 20 days with prolonged hypoxia caused by surgical subglottic stenosis of the trachea by 50%. The studies showed that 30 and 60 days after the onset of hypoxia changes such as emphysema and chronic bronchitis developed in the lungs showing an increasing tendency, while in the myocardium microgranular disintegration and fatty infiltration of muscle fibres with simultaneous disappearance of glycogen was seen in the first period-after 30 days - while later, after 60 days fibrosis developed.


The usefulness of Resusci-Anne manikin in teaching modern methods of resuscitation. From experiences gained during the training of personnel the authors evaluate the effectiveness of teaching the principles of modern methods of resuscitation. They concluded that there are no essential differences in the preparation of carrying out resuscitation precedures between laymen and medical personnel. It is necessary to organize refreshing courses periodically. The Recording Resusci-Anne manikin with a device controlling the correctness of resuscitation procedures has been found to be an indispensable training aid in teaching the principles of resuscitation.


A scanning electron microscope study of the interstitial tissue of the canine testis. Scanning electron microscopy (SEM) is a potent tool that is especially valuable in interpreting the three-dimensional relationships of cells within tissues. This type of information is obtainable from thin sections in transmission electron microscopy (TEM) only by reconstructions of serial sections. The arrangement of the interstitial cells of the testis in relation to the capillaries and lymphatic channels, in particular, is easier to visualize in SEM than in TEM. Cytoplasmic constituents, as well as cell surface modifications, are demonstrable by this technique. The presence of droplets, presumably lipid droplets, both within and on the Leydig cells and the lymphatic endothelial cells, is quite evident. Other cytoplasmic structures are also apparent. For example, the possible functional significance of "openings" that are seen by SEM on the septa that surround lipid droplets is discussed relative to the appearance of the same area as seen in thin sections or in freeze-fracture replicas. SEM should become a very useful method for studying cytological and morphological alterations that occur in testicular tissue that is subjected to physical or chemical manipulation.


The postnatal development of the junctional complexes of the mouse Sertoli cells as revealed by freeze-fracture. Mouse testes of newborn to adult were examined by freeze-fracture. Between the newborn Sertoli cells, gap junctions consisting of aggregations of the intramembranous particles (about 8 nm in diameter) are frequently found. Some of the junctions are about 1 mum in diameter and show particle-free regions in the aggregation. Linear arrangements of a few particles, which appear to be the initial formation of the occluding junctions, are seen in the newborn sertoli cells. The occluding junctions are arranged in a meshwork, in which the gap junctions are situated between the stages of newborn to six days of age. The particles of the occluding junctions are predominantly located on the B face in the center of the groove instead of the A face of the ridge. The occluding junctions do not appear to surround the entire circumference of the Sertoli cell of the 6-day-old mouse. The gap junctions decrease in size. In later stages, many parallel occluding junctions (up to forty in number) are found over one Sertoli cell surface and are distributed circumferentially around the entire cell surface, indicating establishment of the blood-testis barrier. The occluding junctions dominate and the gap junctions diminish in number as development proceeds.


Parietal eye-pineal morphology in lizards and its physiological implications. Pineal complexes in 85 species of lizards examined comprised seven morphological types. Members of the same family do not necessarily have the same pineal complex type. "Regressive" parietal eyes were not common except in certain arboreal lizards, primarily from the family Chameleontidae. The parietal eye is often retained in burrowing lizards, presumably because these animals are occasionally exposed to light and the parietal eye is a more suitable photoreceptor for a burrower than are lateral eyes. The pineal of certain lizards possesses a finger-like projection that extends toward the parietal eye. This extension, along with pineal wall convolutions, results in more photoreceptor cells oriented for maximal absorption of light. It is rare to find convolutions and an extension in the same pineal. Cartilage deposits and blood sinuses may modify the intensity and wavelength of light reaching the pineal. These observations suggest that the intracranial pineal of lizards is a more important photoreceptor than was previously realized, a situation that may be a factor in the occasional "failure" of parietalectomy experiments.


Liver hepatocyte mitotic activity after a single injection of phenobarbital in immature male rats. In contrast to multiple injections of phenobarbital, a single injection of 50 mg/kg body wt of phenobarbital into immature male rats results, after a transient increase in hepatocyte mitotic activity, in a marked decrease in hepatocyte mitotic activity to below control levels by day 3, followed by a return to control levels by day 5. This unusual pattern of hepatocyte mitotic activity can be called fourth again by a second injection of 50 mg phenobarbital/kg body wt. However, a single injection of 50 mg/kg body wt of phenobarbital into immature male rats results in a pattern of change of liver wet weight, protein, and aminopyrine demethylase activity which is similar to that observed after multiple injections of phenobarbital, except that the changes are smaller in magnitude. Liver wet weight, protein, and aminopyrine demethylase activity increase and reach a peak within two days after phenobarbital injection, and then they return to control levels by five days. The same pattern of change in liver wet weight, protein, and aminopyrine demethylase activity can be elicited again by a second injection of 50 mg phenobarbital/kg body wt.


An IGG1 allotype in cattle.

An IGG1 allotype in cattle. This paper presents evidence for an IgG1 allotype detected by a sheep antibovine serum. The character which appears to be inherited in a simple Mendelian way has been named G1a1.


Studies on hemoglobin variants in Korean cattle. 814 hemoglobin samples from Korean cattle were investigated by starch gel electrophoresis for the detection of hemoglobin variants. A new variant of cattle hemoglobin, called Hb, H, was recognized. It has a slower rate of migration than Hb A. Hemoglobin types from 814 Korean cattle were as follows: 652 of Hb AA type (80.1%), 133 of Hb AB (16.4%), 12 of Hb AC (1.5%), 9 of Hb BB (1.1%), 2 of Hb BC (0.2%), 4 of Hb AH (O.5%), 1 of Hb CH (0.1%), 1 of Hb HH (O.1%). These figures correspond to the frequencies: HbA = 0.893, HbB = 0.093, HbC = 0.009, HbH = 0.004.


Blood groups and serum protein polymorphisms in the Pitman-Moore and Ohmini strains of miniature pigs. The variations of blood groups and biochemical polymorphisms in the populations of the two miniature pig strains reared in Japan were investigated in this report. The variations in eight blood group systems were investigated by using serological techniques, and five serum protein systems by using starch gel electrophoresis. The Pitman-Moore strain showed no variations in K, O, Tf, Cp and Am systems, but showed plymorphisms in A,E,F,G,H,L,Pa and Hpx systems. The Ohmini strain showd no or little variations in E,F,G,Tf,Pa and Cp systems, but showed polymorphisms in A,H,K,L,O,Hpx and Am systems. From the results of investigation of genetic similarities among nine pig populations including various breeds, it was made clear that the two miniature pig strains were very different genetically, and the Pitman-Moore strain was genetically closer to European large pig breeds than to East Asian native pigs, while the Ohmini strain was close to Thai and Philippine natives.


Electrophoretic variation in intertidal and subtidal organisms in Puget Sound, Washington. This paper presents information on the biochemical properties (via starch gel electrophoresis) of 26 marine species (15 fish and 11 invertebrates). Evidence is presented on 48 polymorphisms found in the 26 species. Estimates of the proportion of the genome heterozygous per individual per species were calculated and ranged from 0.000 to 0.176 for the invertebrates and from 0.000 to 0.074 for the fish species. Estimates of the percentage of loci polymorphic per species for invertebrates were 0 to 54%; for the fish species, the range was 0 to 20%.


Polymorphism of phosphoglucomutase in cattle leucocytes. By menas of starch gel electrophoresis the polymorphism of the phospoglucomutase isozymes PGM1 has been investigated in cattle leucocytes. The phenotypess and allele frequencies of PGM1 are demonstrated in a series of 106 complete and 221 incomplete families of "Deutsche Schwarzbunte". The segregation of the 327 daughters' phenotypes agree with the formal genetic model of 2 codominant autosomal alleles. The observed heterozygous PGM1 type is more frequent in mating types and progenies as expected under equilibrium.


J blood group active lipoproteins extracted from bovine erythrocytes. Ghosts of J-positive bovine erythrocytes were frozen overnight, thawed the next day, washed with ion-free water, and then extracted with a water-n-pentanol mixture. After centrifugation, the aqueous phase contained a great deal of the membrane proteins and lipids in a soluble form along with the J blood-group activity. After preparative ultracentrifugation, about 2/3 of the J activity were recovered in the high-density lipoprotein fraction, while the low-density lipoprotein fraction contained 1/3 J activity. This result is consistent with out finding that on treatment of the stroma lipoproteins with dextran sulphate, about 2/3 of J activity were recovered in the supernatant, 1/3 in the precipitate. These fractions obtained by dextran sulphate treatment were characterized by protein and lipid assay.


A transferrin variant Tf I in crosses of the wild and domestic pigs. In crosses of the wild pig (Sus scrofa attila Thomas) with the domestic pig a transferrin variant, Tf I, was detected, electrophoretic mobility of which was slightly faster than the mobility of the variant Tf A. From the results of starch gel electrophoresis, isolation, neuraminidase treatment, autoradiography, and genetic analysis of several families, it can be concluded that the Tf I variant is genetically controlled by the allele Tf1. Thus the number of alleles in the transferrin system of the pig has increased to six (Tf1, TfA, TfB, TfC, TfD and TfE).


Environmentally triggered thrombophlebitis. Ten randomly selected patients with recurrent non-traumatic thrombophlebitis of unknown etiology were studied using a comprehensive environmental control method. All cleared their phlebitis without medications. Using withdrawal and challenge of incitants, eight of 10 patients had their phlebitis reproduced. The numerous single triggering agents were common-place inhaled and ingested foods and chemicals.


Hypersensitivity as a cause of dermatologic and vaginal moniliasis resistant to topical therapy. The finding of multiple respiratory or skin allergies together with a high rate of improvement by desensitization leads the author to conclude that allergy is a predisposing factor for the chronicity or recurrence of vaginal or dermatologic moniliasis. Desensitization with Candida albicans antigen was the mainstay in the treatment of resistant dermatologic or vaginal moniliasis and the sole form of therapy in cases of nail involvement with deep seated lesions out of the reach of topical agents.


High risk factors for childhood asthma.

High risk factors for childhood asthma. Comparing school age asthmatic and non-asthmatic children from strongly allergic families, who contracted atopic dermatitis in early infancy, the following findings in the asthmatic boys emerged: a lower standard of education of their mothers, persistence of the infantile eczema beyond the age of two and several psychological factors relating to the child, the mother and maternal grandparents.


Serum immunoglobulins in children with asthma associated with severe respiratory tract infections. In a group of 25 selected children with asthma associated with repeated, severe respiratory tract infection, a high incidence of IgA deficiency and elevated IgE levels were found. This may be of importance in the evaluation of such patients.


Studies of atmospheric pollen in Tehran, Iran, 1974-75. A Durham sampler was used to study atmospheric pollen in Tehran, 1974-75. More than 18 different pollens were identified and counted. Tree pollens were present from the first week of February to the second week of October. Grass pollens were seen from the first week of May to the middle of November. Weed pollens appeared in the middle of May and were present until the last week of December. Examination of 1,000 patient files indicated that the largest number of patients sought medical help during peaks of pollinations.


Light a candle.

Light a candle. Numerous forces are presently deployed which threaten to produce largescale changes in medical practice and the systems of providing medical care. Some of these changes may be advantageous but others are likely to have deleterious effects on the quality of care, on the physician-patient relationnship and on the physician's freedom to practice as he sees fit. While certain of these pressures cannot be easily diverted, much can be accomplished with a modicum of effort to sway public opinion, the news media, the legislators and the bureaucratic regulation makers. Physicians, both individually and through their societies, must make this effort or suffer the pain of seeing immense decisions made without their leadership or intellectual guidance.