Nutritional correlates of child development in southern Tunisia. IV. The relation of deciduous dental eruption to somatic development. Deciduous dental eruption in a group of 658 children below 3 years of age in Southern Tunisia was found to be correlated with the general somatic development. On the other hand, this association was less close than that among the different components of somatic growth, suggesting that dental eruption is less affected by the factors which delay somatic growth in that area. Attempts were made to obtain methods of estimating the ages of children using the number of erupted deciduous teeth, both by means of regression equations and by a table of the median age of children with different numbers of pairs of teeth. In both cases the estimates obtainable are not accurate enough to do more than divide the children into coarse age groups. It is concluded that in anthropometric work there is no substitute for accurately known chronological ages.


Control of the pattern of perithecium development in Sordaria fimicola on agar medium. In a Sordaria fimicola (Rob.) Ces. and de Not. colony grown on agar medium in a petri plate, perithecia developed in a narrow band around the plate edge after the colony margin reached the edge. Physical wounding of the colony carried out shortly before or during the time perithecia were developing around the plate edge stimulated perithecium development in the wound area. Diffusion barriers were created by cutting small trenches in the agar parallel to the plate edge. The trenches were made at several different positions between the plate center and edge using cultures of several different ages, and the resultant distribution of perithecia along the trench edges suggested that the colony center and periphery produce diffusible inhibitors of perithecium development. These inhibitors may be responsible, in part, for the observed pattern of perithecium development in the colony.


On the non-hormonal control of the termination of regeneration. Simultaneous amputation at three different anterior and three posterior levels in the earthworm Eisenia foetida did not produce any measurable effect on the number of segments regenerated posteriorly compared to controls with intact heads. In every group, the number of segments formed depended only on the level of the posterior cut, declining by ten every time the level of the posterior cut was moved ten segments further from the head end. Repeated anterior amputation to prevent regeneration of the brain and subpharyngeal ganglia was without effect. No consistent differences were observed in the anterior neurosecretory cells either at the start or the end of regeneration. These results are discussed in relation to the "progress zone theory," the limited clonal cell life theory, and the theory of "sequential cumulative inhibition." It is concluded that the information determining the number of segments regenerated posteriorly resides in the tissues adjacent to the cut surface.


Amino acid profile of bovine bone during growth. The amino acid profile of bovine bones at 2, 25 and 130 months of age was examined and the data were expressed as amino acid residues per 1000 total amino acid residues recovered. As age advance proline and hydroxyproline significantly increased in whole bone (P less than .01), while valine, tyrosine, methionine and histidine decreased (P less than .01). To a lesser extent phenylalanine and glutamic acid decreased with increasing age (P greater than .05). A substantial increase (P less than .05) in glycine and arginine, and a considerable decrease (P less than .05) in valine, tyrosine, methionine and histidine occurred between young (2 months) and intermediate (25 months) age bovine bone. The largest differences in amino acid distribution during growth were observed in bones from the young and intermediate age groups. Lower amounts of glycine were present in lumbar vertebra (P less than .05), whereas the highest amount of glycine was found in sacral vertebra when vertebra, ribs and femurs were compared. Proline and hydroxyproline residues were highest in the rib and femur. Vertebrae often contained higher levels of threonine, arginine, histidine, lysine and aspartic acid than either the rib or femur.


A canonical discriminant analysis of post-embryonic development in Notonecta Maculata fabricius (Insecta:Heteroptera). A multivariate method, canonical discriminant analysis, was used to discern a pattern of growth in Notonecta maculata. A stepwise procedure reduced the 11 metrical characters measured on individuals of both sexes, from the 1st larval stage to the adult, to 4 significant variates which were used in the canonical analysis. The four canonical variates accounted for the meaningful part of the variablity. Relying on bivariate allometry and on an experimentation with a juvenile hormone analogue, each independent direction of variation was related to combined effects of such biological factors as a general growth trend, sex and juvenile hormone.


The effect of cold stress on muscle growth in young chicks. The effect of cold stress on muscle growth in young poultry stock has been examined during an experiment involving one hundred and eight chicks. They were divided into two groups, namely the control group and the cold stress group. The newly-hatched chicks of broiler type were chilled at a temperature of 10 degrees C for a total of four hours. The breast and thigh muscles of one side of each bird were analyzed for fat, protein, potassium, magnesium, calcium, and sodium during the two weeks after hatching. In the stressed chicks, body weight, breast and thigh muscle weight were consistently lower over the fortnight than in the controls. The body weight of the stressed birds was increased by two-fold, whereas, in the controls, the increase was there and a half times. The breast and thigh muscle weights of the stressed chicks increased by seven times and two times, respectively. In the normal birds breast and thigh muscle weights were enhanced fifteen times and four times, respectively. The protein content of the breast muscle in the normal birds was enhanced by thirty-fold and that of the thigh muscle by five-fold. In the stressed chicks the increase in the protein content in the breast muscle was twelve-fold and that of the thigh muscle was two-fold. Muscle fat content was lower in the chilled birds than in the controls. Levels of potassium and magnesium were also lower in the stressed chicks than in the normal birds.


Sexual dimorphism in dentition mineralization. This study determined for 121 boys and 111 girls of the serial experimental group of the Burlington Growth Centre the age, time interval and age sequence of 14 stages of mineralization of all tooth types. The two sexes differed significantly in the age at which the stages of tooth mineralization appeared, and in the length of the interstage intervals. In the canines, there was maximum sex difference in mineralization, which was almost 20 per cent and resulted from a delay in the boys. Changes in sequence of mineralization were due to delay rather than to acceleration. Sex differences in tooth mineralization manifested themselves before puberty, and mineralization was not accelerated at puberty. In contrast, post-pubertal mineralization of third molars appeared to be accelerated in both sexes and occurred earlier in the boys.


Gastric emptying following vagotomy and antrectomy and proximal gastric vagotomy. Gastric emptying of solid meals labelled with 129Cs was studied in patients for up to one year after vagotomy and antrectomy or after proximal gastric vagotomy. Significant delay was found one month after vagotomy and antrectomy but this had returned to normal by six months. No delay was found after proximal gastric vagotomy. The effect of posture on gastric emptying was also studied in the same subjects. No significant differences were found between gastric emptying in the supine or sitting positions after solid meals.


Electronmicroscopic observations on the effects of orally administered aspirin and aspirin-bicarbonate mixtures on the development of gastric mucosal damage in the rat. The effects of administering a single dose of (200 mg to 50 mg/kg body weight) aspirin or an equimolar mixture of aspirin (200 mg/kg body wt) with sodium bicarbonate on the fine structure of the rat gastric mucosa were investigated in order to establish the role of particles of the drug in the development of gastric damage. The sequence of cellular events involved in the development of a lesion and the influence of short-term starvation were also investigated. Aspirin-bicarbonate solutions produced much less damage in starved rats than aspirin suspensions given at low (50 mg/kg body weight) or high therapeutic doses (200 mg/kg body weight). Also, when non-starved rats were given 200 mg/kg aspirin, only slight damage was observed. The presence of particles of the drug in intimate contact with the mucosa is thus important in the development of gastric damage. A sequence of events with time involving direct physical exfoliation of mucosal cells and selective structural damage to parietal cells followed by structural damage indicative of a disturbance to oxidative and biosynthetic functions in cells near the developing erosion was observed. The implications of these results on the development of aspirin-induced lesions are discussed.


A search for a transmissible agent in Crohn's disease. Controversy exists as to whether a transmissible agent is responsible for Crohn's disease. Previous reports have suggested that sarcoid-like granulomas can develop in animals following inoculation of homogenates derived from bowel affected by Crohn's disease. This study involved the injection of Crohn's tissue homogenates into experimental animals under a variety of conditions which might be expected to favour the demonstration of such an agent. Homogenates have been inoculated into the ileum of rats, mice, and rabbits and also given inoculated into ileum and footpads of rats which have previously been rendered lymphoedematous by surgical interruption of the draining lymphatics. Bowel homogenates from a total of 17 patients with Crohn's disease have been injected into 91 experimental animals. No macroscopic or microscopic changes indicative of Crohn's disease were detected. Thus study does not support the suggestion that a transmissible agent is present in Crohn's disease.


A case of  'Crohn's carcinoma'.

A case of  'Crohn's carcinoma'. A case of adenocarcinoma of the ileum, occurring in an area concomitantly the site of Crohn's disease, is described. Examination of the literature suggests that there are certain characteristics of the small bowel carcinoma which arises in Crohn's disease. These include invisibility of the tumour on macroscopic inspection, dysplasia in the surrounding mucosa, and a peculiar endometriosis-like pattern of invasion. The finding that these tumours have certain characteristics is taken as evidence that carcinoma is a complication of Crohn's disease of the small bowel.


The immune response of phiX 174 in man. III. Evidence for an association between hyposplenism and immunodeficiency in patients with coeliac disease. The ability of patients with coeliac disease to produce primary and secondary antibody in response to a new antigen has been tested. Eight patients with coeliac disease were injected intravenously with the coliphage phiX 174. Antibody levels were measured throughout the primary response. On day 28 a second injection was given and the secondary response was also studied in detail. The production of antibody in the primary response is lower than in a group of normal subjects. The secondary response is severely reduced and the difference between the coeliac group and controls is highly significant. The secondary response in the coeliac patients contains a much higher proportion of IgM antibody than normal. These abnormalities correlate approximately with clinical status and with hyposplenism. It is concluded that in patients with coeliac disease the ability to produce antibody is impaired, with a defect in switching from IgM to IgG antibody.


Regional differences in oxalate absorption by rat intestine: evidence for excessive absorption by the colon in steatorrhoea. Clinical studies suggest that steatorrhoea can be associated with excessive absorption of dietary oxalate. We examined the influence of bile salts, Ca++, and long-chain fatty acid on the absorption of oxalate and water by rat intestine in vivo. Absorption was measured under steady-state conditions during single-pass infusions. Each intestinal segment served as its own control. In jejunum, 10 mM taurocholate, the principal salt in rat bile, depressed absorption of oxalate and water. Absorption was not depressed further by Ca++ or linoleic acid. In ileum, 10 mM taurocholate did not inhibit absorption. Linoleic acid, 2 mM, depressed absorption of both oxalate and water. In colon 10 mM taurocholate decreased absorption. Net water transport was depressed further when linoleic acid was added to the infusion, but oxalate absorption was enhanced. Ca++ negated these effects of linoleic acid. It is concluded that long-chain fatty acids may enhance the absorption of oxalate from the rat colon. This observation may be relevant to understanding hyperoxaluria in patients with steatorrhoea.


The relative potency of the Crick-Harper-Raper unit and the GIH clinical unit of secretin. A reinvestigation of the relationship between the Crick-Harper-Raper (CHR) and the GIH clinical units (CU) of secretin has been undertaken in anaesthetized cats with the knowledge that for some time before 1970 the CHR standard used by The Boots Company to assay secretin had lost some specific activity. One clinical unit of GIH secretin (batch no. 17421) is 3-8 times more potent than 1 Crick-Harper-Raper unit of restandardized Boots secretin (batch no. 142) in increasing the flow rate of pancreatic juice, and four times more potent in increasing the amount of bicarbonate.


[Blood parasites of small wild mammals in Czechoslovakia]. The author investigated 4,853 specimens of wild living small mammals (43 species: Insectivora, Chiroptera, Lagomorpha, Rodentia, Carnivora) from Czechoslovakia for blood parasites. Trypanosomes were found in Talpa europaea, Sorex alpinus, Crocidura suaveolens, Myotis myotis, Apodemus sylvaticus, Apodemus flavicollis, Mus musculus, Rattus norvegicus, Clethrionomys glareolus and Microtus agrestis. Babesia was detected in Myotis emarginatus, Myotis myotis, Clethrionomys glareolus, Microtus arvalis and Microtus agrestis. Grahaemella was found in Talpa europaea, Sorex araneus, Neomys fodiens, Neomys anomalus, Myotis emarginatus, Myotis myotis, Apodemus sylvaticus, Apodemus flavicollis, Apodemus microps, Apodemus agrarius, Mus musculus, Clethrionomys glareolus, Arvicola terrestris, Pitymys subterraneus, Microtus arvalis, Microtus agrestis, and Microtus oeconomus. Spontaneous Bartonella-infection was ascertained in one Microtus arvalis and, in erythrocytes of one Sorex araneus, parasitic organisms very similar to Bartonella were found.


Synanthropy of Anthomyiidae, Muscidae and Calliphoridae (Diptera) in Cuba. The material of 22302 flies of Anthomyiidae, Muscidae and Calliphoridae collected by trap-method in Cuba 1966 was qualitatively and quantitatively analysed. Relative density, seasonal incidence and food preference were ascertained in 20 species. In potential vectors of human diseases the ecological characters and classification of synanthropy are given.


L-dopa therapy combined with peripheral decarboxylase inhibitor (MK-486) in Parkinsonism. Eighteen patients with parkinsonism were treated with a combination of L-dopa and peripheral decarboxylase inhibitor, L-alphahydrazinomethyldopa (MK-486). Modification of L-dopa effect by MK-486 was also studied in parkinsonian patients as well as in cats. (1) Concentrations of dopa and dopamine in plasma and brain were measured in cats following intraperitoneal injection of L-dopa alone (100 mg/kg) or combined with MK-486 (10 mg/kg). Dopa levels in plasma and brain in the combination with MK-486 were three times as high as in L-dopa alone. Dopamine levels in caudate nucleus and putamen were increased nearly fourfold with the combination. (2) Plasma dopa and dopamine levels were measured in parkinsonian patients. Clinical pharmacological studies disclosed that a 1 : 10 ratio of MK-486 to L-dopa in dosage was preferable. (3) Maximum plasma dopa levels with the combination were four times those following L-dopa alone. Plasma dopa sustained a high level over a period of five hours. MK-486 markedly reduced plasma levels of dopamine. (4) There was no significant difference in dopa and dopamine levels in cerebrospinal fluid between L-dopa alone and a combination of MK-486, but dopamine levels in the CSF were still high at four hours after the combination of MK-486. (5) In clinical studies of eighteen patients with parkinsonism, the effectiveness of the combination therapy (mean dosage of L-dopa: 750 mg/day) was observed in all cases. Marked improvement was noted in 10 cases out of 15 (67%) with akinesia, in 12 cases out of 17 (71%) with rigidity and in six cases out of 14 (43%) with tremor. Maximum plasma dopa levels were higher in those cases with marked improvement, and were highest in patients with diskinesias as a side effect. (6) An addition of vitamin B6 did not show adverse effects. (7) Transient nausea and vomiting as a side effect, less severe than those experienced with L-dopa alone, were noted in five cases (28%). Dyskinesias in extremities, face, mouth and tongue were observed in six cases (33%). These dyskinesias were seen in a high percentage of cases with marked improvement and were never observed in the extremities contralateral to the side of thalamotomy.


A case of Déjerine-Sottas disease with schizophrenic symptoms.  A clinical and pathological study. A case of hypertrophic interstitial neuritis with a disturbance of intelligence and schizophrenic symptoms was reported.  The patient, a 41-year-old male, showed monologia at the age of 14 and auditory hallucination at the age of 21.  He was diagnosed as schizophrenia.  Torsion of the head to the right side and muscular atrophy were also noticed at 21 years.  Atrophy of the muscles progressed gradually, particularly in the distal parts of the upper and lower extremeties.  Psychiatric examination revealed schizophrenic symptoms such as auditory hallucination, thought disorder, lack of spontaneity, autism, apathy, etc.  There was also a disturbance of intelligence (imbecility).  In neurological examination, the torsion of the head to the right side, slight exaggeration of the peripheral reflexes, muscular atrophy in the distal parts of the extremeties were noted.  The bilateral ulnar nerves were markedly hypertrophied.  The biopsy of the right ulnar nerve revealed a remarkable thickening of the endoneuria and "onion bulb" formations.  A large amount of the interstitial accumulation of PAS positive substance, which showed metachromasia in cresyl violet staining, was also noted.  Schwann cell processes were proved electron-microscopically to surround the myelin sheaths and some of them meandered and extended and into the metachromatic substance.  The basement membrane of the sheath cell was hypertrophic in some portions and elongated into interstitium.  The nucleus of the sheath cell was hyperchromic and showed marked atrophy.  Histological examination of the biopsy specimen obtained from the gastrocnemius muscle suggested neurogenic muscular atrophy.  The relationship among the hypertrophic interstitial neuritis, schizophrenic symptoms, disturbance of intelligence and torsion of the head was also discussed.


Neurotoxicity with chloramphenicol--an electron microscopic study. The peripheral nerve and spinal ganglion of chloramphenicol-administered and normal animals were examined mainly with the electron microscopy.  The experimental animals consisted of three dogs and one rabbit.  They were highly injected or given orally high doses of chloramphenicol with a duration from 70 to 130 days.  Pathological finginds were briefly summarized as follows.  In the sural nerve the changes in myelin sheaths and Schwann cells were more prominent than those in axons.  The myelin sheaths were swollen and had a tendency to be curled and compress the azon in some fibers.  Other fibers showed the degeneration of myelin sheaths, revealing fragmentation, thinning, and honeycomb structure.  The changes in axons were mild, showing an increase of neurofilaments and local accumulation of mitochondria.  Schwann cells were often hypertrophied and abundant endoplasmic reticula, vacuoles and ribosomes were observed in the cytoplasm.  The processes of Schwan cells were not active, but the picture that a myelinated fiber was surrounded by some processes of Schwann cells was seen in some occasions.  In the posterior root ganglion at the lumbar cord, some of nerve cells showed changes, such as breakdown of Nissl substance, swollen mitochondria and indentation of nuclear membrane.  The satellite cells showed no significant change.


Ultrastructure of intracisternally accumulated dense particles observed in nerve cells of rat cerebellar nuclei. Peculiar dense particles were accumulated within smooth-surfaced cisternae of some neuronal perilarya of cerebellar nuclei in rat.  The particles were 200-450 A in size and spheroidal or slightly irregular in outline.  They were low in contrast after uranyl acetate treatment, whereas they showed increase in electron density after uranyl and lead staining.  Wigh respect to the possible nature of these intracisternal dense particles, the following interpretation was discussed.  The particles concerned were probably identified as glycogen which had been synthetized by the agranular endoplasmic reticulum as an unusual cytological event.


Effect of L-dopa administration to fine structures of brain, heart and kidney in rats, with special reference to appearance of microvascular thrombosis and its pathological significance. L-dopa (100-200 mg/kg/day) was given orally to rats for one, two, or three months.  The cerebrum, cerebellum, heart and kidney were then examined using the light and electron microscope.  With the light microscope, there was observed the occurrence of small hemorrhagic foci and occlusion of the capillaries, venules and occasionally small veins by amorphorus eosinophilic material or agglutinating red blood cells in all the tissues examined.  On the other hand, with the electron microscope, there was seen the presence of two distinct changes in the brain, heart and kidney, which were never found in the corresponding tissues from the control rats.  One was concerned with intravascular abnormalities, i.e. formation of thrombi in the microvasculatures.  Above all, microthrombi that were thought to be equivalent to amorphous eosinophilic material in light microscopy consisted of diffusely distributed, electron-dense, fine granular substances and randomly scattered, much electron-denser, large granular material.  The other was concerned with mitochondrial alterations in the parachymal cells, i.e. nerve cells, cardiac muscle cells and renal parenchymal cells.  In general all the changes that were detected by search at both light and electron microscopic levels tended to be developed increasingly with prolongation of the period to sacrifice from commencement of L-dopa administration so that effect of L-dopa on their formation was apparently time related.


The effect of electrical stimulation of the hypothalamus and other brain areas on urea cycle enzymatic activities in the liver in rabbits--experimental studies on brain and liver interrelationship--. Changes in urea cycle enzymatic activities in the liver induced by intracerebral electrical stimulation in rabbits with chronically implanted electrodes in the hypothalamus, the thalamus, and the limbic area were studied in comparison with these activities in non-stimulated controls. In stimulating the ventromedial nucleus of the hypothalamus, the two-hour sessions were followed by significantly reduced activity in arginase and the arginine synthetase system in the liver, but the six-hour stimulation sessions were followed by normal range activity in these enzymes. In stimulating the lateral hypothalamic area, the two-hour sessions were followed by only slightly reduced activity in the arginine synthetase system in the liver. Stimulation of the center median nucleus of the thalamus, the medial area of the amygdala and the dorsal hippocampus produced no significant changes in urea cycle enzymatic activities in the liver. The possibility that ammonia metabolism in the liver may be modified through some functional linkage between the brain and the liver was suggested.


Protein synthesis and amino acid accumulation during development in the rat: dissociation of diaphragm and heart muscle sensitivity to insulin. Insulin is released into the circulation early during fetal life, but the physiological significance of the hormone in the fetus is still unclear. The present study was undertaken to evaluate the possible effects of insulin on the protein metabolism of skeletal and heart muscle during the perinatal period in the rat. When incubating hemidiaphragm in a bicarbonate buffer, 0.1 U/ml ox insulin failed to enhance the incorporation of leucine-4,5-3H into muscle protein before birth and during the immediate neonatal period. From 3 days of age onwards a stimulatory effect of insulin on protein synthesis was constantly observed. While insulin thus was ineffective in promoting protein synthesis in hemidiaphragms before the third postnatal day, it significantly enhanced the synthesis in heart muscle at an earlier stage of development. Insulin stimulated the uptake of alpha-aminoisobutyric acid-1-14C into the diaphragm muscle during late fetal life as well as through the early neonatal period. The role of insulin in protein metabolism during fetal life may thus be limited to the augmentation of amino acid transport in skeletal and heart muscle and to a stimulatory effect on protein synthesis only in certain tissue(s), e.g. heart muscle.


Effect of hormonal environment on sterol concentrations of rat aorta and plasma. Cholesterol and cholesterol esters were measured on day 90 in the plasma and aortas of rats treated on day 4 as follows: control, gonadectomy, testosterone propionate (TP), estradiol-17beta (E). Sex differences were observed in sterol concentrations of control animals but were abolished by castration. TP and E significantly altered sex gland weights, aorta cholesterol and plasma cholesterol esters of both sexes. Little effect on plasma cholesterol or esterified cholesterol of the aorta was noted in any treatment group. A dose effect of E was observed in organ weights and sterols of male rats.


A model of closely assembled consecutive enzymes on membranes: formation of hydroxycinnamic acids from L-phenylalanine on thylakoids of Dunaliella marina. p-Hydroxycinnamic acid was found to be located within the plastids of the green alga Dunaliella marina. Thylakoid fractions desintegrated by ultrasonic treatment were capable of converting L-phenylalanine into o- and p-hydroxycinnamic acids; the hydroxylation reaction was increased by addition of NADPH. Hydroxycinnamic acids produced when [3-14C]cinnamate was incubated with varying amounts of [4'-3H]L-phenylalanine exhibited a 3H/14C ratio 10-150 times higher than that of the cinnamic acid reisolated from the incubation mixture. The lack of equilibration between cinnamate formed from L-phenylalanine and cinnamate added to the solution supports the hypothesis that cinnamate as an intermediate in hydroxycinnamate formation remains bound to the membrane enzyme complex. A model of membrane-bound multienzyme complexes is proposed for the conversion of aromatic amino acids into phenols.


The conversion of L-phenylalanine into benzoic acid on the thylakoid membrane of higher plants. The conversion of L-phenylalanine into benzoic acid and other aromatic carboxylic acids was investigated in Nasturtium officinale (watercress), Astilbe chinensis, and Hydrangea macrophylla in vivo and in vitro. Comparative feeding experiments with radioactively labelled L-phenylalanine and cinnamic acid administered to intact leaf discs of A. chinensis indicated a rapid formation of benzoic acid from L-phenylalanine, whereas cinnamic acid was a poor precursor. Using a pulse-chase labelling technique followed by a fractionation of the tissue into subcellular components, chloroplasts could be identified as the predominant, if not exclusive, site of benzoic acid formation in A. chinensis. Experiments in vitro with chloroplasts and thylalkoids of N. officinale, H. macrophylla, and A. chinensis demonstrate the capacity of thylakoid membranes to catalyze the degradation of L-phenylalanine to benzoic acid. The results obtained upon stimultaneous incubation with [4'-3H]L-phenylalanine and [3-14C]cinnamic acid lead to the hypothesis that the reaction of L-phenylalanine to benzoic acid proceeds via a cinnamic acid pool which is different from that of soluble cinnamic acid.


On the bound state of alkali cations in subcellular preparations of rat liver. Gel filtration and ion-specific electrodes were used together with atomic absorption spectrophotometry in a search for substances in rat liver which are capable of binding alkali cations. In the cytosol, a material which binds K specifically and reduces the ion activity of potassium can be detected. The binding material, which may be destroyed by alpha-chymotrypsin, has been purified about 100-fold. Its molecular weight is around 5 x 10(3). 1 muval K becomes bound per 20-40 amino acid residues; the total binding capacity may amount to 10-15% binding of the K in rat-liver cytoplasm. Washed nuclear residues, consisting mainly of chromatin, are capable of binding Na in a cation-specific mode. DNA and RNA are ruled out as binding material, so it is assumed to consist of protein, and would then contain about 20 amino acid residues per Na. The cation-binding processes are discussed with regard to nucleo-cytoplasmic sequestration of Na and K, with consequences for the cellular chemi-osmotic gradients, and for the regulation of gene activity in the nucleus.


Immunological studies on the localization of phosphatidylglycerol in the membranes of Mycoplasma hominis. Phosphatidylglycerol is the main component (87%) of the membrane phospholipids of Mycoplasma hominis. It is immunologically active. Antibodies directed against phosphatidylglycerol were detected in rabbits intravenously immunised with native M. hominis or isolated M. hominis membranes. The intravenous method of immunisation was chosen in order to select for a response to surface antigenic determinants. Anti-phosphatidylglycerol antibodies were induced in rabbits by intravenously injecting the flocculated complexes of methylated bovine serum albumin and a phosphatidylglycerol/phosphatidylcholine/cholesterol mixture. These antibodies were specifically bound to intact M. hominis, as shown by complement fixation and Coombs tests. Native M. hominis were not agglutinated by anti-phosphatidylglycerol antibodies; but after partial digestion of the membrane proteins with Pronase, the mycoplasmas were heavily agglutinated by the anti-phosphatidylglycerol antibodies. The same amount of anti-phosphatidylglycerol antibodies was bound to intact M. hominis, containing 600 mug of phosphatidylglycerol as to 6 mug of phosphatidylglycerol in the optimal configurational arrangement of a mixed phosphatidylglycerol/phosphatidylcholine/cholesterol micelle. It is concluded that the major part of the phosphatidylglycerol in native M. hominis membranes is masked, probably by membrane proteins, and is not accessible to the anti-phosphatidylglycerol antibodies.


[Isolation and properties of a preparation of arterial collagen solubilized by pretreatment with alkali (author's transl)]. The acid-soluble, highly cross-linked aorta collagen, of which about 30% can be converted into a soluble form by alkali treatment, followed by extraction with aetic acid, was obtained predominantly in the form of monomeric, helical molecules, as indicated by the value for the intrinsic viscosity and its behaviour in sodium dodecylsulphate disc electrophoresis. Apart from decreased values for tyrosine (0.26%), arginine (4.4%) and aspartic acid (3.9%), the amino acid composition of the aorta collagen fraction was similar to that of the acid-soluble calf skin collagen. This finding, together with the cyanogen bromide peptide pattern, shows that the collagen extracted from the artery is predominantly type I. Treatment with alkali probably shortens the alpha1-CB6-peptide by about 45 amino acids. The collagen extracted from artery was compared with acid soluble skin collagen by sodium dodecylsulphate polyacrylamide electrophoresis. The arterial collagen showed a marked increase in the rations alpha1 to alpha2 (4:1), alpha to beta (3:1) and beta11 to beta12 (2.5:1). Compared with acid soluble skin collagen, the aorta collagen contained twice as much galactose and glucose (13.5 and 9.6 nmol/mg protein respectively), which are bound to hydroxylysine. 50% of the hydroxylysine residues are unsubstituted, 15% are present as galactosyl hydroxylysine, and 35% as glucosyl-galactosyl hydroxylysine. On the basis of its reported properties, arterial collagen obtained by the method of Fujii appears to be a suitable substrate for the study of the enzymic synthesis and enzymic degradation of hydroxylysine glycosides of native arterial collagen.


Structure and activity of insulin, XIII. Specificity of the arginine-guanidino group in biologically active tetrapeptides of the insulin sequence B 22-25 (Arg-Gly-Phe-Phe). The biologically active partial sequence Arg-Gly-Phe-Phe (position B 22-25 of the insulin B chain) in the form of the synthetic tetrapeptidamide, was compared in several bioassays with the following analogous synthetic peptides: homoarginyl-, ornithyl-, lysyl-, citrullyl-, alanyl- and NG-nitroarginyl-Gly-Phe-Phe-NH2. The syntheses of the lysyl- and alanyl-tetrapeptidamides are described. After intraperitoneal injection of the peptides in doses of 3-100 mumol per 100 g rat, together with [U-14C]glucose, the natural sequence Arg-Gly-Phe-Phe showed the highest insulin like activity (incorporation of labeled carbon into the diaphragm). The activity of the homoarginyl peptide was a little weaker. The ornithyl- and the lysyl-peptide, however, showed a remarkably diminished activity. The activity of the citrullyl-peptide was even lower and the alanyl-peptide was inactive. In vitro assays with rat diaphragm showed the same range of effects for the elevation of glucose uptake and glycogen content of the diaphragm. The activity decreased in the following order: Arg- greater than Har- greater than Orn- greater than Cit-Gly-Phe-Phe-NH2. Alanyl- and Nitroarginyl-Gly-Phe-Phe-NH2 were without effect. In isolated fat cells the glucose oxidation was enhanced significantly only by the arginyl-peptide. The results show that among the structures examined the guanidino group carried by the C5 chain of arginine is the most effective. The results are in accordance with our preceding work [1] using semisynthetic insulins obtained from natural A-chain and synthetic B-chain variants. In these products the replacement of Arg B 22 by ornithine or lysine also led to drastically diminished activity and after replacement of Arg B 22 by alanine the activity also disappeared.


Elevated serum growth hormone in protein-deprived rats, and decreased liver RNA after hypophysectomy. Serum growth hormone was significantly higher in rats fed on a non-protein than on a 25% casein diet. In both dietary groups, hypophysectomy provoked a decrease in the RNA/DNA ratio of the liver, and, especially in the protein-deprived rats, a decrease in the RNA synthesis per liver cell, measured as the product of the RNA/DNA ratio, and the ratio of specific RNA activity to specific nucleotide activity, two hours after administration of [3H]orotic acid. In the protein-deprived rats, full reconstitution of these figures was obtained with a combination of growth hormone, hydrocortisone and triiodothyronine, but not quite with growth hormone alone. The possible role of growth hormone in protein deprivation is discussed.


The quantitative protein composition of calf thymus chromatin. The proteins of calf thymus chromatin were analysed quantitatively using a combination of polyacrylamide and cellogel electrophoreses. Quantification was achieved by determining the staining values of each purified histone with amido-black. The results indicate that, on average, 700 molecules histone F1, 850 of F2al, 1440 of F2a2, 1 890 of F2b, 2380 of F3 and 500-1000 non-histone molecules are bound per 10(5) base pairs of DNA. This suggests a moderately dense protein covering of the DNA.


Minnesota: the impact of a community hospital's psychiatric unit on a regional state hospital. A community hospital serving part of a state hospital's receiving area opened a psychiatric inpatient unit. The authors studied the impact of the new unit on the number of psychiatric admissions to the state hospital, and also sought to determine if the two facilities provided duplicate services to the area. In comparing admission rates to the state hospital before and after the opening of the community unit, they found the unit did not have a significant impact. In comparing sample groups of patients at the two hospitals, they found that each served a different socioeconomic group and therefore did not offer duplicate services.


Studies on hepatic uptake of antigen. III. Studies of liver macrophage function in normal rats and following carbon tetrachloride administration. A technique of pronase digestion followed by density gradient centrifugation was used to study the morphology and phagocytic function of isolated rat liver macrophages in the normal rat and at varying times after the in vivo administration of carbon tetrachloride. Administration of the hepatotoxin results in a transient fall in the number of isolated macrophages. This deficit is corrected by a rapid influx of mononuclear cells from elsewhere in the animal which quickly differentiate into liver macrophages. Despite changes in the morphology of isolated macrophages, no evidence was found to suggest in vitro functional impairment of these cells. In vivo studies of intrahepatic shunting showed that this became a significant phenomenon 6 hours after the administration of the hepatotoxin. The enhanced antibody response to sheep red cells which occurs after carbon tetrachloride administration appears to be due to a series of events in which the decrease in the number of liver macrophages is an early significant factor, while intrahepatic shunting is a major contributing factor at a later time.


Modifications in the handling in vitro of 125I-labelled keyhole limpet haemocyanin by peritoneal macrophages from mice pretreated with the adjuvant Corynebacterium parvum. Peritoneal macrophages were isolated from C. parvum-pretreated (CP) and normal CBAT6T6 mice and their in vitro handling of 125I-labelled Keyhole limpet haemocyanin (125I-labelled KLH) studied in relation to the humoral anti-KLH responses induced in corresponding animals. CP pretreatment exerted an adjuvant effect on the production of anti-KLH antibodies, both IgM and IgG, which was also demonstrable with a normally subimmunogenic dose of antigen. There was a clear difference between the handling of 125I-labelled KLH by CP and normal macrophages. The initial uptake of the antigen by CP macrophages was slower than that by normal ones. Moreover, 125I-labelled KLH was degraded to a lesser extent within CP macrophages, although the rates of antigen digestion were similar in both kinds of cells. The lower extent of 125I-labelled KLH degradation within the CP macrophages was due to a larger amount of antigen being retained on the cell membrane, where it escapes digestion. The findings suggest that intensified presentation to lymphocytes of antigen on the macrophage surface could be a causal factor in the adjuvant action of CP.


The effect of a synthetic double-stranded RNA on IgC1 and IgE production by guinea-pigs. A comparative study with lipopolysaccharide. The effect of synthetic complexes of polyribocytidylic acid (poly-IC) on the production of homocytotropic antibodies by guinea-pigs was studied. It was observed that poly-IC has a definite adjuvant effect on the production of both IgG1 and IgE. The adjuvant effect was present when poly-IC was injected 24 hours after the antigen, but was absent when the polynucleotide was injected 48 hours after the antigen. In comparison with lipopolysaccharide (LPS) the adjuvant effect of poly-IC was weaker, more than 0.5 mg/kg of this polynucleotide being required to show an adjuvant effect, whereas only 20 mug/kg of LPS was enough to show a positive adjuvant effect. Furthermore, considerably less antibody was detected in the animals stimulated with the polynucleotide.


Role of a non-committed accessory cell in the in vivo suppression of a syngeneic tumour by immune lymphocytes. CBA/J mice bearing a methylcholanthrene-induced sarcoma exhibited concomitant immunity to the tumour. The cellular basis for this immunity was investigated by local transfer of mixtures of lymphoid and tumour cells into the footpads of syngeneic mice. Peritoneal exudate cells obtained from tumour-bearing mice 1 day after intraperitoneal injection of saline had a marked tumour-suppressive effect, whereas normally resident peritoneal cells did not. Peritoneal exudate cells from which adherent cells had been removed ('lymphocytes') had a suppressive effect at high or low lymphocyte: tumour cell ratios in normal recipients. In irradiated (450 R) recipients the lymphocytes were suppressive at high ratios only. At low ratios the lymphocytes were suppressive only if the irradiated recipients had been partially shielded or if the lymphocytes were admixed with peritoneal exudate cells from normal mice. It is concluded that an amplifying mechanism, possibly involving macrophages, can operate in tumour cell suppression initiated by immune lymphocytes.


Maternal-foetal transfer of normal IgM in the rabbit. Rabbits foetal sera harvested on the 28th day of gestation and sera from newborn rabbits were subjected to chromatography on Sephadex G-200. IgM and IgG were found in these sera. These immunoglobulins carried only maternal allotypic specificities and therefore, were not synthesized by the foetuses, but were transferred from the maternal circulation. The elution profile of the IgM found in the foetal sera and in sera from newborn rabbits indicated that this immunoglobulin was in its polymeric form. It was concluded that relatively high concentrations of polymeric IgM are transferred from mother to foetus.


Merozoite vaccination against Plasmodium knowlesi malaria. Free malarial merozoites isolated from in vitro cultures of P. knowlesi and emulsified with Freund's complete (FCA) or incomplete (FIA) adjuvant were used to vaccinate twelve Rhesus monkeys against the uniformly lethal infection caused by P. knowlesi. Initial challenge of six monkeys with the same parasite variant as used for vaccination produced no detectable infection in three monkeys, while three others developed low-grade parasitaemia (maximum 1.5 per cent), which terminated after 6-11 days. Vaccination with merozoites in either FCA or FIA induced protection against homologous variant challenge. Six other monkeys were challenged first with a parasite variant different from that used for vaccination. Two animals immunized with merozoites in FIA alone or in FCA on only one occasion developed fatal infections. The other four animals vaccinated at least twice with merozoites in FCA showed low-grade parasitaemia (maximum 1.5 per cent) which terminated after 8-12 days. Eight monkeys rechallenged on eleven occasions at intervals of up to 16 weeks were completely resistant to several variants and a distinct laboratory strain of P. knowlesi, but developed chronic malaria similar to that in unimmunized controls when challenged with a different species of malaria, P. cynomolgi bastianellii. It is concluded that merozoite vaccination of Rhesus monkeys induces immunity against the erythrocyte stages of P. knowlesi far greater in degree and significantly broader in variant specificity than that achieved by previous methods of immunization or by repeated drug-controlled infections.


Screening of indigenous plants for anthelmintic action against human Ascaris lumbricoides: Part--II. Alcoholic extracts of the rhizomes of Alpinia galanga, Andrographis paniculata, bark of Cinnamomum zeylanicum, rind of Citrus decumana, Desmodium triflorum, seeds of Hydnocarpus wightiana, rhizomes of Kaempfaria galanga, Lippia nodiflora, tender leaves of Morinda citrifolia, rhizomes of Pollia serzogonian, Tephrosia purpuria and rhizomes of Zingiber zerumbeth showed good in vitro anthelmintic activity against human Ascaris lumbricoides. While, the alcoholic extracts of the bark of Alibzzia lebbek, the bulb of Allium sativum, rhizomes of Alpinia calcaratta, rind of Citrus acida, rind of Citrus aromatium, rind of Citrus medica, rhizomes of Curcuma aromatica and rind of Punica granatum showed moderate invitro activity.


Studies on morphine analgesia.

Studies on morphine analgesia. Several agents with specific action on biologically active substances in brain were investigated for their influence on morphine analgesia. It was observed that imipramine, chlorpheniramine, and haloperidol antagonized morphine analgesia. The probable mechanism of action has been discussed.


Cardiac function during vagus escape.

Cardiac function during vagus escape. It is generally believed that the stimulation of vagus nerve has no direct effect on ventricular myocardium. But recent work has demonstrated clear-cut negative inotropic effect of vagal stimulation on ventricles. In an attempt to study further the effect of vagal stimulation on heart, 15 dogs were studied hemodynamically under nembutal anaesthesia. Bilateral vagotomy caused 9% elevation of heart rate whereas arterial pressure and cardiac output increased by 5% and 3% respectively. Stroke volume output decreased by 8%. Stimulation of the cut peripheral end of vagus caused cardiac standstill followed by vagus escape. During the steady state of vagus escape there was marked reduction in arterial pressure, heart rate and cardiac output, but the stroke volume was significantly elevated above the mean control. These findings suggest that when heart rate decreases, the stroke volume increases in order to restore the decreased cardiac output and that this happens inspite of the negative inotropic effect of vagal stimulation. Thus the Frank-Starling mechanism has a very significant role in an intact organism with normal hemodynamics.


Involvement of Central adrenergic mechanisms in the induction of cardiac arrhythmias by aconitine nitrate administered intraventricularly. Aconitine, 10 mug, administered intraventricularly in cats produced cardiae arrhythmias. Intraventricular administration of phenoxybenzamine, propranolol and practolol abolishes the centrally induced cardiac arrhythmias. Intraventricular reserpinization also abolished these cardiac arrhythmias whereas intraventricular administration of 6-hydroxydopamine and tetrabenazine had no effect. Brain stem noradrenaline probably plays a role in these centrally induced cardiac arrhythmias by aconitine.


Further studies on the mechanism of rise in blood pressure and tachycardia after intraventricular administration of aconitine. Intraventricular administration of aconitine nitrate (10 mug) consistently produced hypertension and tachycardia. Peripheral vaso-constriction due to increase in central vasomomotor tone mainly responsible for hypertension whereas stimulation of central beta-receptors with sympathoadr renal discharge responsible for tachycardia.


Effects of prolactin and LH on the activity of delta5-3beta hydroxy-steroid dehydrogenase, dihydro-orotic dehydrogenase, b-hydroxybutyrate dehydrogenase and glucose-6-phosphate dehydrogenase in the testis of the dwarf mice. The activity of delta5-3beta Hydroxysteroid hydro-genase, dihydro orotic dehydrogenase, B-Hydroxybutyrate dehydrogenase and glucose-6-phosphate dehydrogenase was studied in the testes of hereditary dwarf mice treated with Prolactin or LH. Two months old dw/dw dwarf mice were injected twice daily, for 14 days, either with 100 mug ovine Prolactin, or 5 mug ovine LH twice a day. Prolactin treatment increased the activity of all the enzymes assessed. Treatment with LH stimulated the activity of all the enzymes as compared to the saline treated animals but less than the Prolactin treated ones. The data bearing that the increased activity of several oxidising enzymes in the testes of hereditary dwarf mice is increased with Prolactin, is consistent with the suggested effect of this hormone on testicular steroidogenesis.


Effect of intravenous infusion of blood on the electrocardiogram of anaesthetised dogs. About 250 to 450 ml of blood was infused within 3 to 5 minutes to study the effect of rapid intravenous infusion of blood on electrocardiogram of 21 anaesthetised dogs. In 16 dogs with initial heart rate above 136/min, i.v. infusion resulted in bradycardia, decrease in P wave amplitude, increase in R wave amplitude and increase in PR, QT and ST intervals. In 3 dogs with initial heart rates above 136/min there was no change in the heart rate, while in 2 dogs with heart rate below 136/min there was tachycardia after the infusion.


Local anaesthetic activity of some new substituted acylamides II. Six new substituted acylamides, chemically related to lignocaine were studied for local anaesthetic activity and toxicity in mice, frogs and guinea pigs. Only one of these compounds, w-pyrrolidino 2, 3, 5, 6 tetramethyl acetanilide was found to possess potency comparable to lignocaine with a slightly higher therapeutic index. Study of the S.A.R. of this group indicated that by removal of two methyl groups at position 3 and 5 in the above compound, a local anaesthetic with greater potency than lignocaine may be obtained. Further exploration of the potentialities of a compound having pyrrolidine group as a part of basic side chain is indicated.


Effect on mental stress on intermediate carbohydrate-and lipid-metabolism. Changes in blood levels of Glucose, Pyruvic acid, Lactic acid, Glycogen, Free Fatty Acids and total Serum Cholesterol have been studied in normal healthy human adults under the effect of mental stresses of pre-examination tension and pre-operative apprehension. A highly significant rise in all the parameters was noted.


Histamine content of the digestive tract of a catfish Clarias batrachus (Linn.) in relation to spawning, sex and seasonal variation. Histamine content of the digestive tract of a catfish Clarias batrachus has been estimated biologically on the atropinized guineapig ileum. A significant decrease of histamine content has been observed with the decrease of gonosomatic index (G.S.I.) during breeding season in female fishes, while no such type of change in histamine content of male fishes during breeding season has been noted. In the summer histamine content of both the sexes was signivicantly lowered in comparison with the histamine content during breeding season in both the sexes. It is concluded that higher histamine content in prespawing female fishes during breeding season may be due to the inhibition of the enzyme histaminase by gonadotrophines. It is also suggested that the route of inactivation of histamine during breeding season may be different in both the sexes, while in summer a common factor may be involved in depletion of histamine content of both the sexes.


Effect of eltroxine and neomercazol on monoamine oxidase from rat tissues. The paper describes the effect of two drugs, (Eltroxine and Neomercazol) on the nature and activity of monoamine oxidase (MAO) in albino rats. Four organs namely liver, kidney, brain and heart were examined from this point of view. Biological activity measurements were done using tyramine hydrochloride as the substrate. The liver MAO from normal as well as the drug treated rats were subjected to DEAE gel filtration studies. These investigations show that there is a significant difference in the biological activity as well as in the actual nature of the enzyme as a result of treatment with the drugs mentioned above.


Effect of diphenylhydantoin and lithium on whole brain serotonin, sodium and potassium in mice. The effect of lithium and Diphenylhydantoin separately and in combination on whole brain serotonin, sodium and potassium were studied in mice. 9 day treatment with lithium was found to significantly raise brain serotonin. Lithium enhanced the sodium lowering effect of diphenylhydantoin. Though neither drug affected brain potassium, combination of the two drugs significantly lowered brain potassium. The possible mechanisms of these effects are discussed.


Studies on the effect of penicillin, streptomycin and isonicotinic acid hydrazide on small intestinal oligosaccharidase. Studies have been done on the effect of Penicillin, Streptomycin and Isonicotinic Acid hydrazide on small intestinal oligosaccharidase and it was observed that the drug penicillin inhibited the enzyme lactase and sucrase by 62.7% and 34.7% respectively, whereas I.N.H. inhibited the enzyme sucrase and maltase by 57.1% and 56.14% respectively. Streptomycin did not show any inhibitory effect on those enzymes. Lactose tolerance test showed impairment of lactose absorption in case of penicillin. Fasting serum sugar level was diminished both in penicillin and streptomycin and the absorption capacity was increased after oral administration of streptomycin.


Effects of Cannabis extract on the response of accessory sex organs of adult male mice to testosterone. Cannabis extract caused a marked reduction in the body weight and in the weights of seminal vesicles, ventral prostate, epididymis, preputial gland and perineal complex (Penis and its bulb and levator ani muscle) of castrated adult male mice. Cannabis extract administration in combination with testosterone propionate (TP) inhibited growth stimulation produced by TP alone. Anti-androgenic nature of the compound is suggested.


[Physiological basis for the therapy of water, electrolyte and acid-base imbalance in infants and children]. The therapeutic measures in the treatment of water, electrolyte and acid-base disturbances is based on the utilization of renal regulatory mechanisms. The treatment in infancy and childhood differs from that in adulthood mainly by the fact that kidney function of the small human being is quantitatively more limited due to its developmental status. Quantity and quality of kidney function in infancy and childhood are discussed. The capacity of the kidney to regulate the amount and composition of body fluids in this age group is less broad. In treating disturbances of water, electrolyte and acid-base metabolism it is, therefore, important to make use of simple diagnostic aids to assess individual renal function. A conceptual scheme for treatment is presented.


[Infusion treatment in severe dehydration (infantile toxicosis)]. Severe dehydration in infants is a common life threatening condition. The therapy of different forms of dehydration has been described. Many practical suggestions for diagnostic procedures have been added. Clinical and pathophysiological peculiarities typical of the treatment of severe infantile dehydration have been stressed.


Effect of iron on leukocyte function: inactivation of H2O2 BY IRON. We investigated the effect of FeSO4 on phagocytosis-associated, increased oxidative metabolism via the hexose monophosphate shunt, with special attention to its effect on H2O2 levels. The availability of glutathione eroxidase and glutathione reductase for H2O2 disposal and hexose monophosphate shunt stimulation also are evaluated. The results show an impairment of phagocytosis-associated hexose monophosphate shunt activity together with an increase both of resting and phagocytosing formate oxidation. These apparently paradoxical findings are resolved by demonstrating a direct enhancement of formate oxidation by FeSO4 in a cell-free system. In addition, measurement of H2O2 concentrations via scopoletin fluorescence shows reduction of H2O2 by Feso4. There is no effect on either glutathione peroxidase or glutathione reductase activities. These data suggest that one mechanism of FeSO4 imairment of microbicidal activity is by its removal of H2O2.


Dextranases from oral bacteria: inhibition of water-insoluble glucan production and adherence to smooth surfaces by Streptococcus mutans. The effect of dextranases (EC 3.2.1.11) from the oral isolates Actinomyces israelii and Bacteroides ochraceus on water-insoluble glucan production by the Streptococcus mutans dextransucrase (EC 2.4.1.5) and sucrose-dependent adherence to smooth glass surfaces by S. mutans was studied. Collection on membrane filters of water-insoluble polysaccharides synthesized from radioactive sucrose was used to demonstrate the marked sensitivity of insoluble glucan formation to the presence of dextranase. Concentrations of A. israelii dextranase as low as 0.002 U/ml inhibited insoluble glucan formation by 60%. Similar results were obtained the the B. ochraceus enzyme. An assay for sucrose-stimulated adherence of S. mutans to smooth surfaces involved attachment of radioactively labeled nongrowing cells to the bottom of glass scintillation vials. This facile and sensitive assay was utilized to demonstrate that sucrose-dependent adherence was affected by low levels of dextranase from either A. israelii or B. ochraceus. Enzyme at 0.005 U/ml reduced adherence of S. mutans by 80%. Treatment of S. mutans cells previously attached to glass with low concentrations of the dextranases resulted in removal of 50% to 60% of the bacteria. The results indicate that dextranase-producing oral bacteria may affect sucrose-dependent colonization of S. mutans on the tooth surface and offer a possible explanation for both the difficulties involved in implanting this bacterium into the human mouth and the limited intraoral transmission of S. mutans from one tooth surface to another.


Experimental pulmonary fibrosis induced by soluble immune complex and 60% oxygen atmosphere. In our previous papers we reported characteristic morphological changes of the capillary endothelium in the lung and of the arterial endothelium. These changes were induced by administration of various soluble immune complexes. In this paper we have induced pulmonary fibrosis in guinea pigs under allergic procedures. Administration of soluble immune complexes alone produces interstitial pneumonia. However, these changes would not normally result in diffuse pulmonary fibrosis. The administration of soluble immune complexes to guinea pigs plus exposure to a 60% oxygen-rich atmosphere yielded diffuse pulmonary fibrosis.


Formation of extracellular lipoteichoic acid by oral streptococci and lactobacilli. Examination of the culture fluids from a number of strains of oral streptococci and latobacilli has shown the presence of an erythrocyte-sensitizing antigen with the properties of lipoteichoic acid. The antigen was isolated from the culture fluids of Lactobacillus casei and Lactobacillus fermentum and characterized chemically and serologically, For other strains, serological evidence for the presence of lipoteichoic acid depends on the reactivity with antiserum specific for the glycerol phosphate backbone. The relative concentrations of the antigen in culture fluids from different organisms, in culture fluids from different stages of growth, and in extracts of organisms was estimated by determining the maximum dilution that fully sensitized erythrocytes; the culture fluid titer, which is the reciprocal of the dilution, varied from 4 to 320. Strains of Streptococcus mutans were generally characterized by a high level of extracellular lipoteichoic acid, the amount being greater than that detectable in cell extracts; this conclusion was confirmed by using the quantitative precipitin method. A high-molecular-weight fraction obtained from S. mutans BHT culture fluid was effective in sensitizing erythrocytes at a concentration of 1 mug/ml, compared with  2 mug/ml required for cellular lipoteichoic acid from L. casei. The detecting procedure depends on the teichoic acid sensitizing erythrocytes but, as shown with L. fermentum, low-molecular-weight nonsensitizing teichoic acid may also be present in culture fluid.


Evidence of fibrinogen degradation in rat anaphylaxis. In active anaphylactic shock of rats pretreated with Bordetella pertussis vaccine, both plasma thrombin clotting time and the amount of antigenically active fibrinogen degradation products in the serum were increased. The formation of clottable fibrinogen fragments was shown by SDS polyacrylamide gel electrophoresis of thrombin-induced clots. When plasma of rats pretreated with 125I rat fibrinogen and then subjected to anaphylaxis was submitted to SDS polyacrylamide gel electrophoresis, fibrinogen-split products were also detected. Fibrinogen degradation results from the proteolytic effect of an activated fibrinolytic enzyme.


An integrated data system for the retail pharmaceutical service. A machine has been designed for use in a retail pharmacy which counts tablets and records the count beside a machine-read bar code indicating the identity of the drug. Such data could be used for retail stock control and passed on for use by wholesaler, manufacturer and prescription pricing bureau for their routine processes. Thus present processes would be greatly simplified and some other advantages gained.


Analysis of traditional strategies to combat world hunger and their results. The traditional strategies proposed for development of the agricultural production of the underdeveloped countries are examined in this article. It is shown that the application of these strategies in the past has proven insufficient to eliminate world hunger. The limitations of these strategies are discussed and proposals are made for achieving the agricultural development in the underdeveloped world that will be necessary to eliminate hunger in the near future.


Capital expenditures and the availability of funds. Data on capital expenditures and the availability of funds assembled from the annual financial and service records of 42 short-term voluntary hospitals in New York City over two decades were used to analyze the behavior of annual capital expenditures on building and equipment assets. Desired expenditures on capital as a factor of production are viewed as being the result of changes in anticipated output and of the substitution of capital for labor. Actual capital expenditures in each year also reflect the availability of flows of nonoperating revenues and the completion of capital programs initiated in previous years. Nonoperating revenues include philanthropy and earnings on financial assets as principal sources. A monetary revenue series, adjusted for changes in hospital charges, was used to measure output and thus to seperate the effects of demand for hospital services and supply of funds on investment behavior. The data were approached as annual aggregates for 42 hospitals over the years 1946-1966 and as annual hospital averages for teaching and nonteaching hospitals over the same period. In both approaches four causal factors-output, substitution, the flow of nonoperating revenues, and a distributed lag-explained about 95 per cent of the sample variance of capital expenditures. Allowing for available funds reduced the average time required for 95 per cent completion of a capital adjustment from 7 to 3 years. Responsiveness of hospitals to these economic variables suggests that socially desired investment can be attained by (a) "monetizing" needs of groups now underserved; (b) improving availability of funds if used for acceptable public purposes; and (c) including consumers in determining institutional and regional priorities.


The purposes of unionization in the medical profession: the unionized profession's perspective in the United States. In the age of the common man, and ever bigger government, inexorable forces have been interposed between the traditionally independent physician in the Golden Age of Medicine in the United States and his patients. These forces; and associated pressures; come from the insurance industry, the hospital industry, and government involvement in the financing of health services. With these forces arrayed against the physician, the author contends that only medical unionism can protect his best interests and can at the same time serve as an effective consumer advocate for the public.


Hospital workers: class conflicts in the making. There is a real and conscious need for hospital workers to have meaningful work and to be adequately recognized for this work, both materially and in terms of respect and status within the institutions in which they are employed. These needs are frustrated by the conditions of work in the large modern hospital. Two main stabilizing forces, operating in part on different sets of workers, prevent hospital workers from collectively asserting their needs against the hospital's priorities. For the unskilled and semiskilled workers there are forces which lead to a typical industrial work ethic-alienation from the content of their work. For the skilled workers, there is the ideology of professionalism. The result is an increasing division of the nonmanagerial hospital work force into two groups with opposing class identifications: a proletarianized body of semiskilled and unskilled workers and a large group of skilled workers who are allowed to participate, through the ideology of professionalism, in the real status of the doctors.


The political economy of medical care. An explanation of the composition, nature, and functions of the present health sector of the United States. This presentation provides an alternative explanation of the present composition, nature, and functions of the health sector in the United States to those frequently given in sociological, economic, and medical care literature. These expalantions usually maintain that the Amcerican health sector is a result of the value system of the assumedly middle class American society. In this presentation it is postulated that the present economic structure of the United States determines and maintains a social class structure, both outside and within the health sector, and that the different degrees of ownership, control, and influence that these classes have on the means of production, reproduction, and legitimization in the United States explain the composition, nature, and functions of the health sector. It is further postulated that the value system is not the cuase, but a sysmptom, of these class controls and influences. The paper is divided into three sections. The first part profices a description of the class structure, which includes the corporate class, upper middle class, lower middle class, and working class, and it describes the mechanisms whereby this structure is maintained and replicated, both outside and within the health sector. The second section analyzes: (1)the production characteristics and social make-up of the thre main sectors of the U. S. economy-the monpolistic, state, and competitive sectors-and it focuses especially on the monopolistic sector, which is assumed to be the dominant sector in the U. S. economy, with its needs determining to a large degree the functions of the social sectors, including those of the health sector; (2) the increasing dominance of the monopolistic sector in the health sector, by means of the financial institutions, which conflicts primarily with the providers'relative control of the financing of health services; and (3) the main conflict in the control of the reproductive (academic) an distributive (delivery) institutions which, it is postulated, is not, as is generally belived, between the providers and the so-called consumers, but rather between the corporate and upper middle classes (including the providers), who control those institutions, and the majority of the U. S. population, the lower middle and working classes, who do not control them...


Health worker strikes: social and economic bases of conflict. Entrenched social and economic inequities combined with spiralling inflation have led to a growing number of health worker strikes. The bases of conflict, as yet unresolved, challenge the caste-like structure of health systems. By highlighting the need for change, health worker strikes may foster an internal dynamism and the more democratic organization of working conditions in health services.


Assessment of the world food situation-present and future. The widespread bad harvests of 1972 in various regions of the world, the consequent reduction in grain reserves, the rapid rise in food prices almost everywhere and its impact on inflation, all have served to draw renewed attention to the problem of hunger which affects millions of human beings in the world today. During the 1974 United Nations World Food Conference many important matters relating to this problem were debated: the creation of international grain reserves; problems concerning world trade of foodstuffs; the current difficulties with certain key agricultural production factors, such as fertilizers; the necessity for organizing a worldwide information system on the situation; and prospects of various harvests and threats of famine in underdeveloped countries. It is often the case that discussion of the hunger problem does not correspond to the gravity of the crisis; true causes of the present situation are not examined, and measures are not adopted that will once and for all--for the first time--abolish hunger. In view of the prospect that the real issues are often ignored, the Transnational Institute provides this analysis in an attempt to clarify what must be done to abolish hunger in the belief that this is within the reach of humanity when and if we are determined to end the irrationalities of the present economic system and the relations of domination which some individuals and countries seek to continue.


Invasive fungal infection in the immunosuppressed host. Immunosuppression, whether arising as a consequence of disease (haematopoietic and lymphoreticular malignancies) or therapy (against hemograft rejection or malignancy results in a higher than normal incidence of invasive fungal infections such as candidiasis, aspergillosis, mucormycosis and cryptococcosis. Normal host defense mechanisms, both immunologic and non-immunologic, are not fully functional and may contribute to the pathogenesis of these diseases.Candida, normally a superficial colonizer, may invade the gastrointestinal, respiratory or urinary tracts. Aspergillus and mucor species may cause hemorrhagic or necrotising pneumonias and secondarily spread to the brain. Cryptococcus may infect the meninges in the appropriate host. Therapeutics for these diseases is limited. Amphotericin B may alter the course of any of the four diseases. Fluorocystosine has found some use in the treatment of candidiasis and cryptococcosis.


The interaction between counseling and methadone in the treatment of narcotic addicts: the challenge of the counseling relationship. Despite the real and symbolic inportance of methadone to the drug addict, the counseling relationship is still central to the rehabilitative process. This paper discusses the unique aspects of counseling relationships in methadone programs due to the interaction of the physiological and counseling components of treatment. A point of view is presented which emphasizes the need for an open and honest discussion of the worker's role and the expectations of the program early in the treatment process as a means of establishing a therapeutic contract. Affirmation of the authority inherent in the worker's role, and in the structure of the program, lends structure to the counseling relationship and facilitates the rehabilitative process. The contract will also help the patient clarify his personal goals of treatment. It has been noted that methadone can speed up the rehabilitative process because it allows the addict to shift his attention away from the craving for drugs. While counseling staff view methadone as a tool to help patients achieve physiological stability so that psychosocial rehabilitation can occur, patients often view methadone as the primary component of treatment. This differing view of the role of methadone in treatment can lead to conflicts between patients and counselors. The skill of the counselor lies in helping the patients move away from a singular concentration on the drug (methadone), by encouraging a longer point of view and the first steps in the process of personal and social rehabilitation.


Comparative circulatory effects of adrenaline and noradrenaline during intra-osseous dental anaesthesia. The effects of intra-osseous dental anaesthesia on heart rate and blood pressure was examined in 17 healthy volunteers. Adrenaline containing anaesthetic solutions were accompanied by increased heart rate and elevated systolic blood pressure which were not acceptable to a high proportion of subjects. Noradrenaline at the same concentration as adrenaline (1/80 000) usually decreased the heart rate and elevated the blood pressure. A few subjects experienced a feeling of weakness in the lower extremities when noradrenaline was injected. Endogenous catecholamine formation in these test conditions gave rise to insignificant circulatory effects.


The importance of bioavailability to the pharmacist. In many places in North America both by law and by delegation by physicians, pharmacists are responsible for choosing a specific brand or supplier of a drug. Only in the past few years, the importance of this selection has become recognized. Although the clinical importance of variations in biovailability is limited to only a few classes of drugs, adequate bioavailability information on which to base such a choice is imperative. Government and non-government groups now seem to be moving rapidly in the direction of providing guidance to pharmacists in drug selection. The lack of in-vivo data, particularly in patients with the disease in which the drug is used, is badly needed by such groups and individual practitioners in order that any decision on product selection be an informed one.


Steroid therapy: still a need for answers. Various methods of steroid administration are reviewed, with emphasis on single dose alternate-day oral administration as compared with daily administration. Alternate-day therapy produces less adrenal and pituitary gland suppression and a reduced frequency of cushingoid features. Furthermore, the ability to resist infection is evidently better preserved. However, an overall therapeutic advantage cannot be claimed as there are few clinical trials with which to make a direct comparison. The numerous studies dealing with this form of therapy lack the rigorous control needed to answer the question of whether alternate-day steroid therapy should be substituted for daily therapy in certain diseases.


Sensitivity of gelatin and albumin to irradiation at 230 NM. Gelatin or poly-L-tyrosyl gelatin shows extensive degradation when exposed to ultraviolet radiation at a wavelength of 230 nm. Bovine serum albumin, a globular protein, exposed either to such ultraviolet radiation or to gamma-irradiation in the solid state resists the photolysis of peptide bonds. Molecular weights are determined by the ultracentrifugal "low speed" sedimentation equilibrium method. The effect of different speeds on the apparent average molecular weight of heterogenous material is clearly illustrated.


On the reactivity of carboxyl groups of ribonuclease-A in anhydrous methanol. The esterification of Ribonuclease-A in methanol/0.1 M hydrochloric acid has been studied by measuring the decrease in the number of titratable groups of the protein and estimating the amount of methanol incorporated. Esterification of nearly five of the 11 free carboxyl groups of the protein resulted in almost complete inactivation of the enzyme. The initial products of esterification have been chromatographed on Amberlite columns, and five partially active methyl ester derivatives of Ribonuclease-A have been isolated. The dimethyl ester, the initial product of esterification with reduced catalytic activity, has the carboxyl groups of Glu-49 and Asp-53 modified. Even in the non-aqueous solvent, as in the native structure of the protein in aqueous solution, these carboxyl groups are the fast reacting ones. Subsquently, the esterification reaction appears to proceed preferentially at the C-terminal region of the molecule. Comparison of the reactivities of carboxyl groups of Ribonuclease-A in acidic methanol to that known in aqueous solutions (with carbodiimides) suggests that the structure of Ribonuclease-A in the non-aqueous solvent resembles, at least in part, the structure in aqueous environment.


Conformational studies on sequential polypeptides. Part V. Synthesis and characterization of (Pro-Leu-Gly)10, (Pro-LeuqGly)n and (Leu-Pro-Gly)n. Syntheses of (Pro-Leu-Gly)n and (Leu-Pro-Gly)n, two synthetic polytripeptide analogues of the non-polar regions of collagen, via the corresponding tripeptide p-nitrophenyl-esters are described. The sequential polypeptide (Pro-Leu-Gly)10 was also obtained by solid-phase synthesis. In the following paper, conformational investigations on these polymers, both in solution and in solid state, will be described.


Purification and heterogeneity of human kininogen. Use of DEAE-chromatography, molecular sieving and antibody specific immunosorbents. Various methods of preparing human kininogen were investigated with an aim to limit the immunoreactive contaminant proteins to permit purification by immunosorption. A five-step procedure is described giving 7.5% yield of highly purified kininogen (pharmacological purity 14--20) from pooled human plasma, and containing approximately 30% alpha-2HS-glycoprotein and 2.8% albumin. Alpha-2HS could not be removed by polyacrylamide gel electrophoresis or isoelectric focusing in column. Analysis of heterogeneity of kininogen after chromatography on DEAE-Sephadex using various linear gradients and gel filtration on Sephadex G-100 suggested that a minor component may be an aggregate, not included in the yield. It remains uncertain whether this component derives from an occasionally observed high molecular form of active kininogen in the primary purification steps in the 7-12 S sieve fractions from Sephadex G-200, and excluded from further purification by pooling. Purification with immunosorbents was investigated using batch operations with antibody specific polymers prepared with antisera insolubilized with ethylchloroformate. It was found that the adsorption-desorption procedure was favourable for immunization purposes in producing highly specific immunologically pure kininogen. The kininogen obtained by this method or by the removal of contaminant alpha-2HS and albumin with the corresponding antibody specific polymers gave similar heterogenous patterns by polyacrylamide gel electrophoresis, indicating a main band of kininogen and several faintly stained bands which responded only to anti-kininogen. With 200 mug of the kininogen protein purified by immunosorption using monospecific antiserum the kininogen precipitation titre was 1:8 after 6--8 weeks in rabbits. With a polymer prepared with 4 ml anti-kininogen serum (1:8) and incubated with 800 mug highly purified kininogen approximately half the protein was desorbed with 2 M and 3 M sodium iodide in the first adsorption-desorption procedure.


Technical considerations of the therapeutic and working alliances. A brief survey of the development of the idea of the analytic pact and its relationship to the concepts of the therapeutic and working alliances has been presented. I have suggested that the therapeutic alliance be defined as the full-scale therapeutic rapport which includes all the the elements favorable to the progress of therapy. This includes such factors as the patient's motivation for treatment based on ego-alien symptoms, positive transference, and the rational relationship between patient and therapist. I have considered the working alliance as more limited in scope and suggested that it be considered as referring to the healthier interpersonal interchange between the analyst and patient. In general, the relationship is in part dependent on the maturer portion of the patient's ego and is related to the reality relationship. I have ascribed the working alliance to the appropriate maturation of many of the ego's functions. It should be noted that the working alliance is actually one of the factors contributing to a good therapeutic alliance. Case reports have illustrated these considerations and amplified the discussion of the alliances, with emphasis on their technical management. These points are pertinent to the general conduct of therapy and the timing of interpretations. Care directed to the building of good alliances can be of great importance in creating a milieu conducive to therapeutic progress. Identification and its role in the development of the working alliance, and the special place of affection for the analyst were discussed and the differences between transference affection and the affection based on the realities between patient and therapist were related to the effects of interpretation.


The therapeutic relationship and deviations in technique. This paper is a study of the framework and boundaries of the patient-analyst and patient-therapist relationships, and is based on the thesis that the manner in which the therapist manages these ground rules implicitly conveys important information about him to the patient, and influences both the patient's ongoing incorporative identification with the therapist and the "field" or person onto whom he projects his intrapsychic fantasies and with whom he interacts. After a review of the relevant literature, a series of fifteen postulates, drawn from previous observations in this area, are presented; each relates to the boundaries of the therapeutic relationship, and to the consequences of deviations and modifications of these boundaries and of the techniques of psychotherapy and psychoanalysis. The main clinical presentation is drawn from the psychotherapy of a patient whose therapist made several deviations in technique, and this is supplemented by the review of several vignettes from the psychotherapeutic and psychoanalytic literature. In concluding, the following are discussed: the manner in which maintenance of the ground rules reflects the intrapsychic state of the therapist; the consequences of deviations in these ground rules, especially on the patient's incorporative identification with the therapist; the manner in which deviations in technique are antithetical to a sound therapeutic alliance, unless a clearcut emergency exists; the unconscious meanings of unneeded deviations in technique for both the patient and therapist; the technical measures needed to modify as far as possible the consequences of an unnecessary deviation in technique; the need for flexibility and humanity within the basic ground rules of therapy and analysis; and the importance of the actualities of the therapist in the therapeutic relationship.


Self-protections in the narcissistic transference. This is a study of two patients who had what might be considered classical examples of narcissistic transferences. They were both severely disturbed persons and one could decompensate into a disruptive psychosis. Consequently it is not surprising that their transference projections would be consonant with their primitive orientations. They projected hateful and hating parts of the self onto the analyst. But within all this hatred was a part of the self that had the potential to achieve good things for the patient. I believe the latter is a special feature of narcissistic transferences that has revieved very little emphasis and a feature that may cause us to view such patients and their projections somewhat more optimistically in terms of their potential for growth and treatability.


Sliding meanings: a defense against threat in narcissistic personalities. Narcissistic defects are often associated with the use of habitual defensive operations in which meanings are shifted in order to protect the self-concept. Such cognitive maneuvers, used as a character style, not only protect against threatening ideas and emotional responses, but also lead to a constellation of traits and patterns of relationship that constitute a narcissistic personality disorder. Reconstruction, with clear designations of a self-as-actor, are useful in the psychotherapy of such persons provided that these reconstructions are done with the utmost tact and concern for maintenance of the therapeutic relationship.


On the interpretive process in psychoanalysis. The concept of interpretation and its function in the psychoanalytic process is updated by emphasizing the analyst's contributions to the psychoanalytic treatment process through his interpretations of resistance and transference. By incorporating Kohut's recent contributions to the psychoanalysis of narcissistic personality disorders into our general considerations regarding the process of interpretation, we have been aided in our effort to unify the theory of the psychoanalytic treatment process. We offer a broadened definition of the interpretative process and stress the added "interpersonal" dimension of resistance and transference, namely, those elements in the development of both, which are affected by the analyst;s personality and the manner of his interpretive and noninterpretive interventions. This makes the artificially sharp dichotomy between verbal and nonverbal interpretations or between interpretations and noninterpretive interventions unnecessary. The recognition of the "self-object" role of the analyst in the narcissistic transferences not only lends more precision to our understanding of archaic narcissistic experiences (whishes, demands, fantasies, etc.), but makes their interpretation within the transference our preferred analytic response. The need to foster the so-called "real relationship" between patient and analyst and the need to deal with such "nontransference" aspects of the relationship noninterpretively is thus replaced with interpretive interventions. To underline our emphasis on the analyst;s contributions to the analytic process, clinical samples and brief vignettes illustrate the manner in which interpretations may retard or promote the analytic process.


The psychoanalytic impasse.

The psychoanalytic impasse. In the study of impediments to the success of psychoanalysis as a treatment method, the character structure of the analysand has received the most attention. Psychoanalysis has come to be used for the treatment of an ever-widening range of psychopathological states, and the analysts have become confronted with a greater incidence and variety of clinical situations which can develop into therapeutic obstacles. Whether the psychoanalytic impasse will become a therapeutic stepping-stone or an obstacle to treatment often depends upon the emotional response of the therapist and his resultant behavior. Accordingly, there has been a heightened interest in the study of countertransference. Some therapists equate the psychoanalytic treatment of patients with severe character deformations with "wild" analysis and therefore feel needless guilt and anxiety when they attemtp to treat patients who suffer from them; thus they increase the likelihood of their becoming therapeutic obstacles. We have considered the psychoanalytic impasse as an inevitable aspect of the analytic sequence and discussed countertransference reactions in this context. Technical complications resulting from adverse countertransference reactions are examined both in terms of the patient's provocations and responses in the analyst. Among the analyst's responses, three were emphasized: (1) helpless fellings which represent the patient's helplessness and vulnerability; (2) rage reactions; and (3) profound anxiety reactions. The patient's need to construct and environment similar to the early traumatic environment within the analysis can become a very difficult situation for a therapist. The resolution or at least understanding of these interactions becomes equivalent to the lifting of infantile amnesia, a step which has been considered the essence of psychoanalytic resolution. Thus, adverse reactions can become keys to the gaining of fundamental insights, permitting the analytic process to continue its inevitable course.


The idealization of insight.

The idealization of insight. Psychoanalysts tend to idealize the classic model of technique, central to which is the development of insight through interpretation. This is so even though from Freud onward they have realized the inapplicability of this model to many kinds of people and clinical exigencies. As a consequence of this idealization, other factors which plausibly contribute to change, and other elements in the psychotherapeutic situation within and outside of the mainstream of psychoanalytic technique, have been inadequately exploited theoretically and clinically. These include the roles of affect, action, and will; the meaning of insight to the patient and insight as a defense against change; some dangers of insight; factors common to all psychotherapy; and the interpersonal relationship. In this paper I discuss these variables and issues, with reference to case examples, suggest that this sociopsychological problems for psychoanalysis can be understood with reference to some aspects of history of psychoanalysis, and suggest some options and opportunities.


Separation-individuation and reconstruction in psychoanalysis. The development constructs of Mahler and her coworkers are seen as clinically based theory which enrich practice. Freud discovered the importance of the infantile past and psychosexual development in particular, he related these findings to the psychodynamics of neurotic structures, and devised a successful therapeutic model based on his findings. Mahler has uncovered and detailed other aspects of infantile mental life, related genetically not to neurotic byt also to other mental structures, thereby broadening the range of applicability of Freud's therapeutic model. Clinical vignettes are offered depicting unresolved residua from the infantile developmental phases described by Mahler. The issue of the analyst's and the patient's conviction concerning reconstructions that attempt to reach across the "primal repression barrier" is discussed. Finally, it is suggested that working through involves, among other things, completion of developmental process that had been interrupted in the childhood of the patient.


The therapeutic aspects of affect.

The therapeutic aspects of affect. A satisfactory psychoanalytic definition and theory of affects has not yet been evolved. In spite of this, analysts work with affects using, for practical purposes, a common-sense definition leading to a therapeutic advantage in coordinating affective and cognitive structures as they appear in the course of a prolonged analysis. Undoing of defenses facilitates this process, allowing the ego's integrative capacities to function more adequately and satisfactorily in relation to inner and outer reality. A developmental hierarchy of affects emerges in this way ranging from primitive--all or none--affective experiences to adult, modified expression of such ego experiences. A brief historical survey of the changing forms of the theory of affects is included, as are clinical vignettes illustrating the therapeutic aspects of dealing with affective expression in the psychoanalytic situation. The therapeutic gains of such work comes about through the integration of earlier affective experiences into more developed cognitive structures allowing a variety of ego functions greater control over adult experiences.


Mobilizing ego strengths.

Mobilizing ego strengths. In certain special situations in psychoanalytic treatment there is a need to mobilize ego strength: (1) those patients who are "so infantile" that they need ego strengthening to mature sufficiently to cope with their lives; (2) patients who regress partially during psychoanalysis and cannot progress without analytic intervention to help strengthen their ego; (3) those patients with a strong tendency toward regression whose egos need immediate strengthening in analysis to prevent an immobilizing regression; (4) those patients for whom a stressful reality situation so undermines their confidence that they fall into a severe regression and need to be helped out of this as an emergency to avoid permanent trouble, such as flunking out of school or getting fired from their jobs. All attempts to mobilize ego strengths require an especially thorough understanding of the psychodynamics and especially of the transference and countertransference. In addition, the patient's ego must be assessed as having the potential for more effective functioning. Usually the patient has been unable to realize this potential because of the various degrees of regression, and the analyst has already made exhaustive analytic interpretation of the unconscious material, including the transference and resistance. He may then shift to a more direct approach, pointing out the patient's ego strengths and giving him an accurate picture of the way he can use these strengths toward his own goals. The aim is to help the patient use his own willpower and ego functions gradually to work on and finally resolve some of his neurotic problems. Accurately and honestly mirroring the patient's ego potentials, encouraging him to use his ego, and providing examples of how others have used their own willpower in comparable situations are usually helpful. The analyst must not impose his own values or goals on the patient but must work with the goals, problems, and strengths the patient has. Seven analytic cases are presented to illustrate different ways of helping the patient to mobilize and utilize his own ego strength. We are not suggesting any new "technique," but only that there is something, which can be recognized as willpower, that can be mobilized for therapeutic effect; the appeal is make primarily by the usual procedure of pointing out reality but with encouragement to the patient in coping with both external and internal stresses, these latter being most often regressive tendencies.


The little prince: psychotherapy of a boy with borderline personality structure. The author describes the history and treatment of a nine-year-old boy who had presented autistic features of withdrawal and bizarre behavior until the age of four and was later diagnosed as suffering from a minimal brain dysfunction. Treatment was recommended because of enuresis, violent arguments, especially with mother, odd interests, fears, dangerous accident-proneness and inability to tolerate physical closeness, and was continued for two years. The therapy dealt initially with apparently typical oedipal conflicts, but interpretations were followed by rage reactions and the emergence of primitive defenses: projection, grandiosity, idealization and depreciation. The therapist was forced into physically controlling the patient's rage, challenging the narcissistic reality distortion and vigorously interpreting the negative transference. Support of the family was secured by monthly joint therapy sessions. Psychotherapy helped the family to resolve a deadlock created by the patient's rages, and helped the patient to progress from a borderline personality organization, with predominance of narcissism and primitive defenses, into a more advanced organization, centered upon masculine identification.


Parkinson's Law in psychotherapy.

Parkinson's Law in psychotherapy. Parkinson's law--work expands or contracts to fill the time available for it--may influence how much and how fast patients benefit from psychotherapy. This is probably most true with respect to brief psychotherapy, and would come about from setting the end at the beginning. This procedure brings forcibly to the fore issues of separation and individuation, in the psychological context of the ultimate termination of life; it counteracts passive, timeless waiting for change to come without the assertion of one's own will and action, and it highlights a variety of ways people characteristically behave with respect to endings. Case examples are offered along with a discussion of practival issues relevant to the use of brief psychotherapy whose ending is predetermined.


On knowing the therapist "as a person".

On knowing the therapist "as a person". The point of departure for this paper is the oft-stated complaint by some patients as well as by some therapists that it is very difficult to know the psychoanalytic therapist "as a person." This complaint reflects the view that psychoanalytic psychotherapists are generally impersonal and cold as a function of their therortical orientation. However, numerous opportunities exist in psychoanalytic psychotherapy treatment situations for patients to be aware of a variety of authentic facets of therapists' personalities. Knowledge of, and reactions to, these facets are an important dimension of psychotherapy, in part because the therapist's personality inevitably colors the nature of the treatment. A patient's reaction to the real components of his therapist may be interwoven with his transference reactions. A case example shows how awareness of the patient's conflict about his knowledge of his therapist signified a major turning point in his therapy.


Visual inhibitions of automobile driving. Three patients in psychotherapy who were symptomatically unable to drive automobiles also gave histories of having been afflicted with oculomotor disorders in childhood. This calls attention to the previously undiscussed visual dimension of automobile driving, which is considered in general terms. The specific question of an inhibition of visual function resulting in avoidance of automobile driving is then raised, and a case illustration given in which the attachment of sexual and aggressive meanings to the act of looking was important in the formation of an automobile driving symptom. The particular impact of ocular deviation on early psychosexual development is explored, using the clinical material as a point of departure.