The effect of tricyclic antidepressants (TA) on the circulatory system in primary arterial hypertension.

The cardio-vascular reactions after i.m. application of 0.4 mg/kg of TA (imipramine, amitryptyline and nortryptyline) were compared in normotonics and patients suffering from essential hypertonia. It was found, that systolic blood pressure decreased significantly after the drugs only in hypertonic patients, whereas diastolic blood pressure fall was marked more in the normotonic group. In both groups, no apparent changes in heart action were noticed after the drugs. The TA caused a stronger increase of urine excretion of NE, E, VMA and NMN and MN in hypertonics than in normotonics.


Studies on kinetics of anturan excretion in man.

The kinetics of anturan excretion was studied. Experiments were carried out on ten healthy volunteers. The drug was given orally once applying three different doses: 100, 200, 400 mg. The contents of the drug in urine were determined by means of the modified method worked out by Wallace. It was found about 42 per cent of the dose was excreted with urine in an unchanged form. The process of anturan excretion may be described according to the one-compartment open kinetic model. The half-life of excretion is 3.5 hours, the excretion constant is 0.20. The formula showing the course of anturan excretion in time has been given. Five examples of the quantitative exposure test have been proposed; they allow the calculation of the absorbed drug dose and thus the degree of poisoning. The test can be also helpful in controlled therapy.


Effect of DDAVP on plasma renin activity in man.

We have investigated in eight healthy persons the effect of a single intranasal dose of 40 microgram DDAVP on plasma renin activity (PRA) in the upright posture. During normal sodium intake there were no differences in the PRA values between the time-control and DDAVP studies. However, during sodium restriction in four subjects with higher initial PRA, DDAVP induced a 40% decrease, lasting no longer than 45 minutes. There was no change in PRA after DDAVP in the other four subjects with much lower initial levels. Although no major or consistent suppressive influence could be demonstrated in the present study, in certain persons with highly stimulated initial PRA levels a transitory slight depression may be expected after a pharmacological dose of DDAVP.


Comparison of isoniazid phenotyping of black and white patients with emphasis on South African blacks.

Black tuberculosis patients from South Africa (S. A.) as well as from Birmingham, Alabama, U.S.A., showed a higher percentage of fast inactivators of isoniazid (INH) than that found in the North American white population, simultaneously sampled. In S. A. blacks, the frequency of fast inactivation was 57.9--59.6%, while in American blacks of Birmingham it amounted to 60.3%; in comparison to the above groups the rate of fast acetylators in Canadian Caucasians was 41.9% and in the USA white population 41.0%. For phenotyping of isoniazid inactivators a urine test was used. In this method the concentrations of INH (including isoniazidhydrazones) as well as acetylisoniazid were determined in the specimens collected 6--8 hrs following a test dose of 10 mg/kg INH.


Systemic thermotherapy (whole body hyperthermia).

This is an article reviewing the literature and our experience to date (six months) in the treatment of cancer using whole body hyperthermia in the first 60 patients. WBHT is an effective method of treating cancer. Patients were treated for a total of eight hours, 180 degrees F for two hours. WBHT was induced by means of two high-flow water filled blankets. Toxicity included fatigue, nausea, diarrhea and first degree burns. There was no evidence of visceral damage. There were no mortalities during the procedure. Objective responses were 50%, subjective responses were 65%. The literature demonstrates and our study confirms that under closely monitored conditions, WBHT is a feasible, safe and active anti-cancer therapy. WBHT may be safely used as an adjunct to other active cancer therapies including X-ray therapy and chemotherapy.


Influence of metoprolol on hemodynamics and respiratory function in asthmatic patients.

Studies of metoprolol in asthmatic patients showed beta 1-selective blocking properties on the adrenergic receptor. Metoprolol in a dose of 40 mg given orally to 9 asthmatic patients significantly decreased the pulse rate at 60 and 120 minutes and the systolic blood pressure at 120 minutes but did not cause any increase of respiratory impedance, measured by the forced oscillation technique. A double-blind test was carried out to compare the effects of metoprolol and inactive placebo on the respiratory response to isoproterenol in 24 asthmatic patients. In the metoprolol group, systolic blood pressure decreased significantly and pulse rate at rest also tended to decrease. There was no significant difference between the metoprolol and placebo groups in the respiratory response to an isoproterenol aerosol.


Drug interactions and side effects of hypolipidemic drugs.

The side effects and drug interactions of clofibrate, cholestyramine and nicotinic acid are reviewed because these hypolipidemic drugs are given for preventive and only rarely curative reasons and because these drugs have been given for many years and often concomitantly with other drugs.


Pharmacokinetics of amikacin (BB-K8) in patients undergoing hemodialysis.

The pharmacokinetics of Amikacin (BB-K8) was studied after administration in an i.v. bolus injection of 7.5 mg/kg to 10 patients with terminal renal impairment undergoing dialysis sessions of 6 hours. A two-compartment kinetic model has been used to describe the bi-phasic decrease of the plasma concentrations of the antibiotic thus establishing the amounts of the antibiotic in the central and peripheral compartments, its elimination being principally through the kidney. During the hemodialysis sessions the average pharmacokinetic parameters of the Amikacin were: alpha = 3.422 h-1 beta = 0.176 h-1 K12 = 1.820 h-1 K21 = 1.327 H-1, K13 = 0.450 h-1, Vc = 9.242 l Vp = 11.455 l Vdss = 20.697 l and delta = 0.377 l/kg. A dosage regimen as a function of the pharmacokinetic parameters is established for patients with terminal renal impairment which guarantees safe and efficient concentrations of the antibiotic.


Clinical pharmacology studies with acenocoumarol.

In two different studies, the relation between plasma concentrations of acenocoumarol and apparent prothrombin levels (Quick test) was investigated, using a new specific analytical method for the assay of the drug. The prothrombin level appeared independent of the plasma concentration of the drug, which is higher in old patients (over 70 years) than in younger patients (under 51 years).


Pharmacokinetics of cefoxitin in patients undergoing hemodialysis.

The parmacokinetics of Cefoxitin were studied after an i.v. administration of 15 mg/kg body weight in 17 patients with terminal renal impairment, 10 of which were undergoing 6 hr hemodialysis sessions. The average pharmokinetic parameters obtained from this kind of patient were the following: alpha = 2.88 hr-1 beta = 0.18 hr-1 K12 = 1.43 hr-1 K21 = 1.04 hr-1 K13 = 0.53 hr-1 Vc = 8.23 l Vp = 11.61 l Vdss = 19.84 l. The amounts of the antibiotic in the central and peripheric compartments are established together with the amount of the antibiotic eliminated as a function of time. The pharmacokinetic parameters are significantly different from those established in the period between dialysis sessions, and thus, the elimination constant reaches a value of 0.28 h-1. The degree of plasma protein binding of Cefoxitin is 41.46% during the hemodialysis sessions. A dosage regimen is programmed as a function of the pharmacokinetic parameters established for this kind of patient. It is recommended that an i.v. dose of 15 mg/kg body weight should be administered at the beginning and end of each dialysis session lasting 6 hours, when the periods between the sessions are 48 hours.


Phenacetin concentrations in portal and hepatic venous blood in man.

After intra-gastric or intra-duodenal administration of phenacetin (200 mg in solution), concentrations of phenacetin and its 0-dealkylated metabolite, acetaminophen, in portal and hepatic veins and in peripheral blood were monitored. A sharp increase in the portal concentration of phenacetin indicated rapid absorption. The concentration ratio of acetaminophen to phenacetin in early portal blood was 0.01--0.11 and lower than the ratio in hepatic vein. The hepatic extraction ratio of phenacetin was calculated to be 0.59--0.78. It is concluded that 0-dealkylation occurs mainly in the liver and only to a limited extent in the gastrointestinal wall.


Dermatomyositis.

Dermatomyositis and polymyositis are diseases which must be carefully defined in each patient. Criteria such as those suggested by Bohan and Peter will help define the disease and exclude other possible causes of myositis. Immunological factors are probably involved in the pathogenesis of the disease, although varied types of injury may manifest  in clinically similar disease. Dermatomyositis, not polymyositis, is related to internal malignancy in adults; however, an extensive malignancy evaluation is not indicated. Therapy with corticosteroids will improve the quality of life, will prevent contractures and calcinosis and may improve the chance of survival. In cases where steroids are ineffective, immunosuppressives may be helpful.


The determination of polycyclic aromatic hydrocarbons at the ng/L level in Ottawa tap water.

Samples of Ottawa drinking water, collected in January and February 1978 were analysed by Gas Chromatography/Mass Spectrometry (GC/MS) for fifty polycyclic aromatic hydrocarbons (PAH) and five oxygenated polycyclic aromatic hydrocarbons (O-PAH), following extraction of the organic species using Amberlite XAD-2 macroreticular resin. In the January sample, thirty PAHs, ranging in concentration from 0.05 to 14 ng/L with a mean value of 3.8 ng/L and a total weight of 114 ng/L and four O-PAHs, ranging in concentration from 0.10 to 1.8 ng/L with a mean value of 0.91 ng/L and a total weight of 3.7 ng/L, were detected. In the February sample, thirty-six PAHs, ranging in concentration from 0.05 to 8.1 ng/L with a mean value of 1.4 ng/L and a total weight of 50.4 ng/L and five O-PAHs, ranging in concentration from 0.20 to 2.4 ng/L with a mean value of 1.0 ng/L and a total weight of 5.2 ng/L, were detected. Twenty-eight PAHs and four O-pahs were common to the two samples. The use of Amberlite XAD-2 macroreticular resin to extract PAHs from drinking water is shown to be effective, although the recovery of individual PAHs from artificially loaded XAD-2 resin varied from 57 to 100%.


Colored gift wrapping papers as a potential source of toxic metals.

Sanitary land fills are the alternate to waste incineration in New Jersey. While industrial waste disposal is controlled, few restrictions apply to the disposal of domestic solid waste. Among the materials of concern from domestic sources are colored gift wrapping papers. Cadmium, chromium, copper, iron, manganese, molybdenum, nickel, lead and zinc were determined in some dozen and a half samples of gift wrapping paper by atomic absorption spectrometry after wet ashing and after simulated leaching. High levels of lead and chromium were found in many of the papers. The leachates showed correspondingly high levels of lead.


Rapid separation on copper powder of total mercury in blood and determination of mercury by flameless atomic absorption spectrometry.

The determination of mercury in blood by flameless atomic absorption spectrometry (FAAS) has been described. Prior to its analysis, the sample was decomposed by combustion and separated on a copper powder micro-column. A special type of cell has been used which gives a better sensitivity compared with the types of cells described in the literature and the method of FAAS analysis has been improved. The sensitivity of 0.1 ng for 1% absorbance was observed and the standard deviation for six determinations at this level was found to be +/- 0.05 ng, for 95% probability.


The Chatham Blood Pressure Study. An application of Bayesian growth curve models to a longitudinal study of blood pressure in children.

Recent developments in statistics have produced powerful methods that facilitate the analysis of longitudinal studies. These methods are illustrated by an analysis of a longitudinal study of blood pressure in children. The results of the study show a clear tendency for blood pressure to increase with age, and Asian children tend to have lower blood pressures than their Caucasian counterparts of the same age. There is evidence to support the hypothesis that blood pressures track.


Regional differences in risk factor distributions, food habits and coronary heart disease mortality and morbidity in Belgium.

Belgium can be divided in 4 major geographical areas: two Dutch speaking areas in the north (Campine and Flanders), a French speaking area in the south (Wallonia) and the Brussels area in between. Significant differences in mean serum cholesterol levels were observed with the lowest level in Campine, intermediate in Flanders and Brussels, and the highest level in Wallonia. Similar differences were observed in the prevalence of CHD and mortality from CHD is also higher in the French speaking part of the country. A survey of food habits since 1959 shows a higher butter and lower soft margarine consumption in the south. However, differences in smoking habits and personality traits also exist.


Breast cancer incidence: geographical correlations in Finland.

Correlation analysis was performed on breast cancer incidence and risk factors in geographical areas of Finland. Breast cancer risk is associated with fertility and taxable income but not with the size of the woman. Trends in risk factors indicate that the rapid increase in the incidence of breast cancer is likely to continue. It is concluded that factors which are reflected by the standard of living and fertility might act independently and not through the nutritional status, for which the size of the woman is an operational indicator.


Cohort analysis of lung cancer in the Netherlands.

A cohort analysis of lung cancer mortality in the Netherlands from 1936--1974 is presented. Apart from small corrections, age-specific lung cancer mortality rates can be expressed as the product of a cohort (generation) factor and an age factor. The cohort factors increase until the 1930 birth cohort, after which there is a rapid decline. The age-risk factors increase smoothy with age. Age-specific incidence curves of past and future years will follow the curve of the age-risk factors provided that the cohort-risk factors are unchanging. The method can be applied to other chronic diseases.


Non-polio enterovirus disease in the United States, 1971--1975.

Reports to the Center for Disease Control on isolation of non-polio enteroviruses for the years 1971--1975 were analysed. During the 5 year period, enterovirus isolations were reported from 7 075 individuals. 90% of these occurred in the 7 month interval of May--November. Enteroviruses were isolated more frequently from males than females for all age groups in all 5 years. The incidence of reported isolations decreased with increasing age, and an inverse relationship between severity of disease and age was suggested. Clinical diagnoses associated with enteroviral isolations included aseptic meningitis, encephalitis, upper respiratory tract disease, non-specific febrile illness, gastroenteritis, pneumonia and lower respiratory tract disease, exanthem, and enanthem.


Blood pressure and migration in children.

The effect of migration on childhood blood pressure levels has been studied by comparing children before and after migration to New Zealand with children who stayed at home on the Pacific atolls of Tokelau. Data were collected in 1971 on 502 children (97% response rate) aged 5--14 years resident in Tokelau and follow-up data were collected in New Zealand and in Tokelau in 1975--1977 (respknse rate 91%). No selection factors were detected before migration. After migration, the younger migrants had significantly higher blood pressures and were heavier, but not taller, than the non-migrants. Weight differences explained some but not all of the blood pressure differences. There were no differences in body size between the 2 groups of older children although the older non migrant girls had higher blood pressure than the migrant girls.


The prevalence of diabetes mellitus in a rural community in Iraq.

A survey was undertaken to estimate the prevalence of diabetes mellitus in a rural community in Iraq. Blood-sugar estimations after glucose-loading were performed on a sample of a village population 15 + years. 4.8% had diabetes and a majority of them had symptoms referable to their diabetic state. Diabetes was totally unknown among this rural population before the survey.


Statistical problems in studying the relative specificities of association between environmental agents and different diseases: a solution suggested.

If an environmental agent is strongly associated with only one disease then that is greater evidence in favour of a casual relationship than if that agent were also strongly associated with other unrelated diseases. Standard regression and correlation analysis are shown to be incapable of answering questions about disease specificity. A simple index, based upon regression, is proposed. The standardised regression coefficients in a regression equation based on the logistic transformation of a death rate are shown to have a particularly simple interpretation in terms of our index. The work is illustrated on an example drawn from the controversy concerning the association between area differences in ischaemic heart disease mortality and water hardness.


A note on Wong's competing risk model.

It is suggested that a method proposed recently by Wong contains an unrealistic assumption. This can be avoided by making an alternative assumption which leads to a slight alteration to one of his equations.


Thermal activation of peroxidase from tobacco leaf mesophyll cell walls.

Cell wall-bound peroxidase isolated from tobacco leaf mesophyll cell walls was found to consist of two isoenzymes (P1 and P2). Each exists in the form of a single subunit with the same molecular weight (35 000) as determined by sodium dodecyl sulphate (SDS) polyacrylamide gel electrophoresis. Both isoenzymes exhibited maximum activities at 70 degrees. P1 increased to 265% and P2 to 140% of the activities assayed at 27 degrees; below this temperature the two isoenzymes had the same specific activity. On hydrolysis, P1 showed a carbohydrate content of 26.22% when the monosaccharides were analyzed by gas liquid chromatography; P2 gave 21.45%.


Peptide--water association in peptide crystals.

The structures of 37 peptide crystals, containing 78 water-peptide hydrogen bonds and 77 other hydrogen bonds involving water, were surveyed to identify the geometry of peptide backbone hydration. In the sample, hydration of peptide carbonyl occurred more frequently than hydration of peptide N--H. The most probable value of the C'=O ... O water angle was near 138 degrees, considerably greater than the 120 degrees to the axis of a lone electron pair on the carbonyl oxygen. Associated water oxygens tended to be in the plane of the peptide bond, bui--H and Ci+1=O atoms, was common in glycine-containing cyclic hexapeptides. The distribution of angles between two hydrogen bonds at a single water molecule, as defined by the three nonhydrogen atoms involved, was centered near the tetrahedral angle.


Urea and guanidine hydrochloride induced dissociation and denaturation of bacteriophage F2 capsid.

A single, low molecular weight protein is found after urea or guanidine hydrochloride (Gdn.HCl) treatment of empty capsids derived from bacteriophage f2. The final product of denaturation is apparently a monomer, existing as a random coil in larger than or equal to 4.0 M Gdn.HCl but in a less extended form in 8.0 M urea. In contrast, an 11 S protein component is isolated after treatment of the intact virus with 4.0 M Gdn.HCl (Zelazo & Haschemeyer, 1969), indicating that RNA plays a role in stabilizing larger subunits. Denaturation by Gdn.HCl occurs in two stages as measured by changes in CD and Stokes radius: dissociation that involves a structural perturbation of aromatic side chains, followed by a major, cooperative transition that evidently results in the loss of all noncovalent structure. Denaturation by urea appears to be a much less cooperative process that occurs in several steps over a wide range of urea concentration (1--7 M). In both urea and Gdn.HCl, dissociation into subunits begins at a lower concentration of denaturant than the major changes in conformation.


Synthesis of analogs of the serum thymic nonapeptide, "facteur thymique serique" (FTS). Part I.

Analogs of FTS (Facteur Thymique Sérique), less than :formula: (see text), a circulating thymic factor, were prepared by replacing the amino acid residues in positions 1, 2, 8 and 9, or by shortening the nonapeptide chain at the N- or C-terminal end. These peptides were synthesized by two different schemes using the conventional synthesis in solution.


Chemical, biological and immunological characterization of separated electrophoretic components of human chorionic somatomammotropin (HCS).

Purified HCS preparations ofter show heterogeneity when assayed by electrophoresis, although they may be considered homogeneous according to other criteria (N-terminal amino acid analysis, gel filtration and ultracentrifugation patterns, etc.). Using DEAE-cellulose chromatography, the two main components corresponding to various degrees of hormone amidation were separated. The deamidation kinetic of the electrophoretically slower migrating component was studied and found to be sensitive to temperature and, to a lesser extent, to pH. Denaturing agents strongly increased the deamidation rate, while no effect was found by raising the ionic strength. No difference was evident between the two components and the parent hormone when compared (on a weight basis) in a specific HCS radioimmunoassay system. Even the precipitin reaction in agar gel with an anti-human growth hormone (HGH) serum did not show variations in cross-reactivity versus HGH. Moreover, groups of guinea pigs immunized with the single HCS components, gave antibodies reacting identically with the components and the parent HCS. The prolactin-like activity of the two components differed when determined by the pigeon crop-sac asay: the slower migrating component proved to be less active than the more deamidated one. On the other hand, the activity in two different radioreceptor assays (employing membranes from rabbit mammary gland and rat ventral prostate) was greater for the faster migrating component.


Synthesis, resolution and charge-donor properties of six tryptophan analogues.

In order to investigate the special function of tryptophan in peptide hormones, six tryptophan analogues have been synthesized, in which structural resemblance has been grossly retained and potentially essential properties have only partially been varied. The L-enantiomers have been isolated after enzymatic digestion of racemic dipeptide derivatives, and charge-transfer properties of the compounds have been studied.


Trinitrophenylation of bovine growth hormone.

Bovine growth hormone was chemically modified with picryl sulfonic acid, at pH 8.4 during 2 and 5 min of reaction. The N-terminal residue provides the most reactive amino group followed by the epsilon-amino groups of lysine 179 and lysines 143, 69, 111, 170 and 166 in decreasing order. These results agree with those obtained previously with equine growth hormone, except that residue 156 is not modified in bovine growth hormone. An important decrease in biological activity occurs between 2 and 5 min of reaction without sensible modification in the alpha-helix content of the molecule.


N.M.R. of 'oriented' monosubstituted amides--cis and trans N-methyl formamide.

The n.m.r. spectrum of N-methyl formamide oriented in a lyotropic liquid crystal solvent shows the presence of the cis as well as the trans forms. Analysis of the spectra due to both the species has been carried out. Possible non-planar distortions at the nitrogen atom for the trans species have been computed using the derived dipolar couplings and the available structural data.


Conformational analysis of N-(tert.-amyloxycarbony-L-proline in the solid state and in solution.

The solid-state conformational analysis of t-AOC-L-Pro-OH has indicated that the molecules are not folded up to form an oxy-C7 peptide conformation, but rather that they are held together through intermolecular O-H .... 0 = C (urethane) hydrogen bonds. The tertiary amide bond is in the cis configuration. In solvents of high polarity strongly solvated species largely predominate. In cyclohexane solution non-associated and associated (involving the carboxyl C = O as the proton acceptor) species are simultaneously present. Obviously, the extent of association increases with increasing solute concentration. The amount of the oxy-C7 form, if any, should be extremely small. It is also demonstrated that CD measurements alone can lead to an incorrect picture of the conformational preferences of amino acid derivatives and small peptides in solution.


Protamines. III. Synthesis of the tetradecapeptide corresponding to the C-terminal sequence 52--65 of galline.

The synthesis of peptides containing blocks of arginyl residues is proposed through amidination of the corresponding ornithyl analogs. In order to test this strategy the ornithyl analog of the C-terminal sequence 52--65 of galline was synthesized by the conventional method. The amidination reaction, performed on fragments of different length and ornithyl-residue content, quantitatively converts ornithines into arginines. The strategy proposed may represent a powerful tool for the synthesis of protamines and other basic proteins.


Electron microscope study on human ceruloplasmin.

Electron microscopy of human ceruloplasmin (CP) molecules revealed a few distinctive types of particle images. Analysis of these images allows to propose a tentative model for CP: six "subunits" (which we call domains) not much different in size are arranged with 32 point group pseudosymmetry. The determination of the number of polypeptides arising at the spontaneous specific proteolytic fragmentation of CP and their molecular weights conform with this assumption. The electrophoretic studies of the CP samples prepared both with and without potent proteolytic inhibitor, PMSF, revealed that CP is a single-chain protein with molecular weight of 130 000. Isolated and stored without PMSF the polypeptide chain of CP undergoes specific proteolytic cleavage which results in the appearance of polypeptides with molecular weights of 16 000, 48 000, and 64 000. The latter two polypeptides degradate to about two- and three-fold decreased molecular weights fragments, respectively. Therefore, the single polypeptide chain of CP contains at least five peptide bonds which are particularly susceptible to proteolytic attack and which connect six principal segments of the chain. The hydrolysis of these bonds results in liberation of the six fragments which were integrated in the enzymatically active globule of CP.


Studies on peptides. LXXXI. Application of a new arginine derivative, NG-mesitylene-2-sulfonylarginine, to the synthesis of substance P and neurotensin.

A new devised arginine derivative, NG-mesitylene-2-sulfonylarginine, Arg(Mts), was employed for the synthesis of hypothalamic substance P and neurotensin. The former was obtained in 74% yield by treatment of the protected undecapeptide amide, Z - Arg(Mts) - Pro - Lys(Z) - Pro - Gln - Gln - Phe - Phe - Gly - Leu - Met(O)-NH2, with methanesulfonic acid in the presence of anisole followed by reduction of the sulfoxide with 2-mercaptoethanol. The latter was obtained in 54% yield by the similar treatment of the protected tridecapeptide ester, Z - Pyr - Leu - Tyr - Glu(OBzl) - Asn - Lys(Z) - Pro - Arg(Mts) - Arg(Mts) - Pro - Tyr - Ile - Leu - OBzl, with methanesulfonic acid. As scavenger, a mixture of anisole-thioanisole-o-cresol (1:1:1, by vol.) was employed to suppress the side reaction, O-mesitylene-2-sulfonation of the Tyr residue.


Empirical torsional potential functions from protein structure data. Phi- and psi-potentials for non-glycyl amino acid residues.

The torsional potential functions Vt(phi) and Vt(psi) around single bonds N--C alpha and C alpha--C, which can be used in conformational studies of oligopeptides, polypeptides and proteins, have been derived, using crystal structure data of 22 globular proteins, fitting the observed distribution in the (phi, psi)-plane with the value of Vtot(phi, psi), using the Boltzmann distribution. The averaged torsional potential functions, obtained from various amino acid residues in L-configuration, are Vt(phi) = 1.0 cos (phi + 60 degrees); Vt(psi) = 0.5 cos (psi + 60 degrees) - 1.0 cos (2 psi + 30 degrees) - 0.5 cos (3 psi + 30 degrees). The dipeptide energy maps Vtot(phi, psi) obtained using these functions, instead of the normally accepted torsional functions, were found to explain various observations, such as the absence of the left-handed alpha helix and the C7 conformation, and the relatively high density of points near the line psi = 0 degrees. These functions derived from observational data on protein structures, will, it is hoped, explain various previously unexplained facts in polypeptide conformation.


Comparative temperature-stability properties of malate dehydrogenases from some thermophilic fungi.

Temperature-activity and temperature-stability relationships of malate dehydrogenases from eight thermophilic fungi were determined. Temperature optima for maximum activity of the enzymes varied between 50 degrees and 60 degrees and the Arrhenius plots were linear between 5 degrees and 50 degrees. The energies of activation ranged from 2.1 Kcal/mol for the enzyme from Sporotrichum thermophile to 9.1 Kcal/mol for that from Penicillium duponti. Heat inactivation kinetics at 50 degrees revealed heat lability of the enzyme from most of the thermophilic fungi. The t1/2's (min) were less than 10 for the enzymes from P. duponti, S. thermophile and Thermoascus aurantiacus; less than 30 for those from Chaetomium thermophile var. coprophile, H. lanuginosa and C. thermophile var. dissitum; and greater than 30 for those from Mucor pusillus and H. insolens. Salts of Na+, K+ and NH4+, and citrate protected the enzymes from H. lanuginosa, C. thermophile var. dissitum and M. pusillus against heat inactivation.


On some EEG patterns in children and adults.

The EEGs of 76 children (6--9 years of age) were classified into five types for the occipital regions (O1 and O2) and into seven types for the central regions (C3 and C4) by the method of EEG pattern discrimination (Sato, Ono et al., 1977). The five types of EEG patterns observed in the occipital regions were: (1) low frequency alpha wave of about 8--9 Hz, (2) Hz alpha wave, (3) low frequency alpha and theta wave, (4) 10 Hz alpha wave and theta wave and (5) irregular wave patterns, while two more types, (6) the low pass and (7) theta wave types, were observed in the central regions. These same types were also observed in the EEGs of 41 adults (20--25 years of age). The amount of difference between the above five and seven types in children and adults were obtained by the generalized (Mahalanobis') distances. In the occipital regions, the percentage frequency of the alpha wave type was the highest followed by that of the alpha and theta wave type, while the frequency of the alpha and theta waves type was the highest in the central regions, followed, next and third in order by the low pass type and the alpha type, respectively.


The effects of lithium chloride on response to salient and nonsalient stimuli in Carassius auratus.

The exploratory behaviour of 20 goldfish was investigated to see whether it was affected by treatment with lithium chloride. When familiar and novel stimuli were readily discriminable, lithium treatment had no effect on exploration. In a second study, using 20 fish, it was shown that when novel and familiar stimuli were less markedly different from each other, exploratory responses to the novel stimulus were reduced by lithium. The findings may be related to a general suppressant action of lithium on the extent of stimulus generalisation, or to a reduction by lithium of the animals' responsiveness to near-threshold levels of stimulation.


Clomipramine and amitriptyline in the treatment of severe pain.

Clomipramine is the most potent 5-HT reuptake blockade agent among the antidepressants. A comparison between the effect of clomipramine and a less powerful 5-HT reuptake blockade agent (amitriptyline) could test the hypothesis that brain 5-HT is a mediator of pain sensation. Groups of patients of either sex, with pain indication of trigeminal neuralgia, tension headache or postherpatic neuralgia, received doses of clomipramine or amitriptyline in a single blind clinical experiment. The results after three months of treatment showed that clomipramine: (1) was better than amitriptyline in treating trigeminal neuralgia; (2) tended to be better in the treatment of tension headache; and (3) amitriptyline is better in treating postherpatic neuralgia. Clomipramine was better tolerated. The results support the hypothesis that in certain pain situations, clomipramine exerts a beneficial effect, not only because of its effect on the depression and anxiety level of the patient, but also via its effects on the 5-HT brain system.


Changes in hippocampal neuronal nuclei in response to environmental stimulation.

The diameter of cortical neuronal nuclei has been reported to increase when animals are reared in enriched, as opposed to deprived, sensory environments. The present study investigated whether analogous neuronal changes occur in the hippocampus. Male Wistar rats were reared in either an enriched or a deprived environment for 80 days after weaning. At the completion of this rearing period both brain weights and hippocampal neuronal nuclear diameters were measured. The enriched subjects exhibited a greater forebrain:hindbrain ratio (3.7% p less than 0.05) when compared to the isolated subjects. No significant differences in mean hippocampal nuclear dimensions could be detected but variability in nuclear size was greater in the stratum granulosum of the isolated subjects (p less than 0.01). It is proposed that this increased variability reflects an environmentally restricted development of these neurons.


Opiate stimulation increases exploration in the mouse.

Adult male Swiss-Webster mice were injected with a low dose of morphine sulfate or vehicle and placed in an apparatus which allowed the assessment of exploratory behavior. Two measures of exploration (rearing, nose poking) were recorded during a single brief exposure. Both exploratory behaviors increased after drug treatment. This suggests opiate involvement in behavioral arousal, and more specifically, in exploratory behavior.


Changes in event related potentials during processing of Stroop stimuli.

In a simplified Stroop test, subjects responded with a button press to either the color or word dimension of Stroop stimuli. Response times were analyzed as a function of condition (color or word), stimulus type (congruent or noncongruent color-word pairing) and visual field of presentation (left or right). Changes in the stimulus evoked potential (Experiment I) and the preresponse (premotor) potential (Experiment II) were measured as a function of the independent variables and hemisphere of recording site. Stimulus type had the expected Stroop effect on response time, with noncongruent stimuli associated with longer RTs. The pattern of changes in the event related potentials suggested that the typical Stroop interference effect (color condition) is localized in the response selection stage of processing. However, the less common reverse Stroop effect (word condition) probably results from more complex processing interactions during encoding of the color and word dimensions.


Habituation and transfer during sleep in cats.

In order to test the concept of "sleep learning", cats were exposed to habituation treatment of auditory stimuli during different stages of the sleep-waking cycle. While it was possible to demonstrate that habituation to an auditory stimulus can take place in paradoxical sleep (PS) and slow-wave sleep (SWS) as well as during periods of wakefulness, it was not always possible to demonstrate a transfer of habituation from the training period to other periods. A complete transfer of habituation occurred between the two sleep periods (PS and SWS); a partial transfer of habituation occurred between the waking period and both of the two sleep stages (PS and SWS), but only a minimal transfer of habituation was found between any one of the sleep stages and the waking period. When the cats were able to transfer the habituation, they also were able to discriminate between the habituating tone and a novel tone. The findings that only minimal transfer of habituation could occur between each of the sleep stages and the waking period do not lend support to the concept of "sleep learning".


Absolute lung density in experimental canine pulmonary edema.

The noninvasive quantification of pulmonary edema could be of importance in patient management. We have developed a portable Compton-scatter densitometer capable of measuring density in the range of 0.1-1 g/cm3 independently of the chest wall. Change in lung density was investigated in 19 dogs with pulmonary edema induced by a combination of raised left atrial pressure and hemodilution. The increase in lung density correlated with the postmortem assessment of lung water (r = 0.862, p less than 0.01) and with hemodynamic indicators of pulmonary edema (r = 0.749, p less than 0.01). Subtracting the intravascular component of lung density did not improve the correlation with postmortem lung water (r = 0.850, p less than 0.01). The measurement of absolute lung density by a Compton-scatter technique may be a potentially useful method of quantifying pulmonary edema.


Serioangiographic study of renal cortical necrosis induced by administration of estrin and vasopressin in rats.

We report a serioangiographic method in rats which permits assessment of the course and dimensions of the renal arteries, the durations of the arterial and venous phases, and the intensity and uniformity of the renal parenchymal filling. The procedure was employed to study the mechanism by which administration of vasopressin to rats pretreated with estrin leads to renal cortical necrosis. The pathogenetic significance of the spasm localized on the larger renal arteries was proved directly; the possible role of the arteriovenous shunt in the development of the renal ischemia was excluded.


The blood-brain barrier: effects of nonionic contrast media with and without addition of Ca2+ and Mg2+.

Trypan blue and 197HgCl2 were used as markers of the increased leakage through the blood-brain barrier which developed after selective injection of different contrast media formulations into the internal carotid arteries of rabbits. Interest was focused on a new, experimental, nonionic medium (C-29) and possible effects resulting from the addition of Ca2+ and Mg2+ to nonionic contrast media. Using 197Hg, it was possible to quantitate the increase in extravasation produced by the contrast media. C-29 caused less damage than either metrizamide or meglumine iothalamate. The addition of Ca2+ and Mg2+ to nonionic contrast media seemed to stabilize the blood-brain barrier.


Cardiovascular effects induced by the injection of a new nonionic contrast medium (Iopamidol): experimental study in dogs.

The hemodynamic effects induced by the injection in the pulmonary artery of the new nonionic water soluble contrast medium Iopamidol were compared with those obtained by the injection of two other currently used contrast media (meglumine diatrizoate and sodium iothalamate). The experiments were carried out in nine mongrel dogs. Hemodynamic variables were continuously measured prior to, during, and for 8 minutes after injection of the contrast media. Injections of iopamidol produced significantly smaller decreases in aortic pressure (p less than 0.01), contractile indices (p less than 0.01), and peripheral resistances (p less than 0.01), and changes in heart rate and in cardiac output were less pronounced. At 3-4 minutes after injection, an increase in Vmaxd was observed with all three contrast media, but it was significantly lower after injecting Iopamidol. The role of hyperosmolality in causing cardiovascular changes is discussed. The less significant changes induced by Iopamidol appear to be the result of its lower osmolality, which is about a third that of meglumine diatrizoate or sodium iothalamate.


Isolated microperfused tubule model to evaluate contrast media transport in normal and occluded renal tubule segments.

We evaluated tubular handling of urographic contrast media in normal and obstructed states by the use of a model which allowed direct evaluation of transcellular flux. Segments of rabbit renal tubule were harvested by microdissection. Individual tubular segments were cannulated by micropipette while immersed in a serum bath. Radioactive iodine-labeled sodium iothalamate was added to the perfusate of normal and distally obstructed nephron segments. Any iothalamate that moved through the tubule wall was recovered in the bath. The tubular epithelium was counted to determine epithelial concentration of iothalamate. A small efflux of contrast medium occurred which was unaffected by acute obstruction and increased pressure. Proximal straight tubules were more permeable to sodium iothalamate than cortical collecting tubules.


[Indications for surgery in adrenocortical disease].

The surgical treatment of adrenocortical diseases indicated for hormone-secreting neoplasms and for definite cases of Cushing's disease. The surgical indication will be discussed. Since primary hyperaldosteronism caused by nodular hyperplasia of the adrenals needs a medical rather than a surgical treatment, a preoperative diagnosis and location of aldosterone producing adenomas has to be performed.


[Adrenal scintigraphy-value and indications in adrenal disease].

Adrenal scintillation scanning is a very useful method in the diagnosis of steroid producing diseases of the adrenal glands. The diagnosis of bilateral hyperplasia and primary adenoma of the adrenal cortex in Cushing's syndrome and Conn's syndrome is possible by this non-invasive procedure. Morphological questions (e.g. the localization of a phaeochromocytoma) cannot be answered. It is not a screening examination.


[Medical support in surgery for pheochromocytoma].

The occurrence of hypertensive crises, arrhythmias and hypotensive crises during surgery for pheochromocytoma can be prevented both preoperatively and intraoperatively by adequate alpha-adrenergic blockade and volume replacement. Only in a few cases is additional beta-adrenergic blockade necessary. Preoperatively the author uses phenoxybenzamine (Dibenicyline) as alpha-blockade in a dose of 20-30 mg daily, and propanolol (Inderal) as beta-blockade in a dose of 4 X 20 mg daily, both given orally. Intraoperatively he gives preference to alpha-adrenergic receptor blockers with a short halflife, i.e. phentolamine (Regitin) and lidocaine or pranolol as the beta-adrenergic blocker.


[Incidence of adrenal metastasis from renal carcinoma].

We analysed the cases of renal carcinoma undergoing operation or autopsy from 1970 to 1978 in respect of their metastasizing to the adrenals. Of the 31 cases undergoing autopsy 10 adrenal metastases were found mostly as a result of a widespread metastasis. Of the operated 74 patients 37 underwent nephrectomy alone and 37 nephrectomy together with prophylactic adrenalectomy. The histologic evaluation of the 37 removed adrenals revealed metastases only in 4 cases. Only one of them proved to be a single metastasis, the other occurring together with other metastatic lesions. The value of the adrenalectomy will be discussed.


[Long-term observations after adrenal surgery].

Long-term observations after adrenal surgery show different results according to indications for operations. The longest period of observation shows 8 patients with adrenal hyperplasia. In 3 of 4 bilaterally adrenalectomised patients no satisfactory results were obtained despite substitution treatment; 4 one-side adrenalectomised patients are in good condition. Operative results of 7 patients with benign phaeochromocytoma are satisfactory. Two patients with malignant phaeochromocytoma developed a local recidive and distant metastases. Carcinoma of the adrenal gland, if not hormonally active, were not diagnosed in early stage, 3 patients died from metastases within 3 years. A 2-years-old girl, who was operated on with hormonally active carcinoma, is in good condition 21 years later.


[Conservative surgery of kidney adrenoma].

Adenomas of the kidney are often tumors of doubtful dignity because the histopathological criteria are unclear and, moreover, the preoperative diagnosis lacks complete reliability. As a result, the clinician frequently has problems deciding on conservative surgery. This is demonstrated in the light of 6 cases of renal adenoma. The surgical management of these tumors depends on exact classification of their dignity by the pathologist. Proposals on the subject are put forward and discussed.


[Conservative surgery of renal pelvic tumors].

In a large series of renal pelvic and ureteral tumors in Belgrade (Jugoslavia), 26 cases of renal pelvic tumors were operated with conservation of the kidney. The indications must be strictly observed, the possibility of a relapse being maximally excluded. The results, under strict indications, are quite well: from 26 operated cases the 12 from 16 followed longer that 5 years are alive and with good kidney function plus 1 with lost kidney. So the 74% success for 5 or more years completely justifies the conservation of the kidney. In other cases the nephroureterectomy must be practised. The author did in 188 cases.


[Cytodiagnosis of pathologic changes in the renal pelvis and ureter].

In 80 cases of roentgenologic filling defects in renal pelvis and ureter, which could be determined exactly preoperatively, we could confirm the diagnostic value of cytology from washings of renal pelvis and ureter (lavage cytology) especially in preoperative diagnosis of carcinoma of renal pelvis and ureter. Twenty of 25 tumors (80%) were detected preoperatively. There were no false positive results. The diagnostic reliability of this method was more accurate than with normal exfoliative urinary cytology from other authors. The results are discussed together with the literature.


[Surgical considerations in congenital hydronephrosis].

The anatomo-operative characteristics of the ischemic stenosis of the juxtapyelic part of the ureter, its embryogenic fundamentals, clinical semiology and urography, emphasizing the signs of the latter for the differential diagnosis of hydronephrosis are presented. The most adequate surgical technique, that is the extirpation of the scleroatrophic part of the ureter, followed by uretero-pyelostomy, with special care in preserving the arteries of the ureter, is summarized and the technique for the postoperative drainage of the kidney is pointed out. The poor effectiveness of other procedures are commented.


[Extraction of ureteral stones using a catheter with 2 inflatable balloons. Preliminary report].

In a preliminary communication a new method for endoluminal extraction of ureteral stones is described by using a catheter with two inflatable balloons. The length of the catheter is about 100 cm and its diameter corresponds to the usual ureteral catheters. It has four openings: the central opening is located at the end of the catheters. Two other lumina open into the two balloons located at a distance of 3-5 cm. An other opening is located between the two balloons. By insufflating and emptying of the distal balloon, the concrement in the ureter is mobilized and caught. By insufflating the two balloons and injection of contrast media through the opening situated between the two balloons, the ureter is ovistended, the stone is mobilized can be extrac "swimming" ie contrast media between the two balloons. Tillenow, o concrements have been extracted from the distal ureter by this method.


[Surveillance of 110 patients after ureterolithotomy].

Between 1971 and 1975 we controlled 110 patients after ureterolithotomy. Early complications were one nephrectomy and two wound-infections. As late complications we saw one partial stenosis of the ureter. Our results show that ureterolithotomy is a low risk intervention.


[Ureterocystoneostomy using the Politano-Leadbetter procedure in adults].

At the Urology Clinic of the University of Berne during a seven-year period 79 ureterocystoneostomies (UCNS) have been performed with adults suffering from various urologic illness. Technique of operation was a modified Politano-Leadbetter procedure. Over 90% success was achieved in the reflux-only group, acceptable results were obtained with patients suffering from ureteral problems due to gynecologic surgical injury or tuberculosis, while reimplantation of megaureters had a low success rate. Early postoperative complications were rare, and mortality due to the operation was zero.


[Results of corrective surgery of hydronephrosis].

The analysis of 120 cases of hydronephrosis and 124 of corrective operations of hydronephrosis (4 bilaterally) from the Urological Clinic in Belgrade, with 81.5% very good and good results, showed the endresult which is dependent from the correctness of the indication for surgical corrective treatment, adequacy of the performed type of the corrective operation, the correctness of its performance, lack of complications and its abolishment even more from anatomical resp. functional state of the kidney before the operation. Less damaged kidneys precede well, and developed damage has a bad prognosis of the corrective operation.


[Experiences with instrumental methods for urinary calculi analysis].

To reduce the urinary calculi incidence by calculi formers, it is important to know the composition of these stones. Unfortunately the chemical analysis does not give very reliable results. Looking for a better method to analyse urinary calculi, three instrumental methods were tested: infared spectroscopy, thermal analysis and X-ray diffraction. The experimental results and economical considerations show that the X-ray diffraction analysis of urinary calculi would meet the goal of improved care of patients with stones.


[New diagnostic examinations in patients with urinary calculi, taking into consideration primary hyperparathyroidism].

The serum levels of total calcium and anorganic phosphate have been the leading parameters in the diagnosis of primary hyperparathyroidism. In addition to these, it is now possible to measure ionized calcium (Ca++) by an ion-selective electrode and parathormone (PTH) by C- and N-terminal radioimmunoassays (RIA). Whereas Ca++ determination and C-terminal PTH RIA represent a diagnostic progress, this can not be claimed for the N-terminal PTH RIA in peripheral venous blood especially in border-line cases.


[Clinical importance of vesico-renal reflux after transurethral resection of bladder tumors].

After any resection of tumors near the ostium you have to expect the vesicoureteral reflux as a complication. If the upper urinary tract is primarily normal, this reflux is of no clinical importance (if of course it is diagnosed and controlled). The resection of the ostium, to be radical, can be done without any doubt. The upper urinary tract is rarely hurted. Concerning out patients it is impossible to see how often the tumor spread in the upper urinary tract by the reflux. However, one must consider it, as one of our cases shows.


[Experiences with a new method of surgery for incontinence].

Our new operation method against the prostatectomy-incontinence is only indicated, if the external urethral sphincter is intact. This possible in 90% of all incontinent patients after prostatectomy. In this situation we can guarantee a good chance of success. An interoperative lesion of the bulbi arteries, which enter in the urethra through the posterior portion of the bulbocavernosus muscle, must be prevented. A lesion of them leeds to a total necrosis of the posterior urethra.


[A device for surgery of phimosis in adults].

A simple device for circumcision in adolescents and adults is described. It is suitable for all kinds of too tight foreskin. In 150 patients we did not see a postoperative hemorrhage or recurrence of the phimosis.


[Treatment of biliary tract carcinoma with metal endoprosthesis].

The application of endoprosthesis in the surgery of biliary tract carcinoma is a very valuable method to prolong the life of cancer patients. The metalendoprosthesis with drain for continuously rinsing the bile duct to avoid incrusation showed good results in 9 patients for short survival time of 5-26 months. Two patients were treated with bifurcated Y-shape prosthesis after resection of bile duct carcinoma.


[Conservative treatment of tibial fractures using Sarmiento's functional technic].

A conservative functional technique of treatment of tibial fractures is described. This method allows the mobilization of knee and ankle joints and early weight-bearing. The leg is fitted into an Orthoplast orthosis fixed to a plastic sole which permits the wearing of shoe and sock. The experience in 56 patients is described. Excellent function results obtained after a relatively short time recommend this type of treatment.


[Clinical considerations on posttraumatic osteitis].

Posttraumatic bone infection very often signifies a life threatening complication. However, it must no longer be accepted that amputation of the afflicted limb be the logical treatment of such a complication. A surgeon who offers the advantages of operative treatment of a fracture to his patient must also be able to control its complications. Osteitis can be treated with a good chance of success. In our clinic 29 bone infections were treated, 13 of them healing without substantial restrictions, 7 with distinct discomfort and 4 with arthrodesis, i.e. 83% healed. However, the treatment may require months and may necessitate further operative interventions. The transfer of such a patient from an acute care hospital to a high altitude clinic offers -- besides the medical and psychological advantage of a continuous long-term treatment plan -- the climatic conditions of sun and high altitude air which apparently act very favorably on the healing process of chronic infections. Of course, the possibility of competent surgical interventions must exist. Thus, with proper therapy the disastrous chain of errors beginning mainly with poor initial care through insufficient treatment can be broken.


[Etiology and prevention of pelvic injuries in traffic accidents].

With hospitalized traffic accident victimes fractures of the pelvis are not very frequent (4-10%). Fatal cases show a higher fracture incidence (20-25%). Pedestrains are with regard to pelvic fractures twice as frequently affected as other road users. Pedestrians over 60 years of age are most often involved. Modifications of the car front structure are expected to lead to significant improvements for the unprotected road user. Seat belts are capable of reducing pelvic fracture with car occupants only in certain frontal collisions. However, the geometry of the lap belt portion is of importance for the overall effectiveness of the belt system.


Combined histochemical and biochemical investigation to the reliability of the demonstration of arylsulphatase activity in cryostat sections.

The reliability of the enzyme histochemical technique, for the demonstration of arylsulphatase activity, using 6-bromo-2-naphthylsulphate as a substrate, is biochemically tested by using partly purified lysosome and microsome preparations from fresh human placenta tissue. Microsomes from frozen placenta with an arylsulphatase deficiency and lysosomes from rat liver, are also investigated. For the biochemical test methods, 6-bromo-2-naphthylsulphate and p-nitrocatecholsulphate are used as substrates. Under similar reaction conditions, varying the pH of the incubation medium and adding inhibitors or activators, the histochemical and biochemical reactions are compared. The results of this study show that the enzyme histochemical technique--except for some limitations--is suitable for the demonstration of microsomal arylsulphatase in cryostat sections.


Parafollicular cells of rabbit thryoid store both calcitonin and somatostatin and resemble gut D cells ultrastructurally.

Both calcitonin and somatostatin have been detected immunohistochemically in rabbit parafollicular cells; only calcitonin has been found in the same cells of the dog, guinea-pig and man. Large amounts of a peptide radioimmunochemically identical with synthetic somatostatin have been detected in extracts of rabbit thyroid. The ultrastructural and staining features of rabbit parafollicular cells differ from those of parafollicular cells in other species, while resembling in part those of somatostatin D cells scattered in the rabbit stomach.


Elemental analysis of solid microscopic samples in the flameless atomic absorption cuvette.

Solid microscopic samples are precisely located by means of a newly developed applicator under microscopic control in the center of a flameless graphite tube cuvette. The parts of the applicator that reach into the cuvette are made of quartz which can be cleaned by heating. The values for the K and Na content of samples such applied are highly reproducible. No contamination could be detected. Solid samples yield higher signals than liquid samples. A method of calibration is described which uses lyophilized pieces of egg albumin containing known amounts of K and Na as standards.


Iseikonic lens implantation in anisometropia.

The implantation of an iseikonic prepupillary intraocular lens in unilateral aphakia usually requires a slight (2 D) myopia of the implanted eye if the two eyes are isometropic. On the other hand, the implantation of an iseikonic implant in one eye of a anisometropic (asymmetric) eye pair can result in unexpectedly high changes in spectacle ametropia, due to differences in axial length or corneal power. The changes in ametropia after iseikonic lens implantation are discussed in relation to preoperative corneal and axial anisometropias. Alternative procedures to iseikonic implantation are described.


300 primary anterior chamber lens implantations: gonioscopic findings and specular microscopy.

A total of 300 consecutive quadruped anterior chamber intraocular lenses were implanted. Gonioscopy was performed in all cases and prospective specular microscopy was performed in the last 97 cases. Iris tucking of at least one lens foot was noted in 28% of the cases. Tucking occurred less often (20% of the cases) when the lens length was 13 mm, increasing with lens lengths longer and shorter than 13 mm. Slight lens rotation was noted in 8% of the cases. Blood vessels (rarely appearing to be neovascular) were noted around an implant foot or in the anterior chamber angle near a lens foot in 30% of the cases. A statistically significant difference in endothelial cell loss was noted between the Choyce lens (18.6%) and the Tennant lens (12.4%).


Peripheral iris erosions associated with pediatric intraocular lens implants.

Eight children in whom 2-loop iridocapsular lenses or 2-loop iris suture lenses were implanted have exhibited peripheral iris erosion adjacent to the IOL haptic, through the iris stroma, and eventually through the iris pigment epithelium. The process appears to be very gradual and these patients have exhibited no signs of iris irritation of hyphema. No treatment has been instituted.


Clinical evaluation of the DBR A-scan unit.

One hundred and eight eyes of 106 patients were evaluated preoperatively with the DBR-300 A-scan ultrasonic instrument. Intraocular lens power was then calculated using the formula supplied with the instrument, and the accuracy of the instrument was evaluated. It was found that 61.1% of the eyes were within +/- 1.00 D of the calculated refractive error and 81.5% of the eyes were within +/- 1.50 D of the calculated refractive error when using a standard 3.5-mm anterior chamber depth. Various factors were then analyzed to determine which factors contributed to the inaccuracy of the instrument. No single factor could be found to account for the slight tendency toward myopia, although several were found to contribute. No single factor was found to contribute to large errors.


Changes in membrane surface areas in mouse parietal cells in relation to high levels of acid secretion.

Levels of gastric acid secretion which may be maximal for the mouse were recorded following treatment with histamine and carbachol. A 30-fold increase over control levels was obtained in perfused animals, corresponding to a fourfold increase over highest levels recorded previously for stimulated mice. Stereological methods were used to estimate surface areas of membrane compartments of parietal cells in control and stimulated animals. Estimates of relative changes in membrane surface areas using a surface ratio method in this case substantiated changes detected by calculating surface densities. Main changes in membrane compartments of parietal cells from animals showing maximal acid secretion were a fourfold increase in free (luminal) surface, a 50% increase approximately in lateral and basal membrane, and a 90% reduction approximately in the tubulovesicular membrane compartment. Following withdrawal of secretagogues, acid secretion usually returned to control levels within 3 hours, but complete reconstitution of the tubulovesicular compartment was not seen within any survival period up to 5 hours. Reappearance of tubulovesicular elements first occurred shortly after the peak of a secretory response in focal cytoplasmic areas containing spherical and indented coated vesicles, and also numerous concentric membrane profiles not previously described in parietal cells. The way in which movement of membrane from the tubulovesicular compartment to the free surface occurs is not yet clear. However, reconstitution of the tubulovesicular compartment during a fall in acid secretion appears to involve movement of membrane from the free surface through coated vesicles, and their progression through indented forms and concentric membrane profiles to vesicles of the tubulovesicular compartment.


Two types of congenital hydrocephalus induced in rats by X-irradiation in utero: electron microscopic study on the telencephalic wall.

Stage-specific incidences of congenital hydrocephalus induced by X-irradiation of pregnant rats showed a bimodal distribution. At a dose level of 200 R, 100% hydrocephalic offspring were obtained by irradiation at embryonic days 11 and 14. When pregnant rats were subjected to 200 R X-irradiation at embryonic day 11, numerous ventricular cells of the telencephalic wall of the embryo became necrotic during the first 2 hours post-irradiation, but the paraventricular cell-to-cell interconnexions made up of zonulae adhaerentes were less affected. Mitosis took place in the surviving paraventricular surface cells throughout subsequent development. The full-term fetus exhibited little change in the cytoarchitectural arrangement of neural cells and neuropils, although it was only about half the thickness of the untreated control. After 200 R X-irradiation at embryonic day 14, most of the ventricular cells became necrotic within 6 hours. The paraventricular cell-to-cell interconnexions were completely destroyed, and never repaired in subsequent development. Mitosis took place either freely in cell clusters, or in rosettes which formed randomly in the telencephalic wall between 48 and 72 hours post-irradiation. The resulting telencephalic wall of the full-term fetus was also about half the thickness of the control. In the outer part of the tissue, the cortical plate made up of differentiating neuroblasts was hypoplastic, but the inner half was filled with numerous heterotopic masses of pleomorphic cells and bundles of primitive axons. The ependymal layer at the paraventricular surface was never formed. Whether the paraventricular zonulae adhaerentes were destroyed or not by X-irradiation was considered to be an important factor in the determination of the subsequent cytoarchitectural organization of the telencephalic wall.


Corticosteroid-induced mandibular growth retardation and palatal malformation in the ICR mouse fetus.

Pregnant ICR mice were treated with triamcinolone hexacetonide at various stages of gestation. The mandibular ramus and its condylar cartilage were studied histologically in both viable and non-viable offspring. In addition, measurements were made of the overall height of the posterior vertical dimension of the mandible and of condylar height and width. Significant changes were noted in these parameters. Concomitantly, marked changes were observed in the various zones of the condylar cartilage. A very high incidence of cleft palate was noted in newborn and stillborn mice previously treated with triamcinolone. A possible correlation between mandibular growth retardation and palatal clefting is discussed.


A radiographic study of the human fetal spine. 3. Longitudinal growth.

Regression equations are presented which describe the growth in length of the various regions of the vertebral column in the human fetus. From 8 weeks on the thoracic is always the longest region and the sacral the shortest, while the lumbar region is longer than the cervical. From the regression equations predictions of fetal vertebral length can be made from fetal age: this should be useful in obstetric practice when diagnostic ultrasound techniques are being employed for the diagnosis of growth disorders and skeletal abnormalities. A different developmental pattern emerges when average 'vertebral units' for each region are compared. The lumbar vertebrae are always the largest with the thoracic, cervical and sacral vertebrae being progressively smaller.


Reactions of transplanted neurocentral synchondroses to different conditions of mechanical stress. A methodological study on the rat.

In order to elucidate the reactions of neurocentral synchondroses to different forces, the first cervical vertebra of 10 or 25 days old rats was transplanted into sex-matched litter mates. Some vertebrae were transplanted as a whole, in some only the ventral part with its synchondroses was transplanted and, in others the lumen was furnished with an expanding sponge or a spring. The transplantation was done subcutaneously and, in the case of the fragments, intracerebrally as well. The synchondroses of the vertebrae transplanted at 10 days did not differ very much from those of the host 5, 10 or 15 days after the operation, whereas in the vertebrae transplanted at 25 days the synchondroses underwent synostosis earlier than in situ. The synchondroses of the transplanted fragments, and especially of those placed intracerebrally, remained open longer than those in the whole vertebral transplants; the sponge and and the spring also delayed closure. In the synchondroses transplanted at 25 days there was a strong reduction in alcian blue staining, whereas in the spring loaded synchondroses the stainability persisted longer, maybe as an adaptation to the tensile force. It seems that the inherent potential of the neurocentral synchondroses to obliterate at a certain time can be altered by changing the biomechanical conditions.


Comparative kinematic analysis of bipedal and quadrupedal locomotion: a cyclographic technique.

This paper shows the convention for, and applicability of, a new computer-aided cyclographic technique for kinematic analysis of locomotion in quadrupeds. Comparison is made of the walking, trotting and galloping patterns of a reference quadruped, Canis familiaris. The method is effective where an investigator required an accurate evaluation of limb movement in the cranio-caudal plane.


Total fibre numbers in cross sections of the semitendinosus in athletic and non-athletic horses and dogs.

The numbers of fibres in the complete cross section of the semitendinosus were estimated in 58 equines and 59 canines of differing types. Animals selected for swiftness--thoroughbred horses and greyhounds--have a greater number of fibres in a cross section of their semitendinosus than other members of their species, whether as neonates or as adults. The numbers of fibres in the cross section increases during growth in both types of animal in each species.


Anatomical closure of the ductus arteriosus: a study in 35 specimens.

The process of anatomical ductal obliteration appears to be gradual and to involve proliferation of intima and media (mainly the latter) producing mounds, mucoid-filled spaces and fragmentation of the internal elastic membrane. Dissociation of the inner media may also be involved. The persistent ductus can be recognized histologically, and its clinical significance is discussed.


Lymphoid response to pregnancy and pseudopregnancy in the rat.

Differences in weight, while cell density and differential white cell count of the thymus, spleen, iliac and popliteal lymph nodes of virgin, 10 days outbred pregnant, 10 days inbred pregnant, 10 days pseudopregnant, and 40 days outbred post-coitum rat were examined. Compared with virgin animals, significant weight gain occurred only in the thymus, spleen and iliac lymph nodes of the outbred group. Significant weight loss from the thymus and iliac nodes, and significant reductions in white cell density of the spleen and popliteal nodes occurred in delivered animals when compared with the virgin group. During pseudopregnancy significant weight loss occurred from the thymus, spleen and popliteal lymph nodes compared with the inbred group, and from the iliac lymph nodes compared with the virgin group. No significant differences were observed between the proportions of proliferating cells in the lymphocyte populations of the thymus, spleen, iliac and popliteal lymph nodes of the virgin group. In the outbred group the proliferating populations of all four tissues rose significantly above virgin levels, while in the inbred group only the iliac lymph nodes showed any significant rise above the virgin value. These findings are discussed in relation to the maternal immunological response to pregnancy.


Transformation of monocytes into amoeboid microglia in the corpus callosum of postnatal rats, as shown by labelling monocytes by carbon particles.

Two successive intravenous doses of carbon suspension were given at 24 hourly intervals into six days old rats. These animals were killed at intervals ranging from 1 to 9 days after the second injection. The corpus callosum and neighbouring structures were examined for cells containing ingested colloidal carbon particles in their cytoplasm. Twenty four hours after the second injection, a variable number of carbon-labelled monocytes were adherent to the luminal wall of blood vessels in the corpus callosum. Numerous carbon-labelled cells appeared to have left the lumen and entered the brain tissue surrounding the vessels. These perivascular carbon-labelled monocytes in the neuropil displayed a large pale nucleus with fine chromatin granules. The phagocytic amoeboid microglia in the corpus callosum were unlabelled at first, although a few cells of a similar nature in the cavum septi pellucidi did show carbon particles in their cytoplasm. Four or five days after the second carbon injection perivascular carbon-labelled monocytes were rare, but carbon particles were now present in the amoeboid microglia. At 8 days amoeboid microglia were virtually absent from the corpus callosum but carbon particles now appeared in cells which closely resembled microglia (flattened nucleus, coarse chromatin, scanty cytoplasm at one pole). The sequential appearance of carbon particles in monocytes, amoeboid microglia, and microglia, suggests that monocytes transform into microglia by way of an amoeboid microglial stage.


Autonomic innervation of the muscles in the wall of the bladder and proximal urethra of male rats.

The muscular coat of the body of the rat bladder is innervated almost exclusively by cholinergic endings:adrenergic endings are rare. In the inner longitudinal muscle layer of the proximal urethra, 53% of 310 autonomic nerve endings observed in close relation to the smooth muscle cells were adrenergic and the remaining 47% cholinergic. The middle circular muscle layer of the proximal urethra was innervated predominantly by adrenergic endings: in this layer 86% of the total of 335 endings examined wre regarded as adrenergic. A similar predominantly adrenergic innervation was noted in the outer longitudinal layer of the proximal urethra. A number of striated muscle fibres arose from the outermost striated muscle layer of the proximal urethra and intruded deeply into the outer and middle smooth muscle layers. These intruding striated muscle fibres also received direct autonomic (mostly adrenergic) innervation. The significance of these findings in relation to the physiology of the lower urinary tracts is discussed.


Withdrawal of chronic chlorpromazine medication: an experimental analysis.

Approximately 50% of all institutionalized, mentally retarded adults receive psychotropic medication to control inappropriate behavior. In this study, behaviors exhibited by five retarded adults were formally observed while they were on and off medication. Each subject had been receiving chlorpromazine for six or more years prior to the start of the study. The drug was withdrawn and readministered using a double-blind B-A-B (drug placebo-drug) design. Effects were highly individualized. Some desirable behavior emerged when chlorpromazine was discontinued.


Suppression of self-stimulation: three alternative strategies.

Four boys with autistic-like behavior were treated for self-stimulatory behavior with three different treatment procedures--time out, differential reinforcement of other behavior (DRO), and overcorrection. All four boys showed a rapid response to the overcorrection procedure. Three boys demonstrated some evidence of decrement in responding with time-out. During the DRO procedure, one showed a modest decrease, two showed no change, but one exhibited a consistent increase in responding under this condition. A multiple baseline applied to one of the subjects failed to reveal any generalization of suppression from one setting to another. A strong but not perfect relationship was found between a frequency and a duration measure of self-stimulation. There was some evidence of negative side effects for one boy during overcorrection and for another during time-out. None of these negative side effects was enduring. There was also some indirect evidence that overcorrection facilitated appropriate play.


Alternating treatments design: one strategy for comparing the effects of two treatments in a single subject.

A little used and often confused design, capable of comparing two treatments within a single subject, has been termed, variously, a multielement baseline design, a multiple schedule design, and a randomization design. The background of these terms is reviewed, and a new, more descriptive term, Alternating Treatments Design, is proposed. Critical differences between this design and a Simultaneous Treatment Design are outlined, and experimental questions answerable by each design are noted. Potential problems with multiple treatment interference in this procedure are divided into sequential confounding, carryover effects, and alternation effects and the importance of these issues vis-a-vis other single-case experimental designs is considered. Methods of minimizing multiple treatment interference as well as methods of studying these effects are outlined. Finally, appropriate uses of Alternating Treatments Designs are described and discussed in the context of recent examples.


Effects of self-instructional training on second- and third-grade hyperactive children: a failure to replicate.

Bornstein and Quevillon (1976) demonstrated generalization from a 2-hour self-instructional training session to on-task behavior in the classroom with 4-year-old overactive children. In an attempt to replicate this work with older children, eight 7- and 8-year-old hyperactive children were assigned to either a self-instructional training group or an attention-practice control group. On-task behavior in the classroom and performance measures in reading and arithmetic were assessed. The level of difficulty of these tasks was varied. The results of Bornstein and Quevillon's (1976) study were not replicated, although the subsequent introduction of a token program significantly increased on-task behavior.


Sensory extinction and sensory reinforcement principles for programming multiple adaptive behavior change.

The role of sensory reinforcement was examined in programming multiple treatment gains in self-stimulation and spontaneous play for developmentally disabled children. Two phases were planned. First, we attempted to identify reinforcers maintaining self-stimulation. Sensory Extinction procedures were implemented in which auditory, proprioceptive, or visual sensory consequences of self-stimulatory behavior were systematically removed and reintroduced in a reversal design. When self-stimulation was decreased or eliminated as a result of removing one of these sensory consequences, the functional sensory consequence was designated as a child's preferred sensory reinforcer. In Phase 2, we assessed whether children would play selectively with toys producing the preferred kind of sensory stimulation. The results showed the following. (1) Self-stimulatory behavior was found to be maintained by sensory reinforcement. When the sensory reinforcer was removed, self-stimulation extinguished. (2) The sensory reinforcers identified for self-stimulatory behavior also served as reinforcers for new, appropriate toy play. (3) The multiple treatment gains observed appeared to be relatively durable in the absence of external reinforcers for play or restraints on self-stimulation. These results illustrate one instance in which multiple behavior change may be programmed in a predictable, lawful fashion by using "natural communities of sensory reinforcement."


Multiple-baseline analysis of a token economy for psychiatric inpatients.

Twelve behaviors selected for reinforcement among 16 chronic psychiatric inpatients were divided into four classes: (a) personal hygiene, (b) personal management, (c) ward work, and (d) social skills. A token economy program was introduced for each class in a sequential, cumulative, multiple-baseline format. Corrections were included for methodological deficiencies frequently enountered in past studies. Treatment variables were systematically monitored, and target behavior rates, levels of global individual functioning, general ward behavior, and off-ward behavior were assessed during baseline, implementation, and probe periods. Results indicated abrupt and substantial increases in performance of most target behaviors, significant improvements in global individual functioning (p less than .025), positive changes in general ward behavior, and increases in social interaction during off-ward activities. The findings provide strong evidence for the efficacy of a token economy and indicate that the multiple-baseline design can be a useful method for evaluating token economy programs.


Generalization by autistic-type children of verbal responses across settings.

Generalization of verbal behavior by autistic-type children across physically different settings was assessed. Four boys learned responses to common questions in two settings at school and were probed to determine transfer of learning to home. Three of the children demonstrated little generalization to home when trained in a cubicle. Greater generalization was indicated when they received training at varied locations. The fourth child generalized most responses to his home regardless of training setting. Simple manipulations of the school environment to more closely simulate home conditions may facilitate transfer of training to the natural environment.


Enuresis control through fading, escape, and avoidance training.

A twin-signal device that provides both escape and avoidance conditioning in ensuresis control is described involving a procedure documented by two case studies. In addition, a technique of fading as an adjunct to the process is utilized with one subject. The results indicate that a combination of operant and respondent conditioning involving escape and avoidance training may be an improvement over the more traditional conditioning procedure.


Medication compliance in chronic asthmatic patients.

In an attempt to assess patient and physician behavior patterns which interfere with effective medical treatment, 100 chronic adult and adolescent asthmatics were asked about the frequency and the nature of their medication non-compliance. The nature of the patient's medication abuse was also related to underlying personality characteristics, as measured by the MMPI Panic-Fear scale. Finally eleven physicians were asked about the frequency with which they asked their patients about over abuse and under abuse of prescribed medications. The results are impressive, showing that 54.0% of the patients reported some type of medication abuse, and that the nature of the abuse may be predicted from the patient's MMPI Panic-Fear score. Perhaps the most important finding was that while over 50% of the patients reported medication non-compliance (under abuse, over abuse, or cyclical abuse), only 27.3% of the physicians said that they routinely inquired about medication abuse. Such a discrepancy suggests one area in which patient and physician characteristics may have a bearing on the effective delivery of medical treatment. The findings underscore the need for physicians to include in their diagnostic procedure a routine inquiry into the patient's patterns of medication non-compliance.


Allergenic factors and symptomatology of respiratory allergy patients.

An attempt has been made in the present study to find out the relationship between the symptomatology of nasobronchial allergy patients of Delhi with markedly positive skin reactions and prevalence of total pollen concentration in the atmosphere, concentration of major individual pollen types, total fungal spores and house dust mites together with climatic factors such as mean monthly temperature and relative humidity. A statistically significant correlation was not found between symptomatology of the patients of Delhi and mean monthly relatively humidity, atmospheric concentration of pollen, fungal spores and house dust mites. A significant negative correlation was observed between symptomatology of patients and mean monthly temperature. Except for the pollen of prospis which showed significant positive correlation with the symptomatology of Delhi patients, a significant positive correlation was absent with respect to other individual pollen types.


A comparative dermatoglyphic study of autistic, retarded, and normal children.

Dermatoglyphic comparisons were made among 32 autistic children aged from 4-10 to 18-11; sex-, age-, and IQ-matched retarded children; and sex- and age-matched normal children. Significant differences were found between the autistic and normal children for distribution of dermal patterns and ridge line disruption, but no significant differences were found for the total mean ridge counts or mean ridge count rankings. Apart from the right hand of the autistic children, there were no unusual scores for digital dispersion ratios. Autistic and retarded children differed only in their distribution of dermal patterns, with the autistic children apparently intermediate between retarded and normal groups. These results indicate that conclusions of unique congenital disturbance in the etiology of autism inferred from different dermatoglyphics may be premature, and that dermatoglyphics may be ineffective in delineating autistic children from other atypical populations.


Personal pronouns and the autistic child.

The long-recognized difficulties of the speaking autistic child with the use and nonuse of personal pronouns ["reversals" and "avoidance"] have been generally attributed either to the nondifferentiation of the self or to the frequently coexisting symptom of echolalia. These explanations are reconsidered in this eclectic analysis from the perspective of current theory and research in development of self and of language. Emphasis is on studies of normal development of personal pronouns and the roles played in that process by listening, echoic memory, mitigated echolalia [recoding], and person deixis. It is concluded that multiple developmental obstacles of a social, cognitive, and grammatical nature underlie the more obvious symptoms and militate against the child's resolution of labels and their referents. Treatment alternatives that de-emphasize the primacy of I are offered.


Perception of contingency and mental retardation.

It is argued that the general learning difficulties exhibited by mentally retarded persons are similar in many respects to the learning difficulties of nonretarded persons who are in a state of learned helplessness (Seligman, 1975) or who are external in locus of control orientation. It is suggested that studies of locus of control and learned helplessness as theoretical constructs both directly concern the perceiving of relationships between behavior and outcomes, and that a systematic investigation of perception of contingency might increase our understanding of some of the learning difficulties of mentally retarded persons. An overview is given of the results of the few studies that have addressed perception of contingency and mental retardation, and suggestions for future research are offered.


Childhood psychosis in the preschool child.

Six cases of childhood psychosis in children 3 to 5 years of age are summarized in order to alert clinicians to include this clinical entity in the differential diagnosis of children with major developmental difficulties. They represent children treated in a day, nonresidential treatment facility in a suburb of New York City. These cases suggest that we reexamine the prevalent interest in a bipolar distribution of childhood psychosis that focuses on children whose psychosis occurs under 3 and over 5 years of age. Children with psychosis occurring between 3 and 5 are currently described as essentially rare, and are characterized by a path of massive deterioration. Our cases indicate that we should be alert to the phenomenon of young children with psychosis appearing at the preschool age, and in whom the course of illness is in a more positive direction.


Measuring musical abilities of autistic children.

Three normal children with reported musical ability and three autistic children were tested for the ability to imitate individual tones and series of tones delivered by voice, piano, and synthesizer. Accuracy of imitation was judged by two independent observers on the basis of pitch, rhythm, and duration. The autistic children overall performed as well as or better than the age-matched normal children. These results are discussed and their implications for future neurological and clinical research are considered.


Double-blind study of thioridazine and haloperidol in geriatric patients with a psychosis associated with organic brain syndrome.

Forty geriatric patients from the psychiatric ward of a state hospital were enrolled in a 12 week double-blind comparative study of the concentrate forms of thioridazine and haloperidol. The objective of the study was to assess the efficacy and safety of these drugs in the treatment of psychosis associated with organic brain syndrome in the elderly. Two types of patients comprised the population, those who had been hospitalized most of their adult lives and those who had not entered the hospital until late in life. Although both drugs produced significant improvement in these patients' symptoms, the improvement with thioridazine tended to be greater than that with haloperidol in most ratings. A plateau effect was seen with haloperidol in contrast to a steady improvement seen with thioridazine. The safety of both drugs was confirmed. Geriatric patients who display both psychotic and OBS symptomatology were found to respond quite well to both drugs, regardless of their previous psychiatric history, but a somewhat more dramatic response was seen with thioridazine.


Self-mutilation of the eye.

While the act of self-enucleation is rare, other self-inflicted eye injuries may be more common. Six patients are reported who have documented histories of ocular self-mutilation. Several common factors are observed in these patients and in other cases reported in the literature: (1) the patient was judged to be psychotic; (2) the patient had a tyrannical conscience; (3) a source of guilt was present; (4) this guilt was displaced to the eye; and (5) an attempt at self-inflicted eye injury was followed by relief from anxiety when completed or by frustration when injury was prevented.


Pathological intoxication--is there such an entity?

Pathological intoxication appears as a diagnostic term in DSM-II and DSM-III, is defined in a psychiatric dictionary and is described in several textbooks. Still, is there really such an entity? Is the small amount of alcohol inbibed incidental rather than causal? It should be borne in mind that alcohol is the popular explain-all of our culture and as such is used as an excuse for everything from sexual indiscretions to well-planned "impulsive" acts. It is likely--and evidence is presented for this conclusion--that so-called cases of pathological intoxication are really dissociative reactions. The existence of pathological intoxication as an entity must remain in doubt unless the disorder can be reproduced under controlled conditions.


Transketolase activity in psychiatric patients.

The thiamine status of 42 physically healthy nonalcoholic psychiatric inpatients was evaluated by measuring transketolase activity in a hemolysate of their red blood cells, before and after addition of thiamine pyrophosphate to the hemolysate. Sixteen patients (38%) showed evidence of thiamine deficiency. Five of these patients had received thiamine-containing vitamins for a period of from 2 fo 47 days prior to testing, suggesting that poor nutrition may not fully account for the thiamine deficiency observed.


Insight and adherence to medication in chronic schizophrenics.

Chronic schizophrenics are well-known for the tendency to not take medication. Clinical observation and studies indicate that insight plays a significant role in medication adherence. This study investigated the roles of insight and perceived benefits from medication by patients. Those patients who had insight, perceived benefits from medication and also perceived a relation between the 2 were more likely to take medication than those who did not have insight nor perceive benefits. A speculative model and possible methods of increasing medication adherence are suggested.


Electromyograph biofeedback as an adjunct to standard psychiatric treatment.

The effectiveness of electromyograph (EMG) biofeedback training was studied among 2 groups of psychiatric patients, and a control group of normal subjects. Both the psychiatric patients and the normal subjects received 6 sessions of training in deep muscle relaxation and biofeedback. The schizophrenic and psychoneurotic patients had significantly lower ratings for pathological symptomatology and abnormal behavior and all groups significantly reduced their level of muscle tension following the treatment; the schizophrenics and normals displayed significantly greater reductions than the psychoneurotic patients. The length of hospitalization for the 2 groups of patients in the study was lower than for similar patients who received standard psychiatric treatment but no biofeedback training. These results suggest that EMG training can be a beneficial adjunctive treatment for severely disturbed patients.


An Isakower phenomenon variant in an initital dream.

The Isakower phenomenon is reviewed, and a psychotherapy case is described. The first 2 dreams of the therapy are felt to be variants of the Isakower phenomenon, and are believed to support several hypotheses in the literature concerning the phenomenon.


Brief reactive psychosis: a psychodynamic interpretation.

The diagnosis "brief reactive psychosis" leaves little implied in the way of etiology or treatment approach. Three case histories are presented to illustrate the term, followed by brief summaries of the major dynamics involved. The older diagnostic term "hysterical psychosis" is discussed, and a parallel is drawn between this form of brief reactive psychosis and others so that they may be psychodynamically understood and that treatment may be rationally based upon this model.


Case studies in neuropsychiaatry. II: Conversion pseudodementia.

A patient is described who experienced pseudodementia as a conversion reaction. The patient was considered to be demented originally because of the evidence for profound cognitive impairment elicited on mental state examination. Careful analysis of the patient's verbal production  in unstructured situations and of her behavior inthe hospital permitted a clinical diagnosis of pseudodementia to be made, a diagnosis confirmed by response to treatment and long term follow-up. Evidence is presented to support the interpretation of her pseudodementia as a conversion reaction.


Renal damage associated with long term use of lithium carbonate.

The authors report 2 cases of renal damage associated with lithium carbonate treatment. The relevant literature is reviewed and supports the claim that the lithium ion may be nephrotoxic. The article concludes with practical recommendations for clinical practice until futher evidence regarding this association is available.


Patterns of drug use in psychiatric inpatient wards.

Drug use was monitored in a total of 2,592 psychiatric inpatients in 6 hospitals. The efficacy was rated as satisfactory in 78% of the drug exposures. Nearly 37% of the patients had an adverse reaction. However, only 1.5% of the reactions were noted as being of major severity.


The early manifestations of adolescent thought disorder.

Clinicians who wait for disturbed adolescents to fulfil the diagnostic criteria for schizophrenia or a toxic psychosis will delay diagnosing a developing thought disorder until the youngster has been taught to be crazy and has become chronically stunted psychologically. Earlier diagnosis can allow more prompt prevention and support and can facilitate treatment and minimize handicapping. No single symptom is diagnostic of a developing thought disorder but thought disruption can be suspected when a cluster of persistent symptoms is present. These early manifestations of teenage thought disorder are presented and discussed.


The significance of the serum levels of vitamin B-1 and magnesium in delirium tremens and alcoholism.

The relation between serum levels of vitamin B-1 and magnesium at admission, and the clinical state was studied in hospitalized patients with either alcoholism or delirium tremens. Vitamin B-1 was deficient in the delirium group, magnesium in both groups. There was no correlation between vitamin B-1 and magnesium levels. Patients with an unfavorable outcome at discharge had lower vitamine B-1 levels and a higher age than patients with a favorable outcome in either group. The magnesium deficiency is discussed for longstanding malnutrition in both groups, the vitamin B-1 deficiency for an unusual high intake of alcohol before delirium tremens started.


Anorexia nervosa and mental retardation: a case report.

This is the first published report of a retarded individual developing anorexia nervosa. The authors discuss the interaction between subnormal intelligence and the presentation of anorexic symptomatology. They also discuss the relationship between this disorder and depression. Anorexia nervosa may not be uncommon in retarded adolescents but may go undiagnosed because of the belief that mentally retarded individuals do not develop this disorder.


Investigations on myelination in vitro. Regulation by thyroid hormone in cultures of dissociated brain cells from embryonic mice.

Cultures of dissociated brain cells from embryonic mice were used to study the influence of thyroid hormone on myelination in vitro. Synthesis of myelin-associated lipids such as cerebrosides and sulfatides was used as an index for myelination. An experimental design, in which the cells were grown on medium containing serum from a thyroidectomized calf, was employed to demonstrate the direct effect of L-3,5,3'-triiodothyronine (T3Y on the biosynthesis of myelin lipids. The cells grown in the presence of hypothyroid calf serum which contained very low levels of thyroid hormones (T4 (thyroxine), 1.2 microgram/ml; T3, less than 25 ng/100 ml) compared to normal serum (T4, 5.8 microgram/ml; T3, 110 ng/100 ml) showed a diminished synthesis of myelin-associated glycolipids. This reduced activity could be restored to normal by including T3 (13 ng/ml) in the medium.


7-Methylguanosine-dependent inhibition of globin mRNA translation by methylglyoxal.

Studies on the inhibition of translation by methylglyoxal of capped and chemically decapped globin mRNAs in the rabbit reciculocyte system strongly suggest that it is cap-dependent. Concentrations of methylglyoxal (0.2 mM), which effected substantial inhibition (80%) of capped mRNA, were only slightly inhibitory (10%) to the decapped species. In addition, the inhibition was K+-dependent with maximal inhibition occurring at the K+ optimum for translation of the capped species, suggesting cap recognition is required for the effect. Results with endogenous mRNA further substantiate that initiation and not elongation is the site of action. These results are consistent with an inhibition due to a newly discovered, rapid reaction of methylglyoxal with the 7-methylguanosine of the cap structure.