[Diagnosis and therapy of hay fever in the clinic for lung diseases and tuberculosis].

In general the special diagnostics and therapy of hay-fever are done by the otorhinolaryngologist. Recently patients are often referred to the Chest Clinic for allergologic diagnostics and for classification of bronchial asthma simultaneously existing. The specialist in the Chest Clinic must be experienced also in the problems of allergic rhinitis, at least in a sufficient extent. Therefore, practical proposals for diagnostics, differential diagnosis and therapy of allergic rhinitis and especially of hay-fever are given in this paper considering recent literature and own experience in an allergologic consulting cabinet.


[Experimental findings after application of Kveim antigen. III. Sensitization of mice with living and killed strains of Mycobacterium avium (author's transl)].

Mice were infected with Mycobacterium avium (serotype I and serotype II). The application of kveim antigen or two kinds of lipid fractions of Mycobacterium avium (serotype I or II) is followed in all cases by typical tissue reactions resembling positive kveim tests. Control animals which only received kveim antigen or lipid fractions of mycobacterium I showed in all cases negative kveim reactions. Sensibilization of mice with killed kinds of Mycobacterium avium I or II leads after application of kveim antigen or lipid fractions (outside and inside lipids of Mycobacterium avium I and II) only in few cases to positive kveim reactions.


[Therapy of sarcoidosis with old tuberculin, blood and BCG. Break in treatment during pregnancy (author's transl)].

In a patient suffering from sarcoidosis stage II the treatment with Old Tuberculin, blood and BCG led to immediate but incomplete remission. With the withdrawal of therapy for safety reasons during pregnancy, a relapse in stage II was observed after delivery. Chest roentgenogramms deteriorated under observation. Thus, treatment was resumed and completed. Sarcoidosis was cured as measured by clinical and x-ray parameters and no relapse occurred under the following observation of more than 10 years. As the time course of disease in 4 other patients with pregnancies was comparable, these results lend further support to the benefit of our therapy and underline the urgent need of a controlled prospective study.


A case of tuberous sclerosis with calcification of angiomatous change in the white matter.

A 5-year-old Japanese boy had had infantile spasms at 5 months of age, and had intractable seizures, adenoma sebaceum and prominent tramtrack-like calcification in the left occipital pole at five years. A neurosurgical operation was performed for the resection of the left occipital focus. Pathological examination showed patchy glial fiber nets on the cortical surface, scattered dysgenetic giant cells both in the cortex and white matter, and calcified angiomatosis in the white matter. These findings correspond to those of tuberous sclerosis and calcified angiomatosis in the white matter.


Myoglobinemia and myoglobinuria in unconscious children.

Myoglobinemia and/or myoglobinuria was demonstrated in 12 of 17 unconscious children studied. Myoglobinemia was noted in patients with serum CPK levels above 200-250 units. Ten of the 12 patients in whom myoglobinemia was present had convulsions. Some degree of renal disturbance was noted in six of seven patients with myoglobinuria. Five patients, including four with renal disturbance, died. In unconscious children with myoglobinuria the possibility of a disturbance of renal function should always be considered.


Problems with the use of conventional anticonvulsant drugs in mentally retarded individuals.

Special problems in the use of anticonvulsant agents in the mentally retarded are reviewed. Effects of barbiturates on mental abilities and of phenytoin on facial appearance are especially undesirable side effects of these agents in mentally retarded individuals. Careful consideration should be given to selection of anticonvulsants that minimally interfere with the long-term rehabilitation of mentally retarded persons. The relationship of paroxysmal EEG abnormalities, episodic violence and hysteroepilepsy to epilepsy is discussed.


Follow-up study of hypotonic forms of cerebral palsy.

In order to ascertain what can develop from cerebral infantile hypotonia, 98 infants suffering from hypotonic forms of cerebral palsy were reexamined after one year and some of them again after another year. It was presumed that hypotonia in infants with so-called hypotonic cerebral palsy is a sign which changes with time. In the ages between 2-4 years 50.2% of the hypotonias decreased and new syndromes appeared. In the ages up to 4-6 years, there was a decrease in 85.7% of hypotonias. The new syndromes were cerebellar in 56 cases, mental defectivity with developmental disintegration in 31 cases, and there were 26 without any cerebral symptomatology. Apart from these two main semeiological groups, there were spastic and dyskinetie syndromes, mostly combined with the cerebellar or mental group, and minor brain, mostly cerebellar, disturbances which developed out of infantile central hypotonias.


Neurological complications of the ring (22) syndrome: a case report.

The first Japanese case of the ring (22) syndrome was described. The patient had diffuse neurological involvement of the central, peripheral nerves and muscles in addition to the phenotypical characteristics of this syndrome.


[Physiological effects of diet enriched in essential fatty acids in young men].

The investigations were carried out on healthy young males aged 20-21 years. Those young men, whose previously different diets were determined by the dietary habits of their families, were selected and grouped under uniform conditions (feeding, housing, physical activity). After 4 months staying under these uniform conditions their diet was changed adding E.F.A. to their previous food rations. Food rations enriched with E.F.A. were given to these young males for 3 months. Then E.F.A. additions to the diet was stopped and the observed subjects received food rations, identical as during the initial 4-month period prior to E.F.A. enrichment, these rations were given during 5 months. Immediately after grouping these men were subjected to biochemical investigation of the serum and to anthropometric and general medical examinations (examination I). The subsequent examinations (II, III, IV) were carried out while the subjects were living under uniform conditions: II) after 4 months on the diet without E.F.A. enrichment, III) after 3 months on the diet enriched with E.F.A., and IV) after 5 months of diet without E.F.A. enrichment (after withdrawal of additional E.F.A.). The investigations were begun on 97 young males (examination I). The consecutive examinations (II, III, IV) were carried out on smaller groups of subjects for reasons on with the authors had no influence. During the experiment, 2-3 times in a month, sample of daily food rations given to the studied subjects and residual food on the plates were taken for analysis. This was done for determination of actual food intake. Through the whole period of the experiment the observed subjects were inquired about additional food consumed. The biochemical investigations of the nutritional state of these young subjects included hematological indices, serum proteins, selected biochemical components in the serum, activity of certain enzymes in the serum, serum lipid components and serum level of certain vitamins. The results of these investigations show the enrichment of diets during 3 months with vegetable fats (sunflower oil, margarine containing 40% of E.F.A.) for increasing the amount of E.F.A. in the whole daily food (together with additional food calculated on the basis of inquiry information) from 14.7 g to 27.7 g (3,2% kcal and 5,8% kcal respectively) has a favorable effect on selected serum lipids. The following changes appeared: decrease of total lipid level, total cholesterol level, cholesterol content of beta and prebeta-lipoproteins levels, free fatty acid level and the favorable changes in the composition of fatty acid in total lipid and selected lipid fractions in the serum. Food enrichment with E.F.A. led to rise the level of linoleic acid and total E.F.A. level and to fall the level of saturated fatty acids. The ratio of polyunsaturated to saturated fatty acids changes favorably both in total serum lipids and in different lipid fraction...


Morphometric study of the effect of hypervitaminosis A on the rat parotid gland.

Hypervitaminosis A induces the following changes in the rat parotid gland: smaller size acini with lower cells and a smaller number of cytoplasmic granules, decreased acidophilia, and smaller nuclei. The striated ducts show smaller, disorganized cells with smaller nuclei, as well as increased secretion in their lumina. These data were confirmed by morphometric techniques.


[Comparison of the mean-term physiological effects of cis or trans docosenoic acids in the rat. I. Digestibility of fatty acids. Effects on growth, organ weights and heart histology].

The mean-term physiological effects of brassidic acid (n-9, trans docosenoic acid) and of erucic acid (n-9, cis docosenoic acid) have been compared to those of their C 18 homologues, elaidic and oleic acid, in a 2(3) factorial experiment; the 3 tested factors are: 1) the chain length of the dietary monoenes (C 22:1 vs. C 18:1), 2) the geometrical configuration of their double bond (trans vs. cis) and 3) the dietary level of linoleic acid (30% vs. 1,7% of dietary fatty acids). Wistar weanling rats have been fed for 16 weeks semi-synthetic diets containing 15% of lipids by weight, in which the fatty acids under study (brassidic, erucic elaidic) ranged to 40%. Although caution has been taken to optimize the digestibility of brassidic acid (interesterification of the lipid mixture, reduced level of calcium in the diet, addition of monoglycerides), it remains lower that of erucic acid. However, because of different levels of food consumption, the absorbed amounts of the two isomers are about the same. With a high dietary supply of linoleic acid, the dietary monoenes (C 22:1 or C 18:1), cis or trans) do not induce great changes in the weight gain of the rats, when adjusted to food consumption; linoleic acid subdeficiency lowers this adjusted weight gain, except when the diet contains oleic acid as the only monoene. These effects do not parallel those observed on the absolute growth of the rats. The trans monoenes, and to a lesser extent, erucic acid, induce an increase of liver weight (adjusted to body weight). The light microscopic histological study of the heart does not reveal any difference between the brassidic acid fed-rats and those fed the C 18:1 monoenes (elaidic, oleic). In contrast, erucic acid induces definite lesions of the myocardium. The dietary level of linoleic acid has little influence on the incidence and the severity of the lesions. The effects of these dietary fatty acids on the lipid contents and fatty acid compositions of different organs will be reported in a second paper.


[Comparison of mean-term physiological effects of cis and trans docosenoic acids in the rat. II. Effects on the lipids and fatty acids of plasma, adipose tissue, liver and heart].

The mean term effects (16 weeks) of brassidic acid (n-9 trans docosenoic acid) and erucic acid (n-9, cis docosenoic acid) on the lipids and fatty acids of different organs in the rat (plasma, adipose tissue, liver, heart) and compared to those of their C 18 homologues, elaidic and oleic acid, in a 2(3) factorial experiment; the three tested factors are: 1) the chain length of the dietary monoenes (C 22:1 vs. C 18:1), 2) the geometrical configuration of their double bond (trans vs. cis) and 3) the dietary levels (30% vs. 1,7% of dietary fatty acids). Experimental details have been reported previously [Astorg and Levillain, 1979]. With a low supply of linoleic acid, brassidic acid, brassidic acid induces a large increase of plasma triacylglycerols (TG), but this can be caused by a slow fat absorption. However, the plasma contents of cis and trans docosenoic acids do not differ greatly. Both docosenoic acids incorporate more into the lipids of heart and adipose tissue than into liver lipids, and, for each organ, more into TG than into phospholipids (PL). In heart and adipose tissue lipids, the percentage of brassidic acid is lower than that of erucic acid. In these 2 organs and in the liver, linoleic acid subdeficiency decreases the incorporation of both C 22:1 isomers into the lipids. Dietary brassidic acid is readily converted to other trans monoenes, mainly elaidic acid, which incorporates into organ lipids. The extent of this chain-shortening may be greater than that of erucic acid (to oleic acid), and this would explain the lower level of brassidic acid found in organ lipids. Last, dietary trans monoenes (brassidic and elaidic acids) induce, as compared to their cis isomers, slight but visible changes in the profile of (n-9) polyunsaturated fatty acids in organ lipids. These results are discussed and related to the fact that brassidic acid does not seem to have the heart pathogenic potency of erucic acid [see part 1 of this paper, Astorg and Levillain, 1979].


Characterization of enhancing factor (EF) prepared from spleen of mice immunized with tetanus toxoid.

In cultures of spleen cells from tetanus toxoid-primed mice a soluble, nonspecific material appeared, which enhanced antibody response in vivo. The active material was purified by gel filtration on Sephadex-G-150 and by affinity chromatography on Con-A lectin. According to the immunological and physiochemical investigation the active material does not contain carbohydrate and its molecular weight is in the 100 000 dalton range.


Plasma fractionation: production and properties of albumin.

The author reviews: 1. the present status of plasma fractionation with respect to the starting material, the quantitative relations of fractionation, how much plasma is fractionated and which fractions are prepared in different parts of the world; 2. the techniques applied in preparation of albumin and plasma protein fractions, with special regard to the cold-ethanol procedures and the new tendencies in the preparation of albumin; 3. the history of the albumin producton in Hungary and 4. his own experiences in fractionation of haemolytic plasma and in fractionation combined with heat-denaturation. A simple two-step modification of the cold-ethanol fractionation is described.


The control of immunobiological preparations in Hungary and its importance for national vaccination programmes.

In Hungary the control of immunobiological preparations has been regulated by legal orders since 1938. In the meantime the pertinent rules have been modifed several times, to keep them abreast with current development. The authority of state control has been vested into the Vaccine Control Department of the National Institute of Public Health (OKI), which in this capacity has maintained an intensive collaboration with the producer of immunobiological preparations, the HUMAN Institute of Serobacteriological Production and Research (HUMAN). As a result, several important vaccine preparations (pox, DPT, DT, tetanus, typhoid and BCG vaccines) employed in compulsory immunization programmes have been improved considerably in respect of safety and efficiency, on the basis of laboratory tests, controlled field trials and epidemiological observations, described in detail in this review.


Biological standardization of potency testing of diphtheria-tetanus-pertussis vaccines.

Active protection tests were introduced for the potency testing of the toxoid components of the DTP vaccine. The standardization of these tests is described, with special attention on WHO requirements. A freeze-dried, adsorbed DTP vaccine was prepared for use under tropical or subtropical conditions. The potency testing of the components of this vaccine is presented in this paper.


Hydrophobic interaction of extracellular protein A from Staphylococcus aureus with octyl-sepharose CL-4B.

Extracellular Protein A from Staphylococcus aureus was shown to bind to alkyl agarose adsorbents of different carbon chain length. Octyl-Sepharose CL-4B was chosen to purify the active material, as the strong interaction with this adsorbent allowed the separation of Protein A from the bulk of the contaminants. Protein A retained its ability to bind to IgG in the presence of up to 3.5 M ethylene glycol as demonstrated by hemagglutination. A theory on the possible involvement of hydrophobic interaction in the binding reaction of Protein A to IgG is advanced.


Fluctuations of the bile oxytetracyclin level on regional administration of the antibiotic.

The elimination of oxytetracyclin on regional administration was studied. The time course of the appearance of the antibiotic in different body fluids determined by a microbological assay method. On the data reported here it is assumed that regional antibiotic treatment can efficiently applied in bacterial cholangitis therapy.


The natural killer activity (cytotoxicity) of lymphocytes.

The authors' own investigations into the spontaneous lymphocyte-mediated cytotoxicity (SLMC) have been reviewed and discussed in th light of literary data. It is suggested that SLMC is a resultant of complex effects contributed by antibodies present in the human serum and those attached to the surface of lymphocytes as well as by spontaneous (sui generis) functions of effector cells. The lymphocytes eliciting SLMC belong to the "O" subpopulation, bear Fc receptors and are presumably, identical with "K" lymphocytes. In animal experiments, the authors have shown that the SLMC reaction directed againt a virus-induced tumour is under polygenetic control primarily governed by gene(s0 linked to the histocompatibility region. In man, similarly as in the mouse, SLMC was found to be a genetically-controlled lymphocyte function in which gene(s) linked to the HLA-A2 B12 or the HLA-A3 B7 haplotype may play a determining role. The authors' clinical observations indicate that LSMC represents an important part of the defense mechanism against malignancies and autoimmune diseases. Estimation and follow-up of SLMC may be useful in monitoring the clinical course.


Mammalian hexokinases: a system for the study of co-operativity in monomeric enzymes.

Kinetic and structural studies have been carried out of two isoenzymes of hexokinase from the rat, hexokinase II and glucokinase. Although both enzymes are monomeric, hexokinase II has a molecular weight double that of glucokinase and resembles a dimer of glucokinase. The co-operativity of glucokinase, which is not observed for hexokinase II, appears to be kinetic in origin rather than the consequence of ineractions between distinct glucose-binding sites.


Studies on the effects of vinblastine and colchicine on Trypanosoma gambiense.

Vinblastine and colchicine induce the anucleate form of Trypanosoma gambiense. Light microscopic studies indicated that the anucleate form was not always produced as a result of inhibition of nuclear duplication, but was formed as a result of delay or inhibition of separation of the two nuclei after completion of nuclear division. Studies showed that vinblastine and colchicine caused disorder in arrangement of axonemal microtubules of the extracellular flagella and increased formation of both protofilaments and the axoneme composed of protofilaments in trypanosomes. Moreover, treatment with colchicine resulted in disintegration of previously existing pellicular microtubules and formation of cytoplasmic projections that appeared as protrusions from a small part of the surface membrane.


[Congenital hemolytic anemia].

The cases of 91 patients with congenital hemolytic anemia (H.a.) are reported. The causes of congenital H.a. and the laboratory test by which the diagnosis and precise subclassification of the disease were facilitated are indicated. Emphasis is placed on the therapeutic significance of splenectomy in those patients In whom laboratory tests with a radioactive marker [Cr 51]indicated that splenectomy could have a beneficial effect.


[Toxic methemoglobinemia in newborns and infants].

It has been analised cases of toxic methemoglobinemia in newborns and sucklings on patients of children department city hospital Sombor in period from 1968 to 1979. In all patients methemoglobinemia was caused with wellwater containing nitrates. Originate of this state depends on: growth of child because in first few month of life they have immature methemoglobin reductase in erythrocyte, hypovitaminosis C and gastrointestinal disfunction. Diagnosis was based on anamnestical data that was used water from unhygenic well, on cyanosis of various intensity and that have disappeared during the treatment with vitamin C and not give any recurrence later. In last years number of such cases is decreasing because of better suply with proper drinking water. Further decrease can be achieved with health education and prophylactic peroral consumption of vitamin C in predisposing regions.


[A disseminated form of histiocytosis X in infants].

Over the last twelve years, only three cases of a dissiminated form of histiocytosis X, in infancy, have been treated at the Institute for Mother and Child Health Care in Novi Sad. The clinical picture exhibits a very characteristic, prolonged (from two to nine months) first stage of the illness. Its general symptoms are: fever, general decline of the infant, seborrheic dermatitis, coughing and recurrent purulent otitis. In the second stage the symptoms are even more pronounced but they depend on localization and the functional deterioration of the organs involved: the lungs, liver, pancreas, skin, bone marrow and lymph nodes. The article underlines the importance of hematological, cytological and histiopathological analyses in diagnosis, and it gives the results for the cases in question. Particular emphasis is placed on the importance of a cytological analysis of the skin scarificate. Two of the patients in question were treated with antibiotics and corticosteroids, while the third received antibiotics, corticosteroids and cytostatics, yet the outcome of all three cases was fatal. This is attributed, in part, to the late beginning of treatment and, in part, to the early age of the patients.


[Factor VII deficit-hypoconvertinemia].

Congenital deficit of Factor VII is a rare deficit perceived within women and men. Clinicaly it is manifested with mild hemoragical diatesa and of laboratory tests: prolonged on stage prothrombin time, reduced activity of Factor VII and normal APTT. In this article we describe the family in which we have found two cases of congenital deficit of Factor VII, biochemical characteristics, differential laboratory diagnosis and correction of deficit in the case of bleeding.


[Allergic reactions in cytostatic therapy].

The cytostatics used in treatment of malignant diseases may, similar to other drugs sensibilize the organism and cause various allergic manifestations. The authors present 6 children with malignant diseases in whom various allergic reactions, from urticaria to a severe form of Stivens-Johnson syndrome, were observed to appear during the treatment with cytostatics. All symptoms of allergy withdrew after the administration of antihistaminics. Difficulties in differential diagnosis of an allergy and tocsic effects of cytostatics are also pointed out.


[Actinomycin D: toxic effects with special reference to hepatic injury].

The action and toxic effects of Actinomycin D are discussed. Emphasized is the appearance of hepatic disfunction, that develops especially when the drug is applied during the first six months after hepatic irradiation. Two children with malignant tumor are demonstrated. In both a temporary hepatic lesion appeared after treatment with Actinomycin D.


[Analysis of the use of blood and blood components at the Dr. O. Novosel Internal Medicine Clinic in Zagreb].

The use of blood and components was analysed during the period of two years in the Dept. of Med. "O. Novosel", Med. Fak. of Zagreb. The blood use factors were compared with those from other hospitals and hospital staff's transfusion practice was judged by them. The use of blood was higher than in the compared hospitals due to the extremly high use in the Dept. of Haematology. This department is highly specialised with predominancy of patients with haematologycal malignancies. The blood factors of other departaments compare well with these from other hospitals. Blood component therapy in an accepted principle and is fully practiced. 77% of all transfusons were given as PRC. Difficulity in management of haemotherapy is clearly seen by the fact that only 72% of reqested doses were supplied by Blood Transfusion Service. For each Rhesus positive received dose of blood it was neccessary to order 1,4 doses and for each A Rhesus negative dose, 2 doses. The worst situation was with B and AB Rhesus negative blood. For one received dose it was neccessary to order 2.9 and 2,8 doses respectively. Similar situation was with blood components. Only 64% of requested platelet concentrates and less than 42% of granulocyte concentrates were obtained. The shortage of blood and blood components is a serious hindrance to the optimal treatment of patients.


Multiple forms of monoamine oxidase in chronic schizophrenia.

Reduced monoamine oxidase was found in the sera of fourty five schizophrenic patients with enzyme level (10 units), only five of these patients show enzyme level identical with minimum range of normal controls. Michaelis constants of schizophrenic patients show great difference from that of the normal controls. Our result suggests that schizophrenic patients possess a qualitatively different monoamine oxidase with an altered molecular structure. Four and five multiple forms were found in sera of normal human and schizophrenic patients respectively, using sepharose 6B, indicated that these different forms were of different molecular weight. Each multiple form is identified by cellulose acetate electrophoresis as they attached to different fraction of serum proteins.


"In vivo", testosterone propionate induced aberrations in Notopterus notopterus.

Germ cell chromosomes of N. notopterus responded ot the higher doses of testosterone propionate peculiarly. Emergence of anomalies like agglutination at terminal ends, clumping and precocious despiralization was evident. The stickiness, breaks, laggard and a few achromatic lesions also appeared. Effect up to 72 hrs stages was evincible and varying occurrences of chromosomal irregularities.


Early stages of experimental atheromatosis.

In female Wistar rats, fed an atherogenic diet, the early changes of serum lipids and the deviation of the vasomotor response to adrenaline and acetylcholine were compared with morphological manifestations. It has been found that the first sign may be detected as the shift in serum lipoproteins and lipids just in a few days. Merging and decrease of alpha-lipoproteins and an increase of the beta-lipoprotein fraction proved as the most sensitive indicator. In the course of several weeks, an alteration of hemodynamic response to adrenaline and acetylcholine occured. The animals revealed a diminished depressoric response to acetylcholie, whereas their blood pressure response to adrenaline in the pressoric phase was decreased but the depressoric phase was markedly expressed. The morphological impairment of the vascular system followed with a delay of several months, although a lipoid infiltration of the liver appeared after 6 weeks of the atherogenic dietary regimen.


The effect of toluene on the hematopoietic system in newt Triturus cristatus.

A macrocytic hypocromic anemia was observed in newts after toluene inhalation, with 2 concentrations, for 6 weeks. Anemia resulted associated with the used dose of toluene. Erythroblast counts, performed on blood smears and on spleen and heart imprints, showed an erythropoietic stimulus during the first weeks of treatment followed by a depressed erythrostimulating action. Differential count of erythroblasts indicated a slow maturation induced by toluene on erythroblasts. An aplasia of the spleen was suggested on the basis of the results from 6 week-treated animals. A reduction in white blood cell count, associated with increased neutrophils and lymphocytopenia, occurred only in the animals treated with the higher concentration of toluene, after 5 and 6 weeks of treatment. A decrease of phagocytic activity of neutrophils, obtained with the in vitro assays, appeared the most relevant finding at the level of lekocyte compartment.


The effects of solcoseryl on the growth and multiplication of chick embryo fibroblasts cultivated "in vitro".

The action of Solcoseryl, a free protein extract of calf blood, was studied on chick embryo fibroblasts cultivated in vitro. Solcoseryl stimulates the permitotic DNA synthesis and increases the number of mitoses.,


Biology of Toxoplasma gondii, its survival in body tissues and liquids, risks for the pregnant woman.

After briefly outlining the biology of Toxoplasma gondii the authors discuss the resistance of the parasite in body liquids and tissues under certain environmental conditions. Parasite resistance and its consequent risk of human infection, particularly for the pregnant woman, is emphasized. Toxoplasma oocysts, the sexual expression of the parasite, and the cyst facilitate the diffusion of Toxoplasma, as they are much more resistant than the trophozoite.


Spleen lipids: effect of whole body gamma irradiation and radioprotective chemicals.

Effect of whole body gamma irradiation (1200 r) on spleen lipid metabolism of male and female rats 24 hrs and 48 hrs after irradiation and the effect of radioprotective chemicals vis. AET, serotonin, their mixture and cystamine on radiation induced changes in spleen lipid metabolism has been studied. In male rats both 24 and 48 hrs after irradiation a significant increase in spleen total lipids, cholesterol, phospholipids, phosphatidylethanolamine and phosphatidylcholine was observed. Administration of AET before irradiation prevented the changes in spleen total lipids and cholesterol but not in phospholipids, which was prevented by prior administration of both serotonin and the mixture of serotonin and AET. In female rats 24 hrs after irradiation only spleen total lipids showed an increase which was prevented by prior administration of cystamine. In male rats, 24 hrs after irradiation the incorporation of NaH2 32PO4 (counts/min/ug PLP and counts/min/g spleen) into spleen total phospholipids, phosphatidylcholine and phosphatidylethanolamine was reduced and this was corrected by prior administration of AET. Serotonin and the mixture of serotonin + AET did not protect the specific activity of phosphatidy choline. In female rats irradiation increased the incorporation of NaH2 32PO4 into phosphatidylcholine, which was not prevented by prior administration of cystamine. The fatty acid composition of spleen lipid of female rats was profoundly altered 24 hrs after irradiation. Palmitic acid and oleic acid showed an increase whereas arachidonic and fatty acid above arachidonic acid showed an decrease, which were corrected by administration of cystamine before irradiation.


Investigation of the muscle tissue biostructure by means of the pressing-out method. III. The water in the rabbit striated muscle tissue.

In the rabbit striated muscle tissue the free and biostructured water content have been investigated using the pressing-out method. The following percent values have been found: 20% bound water to cell colloids and different cell particles, 61% biostructure-integrated water and 19% free water.


Biomicroscopic observations on the regulation of the mesenteric arteriolo-venular anastomoses.

The behaviour of the arteriolo-venular anastomoses was investigated. Observations were completed by the electrical stimulation of the superior mesenteric artery. During stimulation a constriction was induced in the arterioles while the gauge of the anastomoses was almost unchanged. An interpretation of this observation is given.


Reduction of oral bioavailability of lignocaine by induction of first pass metabolism in epileptic patients.

1. The pharmacokinetics of lignocaine following single oral and intravenous doses have been investigated in six normal volunteers and in six patients receiving chronic antiepileptic drug therapy. 2. After intravenous administration, serum lignocaine levels declined biexponentially in all subjects. The serum clearance (mean +/- s.d.) was slightly higher in the patients (0.85 +/- 0.09 v 0.77 +/- 0.07 l/min) but the difference was not statistically significant. 3. Lignocaine bioavailability after oral administration was more than two-fold in the patients than in the normal subjects (0.15 +/- 0.06 v 0.37 +/- 0.09, P < 0.001). 4. It is suggested that the reduced bioavailability of lignocaine in the patients is a consequence of stimulation of hepatic first-pass metabolism by antiepileptic drugs.


Effects of subjects' sex, and intake of tobacco, alcohol and oral contraceptives on plasma phenytoin levels.

1. Steady state plasma phenytoin levels in 210 epileptic patients were studied by computerized analysis of covariance to determine whether the subject's sex, alcohol intake, tobacco smoking or use of oral contraceptives influenced the relation between plasma drug level and drug dose. 2. Sex, tobacco smoking and alcohol usage had no statistically significant effect. There was a trend towards higher phenytoin levels relative to drug dose in oral contraceptive users. 3. This finding prompted an additional study of plasma phenytoin levels in 40 oral contraceptive users and 135 aged matched non-users. Analysis of covariance again showed higher plasma phenytoin levels relative to drug dose in users of oral contraceptives (P = 0.061). 4. This finding raised the possibility that the relation between plasma phenytoin level and drug dose differed between males and females who did not use oral contraceptives. However, when the relation between plasma phenytoin levels and drug dose was compared in 159 females who did not use oral contraceptives and 101 males (both groups aged 15 to 70 years) no statistically significant difference was found.


Effect of increased bioavailability of phenytoin tablets on serum phenytoin concentration in epileptic out-patients.

1. The bioavailability of a brand of phenytoin tablets used in Finland was improved in 1976. In the present retrospective study serum concentrations of phenytoin, measured before and after the change of bioavailability, are compared in 50 epileptic out-patients, who for various reasons used exactly the same dose of phenytoin tablets and of other drugs despite the increased bioavailability of phenytoin. 2. The mean increase of serum phenytoin steady-state concentration was about 70% after the change of bioavailability but there were considerable interindividual differences in the response. The mean increase in serum phenytoin was only 28% in patients with serum phenytoin concentrations 5 microgram/ml or less but the mean increase was 100% in patients with serum phenytoin between 5 and 10 microgram/ml. In patients with serum phenytoin concentrations more than 10 microgram/ml the mean increase in concentration was 60-80% after the improvement of bioavailability. However, in these groups of patients some clinically manifested phenytoin intoxications enforced the patients to the control and to dose reduction obviously before the steady-state concentration of phenytoin was reached. 3. On the basis of our experiences and those reported in the literature some proposals are presented to be considered when the bioavailability of phenytoin or of another drug with a narrow therapeutic range and a dose-dependent kinetics has to be changed.


Plasma propranolol concentrations and the erythrocyte sedimentation rate.

1. The plasma propranolol concentrations after a single oral dose of 40 mg were measured in 25 patients with rheumatoid arthritis and compared with those of 16 patients with Crohn's disease from a previous study. Thirteen healthy volunteers were used as controls. 2. In both diseases some high and some low values occurred. This scatter did not correlate with any symptoms or biochemical or haematological data other than with the erythrocyte sedimentation rate (ESR). 3. Both sets of patients were therefore separated into two groups depending on whether or not their ESRs were above or below 20 mm/l h. In both diseases the plasma propranolol concentrations of the patients with a raised ESR were significantly higher than the controls as well as those of the low ESR group. 4. In rheumatoid arthritis the plasma propranolol concentrations of the patients with a low ESR did not differ from those of the controls, but in Crohn's disease they remained significantly higher. 5. In one patient with Crohn's disease there was a dramatic rise in propranolol concentrations during an exacerbation (ESR 91 mm/l h) compared with those during a remission (ESR 20 mm/l h). 6. A difference in smoking habits did not seem to have been responsible for the difference in plasma propranolol concentrations.


Comparison of medigoxin and digoxin in the control of atrial fibrillation.

1 Medigoxin (Lanitop) 300 microgram/day and digoxin (Lanoxin) 500 microgram/day were compared in cross-over studies on healthy volunteers and on patients with uncontrolled atrial fibrillation. Serum glycoside concentrations were measured by radioimmunoassay and ventricular rates by ECG. The two regimens appeared to be therapeutically equivalent. 2 The mean serum glycoside concentration in the steady state and the rate at which this state was attained were similar with both drug regimens in the healthy volunteer group. The between-subject variation in serum glycoside concentration was not significantly less during medigoxin administration. 3 The renal clearance of serum glycoside was much lower during medigoxin administration both in healthy volunteers and in patients. This was not due to a difference in serum protein binding. The relatively small dosage requirement for medigoxin was attributed partly to a lower clearance rate and partly to more nearly complete absorption. 4 During the first 2 weeks of the patient study there was a substantial rise in mean serum glycoside concentration and a corresponding fall in ventricular rate. This was attributed to more consistent self-administration of digoxin. The subsequent change to medigoxin had no further effect on mean glycoside concentration, ventricular rate or frequency of ventricular ectopic beats. 5. An attempt to compare the onset of the ventricular rate response to a single oral dose of medigoxin with that to digoxin gave inconclusive results.


Glycolytic type I white muscle fibres lack butyrylcholinesterase activity at acetylcholinergic end plates.

Type I white fibres constitute the pale band of the pigeon serratus metapatagialis (SMP) muscle. The histochemical activity of succinate dehydrogenase (SDH), lactate dehydrogenase (LDH), acetylcholinesterase (AChE) and butyryl cholinesterase (BuChE) was studied in these unique muscle fibres. The muscle fibres possess low SDH but reciprocally high LDH activity. These tonic glycolytic fibres displayed high AChE activity at the myoneural junctions, but the latter lacked BuChE activity. Both AChE and BuChE activities were, however, present at the neuromuscular junctions of the twitch muscle fibres of the SMP muscle. Since BuChE is a precursor in AChE synthesis, the slow-tonic muscle fibres probably depend solely on the AChE transported axonally.


Light and electron microscopic investigation of in vitro starch synthesis in chromoplasts.

Chromoplasts having a globular inner structure in the petals of Forsythia suspensa can form starch grains in their stroma when incubated with glucose solution. The same result was obtained with chromoplasts, similar in structure, from Laburnum anagyroides and Ranunculus acer. Fibrillar chromoplasts in tepals of Lilium croceum are able to synthesize starch in vitro, not, however, from glucose but from glucose-1-phosphate. This starch differs from the above mentioned both in respect of electron microscopic structure and digestibility with alpha-amylase, a feature presumably caused by the relatively high activity of the branching (Q) enzyme. The substrate specificity of Lilium-starch synthesis can be explained by blocking of the phosphorylation of glucose in the cytoplasm, rather than by the selective permeability of the plasmalemma.


Comparative levels of lysozyme activity in larvae and pupae of Galleria mellonella after particulate and soluble materials injection.

Using an assay system for lysozyme activity determination in which haemolymph was compared in activity to known standards, the quantitative shifts in the lysozyme activity level of larvae and pupae of Galleria mellonella, after particulate and soluble materials injection, were compared. The level of this activity in all injected larvae was higher fro that of pupae, but the immune response of pupae was more effective in all treatments when compared with activity in the non-injected controls. Furthermore, there was a significant higher level of lysozyme activity in pupae subjected to mechanical immunizing agents, except inversed pupae in  which alternation in activity was not significantly different from activity in the corresponding nonexposed insects. Although the exact role of lysozyme in insect immunity is still uncertain, it is possible that this lysosomal enzyme may degrade the cell wall of susceptible parasites prior to being phagocytosed, and thereby act as a nonspecific inducible humoral defence molecule.


Comparison of steady state phenytoin metabolism in alcoholic immediately after drinking ceases and three weeks later.

Chronic use of alcoholic beverages as found in American alcoholics changes the rate of phenytoin metabolism but the prevalence of this change is not known because too few patients have been studied and no observations exist on its persistence after drinking ceases. This study reports observations in four alcoholic patients.


Effects of cortical, hypothalamic, and hippocampal lesions on chronic alcohol intake and preference in rats.

The effects of cortical, hippocampal, and suprachiasmatic (hypothalamic) lesions on forced alcohol consumption, alcohol preference and the distribution of alcohol intake throughout the day were examined in rats. Controls included by hypothalamic sham-operated and unoperated groups. Baseline water intake during light and dark and initial alcohol preference (10% alcohol versus water) were determined. All animals then were placed on a forced alcohol consumption regimen consisting of ad lib lab-chow and 10% ethanol in water. On the sixth day of each week during the alcoholization regimen, light and dark phase alcohol intake was assessed and on the seventh day of each week, a 24-hr, two-bottle alcohol preference test (10% ethanol) was given. After nine weeks on the forced alcohol regimen, all animals were given a seven day "withdrawal" period consisting of access to plain water and to 10% alcohol in water. Throughout both the forced alcoholization and withdrawal periods, the lesioned groups, especially the cortically lesioned group, displayed a significantly greater preference for the 10% alcohol solution than any of the control groups. Control and lesion groups did not differ significantly in their preference for a 5% alcohol solution or for a quinine solution, suggesting that simple taste threshold changes probably would not account for these data. The results are discussed in terms of the possibility that the brain lesions may have rendered the animals more sensitive to the "addictive" and/or reinforcing properties of ethanol.


Diagnosis of alcoholism: the Munich Alcoholism Test (MALT).

The purpose of our project was to develop and empirically test a diagnostic instrument which would permit sufficiently reliable differentiation between alcoholics and healthy as well as sick persons and which would also be easy and economical to administer. For this purpose, roughly 250 diagnostically relevant items were selected from the extensive literature on alcoholism and, with a total of 1335 patients (661 of these were alcoholics), were evaluated in three separate phases for their ability to differentiate. The best items were selected on the basis of various statistical criteria and then cross-validated. The result is the Munich Alcoholism Test (MAT) which consists of two complementary parts: a 7-item physician's assessment part and a 24-item self-assessment part. In a cross-validation study on 675 unselected in- and outpatients a validity of r = 0.94 was obtained. The reliability of the self-assessment part was r = 0.84.


Rate of alcoholism diagnoses in community mental health centers: the effect of the presence of an alcoholism treatment program.

In this study, it was hypothesized that community mental health centers (CMHCs) with distinct alcoholism treatment programs (ATPs) would diagnose alcohol problems at a greater frequency than would centers without ATPs. It was also hypothesized that psychoses, personality disorders, and transient situational disturbances would be diagnosed more frequently in CMHCs without ATPs. Yearly diagnostic admission data from nine of Nebraska's CMHCs (four with ATPs, five without) were used. It was found that CMHCs with ATPs diagnosed significantly more alcohol problems than did CMHCs without ATPs (23.5% vs 4.2%). In addition, it was found that CMHCs with ATPs diagnosed significantly lower totals of transient situational disturbances than did CMHCs without ATPs. No differences were found between CMHCs on totals of other diagnostic categories. Practical implications and several alternative explanations for the findings are discussed.


Empirical correlates of self-report drinking measures.

Self-report questionnaires assessing various drinking behaviors and constructs were administered to subjects in two separate empirical studies of longitudinal drinking patterns. The results suggest that self-report measures of both specific and general drinking behavior accurately differentiate drinkers who vary in frequency and intensity of alcohol consumption.


Relationships of subclinical depression, psychopathy and hysteria to patterns of alcohol consumption and abuse in males and females.

Personality studies have consistently indicated a high prevalence of both psychopathy and depression among chronic alcoholics. This study examined the relationship of subclinical depression, psychopathy and hysteria (MMPI) to reported alcohol consumption and abuse (MAST scores) in a normal population of 18--21 year-olds. Both depression and psychopathy were positively related to frequency of consumption whereas hysteria was not. Separate analyses of the data were conducted by sex. Psychopathy and depression were positively related to consumption among males but not among females. Hysteria was positively related to consumption among females but not among males. Regarding abusive drinking, both depression and psychopathy were related to MAST scores among females whereas only psychopathy was among males. Hysteria was unrelated to MAST scores among both sexes. These results support the hypothesis that different psychological processes are involved in the drinking behavior of males and females. The results also underscore the importance of distinguishing simple consumption from abuse. Within the male and female groups, those personality variables related to consumption were not necessarily related to abuse and vice versa.


Muscle tension and experienced control: effects of alcohol intake vs biofeedback on alcoholics and non-alcoholics.

Tension reduction has often been implicated as a central cause of excessive alcohol consumption among alcoholics, based on the premise that drinking reduces tension and reinforces subsequent overconsumption. Also, cognitive and personality variables clearly mediate the effects of alcohol. Drinking may be a means of increasing the degree of control experienced over internal and external sources of tension. Integrated frontalis EMG levels for a group of 74 alcoholic patients were significantly greater than for 74 non-alcoholics. During a period of alcohol consumption, significant change scores were found between alcoholic (N = 18) and non-alcoholic (N = 18) groups for both EMG and experienced control (EC). Significant changes were found within both groups on EMG but only for the alcoholic group on EC. During a biofeedback period, there were significant differences between alcoholic (N = 12) and non-alcoholic (N = 12) groups on both baseline measures, EMG and EC. Increases in EC were significantly related to decreases in EMG in both groups.


Recovery of cognitive abilities in male alcoholics.

Recovery of cognitive functioning in male alcoholic patients during 3 months abstinence was assessed using a shortened version of the Wisconsin Card Sorting Test (WCST). Twenty-four alcoholic patients were tested after 2 to 3 weeks of sobriety and at 11 to 12 weeks post-drinking, while a second group of 24 alcoholic patients was tested only after 11 to 12 weeks of sobriety. A control group of 24 healthy males also received the WCST. After 3 weeks of sobriety, alcoholic patients completed significantly fewer categories and made more errors than control subjects. Alcoholic patients also made more perseverative response than did controls. At 12 weeks post-drinking, the performance of alcoholic subjects was intermediate to that of controls and to alcoholic patients tested following 3 weeks of abstinence and did not differ significantly from either group. The results suggest that following the acute withdrawal period alcoholic patients experience difficulties in conceptual abilities and in the capacity to shift cognitive sets when appropriate. After nearly 3 months of abstinence, partial but not complete recovery of these abilities is evident.


Splitting as a defense mechanism in children of alcoholic parents.

This paper is an attempt to identify an antecedent of overt symptomatology in children of alcoholic parents. Through art and verbal productions, within the context of a structured learning experience, primitive ego defenses and severely impaired object relations can be detected. The concept of splitting vs. repression in object relations theory and its implications for the future functioning of the child is discussed. Clinical material illustrating differences between the child who utilizes mature ego defenses and the child who resorts to splitting is presented.


Thought disorder in alcoholics.

Research on cognitive impairment in chronic alcoholics has generally focused on pathology associated with organic brain damage. On the other hand, deficits more typical of the functional psychoses have been less explored, due to the absence of appropriate tests. By using the Thought Disorder Rating Scale (TDRS) recently developed at our Center, however, we have tested chronic alcoholics for the presence of classical symptoms of thought disorder. This test is based on the assessment of the patient's verbal behavior by an experienced clinician. Twenty subjects free of psychosis, severe withdrawal symptoms, and medical illness were, after detoxification, administered a test battery which included the TDRS, the Bender-Gestalt Test, and the Zung Self-rating Depression Scale (SDS). Five scored pathologically for thought disorder and of them four had abnormal Benders; whereas only two of 15 of those without thought disorder had abnormal Benders (t = 2.84, p < .01). Although SDS scores for both groups were in the depressed range, there was no significant difference between SDS means for the two groups. TDRS scores for these alcoholics are compared with those for other diagnosed groups, and implications for future investigation are discussed.


Alcoholism-related content in the MMPI: item analysis of alcoholics vs. normal and general psychiatric populations.

An analysis of alcoholism-related content in the MMPI was undertaken using an alcoholic population, a psychiatric population and two normal populations. The alcoholic and psychiatric groups were drawn from facilities in the Minneapolis-St. Paul area, and the normal populations were the Hathaway Adult Group and the Mayo Clinic nonpsychiatric patient group. A derivation study and a cross-validation resulted in the identification of three item pools: 1) that discriminate alcoholics from both normals and psychiatric patients, 2) items that discriminate alcoholics from normals only, 3) items that discriminate alcoholics from psychiatric patients only. Only seven items discriminate both male and female alcoholics from both normals and psychiatric patients. These items have substantial face validity. As the core of alcoholism-related content in the MMPI, they can serve as a stem for the development of scales with more specialized purposes.


Continuities in the olfactory deficits of chronic alcoholics and alcoholics with the Korsakoff syndrome.

Olfactory dysfunction, a finding prevalent among alcoholic Korsakoff patients, was investigated in long-term alcoholics with Korsakoff's Syndrome. The results demonstrate that alcoholics are impaired on odor quality discrimination but performed normally on complex hue discriminations. These findings support the hypothesis that chronic alcoholics and alcoholic Korsakoff patients represent two points on a single continuum of cognitive deterioration associated with alcohol abuse.


Treatment outcome for alcoholics as a function of therapeutic effort.

The association between therapeutic effort measured in terms of reimbursements for services and several treatment outcome variables was examined. A sample of clients regarded as definitely alcoholic was grouped into five categories according to the amount of money reimbursed for treatment in a fee-for-service arrangement. A systematic positive relationship was found between the amount of treatment measured in dollars and therapeutic outcome measured by remission rate and income. The data suggest that there may be an optimal cutoff for resource investment, above which no further treatment gains are achieved. Such information can provide a basis for program management decisions and suggests important implications for assumptions regarding alcoholism.


A clinical-interactive approach to alcoholism treatment evaluation.

This presentation is concerned with a particular approach to empirical evaluation of psychologically-oriented alcoholism treatment which offers hope for results that are more relevant to clinical applications than has been the case with past empirical research. This particular approach has been termed, for want of a better term, a "clinical-interactive" one for two reasons. First, the psychological makeup of alcoholic patients and the experiential nature of the treatment process they undergo constitute much of the focus of investigation, providing more vivid conceptual bridges to clinical applications. Second, treatment is conceived of as a result of the interaction between the nature of the patient and the patient's experienced involvement in various aspects of the treatment process and openness to continued treatment involvement, rather than as categorically different formal treatment procedures. In what follows, the utility of this approach will be illustrated with respect to the sort of prediction models applicable to alcoholism treatment as explored in a pilot study.


Monitored Antabuse in the emergency room.

The Southern Tier Alcoholism Rehabilitation Service (STARS), a full-service treatment program, has for some time offered monitored antabuse to a few selected patients. This is given daily on an outpatient basis in the emergency room of the general hospital in which we are located. Over 100 patients have been served. This has been helpful for two kinds of patients: 1) those self-motivated voluntary patients making use of this on a short-term basis to extend structure, reassurance, support, and other rehabilitation services following a period of inpatient detoxification, or to get "realigned" following a brief slip, and 2) those poorly motivated patients using this on a long-term basis at the direction of the courts. About half of this latter group have been unsuccessful alumni of 30-day treatment programs outside the community. The program ensures a long-term (several months) period of sobriety in the patient's home setting, offering a chance to develop new life styles, support systems, and respect which can eventually become self-sustaining. It is unlikely that these changes would come about while the patient continued actively drinking. Specific procedures of administration, record keeping, confidentiality, and payment are discussed. The cost-effectiveness to motivated patients and cost-avoidance to taxpayers and third-party payers while providing effective therapy to long-term patients are significant advantages of the program.


The use of haloperidol to control agitation/violence during admission to an alcohol detoxification center.

In a consecutive 24 month experience at a medical, non-hospital, alcohol detoxification center operating under a Uniform Alcoholism Act, the R.N.'s option (in the standing orders) for use of haloperidol (5 mg I.M.) proved remarkably beneficial in the control of agitation combativeness, or violence exhibited on admission. There were 24 instances of use during 6,947 admissions and undesired side effects were rare even in patients receiving the drug on multiple admissions.


Screening for alcohol problems among the unemployed.

Of 2,996 welfare recipients applying for CETA benefits at the Milwaukee office of Jewish Vocational Service between 3/1/78-9/30/78, a 10% sample (N = 309) was screened for assessment of alcohol problems. After obtaining voluntary informed consent from participants (6% declined), trained interviewers individually administered a 16-item alcoholism At-Risk Questionnaire (ARQ) based on observations by NCA's Criteria Committee; a standard form of the 25-item Michigan Alcoholism Screening Test (MAST); and a 35-item interview structured around a selectively modified version of NCA's Criteria for the Diagnosis of Alcoholism (CRIT). Analyses of data suggested that our ARQ was of little value in discriminating between problem drinkers and other persons, although significantly correlated with MAST and CRIT scores. Using a conventional scoring of the MAST, 53.6% of the sample appeared to have significant alcohol problems, while our CRIT identified only 31.9% as problem drinkers. By combining the MAST + CRIT in a unique scoring system, a more conservative estimate of 36.57% problem drinkers, with an estimated error rate of 1.63% false negatives and 23.45% false positives, was determined. Further modification of MAST + CRIT scoring led to a revised estimate of 25.41% problem drinkers with estimated false-positive and false-negative rates of 7.55% and 6.5% respectively. Implications for research and plans for further modifications of screening procedures are discussed.


Social activity and drinking patterns.

This paper reports data on the relationship between social activity and daily alcohol consumption in a random sample of adults in metropolitan Boston. The findings indicate that the frequency of going to bars and attending parties was significantly related to daily alcohol consumption.


The effect of ethanol consumption on trace elements in the fetal rat.

It is postulated that in the fetus trace element alternations secondary to maternal alcohol ingestion contribute to fetal alcohol syndrome. Female Charles River CD rats were given a semi-synthetic diet through two pregnancies. Half of the animals received 6% ethanol (v/v) in their drinking water. The animals were divided into the following groups: Control group received the diet ad lib, alcohol group received the diet and alcohol ad lib, pair fed group received a diet isocaloric with the alcohol group, and the alcohol + ZnMg group received the basal diet with added magnesium, zinc and alcohol. On the twenty-first day of gestation animals were sacrificed and iron, copper, zinc and magnesium measured in maternal and fetal tissues by atomic absorption spectrophotometry. The results indicated significantly reduced fetal zinc in the alcohol group while copper and iron levels were increased. In maternal tissues, only the femur was affected. Zinc and magnesium were significantly reduced (p < 0.01) while iron was increased (p < 0.01). The observed effects were not due to reduced food intake. The expected changes in tissue zinc and magnesium were prevented by diets fortified with these minerals. These results are consistant with our hypothesis that alcohol interferes with trace element metabolism during pregnancy and that diet can be manipulated to alter its effects.


An examination of male and female alcoholics' perceptions of their present and ideal family environments.

The impact of alcoholism on family life is of major interest to the alcohol field. A comparison between male and female alcoholics' perceptions of their present and ideal family lives was conducted through use of a self-report questionnaire. The data revealed no difference between them regarding their perceptions of their present lives, but significant differences in their perceptions of the ideal family environment. The generic impact of alcoholism and the changing sex roles of men and women are given as possible explanations for these results.


Cirrhosis mortality among American Indian women: rates and ratios, 1975 and 1976.

National sex-specific cirrhosis mortality data for 1975 and 1976 are examined for American Indians, and comparisons are made with two other major racial groups. Females account for almost half of the total cirrhosis deaths among Indians, compared to about one-third of the deaths among each of the other two racial groups. The ratio of male to female death rate is about 2 to 1 for Whites and Blacks, and about 1 to 1 for American Indians. In 1975 one out of four deaths among Indian women of ages 35--44 was attributed to cirrhosis. The age-specific mortality rate for Indian women age 35--54 is about 103 per 100,000 in 1975 and about 128 per 100,000 in 1976, compared to about 37 per 100,000 for Black women and 15 per 100,000 for White women for these years. Rates for male Indians exceed those for female Indians and exceed those for White and Black males. Age-adjusted rates are also presented, and potential areas for future research are suggested.


Neuropsychological impairment in female alcoholics.

Cognitive performance of women alcoholics was assessed to determine whether level and pattern of impairment would be similar to that found in male alcoholics. Subjects were 25 female alcoholics enrolled in residential treatment and 25 female nonalcoholics equated on age, education and vocabulary. Both groups were screened for medical and drug problems before neuropsychological testing.


Psychosocial differences between male and female alcoholics.

This study was designed to further explore and compare psychological characteristics in male and female alcoholics at an inpatient treatment program of an urban general hospital. In addition to comparing male and female variables, the study also sets out to determine whether there is any correlation between depression and female alcoholics.


Maternal heavy drinking related to delayed onset of daughters menstruation.

Maternal drinking during pregnancy was related to filial age at menarche. Daughters showed a trend to late menarche if their mothers drank heavily during pregnancy.


Effect of ethanol on cholesteryl ester hydrolases in adrenal.

An assay of cholesteryl ester hydrolase activity of microsomes from guinea pig adrenal indicated maximal activity at pH at pH 4.0 and 5.5. When ethanol was added to the microsomes, these enzymes showed differences in response with increasing ethanol concentration. Rats administered 15% ethanol as drink for 4--5 months showed a small (20%) increase in cholesteryl ester hydrolase (pH 4.0) activity in adrenal as compared to controls. However, a 50% decrease in cholesteryl ester hydrolase activity resulted when rats were administered ethanol by intragastric tubing technique (15 days) as compared to controls treated similarly with saline. The decrease in cholesteryl ester hydrolase activity was correlated with an increase in cholesteryl ester level in serum. In a different study, rats intubated with an acute dose of ethanol showed an increase in adrenal cholesteryl ester hydrolase activity as early as 1 hr after administration. This effect seemed to last for about 24 hr before activity returned to control level. It is concluded that different modes of ethanol administration to rats may elicit a change in cholesteryl ester hydrolase activity in the adrenal. An increase in cholesteryl ester hydrolase activity may be related to an increase in steroidogenic activity and activation of adrenocortical function.


A comparison of the effects of ethanol and acetaldehyde on glucose production from various precursors by isolated rat liver cells.

A comparison of the actions of ethanol and acetaldehyde on glucose production from various precursors by isolated rate liver cells was made to evaluate the role of acetaldehyde in the effects of ethanol. Both ethanol and acetaldehyde stimulated glucose production from pyruvate, inhibited glucose production from glycerol, xylitol, and sorbitol, and both had no effect with fructose. Ethanol, but not acetaldehyde, inhibited glucose production from lactate, dihydroxyacetone and alanine. The inhibitory effects of ethanol and acetaldehyde were prevented by methylene blue, an aritificial electron acceptor. The similarities in the actions of ethanol and acetaldehyde on glucose production from some substrates, e.g. pyruvate, glycerol, xylitol and sorbitol suggest that the metabolism of acetaldehyde may contribute to the effects of ethanol on gluconeogenesis from these substrates. Differences in the actions of ethanol and acetaldehyde on glucose production from other substrates reflect the different compartments, cytosol for ethanol, mitochondrial for acetaldehyde, in which these compounds are metabolized in the liver.


Acute metabolic interaction of ethanol and drugs.

Addition of ethanol in vitro was found to inhibit the microsomal metabolism of a variety of drugs such as meprobamate, aminopyrine, pentobarbital and zoxazolamine. In all cases, a mixed type of inhibition was obtained. When the concentration of alcohols of different chain lengths required to inhibit 50% of the metabolism of drugs was plotted against their corresponding octanol-water partition coefficients (Po/w) it was found that the inhibitory potency of alcohols is linearly related to the partition coefficients, with a slope of 0.98. In vivo acute administration of ethanol also resulted in decreased whole body metabolism of meprobamate, aminopyrine, pentobarbital, zoxazolamine and aniline. In vitro addition of pentobarbital, phenobarbital and meprobamate had no significant effect on ethanol metabolism by liver slices. Acute pretreatment with these drugs also had no effect on the rate of ethanol metabolism in vivo as measured in the whole body or as estimated from the rate of decrease of blood ethanol concentration. It appears therefore that acute metabolic interaction of ethanol and drugs is a one sided phenomenon, i.e. ethanol inhibits drug metabolism, whereas drugs do not inhibit ethanol metabolism. Ethanol inhibition of drug metabolism in vitro appears to result from a modification of the lipophilic milieu that surrounds the cytochrome P-450 in the microsomal membrane. Interference with the hydrophobic sites may either directly or indirectly affect the catalytic activities of the microsomal enzyme.


Transport of small bowel contents after interposition of an antiperistaltic jejunal segment in the rat.

The effect of antiperistaltic jejunal segments on small bowel transport was studied with an experimental technique permitting quantitative studies of propulsive as well as non-propulsive intestinal motility. 79 rats were provided with a permanent duodenal catheter and at the same laparotomy an anti- or isoperistaltic bowel segment based on 1, 2 or 3 mesenteric end-arcades was inserted at the midpoint of the jejunum. The evaluation of intestinal motility 1 week later indicated that an antiperistaltic segment of the rat jejunum has to be made at least 6 cm long, i.e. based on 3 mesenteric end-arcades in order to retard the propulsion of luminal contents. Not even this relatively long antiperistaltic segment was found to influence propulsion through bowel segments proximal to it, and distally the propagation velocity was accelerated. This implied that the total small bowel transit was unaffected. The non-propulsive intestinal motility, i.e. the mixing of small bowel contents was increased by the long reversed loop. The possible beneficial effect of antiperistaltic jejunal segments in short bowel syndrome and post-vagotomy diarrhoea in man may thus be attributed not to a retardation of the propulsive intestinal motility but to an increase in the non-propulsive intestinal motility.


Effects of bile acids on mucus secretion in the dog colon.

The effects of unconjugated bile acids on colonic mucus production have been studied in the dog. Isolated segments of both ascending and descending colon were simultaneously perfused with either chenodeoxycholic, deoxycholic or cholic acid and the mucus production estimated from the total hexose output. Each bile acid produced a significant increase in mucus output in both the right and left colonic segments. There were no differences between the right and left colon in terms of mucus output for any of the bile acids studied. Deoxycholic had a greater effect than chenodeoxycholic which had a greater effect than cholic acid in colonic mucus production. Further, these effects on mucus secretion were completely reversible. In diarrhoea associated with disease or resection of the ileum, the effect of bile acids on mucus secretion may be as important as their effects on the inhibition of water and electrolyte absorption.


Evaluation of the microsphere method for determination of cardiac output and flow distribution in the rat.

The radioactive microsphere technique was applied to determine simultaneous cardiac output and flow distribution in the rat. Left ventricular injections of large numbers of microspheres were given, without significant adverse effects, allowing determination of flow to organs and tissues with low perfusion rates. In order to determine coronary blood flow it was necessary to excise the inner lining of the left ventricle, thus eliminating activity from deposits of microspheres. Cardiac output determination showed less variation with the sampling catheter in the abdominal aorta than in the femoral artery. It is concluded that the microsphere method can be conveniently used for hemodynamic studies in the rat, and that the abdominal aorta is the preferred site for the placement of the reference catheter in the rat.


Early identification of hearing impaired infants: Public Law 94-142 falls short.

Public Law (P.L.) 94-142, although greatly increasing the physician's role in delivery of services to handicapped children, falls short in meeting the needs of hearing impaired children from birth to 36 months in that it does not mandate referral services until age three years. The literature has shown that both conductive and sensorineural hearing losses cause delay in the development of normal speech and language. Further, those children identified and treated earlier demonstrate higher skill levels on speech and language tasks than those children identified late. The High Risk Register for hearing loss has been found a reliable means to identify such children. Given that the most critical period for learning language is from birth to three years and that at least two objective and reliable procedures for evaluating the hearing of infants and pre-school children, Impedance Audiometry and Brainstem Evoked Response Audiometry, are becoming more readily available in the United States, it is no longer acceptable to support the "wait and see" approach in referring suspected hearing impaired children for auditory, speech, and language diagnostics and habilitative intervention.


Autosomal recessive non-syndromal progressive sensorineural deafness in childhood. A separate clinical and genetic entity.

In a family with 11 children, three sibs (two boys and a girl) show progressive sensorineural deafness, first noticed at ages 4, 7 and 11, respectively. The progression of deafness was registered in each of these sibs over a period ranging from 9 to 15 years. The speech perception has simultaneously diminished, as observed also in the case of recruitment. The parents and the other sibs in this family have normal hearing. The parents were demonstrably consanguineous, and autosomal recessive transmission is therefore postulated. A syndromal diagnosis could not be established because general physical, neurological ophthalmological and haematological examination as well as urinalysis revealed no associated characteristics. A syphilitic infection was therefore also excluded as a possible cause. Pendred's syndrome was excluded by means of a potassium perchlorate test. It is believed that these three sibs are suffering from autosomal recessive non-syndromal progressive sensorineural deafness - a type of deafness hardly mentioned in the literature. Several authors differentiate this type of deafness from autosomal recessive early-onset neural deafness.


The occurrence of negative middle ear pressure in children: an analysis of supposed associated factors.

This study analyzed the occurrence of negative middle ear pressure in various groups of children by comparing them with control groups. A screening procedure recording middle ear pressure and screening audiogram was performed several times throughout the year in an unselected group of 352 seven-year-old children. From about 4000 measurements of middle ear pressure an average value for each child was calculated. By applying thresholds of pathology of -160 mm H2( and -240 mm H2O, the occurrence of pathology in the different groups was analyzed. A medical history of each child was obtained by questionnaires answered by parents, giving information concerning allergy, previous adenoidectomy, previous exposure to respiratory tract infections and the social group of the family. A score of dental caries was obtained in each child. Furthermore, the relationship to antibiotic treatment and the child's use of swimming pools was analyzed, based on single measurements. The use of swimming pools seems to be beneficial to children suffering from a negative middle ear pressure. However, the other variables showed no relationship to negative middle ear pressure. It is concluded that other unknown factors must be involved in the development of negative middle ear pressure and chronic OME in children.


Infiltration of the tensor tympani and stapedius muscles in otitis media. An experimental study in the cat.

A longitudinal sequential study of otitis media was done in an experimental animal (cat) using eustachian tube obstruction. Fifty animals were used. Cellular infiltration of the tensor tympani and stapedius muscles was studied in a continuum from day 1 to 6 months after inducing otitis media. We observed that there is infiltration of the connective tissue of both muscles in otitis media, and that the cellular changes follow the same pattern as that seen in the mucoperiostium and the round window of the middle ear, although to a lesser degree. In this first report of sequential changes in middle ear muscles in otitis media, clinical implications of these findings are discussed.


Restricted nasal respiration, influence on facial growth.

Used as models on restricted nasal respiration, 11 individuals with a unilateral inborn occlusion of the nose were examined with regard to growth of the mid-facial skeleton. The preference to oral breathing, also a fairly constant feature in patients with chronic or allergic rhinitis with hyperplasia of the pharynx tonsil, appeared to result in a significant underdevelopment of the maxilla in the saggittal plane.


Auditory brain stem responses of kernicterus infants.

Auditory brainstem evoked responses (ABRs) and behavioral audiometry in 25 infants with kernicterus were studied to determine the level of the lesion causing their hearing disorders. ABR thresholds, peak latencies of wave I and V, and interwave latency of wave V-I were measured; behavioral audiometric thresholds were determined through conditioned orientation reflex audiometry (COR). Eighty-eight per cent of infants with kernicterus who showed ABR threshold elevation with respect to age-matched normals, were found to show ABR abnormalities associated with peripheral hearing loss, and 84% of these were found to have COR threshold elevation. The ABR abnormalities were threshold elevation of wave V, prolonged latency of wave I and V, and the absence of ABRs. However, no brainstem lesion pattern was found in our cases. Our results suggested that at least some lesions which produce hearing disorders in kernicterus occur in the cochlea or auditory nerve.


Cross-peptide bond 13C--15N coupling constants by 13C and J cross-polarization 15N NMR.

Comparative 13C--15N coupling constants are reported for the linear dipeptide tBoc-L-[U-13C]Ala-[15N]GlyOMe and the corresponding cyclic diketopiperazine, both in dimethylsulfoxide (DMSO) and, upon removal of the tBoc group, in water solutions. Spectra were obtained by 13C NMR and by the first application of J cross-polarization (JCP) 15N NMR, which greatly reduces the time required to accumulate 15N NMR spectra. In DMSO there was evidence for the formation of complexed species which were not present in water. The values obtained for the cross-peptide bond coupling constant 2J13C alpha--15N were consistently less (by 2.2 Hz in DMSO, 4.3 Hz in water) for the cyclic than for the linear peptide, which may be related to the cross-peptide bond conformation. The 15N resonance for the cyclic peptide was shifted only 2 ppm downfield from the linear peptide chemical shift value in both solvents.


A three-step method for isolating a few to several hundred milligrams of protein.

An operationally simple general protein isolation method was devised from three previously available separation tools, and was tested by application to two demanding fractionation problems and for yield. One test system was the isolation by gel electrofocusing of two model proteins with pI values of 4.6 and 4.8, bovine serum albumin and ovalbumin, with a load of 220 mg each. The other test was the isolation of 10 mg of human growth hormone isohormone B from a mixture of closely migrating other isohormones. The three-step procedure comprises of: (1) separation into zones of homogeneous protein by gel electrofocusing; (2) excision of the zones of homogeneous protein from the gel followed by concentration of the protein to a small volume of solution by means of Steady-State Stacking; (3) purification from polyacrylamide-like contaminants and non-volatile buffers by gel filtration followed by lyophilization. The average overall recovery was 70--80%.


Reaction electrophoresis.

The differential mobilities of compounds in an electric field are important analytical criteria and we can use them to bring electrophoretically pure components of a mixture medium on which they are separated. To this end, the compound undergoing reaction are brought into positions on the carrier to assure optimal contact between selected fractions, within a predetermined domain of time and distance. The appearance of a product defines their reactivities, and the product's continued migration on the same carrier can provide the first key to its identity as is demonstrated and discussed. The method is called reaction electrophoresis and it will be of particular use in studies with labile components. It is illustrated here with the coupling reaction of the sodium salt of 1,4-naphthol sulfonic acid and tetrazotized o-dianisidine.


Use of automated chromatography on the amino acid analyzer with lithium citrate buffers to separate nucleic acid bases, nucleosides, nucleotides and their precursors.

A simple and sensitive method has been developed to separate nucleic acid bases, nucleosides, nucleotides and their precursors by automated chromatography using the amino acid analyzer with lithium citrate buffers. The method is sensitive to a concentration of 5 nmol, linear in the range of 5--100 nmol, and resolves almost all the bases, nucleosides, nucleotides and their precursors of physiologic importance.


Resolution of D- and L-galactose peracetates as their bis(ethyl L-lactate) acetals by gas-liquid chromatography.

Reaction between ethyl L-lactate and each of a pair of sugar enantiomers, the peracetylated D-galactose and L-galactose diethyldithioacetals, produced two acyclic diasterioisomers. They could be separated by conventional gas-liquid chromatography. The corresponding fucose diastereomers were also separated. This process should make it possible to develop a general analytical method by which small amounts of enantiomeric sugars can be identified and their quantities measured.


A new technique for desorbing substances tightly bound to affinity gels: flat-bed electrophoretic desorption in Sephadex via isoelectric focusing (FEDS-IEF).

In some cases, proteins and other molecules which are tightly bound to affinity gels can be recovered under mild conditions by electrophoresis. We have extended this technique by running electrophoretic desorption in flat-beds of Sephadex in the presence of ampholytes (FEDS-IEF). A number of advantages of this technique are noted: due to the geometry of the apparatus, high voltages can be used which result in short running times; there are no physical barriers to the migration of the protein and no abrupt conductivity drops; desorbed samples are easily located and recovered; and relatively large sample loads can be readily accommodated. Running times are very sensitive to the experimental conditions. Affinity gels should be applied as a narrow zone, distant from the anticipated banding position of the desorbed species. A wide ampholyte interval is generally recommended. The system appears to be gentle and flexible enough to allow investigators to optimize the conditions for desorption of various affinity gel systems.


Improved separation of modified nucleosides from tRNA hydrolysates: the patterns of tRNA methylation in rat tissues.

A sensitive and reproducible method for the isolation of minor nucleosides derived from tRNA is described. The nucleosides obtained from enzymatic digestion of tRNA are separated into several groups using a QAE Sephadex column and increasing concentrations of boric acid in a step-wise manner. The nucleosides in each group are separated by isocratic elution from a preparative Partisil 10-SCX column and high-performance liquid chromatography at ambient temperature. With this method we have determined the patterns of tRNA methylation in vitro with extracts from rat bone, liver, kidney and adrenal glands. Although different tissues appear to contain the same tRNA methyltransferases, the patterns of methylated nucleosides are different.


Direct analysis of continuous relaxation spectra.

The dynamic response of a complex biological or chemical system to a perturbation must often be described by an integral over an effectively continuous relaxation spectrum. Because of its well known instability to experimental error, the direct estimation of the spectrum is generally considered unfeasible. However, we show that good estimates can be obtained by constraining the spectrum to be the smoothest one that is consistent with the data. Also constraining the spectrum to be non-negative, if there is a priori knowledge of this, can further increase its accuracy. The method is completely automatic in that no initial estimates or assumptions about the functional form of the spectrum are necessary. Therefore models can be tested more rigorously and objectively since the functional form that they predict for the spectrum need not be assumed at the outset of the analysis as with parameter-fitting procedures. The method is illustrated on simulated data on the photodissociation of CO from heme proteins at low temperatures. The nonuniqueness of the solutions is discussed.


A new spectrophotometric cuvette holder for low temperature studies; its application to the study of carbonmonoxyhemoglobin oxidation rate.

A new spectrophotometric cuvette holder to be used for subzero temperature is described. The device is easily adaptable to a commercial spectrophotometer and it was checked down to --40 degrees C. Satisfactory mixing of the reactants contained in the cuvette at low temperatures is attained using a special stirrer and suitable solution volumes. The rate of carbonmonoxyhemoglobin oxidation by K3Fe(CN)6 at different subzero temperatures has been studied using this apparatus; the results are in agreement with the extrapolated data at room temperature.


A simple method for elimination of RNAase contamination from DNAase preparations.

RNAase which usually contaminates commercial pancreatic DNAase preparations can be removed by affinity chromatography on agarose-coupled anti-RNAase antibodies. RNA treated with purified DNAase can be re-isolated intact, as determined by polyacrylamide gel electrophoresis under denaturing conditions. This method might be applicable to purification of other preparations which are used in RNA research, such as PNPase (polynucleotide phosphorylase) and specific antibodies for polysome immunoprecipitation. The non-specific binding of DNAase in our system is less than 5% and the loss of specific activity of DNAase I is less than 1%.


A rapid method for the separation of large and small thymocytes from rats and mice.

Thymocytes from rats and mice have been separated into large and small cell populations in high yield and purity by isopycnic centrifugation in a discontinuous (three-layered) gradient of Percoll. Cells are mixed with the middle layer and during low-speed centrifugation the small, denser cells sediment to the bottom interface whilst the large, less dense cells float to the top interface. Red blood cells, and small debris particles separate into the bottom and top layers respectively. Studies on the uptake of [3H]TdR show that the small cells are non-dividing while more than half of the large cells are capable of division.


Iontophoretic application of idoxuridine for recurrent herpes labialis: report of preliminary clinical trials.

In clinical trials on six patients the antiviral drug idoxuridine (Stoxil) was applied by anodal (+) iontophoresis to 14 recurrent herpes labialis lesions. Results were characterized by immediate relief of discomfort and swelling, rapid appearance and coalescence of vesicles, minimal or no spread of the lesions, and accelerated healing with minimal or no scab. These encouraging trials indicate that a full-scale, double-blind, controlled clinical study should be carried out to determine whether iontophoresis is the optimal method of applying idoxuridine to the surface lesions caused by herpesvirus.


The placebo and its role in clinical pharmacology.

This paper reviews literature concerning the placebo with respect to its true meaning, and possible modes of action. It also considers the type of person most likely to respond to the placebo effect. These factors are then discussed with a particular emphasis being put on the significance of the placebo in clinical pharmacological studies.


Simultaneous investigation of the cerebral circulation and cortical bioelectrical activity in dogs under the influence of piracetam.

By means of the methods of local cerebral rheoencephalography (REG) and electroencephalography (EEG) the effect of piracetam (1-acetamide-2-pyrrolidone, Pyramem) on cerebral circulation and brain bioelectrical activity was studied in acute experiments on dogs. The following REG parameters were assayed: anacrotic section of the curve and its relative part, amplitude and dicrotic index. The influence of the preparation on the spontaneous EEG was studied by means of surface electrodes, pH, pO2, and pCO2 were determined in blood samples from femoral artery and superior sagittal sinus and arterio-venous differences of O2 (AVD-O2) and CO2 (AVD-CO2) were calculated. The arterial pressure and ECG were followed continuously. The results showed that after piracetam administration (100 mg/kg i.v.) an improvement of the REG parameters is observed: increase of the amplitude and decrease of the values of the relative part and dicrotic index. The changes observed indicated cerebro-vascular resistance decrease and increase of the cerebral blood volume. The AVD-O2 increased and the negative AVD-CO2 decreased. The EEG data indicated an improvement in the functional state of the brain cortex. Suggestions as to mechanism of piracetam effect and the usefulness of the methods were made.


Simultaneous spectrophotometric determination of oxidized and reduced glutathione in human and rabbit red cells.

An improved spectrophotometric procedure for oxidized and reduced glutathione determination in erythrocytes is described. The method is based upon a reaction using Ellman's reagent. It gave recoveries of 99 and 90% for both GSH and GSSG. The use of oxidized glutathione as an internal standard makes it accurate for simultaneous assay. The method offers the advantage of not having to use alkylation products to prevent oxidation of GSH during protein precipitation. Data are presented to demonstrate reliability and simplicity of rapid estimation of GSH and GSSG.


In vitro activity of netilmicin and cefotaxime compared to that of other aminoglycosides.

In vitro activity of netilmicin, cefotaxime, amikacin, dibekacin, gentamicin and tobramicin was compared against clinical isolates in Antibiotic Medium 3 at pH 7.1 and human plasma water at pH 7.8. Except against Pseudomonas aeruginosa the aminoglycosides were generally more active in plasma water than in broth. Against P. aeruginosa higher concentrations were required to inhibit or kill the strain in the plasma water. Cefotaxime was not tested against these organisms. Against E. coli, K. pneumoniae and Proteus species cefotaxime was found to be more active than the aminoglucosides, both in broth and plasma water. Its activity against Staph. aureus was markedly less than that of the aminoglycosides. Tobramicin showed a higher activity in plasma water only against Proteus species.


Influence of hepatic insufficiency in pharmacokinetics of drugs: example for an anthranilic diuretic.

Hepatic insufficiency is responsible for numerous modifications of drug metabolism and pharmacokinetics, because the liver is the most important organ for the transformation and, with the kidney, elimination of drugs. Pharmacokinetics of furosemide, an anthranilic diuretic, was compared in normal subjects and cirrhotics with hepatic insufficiency, after oral administration. In patients, we observed few modifications of the bioavailability. The total elimination of the drug was normal when the urinary excretion compensated a slight reduction in biliary secretion, but when this reduction was important the total clearance of furosemide decreased. In urine, the elimination time was lengthened, but the percentage of excretion was about the same as for normal subjects. The pharmacological effects were also modified for cirrhotics with decrease of sodium and water excretion, for the same blood concentration of drug as in controls. Also, we observed a shift between the salidiuretic effect and the blood concentration in patients, when there was an exact concordance of these times in control subjects. Two hypotheses have been proposed to explain this phenomenon: (1) modifications in hepatic metabolism or, (2) in drug protein binding.


Pc 1 Duarte, a common polymorphism of a human brain protein, and its relationship to depressive disease and multiple sclerosis.

Pc 1 Duarte, a common variant of a human brain-specific protein, is present in one-third of the control population and has a gene frequency of 0.17. There was a significantly increased frequency of mutant heterozygotes and homozygotes among individuals with depressive disease. This is consistent with a model in which Pc 1 Duarte is the major gene in depressive disease, acting in conjunction with an environmental threshold effect.


Morphology and intracortical projections of functionally characterised neurones in the cat visual cortex.

The neuronal structure and connectivity underlying receptive field organisation of cells in the cat visual cortex have been investigated. Intracellular recordings were made using a micropipette filled with a histochemical marker, which was injected into the cells after their receptive fields had been characterised. This allowed visualisation of the dendritic and axonal arborisations of functionally identified neurones.


Ocular findings in Bell's palsy.

Thirty-three patients with Bell's palsy underwent ophthalmic examination, including Schirmer testing, corneal sensitivity measurement, and electromyography. Sixteen patients returned for follow-up after one year. Sixty-one percent of the patients initially showed punctate fluorescein staining of the inferior cornea. Electromyographic studies demonstrate a high correlation between orbicularis function and the presence of corneal epithelial staining. Our results demonstrate a high frequency of minor corneal involvement in the acute phase of Bell's palsy. Healing of the epithelial defects follows improvement in orbicularis function.


Chalcosis: a study of natural history.

Ten patients harboring a small, intra-vitreal, copper foreign body in one eye for 4 months to 29 years have been studied clinically and electrophysiologically. Nine of the ten affected eyes had a visual acuity of 20/60 or better. Some asymmetry existed in the electrophysiologic responses of seven affected eyes as compared to the controls, but all of these responses were within the normal range. The electroretinogram was reduced in one eye but was consistent with vitreous opacification. Vitreous opacification and copper deposition in the macula were potentially serious sequelae observed in four eyes. Small, intraocular copper foreign bodies can be tolerated for long periods of time without retinal toxicity, but vitreous changes of maculopathy may necessitate intervention.


Incidence of fluorescein angiographic subclinical macular edema following phacoemulsification of senile cataracts.

Fluorescein angiograms were performed in 90 patients the first and sixth week after removal of non-traumatic cataracts by phacoemulsification. The incidence of macular edema was found to be one half that reported in the literature for a comparable group of patients following intracapsular cataract extraction. The difference in incidence of macular edema between the phacoemulsification and the intracapsular groups seems dependent on the presence of the posterior capsule and perhaps the small size of the phacoincision. One of 21 maculas with angiographic evidence of edema developed clinical cystoid macular edema.


Phacoemulsification and the retina: cystoid macular edema.

An on-going study of results and complications in a series of 1055 cataract extractions, done by Kelman phacoemulsification with up to five and one-half years' follow-up, showed that the incidence of cystoid macular edema (CME) is significantly less when the posterior capsule is left intact. This applied to capsulotomy at the time of surgery or elective discission later, with or without vitreous disturbance. CME was suspected clinically and confirmed or denied, in most cases, by fluorescein angiography.


Five years' follow-up in the surgical management of cataracts in high myopia treated with the Kelman phacoemulsification technique.

With the advent of phacoemulsification, much interest has again been rekindled in extracapsular cataract surgery and its effects on the vitreoretinopathies associated in high myopia. Since 1972, 278 patients with high myopia greater than --7.50 D, as as determined by axial length echography, have been operated on by the author. The five-year follow-up with statistical analysis of these cases is presented. Comments as to the merits of extracapsular versus intracapsular surgery in high myopia will be set forth.


Why use the operating microscope in orbital surgery?

We think the use of the operating microscope in deep orbital surgery is essential for a safer and more accurate removal of the tumors that occupy this difficult surgical location.


An adapter to aid in slit-lamp biomicroscopy of the supine patient.

Slit-lamp biomicroscopy of the supine patient can be achieved with the use of the Zeiss 100/16 slit lamp and an adapter to hang it from the microscope stand. Coaxial, collimated illumination can be used for fundus biomicroscopy with the method described.


Comparison of the bronchodilating action and of the tolerance of fenoterol and isoproterenol aerosols.

Fenoterol aerosol (400 micrograms) and isoproterenol aerosol (200 micrograms) were compared in a double blind cross-over trial in 59 patients with reversible broncho-obstruction. Measurements of VC, FEV1, respiratory impedance (ZR), blood pressure and pulse rate as records of subjective symptoms, râles and side effects, were made over a period of 180 minutes. After fenoterol FEV1 increased significantly from the 15th minute till the first hour. After isoproterenol an increase of this parameter was obtained only at the 15th minute. The decrease in ZR was always larger with fenoterol than with isoproterenol. This difference was significant at the 2nd hour (P < .05) and at the 3rd hour (P < .01). In a group with severe obstruction the airway obstruction improved more with fenoterol than with isoproterenol (P < .01). The functional improvement induced by 400 micrograms fenoterol appeared to be more potent and of longer duration than the improvement caused by 200 micrograms isoproterenol. Moreover it appeared more rapidly after administration.