Epidemics of haemorrhagic cystitis due to influenza A virus.

The present communication describes studies on thirty-three patients with haemorrhagic cystitis. The current epidemic variant of influenza type A virus, A/Tehran/5/75 (H3N2) [antigenically similar to A/Port Chalmers/1/73 (H3N2)], was recovered from the throats of eighteen and the urine of three patients. HI antibody rises to A/Tehran/5/75 virus were detected in over 50% of the cystitis patients tested.


Accidental ingestion of poisons and child personality.

The personality of 105 children under 5 years of age admitted to Cardiff Hospital was compared with 105 control children by means of a semantic differential test. Poisoning-children were significantly more anxious (P less than 0-008), harder (P less than 0-01), and more active (P less than 0-04) than controls. They also caused more worry (P less than 0-04) and put other than food more ofter in their mouths (P less than 0-002). There were no significant differences in the age of walking, and the ages of becoming clean and dry between cases and controls. However, poisoning-children had significantly more accidents and hospital admissions than did controls. The relevance of these findings, particularly in relation to the important role of family stress, to the aetiology of accidental poisoning in childhood is discussed.


Epistaxis and hypertension.

The status of nose bleeding as a symptom of high blood pressure has been studied in patients admitted because of epistaxis. Twenty-six patients with a factor predisposing to nasal bleeding had age- and sex-adjusted systolic and diastolic scores similar to those of the general population. One hundred and sixty-eight patients with no such factor formed a different population with significantly higher age- and sex-adjusted systolic and diastolic scores. It is concluded that epistaxis is a true symptom of hypertension.


Treatment of acute hepatic encephalopathy with L-dopa.

A clinical report of a 30-year-old woman who developed acute hepatic failure in the fifth month of pregnancy is presented. L-dopa administration resulted in a marked improvement in both level of consciousness and electroencephalogram. The literature dealing with L-dopa therapy in hepatic encephalopathy is reviewed.


Cardiac tamponade and acute renal failure following Salmonella agona pericarditis.

A 19-year-old female presented with cardiac tamponade complicated by acute renal failure. Salmonella agona was cultured from pericardial aspirate after repeated pericardiocentesis in several sites. Treatment with ampicillin and intermittent haemodialysis led to complete recovery.


Carcinoid tumour of the cervix.

A case of non-metastatic carcinoid tumour of the cervix is described from a patient without the carcinoid syndrome. The rarity of carcinoid tumour involving gynaecological structures other than the ovaries is discussed and a bried review of carcinoid disease presented.


Inappropriate anti-diuretic hormone (ADH) secretion in association with carcinoma of the bladder.

A case of carcinoma of the bladder complicated by the syndrome of inappropriate anti-diuretic hormone secretion is reported. Management of the syndrome is discussed.


Non-African Burkitt lymphoma presenting as dysphagia.

Cases of non-African Burkitt lymphoma are rare, but the clinical manifestations of this and the African type are similar. The authors believe that this patient is the first described presenting with dysphagia without intrinsic gastrointestinal disease.


Chlorpromazine-induced haemolytic anaemia in anorexia nervosa.

Two patients with anorexia nervosa who developed progressive haemolytic anaemia during chlorpromazine therapy are presented. In each case, withdrawal of the drug alone led to a prompt haematological response. Drug-induced oxidant damage is proposed as being the underlying haemolytic mechanism.


Fatal digoxin overdose.

Overdosage with cardiac glycosides is well documented, but not usually fatal. A case is described in which cardiac arrest in asystole was associated with a serum digoxin level of 50-4 microgram/1, the highest concentration yet reported after oral administration.


Leiomyosarcomatosis of probable uterine origin with long survival--a case report.

A case of leiomyosarcomatosis is presented. Over a period of 15 years the patient underwent seven operations to remove eleven tumours, the largest as big as a football, before dying of widespread metastases: between operations the patient was remarkably well. The disease was almost certainly of uterine origin from apparently benign fibroids, and photomicrographs are provided as supportive evidence. The various modes of presentation of abdominal leiomyosarcoma--mass, pain, obstruction, fistula, anaemia--are illustrated in the case report. The value of repeated palliative surgery in such cases is emphasized.


Staphylococcal septicaemia with disseminated intravascular coagulation associated with acupuncture.

A case of disseminated intravascular coagulation due to staphylococcal septicaemia is described in which the source of infection was likely to have been acupuncture therapy.


[Elements to be taken into consideration in the establishment and supervision of respiratory rehabilitation programs].

For a good respiratory re-education, the handicap must be analyzed together with its causes and mechanisms, in relation with the patient's social environment, his age and profession. The handicapping factors should be analyzed in a medico-social (pollution, weather) and medical context by detecting the affection involved and the functional analysis. The latter is deduced from the clinical signs and measurements defining the functional syndrome justifying an appropriate treatment. The importance of the handicap is drawn out of the clinical measures of maximum effort studied by ergometry. There are 2 levels of handicap (without alteration of blood gases at rest) and of respiratory insufficiency: simple or complicated by decompensation bouts enabling the choice of re-adapatation methods correlated with age an environment. Clinical and functional supervision as well as the study of the integration in the environment, form the basis of the analysis of results obtained in 2 comparable groups or in one homogeneous group subjected first to a simple medical treatment, then to re-adaptation.


[What interview methods can one propose in respiratory insufficiency before rehabilitation?].

In view of the readaptation of patients with respiratory insufficiency, the interrogation should aim at a clinical synthesis and define the sociological, familial and psychological context. It can be done by two ways; both with their pros and cons: 1) directed or self interrogation; 2) free talk or open questions. The first way is more specific, scientific, but less personal while the second is more personal though less objective. The latter is to be prefered, but a certain neutrality should be kept.


[Rehabilitation of respiration in outbreaks of bronchial superinfection].

The authors analized the effect of reeducation on patients with an exacerbated bronchial stasis and mucostasis. The group studied was composed of 103 patients suffering from chronic bronchitis, with or without pulmonary emphysema, bronchial asthma and bronchiectasis. Examination methods and breathing reeducation methods were briefly reported. Values measured before and after reeducation enabled by comparison the appreciation of this as an independent method. The rates of pulse (P less than 0.005), of breathing (P less than 0.001) and of systolic pressure (P less than 0.05) were influenced favourably by reeducation. The average quantity of sputum per day increased by 69% (P less than 0.001) specially in asthmatic patients, in itself an important improvement. After exercise there was a slight decrease of PaO2 and SaO2, but after 2 hours of rest, improved values for PaO2 (P less than 0.05), SaO2 (P less than 0.05) Raw (P less than 0.05) and SGaw (P less than 0.05) were noted. The transitory decrease was probably due to tired respiratory muscles and auxillary respiratory muscles. Breathing reeducation favourably affected the clinical conditions, the sputum production, mucostasis, blood-gases exchange, and decreased the airways obstruction. For a greater objectivity, different methodological approaches should also be considered.


[Exercise retraining].

Among the essential positive facts resulting from the physical training of patients with moderate to severe obstructive bronchopneumopathy, the following should be noted:-- the maximal capacity for work increases on average by 10%;-- physiologically this increment of work maximal capacity corresponds simply to a better extraction of oxygen by the muscles;--no specific central haemodynamic modification is usually observed at maximum or sub-maximum level;-- after training there is a favourable evolution of the PaO2 at rest. In the absence of spirographic modification and diffusion capacity, this increase of PO2 seems to result from an improvement of the ratio ventilation/perfusion.


Long term oxygen therapy.

In summary, we find that long term oxygen therapy is practical, that it can lower both pulmonary arterial pressure and the red cell mass, and also reduce the time spent in hospital. It is yet to be ascertained by a controlled trial if these improvements are significant when compared with those obtained in similar patients treated without oxygen. The Union Carbide Walker system is a convenient and relatively cheap way of giving oxygen over this long period. Although oxygen on exercise improves these patients' exercise tolerants, it would appear that weight of the Oxygen Walker might prevent much advantage to be taken of this in these severely disabled patients if the patient actually carries the Walker himself, but this portable system greatly increases the patient's social mobility.


[Factors influencing particle measurement of aerosols and their retention in the lung].

The dimensional characteristics of the particles of an aerosol depend on the means used for producing them. Mechanical spray and ultrasonic dispersion give polydispersed particles. On the other hand, centrifugal atomization produces a monodispersed aerosol. Particle retention in the lung system depends on the particle diameter. In addition, retention varies according to the respiratory characteristics: it is minimal for about 15 inspirations per minute. Using iron-59 labeled particles, it was shown that the degree of retention varies considerably from one individual to the other and accessibility to the depths of the lungs is decreased under the effect of certain lesions. Bronchial retention appears to be increased in smokers.


[Methodology of evaluating results of a rehabilitation technic].

The author presents a methodology to be used in all readaptation techniques, whatever the importance of the handicap and the technique used. He particularly insists on the necessity not to combine methods (mechanical and medicinal therapeutics...) if the efficiency of the different physical methods of readaptation is to be properly assessed.


[Methods of evaluating results of physical rehabilitation].

Besides simple techniques of control of a readaptation program, the authors stress the importance of quantifying the intensity of the efforts imposed. They propose the comparative study of different parameters measured precisely at the level of well tolerated submaximal work: VE/VO2, SaO2/VO2 which they analize together with the effort test standardized by the EEC.


[Results of rehabilitation in pneumonectomy patients].

Up to now, there is in France no rehabilitation program after pneumonectomy but social security and kinesitherapy. Medical, functional and economical survey of 219 subjects operated 1 to 20 years earlier shows that, as far as return to work and psychological adaptation are concerned, these factors weight at least as much as severe respiratory insufficiency. Before setting up a program of rehabilitation one should study these factors and others that may eventually influence psychological equilibrium.


[Psychological rehabilitation of chronic pulmonary patients].

The readaptation of chronic pulmonary patients must be undertaken on a wide scope and particularly psychologically, considering the anxiety and immaturity of these patients. Whatever the length of the pulmonary disease and its treatment, they should benefit from a physical training together with a social and psychological help.


Evaluation of a clinical method of gait analysis.

Data on step and stride length, step width, foot angle, and cadence were collected from a sample of 30 normal women. The gait patterns were recorded on white paper by a method which involved the application of moleskin and ink to the soles of the subjects' shoes. The purpose of the investigation was to demonstrate the validity, technical reliability, and clinical feasibility of this method of gait analysis. The values obtained compared favorably with the results of a similarly designed laboratory study cited in the literature. In addition, the method was easy to apply, was not time consuming, and yielded data which were reproducible at greater than a 95% level of confidence.


Effect of sensory integrative therapy on the neurometer development of retarded children.

Three groups of trainable mentally retarded children participated in three different motor programs for an eight-month period. Children receiving sensory integrative therapy showed the greatest gains on test batteries for reflex integration and gross and fine motor skills. Children in a developmental physical education program demonstrated greater improvement on the same test batteries than a third group of children who participated in a recreational, adaptive physical education program and an "arts and crafts" oriented therapy program. Results of data analysis indicate that neuromotor development may be enhanced more effectively by activities which facilitate improved postural responses rather than by practice of specific motor skills.


An integrated problem-solving curriculum design for physical therapy education.

Development of and experience with an integrated problem-solving curriculum design for physical therapy education is presented. The basic themes which relate discrete subject areas and a method of organizing the content around the themes are described. Problem-solving learning experiences are sequenced from the simple to the complex around the kind of situations found in clinical practice. Clinical education is integrated throughout the curriculum, and a calendar is developed based on the content of the learning experiences rather than the traditional university calendar.


Autism: an approach to learning.

The literature on autism as a childhood disorder is briefly reviewed, concentrating on diagnosis and methods of treatment. The autistic child is treated as a complex organism with many unknown factors in his development. A dysfunction in sensory integration is thought to interfere with the development of physical, intellectual, and emotional behavior. Because the primary cause of autism remains undetermined, no simple or direct approach to the treatment of the autistic child is known. The approach used for training autistic children at a summer camp sponsored by the North Carolina Society for Autistic Children is described, including the operational structure, daily activities, and training techniques. Informal observations of the physical and psychomotor characteristics of the children are discussed, and a short case report is included.


Cast-bracing. Principles, indications, and applications.

The advantages of the cast-brace include early independence in amublation resulting in decreased length of hospitalization and increased functional activities; increased knee function which allows sitting; avoidance of surgery and the possibility of concomitant complications; promotion of healing by decreasing edema and increasing callous formation; and decreasing the chance of delayed union; non-union, and refracture of the femur.


Therapeutic program for the learning disabled child.

Thirty-two children, diagnosed as having learning disabilities, were evaluated according to developmental scales for problems in perceptual-motor, visual, and auditory skills by a physical therapist. Of these children, 12 had significant deficits in all these areas and remedial therapy was prescirbed. Short-term goals and long-term goals were defined. Parents were instructed in home programs to be carried out three times a week which were designed to supplement the w-ekly therapy sessions. After eight weeks, significant improvements were seen in identification of body parts, movement in space, gross motor activities (activities without rhythm components), and shape constancy. Appropriate classroom recommendations were made based on these results and the evaluations of other professionals as the child reached school age.


Rapping with a chaplain.

Group discussions for senior physical therapy students, led by the hospital chaplain, were held at the University of Florida Medical Center. The idea for these "rap sessions" originated with the Department of Physical Therapy at Shands Teaching Hospital. The content of the discussions grew out of the students' experiences during their clinical assignments. The experience was deemed beneficial to the learning process by students, clinic staff, and faculty and helped to create a more relaxed atmosphere for learning in the clinic.


Development of an outcome assessment and informational system for physical therapy. A multi-institutional project.

The profession of physical therapy needs an outcome assessment and informational system developed specifically for it. The goal-oriented assessment system and data collection procedures which use electronic data processing are an attempt to satisfy that need. The purpose of this project was to demonstrate that an electronic data processing of physical therapy services system could be adapted and implemented on a multi-institutional basis. Physical therapy departments in four community general hospitals in New Jersey implemented the program by applying the data base to all discharged patients during a six-month period. The program was again modified at the conclusion of actual use so that the requirements of all participating institutions would be satisfied. This outcome assessment and informational system can contribute to objective evaluation of physical therapy care.


Accelerographic, temporal, and distance gait factors in below-knee amputees.

Gait characteristics of 19 patients with a unilateral below-knee amputation were studied. The accelerographic and foot placement method used in this study allowed for simultaneous acquisition of data commonly obtained in the experimental laboratory (acceleration) and data easily gathered in the physical therapy clinic (temporal and distance factors). The following results may be of interest to the clinician: 1) measures of cadence, stride length, and velocity were highly related and the magnitude of these measures was below commonly accepted values for normal; 2) the below-knee amputees spent more time in stance phase on their uninvolved lower extremity than on their involved (prosthetic) extemity; 3) the step length from heel strike of the uninvolved lower extremity to heel strike of the involved (prosthetic) lower extremity was greater and accomplished in less time than the opposite step; and 4) smoothness of the gait pattern and any single temporal and distance factor exhibited low statistical relationships.


Financial aspects of clinical education to facilities.

The financial aspects of clinical education for full-time junior and senior physical therapy students as related to facilities offering clinical affiliatins were determined. A questionnaire concerning supervisory expenses, student support, direct and indirect costs returned by 35 facilities of all types provided the basic information. Comparisons of costs and revenues were made for junior and senior students separately and for facilities according to type, size,and personnel involved in student supervision.


Cervical traction. Review of literature and treatment guidelines.

This article is a review of the literature on cervical traction. The various mechanical factors most relevant to cervical traction are organized and discussed. The factors presented are 1) neck position, 2) traction force, 3) duration of traction, 4) angle of pull, and 5) position of the patient. Treatment guidelines are suggested based on interpretation of the literature.


[Hemostatic processes in aneurysmal hemorrhages].

Pathogenetic, diagnostic, and therapeutic problems and questions associated with ruptured cerebral aneurysms assume good knowledge of hemostatic processes. The three factors affecting hemostasia, namely, vasoactive, coagulative, and fibrinolytic risk factors in the blood, cerebro--spinal fluid, and at the site of damage to the vessel wall, are discussed withparticular reference to a thrombosing aneurysm. In the case of secondary hemorrhages it is necessary to determine the cause or pathogenesis, respectively, of the disturbance of coagulation or increase in fibrinolysis in order to be able to take suitable therapeutic measures and reduce the risk of secondary bleeding occurring within the first critical weeks after aneurysmal rupture.


[Cardiac involvement in chronic alcoholism].

Electrocardiographic examinations of thirty- to fifty-year-old patients with chronic alcoholism showed a variety of ECG alterations. Similar results obtained for cardiomyopathies suggest, at least for some of the sufferers from alcoholism included in this investigation, cases of alcoholic's cardiomyopathy. It is only by abstinence from alcohol that a complete regression of alcoholic's cardiomyopathy may be brought about. Anyway, it is recommended that sufferers from chronic alcoholism should be cardiologically examined at certain intervals of time.


[Multiple sex drive abnormalities in a patient with Klinefelter's syndrome].

The authors report various sexual instinct disturbances and, more specifically, exhibitionism and pedophilia of a 25-year-old patient with Klinefelter's syndrome. The patient had committed several punishable offenses and was referred to our specialty clinic for psychologic and psychiatric examinations. Aspects of psychopathology and causal etiopathogenetic relationships of the authors' own observations are discussed and compared with those reported in the literature. Environmental factors are considered to be primarily responsible for the development of sexual perversions. The Klinefelter syndrome as such may be regarded as being of predispositional importance only.


[Neurocybernetic basis of hallucinations and related illusions].

Present concepts of circuits of neurons involved in the development of regular perception are used as a basis for discussing possible processes proceeding in these circuits and producing hallucinations and other illusions and false perceptions in mental patients or normal subjects.


[Some peculiarities of lithium intoxication in the elderly].

This is a report on two 73- and 68-year-old female patients with monophasic mania, who had been treated with lithium compounds for six years (without showing any complications) and who, because of a relapse of mania, were therapeutically treated with lithium compounds on an inpatient basis. The intoxications observed in the two female patients are described. Also discussed are the peculiarities of lithium intoxication in old age.


[Treatment of alcoholics with cerebro-organic deterioration and no understanding of their illness (author's transl)].

A report was made of the methods of operating and setting up a ward in the psychiatric county hospital Weinsberg. This ward specializes in the treatment of alcoholics with cerebroorganic deterioration, who are unmotivated for therapy and have no understanding of their illness. One behavioral method is used during clinical treatment to control the alcohol intake was presented. Sociotherapeutic measures to help the patient abstain from alcohol after his release were discussed.


Anterior pituitary hormone secretion in chronic schizophrenia--an approach to neurohumoral mechanisms.

Prolactin, FSH, LH and TSH were determined in repeated samples of serum from 16 unmedicated male patients with chronic schizophrenia. Changes in the mental states between the 2 occasions were related to changes in hormone levels. Significant inverse correlations were established between prolactin and incoherence of speech, between prolactin and total positive symptoms and between FSH and poverty of speech. A significant positive correlation was established between FSH and delusions. These findings are discussed in the context of evidence concerning the role of monoamines in the control of anterior pituitary function, and of the dopamine and other monoamine hypotheses of schizophrenia. Although prolactin secretion was not as low, as would be predicted on the basis of the dopamine overactivity hypothesis of schizophrenia, the relationship between symptom change and change in prolactin secretion was consistent with the hypothesis that increasing symptom severity is associated with increasing dopamine release from the tubero-infundibular system.


A reappraisal of body perception disturbance in anorexia nervosa.

Previous research has suggested that patients suffering from anorexia nervosa tend to overestimate their body size, whereas normal females tend to be very accurate in this respect. This paper presents the results of further investigations of body perception amongst anorexic and normal females. The results, in contrast to earlier findings, indicate no such difference between groups. Detailed analysis of the data, however, points to the likelihood of certain differences between the present group of anorexic patients and previous groups. Moreover, it seems that body perception disturbance is not a consistent feature of anorexia nervosa and is only present amongst some patients at certain stages during their illness. On subdividing the anorexic group it was demonstrated that patients who vomit tend to overestimate their size more than do non-vomiters. It also seems likely that normal females are far from homogeneous in terms of body perception. In line with previous findings, a direct relationship was found between marked overestimation of body size and an early relapse. Evidence is also discussed which suggests that body perception disturbance is not specific to anorexia nervosa and may reflect an abnormal sensitivity about body size associated with such factors as the anticipation of an undesired change in weight, extreme concern about slimness and anxiety about putting on weight.


Awareness of body dimensions during pregnancy: an analogue study.

Two alternative explanations of the body-image abnormality in anorexia nervosa patients are outlined: namely, the 'abnormal sensitivity' and 'adaptational failure' hypotheses. Evidence relating to these 2 conflicting hypotheses was obtained from body-perception measurements carried out on groups of pregnant women. In the first study 40 pregnant women, at approximately 4 month's duration, were found to overestimate their bodily dimensions, albeit to a lesser extent than the previously tested group of anorexia nervosa patients (Slade & Russell, 1973a). When they were subdivided on the basis of a history of weight change over the previous 12 months, the 'stable weight' subgroup was found to overestimate significantly more than the 'weight gain' and 'weight loss' subgroups. In a second study 16 of the original group of pregnant women were retested at approximately 8 month's duration. Although their weight and bodily dimensions had increased on retesting, their tendency to overestimate was found to be significantly reduced. It was concluded that the phenomenon of body-image disorder is not specific to anorexia nervosa, extending not only to patients with obesity and to some normal women, but also to women during pregnancy. Moreover, the 'abnormal sensitivity' hypothesis was considered to fit these and other recently accumulated data better than the alternative 'adaptational failure' hypothesis. Some of the theoretical and clinical implications of these findings are discussed.


Perceptual distortion of body image in adolescent girls: distortion of body image in adolescence.

Body image estimations in 86 normal-weight adolescent girls showed (a) a tendency to overestimate body width and underestimate body length and (b) an association between the younger ages and the extent of overestimation of body width. In particular there is a sharp drop in overestimation between ages 10 and 11 and thereafter a more gradual and non-significant decline. These age-specific normative data are useful in assessing body image distortions in a variety of medical and psychiatric disorders.


Schizophrenia and coeliac disease--the nature of the relationship.

To test the hypothesis of an association between schizophrenia and coeliac disease, the sera of 380 chronic schizophrenic in-patients in two mental hospitals in the West of Ireland have been screened for the presence of reticulin antibodies. Antibodies were found in 26 patients. Twenty-one of these patients were further studied by proximal duodenal mucosal biopsy. None of the biopsies showed the morphological and histological features found in untreated coeliac disease. The incidence of reticulin antibodies in schizophrenic patients and controls is similar. The findings of this study lead to the rejection of the hypothesis of a positive genetic relationship between schizophrenia and coeliac disease.


Epileptic seizures induced by psychotropic drugs.

On the basis of information abstracted from case histories, 41 patients who had experienced epileptic seizures thought to be due either to treatment with psychiatric drugs or to withdrawal from sedative drugs were compared with a control group of patients. Those who had experienced seizures were more commonly first born and had a history of post-natal brain damage. During the week preceding the seizure there had been a marked increase in drug prescribing. The implications for drug management are discussed.


Hysterical fits previously diagnosed as epilepsy.

Seventeen patients with hysterical fits, previously diagnosed and treated by neurologists as epileptics, were distinguished from a matched control group of 17 epileptics by 5 factors: a family history and personal history of psychiatric disorder, attempted suicide, sexual maladjustment, and a current affective syndrome.


Depressive illness: the role of aggression further considered.

Measures of depression and undischarged drive were obtained for 292 psychiatric in-patients. In 200 of these cases inhibition of aggression was also assessed. All patients were classified as being endogenously depressed, reactively depressed, or as suffering from non-depressive primary disorders. The latter group was subdivided into secondarily depressed and non-depressed groups. The 3 depressed groups were then compared with the non-depressed subjects in respect of drive level and inhibition of aggressionmall 3 depressed groups showed significantly higher driver level than did the non-depressed subjects. The endogenous depressives also inhibited significantly more of their aggression than did the non-depressed subjects. The results are consistent with a drive inhibition theory of depression. However, while endogenous depression seems to be associated more specifically with the inhibition of aggression, reactive depression may be associated rather with the inhibition of drive generally.


People who deliberately poison or injure themselves: their problems and their contacts with helping agencies.

A representative sample of 130 people was interviewed shortly following self-poisoning or self-injury. The interview method is described. Events in the week prior to the attempt, and the incidence of various kinds of chronic problems are reported. Events involving key relationships were much more common than other kinds. The most important event was a quarrel, particularly in the 48 hours prior to the attempts and more common with female than with male attempters. The possible relevance of quarrels to understanding overdose behaviour is discussed. Nearly a third were receiving non-psychiatric treatment at the time of the 'attempt'. Approximately one quarter were currently receiving psychiatric treatment and a half had received it at some time. A substantial proportion had been admitted to either psychiatric or non-psychiatric hospitals within the past year. The proportions indicating the need for various kinds of help are reported. Most people said they needed 'someone to talk to'. More than half had been in contact with some form of helping agency during the week prior to the attempt. The possible significance of these findings is discussed. An attempt was made to look for 'syndromes' or groupings of problems. The resulting analysis, whilst of interest, did not lead to a satisfactory method for classifying individuals. It was concluded that a more satisfactory typology of 'attempters' is likely if types of relationship problems are investigated in more detail.


Neurotic illness in the families of children with asthma and wheezy bronchitis: a general practice population study.

In a controlled population study 111 families of children with asthma and wheezy bronchitis were screened. The mothers of asthmatics suffered more depressive illness than controls. This correlates with the severity of the child's asthma. There was no difference in immunological status between depressive and non-depressive mothers of asthmatics.


Predicting success in psychiatric training for foreign medical graduates: II. Patterns in course.

Faculty ratings of 22 foreign medical graduates ('FMGs'), all of whom entered psychiatric residency training at the University of Missouri-Columbia from 1966 through 1973, were compared with those of a similar group of North American medical graduates ('AMGs'). An on-going evaluation programme provided data for a variety of parameters ranging from 'theoretical knowledge' to 'clinical skills'. Results indicated that in most of performance the median FMG started at a level substantially lower than that of the median AMG and very slowly caught up. When achievement criteria were utilized it became apparent that, at least by the third year of training, 'superior' FMGs could equal or surpass the median performance of 'superior' AMGs, whereas 'marginal' residents, whether foreign or native-born, seldom attained even competence in most major spheres of functioning. Implications of these findings and those in related studies are discussed.


Psychiatric morbidity among West Africans and West Indians living in London.

All west Africans and West Indians living in Camberwell who made a psychiatric contact between 1 January 1965 and 31 December 1968 were selected using the Camberwell Psychiatric Register as a sampling frame. Inception rates of psychiatric illness were then calculated using the 1966 10% census figures for West Africans and West Indians in Camberwell. The rates found were compared to those among the British living in Camberwell. For each major diagnostic caterogy, with the exception of reactive depression and paranoid states, the inception rates are significantly higher among West Africans than West Indians. They are also significantly higher among West Indians than British. However, the differences in inception rates are generally greater between West Africans and West Indians than between the latter and the British.


The characteristics of psychiatric patients readmitted within a month of discharge.

From the Camberwell Register it was found that 9-14% of all admissions in the years 1965-70 were readmissions within a month of discharge. The characteristics of these patients were compared with the total population admitted. No particular diagnostic category was associated with rapid readmissions but the rapidly readmitted group contained a high proportion of young patients and divorced or separated patients. The case notes of rapidly readmitted patients were examined and compared with the case notes of a control group. The circumstance which predisposed patients to require rapid readmission was the degree of socially disruptive behaviour of the patient. Patients benefited from readmission and the reasons for this are discussed.


Implementation of legislative requirements for emergency medical services in prepaid group practice organizations.

The Health Maintenance Organization Act of 1973, the Emergency Medical Services (EMS) Systems Act of 1973, and other laws are examined for their effects on the organization and management of emergency services in prepaid group practice plans (PPGP). The study was conducted in 1974-75 by the Group Health Association of America. The data were gathered through interviews with administrators and providers of seven PPGPs and with leaders of health planning agencies in the same communities, as well as through reviews of internal documents and a 1-month utilization survey of emergency and urgent care services in each PPGP. Effects of the laws were found to be limited, with the health maintenance legislation appearing to have the greastes effect on the design of emergency servide models. In most localities, two parallel systems may operate in offering round-the-clock emergency care and programs to educate members and the public about the appropriate use of emergency facilities. The EMS legislation has had minimal effects on the design of emergency services in the PPGPs. The emergency services component is the most transitional aspect of the PPGS nad the one most amenable to change. Revisions have come through changes in internal management policy and from demands of subscribers. A regulating inference in the operation of the PGP, in the area of emergency services as well as in the delivery of primary care services, is that the plans must compete, both in costs and benefits, with available indemnity insurance coverage. The market dictates premium levels without regard to associated benefits. Additional costs for broader coverage and administrative regulatory mechanisms must be borne by the subscriber in the form of increased premiums. As a result, the utilization of expensive emergency care must be carefully controlled, and this restraint is often accomplished by requirements specifying which health problems are appropriate for the provision of emergency care, rather than by delaying assistance until the plan's office hours. The furtherance of the PPGP concept, that the entire health care of the individual person is provided and financed by one organization, definancedby one organization, detracts from the viability of a central body charged with the coordination of the delivery of all emergency services in the community. It results not only in duplication of effort but often in the establishment of potentially antagoistic organizations.


A simplified method for approximation of shortages of rural physicians.

The distribution of physicians can be mapped and shortage areas and the number of physicians needed in them can be determined by use of the simple, inexpensive method described. However, the limitations of the methodology must be borne in mind. One should visualize the physician shortage as only a rough indication of the need for primary health care services. More detailed analysis of each area may be required before a new service is actually established, for example, developing a community profile of the planned service area (age sex mix, income, education, race, occupation, and so on), surveying service-level expectation in the community, or studying patients' use of primary care providers in neighboring areas. Even more important may be the selection among a number of possible choices of service alternatives, such as satellite practices, use of physician's assistants or nurse practitioners, or group practices. Estimates based on simplified data and approximations are useful in leading planners to areas of probable undersupply and in helping them to avoid the problems of oversupply. These estimates identify target areas that appear to have physician shortages and point out where more refined analysis should be concentrated.


Diphtheria on Skid Road, Seattle, Wash., 1972-75.

From July 1972 to December 1975, an unusual outbreak of diphtheria in Seattle, Wash., resulted in a total of 558 cases and carriers, mostly among heavy alcohol users. Skin infections were predominant. Four white men died. The highest attack rate was among native American Indians. Environmental contamination and poor personal hygience were believed to be important in continuation of the epidemic, but could not be proved. Control measures included casefinding, isolation and quarantine, sanitizing dwelling units and mass immunization with Td toxoid. The high-risk geographic area was the city's Skid Road. This area continues to be the reservoir of continuing infection, but not all population subgroups there have been at equal risk. Spread to other geographic areas of the city and county has been minimal and remains under control.


Venezuelan equine encephalitis vaccination survey in Arizona and New Mexico, 1972.

Field studies were conducted in 1972 to determine the immunization status of equines along the Mexico, Arizona, and New Mexico borders. Interviews with horse owners were conducted along roads selected at random in the counties of Santa Cruz and Yuma, Ariz., and in Dona Ana County, N. Mex. At least 450 horse owners in each county were asked about the vaccination status of their animals, and information was taken on 1,260 animals. Blood specimens were obtained from every third equine, regardless of stated vaccination status, and tested for the presence of Venezuelan equine encephalitis (VEE), western equine encephalomyelitis (WEE), and eastern equine encephalomyelitis (EEE) neutralization antibodies. Serum samples were collected from 446 equines in the 3-county area; only 227 (50.7 percent) had both a history of VEE vaccination in 1971 (including 20 vaccinated in 1972) and serum neutralization antibody against VEE. Of the remaining 220 with no detectable neutralization antibody to VEE, 197 (89.5 percent) had a history of VEE vaccination in 1971 (including 5 revaccinated in 1972), 14 (6.4 percent) had no history of vaccination, and 9 (4.1 percent) had an unknown vaccination status. Eighty-two percent (160 of 1971) of the equines with a history of VEE vaccination and presence of dectectable WEE or EEE antibodies, or both, had no detectable levels of VEE antibody. Therefore, the results of this study suggest that the presence of WEE or EEE antibodies, or both, may suppress the development of dectable vaccine-induced VEE antibody response in the equine. As a result of this investigation, the U.S. Department of Agriculture, as an added precaution, recommended the revaccination of equines in areas of the United States bordering Mexico.


Trends in cancer incidence in Allegheny County, Pennsylvania, 1937-71.

Cancer incidence rates by race, sex, and cancer site were obtained from the Third National Cancer Survey for the years 1969-71 for residents of Allegheny County, Pennsylvania. When the sex-site-specific rates for 1969-71, as well as incidence rates from surveys in the county in 1937, 1947, and 1957-58, were compared with U.S. rates for 1937, 1947, and 1969-71, a number of significant changes in incidence were observed. Male incidence of cancers of the lung, bronchus, and trachea increased steadily between 1937 and 1969-71 both in Allegheny County and the United States. In the county, female incidence rates for these cancers decreased in the period 1947 to 1957-58 but showed an average annual increased of 9.2 percent in the interval 1957-58 to 1969-71. Incidence rates for county males increased by an average of 4.4 percent per year from 1957-58 to 1969-71. For stomach cancer, incidence rates for both sexes have decreased sharply in the county and in the United States. In the county, stomach cancer rates for females declined by an annual average of 4 percent from 1957-58 to 1969-71, while those formales dropped 2.1 percent. There appears to have been a steady decline over time in cervical cancer in Allegheny County, although the average annual rate of decrease of 2.8 percent for the latest interval (1957-58 to 1969-71) is not as large as the decrease of 3.9 percent per year from 1947 to 1957-58. Breast cancer rates for the county appear to have been steadily, although slowly, increasing at an average rate of about 0.6 percent per year, in contrast to almost constant U.S. rates. The county's breast cancer incidence rate for 1969-71 almost equals the U.S rate. There have been steady increases in prostate cancer incidence in both Allegheny County and the United States since 1937. For all sites combined, male cancer incidence rates increased, while those for females slowly decreased in both Allegheny County and the United States during the interval 1937 to 1969-71. In the county, male rates for the interval 1937 to 1969-71 increased an average of 1 percent per year, while female rates declined approximately 0.3 percent annually.


A case of rotary dislocation of atlas on axis.

An unusual case of rotary dislocation of atlas upon axis is presented. Included in the article are associated causes, the articulations of the area, a case history and radiological assessment. The article ends with the radiographic and technical factors involved.


Tricuspid and right ventricular infundibular obstruction associated with calcified right ventricular pseudo-tumour. Radiologic and pathologic aspects.

The authors describe a rare 'pseudo-tumour' in the right heart, discovered after a cerebrovascular accident (paradoxal embolus probably). The mass occupied the anterior leaflet of the tricuspid valve. Its mobility and numerous calcifications facilitated diagnosis, determination of its exact position, and evaluation of haemodynamic consequences. The histopathologic features are reported, and its aetiology is discussed.


Pulmonary lesions caused by blunt chest injury.

This discussion of pulmonary lesions caused by blunt chest injury points out the importance of chest X-rays, particularly in the case of costal fractures, contusion of the lungs, and respiratory distress syndrome.


Semiselective renal angiography, a useful method for evaluating the vascular supply in both kidneys.

A list of methods of semiselective renal angiography is presented. One of these methods is described. A series of 151 semiselective and 41 aortorenal angiographies is analyzed. The results are evaluated by comparing the visualization of the peripheral renal arteries and by comparing the opacification of other cranial branches of the abdominal aorta. Semiselective renal angiography is a useful method in cases requiring the examination of both kidneys.


Postoperative pelvic gas collections mimicking abscesses or bowel injury.

Extraperitoneal gas collections were routinely found in the pelvic soft tissues following abdominal hysterectomies in 35 patients. These collections have the typical appearance of extraperitoneal gas, are absorbed gradually, and should not be confused with pelvic abscesses or bowel injury. There was no trapping of gas in the pelvic soft tissues following vaginal hysterectomies in 15 patients.


[Proposals for standardizing the image quality of mammography (author's transl)].

The radiography of phantoms is not sufficient to test the image quality of mammography. In addition, patients mammograms have to be evaluated using our proposed quality criteria.


Adverse reaction to 99Tcm sulfur colloid in a routine examination. A case report.

The case of a patient in whom an allergic reaction developed after injecting 99Tcm sulfur colloid for a routine liver scan is herein presented. Since this reaction did not appear when injecting the same patient 99Tcm polyphosphate for a bone scan, it can be assumed that the allergic reaction was due to the stabilizer.


[The appropiate film for mammography (author's transl)].

Comparison of industrial film with long processing time and "90-second-Film" with film-screen combination showed the first type with long processing time to be distinctly superior. Number and shape of tiny clustered microcalcification were taken as criteria for correct visualization. Under present technical and geometrical conditions only industrial type film with long processing time gives high diagnostic accuracy in early breast cancer which depends to a large degree on proper delineation of microcalcifications.


[Problems of image quality in mammography. Avoidable technical errors in performance and evaluation of mammograms (author's transl)].

Frequent serious technical errors in mammorgraphy proved to be due to incomplete outlining of the breast, underexposure and blurring. These errors are in most cases secondary to incorrect positioning, absence or improper adjustment of automatic exposure system, insufficient quality of x-ray tube, and use of inappropriate films. Each mammogram should be exposed in such a way so that the film reading can be done using a bright halogen lamp and a twofold magnifying glass. Grain, blurring and artefacts should not interfere with the visibility of diagnostically important details such as microcalcifications of the size of about 0,1 mm.


[Spontaneous Visibility of the Mammary Ducts in Plain Mammography (author's transl)].

Mammary ducts become visible as negative contrast in the mammogram. This is caused by an increased contents of fat or oil in the mammary secretion. The secretion of lipides can indicate hormonal disregulation.


[The oblique mediolateral view of the breast (author's transl)].

The oblique mediolateral position provides the single most important view in mammography. It ensures optimal delineation of the largest possible area of the mammary gland including the axilla thus making an additional axillary view unnecessary. In a considerable precentage of cases it is usefull to take a film size of 20 x 30 cm instead of 18 x 24 cm. This view provides better results in radiomammography compared with xeromammography under present technical conditions.


[Efficiency and practicability of the oblique mediolateral view as one-view mammography (author's transl)].

With one-view mammography the detection rate for carcinoma would seem to drop considerably, in the screening situation for early carcinoma (T0 and T1) down to 50 to 60% under unfavourable conditions. The precentage of mammographic findings not completely cleared up by one-view mammography amounts to 54% among our patients. One-view mammography therefore seems to be justified neither as screening nor as routine procedure.


[Differential diagnosis of the microcalcifications. The calcified mastopathic microcyst (author's transl)].

Coarse plaqued calcifications which were up to now regarded as typical for sclerosing adenosis appear on the lateral films often as sickle- or linear shaped configurations. This pattern - described by the author as "tea-cup-phenomenon" corresponds to the microcyst filled with calcium milk. The sclerosing adenosis cannot be identified with this type of calcification.


[Method for preoperative localization of non-palpable microcalcifications within the mammary gland (spherical marking) (author's transl)].

A method for preoperative localization of non-palpable suspected microcalcifications within the mammary gland is described. This procedure is superior to the conventional methods with methylenblue.


[Roentgenmorphology of the sulcus of the extensor carpi ulnaris muscle (author's transl)].

For the roentgenographic definition of the form of the Sulcus extensor carpi ulnaris muscle 500 plain roentgenfilms of the wrist were examined. Three types were differentiated: Type I narrow sulcus, type  II large sulcus, and type III no sulcus. In types Ia and IIa the distal end was slanted. They were classified as forms with increased concomitance of lesions of the radial part of the wrist. Consequences for joint mechanics are briefly discussed.


[The Blount's disease (author's transl)].

This case concerns a boy aged 7 years with Blount's disease. The authors describe the clinical, biochemical and radiological picture of this disease which embrace both tibiae and render standing and walking very difficult.


Radiologic recognition of bronchopleural fistula.

Examination of more than 30 cases of bronchopleural fistula (BPF), of diverse causes, including 6 following resectional surgery, revealed a distinctive configuration of air/fluid collections in the pleural space. Maler in 1940 independently observed that loculated BPF pockets conform in shape to the adjacent chest wall. With the most common posterior costophrenic angle location, there is a wide air-fluid level in the frontal view, but on lateral films the anteroposterior diameter is narrow. In contrast, abscess cavities tend to be spherical and farther from the ribs. Use of these plain film criteria permits earlier and more confident diagnosis.


The primary double-contrast examination of the postoperative stomach.

Examination of the postoperative stomach is a difficult and often confusing procedure. Traditional methods of investigation have depended on using small amounts of barium as well as appropriate pressure and positioning. The authors feel that the well-established technique of double-contrast radiography of the upper gastrointestinal tract (with appropriate modifications) is both easier and more diagnostic; moreover, with the exception of suspected perforation or anastomotic rupture, there are no contraindications to the use of gastrointestinal hypotonia, distension, and barium coating of the mucosa regardless of the presenting symptomatology or the acuteness or chronicity of complaints.


The use of prostaglandin F2 alpha in selective hepatic angiography.

Comparison has been made between slow infusion hepatic angiographic studies obtained before and after the intra-arterial injection of prostaglandin F2 alpha. The prostaglandin injection resulted in increased caliber of the hepatic arteries, increased opacification of the parenchyma of the liver and improved visualization of the wall of the gallbladder. Poorly vascularized metastatic lesions were better shown on the prostaglandin studies, and carcinoma of the gallbladder was diagnosed in two instances. The demonstration of highly vascularized metastatic tumor was enhanced on the prostaglandin studies, but further improved after the injection of angiotensin.


Surgery and the progression of the occlusive process in patients with peripheral vascular disease.

The angiograms and clinical records of 42 patients with arteriosclerosis obliterans who underwent repeat angiography were analyzed in order to correlate the effects of surgery with progression of the occlusive process in native vessels. Occlusive disease progressed significantly faster in operated limbs (77%) than in nonoperated limbs (44%). When progression occurred, it was more likely to take the form of occlusion in operated limbs (85%) than in nonoperated limbs (61%). Graft closure was associated with a 93% incidence of disease progression, but even limbs with patent grafts had a more rapid progression than the nonoperated limbs (62% vs. 44%). There was a good correlation between the presence of symptoms and the angiographic progression.


Scattered radiation doses to infants and children during EMI head scans.

Scattered radiation doses to the eyes, thyroid and gonads of infants and children undergoing EMI head scans have been measured with thermoluminescent dosimeters. An average skin dose of 1.3 rad per scan was measured. Results are reported relative to incident skin dose and indicate that it is likely that there is no somatic or genetic hazard due to scattered radiation during an EMI head scan.


Computed tomography as an adjunct in the staging of Hodgkin's disease and non-Hodgkin's lymphomas.

Computed tomography (CT) of the abdomen has been evaluated as an adjunct in the staging of 25 patients with Hodgkin's disease and non-Hodgkin's lymphomas. Enlarged para-aortic nodes were consistently identified as were splenomegaly and larger splenic nodules. While lymphography and other staging procedures remain necessary in the evaluation of such patients, CT provides additional information useful to the surgeon. The cross-sectional display aids in the planning of appropriate therapy ports since the adenopathy is often found to be more extensive than was demonstrated at lymphography.


Application of longitudinal magnification effect to magnification stereoscopic angiography: a new method of cerebral angiography.

A new method of stereoscopic cerebral angiography has been developed which employs 2X radiographic magnification. In order to obtain the same depth perception in the object as with conventional contact stereoscopic angiography, one can made the x-ray exposures at two focal spot positions which are separated by only 1 inch (2.5 cm), whereas the contact technique requires a separation of 4 inches (10 cm). The smaller distance is possible because, with 2X magnification, the transverse detail in the object is magnified by a factor of two, but the longitudinal detail, which is related to the stereo effect, is magnified by a factor of four, due to the longitudinal magnification effect. The small focal spot separation results in advantages such as improved stereoscopic image detail, better image quality, and low radiation exposure to the patient.


Anterior pontomesencephalic vein and basilar artery in exophytic brainstem gilioma.

The angiographic differentiation of an intrinsic exophytic brainstem glioma from an extra-axial posterior fossa tumor is not always easy. The location of the basilar artery alone may not be significant. Displacement of the anterior pontomesencephalic vein anterior to the basilar artery appears to be a reliable indicator of an intrinsic exophytic brainstem glioma.


Metrizamide in pediatric myelography.

Metrizamide, a new water-solution iodinated contrast medium, was evaluated in 63 infants and children, most of whom had lumbosacral or low thoracic lesions. The diagnostic quality was found to be good, and no serious complications or permanent sequelae were encountered. Chief complications were headache, nausea, vomiting and fever. No myoclonic spasms or convulsions were seen. The advantages and disadvantages of metrizamide are discussed.


Scintigraphic diagnosis of ischemic intestine with technetium-99m sulfur colloid-labeled leukocytes.

Positive scintigrams were obtained in 13 of 15 dogs injected with technetium-99m sulfur colloid-labeled leukocytes following the experimental production of intestinal ischemia. The radioactivity of the ischemic intestines averaged 5.9 times that found in normal control segments of intestine from the same animal. Labeled leukocytes may be used as a rapid noninvasive technique for the early identification of ischemic intestine.


The effect of tin on the tissue distribution of 99mTc-sodium pertechnetate.

When tin complex is administered prior to the injection of 99mTc-sodium pertechnetate, the distribution of the tracer is altered such that: (a) the concentration at foci of cerebral pathology is drastically reduced; (b) the concentration in the stomach (mucus cells), thyroid and salivary glands, and choroid plexus is greatly increased; and (c) there is a shift of the tracer from the plasma to the red blood cells. Bone studies utilizing a tin complex should be done after other organs have been evaluated.


A new technique for the evaluation of the adrenal gland with gray scale ultrasonography.

Recent improvements in ultrasound instrumentation have provided the potential resolution to visualize the normal adrenal gland. However, conventional scanning approaches lack precise anatomic alignment. A new technique for scanning the adrenal gland and the results of a prospective evaluation of normal adrenal glands are presented.


Antenatal ultrasonic demonstration of fetal bowel.

Although ultrasound evaluation of the adult gastrointestinal tract is largely impossible because of bowel gas, the fetal bowel is fluid-filled and therefore not subject to this limitation. In our experience, the fetal bowel pattern can be recognized and antenatal abnormalities detected.


Prenatal fetal abdominal ultrasonography and diagnosis.

Despite the advent of gray scale recording, the feasibility and advantages of antenatal fetal ultrasound diagnosis have not received sufficient attention. This paper describes ultrasound fetal abdominal anatomy and illustrates prenatal diagnosis based on anatomical landmarks.


Ultrasonic diagnosis of thanatophoric dwarfism in utero.

There are several types of short-limbed neonatal dwarfism. Before the delineation of thanatophoric dwarfism many dwarfs who died early in infancy were labeled "achondroplastic." Intrauterine radiological diagnosis is possible and the clinician may be alerted to the possibility of the condition by noting short squat limbs with a relatively large head on ultrasound examination, especially in cases of hydramnios.


Primary ultrasonic detection of a double carcinoma of the colon.

Abdominal sonic scanning revealed two irregular, circular masses with light central reflexes followed by an acoustic shadowing effect. The diagnosis of two colonic tumors was subsequently confirmed by barium enema examination and surgery. Ultrasonic examination is capable of detecting colonic tumors above a certain unspecified size.


Ultrasound in the staging of lymphoma.

Ultrasonography of the abdomen and pelvis was performed in 16 patients with lymphoma who underwent clinical and pathologic staging. The results of the ultrasound examinations were correlated with the pathological findings as were the results of gallium-67 scans, inferior vena cavagrams and lymphangiograms obtained in the same group. Analysis of the data indicated accuracies in the 80-90% range and specificities of greater than 90% for ultrasound. The sensitivity of ultrasound was somewhat lower, in the 60-70% range. These findings compare favorably with those of the other diagnostic procedures evaluated and indicate the usefulness of ultrasound in the staging of lymphoma.


The significance of residual disease after external irradiation of squamous-cell carcinoma of the oropharynx.

366 patients with squamous-cell carcinoma of the oropharynx treated by external irradiation were studied to see whether residual disease at the end of treatment influences control. The frequency of recurrence was found to be significantly greater when residual disease was present. When the total dose was determined by the degree of regression of the primary lesion during treatment rather than the initial tumor volume, recurrence was significantly more frequent. Forcing the dose beyond a level suitable for the original volume of disease failed to prevent recurrence in patients with residual disease, most likely due to the hypoxic state of the remaining tumor cells.


The position of the superior articular process of the cervical spine. Its relationship to cervical spondylotic radiculopathy.

Cervical spondylotic radiculopathy is likely to develop when the superior articular process is anterior to the posterior margin of the vertebral body, as determined by lateral radiographs of the spine.


Improved dynamic and static imaging of abdominal aortic aneurysms.

The authors describe a technique for rapid, convenient in vivo labeling of circulating erythrocytes with 99mTc and the application of this technique to the evaluation of abdominal aortic aneurysms. Dynamic perfusion images and equilibrium blood pool images were obtained in 9 patients with documented aneurysm, and 7 of them indicated an aneurysm on the radionuclide study.


Method for localizing and calculating vaginal dose in brachytherapy.

Contrast agents in the vagina are being used to determine the position of vaginal surfaces relative to applicators in an effort to assess dose at these sites. Computer treatment planning allows consideration of dose at many more sites than was formerly possible, but dose prescription to critical tumor volumes then becomes of greater importance. Vaginal reference dose points VR, VL, VA, and VP are proposed. With dose specification determined at these points, the problem of low vaginal dose from overly wide vaginal ovoid geometries and related difficulties can be avoided. Attention to central vaginal doses can reduce the probability of central pelvic recurrence in the vagina. We have found the VR, VL doses were much larger than VA, VP doses in standard loaded implant configurations.


Determination of X-ray spectra incident on and transmitted through breast tissue.

X-ray spectra incident on and transmitted through breast tissue were measured using a fresh whole excised breast. These spectra and corresponding radiographs show that hardening of the beam from a molybdenum-anoda x-ray tube by a 0.5-mm AI filter instead of the conventional 0.03-mm Mo filter allows shorter exposure times and reduces patient exposure. Acceptable image contrast is preserved in mammography of thick or dense breasts.


Transfrontal cavernous sinus venography. A simple method of selective superficial venous compression.

The authors describe a simple technique of selective superficial venous compression for transfrontal cavernous sinus venography. Sponge-rubber blocks are positioned at the nasomalar angle and held in place with Velcro, with a second set placed just above the orbit. The blocks are kept in place all during filming, resulting in reproducible opacification of the cavernous sinuses despite changes in the position of the patient's head.


A simple device for dependent compression mammography.

The authors describe an inexpensive device which displaces the dependent breast from the chest wall for optimum and uniform compression of breast tissue during mammography. Exposure is reduced, detail is enhanced, and superimposed structures are spread out. The filming time is about five minutes, and repeat or additional views are rarely necessary. The authors feel that by using this device, they have not missed any posterior lesions in more than 10 years of use. Even dense breasts are adequately visualized with this technique.


Orthopantomography of the cervical spine.

The authors describe the application of orthopantomography to study of the intervertebral foramina of the cervical spine in patients with cervical spondylosis. Other structures such as the lateral mass of the cervical spine can be studied by altering the speed of the rotating film holder, which in two changes the width of the arch of the focal layer.


Cervical spine lateral horizontal beam technique.

Two techniques are suggested for satisfactory horizontal beam laterals in the operating room for fusion level localization: (a) the prone cervical myelographic lateral in which a modification is suggested for the "swimmer's position; and (b) patient supine with a 15 X 30-cm rolled sheet placed under the occiput and/or midline upper dorsal spine, which enables the shoulders to drop to the table, clearing the low cervical spine.


Telling children about diagnostic radiology procedures.

Illustrated explanations of various diagnostic radiology procedures have been designed to inform children and their parents precisely what will occur during the examinations. These explanations have been well received and may be requested from the author's.


Densitometry of single-emulsion film.

The measured optical density of single-emulsion films depends on the film orientation. The orientation of the emulsion influences the amount of scattered light entering the detector. It is suggested that this measurement be done with the emulsion side facing the light detector.


New technique for pelvic venography during ascending phlebography.

A technique of pelvic venography making it possible to obtain satisfactory opacification of the iliofemoral segment of the pelvic veins consistently during ascending phlebography is described. The main features are the compression of the inferior vena cava with a compression band and balloon, and the use of a large amount of contrast material.


Delayed imaging to distinguish bone lesions from urinary tract activity.

In 28/1,400 patients examined by bone imaging two hours after injection of 99mTc-polyphosphate or diphosphonate, it was found that activity in the urinary tract obscured the bony pelvis, making assessment of this region difficult or impossible. In several patients additional images were obtained 24 hours after the injection when decreased activity in the urinary tract allowed the pelvis to be more satisfactory visualized.


[Phagocytic activity by guinea-pig peritoneal macrophages and human peripheral leukocytes irradiated in vitro (author's transl)].

A dose/effect curve for phagocytic activity of guinea-pig peritoneal macrophages and human peripheral leukocytes was determined ranging from anti-inflammatory to immunosuppressive doses. The nitroblutetrazolium reduction test was used stimulating the phagocytes by latex microspheres. A significant enhancement of phagocytic activity by low doses of gamma radiation was observed in guinea-pig macrophages.


[Radiologic patterns of pulmonary edema in chronic pulmonary diseases (author's transl)].

Three atypical patterns of cardiac failure and pulmonary edema, as frequently seen in chronic obstructive pulmonary diseases, are described; I. regional; II. miliary-like; III. Swiss-cheese like. Their importance in early diagnosis of pulmonary edema is discussed in the light of a review of a series of 98 patients whose pulmonary function was also investigated. Examples and statistical data are drown from this series.


Blood flow measurements with radionuclide-labeled particles.

When appropriately and correctly applied, the microsphere technique is relatively simple and extremely accurate. Distribution patterns, both of total systemic arterial blood flow or venous return as well as within specific organs, can be measured. Several techniques have been applied to quantitate flow using microspheres; the reference sample method is extremely simple and by far the most accurate of all. Collection of venous effluent is perhaps more accurate but requires extensive surgery and is almost certainly the least physiologic. Other methods used for quantitation, such as bolus injections of indocyanine green dye or in fusions of diffusable indicators, are considerably less accurate and therefore significantly reduce the reliability of the microsphere technique. Selection of the appropriate size microspheres allows for definition of arteriovenous anastomoses as well as the measurement of organ blood flows and distribution of blood flow within those organs. In most instances, smaller microspheres (15mu diameter or 8-10mu diameter) have significant advantages over larger ones. They are distributed more like red cells, obstruct less of the vascular bed, are less variable in size, and can be given in significantly greater numbers. This latter point is important, since the statistical criteria need to be satisfied and the use of small spheres allows for the more reliable measurement of blood flow to small organs or to small regions of organs.


[Angiography in the diagnosis of neurinomas of the acoustic nerve (author's transl)].

40 cases of neurinoma of the acoustic nerve, studied by vertebral arteriography and controlled at surgery are reviewed. The angiographic signs of the lesion are analysed and a number of examples presented.


[Unusual progression of a case of moyamoya (author's transl)].

Angiographic follow-up of a case of moyamoya after three years revealed the appearance of arteriovenous anastomosis between the middle meningeal artery and the sigmoid sinus.


[Relationship between the renal electrical impedance variations with glomerular filtration rate changes in dogs (author's transl)].

Records of the electrical impedance were obtained by means of surface electrodes placed on ventral and dorsal sides of the left kidney of anesthetized dogs. Changes of the renal electrical impedance resulted from alterations of the glomerular filtration rate caused by decrease of blood renal pressure to 80 and 50 mm Hg either due to constriction of the aorta or bleeding. The relation were established also by using physiological solution's infusion. The results showed that changes of the means of renal electrical impedance were in opposite direction to changes in glomerular filtration rate. The electrodes employed were constituted of two parts: one fixed and another adjustable and flexible, possibiliting a good contact with the renal surface independently of the kidney size.


[Immune response to heart in rabbits: study of cellular and humoral immunity (author's transl)].

Four groups of rabbits injected with cardiac tissue and complete Freund's adjuvant or aluminum hydroxide gel adjuvant and two groups only injected with aluminum hydroxide gel adjuvant or complete Freud's adjuvant were studied. The humoral and cellular immunity in immunized animals was studied using heart soluble and insoluble extracts. The tests results from hemagglutination, immunoelectrophoresis and immunofluorescence have presented cross-reactions among sera and hearts of the several species. Similar cross-reactions were not revealed by immunodiffusion. The immunoelectrophoresis and hemagglutination reactions were related to heart soluble extract and the immunofluorescence reactions were related to insoluble extract located in sarcolemal, subsarcolemal and intermyofibrilar sites. By hemagglutination, it was verified the presence of antibodies to heart and skeletal muscle in the antisera. Is was not possible to negative completely the reactivity of these antibodies to heart by absorptions with skeletal muscle. Inhibition tests to leucocytes migration revealed that leucocytes from immunized animals present migration inhibition when faced to antigens sedimented at.....56.500 g.


Histochemistry of the amyloid substance from familial amyloidotic polyneuropathy.

The histochemical properties of the amyloid substance from familial amyloidotic polyneuropathy (FAP) were studied. The results showed differences among the FAP amyloid and the others amyloid substance. The main difference being that FAP amyloid substance was free of or only contain a small amount of protein. It contains acid and neutral glycidic substances, constituting its major part.


[Chromosome complements of eleven bird species of the orders columbiformes, passeriformes and tinamiformes (author's transl)].

The chromosome complements of 11 species of birds from the Columbiformes, Passeriformes and Tinamiformes Orders are described. Their karyotypes' evolution are discussed and pericentric inversions, centric fissions and/or fusions seem to have been of great importance. Banding patterns in the several Orders will be of great importance to know better the mechanisms of chromosomal evolution.


Comparative hypoglycemic and hypoketonemic effects of tolbutamide and glypentide in rat.

Fed and 24 h fasted rats were treated by stomach tube with different doses of either tolbutamide or gluypentide and they were compared with controls treated with placebo. At low doses glypentide was ten times more effective as hypoglycemic agent than tolbultamide whereas it was only twice as effective in the fasted rats. Supramaximal doses of either drug produced the same effect decreasing blood glucose levels. Both drugs were able to decrease the rise of blood ketones in fasted rats, but the comparative effect was not parallel to the one observed on glycemia and not proportional to the doses used. The different responses are interpreted as function of the hypoglycemic effect, which would be mainly mediated through the insulinotropic action of these drugs, while the hypoketonemic would be the result of both their insulinotropic effect and their direct action on lipolysis and ketogenesis.


[Effect of dextropoxyphene on oxidative phosphorylation in brain and liver of rat (author's transl)].

Dextropropoxyphene hydrochloride increases significantly oxygen uptake in whole rat brain homogenates at concentrations of 10(-4), 10(-5), 10(-6) M when using sucrose 0.25 M pH 7.4 as incubation medium. If substrate and cofactors are added to the sucrose, this drug decreases oxygen uptake at 10(-3) M concentration in brain and liver rat homogenates, and it also decreases significantly the P:O quotient of mitochondria in both organs by uncoupling the oxidative phosphorylation.


Effects and interactions of furosemide and acetazolamide on tubular function in rat kidney.

Furosemide and acetazolamide effects on tubular function in rat kidney have been studied by micropuncture. Furosemide produced a marked rise in fractional proximal fluid reabsorption when urine loss was not replaced, and sodium excretion rose significantly indicating a distal effect. If urinary losses were replaced proximal fractional reabsorption was depressed and fractional sodium excretion increased more than 60%. After replacing urinary losses, acetazolamide had a greater depressive effect on proximal tubular fluid reabsorption than furosemide but sodium excretion values were about 1/3 of those obtained with furosemide. Superimposition of one drug during the action of the other resulted in potentiation of proximal inhibition, suggesting a different mechanism of action. The changes observed in potassium excretion are of great interest. Separately, furosemide or acetazolamide produced kaliuresis. When furosemide was administered during acetazolamide diuresis, however, potassium excretion was reduced despite the sharp rise in sodium excretion.


Validation of a radioimmunoassay for rat thyrotrophic hormone. II. Comparison with results obtained by bioassay.

As previously reported a heterologous radioimmuoassay (RIA) system was developed for the determination of rat thyrotrophic hormone (TSH), using guinea-pig antiserum against bovine TSH and a purified murine TSH for labeling. With this RIA system it is possible to detect TSH in plasma from normal rats, to follow its decrease during ether anaesthesia, and to differentiate between the TSH levels of normal rats and those of hyphophysectomized or thyroid hormone-treated rats; in appears to be free from interferences due to high circulating gonadotrophin levels. Several preparations containing high concentrations of rat TSH were assayed simultaneously by this RIA and the McKenzie TSH bioassay. Bioassay values, especially for plasmas, tended to be higher than those obtained by RIA. The mean ratio of bioassay to RIA values for the limited number of samples tested so far is about 1.5 +/- 0.2. Therefore, it does not appear correct to express rat TSH values obtained by RIA in biological potency units; they should only be given in terms of weight equivalents of an international rat reference preparation.


Protein distribution is submitochondrial particles after lipid peroxidation.

Three fractions of submitochondrial particles were isolated by differential centrifugation of mitochondrial inner membranes incubated with 1 mM ascorbate. Proteins were separated by polyacrylamide gel electrophoresis and their pattern was found to be different for the three fractions. These results are in agreement with previous work which showed the dissimilar enzyme distribution and chemical composition of these submitochondrial particles and pointed out the heterogeneity of the inner mitochondrial membrane.


Catalase and peroxidase activities, chlorophyll and proteins during storage of pea plants of chilling temperatures.

The effect of chilling temperatures on the catalase and peroxidase activities, soluble proteins and chlorophyll contents of excised organs of Pisum sativum plants has been studied. In leaf and stem tissues, storage at 0 degrees C did not bring about any statistically significant variation in the levels of heme enzymes, proteins and chlorophyll during four days. On the contrary, in root tissues catalase activity experimented a statistically significant depression after the onset of cold storage and during the whole treatment, whereas the other parameters remained nearly constant. Results obtained showed the suitability of storing plant material at 0 degrees C for the stabilization of catalase, peroxidase and chlorophyll in leaves and stems, as well as of peroxidase activity in roots.


Stimulation of renin release by prostaglandin E2.

The effect of different doses of prostaglandin E2 on renin secretion in isolated perfused rat kidney has been studied. The infusion of 5 ng/ml of prostaglandin E2 produced a significant rise on renin secretion compared with control group. A dosage increase of prostaglandin E2 (10 and 50 ng/ml) produced an increase in the released renin. From this a correlation between doses and responses can be obtained. The perfusion pressure was slightly--but significantly--modified with the highest dose of prostaglandin (50 ng/ml). The possible pathways of action are dicussed.


A simple modification to the radiochemical assay of cortisol which avoids the extraction from serum.

A modification to the radiochemical assay method to measure cortisol in serum, that renders unnecessary the extraction of cortisol from a serum sample is described. The serum is heated at 60 degrees C for 3 hours, thereby transcortine is destroyed, then competition binding assay follows as usual.


[Physical exercise as a functional test of hgh secretion (author's transl)].

The efficiency of L-dopa and exercise tests have been compared to diagnose the lack of human growth hormone. Both tests gave similar results. The exercise test is recommended as a screening method in large populations to discard growth inhibition due to HGH deficiency, because of its easy, quick and painless application to patients.


[Relation between urinary catecholamine and gonadotrophins and sexual hormones (author's transl)].

The urinary excretion of the norepinephrine, epinephrine and the norepinephrine/epinephrine ratio and its modifications by the ovariectomy, adrenalectomy, hypophysectomy and the administration of sexual hormones and gonadotrophins were studied in female Wistar rats. The ovariectomy increased epinephrine excretion and decreased the studied ratio. The adrenalectomy increased norepinephrine and the ratio levels and diminshed epinephrine excretion. Norepinephrine and norepinephrine/epinephrine ratio elimination increased in the ovariectomized and adrenalectomized rats. The sexual hormones did not alter catecholamine levels in the ovariectomized and adrenalectomized animals and were not effective to restore the control levels. The norepinephrine/epinephrine ratio reached a maximum under progesterone effects. Both urinary catecholamines rose in ovariectomized and hypophysectomized animals. The chorionic and the equine gonadotrophins did not restore the control levels, but they had a tendency to do it. The results showed the existence of a close interelationship between the sympathetic system and the sexual hormones and gonadrotrophins function, that could be related to regulatory mechanisms of the hypophyseal gonadotrophins secretion.


The discriminative stimulus properties of morphine in female rats chronically depleted of dopamine.

Female rats, 14 days of age, were chronically depleted of brain dopamine (DA) by the intracisternal administration of 6-OHDA 30 minutes following (i.p.) administration of desmethylimipramine (DMI). Dopamine depleted (DA) rats and their respective controls were trained to discriminate morphine from saline in a double bar discrimination task. While dopamine depletion did not hinder learning of the task, it markedly reduced morphine's suppressive effects as measured by response rates. Indications of stimulus generalization to methadone and haloperidol were observed in both groups via dose response tests. In addition, chronic morphine injections appeared to cause a repletion of DA in the DA group. Acute morphine-doses or chronic saline treated DA rats exhibited a 64-85% depletion of DA, while DA rats administered morphine chronically displayed a lesser depletion (42-46%).


Styrene and acrylonitrile induced depression of hepatic nonprotein sulfhydryl content in various rodent species.

Adult female mice, male rats, female hamsters and male guinea pigs received various doses of styrene (150-1000 mg/kg of body weight) and acrylonitrile (20-80 mg/kg of body weight) intraperitoneally. Both styrene and acrylonitrile caused a depression of the hepatic nonprotein sulfhydryl content. Mouse was the most vulnerable and rat the most resistant species to the effect of both of these two important plastic monomers.


Observations on the monamine oxidase activity of rat vasa deferentia, major blood vessels and human saphenous vein.

Monoamine oxidase (MAO) activity was characterized using whole tissue homogenates and kynuramine as the substrate. In rat vasa deferentia, kynuramine deamination was differentially inhibited by clorgyline, less so by deprenyl and not at all by pargyline. These studies, and mixed substrate experiments with tryptamine, proved that kynuramine is a substrate for MAO types A and B. Experiments made with rat abdominal aorta and inferior vena cava disclosed clorgyline-sensitive and resistant MAO activity, the latter being inhibited by semicarbazide but not by deprenyl or pargyline. No semicarbazide-sensitive species of MAO was found in human saphenous vein which also differed from the rat vasculature in that the predominant MAO activity was of the B type. It is concluded that kynuramine is also a good substrate for clorgyline-resistant enzymes and that rat vasculature may be a poor model for predicting deaminating mechanisms in human venous tissue.


Influence of morphine on protein synthesis in synaptic plasma membranes of the rat brain.

The effects of acute and chronic morphine treatment on the incorporation of 3H-lysine into synaptic proteins were studied. No changes related to tolerance development were observed in the total incorporation of 3H-lysine into cortical or subcortical synaptic plasma membrane (SPM) or synaptic soluble proteins. Two populations of subcortical SPM were prepared, one from light (L) and one from heavy (H) nerve ending particles. When the labeled SPM-L proteins were separated by means of sodium dodecyl sulfate disc gel electrophoresis, an increased amount of label was found in the high molecular weight region of the gel. This increase depended on the rate of tolerance development. In contrast to the results found in the SPM-L gels, chronic morphinization significantly decreased the amount of high molecular weight labeled protein recovered from SPM-H gels.


Inhibition of the metabolism of cocaine by SKF-525A.

In vitro and in vivo studies in rats indicate cocaine to be metabolized primarily in the liver to form benzoylecgonine and norcocaine. The formation of these metabolites was significantly hindered by SKF-525A, a microsomal enzyme inhibitor. In in vivo studies, pretreatment of rats with SKF-525A prior to receiving cocaine resulted in increased amounts of unchanged cocaine in the brain. No accompanying increase in spontaneous motor activity was observed for these animals, indicating a possible role for metabolites in the stimulant action of cocaine.


Possible significance of clozapine-induced increase in brain dopamine.

Clozapine elevates the concentration of dopamine in the brains of mice injected with doses of 5-20 mg/kg while a 40 mg/kg dose has no effect. This biphasic change in dopamine content is seen in both the striatum and olfactory tubercle. The elevated dopamine concentration is dose-dependently antagonized by apomorphine, while a corresponding clozapine-induced reduction in norepinephrine concentrations is unaffected by apomorphine. These results suggest that part of the action of clozapine may be to reduce the release of dopamine.


The effects of methaqualone on the temperature regulation of mice.

Methaqualone produces dose and time dependent changes in the rectal temperature of mice. More specifically, the drug produces poikilothermia. This effect appears to be produced by methaqualone itself rather than a liver metabolite since SKF525A, a compound known to block drug metabolizing enzymes in the liver, does not abolish the phenomenon. Tolerance to the temperature altering effects of methaqualone is also shown.


Penetration of some O-and/or N-methylated norepinephrine derivatives through the rat blood brain barrier.

Methods for the determination of a number of O and/or N-methylated derivatives of norepinephrine were developed. The IP injection of these compounds into rats shows quick absorption and short half-lives in plasma, liver and brain. Most compounds do not cross the Blood-Brain-Barrier (BBB) due to low lipid solubility. However, lipid solubility is not a sole determinant. Compounds which have at least one of the 2 phenolic hydroxyl groups methylated and possess a tertiary amino group do cross the BBB readily.


Effect of pretreatment with antiinflammatory agents on paraquat toxicity in the rat.

Aspirin (ASA), indomethacin (IND), hydrocortisone (HYC) or 0.25% agar (control) were administered (p.o.) daily to rats for 5 days. Following drug pretreatments, the activities of cytosolic superoxide dismutase (SOD), glutathione peroxidase (GP) and glutathione reductase (GR) were elevated 30-70%, 5-25% and 8-25%, respectively. In a second experiment, rats pretreated as above were injected (ip) on the 5th day with paraquat (PQ) (29 mg/kg). Rats in each group expired more ethane 2 hours after PQ injection. After 22 hours, expired ethane returned to zero time levels. All control rats died within 48 hours after PQ injection. At the end of 48 hours, rats pretreated with ASA, IND, or HYC demonstrated survival rates of 13%, 31%, and 47%, respectively. PQ injection produces marked elevations of SOD (82%), GP (328%), and GR (36%) in the lungs of PQ-injected controls rats over non-PQ injected controls. Elevation of these enzymes were also noted in drug-treated rats after PQ injection but at values less than PQ-injected controls. Anti-inflammatory drugs were tested in rat liver homogenates for their ability to inhibit thiobarbituric acid (TBA) reactive product formation. Only the addition of HYC resulted in a decrease formation of TBA-reactive products. Thus in vitro studies suggest that the antiinflammatory drugs tested, other than HYC, may have other mechanisms of actions in addition to inhibition of lipid peroxides.


Effects of monoamine oxidase inhibitors on the borohydride stabilizable binding of serotonin and tryptamine in brain.

The in vivo and in vitro effects of various monoamine oxidase inhibitors (MAOI) on the borohydride stabilizable finding of serotonin (5-HT) or tryptamine in brain was investigated. A significant correlation between the extent of Mao inhibition and the amount of stabilized binding of the indolealkylamines was demonstrated. All hydrazine-type MAOI and harmine, a reversible nonhydrazine-type MAOI, employed in vitro, were shown to decrease the binding. beta-Phenylisopropylhydrazine apparently blocks the receptor carbonyl groups in the brain in vitro as well as in vivo.


3,4,3',4'-tetrachloroazobenzene: a potential environmental toxicant.

3,4,3',4'-tetrachloroazobenzene (TCAB), a potential environmental toxicant formed in the industrial manufacturing and the microbial degradation of chloroanilide herbicides, has been prepared in 87% yield by an improved procedure. In vitro experiments with C3H/10T1/2 cells have shown that TCAB is toxic to mammalian cells, which may be correlated with observable cytological changes. TCAB has also been found to be weakly mutagenic by the Salmonella/microsome test. In addition, C3H/10T1/2 cells are transformed following a ten day incubation with TCAB. These data suggest the potential health hazard associated with the environmental occurrence of TCAB.


Effects of lead and cadmium on adrenal and thyroid functions in rats.

Seventy sexually mature male rats were injected with lead (50 and 250 mcg), cadmium, (50 and 250 mcg) and a mixture of lead (25 mcg) and cadmium (25 mcg) for 70 days. TSR results show that 250 mcg cadmium had a stimulating effect but 1/10 of the dose of cadmium plus 25 mcg lead had the opposite effect. Plasma thyroid hormones indicated that 50 mcg lead had a stimulating effect on T4 but cadmium and a mixture of lead and cadmium had a suppressing effect on both T4 and T3. Plasma corticosterone and adrenal cortical histology showed increased adrenal function in animals treated with 50 mcg lead, 50 mcg and 250 mcg cadmium and a mixture of lead and cadmium. The data indicated that cadmium had more deleterious effects on thyroid and adrenal function than lead.


Toxic interactions of stimulants, narcotics and narcotic antagonists.

This study examines the lethality of combinations of central nervous system stimulants, narcotics and narcotic antagonists in rodents housed individually. The lethality of mice and rats from d-amphetamine was potentiated by methadone, cyclazocine and morphine, in that order of potency. Naloxone did not enhance lethality from d-amphetamine in mice, whereas it did antagonize lethality from morphine-d-amphetamine interactions. Naloxone did slightly enhance lethality from d-amphetamine in rats, but at a higher dose than those found to antagonize the lethality from morphine-d-amphetamine combinations. Methadone also enhanced the lethality from cocaine. These results have important implications for drug abusers and for patients being treated for narcotic addiction with either a methadone maintenance program or a cyclazocine administration program.


Induction by carbon tetrachloride of a lipid peroxidation inhibitor (LPI) present in rat liver soluble fraction.

Oral administration of an adequate amount of carbon tetrachloride to rats resulted in an increase in the ability of the soluble fraction to inhibit microsomal NADPH-dependent lipid peroxidation. Aso, feeding of a fat-free, high carbohydrate diet to rats led an increase in the ability of the soluble fraction to prevent lipid peroxidation. Partial purification of the soluble factor inhibiting lipid peroxidation (LPI) by means of polyethylene glycol 6,000 (PEG) fractionation and hydroxylapatite column chromatography indicated that LPI is not glutathion peroxidase.


Deficiency of vitamin B6 in women taking contraceptive formulations.

The specific activities (S.A.) of the glutamic oxaloacetic transaminase from erythrocytes (EGOT) of 75 women taking 16 diversified contraceptive formulations were determined by the principle (CAS) of unsaturation and saturation of receptors of the Coenzyme-Apoenzyme-System with the coenzyme, pyridoxal 5'-phosphate. 52 women were not taking pyridoxine; 20 were taking 1-5 mg; 3 were taking 25-100 mg. The mean basal S.A. of the 52 women without pyridoxine was lower (p less than 0.01) than for the 20 on  1-5 mg. The mean basal S.A. for the women on 25-100 mg was higher (p less than 0.01) than for the women without pyridoxine. The mean % deficiency for the women on 25-100 mg was negligible and lower (p less than 0.01) than 18+/-8 for the 52 women, and 14+/-6 for the 20 women. These data indicate that 1-5 mg of pyridoxine is inadequate for women on contraceptives. The requisite daily dosage is projected at 50-100 mg. Other data indicate that 5-12 weeks of supplementation with pyridoxine can be required to reach a stable "ceiling" of S.A. of EGOT. This period indicates some regulatory mechanism by diminished levels of the apoenzyme upon gene expression to bring about normal levels of the transaminase.


Penicillamine effects on enzyme efflux from skeletal and heart muscle.

We have previously shown that pretreatment of mice with diethylstilbestrol (DES) or prednisolone (Pr) lowered enzyme efflux from isolated mouse skeletal muscle. These same agents also lowered the high serum enzyme activities in boys with Duchenne's muscular dystrophy (DMD). In a continuing search for other agents with similar effects, the influence of penicillamine (Pe) on enzyme efflux from isolated muscle was assessed, because it lowered the high plasma creatine phosphokinase (CPK) and produce beneficial effects in avian muscular dystrophy. Three groups of mice received 0, 1, or 10 mg Pe daily for 14 days. All mice were given supplementary pyridoxine. The egress of CPK and lactate dehydrogenase from the isolated left gastrocnemius and heart was determined over a 5 hour period. Pe produced more modest effects than did DES or Pr. The 10 mg dose reduced enzyme efflux from the gastrocnemius by 10%. In contrast, heart enzyme efflux was augmented by 20%. Similar dose-related disparate effects on enzyme efflux from skeletal muscle and heart have been previously noted for DES and Pr. Pe is the third agent found to lower the high serum enzyme activities in muscular dystrophy and reduce gastrocnemius enzyme efflux from isolated mouse skeletal muscle. This further establishes the usefulness of the mouse assay for identifying agents that lower the high serum enzyme activities in muscular dystrophy.


A rapid sensitive radioassay for serum native and denatured DNA.

A radioassay for human serum DNA using 3H-actinomycin D was developed and evaluated. The assay was found to be technically simple, precise, sensitive and specific for DNA. Both native and denatured DNA levels could be measured using a nuclease specific for sDNA, since denatured DNA reproducibly bound 3H-actinomycin D under the assay conditions. Analysis of human sera yielded results in accord with those previously reported for man.


Simultaneous assay of the methylxanthine metabolites of caffeine in plasma by high performance liquid chromatography.

A fast and sensitive method by high performance liquid chromatography for the quantification of the methylxanthine metabolites of caffeine in human plasma is described. Plasma is extracted with 20% isopropanol in chloroform and the evaporated residue is redissolved and chromatographed on silica gel using dichloromethane containing 2.2% of a solution of methanol-ammonium formateformic acid (100:0.02:0.017). The method is suitable for metabolic and pharmacokinetic studies of all mono- and dimethylxanthines in plasma. The limits of quantification, with C.V. of 10% or less are 40 ng/ml for the dimethylxanthines, 100 ng/ml for 3- and 7-methylxanthine and 500 ng/ml for 1-methylxanthine.