Immunoglobulin IgG1 metabolism in new born calves.

The half-life of IgG1 immunoglobulin was measured in six neonatal calves following a meal of iodine-125 labeled IgG1 in colostrum derived from their dams. The half-life as measured by the decrease in plasma concentration of IgG1 was 19.9 +/- 1.9 days. However, the half-life as measured by the disappearance of [iodine-125]IgG1 from the plasma was 11.5 +/- .6 days. The latter value is closer to the true half-life because it is not affected by endogenous production of IgG1 by the tissues of the young calf. A decrease in the specific activity of plasma [iodine-125]IgG1 with time representing the body "pool" of IgG1 (half-life 25.8 +/- 6.1 days) suggests that the calf from birth to about 20 days of age is capable of synthesizing a significant amount of IgG1 immunoglobulin.


Radiotherapy for aggressive and destructive keratoacanthomas.

An experience of treating five cases of aggressive and destructive keratoacanthomas by radiotherapy is recounted. The results were satisfactory in every instance.


A review of modern concepts of healing of cutaneous wounds.

Basic-science aspects of wound healing are discussed in the light of recent developments in wound-healing research. The author discusses wound healing in six, arbitrarily chosen phases, namely, inflammation, epithelialization, vascularization, contraction, collagen synthesis and late remodeling of scars that occur simultaneously in concert, but in such a manner that enables one to distinguish clinically between healing by primary intention and healing by secondary intention.


The biologic actions of solar radiation on skin with a note on sunscreens.

Adverse effects of excessive cutaneous exposure to solar radiation are hazards of considerable importance. As public health measures, new attitudes about sunbathing and new practices to counteract those adverse effects, especially for high-risk individuals, appear warranted.


Surgery on patients receiving anticoagulants.

Patients on anticoagulants may undergo surgery if the anticoagulants are carefully controlled and if contraindications are respected. Patients being treated for thromboembolism should have their clotting times maintained at close to two times normal levels if they are on heparin, or their prothrombin times similarly maintained if they are an oral anticoagulants.


Cryotherapy with solid carbon dioxide in the treatment of nevus flammeus.

Thirty-five infants with nevus flammeus were treated with carbon dioxide snow at intervals of two weeks. The treatment was initiated between the first and eleventh week, and improvement was found to be best when started between the age of 3 and 6 weeks. The result was excellent in 8 cases, good in 11, fair in 12, and poor in 4.


The present state of trend detection and prediction in patient monitoring.

An investigation has been carried out into the suitability of the following techniques for trend detection and forecasting in patient monitoring: Cusum; Trigg's Tracking Signal; The Patient Condition Factor; The Patient Alarm Warning System; Box-Jenkins models and the Harrison-Stevens Bayesian approach. The latter holds considerable promise since it is flexible and can be implemented on a microprocessor. Consideration has also been given to the need for a better knowledge of the statistical properties of the variables to be monitored and the problems of combining trends detected in severable variables.


Chemabrasion, a combined technique of chemical-peeling and dermabrasion.

Chemabrasion was coined to designate a simple, single procedure in which a deep, full-face chemical peeling is followed immediately by dermabrasion. The procedure detailed differs from other techniques in which chemical peeling and dermabrasion are practised together. Certain advantages over chemical peeling and dermabrasion used singly or together in different areas of the face are pointed out. In an early observation of results after a one-year follow-up, it is the author's opinion that the combined procedure yields the benefits of chemical peeling and dermabrasion without increasing the complications of either.


Use of steel pins in hair transplantation.

Steel pins are used to stabilize hair transplants by preventing transplanted plugs from becoming elevated, depressed or turned in the wrong direction. The pinning procedure is less traumatic to hair follicles than is tight bandaging and bleeding is more easily controlled. Patients so treated have improved final appearances. The authors' technique of using steel pins is described.


The use of transcutaneous oxygen electrodes in intensive therapy.

The use of transcutaneous monitoring of the PO2 in patients in an adult intensive therapy unit has been found to be a simple and reliable procedure. The electrodes were heated to 44 degrees C in order to obtain a near maximal response. In individual patients, the transcutaneous reading may be up to 20 per cent different from the arterial value. However, the difference is reproducible for a given patient and does not detract from the value of the technique in following trends. The ease of use of the non-invasive transcutaneous technique has brought to light numerous instances of marked fluctuations occurring in patients oxygen tensions.


Some special aspects of hair transplantation.

The desire for an improvement in appearance and the strong emphasis currently placed on contemporary hair styles for men, have increased the number of requests for hair transplants during the past decade. Esthetics is probably the strongest motivation.


Hydrothorax, a complication of the insertion of central venous cannulae.

Hydrothorax developing in a patient after insertion of a central venous cannula is described. The cannula appeared to be in the superior vena cava on chest X-ray, and the condition only became apparent 48 hours after insertion.


Bronchial response to inhaled prostaglandin F2alpha in patients with common or aspirin-sensitive asthma.

The effect of aerosolized prostaglandin F2alpha (PGF2alpha) on specific airway resistance (SRaw) has been measured in patients with common (n = 10) or aspirin-sensitive asthma (n = 5). In all subjects PGF2alpha caused a dose-related increase in SRaw, but considerable individual differences in sensitivity were observed. The patients with aspirin intolerance did not differ from regular asthmatics in terms of their response to PGF2alpha. Two types of reactions to PGF2alpha could be distinguished from their time-course: immediate and short-lasting (3 cases) or delayed and long-lasting (12 cases). Inhalation of a beta-adrenergic drug rapidly and completely reversed the effect of PGF2alpha, suggesting that the increase in SRaw was due to bronchospasm. In 7 subjects the inhalation of an anticholinergic drug (SCH 1000) prior to PGF2alpha inhibited to a large extent the effect of the latter, suggesting that the cholinergic system played an important role in the bronchial response to PGF2alpha. In 9 subjects no correlation was found between the bronchial sensitivity to carbachol and PGF2alpha.


Experimental studies of sensitization to beryllium, zirconium, and aluminum compounds in the rabbit.

In a study designed to assess the potential sensitizing and granulomagenic capacities of selected metallic salts, rabbits were inoculated intradermally with zirconium aluminum glycinate (ZAG), sodium zirconium lactate (NZL), aluminum chlorhydrate (ACH), BeSO 4, and ovalbumin (OVA) by single and multiple injections. Animals immunized with BeSO4 and with OVA developed delayed skin reactivity as well as antigen-specific alveolar macrophage migration inhibition. Neither single nor multiple injections of ZAG or ACH resulted in clear-cut positive skin reactivity, macrophage migration inhibitory factor (MIF) production, or lymphocyte stimulation. Rabbits inoculated with multiple injections of NZL (500 microng) showed some marginally positive macrophage migration inhibition and skin reactivity. Histologically, ZAG and ACH were found to induce well-organized foreign-body granulomas after intradermal injection in both normal and inoculated rabbits. NZL and BeSO4 also induced skin granulomas, but these were less organized and distinct. Cell viability and ultrastructural studies indicated that BeSO4 was highly toxic for isolated alveolar macrophages in vitro at concentrations above 10 microng/ml, but NZL and ZAG did not exert such an effect at these dose levels. BeSO4 also depressed lymphocyte stimulation in sensitized animals which demonstrated delayed skin reactivity and macrophage migration inhibition.


Variation in theophylline clearance rate with time in chronic childhood asthma.

Wide theophylline clearance rate (TCR) range between different individuals has been reported, but little is known about its change with the passage of time. Optimal theophylline therapy for asthma aimed at plasma or serum levels of 10 to 20 microng/ml is now strongly recommended. Significant TCR variability with time might easily result in theophylline levels in the toxic or subtherapeutic ranges. Thirty severe asthmatics (mean age, 13 yr) received 24 hr constant intravenous infusion of 1 mg/kg/hr aminophylline USP. TCR was determined after a steady state was reached. Twelve of these patients with persisting poorly controlled asthma underwent repeat infusion for TCR determination at intervals of 1 to 8 mo (mean, 4.7 mo). When these results were compared to the initial individual TCR, the mean absolute change was 28 +/- 24% (mean +/-SD). Thus, this significant individual variation in TCR with the passage of time (p less than 0.01) requires periodic monitoring of plasma theophylline levels in severe asthma treated by optimized theophylline dosage.


Lymphopenia in acute nitrofurantoin pleuropulmonary reactions.

Each of 5 patients with acute nitrofurantoin pleuropulmonary reactions had profound lymphopenia and 4 had eosinophilia developing early in the clinical course after the drug was withdrawn. The 2 patients tested had only one third of the normal numbers of E rosettes (T lymphocytes) in the peripheral blood during recovery. Lymphoblastic transformation tests with purified nitrofurantoin were done in 3 patients and all of them were negative; responses to phytohemagglutinin, concanavalin A, and pokeweed were decreased but still normal. The diagnosis of various nitrofurantoin hypersensitivity reactions relies on clinical data. The mechanisms of these reactions presently remain unclear.


The dietitian in primary health care.

This statement was prepared by The American Dietetic Association for use in a study on the development of an integrated manpower policy for primary care being conducted by the Institute of Medicine, National Academy of Sciences, Washington, D.C. Basically, it is concerned with the role of the dietetics profession in primary care. It is divided into the following sections: (a) Definition of the dietitian and her position regarding the importance of nutrition in all health and health-related programs; (b) present role of dietitians in both in- and out-patient settings; (c) barriers to carrying out the full potential of nutritional care in improving health; and (d) action recommended to maximize the positive influence nutritional services could have and to identify a nutrition component in any comprehensive health care program. Funding of nutrition services in health and medical programs for primary care would be expected to result in cost containment for total health care, as well as improvement in the health and quality of life of the population.


Coordinated education in dietetics.

Details essential in implementing coordinated education in the preparation of the professional dietitian are described. Consideration is given to semantics, with clarification of terms posing problems in the smooth evolution of coordinated programs. Four phases of transition from the traditional to the coordinated process are illustrated: (a) Integration of the clinical phase into the undergraduate years; (b) interrelation of subject matter among departmental courses; (c) trans-disciplinary coordination; and (d) on-going evaluation of the curriculum in terms of professional practice. Also addressed are barriers to change in professional education. The ultimate goals are a balance between standardization and accountability and a climate in which academia has the liberty to meet demands in an innovative fashion.


Nutritional knowledge and attitudes of physicians.

A closed-end questionnaire, containing fifty-five knowledge questions and twenty attitude statements, was mailed to physicians on the mailing list of the Nebraska Medical Association who expressed a willingness to participate in this study. The data reported are based on the responses of 292 physicians (22 per cent of the total possible sample). Twelve per cent indicated they had received no nutrition education in medical school, either as a specific course or integrated with other subjects. Eighty-eight per cent had access to a clinical dietitian, with 40 per cent reporting frequent use of this service. Physicians answered 65 per cent of the knowledge questions correctly, with a tendency to score higher on basic nutritional knowledge questions than on those relating to therapeutic nutrition. Attitudes toward nutrition were generally favorable. There was a significant negative, though moderate, correlation (r = -0.188) between years in practice and nutritional knowledge. No significant relationship was found between nutritional knowledge and attitude. The findings of this study suggest that nutrition education should be considered as an area for postgraduate courses for physicians. Also, a need for a greater awareness and utilization by physicians of the dietitian's potential as a nutritional consultant is indicated.


Zinc content of selected foods.

Selected food items appearing on 24-hr. dietary recalls of nineteen volunteers were analyzed for zinc by atomic absorption spectrophotometry. Consistent and reproducible results were obtained for the zinc content of the foods. Values ranged from 0.02 +/- 0.01 mg. zinc per 100 gm. for fruit cocktail to 6.77 +/- 0.03 mg. per 100 gm. for London broil. Foods in the meat group had the highest zinc values (0.40 to 6.77 mg. per 100 gm.), followed by the breads and cereals (0.30 to 2.54 mg. per 100 gm.); milk and milk products (0.36 to 0.49 mg. per 100 gm.); vegetables (0.12 to 0.60 mg. per 100 gm.); and fruits (0.02 to 0.26 mg. per 100 gm.)--in that order. When comparisons with published values for zinc content of foods were possible, there was good agreement with the values obtained in this study. Using the zinc content of the analyzed foods, dietary zinc intakes based on 24-hr. recall records were calculated for the nineteen volunteers. Mean dietary zinc intake was 13.3 +/- 7.6 mg. and showed a high positive correlation to dietary energy (r = 0.85) and protein (r = 0.90) intakes. Analyzed zinc content of two food composites containing beef was twice that of four food composites not containing beef.


Tocopherols in canned entrées and vended sandwiches.

Determination was made of alpha-, beta-plus-gamma-, and delta-tocopherol contents of brand-name canned entrées from a supermarket and from vending machines on a college campus, of several home-prepared entrées, and of sandwiches from vending machines in Spokane, Washington. Amounts of total tocopherols in canned entrées were small, ranging from none detected to 0.66 mg. per 100 gm. food. Similar home-prepared entrées, however, contained 0.41 mg. to 1.55 mg. Tocopherols in vended sandwiches ranged from 0.05 mg. to 1.86 mg. per 100 gm. sandwich. Results are also expressed as total tocopherols per serving (I.U.). These convenience foods contribute only a small amount to the day's intake of vitamin E.


Adapting the 24-hr. recall for epidemiologic studies of school children.

Chemical analysis of food actually eaten would be the most accurate method for analyzing the diets of children, but this technique is not feasible for most nutrition staffs. An improved 24-hr. dietary recall can be used by a small, well trained staff to collect more reliable data on a large number of school children. Vigilant monitoring of school lunch operations, incorporation of known recipes in the ETNV, and organizing probing techniques are necessary to insure the reliability of the tool. The low coefficients of variation of duplicate recalls noted in the study indicate that the error of measurement between interviewers is small, if the tool is carefully tested and sophisticated before use in the field and if observers are carefully trained by a written protocol.


Senile dementia: treatment with deanol.

Recent research indicates a possible cholinergic involvement in memory processes and thus the possibility that acetylcholine deficiency may underlie memory impairment in senile dementia. Deanol (2-dimethylaminoethanol), which is assumed to increase brain acetylcholine, was given openly for 4 weeks to 14 senile outpatients, to determine the safety of the drug and whether or not it reduces cognitive impairment. The dosage was gradually increased to 600 mg three times daily during the first two weeks, with no adverse effects. Ten patients improved globally and 4 were unchanged (p less than .01). The total score on the Sandoz Clinical Assessment-Geriatric (SCAG) was lowered by the third week (p less than .01), primarily as a result of reduced depression, irritability and anxiety, and increased motivation-initiative. However, neither the clinical ratings nor an extensive pre- versus post-treatment series of cognitive tests revealed changes in memory or other cognitive functions. Since a similar separate study with a different compound produced no behavioral changes, it is unlikely that the improvement with deanol was due entirely to placebo effects. The results thus suggest that although deanol may not improve memory, it may produce positive behavioral changes in some senile patients.


Attempted suicide among the aged.

Although the rate for suicide in old age is high, the rate for attempted (unsuccessful) suicide is low. Among the elderly, suicide-attempt groups have more physical disorders, more psychoses, and more psychopathologic findings, and are under-represented demographically. Fifty percent of the elderly suicide attempters have organic brain syndrome (OBS), compared to only 5-10 percent of the "normal" population over age 60. Among what might be expected to be a high-risk suicide population, OBS apparently interferes with the success of suicide attempts by impairing coordination, planning, determination, and awareness of reality.


An evaluative study of Silver's Cerebral Function Test.

The aim of this study was to evaluate the usefulness of Silver's Cerebral Function Test in predicting the management and placement of patients admitted to a psychogeriatric hospital. Overall, 205 consecutively admitted patients and 54 age-matched controls living in the community were examined, thereby greatly extending the normative data for the test. The results indicated that this brief, easily administered test could distinguish the patients from the controls. Also, the selected cut-off score of 28 significantly differentiated between patients able to benefit from rehabilitation and occupational therapy programs and those who required primarily maintenance care. The test-retest reliability of the test was good (r = 0.91).


Calcium metabolism in aging inhabitants of mountain versus seacoast communities in the Kii Peninsula.

A survey was conducted on age-related changes in various measures of calcium metabolism in 609 men and women over the age of 30 (more than half were over the age of 60) in two communities of the Kii Peninsula at the central southern tip of the Japanese mainland. One community was on Oshima Island, with adequate nutritional intake; the other community was in the mountainous Shichikawa district, with a low intake of calcium and protein. The subjects of the Shichikawa study showed shorter stature, higher prevalence of lumbago, thinner clavicular cortex, lower serum levels of phosphorus, total protein and cholesterol, and a higher level of alkaline phosphatase than did the subjects of the Oshima study. There was no difference in the serum calcium levels.


Some risk factors in pathologic aging.

A clinico-epidemiologic prevalence survey was conducted in the sub-mountainous area of Northern Bohemia, which is distinguished by the highest proportion of aged people in Bohemian countries. It involved 6057 persons of the 70-79 age group, 1718 persons of the 80-89 age group and 139 persons of the 90+ group, plus control subjects in various other groups. In this study an attempt was made to find an effective measure of the presumed risk factors of pathologic aging in persons of the 70-105 age group. The data were analyzed by the method of coincidence of two parameters of binomial decomposition on the computer Odra. The quantity dependence of the signs was determined, and an index of the compound-risk factor of pathologic aging was calculated. When the numerical value of the index is lower than 56.9 +/- 4.36 for a group of males or 50.3 +/- 3.55 for a group of females, the probability is that a given person in those groups will survive to an advanced age. The total risk is higher for the male sex. Of considerable importance are the genetic burden, external environmental causes, harmful habits, certain "civilization" diseases, and other factors such as disturbed social contacts and defective nutrition.


On-site geropsychiatric services to guests of residential homes.

During a 7.5-year liaison between a 152-bed residential (multi-level care) home for the aged and a psychiatrist-social worker team, 58 of the 339 residents were referred to the team. With increasing expertise of the staff of the home and with early psychosocial intervention, the need for psychiatric hospitalization dropped virtually to zero. Of the 23 persons currently referred, 65 percent are recovering well with psychiatric-social-nursing support and psychotropic drugs; another 26 percent are achieving significant behavioral improvement without change in their chronic mental confusion. The average time required of the psychiatrist proved to be four hours monthly; telephone consultations averaged two hours monthly. About half an hour per week was spent in conference between the psychiatrist and social worker, to allow achievement of mutual goals. Appropriate one-site psychiatric-social therapy permitted continuity of care and usually prevented threatened disruption of the residnets' lives. Thus the modest investment of time by the psychiatrist and social worker improved the level of life satisfaction, not only for the patients but for the Home.


Brief psychotherapy: a case report illustrating its potential effectiveness.

The advance of industrialization in Mexico and elsewhere has brought about psychosocial problems of aging similar to those encountered in the United States. A case study is presented of a 64-year-old Mexican widow who had suicidal thoughts and feeling of uselessness. External constraints on the therapist dictated that psychotherapy be completed within 15 days. A strategy of brief psychotherapy was adopted. The focus was not on establishing transference, probing the unconscious or reconstructing the patient's personality, but on identifying problems and formulating practical solutions promptly. Four hour-long sessions were sufficient to gather information and to counsel the patient and her family. The diagnosis was depression. Treatment centered around increasing the quality of the patient's activity. The initial success of these measure made for a good prognosis. Both patient and family were advised of the availability of antidepressant drugs, and advised against relocating the patient.


Intra-hospital transfer: effects on chronically ill psychogeriatric patients.

Since the Vermont State Hospital was approaching a major transition period, it was decided to study systematically the effects of intra-unit and inter-unit transfer on its psychogeriatric patients. Ten patients were assessed by means of four standardized measures in the intra-unit study, specifically investigating the effects of integrating wards previously devoted either to chronic or to acute psychiatric illness. Twenty-five patients from a specialized geriatric unit were evaluated, by separate investigators, with respect to changes occuring as a result of their transfer to regional mixed units. The critical incident log, the problem classification form, and the clinical global impression showed some changes, for which there were several possible explanations. None of the changes was as dramatic as predicted by staff members holding divergent views prior to the study. The optimists predicted a "blossoming" of the psychogeriatric patients in the mixed, regional units, whereas the pessimists prophesied dire consequences. The group of patients studied was not completely homogeneous with respect to the effect to transfer. Clinical assessment after transfer could be relied on to detect improvement in some of these psychogeriatric patients and deterioration in others. Some understanding of the complexity of the multifactor determinants of change developed along with increased cooperation among the investigators and the nursing staff. A middle ground of mutual respect for fresh ideas and an appreciation for years of experience was reached.


Effect of age and weight on plasma glucose and insulin responses in the rat.

Plasma glucose and insulin responses to orally administered glucose were determined in rats of varying ages and weights. The results indicated that glucose tolerance tends to deteriorate as rats grow from 1 month to 9 months of age. This change in glucose tolerance was associated with an increase in the response of plasma insulin to glucose, consistent with the hypothesis that the decline in glucose tolerance is due to a loss of normal insulin sensitivity. The changes in glucose and insulin responses could not be explained entirely on the basis of the associated weight gain. They seemed to be at least partially secondary to either age or an age-related factor other than obesity.


Reactivation of tuberculosis in old age.

Reactivation of tuberculosis in old age has been reported by several authors. This article confirms these findings and presents another 5 examples. Lack of adequate chemotherapy during the first clinical episode may be an important factor in reactivation, especially in debilitated patients.


Sideroblastic anemia in an elderly patient.

A 91-year-old man had been treated for iron-deficiency anemia for four years before admission to the Geriatric Unit of the Hasharon Hospital because of cardiac insufficiency and epigastric pain. In the Unit, laboratory studies revealed, in addition to hypochromic anemia, a high level of plasma iron and a reduced iron-binding capacity. The low reticulocyte count in the peripheral blood despite hyperplasia in the bone-marrow erythrocyte series, the rapid disappearance of radioactive iron from the plasma, and the impaired erythrocytic uptake of iron were all indicative of the ineffective erythropoiesis. The findings suggested the possibility of sideroblastic anemia, and examination of bone-marrow aspirates stained for iron confirmed this diagnosis.


Idiopathic hemochromatosis: case report of a patient presenting with neurologic symptoms.

Idiopathic hemochromatosis is an iron-storage disease more common in men than in women. It is characterized clinically by diabetes mellitus, cirrhosis of the liver, pigmentation of the skin and cardiac failure. The diagnosis may be overlooked when the presenting symptoms do not follow the pattern. A case is reported which was diagnosed after an onset that featured neurologic symptoms.


Treatment approaches with the psychiatric elderly.

In reviewing the literature on treatment approaches with the psychiatric elderly, a large number of studies were found which espouse comprehensive rehabilitation programs that usually require supplementation of existing personnel and expansion of facilities. Although some agencies and institutions are fortunate in securing the needed funds for such program implementation, most others face the reality of limited personnel and funding cutbacks. This paper briefly reviews modalities which do not demand additional expenditures for specialized facilities in the treatment of chronically ill geropsychiatric patients.


A program of balanced physical fitness in the preventive care of elderly ambulatory patients.

A program of balanced physical fitness incorporated into a medical "team" approach to treatment contributed significantly to the general health of elderly ambulatory patients. Each week for eleven months, 13 patients were given one hour of balanced exercise and encouraged to perform it for two additional hours per week. Initial differences favoring the control group. Physicians' single-blind assessment of the two groups resulted in significantly better health ratings for the patients who had received the therapeutic exercise program than for those who did not participate.


Patient response to thin hydrogel contact lenses.

This study was designed to evaluate the patient response to experimental Bausch & Lomb thin F series SOFLENSES. The center thickness of these lenses was 0.04-0.06mm compared to 0.14-0.16 mm for the conventional F series lenses. Eight of the twenty-three subjects fitted (35% of the patients, 39% of the eyes) were successful by the standard of Sarver, Harris and Polse. The principal reason for failure was discomfort, which was often associated with poor centration and arcuate staining. Neither vertical corneal striae nor significant corneal thickening were observed during the eight hour wearing periods. Lens handling was a major problem. During the eight weeks of the study 35% of lenses used were torn. Our results indicate that even though thin F series SOFLENSES cause less corneal edema than conventional F series SOFLENSES, the overall patient response to these thin lenses is less favorable than the response to conventional SOFLENSES. Further research with thin hydrogel lenses is needed to determine if the patient response can be improved by altering such lens parameters as diameter and/or curvature.


A pilot study of the effect of soft contact lenses on intraocular pressure.

It is common for the initial application of any contact lens to a cornea to produce an irritative response. There is almost no information in the literature regarding what effect this irritation produces, particularly upon the intraocular pressure (IOP). In this study we analyzed IOP changes in soft contact lens wearers of six months time. The results showed no significant difference between pre-fit IOP and that after six months. Based on individual responses there may be some implications for the use of IOP measurement when fitting soft contact lenses.


The osmotic variable.

Patients were found to differ in their prefitted tear osmotic baselines. Although such differences appeared small, they did represent the "safety margin" (i.e., against osmotic edema) each patient had against a "hypotonic shift" when receiving a hard (PMMA) contact lens.


Detection and measurement of corneal alterations due to conventional contact lens wear.

Corneal changes, especially edema, are discussed, with the purpose of offering a selection of many tests intended to give the practitioner indications of the response of the eye to contact lens wear. Some old, some current, and some futuristic techniques, including a few now operative but largely experimental, are mentioned, as is a concluding opinion of the minimum clinical routine providing the "best" information of the edema state.


Corneal deadaptation--the case against abrupt cessation of contact lens wear.

Severe corneal deformations and visual acuity loss frequently result from abrupt cessation of hard contact lens wear. The concept of corneal deadaptation, or the gradual reduction of wearing time over a period of several weeks is suggested as a means of minimizing the deformations and acuity losses.


Research in orthokeratology. Part V: Results and observations--recovery aspects.

In this paper, the recovery profiles of changes produced by a defined orthokeratological technique are presented and discussed. The manner and degree in which the eye responds after the removal of contact lenses was shown to be highly individualistic in nature. Even so, certain trends were evident. It was found that the alterations produced by orthokeratology were rarely permanent; however, complete recovery was usually not observed.


Adaptation to hydrogel contact lenses: variations in myopia and corneal curvature measurements.

Forty patients wearing lenses (soflens) were examined regularly for 3 months. During the first month the mean myopia gradually increased to 0.12 D more myopia and increased linearly to 0.50 D more myopia at 3 months. The mean corneal curvature flattened during the first 3 weeks, but steepened to about 0.37 D at 3 months. The process of myopia changes are not attributed solely to the anterior corneal curvature, but may also be the result of variations in the posterior corneal curvature, corneal thickness and index refraction as well as a change in the depth of the anterior chamber.


Hypnosis and suggestion for fitting contact lenses.

Language is important in the creation of a painful or non-painful context for fitting contact lenses. This article discusses two types of language use and demonstrates the consequent experience each creates for the patient. The authors also emphasize the importance of acceptance and utilization of responses offered by the patient to further the goals of a comfortable fitting experience. Finally, this article provides an example of a reliable and successful technique for rapidly inducing hypnosis for the purpose of obtaining a comfortable lens fitting.


C.A.B.: a practical contact lens option?

The rigid contact lens continues to offer many prescription features which are difficult to match in the flexible lens realm, e.g.,: readily measured parameters, predictable optics, low production cost and minimum patient care requirements for reasonable hygienic safety. But poor tear pump efficiency remains a challenge in many conventional (i.e., PMMA) cases, even today. Oxygen permeable rigid materials represent the obvious solution to this problem, but how adequately do they perform? Two such materials are examined in this report in relation to the oxygen needs of the cornea.


The "aging" of a HEMA contact lens.

The physical characteristics and attendant patient complaints associated with termination of the useful service lives of 26 HEMA lenses are compared with the characteristics of a control (undispensed) population of such lenses.


Tissue levels of S-adenosylmethionine in aging rats.

The tissue levels of S-Adenosylmethionine (SAMe) in 30-mo.-old rats were measured, and a remarkable decrease was observed compared to adult rats. The synthesis of SAMe by the methionine-activating enzyme and its utilization by COMT were investigated in different tissues. The activity of the synthesizing enzyme was unchanged in the liver and brain of adult and senescent rats, while COMT activity appeared to be higher in the aging rats. Thus, the result indicates that the decrease of same in these organs of senescent rats is due to the increased utilization rather than the decreased synthesis of this methyl donor compound.


Human physiological adaptability through the life sequence.

Changes in organ function from birth to old age were investigated from published data. In essence, the observations of Shock and colleagues on maximal breathing capacity, vital capacity, glomerular filtration rate, renal plasma flow, basal metabolic rate (BMR), ulnar nerve conduction velocity, cardiac index, and intracellular water (ICW) for the age period 30 to 85 years were extended to the time of birth. There were two principal findings. First, with the exception of BMR and ICW, these functional indices increased from a low point at birth to a maximum between 3 and 20 years of age and then after 30 years declined progressively to 85 years; BMR declined from a maximum in infancy and ICW peaked at about 30 years and then declinded. Second, the coefficient of variation increased regularly from birth to old age. Because the peak of organ function coincided with the period of minimal mortality, the curve of organ function across the life sequence was considered to represent changes in adaptive capacity. Supporting evidence from studies of physical fitness, thermoregulation, and seasonal change of mortality was considered. It was concluded that these shifts in adaptive capacity between birth and old age were fundamental baselines for investigations of the epidemiology of health.


Neurological manifestations of aging.

A group of 51 socially active, self-declared neurologically normal subjects ranging from 61 to 84 years of age were studied with a battery of clinical neurological examinations and a semiquantitative vibration perception test. None of the subjects showed a consistent pattern of neurological deficit that could be identified as pathological. On review of systems, the most frequent complaints were difficulty remembering names, numbness and tingling of fingers and toes, and headaches. In the neurological examination, the most commonly observed abnormalities were positive palmomental reflex, snout reflex, abnormalities in pursuit eye movements, convergence insufficiency, and minor mistakes in perception of light touch. There was no apparent trend of worsening of symptoms and signs with advancing age. In the semiquantitative testing of vibration perception, there was a slight trend toward worsening of vibration perception in the upper and lower extremities with advancing age. Motor abnormalities were absent, and there were relatively few subjects who showed reflex abnormalities. This study confirms the previously reported diminution of vibration perception with aging. Caution must be exercised before attributing myotatic reflex and motor abnormalities to the aging process alone.


Psychogeriatric hospital admissions from the community and institutions.

In a sample of 100 psychogeriatric admissions to three Toronto hospitals, the elderly in other institutions, including old age and nursing homes, and those living alone in the community were over-represented. Patients who had lived with relatives, on the other hand, were found to be at low risk for psychogeriatric hospitalization. These three groups of patients were compared using information obtained from psychiatric and social interviews with patients and informants, usually close relatives. Identification of specific needs for the various groups and the implication of these differences for the improvement of psychogeriatric care and prevention of unnecessary hospitalization are discussed. Institutional residents suffered more major physical illness, were less able to maintain functional independence, were referred more often for harmful behavior, were more socially isolated, and had a poorer outcome than community patients. Patients living along lacked familial support, but were not otherwise more socially isolated that those living with relatives, and showed no other deficits. The subjective and objective burdens on the patients' families before admission were considerable. The results are consistent with previous literature on the elderly.


The perception of induced dental pain in young and elderly women.

Pain threshold for electrical stimulation of healthy, unfilled teeth was studied in young and elderly women. Using the methodology of Sensory Decision Theory, ability to discriminate between suprathreshold shocks (d') and response bias were also assessed. No difference in threshold was observed betweeen the young and elderly groups. The elderly women were poorer at discriminating between suprathreshold shocks than the young women. These results were interpreted to reflect the integrity of highthreshold dental pulp afferents in the elderly and a central nervous system deficit on the part of the elderly for discriminating between such shocks. Significant age differences in response bias were also observed. Elderly subjects were biased against reporting shock as very faint pain compared to the young subjects and they restricted the range of their criteria across the six-point rating scale.


Aging and decision criteria for the detection of tones in noise.

The performance of young (18--22 years) and old adults (55--64 years) on an auditory task was compared using signal detection procedures. Subjects used a confidence rating scale to report the presence or absence of a 6000 Hz pure tone embedded in Gaussian noise. The tone was set at eigher 35, 50, or 65 dB SPL. Younger subjects showed perfect sensitivity at all dB levels, and the sensitivity of older subjects increased as a function of the dB level. Discrimination was then tested at 20 and 30 dB in another sample of younger subjects. We found that this group tended to respond much less conservatively than the older group, even though the task was of comparable difficulty.


Locus of desired control and positive self-concept of the elderly.

In two studies, positive self-concept correlated with belief in one's internal locus of desired control. Examining only institutionalized subjects, the first study found this relationship to be particularly prominent for male subjects (r = .68). In the second study, comparing institutionalized persons sampled from several homes for the aged and noninstitutionalized elderly, this relationship was once again most prominent for the institutionalized males (r = .53). Among these studies internality also correlated positively with nurses' rating of subject's happiness, self-ratings of contentment and happiness, and correlated negatively with length of residency in old age home and age. In response to concerns raised by Rotter (1975) over locus of control research and issues raised by Mischel (1968, 1973) and others concerning personality research in general, the present study used a more situationally specific locus of control measure specially designed to take into consideration the environmental circumstances as well as interests of the subject population being studied. Included in the measure is a desire of outcome index which added substantially to the validity coefficient.


Cautiousness in adulthood as a function of age and payoff structure.

Eighteen young (mean age = 21.50; SD = 2.23) and 18 older (mean age = 68.17; SD = 3.13) adults participated in a vocabulary task involving varying degrees of risk with a payoff structure that varied either directly or inversely with risk. In contrast to prior research using constant payoff structures, the results did not indicate that older adults are more cautious than young adults. Further, for both age groups, risk-taking is a function of payoff structure. The data clearly question the generalization that the elderly are more cautious than young adults and suggest that risk, as a concept, should not be considered independently of payoff.


Subjective adaptation to loss of the work role: a longitudinal study.

Both social psychologists and social gerontologists have expressed considerable interest in adaptation to the loss of central life roles. The relationship between retirement and morale, where morale is viewed as an indicator of adaptation, is an example of research within this theoretical framework. In this study, longitudinal data for a select sample of 58 male subjects were used to examine intensively the process of adaptation to retirement. The strongest finding was evidence of high levels of adaptation in the sample as reflected in the overwhelming stability of morale over time. Multiple regression analysis indicated that social resources, particularly marital status and socioeconomic status, condition the relationship between adaptation and retirement. In summary, our analysis supports current suggestions that retirement be viewed as an event which occasions a complex social process of adaptation conditioned by a variety of resource and temporal variables.


An exploratory study of sources of stereotypes of old age among administrators.

This exploratory study examines the relative effects of individual, client, and organizational characteristics on stereotypes of the aged held by nursing home administrators. Data from 45 administrators suggest that client characteristics may be more important than personal or organizational dimensions in explaining variation in perceptions of the aged. Sex of clients and other status characteristics affect attitudes toward the aged and possibly the quality of care.


Aging and voluntary association participation.

This longitudinal analysis examines changes in voluntary association participation levels over a 4-year period using data from the middle age of the Duke Adaptation Study (N=374) and over a 2 1/2-year period using data from a study of older persons in Oberlin, Ohio (N=104). The findings showed; the extent of participation was high in both samples; mean levels of participation remained essentially unchanged; persons with stable or increasing participation levels outnumbered those with declining levels; and persons not participating at the time of the initial interview were unlikely to be participating later, while those who were participating initially were likely to have continued their participation. Contrary to predictions of declining activity based on disengagement theory, aging appears to be accompanied by stability and continuity in levels of voluntary association participation.


Congenital deficiency of the ulna.

Twenty-three patients with ulnar ray deficiency were studied and the deformities described by combining Kummel's and Swanson's classifications. An individualized, functionally oriented management program is recommended with early resection of the fibrocartilaginous remnant to prevent shortening, radial bowing, and possible malrotation. Rotational deformity can be corrected by wedge osteotomy, rotation osteotomy, or proximal radial ulnar synostosis. Improved motion at the elbow can be obtained by release of contractures or resection of the radial head. Wrist deformity may require resection of the ulnar remnant and a wedge osteotomy of the radius.


Lengthening of the ulna in radial agenesis: a preliminary report.

In two patients with bilateral radial agenesis, the ulnas were divided and lengthened in a modified Abbott-Anderson device with a gear box controlled by an electric motor to obtain from one to 2 mm. per day of gradual distraction. Three centimeters of length was achieved in 3 weeks. Bone bridged the gap in 3 months and was mature in 6 months. Repeat osteotomy and lengthening was done 12 to 18 months later. All secondary lengthening operations required bone grafts. Total length gained ranged from 5.4 to 6.4 cm.


Congenital triangular bones in the hand.

From the literature we found reports of 105 patients whom we judged had a triangular deformity of one of the bones of the hand or foot. We found 49 patients of our own with 84 delta-shaped phalanges limited strictly to the hand. This represents an incidence of 3.5% of our congenital abnormalities of the upper extremity. The deformity is associated with many abnormalities: syndactyly, polydactyly, symphalangism, triphalangeal thumb, cleft hand, and hypoplastic hand are the most frequent Triangular deformity of the bone of the index finger usually is associated with Apert's syndrome. Triangular deformity of the proximal phalanx of the ring finger often is found with central polydactyly. Our average follow-up time on these 49 patients was 14 years, giving us a chance to establish some guidelines and general rules about the natural history and treatment of the delta bone.


A systematic study of the oblique retinacular ligament of the human finger: its structure and function.

A dissection of 14 preserved and two fresh human hands, a total of 64 fingers, all from different individuals, showed the oblique retinacular ligament to vary incompleteness and to be functionally present in only 40 to 50% of the specimens, except for the ulnar side of the ring finger where it was present in over 90%. When present, it was made taut by flexion of the distal phalanx, regardless of the postition of the proximal interphalangeal joint. Excision of the ligament when present or in its absence in these fingers, did not alter the coordinated motion of the interphalangeal joints produced by traction on the extrinsic flexors and the lateral bands. In absence of the ligament, a constant finding was the presence of a proximally located osteocapsular ligament which became taut on extension of the proximal interphalangeal joint.


Degenerative arthritis of the carpometacarpal joint of the thumb: a clinical follow-up of eleven Niebauer prostheses.

Eleven patients with disabling osteoarthritis at the base of the thumb were treated with a Dacron-reinforced trapezium replacement arthroplasty. Examination from 1 to 3 years later (average, 20 months) showed that all patients were satisfied, principally because of relief of pain. The range of motion and stability were satisfactory, although far from normal. Postoperative dislocation did not occur. This problem was eliminated by correcting hyperextension of the metacarpal phalangeal joint and by reinforcing the capsule over the trapezium with a buttress created by transferring half of the distal end of the flexor carpi radialis to the insertion of the extensor carpi radialis longus. None of the prostheses fractured and no bone erosion was seen on postoperative roentgenogram.


Camptodactyly: an analysis of sixty-six patients and twenty-four operations.

Camptodactyly is a nontraumatic flexion deformity of the proximal interphalangeal joint. The literature pertaining to its etiology and treatment is reviewed. An analysis of 66 patients with 110 affected hands is discussed with particular reference to the natural history of this deformity and the results of 24 operative procedures. Improvement was noted in less than 20% of 32 patients treated nonoperatively and followed for an average of 30 months. Corrective types of operative procedures in 20 hands resulted in improvement in only 35%. A treatment plan dependent on the age of the patient, the presence or absence of osteocartilagenous changes at the proximal interphalangeal joint, and associated anatomic abnormalities is presented.


Variation in serum immunoglobulin levels in acute trichinosis.

An early rise in serum IgE levels was observed in five of seven patients with acute primary trichinosis. Parallel increases in the total IgG, IgM, and Iga levels, as well as specific IgG and IgM antibody titres to Trichinella spiralis larval antigen, were detected in two. The elevated levels persisted long after the clinical recovery of the patients.


Intestinal helminth parasites of the ray Raja naevus in British waters.

Five cestode, one monogenean, and two nematode species comprised the "normal" intestinal helminth fauna of Raja naevus in British waters. An additional two nematodes, a digenean, an acanthocephalan and a crustacean recorded are considered to be accidental infections. Geographical differences in the species composition and level of infection are noted and discussed. Short descriptions of the tetraphyllidean cestode Echeneibothrium sp. and the nematode Capillaria sp. are given, but the species, although probably both new, are left unnamed. The intensity of cestode infections show two patterns associated with host length and these are discussed in relation to variations in host diet. Speculations are made on the cestode life cycles. Only Echeneibothrium sp. numbers showed any significant variation associated with host sex.


An evaluation of ethyl-6-ethoxybenzothiazole-2-carbamate (Sch 18099) for anthelmintic activity in domestic animals.

Ethyl-6-ethoxybenzothiazole-2-carbamate (Sch 18099) was evaluated for efficacy against natural helminth infections in ponies, pigs, lambs and chickens. Sixteen critical trials were conducted in ponies at dosages of 15 to 150 mg/kg. At 15 mg/kg, efficacy against adult and larval Oxyuris equi was 100% and 91% and against small strongyles it was 98%. Efficacy levels were 95% against Strongylus vulgaris and S. edentatus at the 20 mg/kg dosage. In two trials at 100 mg/kg efficacy against Parascaris equorum was 77%. No efficacy was observed against Gastrophilus spp. or Anoplocephala spp. In swine single oral doses of 10 to 100 mg/kg were not effective. 500 ppm Sch 18099 in the diet for seven days resulted in 100% efficacy against Ascaris suum and Trichuris suis but had no effect on Stongyloides ransomi. Efficacy at 250 ppm against A. suum was 77%. Efficacy at 200 mg/kg in lambs was greater than 90% for Haemonchus contortus, Trichostrongylus axei, Marshallagia marshalli, Bunostomum trignocephalum, Oesophagostomum columbianum, Trichuris ovis, and Chabertia spp. Efficacy was less than 80% for Trichostrongylus vitrinus, Nematodirus filicollis, Ostertagia circumcinta and Cooperia curticei. Except for O. circumcinta and C. curticei, drug efficacy was reduced for these worms in lambs treated at 100 mg/kg. Efficacies of 14.3-89% against Ascaridia galli were obtained with dietary levels of 125-1000 ppm Sch 18099 fed for 7 days. Efficacy of 100% was recorded against Heterakis gallinarum at the 1000 ppm dietary drug level.


On two new linstowiid cestodes from Australian dasyurid marsupials.

Two new species of the genus Oochoristica Lühe, 1898 from Australian dasyurid marsupials are described and their affinities discussed. The new species are O. antechini sp. nov. from Antechinus macdonnellensis and O. eremophlia sp. nov. from Antechinus rosamondae.


Revision of the genera Longistrongylus Le Roux 1931, Kobusinema Ortlepp, 1963 and Bigalkenema Ortlepp, 1963 (Nematoda: Trichostrongylidae).

The species of the genera Longistrongylus, Kobusinema and Bigalkenema are redescribed. Kobusinema and Bigalkenema are considered synonyms of Longistrongylus and their species are transferred as new combinations. Bigalkenema neveulemairei (Gutteres, 1947 Jansen, 1958 and Longistrongylus muraschkinzevi (Shulz and Kadenatsii, 1950), Jansen, 1958 are considered species inquirendae. A key to the species of the genus Longistrongylus is given and their hosts and geographical localities are listed.


Investigations of the unimiracidial infection of Schistosoma intercalatum in snails and the infection of the final host using cercariae of one sex.

Infection with single miracidial doses of Schistosoma intercalatum from Cameroun in Bulinus forskalii and from Zaire in B.globosus resulted in an equal number of male and female infections. The cercarial production of both sexes started at the same time. The male infected snails produced a greater number of cercariae, because of the longer duration of infection. The recovery of schistosomes from infection with male and female cercariae was for S. intercalatum, Zaire, 38.8 +/- 10.6 and 18.7 +/- 14.0 respectively. For S. intercalatum from Cameroun, with single sex cercariae from two different populations of intermediate hosts from Zaire and Cameroun were 38.3 +/- 7.3 (male); 20.3 +/- 9.3 (female) and 35.0 +/- 8.7 (male); 12.2 +/- 4.5 (female), respectively.


Schizorchis arfaai sp. n. (Cestoda: Anoplocephalidae) from the wood-mouse, Apodemus sylvaticus, in Caspian area of Iran.

Schizorchis arfaai sp. n. is described from the wood-mouse in the Caspian area of Iran and its morphological characteristics compared with those of the five previously known species of Schizorchis Hansen, 1948.


Influence of immunosuppressants on the establishment of Paragonimus miyazakii in albino rats.

The present investigation has shown that combined treatment with dexamethasone and prednisolone of with hydrocortisone and dexamethasone enhances the susceptibility of albino rats to Paragonimus miyazakii, presumably by suppressing the host's immune responses. In the rats given these combined treatments, the size and egg production of worms were markedly increased. Use of dexamethasone or prednisolone alone had relatively little influence on the growth and maturity of P. miyazakii. In serological analysis and agar double diffusion, considerable differences were recognized between the gamma-globulin fractions and antigen-antibody systems (precipitin bands) of the treated groups and the untreated group. The mechanism of action of these immunosuppressants in this system remains obscure.


Current sociological research in Canada: views of a journal editor.

On the basis of submissions to the Canadian Review of Sociology and Anthropology and to the Annual Meetings of the Canadian Sociological and Anthropological Association, sociology in Canada may be described as social problem oriented, empirical, and atheoretical. There is a strong interest in research on ethnicity and on immigrant adjustment, reflecting a continuity with earlier periods of sociology in Canada, and on deviance and social control. Research on stratification, social mobility, and the family has been relatively neglected. As sociology in Canada shares the interest of "mainline" sociology, it has not escaped criticism or attempts to change its direction. A general model, identifying influences on the formulation of investigative issues in sociology, is used to interpret these criticisms and responses to them.


Allele frequencies in a cat population in Budapest.

Allelic frequencies were determined for the domestic cat population of Budapest, Hungary. Most of the frequencies are in the range of those of western European populations, but there are two unusual features. The first is the apparent absence of blotched tabby and a relatively high frequency of Abyssinian tabby. The second is in the distribution of frequencies of white spotting phenotypes. There is an approximately normal distribution around the most common pattern, which is 50 percent white fur, contrasted to western populations in which frequency is maximal between approximately 10-30 percent white fur and declines with increasing white fur.


Peroxisomes in pulmonate gastropods.

Organelles with the morphologic characteristics of peroxisomes have been found in the cells of the kidney sac of two terrestrial pulmonate gastropods. Arion ater and Ariolimax columbianus. These peroxisomes appear in profile as circles or ellipses, 0.25 micron in diameter and 0.3-0.8 micron long; They have a finely granular matrix and a single-limiting membrane; the organelles are extensively associated with smooth endoplasmic reticulum. Some Ariolimax peroxisomes contained structures reminiscent of nucleoids while those of Arion did not. The peroxisomes of Arion ater show a strongly-positive staining reaction with the 3,3'-diaminobenzidine technique, which is inhibited in the presence of aminotriazole. Peroxisomes of Ariolimax columbianus did not show a positive reaction, despite a number of variations of the 3,3'-diaminobenzidine protocol. Speculations are made concerning the biochemical reasons for this cytochemical behavior. Peroxisomes in both tissues were negatively stained while lysosomes were positively stained in acid-phosphatase incubations.


A familial occurrence of osteogenesis imperfecta.

The familial occurrence of a mesenchymal disorder--Osteogenesis imperfecta--is reported. A pedigree analysis reveals a pattern that concurs with one suggested mode of inheritance for the disorder. However, additional information is deemed necessary before an unequivocal etiology can be established for the connective tissue disorder.


Control of extraction of deoxyribonucleic acid and apurinic acid by polyethylene glycol in Feulgen hydrolysis.

The polymer polyethylene glycol combined with hydrochloric acid was used during the hydrolysis stage of the Feulgen method in order to limit the movement of the soluble molecular fragments developed through hydrolytic breakdown of the deoxyribonucleic acid. The diffusion of the purines was not influenced by the addition of concentration of the polymer up to 30%. On the other hand, a substantial retardation of the extraction of deoxyribonucleic acid and apurinic acid was noted. This indicates that deoxyribonucleic acid and apurinic acid are extracted in chains of considerable length. The decrease in diffusion rate was greater at 1 M HCl than at 0.3 and 6 M HCl, which indicates that the deoxyribonucleic acid-apurinic acid fragments are larger at the medium concentration of acid than at the low and high concentrations. The results thus strengthen the view that deoxyribonucleic acid and apurinic acid are extracted in chains during hydrolysis, and that the critical length at which the chains becomes diffusible is one of the main factors determining the form of the Feulgen hydrolysis curve. The use of polyethylene glycol to extend the maximum of the hydrolysis curve, and thus to make the temperature and time of hydrolysis less critical, is recommended.


Ultracytochemical demonstration of monoamine oxidase activity in nervous and non-nervous tissue of the rat.

A method is described for the ultrastructural localization of the enzyme monoamine oxidase based on the formation of an osmiophilic formazan from the tetrazolium salt (2-(2'-benzothiazolyl)-5-styrl-3-(4'-phthalhydrazidyl) tetrazolium chloride) (BSPT) and using tryptamine as substrate. It was tested in rat heart, liver, adrenal cortex and medulla, kidney, pineal gland, cerebral cortex and cerebellar cortex and was found to provide good ultrastructural preservation, high contrast of the specific, enzyme-dependent precipitate and improved sensitivity. Monoamine oxidase activity was found in the mitochondrial outer compartment, nuclear envelope and endoplasmic reticulum in all organs studied; it was also seen occasionally in plasma membranes of liver and heart. Similar localizations were observed in interstitial cells and capillary endothelial cells. The enzyme-dependent nature of the observed precipitate was verified by control experiments consisting of incubation of overfixed tissue, omission of substrate from the incubation medium, and incubation in the presence of a specific, nonreversible inhibitor, pargyline. These studies confirm and extend the results of cell fractionation studies using liver, demonstrate the widespread distribution of monoamine oxidase in tissues, and suggest that monoamine oxidase plays important functional roles in extraneuronal cells.


Homosexuality and the ethics of behavioral intervention: Homosexuality, the ethical challenge.

It is suggested that behavior therapists have not attended sufficiently to the factors influencing the desire of some homosexuals to change their sexual orientation. Therapists of all persuasions constantly make decisions for their voluntary clients, encompassing both the goals of therapy and the means to be used to achieve those goals. A perusal of the psychotherapy and behavior therapy literature indicates that therapists generally regard homosexuality as undesirable, if not pathological. Since professionals are unlikely to work on treatment procedures unless they see a problem, it is probable that the very existence of change-of-orientation programs strengthens societal prejudices against homosexuality and contributes to the self-hate and embarrassment that are determinants of the "voluntary" desire by some homosexuals to become heterosexual. It is therefore proposed that we stop offering therapy to help homosexuals change and concentrate instead on improving the quality of their interpersonal relationships. Alternatively, more energy could be devoted to sexual enhancement procedures in general, regardless of the adult gender mix.


IgG immunoglobulin deficiency in muscular dystrophic chickens.

Plasma immunoglobulin profiles of New Hampshire strain muscular dystrophic chickens were determined by radial immunodiffusion, immunoelectrophoresis and polyacrylamide gel electrophoresis. Muscular dystrophic chickens have reduced levels of IgG but maintain normal levels of total serum proteins, IgA and IgM. The relationship and significance of the IgG deficiency to muscular dystrophy remains to be determined.


Gene frequencies in the cat deme of Tampa, Florida.

The frequencies of mutant alleles at five loci were calculated for a sample of cats from the deme of Tampa, Florida. Owing to certain diagnostic problems, precise comparisons to other populations are unwarranted. However, there is general concordance with other U.S. cat populations.


Homosexuality and creativity.

Despite heightened interest in both homosexuality and creativity, as well as theoretical and anecdotal evidence linking the two, there are virtually no empirical data relevant to this hypothesized relationship. Four groups of homosexuals (activists, social homosexuals, clients of a college counseling center, and artistic homosexuals) and four groups of control heterosexuals matched on age, educational level, and verbal intelligence were administered a battery of tests that included nine measures of aspects of creativity. Of the 36 possible comparisons, nine significant mean differences were obtained, but in all cases homosexuals scored lower. There is thus no support for the contention that homosexuals are more creative.


Detectability and perceptions of a transsexual: implications for therapy.

Transsexuals are concerned with being accepted in straight society, that is, "passing" successfully. Ninety-one undergraduates were shown a videotaped discussion of interracial dating by five heterosexual biological females and one cross-dressed male transsexual. Experimental subjects, who had been previously informed of the presence of the transsexual, were all able to identify her, significantly more than control subjects who had not been given this set. Ratings were obtained on eight personal attributes of the transsexual and the five biological females prior to the subjects' attempts to identify the transsexual in the group. The results of these ratings indicated that detection of the transsexual was related to perceived femininity and happiness. Based on these findings and subjects' reports of how they correctly identified the transsexual, suggestions were made for a therapy package to assist transsexuals in minimizing the probability of their detection.


Legal and social ambivalence regarding homosexuality.

Social controversy and legal ambivalence have been prevalent regarding homosexuality. Guardians of tradition, such as the churches, the mental health professional organizations, and the legal experts, have all moved toward decriminalization in their own fashion. Yet this thrust has been halted by a recent Supreme Court decision. The homosexual may have to retreat to the closet unless renewal occurs. Some information is available on what societal and behavioral changes will occur as the laws change. However, a more scientifically adequate information base, as well as political courage, is required before those seeking decriminalization are likely to succeed.


Impact of a natural catastrophe on life events.

A major earthquake struck Peru in May 1970. This post-quake study compares the impact of this natural catastrophe on the residents of two different cities; one was 90 percent levelled by the quake and one was untouched. A relatively homogeneous population of Peruvians obtained from the two cities completed two paper-and-pencil tests, the Social Readjustment Rating Questionnaire (SRRQ) and the Schedule of Recent Experience (SRE). Both questionnaires were adapted from the SRRQ which had been translated for studies in Spain and EL Salvador. The data from the SRRQ generated two Peruvian Social Readjustment Rating Scales (SRRS), one for each of the cities studied. The differences in the two scales were striking. The lowest intra-cultural correlation yet observed on four studies was obtained. Comparison with a United States population yielded no significant relationships (rs = 0.15), the first time this has occurred in nine intercultural studies. A comparison of the profile of items generated by their subjective magnitude estimations indicated striking qualitative and quantitative differences between the two populations. The SRE generated frequency of occurrence of items and life change magnitudes in five proscribed time intervals. Significant differences in these two quantitative indices (including the health change items) were observed in the two populations in some of the time intervals and not in others. The data formulated suggest that the occurrence of a natural catastrophe--an earthquake which devastated one city--accounted for much of the difference observed between the populations of the two cities.


Medical-surgical differences in hospital stress factors.

Psychosocial stress due to the experience of hospitalization was ascertained for 535 medical and surgical patients in a community hospital, using a Hospital Stress Rating Scale, Medical-surgical differences along nine dimensions of stress as measured by this scale were examined, using analysis of covariance to control for the effects of patient characteristics known to be associated with scores on the Hospital Stress Rating Scale. The controlled variables were age, education, number of previous hospitalizations, number of years since last hospitalization, and seriousness of illness (Seriousness of Illness Rating Scale). The analysis of covariance results indicated higher perceived stress for surgical patients on the dimensions of unfamiliarity of surroundings, loss of independence, and threat of severe illness. Medical patients scored higher on the dimensions of stress due to financial problems and lack of information. The authors discuss how these findings might be incorporated in experimental studies designed to reduce stress among hospital patients.


Emergency decision making: a theoretical analysis of responses to disaster warnings.

This article presents a theoretical model of emergency decision making that focuses on the decision maker's answers to basic questions evoked by warnings or signs of danger. Effective emergency decisions are most likely to be made, according to the theory, when a vigilant coping pattern is dominant, which requires that the following four mediating conditions are met: 1) awareness of serious risks if no protective action is taken; 2) awareness of serious risks if any of the salient protective actions is taken; 3) moderate or high degree of hope that a search for information and advice will lead to a better (i.e., less risky) solution; and 4) belief that there is sufficient time to search and deliberate before any serious threat will materialize. When one or another of these conditions is not met, a defective coping pattern, such as defensive avoidance or hypervigilance, will be dominant, which generally leads to maladaptive actions. In addition to suggesting new interventions for facilitating adaptive behavior in emergencies, the theoretical model provides a basis for integrating disparate findings from psychological research on the effects of warnings and confrontations with danger.


Suppressor lymphocytes in young and aged humans.

Using human peripheral lymphocytes activated by concanavalin A (Con A), we observed suppression of the normal lymphocyte response to mitogens and allogeneic cells. The suppressive effect requires at least a 24 hr activation period of lymphocytes with ConA and is dose dependent. Activation of the suppressor population and stimulation of the responding population with mitogenic doses of ConA caused suppression of the response to mitogens, whereas activation and stimulation with submitogenic doses generally caused enhancement of the response. Responding lymphocytes showed individual variation in their ability to be suppressed by ConA-activated lymphocytes. This variable suppression could be demonstrated in autologous or allogeneic lymphocytes stimulated by ConA and also in the mixed lymphocyte reaction. ConA-activated lymphocytes derived from an aging human population differ from those of young individuals in showing a variable loss of suppressor activity. The decline of this suppressive phenomenon in aged humans may provide an explanation for the increased frequency of autoantibodies seen in the aging human population.


Receptor-binding sites on C3 and C3b.

Human erythrocytes carry C3b receptors: Daudi lymphoid cells carry exclusively C3d receptors. With these two types of cells, it could be shown that isolated, uncleaved human C3 and soluble C3b possess two stable binding sites: SBS1-specific C3b receptors, and SBS2-specific for C3d receptors. Upon binding of freshly cleaved C3b (nascent C3b) via its labile binding site (generated on C3b through cleavage of C3) to the C3 acceptors on cell surfaces, the SBS2 becomes concealed. Kinetic experiments show that immediately after the action of fetal calf serum or partially purified C3b-inactivator on EAC1423b the SBS2 is accessible again. The reappearance of SBS2 does coincide with cleavage of surface-bound C3b into C3c and C3d but not with the release of C3c from the cell; C3c remains attached and is released only with delay. Concomitant with the cleavage event the number of SBS1 is reduced, stressing the importance of an unaltered steric configuration of the C3b structure for the expression of SBS1. An alternative explanation might be that the SBS1 is located at the site connecting C3c and C3d, so that it becomes altered upon dissection of the two fragments.


Kinetic studies on the fragmentation of the third component of complement (C3) by trypsin.

The kinetics of cleavage of C3 by trypsin was analyzed by electrophoresis in agarose and in polyacrylamide gels containing sodium dodecyl sulfate and the data obtained were used to construct an anatomical model for C3 showing the sites of tryptic attack, the fragments generated, and their composition. Trypsin was shown to cleave C3 in a stepwise fashion. The attack was initially directed at the alpha-polypeptide chain and resulted in the generation of C3a and C3b. Further cleavage of the alpha-chain of C3b, converted it into C3b1 and then into C3d and C3c. Cleavage of the beta-chain by trypsin occurred only at the C3c stage with the release of a small peptide (m.w. 12,000) from C3c and the formation of C3c'. On immunoelectrophoresis, C3c' had a less anodal mobility compared to the beta1A mobility of C3c. C3a, once formed could be further cleaved to give residual fragments with decreasing net positive charge. Exposure of C3 to acid conditions, pH 5.0 or below, rendered the molecule exceedingly susceptible to tryptic degradation.


The effect of BCG on experimental cutaneous leishmaniasis in mice.

The effect of administration of live Bacillus Calmette-Guerin (BCG), a nonspecific immunostimulant, on the course of experimental cutaneous leishmaniasis in mice was investigated. BALB/c mice were injected in the footpad with Leishmania tropica, NIH S-strain; in mice that were not pretreated with BCG this produced a reproducible fatal infection characterized by local inflammation, regional lymphadenopathy, and dissemination of parasites with hepatosplenomegaly. In mice that were pretreated with BCG and similarly infected with L. tropica there was a reduction in the severity of cutaneous disease and a significant (p less than 0.005) decrease in mortality without evidence of visceralization.


Immune complex-induced platelet aggregation and 3H-serotonin release: microtechnique for an assay of virus and mycoplasma antigens or antibodies.

Human platelets are very sensitive indicators of immune complexes. The microplate test presented employs aggregation and/or release reaction of platelets as parameters of an antibody and antigen assay. The measurement of the release reaction is approximately 5 times more sensitive than the examination of aggregation patterns. Antibody titres of patients' sera attained values of 1/780,000 for adenoviruses and Mycoplasma pneumoniae. The determinations of 3H-serotonin release quantitative and therefore allow the equivalence point of a specific antibody/antigen interaction to be shown. This also provides the basis for reliable titre determinations in patients' sera with non-specific, direct platelet reactivity. If such an antiserum is titrated against the corresponding antigen, the release measurements reveal dose-response relations which are characteristic for an effect medicated by immune complexes.


The influence of the serum/PHA ratio, microplate well shape and 2-mercaptoethanol on the stimulation of different numbers of cells in lymphocyte cultures from the chinese hamster.

Conditions for microculture of Chinese hamster lymphocytes are described which allow measurement of thymidine uptake with 6000 to 1000 lymphocytes per culture. The relationship between degree of cell stimulation, PHA concentration culture surface and cell concentration is described, as well as the influence of addition of 2-mercaptoethanol to the cultures.


Affinity chromatography of antiserum to a gram negative organism.

An immunoadsorbent method is described for the purification of antibody directed against gram negative bacteria. Two anion exchange materials were compared for their ability to immobilize whole cells of Veillonella alcalescens, a gram negative oral bacterium. Purified antibody preparations were applied to the columns and subsequently eluted with various combinations of desorbing buffers. The quantity of recovered antibody was measured and its activity assayed, using a microagglutination technique. The highest levels of protein and specific antibody activity were recovered from Dowex-1-acetate columns desorbed by a combination of borate buffer pH 10 and 3 M KSCN pH 6, followed by levels of specific antibody activity obtained from a DEAE cellulose column desorbed by glycine--HC1, PBH 2.3.


Effects of dermatitis, stripping, and steroids on the morphology of corneocytes. A new bioassay.

This study was designed to investigate the effects of increased or decreased epidermal turnover on the morphology of human corneocytes. The desquamating portion of the stratum corneum was sampled with the detergent scrub technique using Triton X-100. The following parameters were measured: size (surface micron2), shape (regular, irregular), nuclear inclusions, trabeculae, and numerical counts. Specimens were obtained from adult males with allergic contact dermatitis (N=18); with tretinoin-induced dermatitis (N=11); after cellophane stripping (N=11); and after treatment of these conditions with topical steroids (N=40). Data from 250,000 cells were analyzed statistically. The reproducibility of the method is good (r=0.934). Corneocytes from skin of patients with allergic contact dermatitis differed from those of normal skin: they were 15% smaller and of irregular shape with asymmetrical trabeculae; 50% were nucleated and about 3 times as many cells were collected per cm2 skin surface. Tretinoin and stripping produced similar but more pronounced effects. Topical steroids significantly improved all parameters (p less 0.01). Betamethasone-17-dipropionate was more effective than the valerate. This bioassay permits sensitive measurements of corneocyte morphology in conditions with altered epidermal cellular kinetics. It provides a method to evaluate steroid effectiveness.


Oral methoxsalen photochemotherapy for the treatment of psoriasis: a cooperative clinical trial.

Extensive psoriasis in 1,308 patients has been treated two or three times a week with oral 8-methoxypsoralen followed by high intensity, long-wave ultraviolet light (PUVA). Excluding 169 patients still under early treatment, psoriasis cleared in 88% and failed to clear in 3%. One percent dropped out due to complications of treatment, and 8% for other reasons. The twice-a-week schedule was superior for patients with lighter skin types. Once a remission was induced, there was no difference in its maintenance when patients were treated once a week, once every other week, or once every third week. Each of these schedules was superior to no maintenance treatment. Immediate side effect of the 45,000 treatments administered in the first 18 months of this study were uncommon, temporary, and generally mild. No clinically significant changes in laboratory screening or eye examinations attributable to PUVA have been uncovered.


Sensitization with Cr, Ni and Zr salts and allergic type granuloma formation in the guinea pig.

Guinea pigs were sensitized to potassium dichromate, nickel sulfate and sodium zirconium lactate by three methods of immunization in Freund's complete adjuvant: Polak, split adjuvant, and maximization (modified Magnusson and Kligman). These were followed after 2 weeks by weekly intradermal injections of 25 microng of the metal salt. Delayed hypersensitivity-like reactions developed 3 to 12 weeks after initial injection. Reactivity, although strong with an increase in thickness of over 0.7 mm and/or diameter of erythema of over 8 X 8 mm, was frequently transient, the animal losing reactivity on subsequent skin test or after 2 or 3 skin tests. In two-thirds of the experiments using sodium zirconium lactate, delayed hypersensitivity-like reactions at 24 hr developed into nodular lesions which reached peak intensity at 8 days and histologically contained histiocytes with an epithelioid cell appearance and giant cells. In some experiments, sodium zirconium lactate-sensitive animals showed cross reactivity with potassium dichromate, but not with nickel sulfate.


Environmental temperature and the percutaneous absorption of a cholinesterase inhibitor, VX.

S-(2-diisoproplaminoethyl) 0-ethyl methylphosphonothioate (VX), an anticholinesterase liquid of low volatility, was applied to the skin of 139 men at environmental temperatures of -18 degrees, 2 degrees, 18 degrees, or 46 degrees C. The skin was decontaminated after 3 hr and the men spent the next 21 hr at about 27 degrees C. The amount of VX penetrating the skin was estimated from the inhibition of red blood cell cholinesterase. The decimal fraction of the dose that penetrated in 3 hr ranged from 0.04 at -18 degrees C to 0.32 at 46 degrees C for the cheek and from 0.004 at +18 degrees C to 0.029 at 46 degrees C for the forearm. Further increase in cholinesterase inhibition after decontamination was evidence of a deposit of VX in the skin. The amount of VX remaining in the skin after decontamination was greater in the forearm and less in the cheek at higher temperatures.


In vitro screening of biochemical activity of folic acid antagonists in skin.

Dihydrofolate reductase (DHFR) inhibitors, which differ from the classical folate antagonists in physicochemical and pharmacologic parameters such as lipid solubility and mechanisms of cellular transport, were screened for DHFR inhibitory activity and biologic activity in newborn rat skin. The most effective drugs from this screen were tested for their effects on de novo DNA synthesis in psoriatic epidermis in vitro. Of the 24 compounds studied, methotrexate (MTX) was the most potent inhibitor of rat skin DHFR (I50=8.6 X 10(-9) M). Methotrexate-dimethylester, methasquin-diethylester, DDEP (2,4-diamino-5-(3',4'-dichlorophenyl)-6-ethylprimidine), and Baker's triazine antifolate (NSC 139105), while less effective than MTX as DHFR inhibitors, were more effective than MTX as inhibitors of de novo DNA synthesis in rat skin in vitro. Baker's antifolate was the only compound tested which was considerably more effective than MTX as an inhibitor of de novo DNA synthesis in psoriatic epidermis in vitro.


Antioxidant-mediated reversal of ultraviolet light cytotoxicity.

Several antioxidants were tested for their protective effect in Chinese hamster embryo cell against ultraviolet light (UVL)-irradiation. Ascorbic acid, DL-alpha-tocopherol, butylated hydroxytoluene, and reduced glutathione were all shown to reverse UVL-induced cytotoxicity. At concentrations tested, no protective effect was detected when any of these antioxidants were added prior to UVL irradiation.


An in situ procedure for the biopsy of pressure-wrapped hypertrophic scars.

A plexiglass device can be incorporated in the therapeutic elastic wrapping of hypertrophic scars. The removal of a small access port on this device permits the exposure of the underlying tissue for full-thickness biopsy without the necessity of first removing the pressure wrapping. The ultrastructural detail of tissues biopsied in this manner more readily reflects the in situ microarchitecture of the pressure-wrapped skin and/or scars.


Immunity to experimental cholera. III. Enhanced duration of protection after sequential parenteral-oral administration of toxoid to dogs.

Protection against experimental cholera after immunization with a purified glutaraldehyde toxoid given subcutaneously (sc), orally, or by a combined sc-oral sequence was compared in dogs. The protection induced by toxoid appeared to be entirely due to antitoxin. Repeated sc immunization with precipitated toxoid resulted in 77% protection at two weeks but no protection at four months. Protection after sc immunization correlated with titers of antitoxin in serum and appeared to result entirely from serum-derived antibody. In contrast, immunization by the sc-oral sequence resulted in prolonged protection (74% at two weeks, P=0.04; 100% after four months, P=0.004; and 57% after eight months, P=0.01) that was not related to the low serum antitoxin titers achieved. This sequence was effective only if the oral booster was given in divided doses. Immunization by oral priming and boosting was ineffective. These results suggest that the sc-oral sequence of immunization is an efficient means of stimulating the enteric immune response to nonreplicating protein antigens and may provide an improved approach to immunization against cholera.


Maternal-fetal pharmacological activity of amikacin.

Thirty healthy gravid patients of six to 20 weeks' gestation each received a single dose of 7.5 mg of amikacin/kg within 24 hr prior to elective hysterectomy. The half-life (t1/2) of amikacin in maternal serum was 2.07 hr. The mean peak concentration of amikacin in the sera of these patients was slightly lower than that in nonpregnant adults. Two-thirds of the placental samples had amikacin concentrations of greater than or equal to 8 microng/g during the 20-hr interval between drug injection and delivery time. In fetal kidney the concentration of amikacin peaked at a level of 22.4 microng/g at 12 hr after administration. The peak concentration of amikacin in fetal urine was 24 microng/ml, and the t1/2 was 3.2 hr. High levels of the drug in fetal urine and low levels in fetal serum (less than 4 microng/ml)  and amniotic fluid (less than 3 microng/ml) were unrelated to high levels found in fetal kidney. Levels of amikacin in fetal lung were 1.4-8.0 microng/g during intervals of 1-16 hr between administration of the drug and time of delivery. With the increasing number of drugs available for use, both potential benefits and risks for the fetus must be considered when prescribing an antibiotic to treat the infected gravid patient, and it should be kept in mind that low levels in body fluid may not be equated with safety.


Diagnosis of experimental encephalitozoonosis in rabbits by complement fixation.

A complement-fixation (CF) test has been developed for detection of experimental encephalitozoonosis in rabbits. The antigen consisted of disrupted homogenates of Encephalitozoon cuniculi spores grown in and released from rabbit choroid plexus tissue culture cells. The test was sensitive and capable of detecting experimental encephalitozoonosis in rabbits as early as 15 days after intracerebral infection. The test was specific for infected animals, and no cross-reactivity was demonstrated between E. cuniculi antigen and Nosema apis, Trypanosoma congolese, Trypanosoma cruzi, rabbit liver powder, rabbit brain powder, and rabbit choroid plexus cell culture. Sera from rabbits infected with Toxoplasma gondii, Eimeria stiedai, and Eimeria perforans did not exhibit antibodies to E. cuniculi. No CF-inhibition activity was detected.


Human toxic neutrophils. IV. Incorporation of amino acids and uptake of 2-deoxy-D-glucose.

Toxic neutrophils were studied for incorporation of amino acids into total proteins and for uptake of a glucose analogue. Both the amino acid incorporation and the uptake of 2-deoxy-D-glucose were increased in toxic neutrophils. This finding may indicate an alteration in the cell membrane of toxic neutrophils.


Pharmacologic factors associated with gentamicin nephrotoxicity in rabbits.

Nine rabbits were given subcutaneous doses of 7.5 mg of gentamicin/kg every 24 hr, and nine were given 2.5 mg of gentamicin/kg every 8 hr for three weeks or longer. Renal function was evaluated by monitoring of the concentration of creatinine in serum and the rate of clearance of gentamicin from serum. In the animals receiving the 8-hr divided dosage, a deterioration of renal function as early as day 7 was demonstrated by the rate of clearance of gentamicin, and deterioration by day 21 was evidenced by the concentration of creatinine in serum; the renal function of the animals receiving the single daily dose was unchanged. There was no relationship between peak or trough concentrations of gentamicin in serum and the development of nephrotoxicity. The animals receiving the 8-hr dosages had a significantly longer daily duration of exposure to concentrations of greater than or equal to 0.1, greater than or equal to 1.0, greater than or equal to 2.0, and greater than or equal to 3.0 microng of gentamicin/ml in serum than did animals receiving the daily dosage.


Penetration of tobramycin into infected extravascular fluids and its therapeutic effectiveness.

The aminoglycoside antibiotic tobramycin was given intramuscularly to 15 patients with infected body fluids (empyema in five patients, peritonitis in five, peritonitis and empyema in one, tracheobronchitis in three, and infection of the pacemaker pocket in one). The infecting bacteria included Pseudomonas aeruginosa, Klebsiella, Enterobacter, Serratia, Escherichia coli, Proteus species, and Staphylococcus aureus. The mean dose of tobramycin was 1.7 mg/kg given intramuscularly every 8 hr for nine to 10 days. Levels of tobramycin in specimens of serum and infected body fluid obtained simultaneously were measured at various intervals after a dose of the antibiotic. Comparison was made between levels of tobramycin and minimal inhibitory concentrations (MICs) of the infecting bacteria. Bacteriological and clinical failures were common if the level in body fluid did not exceed the MIC. In patients with levels of tobramycin in body fluid that were higher than the MIC, cures were frequent. Drainage of infected body fluids is a necessary part of successful therapy of these infections.


Lesions in guinea pigs infected with Coxiella burnetii strain M-44.

Guinea pigs inoculated with the live M-44 vaccine strain of Coxiella burnetii were examined grossly and microscopically for the presence of Q fever-related lesions. Mild myocarditis was observed in 38% of the infected animals but in none of the control animals. Livers showed significant incidence of hepatitis, necrosis, and granuloma formation, especially during the first eight days of the infection. A much lower incidence of splenitis was also found but was considered to be of borderline significance. Generally, lesions were mild in nature, and none seemed to endanger the life of the animal or to cause observable distress.


Comparison of concentrations of amoxicillin and ampicillin in serum and middle ear fluid of children with chronic otitis media.

Twenty-eight children aged five to nine years with chronic serous otitis media received a single dose of either ampicillin or amoxicillin by the oral route 1-2 hr before the removal of middle ear fluid by ventilation tubes inserted through the tympanic membrane. At the time middle ear fluid was obtained, a sample of blood was drawn from the patient, and levels of antibiotic in both specimens were microbiologically assayed by a disk diffusion method. Levels of amoxicillin (mean+/-standard error [SE], 1.48+/-1.6 microng/ml) in middle ear fluid were consistently and significantly higher (P less than 0.05) than levels of ampicillin (mean+/-SE, 6.2+/-5.0 microng/ml).


The effect of decreased renal function with and without reduction in renal mass on 1,25-dihydroxycholecalciferol production in rats.

Decreased production of 1,25-dihydroxycholecalciferol (1,25-(OH)2D3) by the kidney may be responsible for vitamin D resistance in renal failure and contribute to renal osteodystrophy. The present studies investigate the effect of reduced renal mass and reduced renal function on conversion of 3H-25-hydroxycholecalciferol to 3H-1,25-(OH)2D3 in vitamin D-deficient rats. Renal mass was reduced by partial or total nephrectomy. Renal function was reduced by ureteral ligation. At comparable degrees of renal function, reducing renal mass decreased 1,25-(OH)2D3 formation approximately proportional to the amount of renal tissue removed. Ureteral ligation without reduction of renal mass also reduced production within the first 24 hours. This may have been caused by the marked hyperphosphatemia which occurred with ureteral ligation. When partial nephrectomy and ureteral ligation were done together the results were additive. The decreased 1,25-(OH)2D3 formation produced by unilateral nephrectomy was not improved 4 weeks after surgery, although renal function had returned to normal.


Relationship of systemic and intrarenal hemodynamics in cirrhosis.

The relationship between systemic and renal hemodynamics was studied in 20 patients with advanced cirrhosis of the liver. Cardiac output was assessed by an indicator dilution technique, and both mean renal blood flow and intrarenal blood flow distribution were determined by the 133Xe washout method. Ten patients had elevated cardiac outputs (7.14 to 13.58 L/min; HCO group), seven patients had normal cardiac ouptputs (5.16 to 6.78; NCO group), and three had low cardiac outputs (3.65 to 4.1; LCO group). Renal hemodynamics did not correlate with cardiac output (r = 0.051; N.S.), since comparable reductions in mean renal blood flow occurred in both the LCO and HCO patients. Similarly, the degree of cortical ischemia, as assessed by percentage flow to the rapid flow component (C1%), did not correlate with cardiac output (r = 0.007; N.S.). Vasomotor instability as assessed by intrapatient variability of sequential xenon washout studies occurred frequently, and its magnitude did not correlate with cardiac output (r = -0.069; N.S.). These studies demonstrate that the abnormalities of intrarenal blood flow in cirrhosis are independent of alterations in cardiac output. Furthermore, the finding of marked intrarenal hemodynamic instability in the majority of patients with cirrhosis suggests that caution should be exercised in interpreting studies assessing the efficacy of vasoactive agents on renal hemodynamics in this disease, since the changes attributed to treatment may merely reflect spontaneous change.


Influence of acute exposure to cigarette smoke on the alveolar macrophage system.

The influence of cigarette smoke on the numbers and viability of alveolar macrophages in the lungs of mice was determined by utilizing techniques for quantitating lung deposition of bacteria and alveolar macrophage harvest. Alveolar macrophages were obtained by pulmonary lavage. The studies were performed under basal conditions, after the inhalation of cigarette smoke and after exposure to bacterial aerosols and cigarette smoke in sequence. Macrophage yields were increased 1.1, 1.2, and 1.5 times basal levels by exposure to cigarette smoke alone for 1, 2, and 4 hours, repectively. The inhalation of Staphylococcus aureus for 30 minutes induced a 2.4-fold increase in macrophage numbers. Within 15 minutes after bacterial deposition, macrophage yields dropped 33 percent, but elevated levels were restored at 30 minutes and then maintained for the remainder of the 4 hour test period. Cigarette smoke introduced immediately after bacterial challenge and maintained for up to 4 hours did not alter the macrophage response provoked by pulmonary deposition of staphylococci. In addition, smoke inhalation had no effect on the cellular characteristics of lung harvests and the viability of alveolar macrophages. These data demonstrate that cigarette smoke provoked an increase in alveolar macrophage numbers and did not have a deleterious effect on the mobilization of alveolar macrophages; namely, the maintenance of a macrophage response in relation to an airborne bacterial challenge.


Effects of methylprednisolone on the physical properties of the human red cell.

Prompted by evidence suggesting preserved red cell deformability in cardiac surgical patients pretreated with pharmacologic dosages of methylprednisolone, we performed in vitro experiments to examine the ability of similar levels of methylprednisolone and hydrocortisone to modify erythrocyte membrane changes produced by metabolic depletion or membrane-active compounds. Variables measured included cell morphology, blood biscosity, membrane deformability, osmotic fragility, red cell cholesterol, and glycolytic intermediates. In incubated samples, methylprednisolone partially prevented the transition of discs to echinocytes, the rise in whole blood viscosity, the decrease in membrane deformability, and the loss of red cell cholesterol which accompany ATP depletion, but it had no apparent effect on red cell glycolysis. The drug also inhibited esterification of cholesterol in cell-free serum. In unimcubated samples to which lysolecithin was added, methylprednisolone partially prevented and reversed morphologic and rheologic responses without affecting membrane cholesterol. Hydrocortisone demonstrated similar properties. Possible mechanisms for these actions are discussed. The concept is advanced that preserved blood fluidity may contribute to the beneficial responses to these drugs in certain clinical conditions.