Gastritis, duodenitis, and bleeding duodenal ulcer following mefenamic acid therapy.

A 46-year-old woman developed hematemesis and melena two weeks after starting mefenamic acid therapy for osteoarthritis of the spine. Esophagogastroduodenoscopy, arteriography, and a laparotomy revealed antral gastritis, duodenitis, and an acute bleeding ulcer in the third portion of the duodenum. Although mefenamic acid has many of the pharmacologic and physicochemical properties of aspirin and produces gastrointestinal ulceration in animals when administered in large doses, the English literature reveals only one case of gastric ulceration and a single instance of upper-gastrointestinal tract hemorrhage associated with its use. This case warns that mefenamic acid may cause serious gastric and duodenal inflammation and ulceration more commonly than is presently suspected.


Somogyi effect in patient with hypopituitarism.

A patient with diabetes mellitus and hypopituitarism developed the Somogyi effect that was characterized by insulin-induced hypoglycemia and rebound insulin-resistant hypoglycemia. This compensatory insulin-resistant hyperglycemia has generally been ascribed to the release of anterior hypophyseal hormones; however, our findings suggest that factors other than anterior hypophyseal hormones are involved.


Pulmonary manifestations in Behçet syndrome. Case report and review of the literature.

Behçet syndrome in association with pulmonary abnormalities is rare. We described a patient with Behçet syndrome who had pulmonary involvement. A review of the literature disclosed 12 similar cases. Thrombophlebitis, superior vena cava obstruction, and hemoptysis are characteristic clinical features of patients with Behçet syndrome and pulmonary infiltrates. Once diffuse pulmonary infiltration and massive hemoptysis appear, the prognosis is poor; death from pulmonary exsanguination is likely to occur. Treatment with cyclophosphamide and prednisone, in addition to blood transfusions, may be beneficial.


[Temporal cochlear changes evoked by prolonged exposure to low intensity noise. Electrophysiological study in guinea pigs].

Behavioral temporal threshold shifts (TTS) have been shown in the chinchilla, to be correlated with cochlear microphonic (CM) and whole-nerve action potential (AP) losses in the sensitivity as well as in maximum voltage. The Guinea-pig's ear differs significantly both anatomically and physiologically from the chinchilla's; as a result, it does not seem to be as susceptible to TTS at non-injurious noise levels, except at those frequency bands were middle-ear impedance and other factors are more favorable. At times varying from 2 hrs to 48 hrs after termination of noise exposures of 48 hrs duration to an octave-band of noise (7-14 KHz) with a sound-pressure level of 95 dB, the CM from the first three cochlear turns as well as the whole-nerve AP were measured in Guinea pigs. Losses in sensitivity as well as in maximum voltage were  found in the CM recorded from the first turn. CM recovered gradually with time, reaching normal levels at about 40 hrs after termination of noise exposures. The AP +showed similar losses. Microscopic examination of the organ of Corti showed no loss of hair cells.


[Determination of fructose, proteins, oxalacetic and pyruvic transaminase in the seminal plasma of vasectomized patients].

Measurement of concentrations of fructose, proteins, oxalacetic and pyruvic transaminases in seminal plasma were performed in a group of 20 normal males, 30 to 40 years old, subjected to vasectomy. There were no statistically significant differences among the values obtained before and 6 months after the vasectomy. In consecuence it is concluded that bilateral occlusion of the vas deferens do not modify the androgenic function of the testis, and that certain enzymes like glutamic oxalacetic and pyruvic transminases are not incorporated to the semen by the testis but rather by the prostate and/or by the seminal vesicles.


[Diffusible blood calcium in children with advanced protein energy malnutrition].

A previous study had shown that in children with third degree protein-energy malnutrition, ultrafilterable or diffusible serum calcium concentrations remain normal, while the protein-bound fraction is low in those with hypoalbuminemia, accounting for over-all hypocalcemia. In order to retest those findings, a new series consisting of 20 small marasmic infants and 16 children with kwashiorkor was studied, using a membrane ultrafiltration procedure. Fifteen eutrophic children served as controls. At time of their admission into hospital, both groups of patients showed hypocalcemia, more so the cases of kwashiorkor. Diffusible calcium was normal, while the protein-bound moiety was significantly decreased in children with kwashiorkor. Upon recovery, protein-bound as well as total calcium concentrations returned to normal values.


[Secretion of prolactin in normal anencephalic newborn infants].

Serum prolactin (PRL) was measured by radioimmunoassay in pregnant women at term and in newborns. In 38 newborns of gestational age 39--40 weeks, concentration of PRL in umbilical venous blood was 280.8 +/- 11.2 ng/ml; in maternal venous blood, concentration of PRL was 347.0 +/- 20.1 ng/ml. In the newborn it was found a significant difference in PRL values between both sexes (p less than 0.05), being higher in males than in females (290.0 +/- 14.6 vs. 260.0 +/- 17.1 ng/ml). In three anencephalic infants, PRL ranged from 92.6 to 369.0 ng/ml; 400 mug of thyrotropin-releasing hormone (TRH) administered as bolus injection evoked a rise in PRL in two out of the three, while synthetic luteinizing hormone releasing hormone (LH-RH) elicited no response of FSH secretion. These observations in the fetus and anencephalic infants confirm that the fetus produces high levels of PRL and that this function is independent of any hypothalamic control. The high levels of gestational estrogens seem to be the direct stimulus on the lactotropes to induce synthesis and secretion of PRL. The role of PRL during gestation has not been elucidated.


[Glomerular filtration rate in newborn infants].

Glomerular filtration rate (GFR) was studied in twelve newborns by means of a single inulin injection. Five of them were of 34 to 35 weeks of gestation (preterm group); the other seven were born between 38 to 41 weeks of pregnancy (term group). Age at time of study varied between three to nine days; weights were normal for gestational age and there was no history of abnormal pregnancy. Inulin was determined according to Schriner's technic and GFR was obtained by Sapirstein's method. GFR was 1.48 +/- 0.70 ml/min in the preterm and 2.40 +/- 0.53 ml/min in the term group less than0.05). However, when body surface was taken into consideration, in the former GFR was 17.28 +/- 8.06 ml/min/1.73 m2 and in the term group 20.64 +/- 4.46 ml/min/1.73 m2; in this way, no significant difference was shown.


[Late amaurotic familial idiocy with curvilinear bodies and finger prints. Report of a case studied using electron microscopy].

A case of late amaurotic family idiocy of "curvilinear bodies" and "finger prints" is presented. The patient was a .7 year-old non-Jewish boy with convulsions and mental deterioration. A male sibling died at age 12 with a similar picture and a younger brother is starting also with the same symptoms. Biopsy of the brain disclosed a PAS, Sudan black and oil red O positive granular material in the cytoplasm of a large population of cortical neurons. An electron microscopy study disclosed that the stored lipid was composed of masses of so-called "curvilinear bodies" and "finger prints". The same material was found within the cytoplasm of a ganglion cell as well as in endothelial cells of mucosa of the rectum obtained by biopsy. This new variety of amaurotic family idiocy does not occur in Jewish people and the stored lipid is not a ganglioside. It is emphasized that rectal biopsies, as well as the electronmicroscope are useful tools for a more precise diagnosis of the form of storage disease.


Studies in Central America and Panama.

Nutrition during pregnancy is recognized as of great importance in public health, not only for the woman herself, but also for the impact that it may have on the present and future of the born child. The pregnant state represents additional nutritional needs which have been estimated by expert groups, in a nutrient-independent manner. The percent increase in nutrient specific recommendations due to pregnancy varies with each nutrient. This would mean that the recommended dietary "pattern" for the pregnant women differs markedly from that of the non-pregnant woman, but this matter needs further study and careful consideration. In areas like Central America and Panama, where malnutrition is prevalent, pregnant women suffer from the same nutritional deficits as the general population. The main nutritional deficits are calories, protein, vitamin A, riboflavin, iron and folates. In some instances like in the case of iron and calories, the deficit seems greater in the pregnant women than in the population at large. The studies give evidence that the new born children of malnourished mothers reflect in some aspects the biochemical changes found in the pregnant women.


Systems analysis in nutrition and health planning: approximate model relating birth weight and age to risk of deficient growth.

This paper summarizes the initial phase of an effort to develop semiquantitative methods for nutrition and health planning. The general approach is to utilize the methods of systems analysis and operations research where appropriate, but the emphasis is on developing a simplified, approximate analysis that government planning groups could conveniently apply in evaluating various potential programs for attaining specific nutrition and health objectives, while satisfying certain constraints (e.g., budget, facilities, personnel). An essential element of the analysis is a model that provides an approximate description of malnutrition (inadequate growth, as indicated by weight for age) and mortality in terms of those variables that can be affected by intervention programs. We have concentrated initially on using the results of two INCAP longitudinal studies to develop models relating the incidence of malnutrition (second and third degree on the Gomez scale) to age and previous growth, including birth weight. The two studies cover rural Guatemalan communities with considerable variability in ethnic, socioeconomic, and ecological conditions. Because they are tentative, the resulting models are discussed only qualitatively and not quantitatively. The models may serve as baselines to estimate the consequences of potential programs aimed at different target groups, such as pregnant women and children whose weights at birth or thereafter fall below prescribed levels. The possible benefits of using models of this nature in nutrition and health planning are discussed.


[Coffee hulls and pulp. XII. Effect of storage of coffee pulp on its nutritive value for calves].

Coffee pulp, dehydrated and stored for 7, 13 and 17 months or ensiled for 4, 10 and 14 months, was studied in calves with a rapid growing rate. Storage of dehydrated coffee pulp did not affect its chemical composition, but ensiling reduced crude fiber and increased its nitrogen free extract content after 10 and 14 months. Three growth trials were carried out with Holstein calves averaging 95 kg in the first and second trials, and 130 kg in the third. Eighteen calves were used in the first trial and 24 in each of the other two. In each trial the animals were divided into three equal groups and randomly assigned to one of the following treatments: control, which contained 48% cottonseed hulls, and the other two, with 30% dehydrated coffee pulp or 30% ensiled coffee pulp. Basically, the difference between trials consisted in the time of storage or ensiling of coffee pulp. In all trials, weight gains of calves fed coffee pulp (1.00, 0.90 and 0.98 kg/day, and 1.06, 0.94 and 1.08 kg/day, respectively) were significantly lower (P less than 0.05) than the weight gains induced by the control ration (1.21, 1.08 and 1.19 kg/day). Feed intake was also lower, but feed conversion ratio was higher for those rations containing coffee pulp. Calf performance was better with ensiled than with deydrated coffee pulp, particularly in the third trial, where the differences in weight gains were significantly higher (P less than 0.05). It is concluded that storage time does not change nutritive value of coffee pulp; and the ensiling is an adequate process for storing pulp during coffee harvesting, and, possibly also, for improving its nutritive value.


Sexual excitement.

Sexual excitement depends on a scenario the person to be aroused has been writing since childhood. The story is an adventure, an autobiography disguised as fiction, in which the hero/heroine hides crucial intrapsychic conflicts, mysteries, screen memories of actual traumatic events and the resolution of these elements into a happy ending, best celebrated by orgasm. The function of the fantasy is to take these painful experiences and convert them to pleasure-triumph. In order to sharpen excitement-the vibration between the fear of original traumas repeating and the hope of a pleasurable conclusion this time-one introduces into the story elements of risk (approximations of the trauma) meant to prevent boredom and safety factors (sub-limnal signals to the storyteller that the risk are not truly dangerous). Sexual fantasy can be studied by means of a person's daydreams (including those chosen in magazines, books, plays, television, movies, and outright pornography), masturbatory behavior, object choice, foreplay, techniques of intercourse, or postcoital behavior.


The social climate of alcoholism treatment programs.

The social climate of four residential alcoholism treatment programs was assessed with the Community-Oriented Programs Environment Scale (COPES). The programs differed in terms of their treatment orientations (aversion-conditioning, milieu therapy) and the sociodemographic characteristics of the patients admitted. Results showed that (1) COPES profiles distinguished between the four alcoholism programs in ways that were consistent with their respective treatment orientations; (2) the type of patient admitted to these programs did not systematically affect their treatment environment; and (3) changes occurring within an alcoholism program resulted in corresponding changes in relevant dimensions of the treatment environment. We also discuss the practical utility of the COPES for assessing alcoholism programs.


[Hodgkin's disease in children. Stage IV. Treatment and results].

Without prior treatment, 13 children with stage IV Hodgkin's disease have received a multiple drug therapy (MOPP). Of these patients, 7 have experienced a complete remission; 3 a partial remission, completed in two cases by radiotherapy on the site of the residual disease, and the third by another combination chemotherapy. Out of the 10 children living as of July 1st 1975, 8 are still on first remission. Tolerance for the treatment has been good. The evolution of the disease and problems of treatment are also discussed.


Nonabstinent drinking goals in the treatment of alcoholism. A clinical typology.

Traditional views in the field of alcoholism have been that alcoholics must achieve and maintain abstinence from alcohol in order to be rehabilitated. In turn, abstinence has been used as the sole or primary criterion of successful treatment. However, abstinence is not necessarily correlated with improvement in other areas of overall adjustment, such as emotional, interpersonal, vocational, and physical health. The recent advent of nonabstinent alcoholism treatment programs, in addition to other clinical data, suggests the need for more specific definitions of nonabstinence, attenuated drinking, controlled drinking, and normal thinking.


[Treatment of non hodgkinian malignant lymphomas in children].

Non Hodgkin Lymphomas are in children nostly diffuse and non or poorly differentiated. The exact frontiers with ALL are difficult to assess. With old classical treatments, the chances of cure were limited to localized tumors (stage I). The present indications of combined intensive chemotherapies, of neuromeningeal prophylaxis, and radiotherpy are analyzed. Preliminary results in 51 children treated first in 1973-1974 are presented. The rate of complete remission is 82%. Actuarial survival rate is 57% at 30 months. The aim and the limitations of treatment protocol are discussed.


Prediction of chronicity in psychiatric patients.

In order to determine the best combination of variables for predicting which patients would be released from state mental hospitals and which would be retained, the 1,500 patients examined in the course of a cross-sectional survey of the residental population of Texas state mental hospitals in 1966 were followed up in 1971. Eighteen variables were selected for discriminant analysis, comparing the patients nerver released from the hospital with those known to be current extrainstitutional residents. The stepwise program selected four variables: (1) length of prior stay; (2) relatives' attitudes toward release; (3) social adequacy; and (4) conceptual disorganization. Applying this model to the study groups, 79% were correctly classified with regard to their in hospitals/not in hospital status, suggesting that early identification of chronicity in future studies is feasible.


Personal and social factors associated with the remission of psychiatric symptoms.

Most studies of "spontaneous remission" involve samples of untreated psychiatric patients. This selection process limits the generalizability of findings to the population of persons with neurotic disturbances. This report concerns a community sample of people with neurotic disorders. Fifty subjects were followed up for five years, using both clinical and quantitative techniques. Almost half lost their symptoms during this time. Various sociodemographic factors, personality assets, and liabilities contribute to the process through which such remissions occur.


[Combined chemotherapy of neuroblastoma. 1st results in 40 children with metastatic form].

40 PATIENTS WITH METASTATIC NEUROBLASTOMA HAVE BEEN Treated by a sequential multichemotherapy made of vincristine, adriamycin and cyclophosphamide. Results of pre-treated complementary investigations are reported and discussed. Criterias are proposed to distinguish four evolutive types and their appreciation is done after three months. The chemotherapy used has no pronounced haematological toxicity, but one varicella and two interstitial pneumonias ended with death. Nearly 2/3 of these streated tumors are drug-responders : 15 complete apparent remissions which are lasting in 11 patients since four to eighteen months; and 13 good partial remissions. One third of the patients are drug-non responders. Actuarial survival of the whole group is 67% at 12 months.


Prognosis in schizophrenia. A ten-year follow-up of first admissions.

Eighty-eight of 92 first admission schizophrenics from 1963, being an incidence by first admission cohort, were followed up between 1974 and 1975. Fifty-eight percent were reported as showing no social or intellectural deficit, and only 8% were unremitting institutionalized, with 51% being considered as having normal economic productivity, and 69% with a good or fair social adjustment. Despite difficulties in comparison, birth, marriage, and divorce rates appear to be not very different from those for the general population, although the percentage of married patients is lower. Deaths would seem greater than expected. Possible reasons for the improved prognosis in schizophrenia are considered to be short initial hospitalization, almost universal use of phenothiazines, use of developing community services (social and psychiatric), and generally good econimic conditions.


[Evolution of methods of chemotherapy in solid tumors in the children].

First, chemotherapy was used to reduce metastatic tumours. Then, instead of a limited number of antimitotic agents, it permited to increase both the number of complete remissions and the survival ratio, mostly in embryonal tumours and lymphomas. The essential purpose of chemotherapy is to kill occult metastases. Combination chemotherapy using many agents with differing modes of action took place of monochemotherapy. In sophisticated schedules, drugs are given intermittently, to synchronizing treatment with the tumour doubling time and the recovery of normal rapidly dividing tissues. Unhappily, its use remains empiric, according to uncertainty about tumoral cell kinetic and modes of drugs action. Immediate toxicity of aggressive schedules prescribe to realize them in specialized pediatric centres. At last, in the future, it will not be enough to cure infantile cancer, but to allow children to live with less sequelae than to day.


Therapeutic outcome as rated by patients, therapists, and judges.

The views of patients, therapists, and research judges were compared as to the degree of success attained in 22 cases of long-term psychotherapy and 15 cases of psychoanalysis. Across all cases, there was a tendency for therapists to overrate their success, as compared to the other two sources; this, together with a tendency of therapists to overlook or misperceive patients' dissatisfaction with treatment outcome, suggested that the failure to recognize and deal with the patient's negative feelings was a factor in a substantial number of unsuccessful treatments. The research judges rated the psychoanalytic cases as successful with much less frequency than either patients or treating analysts; the disparity seemed partly due to differing frames of reference, but may also have relected the participants' needs to feel that their efforts had been worthwhile.


The Capgras phenomenon.

The underlying diagnosis of Capgras delusion is not found to be exclusively paranoid schizophrenia, nor is the sex exclusively female, as once was believed. Organic factors play a predominant role in many patients, and 41% of the cases are males. The age at diagnosis in those considered to be schizophrenic is older than is usually expected.


A neuropsychological study of polydrug users.

The long-term neuropsychological effects of persistent nonmedical drug use are still unknown. In this study, 22 young men, all extensive "polydrug" users, were examined while free from drugs for an average of 60 days by means of the Halstead-Reitan Neuropsychological Test Battery. Their performance was compared to that of age-education-sex-matched neurologically intact medical patients and a similarly matched group of neurologically impaired patients. Blind independent ratings of test protocols by two experienced clinicians judged 41% to 64% of the drug users, 11% to 26% of the medical patients, and 84% to 89% of the neurologic patients to be impaired. Interpretation of these results suggests that in some individuals, heavy "polydrug" use may be associated with neuropsychological dysfunction, which persists at least an average of two months beyond cessation of drug use.


Cardiovascular and subjective effects of intravenous cocaine administration in humans.

Nine volunteer subjects were tested with intravenously administered cocaine hydrochloride in doses ranging from 4 to 32 mg, as well as 10 mg of dextroamphetamine sulfate. Measures of cardiovascular and subjective effects were made. Generally parallel dose-effect functions were obtained for heart rate, blood pressure, Addiction Research Center Inventory scores, Profile of Mood Scales, and subject ratings. A substantial effect on each of these variables was recorded after 8 mg of cocaine. The increase continued and peaked at approximately 16 mg after which it usually leveled off. Ten milligrams of dextroamphetamine generally had an effect comparable to 8 to 16 mg of cocaine.


Traumatic common peroneal nerve palsy: a retrospective study.

A retrospective analysis of 26 consecutive cases of traumatic common peroneal nerve palsy seen during a four-year period in the Department of Rehabilitation Medicine at New York Medical College was carried out. Fifteen were complete lesions, nine were incomplete lesions, and there were two cases of neurapraxia. Among the factors studied were etiology, age, sex, associated injuries, electrodiagnostic findings, and prognosis for recovery. The ultimate functional status of the patients was evaluated up to three years following injury. Of the patients, 19.2% recovered fully, and 26.9% showed partial recovery. The maximum time of recovery was achieved in 15.5 months in complete lesions and 9.5 months in incomplete lesions. The relationship of peronneal nerve injury to fractures of the femur is emphasized. The indications for medical, surgical and rehabilitative management are discussed.


Mobile velocity-controlled respirometer: description and performance capabilities.

An apparatus modeled after the Scram respirometer designed by Corcoran is described in terms of design, specifications and performance capabilities. The results with the use of this apparatus in a study of 14 able-bodied adults of five controlled walking speeds are compared to those of a similar study previously reported by Corcoran and Brengelmann. Oxygen consumption (ml O2/kg body wt/min) increases proportionately to the square of the velocity of walking. Results of the two investigations are parallel, although the present report demonstrates a greater male-female difference at all speeds. Uses and limitations of the apparatus are considered.


Scheuermann's kyphoscoliosis associated with Charcot-Marie-Tooth syndrome.

Much confusion and disagreement exists regarding the classification and characteristics of inherited disorders manifesting neurogenic muscular atrophy. Many authors consider Charcot-Marie-Tooth syndrome (CMTS) and Roussy Levy syndrome (RLS) forme fruste or variants of Friedreich's ataxia (FA). Familial kyphoscoliosis has often been described in FA and RLS but not with CMTS. The purpose of this paper is to present detailed clinical and laboratory findings in a family with three cases of Scheuermann's kyphoscoliosis and CMTS in three generations. In all cases Scheuermann's kyphoscoliosis was associated with pes cavus, markedly diminished vibratory and position sensation in the lower extremities, absent deep tendon reflexes and muscular atrophy, predominantly of the distal muscles. Fine rhythmic tremor of outstretched hands and positive Romberg sign were present in one case only. Serum creating phosphokinase was elevated in two cases. Motor nerve conduction studies revealed impaired function in the median, ulnar, tibial and peroneal nerves. Sensory nerve conduction wal also impaired in median and ulnar nerves. There was evidence of left ventricular hypertrophy in one case only. The nosology and relationship between CMTS, RLS and FA are discussed.


Tibial compartment syndromes in burn patients. A report of four cases.

Anterior and posterior motor compartment syndrome have been observed in four burn patients. Recognition was difficult because of multiple concurrent problems, including burns and thrombophlebitis of the involved extremities. Early fasciotomy was performed in one case, with good return of function. Muscle necrosis occurred in two patients in whom diagnosis was delayed. Electromyography is of benefit in confirming the diagnosis and providing follow-up management. It is important to maintain a high index of suspicion of this syndrome in patients with overlying burns.


Acute blunt traumatic rupture of the diaphragm in children.

Two patients had acute rupture of the diaphragm from blunt trauma. One was a 10 1/2-month-old infant, the youngest yet reported with this condition to our knowledge. He required emergency repair because of increasing encroachment on respiratory function by the hernial contents during the early hours of observation. The second patient, a ten-year-old boy with an associated fractured femur, underwent successful repair of a diaphragmatic laceration that included the pericardium. In this case the approach via the abdomen, used to rule out associated intraperitoneal injuries, actually facilitated the repair, particularly that of the diaphragmatic pericardium.


Pancreatitis and severe metabolic abnormalities due to phenformin therapy.

Two elderly diabetic patients with abdominal pain were demonstrated to have complications of phenformin hydrochloride therapy. The first developed severe lactic acidosis treated with sodium bicarbonate given intravenously and followed by rebound alkalosis. The second showed severe acidosis (specimens for lactate determination were unfortunately unsatisfactory for analysis) and similar alkalotic rebound after therapy. She then developed severe pancreatitis, proved at operation, no cause for which other than phenformin was apparent. Poor renal and hepatic function predispose to these conditions by increasing serum phenformin levels and by decreasing urinary excretion of its metabolites. The acidosis should be treated judiciously with sodium bicarbonate administered intravenously. A rebound alkalosis, ensuring as the accumulated lactate is metabolized, is best treated by potassium chloride and ammonium chloride given intravenously. The mechanism by which phenformin causes pancreatitis is unknown, but termination of therapy causes cessation of the pancreatitis.


Transient bile duct obstruction. Response of serum bilirubin and alkaline phosphatase levels in the rat.

The immediate evolution of changes in serum bilirubin and alkaline phosphatase levels during and after brief temporary occlusion (12 hours or less) of the main bile duct was studied in the rat. Transient obstruction of the main bile duct of more than one hour was characterized by a simultaneous increase in serum levels of both bilirubin and alkaline phosphatase. The time required for return to normal values was less for bilirubin than the duration of a brief obstruction and was more prolonged for alkaline phosphatase than the duration of obstruction. In obstruction of four or more hours, it was rare to find an isolated elevation of serum bilirubin; this occurred when the control value for alkaline phosphatase levels was low and their relative increase was obscured. Thus, an isolated increase in the serum bilirubin level is infrequently compatible with obstruction of the bile duct, even when transient and of brief duration. Conversely, isolated elevation of serum alkaline phosphatase levels in an acute abdominal syndrome may indicate relieved biliary obstruction.


Thrombosis in a cavernous left-sided inferior vena cava. An unusual abdominal mass.

A 19-year-old man had an abdominal mass and swelling of the left thigh. The presumptive diagnosis was lymphoma. On exploration the mass proved to be a thrombosed multiloculated "cavernous transformation" of a venous structure, presumably the inferior vena cava, which on postoperative cavogram was shown to be otherwise absent. The venous system of the left lower extremity showed phlebographic evidence of old thrombosis, but that of the right lower extremity was normal. The patient did well without further treatment, despite some residual swelling of the left thigh. To our knowledge, this precise combination of inferior vena cava anomalies has not been encountered before; certainly not presenting as a mass.


Cogan syndrome associated with mesenteric vascular insufficiency.

Nonsyphilitic interstitial keratitis and deafness was first described as a distinct entity by Cogan in 1945. For years thereafter, it was believed to involve only the ocular and aural systems. It is gradually becoming apparent that the syndrome can also include other organ systems by affecting their blood supply. A patient with diagnosed Cogan syndrome subsequently developed mesenteric vascular insufficiency that was surgically corrected. This report lends more support to the belief that nonsyphilitic interstitial keratitis with deafness is only one manifestation of a more generalized vascular disease.


Ultrasonic flow detection for localization of splenic and renal veins.

The selective splenorenal shunt is currently recommended as an alternative procedure to portocaval shunting. However, this operation is technically more difficult, particularly the localization of the renal vein in patients with thickened retroperitoneal tissues. The Doppler flow detector has helped us identify the splenic and renal veins, and we suggest the intraoperative use of this instrument in situations where difficulty is encountered.


A simple method for deep ligatures.

The Kocher forceps can be used to facilitate ligature of a vessel deep in the surgical field.


Superior thyroid artery cannulation for monitoring carotid artery operation.

Superior thyroid artery cannulation during carotid endarterectomy and coupling the cannula to a three-way stopcock with an anaeroid manometer allows the surgical team in the operating field to monitor mean pressures and to draw blood samples for gas analysis from the common, the internal, or the external carotid artery. The technique has been applied in 118 patients without related complications.


Use of disposable Velcro sleeves on gastrointestinal clamps and forceps.

Observed need for an atraumatic manner of holding and occluding stomach and intestine led to the development of a Velcro sleeve applied to various modified gastrointestinal clamps and forceps. The sleeve was found to hold more securely with minimal coaptation than previously used instruments, and to hold more atraumatically with heavy coaptation.


Salvage after anastomotic leak in Crohn disease. Utilization of a new, simple diverting ileostomy.

It may be possible to manage an anastomotic leak following resection for Crohn disease by drainage, suture, and proximal loop ileostomy. This report describes success with a simple diverting ileostomy.


How to control the blood glucose level in the surgical diabetic patient.

This report is a sequel to "Why Control Blood Glucose Levels?" (Arch Surg 111:229, 1976), which linked complications of diabetes mellitus to poor control. Hyperglycemia, increased gluconeogenesis, nitrogen wasting, and increased ketogenesis occur in the perioperative period, partly as a result of contrainvents are aggravated in the diabetic. Zones of levels of blood glucose control are charted, as well as the corresponding insulin needs for each of these zones. Intermediate insulins should provide basic coverage; regular insulin is recommended only as a supplement. Several blood glucose determinations per day are necessary to maintain control. The hazards of dependence on urine testing and the "sliding scale" for control are among a number of caveats discussed.


The excluded small-bowel segment. A source of complications after small-bowel bypass.

Two cases of obstruction of the bypassed small intestine after jejunoileal shunt for obesity are presented. These cases illustrate the possible failure of radiologic visualization of the obstructed bowel since no gas traverses this bowel, as well as two of the possible causes-internal herniation and volvulus. A third cause, intussusception of the blind loop into the colon, has been reported. Obstruction of the bypassed bowel demands surgical intervention and could lead to perforation and peritonitis if untreated. Its prevention involves the closure of all mesenteric defects at the original operation. Surgeons should be aware of the possibility of these conditions in any patient who has had a small-bowel bypass operation.


Duodenojejunostomy in gastric operations for postbulbar duodenal ulcer.

In two cases, two different techniques of duodenojejunostomy were employed as an alternative to an insecure closure of the "difficult duodenal stump." The arrangements are either duodenojejunostomy Roux-en-Y or isoperistaltic jejunal interposition. A single-layered suture line is employed. The ampulla of Vater is visualized during the construction of these anastomoses. In addition to obviating a tenuous stump closure, this technique has the theoretical advantage of providing internal drainage.


Perfusion therapy for extremity melanoma.

Because of their initial appearance on extremities, malignant melanomas lend themselves to isolated chemotherapeutic perfusions. Perfusion is attractive because one can deliver effective cytotoxic drugs without systemic toxicity. We are reviewing 20 patients treated between 1960 and 1973 with isolated perfusion. Melphalan (L-phenylalanine mustard) was the drug of choice. Eleven of the 20 patients had previous surgical treatment. Three of the 11 patients are still alive from 27 to 72 months postperfusion. Eight died after an average survival time of 33 months. Of the seven patients who underwent perfusion as primary therapy, four patients are alive from 25 to 76 months postperfusion, and three died after an average survival time of 34 months. There is direct correlation between stages and levels of melanoma, and perfusion and prolonged survival time.


Surgical treatment of mal perforans.

Mal perforans is a chronic foot ulcer commonly found in diabetics with neuropathy. Although it will often respond to conservative measures, recurrence is frequent and brings with it the risk of spreading infection and serious destruction of tissues. Surgical treatment of seven patients, based on excision of the distal metatarsal bone (five patients), or excision of the distal metatarsal and amputation of the first toe (two patients), gave satisfactory results and is indicated to achieve long-term healing. A special shoe, designed to remove pressure from the healing areas as well as from potential new pressure points, was used in the last four patients.


Urologic complications following abdominoperineal resection of the rectum.

Perusal of the records of 111 consecutive patients who underwent abdominoperineal resection of the rectum for malignant diseases of the rectum or anal canal for postoperative urologic complications revealed that the urethra had been injured in two patients, the bladder in none, and the ureter in five. In only two of these last five patients was the late result of treatment of the ureteric injury satisfactory. The late result of treatment of the two urethra injuries was good. All the patients had been treated with an indwelling catheter for at least ten days after the operation. About one third of the patients still had disturbances of micturition two weeks after the operation, but only one required a permanent indwelling catheter.


Left colon gangrene after acute inferior mesenteric artery occlusion.

We report here an experience with five patients, aged 58 to 70, suffering gangrene of the left colon after spontaneous inferior mesenteric artery occlusion. All cases were the result of arteriosclerosis; in two, small aortic aneurysms were present and might have been responsible for emboli to the inferior mesenteric artery. The dead bowel was resected in all patients; three patients survived. No primary anastomoses were done and they are not recommended. Because ligation of the patent inferior mesenteric artery has been done so often without ill effects during aortic surgery, the collateral circulation to the left colon can be considered excellent. Gangrene is therefore rare and requires major interference with collateral circulation by emboli or arteriosclerotic occlusion. The clinical symptoms and signs may be confusing.


Vertebral artery bypass.

The origin of the vertebral artery is a frequent site for the development of stenosing lesions. The flow deficit caused by the stenosis of one vertebral artery is normally compensated for by intracranial anastomosis between the carotid and basilar arteries or by the opposite vertebral artery. A number of patients, however, have inadequate intracranial anastomosis and hypoplasia or stenosis of the opposite vertebral artery, and symptoms of brain ischemia develop. We describe here four cases in which a new technique, a subclavian vertebral artery autogenous vein bypass graft, was used to deal with the diseased segment of the vertebral artery. Transient postoperative problems included lymphocele and Horner syndrome. All four bypasses were patent at the time of angiography one week postoperatively. All four patients were relieved of symptoms of vertebrobasilar insufficiency.


Drug-induced colitis as a surgical disease.

Colitis has been reported after parenteral administration of penicillin, ampicillin, streptomycin, tetracycline, and, most recently, lincomycin and its analogue, clindamycin. An incidence of diarrhea and accompanying proctocolitis as high as 20% with or without pseudomembrane formation has been noted. In most cases, withdrawal of the drug, supportive measures, and administration of corticosteroids have resulted in reversal of the colonic disease. In the past year, however, it has become apparent that there is a substantial mortality (as high as 38%) associated with the conservative management of this entity. We have used subtotal colectomy as a life-sparing procedure, and we report here its application in two specific instances, along with the clinical course, roentgenographic findings, and laboratory data. We believe drug-induced colitis is increasing in frequency and severity and is of importance to the surgeon.


Five-year survival following cryosurgery for oral cancer.

In the years 1964 through 1970, sixty selected patients with oral cancer were treated by freezing in situ with the intent to cure the disease. Early results demonstrated the suitability of the method for high-surgical-risk patients and showed that the technique permitted avoidance of bone-sacrificing operations. Five-year survival statistics show that cryosurgery was most successfully used on small to moderate-sized cancers without cervical lymphadenopathy. The results justify continued use of cryosurgery in carefully selected patients.


Peptide treatment of postgastrectomy obstruction.

Seventeen patients with symptoms of acute or chronic postgastrectomy obstruction of a life-threatening nature have been treated with a peptide substance that is isolated from the bovine neurohypophysis (coherin) and has a regularizing effect on the electromotor performance of the small intestine of the dog and man. All patients treated in this study were relieved of their obstructive symptoms. After weight gain began, the majority of patients with acute obstruction were able to discontinue coherin therapy. Five patients with chronic obstruction have required prolonged treatment with coherin to maintain normal alimentary function.


Prognostic factors in glaucomatous visual field loss.

A retrospective review was conducted of 31 patients with bilateral elevations of intraocular pressure and unilateral glaucomatous visual field loss. Nine (29%) of the fellow eyes developed visual field loss during a three- to seven-year follow-up period. Of the 13 fellow eyes that had an initial intraocular pressure greater than 26 mm Hg, eight (62%) developed visual field loss, as opposed to one (6%) of the 18 eyes that had lower intraocular pressures. Of the 11 fellow eyes whose intraocular pressures exceeded 24 mm Hg, either treated or untreated, on more than 50% of the measurements, seven (64%) lost visual field, whereas in the 20 eyes whose intraocular pressures were lower, only two )10%) lost visual field.


Retinal lesions in tuberous sclerosis.

Retinal lesions in 116 patients with tuberous sclerosis included three types: the relatively flat, semitransparent, non-calcified tumors; the more commonly described nodular, calcified tumors; and a third lesion that possessed features of the other two. Other less definite pigmented and plaque-like lesions also were seen. The evolution of a relatively flat, noncalcified lesion into an elevated nodular, apparently calcified lesion during an interval of two decades was photographically recorded.


Oculomotor palsy following dental anesthesia.

Paralysis of the right third and fourth cranial nerves, lasting for about six weeks, occurred in a patient following the injection of procaine hydrochloride in the area of the right superior alveolar artery. Ocular complications of dental anesthesia are rare and are probably caused by intra-arterial injection of anesthetic that reaches the orbit via an anastomosis between the middle meningeal and ophthalmic arteries. Such complications include transient oculomotor palsies and permanent or transient loss of vision.


Unilateral afferent pupillary defects in asymmetric glaucoma.

Unilateral relative afferent pupillary defects are associated with unilateral prechiasmal lesions affecting the retinomesencephalic pathway. Five patients with unilateral or asymmetric glaucoma and relative afferent pupillary defects are presented. The lack of descriptions of relative afferent pupillary defects in unilateral glaucoma may be explained by the frequency with which these patients are treated with miotics, the association of trauma, and the presence of anatomic alterations of the iris. It is important to distinguish unilateral afferent pupillary defects in glaucoma from those associated with other neuro-ophthalmic disorders that require more invasive diagnostic procedures.


Lid taping in the preoperative management of tearing or asthenopia.

We will describe the use of tape as an aid in the preoperative management of tearing due to horizontal lid laxity or ectropion and of "tired eyes" due to dermatochalasis, drooping brows, or ptosis.


Effect of the intraocular lens on intraocular pressure.

In the Miami Intraocular Lens Collaborative Study, 17 patients with glaucoma had a Copeland lens implanted at the time of cataract extraction. Seven additional glaucoma patients received a Binkhorst lens. Lens implantation did not adversely affect intraocular pressure or control of glaucoma, except in one patient who developed central retinal artery occlusion with rubeosis 1 1/2 years postoperatively and in one patient who had the lens removed because of iritis with uncontrolled glaucoma. Of 606 eyes that did not have glaucoma before cataract extraction and Copeland lens implant, many had transient postoperative pressure rise. Twenty-six (4.3%) developed prolonged pressure elevation. Nineteen patients were maintained on long-term medical therapy. The other seven were patients with iritis and glaucoma who had the implanted lens removed, including one who later had glaucoma surgery and one whose eye was later enucleated.


Hemorrhagic detachment of the peripheral retinal pigment epithelium.

Six patients had hemorrhagic detachment of the peripheral retinal pigment epithelium. Abnormal neovascular nets in older individuals, under the retinal pigment epithelium and originating from the choriocapillaris, may well be the cause of such hemorrhagic detachments. This lesion must be differentiated from choroidal tumors, choroidal detachment, and uveal effusion.


Malignant melanoma of the skin metastatic to the eye. Frequency in autopsy series.

Results of histopathologic examination of the eyes of 15 consecutive patients with metastatic malignant melanoma arising in the skin demonstrated evidence of intraocular metastasis in five patients. The metastases were microscopic, epithelioid, minimally pigmented, and occurred in both the choroid and the retina. All patients were asymptomatic. Those patients with ocular metastases all had primary malignant neoplasms of the superficial, spreading variety and associated central nervous system metastases.


Essential iris atrophy. Report of a case.

The clinicopathologic findings in an eye from a 40-year-old man with essential iris atrophy are reported. Noteworthy is the proliferation of corneal endothelium and a laying down of a new Descemet (cuticular) membrane over the trabecular meshwork and in areas of anterior peripheral synechiae formation over the pseudoangle. The histologic characteristics favor a vascular cause for the condition, but the evidence is circumstantial.


Flammability of disposable surgical drapes.

We discuss the high degree of flammability of disposable surgical drapes. The results of two separate tests and corresponding photographs are presented to verify the flammability. We stress the importance of the flame spread rate.


Microsurgical approach to intraorbital tumors. Technique and instrumentation.

We believe that, with the modified Krönlein lateral orbitotomy microsurgical approach, most orbital tumors can be successfully removed with reduced morbidity and complications, compared with the frontotemporal craniotomy or the standard Krönlein lateral orbitotomy. The cosmetic result is quite satisfactory, and the hospital stay should be brief. The use of the operating microscope and the specifically designed and modified instruments for retraction and dissection in the orbit, combined with the efficiency of the self-irrigating bipolar coagulating forceps, add a new dimension to the safety and efficiency of orbital surgery.


Retinal tears 180 degrees and greater. Management with vitrectomy and intravitreal gas.

A new technique for the treatment of giant retinal dialysis of 180 degrees or more has been devised. After the lens and vitreous have been removed via the pars plana, the patient is rotated into a prone position on a special operating table. The retina is unfolded by filling the eye completely with gas and is held in place by gas. The patient is then brought back into the normal supine position, and a scleral encircling procedure is added. The initial success rate of reattachment is 12 out of 14 cases. Afterward, many eyes develop massive periretinal proliferation. After six months or more of follow-up, the retina remained attached in six of 14 cases.


Cilioretinal arteries. A study based on review of stereo fundus photographs and fluorescein angiographic findings.

The incidence of cilioretinal arteries in 2,000 eyes of 1,000 consecutive patients was determined by review of stereo color fundus photographs and fluorescein angiographs. One or more cilioretinal arteries were present in 49.5% of all patients or in 32.1% of the eyes. The arteries occurred bilaterally in 14.6% and contributed to some portion of the macular circulation in 18.7% of the patients. A great deal of variability of size, number, and distribution of cilioretinal vessels was observed. Prior studies that were based on direct visualization of the fundus have reported cilioretinal arteries in 7% to 29.6% of patients examined. Careful review of stereo fundus photographs and early phase fluorescein angiographs aided in the observation of these vessels that might otherwise have been unrecognized. We believe the method of review accounts for the high incidence of cilioretinal arteries in our series.


Treatment of vaccinial keratitis with vidarabine.

Vaccinial epithelial keratitis was produced in rabbits. When the therapeutic effect of vidarabine on the experimentally-induced disease was evaluated and compared to the effect of idoxuridine, vidarabine was found to be highly effective, substantially more effective than idoxuridine, and nontoxic to the eye.


Light damage in the developing rat retina.

The effect of bright light on the retinas of developing albino rats was studied electron microscopically. The newly formed outer-segment lamellar membranes of newborn rats raised in continuous bright light appear to be less sensitive to the damaging effects of light, compared to those of rats raised under normal light conditions for at least two weeks. It seems to take about two days before the membranes show damage from continuous exposure to fluorescent lamps. The same brightness damages the adult outer segments within a few hours. Despite the severe damage to the outer segments, the rest of the retina develops normally for one month, and then the photoreceptor cells undergo degeneration. The retinas that have been exposed to bright light for two weeks after birth show considerable damage, but these retinas regenerate in six months.


Kinetics of topically administered prednisolone acetate. Optimal concentration for treatment of inflammatory keratitis.

Two types of quantitative measurements were made in rabbit corneas. First, the level that varying concentrations of topically administered prednisolone acetate attained in the cornea and aqueous humor was determined. Then, the ability of varying concentrations of this corticosteroid to suppress corneal inflammation was ascertained. The maximum dose-response curve for anti-inflammatory effect in the cornea was achieved by the 1.0% concentration, the highest concentration commercially available. Higher concentrations permitted greater quantities of the drug to gain access to the cornea and aqueous humor but produced no measurable increment in anti-inflammatory effect. These experimental observations suggest that concentrations of prednisolone acetate higher than 1.0% have an increased potential for toxicity without offering additional therapeutic benefit.


A do-it-yourself fixation device for the ophthalmologist's office.

A visual fixation device that is useful for maintaining subject gaze in one direction during ophthalmologic examinations has been devised. The unit can be constructed from a few inexpensive electronic components.


Synchronous bilateral fluorescein angiography. A new technique.

Simultaneous angiography of both eyes allows the synchronous measurement of the arm-retina-time and the retinal circulation time in each eye. The dye-filling pattern of retinal arteries, choroid, disc, and cilioretinal vessels can be compared. A new method of simultaneous fluorescein angiography of both eyes, using two fundus cameras, is demonstrated. Each camera is operated by a separate power unit, thereby providing sufficient light energy for one picture every 0.6 second. The fluorescein is injected by means of an automatic injector in order to create a compact dye bolus. Simultaneous angiograms of a healthy patient and of a patient with unilateral carotid occlusion are shown.


Unilateral retinitis pigmentosa and pit of optic disc.

A 59-year-old woman had an unusual association of unilateral retinitis pigmentosa and optic pit with macular pathologic features in the same eye. A general ophthalmic and electrophysiologic investigation characterized the patient's condition functionally, without defining the basic defect responsible for this peculiar association. While an exact explanation of this occurrence cannot be given at this time, the possibility of coincidence or abiotrophy with developmental defects can be suggested as its intimate mechanism.


[Ventrale derotations-spondylodesis (author's transl)].

Results about 26 cases operated with the new developed "Ventrale Derotations-Spondylodesis". The first results with this new method are better than the results of the Harrington and the Dwyer method as it allows the operative derotation and lordosation. The risk of the operation put in relation to the distraction method by Harrington seems less. The importance of the operation one can't put into relation to the rather simple postoperative treatment. The results of the first 19 cases give the impression that the advantages of the Ventral Derotations-Spondylodesis make this method prefer to other instruments in the operative treatment of scoliosis.


[A new hip milling machine for preparation of the hip acetabulum for total hip prothesis (author's transl)].

The problemes of the exact preparation of the hip acetabulum for implantation of total hip prothesis have caused the development of several milling machines. Two sorts of construction predominate. Their disadvantages, especially the fact, that there is now mechanism, while is able to carry of the milled tissue, gave rise to construct a new milling machine. In cooperation with engineers of the branch mechanical engineering a new model was developed. The characteristic features are described and explained by pictures. The milling basket will be fastened on the ground plate by a quick fastener. In this way we get a hemisphere cavity, which is able to absorb all the milled tissue without any residue. A grasp will be connected with the drive shaft and guarantee an exact and rightangeled direction. The clinical tests have shown, that the new milling machine with the grasp especially is qualified for use in the osteoporotic senil bone too.


[Fractures of the femural shaft following trepanation of the corticalis and how to avoid it. At the same time an article on changing hip endoprothesis (author's transl)].

The problem of trepanation of the corticalis is investigated in 2 cases of femoral shaft fractures following a lateral trepanation of the femur, which can very often not be avoided in performing a necessary change of the hip prothesis. It can be demonstrated that because of the stress on the femur and its mechanical characteristics (material distribution, density distribution, breaking strength, "structure" strength and the histological structure), a lateral trepanation of the femoral corticalis is weakening the bone in its mechanically most stressed part whereas an anterior fenestration is mechanically much better. Considering the distribution of the strain in differently formed notches with rapid increase of strain with local rigidity in a pointed notch a mechanically much better rounding of the notch is suggested.


[Experience and results with the Loeffler operation for osteoarthritis of the knee joint (author's transl)].

A follow-up in 1975 of a group of patients that had previously been checked in 1972 after Loeffler's operation gave the following results: 1972: 40 patients where examined; of these, 90% where satisfied with the operation. 1975: 29 of the above group where re-examined; of these, 72.5% where satisfied with the operation, i.e. approximately 3 out of 4. From these result it follows that, in selected cases, there are favourable indications for the use of Loeffler's operation. Thus, modern medical practice should not forgo the use of operative methods which, at a minimum of risk to the patient, yield a considerable and long lasting positive result.


[Tabic arthropathy from an orthopedic view-point (author's transl)].

28 patients, who were suffering of tabique alterations of joints, the time between infection and the first localisations and therapy are discussed. The differential diagnosis, as far as it is interesting the orthopadien physican, is explained.


[Experience with operative leg lengthening (author's transl)].

The author reports on 175 cases of leg lengthening operations for leg equalisation by means of Wagners and Andersons procedure. None of the occuring complications prevented the operation being successful. So the methods offer an useful alternative to shortening osteotomies and epiphysiodesis.


[The indication for intertrochanteric osteotomy of the femur based on late results (author's transl)].

57 intertrochanteric osteotomies of the femur were performed in 43 patients during childhood. A statement about late radiographic results is made, based upon follow-up examination after cessation of growth of the upper end of the femur. Attention was given to the development of the CCD-angle, the AC-angle, the CE-angle as well as the development of antetorsion. Further-more the evaluation included the development of the caput-epiphyseal angle as well as the development deformities of the caput femoris. The data presented show that satisfactory results can be obtained through Bernbeck's method and also through the presently used derotation-varisation-osteotomy involving wedge removal. However, the results show that the correction of CCD-angle and antetorsion alone frequently is not sufficient. Thus the acetabulum deserve greater consideration is discussing intertrochanteric osteotomy in childhood.


Blood viscosity in man following decompression: correlations wiht hematocrit and venous gas emboli.

Whole blood viscosities were measured in U.S. Navy personnel before and after chamber compressions to 5 ATA (132FSW) and 7.4 ATA (210 FSW) by a new method described here. Bubble scores as a quantitative measure of venous gas emboli were determined during decompression and for 30 min thereafter. Hematocrit was measured both before and after each dive. There were five cases of decompression sickness in the two groups. No significant changes in whole blood viscosity, or hematocrit, were noted either in the group that was affected by decompression sickness or in all of the subjects taken as a group. No correlations between total bubble score and changes in viscosity or hematocrit could be made. These results imply that no major changes in viscosity occur in the usual forms of decompression sickness encountered in human beings.


Effect of ethyl alcohol on lonic calcium and prolactin in man.

Earlier animal studies suggested that there might be physiologically significant changes in serum calcium following administration of ethyl alcohol. Ionized and total calcium were measured in five normal male subjects following the oral ingestion of 200cm3 of 50% ethyl alcohol. Although blood alcohols reached intoxication levels in all subjects, no significant change in ionized calcium or total calcium occurred. It is unlikely that alcohol contributes to the risks of hypocalcemia or hyperventilation and anxiety in individuals performing in adverse environments, although there is little question it contributes to other risks. Even though two-fold elevations in plasma prolactin have been described in men with chronic alcoholism, no significant changes in plasma prolactin occurred during acute alcohol ingestion. Awareness of the significant increase in plasma osmolality, which has been demonstrated with alcohol, is important to avoid inappropriate therapy, since individuals performing in adverse environments are at risk of becoming dehydrated.


Hearing under stress: IV. a speech delivery communication system for utilization in high ambient noise environments.

Many communication systems have been devised to improve the individual's ability to receive speech information in the presence of ambient noise. The purpose of this study was to determine the effectiveness of a speech delivery system which combined a high degree of ambient noise attenuation with the ear's own natural amplification phenomenon--the occlusion effect. It was demonstrated that occlusion of the auditory system at the level of the external auditory meatus, in conjuction with bone-conducted speech stimuli presented at the mastoid, was most effective in providing high speech discrimination ability with significant attenuation of ambient noise.


Effect of space flight factors on the mammal: experimental-morphological study.

On the basis of a morphological examination of 27 rats that made a space flight and were sacrificed on the 1st-2nd and 26-27th days postflight, it has been shown that the 22-d space flight has produced no significant changes in the structural organization of vital organs of the animals. However, a space flight exposure is not indifferent for animals and leads to the development of morphologically visible changes in individual organs and systems (musculo-skeletal system, hemopoietic organs, hypothalamic-pituitary-adrenal system, renal juxtaglomerular system). The detected changes are reversible, nonspecific, and develop in animals exposed to ground-based hypokinetic and other stress experiments.


Performance of isolated rat hearts perfused with helium- or nitrogen-containing, gas-saturated solutions.

Effects of helium on the isolated perfused rat heart were studied employing the Langendorff technique. The perfusate consisted of Krebs-Henseleit solution saturated with one of three gas mixtures: 1) 95% O2-5% CO2, 2) 50% O2-45% He-5% CO2, and 3) 50% o2-45% N2-5% CO2. Contractile indices measured revealed the performance of hearts with the helium mixture to be equivalent to those perfused with the 95% O2-5% CO2 mixture. Those perfused with the nitrogen gas mixture exhibited contractile activity lower than that in the other two groups. It was concluded that helium exerts a direct effect on the coronary vasculature of the isolated rat heart by reducing its resistance to flow. A greater oxygen delivery to hearts perfused with the He-saturated solution compared to the N2-perfused hearts may account for the difference in performance.


Hypergravity effects on normal and avulsed developing avian radii.

Rhode Island Red female chicks were subjected to complete closed fracture of the right radius at 2 weeks post-hatching. The animals were allowed to heal for 1 week at either earth gravity or 2 G hypergravity state with control and estrogen-injected groups. Intact and fractured radial length, weight, average epiphysial-diaphysial diameters, and length, width, and weight of healing fracture callus were measured. Daily 2000 IU estrogen administration for 7 d increased intact radial length. Estrogen augments the effects of the 2-G state by inhibiting growth and depleting the mass of both intact and fractured radii and by decreasing the average distal epiphysial diameter of fractured bones. Animals exposed to the hypergravity state without hormonal treatment showed decreased fractured radial length, weight, and smaller proximal epiphysial diameters. The measurable parameters of the fracture callus (width, length, and weight) were depressed by the hypergravity state regardless of whether the animal was untreated or supplemented with estrogen.


Accumulative effects of 2 weeks' exposure to a 2-G hypergravity state and estrogen treatment upon intact and fractured radii of young female birds.

Female birds were subjected to closed fractured of the right radius at 2 weeks post-hatching and allowed to heal for 14 d. The animals were maintained at either earth gravity or a 2-G hypergravity state with control and 2000 and 4000 IU Estrone-(estrogen) injected groups. Intact and fractured radii were measured for length, weight, average epiphysial-diaphysial diameters, and length, width and weight of fracture callus. Animals receiving 2000 IU estrogen treatment showed decreased intact and fractured bone weight, as well as smaller diaphysial diameters. Fractured, but not intact, bone length was decreased by the two estrogen levels without affecting the callus parameters. Bone weight and average epiphysial diameters of both intact and fractured radii were decreased by the hypergravity state. Intact bone diaphysis and fractured bone length were similarly affected. Large, 4000 IU, estrogen levels potentiated the hypergravity state and reduced distal epiphysial diameter of intact radii.


Oxygen microelectrode response to oxygen pressures up to 15 ATA.

Polarographic measurements of oxygen at high pressures were made at 21-22 degrees C with open-type Wood's metal microelectrodes with tip diameter about 5 mu. Although the sensitivity of the individual electrodes ranged from 3.1 x 10(-10) to 8.8 x 10(-12) amps/mm Hg of O2, the oxygen current was always a straight line function of Po2 from 21% O2 at ambient pressure (Po2 = 160 mm Hg) to 100% O2 at 200 psig (Po2 = 11,102 mm Hg). Compression to 200 psig with 100% nitrogen produced no significant change in microelectrode current, showing that the microelectrodes are insensitive to pressure alone.


LDH isoenzymes of skeletal muscles of rats after space flight and hypokinesia.

Carbohydrate metabolism of the red-soleus and mixed-plantaris muscles of rats was studied during their exposure to weightlessness and hypokinesia. With respect to the isoenzyme spectrum of LDH, it was shown that the red and mixed muscles reacted differently to the 22-d orbital flight and hypokinetic exposure. The greatest changes of the LDH spectrum in the soleus muscle were found on the 15th hypokinetic day. These changes were similar to the changes in the soleus muscle of flight rats. The most significant changes of the LDH spectrum in the plantaris muscle were detected on the 60th hypokinetic day. No differences were found in the LDH spectrum of the plantaris muscle between the flight and control animals. Our study gives evidence that disturbances in carbohydrate metabolism play a major role in atrophic and dystrophic developments in skeletal muscles during a reduced functional load on them.


Metabolic and hormonal mechanisms of mineral metabolic adaptation to induced hypokinetics in rats.

During simulated hypokinetics, many biological functions have a tendency to stabilize at different levels with the passing of time. In this experiment, hypokinetic exposure was induced in albino rats by the suspension method for 5 weeks. A new plateau in urinary K+ excretion was attained during the third week, after a transient decrease during the first week. Since the formation of this steady plateau is considered a manifestation of the adaptation of this function, the hypokinetic exposure period was divided into a prestabilized phase and a stabilized phase. To ascertain the biochemical mechanisms of this adaptation process, the effects of aldosterone and anti-aldosterone substances (e.g., tetracycline) on K+ and Na+ excretion patterns in each phase were investigated. Decreasing aldosterone activity in the prestabilized phase and increasing activity in the stabilized phase are recognized as one of the main factors in the renal adaptation process to hypokinetics.


Morphological manifestations of functional changes in the hypothalamic-pituitary neurosecretory system and kidneys of rats after space flight.

Morphological examination of the hypothalamic-pituitary neurosecretory systen and kidneys of rats flown for 22 d and sacrificed 2 and 27 d postflight was carried out. By histological and histochemical methods, indications of increased activities of the hypothalamicpituitary neurosecretory system and the juxtaglomerular apparatus of kidneys were found. The changes were reversible and by the 27th postflight day returned to the normal. It is suggested that the changes in the above systems may be produced not only by flight effects but also by readaptation of animals to 1 g.


Comparison of the subjective intensity of sinusoidal, multifrequency, and random whole-body vibration.

An intensity matching technique was used in two experiments to test the independent component method for evaluating complex vibration environments, recommended by current vibration standards; In the first experiment, seated subjects adjusted the intensity of a 25 Hz sinusoid to match the subjective intensity of 11, 17, 40, and 63 Hz simusoids, presented either singly or in combinations of two, three, or four frequencies. In the second experiment, 25 Hz was again used to match the subjective intensity of third octave bands of random vibration with center frequencies of 16, 20, 25, 31;5, and 40 Hz, presented either singly or in combinations of two, three, or four bands. The results showed that the acceleration of the matching response increased significantly as the number of sinusoids or third-octave bands in the stimulus increased; These findings indicate that the independent component evaluation method will underestimate the severity of complex vibration environments, and suggest that their perceived intensities may be more accurately reflected by the weighting technique included in the standards as an alternative evaluation method.


Hematologic changes in man during decompression: relations to overt decompression sickness and bubble scores.

In order to determine whether asymtomatic gas phase separation causes hematologic abnormalities, studies were carried out following two dive series, one to 210 feet of sea water (FSW) for 50 min and the other to 132 FSW for 30 min. Studies included white and red cell count, red cell indices, platelet count, ESR, fibrinogen, fibrin split products, prothrombin time, partial thromboplastin time, coagulation factors II, V, VII, VIII, and X, clot retraction, platelet aggregation and adhesion, euglobulin lysis time, and platelet factor III. Changes were seen in platelet and white cell count, prothrombin time and partial thrombo-plastin time. White cell count was the only variable which correlated with total bubble score. The results are presented and implications of the findings discussed.


What EEG criteria for diving fitness?

The authors have tried to consider EEG criteria applicable to fitness for diving. In a study of 90 professional divers, 37 (41%) displayed patterns susceptible of being interpreted as falling outside of strict normalcy. These patterns have sometimes been considered incompatible with diving, or even pathological by some authors. Considering the fact that these subjects were in good health, the value of these EEG signs is discussed in comparison with the literature. A general guideline is proposed placing subjects in three groups: fit, unfit, and questionable. In the last case, a final decision is taken in each individual case in agreement with the other medical examinations and based on the type of diving considered. Some explicit EEG criteria of definitive or temporary fitness and unfitness are proposed.


Sopite syndrome: a sometimes sole manifestation of motion sickness.

Drowsiness is one of the cardinal symptoms of motion sickness; therefore, a symptom-complex centering around "drowsiness" has been identified which, for convenience, has been termed the sopite syndrome. Generally, the symptoms characterizing this syndrome are interwoven with other symptoms but under two circumstances the sopite syndrome comprises the main or sole overt manifestation of motion sickness. One circumstance is that in which the intensity of the eliciting stimuli is closely matched to a person's susceptibility, and the sopite syndrome is evoked either before other symptoms of motion sickness appear or in their absence. The second circumstance occurs during prolonged exposure in a motion environment when adaptation results in the disappearance of motion sickness symptoms, except for responses characterizing the sopite syndrome. Typical symptoms of the syndrome are: 1) yawning, 2) drowsiness, 3) disinclination for work, either physical or mental, and 4) lack of participation in group activities. Phenomena derived from an analysis of the symptomatology of the sopite syndrome are qualitatively similar but may differ quantitatively from abstractions derived in other motion sickness responses. One example is the sometimes unique time course of the sopite syndrome. This implies that the immediate eliciting mechanisms not only differ from those involved in evoking other symptoms, but, also, that they must represent first order responses. Diagnosis is difficult unless the syndrome under discussion is kept in mind. Prevention poses a greater problem than treatment.


Serum uric acid, cholesterol, and psychological moods throughout stressful naval training.

Navy recruits, all 51 volunteers for a preliminary underwater demolition team (UDT) training program, were followed through 4 weeks of training; 27 men passed and 24 failed the training course. Serum uric acid and serum cholesterol levels, as well as psychological moods data were collected on all volunteers at the start of training and at the end of each of the four training weeks. Men who passed training were compared to those who failed. In addition, these same measures were carried out with a control group of 66 naval recruits. Pre-UDT trainees who passed the program demonstrated high levels of positive moods, early peaks in serum uric acid level, and stable serum cholesterol levels throughout training. These findings supported previous work with successful UDT trainees. Pre-UDT trainees who failed the program demonstrated intermediate levels of positive moods, a midtraining period peak in serum uric acid, and a significant rise in serum cholesterol during the final 2 weeks of the course. The serum cholesterol rise seen during a period shortly prior to failure substantiates previous findings. A comparison group showed low levels of positive moods, an initial peak in serum uric acid, and stable serum cholesterol levels. Two mood scales had siginificant correlations with serum uric acid for only men who passed training. A motivation scale, given at the start of training, correlated with serum uric acid levels for men who failed training.


Sex ratio in offspring of pilots: a contribution to stress research.

An old rumor - lately substantiated by statistical examinations from England - to the effect that pilots of high-performance military aircraft are "girl-fathers", could be reduced to absurdity through a comprehensive questionnaire investigation in the German Federal Armed Forces. Spermiogenesis does not seem to be disturbed by professional-specific influences (Radar radiation, G-forces etc.), as implied by the questionnaire findings. In times of high flying and personal stress (first 1000 flying hours) military jet pilots are even "boy-fathers". As soon as flying becomes a routine matter (after the 1000th flying hour) and thus less stressful, jet and helicopter pilots even become "girl-fathers". The pilots of military transport aircraft show no deviation from the control group of the male population of the Federal Republic of Germany with respect to the sex ratio of children procreated by them. The intention of this somewhat curious study was established by considerations that pilots would be entitled to protection and/or compensation for damages incurred in cases where their procreative capacity had been detrimentally affected by activities in the line of duty.


A Z-axis recumbent rotating device for use in parabolic flight.

A prototype apparatus for exposing persons to rotation about their Z-axis in parabolic flight is described. Although it resembles Earth-horizontal axis devices, added features are its strength and portability, and the fiber glass "couch" with adjustable elements providing support and restraint. Even under ground-based conditions, this device provides unique opportunities for investigations involving not only canalicular and macular mechanoreceptors, but also touch, pressure, and kinesthetic receptor systems.


The isolation and characterization of bilirubin diglucuronide, the major bilirubin conjugate in dog and human bile.

The chemical structure of the major conjugate of bilirubin was unequivocally elucidated by structural analysis. The conjugated bilirubins were first separated from the lipid components of human duodenal aspirates or dog gall-bladder bile, and then resolved by t.l.c. into a series of tetrapyrroles. The major tetrapyrrole was then converted into its more stable dipyrrolic azo derivative for further analysis. The conjugated moiety of the azopigment was characterized after methanolysis with sodium methoxide. This reaction yields two types of product, those soluble in water and those soluble in organic solvents. The organic-soluble fraction was shown by t.l.c. and mass spectrometry to contain the methyl esters of the dipyrrolic azo derivatives of bilirubin. The water-soluble materials were analysed by enzymic procedures, t.l.c., n.m.r. spectrometry and combined g.l.c. and mass spectrometry. This analysis showed that the only water-soluble product resulting from the methanolysis was glucuronic acid. The structure was identical with that of pure standards, on both mass spectrometry and n.m.r. spectroscopy. No contaminating moieties were found. Quantitative measurement indicated that the glucuronic acid had been released in a 1:1 molar ratio with the resulting methyl esters of the dipyrrolic azo derivatives of bilirubin. This unequivocally establishes bilirubin diglucuronide as the major pigment present in bile. Past problems with identification of bilirubin diglucuronide were shown to originate from procedures which resulted in incomplete separation and isolation of the azopigments of the conjugated bilirubins, owing to contamination by biliary lipids.


Is a Schiff base involved in the mechanism of the delta4-3-oxo steroid 5alpha- or 5beta-reductases from mammalian liver?

The saturation of the delta4-double bond of delta4-3-oxo steroids by the mammalian 5alpha- or 5beta-reductases is by an enzyme mechanism that does not involve a Schiff-base intermediate.


A low-molecular-weight protein from rat liver that resembles ligandin in its binding properties.

A protein of S20,W 1.6S and mol.wt. 14000, which binds covalently a metabolite of the aminoazodye carcinogen NN-dimethyl-4-amino-3'-methylazobenzene, was isolated from rat liver cytosol from both carcinogen-treated and normal rats. The protein binds non-covalently palmitoyl-CoA, fatty acids, bilirubin, sex steroids and their sulphates, bile acids and salts, bromosulphophthalein, diethylstilboestrol and 20-methylcholanthrene with a wide range of affinities. The protein is isolated as three components with isoelectric points of 5.0, 5.9 and 7.6 by a method involving isoelectric focusing. All three components have closely similar amino acid analyses, tryptic-peptide 'maps' and u.v. spectra. Each single component redistributes into all three on further electrophoresis. However, the three forms differ in their binding characteristics, the form of pI 7.6 having much the highest affinity for compounds bound non-covalently. The protein was identified immunologically in rat liver, small intestine, adipose tissue, skeletal muscle, myocardium and testis. The protein was compared with other hepatic binding-protein preparations of similar molecular weight.


Lipids associated with bovine kidney glomerular basement membranes.

1. After incubation of bovine glomeruli with D-[U-14C]glucose, about 21% of the total radioactivity is found in lipid extracts of glomerular basement membranes. 2. The concentration of lipids in glomerular basement membranes (4.3% of dry wt.) is lower than in the residual glomerular particles (10.8% of dry wt.). The concentrations of neutral lipids (13.9%), phospholipids (46.7%) and cholesterol (37.9%) in the total lipid extract of the glomerular basement membranes, however, differ from those in the residual glomerular particles (15.6, 54.0 and 30.9% respectively). Though residual glomerular particles show a higher lipid content, the radioactivity in this fraction only amounts to 38% of that found in the glomerular basement membranes. 3. The specific radioactivity of total glomerular basement-membrane lipids (12 600 d.p.m./mg) is about 4 times as high as that of the glomerular basement membranes. The specific radioactivities of the individual lipid components, however, differ. The highest values are found for phosphatidylcholine and triacylglycerols. The largest proportion of the radioactivity is found in the glycerol of the glycerides. The radioactivity in the fatty acids is much less and does not differ significantly in the various classes of lipids. 4. G.1.c. of methyl esters of the fatty acids does not reveal a clear difference between the fatty acid compositions of glomerular basement membranes and residual glomerular particles. 5. Treatment of glomerular basement-membrane preparations with ultrasound, the generally used procedure for glomerular basement-membrane preparations, drastically decreases the lipid content of glomerular basement membranes. 6. It is concluded that lipids are associated with the basement membranes. Further, the comparatively high radioactive labelling suggests that glomerular basement-membrane lipids may be an interesting class of substances for further pathological studies.


Study of poly-L-lysine conformations in aqueous methanol solution by using polarized Raman techniques.

Raman polarization measurements of the amide I band are reported in ionized poly-L-lysine dissolved in aqueous methanol. The observed changes with methanol concentration, attributed to changes in coil conformation and to the helix-coil transition, represent a novel method of measuring polymer conformation. Polarization measurements as a function of temperature yield values of the energy differences between rotational isomeric states in the coil. deltaH, of 8.8 +/- 0.7, 10.4 +/- 1.1 and 10.8 +/- 1.5 kJ/mol at methanol concentrations (v/v) of 85, 80 and 70% respectively. The stabilization energy of the helix is estimated at 9.3 kJ/mol.


Chymotrypsins from the deer (Cervidae) family. Isolation, partial characterization and primary-structure studies of chymotrypsins A and B from both moose (Alces alces) and elk (Cervus elaphus) pancreas.

1. An anionic and a cationic chymotrypsin (EC 3.4.21.1) were isolated from the pancreas glands of the moose (Alces alces) and elk (Cervus elaphus). The A and B chymotrypsins from each species were purified to homogeneity by (NH4)2SO4 fractionation, affinity chromatography on 4-phenylbutylamine-Sepharose and ion-exchange chromatography on DEAE- and CM-cellulose. 2. The molecular weight and pH optimum of each chymotrypsin were similar to those of the corresponding ox A and B chymotrypsins. 3. The substrate specificities of the chymotrypsins were investigated by digestion of glucagon and the oxidized B chain of insulin. The primary specificity of each chymotrypsin for aromatic amino acid residues was further established by determining the Km and kcat for the hydrolysis of a number of synthetic amino acid ester substrates. 4. The amino acid composition and total number of residues of moose and elk chymotrypsin A were similar to those of ox chymotrypsin A. An even greater similarity was observed among the B chymotrypsins of the three species. 5. The A chymotrypsins of moose and elk were fragmented to their constituent 'A', 'B' and 'C' polypeptide chains by succinylation (3-carboxypropionylation), reduction and alkylation of the native enzymes. In each case, the two major chains ('B' and 'C') were separated and isolated. By comparison of the amino acid compositions of moose, elk and oxy 'B' and 'C' chains, a greater difference was observed among the three A chymotrypsins than was suggested by the amino acid compositions of the native enzymes alone. 6. Peptides were isolated from the disulphide bridge and active-site regions of the A and B chymotrypsins of moose and elk by diagonal peptide-'mapping' techniques. From the amino acid compositions of the isolated peptides (assuming maximum homology) and from a comparison of diagonal peptide 'maps', there was established a high degree of primary-structure identity among the mooae, elk and ox chymotrypsins. Tentative sequences were deduced for the peptides isolated by diagonal peptide 'mapping'. 7. Details of the isolation procedures of the moose and elk chymotrypsins A and B and the amino acid analyses of some peptides obtained by diagonal peptide 'mapping' have been deposited as Supplementary Publication SUP 50064 (27 pages) at the British Library Lending Division, Boston Spa, Wetherby, W. Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1976) 153, 5.


A new method for deriving steady-state rate equations suitable for manual or computer use.

A schematic method for the derivation of steady-state enzyme rate equations by using the Wang algebra is described. The method is simple, easy to learn and offers a substantial decrease in analytical effort over previously published algorithms. Being essentially an algebraic procedure the method can be readily computerized. Computer programs in BASIC and ALGOL languages have been deposited as Supplementary Publication SUP 50065 (19 pages) at the British Library (Lending Division), Boston Spa, Wetherby, W. Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on the terms indicated in Biochem. J. (1976). 153, 5.


A method for the purification of milligram quantities of stable human phosphatidylcholine-cholesterol acyltransferase.

A method for processing 3 litres of human plasma for the purification of phosphatidylcholine-cholesterol acyltransferase is described. The method involves (NH4)2SO4 fractionation, citric acid treatment, and DEAE-cellulose and hydroxyapatite chromatography. At this stage the enzyme preparation is purified approx. 8000-fold. This preparation appears to be free of lipoproteins as determined by immunoelectrophoresis against anti-human serum and is minimally contaminated with albumin (less than 30 mug/mg of enzyme protein) as determined by immunodiffusion. The activity of the enzyme was stable for 4 days, but most of its activity was lost after 20 days On electrophoresis on 5% polyacrylamide gel, a fast-moving band with enzyme activity and a slow-moving band with no enzyme activity was observed. A faint band of albumin was also present. Extracts of enzymically active bands cut from ten gels and then pooled and extracted with 0.15 M-NaC1/4mM-sodium phosphate, pH 7.0, showed a single band on re-electrophoresis on 5% polyacrylamide gel.


Molecular forms and activities of glycosidases in cultures of amniotic-fluid cells.

Ion-exchange chromatography of gel filtration demonstrated the presence of different molecular forms of nine lysosomal enzymes in cultured amniotic-fluid cells. The patterns of molecular forms were similar to those known from skin fibroblasts and liver tissue. During cultivation total enzyme activities fluctuated with the number of passages, without any consistent trend of increase or decrease, and without correlation to the dominating cell type in the culture.


The determination of methionine in proteins by gas-liquid chromatography.

Intact methionine residues in proteins were rapidly and precisely determined by measuring methyl thiocyanate released during the reaction with CNBr and separated by g.l.c. Conditions for the reaction and for chromatography on columns of Porapak P-S are described. The recovery of methyl thiocyanate from several methionine derivatives and analogues were examined. Carbamoylmethionine was adopted as a stable primary standard and ethyl thiocyanate as internal standard. The measured methionine content of several isolated proteins was close to the theoretical value indicated by previous work and the results for these and a range of food proteins agreed well with results obtained by ion-exchange chromatography after performic acid oxidation. Since CNBr does not react with methionine sulphoxide and a preliminary hydrolysis is not required, the method discriminates between methionine and any methionine sulphoxide that may be present. It could be useful in studies on the nutritional availability of methionine in processed foods.


Mode of interaction between beta-lactam antibiotics and the exocellular DD-carboxypeptidase--transpeptidase from Streptomyces R39.

The exocellular DD-carboxypeptidase-transpeptidase of Streptomyces R39 is inhibited by beta-lactam antibiotics according to the same general scheme of reaction as the exocellular DD-carboxypeptidase-transpeptidase of Streptomyces R61. However, the values for the kinetic constants involved in the reaction are very different for the two enzymes and provide an explanation for the observation that the R39 enzyme is more sensitive to beta-lactam antibiotics than the R61 enzyme. Further, particular beta-lactams influence the kinetic constants to different extents depending on the source of the enzyme, so that a physical basis for the spectrum of antibiotic activity against particular enzyme systems is provided.


Isolation of (copper, zinc-) thioneins from pig liver.

The copper-binding proteins with mol. wt. of approx. 12000 in the cytosol of pig liver have been identified as copper-thioneins. They contain variable amounts of zinc, with approx. 10% total metal in the protein. The molar cysteine/metal ratio is approx. 2:1.


The nature of the 5'-linked 5' nucleotide sequence at the 5' end of rabbit globin messenger ribonucleic acid.

Poly(A)-containing messenger RNA isolated from rabbit reticulocytes as estimated by periodate oxidation and condensation with [3H]isoniazid has two oxidizable end groups per molecule of mol. wt. 220000. When the mRNA is subjected to stepwise degradation by beta-elimination, only one oxidizable end-group is found. This indicates that one of the 2',3' hydroxyl end-groups is linked through the normal 3'--5' phosphodiester bond, but that the other is linked in such a way that after stepwise degradation no new 2',3 hydroxyl group is revealed. This structure could be a 5'-linked 5'-phospho di- or tri-ester. On digestion with ribonuclease the isoniazid-labelled RNA produced oligonucleotide hydrazones consistent with a poly(A) sequence at the 3' end plus fragments that are not found after stepwise degradation. These fragments have a charge of --6 and --8 from pancreatic ribonuclease or --7 from ribonuclease T1 digestion. These charges are changed to --3.4 and --4.1 after pancreatic ribonuclease, ribonuclease T2 and alkaline phosphatase digestion. methyl-3H-labelled-poly(A)-containing RNA isolated from late erythroid cells contain a methyl-labelled fragment resistant to endonuclease and phosphodiesterase II digestion. After digestion with phosphodiesterase I this fragment produces methyl-3 H-labelled nucleotides with the electrophoretic mobility of pm7G and pAm. It is concluded that globin mRNA has the 5' sequences m7G(5')ppp'AmpYpGp ... and m7G(5')pppAmpApGpYp.


Kinetic and spectral properties of rabbit brain 4-aminobutyrate aminotransferase.

Purification and 4-aminobutyrate-2-oxoglutarate aminotransferase (EC 2.6.1.19) from rabbit brain is described. The method was used as a routine to give between 5 and 10mg of pure enzyme from 750 g of rabbit brain. The enzyme is a dimer made up of subunits each with a mol. wt. of 58000. An absorption spectrum of the freshly prepared enzyme shows peaks at 415 and 330 nm. Treatment of the enzyme with the substrate 4-amino-butyrate or glutamate produces a decrease in the 415 nm and an increase in the 330 nm peak. This conversion, which is attributed to an aldimine into ketimine step in the reaction, is sufficiently slow when 4-aminobutyrate is the substrate to allow it to be followed by stopped-flow spectrophotometry. A first-order rate constant was determined for this step (12s-1) and compared with the turnover number for the enzyme derived by steady-state methods (9.5S-1). The first-order rate constant when glutamate was used as substrate was estimated to be approx. 30s-1.


Affinity purification and some molecular properties of human liver alkaline phosphatase.

Alkaline phosphatase from human liver was purified to homogeneity. The purification procedure included solubilization with butanol, fractionation with acetone, and chromatography on concanavalin A-Sepharose, DEAE-cellulose, Sephadex G-200 and DEAE-Sephadex. Purity was established by standard and sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. The isoelectric point of the protein was determined to be 4.0. Sephadex-gel filtration gave a mol.wt. of 146000, although a higher value was obtained in the presence of 100mM-NaC1. The subunit mol.wt. 76700, was determined by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis. Neuraminidase treatment resulted in two enzyme-activity bands on isoelectric-focused gels with isoelectric points of 6.6 and 6.8. The desialylated enzyme gave only one protein band on sodium dodecyl sulphate/polyacrylamide-gel electrophoresis with a subunit molecular weight indistinguishable from that of the non-neuraminidase-treated protein. The desialylated enzyme was more readily denatured by sodium dodecyl sulphate in the presence of mercaptoethanol than was the native enzyme.


Ligand-apomyoglobin interactions. Configurational adaptability of the haem-binding site.

1. The interaction of the haem-binding region of apomyoglobin with different ligands was examined by ultrafiltration, equilibrium dialysis and spectrophotometry, to study unspecific features of protein-ligand interactions such as they occur in, for example, serum albumin binding. 2. Apomyoglobin, in contrast with metmyoglobin, binds at pH 7, with a high affinity, one molecule of Bromophenol Blue, bilirubin and protoporphyrin IX, two molecules of n-dodecanoate and n-decyl sulphate and four molecules of n-dodecyl sulphate and n-tetradecyl sulphate. 3. The number of high-affinity sites and/or association constants for the alkyl sulphates are enhanced by an increase of hydrocarbon length, indicating hydrophobic interactions with the protein. 4. Measurements of the temperature-dependence of the association constants of the high-affinity sites imply that the binding processes are largely entropy-driven. 5. Binding studies in the presence of two ligands show that bilirubin plus Bromophenol Blue and dodecanoate plus Bromophenol Blue can be simultaneously bound by apomyoglobin, but with decreased affinities. By contrast, the apomyoglobin-protoporphyrin IX complex does not react with Bromophenol Blue. 6. Optical-rotatory-dispersion measurements show that the laevorotation of apomyoglobin is increased towards that of metmyglobin in the presence of haemin and protoporphyrin IX. Small changes in the optical-rotatory-dispersion spectrum of apomyoglobin are observed in the presence of the other ligands. 7. It is concluded that the binding sites on apomyoglobin probably do not pre-exist but appear to be moulded from predominantly non-polar amino acid residues by reaction with hydrophobic ligands. 8. Comparison with data in the literature indicates that apomyoglobin on a weight basis has a larger hydrophobic area avaialble for binding of ligands than has human serum albumin. On the other hand, the association constants of serum for the ligands used in this study are generally somewhat larger than those of apomyoglobin.


Abnormal carbohydrate composition of the major penetrating membrane protein of En(a-) human erythrocytes.

The major penetrating membrane glycoprotein (band 3) was isolated from En(a-) and normal human erythrocytes. The two proteins differed only in carbohydrate composition. Band 3 from En(a-) erythrocytes contained greater amounts of galactose and N-acetyl-glucosamine. The loss of the sialoglycoprotein sialotetrasaccharides in the En(a-) cell is not compensated by the appearance of these units in band 3 of En(a-) erythrocytes.


Removal of adsorbed elastase from partially digested elastin.

Bovine ligamentum nuchae elastin that had been partially digested by porcine pancreatic elastase and then thoroughly washed with 0.2 M-NaC1/0.05 M-sodium borate solution continued to release peptide fragments in solution. Complete removal of elastase from the elastin surface required extraction with dilute alkali, a procedure that does not irreversibly inactivate the enzyme or hydrolyse elastin.


Modification of brain deoxyribonucleic acid base content with maturation in normal and malnourished rats.

The mol percentage of 5-hydroxymethylcytosine is 2.2 times greater in the adult than in 2-day-old rat brain DNA. The concentration of 5-hydroxymethylcytosine falls in corresponding liver DNA preparations. This normal increase in brain 5-hydroxymethylcytosine is abolished in rats placed on an 8%-protein diet 5 days after birth.