Hypophosphatasia: a developmental anomaly of alkaline phosphatase?

This report deals with quantitative and qualitative investigations of alkaline phosphatase in two unrelated infants with the severe infantile form of hypophosphatasia. Both affected infants had no detectable leukocyte alkaline phosphatase activities and both sets of parents and one sibling tended to have low but variable leukocyte enzyme activities. Normal duodenal juice alkaline phosphatase activity was present in the one patient in whom it was measured and a wide range of variation in enzymic activity was observed in the stools. There was no significant difference in the stool enzyme activity between both patients with hypophosphatasia (42.01 +/- 9.77 U) and control infants (40.55 +/- 6.29 U). However, the heterozygous parents had values significantly lower than the control adults (2.10 +/- 0.47 as compared with 19.10 +/- 4.44 U). Intestinal bacteria did not contribute significantly to the stool alkaline phosphatase activity. Enzyme activity was present in the bile of one of the patients and nearly absent in that of the other. Three "inducers" of alkaline phosphatase were given to both patients (phenobarbital, vitamin A, and corticosteroid). No clinical improvement or rise in serum alkaline phosphatase activity was observed during the trial of therapy with these agents. However, a significant increase in the activity of serum acid phosphatase was demonstrated during the course of vitamin A administration, suggesting an in vivo action of vitamin A on the lysosomes through decreasing the stability of the membrane and releasing acid phosphatase to the serum. Quantitative determination of tissue alkaline phosphatases from autopsy tissues was highly variable: no activity was found in bone, lungs, or spleen of either infant; there was a discrepancy in liver and kidney alkaline phosphatase values (zero in one patient and present in the other) and activity was present in the intestinal mucosa of both. Qualitative analysis of kidney, liver, and intestinal alkaline phosphatase revealed some differences between the patients and control subjects in heat inactivation and phenylalanine inhibition (Table 3). Starch gel electrophoresis of the liver preparation of one patient disclosed a single band which had greater mobility than that of six control subjects matched for age. Liver extracts from a premature and from full term newborns showed two bands. The single band of the patient's liver enzyme corresponded to the newborn's fast moving component. In addition, the intestinal enzyme prepared from the same patient had an extra band when compared with age-matched control subjects.


Effect of umbilical artery catheters on blood flow and oxygen supply to extremities.

The effect of catheter placement in the abdominal aorta on the blood flow and oxygenation of lower extremities was evaluated in 30 New Zealand rabbits, weighing 0.55-3.5 kg, by inserting 3.5 and 5.0 French polyvinyl chloride catheters, of the type commonly used for umbilical artery catheterization, through the femoral artery, advancing 15-20 cm, and leaving in place for 10-30 min. Arterial blood pressure (BP), common iliac artery blood flow (BF), gracilis muscle tissue oxygen availability (O2a), and subcutaneous temperature (T) in the foot were continuously monitored before and during catheter placement and after withdrawal. There were no changes in the physiologic variables measured in the contralateral leg when the catheter remained below the aortic bifurcation; however, when the catheter was advanced 15-20 cm into the abdominal aorta, a decrease in lower extremity BF, O2a, and T occurred. Because the length of catheter insertion was maintained constant in each animal, the decreases in BF, O2a, and T are related to the relative dimensions of the vessel and the catheter. The ratio of catheter to vessel diamter, in addition to the site of catheter placement, should be considered during the clinical application of arterial catheters. Reduction in blood flow could be detected by continuous differential monitoring of core and extremity temperature or extremity muscle oxygen availability.


A comparison of the active stiffness of fetal and adult cardiac muscle.

This report described the in vitro analysis of the series elasticity of ventricular myocardium isolated from five fetal lambs and six adult sheep. Active compliance measurements were obtained by quick releases utilizing a closed loop servosystem and electromagnetic positioning device to control cardiac muscle length or tension. Right ventricular moderator bands were obtained from five fetuses (average 139 days of gestation, term=147 days), and compared with two adult moderator bands and four adult right ventricular trabeculae carneae. After correction for equipment coupling the experimental load extension data were fit to an exponential expression by a least squares technique: strain=1/b ln (1 + stress/a). When fetal and adult data were compared, no age-related differences in the constants were observed (a=0.185 +/- 0.062 SE (fetal) and 0.159 +/- 0.03 g/mm2 (adult); b=40.4 +/- 5.2 (fetal) and 43.1 +/- 5.2 (adult); and ab=7.39 +/-2.34 (fetal) and 5.27 +/- .99 (adult). However, significant variation existed in the histologically determined amount of contractile tissue present in muscle samples from both fetus (57-85%, average=74.0 +/- 4.9) and adult (64-94%, average=82.3 +/- 5.3). Wihtout regard to age, a signficant correlation was found between the b stiffness constant and the amount of contractile mass present in cardiac muscle. Thus, it is concluded that there is no age-related difference in the stiffness of fetal and adult ventricular muscle. However, there is a significant relationship between active compliance and true muscle mass.


Pseudohypoaldosteronism due to sweat gland dysfunction.

Pseudohypoaldosteronism is an uncommon disorder characterized by urinary sodium wasting and is attributed to a defect in distal renal tubular sodium handling with failure to respond to endogenous aldosterone. Sweat electrolyte values in other reported patients, when measured, have been normal. A 3.5-year-old girl developed repeated episodes of dehydration, hyponatremia, and hyperkalemia during the first 19 months of life. Serum sodium was as low as 113 mEq/liter and potassium as high as 11.1 mEq/liter. Her plasma and urinary aldosterone levels were persistently elevated (Figs. 1-4). Unlike patients with classic pseudohypoaldosteronism she demonstrated no urinary sodium wasting (Figs. 2 and 3). During episodes of hyponatremia and reduced sodium intake her urinary sodium was less than 5 mEq/liter. In addition, her sweat sodium concentration was consistently above 125 mEq/liter and salivary sodium concentration above 58 mEq/liter. Her chest x-ray, 72-hr fecal fat excretion, serum and urinary pancreatic amylase (amy-2) were normal, providing no evidence for cystic fibrosis. It is proposed that this patient represents a new variant of pseudohypoaldosteronism with excessive loss of sodium from the sweat and salivary glands instead of the kidneys.


Effect of propionic acid on fatty acid oxidation and ureagenesis.

Propionic acid significantly inhibited 14CO2 production from [1-14C] palmitate at a concentration of 10 muM in control fibroblasts and 100 muM in methylmalonic fibroblasts. This inhibition was similar to that produced by 4-pentenoic acid. Methylmalonic acid also inhibited 14CO2 production from [1-14C] palmitate, but only at a concentration of 1 mM in control cells and 5 mM in methylmalonic cells. Propionic acid (5 mM) also inhibited ureagenesis in rat liver slices when ammonia was the substrate but not with aspartate and citrulline as substrates. Propionic acid had no direct effect on either carbamyl phosphate synthetase or ornithine transcarbamylase. These findings may explain the fatty degeneration of the liver and the hyperammonemia in propionic and methylmalonic acidemia.


Multiple enzyme defects in familial hyperlysinemia.

Lysine-ketoglutarate reductase (EC. 1.5.1.8) deficiency in skin fibroblasts has been previously reported in patients with familial hyperlysinemia, providing an adequate explanation for the biochemical derangements noted clinically. In the present study, analysis of liver obtained at autopsy from a patient with familial hyperlysinemia confirmed the lysine-ketoglutarate reductase deficiency but, unexpectedly, also revealed an absence of saccharopine dehydrogenase (EC. 1.5.1.9) and saccharopine oxidoreductase activity. Skin fibroblasts from two siblings with the disease and a third patient from an unrelated family were also deficient in all three enzymes (lysine-ketoglutarate reductase, average 9%; saccharopine dehydrogenase, average 4%; saccharopine oxidoreductase, less than 10% of normal). The possibility that saccharopine dehydrogenase is a substrate-inducible enzyme was investigated by maintaining normal skin fibroblasts in a medium with minimal lysine concentration, and exposing hyperlysinemic fibroblasts to elevated saccharopine concentrations. There was no significant modification in saccharopine dehydrogenase activity.


The transplacental migration and accumulation in blood of volatile organic constituents.

Gas chromatographic-mass spectrometric analysis of profiles of low molecular weight volatile organic constituents obtained from cord blood and maternal blood samples collected at birth reflect transplacentally acquired compounds. The transplacental passage of halogenated hydrocarbons, plastic components, and abnormal accumulations of compounds have been demonstrated. In the 11 paired cord blood-maternal blood samples analyzed, the relative amounts of constituents in cord blood closely correspond to those quantities present in the maternal blood. However, some of the over 100 components are present in the cord blood in significantly higher concentrations than in the maternal blood, suggesting a possible selective one-way transfer of certain constituents into the fetus. Benzene, carbon tetrachloride, and chloroform are present in quantities equal to or greater than in maternal blood. In one infant with a lumbosacral meningomyelocele abnormally high concentrations of acetone, other components, and the food preservative 2, 6-di-tert-butyl-4-methylphenol (BHT) were identified.


Heme synthesis in hereditary hemolytic anemias: decreased delta-aminolevulinic acid synthetase in hemoglobin Köln disease.

The activities of delta-aminolevulinic acid (ALA) synthetase and ALA dehydratase in cord blood erythrocytes of newborn infants and peripheral blood red cells of patients with beta-thalassemia major, beta-thalassemia intermedia, hemoglobin Köln (Hb Köln) disease, sickle cell anemia, and pyruvate kinase deficiency were studied. The activity of ALA dehydratase did not vary appreciably with the number of immature RBC (reticulocytes and nucleated red blood cells) or the severity of the hemolytic anemia except in pyruvate kinase deficiency. The activity of ALA synthetase was linearly correlated with the number of immature RBC (r=0.974, p is less than 0.001). The ALA synthetase activity was significantly decreased in the RBC of Hb Köln (p is less than 0.01) when compared with the activity in immature RBC of newborns and of patients with pyruvate kinase deficiency, sickle cell anemia, and thalassemia intermedia.


Detection of urinary tract infections in 3- to 5-year-old girls by mothers using a nitrite indicator strip.

A program to detect urinary tract infections among 3- to 5-year-old girls was conducted in Madison-Dane County, Wisconsin using local pharmacies as the distribution site for test kits. Screening was conducted at home by mothers with a nitrite dip-strip on three consecutive first morning specimens. Twenty-one percent of the target population participated during a one-month study period. Eighteen cases were found among 1,573 participants (1.1%). In addition, 243 girls other than those in the target area or age group participated and yielded eight additional cases, for a total of 26 cases among 1,816 total participants. The rate of false-positive nitrite tests was 0.3%. Newspapers were the most effective means of alerting the public to the program. The only factors which were associated with less awareness or participation were low socioeconomic and rural residence. Past history of infection, minor urinary symptoms, and pyuria were common among the bacteriuric girls. Immunoglobulin-coated bacteria suggestive of tissue invasion were present in one third of the cases. Vesico-ureteral reflux was present in five and caliectasis in two of 23 girls studied. Despite the likelihood that some bacteriuric girls, particularly those infected with gram-positive organisms were not detected, screening at home appears to be a highly efficient method of detecting urinary tract infections in large populations of preschool children.


Phototherapy for neonatal hyperbilirubinemia in "healthy" and "ill" infants.

The effectiveness of phototherapy for nonhemolytic hyperbilirubinemia was evaluated in two groups of closely matched newborns, one group consisting of "healthy" and the other "ill" infants. Phototherapy was equally effective in reducing bilirubin levels in both groups of infants. It would seem to be the treatment of choice in all infants with nonhemolytic hyperbilirubinemia, especially ill infants in whom its simplicity, safety, and effectiveness would make it an ideal form of therapy.


The hematology of bacterial infections in premature infants.

A series of premature infants was studied for the presence of bacterial infection. On the basis of clinical evidence and bacteriological studies, they were divided into three groups in which sepsis was considered to be proven, possible, or unlikely. Band neutrophil counts were elevated most frequently in the "sepsis-proven" group and the elevation occurred usually within 24 hours of onset of signs of disease. Qualitative changes in neutrophils (Döhle bodies, toxic granulation, and vacuolization) were more frequent in the sepsis-proven group and, together with the band count, provided valuable techniques for the diagnosis of bacterial infections. Thrombocytopenia occurred frequently in the sepsis-proven group and seemed to result from increased utilization or destruction of platelets rather than failure of production. In such cases, evidence of intravascular coagulation was minimal and it was concluded that thrombocytopenia had resulted from a direct effect of the bacteria or its products on platelets and/or endothelium.


Nosocomial staphylococcal cervical lymphadenitis in infants: report of an outbreak.

Staphylococcus aureus infections developed in 16 of 721 infants born at a general hospital during a six-month period (October 1972 to March 1973). Twelve of the 16 affected infants had cervical adenitis, which usually became manifest two to four months after they were discharged from the hospital. Although most infants with adenitis underwent incision and drainage procedures, physicians noted few constitutional symptoms. Staphylococcal phage types from infants with adenitis were identical to phage types commonly recovered from colonized newborns and nursery personnel at the hospital. Despite the long period between hospital discharge and onset of clinical symptoms, cases of cervical adenitis were probably nosocomial in origin.


Bacteremia in children: an outpatient clinical review.

In a 20-month period, 1,783 children seen in the pediatric outpatient department had blood cultures performed and 117 (6.5%) of these children had bacteremia. Two thirds of the isolates were Diplococcus pneumoniae and Hemophilus influenzae b. Ninety-three percent of children with H. influenzae b bacteremia and 20% of children with pneumococcal bacteremia had soft tissue involvement at the initial visit. Most children with positive blood cultures (102) were previously well and beyond the newborn period and many (46) had seemingly trivial illnesses initially: upper respiratory tract infection, fever of unknown origin, otitis media, and diarrhea. In the absence of soft tissue infection, the latter three diagnoses correlated best with bloodstream invasion. Nineteen children had persistent bacteremia and five developed soft tissue complications not noted initially. Two factors, age between 7 and 24 months and temperature between 39.4 and 40.6 C, showed increased specificity for bacteremia but were sensitive only for pneumococcal disease. A temperature larger than or equal to 40.5 C showed more specificity for bacteremia than lesser fevers. A white blood cell count greater than 20,000/cu mm was poorly sensitive, and pulmonary infiltrates were neither specific nor sensitive for positive blood cultures. Five bacteremic children had aseptic lymphocytosis in the cerebrospinal fluid. Two days of intravenous antibiotic therapy and eight days of oral therapy were adequate for pneumococcal bacteremia without soft tissue involvement. This therapy may not be without soft tissue involvement. This therapy may not be ideal, however, since other routes and duration of therapy were not evaluated.


Insecticide exposure of mothers and newborns in a rural agricultural area.

Pregnant women in a rural agricultural area were found to have levels of residues of chlorinated hydrocarbon insecticides in their serum which were comparable to those found in occupationally exposed men. Cord blood of offspring also had significant residue levels. Residues were higher in blacks and in mothers living in rural areas where exposure was more intense. In newborns no signs or symptoms compatible with acute chlorinated hydrocarbon poisoning were found. Despite the lack of DDT use during most of the study period, over 90% of the mothers. 84% of the black newborns, and 45% of the white newborns demonstrated evidence of recent DDT exposure.


ABO hemolytic disease in Puerto Rico and North Carolina.

A prospective study was carried out at the University of Puerto Rico Hospital (UPRH) and at the North Carolina Baptist Hospital (NCBH) in order to establish the incidence of ABO hemolytic disease (ABO HD) in the two populations and to determine the relationship of intestinal parasitic infection of the mother to ABO HD in the infant. The incidence of ABO HD among UPRH at risk pregnancies (type O mother with type A or B infant) was 28.3% or 1 in 3.5 as compared with 18.4% or 1 in 5.4 of NCBH at risk pregnancies (P less than .05). Indirect Coombs' tests in cord sera, representing the passive transfer from mother to fetus of antibodies directed toward antigens on the infants' erythrocytes, were positive in 58.8% of UPRH at risk infants as opposed to 40.4% of NCBH at risk infants (P less than .001). Maternal isohemagglutinin titers at term were higher in type O UPRH mothers than in type O NCBH mothers (P less than .01). A relationship between helminth parasitic infection of the mother and ABO HD in the infant was suspected but not proved.


Post-traumatic anterior hypopituitarism.

Reports of anterior pituitary insufficiency following closed head trauma are unusual. In those cases reported, extensive endocrinologic evidence to support the clinical syndrome is often lacking. The present report documents a case of anterior pituitary insufficiency in a 14-year-old girl following a skull fracture. Endocrine evaluation one year after her automobile accident revealed hypopituitarism minifested by cachexia, hypothyroidism, hypoadrenocorticism, and hypogonadism with regression of secondary sex characteristics. Laboratory studies demonstrated deficiencies of both trophic and peripheral anterior pituitary hormones. The patient has responded to replacement therapy and is clinically well. A review of previously described cases is included.


Delivery of health care for children: report of an experiment.

This paper summarizes an experiment evaluating the effectiveness of primary pediatric care delivered to a sample of low-income inner-city families. Primary pediatric care in this study was similar to pediatric group practice. The study findings indicated that the effects of primary care compared with the episodic care received by the control families were appreciable. This included the decreasing of hospitalizations, operations, illness visits, and appointment breaking; increasing of health supervision visits, preventive services, and patient satisfactions; and accomplishing these changes at a lower cost. Patient morbidity was not altered. Medicaid made no difference in the care patterns of the experimental families and apparently benefited only those control families who were white. The controlled clinical trial offers the best opportunity to compare different models of priervices for children.


Removal of foreign bodies from esophagus and stomach with flexible fiberoptic panendoscopes.

Accidentally swallowed foreign bodies were removed from the esophagus or stomach in six children using flexible panendoscopes. Complications did not occur. The increased flexibility of these new instruments allows removal of objects from the stomach that would previously have required gastrotomy. Our experience suggests that fiberoptic endoscopy should be used for removal of foreign bodies.


Citrullinemia: phenotypic variations.

An 18-month-old female infant was found to have citrullinemia on routine plasma screening by the Scriver Method at 5 days of age. At 10 days of age, plasma citrulline concentration was 0.704mumol/ml (normal, 0.010 to 0.030mumol/ml) and has remained 60 to 80 times higher than normal. Urine citrulline concentration was markedly elevated. Hyperammonemia occurred at 1 month of age. The serum ammonia concentration was 473mug/100 ml (normal, 50 to 250 mug/100 ml) and rose to 770mug/100 ml at 4 months of age. Dietary protein was restricted to 1.6 gm/kg/day. Without further change in protein intake, the serum ammonia concentration decreased to 280mug/100 ml and, since then, it has returned to normal. The addition of three synthetic L-amino acids was required for a short time during dietary therapy. At 10 months of age, the infant was given a normal diet. At 18 months of age, her physical and mental development is normal. Activity of argininosuccinic acid synthetase measured in skin fibroblasts was 0.0037mumol of radioactive carbon dioxide per milligram of protein per hour. To demonstrate heterozygosity, fasting plasma citrulline concentrations were measured in five members of the family. Comparison of findings in this patient with those reported in the literature suggests phenotypical variation of the disease, probably due to genetic heterogeneity.


Variable efficacy of glucocorticoids in congenital adrenal hyperplasia.

We have examined the suppression of urinary pregnanetriol and 17-ketosteroids during treatment with cortisol, cortisone, prednisone, and dexamethasone in eight patients with congenital adrenal hyperplasia. A large individual variation in response to each agent was observed. In some individuals, cortisone is less effective than its generally accepted potency would indicate. At equivalent glucocorticoid dosage, dexamethasone was twice as effective as the other steroids in suppressing urinary 17-ketosteroids and pregnanetriol. The potency of dexamethasone in suppressing adrenal function was 80 times that of cortisol, about twice its generally accepted potency as a glucocorticoid or anti-inflammatory agent.


Cyclophosphamide in the treatment of idiopathic nephrotic syndrome.

Fifty-three patients 3 1/2 to 20 years of age with steroid-dependent idiopathic nephrotic syndrome (INS) were treated with cyclophosphamide and prednisone. Two dosage schedules were used: a short course (SC) at 3 to 5 mg/kg/day for six to eight weeks and a longer course (LC) at 3 to 5 mg/kg/day for eight weeks followed by 1.5 to 2.5 mg/kg for an additional four weeks. Prednisone was administered concurrently at 50 to 75 mg/sq M every other day. Twenty-nine patients were in the SC group and 24 in the LC group. The two groups did not differ significantly as to age at onset of idiopathic nephrosis nor as to the duration of the INS prior to cyclophosphamide therapy. All patients were followed for a minimum of 42 months after cyclophosphamide therapy. The SC was associated with a higher relapse rate during the first year than the LC (42% and 8% respectively, .01 larger than P less than .025). At 42 months 63% of the LC group were in remission compared with 21% in the SC group.


The ventilatory response to carbon dioxide in asthmatic children, measured by the mouth-occlusion method (Pm100).

Ventilatory responses to carbon dioxide vary widely in patients with bronchial asthma; some have a high response despite increased airway resistance. This paradoxical response was studied in 31 asthmatic children and 22 age-matched healthy children. Measurement of the ventilatory response to carbon dioxide with a conventional rebreathing method showed wide variation in the patients, paralleling the degree of their airway obstruction as measured by the one-second forced expiratory volume and maximal midexpiratory flow rate, but their mean response was similar to that in the control subjects. The ventilatory response was then determined with a new index (Pm100), which rises linearly with increasing carbon dioxide concentration. Despite wide variation in the slope of Pm100 in the patients, their mean response significantly exceeded normal, confirming that the neurochemical drive is increased in bronchial asthma.


Toxic megacolon of ulcerative colitis in infancy.

A 12-week-old white male infant with ulcerative colitis and toxic megacolon is described. His diarrhea and rectal bleeding responded to prednisone. He subsequently developed toxic dilatation of the transverse colon while on salicylazosulfapyridine and one week after discontinuation of prednisone. His toxic megacolon disappeared during close medical observation, readministration of prednisone, and avoidance of repeated abdominal examinations. One year later sigmoidoscopy showed only friable mucosa and the barium enema showed the presence of ulcerative colitis but with improvement from the initial study. Currently he is taking 375 mg of salicylazosulfapyridine daily. Growth and development are normal and he is asymptomatic.


Neonatal hypoglycemia revisited, 1975.

Between 1971 and 1973, the frequency of neonatal hypoglycemia was 4.4/1,000 total inborn live births or 15.5/1,000 low-birthweight infants. During that same time, of 257 transferred infants, 13 or 5.1% were hypoglycemic. The hypoglycemic manifestations differed between the inborn and outborn infants as well as from those previously described for transient symptomatic hypoglycemia. This required a new classification for low blood glucose values in the neonate, based on intrauterine nutrition, stress, symptoms, and underlying pathology. Four categories were defined: category I: early transitional hypoglycemia; category II: secondary hypoglycemia; category III: classical transient hypoglycemia; and category IV: recurrent, severe hypoglycemia. One outborn infant was in the latter group due to beta-cell hyperplasia and was only cured after a 90% pancreatectomy. Data revealed that early treatment of perinatal asphyxia was associated with a decreased frequency of hypoglycemia. While not a prospective survey, the evidence suggested that current neonatal intensive care may decrease the frequency of transient symptomatic neonatal hypoglycemia.


The automobile and heat stress.

This study suggests that the thermal burden of poorly ventilated parked automobiles can be considerable, particularly when the automobiles are exposed to direct sunlight. Leaving the windows open two inches does not appear to be protective. The pratice of exposing infants and toddlers to such thermal risk appears to be common and the need for adequate ventilation unrecognized. Education measures stressing the use of carseats and other safety devices should include the potential hazards of high temperature in parked automobiles.


Measurement of human chorionic gonadotropin (HCG) concentrations in paired maternal and cord sera using an assay specific for the beta subunit of HCG.

Human chorionic gonadotropin (HCG) concentrations were determined in paired maternal and cord sera using an essay specific for the beta subunit of HCG. The sera of 46 mothers and 46 infants, 24 female and 22 male, were studied. Results were compared to those obtained using a radioimmunoassay for luteinizing-hormone (LH) which cross-reacted with HCG. With either assay system, mean maternal HCG concentrations were lower when the sex of the fetus was male than when the sex of the fetus was female. Mean cord HCG concentrations of male (0.09 +/- 0.02 IU/ml) and female (0.09 +/- 0.04 IU/ml) infants were not different as determined by the beta HCG assay. In contrast, the mean cord serum concentration of HCG was significantly greater (P less than .005) in male infants (0.29 +/- 0.05 IU/ml) than in female infants (0.23 +/- 0.09 IU/ml) as determined by the cross-reacting assay. HCG concentrations were lower in both maternal and cord sera when assayed in the specific HCG system than when assayed in the cross-reacting system. There was a significant correlation (r=.9; P less than .005) between the results obtained with the two assays in both maternal and cord blood. Regardless of the assay system employed, the cord serum concentration of HCG was markedly less than the corresponding maternal serum concentration. There was no correlation between maternal and cord serum HCG concentrations with either assay. These data are in agreement with the results of previous studies employing less specific methodology which indicated that maternal serum HCG concentrations were less when the fetus was male than when it was female. They are also consistent with a placental barrier effect with regard to HCG transfer to the fetus. The difference in results obtained in cord blood with the two assay systems suggests that the newborn male infant secretes more LH and/or alpha LH subunits than the newborn female infant.


Hypoglycemia in small-for-dates newborn infants.

In 24% (18 out of 76) small-for-dates a "significant" though asymptomatic hypoglycemia was demonstrated during the first six hours of life. The cord blood glucose concentration was lower in the hypoglycemic compared to that of the small-for-date normoglycemic group. In the hypoglycemic infants, the disappearance rate of glucose was significantly elevated and the lipid mobilization disturbed. It is suggested that a lack of lipids for energy metabolism increases the glucose expenditure and hence increases the risk for hypoglycemia.


Sleep apnea in eight children.

Eight children, 5 to 14 years of age, were diagnosed by means of nocturnal polygraphic monitoring with a sleep apnea syndrome similar to that seen in adults. Excessive daytime sleepiness, decrease in school performance, abnormal daytime behavior, recent enuresis, morning headache, abnormal weight, and progressive development of hypertension should suggest the possibility of a sleep apnea syndrome when any of these symptoms is associated with loud snoring interrupted by pauses during sleep. Surgery may eliminate the clinical symptomatology.


Chronic illness in childhood: a regional survey of care.

Patterns of care provided by primary physicians for children with chronic physician illnesses are examined. Pratices of pediatricians are compared with those of general practitioners in a ten-county region in Upstate New York. Data collected from 82 physicians surveyed in nine rural counties and one urban area indicate that, on the average, 7.4% of all children seen annually have one or more chronic conditions. Most such children are referred to subspecialists for part or all of their care; the frequency of referral, however, depends chiefly on the nature of the disorder. Primary responsiblity for the broader aspects of care is more often assumed by rural than urban physicians and more often by general practitioners than pediatricians. Nevertheless, mental, social, and some technical services are generally underutilized by groups of primary physicians.


Intellectual performance of 36 phenylketonuria patients and their nonaffected siblings.

Thirty-six patients with a confirmed diagnosis of phenylketonuria (PKU) were identified and placed on dietary therapy before reaching 121 days of age. These children are currently between 4 and 6 years old, and have been given the Stanford-Binet Intelligence Scale. Subsequently, their normal siblings of closet age were selected as matched-pair controls and were also tested with the Stanford-Binet. The mean age of the PKU sample when tested was 50.0 months, and 50.9 months for the normal controls. The 36 index patients scored a mean IQ of 94 and their nonaffected siblings obtained a mean IQ of 99. This five-point mean difference was significant at the .02 level, and suggests the presence of a minimal intellectual impairment associated with PKU, even when treatment begins early and is rigorously monitored.


Severe staphylococcal sepsis in adolescents.

During the three-year period beginning in early 1972, nine previously healthy children, ages 8 to 15 years, presented with manifestations of life-threatening septicemia due to coagulase-positive Staphylococcus aureus. In no patient was a predisposing cause for such infection, such as immunologic deficiency, drug abuse, or previous antibiotic or immunosuppressant therapy, discovered. Seven patients manifested evidence of bone and/or joint infection, while eight had pulmonary disease of varying degrees of severity, characterized initially by multiple small septic pulmonary emboli. One patient succumbed to the pulmonary complications of her disease. S. aureus was recovered from specimens of blood (seven patients), joint fluid (four), bone (four), pleural fluid (two), urine (one), sputum (one), and pericardial fluid (one). All organism isolated were methicillin-sensitive; isolates from only one patient were penicillin-sensitive. In several instances, lack of clinical response was related to delay in adequate surgical drainage of infected material. Review of hospital records for the preceding five-year period failed to reveal similar cases of severe systemic staphylococcal infection in healthy adolescents. Although no direct evidence for a causal relationship is available, the occurrence of these cases corresponds temporally with implementation of restrictions upon the use of hexachlorophene.


Hypoglycorrhachia in pediatric patients.

Hypoglycorrhachia (abnormally low cerebro spinal fluid glucose content) eludes exact numerical definition, largely because of the dynamic equilibrium between blood and CSF glucose. A group of 181 pediatric patients with a CSF glucose less than 50 mg/100 ml or a CSF/blood glucose ratio less than 0.50 were studied. Hypoglycorrhachia was present in patients with bacterial meningitis, aseptic meningitis, meningeal carcinomatosis, subarachnoid hemmorrhage, and hypoglycemia. Markedly diminished CSF glucose values were seen primarily in patients with bacterial meningitis. Higher CSF/blood glucose ratios predominated in those with hypoglycemia and neonates with low-normal blood sugars. Following bacterial meningitis and hypoglycemia, aseptic meningitis (including five children with documented enterovirus meningitis and one with documented mumps meningitis) was the third most common cause of hypoglycorrhachia in children. When readily available, positive CSF viral cultures may allow early cessation of antibiotic therapy in two types of patients with meningitis and hypoglycorrhachia: (1) those receiving previous recent antibiotic therapy, and (2) those with CSF findings more typical of a bacterial meningitis.


Acute fluoride poisoning.

Fluoride poisoning is a potentially severe environmental hazard for children. A case of fluoride poisong is presented which was manifested by severe hypocalcemia, ventricular arrhythmias, and respiratory failure. Treatment of this poisoning, including peritoneal dialysis, is discussed. The kinetics of fluoride distribution as measured in this patient suggest a rapid binding of ingested fluoride to bone, followed by gradual release and excretion. Peritoneal dialysis resulted in no significant fluoride removal.


Regional obstetric anesthesia and newborn behavior: effect over the first ten days of life.

This study examined the effects of carefully controlled amounts of analgesic premedications and anesthetics administered to mothers during delivery on the behavior of the newborn over the first ten days of life. The subjects were selected to minimize the synergistic effects of medication and other stress factors, such as abnormalities of pregnancy, labor, or delivery. The effects of these drugs on the behavior of these infants was small. The data provide a picture of the behavioral recovery of a group of minimally stressed newborns.


[Investigations concerning bovine gastro-intestinal strongyles. II. Seasonal variations in the herbage infestation with infective larvae (author's transl)].

Ecological studies of bovine gastro-intestinal trichostrongylide larvae have been carried on during a three-year period (1972-1974). The studies mainly included pastures grazed by heifers (2nd time grazing cattle). Examination of the herbage samples was based on washing and filtration (sieve mesh-size 36 and 28 mu) followed by Baermann test on the debris. The pasture infestation with infective larvae (L3) followed a nearly stereotype seasonal pattern (cf. fig. 2 and fig. 3): A considerable larval population survived on the pasture during the winter, the infestation decreased strongly during April-May, was low during June and beginning of July, and increased from the middle of July to reach a peak in September-October. The infestation was usually much higher just around the faecal pats than in the rest of the pasture area (cf. fig. 3). The observed populations of trichostrongylide larvae were dominated by Ostertagia (ostertagi), but included other species as well, e.g. Cooperia (oncophora), Nematodirus spp., etc.


Interaction effects of epidemiologic factors in the feline urological syndrome.

Disease-associated factors are most often evaluated individually, while as disease determinants they act in mutual combinations. Applying simple epidemiologic methods, the present study evaluates the effect on occurrence of the Feline Urological Syndrome (FUS) of combining categories within sex, diet and activity. Some factor interactions could be described as additive, while certain combinations acted in a synergistic fashion. The apparent overall effect which might be explained by the excess-risk categories within these three factors was found to account for approximately 90% of the total occurrence of FUS in the population at risk. As a further result of the epidemiologic methods applied, a possible pathogenesis is outlined. It involves relative impairment of kidney function affected through two pathways: increased kidney working load and decreased kidney capability, both associated in various ways with castration, high levels of dry cat foods, and indoor confinement.


[The serum pepsinogen analysis and its relation to bovine ostertagiasis (author's transl)].

An outline of literature on the pepsinogen analysis and its application, especially within the veterinary parasitology, is given. The pepsinogen content of the blood in experimental infection with Ostertagia larvae is mentioned. The authors state their own experiences with the analysis. Testing of 100 parasite-free calves kept indoors gave a mean value of 0.5 units tyrosin/litre. 95 of the calves were within the range 0.3-0.7 units. Flutuations of serum pepsinogen in the course of a subclinical infection in 6 calves during their first grazing season are described and compared to pasture contamination and egg excretion of the calves. In a second experiment the authors give a critical evaluation of the correlation between pasture contamination, weight gain, pepsinogen, and eggs in faeces. The correlation between pepsinogen and weight gain was found to be considerably higher than the correlation between e.p.g. and weight gain. A highly significant correlation between pasture contamination and serum pepsinogen (r=0.60-0.75) was found. The correlation between pasture contamination and e.p.g. was considerably lower (r=0.10-0.43) and only significant in a single case. The value of pepsinogen determinations in epidemiological experiments and weight gain experiments with calves is emphasized and the authors indicate possibilities of their application in practice.


[Toxicity of the PVC-plasticizer di(2-ethylhexyl)phthalate (author's transl)].

The plastizicer di(2-ethylhexyl)phthalate (DEHP) is produced in hundreds of thousands tons and has got a widespread use in a multitude of PVC-plast products. In the present review the toxicology and possible harmful environmental effects of DEHP is discussed. The four following topics have also been considered: 1. The solubility of DEHP in water and the complex between DEHP and fulvic acid. 2. Residues and metabolites of DEHP in fish and invertebrates. 3. The metabolites of DEHP in rat, where four major metabolites have been found (fig. 1). 4. The problem concerning residues of DEHP in blood stored in PVC plastic bags for transfusion and the relationship of DEHP to microaggregation of platelets in stored blood. Although the oral LD50 in the rat, mouse and rabbit is about 30 g/kg, its toxicology reveals problematic features such as high toxicity to some invertebrates, specific effects on the nervous system of fish and teratogenic effects in rats.


[Artificial insemination in pigs: study of conception conditions with use of 2 inseminations in heat with about 24 hours interval].

140 sows and gilts of Danish Landrace were inseminated twice per heat with an interval of approximately 24 hours. Half of the females had their first insemination with semen of Danish Landrace and their second insemination with semen of Yorkshire, the other half vice versa. 114 females became pregnant. At farrowing the number of offspring of Danish Landrace and/or Danish Landrace X Yorkshire per sow/gilt was registrated. The results have been set out in tables I and II, from which it can be seen, that 59% conceived only after first insemination, 18% only after second insemination and 23% after both first and second insemination. In the last group 52% of the offspring were from the first insemination and 48% from the second insemination. In the sows no increase in av. litter size after two inseminations was found. The results are discussed and apparent discrepancy with earlier results is explained with a presumbably existing competition in the female genital tract between sperms from two inseminations at different times in the heat, resulting in ageing of the first inseminated sperms.


Inoculation experiments with Bordetella bronchiseptica strains in SPF pigs.

The progeny of 9 SPF gilts fed a balanced ration (Table I) was used in an inoculation experiment with field strains of Bordetella bronchiseptica isolated in herds suffering atrophic rhinitis. Acute rhinitis was produced within a week after intranasal inoculation of B. bronchiseptica into 1 to 11-day-old piglets. Coughing occurred in some of the exposed pigs, but signs of pneumonia did not develop. A few pigs were killed at intervals of 1 to 3 weeks after exposure. These pigs all showed histological lesions in the turbinate and B. bronchiseptica was recovered from various parts of the respiratory tract. Pigs killed 3 weeks after inoculation showed advanced turbinate atrophy (Tables II and III). Among inoculated litter mates reared to slaughter weight, only one developed clinical signs (slight) of atrophic rhinitis, and a tendency towards an elimination of the B. bronchiseptica infection from the accessible part of the nasal cavity was noticed during the growth period. By examination of nasal swabs collected when the pigs were 10 to 13 weeks old, Mycoplasma flocculare was isolated as well from pigs inoculated with B. bronchiseptica as from the control pigs. The growth rate of the experimental pigs was high and no difference in feed consumption or feed conversion occurred between the exposed pigs and the control pigs. By post mortem examination of the snouts from the pigs slaughtered at approx. 85 kg live weight, severe atrophic rhinitis was not found. Approximately one third (32%) of the exposed pigs showed slight atrophic rhinitis lesions (Table IV). The results are discussed and it is concluded that the isolated B. bronchiseptica strains are pathogenic in young pigs and able to induce turbinate atrophy 2 to 3 weeks after inoculation. Turbinate atrophy induced in pigs a few weeks old, may apparently restore completely or almost completely during the growth period. Under the provided experimental conditions, infection with B. bronchiseptica did not result in the development of a lasting, growth-retarding atrophic rhinitis.


[An outbreak of lipoid liver degeneration (LLD) in Atlantic salmon (Salmo salar) in a fish farm and attempts to cure the disease (author's transl)].

A description of a field experiment on the therapeutic effect of 4 different drugs against lipoid liver degeneration is given in a natural outbreak of the disease in a fish farm. The diagnosis was based on pathological and histopathological changes in the liver and characterized on the basis of the degree of ceroid deposited in the liver cells. The size and weight of the fish had no influence on the deposition, but it was shown that LLD caused a higher mortality in Atlantic salmon than in rainbow trout, showing a weekly mortality of 2.5 and 0.3%, respectively. In the field experiments therapeutic effect was obtained with 1) Vitamin E, mixed into the feed in amounts of 90 mg alpha-tocopherol + 450 mg ethoxyquin pr. kg wet feed. 2) A combination of alpha-tocopherol and selene mixed into the diet in amounts of 20 mg tocopheryli acetas and 0.4 mg natrii seleniis pr. kg wet feed. The cause of the disease is not verified, but it seemes that rancid material in the diet was the main etiological factor. Predisposing factors influencing the peroxydation of the feed under practical conditions in Norwegian fish farms have been discussed.


The prevalence of Trichinella spiralis in foxes (Vulpes vulpes) and other game species in Denmark.

A survey of the rate of infection with Trichinella spiralis among game animals in Denmark is given with special regard to foxes. A total of 5084 foxes and 293 mustelidae were examined, most of them by a combined digestion and Baermann technique. Deep-frozen samples were examined by a method including digestion, filtration, and sedimentation. Four foxes were found infected (cf. Fig. 1). Three of them were shot inside or just outside a fenced area within which wild boars had previously been found infected. It is concluded that Trichinella infection in Danish free-living carnivores is very rare and that the prevalence in foxes is low compared to most European countries.


[Secretion of gonadotropins during sleep. Changes during secondary amenorrheas].

4 females with secondary amenorrheas underwent sleep polygraphic recordings together with blood samples for measurements of LH, FSH and  GH, 3 normal females served as controls.  Among normal subjects LH and FSH secretion showed a pulsating pattern around the time of ovulation, appearing as secretory episodes throughout the night, without any relationship with sleep stages. In amenorrheas, 3 types of abnormalities could be identified: the first was a lack of secretory episodes of LH and FSH associated with an abnormal pattern of GH (9 subjects). The second was an hypersecretion of LH and a decrease of FSH secretion together with a normal secretion of GH in 4 subjects with a Stein-Leventhal syndrome. The last one was an hypersecretion of LH and FSH together with a normal pattern of GH in a subject with an early menopause. These results are discussed according to the present data on the part of neurotransmission in the regulation of ovulation and the 2 types of sleep. Furthermore secretory abnormalities of LH and FSH together with a disconnection between GH secretion and the stages of sleep lead to question the possibility of interrelationships in the secretory mechanisms of these different hormones.


[Compression of the posterior branch of the radial nerve. An unknown etiology of certain paralysis and certain refractory epicondylalgies].

In certain circumstances, compression of the posterior branch of the radial nerve (posterior interosseous nerve) may be caused either by transverse fibrous bands in front of the articular capsule of the elbow, by the anterior border of the 2nd radial, by Frohse's lugament or by the superficial part of supinator brevis. Such problems may be accentuated by repeated dorsal flexion movements of the wrist, with hyperextension of the elbow and above all in prosupination. Clinically, they may result in either complete paralysis (2 cases), or in a syndrome of refractory epicondylar pain with nerve involvement (4 cases). The approach described by the authors permits complete exploration of all the potential points of compression and good results were obtained in the five patients who underwent surgery.


[Thoraco-abdominal angiotomography. 280 explorations].

Angiotomography invariably imrpves the quality of the images obtained in vascular radiology, with respect to both vascular anatomy and pathology. Its contribution is obviously essential when, for technical reasons, arterial opacification is only mediocre (extended angiocardiopneumography). In the arteriolar study of deep seated or voluminous organs, its eliminates superimpositions, makes tri-dimensional study possible and provides a means of studying fine arterioles, useful in diagnosis and difficult to demonstrate using conventional techniques. Its principle limitations are technological in character. Accepting precise and clearly defined rules in its indications and realisation, appropriate equipment, and a constant effort in the analysis and reading of its results, it is reasonable to hope that angiotomography will quickly add a new dimension to vascular studies.


[Paralysis following Dimer X radiculography].

The authors report four cases of cauda equina syndrome following Dimer X radiculography. The cases are described and commented upon. The conclusion is that Dimer X is a substrate associated with a certain degree of toxicity. Indications for and technique in sacroradiculography should be rigorous.


[Value of carcino-embryonic antigen assay in the evaluation and surveillance of breast cancer].

With the method used, the concentrations of carcinoembryonic in antigen serum can be said to be abnormal above 10 ng/ml. The concentrations are normal in benign mastopathies. In 131 cases of breast cancer were studied, they are high in 8 p. cent of T1 and T2 breast cancers, and in 53.9 p. cent of T3 and T4 cancers. They are high in 22 p. cent of cases in the first perceptible phase of their disease, and 92 p. cent relapsed cases. They are also high in 23 p. cent of cases without metastasis, in 32 p. cent of cases with only nodal metastasis, in 82 p. cent of cases with extra-nodal metastasis, and in 94 p. cent of cases with nodal and extra-nodal metastasis. Concentrations of carcinoembryonic in antigen serum which are abnormal before treatment and which do not completely return to normal after treatment, of which rise again, enable one to predict the appearance of a metastasis several months before its clinical manifestation. Determination of the concentrations of carcinoembryonic in antigen serum therefore deserves to become part of the battery of routine for all breast cancers. An initial high concentration is an argument for suggesting systematic chemotherapy. The fluctuations in the concentrations of carcinoembryonic in antigen serum under chemotherapy allow one to assess the efficiency of the treatment.


[Role of computerized axial tomography in neuroradiology. 1st results].

On the basis of their experience, the autors report the results obtained after 1500 examinations in the study of space occupying hemispheric lesions and in the study of cerebral atrophy.


[The changes of survival of patients hospitalized in a resuscitation service].

In order to define criteria of prognosis for patients hospitalized in intensive care units, 2105 cases of patients treated for an acute life threatening illness for 4 years were reviewed. According to severity of initial illness, 3 groups were defined: Ist one initial illness, presumably reversible (55,3%), IInd, several initial illnesses presumably reversible (27,7%), IIIrd, one or several initial illnesses, with at least one of them presumably irreversible (17%). Total mortality was 31,3%, significantly lower in women than in men. According to groups, mortality was 8,7% in the Ist, 42,7% in the IInd (p less than 0,0001), 88,8% in the IIIrd (p less than 0,0001). In any group prognosis was influenced by the type of initial disease (respiratory, circulatory, renal or metabolic, septic, neurologic and hepato-digestive failure). In groups I and II mortality was greater when high risk factors exist, and is more and more bad with age, but always minus that 50%. In the group III mortality was the same with or without high risk factors, was not influenced by age, and was always near 90%. For 4 years, mortality significantly lowered in the group II, from 57% to 29%. We conclude that treatment in an intensive care unit of life threatening visceral acute failure has a poor result when this later is related to an chronic or non presumably reversible disorder. In other cases high risk factor, particularly old age, is not a contre indication to treatment in an intensive care unit.


[Pseudo-anaphylactic reaction to procaine-penicillin G. 3 cases of Hoigne's syndrome].

On the basis of three cases, the authors review the clinical picture of Hoigne's syndrome, characterised by the development of acute manifestations, essentially psycho-sensorial, immediately following the injection of procaine penicillin G (PPG). The syndrome is due to the passage into the circulation of micro-aggregates of PPG and has no immuno-allergic basis. Subsequent treatment with penicillin is not contraindicated.


[Electrocardiographic abnormalities during meningeal hemorrhage].

The electrocardiogram (E.C.G.) was recorded in 100 cases of meningeal hemorrhages. The most frequent abnormalies encountered were bradycardia (32%) and inversion of the T wave (34%). Rhythm and conduction problems were less frequently found. Bradycardia was frequently and T wave inversion rarely found in cases without disturbances of consciousness and those with favourable prognosis. The contrary was found in comatous patients and cases with lethal outcome. The existance of an aneurysm and the location of it did not influence the type of electrocardiographic abnormalies. The influence of the parasympathetic and especially the sympathetic nervous systems is emphasized.


[Metabolism of fibrinogen in the cirrhotic patient. Dynamic study by isotope method].

The authors studied the metabolism of fibrinogen labelled with iodine 125 in 57 cirrhotic patients and 25 controls. Their results show that if the 82 subjects are grouped according to biological period values (T) and plasma pool (N.I.) of each of them, 4 distinct populations emerge. In each  of these 4 groups a physiopathological interpretation of fibrinogen metabolism may be proposed. In the context of consumption coagulopathies in cirrhosis, the examination is of real value and offers an objective criterion of therapeutic effectiveness.


The influence of the known radioprotective compounds on the metabolism of red blood cells. I. Effect of cysteamine on the cellular level of the intermediates and coenzymes.

Cysteamine added to the human blood samples in the final concentration of 6.5 X 10(-3)m, 1,9 X 10(-2) M and 3,8 X 10(-2) M exerts a significant effect on the metabolism of erythrocytes. The chromatographic determination of carbohydrate intermediates and coenzymes in red blood cells indicates that in lower concentration of the drug the rate of anaerobic metabolism of glucose is increased. Higher concentration of cysteamine (3.8 X 10(-3) M) enhances aerobic catabolism of glucose in pentose shunt.


The influence of the known radioprotective compounds on the metabolism of human red blood cell. Part II. The influence of cysteamine on enzymic systems.

The influence of cysteamine on the metabolic activity of red blood cells has been estimated in vitro. Cysteamine has a marked influence on the activity of mainly aldolase F-1, 6-P and glucose-6-P dehydrogenase in red blood cells in vitro. The anaerobic metabolism of erythrocytes is more active in the presence of lower doses of cysteamine. Higher concentrations of radioprotector stimulate the pentose phosphate shunt.


Convulsive thresholds and the activity of anticonvulsants in electroseizure test. The role of serotoninergic system.

The effect of different compounds modifying the activity of serotoninergic system on the convulsive threshold and on anticonvulsant action of phenyltoin (PHEN) phenobarbital (PHB), m-bromophenyl succinimide (BPHSI) and acetazolamide (ACA) in electroseizure test was studied. The obtained results suggest that 5-HT plays a significant role in the convulsive threshold and in ACA anticonvulsant action. No correlation, however, was observed between anticonvulsant action of the studied drugs and their influence on 5-HT level in brain.


Influence of lithium chloride on rabbit's EEG and behavior.

The effects of intravenous or intrahippocampal injections of lithium chloride dissolved in bidistilled water were investigated on rabbits with chronically implanted canniulas and electrodes. Bioelectric activity of the limbic structures and behavior were analyzed. Electrical activity was recorded by means of bipolar electrodes implanted chronically in the dorsal hippocampus, the gyrus cinguli, the amygdaloid complex and the medial hypothalamus, LiCl inhibited electric activity of the limbic structures and caused a reduction of spontaneous motor and exploratory activity of rabbits.


Studies on aminophenazone and phenobarbital release from suppositories prepared on different bases.

Employing in the studies in vitro the dynamic system, we investigated aminophenazone (APH) and phenobarbital (PHB) release through semipermeable membrane from suppositories prepared on different bases, namely. Massupol, Oleum Cacao, H-15 Witepsol, Imhausen Suppositorien Masse SB, 1500 polioxyethylene glycol. The rate of APH liberation was highest from Imhausen and lowest from H-15 Witepsol; PHB was released most rapidly from Oleum Cacao, the poorest results being observed in the case of polioxyethylene glycol.


Kinetic evaluation of thiopentone sodium stability in aqueous and propylene glycol medium.

Stability of thiopentone sodium (TP) was investigated by means of accelerated testing at elevated temperature and pH ca. 10. The experiments carried out do not argue for propylene glycol as a good solvent for the preparations of an injectable TP solution because the shelf-life time predicted is more favourable for the aqueous solution.


Derivatives of 3, 3-spirobi-5-methyltetrahydrofuranone-2 as potential neurotropic agents. Part I.

Starting from 3,3'-spirobi-5-bromomethyltetrahydrofuranone-2 (2) the amino derivatives 3a--g were obtained. The pharmacological examination showed that the new compounds are deprived of the hypnotic activity characteristic for 3,3'-spirobi-5-methyltetrahydrofuranone-2 (2) and behaved in most tests as tranquillizers.


Using ultrasound to assess the fetus at risk.

In early pregnancy, ultrasonic scanning is valuable if the patient's menstrual history is unreliable or if uterine size is less than expected. The crown-rump length of the embryo can be measured from the sixth week of gestation, and pulsation of the heart detected from the seventh. The crown-rump length of the early embryo gives precise information about maturity. Somewhat later in pregnancy, fetal maturity and growth rate can be assessed accurately by measurement of the biparietal diameter. The head circumference and the fetal upper abdominal circumference together give the head-abdomen ratio, which can be helpful in assessing fetal nutrition. The abdominal circumference also may be used to predict fetal weight.


Ipma annals from the 60th interstate postgraduate medical assembly.

The menopause is a fact of life for every woman, and how it affects her depends on her physiologic makeup and on her emotional health. An empathetic physician is a great help to the patient going through this stage of life. Whether to offer hormone replacement therapy is a question each physician in general or gynecologic practice must answer.


Traumatic injuries: office treatment of deep bruises.

Local application of cold, compression, and elevation of the injured part are the mainstays of emergency care of a suspected deep bruise. Lack of treatment may have unpleasant consequences, such as muscle shortening.


Gastrointestinal disorders: the role of diet in cause and management.

Diet has a definite role in certain gastrointestinal disorders, and dietary manipulation often is beneficial. In other cases, such as peptic ulcer, traditional dietary therapy cannot be justified by available evidence.


Recognizing and treating deep neck infection.

Deep neck infection has ominous implications if not detected and treated in an early stage. The anatomic relationships of head and neck spaces encourage spread of infection. Immediate hospitalization and constant monitoring of the patient after diagnosis are mandatory.


Neonatal nutrition: an overview.

Some everyday practices in infant feeding, such as waiting eight hours after birth, have no logical or scientific foundation and their value should be reassessed. The first feeding should always be with sterile water because it is less irritating to bronchoalveolar epithelia than are dextrose solutions. Large, low-birth-weight infants present few feeding problems but require closer supervision than normal mature neonates. Optimal feeding techniques have not yet been devised for tiny preterm or ill neonates. Application of special techniques to provide these infants with even minimal caloric requirements for several days or weeks after birth should only be attempted in centers capable of providing special, around-the-clock care and meticulous monitoring of metabolic parameters.


Neonatal hypoglycemia and hyperglycemia: two unique perinatal metabolic problems.

Hypoglycemia is a frequent, potentially morbid disease in the newborn. Most infants who are at risk can be identified either prior to or immediately after birth. A knowledge of those factors that cause or potentiate the development of hypoglycemia can alert the physician as to which infants require close observation and frequent monitoring of blood glucose. Care in interpretation of laboratory data is important in establishing the diagnosis. Prompt treatment can prevent permanent damage and promote intact survival in these infants. Hyperglycemia has been reported with the use of parenteral glucose in infants of very low birth weight. Rate of glucose infusion appears to be a critical factor in the development of hyperglycemia in these infants. The hazards of allowing fasting hypoglycemia to develop by inappropriate withholding of early calories and of causing hyperglycemia by injudicious use of parenteral glucose infusions in the tiny neonate show the critical need for constant monitoring of blood glucose both by screening techniques and by laboratory determinations.


Appraising current therapy for breast cancer; 1. surgery.

Breast cancer is an extremely unpredictable type of lesion, due in part to its hormone dependence. Although minimal resection may suffice for those patients with great host resistance, radical or modified radical mastectomy is the treatment of choice unless distant metastases are evident.


Nutrition and human milk.

The nutritional composition of human milk is specifically suited to the needs of the human infant. In addition to eliminating the chance for contamination, human milk provides active protection against infection, and breast-fed babies have fewer metabolic anomalies and are less subject to allergy than formula-fed babies.


Office gynecology: managing dysmenorrhea.

In addition to symptomatic or endocrine treatment, management of dysmenorrhea requires an understanding of the constitutional and psychogenic factors that play a role in the symptoms associated with the ovulatory cycle.


Cardiology: prolapsed mitral valve syndrome.

A patient with the prolapsed mitral valve syndrome may have no symptoms referable to the heart or, at the other extreme, may have disabling chest pain, severe arrhythmias, and electrocardiographic abnormalities. The syndrome is characterized by a midsystolic click and a late systolic murmur. The mechanism responsible for the valve deformity appears to be related to myxomatous degeneration. Associated ECG abnormalities strongly suggest myocardial disease. The diagnoses is established by echocardiography or cineangiocardiography.


Pulmonary problems: small pneumothorax requiring catheter drainage.

In patients with chronic bronchitis and emphysema who have evidence of respiratory decompensation, often even a pneumothorax displacing 10% or less of the hemithorax may require catheter drainage as an adjunct to therapy. Three illustrative cases are presented.


Superficial and cutaneous fungal infections: diagnosis and treatment.

Fungal infections usually have characteristics that make them easily identifiable. In most cases, clinical diagnosis can be readily confirmed by examining the lesions under Wood's light or by placing infected material in potassium hydroxide solution and examining the preparation microscopically. Dermatophytes can be rapidly detected by culturing material on the recently developed Dermatophyte Test Medium. The development of topical antifungal agents with broad spectrums of activity has considerably simplified treatment. In most cases, culture on Sabouraud's agar to determine exact genus and species before starting therapy is no longer necessary.


Artificial cardiac pacing: 2. follow-up and complications.

Following insertion or implantation of an artificial cardiac pacemaker, both physician and patient are involved in aftercare to monitor the patient's cardiac status, the condition of the implantation site, and the function of the pacemaker. Among the complications that may occur are pacemaker malfunction and perforation of the ventricles. The physician and patient must also be alert to the possibility of electrical interference and to the physiologic factors that can modify pacemaker function.


Teenage alcohol use.

Approximately 39% of the in-school adolescent population of the United States can be classified as at least moderate drinkers, and as many as 28% may be problem drinkers. More adolescent boys than girls are drinkers, but the number of girls who drink is increasing, as is the number of drinkers age 13 and under. Adolescent drinking patterns are influenced by parental drinking models, peer structure, and other sociopsychologic factors. Teenagers who drink are likely to have parents and peers who drink and to have contact with religious organizations and other social systems which they perceive as not disapproving of drinking. Abstainers, on the other hand, usually have nondrinking parents and peers and are more likely to be associated with social institutions which disapprove of drinking. A significant proportion of the current adolescent population may enter adulthood  with harmful drinking habits already ingrained. If intervention and treatment are to be effective, the social network which supports alcohol use among teenagers must be taken into account.


Factors influencing the choice of antihypertensive agents.

Personal, social, and medical factors unique to individual patients have a bearing on the efficacy of specific antihypertensive agents and on the frequency and severity of side effects. The factors relate to age, sex, occupation, potential for adherence to a prescribed program of therapy, and associated health problems. The importance of a simple, inexpensive program is emphasized.


Effect of high dietary copper on gizzard integrity of the chick.

Six experiments were conducted with male broiler chicks kept in battery brooders to investigate the effects of feeding diets high in copper on the integrity of the gizzard lining. Conventional and corn starch-soy basal diets were used. Slight improvements in body weight gain and/or feed efficiency were observed when the diets were supplemented with 250 p.p.m. copper as as CuSO4-5HSO, but higher levels (500 to 1000 p.p.m.) depressed growth and decreased feed efficiency. Little or no gizzard erosion was seen in birds fed the practical ration without added copper. Gizzard erosion was observed with 250 p.p.m. copper and the severity of the condition increased with higher levels. With the same level of copper supplementation, severity of gizzard erosion was greater when chicks were fed the corn starch-soy diet than when fed the practical diet. Adding 0.5 p.p.m. selenium to the practical diet containing 1000 p.p.m. copper slightly improved the appearance of the gizzard lining, although the subjective scoring index was significantly (P less than 0.05) lower in only one of two experiments. The addition of zinc, vitamin E, and vitamin B12 did not prevent the gizzard damage caused by high copper levels. Severity of gizzard erosion was significantly reduced by adding 0.35% cholic acid to the semipurified diet with 500 p.p.m. copper, but not to the practical diet with 100 p.p.m. copper. There was no correlation between acidity of the gizzard contents and severity of the erosion.


Effect of high dietary copper on fatty acid composition of the chick.

Three experiments were conducted to study the effect of varying levels of dietary copper on fatty acid composition of adipose and liver tissue of male broiler chicks. Chicks were fed the experimental diets to 4 weeks at which time leg adipose and liver samples were obtained for fatty acid determination. Adding 500 or more p.p.m. copper to either a practical or corn starch-soy basal diet caused significant changes in fatty acid composition but the differences were variable perhaps due to a depression of growth caused by these levels of copper. Fatty acid composition of the tissue was not greatly affected by adding 250 p.p.m. of copper to the practical diet which contained 1.5% poultry fat. When a corn starch-soy diet was fed with 0, 2, or 8% added corn oil, the ratio of 16:0 + 18:0 to 16:1 to 18:1 was not lowered in leg adipose lipids by copper supplementation (250 p.p.m.) with any level of added corn oil. With liver lipids copper appeared to reduced the ratios in birds fed the diets with 0 or 2% added corn, but the differences were not statistically significant. The results indicate that using copper levels in practical diets that do not depress growth rate will not have much effect on fatty acid composition of carcass lipids and probably not on physical characteristics of the fat.


Selection of broiler chickens for a high and low incidence of tibial dyschondroplasia with observations on spondylolisthesis and twisted legs (perosis).

Radiography was used to select normal birds and affected with tibial dyschondroplasia from a commercial stock of broiler chickens. Birds were selected for three generations and mated like to like in an attempt to establish low and high incidence strains. Incidence of tibial dyschondroplasia in the low incidence strain was reduced to negligible levels while it was increased in the high incidence strain. Incidence of the defect in the high incidence strain could be influenced by diet. Observations during the selection program on the incidence of spondylolisthesis and twisted legs in birds younger than eight weeks of age indicated that these other skeletal defects were unrelated to tibial dyschondroplasia.


Immunoglobulins of the chicken antibody to Newcastle disease virus (Mukteswar and F strain).

The qualitative and quantitative development of chicken immunoglobulins in response to R2B (Mukteswar) and F strain of Newcastle disease virus was studied. One primary (R2B) and two secondary (R2B - R2B, F - R2B) vaccination trials were conducted. Sera was collected at weekly intervals and analyzed. There was an increase in total serum protein content in parallel to an increase in serum neutralizing (SN), hemagglutination inhibition (HI), and precipitating antibodies. The SN, HI and precipitating activities were detected both in IgM and IgG immunoglobulins when sera were treated with mercapto-ethanol. However, Sephadex G-200 fractionated sera showed only SN activity in the IgM fraction, whereas the IgG fraction showed both HI and SN activity. Serum IgM antibodies appeared during the first week following vaccination, then diminished, then rose again following secondary vaccination. Apparently, immunoglobulin induction and serological activities were not significantly influenced by the age of the chickens.


Response to selection for time interval between ovipositions in the hen.

Data were collected from seven generations of selection for reduced time interval between oviposition in a line of Single Comb White Leghorns. This study involved 151 sires, 539 dams, and 2100 female progeny. Oviposition time was measured from 174 to 280 days of age. The only deliberate selection practiced was for reduced oviposition time interval. The mating system was random with the restriction of full or half sib matings. The reduction in oviposition time interval has been 73 minutes or 4.8 percent. There were no significant changes for total egg number, body weight or age at first egg. Rate of lay after reaching 50 percent production to 280 days has increased (P less than .07). Egg weight has declined five percent. Heritability estimates for intra-clutch time interval from correlations were .33 +/- .08, .36 +/- .09 and .35 +/- .15 by sire, dam, and combined components, respectively, .36 +/- .15 by regression of offspring on dam and .39 for realized. The magnitude of the selection differential decreased, over time. The genetic correlation of time interval with early production (280 days) was --.43 +/- .13, and with total egg production (500 days) was .20 +/- .27. The genetic correlations of time interval with egg weight and age at first egg were high and positive; and with body weight, it was negative. The increase in clutch size and the days between clutches during the time of this study were both highly significant.


Antibody-mediated immuno-regulation in chick embryos and baby chicks.

Two- and three-week old chicks that received at hatching serum from either unimmunized birds or from chickens immunized with bovine serum albumin responded with normal hemagglutinin titers to immunization with mouse erythrocytes (MRBC). Other chicks administered at hatching or as embryos with homologous serum high in anti-MRBC activity responded poorly to MRBC immunization. When donor serum samples collected on different days after immunization were tested, the immunosuppressive capacity was negligible the first two days, increased in potency thereafter to a maximum level by the end of the week. The increase with time in the inhibiting property of the donor serum paralleled the serum anti-MRBC hemagglutinin response profile. The immune capacity of the antibody-treated recipients was severely depressed for over two weeks. By the fourth week, however, the immune responsiveness to MRBC, as measured by serum hemagglutinin titers and production of antigen sensitive units, had recovered to near normal levels.


The effect of age and sex on the rate of change of fatty acid composition of turkeys following a change of dietary fat source.

Small White turkeys were fed 10% dietary rapeseed oil or animal tallow to 6, 12 or 18 weeks of age. The dietary fat was then changed from rapeseed oil to tallow or from tallow to rapeseed or corn oil. Weekly core samples of skin and subcutaneous fat were taken for nine weeks after each change of dietary fat. The half-time (t 1/2) of the exponential rate of change of individual fatty acids was unrelated to either the fatty acid carbon chain length or the degree of unsaturation. The average t 1/2 of 2.4 weeks was influenced by sex, with more rapid change of fatty acid composition in females than males during the first but not later periods, and by age, with decreasing rate of change of fatty acids as the birds approached maturity. The extent of change of fatty acid composition in response to dietary fat decreased with age. The data presented will aid in predicting the carcass fatty acid composition of turkeys fed specific dietary fats and in estimating the effect of a change of dietary fat on carcass characteristics.


The effect of sulfaquinoxaline feed medication on the immunologic response to a Pasteurella multocida vaccine administered to turkeys via drinking water.

Five groups of turkeys received C.U. strain Pasteurella multocida vaccine in the drinking water for one day. One group received the 0.1% level of sulfaquinoxaline feed medication at the time of vaccination, while 4 other groups received the feed medication 1, 2, 3 and 4 days after vaccination, respectively. Two weeks after vaccination all groups were exposed to a virulent P-1059 strain of P. multocida by the drinking water route. The results suggest that turkeys on the feed medication at the time of vaccination and possibly those receiving the initial fed medication the next day, failed to experience a satisfactory immunologic response. The possible ill effects of the sulfaquinoxaline feed medication on the duration of the immunity was not determined. A schedule and level of feed medication approved by the Food and Drug Administration was used; namely, 2 days on the 0.1% level, 3 days on a normal ration, and then 2 additional days on the 0.05% level of sulfaquinoxaline feed medication.


Effect of dieldrin and calcium on the performance of adult Japanese quail (Coturnix coturnix japonica).

Two experiments were conducted to determine the effects of dieldrin and calcium on reproductive performance of quail. At 25% egg production the quail received diets containing 0,10 or 25 p.p.m. of dieldrin for 6, 28-day periods in experiment 1 and 0, 5, or 25 p.p.m. of dieldrin for 4, 28-day periods in experiment 2. Pesticide treatments were employed with diets containing 0.5% and 3.0% calcium. The results show that egg shell thickness, cracked eggs, egg production, feed consumption, egg weights, fertility, hatchability and body weights were not affected by dieldrin treatments. However, egg shell thickness, cracked eggs, egg production and hatchability were adversely affected by the lower calcium level. Female body weights were consistently heavier for the low calcium diet. Mortality increased in the presence of 10 and especially 25 p.p.m. of dieldrin. Livability of chicks from hens receiving rations with 10 and 25 p.p.m. of dieldrin was significantly lower than those fed no dieldrin. In summary, dieldrin was without effect on egg shell quality or other reproductive factors but did exert a detrimental effect on adult mortality and livability of progeny.


The choline requirement of broiler chicks during the seventh week of life.

Male crossbred chicks were used to quantify the choline requirement and choline-sparing value of methionine and betaine for broiler chicks during the seventh week of life. The sulfur amino acid (SAA) requirement of male and female chicks was also determined. In all assays a crystalline amino acid diet containing 14.9% protein equivalent and 3400 kcal. M.E./kg, was employed. Increasing increments (0.08%) of SAA (equal mixture of DL-methionine and L-cystine) were fed from 0.38 to 0.70% of the diet. Least squares analysis indicated SAA requirements for maximal weight gain of 0.61 and 0.62% of the diet for males and females, respectively. The choline requirement was determined by feeding six levels of choline in the presence of 0.62% SAA. Gain but not gain/feed responded linearly to choline addition. Least squares analysis of gain indicated a dietary choline requirement of 358 p.p.m. of 30.6 mg./day. The choline-replacement value of methionine and betaine was found to be minimal.


Studies on the accessory reproductive organs in the drake. 1. Addition to semen on the fluid from the ejaculatory groove region.

This study was performed to clarify whether the semen from the vasa deferentia is diluted with a fluid before ejaculation and to locate the ejecting region of the fluid. Vas deferens semen, ejaculated semen and the fluid ejected from the ejaculatory groove region were obtained from the drake and their characteristics were determined. The mean concentration of ejaculated semen, 9.46 millions/mm.3, was nearly half as much as that of ampulla semen (semen contained in the dilated portion of the vasa deferentia; 20.40 millions/mm.3), and the former had positive aldose color reaction in contrast with complete negative reaction in the latter, suggesting that ampulla semen might be diluted twofold with a fluid containing aldose before ejaculation. The aldose positive fluid was observed to be ejected from the ejaculatory grove region of the cloaca and it could be collected from the vasectomized drake using an artificial vagina. Thus, the ejaculated semen of the drake, about 0.4 ml. in volume, was considered to be a mixture of the semen ejected from the vasa deferentia (estimated to be about 0.2 ml.) and the fluid ejected from the ejaculatory groove region (about 0.2 ml.). The pH value, glucose content and electrophoretic pattern of protein of the ejecting fluid were similar to that of blood plasma, and it was assumed that the fluid might be a fluid of blood origin.


Performance of chicks fed diets formulated to minimize excess levels of essential amino acids.

Studies were conducted in which levels of essential amino acids in excess of the minimum requirements were minimized in broiler diets composed of commercially available feed stuffs and synthetic amino acid supplements. Growth rate and efficiency of feed utilization of chicks fed such diets were equal to that attained by chicks fed diets formulated by conventional means when grown under conditions where heat stress was not a factor and significantly improved when fed under conditions of heat stress. Improvements were obtained in efficiency of protein and calorie utilization using this technique of formulation.


In vitro development of secondary blastodiscs from dispersed blastoderm cells of Gallus domesticus.

A study of the in vitro growth of embryonic structures from dispersed blastoderm cells is reported. The specific type of blastoderm cells with the capability of growing on the coverslip developed into the discoidal embryonic structures resembling those of avian species. The glass surface was apparently an initiator of differentiation into at least three types of cells specifically distributed in the blastodisc. Groups of structures formed were evaluated at 6, 12, 24 and 36 hours to study the developmental pattern in vitro and to estimate the number of cells per structure. Microscopic examination of the area pellucida revealed that all three basic germ layers were established after 24 hours of incubation in vitro. The 36 hour stage was represented by bulky growth of mesodermal-like cells and changes in hypoblast layer where some of the cells degenerated and some were transformed to mesenchymal spindle-like cells.


The resistance and carrier status of meat-type hens exposed to Mycoplasma synoviae.

Forty-eight 32-week-old meat-type females, free from Mycoplasma synoviae (Ms.) and Mycoplasma gallisepticum (Mg.) were aerosol exposed with a 24-hour broth culture of Ms. 1331 and placed in 3 pens. 16 birds per pen. Two males were placed in each of the 3 pens and used as contact birds. All birds were bled at 2, 4, 7, 10, 14, 24, 26, and 30 weeks post Ms. exposure. After the 24-week bleeding, the females were equally divided into 4 pens. All females in 2 of the pens were given a foot pad injection of 0.3 ml. of Ms. 1331 broth culture. Ms. isolation attempts were made from the trachea of all birds at 2, 14, and 24 weeks post Ms. exposure. Ms. isolation attempts were made from all eggs produced, either from the allantoic fluid and egg yolk of 17- or 18-day-old embryos, dead embryos, and infertile eggs, or from the tracheas of day-old progenies. Each day-old progeny was bled. Ms. and Mg. serum plate tests were conducted on the serums from the progeny and adult birds from each bleeding. Ms. hemagglutination-inhibition (HI) tests were conducted on the serums of the adult birds. In the Ms.-exposed birds, the geometric mean HI titer of the serums from each bleeding rose significantly over the previous bleeding. The percentages of Ms. serum plate reactions increased with length of time after Ms. exposure. There were false Mg. serum plate reactions in the early stages of Ms. infection. A foot pad challenge with a broth culture of Ms. 1331 24 weeks after Ms. exposure did not significantly increase the geometric mean HI titer over the Ms. exposed birds that did not have a Ms. foot pad challenge. Ms. was isolated from the trachea of 91.6%, 100%, and 100% of the Ms.-exposed birds at 2, 14, and 24 weeks after Ms. exposure, respectively. There were 35 Ms. isolates from 575 attempts from 17- or 18-day embryos, dead embryos, or infertile eggs, and 7 Ms. isolates from 67 attempts from the trachea of day-old progenies. All isolates were made from eggs collected from 6 through 31 days afer Ms. exposure. No isolations were made from 1760 attempts made from eggs collected from 32 through 210 days after Ms. exposure, including eggs collected from Ms. foot pad-challenged birds at 168 days after Ms. exposure. There were 312 broilers reared from eggs collected from the 22 through 24 weeks after Ms. exposure. The broilers were marketed at a federally inspected poultry processing plant. Their records showed 3 birds condemned for septicemia-toxemia, but none were condemned for air-sacculitis or synovitis. Twenty-four serums from the broilers that were positive to Ms. or Mg. serum plate tests were all negative to the Ms. and Mg. HI tests. Ms. serum plate reactors began to show up in the day-old progeny from eggs collected beginning on the 76th day after Ms. exposure. There were 16.0% (80/500) positive to the Ms. serum plate test from eggs collected from the 76 through 126 days after Ms. exposure and 14.0% (52/372) from eggs collected from the 169 through 210 days after Ms. exposure.


The relationship of circulating levels of estrogens, corticosterone and calcium to production performance of adult turkey hens under conditions of increasing ambient temperature.

Turkey hens were exposed to stepwise increases in ambient temperature from 21degreesC. to 25degreesC. to 30degreesC. to 35degreesC. at two-week intervals. Dietary calcium levels of 1.54, 2.01 and 2.48% were fed. Production data and circulating levels of estrone, estradiol-17-beta, corticosterone, total calcium, bound calcium, and unbound calcium were studied. The dietary calcium levels had no significant influence on any of the results. The temperature increase caused a significant (P less than .05) decrease in plasma levels of calcium and estrone, egg production, shell thickness and egg weight. The temperature increase caused a significant (P less than .05) fluctuation in plasma corticosterone levels but had no apparent effect on the plasma estradiol levels. With the temperature increase, unbound plasma calcium levels and plasma corticosterone levels showed a significant (R greater than or equal to 0.50, P less than 0. less than .01) positive correlation to egg production.


Replication of herpesvirus of turkeys in chick fibroblasts.

An ultrastructural study of chick embryo fibroblasts infected with herpesvirus of turkeys (HVT) revealed that infection produced degenerative effects in the cells ranging from alteration of cellular structures to complete lysis of the cells. Infection was indicated by margination of the nuclear chromatin, the presence of nuclear and cytoplasmic virions, destruction of mitochondria, loss of rough and smooth endoplasmic reticulum, and polykaryocytosis. Viruses entered the cell by penetrating the cytoplasmic membrane, and replication took place within the nucleus. Small nuclear particles observed as aggregates in the presence of few herpesvirions appeared to be a part of the replication of the virus. Viruses were released from the cell nucleus either naked or enveloped. Where karyolysis occurred, naked viruses were released as the karyoplasm diffused into the cytoplasm. Enveloped viruses were not observed leaving the nucleus, but it appeared that departure could have occurred by the budding of the viruses through the nuclear membrane. Where complete lysis of the cells occurred, the naked viruses were released into the extracellular fluid. Enveloped viruses were observed only in intact cells. Viruses which were observed extracellularly were naked viruses, and those that were observed entering the cell by penetrating the cytoplasmic membrane were also naked. This evidence suggests that in vitro HVT does not require the envelope to be infective.


Effect of fish and poultry byproduct meal on the small intestine and gizzard of broilers.

Commercial mixed-sex broiler chicks were used in two experiments to study the effects of various levels of Peruvian fish meal (PFM), menhaden fish meal (MFM) and poulty byproduct meal (PBPM) on the small intestine and gizzard. Intestinal and gizzard lesions were observed in broilers receiving finisher diets containing 7% or 12% PFM. The broilers receiving diets containing 12% MFM or 12% PBPM had intestinal and gizzard lesion scores that were not significantly different from those of the control broilers. The severity of intestinal lesions was greater than that of gizzard lesions in most groups. The causative agent in the PFM has not been identified.


A bioassay for true metabolizable energy in feedingstuffs.

In 12 experiments with S.C.W.L. roosters it was shown that for each of 12 feedingstuffs there was a linear relationship between feed input and the amount of energy voided as excreta. In the 24 h. period, following 21 hr. of starvation, roosters receiving no feed excreted 4.07 kcal./kg. of body weight. When dextrose was fed the energy voided as excreta did not increase with dextrose input; consequently, the true metabolizable energy (T.M.E.) value of dextrose is its gross energy value. The T.M.E. values were not affected by the level of feed input and appeared to be additive. A simple, rapid assay for T.M.E. was developed, based on gross energy assays of the test feed and of excreta voided over 24 hr. by roosters force fed the test feed and other starved over the same period.


The ability of hens to regulate phosphorus intake when offered diets containing different levels of phosphorus.

Two experiments were conducted to determine the extent and ability of laying hens to regulate their phosphorus (P) intake when offered a choice of diets containing different levels of phosphorus. In the first experiment, Babcock B-300 hens, 72 weeks old, received a choice of diets offered in each of two plastic cups. The dietary choices of P levels included: 0.75 percent P vs. 0.75 percent P diet (control), 0.19 percent vs. 0.46 percent P, 1.00 percent vs. 2.43 percent P and 0.19 percent vs. 2.43 percent P diet. The cups were weighed and replenished every three days. After one month, the calcium level in all diets was increased from 3.00 to 6.00 percent calcium and the experiment continued for a second month. The second experiment involved the same dietary choices of P with a constant level of 3.00 percent calcium. Hens in this experiment were 48 weeks old. In both Experiments 1 and 2 the daily feed consumption was determined by weighing all cups at two hour intervals for two days. This procedure was performed after hens had been on the experimental regime for one month. Hens in both experiments clearly regulated their intake of P when offered the above choices. Hens avoided the consumption of the 2.43 percent P diet in favor of the diet containing less P. Consumption of the 2.43 percent P diet, even when avoided to a large extent, reduced both egg production and egg specific gravity. Increased calcium levels in the diets resulted in an increase in consumption of the 2.43 percent P diet. Young hens demonstrated a significant increase in consumption of the 0.46 percent P diet over the 0.19 percent P diet. Both old and young hens in the 0.46 percent P vs. 0.19 percent P group in both experiments maintained egg specific gravity, egg weight and egg production at levels comparable to controls. Results of the two hour feed weighings showed that laying hens in the 0.19% vs. 2.43% P group exhibited a noon-time peak in preferential consumption of P, followed by a marked afternoon-evening decline. This decline occurs both for relative and absolute P intake.


Ultrastructural changes induced by chronic aflatoxicosis in chickens.

Effects in chickens of a low concentration of aflatoxin in the diet were investigated. After eight weeks, heart, pancreas, and liver tissues were examined by electron microscopy. Most damage was to liver; changes were observed both in individual parenchymal cells and in tissue organization. Proliferation of bile duct epithelial cells was extensive. The pancreas showed little change and was, therefore, a good organ for observation of early and/or mild ultrastructural changes associated with aflatoxicosis. The priority of initial nuclear change over cytoplasmic change was indicated in this organ. In the myocardium, the only significant changes were in mitochondria. Mitochondria of liver and pancreas were not altered. Leukoviruses were observed in the tissues of one aflatoxin-treated bird.


Various types of diets, sources of energy, and positive energy balance in the induction of fatty liver hemorrhagic syndrome.

Adult female chickens were force-fed a corn-soy base diet at 150% of the daily amount consumed by those allowed the same diet ad libitum. Other hens were force-fed diets isocaloric to the 150% group just mentioned, but diet composition was adjusted so that 2/3 of the metabolizable energy (M.E.) came from the corn-soy diet and 1/3 from either corn oil or glucose; or force-fed a low energy diet accounting for 2/3 of the M.E. and corn oil 1/3 of M.E., or a purified diet accounting for all M.E. Fatty liver-hemorrhagic syndrome (FLHS) was induced in all force-fed groups with only the low energy diet plus corn oil having produced a significantly lower score for FLHS. However, the livers from the hens of the latter group had as much lipid, and the hens gained at least as much weight as those in other force-fed groups. During the third week of the experiment M.E. was determined along with a partition of energy among eggs, basal metabolism, body weight gain, and subsistance plus heat increment (H.I). The data showed that the hens force-fed corn oil had lower H.I. values indicative of associative dynamic action of fats at a plane of nutrition above normal. The data revealed that various types of diets and sources of energy in excess can induce FLHS, and this is discussed in terms of FLHS arising out of a positive energy balance.


The effect of dietary selenium level on lead toxicity in the Japanese quail.

Previous studies (Parizek et al., 1969) have shown significant interactions between selenium and certain heavy metals, particularly mercury and cadmium. Since these elements have an affinity for sulfhydryl groups, it was proposed that a similar interaction might exist with lead. In an initial experiment, adult quail hens were given diets supplemented with 0 and 1 p.p.m. selenium and 0, 500 and 1000 p.p.m. lead in a 2 X 3 factorial arrangement. After 32 days of feeding, body weight, liver weight and egg production decreased in birds fed lead while kidney weights increased. Highly significant decreases in red blood cell delta-aminolevulinic acid dehydratase (RBC-ALAD) activity occurred when lead was added to the diet. Control RBC-ALAD activity was 1337 versus 105, 91, 156 and 110 nmol. porphobilogen produced per ml. of erythrocyte per hour (nmol. PBG/ml. RBC/hr.) for the 500, 1000, 500 plus selenium and 1000 plus groups, respectively. After 85 days of feeding lead to male birds in a second study, selenium appeared to have variable effects on the concentration of lead in liver, kidney and tibia. Selenium supplementation to lead diets resulted in significantly increased levels of lead in kidney tissue while little or no effects were observed on liver or tibia lead levels. RBC-ALAD activity was significantly reduced with lead supplementation and no effect of selenium addition was observed. Electrophoretic gels of serum from birds fed lead containing diets showed increased protein bands in the transferrin and globulin regions regardless of the presence of 1 p.p.m. selenium. A third study was conducted to determine the effects of supplementing an isolated soy protein diet with 0 and 1 p.p.m. selenium and 0 and 3000 p.p.m. lead. Selenium supplementation improved body weights over controls while lead additions caused reduced egg production and ALAD activity. Lead feeding increased tibia/body weight ratios and lead concentrations in liver, kidney and tibia. No significant interaction between lead and selenium was observed.


Magnesium deficiency, requirement and toxicity in the young Japanese quail.

Studies of magnesium deficiency, requirement and toxicity in the young Japanese quail (Coturnix coturnix japonica) were conducted. Day-old birds were fed an adequate purified diet containing 35% soy protein to 2 weeks of age. Residual magnesium in the diet without any added magnesium salts was 21 p.p.m. magnesium was supplied by graded amounts of MgSO4 to a total of 11 levels ranging from 125 to 2,000 p.p.m. Deficiency signs included poor growth, and occasionally excitability, gasping and convulsions. Most mortality occurred during the first 7 days. The maximum dietary magnesium concentrations that produced the minimal significant deviation from normal values for mortality, body weight, hemoglobin and tibia ash was 225, 200, 250 and 250 p.p.m., respectively. Based on these measurements, 300 p.p.m. magnesium is considered adequate to meet the young quail's requirement under the conditions of these experiments. With 2,000 p.p.m. magnesium, the only adverse effect was an increase in mortality. Between 200 and 1,000 p.p.m. magnesium there was a linear relationship between concentration of magnesium in the tibia and the log of the concentration of dietary magnesium. This suggests that tibia magnesium concentration might be useful for bioassay of magnesium in foodstuffs.