Lymphocyte transformation studies in Mycoplasma pneumoniae infections.

The in vitro transformation of lymphocytes stimulated by a Mycoplasma pneumoniae preparation was measured by the uptake of 14C-thymidine. The lymphocytes from five patients with M.pneumoniae pneumonia showed a high degree of responsiveness when they were compared to the lymphocytes taken from eleven healthy control subjects who lacked M.pneumoniae antibodies. Another four patients with an acute affection of the central nervous system and serological evidence of an actual or recent M.pneumoniae infection had a lymphocyte response within the same range as that of the controls. The transformation of lymphocytes was studied at intervals for seven months after the onset of the illness in one of the patients with pneumonia. These studies showed an increasing response to a small dose of mycoplasma antigen. Lymphocyte transformation induced by other microbial antigens was studied in three pneumonia patients during and after convalescence. The first responses were low and increased more steeply than the response to M.pneumoniae. The later responses to the mycoplasmal and to the other microbial antigens increased in parallel. The usefulness of incorporating other microbial antigens in the evaluation of the patient's immune response to a relevant antigen in this type of experiment is discussed.


Epidemiology of Mycoplasma pneumoniae infection in the United Kingdom: an analysis of reports to the Public Health Laboratory Service of England and Wales.

Infection with Mycoplasma pneumoniae appears to follow a cyclic pattern in the United Kindom, with periods of increased prevalence lasting about two years. Outbreaks occurred in 1971-1972 and 1974-75, and probably also in 1967-68. Infection confirmed by laboratory tests appeared to be commonest in older children, especially those aged 5-14, and least common in adults over 65 years of age. Lower respiratory tract infection was the clinical feature most frequently reported.


The laboratory diagnosis and epidemiology of Mycoplasma pneumoniae in Switzerland.

The analysis of approximately 60,000 serum samples collected from patients with different clinical symptoms between 1965 and 1975 in Switzerland yielded positive reactions indicating a recent infection with Mycoplasma pneumoniae in 2-30% during this period. Among 1,555 patients with clinical symptoms of an acute respiratory infection, 359 patients or 23% had antibody titers indicating a recent infection with M.pneumoniae. On the basis of these results it is concluded that M.pneumoniae is the most frequent cause of acute infections of the respiratory tract.


The frequency of Mycoplasma pneumoniae antibodies in a Calabrian population.

The epidemiological survey was carried out in a Calabrian population in order to ascertain the incidence of antibodies to Mycoplasma pneumoniae. In the past it has been felt that this infection does not occur in Southern Italy. We have found an incidence in our survey equal to that of the other countries. It was impossible to tell when these infections had occurred and the possibility of a continuing survey is discussed.


A general practice survey of the incidence of Mycoplasma pneumoniae infections.

An epidemiological survey was carried out at two centres in the north of England (Liverpool and Sunderland). One hundred and twenty patients were included in this survey to determine the relative incidence of Mycoplasma pneumoniae infections in patients who present to their physician with an acute lower respiratory tract infection. Data were available at the end of the survey in 115 patients. Only one patient had a positive test for M.pneumoniae. There were nine patients who had a positive antibody test for either influenza or para-influenza. Four patients had a positive test for respiratory syncytial viruses. This survey points out the problems in the clinical diagnosis of respiratory infections in general practice.


The treatment of primary atypical pneumonia with intravenous doxycycline: a report of clinical observations.

Seventeen cases of primary atypical pneumonia which were probably caused by Mycoplasma pneumoniae were studied as in-patients in hospital. All of these patients were treated with intravenous doxycycline and responded quickly to therapy. It has been shown that approximately 30-50% of the cases with primary atypical pneumonia are caused by M. pneumoniae. The remainder of the cases are caused by either viruses or possibly rickettsiae.


Hospital treatment and diagnosis of Mycoplasma pneumoniae pneumonia.

A study was started in 1972 in order to determine the true etiology of patients who presented with obscure pulmonary infiltrates. Patients who were included in this study had sera drawn on two occasions. Complete testing was performed for the various viruses and also for Mycoplasma pneumoniae antibodies. The study continued through 1975 and a total of 159 patients were included. Of these 159 patients, 28 had positive complement fixation tests for M. pneumoniae antibodies. The clinical profile and treatment course is outlined and discussed.


Mycoplasma pneumoniae as a cause of pneumonia, lung abscess and pleural effusion: a case report.

A case report of a 26 year-old asthmatic male is outlined in order to show the clinical features and unusual development pattern of pulmonary disorders and pleural effusion with a Mycoplasma pneumoniae pneumonia. A literature review is included in order to put this unusual case into perspective.


Myocarditis and severe bilateral bronchopneumonia caused by Mycoplasma pneumoniae.

A man with severe bilateral bronchopneumonia and a right lobar consolidation caused by Mycoplasma pneumoniae, had a concurrent myocarditis. The possible aetiology of the patchy pulmonary opacities is discussed. A literature review of cases of myocarditis associated with M.pneumoniae is presented.


The results of pulmonary function tests in patients infected with Mycoplasma pneumoniae.

A comparative study was undertaken in order to ascertain the effects of a Mycoplasma pneumoniae infection on pulmonary function. It appears that the literature has many articles devoted to the clinical symptomatology of this type of infection but there is very little information available on the abnormalities which occur in the lungs with this infection. The patients who were used as a comparative model had lung lesions which gave a similar radiographic appearance. The significant finding was that an obstructive syndrome with increased airway resistance was noted in the M.pneumoniae pneumonia patients.


Pulmonary function in children with Mycoplasma pneumoniae pneumonia.

Nine children between the ages of seven to 12 were studied. All of these children had an acute unilateral pneumonia caused by Mycoplasma pneumoniae. Regional pulmonary function studies were performed with the aid of an Xe133 radio-spirometry. It was shown with this technique that the ventilation of the infected part was more reduced than the perfusion during the acute stage. Fourteen to 22 days after the onset of the disease three children had normal chest X-rays but abnormalities of the pulmonary function tests. In one child this abnormal function persisted at the third follow-up some months later. By the use of regional pulmonary function studies subtle abnormalities can be observed which would normally be overlooked when examining the pulmonary function of both lungs.


Patterns of personality developement in middle-aged women: a longitudinal study.

Personality development was examined in two groups of women studied since adolescence who were judged psychologically healthy at age fifty: 1) Independants, whose health improved from forty to fifty, were ambitious and intellectual. 2) Traditionals, healthy at both ages, were gregarious and nurturant. Traditionals showed steady personality growth since adolescence. Independents were constricted at age forty but recovered by fifty. These patterns are compared in terms of the fit between personality and sex role. Traditional personalitites fit conventional feminine roles, accounting for their health throughout the middle years. Independents improved when disengaging from mothering freed them to develop their more assertive skills.


Personality organizations of well-functioning younger people and older adults.

Person clustering of Q sort items for two longitudinal samples, studied at four periods from adolescence to middle adulthood, were generated for the sexes separately. After correlations between the resulting sixty-eight clusters showed that common personality organizations existed across time, sex, and samples, a second order clustering of the first sixty-eight was done which reduced the number of clusters to four. The first cluster represented a well-functioning organization, and comparisons were made of its hierarchial ordering of attributes between the longitudinal samples and a geriatric sample. Although both groups were dependable and productive, they diverged in the importance of intimate interpersonal relations and in their self concepts. The older people were more tender and intimate, but conserving of their own integrity, while the younger groups were more assertive and cognitively invested, as they must be to deal with their different life situations.


Midlife marriage: sex differences in evaluation and perspectives.

Perceptions of marital relations are examined in a white middle and lower-middle class sample representing three life stages: newlyweds, middle-aged parents facing the empty nest, and persons about to retire. Descriptions of spouses are analyed in terms of positive/negative evaluations and the respective importance given to role and interpersonal components of the marital relationship. Middle aged respondents were shown to place greater emphasis on role performance than did the remaining groups, and middle-aged women gave the least positive evaluations of marriage. Midlife marital satisfaction is examined in relationship to affect toward children, socioeconomic status, value orientations, and life satisfaction.


Middle age: some early returns-a commentary.

Four papers, differing in research design and using both longitudinal and cross-sectional data, came to a number of convergent conclusions: there was little evidence for a midlife crisis; stability was most prominent during the forty-to fifty-year decade; sex differences were striking, this period being most stressful for women; stable personality characteristics show interactions with role-stage expectations. Caveats as to generalizability of conclusions and lack of cohort comparison were stated. Certain theoretical issues were discussed related to the meaning of "middle age," developmental dynamics, and sources of stability and change.


Masculinity/femininity of the generations: as self-reported and as stereotypically appraised.

Three hundred seventeen adults divided among the younger adult, middle aged, and old generations were asked (a) to judge which of the three generations was most and least masculine/feminine in overall personality style, masculine/feminine in interests and possession of gender skills, and pressured by society to do masculine/feminine sorts of things; and (b) to rate self along each of these dimensions on a Likert scale. Self-reports and beliefs about the generations did not vary as a function of membership in a generation. Young adults and middle aged were belived to be the most feminine and middle aged the most masculine in overall personality style. The middle aged were judged as possessed of the most feminine and masculine interests and the most skilled in feminine endeavors. Middle aged and young adults were judged equally possessed of masculine skills. Social pressure to do masculine and feminine activities was seen as falling equally heavily on younger adults and middle aged. The old were judged as next-most possessed of feminine skills while judged least along the other dimensions.


Identity and crisis in middle aged men.

The authors selectively review disparate literature bearing on the issue of the male mid-life transition. There is considerable evidence that the entrance into middle age is associated with stress and often maladaptive patterns of reaction. There is little available information, however, on the specific nature of the stressors, their differential impact, or the factors associated with the individual's attempted style of adaptation to them. Through the process of exploring relevant findings from sociology, social and clinical psychology, and popular fiction we attempt to specify a working model of the experience of entering middle age. The authors see this model as being of heuristic value in that it specifies a number of dimensions to be operationalized which may, together, provide a more holistic view of the changes in the self-system undergone by the middle aged male.


Are aged blacks who manifest differences in community security also different in coping reactions?

Seventy-two aged Blacks, equally divided between those residing in a high-rise public housing project and those living in the community awaiting admission were interviewed to test the theory that differences in community security would predict differences in coping reactions. Data on perceived community security and reported medical, social and mental coping reactions were colleted, using a simply and directly worded, precoded, stimulus-response instrument developed by the author. Respondents were assigned to either a high or to a low community security group by two methods: first, they were assigned a place of residence; next, they were assigned according to their obtained community security score. Results in general supported the theory. Of the two empirical indicators of community security, however, larger differences in coping reaction scores were found in the high scoring and low scoring community security groups than in the high-rise and community groups.


Glimpses into the social world of middle age.

This paper describes briefly the two cohorts recently followed up in the long term longitudinal research program at the Institute of Human Development at Berkeley, and notes the characteristics of those members who remain under study. It then presents a few findings on the occupational carreers and work orientations of both men and women, notes certain personality correlates of career patterns in the middle years, and briefly touches on marital satisfaction as related to work status.


Impaired general cell-mediated immune functions in vivo and in vitro in patients with nasopharyngeal carcinoma.

General cell-mediated immune (CMI) functions in NPC patients were investigated by the in vivo Mantoux and in vitro lymphocyte response to PHA assays. Thirty-eight (50%) of 76 untreated NPC patients were hyporesponsive in the Mantoux assay compared to 27 (25%) of 110 control patients. Forty-three (65.2%) of 66 untreated NPC patients also showed lymphocyte hyporesponsiveness to PHA compared to 15 (15.5%) of 97 control patients. Combined deficiencies were observed in 35 (42.2%) of 83 NPC patients compared to only 2 (3.3%) of 61 control patients. No difference in the frequency of immunodeficiency was observed between "early" and "late" disease patients. CMI functions of treated "remission" NPC patients were found to be impaired to the same extent as those of untreated NPC patients.


Design of experiments using the microcytotoxicity assay.

Examination of data from the microcytotoxicity assay revealed that the number of surviving target cells varies systematically both between microtest plates and within plates. If the layout of treatments on the plate is not planned carefully, these effects decreased precision and introduce bias. It is recommended that treatments which are to be compared be placed close together on the plate; for example, a plate with 96 wells might be considered as 24 blocks of 4 wells, with the treatments placed within these blocks. Data can be analyzed by means of paired t-tests or randomized block analysis of variance. These design changes remove the effect of systematic variation and increase the precision of the assay.


Production of tumor-specific inducer of cellular cytotoxicity by lethally irradiated mice.

Antisera taken 1 or 2 days after inoculation of BALB/c mice with transplantable sarcoma cells or Moloney sarcoma virus (MSV) induce tumor-specific cell-dependent cytotoxicity in vitro. In the present experiments, lethally irradiated ("immunosuppressed") mice were tested for the early appearance of the serum factor responsible for this anti-serum-dependent cell-mediated cytotoxicity (E-ADC). BALB/c mice were infected with MSV, syngeneic sarcoma cells or sheep red blood cells 24 h following irradiation with 900 R. Sera were obtained from MSV and tumor cell recipients 48 or 72 h later and tested for E-ADC activity. Spleen cells from SRBC recipients were tested at day 4 or 5 for ability to form direct plaques in a modified Jerne plague assay. Although the anti-SRBC response was obliterated in the irradiated mice, the E-ADC response appeared to be unimpaired. These studies indicate that newly synthesized immunoglobulin is not required for the formation of the E-ADC factor.


The distribution and fate of blood-borne 125IUdR-labelled tumour cells in immune syngeneic rats.

Radiolabelled sarcoma cells injected into the tail veins of normal rats were held up almost exclusively in the lung, and were not observed to pass through into the systemic circulation. Intramuscularly injected tumour cells were retained at the site of injection. Radioactivity was lost from both sites though more rapidly from the lung than from muscular tissue and was probably the result of tumour-cell death. Alveolar macrophages did not take part in the destruction of tumour cells in the lung. There was an increased rate of radiolabel loss from the lungs of hyperimmune, post-excision and tumour-bearing rats, as compared with normal rats. The destruction was immunologically specific; it was detected earlier, was more comprehensive in the hyperimmune and post-excision animals than in tumour-bearing animals, and correlated with the ability of the hyperimmune and post-excision animals to reject larger numbers of intravenous unlabelled tumour cells, than the tumour-bearing rats.


Some international differences in treatment and survival in breast cancer.

In a recent study, 5-year survival rates for breast cancer patients in Boston (Massachusetts), Glamorgan (Wales), Slovenia (Yugoslavia) and Tokyo (Japan) were 57.3%, 49.5%, 41.9% and 74.9%, respectively. In this report, data are presented on the types of treatment used in the four areas and on the relationship of differences in treatment practices to the differences in survival rates. Generally, surgically treated patients who also had radiotherapy had lower survival rates than patients in the same area who had similar operations without radiotherapy. In each area, the survival rate was higher for patients who had radical mastectomy than for those who had simple mastectomy. The Japanese patients had the highest survival rate within nearly every treatment and extent-treatment category. Thus, the high survival rate of these patients was not explained by the variables considered. Survival differences between Boston, Glamorgan and Slovenia were largely explained by differences in extent of disease and type of treatment. As the nature of the treatment--survival trends was consistent with the interpretation that treatment tended to be selected according to apparent prognosis, the degree to which treatment customs were determinants of the differences in survival rate among the three areas is uncertain.


The role of 9-hydroxybenzo(a)pyrene in the microsome mediated binding of benzo(a)pyrene to DNA.

A study of the liver microsome-mediated binding to added DNA of the phenol metabolites of benzo(a)pyrene (BP-OH) and of 7,8-dihydro-7,8-dihydroxybenzo(a)pyrene (BP-7,8-diol) suggested that as in the case of BP itself the reaction was catalysed by the enzyme aryl hydrocarbon hydroxylase. The addition of glutathione to the microsomal incubation inhibited the binding of BP and BP-OH more than that of BP-7,8-diol. Analysis by LH20 chromatography of the deoxyribonucleoside products from BP-DNA showed greater inhibition by glutathione of formation of the major product believed to result from further metabolism of BP-OH, than of the product arising by metabolism of BP-7,8-diol. The chromatographic behaviour and fluorescence spectrum of this major product were consistent with its derivation from 9-hydroxybenzo(a)pyrene (BP-9-OH) and furthermore suggested that BP-9-OH-4,5-oxide was the derivative whose reaction with DNA yielded this microsome-mediated BP-DNA product.


Demonstration of tumor-associated immunity with a leukocyte adherence inhibition (LAI) assay.

A modification of the leukocyte adherence inhibition (LAI) assay of Halliday was used to search for immune reactions against tumor-associated antigens of mouse tumors as well as against embryonic antigens in such neoplasms. Soluble antigen extracts were prepared from transplanted (BALB/c) methylcholanthrene-induced sarcomas and carcinomas, from normal BALB/c embryos taken at 14-18 days' gestation and from kidneys and livers of adult BALB/c mice. Peritoneal cells (PC) from mice immunized against syngeneic tumors gave leukocyte adherence inhibition more commonly when exposed to antigens prepared from the same tumor than did PC from normal (untreated) mice or from mice immunized against a different tumor. However, different tumor antigen preparations varied vastly in their ability to give specific adherence inhibition; some preparations consistently gave a high tumor-specific inhibition, while others did not. This may explain why the degree of reactivity observed was low and its tumor specificity not absolute when data obtained with all different antigen extracts were pooled. PC from multiparous mice gave adherence inhibition when exposed to antigenic extracts from syngenic mouse embryos or from tumors, as compared to PC from virgin mice exposed to the same extracts. Furthermore, PC from tumor-immunized mice reacted more commonly against antigen extracts from mouse embryos than did peritoneal cells from normal untreated mice. Adherence inhibition was not observed when PC from tumor-immunized or multiparous mice were exposed to antigen extracts from adult syngeneic livers or kidneys.


The reaction of (+/-)-7alpha, 8beta-dihydroxy-9beta, 10beta-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene with DNA.

The reaction of (+/-)-7alpha,8beta-dihydroxy-9beta,10beta-epoxy-7,8,9,10-tetrahydrobenzo(a)pyrene (BP diol epoxide) with DNA, followed by enzymatic hydrolysis and LH 20 Sephadex column chromatography, yielded products containing a purine deoxyribonucleoside linked to a 7,8,9,10-tetrahydrobenzo(a)pyrene derivative. DNA containing tritiated adenine or pyrimidines gave little or no tritiated products, showing that reaction occurred chiefly with the guanine residues. Results with 8-(3H)-guanine-labelled DNA, and studies on the protonation and ionization of the products in acid or alkaline media, led to the formulation of the main product as an N2-substituted guanine derivative. The reaction of BP diol epoxide with deoxyadenosine and deoxyguanosine gave further nucleoside derivatives which were probably minor products in the reaction with DNA. Treatment with strong acid unexpectedly converted each of the isolated products to free guanine or adenine.


Intra-lesional injection of immunostimulants in bilateral rat tumors.

Rats grafted with either two or six fragments of isogenic methylcholanthrene-induced transplantable fibrosarcomas were treated IT1 with living BCG or killed C. parvum or a mixture of both immunostimulants. Various tumor combination and therapeutic agent dosages were compared. When two fragments of the same tumor McFiFi2 (S) were grafted simultaneously, IT treatment of one of these with 2 mg of BCG induced cure of both in 50% of the animals, but IT injection of 2 X 10(9) C. parvum was completely without effect in this situation. The prognosis was however, improved when the dose of immunostimulant was increased. The best results were obtained when each individual tumor in rats with two or six simultaneous identical grafts were treated with a mixture of BCG and C. parvum. The combination of IT immunostimulant treatment and surgical excision of the treated lesion demonstrated a persistence of the curative effect on the remote untreated tumor. Double grafting with isologous non-identical tumors revealed the influence of tumor burden and of the specificity of anti-tumor action of the treatment. The distant specific regression obtained in this system implies a specific immunological mechanism mediated by effector cells and/or antibodies which can circulate, identify the target cell and destroy it. This is in accordance with morphological observations. The intimate contact between BCG and the growing structured tumor is necessary for the therapeutic phenomenon.


The sickness impact profile: conceptual formulation and methodology for the development of a health status measure.

The development of a health status measure, the Sickness Impact Profile (SIP), is described in terms of both its conceptualization and methodology. The need for a health status measure that is sensitive and appropriate, based on sickness-related behavior, and culturally unbiased, is discussed. A model of sickness behavior is presented as a guide for methodological development. The description of the initial developmental stage of the SIP includeds detailed discussion and documentation of the collection, sorting and grouping of items that comprise the SIP, scaling of the items, scoring of the instrument, and testing and revision of the prototype instrument. Results of preliminary tests of reliability, validity, and administrative feasibility are presented. Subsequent steps in revision and finalization, now under way, are outlined.


Unmet needs as sociomedical indicators.

This paper discusses the Meharry Medical College Study of Unmet Needs designed to measure the effectiveness of alternative health care delivery systems: (a) comprehensive care with broad outreach, (b) comprehensive care with limited outreach, and (c) traditional care. Unmet needs are defined as the differences between services judged necessary to deal appropriately with health problems and services actually received. The central hypothesis is that comprehensive health programs will be more effective than traditional care in reducing unmet needs. Unmet needs are viewed as measures of program outcome and are one of several types of sociomedical indicators which use factors other than biomedical or biological states as measures of outcome. The distinction is made between unmet needs are discussed and the relatively limited focus of these is contrasted with the more comprehensive Meharry approach. Household interviews and clinical examinations provide the data base for deriving professional judgements of unmet needs in the medical, dental, nursing, and social services areas. The Meharry work suggests several areas in which further work on unmet needs would be useful.


Evaluation of health care quality by consumers.

Ideological and conceptual issues arising out of the involvement of consumers in health care quality determination are identified. Historically and currently, criteria and procedures for quality review and assessment have reflected the values and interests of the professional providers of health care. This perspective restricts the role of the consumer to that of either a nonparticipant or a data source, at best. If the social values and merits for health care provision of consumer involvement in quality determination are to be realized, then this perspective will need to be modified, and our knowledge base of consumer criteria of health care quality will need to be enlarged. Although the perspectives of probiders and consumers are thought to the antagonistic, they may not, in fact, be so. Some suggested areas of needed research, necessary to policy development and implementation, are offered.


Constructing social metrics for health status indexes.

Health status indexes used to make collective decisions satisfying the principles of equality and social minimum must incorporate a social metric for health. Any index or indicator applied to populations for determining health status or to health programs for evaluating outcome must confront the question of who prefers which states of health under which circumstances? Utility models, psychometric scaling, and empirical social decision valuation have been used to measure preferences for states of health. Efforts should be directed toward constructing social metrics for health that are prospective, context-independent, relevant, community-wide, ratio scalled, sensitive, empirically validated, and applicable to program evaluation. These efforts represent the application of normative social theory to research, an important advance in uncovering the mysteries of social action and its consequences.


Reproductive efficiency as a social indicator.

An index of reproductive effiency (RE) is proposed as a social indicator that will meet the need to consider various forms of pregnancy wastage, to compare their relative costs, and to guide reproductive health policy accordingly. This article discusses conceptual and measurement aspects of RE. Conversion of wanted to unwanted pregnancies and the reverse, interpretation of abortion in relation to other pregnancy outcomes, defining the end point for the reproductive process and criteria for the events to be included as significant outcomes are conceptual issues. Measurement problems include: whether aggregation is justified, prospective and retrospective tracking of outcomes, record limitations, duplication of adversities in a single pregnancy, and selection of optimal rate for comparison. A measurement of RE for the entire United States based on the National Natality Survey of 1964-1966 is presented, showing 74.5 percent of pregnancies resulting in healthy liveborn infants. For those years, data on abortions could not be included. Within the group of reported pregnancy losses, the importance of congenital abnormalities and low-birth-weight babies is enhanced by application of economic weights based on associated medical care costs. Changing opportunities for birth timing, prenatal and infant care, and control of family size are social means of reducing adverse outcomes associated with teenage pregnancy and high-parity births, often found together with poverty. Successive increments in RE may be progressively more expensive to achieve, and cost effectiveness comparison will be necessary.


Indicators of health status in adolescence.

The study reported here is based on data obtained in 1968-1970 from a representative community sample of urban black youths in the United States aged 12-17 years, inclusive. Analysis is directed at conceptual and methodological issues in measureing health status. It suggests the need for greater attention to subjective self-evaluated self-reported components of health status, specified here as "ontological" health. This is related to health and illness behavior generally, to utilization of health services more particularly. The case is made for a multiple-indicator approach to measuring health status as being more consistent with the multidimensional phenomenon to which it refers. The method used in this study for deriving a composite health status index from four component self-reported indicators is described. The distribution of the sample on this composite was used to identify self-reported health conditions that warrant attention from providers of adolescent health services. Since subjective evaluations influence experienced severity of health problems, the health status composite index was applied in this study as a means of discriminating differntial seriousness in self-reported health problems. Finally, some differences between indications of "ontological" health and "medical" health also are analyzed for commonalities and differences between them.


Comments on health indicators: methodological perspectives.

This paper discusses several basic conceptual and methodological problems in the development and use of health indicators. We observe that two tendencies of the health indicators movement may deter progress toward producing informations of health status indexes and the tendency to conceptualize "health" in terms of expansive definitions should measure variables specified by a social system model and should be scaled according to units that are relevant to decision-making criteria.


Social and behavioural aspects of venereal disease among resident male university students.

A study of 1500 male students at Banaras Hindu University, Varanasi, India was conducted to establish the prevalence and related social and behavioural aspects of venereal diseases. The prevalence was found to be 3.93 per cent. The majority of the students (86.4 per cent) belonged to the Hindu religion which is based on the caste system. Students from the Vaishya caste were more affected with venereal diseases. The social acceptability of having more than one wife had a definite impact on the incidence of venereal diseases. Students who practised masturbation and homosexuality were also more affected with venereal diseases. Prostitutes were the main source of infection. It was found that 28.8 per cent of these students had been infected on a previous occasion.


Response variation and location of questions within a questionnaire.

In a questionnaire administered to a general population sample of 1673 adults, a 14-item scale of social desirability was divided into two groups of questions, almost evenly divided between desirable and undesirable behaviour, the percentage answering 'true' was higher when the question was asked early than when it was asked late. The difference was statistically significant for five of the 11, four of them relating to socially undesirable behaviour. The results indicate that responses can be dependent on the location of questions in a questionnaire, and that the effect of question location may not be the same for groups with different personal characteristics. For this reason, it seems unwise to alter the administration or design of a questionnaire in any way if the results are to be compared directly to those of other studies, unless the altered questionnaire is standardized against the original version.


Birth order, maternal age and birth interval in epidemiology.

Foetal wastage and congenital malformations are not so closely associated with birth  order, maternal age and birth interval as is suggested by data pooled across sibships of different sizes. The point could only have been established by data on large numbers of individual sibships. Maternal age, parity and birth interval are convenient but confusing variables to work with. However if they are to be used, it is essential to recognize that if the condition being studied may be associated with fertility of the parents, one needs to ascertain numbers of completed sibships containing affected cases. Incidence rates by age, parity and birth interval imply nothing by themselves.


Aspects of the epidemiology of suicide in England and Wales.

This paper is concerned with the variations in suicide rates in the 161-171 local authorities in England and Wales during the 11-year period 1961-71. Analysis of the overall secular trends shows that the rates for both males and females reached a peak in 1963 and subsequently declined at a steady rate. Virtually the whole of this reduction is associated with the fall in the number of poisonings by domestic gas. Suicide rates were about 50 per cent higher in males than in females and tended to increase with increasing age and, in general, were higher in the county boroughs than in the (more rural) county authorities. There is a marked variation in terms of geographical area, with the highest rates being reported in the London and South-East Region and the lowest rates in the South-East Wales and Northern Regions. There are also systematic differences between the various conurbations, with the highest rates in London and South-East Lancashire and the lowest in Merseyside and the West Midlands. The variations between individual local authorities are then considered and it is shown that as much as 99 per cent of the total variation can be explained in terms of a small number of variables which represent the general characteristics of the the local authority and the population. The most important of these variables is the proportion of single-person housegolds, which accounts for about three-quarters of the variation in the male suicide rates and more than half of the variation in female suicide rates. The significance of these results is discussed, with particular reference to the effect of the detoxification of the domestic gas supply during the period of study.


Suicide and self-poisoning in Great Britain and Ireland.

Reported national rates of suicide remain fairly stable from year to year and considerable differences persist between countries. Reported rates of suicide also differ from actual rates according to the social influences and the legal procedure both in attributing suicide and also in how the death is recorded and coded. This paper compares the rates of suicide and non-fatal self-poisoning in Scotland, England and Wales, and Ireland, and also examines suicide rates in people born in Ireland but now resident in England and Wales. The rise in overdose admissions to hospital which is continuing in relative degrees in all communities of Great Britain and Ireland, except Northern Ireland, does not seem to be correlated with trends in fatal suicide behaviour. Further studies on all aspects of the subject are needed to clarify the social determinants involved and to identify ways in which further increases can be contained.


Occurrence of gout in Copenhagen males aged 40-59.

As part of a cardiovascular survey study on the relationships between physical fitness and coronary heart disease, 5249 Copenhagen males aged between 40 and 59 were interviewed to identify a history of gout. Subjects who had experienced attacks of painful swelling, with abrupt onset and remission in one to two weeks, diagnosed and treated as gout by their own physician, were regarded as having experienced gout. In an initial cross-sectional examination, 86 men fulfilled the criteria. At a one year follow-up examination it was discovered that 56 men had had gout during the year of observation. Among these 18 were new cases. At the end of the study a total of 104 men had experienced gout and these were compared, with respect to the continuously distributed variables, those 104 gout subjects were compared to 208 computer selected age-matched controls drawn at random from the entire sample. The gout cases were found to have higher relative weights, higher diastolic blood pressure and lower levels of physical fitness estimated by use of a bicycle ergometer test. Angina pectoris occurred more frequently among the gout cases than among controls. No significant differences in the occurrence of myocardial infarction, intermittent claudication or renal stones were found. The habits of smoking and coffee consumption were equal in gout cases and controls. Alcohol consumption and consumption of drugs were higher in gout cases than controls. Gout was the most frequent in the lowest social classes.


Psycho-social effects of home care: results of a randomized controlled trial.

A randomized controlled trial was conducted to evaluate the efficacy of the early transfer of hospital in-patients to home care. This paper reports rates of return to normal role functions in work, leisure and household roles for patients who received any of five surgical procedures. With regard to return to work or leisure tasks, no statistically significant differences were observed between groups for any of the procedures. The rates of return to household activities were greater for home care patients than they were for controls in the cases of cholecystectomy and procedures for anal and rectal fistula.


A classification of sociomedical health indicators: perspectives for health administrators and health planners.

The conceptualization and operationalization of measures of health status are considered. Health indicators are conceived as a subset of social indicators, and therefore, as any social indicator, they are viewed as derivative from social issues. The interrelationships of different frames of reference for defining and measuring health that have accompained three distinct health problem patterns in the United States are viewed from a developmental perspective. Mortality and morbidity rates, the traditional health indicators, by themselves no longer serve to assess health status in developed nations. Their deficiencies as indicators serve as background for a classification schema for sociomedical health status indicators that relates health definition frames of reference, measures of health status, and health problems. The role of a group of health indicators-sociomedical heath indicators-in the current formulation of health status measures is assessed.


Familial aggregation of chronic respiratory disease: use of National Health Interview Survey data for specific hypothesis testing.

The 1970 National Health Interview Survey included questions on respiratory disease and smoking habits. The new data were released in July 1974. Data consisted of information on approximately 116,000 persons from 37,000 households selected randomly from 357 primary sampling units. To test a hypothesis about familial clustering of chronic respiratory disease in households, we selected as index households those having an adult (aged 35-54 years) reporting a diagnosis of asthma, bronchitis, or emphysema and also having first order relatiaves less than age 35. Index households were matched with households from the same neighbourhood having an adult aged 35-54, of the same sex as the diseased person in the index household, without disease and with all other adults 35-54 without disease, and which had first order relatives less than 35 living in the same household. Analysis was carried out using Cochran's d-test to compare frequency of respiratory disease in persons less than 35 in each group. There was a strong association (P less than .001) between persons over 35 with chronic respiratory diseases and the disease rate in their first order relatives. The association could not be explained by differences in demographic variables and smoking habits.


Changes in respiratory symptoms related to smoking in a teenage population: the results of two linked surveys separated by one year.

Data on respiratory symptoms and smoking for 2749 white American high school students from two linked surveys, separated by a one year lapse, are presented. There was a significantly higher likelihood of smoking at second survey among those who had initial symptoms. (There had been no educational efforts linking smoking and respiratory symptoms in the interim.) This difference was almost entirely contributed by those who had been ex-smokers and light (less than or equal to four cigarettes/day) smokers at first survey. Initial ex-smokers and light smokers also had, overall, least fixed smoking habits. Whatever the initial smoking or symptom status, symptoms at second survey were far more likely with current smoking. Controlling for initial symptom and smoking status, the gradient of symptoms between current smokers and non-smokers was over two and a half fold, except among those who had had symptoms and had not been smoking, and whose initial symptoms presumably arose from causes other than current cigarette smoking. Even among that group, symptoms at second survey were half as likely again among those who reported having become smokers (p less than-001). There were also strong linear trends of increased likelihood of symptoms with increased numbers of cigarettes smoked. Symptom rates at second survey of those who had symptoms a year earlier, and who stopped smoking during the year, were not as low as for those who also stopped smoking, but who had not had initial symptoms, suggesting that symptoms associated with smoking were not completely reversible in the time interval of this study. The difference, however, was not significant.


Survival experience of a cohort of carbon disulphide exposed workers from an eight-year prospective follow-up period.

A cohort of 343 men from a viscose rayon factory in Finland with at least five years of exposure in carbon disulphide (CS2) was followed from 1967 to 1975 with respect to coronary heart disease (CHD) mortality. The exposed cohort had over twofold excess death rate from CHD relative to a matched reference group. Statistical separation of causes other than CHD revealed a difference of two years in the life expectancies of the two populations for the age interval of 25 to 54 years. The coronary mortality had, however, decreased since protective measures were instituted at the plant after the fifth year of follow-up, leaving only one-fifth of the original group exposed and reducing the level of CS2 exposure for them to less than 10 ppm. This trend, although tentative due to the limited experience after the intervention, seems to suggest that the risk of coronary death for the formerly excessively exposed workers can be influenced and lessened to a normal level.


Recent trends of large bowel cancer in Japan compared to United States and England and Wales.

The death rate from tumours of the colon and rectum has risen rapidly in Japan since World War II. The rate of increase is greater in tumours of colon than in tumours of rectum. It is similar in males and females. It is large among the elderly, and this may be due to improvements in certification. But the difference between the Japanese and the US population is substantial at all ages. It is not known whether the current increase in the mortality of Japanese from tumours of the large bowel is due to differences between birth cohorts established early in life, or whether the differences developed after the end of World War II. Japanese who die of these tumours are younger than Americans, even when the age distribution of the populations is allowed for. This effect is produced by the differences between cohorts, and the age distributions within cohorts are closely similar in the two populations. The sex ratio for tumours of rectum rises with age in Japan in the same way that it does in the West, but the sex ratio of tumours of colon is apparently independent of age.


Mortality from ischaemic heart disease--inter-town variation and its association with climate in England and Wales.

In both seasonal and inter-town variation, the mortality from ischaemic heart disease in England and Wales in 1969-71 is very highly correlated with temperature. Also in the inter-town variation, IHD mortality is highly correlated with rainfall and with socio-economic index. It is postulated that the same mechanism of body cooling underlies seasonal, inter-town and socio-economic variations in IHD mortality. The first law of thermodynamics states the heat and energy are equivalent. Therefore to maintain body temperature against an increased thermal gradient (caused by a lower environmental temperature as in seasonal variation, or a temperature-rainfall interaction as in inter-town variation) more energy must be expended by the body or, alternatively, the body must reduce heat loss by increasing thermal insulation. It is to be expected that there will be many accompanying changes in physiological parameters and several of these are discussed.


Laser Raman spectroscopy of snake venom neurotoxins: conformation.

Laser Raman spectra of neurotoxins of Pelamis platurus (yellow-bellied sea snake) and Laticauda semifasciata (broad-banded blue sea snake) were investigated. The amide I band appeared at 1672 cm-1 for both toxins, which presents an indication of anti-parallel beta structure. Since this agrees well with the result from the CD-ORD studies of snake neurotoxin, it was concluded that snake neurotoxins mainly consist of beta structure. The amide III band appeared at 1245 cm-1 for P. platurus toxin and 1248 cm-1 for L. semifasciata toxin. The four disulfide bonds present in the toxin have a very similar geometry. After vigorous heat treatment, the backbone configuration of the toxin molecule basically remained the same although it was partially denatured. The major peak at 512 cm-1 was not altered by the heat treatment but a new shoulder appeared at 546 cm-1. This suggests that a new type of S-S stretching vibration (trans-gauche-trans) was produced as a result of heat treatment. However, the majority of the S-S vibrations remained in the gauche-gauche-gauche orientation. A substantial change in the interactions between a tyrosine aromatic ring and neighboring residues was apparently the alteration caused by the heat treatment.


Studies on the primary structure of bison pancreatic ribonuclease.

Bison pancreatic ribonuclease was isolated by affinity chromatography. Thermolysin and tryptic digestion of denaturated protein, and subtilisin digestion of native protein yielded peptides, which were purified and submitted to amino acid analysis. These peptides, together with partial sequence data obtained by Stewart & Stevenson (16) overlap the entire amino acid sequence of bison ribonuclease. No differences with bovine ribonuclease were found, although there may be differences in state of amidation of some residues.


Structure-activity studies on mammalian tissue lytic enzymes: chemical characterization and substrate specificity of rat kidney nuclear lysozyme.

Studies on the structure and substrate specificity of purified rat kidney nuclear (RKN) lysozyme are reported. The carboxyl and amino terminal residues of RKN-lysozyme were found to be leucine and alanine respectively. The amino acid composition indicated similarities and differences as compared with that of hen egg white (HEW) lysozyme. There were alterations in the nine amino acid residues, Lys, His, Arg, Asp, Glu, Pro, 1/2 Cys, Tyr and Trp. The other nine residues were present in identical proportions to those of HEW-lysozyme. The decrease in the arginine and aspartic acid residues was found to be compensated by the increase in the number of lysine, histidine and glutamic acid residues. The overall ratio of the acidic to basic amino acids has thus been conserved in the mammalian enzyme. In addition, RKN-lysozyme contained decreased numbers of Trp, Tyr and 1/2 Cys, and increased numbers of proline residues as found in HEW-lysozyme. RKN-lysozyme did not cross react with heterologous antibodies produced against HEW-lysozyme, and vice versa. RKN-lysozyme showed distinct specificity towards the lysis of M. luteus. Against this substrate, it was three times more efficient than HEW-lysozyme. It also cleaved E. coli B, but its efficiency was half as much as with M. luteus. However, it cleaved P. septica and B. subtilis at a rate similar to HEW-lysozyme under identical conditions.


Polypeptide models of collagen: synthesis of (Pro-Pro-Ala)n and (Pro-Pro-Val)n.

The synthesis of two collagen models (Pro-Pro-Ala)n and (Pro-Pro-Val)n is reported. Preliminary examination suggests that (Pro-Pro-Ala)n may exhibit some properties of collagen-like polypeptides whereas (Pro-Pro-Val)n, does not have a collagen-like character.


Ego functioning during paranoid regression.

This paper is based on the psychotherapeutic work with a paranoid schizophrenic man during a period of acute psychotic regression lasting approximately two weeks. The author reviews what seemed to be the precipitating factors in the decompensation, then elaborates descriptively and speculatively on two major aspects of ego functioning during the regression, namely, the experiences of fragmentation and of dedifferentiation. The role that seemed to evolve for the therapist is also discussed as it relates to the aforementioned aspects of ego functioning. Finally, a tentative hypothesis is developed concerning pretense as one possible genetic factor in these ego disturbances.


Victim, victimizer: interaction in the psychotherapy of borderline patients.

Borderline and narcissistic patients suffuse relationships with intense pregenital aggression to which the therapist, despite his level of training or self-understanding, is not totally immune. Aggression is considered an energetic expression of the narcissistic defense against vulnerability. The therapist is subject to a continuing siege of projections and projective identifications. Vigilance against repetitive sadomasochistic interactions is a necessary and often wearying extension of therapeutic concern. Most necessary, too, is the willingness to make second efforts at understanding the patient's vulnerability. Such understanding comes from attentiveness to countertransference feelings.


The self as a transitional object: its relationship to narcissism and homosexuality.

Men with significant narcissistic and homosexual trends can show a tendency to experience a part of the self as a transitional object. Specifically, these men regard themselves as dolls. Excerpts from three psychoanalytic cases are offered to demonstrate this clinical finding. It is believed that this occurrence represents a significant arrest in the development of the self. The recognition, interpretation, and reduction of this transitional phenomenon constitutes a significant therapeutic experience in the analyses of these men.


Transitional phenomena and therapeutic symbiosis.

This paper suggests that the analyst (or therapist) can best understand transitional-object phenomena as being tributary to, or consisting in various different facets of, the--for him in his work with patients--more comprehensive realm of therapeutic symobiosis. The author highlights data concerning objects or phenomena which are transitional for both patient and analyst concomitantly. He suggests that the patient's symptoms have become, early in the phase of therapeutic symbiosis, transitional objects for both patient and analyst simultaneously. As with the patient's symptoms, so with his transference images of the analyst: it is suggested that, in order for any effective transference analysis to occur with any patient, whether neurotic, borderline, or psychotic, the analyst must have come to accept at least a transitional-object degree--if not more deeply symbiotic degree--of relatedness with the particular transference image which is holding sway presently in the analysis.


Object choice and actual bisexuality.

Actual bisexuality is to be distinguished from homosexuality in a latent state and from conscious bisexual fantasies. Contemporary social changes have caused an increased demand for help for those men and women capable of engaging in protracted heterosexual and homosexual relations. Among such people narcissistic and borderline states are common. Clinical material is presented in some detail. The author suggests that the condition is associated with a tendency to be caught up between the anaclitic and narcissistic types of object choice. The concurrent involvement with a male and female love object against a background of pseudogenitality creates the illusory appearance of two objects being involved, covering up the fact that there is splitting of the original love object together with severe preoedipal disturbance.


Transvertism: a disorder of the sense of self.

Transvestism is not simply a sexual disorder, but is best understood as primarily a disorder of the sense of self. A descriptive background of transvestism is provided through a review of developmental history, clinical course, presonality structure, and family history. The predominant transvestic fantasies and their modes of enactment are described. The disorder of the sence of self that gives rise to transvestic behavior is identified as a split in the ego into incompatible male and female gender identities. The split is attributed to an early identification with the mother as a defense against unresolved separation anxiety engendered during the separation-individuation phase of infantile development. The effect of this split upon the sense of reality, object relations, and adaptation to stress in transvestism are examined for a psychodynamic point of view.


Empathy and intuition in becoming a psychiatrist: a case study.

This paper, through the use of the case study, presents the idea that the beginning psychiatrist must often depend on his own native intuition and emphathic skills during his early clinical work. A case is presented in detail to show that amide the anxiety, freshness, and inexperience typifying a beginning psychiatrist, a psychotherapeutic treatment that benefits both the patient and the psychiatrist can be carried out. The growth of the patient and the therapist is described over the course of a three-month hospitalization.


On becomine a psychiatrist: discussion of "Empathy and intuition in becoming a psychiatrist," by Ronald J. Blank.

Using the data from Blank's (1976) description of his clinical efforts with his first patient, selected tissues on becoming a psychiatrist and psychotherapist are explored. Considered among the motives for entering this profession are opportunities for the therapist to projectively identify into his patients, and to introjectively identify with and contain his patients' psychopathology. The relationship between empathy and intuition on the one hand, and projection and projective identification on the other, is also studied, as is the need for the application of the validating process in confirming all so-called empathic and intuitive responses on the part of the therapist. Counter-transference influences on the experience and use of empathy and intuition are also investigated. The development of therapeutic misalliances and framework "cures," the distinction between transference and nontransference, the constructive elements contained in essentially countertransference-based interventions, the mastery of countertransference difficulties, and the choice of insight-oriented versus noninsightful therapeutic modalities are discussed.


Toward a general concept of the therapeutic process.

Using clinical psychoanalytic theory as a unifying concept, an attempt is made to observe, interpret, and integrate the therapeutic process in a wide variety of psychotherapies. All psychotherapy, regardless of specific form or technique, is viewed as an interpersonal or intrapersonal process, and should be understandable from a psychoanalytic perspective. Ten common factors are selected: structure of the therapeutic situation; the therapeutic relationship; management of anxiety; drives and their derivatives; mechanisms of defense; identification; regression; catharsis and abbreaction; external reinforcement; structural change. The various psychotherapies are compared regarding each of the ten factors.


Psychotherapists' passivity--a major training problem.

A major problem encountered in the early psychotherapy training of psychiatric residents, psychologists, and social workers is the tendency for the student to take an inappropriately passive and silent role. Rather than actively engage patients in a therapeutic alliance, beginning students have the tendency to remain withdrawn and inarticulate. This often reaches extreme proportions and may later significantly block treatment progress. Clinical vignettes are presented to show the range and variety of hyperpassive behavior in psychotherapy training and the potential crippling and destructive effects on the treatment process. This is not to imply that there is no danger in excess activity on the part of the therapist. Indeed, not all silence need be destructive. However, detachment, withdrawal, and excess silence--attitudes often fostered by our training programs--can be markedly destructive to both patients and treatment. Psychodynamic factors causing this situation are reviewed. A variety of methods and strategies are recommended for dealing with it. If the supervisor remains alert, the problem can be significantly resolved before it interferes with treatment. In this way, the student will be helped to overcome one of the major ealry hurdles of training.


The Ellsberg psychoanalytic situation.

The author proposes to explore an event that received nationwide publicity through the Watergate investigation: the burglary of the office of a Los Angeles psychoanalyst believed to be treating Dr. Daniel Ellsberg. A brief questionnaire, with an accompanying letter, was mailed to all members of the American Psychoanalytic Association. It requested voluntary information on the reaction of their patients to the aforesaid particular event. The results of the study was then evaluated as serving hopefully an indirect inquiry into psychoanalytic practice. This paper is based on an adjusted sample of 861 respondent psychoanalysts, who reported on a total of 5,074 analysands. The resultant figures indicate that a high percentage of the analysand sample was silent concerning the office break-in during the eight-week period following the national publicity given the event. Of the small percentage of analysands that did present material concerning the event, the survey found that they were the patients of only 84 analysts of the entire sample of 861. The absence of reference to the Ellsberg Affair in so many patients may have been due to (1) the fact that analysts create an analytic situation which has a basic quality of interference such that events of this kind do not get communicated, and (2), more important, the fact that analysts through some defensive need failed to take cognizance of references to the Ellsberg Affair in dreams or in the latent content of the associations of their patients. A "natural" psychoanalytic experiment has been studied, and the results are offered for consideration.


Conservatism and liberalism: a psychoanalytic examination of political belief.

A review of the historical development of conservative and liberal through reveals contradictory basic assumptions: the former views man as essentially evil by nature, and places its priorities upon self-restraint; the latter views man as essentially good, and with umlimited capabilities, and celebrates his efforts at creating a perfect society for himself. Three clinical vignettes are recounted in which the patient's intrapyschic organization found support from a hormonious political philosophy. It is suggested that conservatism and liberalism offer the individual an ideological resolution to the narcissistic injuries he experiences as a consequence of life's inevitable and developmentally determined disappointments.


Homogamous and heterogamous marriages.

This paper explores two marital constructs set forth by Peter Giovacchini. The first is based on a symbiotic reenactment in which the investment of both partners is tenacious and reciprocal, an attachment which Giovacchini refers to as a "character object" relationship. It represents intrapsychic homogramy. In the second construct, this deep form of attraction is absent and the dyadic bond is superficial, frequently transitory. The latter couples do not require an elementary, intrapsychic bond but do share particular defensive traits or symptoms. Thus these unions are termed "symptom object" relationships and are characterologically heterogamous. By means of a group case study approach, this distinction was statistically supported. Furthermore, it was found that homogamous marriages stay in treatment longer, maintain a lower divorce rate, and respond best to individual psychoanalytic psychotherapy. Heterogamous marriages, by contrast, show a higher divorce rate and tend to leave therapy prior to termination. The research also suggests that the initial treatment of choice for this type of marriage may well be conjoint or group psychotherapy.


Symbiosis and intimacy.

The symbiotic phase of development is crucially involved in determing the nature of psychopathology as well as promoting psychic processes that are involved in creative activity and intimate object relationships. In a well-established object relationship, the partners relate to each other in a symbiotic fashion. From the analysis of married persons (and some clinical material is presented in this paper), the author concludes that the fundamental character structure, psychopathological or otherwise, of each spouse is identical. Exceptions to this conclusion exist, but here one is dealing with an object relationship that is superficial and transitory. Symbiotic fusion regularly occurs in creative activity and empathic intimate relationships.


Psychological unevenness in the academically successful student.

Among students seen is psychoanalytic psychotherapy, there is a group who present the paradoxical clinical picture of great academic success alongside of quite primitive features in other aspects of their psychological functioning. This article offers an early developmental formulation of this aspect of these students. A clinical description of these patients is presented, including the observation that for each the early mother-child relationship seems to have been characterized by a predominant focus on maternal needs. A case history and summary of therapy of one of these students is discussed. Aspects of the mother-child relationship are explored by means of historical data, memories, and most important, through various transference and countertransference manifestations. The nature of this early relationship is then discussed in terms of the work of Donald Winnicott and Masud Khan. Finally, an overview of therapy is presented along with a discussion of some forms of resistance and some countertransference problems that often arise in the course of therapy with such students.


Alan Strange as an adolescent: a discussion of Peter Shaffer's Equus.

Psychoanalytic knowledge of adolescence helps us to understand the protagonists of Peter Shaffer's play Equus. Alan Strang, the seventeen-year-old who maimed six horses, had undergone a retreat from oedipal wishes to narcissism typical of teenagers. His fragile attempts at achieving a sound sense of identity are undermined when his seeking of a noninestuous object produces panic and impotence. Dr. Dysart, the psychiatrist who envies his patient's passion, and fears hurting him through treatment, displays in an exaggerated way countertransferences often seen in therapists of adolescents. In addition, his doubts have some foundation in that the treatment he employs, catharsis, can encourage primitive defenses and the outpouring of uncontrolled, unneutralized drive derivatives. This is more likely to prevent adaptive creativity than the cure the doctor dreads. Finally, some technical problems in dealing with sublimations in psychoanalysis (which is not Dr. Dysart's form of treatment) are discussed.


Equus and the psychopathology of passion.

Peter Shaffer's play Equus is discussed in terms of its views on the concept of passion. The major characters show clear indications of psychopathological expressions of passion. Alan's pathology is highlighted by his psychotic identification with Equus and his binding of the horses. Dr. Dysart's pathology is seen in his greatly inhibited sense of passion. He envies Alan's passion and shows "countertransference" toward treating him. Both characters are studied in terms of level of object relations, ego functions, and unconscious fantasy.


Discussion of papers on Equus.

Three points are discussed concerning Equus and the preceding papers: (1) Because a play is not a free association obtained within the context of the analytic situation it is most difficult to "analyze." (2) The central theme of "passion" in Equus would seem to relate to the vicissitudes of infantile omnipotence, as noted in both the content of the play and the process of playwrighting. And (3) in Equus, the playwright not only creates a reality out of a fantasy, but "tricks" the audience into being a participant in the scopophilic activities depicted.


Intersecting languages in psychoanalysis and philosophy.

The introduction establishes a general view of the literature in which philosophers have profited from their encounters with analysis. It provides a frame within which to present more specific ideas about the method and language of psychoanalysis as viewed by philosophers. The method of interpretive reconstruction is unfolded from its original context of Freud's archaeological analogy. Further, the vocabulary of reconstruction, which is an intimate part of this analogy, is employed by Anna Freud is her discussion of defense mechanisms. Texts are cited and explicated. Meanwhile, the method of reconstruction is given independent, though related, application in the work of R. G. Collingwood, an archaeologist-philosopher-historian. The juxtaposition of Freud and Collingwood suggests that the methods of philosophy and analysis are more alike than the particular problems they try to solve. Both methods are oriented toward solving the problem of discovering meaning amid absurdity. The introduction of two specific examples lends substances to this claim. In the final section on the practice of interpretation, the question is raised as to how the introduction of the method of reconstruction affects the debate about the epistemological status of psychoanalysis as a science. Psychoanalytic knowledge shows itself to be more like that available to the historian than that accessible through physical theories. Still, physics and analysis can be compared. One must look to the interpretation of symbols. In psychoanalysis, giving an interpretation--in which nonsense becomes understandable--is a form of explanation. This methodological result suggests a conclusion about the relation between metapsychology and clinical practice.


Sartre's contribution to the understanding of narcissism.

As a means for presenting Sartre's insights into the narcissistic problems of the self, we have used his phenomenological system as articulated in Being and Nothingness (1943) to illuminate these issues in the personality of Roquentin, the hero of his novel Nausea (1938). Roquentin attempts to stabilize his fragmenting self and to avoid "nausea" by using three mechanisms which Sartre argues maintain the self from drowning in the objects of the self. These are "reflection," "temporality" (continuity through time), and "being-for-others" (how we experience another's view of ourselves). In Sartre's conception of being-for-others lies many clinically useful insights which can be used to explain both the structure and the instability of the transferences seen in the treatment of narcissistic personality disorders. Sartre demonstrates by implication that the patient must maintain (by using bad faith, i.e., disavowal) that the therapist is acting freely, or these transferences collapse. Thus, the patient must feel he is the unique and special "occasion," of any warmth, empathy, or compliments. A case example is included to illustrate these issues of freedom and bad faith.


The mirror transference in the psychoanalytic psychotherapy of alcoholism: a case report.

The development of a mirror transference in the successful outpatient psychoanalytic psychotherapy of an alcoholic patient is described in this paper. Important features of the case were a very severe initial period of resistance, a dramatic shift from a climate of bitterness and rancor to one of quiet and satisfaction that coincided with the establishment of the mirroring relationship, then recall of important genetic material, and finally, a period of many gains in the patient's contemporary relationships. Very few interpretations were given. The psychotherapy was chiefly an attempt to provide the object relationship that would be therapeutic, an archaic relationship of the grandiose self and the mirroring self-object. The theoretical work of Balint and Kohut was applied to this problem (with the alcoholic patient) and proved extremely helpful in predicting the major turning points in the psychotherapy and in guiding the strategy of the therapist. The principal difficulty not fully predicted was the extent and depth of the resistance to a positive transferace; once this resistance was overcome, the psychotherapy proceeded in a way similar to that generally described by Kohut with regard to patients who became involved in a mirror transference.


Psychotherapeutic schema based on the paranoid process.

A psychotherapeutic schema is proposed based on the analysis of the paranoid process. The paranoid process involves a paranoid construction of the patient's view of reality and his environment, particularly the social environment. The paranoid construction sustains and makes sense out of the patient's projective system. These projective elements reflect and are derived from the introjects--the internalized objects around which the patient's inner world and his experience of himself are organized. The schema aims at focusing the therapy on these introjects as central to the psychopathology. The following steps of the schema are outlined and discussed: establishing the therapeutic alliance, defining the projective system, testing reality, clarification of the introjects, derivation of the introjects, motivation of the introjects, mourning of infantile attachments, emergence of transference dependence, transference resolution, and termination.


Development of neurophysiological indices of retardation: interhemispheric asymmetry of the visual evoked cortical response.

Visual evoked cortical responses (VECRs) were recorded from the left (O1) and right (02) hemispheres at varying interstimulus intervals (ISIs) in children who were either: Normal (dextral), Dextral Retardates, or Sinistral Retardates. Latencies of N1 and P2 components of the VECR were stable and similar for both hemispheres in all groups. There was an asymmetry between the hemispheres for N1-P2 amplitude: right greater than left in Normals; this direction of asymmetry was also present in Sinistral Retardates, but was reversed in Dextral Retardates. The direction of normal VECR asymmetry was the reverse of that previously established for the auditory evoked cortical response (AECR) amplitude (Richlin, et al., 1973; Matsumiya, et al., 1972; Morrell & Salamy, 1971; Wood, et al., 1971). It is suggested that some neural mechanism of the retardates may allow excessive non-verbal stimulation of the normally "verbal" hemisphere. The electrical activity of the brain consequent to auditory or visual stimulation appears to depend upon: the modality of stimulation, the mental status of the individual, and his handedness. These factors have led to the establishment of an additional index to provide differential diagnosis of the mental status of the child.


Levels of norepinephrine in rat cerebellum after administration of the convulsant 3-mercaptopropionic acid.

The level of norepinephrine in rat cerebellum was assayed after the administration of the convulsant 3-mercaptopropionic acid. Decrease in norepinephrine was observed after the onset of seizure. The results were compared with those of GABA which were diminished both during and after convulsions. The decrease of GABA was prior to that of norepinephrine.


The differential effects of semantic, acoustic, and nonverbal distraction on Korsakoff patients' verbal retention performance.

Korsakoff and alcoholic control patients' verbal retention performance was assessed following either acoustic, semantic, or nonverbal distractor activity. Both patient groups were similarly affected by the degree of relatedness between the distractor and the memoranda. Semantic distraction produced more verbal forgetting than acoustic, which in turn, caused more forgetting than the nonverbal tasks. The Korsakoff patients' verbal retention, however, became increasingly impaired, relative to the controls, as the level of similarity between the distraction and the memoranda increased. These results suggest that Korsakoff patients have  difficulty performing verbal analyses which incorporated the distinctive physical, phonemic and semantic features of the memoranda into the development of their verbal memory traces.


A neuropsychodiagnostic model.

Central Nervous System pathology in children is regarded as a neurophysiological and/or neuroanatomical disorder leading to the production of a broad spectrum of symptomatic indicators, many of which are psychological in nature. This fundamental relationship between neurological integrity and various categories of psychopathology represents the theoretical core of a specific diagnostic rationale elaborated in the context of a neuropsychodiagnostic model. A battery of psychological tests, as one component of a more general assessment approach, is proposed as a psychoeducational method complementing the more traditional medical approach to the diagnosis of various neuropathological conditions in children, especially minimal brain damage/dysfunction.


Fucosidosis: ultrastructural study of conjunctiva and skin and enzyme analysis of tears.

Conjunctival and skin biopsies from two new patients with fucosidosis were studied by electron microscopy. In both tissues, the connective tissue cells and the capillary endothelial cells were filled with single membrane limited inclusions of two types: (1) Clear inclusions containing a fibrillogranular reticulum. (2) Dark inclusions with a dense granular material. Specific stainings in ultrastructure suggest that these inclusions contain oligosaccharide chains. The ultrastructural aspect is characteristic for fucosidosis. Enzyme studies on tears realized an easy and secure technique for the diagnosis of the disease.


Analog vs. digital photogrammetry for optic cup analysis.

This report compares the reproducibility of analog and digital photogrammetry for topographical analysis of the optic cup. Ten simultaneous stereophotographs of each of three optic discs were taken with the Zeiss fundus camera plus a twin-prism stereoseparator. Digital processing produced photogrammetric contours of the optic cup and estimates of its geometry. Optic cup contours from the same stereopairs were also drawn with an analog stereoplotter and were analyzed by manual planimetry. The reproducibility of digital photogrammetry and analysis for estimation of cup depth, cup width, cup cross sectional area, and cup volume was concluded to be generally superior to the reproducibility of analog photogrammetry and manual analysis.


Morphological fiber types of retractor bulbi muscle in mouse and rat.

Retractor bulbi muscles of mouse and rat were examined by light and electron microscopy. Two morphological fiber types were observed, analogous to Type I and Type II cells of skeletal musculature and comparable to fibers observed in the global region of the rectus extraocular muscles of these species.


Adaptive programming of phasic and tonic components in saccadic eye movements. Investigations of patients with abducens palsy.

Two patients with unilateral abducens palsy used their paretic-but visually superior-eye for fixation. In these patients, adaptive changes of saccadic amplitude and of the relation between phasic and tonic components of saccades were found. These changes led to a reduction of foveation time.


On the site of strabismic suppression.

A grating pattern presented to one eye of an individual capable of alternating suppression induces a visual aftereffect (contrast threshold elevation), even when the pattern is phenomenally suppressed from vision. This finding indicates that strabismic suppression occurs within the visual system after the site of the aftereffect, and points out a similarity between strabismic suppression and binocular rivalry suppression.


Rabbit corneal epithelial cells grown in vitro without serum.

Primary outgrowth cultures of normal rabbit corneal epithelium can be initiated and propagated in vitro up to 6 days in serum-free medium. By the eighth day the majority of cells have ceased to divide. Epithelial cells grown without serum show DNA synthetic activity at a level comparable to control cultures grown with added serum.


The measurement of ocular transmittance and irradiation distribution in argon laser irradiated rabbit eyes.

The transmittance of the ocular media has been measured in vivo in rabbit eyes using an argon laser light source and microthermocouple sensor. The intensity profiles at the cornea and retina were measured with the thermocouple and the ratio of the power associated with the intensity profiles indicated the fraction of light power reaching the retina. Measurements from 10 rabbits indicated a transmittance coefficient of 0.85 for wavelengths between 488 and 514.5 nm.


An explanation for the long duration of mydriatic effect of atropine in eye.

The mydriatic effect of topically applied 3H-atropine (2%) was compared in the pigmented rabbits (black fur and dark brown irides) and nonpigmented (albino) atropinesterase-negative rabbits. The duration, t1/2, of the mydriatic effect in the nonpigmented and pigmented rabbit was 43.5 and greater than 96 hours, respectively. At hour 96, the tissue 3H-atropine in the pigmented iris was greater than that in the nonpigmented iris by the factor of eight. The longer duration of mydriatic effect in the pigmented iris is explained by the slow release of the bound drug from the pigment onto the muscarinic receptors.


Origin of ghost cell in Coats' disease.

A morphological study of Coats' disease was performed with light and electron microscopy. The choroid was intact throughout. The pigment epithelial cells showed proliferative changes, being thickened in two or three rows. The transitional form of ghost cell was observed in contact with the pigment epithelial layer, then migrated toward the subretinal space, and finally invaded the detached retina. It was concluded that the origin of ghost cell in Coats' disease was the pigment epithelium.


An analysis of the value of additional diagnostic procedures.

When several diagnostic procedures are performed on a patient, the probability of his having or not having a specific ailment will change as the result of each procedure is known. This paper describes how such a change is readily calculated using Bayes' theorem. Information theory is also used to find the increment in information from each successive test. Numerical estimates are made using data pertinent to lung X-ray examinations. Finally, some implications for diagnostic examinations in general are drawn.


Cardiac volume measurement errors.

Measurements of cardiac volumes based on biplane radiographic data exhibit a cyclical variation as the heart is rotated with respect to the radiologic instrumentation. This study develops a theoretical basis for evaluating the measurement errors due to orientation, that explains the cyclical variation. Since this type of measurement error is always one of overestimation, better accuracy will be obtained if several views are performed at varying orientations and the smallest of the resulting values is used as the measurement.


Organ culture of rodent prostate. Effects of polyamines and testosterone.

Prostate organs were maintained in culture for 14 days on a plasma clot to which insulin, testosterone, spermine, and spermidine were added. Explants cultured in the control medium (embryo extract and chicken plasma) showed regressive changes and there was complete necrosis by the 5th day.  When cultured in the presence of testosterone plus the control medium the explants continued to maintain their epithelial height and stromal characteristics after 5 days. By the 7th day regressive changes similar to those seen for explants cultured in the absence of testosterone were observed. With spermine and spermidine in the medium along with insulin and testosterone, the stromal and epithelial integrity of the explants was kept intact for 14 days. When either testosterone or spermine was omitted from this list of additives, survival and maintenance of normal morphology were greatly impaired. Omission of spermidine did not affect results if the other chemicals were added. No attempts were made to maintain cultures beyond 14 days.


Activation of serum complement by contrast media.

Evidence is presented for the activation of serum complement by contrast media, in vitro and in vivo. Activation as a function of concentration was measured and the increasing order of effectiveness was found to be metrizamide, iothalamate, diatrizoate, acetrizoate, iodipamide and iopanoate. This order is the same as for protein binding and enzyme inhibition. The activation mechanism for iodipamide, and by inference for the other compounds, does not involve gamma-globulin aggregation. Serial daily injections in normal dogs resulted in substantial declines in serum complement over several days. Guinea pigs which were depleted of serum complement with cobra venom factor were found to be no less sensitive to lethal doses of iodipamide than those with normal complement. Implications of these findings are discussed.


Effect of prolactin on the metabolism of androgens by the rat ventral prostate gland in vitro.

When homogenates of rat ventral prostate glands were incubated with varying amounts of prolactin (0.2, 0.8, or 2.0 IU per ml), there were significant alterations in the bioconversion of [3H]testosterone and its principal radiometabolites. A 2.0-IU per ml dose of prolactin significantly reduced the metabolism of labeled testosterone in the prostate gland (P less than or equal to 0.01). Similarly, the amounts of [3H]5alpha-androstane-3beta,-17beta-diol ([3H]androstanediol) formed from [3H]testosterone were significantly lower (P less than or equal to 0.05) in the prolactin-treated groups than they were in the controls. Only the highest dose of prolactin (namely, 2.0 IU per ml) impaired the conversion of [3H]testosterone to [3H]17beta-hydroxy-5alpha-androstan-3-one and to [3H]-dihydrotestosterone in the homogenates of rat ventral prostate glands. These findings suggest that prolactin is capable of exerting intracellular actions as evidenced by its ability to interfere with steroidogenesis in androgen-dependent tissues.


Antibiotics and chemotherapeutics in renal lymph. An experimental study in dogs.

Renal lymph concentrations of ampicillin, carbenicillin, cephacetrile, cephaloridine, and nitrofurantoin were determined in a total of 28 dogs during constant infusion of the drugs together with [125I]iothalamate and [131I]o-iodohippurate for simultaneous determination of glomerular filtration rate and effective renal plasma flow. The lymph concentrations of the radiolabeled clearance substances, serving as a standard were compared to those of the antimicrobial agents. The lymph concentrations of the four antibiotics were all significantly lower than the respective simultaneous arterial plasma concentrations. The nitrofurantoin lymph concentrations were equal to the simultaneous plasma concentrations. It is concluded that the renal lymph concentrations of antibiotics and chemotherapeutics do not exceed the simultaneous plasma concentrations unless the urine flow is obstructed.


Influences on the rate of absorption of the cholecystographic contrast medium iosumetic acid in man.

Groups of 5 fasting male and female patients aged 32-83 years were each given 3 gm of the cholecystographic contrast medium iosumetic acid in micronized form (particle size less than 20 mum); Group I with 150 ml tea (standard administration);  Group II with 500 ml tea; Group III with 150 ml tea plus 10 mg metoclopramide (Paspertin) 5 min p. admin. i.v.; and Group IV with 150 ml tea and 3 gm sodium bicarbonate. Blood samples were taken in the period up to 6 hours after administration in order to determine the iodine concentration according to the method of Juegst and Stauch. In Groups I and II maximum blood levels were reached 2.1 +/- 0.4 or 2.0 +/- 0.4 h p. admin. respectively, in Group III 1.6 +/- 0.2 h p. admin (in comparison to Group I: p less than 0.05) and in Group IV the maximum level was reached after only 0.9 +/- 0.2 h p. admin. The difference between Group IV and the other three groups is statistically significant (p less than 0.01). A half-life of 0.3 +/- 0.1 h was calculated for absorption in Group IV.


Innervation of pelvic viscera in the rat. Evoked potentials in nerves to bladder and penis (clitoris).

In 29 rats, responses evoked by pelvic and hypogastric nerve stimulation were recorded from postganglionic nerves to bladder and penis (clitoris). Responses to pelvic nerve stimulation had nonsynapsing and synapsing components. The nonsynapsing component was relatively large in main nerve to penis and small in lateral nerve to penis and nerves to bladder. Pelvic nerve fiber synapsing on pelvic ganglion neurons to bladder had a large subliminal fringe, while fibers synapsing on neurons supplying penis (clitoris) had a small subliminal fringe. Recruitment was greater in nerves to bladder and lateral nerve to penis (clitoris) compared to main nerve to penis (clitoris), indicating more synapsing fibers in the former nerves. Almost all hypogastric fibers to bladder were direct. A small subliminal fringe was demonstrated for hypogastric fibers synapsing on neurons supplying penis. No subliminal fringe was evident for the bladder. Pelvic and hypogastric nerve interaction on pelvic ganglion neurons could not be demonstrated with either single shock or tetanic trains of conditioning stimuli. With antidromic stimulation, conduction velocities of afferent fibers in pelvic nerve ranged from 0.15 m per sec to 2.9 m per sec. In hypogastric nerve they ranged from 0.35 m per sec to 2.8 m per sec.


Ureteric vascular and muscle coat innervation in the rat. A quantitative ultrastructural study.

The application of a quantitative ultrastructural approach to the study of the innervation of the smooth muscle in the wall of the ureter of the rat has revealed major differences in the structure of the nerves in the muscle coat and in the walls of the arterioles. The high density of adrenergic terminals in the periarteriolar nerves is consistent with the distribution of many of the postganglionic sympathetic axons that run in the ureteric nerves to blood vessels and the low density of both adrenergic and cholinergic terminals in the intramuscular nerves implies that the autonomic nervous system plays only a secondary role in controlling the activity of the muscle. The mean size of the intramuscular nerves corresponds to that of the nerves in the submucosa and terminals of the kind that occur in the submucosal nerves are numerous. The function of axons with such terminals and their possible involvement in the transmission to the central nervous system of pain impulses is discussed.


The autoimmune response to male reproductive tissues of rabbits. IV. Induction of autosensitization to central accessory tissue by the intraabdominal release of endogenous secretions.

A study is described in which tissue- and secretion-specific autosensitization was induced in adult male rabbits through intraabdominal cannulation of one or more of their central accessory glands. Both primary and secondary humoral antibodies were elicited by this procedure, as determined by tanned cell hemagglutination and passive hemolysis, i.e., complement fixation. The secondary antibody responses were elicited by (i) cannulation of animals which had been previously stimulated by cryosurgery or combined cryosurgery and injection of pooled accessory tissue extract, and (ii) isoinjection of previously cannulated animals with accessory tissue extract. Primary antibody responses were less in animals castrated at the time of cannulation compared to those in noncastrated animals; but, paradoxically, subsequent challenges with tissue extract induced higher secondary antibody titers in castrated animals. These observations may be explained in castrates by (i) reduced uptake of antibodies--a result of the sparing effect on circulating antibodies in castrated animals because of accessory tissue atrophy, or (ii) increased production of antibodies through postcastration immune enhancement. In noncastrates secondary antibody depression may be related to (i) increased absorption of antibodies by an accessory gland complex which is much larger than that found in castrates, or (ii) tolerance, due to exposure of the antibody-producing system to excess accessory tissue antigen.


Prostatic fluid and tissue concentrations of ampicillin after administration of hetacillin ester (BL-P1761).

Ampicillin concentrations in prostatic fluid and tissue were studied in dogs after constant intravenous infusion of ampicillin (three dogs) and a lipid-soluble methoxymethyl ester of hetacillin, BL-P1761 (six dogs). Prostatic fluid ampicillin concentrations as determined by bioassay were found to be approximately 15 times higher after administration of hetacillin than after a similar amount of ampicillin. The prostatic fluid concentrations after hetacillin ester administration were approximately one-half of the simultaneous plasma concentrations. This hetacillin ester is thus the first penicillin compound shown to be penetrating the blood-prostatic fluid barrier, resulting in clinically relevant prostatic fluid concentrations.


Structure and function of the rabbit bladder altered by chronic obstruction or cystitis.

Decreased muscle contractility has been observed in association with intercellular collagen deposition after acute urinary obstruction. Chronically induced (2 months) bladder neck obstruction in rabbits produced similar marked changes in the ultrastructure of the bladder wall, with widening of the intercellular spaces and formation of collagen. Resting intravesical pressure was greater in animals with bladder neck obstruction than in the controls, yet response to stimulation was not impaired. Bacterial cystitis, in contrast, produced no consistent change in ultrastructure but the response of intravesical pressure to pelvic nerve stimulation was reduced. It is concluded that intercellular collagen deposition is not responsible per se for impaired conduction of nerve stimuli; perhaps discrete conduction pathways exist in the detrusor and the intercellular electrotonic spread of action potentials is not essential for contraction.


Effect of testosterone, dihydrotestosterone, estradiol, and prolactin on the weight and citric acid content of the lateral lobe of the rat prostate.

This study has been designed to investigate possible potentiation of testosterone and dihydrotestosterone by estradiol and prolactin in augmenting weight and citric acid content of the rat lateral prostate. Using these parameters, we hoped to indirectly assess the effect of estradiol and prolactin on 5alpha-reduction as it acts on the conversion of testosterone to dihydrotesterone. In the first part of the study, 87 castrate and 14 control rats were used to assess the effect of testosterone or dihydrotestosterone when supplemented with estradiol; in the second part of the study, 121 castrate-hypophysectomized rats separated into three groups according to age and stage of maturation were used to assess the effect of prolactin in supplementing testosterone and dihydrotestosterone. Estradiol appears to have a greater effect on 5alpha-reduction than does prolactin; however, other pathways of androgen metabolism are altered by these agents. These alternate pathways are discussed.


In vitro dog detrusor strip contractile responses and calcium ion activity.

In vitro detrusor strip experiments show that the presence of calcium ion is essential for spontaneous and bethanechol-induced detrusor contractile activity. 45Ca uptake experiments show that detrusor strips subjected to bethanechol show increased 45Ca uptake with significant decrease in total muscle strip calcium. There is a significant increase in the percentage of calcium exchange, suggesting that calcium efflux has exceeded influx. Kinetic analysis of 45Ca uptake by detrusor strips shows more 45Ca to reside in the slow component of strips following exposure to bethanechol. This suggests that calcium associated with bethanechol-induced contractile activity comes to occupy intracellular or more tightly bound membrane sites.


Cathechol-O-methyl transferase activity in the individual human platelet populations.

COMT activity is present in many animal tissues, but there is no evidence on the presence or the functional role of COMT activity in platelets. The present work reports the results obtained on COMT activity in the individual platelet populations separated by a discontinuous sucrose density gradient. In the young platelet populations the activity is remarkable higher than in the old and light populations. Low values of COMT activity in the old platelets may reflect platelet senescence.


Urea cycle enzymes in the liver of a dolphin Platanista indi.

Urea cycle enzymes are all shown to be active in dolphin liver. Acetylglutamate-independent cytoplasmic carbamylphosphate synthase is also present. Arginase is a basic protein, although less markedly basic than the dog enzyme. It is 118 per cent activated by heating at 50 degrees. Optimum pH is 10.5. Co++ and Ni++ inhibit the enzyme. AMP deaminase, glutamicoxaloacetic transaminase, glutamate dehydrogenase and ornithine transaminase are also active in dolphin liver.


DNA synthesis in isolated mitochondria: effect of thyroidectomy and of triiodothyronine administration in vivo.

The incorporation was studied of labelled deoxy-ribonucleosides triphosphates into acid-insoluble material by isolated liver mitochondria, obtained from either normal young male rats, or thyroidectomized at weaning, or thyroidectomized and then treated with triiodothyronine (T3). The incorporation extents in normal animals decreased with the age starting from the weaning until the 210th day. Thyroidectomy reduced the incorporation  extent to about 70% of the values observed in normal animals. During the T3 treatment of thyroidectomized rats a sharp increase of incorporation was observed one day after the first administration, followed by a decrease from the 1st to the 3rd day; successively the incorporation extent remained unchanged until the 12th day. Finally, evidence was provided that T3 doses used were thyreomimetic and definitely lower than the thyreotoxic ones.