A procedure for drug screening without the need to transport urines: use of ion exchange papers and hemagglutination inhibition.

A procedure was devised for screening for drug abuse in urine specimens by adsorbing the drugs onto papers loaded with ion-exchange resin. The drugs were then eluted from the papers into aqueous saline buffers, which were analyzed by hemagglutination inhibition with antisera specific for morphine, methadone, or barbiturates. The procedure combines the convenience of the ion-exchange papers with the precision and sensitivity of the immunoassay. The preliminary treatment consists of local treatment of urine specimens collected at many distant clinics with ion exchange papers that adsorb 50-65% of alkaloid drugs and 25% of barbiturates and can be shipped, after drying, in simple envelopes by regular mail to a central analytical laboratory for processing. At the central laboratory, portions of specimens are reconstituted in aqueous saline buffers, while drugs from other portions are extracted with solvents at appropriate pH. Drugs are detected in the reconstituted aqueous media by hemagglutination inhibition and spectrophotofluorimetry and confirmed in the solvent extracts by thin-layer chromatography. Recovery of labeled drugs after this treatment and urine screening data showed that the procedure is safe, convenient, and reliable in the case of opiate alkaloids, methadone, amphetamines, and phenothiazine tranquilizers but is less suitable for detection of barbiturates.


Geriatric primary hyperparathyroidism.

Primary hyperparathyroidism occurs in a significant number of patients over 60 years of age; about one-third of the 182 patients we studied were in this age group. Primary hyperparathyroidism has been recognized with greater frequency in recent years, particularly in patients without manifestations of renal lithiasis or osteitis fibrosa cystica and in older patients. Age alone is not critical in the occurrence of serious complications from hypercalcemia, the presence of other life-endangering disease, or the development of major postoperative complications in the management of primary hyperparathyroidism. A liberal but selective policy is advocated in advising operation for primary hyperparathyroidism in the elderly. Different clinical patterns of primary hyperparathyroidism are recognized in all age groups. The operative procedure for primary hyperparathyroidism is determined primarily by the surgeons at the time of operation, on the basis of gross characteristics of the parathyroid glands. A precise correlation is not found between microscopic changes, gross changes, and clinical features of primary hyperparathyroidism.


Systemic consequences of acid-base disorders.

It is apparent that disturbances in acid-base equilibrium, particularly in the direction of acidosis, interfere with the normal physiologic function of a number of organs. While the effect on each organ system may not be severe, and while adequate compensatory mechanisms may come into play, cummulative involvement of a number of organs, especially when the changes are acute or left untreated, may prove fatal.


Cluster headache.

Cluster headache is a relatively common form of vascular headache. Its characteristic clinical pattern should allow definitive diagnosis in the vast majority of cases. Extensive diagnostic evaluations are not indicated. Treatment is generally unsatisfactory but helpful in a number of cases. It has a limited natural history and is essentially a benign condition.


A brief program to upgrade the skills of community caregivers.

This paper describes a program to train community caregivers in mental health-related skills. The goal of the program was to enhance the participants' knowledge of family intervention techniques and to produce more favorable attitudes toward family intervention. A quasi-experimental design was used to evaluate the program and is described in detail.


Unique contributions of churches and clergy to community mental health.

Good principles and practices of community mental health have been demonstrated by religious communities and leaders within these communities for many years. Using Caplan's model of primary-secondary-tertiary prevention, this paper articulates the unique and cooperative contributions of present-day religious institutions and personnel to the total community mental health endeavor. The validity of church's and clergy's involvement is supported by research data and is consistent with the social-psychological models of conceptualizing emotional problems. Consultation from mental health professionals can aid churches and clergy to actualize even more fully their contributions to community mental health.


Planning the phasedown of mental hospitals.

With impending fiscal shortages limiting the growth of new community mental health services and the ability of mental hospitals to perform contemporary tasks remaining dubious, increased attention is being directed throughout the country to the role of state hospitals. Citizens and professionals in Massachusetts concluded that the needs of individuals now treated in mental hospitals are better met via community-based services as they become available than by services now provided in state hospitals. Consequently, public mental hospitals should be phased down over a 5-year period of time and their funds redeployed to community services. Among the factors affecting the success of this program shift are continuity of care for discharged patients, community acceptance of the mentally ill, and redeployment of personnel to community facilities.


Contracting in crisis intervention.

The use of contracts in the social services is an important area that needs to be looked at. This paper is concerned specifically with the use of contracts in one particular part of social services: crisis intervention. Contracts that define the working relationship between the client and mental health counselor can be beneficial for both when they attempt to solve the problems that contributed to the crisis situation. There are five benefits to be gained from the use of contracts in crisis intervention and they are briefly discussed.


Performance of psychiatric hospital discharges in strict and tolerant environments.

Community mental health professionals are greatly concerned with the type of social environment most conducive to helping patients remain outside psychiatric institutions and improving the quality of their lives in the community. This paper examines the tolerance of deviance characterizing significant others in the patients' environment as it relates to community tenure and selected measures of performance and quality of life of the older patient in the community. A possible role is suggested for differential tolerance of deviance in the lives of patients discharged from psychiatric hospitals. Although it would appear that patients may return to the hospital at a higher rate from low tolerance environments, it may be that for patients who remain in the community, the quality of life may be better in low tolerance environments in terms of social interaction and life satisfaction. The deviance model is of value in the continuing efforts to understand the role of the social environment in the community life of discharged patients.


The adjunct consumer group.

Little by little, the community is becoming aware of the Weber Mental Health Center and PAAG. A recent study shows that the community approach leads to high visibility; PAAG activities were known by 37% of 1,000 people recently interviewed. This compares to 5%, 7%, and 15% having knowledge of other more traditional medical centers in Utah. It is felt that this approach is an important part in putting the community mental health center in proper perspective in the community. It is felt that the adjunct consumer group provides almost infinite flexibility to meet human needs. As a result, the Northern Utah Unit of the State Hospital will remain closed, largely because PAAG is serving the community.


Family therapy research in applied community settings.

This paper discusses family therapy research in applied settings and highlights those methodological issues relevant to the program evaluator as compared to those relevant to the basic researcher. Four general methodological issues are discussed: design adequacy, issues related to dependent measures, situational factors, and issues of generalization and duration of treatments. Two specific, well-validated applications of family therapy are elaborated; and finally several conclusions are drawn regarding future research strategies.


The mental health center's role in school consultation: toward a new model.

The 1965 Boston Conference on the Education of Psychologists for Community Mental Health recommended a broad movement into the field of education and the development of the consultation function in an array of settings. The coordinator of that conference--at which the term "community psychology" was coined--presents a model for extending and redefining the traditional mental health--school consultation model. In this model consultation that is reaction to an existent problem by the clinical "expert" is integrated with a comprehensive model of collaboration that moves in the direction of systems change. The concept is presented through a case history of successful school--mental health center collaboration, a documentation of a full consultation service program to a large school system.


Criteria for appropriate and inappropriate referrals to a crisis clinic.

The purpose of this study was to develop criteria for appropriate and inappropriate referrals by telephone counselors to a crisis clinic. Interviews were conducted with staff members and volunteers of the Suicide Prevention and Crisis Service to explore possible criteria for making a referral. Nine criteria for inappropriate referrals and eight criteria for appropriate referrals were established. Data were then collected from a larger sample of staff members and volunteers (N=56) in the form of a ranked-order questionnaire, and differences between the staff and volunteers were examined. Rankings were significantly different for only 2 of the 17 categories suggesting that there is general agreement between staff and volunteers on the criteria for appropriate and inappropriate referrals for counseling. Policy implications of the accepted criteria are discussed.


Impact of a personnel workshop on the behavior of support employees toward new patients in a psychiatric outpatient clinic.

Thirty new patients in a psychiatric outpatient clinic rated the friendliness, interest, politeness, and informativeness of three functionally distinct groups of support employees. Following a personnel workshop, designed to increase the ability to relate to clients and the understanding of patient problems, ratings were obtained from 30 additional new patients. The overall ratings were favorable, both before and after the workshop, for all employee groups on all behavior variables. One employee group received higher ratings than the other two, and the staff members were perceived by the patients as more informative than congenial. The workshop resulted in increased amicability and decreased informativeness.


An analysis of contingencies in the Appalachian coalfields.

The history of the Appalachian coalfields points to the inescapable conclusion that affluence and deprivation alternate according to the demand for coal in the national economy. Although this process has frequently been described, it has never been adequately or comprehensively conceptualized. If, however, the region is viewed in terms of contingencies selecting responses, it is possible to regard the population as operating according to a variable-interval schedule. Implications of such a schedule and recommendations for redesigning the contingencies are made.


A real-time software system on the PDP-11 for two-channel EEG spectral analysis during surgery.

Three functions are performed in real time by a stand-alone PDP-11-assembly language program. First two channels of EEG data are acquired by quantization techniques; second spectral analysis of the EEG data is carried out; third the resulting spectra are displayed as time compressed spectral profiles on an X-Y plotter. The method provides EEG time trends during anesthesia, permitting evaluation of brain functions.


MUMPS--an economical and efficient time-sharing system for information management.

MUMPS, the Massachusetts General Hospital Utility MultiProgramming System, is a compact time-sharing system for information management. This paper discusses the historical development of MUMPS and describes the basic modules found in its implementation. Detailed descriptions of the time-sharing executive, MUMPS language interpreter, input/output file system, and global data base are given, emphasizing their integration into an easy-to-use yet powerful system for application program design, development and maintenance.


Finding condensed descriptions for multi-dimensional data.

We describe two programs that may be used to find condensed descriptions for data available in a contingency table or in a covariance matrix in the case that these data follow a multinomial or a multivariate normal distribution, respectively. The programs perform a stepwise model search among multiplicative models by computing appropirate likelihood-ratio test statistics.


A discriminant analysis for qualitative data with interactions.

Two linkable computer programs have been developed for a discriminant analysis with qualitative variables, which permit taking into account 1st order interactions. The first program is used to estimate the parameters required in the second program. The second program allows a classification of new cases as well as an unbaised estimation of error rates.


Respiratory response of intact Gallus domesticus to sinusoidally varying inhaled carbon dioxide.

Sinusoidal variations of CO2 were applied to anesthetized White Leghorn cockerels enclosed in a body plethysmograph. Waveforms were 2.5% mean plus 2.5% peak sine wave CO2 in air, at frequencies of 0.011 to 0.467 rad/s. Reflex variation in tidal volume and respiratory interval in response to the inputs of sinusoidally varying fractional content of inhaled CO2 for nine points within the above range of driving frequencies were recorded breath-by-breath. A least squares best-fit procedure was used to estimate mathematical input-output relationships (transfer functions) between the outputs, tidal volume (VT) and respiratory interval (1/f), and the single input, inspired CO2 fraction. For VT, a three time constant model most closely fitted the data. Two time constants, 80 s and 3.9 s, were associated with negligible delay; the third, 14 s, has a 0.35 s time delay. Dynamics of VT and interval reflex responses differed significantly suggesting that they are regulated by separate mechanisms.


Parametric sensitivity analysis of a homeomorphic model for saccadic and vergence eye movements.

A non-linear sixth order homeomorphic model, fitted with parameters based on eye movements and physiological data, was tuned so that it provided good simulations for the shapes of the magnitude, velocity and acceleration trajectories. Excellent quantitative agreement was obtained in terms of the Main Sequence diagrams for human eye movements. Parametric sensitivity analysis was done for a saccade of ten degree amplitude, a physiologically normal magnitude at which experimental data is both abundant and relatively noise free. Among the many useful results of this sensitivity analysis are that pulse width (PW) and pulse height (PH) were confirmed as the two controlling parameters for the human eye movement model. Output behavior was relatively insensitive to variations of the passive elements of the plant. This analysis also pointed out that more physiological data are needed to understand the role of the non-linear force-velocity relationship of the extraocular muscles.


Interactive editing of biomedical data.

Editing options of an interactive graphical-biometry statistical system are described. A method for screening using a highly reduced data file is illustrated. By utilizing properties of sample Fourier coefficients, the problem of component overlap can be resolved. This, in turn, tends to free edited statistical information from the contamination or truncation inherent in the usual screening process.


Digital simulation of the membrane voltages and currents in nerve and muscle fibers.

This paper describes digital computer simulations of the membrane voltages and currents in axons and muscle fibers. The simulations, which allow calculations ona nonuniform fiber, are based on the discrete Hodgkin-Huxley and Falk-Fatt equations. An efficient algorithm is used to solve the set of equations generated. Calculations are made of the voltage and current at the natural end of a muscle fiber and the results are compared with measurements by other investigators.


Instability in a hippocampal neural network.

Four computer models, HM1-HM4, of a particular hippocampal neural network have been developed. The models represent two cell populations, the pyramidal cells and the basket cells; the populations are coupled so that pyramidal cells are inhibited by activity they excite in the basket cell population. In models HM2-HM4, this recurrent inhibitory pathway contains a temporal dispersion element. Models HM3-HM4 place the pyramidal cells in an additional recurrent excitatory feedback loop. HM4 represents a pair of interacting hippocampal networks. Simulated network responses to single-shock stimulation are presented for various parameter values of the four models. Calculations are extended more than one second following stimulation. Particular attention is given to simulation of network instabilities. Simulated neural activity is discussed in view of experimental work on normal (nonepileptogenic) and epileptogenic hippocampal cortex.


The geometry of the Hodgkin-Huxley Model.

The Hodgkin-Huxley model for the "space-clamped" (i.e., having variables independent of position) squid giant axon is described by a system of four coupled nonlinear ordinary differential equations. In this study, the behavior under various conditions of the solution vector of these equations is predicted qualitatively. This is done by studying the geometry of the phase space of an approximation to the four dimensional system obtained by assuming that the two "rapid" components of the system, V and m, are described by algebraic rather than differential equations. Using this method, known properties of the solution of the Hodgkin-Huxley equation, such as threshold, repeated oscillation under constant current stimulus, etc., are explained qualitatively. The direct relation between the Hodgkin-Huxley equations and simpler systems such as the Fitz Hugh equations, which have been used as an aid to the understanding of the Hodgkin-Huxley model, is examined. The roles of the various activation and inactivation components of the Hodgkin-Huxley model are clarified and the effect of modification of those components is studied.


Comparison of electrical activity and behavioral correlates of neural networks in the cat and locust.

Extensive experimental data are available on the neural activity and behavioral correlates of specific networks in the locust and in the cat and rabbit. Two networks were selected for comparison, one involving visual movement detector interneurons in the locust and the second a hippocampal network in mammals. Both networks receive inputs correlated with motor activity. Each network was simulated using CSMP, a Continuous Systems Modeling program developed initially by IBM. Signals along the two simulated networks were calculated when similar inputs were applied. In addition, approaches toward relating behavior to neural activity were compared in the two networks.


Persistent cecal dilatation in a lactating dairy cow.

Cecal dilatation in cattle is usually manifested by a syndrome of intestinal obstruction requiring surgical intervention. A patient is presented persistent dilatation of the cecum for ten months without evidence of impaired appetite or milk production. The initial clinical signs, progress of the case, and laboratory data are described.


Preliminary investigation of the life history of Filaroides hirthi Georgi and Anderson, 1975.

Filaroides hirthi lungworm infection increased as a function of age among 47, 9 to 32 week old Beagle pups at a commercial breeding establishment. Probit analysis of these data yielded an estimate of 50% infection was by age 17.4 +/- 3.7 weeks. This parasite and/or its associated lesions remained in at least 40% of infected Beagles at least 10 months after exposure to infection had ceased. Reinfection rendered improbable by the nature of the new environment, a laboratory animal colony. Repeated efforts have failed to demonstrate by the Baermann technique eggs or larvae of this parasite in the feces, bronchial mucus, or intact lung tissue of infected Beagles. All efforts to identify an intermediate or alternate definitive hosts have likewise proved unavailing. Piperazines, dichlorvos, thiabendazole, dithiazanine iodide, and levamisole appear to be without effect on the proportion of Beagles infected. The diet, which contained uncooked meat, was fed in a controlled experiment to 10 Beagles from an uninfected source without producing a single case of F. hirthi infection. Life cycles of other members of the superfamily Metastrongyloidea and possible explanations for the non-patency of F. hirthi infection are discussed.


Analysis of the microfilarial periodicity of Dirofilaria immitis.

Microfilarial periodicity displayed by dogs infected with Dirofilaria immitis was analyzed using the methematical model proposed by Sasa and Tanaka (S.E. Asian J. Trop. Med. and Pub. Health 4, 1974, 518-536) except that Pearson's product-moment correlation test was substituted for their Chi-square analysis to estimate goodness of fit. Samples were drawn at 3 hour intervals for periods of 24 or 48 hours in a series of 10 studies conducted on 4 dogs. No significant differences were observed in microfilarial concentration between samples of venous and cutaneous capillary blood. Significant correlation of observed microfilarial densities with the values predicted by the model were observed in 7 of the 10 studies with r2 values ranging from 78.8 to 95.3%. The periodicity index ranged from 28.33 to 53.50 in these 7 studies and thus fell in the subperiodic category. The estimated hour of peak microfilarial density was not confined to the late afternoon as generally believed; for example, values of 04:00 and 22:00 hours were observed. Thus D. immitis microfilaremia cannot accurately be characterized either as diurnal or as nocturnal. Observation of the behavior of the experimental dogs led to an hypothesis that emotional and environmental stresses placed on the host may induce transients in the microfilarial density that may overwhelm or obscure the periodicity function.


A serological and bacteriological survey of canine brucellosis in Mexico.

Using agglutination procedures, 203 human and 500 dog sera collected in Mexico City were tested for canine brucellosis. Blood samples from the 500 dogs also were cultured for Brucella canis (B. canis). Positive agglutination titers (1:100 or greater) were found in 27 (13.3%) of the human and 140 (28.0%) of the dog sera tested. B. canis was isolated from the blood of eight dogs. The disease was experimentally produced in susceptible dogs by inoculation with one of the isolated strains.


Diaphragmatic hernia in horses.

The clinical and necropsy findings of three cases of diaphragmatic hernia admitted to Ontario Veterinary College between September 1973 and August 1974 are described. The physical signs of these and other reported cases are discussed, as are methods of diagnosis. Definitive diagnosis is best arrived at by exploratory laparotomy.


Yeasts in bovine semen.

A total of 129 semen samples from 62 bulls were examined for the presence of mycelial yeasts. Nine species of mycelial yeasts were obtained from the semen; Candida parapsilosis and C. tropicalis were the most frequently isolated organisms. Semen samples from 30 of the bulls had mycelial yeasts present.


Cuterebra encephalitis in a dog.

Encephalitis was diagnosed in a 3 1/2-month-old puppy, based on neurological signs, and cerebrospinal fluid examinations. Verminous encephalitis from a migrating Cuterebra sp. larva in the right cerebral hemisphere was confirmed at necropsy.


28Mg kinetics in ewes fed normal or tetany prone grass.

Balance studies and a kinetic evaluation of magnesium metabolism with 28Mg were performed on 6 non pregnant ewes, fed first a young normal dried grass, then frozen tetany prone grass. After changing to the tetany prone grass, there was a small drop in blood Mg and a significant urinary decrease of Mg. Mg balance and endogenous fecal excretion were not significantly modified. Total output of Mg from the pool was reduced. The release of Mg from slow exchanging tissues was very low in tetany prone grass fed ewes. The results suggest that hypomagnesemia in ewes fed tetany prone grass could possibly be related to a shift of body magnesium from blood to some other tissue.


A comparison of aphasic and non-brain-injured adults on a dichotic CV-syllable listening task.

A dichotic CV-syllable listening task was administered to a group of eleven non-brain-injured adults and to a group of eleven adult aphasics. The results of this study may be summarized as follows: 1)The group of non-brain-injured adults showed a slight right ear advantage for dichotically presented CV-syllables. 2)In comparison with the control group the asphasic group showed a bilateral deficit in response to the dichotic CV-syllables, superimposed on a non-significant right ear advantage. 3) The asphasic group demonstrated a great deal of intersubject variability on the dichotic task with six aphasics showing a right ear preference for the stimuli. The non-brain-injured subjects performed more homogeneously on the task. 4) The two subgroups of aphasics, a right ear advantage group and a left ear advantage group, performed significantly different on the dichotic listening task. 5) Single correct data analysis proved valuable by deleting accuracy of report for an examination of trials in which there was true competition for the single left hemispheric speech processor. These results were analyzed in terms of a functional model of auditory processing. In view of this model, the bilateral deficit in dichotic performance of the asphasic group was accounted for by the presence of a lesion within the dominant left hemisphere, where the speech signals from both ears converge for final processing. The right ear advantage shown by one asphasic subgroup was explained by a lesion interfering with the corpus callosal pathways from the left hemisphere; the left ear advantage observed within the other subgroup was explained by a lesion in the area of the auditory processor of the left hemisphere.


Aphasics' sentence repetition behavior as a funciton of grammaticality.

Twenty asphasics repeated grammatical and ungrammatical sentences. Ungrammatical sentences were characterized by violations of syntactic and/or semantic structure. Aphasics repeated accurately more grammatical than ungrammatical sentences. Ungrammatical sentences with violations of syntactic structure were repeated less accurately than those with preserved syntax. Aphasics' repetition errors were classified as: incorrect repetition, inapropriate correction, morphological error, lexical deletion and substitution responses. Repetition errors appeared to result from performance deficits, such as reduced retention span and physiological limitations of the speech musculature. Results suggest that asphasics are to some extent guided by a greater residual linguistic knowledge or competence than might be inferred from their spontaneous production.


Personality factors in jargon aphasia.

The personality background of 20 patients with jargon aphasia was compared to that of a standard aphasia group with particular reference to features of the so called anosognosic personality; denial or marked overt fear of illness and strong work orientation. Such attitudes toward illness were found in 19 of 20 jargon subjects, and seven of the comparison group. Nineteen of the jargon patients and eleven of the non-jargon asphasics were described as highly work oriented. The premorbid personality was also significantly related to the type of denial of the speech deficit, and to related aspects of behavior. Patients with strong premorbid denial explicitly and completely denied their asphasic deficits, and were affable, bland or unconcerned. Patients with a history of overt fear of illness had implicit or mixed forms of denial, and showed disturbed, agitated, paranoid and often psychotic behavior. The type of denial is thus related not only to premorbid personality, but to observable behavior in hospital. The observations are regarded as providing additional evidence for the view that jargon may be regarded as "anosognosic aphasia," and represents not only a linguistic deficit, but an adaptation to the deficit.


The "tip-of-the-tongue" phenomenon in aphasia.

Forty-two male aphasics, classified as Broc's, Wernicke's, anomic, and conduction, were examined for their ability to partially retrieve acoustic features of words they could not provide in a confrontation naming task (the "tip-of-the-tongue" phenomenon). The results indicated that conduction aphasics were superior to Wernicke's and anomic asphasics in their ability to identify both the first letter and the syllabic length of the words they could not name. Since the aphasic groups were comparable in their naming difficulty, the findings could not be attributed to degree of wordfinding impairment. The difference between groups that were obtained using the TOT technique are discussed with regard to differences in the word finding process.


[A case of bilateral lesions in the temporal convexity: attempt to define symptoms].

The case is reported of a boy aged 15 who suffered a bilateral lesion of the temporal convexity after a brain traumatism; he died 5 years later and the symptoms during that period are described. The clinical picture is adequately described neither under the title of dementia, nor under that of aphasia. The concept of an abolition involving the systems of cultural mediation (linguistic, technical) is introduced. The status of echolalia and echo-praxia is discussed.


Short-term recognition memory in relation to severity of head injury.

Short-term recognition memory for random shapes was studied in 24 patients with head injury. The severity of head injury as indexed by duration of coma was closely related to impairment in performance. Disruption of short-term recognition memory was associated with neurologic deficit, asphasic disturbance, and signs of brain stem involvement. Performance was not related to association value of the shapes irrespective of linguistic competence. The findings are discussed in relation to recent studies of continuous recognition memory after head injury and hypotheses concerning neurological dysfunction in head injury.


The coin lesion story: update 1976. Twenty years' experience with thoracotomy for 179 suspected malignant coin lesions.

We reviewed 179 patients who had undergone thoracotomy and resection of a suspected malignant coin lesion of the lung over the past 20 years to see if a policy of early thoracotomy was therapeutically valid. The average diameter of all lesions was 1.6 cm; the average diameter of 27 malignant lesions (15 percent) was 1.8 cm. Follow-up of the 27 patients with malignant neoplasms was 100 percent. The present survival rate of the 19 patients with primary lung cancer is 89 percent (17/19). Of 12 cases of primary lung cancer followed for five years, ten (83 percent) survived. The five-year survival of the eight patients with metastatic lesions was 25 percent (2/8). There were no postoperative deaths and few serious postoperative complications (four patients or 2 percent). Very small primary lung cancers detected and treated early do have the same poor prognosis as larger primary cancers.


Clavicular Auscultation. Preferential clavicular transmission and amplification of aortic valve murmurs.

Clavicular transmission of aortic valve murmurs was investigated in 15 consecutive patients. In all patients, transmission to the clavicle of aortic systolic murmurs was detected both by auscultation and by phonocardiographic studies. Of seven patients with aortic diastolic murmurs, auscultation revealed clavicular transmission in six, but only four were recordable. There was increased murmur amplitude over the clavicle in 13 out of 15 cases. In contrast, murmurs were attenuated over the subclavian artery in eight out of nine and over the carotid artery in nine out of 11 patients. We conclude that clavicular auscultation regularly discloses aortic valve murmurs. The aortic systolic murmurs are consistently propagated to the clavicle, where they are usually conspicuously amplified. Aortic systolic murmurs are less frequently transmitted to the carotid and subclavian arteries, where they are usually considerably attenuated. Clavicular auscultation appears to be more rewarding than the traditional search for transmission of aortic murmurs to the carotid artery.


A test of the practical value of estimating breath sound intensity. Breath sounds related to measured ventilatory function.

Each of four examiners performed standardized physical examinations on a group of patients who had just undergone tests of ventilatory function. The intensity of breath sounds heard with deep inspiration was graded on a rating scale of 0 to 4; the grades in six areas of the chest were added to give a total score, with possible values ranging from 0 to 24. Correlation of breath-sound scores with percentage of predicted forced expiratory volume in one second (FEV1) was significant at the 1 percent level for all of the examiners. Differences between the examiners in their assessment of breath sounds were not statistically significant. Grading the loudness of breath sounds was a poor screening test for mild ventilatory abnormality, but normal breath sounds nearly excluded the possibility of severe reduction in the FEV1. Definitely reduced breath-sound intensity was strong evidence for the presence of obstructive pulmonary disease.


The prognosis of sarcoidosis in children.

Of 28 children with sarcoidosis, who have a mean follow-up period of approximately nine years, five (18 percent) have sustained severe damage from the disease. Two of these patients suffer from blindness, and three others have severe restrictive pulmonary disease. There has so far been no fatality. The presence of cutaneous lesions suggests a guarded prognosis, but the effectiveness of corticosteroid therapy cannot be accurately determined. The degree of pulmonary involvement evident on the chest x-ray film at the time of diagnosis is not always indicative of the ultimate prognosis.


Echocardiographic diagnosis of double-outlet right ventricle.

An echocardiographic technique (V scan) for confirming the diagnosis of double-outlet right ventricle is described. The technique demonstrates a frequent pathologic feature of double-outlet right ventricle, ie, origin in both great arteries side by side and anterior to the ventricular septum. The V scan offers greater diagnostic accuracy than the mere demonstration of mitral-semilunar valvular discontinuity.


Value of serial apexcardiograms during and after myocardial infarction.

Apexcardiograms were systematically recorded serially in 40 patients after acute myocardial infarction, in an additional 21 patients with proven aneurysms, and in 18 patients with good ventricular performance following myocardial infarction. Abnormalities of the "A" wave and systolic waves of the apexcardiogram correlated well with akinesia or dyskinesia proven by cinefluoroscopic and cineangiographic studies. Third and fourth heart sounds and apical systolic murmurs also correlated well with evidence of ventricular dysfunction. This study indicates that the apexcardiogram is a good qualitative tool for serially assessing patients following acute myocardial infarction and that the results on invasive study may be predicted in most patients.


Multiple lesions of the conduction system in a case of cardiac rhabdomyosarcoma with complex arrhythmias. An anatomic and clinical study.

Anatomic and electrocardiographic correlations in a case of primary cardiac rhabdomyosarcoma are examined. Interatrial and atrioventricular conduction disturbances were associated with multiple lesions involving the alleged internodal pathways, together with atrial-atrioventricular nodal connections. The clinicopathologic findings seem to be consistent with the hypotheses of the functional and morphologic value of Bachmann's fascicle, and of the inherent pathways of interatrial and internodal conduction in health and disease.


Limited form of Wegener's granulomatosis.

A 40-year-old man had a pathologically proved limited form of Wegener's granulomatosis complicating recurrent and massive hemoptysis from his cavitary pulmonary lesion. Of significant interest and clinical importance is the unusual location of the patient's pulmonary lesion, occurring in the posterior segment of the right upper lobe. This experience demonstrates that the location of the pulmonary nodule is not necessarily useful in distinguishing Wegener's granulomatosis from infectious granulomatosis, particularly tuberculosis.


Pulmonary botryomycoma.

A patient with a mobile mass of anaerobic organisms in the pulmonary parenchyma is presented. Radiographically it resembled a fungous ball. This observed botryomycoma may be part of the spectrum of aspiration pneumonia.


Recurrent ventricular tachycardia due to reentry within the bundle branches.

A case of recurrent ventricular paroxysmal tachycardia in a young man without obvious heart disease is described. Posttachycardiac T-wave inversion followed the arrhythmic episodes. Programmed stimulation of the heart in association with intracardiac recordings showed evidence in favor of reentry within the bundle branches and its divisions during tachycardia. A critical prolongation of the H2-V3 interval preceded each paroxysm of tachycardia.


Modified exclusion technique for complicated esophageal perforation.

A case of complicated spontaneous esophageal perforation is presented. The control of gastroesophageal reflux by esophageal banding appears to be a crucial factor in healing. Using a modified esophageal exclusion technique without sacrifice of the esophagus proves to be both effective and lifesaving.


Prophylactic irradiation of the lung in Ewing's sarcoma.

A patient with Ewing's sarcoma of the left scapula received prophylactic radiotherapy to the left lung following wide excision of the tumor. While the left lung remained free of tumor, there was metastatic invasion of the right lung within ten months of the initial diagnosis of the disease. Since Ewing's sarcoma frequently metastasizes to the lungs, it is suggested that prophylactic irradiation of the lung may be of value in the prevention of metastases.


Pulmonary varices. Report of two cases and review of the literature.

Two cases of pulmonary varices are presented. The lesion is rare, and only 32 cases have been reported in the literature. Although the lesion is benign in nature, complications are possible, and death has occurred from rupture of the varix intrapleurally or into the bronchial tree.


Striking electrocardiographic changes associated with pheochromocytoma. Masquerading as ischemic heart disease.

A patient with pheochromocytoma presented striking electrocardiographic changes mimicking ischemic heart disease at one time and acute pulmonary embolism at other times. Diffuse left ventricular hypokinesia was demonstrated in the presence of normal coronary arteries. Following removal of the pheochromocytoma, the electrocardiographic abnormalities disappeared.


Echocardiographic diagnosis of thrombus on a heterograft aortic valve in the mitral position.

Echocardiographic studies were used to diagnose a thrombus adherent to the ventricular surface of a stent-mounted porcine aortic heterograft valve in the mitral position. Multiple, intense, irregularly thickened echoes were present within and behind the anterior and posterior heterograft valvular stent. This suggested the presence of adherent biologic material, such as a thrombus. The abnormal echocardiographic findings are compared to the findings in a normally functioning porcine heterograft aortic valve in the mitral position.


Sudden disappearance of electrocardiographic pattern of anteroseptal myocardial infarction. Result of superimposed acute posterior myocardial infarction.

In a 76-year-old man an electrocardiographic pattern of acute anteroseptal myocardial infarction disappeared suudenly. At necropsy, a more recent posterior myocardial infarct was found, in addition to an acute anteroseptal infarct. "Normalization" of the electrocardiogram from the pattern of anteroseptal myocardial infarction in this case resulted from the loss of opposing electromotive forces in the posterior wall because of posterior infarction.


Influence of immunosuppression on the action of antimycobacterial drugs in experimental tuberculosis. I. Effects of isoniazid, rifampicin and streptomycin on the survival of tuberculous mice immunosuppressed by azathioprine (Imuran).

The influence of the host immunosuppression on antimycobacterial effects of isoniazid, rifampicin or streptomycin was studied on animal models. Differences in survival rates of mice influenced or uninfluenced by azathioprine (Imuran) and exposed to six applications of antituberculous drugs (given once a day in the monotherapy) were statistically evaluated. The dose-dependent antimycobacterial effects of rifampicin or isoniazid were not significantly altered by the immunosuppression of the host. In contrary to that definite dose-dependent effect of streptomycin, observed in azathioprine-uninfluenced mice, cannot be confirmed in immunosuppressed mice in which no effect of streptomycin on the survival of tuberculous mice could be estimated.


Treatment of human leptospira infections with semicillin (ampicillin) or with amoxil (amoxycillin).

Ampicillin (Semicillin) and Amoxycillin (Amoxil) have a strong leptospirocidal effect in vitro and also in vivo. We have tested these drugs on 28 patients suffering from Leptospira infection. The patients generally received per os 3 g Ampicillin (Semicillin) or 2 g Amoxycillin (Amoxil) per day over a period of 6 days. In the groups treated with Ampicillin and Amoxycillin the average durations of fever during the treatment were 1.6 and 1.2 days, respectively. In the first group (Ampicillin) a 'second wave of fever' occurred in one case (5%) and in the second group (Amoxycillin), in 0% (as compared to 22% after treatment with benzylpenicillin). On the basis of our experiences, Ampicillin and Amoxycillin are strongly recommended for the treatment of human Leptospira infections.


Distribution of sulfonamides and sulfonamide potentiators between red blood cells, proteins and aqueous phases of the blood of different species.

The uptake of sulfonamides and sulfonamide potentiators by plasma albumin, red blood cells and hemoglobin of man, ox, rabbit and mouse has been determined. From the figures obtained the distribution of these compounds between cells, macromolecules and aqueous phases of blood has been calculated. In most cases more than 50% of a total sulfonamide in blood is bound to plasma albumin. The time necessary for establishment of concentration equilibrium of the drugs investigated between erythrocytes and surrounding medium varies between a few seconds and several minutes, differences between the species being encountered. Hemoglobin binding of the drugs is much smaller than albumin binding. Nevertheless, drug concentration within the erythrocytes is generally higher than in the surrounding medium.


Diagnostic evaluation of the juvenile offender: toward the clarification of often overlooked psychopathology.

On the basis of previously reported findings that a high percentage of court-referred children suffered from serious psychopathology other than sociopathy, attention is called to some essential, though often overlooked, elements of diagnostic evaluation of delinquents. Emphasis is on a meticulous history, including careful attention to the significances of family histories of serious psychiatric and/or neurological disorders. The importance of a detailed perinatal and medical history, with emphasis on determining a possible history of significant insult to the central nervous system, is stressed. A systematic mental status evaluation is strongly recommended. Techniques for assessing the existence of significant hallucinatory and delusional experiences in children are suggested. The uses of psychological and neurological evaluations to augment the psychiatric are discussed. The poor social situation from which many delinquents come as well as the obvious intrafamilial psychodynamic factors influencing delinquent behavior are recognized as frequent impediments to the search for less obvious psychotic and/or organic vulnerabilities in the juvenile offender. Case histories of several children who had previously been dismissed as merely sociopathic, illustrate the thesis of the paper.


The psychological reactions of children with neurological problems.

The diagnosis of a neurological disorder can be confusing and frightening to a child, particularly if he is not given a reasonable explanation for his symptoms and the medical procedures that have to be carried out. If such children experience seizures, they frequently identify them with the possibility of death, and they become overly concerned about bodily functioning. A loss of self-esteem often results, particularly if there are school problems. Reactions are varied: some children become extremely cautious in their activities to avoid further seizures; some seem to "defy death" by placing themselves in dangerous situations; some misinterpret fairly benign events in terms of their misconceptions about themselves. Much distress can be avoided by providing adequate information both to the parents and the child and by giving them adequate opportunity to ask questions and ventilate their feelings, perhaps with a therapist, in this time of crisis.


The multiproblem family presents in a children's outpatient psychiatric clinic.

This study focuses on children from multiproblem families when they appear at an outpatient psychiatric clinic for children. The sample consisted of the first 50 children and their families referred to a large children's outpatient psychiatric facility early in 1974. A multiproblem family was defined in terms of the number of helping agencies and/or professionals contacted by family members within the 3-year period prior to the current psychiatric evaluation and by the number of households in which the designated child patient had lived. Eighteen percent of the 50 cases met the criteria established for a multiproblem family. These indicators successfully differentiated multiproblem from nonmultiproblem families along a number of socioeconomic, demographic, family health, and family stability dimensions. Special difficulties encountered in psychiatrically evaluating children of such multiproblem families are presented, and ways of dealing with them are discussed.


Parenting for foster parents.

A parenting course for foster parents was described with a follow-up evaluation utilized to determine its effectiveness. The content of this broad-based course included learning theory, principles and techniques, communication skills, methods of conflict resolution, developmental considerations, and information about community services. Results of the evaluation suggested that most of the participants had found the course helpful and were using the knowledge acquired.


Learning of imitate in infancy.

Theories of imitation learning are examined regarding their account of how the infant acquires the ability to emit a response which resembles a response previously exhibited by another. Each theory suffers from 1 or more of the following problems: logical inconsistency, incompleteness, and lack of empirical support. 3 of the views (associative thesis, discriminative learning thesis, and acquired value of the relational stimulus of similarity) are not mutually exclusive, and, therefore, they could be included in a theory of learning to imitate. However, none of these learning theses deals with the fact that imitation requires the infant to consistently abstract similar features from stimuli which differ on various dimensions. Hence, consideration is given to the role of cognition in a theory of learning to imitate.


Rate of habituation and visual memory in infants.

This study investigated 17-week-old infants' response to discrepancy as a function of rate of habituation. 36 subjects were repeatedly shown a pattern containing 4 geometric shapes until they reached a proportional criterion of habituation: each infant's fixation time had to decrease by at least 50%. On the basis of 2 nonoverlapping distributions of trials to criterion, fast and slow habituators were identified. Recovery of fixation time was found for both fast and slow habituators when a discrepant stimulus was presented following habituation. These data were interpreted as reflecting developmental differences in encoding. After several interpolated trials with the new pattern, the infants' response to the original habituation stimulus increased, suggesting that the interpolated trials had interfered with their memory for the habituation stimulus.


Infant attention to auditory discrepancy.

Groups of 7 1/2-month-old infants heard 1 of 8 episodes consisting of no, slight, moderate, or a large discrepancy between a habituated standard and a transformed auditory stimulus. The patterns of cardiac deceleration, regarded as an index of attention supported the hypothesis that attentiveness is an inverted-U function of the degree of discrepancy between stimulus event and schema.


A preliminary study of some ecological correlates of child abuse: the impact of socioeconomic stress on mothers.

The ecological correlates of child abuse and maltreatment are explored. A model which focuses on the degree to which mothers are given support for the parent function is considered. This model, based on studies by Gil (1970) and Bronfenbrenner's (1974c) analysis of "support systems for parents", is examined empirically. Data on rates of child abuse/maltreatment for counties in New York State - based on reports made pursuant to a new, more stringent 1973 reporting law - are examined in light of indices of socioeconomic and demographic characteristics of the 58 counties under study. The data suggest that the degree to which mothers in a particular county are subjects to socioeconomic stress without adequate support systems accounts for a substantial proportion (36%) of the variance in rates of child abuse/maltreatment across New York counties, while economic conditions more generally affecting the family account for 16% of the variance. Application of them empirical model (based on the stepwise multiple regression analysis) to 2 additional samples of child abuse/maltreatment reports (1974) in New York State counties yields results consistent with the initial sample from which the multiple regression equation was drawn.


Spectrum analysis of the cry sounds of well-nourished and malnourished infants.

The cry sounds of 12 well-nourished and 12 malnourished male infants were compared using behavioral and acoustic measures. The cry of the malnourished infant had an initial longer sound, higher pitch, lower amplitude, more arrhythmia, and a longer latency to the next cry sound than the cry of the well-nourished infant. The similarity betweenthe cry of the malnourished infant and the cry of the brain-damaged infant suggested tha malnutrition may affect the regulatory function of the central nervous system. This hypothesis was supported by additional findings which showed that the abnormal cry patterns in the malnourished infants were associated with a low-level orienting response to a pure tone stimulus as measured by the magnitude of heart-rate deceleration.


Short-term memory and equivalence judgments in normal and retarded readers.

Matched groups of normal and disabled readers were required to perform same/different judgments in which the interval between standard and comparison stimuli was either 0, 1, or 6 sec. Standard and comparison stimuli were either the same, different in element order, or different in actual elements present. Retarded readers performed as well as controls on same tasks in all 3 delay conditions. Difference tasks discriminated retarded readers on 1- and 6-sec conditions, but not on 0-sec conditions. Differences in order and gross element distinguished retarded from adequate readers equally well. The results are interpreted to indicate a deficit in short-term memory in retarded readers, but only for tasks requiring a difference judgment.


Peripheral vision in children and adults.

Threshold luminance necessary to evoke an eye movement was evaluated as a function of age (6-21 years) and visual angle (6 degrees-42 degrees from the fovea). Results were comparable to those of static perimetry in older subjects but showed little narrowing of the visual field in younger children.


A critique of "obstetrical pain-relieving drugs as predictors of infant behavior variability".

Aleksandrowicz and Aleksandrowicz (1974) concluded that "the use of obstetrical drugs is related to a considerable degree, to infantile behavior over the first month of life" (p. 944). Questions are raised about the adequacy of a number of their procedures. These questions are serious enough to disturb the foundation for any conclusions.


The adjustment of reaching behavior to object distance in early infancy.

The prehensile activity and looking behavior of 2- and 5-month-old infants were videotaped in the presence of objects placed within and beyond possible contact distance. There was only a consistent adjustment of reaching behavior to stimulus distance in the case of the 5-month-old group. The distance discrimination evident in the prehensile activity of the older infants was paralleled by a reduction in the amount of attention paid to far objects.


The effects of training specific mnemonics on the metamnemonic efficiency of retarded children.

The effects of training specific mnemonic skills on recall readiness were evaluated in 2 groups (MA 6, MA 8) of educable retarded children. Equal numbers of S at each age were instructed in an anticipation, rehearsal, or label strategy. On the first posttest (prompted), label training did not affect performance, but anticipation and rehearsal training facilitated recall readiness estimation for both younger and older children. However, on 2 subsequent posttests (unprompted, 2 days and 2 weeks after training), the younger S returned to their pretraining competency, while the older group maintained high performance. Consideration of observational data suggested that overt activity related to the trained mnemonic correlated with recall readiness efficiency for the older but not the younger group. Even though younger children produced the strategy, the failed to monitor its effectiveness. The implications of training specific mnemonic skills are discussed in relation to developing metamnemonic efficiency.


Children's recognition memory for written sentences: a comparison of good poor readers.

In 18 pairs of fifth-grade males matched on sex, CA, and IQ, 1 was a good reader and 1 a poor reader. Each child read 8 3-sentence acquisition stories, subsequently performed a card-sorting task, and finally a recognition test consisting of 40 sentences which either were in the acquisition set or were 1 of 5 kinds of transformation. Retention was better for semantic aspects of the stories, but retention of tense was poor. Good readers mad fewer recognition errors than poor readers on new sentences which were true inferences from the acquisition list and on tests for retention of tense and number.


[Modification of the oxygen supply of the small intestine demonstrated on the ileus model].

Elevation of the intraluminar pressure of rabbit ileum lowers the oxygen supply of the bowel wall in a pressure dependent manner. After decompression local PO2 exceeds the initial values. The infusion of Rheomacrodex-Sorbit induces an increase of local PO2 in the nondistended ileum. The reaction is enhanced in the distended bowel. The application of glucagon does not influence tissue PO2 significantly in either the distended or the undistended bowel. The infusion of Rheomacrodex-Sorbit as well as decompression of the distended bowel are recommended to improve oxygen supply of bowel wall in ileus.


[Treatment of pathologic fractures].

Eight pathologic fractures of benign and 52 of malignant origin are reported. Open reduction and rigid internal fixation should be performed to give the patient the use of his affected limb as soon as this can be accomplished. Treatment consists of internal fixation in lesions of the shaft and prosthetic replacement in the case of lesions near joints. Only very rarely a primary amputation must be performed. Malignant fractures are most frequently caused by metastases from breast cancers. The treatment will at least make nursing easier, and three-quarters of these patients can be mobilized. The combination of surgical treatment and radiotherapy is discussed. In spite of this approach the average time of survival of 14 months is short because a pathological fracture due to a malignant tumor is a late symptom of the disease.


[Agastric dystrophy after gastrectomy].

A follow-up of 9 patients was performed 5-11 years subsequent to total gastrectomy. Biochemical findings were normal. Compared to a normal control group vitamin A absorption indicative of fat assimilation was unaltered. Subjects regained preoperative weight and presented no signs of malnutrition. Eight patients suffered seriously from reflux. Five patients showed dumping symptoms. Endoscopic specimens from jejunal mucosa were found to be normal. It seems that postoperative complaints described above may be prevented by reasonable operative measures.


[Primary retroperitoneal tumors. Symptoms-diagnosis--therapy].

Symptoms, diagnosis, and therapy of primary retroperitoneal tumors are presented with reference to 50 of the authors' cases. Seventy to 80% of the tumors are malignant; the most frequent are sarcomas. Males and females are equally afflicted; most cases are found within the 50-60 yearage range. First symptom is generally the palpable abdominal tumor. The diagnostic procedure of choic ist i.v. urography as well as selective angiograpms. At the time of diagnosis only 30-40% of tumors can be resected. Postoperative mortality ist about 10%. Seventy percent of tumors are radiosensitive. Prognosis can be considerably improved by postoperative radiation. Survival times of more than 2 years in patients presenting with malignant primary retroperitoneal tumors are exceptional.


[Cartilaginous tumors of the skeleton].

Chondrogenic tumors of the skeleton are divided into 6 separate groups: 1. chondroblastomas 2. chondromyxoidfibromas, 3. osteochondromas (cartilaginous exostoses), 4. enchondromas, 5. periostal chondromas, and 6. chondrosarcomas. The presentation of the different types of tumors demonstrates the pathogenesis, pathology, clinical findings, treatment, and prognosis. States of tumors before and after operative treatment are illustrated.


[Cultivation of the epithelium in burns].

Comparison of two groups of burned patients shows that patients who were treated by wound solution stayed a significantly shorter time in hospital. The group with healing under the scab (PQB) had indeed slighter skin lesions, but syated a much longer time in hospital. The great advantage of treatment of burned wounds with wound solution is seen in the relief of pain of the patients. Aslo, physical exercises can begin immediately. Wound solution needs no anaesthesia for necrolysis. The shortening of the healing time results in stimulation of the marginal epithelium and growth of autologous transplanted cells on the wound.


[Polyposis coli. Comparison between the familial and non-familial form].

Since 1970 16 patients with polyposis coli have been treated at the Department of Surgery, Medical School, Hannover. Of these, 9 patients showed the classic type of familial polyposis, while 7 patients denied a positive family history. Comparing both groups, the nonfamilial type of polyposis coli can be separated as well from the familial polyposis as from multiple adenomas of the large bowel. Operative treatment in both groups of polyposis coli and management of nonfamilial polyposis coli are discussed.


[Preserving of continence in the treatment of familial polyposis of the colon. Technic of peeling off of the rectal mucosa].

The paper deals with the problem of preserving the rectum in the therapy of familial polyposis of the colon. According to our own experience and recent publications we cannot support the preservations of the rectum. Nevertheless, in order to preserve continence, we peel off the cylinder of the mucosa of the rest of the rectum (Devine und Ravitch). We have modified this procedure according to the Hochenegg pull-through and have operated successfully on two patients.


[Preliminary observations on the clinical use of calcitonin. Treatment and postoperative prevention of pancreatitis].

Calcitonin was administered to 4 patients presenting with acute pancreatitis as well as to 6 patients presenting with postoperative pancreatitis. Prophylactic administration was performed in 3 cases consecutive to pancreatic interventions. Following calcitonin all patients showed considerable improvement of clinical course. Although 8 patients recuperated completely 2 patients died from independent complications. After prophylactic administration of calcitonin the postoperative course was uncomplicated without demonstrable increase in serum amylase. It is emphasized that only early case histories are reported; their verification will depend upon the results of a controlled survey presently being performed.


[Histological research on the effect of viruses on wound healing].

The influence of pure virus solution on wound healing was studied in animals. The rate of disturbed wound healing was proportional to the concentration of the virus solution. Severe necrosis without inflammatory reaction could be demonstrated histologically.


[Treatment and prognosis in vertebral fractures in children and adolescents].

Twenty-six children and adolescents with a total of 65 vertebral fractures are reported. Sixteen patients could be followed up an average of 3 1/4 years after the accident. The questions of growth disturbance after vertebral body fractures and adequate treatment are chiefly considered. -Most of the fractures occurred in the midthoracic spine. As a rule they were serial fractures. -Fractures of the vertebral body with sagittal wedge deformity alone have a better prognosis than those with concomitant sagittal and frontal wedge deformities. Whereas those in the first group correct themselves partially or completely during subsequent growth, improvement in the wedge deformity was only observed in about one-third of the patients in the second group. When the end-plates were fractured, there was no correction and there was a lack in vertebral growth. Severe destruction of the cartilagenous plates and intervertebral discs led to a fusion of the corresponding segment. Increase in wedge deformity was observed twice. -Slight axial deviations of the intervertebral discs following vertebral body fractures are compensated for during growth in most cases. In comminuted fractures, the axial deviation persists but can be compensated for by the adjacent segments of the spine. In instable fractures, it can increase in spite of treatment in a Milwaukee corset. -No difference was found between the children treated with a hyperextension plaster corset and those treated functionally. On the basis of the results, the fracture types which should be treated functionally and those for which a plaster cast is recommended are indicated.


Localization by Q-banding of mitotic chiasmata in cases of Bloom's syndrome.

The distribution of mitotic chiasmata from the lymphocytes of three patients with Bloom's syndrome was studied by Q-banding. An estimate was made of the average brightness of the human chromosomes and of the brightness and length of the Q-regions. A strong relationship was found between the average darkness of a chromosome and its chiasma density. The shorter and darker Q-regions contained more chiasmata, with the exception of the chromosome tips which had lower chiasma densities. A few "hot spots" had particularly high chiasma densities. Centric regions contained 17% of the chiasmata. The data are consistent with the assumptions that chiasmata are favored in darker regions and at borders between light and dark regions.


BrdU-33258 Hoechst analysis of DNA replication in human lymphocytes with supernumerary or structurally abnormal X chromosomes.

BrdU-33258 Hoechst techniques have been used to characterize DNA replication patterns in lymphocytes from hunam females with supernumerary or structurally abnormal X chromosomes. Fluorescence analysis permits identification of late replicating X chromosomes in a very high proportion of cells and affords a high resolution method for determining the interchange points of X-X and X-autosome translocations. Asynchrony among terminal replication patterns of multiple late replicating X chromosomes within an individual cell can occasionally be demonstrated. The arms of isochromosomes usually exhibit symmetrical fluorescence patterns, with replication terminating in bands Xq21 and Xq23 (predominant pattern) or in bands Xq25 and Xq27 (alternative pattern) in both arms. In the vast majority of lymphocytes containing a balanced X-13 or X-19 translocation, the normal X is late replicating. However, DNA synthesis in the translocation products occasionally appears somewhat delayed relative to that expected for an early replicating X, consistent with possible position effects on replication kinetics.


Relative DNA contents of somatic nuclei of ox, sheep and goat.

Diploid ox nuclei contain about 14% more DNA than nuclei from sheep of the same sex. Goat nuclei have a similar DNA content to those of sheep. In view of the similar chromosome banding patterns in these species, it appears that chromosome evolution must have involved numerous minute interstitial deletions of additions of DNA. Although chromosomes which have similar banding patterns in these three species may be regarded as homologous in this respect, and can be regarded as having a common evolutionary origin, they are not homologous for the quantity of their DNA.


The chromosomal localisation of satellite DNA in Ptyas mucosus (Ophidia, Colubridae).

Ptyas mucosus male DNA has a repetitious DNA satellite (p = 1.700 g cm-3) constituting 5% of the haploid genome. In situ hybridisation of radioactive complementary RNA (cRNA) has revealed that satellite sequences are located in the centromeric region of one pair of macrochromosomes and in the terminal region of 8 pairs of microchromosomes. These regions are constitutively heterochromatic as revealed by C-banding. The possibility of involvement of satellite rich microchromosomes in nucleolus organisation is discussed.


Proportionate representation of rDNA and Balbiani ring DNA in polytene chromosomes of Chironomus tentans.

Attention was focussed on the question whether the most active genes of the polytene genome of Chironomus tentans, i.e. rDNA and Balbiani rings, have undergone the same number of duplications as the bulk of the genome. RNA was extracted from isolated salivary glands, enriched for messenger RNA by poly U sepharose chromatography, and labelled with 125Iodine. In situ hybridization showed that, apart from rRNA, Balbiani ring 1 and 2 transcripts are the major hybridizing RNA species present in this enriched preparation. BR1 hybridized only at the b-region. Transcripts of BR6 and puff I 17B are shown to be salivary gland specific and hybridize in situ to an extent of less than 5% of the RNA hybridized to BR1 plus BR2. Saturation hybridization levels of rRNA and Balbiani ring (BR1 plus BR2) RNA with polytene DNA from salivary glands were determined and compared with the saturation levels measured for DNA from adult flies and larvae. rRNA hybridized to the same level (0.09%) with polytene DNA as with DNA from primarily diploid cells (adult fly DNA) or from larvae. An equal hybridization level (0.04%) with each of these three types of DNA was also obtained for BR RNA. The results demonstrate that, during polytenization in C. tentans, the genes for rRNA and BR1 and 2 are duplicated to the same extent as the bulk of the genome.


RNA, RIBOSOMAL/*BIOSYNon of ribosomal 5S RNA genes in Chironomus thummi by in situ hybridization of iodinated 5S RNA.

5 S RNA of Chironomus thummi larvae was purified from total phenol extracted RNA by gel filtration and labelled to about 10(7) dpm/mug with carrier-free iodine-125. After hybridization in situ of 125I-5 S RNA and autoradiography only region B3c-e (containing two "normal" and two very faint bands) of chromosome II of salivary gland cells was highly labelled. In chromosomes of an animal showing pairing discontinuities a clearly "heterozygous" labelling of the 5 S RNA region was found. Region B3c-e shows no clearcut morphological signs of puffing or autoradiographically detectable 3H-uridine incorportion in spite of a continuous synthesis of 5 S RNA in salivary gland cells.


Psychotic exacerbations produced by neuroleptics.

Thirteen schizophrenic patients who developed abnormal psychotic behavior as an adverse reaction to a neuroleptic are described. A. Three patients showed a marked increase in the psychopathology during neuroleptic treatment. These episodes were treated by decreasing or discontinuing the neuroleptics. They did not respond to anticholinergic durgs nor did they respond to an increase in dosage, (another side effect previously reported and referred to here) indeed this treatment worsened the situation. B. Ten patients showed a mixed picture of catatonic excitement or inhibition on neuroleptics and several developed hallucinatory episodes. All of these exacerbations were terminated by anticholinergic injections. Other more familiar CNS abnormalities produced by neuroleptics are briefly discussed.


Psychotropic drugs in opioid addicts on methadone treatment.

Psychotropic drug treatment of persons on methadone maintenance is discussed. Patients with clear target symptoms, such as anxiety, depression, or psychosis responded just as non-opioid addicts would to the major psychotropic agents. The minor tranquilizers are felt to be of doubtful value, and subject to abuse. Sleep disturbances cannot be treated by the usual means, as the drugs needed again are abused. However, chlorpromazine shows some promise here. Methods of drug delivery and goals of treatment must be adapted to the realities of this patient-group's characteristics, particularly anti-social traits, poor motivation and unreliability. Psychotropic drugs are unlikely to be of aid in multiple drug abusers, personality and character disorders, and opioid withdrawal. Four case histories are presented.


Depressive syndrome induced by oral contraceptives.

It has been demonstrated that a small proportion of women taking oral contraceptives develop a depressive syndrome characterized by despondency, tension, and changes in sex desire. Although disturbed tryptophan metabolism induced by estrogen has been held responsible for this syndrome, the role of psychological factors should not be overlooked. Recognition and management of the syndrome require information concerning the pharmacological actions of oral contraceptives and the personality make-up of the patient.


A brief method of screening for alcoholism.

Subjects given a research diagnosis of alcoholism were evaluated to determine whether key symptoms exist which provide a means of rapid screening for alcoholism. Alcoholic subjects were compared with a large control group of non-alcoholics. A very high percent of alcoholics was identified by the subject's report that he or others believed the subject drank too much. Few non-alcoholic subjects reported that either they or others had such beliefs. Thus, several easy questions can serve as highly reliable screening tests for alcoholism.


Medicinal use of hypodermic needles in an addict patient population.

Narcotic addicts may become so conditioned to the use of hypodermic needles that self-injection without a drug may become pleasurable. This phenomenon has raised the question as to whether addicts in treatment should be administered any medication by hypodermic needle for fear of precipitating withdrawal or inducing a craving for heroin. In this study addicts in treatment were given a medicinal needle challenge but there were no documented deleterious effects.


Treatment of a 15 year old hebephrenic girl in a community hospital.

The preceeding discussion and case histroy illustrate the modern eclecticism which must be utilized in a synergistic manner to effect remissions in psychiatric illnesses heretofore unresponsive to treatment. The community psychiatrist must be capable of functioning in the face of adversity and sometimes must receive the criticism of his peers with equanimity and tolerance by accepting the opportunity as a challenge to educate colleagues to the full potentiality of modern psychiatry.


[Poliomyelitis epidemic in a district of Freiburg i. Br. in autumn 1975 (author's transl)].

In the autumn of 1975 five cases of poliomyelitis occurred within 6 weeks in German children of families of low socioeconomic class. They lived in two districts of Freiburg with close familial and occupational contacts. One child had been immunised against polio once orally several years ago and none of the others were immunised. The clinical course and results of investigations of the environment are reported. Included is the state of immunisation of 472 school beginners in Freiburg schools and the antibody levels of 284 children aged 1 to 10 years from Freiburg and the adjoining areas.


[Endocarditis lenta caused by Lactobacillus salivarius subsp. salicinicus (author's transl)].

After two tooth extractions performed without antibiotic cover endocarditis lenta occurred in a ten-year-old girl. The causative organism isolated was Lactobacillus salivarius subsp. salicinicus, the first such reported case. The child has a small, haemodynamically insignificant, ventricular septal defect. A cure was achieved after long-term administration of penicillin G in high doses, at first combined with ampicillin. There were no complications.


[The influence of saralasine on blood pressure and renal function in Bartter's syndrome and decompensated hepatic cirrhosis (author's transl)].

Infusion of the angiotensin-II-antagonist saralasine led in one patient with Bartter's syndrome and one patient with decompensated hepatic cirrhosis, both of whom had a markedly raised plasma renin activity, to a fall in systolic and diastolic blood pressure. The results indicate that in normotensive patients a raised angiotensin II concentration in blood is haemodynamically important for the level of blood pressure if plasma renin activity is raised. In normotensives with normal plasma renin activity saralasine in the usual dosage (4.2 mug/kg-min) does not influence the blood pressure.


[Frequency and pathogenis of thrombocytopenia in cardiac failure].

In 395 consecutively investigated patients with cardiac failure of varying aetiologythe platelet ocurt in venous blood was less than 100 000/mm(3) in 5.3% and below the 2s devaition (less than 136 000/mm (3)) in 19.2. The average platelet count of the whole group was 197 500 +/- 70 800/mm (3) which was significantly lower (P less than 0.001) than in normal controls (n = 128). In 6 patients a (51)Cr study of platelet kinetics was performed; the results support the conclusion that the faculatative thrombocytopenia in cardiac failure is mainly,but not exclusively, due to an increased uptake of platelets in the congested spleen.


[Aplastic anaemia and thymonal].

The combination of aplastic anaemia and thymona was observed in a 49-year old woman. Concomitant with severe normochromic anaemia and reticulocytopenia was a cell-rich bone marrow smear in which erythropoietic precursors were almost absent. Immunological phenomena could not be demonstrated. The erythropoietin level was maximally increased. Pathological anatomy typically revealed a predominantly spindle-cell thymonal with only minor capsular invasion.


Tinidazole: a review of its antiprotozoal activity and therapeutic efficacy.

Tinidazole, a synthetic imidazole derivative, has been used in the oral treatment of several protozoal infections - trichomoniasis, giardiasis and amoebiasis. Among the protozoal organisms inhibited by tinidazole are Trichomonas vaginalis, Trichomonas foetus, and Entamoeba histolytica. In vitro, tinidazole has been shown to possess antiprotozoal activity at least comparable to, and in some cases greater than, metronidazole. Tinidazole also has activity against some Gram-negative anaerobic bacilli, including Bacteroides spp. Following oral administration of a 2g dose, like metronidazole serum levels peak in about 2 hours but persist for longer. Any clinical significance of the longer plasma half-life (tinidazole 12.5h; metronidazole 7.3h) has yet to be demonstrated. Tinidazole is approximately 20% bound to plasma proteins. Only unchanged drug has been found in the plasma and urine of tinidazole-treated subjects, although metabolites have been detected in animal studies. A single 2g dose of tinidazole has been shown to be effective therapy in vaginal trichomoniasis and in urogenital trichomoniasis in males. Single-dose therapy in general offers advantages in regard to convenience, and in the treatment of a sexually transmissible disease such as trichomoniasis, single-dose therapy facilitates compliance of patient and sexual partner. In comparative studies, tinidazole, in both single-dose and traditional multiple-dose regimens, has been shown to be equivalent and often superior to other antitrichomonal agents, including metronidazole. In intestinal amoebiasis, tinidazole has been evaluated after both once-a-day and multiple daily dose regimens, with the former giving slightly better results. When both metronidazole and tinidazole were administered in multiple daily dose regimens, the two agents yielded similar cure rates; in one study fewer tinidazole-treated patients required a second course. Tinidazole has also been successful in some cases of amoebic liver abscess, but an advantage over metronidazole has not been demonstrated. Results in the treatment of giardiasis, especially with the single-dose regimen, are promising, and in one study, tinidazole proved effective in infections resistant to metronidazole. Even in large doses, tinidazole has been well tolerated, although rarely vomiting may occur and the patient may need to be re-treated with a multiple dose regimen.


Human chorionic gonadotropin: acetylation of tyrosyls with N-acetylimidazole.

When human chorionic gonadotropin (hCG) was treated with a 20-fold molar excess of N-acetylimidazole in aqueous solution, two tyrosyls were acetylated, resulting in a 50% reduction in in vivo biological activity. With increased quantities of reagent, the number of tyrosyls acetylated increased but with no further decrease in the biological activity. In vitro biological activity (binding to hCG receptors) of the hormone was not affected at all. Acetylation in urea increased tyrosyl modification, accompanied by acetylation of some lysyls, yielding a product in which all seven tyrosyls were acetylated and both in vivo and in in vitro biological activities were completely abolished. Deacylation with hydroxylamine partially restored biological activity of some but not all of the modified products. When individual hCG subunits were treated with the same reagent, the number of tyrosyls acetylated in each subunit again increased with increasing amounts of reagent, up to three in the alpha subunit and two in the beta subunit in the absence of urea. The tyrosyls in the beta subunit appeared less reactive to the reagent than those in the alpha subunit. Subunits modified to these extents retained ability to recombine as examined by gel electrophoresis, but the recombined products varied considerably in both in vivo and in vitro biological activities. A completely tyrosyl-acetylated product of hCG-alpha did not combine with intact hCG-beta, while fully modified hCG-beta did with intact hCG-alpha.


Regulation of adenylate cyclase coupled beta-adrenergic receptors by beta-adrenergic catecholamines.

Injection of frogs with beta-adrenergic catecholamines produced a selective desensitization (loss of responsiveness) of the erythrocyte membrane adenylate cylase to subsequent stimulation in vitro by isoproterenol. Basal, prostaglandin E1- and fluoride-sensitive enzyme activities were unaffected. A 77% (p less than 0.001) decline in isoproterenol-responsive enzyme activity in the cells from the treated animals was observed with no change in the Km for isoproterenol stimulation of the enzyme (concentration causing 1/2 maximal enzyme activation). The decrease in catecholamine-sensitive adenylate cyclase was accompanied by a parallel 68% (p less than 0.001) fall in the apparent number of beta-adrenergic receptors in the erythrocyte membranes, assessed by (-) (3H)alprenolol binding studies. There was no change in the affinity of the receptor binding sites. The catecholamine-induced desensitization and fall in the beta-adrenergic receptor number were both concentration and time-dependent and displayed beta-adrenergic specificity. Isoproterenol was more potent in desensitizing cells and in lowering the receptor number than was norepinephrine. The beta-adrenergic antagonist propranolol, but not the alpha-adrenergic antagonist phentolamine, blocked the desensitizing effects of isoproterenol. Propranolol itself, however, did not cause desensitization. Cells became resensitized to the stimulatory effects of catecholamines, in association with a return in beta-receptor number, when propranolol was injected into previously desensitized animals. The changes in receptor number in membranes from desensitized and resensitized animals were also reflected in soluble receptor preparations. The protein synthesis inhibitor cycloheximide did not affect either desensitization, resensitization, or the changes in receptor number which accompanied the changes in adenylate cyclase sensitivity to catecholamines. These findings suggest that the chronic occupancy of beta-adrenergic receptors by beta-adrenergic agonists (but not antagonists) decreases the number of functional beta-adrenergic receptor binding sites and, hence, lowers the responsiveness of adenylate cylase to catecholamine stimulation. The lack of effort of cycloheximide on these regulatory effects suggests that "inactivation" and subsequent "reactivation" of the receptors, rather than changes in receptor turnover, are involved.


Studies on the antitesticular action of DL-6-(N-2-pipecolinomethyl)-5-hydroxy-indane (PMHI) in the rat.

Both prepubertal and adult rats were treated with a single oral dose of either 60 mg or 120 mg of dl-6-(N-pipecolinomethyl)-5-hydroxy indane maleate (PMHI) per kg of body weight. Their testicular weights were drastically reduced compared with those of the controls. A follow-up, beginning on the third day post-treatment and continuing for a period of 50 days, showed that the body weight growth of PMHI-treated rats was not retarded. The hormonal profile indicated that, except for FSH which showed a transitory elevation in PMHI-treated immature rats, the serum levels of LH, estrogen, and testosterone were indistinguishable from those of the controls. Testicular histology revealed that the spermatogenic process in PMHI-treated rats recovered at a dose-related rate. EM sections of testes of adult rats indicated that cytoplasmic vacuolation appeared in the Sertoli cells 5 h post-treatment. The consequent cascade of arrested spermiogenesis included abnormal acrosomal condensation of spermatids and sloughing of polynucleated spermatids. Some spermatocytes also seemed to be affected, but spermatogonia and Leydig cells remained intact. These results indicate the PMHI acts primarily on Sertoli cells and causes arrest in the spermiogenetic stage of the spermatids. At a higher and toxic dose of PMHI, however, the earlier germinal elements might also be affected, due to the extensive damage to the supporting Sertoli cells.


Calcium metabolism during lactation: enhanced effects of thyrocalcitonin.

Lactating rats were compared with nonlactating controls, with regard to the intake and absorption of calcium, serum calcium level, and te protective effect of thyroacalcitonin (TC) against hypercalcemia and hyperphosphatemia. While consuming a commercial diet, intact, nonfasted lactating rats maintained a serum calcium level of approximately 9 mg/100 ml, which was 1 mg/100 ml lower than that of nonlactating controls. The level rose to that of the controls within one day after removal of the litters from the mother. Compared with nonlactating rats, lactating rats had a three-fold higher calcium intake and a six-fold higher rate of net absorption of calcium. After intragastric calcium (10 mg/100 g body wt) the increase in serum calcium was small (1 mg/100 ml) 2 h later in both groups of sham-operated rats but was markedly increased in thyroparathyroidectomized groups, with the lactating rats showing a significantly greater increase than the nonlactating rats. The injection of a small dose of porcine thyrocalcitonin completely counteracted this hypercalcemia in lactating rats, but did not have any effect on nonlactating controls. Protection by the thyroid gland against hyperphosphatemia after intragastric calcium also was significant in both lactating and nonlactating rats. The results show that TC is much more effective in lactating than in nonlactating rats, suggesting that TC may be of particular importance in lactation by restricting elevations of serum calcium and phosphorus levels after eating, thereby aiding in conservation of these ions.


Studies on the transfer of steroid hormones across the blood-cerebrospinal fluid barrier in the Rhesus Monkey.

Indwelling canulae were placed in the lateral ventricles of the brains of six adult male rhesus monkeys, and the movement of estradiol-17beta (E2), testosterone (T), and 5alpha-dihydrotestosterone (DHT) across the blood-cerebrospinal fluid (CSF) barrier was measured. Serial samples of blood and CSF were collected every 30 minutes during a 6 hour infusion of the tritiated steroids, and the quantity of free steroid in the blood and CSF was determined by recrystallization to constant specific activity. During the course of the 6-hour infusion, the average CSF concentration of steroid, expressed as dpm/ml, was about 3.5% of the concurrent plasma level of E2, 1.6% of the concurrent plasma level of T, and 0.08% of the concurrent plasma level of DHT. It is proposed that these differences in steroid transfer can be attributed to differential binding of these steroids to testosterone-estrogen-binding globulin (TeBG) in plasma.


Physiological cortisol levels block the inhibition of vascular reactivity produced by prolactin.

Cortisol in concentrations similar to the unbound levels of the hormone in human plasma can reverse the inhibition of vascular reactivity produced by prolactin. In the rat mesenteric vascular bed, cortisol alone in similar concentrations had no significant effect on the pressor responses to norepinephrine: the action of cortisol was seen only when prolactin was present. The relationships between the effects of different concentrations of prolactin and cortisol suggest that at some point there is a competitive interplay between the effects of the two hormones. There is indirect evidence that this interplay is at the level of prostaglandin synthesis or release. We suggest that cortisol has no effect on basal prostaglandin production but blocks the synthesis or release occurring in response to polypeptide hormone stimulation.


Effects of intraventricular catecholamines on luteinizing hormone release in ovariectomized-steroid-primed rats.

The effects of intraventricular norepinephrine (NE) and dopamine (DA) were studied in the awake, freely behaving rat. In long-term ovariectomized, estrogen-progesterone-primed (OVE E2-P) animals, blood samples were taken via indwelling intra-atrial catheters before and after intraventricular infusion of either pH-adjusted saline, NE )5 mug, 15 mug, 20 mug), or DA (4 mug, 15 mug), and plasma LH was measured by radioimmunoassay. Under urethane anesthesia, records were made of the effects of intraventricular saline and NE on the electrical activity of the arcuate nucleus in the form of multi-unit spike activity. In unanesthetized animals, intraventricular NE caused marked changes in behavior. The typical response consisted of three phases: generalized activation (5-7 min), feeding (5-15 min), and sleep 1-2 h). DA exerted similar behavioral effects but without the marked sleep phase characteristic of the NE response. The effects of the catecholamines on LH output were significant increases in plasma LH levels for all NE doses tested (5 mug, p less than .025; 15 mug, p less than .05; 20 mug, p less than .005), while DA had no effect. The dynamics of the LH response to NEwere similar at all dosage levels, and the increase caused by 20 mug NE was found to be essentially equal to that induced by a quick intravenous infusion of 1.25 ng LHRH. Arcuate nucleus multi-unit spike activity (MUSA) showed a clear response to intraventricular NE at a dosage capable of stimulating the release of LH. In every case, the initial effect was a decrease in spike activity. These results, considered in relation to previous findings, suggest that NE may be stimulatory to neurons secreting LH-releasing hormone (LHRH). The decrease in arcuate nucleus MUSA in response to NE implies that certain elements of this nucleus are inhibited during LH release, perhaps the dopaminergic tuberoinfundibular neurons.


Evidence for the simultaneous uptake and release of certain estrogens by the splanchnic area in the dog.

Splanchnic extractions of total radioactivity, unconjugated radioactive estrogens, radioactive estrone glucosiduronate, and radioactive estradiol-17beta glucosiduronate(s) were determined in dogs following the infusion of (3H)estrone glucosiduronate and of (3H)estrone. Splanchnic extractions of radioactive estradiol-17alpha-3-glucosiduronate were determined after (3H)estrone glucosiduronate infusion. The mean splanchnic extractions of total radioactivity after (3H)estrone glucosiduronate and (3H)estrone infusions were positive and similar (42.2 +/- 2.4% (SE) and 34.9 +/- 2.4% (SE), respectively). The mean splanchnic extraction of unconjugated radioactive estrogens after (3H)estrone glucosiduronate infusion (39.3 +/- 2.6%) was significantly less than that after (3H)estrone infusion (86.4 +/- 2.3%). The difference was best explained by different rates of formation of unconjugated from conjugated estrogens, suggesting, in turn, that simultaneous uptake and formation of unconjugated estrogens occur in the splanchnic area. The mean splanchnic extraction of extradiol-17alpha-3-glucosiduronate was 33 +/- 3.9%. The mean splanchnic extraction of radioactive estrone glucosiduronate after (3H)estrone glucosiduronate infusion was positive (54.7 +/- 2.3%) and after (3H)estrone infusion was negative (-50.8 +/-8.8%. The mean splanchnic extraction of estradiol-17beta glucosiduronate(s) was also positive (32 +/- 2.4%) after (3H)estrone glucosiduronate infusion and negative (-37.9 +/- 11.0%) after (3H)estrone infusion. These values are taken to indicate that simultaneous uptake and formation (from unconjugated estrogens) of both estrone glucosiduronate and estradiol-17beta glucosiduronate(s) occur in the splanchnic area, and that after (3H)estrone infusion, the rate of formation greatly exceeds t


Relative biologic activities of human and bovine parathyroid hormones and their synthetic, NH2-terminal (1-34) peptides, as evaluated in vitro with renal cortical adenylate cyclase obtained from three different species.

The relative biologic activities of native human parathyroid hormone, hPTH (1-84), native bovine parathyroid hormone, bPTH (1-84), and their respective synthetic, NH2-terminal, biologically-active (1-34) fragments were compared in vitro using adenylate cyclase preparations from human, chicken, and rat renal cortex. The concentrations of the hormones required for half-maximal stimulation of the enzymes were determined from dose response curves. bPTH (1-84) had greater apparent activity than hPTH (1-84), using rat or chicken renal adenylate cyclase, but, with human renal adenylate cyclase, the apparent activities of the two hormones were equal. Synthetic hPTH (1-34) possessed about 1/10 of the apparent activity of hPTH (1-84) in all three adenylate cyclase systems. However, (GLU22)bPTH (1-34) was about equal inapparent activity to bPTH (1-84) in the three systems. We propose that different rates of hormone degradation at or near renal receptor sites may be responsible for the dependence of the relative biologic activity on the assay system used. In the case of hPTH a peptide chain longer than (1-34) may be required for the full biologic activity of the hormone...


Effect of suckling on plasma prolactin and hypothalamic monoamine levels in the rat.

In lactating rats that were separated from their pups for 8 hours, suckling induced a rapid rise in plasma prolactin levels. Correlatively, it induced a depletion in dopamine (DA) and serotonin (5-HT) Concentrations within the hypothalamus as early as 5 min after the onset of suckling. This depletion lasted as long as the stimulus was maintained. A parallel increase in the level of the metabolite of 5-HT, 5-hydroxyindolacetic acid (5-HIAA), was observed. Under these conditons, the ratio of 5-HIAA/5-HT is augmented. This ratio is a good index of turnover of the transmitter. Suckling affected neither the content of noradrenaline (NA) in the hypothalamus nor the levels of any amine tested in the cerebral cortex. When pups were separated from their mother for 24 hours, suckling no longer resulted in changes in either plasma prolactin levels or hypothalamic DA, 5-HT, or 5-HIAA concentrations. We have concluded that the activation of a discrete system of 5-HT containing neurons is associated with the triggering effect of suckling on prolactin release.


Cortisol and GH responses to D- and L-amphetamine in monkeys.

Equimolar doses of D-amphetamine and L-amphetamine, and a water placebo were injected intravenously on different days into rhesus monkeys, and their plasma cortisol and GH responses were determined over a 3-hour period. D- and L-amphetamine (but not the placebo) equally suppressed plasma cortisol concentration and equally increased plasma GH concentration. Pretreatment of the monkeys with large doses of pimozide, a specific dopamine receptor blocker, did not appear to block the hormonal responses to either isomer of amphetamine. The results suggest that the hormonal responses to both D- and L-amphetamine were mediated by noradrenergic neurones stimulatory to GH and inhibitory to ACTH, and that D- and L-amphetamine exert equipotent noradrenergic effects in the neuroendocrine system.


The metabolism of cortisol by term baboon neonates (Papio papio).

The metabolism of iv administered (4-14C)cortisol (F) was examined in 3 female, spontaneously delivered, term baboons less than 24th old. Sixty and 80% of 14C was recovered in urine within 24 and 68 h,respectively. The distribution of urinary 14C was 44.7% unconjugated, 18.1% glucuronoside, 3.3% sulfate, and 24% unextractable with ethyl acetate. The metabolites were isolated by chromatography and crystallization. Eight per cent of unconjugated and 60% of glucuronoside metabolites were more polar than the cortols, the majority being unknown I (Rf 0.15), and unknown II (Rf 0.35), (csf., 6beta-ol-F), Rf 0.44, ethyl acetate-chloroofrmmethanol-water, 25:75:50:50). Unconjugated cortisol plus cortisone (E) represented less than 1% or urinary 14C and tetrahydrocortisone (THE) glucuronoside represented 1.2%. Excretion of tetrahydrocortisol (THF) and products of side-chain cleavage were negligible. Excretion of 20beta-hydroxy metabolites and 6beta-ol-F was less than or equal to 5% of urinary 14C. The cortisol production rate (mean +/- SE) calculated from the specific activity of THE was 4.95 +/- 1.92 mg/day. The glucuronoside/unconjugated 14C-ratio (0.4) contrasts with those previously reported in nonpregnant (4.0), pregnant (1.0), and postpartum (1.3) animals, indicating that the metabolic pattern in newborns is an exaggeration of that in pregnancy. In neonates, unknown I and II compensate quantitatively for decreased glucuronoside excretion. Unknowns I and II are derivatives of THF and THE, suggesting that increased hydroxylase or deficient glucuronyl transferase, rather than impaired delta4-reductase, is responsible for decreased glucuronoside excretion. The low F production rate, reduced glucuronoside formation, and increase in highly polar compounds relative to nonpregnant adults resemble the situation in humans. However, the reduction in glucuronosides is compensated for, quantitatively, by highly polar metabolites, which are extractable from baboon urine with ethyl acetate but are nonextractable from the urine fo human neonates.