Cultural change and its relevance for human genetics. The first part of this paper summarizes conclusions drawn from theoretical analysis of cultural change, as appeared in various papers (published and unpublished) by the author in collaboration with Marc Feldman. Among conclusions emphasized are the tendency to homogeneity of cultural traits with most mechanisms of cultural transmissions, the great variation in rates of change and conditions determining them, and the major factors responsible for change. The possibility of genetic variation in learning ability adds considerable complications and determines joint biological and cultural evolution. In the second part of the paper, one very specific example of biological and cultural coevolution is outlined. Archaeological information shows that agriculture spread slowly from a Near East area of origin of domestication of plants and animals. The spread towards Europe is particularly well mapped. There are good reasons why the spread of agriculture may have been accompanied by a spread of farmers from the area of origin. It turns out that synthetic gene maps of Europe showing such a spread of farmers would be an excellent explanation for the geographic distribution of genes in Europe.


Prenatal testing for birth defects and nursing practice. Recent advances in the prenatal diagnosis of birth defects including amniocentesis, ultrasound and fetoscopy are discussed. Indications, technical considerations and limitations are presented. Parental reactions to the stresses encountered during the process of prenatal diagnosis are related. Implications are identified for nursing care practice in different clinical settings including prenatal diagnostic units, paediatric services, obstetrical services and in the community.


Measuring life satisfaction in an elderly female population. The study described in this paper was undertaken as part of the pilot work for a main study, which attempts to evaluate the effectiveness of health visitor intervention on an elderly female population in Scotland. The Life Satisfaction Index A (Neugarten et al. 1961) was modified by the researcher and tested on a female Scottish population and is subsequently being used as one of three outcome measures of health visitor intervention.


Protocol for intravenous barbiturate therapy in increased intracranial pressure in a community hospital. A barbiturate protocol for control of raised intracranial pressure is presented in detail. Since the nursing staff may be responsible for maintaining cerebral perfusion and normal ICP with barbiturates, mannitol, fluids, and pressor agents, it was thought that a detailed description such as presented might be useful. We have shown that complex management protocols can easily be managed, even in smaller, non-university community hospitals. The present state of brain injury management by barbiturates, guided by ICP monitoring, even at this early stage of development, seems to show promise as the latest adjunct in the care of this difficult problem.


The neurologic examination in patients with central nervous system trauma. The neurological assessment of the head injured patient must be integrated into the emergency management and daily care of the patient. Neurosurgical nurses are in the best position to perform serial neurologic examinations and assess changes in the patient's clinical picture. If this added responsibility is assumed, neurosurgical nurses must take an active role in improving assessment skills. The improved assessment of the head injured patient will result in early intervention in the patient's course to avert potential problems, thus resulting in improved morbidity and eventual outcome. As neurosurgical nurses expand their roles in nursing, improved patient assessments are mandatory to deliver optimal patient care.


MBO and performance appraisal.

MBO and performance appraisal. Using an MBO approach, a nurse administrator tapped the resources of her staff to diagnose and resolve a performance appraisal problem. A new performance evaluation system that embodies the concepts of MBO resulted. Through this process, MBO was implemented at the unit level, where it had previously been resisted.


Pharmacology program produces results.

Pharmacology program produces results. A traditional inservice pharmacology program presented problems for the participants, educators, and head nurses and, despite the program, a significant number of medication errors occurred. A new program, based on principles of adult education, has had positive effects on patient care and is viewed favorably by educators and participants. The results suggest that competency-based education in other areas could have similar benefits.


The planning process and development of a time line. Careful organization is the key to effective facilities planning. This article outlines the major steps in organizing a planning effort and discussed techniques for estimating project time and manpower requirements. Methods for reducing the duration of the project are also briefly discussed. The information can be generalized for use in planning any complex project.


Two management systems in a nursing private practice group. Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.


Nurse turnover in the newborn intensive care unit. Nurse retention has become a significant issue in the newborn intensive care units for two main reasons: 1) the quality of care declines as it is delivered by inexperienced nurses, and 2) the cost of orienting new nurses is exorbitant. "Stress" has been implicated as one of the important factors in nurse retention; it appears that a paradox exists in that the stress/excitement that attracts a nurse to the newborn ICU in the first place may ultimately drive her away. We attempted to define stress factors in the Turner Newborn Intensive Care Unit at Hermann Hospital in Houston, Texas, and to develop management methods to decrease stress. Over a three-year period, during the implementing of new programs, nurse termination rates decreased significantly, as did turnover.


Neonatal circumcision.

Neonatal circumcision. The American Academy of Pediatrics has stated that there is no valid medical reason for performing routine neonatal circumcision. Although the issue is hotly debated in medical circles, little attention has been given to the issue in the nursing literature. It is important that nurses understand the medical, social, religious, and child care issues involved in order to help parents make informed decisions regarding circumcision of their neonate.


Home birth--a manifestation of aggression? An increasing number of women today are choosing to have their babies at home. Health professionals concerned about the welfare of both mother and baby sometime tend to respond to these mothers by lecturing rather than listening. This tends to block communication. As a result, women become frustrated and often leave the health care system. This paper attempts to understand the behavior of women who seek a home birth and hypothesizes that these women are responding in a normal, healthy manner to threats imposed by present maternity care. Viewing women who seek home birth from this perspective would tend to facilitate communication. Through open communication the home birth option can be viewed not as a movement or fad, but as a growth period for women and maternity care.


Estrogens + patient package insert = confused patients. A brief review of the patient package inserts concept and estrogen pharmacology is presented. Then the need for patient education is discussed along with recommendations for a team approach to managing patient anxiety by helping patients understand the estrogen-containing products they are using.


The relationship of age to nurses' attitudes toward abortion. An attitude questionnaire was distributed to 200 nurses to study the relationship of age to nurses' attitudes toward abortion. Of 139 responses, 128 were usable. The data showed that for this sample a combination of age and religion had the greatest influence on attitudes. With the exception of Catholic nurses, nurses 30 years of age and over were found to have attitudes at least as approving as those of nurses under 30.


Enhancement of mother-infant social interaction. Thirty infants were assessed on the third day after delivery to determine their individual capabilities for social interactions. A modified Brazelton Neonatal Assessment Scale was used. The infant's mothers were interviewed to determine their perceptions of the social behavioral potential of their neonates. It was found that mothers had expected and did observe behaviors which the Brazelton Scale measures. The mothers did not, however, realize the purposeful nature of behavior such as response decrements to stimuli and finger sucking. Incorporation of this information in the lay literature related to childbearing and childrearing and in expectant parents' classes is recommended. A further recommendation considers the nurses' active role in contributing to the enhancement of maternal-infant social interaction during the early neonatal period.


The relationship between previous elective abortions and postpartum depressive reactions. To test the hypothesis that primiparas who have had a previous elective abortion will have a higher incidence of depressive reactions postpartum than will primiparas who have not, 48 women pregnant for the first time and 25 who had had one abortion were interviewed six to eight weeks postpartum. No significant difference in the incidence of depression between the two groups could be found. In addition, when associations between their mean depression scores and other variables such as planned pregnancy, preferred infant sex, identified obstetrical problems, help at home, experiencing the baby blues, and an identified recent sad life event were calculated, no significant differences were noted. Spontaneous comments from the previously aborted women suggested that anxiety during pregnancy concerning the infant's health was a greater source of discomfort than was postpartum depression.


Unwed adolescent primigravidas identify subject matter for prenatal classes. The purpose of this descriptive study was to identify areas that the unwed 15- to 19-year-old primigravida felt should be included in prenatal classes. The sample consisted of 15 subjects, three from each year of age, 15 through 19. Data were collected by a structured interview. The findings revealed that these adolescents tended to select topics for prenatal classes that were self-oriented, the most important topic identified being the labor and delivery process. However, the other traditional prenatal class topics were not the major concerns of these adolescents. They preferred a group-discussion-oriented class. These findings could be useful for nurses teaching adolescent prenatal classes.


In vitro antibiotic susceptibility of bacteria isolated from prostatic fluid. Bacterial isolates from expressed prostatic secretions were tested in vitro for susceptibility to five antimicrobial agents used in the treatment of prostatitis. Comparisons of susceptibility and resistance were made between minocycline and each of the other four agents: tetracycline, cephalexin, ampicillin, and trimethoprim-sulfamethoxazole. A high percentage of the isolates from patients with prostatitis which were resistant to tetracycline and trimethoprimsulfamethoxazole were susceptible to minocycline.


Oxacillin-induced lysis of Staphylococcus aureus. Six clinical isolates of Staphylococcus aureus were compared for their relative susceptibilities to the killing effects of oxacillin. Three of the strains had minimum bactericidal concentrations which were >10 times the minimum bacteriostatic concentration for this antibiotic and were designated tolerant (Tol(+)). The other strains had minimum bactericidal concentrations which were comparable to the minimum bacteriostatic concentration (Tol(-)). Lysis curves of these strains revealed that the Tol(+) strains exhibited a diminished rate of lysis when inhibited by oxacillin. This reduced rate of lysis was reflected also in a reduced rate of viability loss when the cells were exposed to oxacillin. During log growth the uptake of [(14)C]glycerol by Tol(+) cells was 1.5-fold greater than that by Tol(-) cells. Glycerol-labeled cells of each phenotype secreted radioactivity when inhibited by oxacillin. However, the Tol(+) strains released over twice as much label as the Tol(-) strains. No difference in the proportion of lipid secreted by the two phenotypes was found. The behavior of 60 to 65% of the labeled material released by inhibited cells during both sodium dodecyl sulfate gel electrophoresis and Sepharose 6B chromatography corresponded to that of lipoteichoic acid. When the major component of secreted material was added to oxacillin-inhibited Tol(-) strains, an inhibition of the lytic response was observed. These results suggest that oxacillin tolerance in S. aureus could be related to the enhanced secretion of an autolysin inhibitor, such as lipoteichoic acid.


Penicillinase-resistant penicillin/gentamicin synergism. Effect in patients with Staphylococcus aureus bacteremia. Gentamicin sulfate has been shown to enhance the effects of penicillinase-resistant penicillins against clinical isolates of Staphylococcus aureus in vitro, but the relevance of this observation to bacteremic patients is unclear. Therefore, serum samples from 14 patients with staphylococcal bacteremia were tested for growth inhibitory and bactericidal effects against the patients' own pathogen while they received a penicillinase-resistant penicillin alone, and again when gentamicin was added to the therapeutic regimen. Addition of gentamicin in vivo was associated with slight improvement in growth inhibitory activity but it caused profound increases in serum bactericidal activity. This effect could not be attributed to higher serum levels of penicillinase-resistant penicillin during gentamicin administration. Addition of gentamicin to penicillinase-resistant penicillin can lead to marked improvement in a patient's serum bactericidal activity against his own staphylococcal pathogen, and should be considered for any patient who does not respond to more conventional therapy.


Protein synthesis in muscles from normal and dystrophic hamsters. Homogenates of hindleg muscle were obtained from control and dystrophic male hamsters, 30 and 190 days of age, and were used to prepare the postmicrosomal pH5-supernatant fraction. The activity of this fraction in the incorporation of [14C]phenylalanyl-tRNA into peptides was increased in the dystrophic-muscle preparations. No such increase was found in brain or liver preparations from dystrophic hamsters. The increased capacity for aminoacyl-tRNA binding that was observed in preparations from dystrophic animals is discussed.


Differential patterns of drug involvement among Israeli youth. The present study tries to link some demographic, social, psycholoogical and attitudinal variables of drug abuse. The findings were centred around the readiness of secondary school youth in Israel to be involved in drugs and their active searching for drug involvement. A dependent variable based on five indices of drug involvement was constructed. It was then related to parental control, peer involvement in drugs, sex differentiation and membership in youth movements. A bi-modal high involvement curve was found, the first mode consisting of youth of low socio-economic strata who are drop-outs, who associate with outside peer groups as an alternative to their shaky and diffused families and lack of involvement in school life. The other mode consists of youth with a higher socio-economic background who are involved with drugs due to their desire for new hedonistic and emotional experiences. Their openness to experiment with drugs is a corollary to their involvement within a peer group which condones and legitimizes narcotics as well as any experiences which irrespective of their source, provide "a good high". There is a sub-group within this group which would be involved with drugs as a partial escape from personal problems.


Contacts with a Canadian "street level" drug and crisis centre, 1972-76. The Calgary Distress Centre/Drug Centre is a "street level" agency that deals with both drug and non-drug related crises. Telephone and drop-in service is available 24 hours a day, seven days a week. The Centre has approximately 60 non-professional volunteers and a paid staff of six. Data about crisis information and counselling contacts over the period 1972-76 are presented and discussed. The Distress Centre/Drug Centre is perhaps a useful model on which to base other crisis intervention facilities. Furthermore, the systematic compilation of data regarding contacts with the agency provides significant insight regarding trends in drug use and evolution of the agency.


Opium use in two communities of Pakistan ---a preliminary comparison of rural and urban patterns. Interviews were conducted to clarify drug use patterns and characteristics of opium users in two communities. Because of the small number of subjects selected from only two communities, the results are not representative of the country as a whole. Nevertheless, in the city of Rawalpindi 90 users were studied and found to have a mean daily opium consumption of 0.9 grams at a cost of Rs. 1.00 ($US 0.10). Opium was taken by mouth once or twice daily. They were solitary users who first used opium as adults, most often for self-treatment of health disorders. The majority were employed males with no history of criminality. In the rural opium-producing village, 28 users were interviewed. They smoked opium three or four times a day in a social setting and reported a mean daily consumption of 11 grams. They were more likely to use the drug for its social and pleasure effects and to have addicts as close friends. The high dose was associated with adverse effects on work performance and with more severe withdrawal symptoms. The findings suggest different intervention strategies for the two populations.


Detection and analysis of paraquat in confiscated marijuana samples. A spectrophotometric method used to test for paraquat in 160 confiscated marijuana samples is described. Twenty of these samples (12.5 per cent) tested positive for paraquat. Nine confiscated hash oil samples tested negative. The identification of paraquat was proven by isolation, chromatography, and spectral methods. The cannabinoids in paraquat positive Cannabis samples were analysed.


Stability of Cannabis sativa L. samples and their extracts, on prolonged storage in Delhi. The percentage rate of change into cannabinoids (Cannabidiol [CBD], tetrahydrocannabinol [THC] and cannabinol [CBN]) was higher in cannabis samples than in the extracts. This is probalby due to the decomposition of acids into corresponding neutral cannabinoids under the conditions of storage. Previous claims that CBD content in plant material is relatively constant are not substantiated by our results. There was a 1.0-2.5-fold increase in CBD content in plant material compared with the extracts. However, the fact that there was no appreciable increase in CBD/CBN content in the stored extracts of the same samples supports the view that the step-wise extraction does not bring the acids into the final extract pure delta 9THC decomposed at a rate of 41 per cent per year under tropical storage conditions. The delta 9THC content decreased in the samples and equally in the extracts though 100 per cent conversion of THC to CBN does not take place. The higher CBN content found in extracts than that expected by the conversion THC to CBN is a result of metabolic conversion.


Forced swimming in rats: hypothermia, immobility and the effects of imipramine. Rats when forced to swim in a restricted space not only became immobile but showed marked hypothermia. The hypothermia was greater than that observed after reserpine or Ro 4-1284 and was not antagonized by imipramine at doses which significantly reduced immobility. Hypothermia induced by forced swimming can therefore be dissociated from the immobility occurring in these conditions and also from drug-induced hypothermia.


[Brain stem seizures (author's transl)]. Paroxysmal symptoms of frequent recurrence and short duration occurring mostly unilaterally and without loss of consciousness have been described under a vast variety of headings. Brain stem origin of these symptoms was presumed. Electroencephalographic recordings usually did not show any paroxysmal discharges. 328 patients were found in the available literature including 9 patients of ours. The seizures were classified by their appearance. Tonic or dystonic, sensory, algetic, ataxic and akinetic-atonic fits were distinguished. The dystonic variety includes the "paroxysmal kinesiogenic choreoathetosis". The "paroxysmal dysarthria and ataxia" was subsumed under the ataxic type. By etiology, seizures were grouped into the cryptogenic and the symptomatic type. The symptomatic variety is frequently caused by multiple sclerosis, and rarely by tumours of the basal ganglia or by vascular disorders. Cranial computertomography showed subcortical lesions in three out of seven patients. In one case cerebral atrophy was found. All types of seizures respond very well to antiepileptic drugs. The prognosis is favourable with the cryptogenic type and unfavourable with the symptomatic variety depending on the underlying disease.


[Transferable antibiotic resistance of Salmonellae isolated at the Novara General Hospital in 1977]. Of 74 strains of Salmonella isolated by the Laboratory of Microbiology of the Hospital of Novara in 1977 and belonging to 20 different serotypes, transfer of antibiotic-resistance, mostly multiple (Streptomycin, Chloramphenicol, Kanamycin, Tetracycline, Ampicillin) has been detected in 78,5% of 28 antibiotic-resistant strains. As in previous investigations made by the same Laboratory, the highest percentages of transfer of resistance have been observed in some serotypes (S. typhi murium, S. panama), while that was observed only in S. enteritidis isolated in 1977. At last in this period was S. wien able to transmit multiple resistance isolated only once.


Characterization of R-plasmids coding for ampicillin resistance from Salmonella species. A sudden increase in the incidence of ampicillin resistance was observed among Salmonella species isolated within New Zealand in 1973--4. This increase was due mainly to the apperance and proliferation of Salmonella newington and Salmonella anatum serotypes resistant to ampicillin. The plasmid complements of 14 ampicillin-resistant S. newington and S. anatum isolates obtained from widely separated geographical areas within New Zealand between 1973 and 1974 were characterized by agarose gel electrophoresis. Each contained one or more plasmids ranging in molecular weight from 1.4 to 42 Mdal. Eleven isolates contained a self-transmissible plasmid of 33 Mdal which encoded resistance to ampicillin. After transfer to Escherichia coli, the 33 Mdal R-plasmids from each of these isolates were shown to be identical by restriction endonuclease analysis. The remaining three strains contained ampicillin R-plasmids having molecular weights of 35, 37.5 and 42 Mdal. These plasmids were shown by restriction endonuclease analysis to be related to the 33 Mdal R-plasmid. We conclude that the 33 Mdal plasmid and its derivatives were responsible for the increase in the incidence of ampicillin-resistant S. newington and S. anatum serotypes among the total Salmonella population.


[An experimental study on pyogenic osteomyelitis with special reference to the analysis of the therapeutic effects of antibiotics in vivo (author's transl)]. Experimental osteomyelitis was produced in mice by the Ueno's method for the purpose of evaluating therapeutic effects of the antibiotics. The results were as follows: 1) Experimental osteomyelitis produced with penicillin-G sensitive bacteria was completely cured by PC-G 1.8 mg per mouse a day, which provided maintenance of the concentration in serum more than 10 times of MIC for over 12 hours. The dosis of 0.18 mg per mouse per day was insufficient to bring a complete healing. 2) Experimental osteomyelitis produced with penicillin-G resistant bacteria did not heal completely, despite the administration of MPI-PC, a synthetic penicillin designed against penicillin resistant staphylococci, in a dosis of 5 mg twice a day, probably by the following reasons. Since MPI-PC is water-soluble, it is difficult to maintain the concentration in serum more than 10 times of MIC for over 1 hour. In other word, the bacteria was exposed to the effective antibiotic concentration for only one hour twice a day. 3) It was experimentally proved that earlier administration of antibiotics following inoculation provided quicker elimination of bacteria. 4) When bactericidal antibiotics were used, administration twice a day in half dosis gave better results compared with the full dosis once a day. 5) This experimental model of osteomyelitis proved quite useful for quantitative analysis of the effects of antibiotics, which would be applicable as a good method for evaluation of antibiotics to be developed in the future.


Evaluation of a primary nursing system using the quality patient care scale. The quality of nursing care at the Children's Hospital National Medical Center was measured with the QualPaCS evaluation instrument before and after the implementation of primary nursing. Significantly higher mean QualPaCS scores under the new primary nursing system at CHNMC suggest that this change improved the quality of nursing care.


Time management.

Time management. Maximization of the nurse administrator's managerial time is the focus of this article. Activities inventory, goal setting, assessing peak and low times, scheduling activities, using transition times, streamlining paperwork, using the telephone, office visits, and meetings are discussed. The author addresses planning, organizing, staffing, directing, and controlling at the organizational level as ways to maximize organizational time.


Control of Christmas holiday census and staffing. Most hospitals experience decreased census during certain holiday periods. The costs related to keeping units open during these periods are major problems for nursing administrators. This article describes a holiday staffing plan that addresses the personal needs of staff and the need to control operations. The same principles may apply at other low census periods such as during summer months, vacation periods, or strikes.


Developing a usable performance appraisal system. A sound, effective performance appraisal system is an important management tool for the nursing administrator. The author describes an approach to developing a performance appraisal system that yields reliable information about performance and is trusted and accepted by both appraisers and appraisees.


[Comparison of the antibacterial activity of ticarcillin with other antibacterial agents (author's transl)]. Antibacterial activity of ticarcillin was determined in comparison with that of sulbenicillin, amoxicillin, cefuroxime, clindamycin and metronidazole against anaerobic bacteria which have been isolated from various clinical materials in this hospital. Growth of more than 90% of Gram-negative anaerobic rod bacteria was inhibited by ticarcillin at its concentration of 100 micrograms/ml. Strains resistant to ticarcillin showed cross resistance against both sulbenicillin and amoxicillin. Antibacterial activity of ticarcillin against Gram-positive anaerobic bacteria was found almost equal to sulbenicillin but slightly inferior to amoxicillin. Cefuroxime was found most inferior among the tested six antibiotics when an inoculation level of 10(8)/ml was utilized, but it showed similar activity to ticarcillin when they were tested with 10(6)/ml inoculation. Approximately 10% of bacteroides strains was resistant to clindamycin while all the strains were sensitive to metronidazole.


Parent-parent support in the care of high-risk newborns. Despite the expertise of professional personnel in supporting parents of high-risk infants, parents with similar previous experiences can play a strong adjunctive role also. One program in which these parents were used as the key resource is described, including organization, actual operation, results, and problems.


Increase in diaphragm use in a university population. A striking increase observed in the demand for the diaphragm method at a contraception clinic for university women was documented by means of a record review and questionnaire. Record reviews completed at the conclusion of each semester from December 1973 to December 1976 showed a statistically significant increase in diaphragm acceptors. In the fall semester of 1976, diaphragm acceptors (49% of 151 patients) surpassed pill acceptors (46%). Data from 123 questionnaires revealed that concern for pill and IUD side effects was the primary reason for diaphragm choice. The study numbers are small, but a definite trend is evident. These educated young women may be forerunners, and an increase in diagphragm use in the general population may be seen in the near future.


Touching the high-risk obstetrical patient. Nurses are reminded that there is a patient, rather than just an array of technical marvels, in the intensive care labor unit. Practical measures for promoting the patient's physical ease are outlined, and the meaning of support is reviewed.


The ffect of early parent-infant contact on newborn body temperature. To determine whether infants who are properly dried and wrapped can be held and warmed by parents in the delivery room without suffering a significant heat loss, temperatures of 100 infants were monitored with electronic thermometers after delivery; 50 were held by one or both parents and 50 were not held but immediately placed in a heated transporter. A two-tailed t test showed no significant differences between temperatures of the two groups.


Considering patient-centered obstetric nursing care: why and how? The authors assay the need for, the procedures involved in, and the benefits derived from a primary nurse approach to providing patient-centered nursing care for those pregnant women who receive their major prenatal and postnatal care through clinic facilities rather than from private physicians.


Perceptions of the school nurse's role.

Perceptions of the school nurse's role. This study identifies and compares perceptions of school personnel (principals, teachers, counselors and school nurses) about the nurse's role in secondary school settings. A two-art questionnaire was utilized. Part one elicited descriptive data, while part two consisted of 50 Likert-type items related to the school nurse's role. Mean perception scores on the 50 items were obtained by job category and compared using a one-way ANOVA. Chi-square analyses were performed on the frequencies of scale values to determine if their distributions, by item, were the same for all job categories. Correlation coefficients were utilized to determine relationships between training levels, experience, direct contact and perceptions. Analyses revealed: (1) Significant differences in perceptions of the school nurse's role between each group of educators and school nurses. (2) No significant relationship between training level, experience, number of contacts with the nurse and perceptions of the school nurse's role.


Mental health and the teacher.

Mental health and the teacher. The emotional atmosphere in a classroom setting is important to the experiences of all students. That atmosphere is affeected by the emotional stability of the teacher. A teacher with personal mental health problems can have a detrimental effect upon all of those students who are associated with him or her. There are a variety of courses and contributing factors of mental health problems. Certain signs and symptoms, at times, can be identified that relate to emotional difficulties. It is important that measures be identified to help teachers with emotional problems. This is not always an easy task, yet it is necessary if the teaching-learning environment is to be of a positive nature. School administrators, teacher preparation programs, teaching peers, and self-analysis all should play a role in identifying one's teaching. This is a task that no one person or agency can accomplish alone. Though often felt to be an uncomfortable issue with which to deal, all educators must become increasingly aware of the problem and be willing to work toward greater emotional health of all teachers.


Cancer education for school personnel.

Cancer education for school personnel. A large segment of our society associates cancer with doom and despair. This negative view appears to originate partially from the public's general lack of knowledge of the disease and of current treatment potential. In response to this lack of information and overall pessimistic attitude, a cancer education course was developed for school teachers and school nurses. The unique two-day course provides cognitive and affective learning experiences. Through the multiple teaching strategies employed, students are able to examine their own health practices, increase their knowledge of cancer and cancer treatment, interact with a person who is successfully living with cancer, and learn how to share information related to cancer. At the conclusion of the course, a comparison of the participants' pretest and posttest scores indicate a statistical improvement in both their cognitive and affective domains.


Relevant curriculum planning in health education: a methodology. Procedures proposed to present a methodology for planning relevant health education curriculum included having students write out questions they felt their peers had about health in the specific content areas of community health, consumer health, diseases, drugs, alcohol, and tobacco, ecology, family life, nutrition, mental health, personal health and safety and first aid. A sample survey was presented where 80 junior high school students wrote a total of 981 questions and 74 senior high school students wrote 786 questions. Implications for the health education curriculum would be as follows: (1) Curriculum can be made relevant if the specific content covered is directly related to problems of daily living: (2) Provide needed cognitive information to meet real or potential problems of students; and (3) Provide guidance for the health educator in planning the kind and the amount of emphasis within the total health education program.


School nursing: current observations and future projections. A questionnaire was sent to 16 nurses in administrative, supervisory, consultant and educational positions to determined the curent state of school nursing. Opinions regarding the future of school nursing were also solicited. The results showed regional variations in the staffing levels, character of nursing practice, and use of school nurse practitioners. There was consensus that a provider image will be necessary and cost effectiveness will be crucial to the future of nursing.


A client-held health record in a health education curriculum. A pilot health education project stressing prevention and individual responsibility was developed and presented at two high schools. The health record, maintained by the individual, focuses on health maintenance and illness prevention; although it allows for recording illnesses as well. Preliminary results are encouraging. Students were interested in the course and the record and indicated their intent to continue using the record. The article describes the health record, the educational process used and directions for future research.


The life-after-death phenomenon.

The life-after-death phenomenon. The life-after-death phenomenon has created student interest and is often a topic initiated by students by students in death education courses. The article summarizes some popular publications about the life-after-death phenomenon and extracts commonalities that potentially affect other topic areas in a death education course or unit. Topic areas such as coping with death, suicide and stages of dying are then examined to note the effect the phenomenon can have on the topical discussions. The article concludes with a section on precautions in teaching the phenomenon.


School water fluoridation.

School water fluoridation. In areas lacking public water supplies and where fluoride is not naturally present in the well water, school fluoridation programs have been shown to be effective and safe. Reductions of up to 38.9% in the rate of dental decay have been reported. Higher levels of fluoride are used in the school water than in public water because of the limited time the children are in school. The relatively low cost of the necessary equipment and chemicals can easily be justified by taking into account the amount of dental decay that can be prevented. Interested parents, teachers, or administrators should contact their state health department for technical assistance.


Community Mental Health Care: new services from old systems. An integrated service system for the mentally disabled must encompass federally supported community centers and state-supported mental hospitals. The vision, of course, has been elusive. Rational coordination and collaboration will be politically difficult but economically necessary to achieve a just--and sane--society.


Abandonment of responsibility for the seriously mentally ill. The road leading to the demise of state responsibility for the seriously mentally ill and the current crisis of abandonment was paved with all the best intentions. Tragically, policies underlying the pattern of abandonment are based on erroneous interpretations of what patients need and what our current techniques can produce to help them. An index of declining hospital census must not be mistaken for the goal of care.


The mental health movement, 1949--1979.

The mental health movement, 1949--1979. Three decades of social experimentation in caring for the mentally ill have yielded many new programs, treatments, personnel, and facilities. Despite administrative complexities and historical divisions, alternatives are already available in general hospitals as well as in community centers. Future policies and priorities will not be clarified through recourse to unrealistic "medical models."


Deinstitutionalization in two cultures.

Deinstitutionalization in two cultures. American and British reformers may act as if reducing the number of beds alone reduces human distress or the incidence and prevalence of psychiatric illness. Deinstitutionalization requires a recognition of changed relationships between patients and staff, and between patients and families. Our two cultures have responded differently to questions of where, by whom, and how to treat their mental patients.


Some mental health premises.

Some mental health premises. The premises underlying our understanding of the nature of mental illness and its treatment are subject to cycles of fashion. Recurring emphasis is too often on structures and too seldom on functions within a system. Publicizing paradigms is no substitute for demonstration of efficacy.


Deinstitutionalization in context.

Deinstitutionalization in context. Unlike other policy developments, which are regular and cumulative or even circular, reforms in mental health have been characterized by a peak-trough movement. Public responses continue to be very different from professional responses to achieving the practical limits of mental health. Ironically, the lack of machinery to integrate special services into a broad national program has mobilized more creative energy in the United States than has been the case in Britain.


Prone immersion physical exercise therapy in three children with cystic fibrosis: a pilot study. Prone immersion physical exercise therapy has been used successfully in the physical rehabilitation of middle-aged adults with moderate to severe chronic obstructive pulmonary disease. The purpose of this pilot project was to evaluate the effects of PIPE therapy in children with cystic fibrosis. Three children with CF, two boys aged 6 and 14 years and one girl aged 15 years, voluntarily participated in the experimental training program. The patients performed individualized group exercise three times a week on alternate days for 28 consecutive weeks at an intensity of approximately 75 percent aerobic capacity. Duration of exercise gradually increased from 15 (3 x 5 minutes) to 60 (3 x 20 minutes) minutes while the rest period after each exercise was constant at two minutes. PIPE training resulted in increased physical work capacity and maximal oxygen consumption in all three subjects. Curiously, these changes were not accompanied by training bradycardia.


Health care workers' role conceptions and orientation to family-centered child care. This study, designed as a correlation survey, was predicated on the existence of belief systems and on the premise that health care workers' orientation to family-centered care can reflect the openness or closedness of their belief systems. It was hypothesized that health care workers' orientation to family-centered child care is directly related to their professional role conception and inversely related to their employee role conception. The two hypotheses were tested on a sample of nursing and medical personnel associated with restorative and preventive care of children in inpatient and outpatient settings in New York City, central Pennsylvania, and the Philippines. Three sets of Likert-type scales were used for data collection from 1974 through 1976. Data were analyzed by correlation technique and the F test. Findings supported the hypotheses, and some demographic factors were found to be reliable predictors of health workers' orientation to family-centered child care and their conception of the professional or employee role. Implications of the findings for nursing practice and education, as well as recommendations for future research, are discussed.


Prenatal education evaluation.

Prenatal education evaluation. Prenatal classes are commonly offered by hospitals with obstetrical units. To evaluate their effectiveness in one hospital, the relationship between the amount of medication used by women during labor and the birth weight of their infants following participation in one of three treatment groups was determined by a multivariate nonorthogonal analysis of covariance design. Women who attended a prenatal class program, it was found, required significantly less medication during labor than women exposed to other structured programs during pregnancy. There were no significant differences in birth weights among the infants born to women in the study. These findings, consistent regardless of age, race, and parity, suggest the value of prenatal education in reducing levels of medication required by women during labor.


Family nurse practitioners: perceived competencies and recommendations. Responses to a mail questionnaire returned by 327 family nurse practitioners throughout the United States provided data for this study. Categories of health problems respondents encountered, from highest to lowest mean frequency, were: cardiovascular and respiratory; neurologic/musculoskeletal; eye, ear, nose, and throat; emergencies; mental health; miscellaneous; gastroenterology; allergy and dermatology; obstetrics and gynecology; genitourinary; endocrine; oncology. Respondents, as a group, judged themselves moderately competent to handle problems they encountered. That is, to the question. "What overall percentage of patient needs and problems you encounter do you estimate you are able to handle without further referral or consultation?," the mean response was 66 percent. Discussion centers on where in the nursing education process family nurse practitioner competencies should be taught.


Reasons nurses participate in continuing education. The study was undertaken to identify dimensions, or motivational orientations that underlie reasons nurses participate in continuing education programs and to determine relationships between these orientations and the legal status of CE and selected demographic characteristics of participants. The sample included 843 nurses who participated in CE programs sponsored by colleges and universities with accredited baccalaureate schools of nursing. Two instruments were used for data collection: a 56-item checklist consisting of reasons for participation (Education Participation Scale) and a personal data sheet. Factor analysis of responses to the EPS indicated that seven motivational orientations underlay the nurses' reasons for participation: compliance with authority, improvement in social relations, improvement in social welfare skills, professional advancement, professional knowledge, relief from routine, and acquisition of credentials. Mean scores on each orientation for the entire sample ranged from 6.55 (professional knowledge) to 1.57 (improvement in social relations) on a 10-point scale. Analysis of variance to determine the relationship between motivational orientation scores and legal status of continuing nursing education revealed no differences among the three legal conditions studied---mandatory, proposed, and voluntary CE---except on the acquisition of credentials orientation. Scores on this orientation varied significantly (p less than .001), but only for respondents employed part-time; for these nurses mean scores were ranked mandatory, proposed, then voluntary. Study findings suggest that, for these nurses, the presence or threat of a mandatory CE law had little influence in motivating participation. Rather, these nurses participated in continuing nursing education programs for reasons related to maintaining professional currency and improving their ability to serve the public.


Nurse practitioner employment, unemployment, reemployment. An estimate for nurse practitioner unemployment is attempted, based on responses of 260 graduates of a single program and published data. Reasons for not working are examined. The activity of NPs is compared to registered nurses. Job changers are compared to those who remained in the same job since graduation. Some of the reasons for unemployment and nonparticipation in the labor force are examined. Suggestive evidence on job changing is reviewed. Finally, policy implications are discussed.


A survey of health needs of older adults in northwest Johnson County, Iowa. In 1975, the 1972 survey by the DuPage County, Illinois, Health Department (Managan et al. 1974) was replicated in an eight-township area of Johnson County, Iowa, to compare and document areas of nursing needs for the nursing division of a rural health center and to determine if the Illinois findings were generalizable to a setting which included both similarities and differences. The DuPage County population was urban, while the Johnson County population had a strong farm background and the majority of the subjects still resided on a farm. The DuPage County sample of 1,466 represented approximately 5 percent of the elderly population. The sample size in the Johnson County study was only 82; however, it represented approximately 10 percent of the elderly in the eight townships of the study area. The method of interviewing in the resident's homes was replicated as was DuPage's method of statistical analysis. Comparison of data from the two counties showed striking similarities in all parameters: health condition, physical functioning accessibility of medical care, social isolation, and service needs. Both studies found need for additional health services. A multiple disciplinary service approach to health needs would assist the elderly to remain in their own homes longer and to improve the quality of their lives. In the Iowa study, four questions to determine satisfaction with present living facilities and with adequacy of income for needed medical and dental costs were added. When these answers were compared to two previous Iowa studies, findings were similar.


Interpersonal trust and empathy in nurse-nurse relationships. The specific purpose of a study that examined interpersonal communication in ongoing nurse-nurse dyads was to ascertain the nature of the relationship between interpersonal trust and empathy in nurse-nurse interaction. Analysis of questionnaire data collected from a sample of 36 diploma school nursing instructors indicated slight correlations between specific trust and general trust and between general trust and empathy. A strong negative correlation was found between specific trust and empathy. Discussion centered on an explanation for the inverse relationship between specific trust and empathy and a proposed model for how trust functions in ongoing nurse-nurse dyads.


Psychiatric aspects of deafness.

Psychiatric aspects of deafness. Paranoia has long been associated with deafness, but the most significant psychiatric questions in the field of deafness concern the effects of prelingual deafness on intelligence, personality, and control of aggressive drives. With intensive language training, an emotionally favorable family situation, and adequate education, prelingual deafness has little or no deleterious effect on intelligence or personality. It does not predispose to major psychotic illnesses, but probably affects character structure in such a way as to accentuate impulsivity, and weaken depressive and obsessional traits. In order to prevent psychiatric morbidity in the deaf, the primary care physician needs not only to be able to diagnose and treat deafness and its causes, but also to grasp the importance of family counseling, adequate communication and education, and vocational rehabilitation for the deaf.


Psychological aspects of menopause.

Psychological aspects of menopause. There are no psychological symptoms specific to menopause, though minor psychological complaints such as irritability may increase in women aged 45 to 55. These symptoms seem to be related to psychosocial stress, social class, or cultural group rather than to hormone imbalance alone. Management requires careful assessment of the medical as well as the psychosocial situation.


Getting alcoholics out of your office, into treatment, and back to your office. There have been important expansions in knowledge about alcohol recently. In this chapter a number of advances pertinent to the family practitioner are summarized. However, technology is not our focus. We are talking first about troubled people. The applications of research may help such people in practice. However, our main concern is for the patients and their families as a primary care practitioner rightly should be. Therefore, scientific study results are interspersed among the sections on a variety of clinical concerns. Alcohol abuse and alcoholism are family affairs. Families are complex interactive systems that serve to maintain themselves and their members. Under certain conditions the powerful forces at work within a family can promote the use of alcohol as an effort to solve problems. This chapter has discussed some methods which may be used to change them. Alcohol also presents a number of specialized problems that may occur in family practice. We include recent modifications in the treatment of withdrawal. Another syndrome increasingly observed is that of the effects of alcohol on the human fetus. The interesting but less usual manifestations of alcoholism are also noted in passing.


Parasympathetic cholinergic vasodilator mechanism in the terminal liver microcirculation in rats. Changes in the diameter of liver sinusoids were studied by an intravital television microscope method in pentobarbital-anaesthetized rats. Dilatation of liver sinusoids was observed during parasympathetic neural stimulation and during acetylcholine administration. Frequency-dependent stimulation-effect relationships were obtained by electrical excitation of intact vagus nerves at supramaximal intensity from 2 to 8 Hz. Acetylcholine concentration-effect relationships were also obtained by intraportal venous infusions of acetylcholine 30 microliter for 5 s from 10(-9) to 10(-2) mol.1(-1). Systemic cholinergic receptor blockade with atropine (1 mg.kg-1) markedly reduced dilatation of liver sinusoids produced by both vagus nerve stimulation and acetylcholine administration. Changes in diameter of liver sinusoids with frequency of neural stimulation and with concentration of administered acetylcholine were also expressed as percentage of observed maximum effect and the respective stimulation-effect curves were constructed such that at a certain percentage of diameter change, the equivalent level of vagus nerve activity was represented by a given concentration of administered acetylcholine. Liver plasma concentration of acetylcholine presumably released during electrical vagal stimulation and reaching liver sinusoids was also estimated and found to be within physiological range. It is therefore proposed that rat liver sinusoids have the capacity for parasympathetic cholinergic vasodilatation.


Inhibition by angiotensin II of some vasopressin effects on renal function in sheep. The effects of intravenous infusions of arginine vasopressin (AVP) alone and with angiotensin II (AII) on renal function were studied in conscious Merino ewes. AVP at 11.5 pmol.min-1 caused an increase in water and electrolyte output which was associated with a rise in glomerular filtration rate (GFR), solute clearance, solute-free water reabsorption and tubular sodium reabsorption. Addition of AII of 100 ng.min-1 generally reversed all of these effects. The filtration fraction, which rose during AVP infusion, increased further when AII was added due to a greater fall in renal plasma flow than in GFR. The diuretic and electrolyte-excreting effects of infused AVP appeared to be brought about by an increase in GFR. It is suggested that this inappropriate effect of AVP, which is secreted in response to water deprivation, could be countered by the simultaneous production of AII.


The effect of ammonium ion concentration on the activity of adenylate cyclase in various rat tissues in vitro. The effects of three different ammonium ion concentrations (0.143; 1.43; 14.3 mmol .1(-1)) on adenylate cyclase activities in liver, muscle, fat and brain tissue in vitro were studied in the rat. At physiological levels, ammonium ions reduced adenylate cyclase activity in liver and fat by about 30%, did not affect enzyme activity in muscle tissue but increased adenylate cyclase activity in brain by 40%. Similar effects were observed at higher ammonium ion concentrations though there were no statistically significant correlations between ammonium ion concentration and the degree of change of enzyme activity.


Effect of the Canadian Air Force training programme on a submaximal exercise test. Validation of the submaximal heart rate/oxygen consumption relationship as an index of 'cardiorespiratory fitness' requires the demonstration of systematic alterations in this relationship concomitant with interventions designed to alter physical fitness. To fulfil those criteria a longitudinal training/de-training study was undertaken. Previously sedentary adult subjects undertook the Canadian Airforce 5BX-XBX exercise programme. Submaximal exercise tests were performed before and after training, and following several weeks cessation of training. A regression line of submaximal heart rate on submaximal oxygen consumption was calculated from the data of each submaximal exercise test. Alterations in the regression lines were examined for each subject individually by testing statistically for difference in slope and elevation between any pair of lines. Subjects who undertook the training/de-training study demonstrated significant systematic alterations in the elevation of the regression lines concomitant with periods of training and de-training. The reproducibility of the submaximal heart rate/oxygen consumption relationship was examined in two additional groups of subjects. Group A repeated a submaximal test on 3 or 4 successive days; Group B were tested before and after 16 weeks of normal activity. Subjects in Group A demonstrated non significant, random alterations in the regression lines on repeated testing and subjects in Group B demonstrated random, though on occasion significant, alterations in the regression lines. The elevation of the submaximal heart rate/oxygen consumption relationship is therefore a valid index for detecting sequential changes in 'cardiorespiratory fitness' in individual subjects.


A comparison of the oxygen consumption/body weight relationship obtained during submaximal exercise on a bicycle ergometer and on a treadmill. It is widely accepted that the relationship between oxygen consumption and body weight obtained during exercise on a bicycle ergometer differs from that obtained during treadmill walking. Experimental evidence to support this claim is lacking. To examine this difference a group of subjects (body weight 41--81 kg) undertook a predetermined level of submaximal exercise on a bicycle ergometer and a treadmill. Oxygen consumption was measured in a steady state at rest (i.e. sitting on the bicycle ergometer and standing on the treadmill) and during the two modes of exercise. A significant positive correlation between oxygen consumption and body weight was obtained under all four conditions of measurement. At rest the two regression lines did not differ in slope or elevation. During exercise the slope and the elevation of the line obtain from treadmill walking were significantly greater than from bicycle ergometer exercise. The 'metabolic cost' of bicycle ergometer exercise, (Vo2 during exercise--V02 at rest), showed no significant correlation with body weight. In contrast, there was a significant positive correlation during walking. It is suggested that these differences have arisen due to a different proportion of the total body weight supported by the subject in the two forms of exercise.


Lactation in the rabbit: mammary blood flow and cardiac output. In anaesthetized rabbits, cardiac output (C.O.) and its distribution to the mammary glands, heart, liver and kidneys have been determined in established lactation (11--13 days), later lactation (26--27 days) and in virgins. During lactation, the volume of circulating blood, C.O., mammary blood flow and mammary weight were significantly greater than in virgins. There were no significant differences in C.O. and % C.O. received by the mammary glands between established and late lactation, and no significant decrease in mammary blood flow in late lactation. The weights of the liver and kidneys were significantly increased in lactation but there were no significant differences in liver, heart (coronary) and kidney blood flow. The rate of growth of the young was positively and significantly correlated with % C.O. received by the mammary glands and mammary weight, but not with C.O. Strong correlation was also observed between the % C.O. received by the mammary glands and mammary weight. There were no significant differences in C.O., mammary % C.O. and mammary blood flow in animals in established lactation 2--3 h and 24 h after suckling (i.e. shortly after and just before suckling). By 48 h after the last suckling mammary blood flow and % C.O., but not C.O., were significantly decreased. Possible factors causing these changes are discussed. The results are discussed in relation to the change in milk composition that occurs in late lactation in this species and to the role and effects of prolactin. It is suggested that events occurring during lactation have different sensitivities to prolactin.


Aminoacyl-transfer RNA populations in mammalian cells chromatographic profiles and patterns of codon recognition. The chromatographic profiles of 20 aminoacyl-tRNAs from rabbit liver were compared to those of rabbit reticulocytes by reverse phase chromatography and the chromatographic profiles of 20-aminoacyl-tRNAs from bovine liver were compared to those of bovine brain. The two rabbit tissues showed significant differences in the elution profiles of most aminoacyl-tRNAs, while the elution profiles of the aminoacyl-tRNAs from the bovine tissues showed fewer differences. The patterns of codon recognition of several aminoacyl-tRNAs fractionated from rabbit reticulocytes have also been compared to those fractionated from rabbit liver.


Significance of maternal uterine proteins in the establishment of pregnancy. Mammalian embryonic development depends on extrinsic support by the maternal organism. During the preimplantation period the growing blastocyst needs favourable environmental conditions, which are provided by endometrial transformations and secretion. The macromolecular composition of uterine secretion at different times before implantation is characterized by a spectrum of protein patterns which change daily. In an attempt to shed light on the significance of the uterine secretion proteins, particularly uteroglobin in the rabbit, in the establishment of early pregnancy, analyses are reported which demonstrate the origin and endocrine control of the synthesis and release of these proteins. In a comparative study of blastocyst development in vivo and in vitro the significance and consequences of asynchrony between the embryonic and maternal reproductive phases are investigated. Particular attention is drawn to uterine influences on the rabbit blastocyst coverings, and how embryonic development can be retarded by abnormal structural transformation of the zona pellucida and the mucin coat. Finally, the covenient experimental systems of pseudopregnancy and of delayed uterine secretion in the rabbit permit an approach the question of whether the uterine macromolecular components constitute a maternal response to the presence of the as yet unimplanted blastocyst.


Molecular and cellular aspects of facultative delayed implantation in the mouse. Various aspects of RNA, DNA and protein synthesis, as well as cellular fine structure, were examined in mouse embryos during the developmental diapause associated with delayed implantation, and during the reactivation of the embryo either by hormonal administration or by culture in vitro. The findings from these studies demonstrate that a cessation of DNA synthesis and mitosis, and a marked decline in the level of protein synthesis, but not of RNA synthesis, accompany diapause. Reactivation of the blastocyst results in the resumption of DNA synthesis and cell division, as well as in quantitative and qualitative changes in protein synthesis. At the fine-structural level diapause is indicated by the accumulation of lipid-like vacuoles, microfilaments, a basal lamina coating trophectodermal cells and the disassembly of polysomes into ribosomes. Significantly, nucleolar morphology remains unaltered during diapause and cisternae of the rough-surfaced endoplasmic reticulum persist at least for the first five days of delay. Reactivation of diapausing blastocysts is associated with the reassembly of polysomes and the accumulation of large quantities of an amorphous material within the cisternae of the rough-surfaced endoplasmic reticulum. Studies of blastocyst growth and development in vitro suggest experimental approaches to the question of the regulation delayed implantation. Finally, the role of ionic balances and concentrations in the control of the onset, maintenance and termination of delayed implantation in the mouse is discussed.


Hormonal control of embryonic diapause and reactivation in the tammar wallaby. Suckling is the most important and best-known influence that the marsupia offspring exerts on its mother but recent evidence suggests that this is not the only way it proclaims its presence. The pregnant female differs from the non-pregnant in several features, which appear to be due to the presence of the conceptus in the uterus. The converse influence of the female on the embryo is best known in kangaroos and wallabies because the facultative and obligate embryonic diapause they exhibit has provided excellent opportunities for experimental investigation of the environmental and hormonal control of early pregnancy. Results from the tammar wallaby, which exhibits both types of diapause, show that the initiation of diapause occurs on Day 8 p.c. The sequence of events that lead to blastocyst reactivation, after removing the suckling stimulus (facultative diapause), takes seven days and involves a reduction in prolactin secretion from the anterior pituitary, reactivation of the corpus luteum, increase in endometrial secretion and reactivation of the blastocyst. The ultimate control of obligate diapause involves alteration of photoperiod but the role of prolactin is still uncertain.


Human chorionic gonadotropin and maternal recognition of pregnancy. The corpus luteum of the ovulatory cycle is essential for establishing and maintaining the first seven weeks of human pregnancy. Progesterone, given parenterally, appears to be a satisfactory substitute for the corpus luteum, known to be the source of this steroid hormone during this period. Moreover, hCG appears to be essential for sustained secretion of progesterone by the corpus luteum, particularly during the first three weeks after fertilization. In primates at least, neutralization of the biological effects of CG during this critical period results in a reduction of blood progesterone levels and the interruption of pregnancy. Although alternative sources of hCG exist, and the physiological relevance of these sources requires further study, hCG appears to be essential component in the maternal recognition of pregnancy.


Blastocyst oestrogen synthesis and the maternal recognition of pregnancy. The maternal recognition of pregnancy takes a number of forms in different species; among the eutherian mammals the maintenance of luteal function and cessation of oestrous or menstrual cycles is an important event in early pregnancy. In the pig the embryos signal their presence in the uterus between Days 10 and 12 post coitum; this time corresponds to the onset of blastocyst synthesis of oestrogens, which are luteotrophic in this species, and it has been suggested that oestrogens may constitute an embryonic signal responsible for maintained luteal function in pregnancy. Although oestrone sulphate, which is formed from oestrogens of embryonic origin by uterine sulphotransferase, has been found in the maternal circulation in high concentrations after Day 15 p.c., its appearance is late relative to the time of maternal recognition of pregnancy. Therefore an alternative mechanism has been sought. The recent finding that oestradiol is capable of reducing uterine prostaglandin F2 alpha secretion (i.e. acting as an antiluteolysin), and that it is present in uterine venous blood as early as Day 12 p.c. in pregnant pigs, suggests a mechanism whereby blastocyst oestrogens may be capable of influencing luteal function.


Antiluteolytic effect of the embryo.

Antiluteolytic effect of the embryo. In several mammalian species, prostaglandin F2 alpha (PGF2 alpha) released from the uterus causes corpus luteum regression, and thereby regulates the length of the oestrous cycle or pseudopregnancy. If the animal becomes pregnant, luteal regression must be prevented since ovarian progesterone is necessary for pregnancy maintenance during at least the first one-third of pregnancy. Evidence is presented that the guinea-pig conceptus produces an antiluteolytic factor which suppresses PGF2 alpha output from the uterus by preventing the increase in uterine PGF2 alpha-synthesizing capacity which occurs around the time of luteolysis. Experiments in unilaterally pregnant guinea-pigs, with either an intact or a transected sterile horn, indicate that this factor acts both locally systemically, though separation of the two uterine horns does greatly reduce its effect on the sterile side. Oestradiol administered during early pregnancy induces abortion, which is associated with a high PGF2 alpha-synthesizing capacity of the uterus. However, luteal regression does not take place while the conceptuses are in the uterus. Spontaneously aborting guinea-pigs behave similarly. The conceptus may therefore secrete a luteotrophic hormone as well. Luteal maintenance during early pregnancy in other species is discussed, since experiments on sheep indicate that the sheep embryo may also secrete an antiluteolytic factor.


Maternal recognition of pregnancy and immunological implications of trophoblast-endometrium interactions in equids. Fertilized eggs reach the uterus of the mare by the sixth day after ovulation whereas unfertilized eggs remain lodged in the fallopian tubes for many months. However, embryo removal studies indicate that the fetal message for luteal maintenance in the pregnant mare is not transmitted until Days 14-16. The equine endometrial cups comprise a series of small, ulcer-like endometrial outgrowths which are present in the pregnant horn of the uterus between 40 and 150 days of gestation. Each cup consists of a discrete colony of large, gonadotropin-secreting, trophoblast cells derived from a specialized region of the fetal membranes which invade the maternal endometrium around Day 37 after ovulation. Histological examination of endometrial cups from horses and donkeys, carrying intra- and interspecific conceptuses and after reciprocal transfer of hybrid zygotes, indicates maternal recognition of paternal transplantation antigens on the endometrial cup cells. This leads to a successful cell-mediated immune reaction which destroys the cups. The development of the local immune response is paralled by a rapid rise in the titre of paterno-specific cytotoxic antibodies in maternal serum. The precise function of endometrial cups in the maintenance of equine pregnancy remains to be elucidated.


Changes in the surface of the mouse blastocyst at implantation. Implantation is a critical event, and perhaps the earliest one, in the maternal recognition of pregnancy. Information transfer from conceptus to mother might occur during, and subsequent to, implantation at the level of cell surface interaction. Therefore, attempts have been made both to identify the phases of implantation during which changes in the blastocyst surface occur and to characterized such changes. In vitro, blastocysts have been found to go through a series of discrete steps which are analogous to implantation in utero, and these steps can be retarded or prevented by the use of either suboptimal culture media or an inappropriate substratum. Morphological surface changes are not apparent when the blastocyst becomes adherent to the substratum; however, marked differences in blastocyst surface structure are revealed by scanning electron microscopy at the onset of trophoblast outgrowth. Studies at the molecular level implicate collagen as having a role in blastocyst adhesiveness, but other cell surface components are also likely to be involved.


When a conception fails to become a pregnancy. Other contributors to this symposium have analysed in great detail the many components that go to make up reproductive success, so it is fitting to conclude with some thoughts about the aetiology of reproductive failure. Firstly, there are occasions when reproduction can be too successful, so that a density-dependent mechanism for inducing early embryonic mortality may be a most valuable protective mechanism. This is particularly true for polytocous species, where it may be necessary to achieve some regulation of litter size by differential embryonic mortality. Even in monotocous species some degree of embryonic mortality may also be advantageous as a way of prolonging the interval between successive births, for if one infant follows too hard upon the heels of another, the normal growth and development of both offspring will be permanently impaired. Embryonic mortality is also likely to be an effective insurance mechanism against the production of genetically defective offspring, because the absence of haploid gene expression will protect the spermatozoon from maternal immunological surveillance systems. With these concepts in mind, it is interesting to look at the nature and extent of embryonic loss in man and animals.


[Fiber type disproportion, a subtype of so-called nonprogressive myopathies (author's transl)]. The clinical course, serological, and electromyographic findings, and also histological, histochemical, and electron microscopic abnormalities of two patients with congenital fiber type disproportion, a subtype of the so-called congenital nonprogressive myopathies, are described in this study. Other important subgroups are discussed regarding both variation and overlapping. As these diseases neither belong to the "classical" myopathies nor to the neuropathies, other possible factors such as a distrubed trophic function of the nerve or abnormalities of the reflex arc are under consideration.


Genetics of staphylococcal enterotoxin B in methicillin-resistant isolates of Staphylococcus aureus. Biophysical and genetic analysis of staphylococcal enterotoxin B (SEB) synthesis in 16 methicillin-resistant (Mecr) Staphylococcus aureus isolates demonstrated that the toxin gene (entB) can occupy either a plasmid or chromosomal locus. Biophysical analysis of the plasmid deoxyribonucleic acid content of these strains by agarose gel electrophoresis revealed the presence of a 1.15-megadalton plasmid in six isolates that appears to contain the entB gene. Genetic manipulation of SEB synthesis by transduction and elimination procedures demonstrated that this plasmid is critical for enterotoxigenesis. Nevertheless, the majority of the Mecr SEB+ isolates (62.5%) analyzed in this investigation were found to lack the 1.15-megadalton plasmid. In at least two of these strains (COL and 57-dk), transduction and elimination procedures showed that entB was chromosomal. Genetic studies involving strains harboring either a plasmid or chromosomal entB gene demonstrated that toxin synthesis was coeliminated with mec. However, analysis of the entB and mec loci by transformation or transduction showed that the genes are not closely linked. On the other hand, transduction of entB, regardless of the donor, was observed when both mec and the Tcr plasmid were jointly cotransduced. This finding suggests that, during transduction, a transient association between entB, mec, and the Tcr plasmid may exist.


Bacterial contamination potential of sterile, prefilled humidifiers and nebulizer reservoirs. Contaminated respiratory therapy equipment may be responsible for the spread of pathogens to hospital patients. This study focused on the potential for contamination of prefilled, sterile, disposable water and saline systems for humidification and nebulization. Gas and liquid samples from 48 prepacked oxygen humidifier/cannula and 26 prepacked nebulization setups were taken at the initial application of devices and at 8, 24, 48, and 72 hour intervals, totaling 386 cultures. All samples from the humidifier units were found to be pathogen-free for up to 3 days. A total of six or 3.84% of the nebulizer samples showed contamination with Enterobacter cloacae after 8 to 24 hours of operation. It was concluded that the potential for contamination of the humidifiers is low for up to 72 hours, but the nebulizer units should be changed after 24 hours even though their contamination rate is markedly lower than that of conventional nondisposable units.


Prolonged repolarization changes following ventricular tachycardia. We have described an apparently healthy young man who presented with ventricular tachycardia of 12 hours' duration requiring cardioversion. Serial electrocardiograms showed persistent ST-T wave changes lasting for more than 40 days after cardioversion. These were attributed to the previous tachyarrhythmia in the absence of any evidence of heart disease at cardiac catheterization or clinically over a 5 year follow-up period.


Variant angina: a nursing approach.

Variant angina: a nursing approach. Variant angina presents as an atypical form of angina caused by coronary artery spasm. Due to the sudden disruption of blood and oxygen supply to the myocardium, a number of severe hemodynamic changes may occur, including life-threatening dysrhythmias, and left ventricular dysfunction. Rapid intervention can alleviate the symptoms caused by the arterial spasm and prevent catastrophic results. The critical care nurse plays a vital role in the diagnosis of variant angina and rapid treatment of the patient.


Acute problems in the coronary care unit that do not require intervention. IV. Acute block in the A-V node. Second- and third-degree (complete) A-V block due to an acute inferior wall myocardiac infarction does not require any treatment if the heart rate (from the junctional pacemaker) is in a range that permits an adequate blood pressure with adequate peripheral perfusion. The patient is watched carefully for any symptomatic fall in blood pressure in order to promptly correct a bradycardia-related fall in cardiac output. The clinical state of the patient with the arrhythmia is treated, and not just the arrhythmia.


Microwave thermography: principles, methods and clinical applications. We review the physical principles, method of operation, measurement limitations, and potential medical applications of microwave thermography. We present detailed results of a study of breast cancer detection at 1.3 and 3.3 GHz, including the dependence of detection rates on microwave frequency, time, tumor depth, and tumor size. At 1.3 GHz, microwave thermography detects breast cancer as well as infrared thermography (true-positive rate = 0.76 when true-negative rate = 0.63). When the two methods are combined, the true-positive rate increases by about 0.1 over that of either method alone.


A new radiation balance microwave thermograph for simultaneous and independent temperature and emissivity measurements. In the past, biomedical temperature measurements by microwave radiometry suffered from variable mismatch (emissivity less than 1) between the specimen under test and the receiving antenna. We have developed an improved radiometer, which simultaneously measures temperature and emissivity, independent by of a possible mismatch. Comparative measurements demonstrate the superiority of the new system as compared to conventional ones.


Millimeter-wave thermography--application to breast cancer. Thermographic studies of 14 patients with breast carcinoma were performed using two millimeter wave scanners for 30 and 68 GHz. Small correlation with infrared thermograms was observed indicating the depth sensing capabilities of millimeter waves. Correlation with mammographic and other clinical findings was good for tumors with medium subcutaneous depth. These preliminary results indicate a need for a statistically more significant number of cases, extension towards lower sensing frequencies and experiments on postoperative specimens and phantom models.


Simultaneous microwave local heating and microwave thermography. Possible clinical applications. A basic experiment showing the possibility of combining microwave local heating of subcutaneous living tissue, and microwave radiometry by the same system was carried out. The combined process may be used - in hyperthermia therapy, for measurement and control of the local temperature, - in some diagnoses using radiometry to detect diseased tissue.


Therapeutic potential of conformal applicators for induction of hyperthermia. One of the basic requirements for effective use of hyperthermia in treatment of cancer is the delivery of uniform heat to specific volumes of tissues and maintenance of the optimal temperature for an appropriate period of time. Preliminary results of temperature distribution in volumes of tissue placed between two conformal applicators energized at 2.45 GHz are presented. The applicators consist of a jointed-circuit antenna array comprising a multiplicity of dipoles backed by a metal cavity filled with a powder of high dielectric constant, and separated from the treatment area by a "beanbag" filled with the same powder. Uniform heating could be achieved in a tissue mass confined between two applicators placed 5 cm apart.


A microwave heating system for improving temperature uniformity in heated tissue. A microwave heating system, designed to improve temperature uniformity in heated tissue, is described. The system employs parallel-opposed waveguide applicators, operating in the TE10 mode at 2450 MHz with the tissue to be heated (i.e. mouse intestine) immersed in a liquid which is both biologically compatible with and dielectrically similar to the tissue. The liquid improves the microwave coupling and avoids shape and size dependent absorption characteristics of the irregularly shaped tissue. Also, by maintaining this liquid at a suitable temperature with respect to that required in the tissue, the thermal losses and hence temperature gradients in the tissue are reduced compared with heating in hot liquid alone.


The mimimum inactivated cell ratio: a concept for the estimation of biological effectiveness of hyperthermic treatment of tissue. The experimental conditions used to investigate the dose-effect relationships for hyperthermic treatment of cells in vitro cannot be realized in vivo. Thus it is not possible to predict the cell inactivation due to a hyperthermic treatment of the tissue in vivo, using the in vitro dose-effect-relationships. However, the in vitro dose-effect curves in combination with the temperature field in vivo make it possible to calculate the lower limit of the biological effect, the minimum inactivated cell ratio (MIR). This magnitude is of clinical relevance. The present paper gives the algorithm for the calculation of the MIR, and discusses the influence of the heat supply time on the local biological effect for a model with spherical symmetry.


Numerical calculation of electromagnetic energy and temperature distribution in a microwave irradiated breast carcinoma: preliminary results. In this study an attempt was made to calculate temperature distribution in a breast tumor irradiated by microwaves. An ellipsoidal model of absorbing dielectric surrounded by a nonabsorbing medium irradiated by a plane wave was considered. The energy was calculated inside and outside the ellipsoid by an analytical method. Three-dimensional and densitographic patterns were calculated for different frequencies, conductivities and shapes of the model. Assuming experimental (in vivo) thermal properties of breast tissue thermal patterns were calculated.


Influence of microwave irradiation on cultured glioma cells I. An enzymatic and scanning electron microscopy study. Temperature-induced variations in the surface morphology of cultured glioma cells were evaluated by scanning electron microscopy. Furthermore, after irradiation by microwave power, plasminogen activator activity was measured in cell cultures. The data suggest that heating of glioma cells to about 51 degrees C causes thermotropic protein transitions of cell surface together with an irreversible loss of plasminogen activator activity.


Experimental studies on the use of microwaves for the localized heat treatment of the prostate. High frequency tumor therapy requests heating of a well defined area, whereas the surroundings should be unaffected. This sort of therapy should be more tolerable than a whole body heating. For this purpose a new developed microwave applicator (433.9 MHz) for local heat application was tested in animals. Using this rectally insertable applicator the prostate of dogs were irradiated. The temperature of the rectum, the urethra and the prostate were measured and recorded using specially developed thermistor probes. The effect of hyperthermia on the prostate and the surrounding tissue was analyzed macroscopically and micromorphologically. It was shown that local heating of the prostate of dogs is possible. The induced damages of the prostate and surrounding tissue is not severe enough to be untolerable.


Cancer therapy with localized hyperthermia using an invasive microwave system. A system has been developed for producing local hyperthermia in small animal tumors by means of an invasive needle microwave antenna. Thermal distributions produced by this system using 1 GHz microwaves have been characterized in mammary adenocarcinomas (MTG-B) implanted in thighs of C3H mice. Therapeutic efficacy by hyperthermia was demonstrated by comparing MTG-B diameters in mice following control, sham or hyperthermia treatment. It is proposed that this system could be employed clinically to provide very local hyperthermia in deep-seated tumors.


A system for reporting quantitative antimicrobic susceptibility test results. A reporting system for the laboratory to communicate quantitative antimicrobic susceptibility test results to the physician in a manner that will optimize proper utilization of such test results is described. Minimal inhibitory concentrations are reported on a scale of clinically achievable concentrations, thus indicating the degree of susceptibility.


Antibiotic activity in vitro against methicillin-resistant Staphylococcus epidermidis and therapy of an experimental infection. Staphylococcus epidermidis is a major pathogen in early prosthetic valve endocarditis and cerebrospinal fluid shunt infections. Approximately 10 to 15% of hospital isolates are methicillin resistant. Ten clinically significant isolates of the latter were collected for antibiotic studies in vitro and in an experimental infection in animals. Time-kill studies of five strains showed gentamicin to be the single most effective antibiotic; however, dwarf colony variants emerged as survivors with two of these strains when challenged with gentamicin alone. The addition of a second antibiotic to gentamicin did not significantly improve the bactericidal rate but prevented the emergence of variant strains. A blood culture isolate of methicillin-resistant S. epidermidis combined with 5% hog gastric mucin was used to establish an experimental intraperitoneal infection in mice. Neither methicillin nor nafcillin treatment reduced mortality below that of untreated animals. Cephalothin treatment delayed early mortality but did not diminish overall mortality. Gentamicin was the most effective single antibiotic, and gentamicin in combination with vancomycin was the most effective regimen overall. The combination of rifampin plus vancomycin was as effective as gentamicin alone. The combinations of cephalothin or nafcillin with gentamicin and cephalothin with vancomycin demonstrated antagonism. The antagonism was not due to multiple injections or drug-drug inactivation.


Theoretical study of hydration of RNA.

Theoretical study of hydration of RNA. The hydration phenomena of A-RNA double helix and the anticodon loop of transfer RNA have been theoretically investigated using the empirical potential energy functions. The hydration schemes of a model compound of A-RNA and a polynucleotide which has the structure of the anticodon loop of yeast tRNAPhe have been determined, and their stabilization energies produced by the introduction of water in the first hydration shell were calculated by considering the hydrated ones as supermolecules. The results indicate that hydration scheme of A-RNA considerably differs from that of B-DNA and stabilization energy due to hydration of A-RNA is not so great as B-DNA. In the anticodon loop structure, however, stabilizing effect of the bound water molecules upon the structure is significant. From the results, the reason why the structure of RNA remains unchanged with the change of hydration degree while that of DNA is altered was studied.


Preferential binding of isoaccepting species of tRNALys and tRNAIle from lupin cotyledons to polyribosomes. Polyribosome-bound and -unbound isoaccepting species of tRNALys and tRNAIle, isolated from lupin cotyledons, were compared by RPC-5 chromatography and it was found that polyribosomes preferentially bind some of the isoaccepting species. The preference in binding of given isoacceptors changes with the age of lupin seedling. The results suggest that the tRNALys species recognising the same codons can affect the rate of translation in lupin cotyledons.


Under-modified Y base in a tRHAPhe isoacceptor observed in tumor cells. A fluorescent wye (Ye) was isolated from tRHAPhe specific to Ehrlich ascites cells. The structure was determined to be alpha-amino-beta-hydroxy-4,9,-dihydro-4,6-dimethyl-9-oxo-1-H-imidazo(1,2-alpha)purine-7-butyric acid: namely the compound lacking methyl carboxyl and methyl groups and thus is an under-modified precursor of hydroxy-Y base present in normal liver tRNAPhe.


Inhibition of deacylation and improvement in N-hydroxysuccinimide ester modification of phenylalanyl-tRNA by dimethyl sulfoxide. We have found that dimethyl sulfoxide significantly inhibits deacylation of Phe-tRNA. This allows a high pH in N-hydroxysuccinimide ester reactions while maintaining a high level of aminoacylated tRNA, improving the overall yield of the Phe-tRNA modification reaction.


Whole-body nuclear magnetic resonance scanning: n.m.r. studies of tumour cells. A technique, field-foxusing nuclear magnetic resonance (n.m.r.) spectroscopy (FONAR), is described for doing n.m.r. scans in large samples. The method utilizes a shaped d.c. magnetic field that confines the n.m.r. signal-producing region of the sample to a small volume called the resonance aperture. The aperture contains the required values of the Ho field to fully bracket the band of the r.f. pulse. The magnet system and r.f. pick-up coil that achieved the first human n.m.r. scan are discussed.


Quantum chemical investigations of charge-transfer interactions in relation to the electronic theory of cancer. The results of ab initio 'supermolecule' calculations of the charge transfer between formamide and methylglyoxal, dimethylglyoxal and ethylglyoxal are compared for several different relative conformations of the constituent molecules. The extent and sign of the charge transfer is similar for all three molecules; the ketoaldehyde acts as an electron acceptor only for the stacked conformation. Similar calculations on alpha-hydroxytetronic acid as a model for ascorbic acid show that it can act as either an acceptor from formamide or a donor to glyoxal.


The search for new cancerostatic agents. Following the lead given by Albert Szent-Györgyi's bioelectronic theory of cancer, work was continued in two major directions: (i) designing new electrophilic molecules, related to methylglyoxal, and (ii) using L-ascorbic acid as a (non-toxic) carrier for methylglyoxal and its derivatives in the form of its acetals. The vinylogue of methylglyoxal, 4-oxopent-2-enal, was expected to be a most reactive electron acceptor, on the basis of quantum mechanical calculations by J.J. Ladik's group. A new reaction, the formation of the ene-2, 3-diol acetal and hemiacetal-hemiketal, was found to occur with 'conjugated' aldehydes, such as methylglyoxal, glyoxal, phenylglyoxal, malealdehyde and acrylaldehyde; the reaction proceeded very smoothly with 4-oxopent-2-enal. The structural determination of these new types of acetals by 1H and 13C n.m.r. spectroscopy and by chemical methods is discussed.


Thermal copoly(amino acids) as inhibitors of glyoxalase I. A number of copoly(alpha-amino acids) have been prepared thermally; some have been found to function as inhibitors of glyoxalase I, an enzyme which occupies a central position in Szent-Györgyi's theory of tumour genesis. These polymers are also of interest in the search for synthetic peptides having carcinostatic activity, since many natural peptides are active. The way in which the inhibitory activity varies with composition of the synthetic polymers has been investigated. Various properties (hydrophobicity, molecular weight, u.v. absorption, kinetic type) have been examined in a search for correlates of inhibitory activity. The relationship to the origin of enzyme control mechanisms is discussed.


Interactions of methylglyoxal with methylamine. Ab initio quantum mechanical calculations are used to study the interactions of the aldehydic group of methylglyoxal with the NH2 groups of protein side-chains, using methylamine as a representative molecule. The hydrogen-bonding interaction, C = O...H - N, results in an electronic charge transfer from methylglyoxal to methylamine in both the ground and first excited triplet states. In this latter state a slight possibility is found for the H atom in the hydrogen bond to tunnel from methylglyoxal to methylamine, leading to the possible formation of two free radical fragments. The approach of methylamine to methylglyoxal in the stacked conformation C...N to form a hemiacetal, associated with electron charge transfer from methylamine to methylglyoxal, is energetically unfavourable in vacuum. The concomitant tunnelling of a proton from a proton-donating solvent molecule to the aldehydic oxygen of methylglyoxal is shown to make this approach favourable. The relative stability of the keto and enol forms of methylglyoxal is also investigated, the keto form being found the more stable in vacuum.


Methylglyoxal production in human blood. The research of Szent-Györgyi and others has suggested that the three-carbon ketoaldehyde methylglyoxal has a potential role in the control of cell growth. Its metabolism to D-lactate (not the L-lactate of glycolysis) is catalysed by the mammalian enzymes glyoxalase I (S-lactoyl-glutathione methylglyoxal-lyase, isomerizing; EC 4.4.1.5) and glyoxalase II (S-2-hydroxyacylglutathione hydrolase; 3.1.2.6), with glutathione as a coenzyme. Direct determination of methylglyoxal in biological tissues is difficult because of the active glyoxalase system. However, the product of the glyoxalase system, D-lactate, should indicate formed or added methylglyoxal. A stereospecific assay was used to measure D-lactate in human plasma; it involved the spectrophotometric analysis of NADH at 340 nm catalysed by D-lactate dehydrogenase (D-lactate:NAD+ oxidoreductase; EC 1.1.1.28) from Lactobacillus leichmannii. Blood collected by venepuncture was used for the determination of the plasma concentration of D-lactate. The mean concentration for seven normal subjects was 0.023 mM +/- 0.002 S.E.M. When the glycolytic pathway in whole blood was inhibited in vitro with fluoride, a significant increase in D-lactate was found (about 0.15 mM/hour at 37 degrees C). Added methylglyoxal also produced an increase in D-lactate formation. Some specific precursors of L-lactate (dihydroxyacetone phosphate, for example) added to whole blood produced an increased concentration of D-lactate, even when glycolysis was not inhibited. This finding indicates that catabolites of glucose lead to methylglyoxal synthesis and suggest a control function for the glyoxalase enzyme system in glycolysis that could be exploited for cancer therapy.


Biological activity of methylglyoxal and related aldehydes. The effect of methylglyoxal and other aldehydes on several biochemical variables has been studied. Aldehydes inhibit amino acid incorporation into proteins, both in reconstituted systems and in isolated hepatocytes. They also decrease the secretion of protein and lipoprotein from hepatocytes into the incubation medium. This inhibition is seen even with prelabelled proteins, which indicates damage to the secretory mechanism itself. This conclusion is strenghened by the fact that aldehydes also decrease the binding of colchicine to liver tubulin. Aldehydes decrease the respiratory rate of mitochondria, as well as mitochondrial swelling induced by phosphate, by Ca2+ or by K+ plus valinomycin. They also partially inhibit cytochrome P-450. When injected into normal rats, aldehydes produce a decrease in the mitotic index of bone marrow cells and of the epithelial lining of the small intestine. A decrease in mitotic index and in cellularity is seen after injecting aldehydes into the peritoneal cavity of rats bearing transplanted ascites AH-130 Yoshida hepatoma. Aldehydes also impair the function of liver cell ligandin and potentiate the increase in cell permeability induced by 5-hydroxytryptamine (serotonin). The meaning of these results is discussed with special reference to the pathogenesis of cellular lesions in carbon tetrachloride poisoning.


The living state and cancer.

The living state and cancer. The surrounding world can be divided into two parts: alive and inanimate. What makes the difference is the subtle reactivity of living systems. The difference is so great that it is reasonable to suppose that what underlies life is a specific physical state, 'the living state'. Living systems are built mainly of nucleic acids and proteins. The former are the guardians of the basic blueprint while the business of life is carried on by proteins. Proteins thus have to share the subtle reactivity of living systems. A closed-shell protein molecule, however, has no electronic mobility, and has but a low chemical reactivity. Its orbitals are occupied by electron pairs which are held firmly. The situation can be changed by taking single electrons out of the system. This unpairs electrons, leaves half-occupied orbitals with positive electron holes, making the molecules into highly reactive paramagnetic free radicals. The reactivity of the system depends on the degree of its electronic desaturation. Electrons can be taken out of protein molecules by 'electron aceptors' in 'cahrge transfer'. When life began, our globe was covered by dense water vapour. There was no light and no free oxygen. Electron acceptors could be made out of trioses by concentrating their carbon atoms as carbonyls at one end of the molecule. The resulting methylglyoxal is a weak acceptor which made a low level of development possible. When light appeared, free oxygen was generated by the energy of photons. Oxygen is a strong electron acceptor. Its appearance opened the way to the present level of development. The transfer of electrons from protein to oxygen is effected by a complex chemical mechanism which involves ascorbic acid.