[In vitro reaction to antibiotics in Klebsiella group organisms isolated from clinical cases (author's transl)]. According to the antibiotic sensitivity tests of 228 Klebsiella, they were found most sensitive resistant to ampicillin and penicillin. A great percentage of them had multiple resistance.


Management of bacterial infections in severely neutropenic subjects. The safety and efficacy of tobramycin, a new aminoglycoside, have been evaluated in combination antibiotic therapy in 49 episodes of infection in 25 neutropenic patients. Tobramycin was used in combination with a cephalosporin in 40 episodes and with carbenicillin in 6. The most common infections were respiratory (21 episodes) and septicaemic (16 episodes). One or more pathogens were identified in 38 episodes, of which 36 were due to Gram-negative organisms. The clinical response was satisfactory in 71% of episodes, and the pathogens were eliminated in 50% of episodes in which follow-up bacteriological investigation was available. No renal, auditory, or vestibular toxicity was observed.


Role supplementation: an empirical test of a nursing intervention. This study tested the effects of role supplementations, as a preventive nursing intervention, on families who were experiencing a transition from a dyadic to a triadic relationship through the birth of a first child. Three groups--experimental (N = 12), control (N = 36), and FamCap (N = 10)--participated. Participation in the role supplementation prograd did not sharpen communication skills, increase skill in role taking, or increase the congruency in role perceptions. The intervention did help experimental group wives to have lower anxiety scores postdelivery than other wives in the study, although anxiety increased in all subjects. Through role supplementation intervention, experimental wives showed significant differences in their perceptions and attitudes toward ignoring the infant, protectiveness of the infant, and responsiveness of intants' needs.


Type A behavior pattern and hypertension among inner-city black women. Inner-city Black women were administered Rosenman and Friedman's A-B interview and invited to discuss stress experiences and traditional coronary heart disease risk factors while their blood pressure was monitored at two-minute intervals. Results revealed the essential reliability of the A-B classification for the sample and demonstrated a general congruence with type A behaviors reported in previous (mostly white male) samples. While type A Black women were not significantly more likely to be hypertensive than type B women, analyses of the intrasubject blood pressure variability revealed an interaction between A-B and hypertensive-normotensive status. Consistent with earlier findings, hypertensives were more variable than normotensives, but this was true only for type Bs; type As were intermediate and not differentiated in their variability. This finding calls attention to the possible adaptive function of type A behavior among stress inner-city Black females and raises the question of whether Rosenman and Friedman's personality theory might be objectionably simplistic.


Educational program evaluation: the University of Vermont family nurse practitioner program. Graduates of the Family Nurse Practitioner (FNP) Program at the University of Vermont, Burlington, were surveyed to determine if the FNPs had enlarged their nursing roles following completion of the program. A sample of Vermont nurses served as a control group. Results of a questionnaire, used to obtain information about the nurses' training, functions, and attitudes, indicated that FNPs performed activities associated with an expanded nursing role more frequently than did their nonpractiioner counterparts. There was evidence that the two groups differed in their attitudes toward various aspects of their nursing roles. The evaluation is an ongoing study; as the number of program graduates increases, further characterization of their roles will be possible.


Relationship of patient-nurse activity to intracranial pressure variations: a pilot study. Persons with increased intracranial pressure (ICP) from all causes are subject to periods of markedly increased pressure. Research since the initial clinical studies in the early 1960s has focused primarily on characteristics of ICP variations in specific pathologies and on mechanisms basic to increases in ICP rather than on the relationship between basic patient-care activities, such as moving the patient in bed, and variations in ICP. Therefore, nine patients with pressure-controlled ventriculostomy drainage systems were observed continuously for up to 24 hours to determine whate, if any, patient-nurse activities were associated with transient of sustained increased ICP. Frequencies of ventricular fluid drainage (VFD) during activity and nonactivity were compared to predicted frequencies. One patient had no VFD; eight patients had greater than predicted incidence of VFD associated with activity and less than predicted incidence associated with nonactivity. The difference between predicted and actual incidence of VFD was statistically significant (p less than .001) for all eight patients. Although each patient displayed individual patterns of specific activity associated with VFD, turning in bed and conversation about the patient's condition were consistent among the sample. Coughing, chewing use of bedpan, and restless movemenss were consistently associated with VFD in patients.


Open-mindedness, rigidity, and the tendency to change inferences among psychiatric nursing staff: a pilot study. To test the relationship between open- and closed-mindedness, between rigidity and nonrigidity, and the tendency of psychiatric nursing staff to alter inferences when given additional information about a patient, the Dogmatism Scale, Form E, And the Gough-Sanford Rigidity Scale were presented to 120 psychiatric nursing staff members, all employed and working directly with patients. Low-dogmatic subjects changed their inferences regarding patient behavior significantly more than high-dogmatic subjects. Although high-rigid subjects changed their inferences about patient behaviour more than low-rigid subjects, the relationship was not significant.


Core competencies of masters-prepared nurses. To identify a common core of process competencies that all masters-prepared nurses are expected to attain, regardless of area of clinical concentration or functional-role goal, a 68-item Process Competency Scale was devised from a conceptual model of the multiple roles of masters-prepared nurses: practitioner, educator, manager, and change agent. Responses from 118 questeionnaires from four groups of respondents revealed that 25 competency items met the criteria established for a core competency. There was uniform agreement that nursing educators should be high-level practitioners and that practitioners of nursing should attain teacher competencies.


State borad examinaions and associate degree program effectiveness. Relative effectiveness of the 13 Washington State associate degree (AD) programs was rated by 102 directors of nursing, AD nursing educators, and state board members. When the programs were ranked according to these ratings and the average of the programs' state board examinations, only a small positive relationship was obtained. State board examinations, therefore, should not be used by state and federal agencies as a composite measure of program effectivensss. Instead, the examinations should remain an assessment of th eminimum competency of individuals.


Nurses' personal death concerns and responses to dying-patient statements. This study investigated the concept that a professional's awareness of concerns about her own death is helpful in the treatment of dying patients by using a fantasy of the subject's own life and death in relationship to her response to dying-patient statements. Data produced by this study supported this concept. The study also examined various defensive strategies to fear of death and their relationship to interactions with terminal patients. The defensive strategies were not found to contribute to the differential changes measured by this investigation.


Milk fever: a case against polypharmacy solutions. One hundred and thirty four cases of hypocalcaemia (parturient paresis) between April and Jul 1976 from 72 herds in the UK and Eire were used to compare the response to intravenous treatments with one of three solutions containing calcium salts. Two solutions contained 8 g calcium, one with added magnesium (1.03 g), a third solution contained 6.2 g calcium. The biochemical response obtained 24 hours after successful treatment from all solutions was similar. The clinical response with both 8 g calcium solutions was similar and significantly superior to that obtained with 6.2 g calcium (P less than 0.02 greater than 0.01). More cases (44 per cent) relapsed after treatment with 6.2 g calcium. There was no evidence that the added magnesium to the calcium solution improved the clinical response of parturient paresis cases in this spring claving season, as had been suggested previously. The herds providing these 134 cases had recorded an incidence of 8.04 per cent for parturient paresis in 1975.


Incidence of resistance to ampicillin, chloramphenicol, kanamycin and tetracycline among Salmonella species isolated in the Netherlands in 1972, 1973 and 1974. The resistance of Salmonellae to drugs has been studied in the Netherlands since 1958. In 1972, 1973, and 1974 respectively, 14241, 13086, and 22927 strains were tested for resistance to ampicillin, chloramphenicol, kanamycin and tetracycline. From 1973 all strains were also tested for resistance to trimethoprim. In the period covered, the yearly incidence of resistance to at least one of the above drugs ranged from 39.2% to 45.6% of all strains obtained from various sources (humans, animals, animal products, sewage, etc.). A new finding in the period 1972 to 1974 was that many multiply resistant strains emerged in S. typhimurium and in S. dublin isolated from calves and cattle. In 1974, 64.4% of all strains of S. typhimurium from these animals appeared to be resistant to ampicillin, tetracycline, chloramphenicol and kanamycin, and 25.5% of those of S. dublin were found to be resistant to chloramphenicol and tetracycline. Of all strains of Salmonellae examined in 1973 and 1974 respectively, 0.15% and 0.22% were resistant to trimethoprim, the main component of the twin-drug cotrimoxazol. Of the 142 strains of S. typhi isolated in 1972 to 1974 two were resistant to tetracycline only, and one was resistant to all four antibiotics. The others had a normal susceptibility pattern.


Synthesis of 125I-labeled N-3-(4-hydroxyphenyl)propionyl aminoacyl transfer ribonucleic acids. A method for the isolation and labeling to high specific radioactivity of individual isoaccepting tRNAs is described. After blocking reactive minor bases by acetylation and iodination of the crude tRNA, a single family of isoacceptors was aminoacylated. Individual isoacceptors were separated by chromatography on RPC-5 and then acylated with the 3-(4-hydroxyphenyl)propionyl ester of N-hydroxysuccinimide. The product was purified by chromatography on BD-cellulose and RPC-5. This derivatized tRNA was then iodinated with 125I- and Chloramine-T to give a product containing between 5 X 10(7) and 3 X 10(8) dpm/microgram. The suitability of such labeled tRNAs for hybridization to homologous DNA in solution and cytological preparations of chromosomes is discussed with particular reference to Drosophila melanogaster.


Adaptation of the tRNA population of maize endosperm for zein synthesis. Maize endosperm, 30 days after pollination is actively synthesizing zein, a storage protein containing high amounts of glutamine. leucine and alanine. Endosperm tRNAs have a higher accepting activity than embryo tRNAs for these three amino acids, but not for some other (control) amino acids. This increase in accepting activity is accompanied by a change in the distribution of the isoaccepting tRNA species corresponding to these three amino acids, but not of the isoacceptors corresponding to some other (control) amino acids. These results are in favor of the theory of functional adaptation of tRNA population.


An inhibitor which interferes with the enzymatic aminoacylation of tRNA. Inactive, frozen and thawed cytoplasmic extracts of 3T3 and SV-101 (3T3 transformed by SV-40 virus) cells contain an inhibitor which blocks the poly(U)-directed incorporation of [14C]phenylalanine into polypeptides, catalyzed by active extracts of these cells. This inhibition is not reversed by adding increased amounts of poly(U). Furthermore, little or no inhibitory activity is observed when poly(U) translation is assayed using precharged [14C]Phe-tRNA. These results suggest that the observed inhibition is not due to the degradation of poly(U) by a nuclease. The inhibitor appears to act primarily at the level of tRNA charging since the synthesis of both Phe-tRNA and Lys-tRNA is impaired in its presence. Evidence is presented which indicates that the inhibitory activity is not due to a high molecular weight protein or nucleic acid. However, the inhibitor appears to be adsorbed to a macromolecule. The inhibitory activity is completely destroyed by ashing.


[Outbreak of Salmonella poona (G group) infection resistant to high concentrations of ampicillin, chloramphenicol, and other antimicrobial agents]. An epidemic that occurred at the Hospital Infantil de México is reported. Salmonella poona (roup G) was isolated in 154 patients: 122 in stool cultures, 23 in blood cultures and 9 in meningitis; out of the latter, 6 were newborns under 2 months of age. The strain showed resistance to several antibiotics: ampicillin, chloramphenicol, gentamicin, kanamycin, tetracycline, carbenicillin, cephalosporine, streptomycin and sulfonamides. Seventy per cent of the strains were resistant to 500 mcg/ml (highest concentration used) and 65% to the same dose of chloramphenicol.


Experimentally induced and natural recovery from the effects of phenylalanine on brain protein synthesis. The decrease in the neural polyribosomes produced during hyperphenylalaninemia could not be restored to normal levels by the injection of other single neutral amino acids. All of the neutral amino acids that are transported with phenylalanine were found to produce an alteration of neural polyribosomes similar to that measured with phenylalanine. However, the injection of a balanced mixture of 6 or 7 neutral amino acids could restore the brain polyribosomes to normal states. Although this experimentally induced recovery did not lower brain phenylalanine concentrations, it did restore the acylation levels of methionyl-tRNA, and in particular, the methionyl-tRNA initiator species. This also led to a concomitant stimulation of the elongation rate of brain polypeptide synthesis. A natural recovery of brain polyribosomal levels (occurring 2 h after 1 mg/g phenylalanine is injected) did not appear to represent a real recovery of neural protein metabolism. Phenylalanine concentrations were increased in the brain, the acylation levels of methionyl-tRNA, alanyl-tRNA and the initiator methionyl-tRNA remained altered, and the rate of ribosome translocation was decreased 28%.


Effect of progesterone on the initiation of respiration of the newborn. On the 30th day of pregnancy, the experimental fetuses in 19 rabbits were injected intraperitoneally with 0.1-1.0 mg progesterone (P). The control fetuses in the contralateral uterine horn were treated with the solvent, sesame oil. Both the experimental and control fetuses were delivered 10 min after treatment by hysterotomy to measure the P concentration of their lung tissue and observe their respiration during the initial 2 h of postnatal life. In comparison with the controls, the experimental newborns had greatly elevated P levels and showed typical respiratory distress syndrome, confirmed by histology.


[Now-a-days positions in legal psychiatry (author's transl)]. The stimulus to this contribution to legal psychiatry has to be seen in the present state of the discussion of some of its premises. To be fully aware of the problem it seems necessary to go back to a very elementary point of view. Thus it becomes evident that there is epistemologically a fundamental difference between the so-called gnostic and the agnostic standpoint, between the psychoanalytical and the phenomenological approach. Furthermore a non-contradictory answer to the present questions only appears consistent with the "agnostic" method, whose formal implications are explained very shortly.


[The relaxation principle in generalized convulsion (author's transl)]. According to the relaxation principle (Selbach) a phase of vagotropic preponderance is preceding to a generalized convulsion and is immediately overcome during convulsion by an increased sympathicus tonus. Conditions of generalized convulsions recently observed by animal experiments, such as high exspiratory neuronal activity and apnea a short time before the fit, and during the fit an increase of inspiratory and reticular neuronal activity as also an increased activity of the renal sympathicus, are thus attached to this two-phase-reaction.


[Yawning in a case with transsecting glioma of the pons (author's transl)]. A patient with ponsglioma got completely tetraplegic and plegic in all muscles innervated by the caudal brainstem nerves (locked-in syndrome). He could not open or close the mouth, but he was able to yawn. It is concluded that the motivation of yawning stems from the sleep inducing system in the region of the raphe-nuclei and is projected directly to the nuclei of the caudal brainstem nerves.


[A clinical and angiographic study of occlusions of the posterior cerebral artery with special reference to the pathogenetic role of oral contraceptives and nicotine-abuse (author's transl)]. A series of 13 cases of occlusions of the posterior cerebral artery are presented as verified by angiography. 9 of these were between the age of 20 and 39. The symptoms and clinical courses are compared with the angiographic findings, especially with the collateral circulation. On the basis of our observations and similar cases reported in the literature the factors, disposing to vascular occlusions are discussed in detail particularly the role of oral contraceptives and nicotine-abuse.


[The dissociated laughing and weeping in apoplectic insult (author's transl)]. A patient with the volitional type of facial palsy showed in the arteriography an obstruction of the middle cerebral artery without affecting the thalamostriatal arteries. As laughing and weeping are motivated in the cerebral trunc they must have been projected through the mesopallium (which includes the thalamus) to the facial nuclei. These two behaviour elements did not show any modification on the paretic side, indicating so, that they are phylogenetic old elements, normally modified by the volitional influence. The original weeping expresses an appeal to the companion, the original laughing the readiness of affilation.


Education of nursing students for better collaboration of client, nurse and physician. The role of the professional nurse in participation with other members of the health care team is exciting and demanding. The professional student at various levels could benefit from the experience in this ambulatory setting to aquire skills and explore the concept of promoting health as well as care of illness. Minnesota has been a forerunner in the passage of legislation which informs the citizens as to the expectations they can hold in relation to their health care. A majority of these rights pertain to the informational needs of persons seeking health care. To comply with the law, the health care providers must be cognizant of the law and acquire skills as students to enable the client to be active and intelligent participants in their health care team, in either acceptance or refusal of care. The opportunity and challenges are obvious. How will we as nursing educators assist our students as practitioners of tomorrow to meet them?


Clostridial myonecrosis ('gas gangrene') during cephalosporin prophylaxis. Four cases of clostridial myonecrosis that developed in open fractures were treated with surgical debridement and with intravenous cephalosporins as antibiotic prophylaxis. All patients recovered following amputation of the involved extremity, and treatment with high-dose penicillin in three cases, and erythromycin plus high-dose cephalothin in the fourth. This complication was not seen in patients with similar injuries that were managed surgically but used other antibiotics, usually penicillin, as prophylaxis. In vitro susceptibility tests of clostridia to cephalothin were performed; the results demonstrated that nearly 50% of clostridia tested were resistant to cephalothin.


How nursing administrators view conflict. Fifty-one nursing administrators attending an institute on administration were asked to respond to two questions: "What is good about conflict?" "What is bad about conflict?" Findings indicated that nursing administrators: made more positive than negative statements about conflict, associated conflict's effects to be greater on people than on task accomplishment, indicated that conflict had greater intrapersonal than interpersonal effects, believed that the beneficial effects of conflict on task accomplishment lie in the realm of problem resolution, and reported that the major negative effects of conflict on task accomplishment were felt on productivity. These findings underscore the complex nature of conflict and its benefits and costs to the individual, organization, and nursing administrator. Views of these nursing administrators are in concert with contemporary behavioral science literature which suggests that conflict is necessary for organizational growth and is not automatically symptomatic of organizational pathology.


A patient classification system by level of nursing care requirements. A classification scheme and an instrument to determine work load, in use since June 1975 in the daily adjustment of supply and demand in the 24 pediatric units of the Sainte-Justine Hospital, Montreal, Quebec, is described. Construction and implementation of the instrument are delineated. The instrument was successful in determing the number of nurses necessary to meet the work load on various units. On the basis of these data, the short- and long-term management of supply and demand of nursing care was examined and the classification system was generalized to all types of patients except psychiatric.


Competence of nursing graduates in technical, communicative, and administrative skills. This survey examined baccalaureate, diploma, and associate degree nursing program graduates regarding their perception of their competency in technical, communicative, and administrative skills and their supervisors' perceptions of their competency. Differences were found among graduates' perceptions of their competency as well as in supervisors' perceptions of graduates' competency in these skills.


Nurses' satisfaction with their work situation. Although job satisfaction  is related to performance within the work setting, precise definitions and methods of measuring satisfaction are lacking, especially in medical settings. This article describes a two-year research project that investigated the concept of occupational satisfaction and methods of measuring this concept among in-and outpatient nurses. The Index of Work Satisfaction, a scale that measures relative importance of various components of satisfaction and attitudes toward the components, as well as an overall summary score, was developed. Methodology of the scale development, utilizing hospital nurses and nurses involved in a private group-practice setting, is described. Analysis of the responses from the nurses indicated that the scale measured occupational satifaction of nurses in both settings.


Birth without violence: a medical controversy. A study of the Leboyer method of childbirth, using six experimental, six control infants, is presented. The hypothesis, increased alertness will be observed in Leboyer infants in the immediate postdelivery period, was upheld.


Faculty influence on nursing students' preferences for practice. To ascertain if faculty preferences affect students' preferences for nursing practice, this study investigated: 1) the convergence of students' preferences with those of their clinical faculty and 2) students' perceptions of faculty characteristics associated with their practice preferences at the completion of a clinical course. Fourteen faculty and 170 junior baccalaureate nursing students were measured at three points in time to determine student preferences for indirect-direct involvement in patient care. Findings did not support the convergence of students' preferences with those of faculty as they progressed through the course. At the completion of the course multiple regressions revealed that students' preferences were associated with preferences they attributed to faculty, their perceptions of faculty reputation among students, students' clinical grades, and their preferences for nursing practice before and after six weeks of the course.


Effect of basic preventive health practices and mass media on the practice of breast self-examination. To assess factors that affected utilization of breast self-examination in 160 women enrolled in masters degree programs--in nursing and in programs outside of health disciplines--a questionnaire sought information about 1) the relationship between practice of six basic preventive health measures and practice of breast self-examination, and 2) changes which occurred in women's practices of breast self-examination subsequent to the October 1974 mass media coverage of Mrs. Betty Ford's mastectomy. Descriptive data about other factors that influenced women's practice of breast self-examination were obtained. Findings indicated a relationship between positive practice of breast self-examination and positive practices of other preventive health measures in women of health and nonhealth orientation up to 35 years of age and under, but not in those over 35 years of age. Significantly increased breast self-examination practices in women of all ages were reported following Mrs. Ford's mastectomy. Implications favorable to the early detection of breast disease are suggested.


[A case of glomerulonephritis and subacute endocarditis associated to Hemophilus aphrophilus septiciemia]. A report is presented on the findings in what is to our knowledge the first described case of glomerulonephritis resulting from Haemophilus aphrophilus endocarditis. After an insidious onset, serious renal failure developed which subsided with antibiotic therapy. Cardiac damage was minimal and the patient recovered his usual state of health, an outcome which has not been so satisfactory in other reported cases of endocarditis due to Haemophilus aphrophilus. The case is discussed with reference to the clinical course of the disease and the microbiologic properties of Haemophilus aphrophilus.


Phenylalanyl synthetase function in cultured fibroblasts from subjects with progeria. Since progeria cells contain a diversity of altered proteins, some aspects of phenylalanyl synthetase function were examined in semipurified extracts of cultured skin fibroblasts using mixed rabbit tRNA as acceptor. No significant differences were found in the Km and Vmax for phenylalanine or ATP in progeria cells compared with controls. Initial velocities of both progeria and control synthetases were lower at late passage owing to either reduced enzyme content or reduced catalytic efficiency. Reverse phase 5 chromatography of tRNAs acylated by progeria and control synthetases gave a single peak of labeled phenylalanine tRNA in all cases with no secondary peaks evident. Total activity of phenylalanyl synthetase in progeria cells was similar to that of control cells at early passage while late-passage control cells had lower specific activities of these synthetases per unit protein.


Purine and pyrimidine nucleotides in some mutant human lymphoblasts. To study the role of purine ribonucleotides as possible regulators of the rate of de novo purine biosynthesis in living human cells, we measured intracellular ribonucleotide concentrations by high-pressure liquid chromatography in a series of cloned human lymphoblast mutants selected by resistance to 8-azaguanine, in which the severity of hypoxanthine-guanine phosphoribosyltransferase (HGPRT) deficiency could be correlated with increases in the rate of de novo purine biosynthesis and increases in intracellular concentrations of phosphoribosyl pyrophosphate (PP-ribose-P). Compared with appropriate normal controls, intracellular purine ribonucleotide concentrations were not reduced in HGPRT-deficient lymphoblasts but there were striking increases in intracellular concentrations of some pyrimidine nucleotides and nucleotide sugars which appeared to be related to the degree of the deficiency. Similar changes were found in lymphoblasts from a Lesch-Nyhan boy. These data support the hypothesis that the accelerated rate of purine biosynthesis in HGPRT-deficient cells result from increases in intracellular PP-ribose-P concentration and not from changes in intracellular purine ribonucleotide concentrations. The possibility that the abnormality of pyrimidine nucleotide metabolism results from coordinate regulation of purine and pyrimidine biosynthesis by PP-ribose-P was not substantiated by measurement of rates of pyrimidine synthesis and experimental elevation of intracellular concentrations of PP-ribose-P after incubation of cells with inorganic phosphate.


Dietary feedback regulation of purine and pyrimidine biosynthesis in man. Ten days after a healthy person has consumed a purine-free isoenergetic diet, the excretion of (endogenous) uric acid reaches a minimum and remains constant thereafter. Purines are absorbed in different degrees from various biochemical sources added to such a diet--little from DNA, nearly all from ribomononucleotides--presumably owing to different rates of hydrolysis. There is always a linear relationship between dietary purine content and uric acid excretion, independent of the source of purine. The findings suggest that dietary purines play a minor role (if any) in the regulation of purine synthesis, contrary to the conclusions of other workers. The demonstration that oral administration of uridine diminishes the oroticaciduria in patients with hereditary oroticaciduria suggested dietary feedback regulation of pyrimidine biosynthesis by pyrimidine nucleosides in the diet. The reduction of allopurinol-induced oroticaciduria by dietary RNA pointed in the same direction. Closer analysis with RNA hydrolysate and isolated purine as well as pyrimidine nucleotides, however, revealed that not only pyrimidine derivatives but also purine mononucleotides diminish oroticaciduria. The nucleotides had no influence on the change in the activity of orotidine-5'-phosphate decarboxylase (EC 4.1.1.23), induced by allopurinol; this makes an effect on the decarboxylase unlikely. The feedback regulation is assumed to act by inhibition of an earlier step.


Factors in the pathogenesis of the brain damage and anaemia in the Lesch-Nyhan syndrome. The possible factors in the pathogenesis of the brain damage and megaloblastic anaemia in the Lesch-Nyhan syndrome are discussed. Disordered growth and function appear to be limited to the brain, bone marrow and general body stature, yet the purine salvage enzyme hypoxanthine-guanine phosphoribosyltransferase (EC 2.4.2.8, HGPRT), although present in variable amounts in different tissues, is ubiquitous, a fact which suggests that other factors than HGPRT deficiency alone determine the pattern of tissue damage. Recent evidence suggests that the specific tissue damage in the Lesch-Nyhan syndrome is due to lack of NGPRT in tissues with relatively reduced purine de novo capability and a greater dependence on purine salvage pathways at certain stages in their development for their supply of purine ribonucleotides. This evidence is presented together with possible mitigating factors operating in the bone marrow.


Hypoxanthine-guanine phosphoribosyltransferase activity in individual erythrocytes: autoradiographic studies in heterozygotes. Heterozygotes for the Lesch-Nyhan syndrome have normal hypoxanthine-guanine phosphoribosyltransferase (HGPRT) activity in their erythrocyte lysates. However, HGPRT activity in lysates from heterozygotes for the partial HGPRT deficiency states is often between that seen in the affected hemizygote and the normal. An autoradiographic technique was developed which demonstrated the HGPRT activity in individual erythrocytes in vitro. This technique revealed that heterozygotes for the Lesch-Nyhan syndrome had erythrocytes that contained normal HGPRT activity but heterozygotes for the partial deficiency had two populations of erythrocytes, one with normal HGPRT activity and the other with the reduced HGPRT activity characteristic of the hemizygote. With these latter heterozygotes, the proportion of HGPRT-deficient erythrocytes agreed with that calculated on the basis of enzyme activity in erythrocyte lysates.


[Laughing in complex partial seizure epilepsy. A video tape analysis of 32 patients with laughing as symptom of an attack (author's transl)]. According to videotape analysis, laughter is a frequent (42.7%) symptom during psychomotor attacks. The results of our investigations show that it is no longer possible to regard it as a "curiosity", as did Janz (1969). It is an epileptic phenomenon like others and a symptom of automatism. It can occur in all phases of an attack. It is not remembered by the patient. We have been unable to establish any connection with age or sex. The form of expression is usually natural but inadequate and no affective motivation has been established. Laughter during an epileptic attack is an inborn emotional expression, structurally triggered by the involvement of the area around the hypothalamus-thalamic nucleus with the process causing the epilepsy. It is not actively experienced and is therefore not conscious and not an expression of the pleasant side of the affective complex moderated by the limbic system. The EEG's showed the usual variations occurring in psychomotor epilepsy. The temporal lobes are particularly involved. There is no "EEG Laughter Pattern". The group of patients considered here consist of severe, therapy-resistent cases of partial seizure epilepsy with pronounced cerebral lesions. In order to determine whether laughter is so common in less severe cases, a comparison group must be investigated. Laughter as a symptom of an epileptic attack is unknown to doctors and nursing staff and thus is either not recorded at all or, only very seldom. "Gelastic epilepsy" so-called does not exist as a nosology entity. This term should thus only be used--if at all--in cases where the laughter, together with a change in the level of consciousness, has over a period of years constantly been the only symptom of an attack, expecially when these attacks first became manifest in earliest childhood and are due to connatal changes in the hypothalamus-thalamic region.


[Basilar artery thrombosis (author's transl)]. Arteriosclerosis is the most common cause of basilar artery thrombosis. Rarely basilar occlusions are observed after cerebral concussion and hyperextension of the neck; occasionally they are founded in craniocervical dysplasia, arteritis and hypercoagulability of blood.--Clinical data and differential diagnostic aspects are demonstrated in 4 own cases and the present literature. Characteristics of clinical symptomatology are discussed with respect to the sites of predilection in distal and proximal part of basilar artery. Angiography examination is the most important diagnostic method and shows prognostic indications by demonstration of collaterals.--The treatment consists of inhibition of blood viscosity, reduction of perifocal edema and stabilization of blood-pressure.


Effect of pulmonary hygiene measures on levels of arterial oxygen saturation in adults with chronic lung disease. The purpose of this study was to determine whether adult patients with chronic obstructive pulmonary disease (COPD) can safely perform pulmonary hygiene measures without compromising their arterial oxygen saturation (SaO2) levels (less than 80 per cent). In 15 male veterans with moderate-to-severe COPD an ear oximeter was used to measure SaO2 levels while subjects completed a series of percussion, deep breathing, and coughing maneuvers in the head-down position (50 degree angle). No clinically significant changes in SaO2 levels were found in 14 subjects during pulmonary hygiene measures, but potentially dangerous symptoms were noted in two subjects. Our study supports the monitoring of objective and subjective symptoms during pulmonary hygiene and discontinuance of the procedure if tachycardia, palpitations, dyspnea, chest pain, or other distressful symptoms occur that might indicate hypoxemia.


GTP hydrolysis during methionyl-tRNAf binding to 40 S ribosomal subunits and the site of edeine inhibition. Three lines of evidence are presented indicating that GTP hydrolysis associated with eukaryotic peptide initiation occurs in the absence of 60 S subunits when methionyl-tRNAf is bound to 40 S ribosomal subunits. An enzyme fraction required for binding of methionyl-tRNAf to 40 S subunits and peptide initiation, tentatively equated with eIF-(4 + 5), has GTPase activity and appears to be responsible for hydrolysis of GTP in the methionyl-tRNAf.eIF-2.GTP complex. Direct analysis of the methionyl-tRNAf.40 S complex formed with with eIF-2 and [8-3H] guanine, [gamma-32P]GTP reveals bound guanine but not gamma-phosphate. Edeine, a peptide antibiotic containing spermidine and beta-tyrosine residues at its COOH terminus and NH2 terminus, respectively, blocks peptide initiation and interferes with binding of methionyl-tRNAf to 40 S ribosomal subunits. Inhibition of binding is observed when the eIF-2-mediated binding reaction is carried out with GTP but not with guanosine 5'-(beta,gamma-methylene)triphosphate or guanosine 5'-(beta,gamma-imido)triphosphate. Edeine was labeled by iodination and shown to bind with high affinity to 40 S but not to 60 S ribosomal subunits. It is suggested that edeine blocks a specific site on the 40 S ribosomal subunit to which a segment of the methionyl-tRNAf molecule is bound during the course of the initiation reaction sequence.


Female adolescent drinking behavior: potential hazards. A recent national survey on the use of alcoholic beverages revealed that 93% of boys and 87% of girls in their senior year of high school had experimented with alcohol, and more than half of the country's seventh graders had tried drinking at least once during the previous year (1973). A review of the literature confirms this apparent increase in drinking by boys and girls. This article reports the increasing use of alcohol by girls and the associated risks. Some predisposing personal and behavioral characteristics are discussed, such as: the particular hazards of fetal syndrome; the significant impact of the physiological and psychological effects of menstruation and other related female phenomena; and the confusion in sex roles (resulting from the inability to freely combine masculine and feminine personality characteristics within onself in a women's liberation environment) accelerating "risk" possibilities in girls.


Involvement for learning in health programs. Health educators are often required to transfer information, influence attitudes and change behavioral patterns. Whether communicating with an individual or a group, it is important to involve the participant in the educational process. Careful analyses of the goals to be accomplished and the techniques used in the educational process will result in significantly improved communications. Strategies are suggested which have been used successfully to break away from the mold which tends to guarantee passive participation on the part of the learner.


Use of value clarification methods in venereal disease education. The use of values clarification methods offers a means of dealing with the social-emotional stigmas associated with venereal diseass. It has become apparent that the facts alone are not sufficient in motivating the individual to seek treatment and cooperate in the epidemiologic process. This article suggests techniques of educating students or patients in order to get them in touch with their own feelings, attitudes, and prejudices. It also fosters understanding of the prevalent social myths and misconceptions about venereal diseases.


[Acceptance of amino acids by transfer RNA in the liver of rabbits in experimental diabetes complicated by glucocorticoid administration]. Alloxan diabetic rabbits were injected with hydrocortisone acetate (1 mg/kg) daily for one week. This led to a more pronounced decrease of acception of 14C-lysine, 14C-alanine, and 14C-leucine by tRNAs as compared to the diabetic status. Diminution of formation of aminoacyl-tRNA in the liver of diabetic animals was the result not only of insulin deficiency, but also of the negative action of glucocorticoids.


[Beta-lactamase activity of bacteria of the genus Proteus]. beta-Lactamases of Proteus and their role in the mechanism of the microbe resistance to penicillins and ceporin were studied. It was found that the beta-lactamase of Proteus had low activity and were produced by both beta-lactamide resistant and sensitive clinical strains of Proteus. The resistant cultures of Proteus produced enzymes more frequently (3.4--5 times) than the sensitive ones. The synthesis of beta-lactamase in the clinical Proteus strains was inducable. The high induction coefficient was achieved only in the presence of high concentrations of the inductor. No significant dependence of the culture sensitivity level of ampicillin and ceporin on the induction level was observed. The most significant part of the constitutive enzyme in Proteus was intracellular, while that of the inducable enzyme was extracellular. No correlative dependence between the culture resistance levels to penicillins and ceporin and the enzyme activity was noted. The beta-lactamase activity was not found in the transconjugants with the in vitro acquired R-factor controlling the ampicillin and ceporin resistance, as well as in the resistant mutants selected on the media with increasing concentrations of the above antibiotics. Induction of beta-lactamase synthesis was not found in these strains either. The ability of Proteus to synthesize beta-lactamase can be lost on the strain storage under laboratory conditions which was not always accompanied by reduction of the culture sensitivity to ampicillin and ceporin. The enzymatic destruction of beta-lactamides was not the main mechanism of Proteus resistance to the above antibiotics.


Heroin in the Netherlands.

Heroin in the Netherlands. All heroin samples seized in the Netherlands in 1975 and weighing more than 10 grams together with all heroin samples seized during September 1976 were analysed by thin-layer chromatography, gas-liquid chromatography and liquid-solid chromatography. Most samples consisted of the so-called Hong Kong No. 3 type. Also the samples found in addicts were as potent as those seized from dealers and traffickers. We attempted to classify the samples into groups or batches, but only in a few cases could we conclude that two or more samples originated from the same batch.


Progesterone and oestrogen in pregnancy and parturition: comparative aspects and hierarchical control. The different ways in which the progesterone requirements of pregnancy are met in various species are reviewed here. Progesterone production expressed in terms of metabolic body weight lies within about one order of magnitude in several species (but not in the rat), whether the hormone is predominantly ovarian or placental in origin. Parturition is usually preceded by a decrease in the plasma concentration of progesterone and the evidence which suggests that a decrease in secretion involves enzyme induction is summarized. In the sheep a sequence of well-marked hormonal changes can be discerned--an increase in fetal cortisol secretion followed by a fall in placental progesterone and a rise in oestrogen and prostaglandin F2alpha secretion. This sequence has been interpreted in terms of hierarchical control theory which envisages a series of levels placed in a descending order of importance and in which there is a downward transmission of a signal from a higher level that modifies activity at a lower level. A dominant level in the hierarchy in the sheep and pig seems to be the fetal hypothalamus and pituitary, but in the rabbit the maternal hypothalamus, pituitary and ovary play a more dominant role.


The role of prostaglandins in parturition, with special reference to the rat. The evidence which suggests a role for prostaglandins in parturition is reviewed, with special reference to experimental observations on the rat. The pregnant uterus can both synthesize and metabolize prostaglandins. The biosynthetic capacity of the rat uterus increases as pregnancy proceeds. This increase, which is especially marked during the last few days of pregnancy, may be oestrogen-controlled. During pregnancy the tissue levels of the major prostaglandin-metabolizing enzyme, 15-hydroxyprostaglandin dehydrogenase (EC 1.1.1.141) is greatly increased. This may prevent aberrant production of prostaglandins from terminating the pregnancy prematurely. The capacity for prostaglandin metabolism begins to fall (perhaps under hormonal control) as the expected day of delivery approaches; this, coupled with an augmented biosynthesis, produces a net increase in uterine prostaglandins which contribute to the process of parturition by causing a decrease in progesterone concentration, increasing the muscular tone of the uterus, and altering uterine haemodynamics. Agents which block either prostaglandin synthesis or metabolism delay or accelerate the parturition process in the rat.


Dilatation of the uterine cervix.

Dilatation of the uterine cervix. Dilatation of the cervix at parturition necessitates changes in the physical characteristics of cervical collagen and glycosaminoglycans which are probably hormone-dependent. The infusion of prostaglandin F2alpha (PGF2alpha) into the arterial blood supply to uterus and cervix of sheep pregnant for about 125 days resulted in cervical dilatation after 24 hours but this response was inconsistent; one factor affecting the response appeared to be the progesterone status, low circulating progesterone being associated with dilatation. Preliminary experiments in goats in which pregnancy is terminated by removal of the corpora lutea at day 125, subject to modification by the administration of progesterone, indomethacin or PGF2alpha, support the view that PGF2alpha evokes softening and dilatation of the cervix but that this is blocked by progesterone.


The influence of the fetal hypothalamus and pituitary on the onset and course of parturition. The possibility that the fetal brain or pituitary either initiates parturition or influences the course of labour was studied in human and rat. The results when corticotropin or neurohypophysial hormones were injected directly into human anencephalic fetuses in utero, and data obtained from 147 clinical records of such fetuses, seemed to show that the fetal brain does not trigger the onset of parturition. On the other hand, the course of labour was seriously protracted in anencephalic fetuses. Gestation length of brain-aspirated rat fetuses was not significantly longer than in sham-operated controls. However, the course of labour was protracted in the brain-aspirated fetuses. A similarly protracted expulsion pattern was observed in Brattleboro rats homozygous for a hypothalamic form of diabetes insipidus. These data all pointed to the likelihood that fetal neurohypophysial hormones stimulate the course of labour. Neither oxytocin nor vasopressin could be demonstrated in the rat fetus on the last day of pregnancy, when specific immunofluorescence was used. However, a closely related compound was found that was identified as most probably being vasotocin. The hypothesis is put forward that this fetal hormone normally stimulates the course of labour.


[The Shy-Drager syndrome (author's transl)]. The most prominent symptom of Shy-Drager syndrome is the asympathicotonic orthostatic (postural) hypotension, which is associated with a number of additional autonomic and neurological disturbances: disorders of micturition, sphincter disturbances, impotence, anhidrosis, hypokinesia, rigidity, pyramidal symptoms, cerebellar dysfunction and nuclear pareses due to anterior horn cell degeneration. The various disorders are not caused by ischemia or hypotension, but they represent parts of a multisystemic disease of still unknown etiology. According to different extension and neuropathological criteria it has been suggested to distinguish two types of neurogenic (idiopathic) orthostatic hypotension. Moreover, differential diagnosis of the Shy-Drager syndrome has to consider postural hypotension occuring as a symptom in some neuropathies and Parkinson's disease. Symptomatology, course, prognosis and treatment of Shy-Drager syndrome are described, as well as relevant findings of apparative investigations, pharmacological and hemodynamic tests and neuropathological findings in autopsied cases reported in the literature. This review was initiated by two clinically investigated cases of Shy-Drager syndrome.


[Neurological and EEG-follow-up studies in head-injured adults: criteria for the clinical diagnosis concussion and contusion (author's transl)]. A stystematic neurological and electroencephalographical follow-up study in 344 head injured adults gave the following results: 1. 52% of all the hospitalized (mostly primarily amnesic) patients had a cerebral contusion. A contusion was assumed in cases with focal neurological signs (13%), amnesias of more than 8 hours (16%) and/or EEG-abnormalities lasting for more than 24 hours (49%). 2. Traumatic EEG-abnormalities were general slowing (43%) and foci (32%). In 40% of the cases with general slowing the slowing (greater than or equal to 1.5/sec) was within the alpha-frequency band and could only retrospectively be assed. 3. The EEG was invariably abnormal in cases with an amnesia exceeding 8 hours. If the amnesia exceeded 1 hour abnormalities were found in 73%. 4. Among the patients with contusion 6.5% had no amnesia, 48% less than 30 minutes and only 30% an amnesia for more than 8 hours. In 75% of the patients with concussion amnesia lasted less than one hour. 5. Skull fractures were mostly combined with contusion (74%). 6. Impaired drive, reduced ability to concentrate, memory deficits, headache and dizziness were significantly more frequent 6 months after contusion than after concussion. 7. 21% of the patients with traumatic dizziness (44%) had a labyrinthine contusion. 8. Among the contusions diagnosed with the aid of EEG recordings 58% would have been missed after exclusive neurological examination and 82% after application of the classical criteria used by surgeons and general practitioners.


[Oneirodelirium in paroxysmal hypersomnia with periodic respiration and obstruction of the airway (author's transl)]. Case report on a patient aged 57 with periodic respiration and paroxysmal tendency to fall asleep in daytime. Between sleep and waking he had typical apnoic intervals with passing, but definite, hallucinations. The cause, in accord with the literature, is considered to have been edema of the upper respiratory tract which followed at times on irradiation of a squamous epithelium carcinoma of the roof of the nasopharynx. The psychologic and respiratory disturbances and the attacks of somnolence proved fully reversible after anti-edematous treatment.


Involvement of phosphoenolpyruvate in the catabolism of caries-conducive disaccharides by Streptococcus mutans: lactose transport. The mechanisms for transport and hydrolysis of lactose were investigated in five cariogenic strains (HS6, AHT, FA1, NCTC 10449, and SL1) representing the four serogenetic groups of Streptococcus mutans. The systems for transport and hydrolysis of lactose had the characteristics of a phosphoenolpyruvate (PEP)-dependent lactose (Lac) phosphotransferase (PT) system and phospho-beta-galactosidase (P-beta-gal), respectively, in all strains tested, except strain HS6. Decryptified cells required PEP and Mg(2+) for transport of the non-metabolizable model beta-galactosides o-nitrophenyl-beta-d-galactopyranoside (ONPG) and thiomethyl-beta-d-galactopyranoside (TMG). Substitution of 2-phosphoglycerate (2-PG) for PEP also stimulated the Lac PT system. Other potential high-energy phosphate donors (adenosine tri-, di-, and monophosphates and guanosine triphosphate) did not stimulate the Lac PT system. Sodium fluoride had no effect upon the PEP-dependent Lac PT system in decryptified cells with PEP as the energy source; however, when 2-PG was used as the energy source, F(-) inhibited ONPG phosphorylation. With intact cells which must generate PEP endogenously, the presence of F(-) in concentration >/= 10 mM completely inhibited the Lac PT system, presumably through inhibition of 2-PG hydrolyase (EC 4.2.1.11; enolase). Both intact and decryptified cells accumulated a phosphorylated derivative of TMG that behaved chromatographically as TMG-phosphate. After alkaline phosphatase treatment, the derivative had an R(f) identical to that of TMG. No beta-galactosidase (beta-gal) activity was detected with ONPG as the substrate; hydrolysis occurred only when ONPG-6-phosphate was supplied as the substrate. Strain HS6 apparently transported lactose by an active transport-type system in which the accumulated intracellular product was the free disaccharide based on the following criteria: (i) ONPG transport and hydrolysis in decryptified cells was not stimulated by PEP; (ii) ONPG hydrolysis occurred in the absence of PEP; and (iii) ONPG-6-phosphate was not hydrolyzed. These data indicate that, in all strains tested except strain HS6, lactose transport was mediated by a PEP-dependent Lac PT system, resulting in accumulation of lactose-phosphate that was hydrolyzed by an enzyme similar to the P-beta-gal of group N streptococci and Staphylococcus aureus; conversely, strain HS6 transported and hydrolyzed lactose by a PEP-independent transport system and beta-gal, respectively.


Testing with puromycin and amino acyl tRNAs that limit the rate of peptide chain extension. With puromycin one can recognize when the synthesis of a given protein is dependent on amino acyl tRNA that is present in rate limiting amount. We demonstrate this use of puromycin by its interaction with another inhibitor, L-o-methylthreonine. L-o-methylthreonine lowers the Ile-tRNA concentration in the cell, thereby inhibiting synthesis of proteins containing isoleucine. In certain rabbits, the alpha hemoglobin chain has three isoleucyl residues and the beta chain none. L-o-methylthreonine thus inhibits alpha globin synthesis in intact reticulocytes from these rabbits. When puromycin and L-o-methylthreonine are used together, the two inhibitors synergize in inhibiting alpha globin synthesis. Hence, puromycin is a more effective inhibitor when the Ile-tRNA concentration is lowered. Cycloheximide and sodium fluoride have different modes of action from puromycin. Neither synergizes with L-o-methylthreonine; instead, the interaction is less than additive. We have found that beta chain synthesis in rabbit reticulocytes is more sensitive than alpha to inhibition by puromycin. This difference could reflect either differences in amino acid sequence or tRNA dependent limitations of beta chain elongation. The switch from fetal to adult hemoglobin in humans does not involve changes in limiting amino acyl tRNA because, for cord blood from infants of different developmental ages, the puromycin sensitivity of incorporation into gamma and beta chains remains constant.


Board requirements for economists who write on medical subjects? A comment on The Condition of Surgery. The conventional economic ideal of supply and demand market forces is inappropriate--and imperfect--in allocating medical resources. The "practice of surgery" includes qualitative and economic values beyond numerical counts of operations or fees. National interests will be better served by regulating the professional requirements for surgical practice.


Quality of care and unnecessary operations: a comment on The Condition of Surgery. Issues of quality of surgical care and unnecessary operations are complex, and they will require more objective and clinically based investigations before reasonable economic judgements can be made. SOSSUS did not shy away from these questions; rather, it kept to its assigned task of describing the distribution and workloads of physicians.


"The study on surgical services for the United States": a valid prescription for American surgery? The overall approach of SOSSUS to the study of surgical services, the interpretation of findings, and policy recommendations are rightly called into question. But singular concern with the consequences of monopolistic control by the profession is no substitute for analysis of the dynamics among demand, production, and supply of surgery. Any delivery system--and many models are feasible--involving consumers, providers, and payers is a market in which multidimensional behavior must be anticipated.


A reply to the comments on The Condition of Surgery. Any system of allocation of services works more efficiently in the consumer's interest when there is competition among suppliers of the service. But this same competition reduces income and options of sellers. Professionals-as-sellers are likely to resist competition by restricting entry into their ranks and the range of qualities to be offered. An informed consumer should be allowed to exercise discretion in choosing among qualities and substitutions. Future policy might well incorporate less reliance on regulation and more on removing barriers to free market factors.


The use of the Premack Principle to motivate patient activity attendance. An investigation of how a behavioral modification technique can motivate institutionalized mental patients to increase their activity attendance.


[Pharmacologic influencing of fetal phospholipide synthesis. Part II: Carnitin - a new way of dyspnea syndrome prophylaxis? (author's transl)]. Carnitine is a body-owned Betaine which is wide-spread in living nature in the form of a physiologic metabolit. On account of its central metabolic function, Carnitine has various effects in the intermediary metabolism. Toxicity of Carnitine is very low. DL-Carnitine hydrochloride (30 mg/kg body weight) was injected into 25 gravid Wistar rats and 24 gravid rabbits, 4 days before the Cesarean section. Compared to the group of controls, the group treated with Bromhexine metabolit VIII, as well as to the group treated with Betamethason, significantly higher values with regard to the content of total phospholipids, lecithine and palmitic acid could be found in the fetal rat lungs. Effects of Carnitine on the phospholipid metabolism are discussed.


Infective endocarditis caused by Streptococcus bovis resistant to the lethal effect of penicillin G. Penicillin G alone is generally recommended for the treatment of infective endocarditis caused by Streptococcus bovis because clinical isolates of S bovis are represented as being uniformly and markedly susceptible to penicillin G. However, two strains of S bovis recovered from two patients with bacterial endocarditis were resistant to the lethal effect of penicillin G. Combination therapy, cefazolin sodium and gentamicin sulfate in patient 1 and penicillin G and gentamicin in patient 2, was necessary; synergy, as manifested by lethal activity against the infecting strains, was demonstrated in the laboratory. We stress the need to determine the minimal lethal concentration of penicillin G for clinical isolates of S bovis. Until such information is available, particularly in life-threatening infections, combination drug therapy, consisting of an aminocyclitol added to a beta-lactam antimicrobic, should be used.


Purification and some properties of the histidyl-tRNA synthetase from the cytosol of rabbit reticulocytes. The histidyl-tRNA synthetase of rabbit reticulocyte cytosol has been purified 84 000-fold to apparent homogeneity with a specific activity of 687 nmol of histidyl-tRNA formed per min per mg of protein. Ten to 15% of the enzyme activity is sedimented with the ribosomes while the remainder is in the cytosol. The purified enzyme has a molecular weight of 122 000 as determined by sucrose density gradient centrifugation. Gel electrophoresis in the presence of 0.1% sodium dodecyl sulfate suggests that it is composed of two similar subunits with a molecular weight of approximately 64 000. The enzyme has a magnesium optimum of 45 mM; however, this is reduced to 5 mM in the presence of an intracellular potassium concentration (160 nM). The enzyme acylates the two histidine tRNA isoacceptors of rabbit reticulocytes with similar Km values and at similar rates.


Regulation of an aspartyl-tRNA species in BHK cells in culture and in solid tumor form. II. The effect of different sera on aspartyl-tRNA in culture. In normal tissues aspartyl tRNA is present in 3 separable components by RPC-5-chromatography, 2 small and early eluting peaks and a major component designated rRNAAspIII. A late eluting peak, tRNAAspIV has also been found in many tumors of human and animals origin, and in BHK 21/13 cells grown in culture, where 27% or more of the total aspartate acceptance occurs in this peak. In contrast, normal tissue studied, i.e., hamster liver or kidney, exhibits less than 2.0% of the total aspartyl tRNA as the late eluting tRNAAspIV. Increasing the level of fetal calf serum in the medium from 5 to 15% resulted in a change from 0.79 to 1.83 in the ratio of tRNAAspIII--tRNAAspIV in BHK cells. Utilizing sera from different species, the percentage of tRNAAspIV was found to vary between 26.8 and 66.0% while the combined percentages of tRNAAspIII and tRNAAspIV varied between 59.5 and 80.8%. It appears that the increased tRNAAspIII was derived from tRNAAspIV and vice versa indicating that there may be a close structural relationship between tRNAAspIII and tRNAAspIV. It was also observed that BHK tumor cells or ascitic fluid enhanced the appearance of tRNAAspIV in normal host liver.


Some recent developments in quantum organic chemistry. The present status of attempted to calculate chemical behaviour in organic chemistry in a quantitative manner is reviewed. Results given by a new semiempirical SCF MO method (MNDO) are reported. Specific topics discussed include the calculation of molecular vibration frequencies, entropies, specific heats, entropies of activation, kinetic isotope effects, and the mechanisms of several organic reactions, in particular the Diels-Alder reaction and the Cope rearrangment.


Biomimetic syntheses of phenols from polyketones. As a result of speculation that many enzymes control polyketone cyclization in vivo by converting a key carbonyl group to a cis-enol ether derivative, we describe two novel biomimetic cyclizations. The first involves condensation of two C6 units derived from triacetic lactone to form an arylpyrone related to aloenin. In the second a naphthapyrone of the rubrofusarin type is formed by condensation of an orsellinic acid derivative with the ether of triacetic lactone.


Selective homogenous and heterogeneous catalysis. Catalysis of organic reactions by micellar aggregates in aqueous solution lacks synthetic utility in its present state, largely for two reasons: first, the selectivity attainable in a loose unstructured micelle is low, with little possibility of attaining the degree of substrate differentiation possible in enzymes, and, second, the scale of reaction is limited, since surfactant must be in large excess over reactant to avoid swamping of the catalytic effect. The discussion will cover initial attempts to overcome these drawbacks. Increased selectivity is apparent in the promotion of ester hydrolysis by micelles of asymmetric chain-functionalized surfactants. In the most favourable circumstances 3:1 discrimination in the rate of reaction of ester enantiomers may be observed. Increased scale of reaction is obtainable when polymer-linked cationic surfactants are used as insoluble catalysts, and these hold promise for various anionactivation reas are used as insoluble catalysts, and these hold promise for varous anion-activation reactions. Specific attention is given to mechanistic aspects of homogenous and heterogeneous catalysis.


Studies on enzyme models and on the enzyme carboxypeptidase A. The enzyme carboxypeptidase A has been extensively studied and is thus a good candiate for chemical models and imitation. A model system was constructec which combined two of the three catalytic functional groups of the enzyme together with the appropriate substrate group, and cooperative effective catalysis was demonstrated. However, the mechanism which the model system used in enzyme-like conditions was unexpected, and this led to a study of the enzyme itself. Carboxypeptidase A was studied by examination of oxygen-18 exchange reactions and the ability of the enzyme to substitute only lytic agents, such as methanol, forthe water which is normally used. The result of these studies is proposed mechanism of action of this enzyme which accommodates the large amount of information already available, and which indicates that this enzyme uses a mechanism similar to that found in the model system. Approaches have also been made to an artificial enzyme which could hydrolyse amides. Cyclodextrin has been functionalized with two imidazole groups placed on opposite sides of the cavity. This material catalyses the hydrolysis of an amide, which binds to the cyclodextrin cavity and then is hydrolysed with the assistance of one imidazole in its basic form and the other one in its protonated form, acting together in a way reminiscent of the cooperation of some of the functional groups of hydrolytic enzymes.


Ideas and experiments in biosynthesis.

Ideas and experiments in biosynthesis. During the past 25 years or so, there has been almost undreamed of progress in understanding the pathways by which living systems synthesize the remarkable range of substances they contain. This progress could not have been made had not isotopes of carbon, nitrogen, hydrogen and oxygen become available in quantity at a time when the intellectual climate was right for their penetrating application in biosynthetic research. It was by his generation of far-reaching ideas about biosynthesis that Sir Robert Robinson made such a major contribution to establishing this right climate. His thinking pointed the way for many studies on living systems. Several examples will be discussed which were of particular interest to Sir Robert, such as the biosynthesis of morphine and colchicine, and another topic which is currently at a fascinating stage of development, the biosynthesis of natural porphyrins. New equipment and techniques, especially 13C n.m.r. spectroscopy and high-pressure liquid chromatography, have helped in a borad study of the biochemical conversion of porphobilinogen into uroporphyrinogen-III which must be formed by some rearrangement process. It is established that a single intramolecular rearrangement occurs and that this step comes at the end of the assembly of four porphobilinogen units which forms the unrearranged bilane.


Biosynthesis in theory and practice: structure determinations. Classical appraoches to structure determinations of natural molecules can be assisted by biosynthetic considerations. Application of these needs some structural evidence, based on degradations and spectra, as to biogenetic type. This evidence can be effectively supplemented by incorporations of precursors labelled with 14C, 13C or 15N, as appropriate, with examinations of the distributions of label in the product. Several examples of both classical and incorporation techniques are reviewed.


Design of a specific oxidant for phenols. Selective ortho-substitution of phenols can be secured, in principle, by attachment of the substituting reagent to the phenolic hydroxy group and subsequent rearrangement of this derivative by a cyclic mechanism into the orthoposition. So far, only one example of this principle (the Claisen rearrangement) is well established. For ortho-hydroxylation, a phenolic ester of selenium(IV) should have the desired properties. Diphenylseleninic anhydride, PhSE(=0)0.Sec(=0)Ph, has proved has proved to be the new reagent for the application of this mechanism. Several phenols, including models of the phenolic ring A of tetracycline, gave o-hydroxydienones, with quinones and phenylselenated species as by-products, when treated with diphenylseleninic anhydride. When the phenols were converted into their corresponding anions before treatment with the anhydridide, the o-hydroxydienones were obtained in good yield free from other products arising from reaction at the para position. When phenols were added to a warm solution of diphenylseleninic anhydride, they were oxidized to the o-quinones even when the phenols were not substituted in para position.


Synthesis of sesquiterpenoids of biogenetic importance. The contribuation made by Sir Robert Robinson to sesquiterpene chemistry and to the development of the biogenetic isoprene rule are discussed. Examaples of the great utility of the Robinson Ring Annelation in synthetic organic chemistry are given with reference to steroid and sesquiterpene systems. Recent modifications to the original method are also mentioned. The close relationship of the eremophilane sesquiterpenes and the spiro sesquiterpenes, which follows from the biogenetic derivation of eremophilone by Robinson, is the basis for the synthetic strategy under discussion leading to chiral spiro sesquiterpenes. This approach makes use of chiral starting material couples with subsequent stereospecific processes leading to sesquiterpenes of stereochemical interest and complexity.


Rules for ring closure.

Rules for ring closure. The ease of formation of cyclic structures shows some regularity which can be described by a set of 'rules' for ring closure. The restrictions on the endocyclic transfer of groups due to SN2 displacements having linear transition states are exemplified by studied on a biogenetic type synthesis of penicillin and, more generally, on the endocyclic attack of a nucleophile attached by a linking chain to an enone or polarized double bond. The formation of five-memebered rings is considered. In base, enones such as 4-hydroxy- and 4-amino-2-methylenebutanoates close exocyclically to give the corresponding five-membered lactones and lactams, respectively. Hydroxymethyl vinyl ketones, however, do not cyclize in base. In strong acid, hydroxy-enones close endocyclically to five-membered ring, as in the formation of cyclic ethylene ketals from acetone and ethanediol. The endocyclic closure of nucleophilic centres to polarized double bonds to give five-membered rings is impeded by restrictions of geometry; these restrictions can be overcome in acid through the generation of oxonium or protonated forms.


Preoperative information and recovery of open-heart surgery patients. Postoperatively, 19 adult open-heart surgery patients were interviewed as to information, included or not included in preoperative instruction, they identified as important to recovery. It was found that subjects desired details of all aspects of their conditions and treatment--preoperatively, operatively, and postoperatively. They had the greatest difficulty with pulmonary aspects of their care postoperatively. Subjects indicated a specific need for more information about the endotracheal tube, the ventilator, mucus, suctioning, deep breathing and coughing, and chest tube removal. Subjects experienced transient, primarily depressive, nonpsychotic postoperative mood changes unrelated to preoperative information, physical manifestations, and/or behavioral manifestations. Subjects regarded the nurse as an important provider of information and found the content of preoperative information satisfactory but wanted more individualization of instruction. They also indicated a need for more family involvement in preoperative instruction to provide them with information of the patient's progress throughout hospitalization. Questions and hypotheses for future research were generated.


Effect of extreme amino acid starvation on the protein synthetic machinery of CHO cells. When CHO cells are incubated under conditions of extreme amino acid starvation, effected by withdrawal of an amino acid from the medium together with genetic or chemical interference with the activity of the corresponding aminoacyl-tRNA synthetase, there is a rapid and profound decline in the functional capacity of the protein synthetic machinery. The effect was observed for all amino acids tested including leucine, asparagine, histidine, methionine and glutamine. This decline in protein synthetic potential appears to be due to a progressive permanent inactivation of the specific aminoacyl-tRNA synthetase concerned, as shown by a decline in the amount of cellular, specific aminoacyl-tRNA and a decline in the cell-free enzyme activity, measured after reversal of the starvation conditions. When cells are left for more than several hours under these starvation conditions, they shrink in size, lose viability and eventually disintegrate, with anomalous rapidity. We suggest that the progressive loss of protein synthetic capacity of the cells is the prime cause of these subsequent events. If the starvation conditions are reversed before cell death, regeneration of the protein synthetic potential occurs rapidly but requires protein synthesis itself, implying the existence of strong control mechanisms for cellular aminoacyl-tRNA synthetase activities.


[In vitro antibacterial activity of tobramycin used in combination with cephalothin or carbenicillin (author's transl)]. Combinations of tobramycin (TOB) with cephalothin (CET) or carbenicillin (CBPC) were evaluated by in vitro test against 161 clinical isolates of Klebsiella pneumoniae, Escherichia coli, indole-positive Proteus, Enterobacter and Serratia marcescens which were not inhibited by 6.25 microgram/ml of CET. The combinations were considered to show synergy when there was a 4-fold or greater reduction in MIC values (FIC index less than or equal to 0.5) of both antibiotics when combined. Synergy of TOB with CET could be demonstrated against 83% of Klebsiella pneumoniae, 78% of E. coli, 44% of Proteus rettgeri and 39% of Proteus inconstans. Synergy of TOB with CBPC could be demonstrated against 78% of Proteus vulgalis, 45% of Serratia marcescens and 28% of Proteus inconstans. Bactericidal effect showing synergy of TOB with CET could be demonstrated against each 2 strains of Klebsiella pneumoniae and E. coli. Frequency of synergy of TOB with CET under the condition of large inoculum size was significantly higher than that of synergy of TOB with CET under the condition of small inoculum size. Synergy of bactericidal effect of TOB combined with CET against Klebsiella pneumoniae and E. coli was more active when they were combined at the same time, than those of when TOB was combined after 2 hours exposure by CET or when CET was combined after 2 hours exposure by TOB. No antagonistic action was observed in these studies.


[Talampicillin hydrochloride: Comparison with amoxicillin and ampicillin in the antibacterial activity and pharmacokinetics (author's transl)]. The antibacterial activities, absorption and excretion of talampicillin hydrochloride were compared with those of amoxicillin and ampicillin. Talampicillin hydrochloride showed a broad-spectrum antibacterial activity against Gram-positive and Gram-negative bacteria as seen in amoxicillin and ampicillin. The antibacterial activities of talampicillin hydrochloride, amoxicillin and ampicillin were quite similar. In experimental murine infection with Staphylococcus aureus, protective effect of talampicillin hydrochloride was superior to ampicillin. For Escherichia coli infection, protective effect of talampicillin hydrochloride was similar to that of amoxicillin, while ampicillin was less active than both talampicillin hydrochloride and amoxicillin. The absorption and excretion of 250 mg equivalent doses of talampicillin hydrochloride, amoxicillin and ampicillin were compared in nine fasting healthy volunteers after oral administration of these antibiotics in randomized triple crossover study. In order to calculate the pharmacokinetic parameters, plasma levels were analyzed using an one-compartment open model, as well as area under the plasma concentration curve (AUC) and urinary excretion. Maximum plasma levels calculated were 2.8 times higher for talampicillin hydrochloride and 1.45 times higher for amoxicillin than for ampicillin. AUC was greater for talampicillin hydrochloride than for amoxicillin and lowest for ampicillin. Urinary excretion of talampicillin hydrochloride as penicillin determined in biological assay was comparable to that of amoxicillin and 1.55 times higher than that of ampicillin. Penicillins can be metabolized to penicilloic acids in the body. After taking into account the penicilloic acid contents in urine, total excretion in urine was 61% for talampicillin hydrochloride, 67% for amoxicillin and 42% for ampicillin during 6 hours after dosing. The absorption of the drugs was evaluated according to the plasma levels, the area under plasma concentration curve and the percentage of excretion in urine. The results obtained showed that talampicillin hydrochloride was well absorbed from the gastro-intestinal tract.


Teaching poetry writing to the old and the ill. When people are separated from the activities and relationships that make life so passionately interesting, they are separated from real accomplishment. A poet's non-therapeutic approach to writing led a group of ill and handicapped nursing home residents, aged 59-93 years, to find new strengths of feeling and ideas. Above all, it gave them the real accomplishment of some beautiful poetry.


Planning and administrative perspectives on adequate minimum personal health services. Public resistance to equal distribution of medical care resources is supported by a union of usually contradictory forces--sophisticated science and superstitious credulity. In a field saturated with ethical imperatives and professional ambiguities, definitions of need become political weapons. Improvement in health policy will involve political doctrine, reorganization of knowledge, and more leverage in state and local government.


The Carter administration's health budget: charting new priorities with limited dollars. Although the budget is described by the Administration as a "full statement of its priorities," policy and spending are bound by past decisions. New program initiatives are limited to a few discretionary programs under the Public Health Service, but the massive budget does reveal personal preferences of the President and the Secretary. Some of these choices may not find congressional favor; yet the entire budget process shows the Democrats again endorsing the categorical approach reminiscent of the New Deal and the Great Society.


Health planning: progress, prospects, and issues. The new Health Planning Act may have prescribed collection of too much data, too soon. There is no refuge in numbers from the social, professional, and political complexities of planning. A mechanistic criterion of "need" breaks down on close examination--we will have to recognize the effect of "availability." There is little or no experience in carrying out policies of selective contraction; modesty in claims and moderation in pursuit of goals are called for.


The professional doctorate: rationale and characteristics. The position that it is time for the nursing profession to develop programs leading to the N.D. degree, or professional doctorate, (for the college graduates) derives from consideration of the nature of nursing, the contributions that nurses can make to development of an exemplary health care system, and from the recognized need for nursing to emerge as a full-fledged profession.  It derives from pride in the accomplishments made by nurses of the past; from discontent with the meager influence that nurses now have; and from anticipation of a future that will be created when a critical mass of nurses are provided opportunities for completing pre-service doctoral study. It derives from confidence that those nurses can and will so influence the health care system that all persons will be properly served with care that promotes their health, restores their function,, and enhances their independence in knowledgeably exploiting their own health-seeking behaviors.


Staff development for leadership.

Staff development for leadership. Leadership, that amorphous concept so essential to nursing and so difficult to describe in its broadest context, can be learned if viewed as a set of behaviors that may be applied selectively to assist a group to move toward its goals. Given a supportive climate, a variety of approaches are effective, including one-to-one consultation, role modeling, goal orientation, and workshops on specific leadership behaviors.


The role of the nursing administrator in collective bargaining. There is little doubt that collective bargaining is here to stay in hospital nursing, and it adds a new dimension to the nursing administrator's area of responsibility. Careful planning and preparation for participation, trust and open communication, an attitude of acceptance, and a focus on the positive aspects of the negotiations will place the nursing administrator in an advantageous position in regard to collective bargaining in any practice setting.


The role of clinical supervisors and head nurses in management. In this article, we have attempted to describe the process of change that occurred within two specific groups of the nursing administrative staff. When we began working with the individuals within this group of nursing managers, each possessed the skills and abilities that met the needs of the system and its concept of nursing at that time. Through discussion of issues related to nursing and nursing management, the clinical supervisors and head nurses developed an expanded concept of their responsibilities related to patient, personnel, and operational management. The initial actions we encouraged them to take related to increasing their involvement in providing direct patient care. Following this, they became more active in the areas of personnel and operational management. Our ultimate goal was to promote their active involvement in all three areas of management. At times, we became impatient with what seemed to be a slow process of change. We believed, however, that it was imperative to move slowly and not push for change beyond their level of readiness. As one of the clinical supervisors recently stated, "Change is fast; progress is slow." Within this group of nursing managers, changes have been made, the goals are being met, and progress is indeed apparent.


Assessment of weight and gestational age. Many established nursery routines are in conflict with the physician's responsibility to the infant and the needs of the mother. While the first hour after birth is a crucial time for the mother and the infant to be together, it is also a time when neonatal problems can be identified and often prevented. Unless a problem is suspected immediately, this first hour of life is not the time for a thorough examination. The assessment of gestational age may be carried out later, in the nursery, when the infant's condition has stabilized and the parents have had an opportunity to view their infant.


Nursing leadership in the critical care setting. The challenge of a nursing leadership role within the critical care setting is most unique in that two competencies are required--clinical and administrative talents. The development of such leaders also presents a challenge to administrators of health care settings. With administrative support of the nurse who aspires to such a role, we will continue to provide the caliber of care required by acutely ill and injured patients. Based on a philosophy of management that promotes both clinical and administrative talents, this plan will not only best serve the patient population of acute/critical care units but will also help foster the professional commitment of nurse practitioners and encourage them to aspire to such roles.


Application of leadership theory: integrating thought and action. While the experienced nursing director may and can make decisions quickly and intuitively, the student and the novice supervisor or director need tools to facilitate the process. The theories are presented not as iron-clad rules, but rather as guidelines to be used in selecting leadership behavior appropriate to circumstantial needs, which can vary widely in nursing.


Apnea in the premature infant: an overview of causes and treatment. In summary, apnea of prematurity is both a primary and a secondary disorder--a reflection of CNS immaturity as well as a response to an underlying problem. Premature infants are extremely vulnerable to developing apnea. Close monitoring by the nursing staff and early detection and treatment of apnea and its associated disorders are essential to insure optimal growth and development of these tiny infants.


Neonatal transport.

Neonatal transport. Communication and teamwork are the keynotes to a successful transport system. This requires a team not only trained in transport details but also able to give emergency care to stabilize the infant prior to transport. The effectiveness of neonatal transport in lowering infant mortality depends on the efficiency of team care before and during transport.


Supporting lactation when mothers and infants are separated: a clinical guideline for perinatal nurses. It has been our intention to describe the vital role a nurse may play in assisting a woman to establish lactation successfully. Stitt indicates that the two most common reasons why women decline to breast-feed are (1) embarassment about their lack of knowledge of techniques and (2) fear of failure. Nurses are in a unique position to intervene constructively in both instances. It is essential for nurses to explore their own feelings about breast-feeding and sexuality and to help each other recognize how attitudes and values affect care. Only through understanding ourselves can we become sensitive to the desires of those who need our care.


The patient with systemic lupus erythematosus. SLE is an illness of unknown cause(s) affecting multiple organ systems, whose diagnosis depends upon a high index of suspicion and knowledge of its clinical manifestations. The American Rheumatism Association criteria may be used as a guide to help direct one's clinical and laboratory approaches. Survivorship appears to be improving and a wider spectrum of disease is appreciated today.


Hemoptysis.

Hemoptysis. Patients presenting with hemoptysis frequently have a serious underlying disease. Even when the amount of blood is minimal, thorough investigation is indicated. Since many different types of diseases give rise to bleeding from the respiratory tract, a careful and thorough diagnostic evaluation is indicated. Treatment depends upon the cause of the bleeding. Massive hemoptysis is frightening and requires more rapid assessment. When bleeding is considered to be massive, surgical intervention rather than conservative management yields the best chance of survival.


Factors influencing tone in rabbit large intestine. Pressure/volume curves obtained in the presence of papaverine have been compared with those obtained under control conditions in rabbit large intestine. Tension/length curves obtained on stimulation of the extrinsic nerve supply to the intestine have been compared with control curves. Evidence is presented for a small contribution of sustained muscular activity to the pressue/volume and tension/length curves. The effect of stretch on peak tension attained by the intestine has also been examined.


The influence of parathyroidectomy upon calcium and phosphate homeostasis in adult sheep. The absorption and secretion of Ca and PO4 were measured with the use of radioactive isotopes in 4 adult sheep before and after parathyroidectomy. Secretion of Ca and PO4 into the stomach and intestines was measured separately. Parathyroidectomy resulted in a negative balance for Ca and PO4 and an accompanying fall in plasma Ca and PO4 concentrations. In the case of PO4 this response was attributed primarily to a reduced intestinal absorption, but for Ca increases in urinary excretion and intestinal secretion also contributed significantly. Secretion of PO4 to the stomach was reduced but endogenous PO4 excretion in the faeces was unchanged which indicated a reduced reabsorption of secreted PO4 by the intestines.


H1 and H2 histamine actions on lung vessels; their relevance to hypoxic vasoconstriction. Pulmonary vasomotor actions of histamine and the possible relationship of histamine to hypoxic pulmonary vasconstriction were studied in anaesthetized cats with one lobe of lung perfused at constant flow and in isolated perfused rat and ferret lungs. In the cat histamine caused dilatation, biphasic responses and constriction with increasing doses. Histamine induced dilatation was better demonstrated during hypoxic vasoconstriction and was reduced by an H2 histamine antagonist; constriction with histamine was abolished by an H1 antagonist. Histamine also caused both vasodilatation and vasoconstriction in ferret lungs. A mast cell stabilizing agent had no effect on hypoxic pulmonary vasoconstriction in cats or rats. This response was unaffected in cats but greatly reduced in rats and ferrets by cyproheptadine, a combined histamine and 5-hydroxy-tryptamine inhibitor. It was unaffected in cats but abolished in ferrets an H1 histamine inhibitor. It was again unaffected in cats but greatly reduced in rats and ferrets by an H2 histamine inhibitor. These species differences may reflect differences in mechanism but more probably reflect non-specific effects of the inhibitors in certain circumstances. However, when drugs nearly abolished hypoxic vasoconstriction, ATP still caused vasoconstriction.


Effects of methacholine on the carotid chemoreceptors. The present electrophysiological study shows that methacholine (MCh), generally regarded as a muscarinic agonist, stimulates the carotid chemoreceptors in pentobarbitone anaesthetized cats. The response consisted of a primary increase in discharge, attributable to nicotinic actions of MCh since it was unaffected by atropine but abolished by mecamylamine, and a delayed secondary increase in discharge, due mainly to bronchoconstriction evoked by MCh. Physostigmine caused similar potentiation of responses to acetylcholine and MCh which implies that acetylcholinesterase is located close to the site(s) at which the drugs act to stimulate chemoreceptor activity. The findings are in agreement with the general principle that chemosensory activity is increased by nicotinic agonists but not by muscarinic agonists.


The effects of two analogues of arginine-vasopressin (ornithine-vasopressin and desamino-D-arginine-vasopressin) on kidney function in sheep. The effects of intravenous infusion of ornithine-vasopressin (OVP) and desamino-D-arginine-vasopressin (dDAVP) were studied in normal and hydrated Merino sheep. In normal sheep, OVP resulted in a diuresis, increased urinary sodium and potassium excretion, and a fall in the plasma potassium concentration. Renal plasma flow remained constant but glomerular filtration rate and filtration fraction rose markedly. dDAVP in normal sheep was antidiuretic, but its only significant effect was a small decrease in plasma osmolality. In the hydrated sheep OVP was antidiuretic and resulted in increased urinary excretion of sodium and potassium, and a fall in the plasma potassium level. Renal plasma flow fell, but glomerular filtration and filtration fraction tended to rise. dDAVP in the hydrated sheep was also antidiuretic but urinary sodium and potassium excretion was reduced. Renal plasma flow and glomerular filtration fell, with a small decrease in filtration fraction. These results suggest that the diuretic effect in normal sheep and the electrolyte-excreting effects in both normal and hydrated sheep of OVP are related to the increase in glomerular filtration, which in turn is dependent on the vasopressor activity of the hormone. The increase in glomerular filtration caused by OVP is due to an increase in the filtration fraction of an unchanged renal plasma flow, which could be brought about by an increase in renal efferent arteriolar tone. The effects of hydration of the sheep were the conventional increased urine flow, decreased urine osmolality and decreased solute-free water reabsorption. Sodium and potassium excretion rose slightly and plasma osmolality fell. Renal plasma flow and glomerular filtration both increased with little change in filtration fraction. These effects could be brought about by suppression of endogenous vasopressin and a decrease in both afferent and efferent renal arteriolar tone.


Acute cold exposure and the metabolism of glucose and some of its precursors in the liver of the fed and fasted sheep. Measurements of total body oxygen consumption, visceral and hepatic blood flow, oxygen consumption, exchanges of amino acids, lactate, pyruvate and glucose were made on sheep fed 3--6 h or 21 h before the experiment and exposed for 3 h to a neutral environment (15 degrees C) or a cold environment (0.5 to 4 degrees C with clipped coat and wind speed 2 m.s-1). Recent feeding significantly increasedd the total oxygen consumption and the oxygen consumption of the viscera and liver. No general release of amino acids from the viscera or uptake by the liver after feeding was detected although the arterial plasma concentration of essential amino acids did increase significantly after feeding. The plasma concentration of most non-essential amino acids also increased except that of glycine, which decreased significantly. Cold exposure increased the total oxygen consumption and reduced the respiratory quotient significantly. Release of amino acids from the viscera was stimulated by cold exposure. There was a variable increase in the hepatic uptake of lactate and alanine when the sheep were fasted and cold-exposed. The liver's glucose output doubled and the blood (arterial) glucose concentration significantly increased in the cold.


A comparative study of ticarcillin plus tobramycin versus carbenicillin plus gentamicin for the treatment of serious infections due to gram-negative bacilli. The combination of ticarcillin plus tobramycin (TT) or carbenicillin plus gentamicin (CG) was used to treat 82 patients with severe systemic gram-negative infection in a prospective, randomized study. Pseudomonas aeruginosa was the primary pathogen in 7 (93 per cent) of these patients. Patients treated with TT responded more frequently (92 per cent or 37 of 40) than patients treated with CG (71 per cent or 30 of 42) (p is less than 0.05). This difference was primarily due to a greater response to TT in patients with pulmonary infections (93 per cent versus 68 per cent) and infections due to Pseudomonas (92 per cent versus 70 per cent). Severity of underlying disease was also an important determinant of response. Except for a greater incidence of hepatotoxicity with CG (23 per cent versus 3 per cent; p is less than 0.02), there was no difference in toxicity, colonization with drug-resistant microorganisms or superinfection between the two treatment groups. The combination of TT appears to be superior to CG for the treatment of pulmonary infections due to Pseudomonas aeruginosa.


Parturient paresis of cows: blood glucose levels. During 1967, 1968 and 1969, blood samples were taken from 83 cows affected by parturient paresis. Whole blood glucose estimations were made on these samples. The range was 1.33 to 10.22 mmol/1 with an average of 3.94 mmol/1. Eighteen cows known to have been affected less than 4 hours had average levels of 3.06 +/- 1.11 mmol/1. All (except one) "previously untreated" cows with levels less than 3.33 mmol/1 were on their feet within 10 minutes whereas cows with higher levels than this had a 28.6% delayed recovery rate. The evidence suggests that low levels have no clinical significance but that higher levels are significant in that they occur as a result of prolongation of attacks of parturient paresis.


Decreased activity of peptide-elongation factors after treatment with cholesterol esterase. 1. Peptide-elongation factors were purified from rat liver and treated with cholesterol esterase and phospholipase A2 immobilized on Sepharose 4B. 2. Binding of L-[3H]-phenylalanyl-tRNA to 40S ribosomal subunits was decreased by approx. 70% and to polyribosomes by 30% in the presence of the binding factor incubated with cholesterol esterase. Treatment of this factor with immobilized phospholipase A2 decreased the binding to smaller ribosomal subunits by only about 15%. 3. Poly(U)-dependent phenylalanine polymerization by ribosomal subunits was decreased to approx. 30% of its original value by treatment of both elongation factors with cholesterol esterase. 4. The normal activity of esterase-treated elongation factor in both the binding reaction and peptide-elongation assay was fully recovered by the addition of cholesteryl 14-methyl-hexadecanoate. 5. Different classes of lipids present in peptide-elongation factor 1 have apparently different functions. Whereas phospholipids are required to maintain the strcture of heavy aggregates of this factor, the presence of cholesteryl 14-methylhexadecanoate is obviously necessary for the normal function of peptide-elongation factors.