Total removal of a parasagittal meningioma of the posterior third of the sagittal sinus and its repair by autogenous vein graft. Case report. Total removal is reported of a parasaggital meningioma that invaded the lateral wall and lateral recess of the posterior third of the superior sagittal sinus. The operation was performed by using a silicone rubber non-collapsible tube with an inflatable balloon cuff at each end for the bypass of the sinus blood, and entailed repair of the defect in the sinus wall by a saphenous vein graft. The clinical results and angiographic findings are presented.


Extraspinal ependymomas. Report of three cases. Spinal ependymomas may rarely arise from heterotopic ependymal cell clusters and thus occur in an extraspinal location. Presentation of three cases and a review of the literature reveal that these tumors have characteristic radiographic and clinical features. They occur mainly in patients in the third decade of life, and present either in the soft tissue posterior to the sacrum or in the pelvis. In the case of posterior tumors, the patient exhibits a mass which is usually mistaken for a pilonidal cyst. Patients whose tumor is pelvic in location present with sphincter disturbances or dysfunction of the sacral nerve roots. Conventional and computerized tomographic studies will reveal erosion of the sacrum. Myelography will demonstrate an extradural mass indenting the thecal sac from below. The protein in the cerebrospinal fluid will be normal. A combined posterior and anterior approach with the goal of complete tumor removal is the procedure of choice. If this is not feasible, then radiation therapy should be employed. Because of the increased incidence of systemic metastases, the average postoperative survival is approximately 10 years.


Myelocystocele with cerebellar heterotopia. Case report. The authors describe a case with well differentiated cerebellar tissue contained in a hydromyelic dilation of the spinal cord, that is, myelocystocele, in connection with a cervicothoracic meningocele. The embryology is discussed.


Sphenoethmoidal meningoencephalocele associated with agenesis of corpus callosum and median cleft lip and palate. Case report. A case of sphenoethmoidal meningoencephalocele associated with agenesis of the corpus callosum and median cleft lip and palate in a baby boy is reported. Two other cases have been reported previously presenting exactly the same findings. It is possible that these malformations constitute a distinct type of congenital anomaly.


Sphenoidal pneumosinus dilatans with bilateral optic nerve meningiomas. Case report. The authors report a case of bilateral progressive visual loss in a patient with a radiological diagnosis of sphenoidal pneumosinus dilatans. At craniotomy, bilaterally symmetrical meningiomas of the optic nerve sheaths were found at the intracranial optic foramina. Reported cases of sphenoidal pneumosinus dilatans as well as bilateral meningiomas of the optic nerve sheaths are reviewed. The possible mechanisms of visual loss in pneumosinus dilatans and the management of nerve sheath and planum sphenoidale meningiomas are discussed.


Primary cerebellar nocardiosis. Report of two cases. The authors describe two cases of primary cerebellar nocardiosis. Confinement of Nocardia abscesses to a localized, accessible portion of the central nervous system should favor surgical cure of this aggressive and often fatal disease. In our two cases multilocularity, tenuous encapsulation, and proximity to the brain stem prevented complete primary excision. Nevertheless, the infections were effectively treated by intensive postoperative antibiotic therapy and, in one case, a second operation to excise the residual abscess. The need for the latter was suggested by the results of sequential computerized tomographic brain scans that were used to monitor the response to antibiotic therapy. In the absence of any apparent extracranial focus of infection and any overt condition that might impair immunological competence, nocardiosis is likely to be omitted from the preoperative differential diagnosis of a posterior fossa space-occupying lesion.


An association of upper respiratory cancer with exposure to diethyl sulfate. A morbidity and mortality study of workers at an alcohol manufacturing plant which included several weak acid isopropyl alcohol units and a strong acid ethanol unit is described. An excess mortality of upper respiratory cancer was found and associated with work on the strong acid ethanol unit. The strong acid ethanol process used resulted in high concentrations of diethyl sulfate, which has been shown to be carcinogenic in animals, and the unit, which closed on 1975, had significant opportunities for worker exposure to diethyl sulfate. These facts, plus previous reports of excess upper respiratory cancer on strong acid isopropyl alcohol units with similarly high concentrations of the animal carcinogen diisopropyl sulfate, lead to the tentative conclusion that diethyl sulfate was primarily responsible for the ethanol unit cancer cases. In the modern weak acid isopropyl alcohol plants, where only trace amounts of diisopropyl sulfate are present and exposures are much lower, the problems found on the old strong acid units do not exist.


Nonsmoking grain handlers in Saskatchewan: airways reactivity and allergic status. This study was carried out to determine whether respiratory disease in Saskatchewan grainhandlers was or was not due to hypersensitivity to grain dust. Sixty nonsmoking grainhandlers, half of whom had low FEV1/FVC ratios and half of whom had high, were studied. The findings in grainhandlers were compared with those in 30 age-matched, nonsmoking teachers. In the group of grainhandlers with low FEV1/FVC ratios, one had developed asthma associated with exposure to grain dust. The majority were healthy, had FEV1/FVC ratios of 70% or greater, and had less evidence of allergic respiratory disease than had age-matched teachers. The studies suggest that non-atopic, nonsmoking men can work in grain elevators without developing respiratory disability, though they may develop a small but significant increase in nonspecific bronchial reactivity to histamine.


Lung cancer mortality in aluminum reduction plant workers. The lung cancer mortaltiy of 5406 men (cohort 1) employed at one aluminum smelter on January 1, 1950, and of 485 men employed at a second plant (cohort 2) on January 1, 1951, is reported. For each man, the total number of years of exposure to tars, number of years since first exposure to tars and an index of exposure to tars expressed in tar-years were calculated. More than 99% of the men in the first cohort and just less than 98% of the men in the second cohort were traced. As of December 31, 1973, 1070 men in cohort 1 had died and death certificates were obtained for 990 men (92.5%). As of December 31, 1973, 64 men in cohort 2 had died and death certificates were obtained for 58 (91%). There were 84 deaths from lung cancer in cohort 1 and 11 in cohort 2. The results showed that the mortality from lung cancer of that portion of the cohorts 1 and 2 combined who had ever been exposed to tars was similar to that of workers never exposed to tars. The mortality from lung cancer of men in cohort 1 was greater than that expected at Quebec provincial rates, but this was probably due to slightly increased lung cancer mortality in the communities serving the industries. Although the total number of cases in cohort 2 was small tuld not be explained on community experience. There was a definite dose-response relationship between lung cancer mortality and tar-years and years of exposure. The standardized mortality ratio for persons exposed for more than 21 years to the higher levels of tars was 2.3 times that of persons not exposed to tars. Although smoking may still be a factor, the evidence suggests that the increased risk of lung cancer is related to employment in definite tar-exposed occupations.


Sulfur dioxide exposure in a smelter. III. Acute effects and sputum cytology. Although acute effects from exposure to SO2 have frequently been observed at low levels in acute exposure experimental studies, it was not known whether or not such effects occur among workers chronically exposed at ranges of 0.3 to 4 ppm of SO2. Measurements of FVC, FEV1, FEF50, FEF75 and FEF50-75, and closing volume were made before and after the workshift for copper smelter workers and controls. Sputum samples for cytological examination were collected. Mean FEV1 and FVC were significantly more smelter workers had a decrease in FEV1 and FEF50 during the day than did controls. More of the smelter workers felt "chest tightness." No change in closing volumes was seen. Smelter workers tended to have a higher percentage of sputum samples with moderate and marked atypia than did controls but the difference was not statistically significant.


Industrial accidents and medication. Is there a relationship? Although health workers are continually concerned about the effects of various medications on the public and especially on employees at work, there have been almost no studies reported which have indicated any relationship between medication taken and industrial accidents. A series of 115 consecutive employees reporting accidents to the DRG Health Center were interviewed as to medication taken in the previous 24 hours. A control group of another 115 employees were also interviewed. We found no difference in the two groups related to medication taken and thus there does not appear to be a direct relationship between medication ingestion and accident rate within this industry.


A mortality study of oil refinery workers. Survival status of 1205 men employed for more than five years in a Canadian oil refinery in East Montreal, from 1928 through 1976, was assessed and death certificates were reviewed. Expected numbers of deaths were estimated based upon age- and cause-specific death rates for the Province of Quebec applied to person-years at work. Oil refinery workers showed a standard mortality ratio lower than expected for all causes of death (SMR = 78.43). Three cancers of the brain were found among young people who died less than 20 years since start of exposure. This was statistically higher than expected. Cancers of the digestive system, though not significantly higher than expected, remained suspect of being associated with work. There is a need to expand this research to other oil refinery workers.


Racial differences in lung function: search for proportional relationships. A comparison of lung function in Caucasian and East Indian woodworkers revealed marked differences in FEV, FVC, AND MMF in relation to predicted age- and height-specific values of these variables reported in the literature. These findings were not attributable to differences in smoking habits, frequency of respiratory disease, or employment characteristics. Rather, they suggested that the standard values employed were inappropriate for East Indians. An attempt was made to confirm previously reported suggestions of consistent proportional differences in lung function between racial groups which would permit the calculation of a single correction  factor. Evidence of a consistent proportional relationship was found for FEV over a wide range of heights and for FVC over a limited range of heights. However, no such relationship was found for MMF.


The crossed straight leg raising test: a diagnostic sign of herniated disc. Increased sciatica on raising the opposite or "well" leg, the crossed straight leg raising (XSLR) sign, is associated with a herniated lumbar disc in 97% of patients. Although XSLR predicts poor response to conservative management, the results of laminectomy are usually good, with 91% of patients returning to work. Myelography is unnecessary for the diagnosis of disc herniation in patients with XSLR. It is possible for patients with this sign to have a normal myelogram, but 90% of them will prove nevertheless to have a herniated disc.


Medical effects of combined industrial exposures. The problem of combined workplace exposures has been long recognized but rarely written about. This article explores some of the problems of approaching and defining-combined exposures, reviews several categories of combined exposures, and emphasizes a practical preventive medicine approach to combined exposures. It is hoped that this article will stimulate other papers in this area.


Argyria: clinical implications of exposure to silver nitrate and silver oxide. This article reports the clinical findings in a work force of 30 individuals who were exposed to silver nitrate and silver oxide. Six individuals had argyria and 20 had argyrosis (deposition of silver in the eye). Measurements of blood silver levels were included as part of the examination. The results of this examination generally support the benign nature of argyria, although the question of silver causing a decrement in kidney function and night vision is not settled. Periodic slit lamp examinations as well as monitoring of silver air concentrations are necessary to assure that engineering controls are actually limiting worker exposure to silver.


Scleroderma simulating vinyl chloride disease. Progressive systemic sclerosis, especially prior to distinctive internal organ involvement can be difficult to distinguish from vinyl chloride disease. A 50-year-old male developed classic scleroderma while working with polyvinyl chloride. Early in his disease he displayed a number of features common to both disorders, including acroosteolysis, sclerodactyly, polygammopathy and circulating immune complexes. Characteristic visceral involvement was the cardinal feature which distringuished his disease from the pseudoscleroderma of vinyl chloride disease.


Strategies for increasing employees' level of exercise and physical fitness. Many organizations are attempting to increase the physical fitness levels of their employees to help stem the rapidly-increasing employer health costs. Using basic economic concepts and models of human health behaviors, this study finds that the time and effort costs of exercise may exceed the present value of the economic benefits of improved physical fitness. These high costs help explain the small incidence of consistent adult exercise and the lack of in-house, on-work-time employer exercise programs. The study concludes that while health education campaigns may be useful, employers must find ways to reduce the time and effort costs of exercise by making  it a low-cost byproduct of more immediately desired outputs or goals.


Utilization of the preemployment health examination in a university staff health service. This study assessed the utilization of a mandatory preemployment health examination (PEHE) for 507 new full-time university staff in 1976. A random sample of 126 new employees was interviewed by telephone. Of the 108(86%) who completed the interview, 80 (74%) had been examined by the staff health service. Notification to take the exam, a reminder, and the employee's perception of its importance were highly associated (p less than 0.0001) with compliance. Only 30% of the food handlers and maintenance personnel ahd their PEHE before employment started; the proportion was similar for all new employees (29%). Therefore, although this staff health service was moderately successful in getting most new employees to have a PEHE, if the value of the examination is to be enhances, more attention must be paid to notifying and reminding all prospective employees. Special consideration is needed to ensure that those in potentially high-risk jobs are examined prior to employment. The role of the university administration in improving compliance is emphasized.


The use of medical records by adjudicators in processing Social Security disability insurance benefit claims. The Social Security Administration contracts with state agencies to process disability claims filed under the Social Security Act. These state agencies employ physicians and lay adjudicators who secure medical reports from physicians, hospitals and clinics, and use these reports in awarding or denying disability benefits. This nationwide study showed that well over half of the lay adjudicators are involved in developing and interpreting medical information independently. This suggests that appropriate hiring practices, adequate training and certification procedures should be instituted to ensure that the lay disability adjudicators are able to conduct their job efficiently and correctly.


Mortality in aluminum reduction plant workers. Mortality in workers at a northwestern United States prebake-type aluminum reduction plant was examined in a historical prospective (cohort) study. Although the standardized mortality ratio (SMR) for all causes of death was low (86), lung cancer (SMR 117), pancreatic cancer (SMR 180), lymphatic and hematopoietic cancers (SMR 184), fatal benign tumors of the brain (SMR 391), and pulmonary emphysema (SMR 204) showed excess deaths. Analysis of mortality by job-exposure category, duration of employment and latency suggests that some of the lymphatic and hematopoietic cancers (especially malignant lymphoma), lung cancers and pulmonary emphysema may be of occupational origin in this worker population.


Carpal tunnel syndrome and selected personal attributes. Carpal tunnel syndrome has been reported to occur between two and ten times as frequently in women as in men. It also has been reported that this syndrome is often associated with the performance of certain manual tasks. Such cases can be considered an occupational disease. This study was addressed to the question: Why do some people develop carpal tunnel syndrome while others do not? Two matching female populations, one with a known history of carpal tunnel syndrome and one without a known history of carpal tunnel syndrome, were selected and differences in hand size and work methods were studied. Both populations were employed in the same production sewing jobs. While differences in hand size were not found, use of forceful exertions and of deviated wrists and pinch hand position - particularly during forceful exertions - were found to be associated with carpal tunnel syndrome.


Pulmonary abnormalities in art glassblowers. Art glassblowing is a profession bringing the lung in close contact with many potential hazards. Forty-seven art glassblowers with a mean age of 34.5 years answered a questionnaire and had pulmonary function studies performed. While this was generally a young, healthy population, 21% had "usual cough" and 31% had wheezing. Pulmonary functions were most often normal. However, using multiple linear regression analysis, the functions associated with volume, VC and FEV1 showed a significant drop with increase in the total lifetime hours exposed to glassblowing. Both the presence of a cough and the production of phlegm were related to hours of exposure. Thus it seems there may be some unknown toxic effect of art glassblowing which in the future may prove to be hazardous to health.


Subclinical effects of chronic increased lead absorption--a prospective study. II. Results of baseline neurologic testing. This report summarizes the results of baseline neurologic testing in a group of apparently healthy workers from a secondary lead smelter and a group of controls from nearby aluminum processing plants. The test battery included a standard neurologic examination nerve conduction measurements, quantitative oculomotor function tests and detailed audiologic studies. Lead workers and controls were intermixed so that the examiners were unaware of the status of any individual being tested. Although the lead workers reported significantly more neurologic symptoms than the controls, relatively few differences were found on quantitative neurologic testing. Decreased deep tendon reflexes occured more frequently in the lead workers than in the controls (22% vs. 11%) but the difference was of borderline significance (p=0.06) and other signs of peripheral neuropathy occurred with equal frequency in both groups. The mean motor conduction velocity and sensory latency measurements were not significantly different in the lead workers and in the controls and, of the six oculomotor function measurements, only the mean accuracy of saccadic eye movements was significantly (p less than 0.01) different in the two groups. High frequency hearing loss occurred with equal frequency and severity in both groups, consistent with the level of noise exposure in the lead and control plants.


Polyvinyl chloride pneumoconiosis: epidemiological study of exposed workers. Among 1216 workers who were employed in a polyvinyl chloride production factory and who had had no previous dust exposure elsewhere, 20 cases of pneumoconiosis were found. Chest x-ray abnormalities were characterized by limited profusion, irregular type and low gravity. All 20 workers had been exposed to high PVC dust levels. The chest x-ray changes were observed after a minimum exposure of five years and, in a small percentage of cases, were associated with slight restrictive respiratory function impairments. Moreover, in the whole group of workers 388 cases (31.9%) were found with non-specific x-ray abnormalities mainly related to age and smoking.


Delivery outcome in women employed in medical occupations in Sweden. A study was made of the delivery outcome in women working in medical occupations in Sweden. One cohort of approximately 1500 women who worked in 31 hospitals for chronic diseases during the period 1965-1975 and who gave birth during those years was studied. Also all women working in medical occupations and delivered during the years 1973-1975 were investigated by matching existing data registers. It was found that caesarian sections and vacuum extractions were used more frequently than expected. A significantly increased perinatal death rate was noted in 1973, but could not be related to any specific occupational exposure known to represent an increased risk. No general increase in malformation rate was seen, but a local cluster, occuring at certain hospitals in the Gothenburg area in 1973-1974 was identified. No support was obtained for the hypothesis that the use of soap containing hexachlorophene is associated with an increased risk of perinatal death or malformation.


Changes in feelings of job satisfaction among alcoholics induced by their employer to seek treatment. Four hundred eighty-eight alcoholics who had been referred by their employers for treatment were included in the study. Data were collected on various aspects of their feelings of job satisfaction when they entered treatment and three, six and 12 months after they had completed the residential phase of treatment and had returned to work. Questions which related to satisfaction with productivity rather than to enjoyment of the work environment and of co-workers had the highest scores (indicating lowest satisfaction) at admission, and showed the greatest change over time. Improvement in job satisfaction over the follow-up year was directly related to positive change in drinking behavior.


The pathology of cartilage in chondrodysplasias. The pathology of four types of chondrodysplasias, viz., type II achondrogenesis, thanatophoric dwarfism, Saldino-Noonan syndrome, and chondrodysplasia punctata were studied. In each of these disorders, cells with features similar to the chief and dark chondrocytes of normal hyaline cartilage were seen to be altered in different ways. There was a total absence of chief cells in type II achondrogenesis. All the chondrocytes present were of one variety at different states of maturation, with the fully matured cell having features of dark chondrocytes. The absence of chief cells was associated with marked diminution of interlacunar matrix and failure of growth plate development. The chief chondrocytes in thanatophoric dwarfism appeared diminished in number. They were probably abnormal functionally as evident by their lack of cytoplasmic vacuolation and the formation of thick, occasionally branched collagen in the matrix. The growth plate was stunted and poorly developed. Striking changes involving the dark cells were noted in Saldino-Noonan syndrome, where unusually elongated dark cells were found in groups within abnormal cystic spaces. The chief cells were large and contained abnormal cytoplasmic filaments. There was no formation of a growth plate. In chondrodysplasia punctata, the chief cells were enlarged and abnormally vacuolated. The matrix showed excessive aggregates of coarse granular material. In addition, there were focal accumulations of highly abnormal chief and dark cells with abnormal matrix which contained increased amount of keratan sulphate and culminated in spotty calcification.


Vascular permeability in the rat gingiva. A model of vessel response in chronic inflammation. The vascular permeability of the vessels of clinically normal gingiva of rats was studied using the colloidal carbon technique. The connective tissue situated underneath the keratinised epithelium was normal, but that subjacent to the non-keratinised epithelium showed some degree of chronic inflammation and as a rule the vessels of the area exhibited increased vascular permeability. In the buccal gingiva the vessels labelled with carbon form loops situated 200 micrometers below the marginal gingiva, while in the interdental gingiva the altered vessels are just below the superficial epithelium. On electron microscopy the vessels in the inflamed areas showed many open endothelial junctions, and also pseudo-fenestration, and endoplasmic vesicles full of carbon. Little is known about vascular changes in chronic inflammation, and the rat gingiva seems to be a suitable model for their study.


The histogenesis of nerve sheath myxoma: report of a case with electron microscopy. The case is described of a 71-yr-old female with a tumour in the pulp of the left index finger. The histology was that of a myxoma of nerve sheath or Pacinian neurofibroma. Electron microscopy of the tumour provides convincing evidence for an origin from the perineural cells. The location of these tumours, suggestive histology and perineural origin provides support for the belief that they arise from sensory nerve endings.


Giant pseudopolyposis in granulomatous colitis. A case is described of an unusual combination of polypois and inflammatory bowel disease of a granulomatous type. A striking feature is the complexity of the polypoidal lesions. The relationship between these lesions and the granulomatous colitis which is probably a variant of Crohn's disease is discussed.


Paranodal vascular spread in breast cancer with axillary node involvement. The presence of tumour cells in the efferent paranodal vessels of tumour-bearing axillary lymph nodes from patients with operable breast carcinoma was associated with a significant reduction in survival time at 5 yr compared to cases with node involvement in which these vessels did not contain tumour cells.


Effect of gonadectomy and oestrogen administration on the response of lymph-node post-capillary venules to infection with Toxoplasma gondii. The effects of gonadectomy and oestrogen administration on the response of lymph-node post-capillary venules to infection with Toxoplasma gondii have been studied in mice. The endothelial cells of the post-capillary venules were significantly higher in the female than in the male controls. Oophorectomy had no significant effect while orchidectomy increased the height of the cells. However, hexoestrol administration resulted in a rise of the height to maximum levels in the female and in the male gonadectomised animals. The endothelial cells of male and female control and gonadectomised mice were higher after infection with Toxoplasma while in the infected hexoestrol-treated animals, lower cells were seen. The number of lymphocytes passing through the post-capillary venule wall was increased by gonadectomy and decreased by hexoestrol administration in both sexes. The same pattern was seen in the infected groups. The influence of sex hormones on the post-capillary venules and its possible contribution to the differences seen in the immune response between the two sexes is discussed.


Biochemical and pharmacological properties of a neurotoxic protein isolated from the blood serum of heavily burned patients. Blood serum of heavily burned patients contains neurotoxic substances which are not present in normal control sera. In the present paper, we describe the purification by gel filtration and ultracentrifugation of such a neurotoxic factor. The purified factor appeared to be a high molecular weight (2 to 3.10(6) daltons) lipoprotein. This factor was present in all the sera of patients with more than 35 per cent of the body surface burned. When injected into rabbits the lipoprotein caused a flattening of the EEG tracing, then trembling and convulsions with bursts of spikes on the EEG. The activity of this neurotoxic substance was enhanced when the permeability of the blood-brain barrier was increased by previous intraventricular injection of collagenase. The presence of such a neurotoxic factor in the blood serum of burned patients, together with the increased serum collagenase activity they exhibit may explain the neurotoxic symptoms observed in them.


Biochemical and pharmacological properties of a cardiotoxic factor isolated from the blood serum of burned patients. Blood serum of severely burned patients contains several substances which are not present in normal sera. One of these substances, a small protein of an approximate molecular weight of 12 to 14,000 daltons displayed a toxic action on the circulatory system. This cardiotoxic factor was obtained in a purified form by alcohol precipitation followed by gel filtration and carboxymethyl cellulose chromatography. The purified preparation seems to be a low molecular weight protein of about 8000 daltons. The biological effects of this substance consist essentially of alterations of the ECG pattern, indicating decreased cardiac output and ischaemia of the cardial muscle. The blood pressure decreases and respiratory function is also altered. The presence of such a toxic factor in sufficient concentration in the blood serum may explain the cardiovascular complications observed in some burned patients.


The mechanical, enzymatic and morphological changes in acute pulmonary insufficiency following the production of a haematoma in rabbits. The production of a haematoma in the hindleg of rabbits represents a simplification of post-traumatic models. The lungs, one of the target organs, show similar micromorphological alterations to those described in traumatised human beings. The lungs of rabbits, bearing a hindleg haematoma for 24 hr, showed a significantly increased incidence of micromorphological lung alterations compared to the control group. Moreover, measurement revealed a significantly decreased lung compliance within the haematoma groups. It was demonstrated that whether the haematoma was subcutaneous or intramuscular, similar alterations were seen in lung histology, and in lung compliance values. Studies on the activity of superoxide dismutase in lung tissue homogenates demonstrated a significant decrease in those rabbits having had a haematoma intramuscularly for 24 hr.


Patella displacement and osteoarthrosis of the knee joint in mice. Surgical stabilisation of the normally medially--subluxing patella of STR/ORT male mice, prevented the normal development of osteoarthrosis in the medial compartment of the femoro-tibial joint. Surgically produced medial dislocation of the patella in non-arthrosis-prone male CBA/ORT mice often gave rise to osteoarthrosis of the medial condyles. This, with further evidence from previous studies, strongly indicates that the high incidence of degenerative joint disease in male STR/ORT mice occurs because of a tendency of the patella to dislocate medially due to some unknown cause.


In-vitro modification of membrane receptors on cells of the mononuclear phagocyte system. EA and EAC receptors have been studied on non-elicited and paraffin-induced macrophages, under a variety of culture conditions in vitro, for up to 7 days. A large decrease in the number of macrophages showing EAC receptors was found after treatment of the cells with BCG, but not "inert" particles such as latex and zymosan. This was reversible by 7 days. In the presence of a toxic material, Al(OH)3, both EA and EAC receptors were partially lost. The results obtained have been related to previous results obtained with cryostat sections of human leprosy skin lesions.


Quantitative comparisons of the pulmonary toxicity of tobacco and NSM smoke. Smoking elicits a panacinar rise in pulmonary alveolar lysosomal activity that is thought to correlate with the irritancy of the smoke. Quantitative image analysis of lung sections stained histochemically for acid phosphatase indicates that tobacco smoke is significantly more irritant than NSM smoke.


Aggressive osteoblastoma.

Aggressive osteoblastoma. The clinical, radiological and pathological features of two cases of an osteogenic tumour with long survival are described. The tumours have the histological pattern of benign osteoblastoma with other more cellular and aggressive features suggestive of a low grade osteosarcoma. They are locally invasive but the absence of metastases indicates that separation from both entities is justified clinically and pathologically. The term aggressive osteoblastoma is suggested.


Granulomatous inflammation in normal and athymic mice infected with schistosoma mansoni: an ultrastructural study. Inflammatory cell types and their interrelationships were studied in hepatic schistosome egg granulomas by correlated light and electron microscopy in thymus-intact and athymic mice. Intact animals developed large granulomas composed of phagocytes, stimulated macrophages, epithelioid cells, eosinophils and mast cells. The lesions peaked in size between 10--14 weeks after infection and tended to heal after 16 weeks. In athymic mice only phagocytes, stimulated macrophages and possible epithelioid cells appeared in the granulomas which were much smaller and less well organised than in intact mice. Virtually no eosinophils or mast cells entered the granulomas. These findings support the idea that development of granulomatous inflammation per se is not determined by CMI, but T cell co-operation seems to be required for its full expression in schistosomiasis. Since CMI closely regulates ingress of eosinophils and mast cells into the granuloma, the nature of T cell co-operation probably occurs at several levels in this complex infectious granuloma.


Ultrastructural types of cell in adrenal cortical adenoma with primary aldosteronism. By means of electron microscopy, three types of cell were identified in the adrenal cortical adenomas obtained by surgery from three patients with primary aldosteronism. They were zona glomerulosa-type cells, compact cells and clear cells. The former two types of cell were quite similar to those found in the zona glomerulosa and the zona reticularis respectively. The clear cell with large lipid vacuoles possessed mitochondria similar to those found in the outer zona fasciculata. The ultrastructure of the vacuoles was rather complex and their relationship to those in the zona fasciculata cell was not clear. Glycogen particles in the beta-form, which were present in the zona glomerulosa and reticularis cell but not in the zona fasciculata cell, were observed within the cytoplasm of this tumour cell. The clear cells of the tumours were therefore considered to possess features of both the zona glomerulosa and the zona fasciculata cell.


Migration of peritoneal polymorphonuclear leucocytes in the rat. The migration of PMNs into inflammatory sites in the rat has been studied using elicited peritoneal cells. These cells exhibit normal random migration and phagocytosis in vitro but their chemotactic response towards activated serum is significantly reduced when compared to cells isolated from peripheral blood. When injected intravenously, peritoneal cells not only show a greatly diminished ability to accumulate in inflammatory exudates but also block the migration of peripheral PMNs. Thus while PMNs obtained from the peritoneum may be suitable for some studies, they are not representative of peripheral cells with respect to their ability to accumulate in inflammatory exudates due to implanted inert sponges.


Early bronchiolar damage following paraquat poisoning in mice. Paraquat causes focal intracellular oedema of the terminal bronchiolar epithelial cells and focal subpleural atelectasis with thickening of the interalveolar septa 1 hr after the administration of an LD50. These changes are progressive, and lead to panacinar atelectasis with necrosis plus sloughing of epithelial cells in many terminal bronchioles. Radioactive phosphatidyl choline (PC) is recoverable by lavage within 90 s of the administration of tritiated palmitate, which supports previous suggestions that one source of pulmonary surfactant is rapid secretion by the terminal bronchiole. Paraquat causes a reduction in the relative amounts of radioactive PC that are recoverable from the airways within 90 s of giving tritiated palmitate. A deficiency of pulmonary surfactant of bronchiolar origin is implicated, at least in part, in the pathogenesis of the acute phase of the paraquat lesion in mice.


Amyloid in localised deposits and plasmacytomas of the respiratory tract. Clinical and histological features of 25 cases with amyloid deposits in the respiratory tract are described. The false cord is the commonest single site of such "primary" amyloid involvement. Evidence of extensive involvement and replacement of seromucinous glands by amyloid was seen in each case. Fourteen cases of plasmacytoma with "secondary" amyloid deposits are also described. The nose and nasopharynx were principally involved as with respiratory tract plasmacytomas in general but a similar association of the amyloid with seromucinous glands was also seen. Electron microscopy showed early involvement of the basal lamina of the duct of a seromucinous gland by amyloid in one case. Possible reasons for the association of amyloid precursors in respiratory tract amyloid with seromucinous glands are given.


The pathology of cot deaths.

The pathology of cot deaths. An examination of the pathological features of 12 consecutive cases of sudden death in infancy was undertaken with particular reference to the lung changes used a combined radiological and pathological study of formalin vapour-inflated lungs. Certain common features in the cases in which there are no post mortem changes to explain death (typical cot deaths) are described and compared with cases with an acceptable cause of death and with control cases. It was concluded that severe dehydration is a potentially avoidable factor underlying cot deaths and many other sudden infant deaths with no explainable causes; that petechial haemorrhages are a constant feature of cot deaths and indicate a respiratory/hypoxic mode of death; that absence of petechiae indicates some other explanation for death. It is suggested that the minor respiratory or other infections which are usually present at autopsy in cot deaths may sometimes exaggerate a preexisting state of dehydration and that the dehydration may contribute more directly to death than the infection.


Carcinoma of the neck in young children: a light and electron microscopic study. Two neck tumours in young children with similar clinical features were compared using light and electron microscopy. Both tumours consisted of uniform sheets of epithelial-like cells and there were scattered stromal elements in one. Tonofilaments in sheets or bundles reminiscent of squamous epithelium were striking in the epithelial cells. Intercellular junctions were frequent but true desmosomes were not seen. Most cells contained a few secretory droplets. Occasional secretory cells, foam cells and cilia were observed. Since these tumours were not sited superficially they are unlikely to have been derived from skin epithelium. An origin in branchial sinus remnants capable of differentiation towards squamous and ciliated epithelia is suggested.


The inflammatory response to endotoxin.

The inflammatory response to endotoxin. A typical inflammatory response resulted from the intravenous injection of endotoxin (E. coli) into living rabbits. Each rabbit was studied at three levels: the microvasculature and supporting tissue in the ear chamber was observed microscopically (up to X200) before, during, and at regular intervals following the injection of endotoxin; leucocyte and platelet counts were made periodically throughout each experiment; and tissue samples for histological study were obtained from each rabbit prior to death. The animal was anaesthetised before histological samples were secured. Within minutes after the intravenous injection of endotoxin, leucocytes were observed sticking to the endothelial cells lining the venules and the arterioles. Emboli appeared in the microcirculation within 10 min. Swelling of the microvascular endothelial cells was evident at 1 hr; oedema and extravasation of the cellular elements followed. The rectal temperature and leucocyte and platelet counts all fell within 10 min. of endotoxin. Histological examination of tissue from the ear chamber and visceral organs showed inflammatory changes. Congestion of the microvasculature, swelling of the endothelial cells, and margination and migration of neutrophils were common histological features in all organs. The earliest cells affected appeared to be the leukocyte and platelet.


Ultrastructural observations on the capillaries of human thyroid tumours. Ultrastructure of the capillaries of malignant and benign thyroid tumours has been examined. The material consisted of biopsies from six cases of thyroid papillary carcinoma, one case of follicular (foetal type) adenoma and six cases of nodular adenomatous goitre. In the group of nodular adenomatous goitre and in the follicular adenoma, the capillary wall was made up of fenestrated endothelium similar to that of capillaries of normal human thyroid. The fenestrae occupied a large area of the endothelial wall. Micro- and macropinocytotic vesicles were frequent in the endothelial cytoplasm. In the thyroid carcinomas the papillary structures always contained numerous capillaries with fenestrated endothelium. The microfollicular area and the solid tumoral areas of the papillary carcinoma showed occasional capillaries with fenestrated endothelium, but many capillaries were lined with continuous endothelium. The capillaries in all the specimens were surrounded externally by a continuous basement membrane which was frequently bilaminate or multilaminate. This study indicates that capillaries with fenestrated endothelium are characteristic of thyroid tumours which arise from follicular cells.


Spindle cell sarcoma of the pulmonary trunk: a case report with histochemistry and electron microscopy. A further case of a spindle cell sarcoma of the pulmonary trunk is reported, with extension to the pulmonary valve and lungs. Some spindle cells contained glycogen and their cell walls acid mucosubstances. Electron microscopy showed two types of cell. The more common were polyhedral with poorly arranged fibrils in the cytoplasm and an abundant fuzzy coat. About 5 per cent of the cells contained neurosecretory granules.


Central nervous system alterations as sequelae of Venezuelan equine encephalitis virus infection in the rat. Alterations of the Central Nervous System (CNS) in rats surviving acute infection with a virulent strain of Venezuelan Equine Encephalitis (VEE) virus were studied by light and electron microscopy. Cavitary necrosis of the cerebral cortex, macrophage activity and degenerative axonal changes were considered to be sequelae of the lesions induced during the acute phase of the infection. Mononuclear cell infiltrates of the neuropil, 3 mth after inoculation, were related to the immune response of the host. Focal lesions and mononuclear cell activity in the brain are thought to be the equivalent of the lesions induced in the CNS of humans during VEE virus infection. The findings are discussed in the light of recent reports of cerebral dysfunction occurring as a sequel of VEE virus infection in children.


The role of resident and exudate macrophages in multinucleate giant cell formation. Peroxidase cytochemistry which differentiates "resident" from "exudate" peritoneal macrophages in guinea pigs, was used in the investigation of the multinucleate giant cells in foreign body granulomas in the peritoneal cavity of guinea pigs. Only a few, small syncytia (two to three nuclei) displayed the cytochemical characteristics of "resident" macrophages. On the other hand, most of the polykarya at the site of inflammation displayed a distribution of peroxidase activity similar to that of "exudate" macrophages. Irrespective of whether peroxidase cytochemistry distinguishes between a distinct type of macrophage or a specific functional stage, the evidence indicates that fusion is much more frequent between macrophages with "exudate" characteristics. Thus, fusion of these latter cells is responsible for the vast majority of multinucleate giant cells in inflammatory sites. In addition, some form of recognition mechanism between macrophages of similar cytochemical characteristics probably also operates since syncytia exhibited characteristics of either "exudate" or "resident" macrophages, but never both.


Aortic body tumours and hyperplasia in the rat. The histologic features of aortic body neoplasia, hyperplasia, and normal aortico-pulmonary paraganglia were described for a series of 56 rats of several strains. Argyrophilic cytoplasmic granules were demonstrated in chief cells of the aortic body lesions, and electron microscopic examination disclosed the presence of electron-dense, membrane-bound granules in these cells. In a series of ageing rats, hyperplasia and neoplasia of the aortico-pulmonary paraganglia occurred more frequently in female WAG/Rij rats than in males of that strain, and more frequently than in males and females of the BN/Bi strain or of the (WAG X BN)F1 hybrid. No apparent causal relationship to chronic hypoxia could be shown, in that no correlation between the development of aortic body neoplasia or hyperplasia and cardiopulmonary disease was found. Aortic body lesions did not appear to occur as part of a multiple endocrinopathy syndrome, although hyperplasia and neoplasia of various endocrine organs occurred relatively frequently in the WAG/Rij strain.


Management of atypical mycobacterial lymphadenitis in childhood: a review based on 380 cases. The medical and surgical therapy of 82 cases of atypical mycobacterial adenitis from Dallas and 298 cases from the literature was reviewed. The 92% cure rate in 149 patients with total surgical excision alone was comparable to the 95% cure rate in 156 patients when excision was followed by antituberculous drug therapy. With incision and drainage in 63 patients the cure rate was 16% whether drugs were given or not. Ten patients were initially treated with antituberculous drugs alone and only one was cured. It is concluded that total surgical excision is definitive therapy for this disease and that antituberculous drugs should be used only when surgery cannot be performed or when complete excision is not possible.


Noninvasive evaluation of ventricular function in cystic fibrosis. The cardiac function of 21 patients with cystic fibrosis was studied using radionuclides and M-mode echocardiography. The patients (mean age 13.2 years, range 4 to 27) had a wide range of clinical and pulmonary function abnormalities (mean Shwachman-Kulczycki score 62.1). Decreased right ventricular ejection fraction was found in 13 of 18 patients (72%); an additional four patients had abnormal septal motion on ECHO. Left ventricular ejection fraction was abnormal at rest in four patients (19%); an additional four patients had borderline low LVEF. The LV pre-ejection period to ejection time ratio increased significantly (i.e., worsening LV performance) with deterioration of S-K score, chest radiograph score, and forced expiratory volume in 1 second. Three of eight patients with normal LVEF at rest had an abnormal response to supine bicycle exercise: LVEF fell in two patients and was unchanged in one. Thus evidence of LV dysfunction was observed in seven of 21 (33%) of the patients; four at rest and in three only during exercise.


Norepinephrine metabolism and clinical response to dextroamphetamine in hyperactive boys. The 24-hour urinary catecholamine metabolites 3-methoxy-4-hydroxyphenylglycol, normetanephrine, and metanephrine were measured in 23 hyperactive boys and 13 matched healthy controls. The hyperactive children excreted lower MHPG and higher NM (low MHPG/NM ratio) amounts than in controls. The administration of d-amphetamine in the dose of 0.5 mg/kg body weight divided over two doses daily for two weeks decreased MHPG excretion in the hyperactive children. When the hyperactive children group was divided into drug responders and nonresponders according to their pre- and post-treatment scores on the Conners Teacher Questionnaire, d-amphetamine administration decreased MHPG excretion in the responders and did not change it in the nonresponders. Percent decrease in MHPG excretion correlated significantly with percent change in the hyperactivity factor of the questionnaire on the Spearman Rank Order Correlation Coefficient. Pretreatment urinary metabolites did not differentiate the responders from nonresponders. It is suggested that a relationship between CNS norepinephrine metabolism and hyperactivity exists and that d-amphetamine may achieve its therapeutic action in hyperactive children by altering CNS NE metabolism.


Choanal atresia and associated multiple anomalies. Seventeen unrelated patients with multiple anomalies of unknown etiology were identified by the presence of choanal atresia. A regularly recurring pattern of associated features involving mental retardation, postnatal growth deficiency, hypogenitalism (males), small ears, cardiac defects, micrognathia, postnatal microcephaly, and ocular coloboma was identified. Choanal atresia when accompanied by multiple anomalies of unknown etiology has a serious prognosis with a predictable pattern of associated defects.


The MURCS association: Müllerian duct aplasia, renal aplasia, and cervicothoracic somite dysplasia. Two patients and 28 others in the literature were ascertained because of congenital vaginal agenesis associated with clinical and/or radiographic evidence of malformations derived from the cervicothoracic somites. In these patients, there was a high incidence of Müllerian duct aplasia/hypoplasia (96%), renal agenesis and/or ectopy (80%), and abnormalities related to cervicothoracic somite dysplasia, particularly 2 to 4 anomalous vertebrae located between C5-T1 (80%). These consistent findings suggest a distinctive non-random association of malformations: Müllerian duct (MU) aplasia, renal (R) aplasia, and cervicothoracic somite (CS) dysplasia (MURCS). Identification of one component of the MURCS association suggests the presence of the other associated anomalies. A hypothesis for the embryogenic pathogenesis of the MURCS association is proposed which attributes the malformations to an alteration of the blastemas of the lower cervical-upper thoracic somites, arm buds, and pronephric ducts, all of which have an intimate spatial relationship at the end of the fourth week of fetal life. A presently unidentified teratogen may be one of the possible causes of the MURCS association on the basis of a lack of familial transmission, normal chromosomal studies, and the similar effects of a known teratogen (thalidomide) on the developing genitourinary tract.


The spectrum of ABO hemolytic disease of the newborn infant. A series of 1,704 infants of blood group O mothers have been studied to determine the relation between the degree of red cell sensitization and the cord hemoglobin and bilirubin concentrations. The infants with blood group A or B had significantly higher cord bilirubin and lower cord hemoglobin concentrations than the group O babies. Those infants whose red cells had the greatest evidence of sensitization had the highest bilirubin and lowest hemoglobin levels. The infants in whom no antibody was demonstrable on the red cells or in the red cell eluate also had significantly higher cord bilirubin and lower cord hemoglobin levels than the ABO compatible group; it is suggested that these infants had sufficient erythrocyte sensitization to produce mild hemolysis. ABO incompatibility represents a spectrum of hemolytic disease extending from those in which there is little laboratory evidence of erythrocyte sensitization, but evidence of hemolysis, to severe hemolytic disease in which erythrocyte sensitization is usually easily demonstrable.


Necrotizing enterocolitis in neonates fed human milk. The incidence of necrotizing enterocolitis encountered in neonates fed only refrigerated human milk was comparable to that in infants fed milk and isotonic formula or isotonic formula alone. The infants fed human milk were significantly (P less than 0.05) smaller, less mature, had lower Apgar scores, and were fed later than the formula-fed infants. The mean age of onset and time between first feeding and onset of NEC was similar among the three groups. These data indicate that refrigerated human milk was not effective in lowering the incidence of NEC. Possible explanations for the occurrence of NEC in neonates fed human milk include: (1) the introduction of a pathogen via contaminated milk; (2) inadequate maternal antigenic stimulation by the neonatal gastrointestinal flora; and (3) adverse affects of storage on cell number and function.


Therapeutic problems arising from the use of the intravenous route for drug administration. The kinetics of drug delivery were studied under conditions of varying iv flow rates and varying sites of drug administration into an iv system. The iv sites and rates were selected on the basis of questionnaire data obtained from nursing personnel. The rate of drug delivery from the iv system was dependent upon the iv flow rate and site of injection of the drug into  the iv system. Under conditions of slow iv flow rates (3 ml/hour) there was the expected time delay required for the drug to begin to be infused but an unanticipated protracted time required for actual completion of the drug infusion. Calculation of theoretical drug blood levels based on the results of these iv studies revealed very different blood levels of drug at respective times, including different peak concentrations, depending on the iv flow rate and site at which the drug was injected into the system. Failure to appreciate the effects of slow iv rates and distal iv injection sites on actual rates of drug administration can adversely affect pharmacokinetic decisions and conceivably influence therapeutic success or failure.


Diagnosis, treatment, and follow-up of neonatal mepivacaine intoxication secondary to paracervical and pudendal blocks during labor. Seven infants developed mepivacaine intoxication secondary to accidental injection during paracervical or pudental blocks or both. All presented with unexplained neonatal depression at birth, tonic seizures (often with apnea) within six hours, and characteristic neurologic findings. Twenty-four-hour urinary excretion produced 12.7 to 37.4 mg, exchange transfusions less than 1.02 to 3.5 mg, and gastric drainage or lavage or both 0.63 to 1.26 mg of mepivacaine. Thus promotion of urinary excretion is the treatment of choice. All six survivors are seizure free and neurologically and developmentally normal at one to 4 1/2 years. With early diagnosis and prevention of severe perinatal hypoxia, the prognosis from intoxication alone is very good.


Adaptation of siblings to childhood malignancy. To explore the impact of childhood cancer, school-aged patients and their healthy siblings from 71 families were given one or more of the following psychologic tests: the Piers-Harris Children's Self-Concept Scale, the Bene-Anthony Family Relations Test, and the Thematic Apperception Test. The siblings showed even more distress than the patients in the areas of perceived social isolation, perception of their parents as overindulgent and overprotective of the sick child, fear of confronting family members with negative feelings, and concern with failure (older siblings only). In other areas, such as anxiety and vulnerability to illness and injury, the patients' and siblings' experience appeared very similar. These results indicate that siblings, like patients, experience severe stress when confronted with a chronic, life-threatening illness such as cancer. In recognizing and attending to their needs, one can practice primary prevention in pediatrics by facilitating their healthy adaptation to a very difficult situation.


Is the elderly primipara really at high risk? During a five-year period, from 1970 through 1974, 26.776 deliveries occurred in our department, of which 55 (0.6%) were in elderly primiparae (EP). This group was compared with two control groups. The first comprised 97 women aged 30--34 years, and the second one, 250 women between 20 and 29 years of age. The parameters investigated were: The gynecologic past history, the course of the present pregnancy, labor, delivery and fetal outcome. In most of the cases, no significant differences were found between the EP group and the control groups. A striking difference was observed in the rate of cesarean sections, which was 49.1% in the EP group, as against only 2.3% in the age group 20--29 years. It may be concluded that by more liberal use of cesarean sections, available means of antenatal care, and prompt intervention in cases of postmaturity and prolonged labor, one can reduce the maternal and fetal morbidity and mortality, and that the EP, although a group at risk, has nowadays a better outlook for both mother and fetus.


Relationships between locus of control, trait anxiety, and state anxiety: an interactionist perspective. This study examined the relationships among generalized expectancy for internal or external control, situational expectancy of control over aversive stimuli, trait anxiety level, and state anxiety reactivity. Seventy-two male subjects, selected from the upper and lower halves of the distributions of scores from the I-E and STAI A-Trait Scales, were randomly assigned to one of three conditions of expectancy of control over electric shock. Repeated measures of state anxiety were taken at three points in the experiment, and subjects were asked to rate the degree of control they expected to have in avoiding shocks. Results, based upon analyses of variance, were interpreted as strongly supportive of the use of the interactionist model in understanding the manner in which personality trait and situational variables interact in the determination of subject expectancies of control and anxiety reactivity.


Investigation of some cord blood components. The practical result borne by our investigations has been the introduction of routine estimation of cord blood total protein. In every case when the concentration is below the 10 percentile value, the clinicians are warned. Further catamnestic studies are needed to judge the values of cord blood cholesterol estimations in screening for familial hyperlipoproteinemias. The hypercholeterolemic infants of the present series, who are 2-3 years old at present, as well as their families must be subjected to repeat analysis. The change in opposite directions of cord blood total protein and cholesterol levels with the advance of gestation was a remarkable finding. This correlation indicates a close interaction between protein and lipid metabolism. Less promising results have been obtained in investigations of the cord blood calcium and magnesium levels, but final conclusions can only be drawn after repeat analyses. Introduction of the routine estimation of these two parameters does not seem necessary at present. Besides clinical data, biochemical parameters have also been found suitable for differentiating small-for-date infants from true prematures. The functional maturity of these infants was shown by the fact that their different cord blood components were normal.


Interpersonal aggression as a function of subject's sex, subject's sex role identification, opponent's sex, and degree of provocation. Ninety-five undergraduates served as subjects in an experiment where they could administer electric shock to an opponent and receive the same from an opponent. The independent variables were subject's sex, subject's sex role identification (as measured by the Bem Sex Role Inventory), opponent's sex, as well as degree of provocation from the opponent. Aggression was defined as level of shock chosen by the subject for the opponent. The results indicated that masculine subjects facing a male opponent were more aggressive than individuals of other sex role identifications whether or not they were provoked. It was also found that masculine males were more aggressive than other males or anyof the females. Furthermore, opponent's sex influenced the males' aggressiveness but had no effect on the degree of aggression in females. Finally, aggression increased in all subjects following increases in provocation. The results are discussed in terms of their implications for pyschological androgyny.


Interpersonal touching and orality.

Interpersonal touching and orality. Sixty-five undergraduates were assigned to guide a blindfolded confederate through a floor maze. The frequency of touching the confederate's skin and the length of time required to complete the trip through the maze were recorded. Each subject was also given a self-administered Rorschach test; an independent count was made of the number of oral responses given. Orality was positively related to touching behavior (r=.39, p=.001) and with speed of guiding the confederate through the maze (r=.31, p=.01).


A data-based typology of depressed adolescents. To develop a data-based classification of depressive adolescents, a face valid depression scale for adolescents was applied to MMPI protocols of 212 adolescent psychiatric patients of ages 12 to 18, to identify a depressive subsample which turned out to have 36 females and 10 males. Complete linkage cluster analysis was applied to this subsample and three hierachically organized depressive groups were obtained: "Restless" and "Socially Frustrated", which joined into a higher order group, and "Endogenous". Discriminant function analysis was applied for differentiating and cross-validating the obtained groups.


Conception and representation of space in human figure drawings by schizophrenic and normal subjects. Seventy hospitalized schizophrenic adults, and 71 normal subjects were given a test consisting of six human figure drawings, arranged in a thematic sequence from a self-portrait to a drawing of a person. The structural components of each human figure were scored and analyzed in an attempt to validate their projective character and to examine influence of psychopathology on cognition. Findings indicated similar constructional trends for both groups, with differences particular to sex, rather than a diagnostic category. It was concluded that conception and representation of space and its configurations will not be influenced by psychopathological processes.


Symptomatology of depression in adolescence. The symptomatology and dimensions of depression in adolescence were studied using the MMPI protocols of 212 adolescent psychiatric patients. A Face Valid Depression Scale for Adolescents was judgmentally developed by five child psychiatrists and psychologists. It included symptoms common to depressive adults and adolescents as well as symptoms peculiar to adolescents, which was confirmed by comparison with adult depression scales. Factor analysis of the scale yielded the following six factors: lack of self-confidence, social abandonment, loss of interests, sadness, somatic symptoms, and acting-out. The second and sixth factors appeared to be particularly characteristic of adolescents.


Differences in the severity of disturbance of behaviors in children receiving inpatient and outpatient psychiatric treatment. This study was conducted to determine if there are differences in the severity of disturbance of behaviors exhibited by children receiving inpatient psychiatric treatment and those receiving outpatient psychiatric treatment based on their parents' judgments of the frequency of occurrence of those behaviors. The same behaviors were found to exist in both treatment groups, but the severity of disturbance of those behaviors in the inpatient sample was significantly greater than in the outpatient sample. The scale used in this study was found to be a valid and useful instrument for predicting inpatient and outpatient status of children. Pratice and research implications of this study are also discussed.


Factor structure and construct validity of "what I think and feel": The Revised Children's Manifest Anxiety Scale. Responses to the Revised-CMAS of 329 children from grades 1 through 12 were factor analyzed. Consistent with current multidimensional theories of anxiety, three primary anxiety factors emerged, supporting the construct validity of the new scale. Implications for interpretation of the revised scale are discussed.


Effects of dogmatism on state anxiety during the analysis and synthesis of new beliefs. Investigated the concept of dogmatism as a defense mechanism and the role of threat in the synthesis of new beliefs by examining the effects of dogmatism on changes in state anxiety (A-State) during the analysis and synthesis of new beliefs. Sixty female college students were selected on the basis of extreme scores on the Dogmatism Scale and the trait anxiety (A-Trait) scale of the State-Trait Anxiety Inventory to work on a task requiring the analysis and synthesis of new beliefs. In support of Rokeach's theory, high dogmatics displayed no change in A-State from the analysis to the synthesis period of the task, while low dogmatics exhibited a significant decline in A-State between the two periods. The clinical implications of these findings were discussed in terms of the role of dogmatism in the processing of personality interpretations and test feedback.


MMPI ratings of suicide risk.

MMPI ratings of suicide risk. Among past attempts to use MMPI data to predict suicidal behavior, there has been a lack of research on the ability of clinicians to identify MMPI profiles of suicidal persons. In this study, the MMPI profiles of 20 male psychiatric patients who committed suicide and the MMPI profiles of 20 male patients who did not attempt or commit suicide were presented to six clinical psychologists with expertise in MMPI interpretation. The clinicians were asked to classify each MMPI profile as coming from a patient who did or did not later commit suicide, and to rate eight variables thought to be relevant to the assessment of suicide risk. Data analysis revealed that the clinicians could not identify suicide and nonsuicide patients from their MMPI profiles. Furthermore, the ratings of the eight suicide variable did not differentiate suicide and nonsuicide patients.


Jo-Jo, Josephine, and Joanne: a study of multiple personality by means of the Rorschach Test. A comparison of three Rorschach protocols of a multiple personality case was presented. Basic features of the personality structures were examined with respect to the psychogram profiles. The evolution of the original personality into the successive ones was assessed both in terms of inter- and intra-protocol variations and thematic analysis. The implications of the Rorschach test findings for the treatment and theory of multiple personality syndrome were discussed.


Synaptic drive and impulse generation in ganglion cells of turtle retina. 1. Light reponses and electrical constants of ganglion cells in the retina of the turtle were examined by intracellular recording in eyecup preparations. 2. In 'on', 'off', and 'on/off' cells, the impulses produced by illumination of the centre of the receptive field arose from slow synaptic depolarizations. The ganglion cells also exhibited inhibitory synaptic potentials. 3. The synaptic depolarization evoked by a step change in light intensity rose more slowly than the response of the cones in which the excitation originated, and the depolarization then declined in spite of a well maintained cone response. This behaviour is consistent with the notion advanced previously that, during transmission to ganglion cells, receptor signals are relayed through the equivalent of a bandpass filter. 4. The e.p.s.p.s evoked by light grew when the membrane was hyperpolarized by injected current and decreased when the membrane was depolarized. The i.p.s.p.s reversed at a level slightly negative to the resting potential in darkness. 5. In neither 'on' nor 'off' ganglion cells did the synaptic potentials evoked by step changes in illumination show the hyperpolarizing phases expected of a linear filter. The absence of hyperpolarizations is consistent with a rectification which permits transmission of depolarizations but not hyperpolarizations from bipolar to ganglion cells. 6. In darkness the membrane potential of some ganglion cells showed random depolarizations which brought the potential near the threshold for impulse generation. 7. With very small spots in the receptive field centre the 'on' responses of ganglion cells to flashes and steps of light grew approximately linearly with stimulus intensity. The step reponse was not, however, related to the flash response by superposition. Larger spots in the field centre gave responses which grew non-linearly with the intensity of even dim stimuli. 8 Depolarizing current passed through the recording electrode elicited a repetitive discharge of impulses. The frequency of firing increased linearly with current strength above a rheobase value of about 10(-10) A. Accommodation occurred during steady currents, the main decline taking place with a time constant of about 15 msec. 9. Strength-latency measurements and bridge records of ganglion cell charging by constant currents gave time constants of 10--20 msec and input resistances of 100--150 M omega.


Cardiovascular and antidiuretic effects of central prostaglandin E2. 1. Unanaesthetized normal and water-loaded rats were tested for cardiovascular and antidiuretic responses to intracerebroventricular (I.V.T.) injections of prostaglandin E2 (PGE2). 2. I.V.T. injections of PGE2 produced tachycardia and a slow rise in blood pressure that reached a peak in 15 min and lasted up to 2 hr. 3. Intravenous pre-treatment with phenoxybenzamine, an alpha-adrenergic blocker, inhibited pressor but not heart rate responses to I.V.T. PGE2. Pre-treatment with propranalol, a beta-adrenergic blocker, inhibited tachycarcia but not pressor responses to I.V.T. PGE2. Atropine attenuated heart rate and blood pressure responses when higher doses of PGE2 were tested. 4. In water-loaded rats, I.V.T. PGE2 produced antidiuretic effects suggesting release of antidiuretic hormone in subpressor amounts. Antidiuretic but not cardiovascular responses to I.V.T. PGE2 were abolished by median eminence lesions. 5. Intravenous PGE2 infusions produced a decrease in blood pressure and no antidiuretic effects, indicating that both responses were centrally mediated. 6. The results indicate that I.V.T. PGE2 produces pressor and tachycardia responses in the unanaesthetized rat which are mediated primarily by centrally mediated sympathetic outflow.


An analysis of the wave forms of photoreceptor potentials in the retina of the chephalopod Sepiola atlantica. 1. Simultaneous intracellular (Vi) and extracellular (Ve) recordings have been made from photoreceptor cells in the retina of the cephalopod Sepiola atlantica. 2. The depolarization of the distal (rhodopsin containing) membrane (Vm) was derived from the Vi and Ve records. 3. All three potentials had very similar time courses in response to short flashes of low intensity but the Vi and Vm responses were much greater in amplitude. 4. At high intensities the amplitudes of Vi and Ve were similar but the wave forms were quite different and it was postulated that a voltage-sensitive potassium conductance change in the proximal membranes of the cell was mainly reponsible for the observed differences. 5. The wave forms of the three responses following long (500 msec) flashes were quite different at all intensities tested. At high intensities there was a slow sag phase in the Vi response, that was mirrored by a slow rise phase in the Ve responses. The reconstructed Vm response was flat during this period of change in the other two responses. 6. The recoveries to the base line of all responses following both long and short flashes were similar in that at high intensities they consisted of at least two phases. The fast phase had a time constant less than 1 sec and the slow component had a time constant of greater than 10 sec. 7. The maximum rates of change of voltage (dV/dt) in both short and long flash responses were linear over a much wider range of intensity values than were the response amplitudes and the rates continued to increase after the peak response amplitude had saturated. 8. The characteristics of the cephalopod responses were compared with those from vertebrate rods and cones and several marked similarities were found.


Facilitation of the lordosis reflex of female rats from the ventromedial nucleus of the hypothalamus. 1. Effects of electrical stimulation of hypothalamic ventromedial nucleus (v.m.n.) on the lordosis reflex of female rats were examined in ovariectomized and oestrogen-primed animals with chronically implanted electrodes. 2. Lordosis triggered either by manual cutaneous stimulation or by male mounting, was facilitated by electrical stimulation of the v.m.n. 3 A gradual increase in lordosis performance followed a relatively long period of stimulation; never less than 15 min and usually about 1 hr of stimulation was necessary for maximum facilitation. Following the termination of stimulation, the performance returned gradually to the control level during a 5--8 hr period. 4. The optimal frequency of stimulation was between 10 and 30 Hz. Threshold for effective facilitation was, on the average, 12.5 microA. 5. Stimulation tended to induce larger facilitation when applied to the lateral side of v.m.n. 6. Pre-treatment with oestrogen was necessary to obtain facilitation by v.m.n. stimulation. The threshold dosage of oestrogen was 2.5 microgram per animal. 7. Stimulation was effective in adrenalectomized rats, in dexamethasone-primed animals, and in rats pre-treated with exogenous progesterone. Thus, adrenal prodesterone release is not required for the v.m.n. facilitation of lordosis. 8. Medial preoptic stimulation with the same parameters suppressed the lordosis reflex. 9. The v.m.n. participates in the control of lordosis by a facilitatory output. The delay before facilitation implies that the v.m.n. is not in the direct reflex-arc for the execution of lordosis. Rather, a summation or interaction process with an unusually long time course is involved.


Deficit in the lordosis reflex of female rats caused by lesions in the ventromedial nucleus of the hypothalamus. 1. The effect of electrolytic lesions of the ventromedial nucleus of the hypothalamus (v.m.n.) on the lordosis reflex has been investigated on ovariectomized female rats. Lesions were made through chronically implanted platinum-iridium electrodes. 2. V.m.n. lesions did not disrupt lordosis immediately, but induced a gradual decline in the reflex. Lordosis performance reached it minimum no less than 12 hr after the lesion, and typically after 36--60 hr. 3. The magnitude of the lordosis deficit was related to the amount of v.m.n. damage. Destruction of other hypothalamic regions was without appreciable relation to the deficit. Within v.m.n., lesion size in the lateral, but not medial portion was significantly correlated with lordosis deficit. 4. Because of the slow time courses of v.m.n. lesions and stimulation (Pfaff & Sakuma, 1978) effects, it is postulated that the v.m.n. is not part of the direct reflex-arc for lordosis. Rather, neurones in v.m.n. are likely to exert a tonic hormone-dependent bias on brain stem reflex paths for this behaviour.


Reciprocal transplantations between the optic tectum and the cerebellum in adult goldfish. 1. The topographic pattern of re-established visual projections after a reciprocal transplantation between tectal and cerebellar tissues was studied in adult goldfish. 2. A rectangular tissue was dissected from the left tectum, and a similar piece from the cerebellum in the same fish. The cerebellar piece was rotated by either 180 or 0 degrees around the dorsoventral axis, and transplanted into the tectum in place of the tectal piece. This tectal tissue was likewise grafted into the cerebellum after either 180 or 0 degrees rotation in the same fish. 3. The tectal graft disappeared from the cerebellum within 2 months after surgery. The operated cerebellum showed a remarkable capability for healing its excised part. No visual responses were recorded from the cerebellum. 4. The cerebellar grafts remained in place within the operated tectum in twenty fish. In fifteen of these fish, tested 3 or 4 months after surgery, the cerebellar grafts did not give any visual responses, unlike the surrounding responsive area of the tectum. These fish showed a partial scotoma in the central area of the visual field, which corresponded to the unresponsive transplanted area of the tectum. Autoradiographic examination after intraocular injection of L-[3H]proline showed that these cerebellar grafts did not contain any noticeable label, in contrast to the extensively labelled surrounding tectal tissues. 5. Sporadic visual responses were recorded from deep layers in the transplanted area of the tectum in five of the twenty fish at early post-operative periods. The receptive fields of these responses were distributed in a correct retinotopic order, regardless of whether the cerebellar tissue had been rotated by either 180 or 0 degrees. Autoradiographic examination, however, revealed that these cerebellar grafts were not invaded by regenerating optic fibres. Instead, they bypassed the interposed cerebellar tissue by making detours beneath the graft on the way towards their appropriate target zones within the tectal tissue. 6. This selective avoidance of a foreign (cerebellar) tissue and the orderly reinnervation of the proper tectal tissue by regenerating optic fibres provide us with further evidence for neuronal specificity.


Voltage-clamp analysis of the potassium current that produces a negative-going action potential in Ascaris muscle. 1. A voltage clamp has been developed for the pharyngeal muscle of the nematode Ascaris lumbricoides and has been used to analyse the potassium current that produces a negative-going, regenerative action potential in this muscle. 2. Depolarizing voltage steps elicit a sustained inward current; returning the membrane voltage to the resting level evokes a strong, transient, outward current. This outward current reverses direction at the same voltage as that reached by the negative-going spike and is identified as the negative spike current. 3. The negative spike current decays with a time constant of 30 msec at voltages more negative than -30mV. This inactivation of the negative spike conductance is removed by holding the membrane at potentials more positive than -15mV. The time constant for removal of inactivation decreases from more than 300 msec at -15 mV to about 30 msec at +10 mV. 4. When inactivation has been removed, the negative spike conductance is turned on by stepping to potentials more negative than -15 mV. 5. Although the reversal potential for this current depends strongly on [K+]o (42 mV/decade), the potential at which the conductance is turned on is independent of [K+]o. 6. External Na+ seems to facilitate the negative spike current. Reduction of [Na+]o reduces its conductance and shifts the reversal potential to more positive values. 7. External Rb+ and Cs+ show voltage-dependent blocking of this current. 8. This K current is different from all the K currents which have been studied previously; however, it is analogous to the classical Na current of nerve and muscle, except for an inversion of the voltage dependencies.


Extracellular space and diffusion barriers in muscle fibres from Megabalanus psittacus (Darwin). 1. Muscle fibres from Megabalanus psittacus (Darwin) were used to measure the exchange of Na+ and Ca2+ between intracellular and extracellular compartments. 2. The size of the extracellular space was evaluated directly from electron micrographs at 6.1 +/- 0.5% (percentage of the fibre volume). The more conventional estimates using Na+ and 134Cs+ as space markers gave higher values, namely, 8.9 +/- 0.7 and 9.5 +/- 1.5%. 3. An average value of 9.2% was used to correct the total Na+ and K+ in the muscle fibres and to estimate the intracellular concentrations of Na+ and K+ as 39 +/- 4 and 202 +/- 11 mM respectively. 4. Na+ (and similar Ca2+) washout curves could be described using a three compartments diffusion model. The data analysed in terms of this model enabled us to estimate membrane permeabilities as PNa+ = 2.7 x 10(-7) and PCa2+ = 2.7 x 10(-7) cm/sec.


On the role of extracellular calcium in triggering contraction in muscle fibres from barnacle under membrane potential control. 1. Single giant barnacle muscle fibres from Megabalanus psittacus (Darwin) were used to establish the possible role of extracellular Ca2+ in triggering the contraction. 2. Peak tension p0 during twitches elicited by depolarizing voltage clamp pulses decreases after the removal of Ca2+ from the external saline. p0 becomes too small to measure after a few minutes, when the model-estimated level of total intracellular Ca has been reduced to 99.5% of its original value and the extracellular Ca in the clefts and/or tubules to about 10%. 3. In fibres where the outward currents were blocked by internal perfusion with Cs+, the curves of the integral of the inward current versus membrane potential and of peak tension versus membrane potential follow a similar pattern. 4. When Ca2+ in the external saline was replaced by Ba2+ or Sr2+, no twitches were generated although depolarizing voltage clamp pulses induced large inward currents comparable to those measured when Ca2+ was present. 5. It is concluded that an increase in Ca2+ in the fibre during the Ca2+ inward current is a necessary condition for the triggering of the development of tension. The data on Ba2+ inhibition is consistent with the hypothesis that there are two different intracellular sites of action for Ca2+.


Changes in mammary function at the onset of lactation in the goat: correlation with hormonal changes. 1. Changes in mammary function and plasma hormone concentrations during late pregnancy and the onset of lactation have been studied in conscious goats.2. Mammary blood flow, oxygen consumption and glucose uptake increased markedly and significantly between 2 days and 0.5-1 day pre-partum.3. The increase in mammary glucose uptake was relatively greater than that of oxygen consumption or blood flow.4. The concentration of citrate in mammary secretion increased; the first significant change was apparent 0.5-1 day pre-partum but the main rise occurred after this time.5. It is concluded that the marked increase in mammary glucose uptake 0.5-1 day before parturition indicates the time of onset of copious milk secretion.6. The first significant increase in the concentration of unconjugated oestrogens in arterial plasma occurred 3 days pre-partum, whereas the first significant decrease in progesterone and increase in 13,14-dihydro-15-oxoprostaglandin F(2alpha) occurred 0.5-1 day pre-partum, thus coinciding with the mammary changes; there was also a peak in prolactin concentrations at the latter time.7. The hormonal changes are discussed in relation to current concepts of the initiation of parturition and the onset of copious milk secretion in this species. It is suggested that the fall in plasma progesterone concentrations triggers milk secretion at high rates.


Free-flow reabsorption of glucose, sodium, osmoles and water in rat proximal convoluted tubule. 1. Reabsorption of glucose, sodium, total solute (osmoles) and water in the rat proximal tubule (pars convoluta) were studied by free-flow micropuncture at normal (saline-infused), suppressed (saline with phlorizin) and elevated (glucose infusion) glucose reabsorption rates. 2. Phlorizin completely inhibited net glucose reabsorption, approximately halved reabsorption of sodium, total solutes and water, and reduced single nephron glomerular filtration rate (SNGFR). 3. In saline and glucose-infused groups, there were no significant differences between SNGFR nor between reabsorptions (fractional and absolute) of either sodium, total solute or water, which were uniformly distributed along segments assessible to micropuncture. 4. Glucose reabsorptive capacity existed along the entire pars convoluta, with highest reabsorptive rates in convolutions closest to the glomerulus (in saline-infused rats, 90% fractional reabsorption at 2 mm, over 95% at end pars convoluta; in glucose-infused rats, 55 and 90%, respectively). 5. In saline and glucose infused rats, a significant correlation existed between net glucose and sodium reabsorption, but the regression slopes differed and correlations became non-significant when the reabsorptive fluxes were factored by SNGFR. 6. For all groups, the majority of tubular fluid (TF) concentrations of osmoles and sodium were lower than those in plasma (over-all mean TFosm)Posm = 0.973 +/- 0.004, P less than 0.001; TFNa /PNa = 0.964 +/- 0.005, P less than 0.001). 7. Correspondingly, calculated osmolal and sodium concentrations in the reabsorbate were greater than those in plasma, and were significantly correlated with distance to puncture site with maximal values in the most proximal convolutions (for osmolality, approximately +79 m-osmole kg-1 water at 1 mm).


The effect of bupivacaine aerosol on the activity of pulmonary stretch and 'irritant' receptors. 1. Experiments have been done on anaesthetized, paralysed and artificially ventilated cats. 2. Vagal single afferent fibres showing discharges in phase with respiration were isolated in the neck. Two types of fibres were studied at different tidal volumes: (i) showing slowly adapting discharges from the pulmonary stretch receptors; (ii) showing rapidly adapting discharges from the lung 'irritant' receptors. The effect of bupivacaine aerosol, administered by positive pressure inflations, was recorded on the pattern of fibre discharge. 3. The pulmonary stretch fibres were further classified into low-threshold and higher-threshold fibres according to the standard criteria. Bupivacaine aerosol blocked activity in all the low-threshold and in the majority of the higher-threshold fibres. 4. Of the rapidly adapting fibres, bupivacaine completely blocked activity at some tidal volumes and markedly reduced it at most others. 5. The fibre activity data are presented. It is concluded that although bupivacaine aerosol markedly reduced impulse activity in all three types of fibres, the data suggest that there is a small difference in the ease with which low-threshold fibres on the one hand and higher-threshold and "irritant" fibres on the other hand are affected. The reasons for this difference in the behaviour are not understood.


Prostaglandins and the sources of their production in a mild inflammatory lesion in sheep. 1. Wound fluid was collected from a subcutaneous lesion in the shoulder region of sheep by implanting a PTFE sampling chamber from which a catheter led to the skin surface. 2. The neutrophil granulocyte numbers and prostaglandin content of the wound fluid were studied, prostaglandins being identified by  thin layer chromatography and measured by bio-assay. The major prostaglandin component was E2. 3. There was no clear relation between the amounts of prostaglandin present and the numbers of neutrophils in the fluid. 4. A subcutaneously implanted double chamber permitted perfusion of the lesion and thereby the study of the rate of prostaglandin production and the rate of disappearance of isotopically labelled prostaglandin from the lesion. The rate of leucocyte entry into the wound fluid could also be measured. 5. When the cutaneous muscle through which the chamber had been implanted was biopsied and incubated in vitro it was found to produce prostaglandin E2 in quantities which could be correlated with the weight of the incubated muscle. 6. These results suggest that a major contributor to the prostaglandin content of the wound fluid is the cutaneous striped muscle.


The effect of dopamine on shivering in the rat. 1. Dopamine (0.5--0.2  mumole) injected into a lateral cerebral ventricle inhibited shivering and lowered core temperature in rats at an ambient temperature of 0--5 degrees C. 2. These effects were inhibited by the dopamine antagonist, pimozide, and imitated by the dopamine agonists, piribedil and apomorphine. 3. Pimozide itself had no effect on shivering. 4. It is concluded that while there are inhibitory dopamine receptors on the cold sensor--shivering pathway in the rat they are not concerned in the normal function of this pathway.


Sural nerve effects on medial gastrocnemius motoneurones in the cat. 1. Excitability cycles for medial gastrocnemius motoneurones were recorded following sural nerve stimuli with amplitudes of 1.5, 3, 5, 10 and 40 times the nerve threshold. The monosynaptic reflex was time-integrated to quantify the motoneuronal output and some implications of this technique are discussed. In particular it is calculated that this method specifically examines the 15-25% most excitable motoneurones of the medial gastrocnemius pool.2. In most cases high amplitude stimulation of the sural nerve caused a triphasic (excitatory-inhibitory-excitatory) change in excitability. Arguments are given to support the conclusion that this represents a corresponding post-synaptic alteration in medial gastrocnemius motoneurone potential. It is concluded that this pattern illustrates the nature of the sural nerve projections to this portion of the medial gastrocnemius pool.3. The first period of excitation began after a latency, corrected to be compatible with intracellular recordings, of 2.8 ms and had a mean duration of 4.0 ms. The minimum stimulus level necessary for this effect lay between 1.5 and 3 times the nerve threshold. The maximum amplitude of this facilitation occurred with stimuli of 3-5 times threshold and was 60-90% of the amplitude of the monosynaptic facilitation which followed stimulation of the lateral gastrocnemius-soleus nerve.4. A period of inhibition followed immediately after the period of excitation and had a mean duration of 16 ms. The minimum stimulus level necessary for this effect lay between 1.5 and 3 times the nerve threshold and the degree of inhibition increased with stimuli up to 40 times threshold.5. The second period of excitation lasted a mean period of 50 ms and was due to activity in high threshold fibres. On average its amplitude was 50% that of the initial excitation.6. Exceptions to this triphasic variation of excitability were found. This result is interpreted as indicating the presence of projections with opposing actions which were simultaneously activated by sural stimuli.


Evidence for primary afferent depolarization of single tooth-pulp afferents in the cat. 1. Responses of single tooth-pulp afferents to electrical stimulation of sites in the trigeminal sensory nuclear complex were recorded from caine teeth in cats. 2. Changes in the excitability of the central terminals of a pulpal afferent after stimulation of other groups of sensory nerves were taken as evidence for changes in their polarization. 3. Electrical stimulation of nerves in other teeth resulted in raised excitability of the central terminals of pulpal afferents lasting up to 300 msec. The greatest effects were observed 30--100 msec after the conditioning stimulus. 4. Increased terminal excitability was also observed after the ipsilateral infraorbital nerve was stimulated. This occurred when only nerve fibres with conduction velocities in the A alpha range were excited. 5. Mechanical stimulation of a canine tooth produced increases in terminal excitability of pulpal afferents innervating the same tooth. 6. A similar effect was also observed after a brief pull on a group of ipsilateral mystacial vibrissae. 7. No evidence of decreases in the excitability of the central terminals of tooth-pulp afferents was obtained with any of the conditioning stimuli.


The effects of acetylcholine and dopamine on carotid chemosensory activity in the rabbit. 1. Intracarotid (I.C.) injection of either acetylcholine (ACh) or dopamine inhibited spontaneous chemosensory activity recorded from the peripheral cut end of the sinus nerve in the anaesthetized rabbit. 2. High doses of ACh (greater than or equal to 50 micrograms I.C.) evoked a slight increase in discharge which preceded the inhibition. This excitation was attributable to a nicotinic action of the drug since it was abolished by mecamylamine. 3. The muscarinic agonist bethanechol inhibited chemoreceptor activity, an effect which was blocked by high doses of atropine, as was the inhibition caused by ACh. Dopamine-induced inhibition was unaffected by atropine. 4. Atropine, in doses sufficient to abolish the vasodepressor effect of ACh, only slightly reduced the inhibitory action of ACh on the chemoreceptors. Also, the vasodilators sodium nitrite and sodium nitroprusside did not appreciably alter chemosensory discharge. It seems unlikely, therefore, that the inhibitory response to ACh is secondary to vascular changes. 5. The inhibitory response to dopamine, but not that to ACh, was blocked by the dopamine antagonist alpha-flupenthixol. This implies that inhibition of chemosensory activity evoked by exogenous ACh was not secondary to dopamine release. 6. The implications of the results are discussed, particularly with regard to the possible physiological role of ACh as a modulator of carotid chemosensory activity.


Sodium transport in the hen lower intestine. induction of sodium sites in the brush border by a low sodium diet. 1. The fluxes of Na were measured on isolated coprodeal mucosa at 1--220 mM-Na from hens on low (L) and high (H) Na diets with the purpose of finding the location and characteristics of Na sites activated in the cellular pathway by L. 2. The influx across the brush border, JNamc, and the transmural fluxes, JNasm and JNams, were determined. Effects on these fluxes of ouabain, 10(-3) M in the serosal solution, and amiloride, 10(-4) M in the mucosal solution, were studied for both dietary states. 3. JNamc was 5--22 (L) and 0--0.8 (H) muequiv/cm2.hr at 130 mM-Na corrected for the paracellular flux of Na. The JNamc (H) is tenfold smaller than found by Choshniak, Munck & Skadhauge (1977). This discrepancy is at present inexplicable. Amiloride completely inhibited JNamc (L). Preincubation in 0 or 130 mM-Na had no effect on JNamc. Ouabain reduced JNamc (L) by only about 37% after preincubation at 130 mM-Na. The Kt of JNamc was 5.1 (L) and 50.6 (H) mM-Na. 4. JNasm was 50 (H) and 61 (L) n-equiv/cm2.hr at 6.5 mM-Na. Ouabain increased JNasm by 360% in the low Na state. The increased JNasm was inhibited 74--100% by amiloride. This is interpreted as a ouabain induced Na-Na exchange at the basolateral Na-K-ATPase and an almost complete block of JNacm by amiloride. A similar exchange of Na at the basolateral membrane in the high-Na state was revealed by 'opening' the brush border for Na with monensin added to the mucosal solution. Amiloride in itself prevented a 50% recirculation of Na via the paracellular route and back across the cells in the low Na state. 5. JNams was 5.6 (L) muequiv/cm2.hr and 187 (L) microA/cm2 at 6.5 mM-Na. Amiloride reduced these values to 0.4 muequiv/cm2.hr and 5.8 microA/cm2. On addition of amiloride the transmural resistance in (L) coprodea at 130 mM-Na increased from 140 to 190 and it remained unchanged at 260 omega cm2 in (H) coprodea. The resistance of (L) birds, 163, was not affected by ouabain, 166 (L) omega cm2. 6. 20:1 NaCl dilution potentials at the mucosal side of 17--18 mV (L) and nearly zero (H) had half-times around 1 sec. Amiloride eliminated completely these diffusion potentials. The short half-time indicates a location in the brush border of sodium specific sites induced by the low-Na diet. This conclusion is oppsite to that described by Choshniak et al. (1977). 7. Ion selectivity, voltage--current and conductance--concentration relations in the presence of amiloride indicated a weakly cation selective and highly hydrated pathway, which was also thick and with neutral sites. This fits a paracellular route with the limiting barrier for ions at the tight junction.


The action of angiotensin II on the baroreflex response of the conscious ewe and the conscious fetus. 1. In conscious non-pregnant and pregnant ewes and in chronic fetal lamb preparations, the beat by beat relationship between pulse interval and systolic pressure was studied during acute elevations in arterial pressure induced by phenylephrine. Baroreflex sensitivity, which was defined as the slope of the pressure-pulse interval relationship when phenylephrine was used to raise pressure, was abolished by atropine and increased by propranolol. Baroreflex sensitivity was less in pregnant ewes and in foetal lambs compared with non-pregnant ewes. 2. These findings suggest that the vagus nerve is responsible for the reflex bradycardia that occurs in the foetus and the ewe when arterial pressure is increased. 3. In both fetal and adult sheep, actue hypertension due to I.V. injection of angiotensin II was not associated with a consistent and progressive bradycardia, such as was seen with acute hypertension caused by phenylephrine. Angiotensin II has no direct chronotropic effect on heart rate in either the adult or the fetus. 4. No linear relationship between arterial pressure and pulse interval was seen when angiotensin II was used to raise pressure in sheep which were treated with propranolol. Therefore the lack of cardiac slowing with pressor doses of angiotensin II was not due to concomitant activation of the sympathoadrenal system. 5. It is concluded that in both fetal and adult sheep angiotensin II reduces the increase in vagal tone which is responsible for slowing of heart rate in response to acute rises in arterial pressure.