Perception of a non-ill participant in a mental health discussion. Describing a mental patient's claim to sanity as symptomatic may increase the probability that others will assimilate non-ill behavior into a pathological framework. In two experiments subjects saw a simulated session of group therapy on videotape. Each videotape contained a therapist, four persons role-playing specific disorders, and one person acting normally. After receiving different instructions, all subjects were asked to categorize the five patients. In Exp. 1 no consistent conclusions were possible because only 2 of 59 subjects said the normal person was not ill. Exp. 2 avoided this "floor effect" by the videotape therapist's agreeing with the normal person's claim of not being ill. The subjects precautioned against believing claims of sanity were most likely to categorize the person exhibiting non-ill behavior. A second group of subjects were not precautioned against believing sanity claims. A third group of subjects, informed of one patient's non-illness, were most likely to differentiate the normal person from those portraying pathological behavior.


Physical fatigue and the perception of differences in load: a signal detection approach. Workload is an important factor related to perception of physical fatigue. Because a person engaged in physical activity eventually leading to painful exhaustion is in a pay-off situation, the paradigm of signal detection might be applicable to the perception of differences in load. Two male track and field athletes, aged 22 and 24 yr., participated in two experiments. In Exp. 1 difference threshold were determined with 25%, 50%, 60%, 65% and 70% of VO2 max as basic loads on a bicycle ergometer. Results showed a decreasing k over increasing work loads, contrary to Weber's law. In Exp. 2 a non-parametric signal detection procedure was used, with 25%, 40%, 50% and 60% of VO2 max as noise levels and a signal intensity of 1.5 watt in every condition. A chi 2 test for a 2-factor design showed only an effect of noise level. The converging results of both experiments led to the conclusion of a relative increasing sensitivity across increasing work loads. The main goal for future research will be to develop the signal detection method as a framework for research on fatigue.


Self-consciousness and locus of control. 179 college students were classified as internal or external in locus of control on the basis of I-E scores. Self-consciousness scores showed external subjects were more socially anxious than internal subjects.


Apparent size contrasts of retinal images and size constancy as determinants of the moon illusion. Kaufman and Rock (1962) and Rock and Kaufman (1962) concluded that the moon illusion is a function of and attributable to apparent distance. They also reported a large framing effect as an exception. Analysis of the effect suggests two components which can account for the illusion independently of apparent distance. These are apparent size contrasts of visual images of discriminable features or objects of the earth with the moon's image and size constancy of the features or objects plus the interactions of the two. Apparent distances to horizons are always a consequence of the necessary conditions for the illusion. They are related to the illusion but are not a determinant of it.


Shedd's formulations concerning the hyperkinetic syndrome--an empirical test of selected features. According to Shedd's (1968) formulations, one of the distinguishing characteristics of hyperkinetic children is the score pattern which they earn on different types of ability tests. Specifically, Shedd's work suggests that IQs from a picture vocabulary test, the WISC, and a drawing test should show the following order relationship: picture vocabulary greater than WISC greater than drawing. This hypothesis was investigated for 62 overactive children (47 boys and 15 girls) enrolled in classes for learning disabled. The findings support Shedd's since IQs from the Ammons' test were significantly higher than WISC IQs which were significantly higher than IQs from the Goodenough-Harris. The magnitudes of the mean differences in scores for the three tests were within the range indicated by Shedd and 51 of the 62 children showed the order of scores he specified.


Relationship of performance on motor activities and reading achievement. The purpose of this study was to investigate the influence of specific motor activities on elementary school-aged children's reading achievement. The subjects were 33 boys and 33 girls in Grade 2 enrolled in the regular program. They were separated equally into one of three groups: Experimental group 1 participated in Frostig activities, Experimental group 2 read books selected for their grade level, while a control group followed the traditional school routine. The two experimental groups were children from predominantly Mexican-American descent; the control group was primarily of Caucasian descent. During the 20-wk. period, the subjects met with their respective group three times per week in 1/2-hr. sessions. The first and second experimental groups showed no significant improvement in reading achievement. It was concluded that the added motor activities did not enhance reading achievement.


Improvement of visual acuity in partially and fully sighted subjects as a function of practice, feedback, and instructional techniques. Three experiments were conducted to examine improvement of partially (20/200 or 6/60) and normally (20/20 or 6/6) sighted adults. Measures of resolution and vernier acuity were examined in the first two experiments to determine whether practice, feedback, and instructions would have differential effects on the degree of visual improvement achieved in a 20-min. testing session. The results indicated extensive visual work to be the important factor in the improvement of impaired vision. The third experiment compared monocular and binocular depth perception of individuals with unilateral optic atrophy. The results yielded an unexpected finding where binocular depth perception was, in most cases, inferior to that of the strong eye alone. The first two experiments demonstrated the possibility of improving impaired visual functions and the third experiment suggests important implications for a theoretical model of depth perception with limited vision.


The golden section: the "true" ratio?

The golden section: the "true" ratio? Seven rectangles with different ratios of the lengths of their sides but of approximately equal areas were presented to 120 subjects to asses their aesthetic preferences for each rectangle. The method of pair comparisons was used for presentation of the rectangles. Subjects tended to prefer the golden rectangle. Also rectangles in the vicinity of the golden rectangle were preferred to those deviating markedly from it.


Evaluation of intelligence in youthful offenders: the Kahn Intelligence Tests. It was hypothesized that there is a correlation between IQs on the Kahn Intelligence Tests and the WAIS. It was predicted that the correlation between the KIT IQs and the WAIS Performance IQs would be significantly higher than those between the KIT IQs and WAIS Verbal and Full Scale IQs. The KIT and WAIS were administered to 30 Negro and 20 white offenders ages 16-0 to 20-11. Pearson rs of .656, .649, and .714 were significant. Contrary to prediction, the r between the KIT IQs and the WAIS Performance was the lowest. Mean IQs were significantly different.


Differentiation of childhood body gestures. 9 expressive body gestures were recorded while 180 boys and girls of three age groups (4--5 yr., 7--8 yr., and 10--11 yr.) individually performed a standardized play task. Analysis of variance showed a significant overall difference in gestures between the sexes, and 5 of the gestures ("limp wrist," "arm flutters," "flexed elbow," "hand clasp," and "palming") occurred significantly more frequently in girls than boys. There was an interaction between sex and age for the "hands-on-hips with fingers forward" gesture. No differences associated with sex of experimenter were found.


An evaluation of rational-emotive imagery as a component of rational-emotive therapy in the treatment of test anxiety. This study evaluated the efficacy of rational-emotive imagery as a component of rational-emotive therapy in reduction of college students' test anxiety. 11 volunteers met for 6 1-hr. group treatment sessions over a 3-wk. period. After 2 initial treatment sessions subjects were randomly assigned to groups given either rational-emotive therapy with rational-emotive imagery or rational-emotive therapy without imagery. Contrary to predictions, improvement between groups on self-report and performance measures was nonsignificant. Failure to obtain differences was attributed to similarities in content of treatment sessions and short treatment time. Combined groups reported significant improvement on all dependent measures. Although the study did not yield the predicted benefits of the imagery, results lend further support to the efficacy of rational-emotive therapy procedures in the reduction of test anxiety.


Effects of color and trait anxiety on state anxiety. A 2 (trait anxiety) X 4 (color) factorial design was used to determine the effects of red, green, yellow, and blue on state anxiety as a function of high and low trait anxiety. The State-Trait Anxiety Inventory was used to assess both traint (A-Trait) and state (A-State) anxiety for the 10 students assigned to each of the eight treatment combinations. High A-Trait students were significantly more anxious while viewing blue, red, and green than were the low A-Trait students and blue produced significantly more state anxiety than did either yellow or green. These results are consitent with state-trait theory and indicate that the effects of color on state anxiety may be confounded with trait anxiety unless the levels of A-Trait are equivalent for each color condition. The role of cultural and individual differences in the relationship between color and emotion and implications for research are discussed.


Effects of relative frequency of knowledge of results on retention of a motor skill. The effects of relative frequency of knowledge of results on the retention of a motor skill was studied. Adams' theory (1971) contends that the perceptual trace of a criterion position gains on increment of strenth each time the feedback stimuli associated with the criterion position are experienced and that it is the strength of the perceptual trace that determines retention. Schmidt's theory (1975), however, suggests that the recognition schema is updated only on trials on which the feedback stimuli associated with the criterion position are experienced in conjunction with knowledge of results and that it is the precision of the recognition schema that determines retention. Two experiments were conducted. The results provided evidence contrary to Adams' theory. Schmidt's theory, however, was only partially supported.


Field dependence and blood cholesterol: an expansion. In a pilot study of 65 newly admitted psychiatric patients the first author evaluated the relationship between cholesterol, uric acid, and field dependence. The results suggested that high uric acid and low cholesterol individuals were more field independent whereas low uric acid and high cholesterol individuals were more field dependent. However, the differences were influenced mostly by the values of cholesterol and little by the uric acid. We have now expanded the sample to 229 consecutive admissions excepting only in-patients that were alcoholics or taking medication that has effects on any of the dependent variables. Included were age, ponderal index (a ratio of height and weight), and sex. For the whole group, field dependence correlated highly with age and cholesterol but less with blood uric acid. Dividing the sample by sex the situation changed. For males field dependence did not correlate with any of the other variables. However, for the females field dependence showed a positive correlation with cholesterol and age and with cholesterol even after correcting for age. Diagnoses did not correlate with any other variables except field dependence as an analysis of variance showed an incrase of field dependence when the patients were divided into three groups: (1) schizophrenics, (2) miscellaneous (including personality disorders), and (3) affective disorders. Again, these results demonstrated no relationship of field dependence with blood uric acid.


Role of two-dimensional surface characteristics in pictorial depth perception. The purpose of the present experiment was to test the hypothesis that flat surface information for the plane of projection is the essential difference between ordinary and pictorial perception. Adults were asked to make relative size judgments of pairs of squares and triangles placed and pictured at various distances. The conditions were: real scene controls, life-size slides and prints, and real scenes viewed through clear glass, textured glass, a screen and a 50-mm lens. The error rate was significantly lower with real scenes than with either slides or prints which did not differ. The control data for real scenes were used for comparison to test for the effects of interposed flat surfaces on size judgments of real scenes. Viewing real scenes through either a clear glass pane or a 50-mm lens increased the error rate two and one-half times that of the controls for real scenes. Neither textured glass nor a screen significantly affected error rate. Results were interpreted as supporting the hypothesis that information about a flat surface for the plane of projection is the critical variable determining the special character of picture perception.


Relationships among measures of preferred tempo and motor rhythm. Male and female subjects (Ns = 100) performed an accuracy task involving consecutive arm swings at a self-paced tempo. Following this, the subjects performed a motor rhythm task keeping in cadence with audio-visual stimuli presented at their preferred tempo. Previous findings regarding the magnitude of individual differences in preferred tempo and within-individual variability were replicated, as was the absence of sex differences for these attributes. With regard to motor rhythm, the findings indicated that (a) constant and variable error, and not absolute error, were the appropriate measures of performance, (b) there were no sex differences either in spatial or temporal accuracy or in trial-to-trial consistency of performance, (c) substantial individual differences were present in rhythmic accuracy, as were moderate individual differences in variability, (d) neither rhythmic accuracy nor variability was appreciably related to preferred tempo, and (e) spatial and temporal accuracy are relatively independent components of rhythmic accuracy.


An analysis of the relationship between cardiac deceleration and correct performance under conditions of constant task difficulty. Previous analyses of the relationship between cardiac deceleration and correct performance suffered from a confounding of task difficulty with performance accuracy. The present analysis indicates that the relationship between these variables still holds and is, in fact, more general under conditions which control difficulty of the task at a constant level.


Influence of professional background and sex of therapist on attitudes towards patients. A brief report of the attitudes of therapists towards psychiatric outpatients, varying in socioeconomic background, insight levels and degrees of disturbances, is presented. Results suggest that the professional affiliation and sex of therapists influenced their attitudes towards the patients.


Conservation of illusion-distorted identity tasks. Four conservation of illusion-distorted identity tasks were presented to 10 boys ranging in chronological age (CA) from 5-5 to 12, and in mental age (MA) from 3-5 to 10-2, to document individual differences among children with delayed development in acquisition of conservation skills.


Number of response alternatives and spatial arrangement on a visual discrimination task. Normal children, 30 each from ages 5 and 7 yr., were administered a visual discrimination test through a programmed learning machine. Visual discrimination was defined as a match-to-sample task in which subjects pointed to the geometric form, number, or printed letter of the alphabet that matched the stimulus form. Procedures were designed to eliminate learning variables. Although both age groups performed well, there was a statistically significant difference in the total performance at the two ages. A 3-way analysis of variance showed age, number of response alternatives, and type of stimulus form were significant variables; all interactions were significant. It appeared that the significant variable for the 5-yr.-olds was the type of geometric configuration, while the variable most important for the 7-yr.-olds was the number of response alternatives. Patterns of errors on the most difficult item showed the 5-yr.-olds made errors involving a reversal or rotation of the stimulus figure, while the 7-yr.-olds made errors involving some detail of the stimulus figure.


The color-word connotative incongruity effect. Two experiments tested the hypothesis that color-naming speed is slower for inconsistent than for consistent color-word combinations as defined by separate semantic differential ratings of color and word components. In Exp. 1 15 undergraduate subjects individually made telegraph-key identifications of consistent and inconsistent instances of yellow or brown color-word combinations. For Exp. 2 and analogue of the Stroop Color-Word Test was constructed in which two cards contained only consistent, and two cards contained only inconsistent, adjective-color combinations. Autonym adjectival pairs, e.g., "hot"--"cold," were used ensuring that two card-pairs contained cards identical in every respect except consistency. Color-naming times of 40 undergraduate subjects for consistent and inconsistent cards were compared. Results of the two experiments supported the hypothesis. Since semantic differential ratings presumably index implicit reactions to stimuli having no obvious relationship to color-naming, these data suggested that a response-competion explanation of semantic-color interaction is incomplete.


Autonomy of image and use of single or multiple sense modalities in original verbal image production. The use of a single or of multiple sense modalities in the production of original verbal images as related to autonomy of imagery was explored. 72 college adults were administered Onomatopoeia and Images and the Gordon Test of Visual Imagery Control. A modified scoring procedure for the Gordon scale differentiated imagers who were moderate or low in autonomy. The two groups produced original verbal images using multiple sense modalities more frequently than a single modality.


Opponent hues in visual masking.

Opponent hues in visual masking. Temporal interactions among opponent and non-opponent hues were investigated in a visual masking paradigm in which both backward and forward temporal sequences were employed. Subjective confidence ratings rather than identification thresholds alone served as response indicators for masking sequences. Results indicate that in the backward sequence (test stimulus followed by masking stimulus) a greater masking effect occurred when the stimuli were of non-opponent hue pairs (red-yellow, red-blue, green-yellow, green-blue) than when compared with opponent hue pairs (red-green, yellow-blue). For the forward sequence (test stimulus preceded by masking stimulus) the masking effect was reduced when compared with the backward sequence. These findings appear to reflect the presumed temporal and spatial antagonistic qualities of opponent hue processes as postulated in the Hering model of color vision.


The spontaneous ending of sleep.

The spontaneous ending of sleep. The last hour of spontaneous awakenings from uninterrupted sleep of 16 young adults was analyzed. In general, sleep was not fitful and broken but a continuation of the sleep process to the point of awakening. There were substantial individual differences in the time of awakening and the stage of sleep from which the sleeper emerged.


Influence of an interpolated non-related motor task on short- and long-term memory learning and retention of a gross motor skill. A control group of young men (N = 28) continuously practiced climbing a free-standing ladder for 20 1-min. "trials" separated by 1-min. rests; after a 1-wk. layoff they practiced 5 additional trials. The learning trend, of the exponential form, y = c - a1e -kx1 - a2e -kx2 was not affected by the layoff. Another group (N = 28) performed the skill in the same manner, except that prior to the layoff the 1-min. Rests were replaced with practice on the pursuit rotor task. This caused a cumulative learning deficit and forgetting during the layoff. Progressive improvement in 5 post-layoff trials (without the rotor) established relearning and overcame the deficit. These effects were statistically significant. They were thought to be caused by the rotor practice interfering with just-learned ladder skill consolidation, so that the gain in skill was not processed into long-term memory.


Cognitive and interpersonal growth during the college freshman year: a structural analysis. The present paper attempts a structural analysis of the relationship between logical operations, personality organization, and personality traits in college students. Since college students cover a wide range of operational abilities, one should be able to examine this age group to see whether or not different modes of thinking are reflected in personality measures. 55 freshmen were administered a measure of formal operations consisting of eight suboperations and a complete score, the Omnibus Personality Inventory, and the conceptual complexity measure. A structural analysis of the interrelationships is discussed in terms of a core cognitive function.


Variations in DDT concentration in muscle tissue of channel catfish, Ictalurus punctatus, from the Des Moines River, 1971. Concentrations of DDT in muscle tissue of channel catfish, Ictalurus punctatus, from the Des Moines River, Iowa, were compared in relation to length, age, sex, and fat content. Residue concentrations were not correlated with sex. Although residue concentrations were significantly correlated with size-related factors and fat content, they varied widely. Therefore, predictions of DDT concentrations in individual catfish on the basis of length, age, or muscle fat content may be grossly inaccurate.


DDT residues in rainwater in New Brunswick and estimate of aerial transport of DDT into the Gulf of St. Lawrence, 1967-68. Residues of DDT were detected in 76 of 101 samples of rainwater collected during spring and summer at several sites in the Province of New Brunswick in 1967 and 1968, and at one site in the Magdalen Islands, Quebec, in 1968. The dominant residue was p,p'-DDT. Levels of DDT and metabolites combined ranged from less than 0.01 to 1.33 microgram/kg. Levels of DDT and metabolites in the pollen of four species of forest trees in New Brunswick ranged from 0.544 to 1.01 mg/kg; such contaminated pollen possibly contributed to residues in rainwater. Residue data for rainwater from two sites were used to estimate the amount of DDT aerially transported into the Gulf of St. Lawrence during July to October 1968.


[Acute duodenal ulcers complicating Listeria meningitis (author's transl)]. The authors report 3 cases of acute complicated duodenal ulcers occurring during the course of Listeria meningitis. These three adults (2 females and 1 male) suffered from localised neurological involvement and, in 2 cases neurovegatative disorders an altered level of consciousness. The ulcers were situated in the duodenal cap, and in each case there were at least 2 large excavated ulcers. These ulcers were the site of late complications on the 13th and 15th days after the onset of neurological disease. In two cases the major symptom was haemorrhage, whilst in the third it subsided leaving a syndrome of peritonitis due to perforation. Treatment in all three cases consisted of vagotomy with pyloroplasty (the ulcers being excised or sutured). All the patients recovered from their digestive complications without relapse despite the persistence 6 and 10 months later of the same neurological problems in two of them. All these facts would be in favour of a neurogenic aetiopathogenesis, via the vagal nerve. Thus acute late duodenal ulcers in patients with neurological disease from a separate enity within the context of stress lesions.


[Posterior mycardial infarction with or without the initial complication of atroventricular block. Short and long term comparative clinical study (author's transl)]. Comparison of the short term clinical course of 2 groups of patients who had suffered a first posterior myocardial infarction complicated during the acute phase (group A) by 2nd or 3rd degree atrioventricular block, or free of such a complication (group B), confirmed two classical concepts: the onset of this complication in one case out of five and a two-fold increase in mortality when it occurs. In the mid- and long term, however, the course is relatively similar in both groups, which do not differ initially in terms of average age, sex distribution nor the usual risk factors of coronary artery disease. In addition, the absence of sudden deaths in group A would suggest that AV block is a definitively regressive complication.


[Cerebral tuberculosis. There clinicopathological cases (author's transl)]. The clinico-pathological report of three cases of cerebral tuberculosis, collected over a 10 year period in a single neurological department from non immigrant patients emphasizes the difficulties of diagnosis and therapy of this disease. Multiple tuberculomas have simulated either an alcoolic encephalopathy in one case or a primitive cerebral tumour in another one. In the third case, the course of an exceptional cerebral miliary tuberculosis was not modified by the treatment. Liver cirrhosis was present in every case.


[Xanthinuria (author's transl)].

[Xanthinuria (author's transl)]. Xanthinuria, described in 1954 by Dent and Philpot, is a rare metabolic disorder, characterised by a deficiency in xanthine-oxidase, a key enzyme in the synthesis of uric acid. It results in hypouricaemia and hypouricuria, the urinary excretion of products of purine synthesis taking place in the form of uric acid precursors: hypoxanthine and xanthine. By virtue of the very slight solubility of xanthine, this xanthinuria may cause urinary lithiasis, in general occurring early. More often, however, the disease is asymptomatic and diagnosed following the chance discovery of hypouricaemia. We report 6 recent cases.


[Approaches to the hip in the child. I. Partial approaches (author's transl)]. It exist multiple approaches to the hip in the child. This first section is devoted to a description of those approaches which offer only limited exposure of the joint. Alongside the medial approach used for joint puncture and the obturator approach, scarcely of any use, three important approaches respecting the integrity of the gluteal muscles may be used: those of Hueter and of Watson-Jones, to the anterior aspect of the neck of the femur and that of Moore, approaching its posterior aspect.


[Evaluation of the effectiveness of a diagnostic examination: from data to medical decision (author's transl)]. It is desirable to assess the value of special investigations by objective criteria. Conditional probabilities are suitable for this purpose. Sensitivity and specificity indicate the prevalence of a sign in a disease. Predictive values estimate the probability of a disease when a sign is present and the probability of absence of disease when the sign is absent. Comparison between the informational value of a sign or examination with concepts of cost or of risk to the patient is then possible. This made be used as a basis for determining a strategy for special investigations in the establishment of a diagnosis.


[Per-operative cholangiography in cholelithiasis: diagnostic value (author's transl)]. This study was aimed at determining the predictive value of pre-operative signs in comparison with those of per-operative cholangiography in the diagnosis of an obstruction in the common bile duct during cholecystectomy for lithiasis. 154 cases were studied. The predictive value of pre-operative signs suggestive of obstruction was 0.46 and that of per-operative cholangiography 0.81. The predictive value of signs suggestive of the absence of obstruction was 0.90 and 1 for per-operative cholangiography. Per-operative cholangiography should thus be performed whenever possible during cholecystectomy for lithiasis.


[Diagnosis and treatment of intra-epithelial carcinoma of the uterine cervix. About 124 cases (author's transl)]. The means for diagnosis, treatment and long follow-up of intra epithelial carcinomas of the uterine cervix are assessed by the authors, about 124 cases seen at the Hotel-Dieu de Paris. The diagnosis is given by cytologic means and mostly by colposcopic examination. When the cylindro-pavimental junction (usual initial focus) is seen in totality, direct biopsies always gave an accurate diagnosis. When the junction is not seen, only a diagnostic--conisation can allow a definitive answer. Two types of surgical treatment were applied: amputation of the cervix conservative of menstrual and/or reproductive functions and, hysterectomy led by vaginal or abdominal route. The patients were followed from 1 to 16 years by the triple cytologic, Schiller test and colposcopic examination: none of them showed any recurrence either of intra-epithelial or of invasive type.


[Diagnosis of pericardial effusion by echocardiography and radionuclide angiography (author's transl)]. Echocardiography and radionuclide angiography are presently the two first choices non-invasive methods for the diagnosis of pericardial effusion. To evaluate the sensitivity and specificity of these methods, a prospective study of 43 consecutive patients was undertaken. Confirmation by tap or autopsy was obtained in 10 cases; for the remainers, strict clinical signs were requested. The results of both methods were classified in a quantitative manner. Our data confirms the greater sensitivity and specificity of echocardiography compared with radionuclide angiocardiography, when small amounts of effusion are present. However, the correlation between the two methods is satisfactory when a greater amount of fluid is present.


[Phaeochromocytoma with psychiatric disturbances. One case (author's transl)]. A case of phaeochromocytoma which presented with hypertension and severe psychiatric disturbances including three attempts at suicide. These psychiatric problems regressed completely following removal of the tumour. Although inconstant, the combination of hypertension and psychiatric problems should always lead to studies for the possible presence of a phaeochromocytoma. The mechanism of these disturbances is not clearly understood but either a direct action of catecholamines on cerebral tissue or changes secondary to blood pressure variations are suggested.


[Approaches to the hip in the child. II. Wide approaches (author's transl)]. A wide exposure of the hip joint is often necessary in the treatment of congenital dislocation of the hip: Salter's or Olliers's approach, and in that of epiphysiolysis: Dunn's approach. This description of these approaches completes a review of the surgical approaches which are used in the child.


[Glutathion-synthetase deficiency with 5-oxoprolinuria. Two new cases and a review of the literature (author's transl)]. Hereditary deficiency in glutathion- synthetase is a rare disease presenting up to now either with a congenital non-spherocytic anaemia or with a metabolic acidosis, most often neonatal and accompanied by a pyroglutamic amino-aciduria (5-oxoprolinuria). These two syndrome may be present together or exist independently. Pyroglutamic amino-aciduria is the result of extension of the deficiency to non-haematopoietic cells, in particular renal. Two new cases of glutathion-synthetase deficiency are reported: both with haemolytic anaemia and moderate pyroglutamic amino-aciduria, in the absence of clinical signs of metabolic acidosis. The clinical, haematological and biochemical heterogeneity of the deficiency is illustrated by these two cases and datas from the literature.


[Infectious pathology and antibiotic usage in hospital. Results of a prevalence survey (author's transl)]. Prevalence surveys of infection and antibiotic usage in hospitals have been performed in U.S.A. on many times, but have never been performed in France. Conducted in a 529 beds hospital, this survey has shown that: - 38% of patients had an infection, - 41% of patients received antimicrobial therapy, - 61% of infections had not a microbiological proof. This prevalence survey is a useful aid for the bearing of the actions of the department of infectious pathology wich supports infection and antibiotherapy in each of their aspects in the whole hospital.


[Calcifying and non-calcifying chronic pancreatitis. A statistical study (author's transl)]. A statistical study aimed at the determination of any possible differences between calcifying and non-calcifying chronic pancreatitis. It would seem that whilst there are differences from a histopathological and biological standpoint, these differences disappear completely as far as postoperative course is concerned. Curiously enough, the long term prognosis was the same regardless of the type of pancreatitis.


[Longitudinal study of 18 cases of prolactin adenoma. Therapeutic results (author's transl)]. Complete endocrinological studies were made before and after surgery in 18 cases of prolactin adenoma (2 giant adenomas and 16 macro-adenomas). Certain points are stressed: the frequency of the haemorrhagic nature of the adenoma in 4 cases, including 1 case of spontaneous necrosis; the great variability in dynamic responses to the TRH stimulation test or inhibition by I-Dopa; the persistence in 14 cases out of 16 of postoperative hyperproclactinaemia, requiring the prescription of 5 to 10 mg/day of bromocriptine, rarely more; the disappearance of total impotence in two male cases as a result of the latter drug, whilst testerone and dihydrotestosterone levels were normal before the beginning of medical treatment.


[Hereditary haemorrhagic telanglectasia in a large Saharan familly. 87 cases in the same family (author's transl)]. Study of a large family in the Sahara led to the discovery of 87 cases of hereditary haemorrhagic telangiectasia in six generations. This disease had not previously been described in Arab families. The particular structure of this family and the high incidence of consanguinity made it possible to study one individual who was homozygous for hereditary haemorrhagic telangiectasia gene. Examination of the family tree confirms the autosomal dominant transmission of the disorder.


[Bronchopulmonary "tumouriet" Rare aetiology of an isolated rounded opacity (author's transl)]. In the case described, the onset of haemoptysis led to the discovery of a rounded opacity at the left base. All investigations being negative, thoracotomy was performed. The diagnosis could then be made by histology. Bronchopulmonary "tumourlets" are rarely seen (184 cases) masses of epithelial cells which are usually discovered by chance within areas of altered pulmonary tissue. Forms with clinical or radiological manifestations are extremely rare, only 4 other cases having been described. The pathogenesis of these tumours has been the object of recent ultrastructural studies which have shown the relationship which exists between "tumourlet" and carcinoid tumour. It would thus seem reasonable to classify "tumourlets" amongst the tumours of the diffuse endocrine system. The authors nevertheless feel that it would be premature to name them as bronchial carcinoids of tumourlet type. The concept of "tumourlet" as a separate entity should be retained.


[Screw-plate with translation for high femoral osteotomy (author's transl)]. A plate designed from the model used by R. Judet for fractures of femoral neck is presented. It is adapted to the fixation of high femoral osteotomy with internal translation, affected or not with valgus or varus. The screwing of the plate, when in place, realizes systematically a compression at the level of the osteotomy. The system is very stable and enables the begining of reeducation without delay.


[Pubertal prolactin adenoma. Eight cases (author's transl)]. Among 70 operated patients with a histologically verified prolactin secreting adenoma, 8 cases (7 girls, 1 boy) presented the onset of clinical signs before, during or immediately after puberty. Two different clinical syndromes were detected. In the younger patient group (4 cases), the first clinical signs at the onset of puberty were arrest of both growth and pubertal development. In the four remaining causes where in puberty had been achieved, primary-secondary amenorrhea and galactorrhea were observed. Sellar tomograms revealed the presence of invasive adenoma in 3 patients, and circumscribed (enclosed) adenoma in 5 cases. In 7 cases, surgical management was by the transsphénoïdal approach, while one patient underwent subfrontal surgery. Post-operative results were a function of tumour size. In the seven patients having undergone transsphenoïdal surgery, 4 patients displayed a return to normal prolactin function. In the remaining patients, post-operative management was conducted with bromocriptin and without radiotherapy.


[B.C.G. osteitis after immunotherapy (author's transl)]. A case of B.C.G. osteitis occuring after an attempt at the restoration of immune function in a patient with Hodgkin's disease. The diagnosis was based upon histological study of a biopsy specimen and the discovery of a B.C.G. strain. Tuberculostatic therapy resulted in local healing. The various complications and side-effects of B.C.G. immunotherapy are reported in the discussion: local reactions, regional lymphadenopathy, systemic infections, hypersensitivity phenomena, pulmonary, bone marrow and hepatic involvement.


[Single centro-hepatic biliary cyst (author's transl)]. This is a rare condition, often presenting late as a result of compression of adjacent organs, as demonstrated by radiological examinations. Laparoscopy reveals only hepatic hypertrophy whilst the intrahepatic lesion is seen on isotope scan, its irregular appearance sometimes leading to confusion with metastatic disease. Study by scanner confirms its cystic nature. This dysembryoplasic nature of this lesion is now generally accepted, its origins lying in the vestiges of the hepatic ducts. Resection of the overling dome is the usual treatment of exteriorised biliary cysts. The evacuation of large central cysts may be associated with haemorrhagic complications as a result of decompression, which explains the need for slow evacuation or even the preference sometimes expressed for excision at the outset, in particular in the case of a left-sided lesion.


[Posterior septal rupture occurring early following myocardial infarction. Surgical repair (author's transl)]. The particular anatomical features of posterior septal ruptures necessitate an adaptation of the technique used in the repair of anterior lesions. The repair may be performed either via a right transventricular approach or via a left transventricular approach, the choice being guided by the topography of the parietal lesions of myocardial necrosis and by the existence and type of associated valvular lesions.


[Spontaneous pneumomediastinum in adults. 10 cases (author's transl)]. Since it is relatively rare, spontaneous pneumomediastinum is often little known to clinicians. Making the diagnosis, however, presents no problem if the three essential signs are present, that is to say: -subcutaneous emphysema of the base of the neck (7 cases), -Hamman's sign, (6 cases), -a paramediastinal air shadow on chest roentgenograms, (8 cases). The condition is brought about by rupture of perivascular alveoli resulting in the migration of air along the pulmonary vessels. The principal advantage of making the diagnosis is that it enables one to eliminate other pain-causing thoracic syndromes, especially myocardial infarction, pulmonary embolus and acute pericarditis. The clinical course is usually benign necessitating no treatment.


[The rheumatoid rosette test in bacterial endocarditis. A non-specific test for inflammation (author's transl)]. The rheumatoid rosette test was performed in 33 patients with febrile valvular cardiopathy. In 19 cases bacterial endocarditis was proved by blood culture or by histological examination. The test was positive in 3 cases out of 5 during the first ten days of the fever (group A1), in 6 cases out of 6 after the tenth day (group A2), and in 4 out of the 8 already treated patients (group A3). In 3 positive cases, successive measurements, before and during treatment, showed a rapid fall in rosette levels. In controls patients, the test was positive 8 out of 9 cases with febrile valvular cardiopathy without endocarditis (group B) and in 5 out of 5 cases in which bacterial endocarditis was probable but not proved (group C). The increase in rheumatoid rosette levels seems therefore to be non specific of bacterial endocarditis. Nevertheless it could be a good test for biological activity of the disease in treated patients. The origin and signification of the rheumatoid rosette forming cells are discussed.


[Placental tumors resistant to usual chemotherapy: treatment with cis-diaminedichloroplatinum (2 case reports)]. As cis diaminedichloroplatinum is active in testicular choriocarcinoma, it was logical to try it for placental choriocarcinoma. This drug has been shown very active on two cases of placental choriocarcinoma resisting to methotrexate and actinomycine D. As cis diaminedichloroplatinum is a very toxic drug, it will be given only in the cases resisting to other and less toxic antimitotics.


[Duodenal ulcer associated with a pyloric microgastrinoma and antropyloric focal gastrinosis (author's transl)]. In a patient with a duodenal ulcer, with acid hypersecretion and moderately disturbed gastrin secretion tests, immunocytochemical examination of the vagotomy-antrectomy specimen revealed a pyloric microgastrinoma (clinically silent and apparently benign) and focal antropyloric gastrinosis. These localised lesions represent a new variant of abnormalities affecting the gastrin cells in the context of hypersecretory duodenal ulcers.


[The Solanum molacoxylon: from the toxic plant to the therapeutic agent (author's transl)]. The solanum molacoxylon (SM) is a plant which grows in South America, whose leaves produce a calcinosis on animal farms. In the aquous extract of the leaves a glycoside of 1, 25 (OH)2D3 has been found. The aquous extracts of the leaves of SM provokes an increase of intestinal calcium absorption without any transformation, because it is active in total nephrectomized animal. If this extract is given during a short time the bone resorption is dramatically increased, nevertheless if it is given chronically an increase of bone formation with an osteosclerosis is observed. This plant increases the plasma and urinary calcium and sometimes the plasma phosphorus. In acute administration the urinary hydroxyproline increases. A few therapeutic assays were done in humans with similar results. These assays suggest that SM could be a natural source of 1,25 dihydroxycholecalciferol.


[Aponeurotomy without cutaneous abduction through aponeurotome (author's transl)]. Leg aponeurotomy is usually effective without any cutaneous abduction. Then we deviced a special tool that enable surgeons to split aponeurosis undercutaneously.


[Aetiological study of aplastic anaemia: analysis of sex, age, profession and habitat in 251 patients (author's transl)]. The sex, age, occupation and residence of 251 patients with aplastic anaemia in adults have been analyzed, and compared to those of the french population. The following observations have been done: excess of males at each age beyond the 20th year; excessive frequency after the 50th year; excessive frequency in the rural population and the inhabitants of villages and little towns; but no excess in the industrial workers. These observations lead to minimize the aetiological responsibility of industrial toxics in aplastic anaemia; at the reverse they invite to look for a possible responsibility of one or several agents used in the rural world.


[Pull-through procedure for carcinoma of the rectum. Results of 65 operations (author's transl)]. These sixty five cases of abdomino-trans anal excision account for approximately one third of 210 operations performed for carcinoma of the rectum. In the context of curative surgery, indications for preservation of the sphincter must be strict in order to permit satisfactory excision inferior to the tumour and to avoid the risk of local recurrence. Post-operative care and early complications involve the segment of colon which must be brought down. Gangrene of the exteriorised colon did not, in general, compromise the definitive result, at the price of an early colostomy which could always be closed later. Long term results are encouraging: 22 patients out of 26 who underwent non-palliative surgery are alive, without recurrence, after 5 years. The functional result can be assessed only after 6 months adaptation. One patient in two considers himself to be normal. The other half are forced to used enemas, and one in four must wear a protective dressing.


[Bacteroides fragilis bacteremias: clinical and evolutive features about 33 cases (author's transl)]. The frequency of non soil dwelling anaerobic infections is increasing. The authors report 33 cases of Bacteroides fragilis bacteremias, and study the responsabilities of different factors of prognosis (especially age and underlying conditions). Nitroimidazoles are very active against all Bacteroides fragilis. This therapy is the drug of choice for such infections.


[Intra-hepatic gall bladder complicated by post-operative stones in the common bile duct. The value of endoscopic sphincterotomy (author's transl)]. Two cases of migration of stones in the common bile duct following operation of cholecystitis secondary to cholelithiasis in an intra-hepatic gall bladder are reported. The authors emphasise the difficulties of the operation. When it was necessary to limit surgery to external drainage, migration of stones to the common duct from the gall bladder left in place is possible. In the two cases presented, endoscopic sphincterotomy resulted in the early expulsion of the calculi and permanent drainage of the common bile duct, a presumptive guarantee against the complications of new migrations.


[Prolonged and reversible encephalopathy in a chronic haemodialysis patient. Probable responsibility of aluminium salts (author's transl)]. A case of encephalopathy with elevation of plasma aluminium level in a patient treated by maintenance hemodialysis is reported. Clinical symptoms were made of moderate impairment of intellectual functions and of intermittent drowsiness. EEG after 3 minutes of hyperpnea evidenced bisynchronous anteriorly dominant intermittent delta waves. Plasma aluminium level, determined by atomic absorption spectrophotometry, was initially at 300 microgram/l (normal range greater than 40 microgram/l). After interruption of aluminium gels, clinical and EEG symptoms slowly subsided in 9 months, plasma aluminium level came down to 145 microgram/l. This picture of encephalopathy could preceede irreversible dialysis dementia in chronic dialysis patients.


[Survey of anthracyclines derivatives in haematology (author's transl)]. Anthracyclines, such as daunorubicin (DNR), rubidazone (RBD) and adriamycin (ADR) are intercalating drugs used in cancer chemotherapy. They inhibit synthesis of DNA and RNA, break DNA and inhibit mitochondrial oxidative chain. Their antitumoral experimental activities depend upon type of drug, tumor and route of administration. After i.v. administration, the drug is present in all tissues except central nervous system. Its disappearance from the plasma is biphasic with a long terminal half life, justifying intermittent chemotherapy. Anthracyclines metabolism occurs mainly in liver micrososomes, and 90% metabolites are excreted in the bile. The main toxicity is cardiac, as a congestive heart failure which appears when a cumulated drug dose is overcome. In man only, a few derivatives have been studied, compounds with activity and no cardiotoxicity are still in research. Action of malignancies depends on type of derivative. We use DNR since 1967, it is a remarkable active drug in induction treatment of AML, it is the only active drug on acute promyelocytic leukemia, and it increases number of remissions in all of adult patients and severe forms of children ALL. Adriamycin (ADR) is active on solid tumors (osteosarcoma, breast and thyroid cancers) and lymphomas. With rubidazone (RBD) we obtain 2/3 of remissions in acute monoblastic leukemia, and it is easier to use than DNR and equally active on AML. RBD is also active on severe cases of lymphomas (lymphosarcomas and Hodgkin's disease). A new compound DEA 14 DNR seems interesting: experimental antitumor activity is high (compared to DNR, RBD and ADR) and it appears to possess activity on solid tumors in man.


[The value of computerized tomography in the exploration and surveillance of diencephalic tumours (4 cases) (author's transl)]. Computerized tomography has transformed the protocol of exploration and surveillance of diencephalic tumours. It gives information concerning their structure, extension and all associated pathology. In addition, the examination is non-traumatic for the patient which in most cases makes it possible to avoid classical neuroradiological procedures with contrast medium, and may be repeated in order to observe the course of these tumours after radiotherapy. Four cases are reported to illustrate the different contributions of CT scanning.


[Non resectable colonic cancer. Results from a test of chemotherapy with simultaneous prescription of VM26, methyl-CCNU and 5 fluoro-uracile (author's transl)]. Thirty nine patients with non resectable colonic carcinoma entered into a phase II combination chemotherapy trial. The patients were treated with a sequential cyclic combination of 3 drugs: VM 26 (60 mg/m2), methyl-C.C.N.U. (120 mg/m2) and 5 fluoro-uracile. Seventeen patients out of 39 (43.6%) are considered as good responders. The median survival time of the overall of this group is 12.6 months; it is of 15,6 months for good responders and of 7 months for non responders. The simultaneous application of B.C.G. do not change neither the level of responses nor the median of survival time. The good tolerance of this protocol let us to propose this combination as an adjuvant treatment for patients surgically treated for a Dukes'C colonic cancer.


[Rectoscopy: a useful tool to diagnose pseudomembranous colitis (author's transl)]. The authors have performed nine rectoscopies in 14 cases of pseudomembranous colitis. A rectoscopic appearance enables eight times out of nine to diagnose the disease, which asserts itself in all cases by biopsies. Out of the nine cases, two had previously undergone an unnecessary laparotomy, and for three cases the diagnosis of rectal tumour established on rectal digital examination is twice set right by rectoscopic appearance and three times by biopsies. In the remaining five cases with mild intestinal symptoms and severe associated disease the diagnosis was only made with autopsies. A systematic rectoscopy with biopsies is indicated in all patients treated with antibiotics who present an unexplained diarrhea, collapsus or acute abdominal syndrom.


[Pharmacological profile of the main psychotropic drugs: place of nomifensine (author's transl)]. Numerous methods of experimental psychopharmacology can be used. They help to draw up the profile of a  new drug and then to compare this profile to those of the main reference drugs. This predictive psychopharmacology gives good results when the new substances is closing resembling already existing substances, but is more difficult with new substances. The most used tests are presented and more precisely those which are particularly used for antidepressants study. The profile of nomifensine ressembles that of the classical antidepressants but has two clear different characteristics: presence of a stimulant component and lack of anticholinergic activity.


[Predictive studies in psychopharmacology (author's transl)]. Once the efficacy of a drug has been proven (by controlled trials), it may be interesting to define "responder" and "non-responder" profiles. This can be done with a non-comparative prediction trial in which initial (pre-treatment) characteristics of subjects with good or poor result are compared, or with a randomized trial in which one attempts to define initial features of favorable or unfavorable cases, which could lead later to a better choice for a future given patient between these therapies (and only these ones) given in similar conditions. Predictor variables can be: demographic, physiologic, nosologic, symptomatic. Statistical methods can be: simple comparison of responses between sub-classes according to one initial feature, or multivariate techniques particularly discriminant analysis (when results are expressed in a dichotomic way), multiple regression (when responses are graded, as with an improvement score). Validation of results of such trials can be done by checking their predictive value on subjects independant of those from which prediction algorithms have been set up.


[Prediction test of nomifensine prescription from symptomatic pre-therapeutic status (author's transl)]. Heighty two outpatients, suffering from reactive or neurotic depression have been treated with a daily 100 mg dose of nomifensine. The symptomatic status before treatment was appreciated by a self-rating scale, the Hopkins Symptoms Check List (HSCL). At the end of the study, the patient again filled out this same rating scale, and also a seven-score amelioration questionnaire. The investigator filled out this same questionnaire and a fourscore global impression scale. We tried to find out if by appreciating initial symptoms with the HSCL, it was possible to predict which patients would be responders to the treatment. The only highly significant result was obtained with a discriminant analysis, which combines 22 items of the pre-therapeutic HSCL and with which it is possible to predict the amelioration measured by the difference between the total pre- and post-therapeutic HSCL notations. The authors point out to the interest of this method in psychopharmacology.


[Methodology of a cooperative study of response predictors in ambulatory depressive syndrome treated with nomifensine]. A multicentric therapeutic survey on ambulatory depressive patients has been designed so as to get data allowing response-prediction. The protocol included:--selection of non psychotic ambulatory depressive patients--one month's treatment with nomifensine--collection of data consisting mainly in a series of visual analogue scales, scored by a phisician and given in several random orders to avoid error of proximity. Data treatment indluded:--a step of checking and codification--the study of relations between global appraisal and characteristics of subjects--the study of initial profile of responders and non-responders, using discriminant analysis and correspondance factorial analysis.


[Malignant hyperthermia of effort or "heat stroke" (author's transl)]. Heat stroke following effort is not confined to hot regions. The authors have seen five cases in the Paris region between 1967 and 1974. It particularly affects young subjects, in pour training or living away from home. Clinically very similar to anaesthetic malignant hyperthermia, it has the same gravity, with a high mortality rate. It may be characterised by the triad: coma, muscular hypertonicity and hyperthermia of over 40 degrees C. Refrigeration, sedation and rehydration are all the more effective when started early. Improved knowledge of malignant hyperthermia of effort, within the more confused context of heat stroke, will ensure that it is recognised more frequently, limit its consequences and lead to better understanding of its underlying cause, the origin of which is undoubtedly muscular.


[The surgical treatment of rupture of the rectus femoris muscle in the sportsman (author's transl)]. Ruptures of the middle and lower part of the rectus femoris muscle are seen essentially in the footballer during a shoot at goal. Often unrecognised initially, they warrant surgical treatment in the sportsman. The anatomical appearances of these complete or partial ruptures are described. The authors propose a new technique of reinsertion, relying upon the posterior aponeurotic layer, using non-absorbable sutures. Results were satisfactory in 10 cases out of 11.


[Cardiopulmonary manifestations of Mycoplasma pneumoniae infections (author's transl)]. Studies to detect the presence of Mycoplasma pneumoniae infection were undertaken in departments of pulmonary medicine, respiratory intensive care, cardiology, between 1973 and 1977. The diagnosis was based upon the complement deviation reaction, with the exclusion or other serological or culture methods. In addition to acute benign pleuropneumonia, 9 cases of severe pulmonary forms were seen: in 4, acute decompensation in the presence of pre-existence chronic insufficiency, and in the other 5 a radiological picture of acute bilateral bronchopneumonia with dyspnoea. Two patients died in a clinical context of progressive coma. Five cardiac forms with a favourable course were diagnosed: one case of acute myocarditis and 4 of acute pericarditis.


[Mo66, a new allele of the HLA-B locus. Preliminary note (author's transl)]. Mo66 is an allele of the HLA-B locus, which is demonstrated by HLA typing of 2 000 unrealted individuals and the members of eight informative families. Mo66 is a rare antigen, with a frequency of 0.65 % in the Languedocian population. Mo66 shows a strong association desequilibrium with HLA-A3. The identification of Mo66 is difficult, without a monospecific serum, because this antigen is united by cross-reactions above all with HLA-B13, but also with HLA-Bw40, HLA-B27, HLA-B12 and HLA-B7. The presence of an anti-Mo66 antibody in some apparently anti-HLA-B27 monospecific sera can provoke some errors in the diagnosis of ankylosing spondylitis and related diseases.


[Histological lesions of the bone marrow in medullary aplasia. Results of a common protocol on 261 biopsies]. In a cooperative study on bone marrow aplasia, 261 bone marrow biopsies have been examined in triple blind. 13 cases were excluded for technical defect, and 37 cases (17%) excluded for erroneous diagnosis (myelofibrosis or leukemia). It remains 176 first biopsies and 35 second biopsies (10th or 20th month). A quantitative depletion of the marrow was observed in 87% of the cases, but in 13 a rich marrow gave way to discuss the morphological definition of marrow aplasia. Framework lesions (reticulin, vessels, bone) and cytologic modifications (histiocytic or plasmocytic infiltrations) have been appreciated, and their importance in the induction of aplasia and in the prognosis is emphasized. Comparison between first and second biopsy has shown a repletion of the marrow in two third of the cases, the early unfavourable character of reticulinic lesions, and the favourable signification of plasmocytosis. A more complete comparison between marrow histology and other parameters of the study will improve the knowledge of physiopathology and prognosis of marrow aplasia.


[Polysulfates, anionic detergents, sodium phosphotungstate and electrophoretic mobility of plasmatic proteins]. Anions with strong electro-negative charges, like sulphuric esters of polysaccharides (heparin, dextran sulphate M.W. 15 00), the sodium salt of polyanethol sulfonic acid (liquoid, Roche), anionic detergents (sodium dodecylsulphate, sodium oleate, sodium deoxycholate), and the sodium salt of phosphotungstic acid were added to human serum or citrated plasma. For each compound several final concentrations were adopted, the highest being 4%. By using microimmunoelectrophoresis and numerous specific antisera against human plasma proteins, it was demonstrated that at pH 8.60 anions increase electrophoretic mobility of the following antigens: lipoproteins alpha and beta; fibrinogen; beta 2-glycoprotein I; beta 2-glycoprotein II ; antithrombin III. All reagents utilized do not react with all these proteins; for instance, only detergents accelerate the migration rate of a lipoproteins. Besides, depending on the protein, this or that reagent may be the most active. Thus, in the polysulphate group, heparin has the highest affinity for antithrombin III, liquoid for fibrinogen and dextran sulphate for beta 2-glycoprotein I.


Conversion of benezene to toluene by methyl donors in man. The level of benzene in blood can be efficiently reduced by the concurrent administration of two groups of organic compounds: (1) methyl donors, such as choline, betaine and methionine; (2) SH-amino-acids such as cysteine and methionine. Methionine belongs to both categories of anti-benzene compounds in  man. The appearance of toluene was demonstrated after the ingestion of choline and betaine followed by the ingestion of a unique dose of pure benzene (free from toluene).


[Peroxidase deficiency in neutrophils in systemic mastocytosis (author's transl)]. A case associating a systemic mastocytosis and an acquired myeloperoxidase deficiency is reported. The myeloperoxydase deficiency is studied by cytochemical techniques in optical and electron microscopy and confirmed by biochemical measures. An important defect in bactericidal and candidacidal activity is demonstrated in vitro in P.N.M. The authors discuss the links between the two anomalies which might bring one more argument for the common origin of both granulocytes and mastocytes.


[Anemia with hypersideroblastosis during anti-tuberculosis therapy. Cure with vitamin therapy]. The unusual occurrence of microcytic anemia with hypochromia, high iron blood levels and excess of sideroblasts in the bone marrow, observed during the treatment of tuberculosis with isoniazid and rifampicine is reported. Three particularities were noted. First, in our experience, the occurrence of this type of anemia has never been noted previously as a result of these two drugs. Secondly, the improvement of the blood abnormalities was obtained by the combined use of vitamin B6 and vitamin C. Thirdly, the anemia was associated with neuropathy, characterized by areflexia and dysesthesia, which improved with vitamin B6 therapy (but not with vitamin C). Some mechanisms are discussed as being possibly the origin of this kind of anemia, particularly  a lack of vitamin B6 resulting from a massive urinary loss of pyridoxal induced by isoniazid as well as both a tissue depletion and an overconsumption of this vitamin. The anemia may be the consequence of a deficiency of hemoglobin synthesis involving probably the first step of the biosynthesis of heme.


A restriction enzyme Tha I from the thermophilic mycoplasma Thermoplasma acidophilum. A type II restriction enzyme (Tha I) has been isolated from the thermophilic mycoplasma Thermoplasma acidophilum. A new method of general application was used to determine the DNA sequence cleaved by the enzyme. Tha I cuts DNA in the centre of the sequence CGCG. Single-stranded DNA is not a substrate. Tha I does not cut T. acidophilum DNA which is presumably modified. This is the first description of a restriction enzyme from a mycoplasma. Because Tha I is easily prepared in large amounts of approximately 10(5) units per gram of cells, it will be a valuable addition to the battery of restriction enzymes used in studies of DNA sequences. It is active at high temperatures and may therefore be useful for special purposes requiring more extreme conditions.


Mapping of the ribosomal RNA genes on spinach chloroplast DNA. Spinach chloroplast ribosomal RNAs have been hybridized to restriction endonuclease fragments of spinach chloroplast DNA. All three RNA species (23S, 16S and 5S) hybridized to a single large fragment when the DNA was digested with either Sall or Pstl. Hybridization of 23S RNA to fragments produced by Smal yielded two radioactive bands which corresponded to the bi-molar 2.5 X 10(6) and 1.15 X 10(6) Mr fragments. 16S RNA also hybridized to two, bi-molar Smal fragments (3.4 X 10(6) and 2.5 X 10(6) Mr) and 5S RNA hybridized to the 1.15 X 10(6) Mr bi-molar Smal fragment. The 23S RNA and 16S RNA cistrons were each also shown to contain a single EcoRI site. From the data it was possible to conclude that the ribosomal RNA genes are located on the inverted repeat region of the spinach chloroplast DNA restriction map [1,2], that the sequence of the cistrons is 16S - 23S - 5S and that the size of the spacer between the 16S and 23S RNA cistrons is approximately 0.90 X 10(6) Mr.


Evidence for the existence of a coat protein messenger RNA associated with the top component of each of three tymoviruses. On centrifugation in a CsCl density gradient the three tymoviruses, eggplant mosaic, wild cucumber mosaic, and okra mosaic, separate into a major bottom component and several less dense minor components. The RNA of the top component is composed of about 90% tRNA and 10% of an approximately 250 000 dalton messenger RNA. The latter induced the synthesis of coat protein when translated in wheat-germ and rabbit-reticulocyte cell-free systems.


DNA associated with hyperacetylated histone is preferentially digested by DNase I. Butyrate-treated cells give rise to massive hyperacetylation of histones and have been used to test the idea that regions of DNA in association with hyperacetylated histones are preferentially solubilized upon digestion with DNase I. Such hyperacetylated histones can be derived from both pre-existing histones or from histone newly synthesized in the presence of butyrate which leads to extreme modification. The DNA in association with both types of hypermodified histone is equally and selectively digested.


Polynucleotides. LII. Synthesis and properties of poly(2'-deoxy-2'-fluoroadenylic acid). 2'-Deoxy-2'-fluoroadenosine was chemically transformed to its 5'-diphosphate and polymerized with polynucleotide phosphorylase to give poly(2'-deoxy-2'-fluoroadenylic acid) [poly(Af)]. Polymerization proceeded smoothly as in the case of poly(A) and the yield of the polymerization was 55%. The UV absorption spectra of poly(Af) closely resembled those of poly(A) and the hypochromicity was 32% at pH 7.0. The CD profile at 25 degrees and neutrality showed similar pattern to that of other poly(2'-deoxy-2'-halogenoadenylic acids) with somewhat larger [theta] values both in the positive and negative maxima. Acid titration of poly(Af) showed a transition point at pH 5.2 and the Tm of the acid form was 37 degrees which was significantly lower than that of poly(A), but similar to that of poly(2'-azido-2'-deoxyadenylic acid). Poly(Af) formed 1:1 and 1:2 complexes with poly-(U) having Tm of 49 degrees and 62 degrees at 0.04M and 0.15M Na(+) concentration, respectively. Poly(Af) also formed a 1:2 complex with poly(I) and its Tm was 36 degrees at 0.05M Na(+) concentration. These data showed that poly(Af) has rather similar properties to those of poly(A), but not to poly(dA).


The chemical synthesis of the anticodon loop of an eukaryotic initiator tRNA containing the hypermodified nucleoside N6-/N-threonylcarbonyl/-adenosine/t6A/1. In this work, the first example of chemical synthesis of oligoribonucleotide containing the hypermodified nucleoside N6-/N-threonylcarbonyl/-adenosine /t6A/ is presented. Synthesis of the heptamer C-C-C-A-U-t6A-A IX, the sequence of which is related to the anticodon loop of the initiator tRNA from yellow lupine, was achieved by: /i/ phosphotriester block synthesis of suitably protected heptamer VI containing an adenosine unit with a free exo-NH2 group, /ii/ highly effective "one-flask" procedure for the transformation of the free exo-NH2 group of adenosine unit of heptamer VI into a N,N'-disubstituted urea system of t6A of heptamer VII /hypermodification/, and /iii/ final deprotection of VIII /32% total yield/ with the use of a new approach for simultaneous hydrogenolysis /PdO-hydrogen-pyridine/ of the p-nitrobenzyl group and 2,2,2-trichloroethyl groups from carboxyl function of t6A and internucleotide phosphates respectively.


Effect of 2',3'-dideoxythymidine-5'-triphosphate on HeLa cell in vitro DNA synthesis: evidence that DNA polymerase alpha is the only polymerase required for cellular DNA replication. We have studied the effects of the nucleotide analogue, 2',3'-dideoxythymidine-5'-triphosphate (ddTTP) on replicative DNA synthesis in HeLa cell lysates. As previously demonstrated (1), such lysates carry out extensive DNA synthesis in vitro, at rates and in a fashion similar to in vivo DNA replication. We report here that all aspects of DNA synthesis in such lysates (total dNTP incorporation, elongation of continuous nascent strands, and the initiation, elongation, and joining of Okazaki pieces) are only slightly inhibited by concentrations of ddTTP as high as 100-500 micrometer when the dTTP concentration is maintained at 10 micrometer. This finding is consistent with the report by Edenberg, Anderson, and DePamphilis (2) that all aspects of replicative in vitro simian virus 40 DNA synthesis are also resistant to ddTTP. We also find, in agreement with Edenberg, Anderson, and DePamphilis (2), that DNA synthesis catalyzed by DNA polymerases beta or gamma is easily inhibited by ddTTP, while synthesis catalyzed by DNA polymerase alpha is very resistant. These observations suggest that DNA polymerase alpha may be the only DNA polymerase required for all aspects of cellular DNA synthesis.


Binding of tRNA nucleotidyltransferase to Affi-Gel Blue: rapid purification of the enzyme and binding studies. Rabbit liver tRNA nucleotidyldransferase bound to columns of Affi-Gel Blue and could be specifically eluted with tRNA. This observation led to development of a rapid purification procedure for the enzyme. The adsorbent was also used to assess interaction of tRNA nucleotidyltransferase with various polynucleotides and substrates. The enzyme could be efficiently desorbed from Affi-Gel Blue by low concentrations of tRNA-C-C, less well by tRNA-C-C-A, and not at all by poly(A), poly(C), ATP or CTP.


Base pairing structure in the poly d(G-T) double helix: wobble base pairs. High resolution nuclear magnetic resonance (NMR) and ethidium bromide binding studies are used to demonstrate that poly d(G-T) forms an ordered double helical structure at low temperatures (below 24 degrees C in 0.3 M NaCl) in which G and T are hydrogen bonded together in a wobble base pair hydrogen bonding scheme as proposed earlier by Lezius and Domin. Alternative hydrogen bonding schemes involving the tautomeric form of either T or G, such as have been proposed to account for mutation rates in DNA synthesis, are eliminated.


A simple method for the computation of first neighbour frequencies of DNAs from CD spectra. A procedure for the computation of the first neighbour frequencies of DNA's is presented. This procedure is based on the first neighbour approximation of Gray and Tinoco. We show that the knowledge of all the ten elementary CD signals attached to the ten double stranded first neighbour configurations is not necessary. One can obtain the ten frequencies of an unknown DNA with the use of eight elementary CD signals corresponding to eight linearly independent polymer sequences. These signals can be extracted very simply from any eight or more CD spectra of double stranded DNA's of known frequencies. The ten frequencies of a DNA are obtained by least square fit of its CD spectrum with these elementary signals. One advantage of this procedure is that it does not necessitate linear programming, it can be used with CD data digitalized using a large number of wavelengths, thus permitting an accurate resolution of the CD spectra. Under favorable case, the ten frequencies of a DNA (not used as input data) can be determined with an average absolute error < 2%. We have also observed that certain satellite DNA's, those of Drosophila virilis and Callinectes sapidus have CD spectra compatible with those of DNA's of quasi random sequence; these satellite DNA's should adopt also the B-form in solution.


Assay of DNA-RNA hybrids by S1 nuclease digestion and adsorption to DEAE-cellulose filters. A fast and accurate assay procedure for DNA-RNA hybrids is described in which exhaustive digestion of unhybridized DNA with S1 nuclease is followed by binding of hybrids to filter discs of DEAE-cellulose. The digested DNA can be efficiently washed from the filters so that background levels of 0.1-0.2% of input tracer DNA can be achieved, in contrast to the much higher (approximately 1-5%) backgrounds obtained using TCA precipitation procedures. Short duplexes, as small as 36 nucleotides in length, which are inefficiently bound to hydroxyapatite, are quantitatively bound to the DEAE-cellulose filters.


Repair replication in replicating and non-replicating DNA after irradiation with UV light. Ultraviolet light induces more pyrimidine dimers and more repair replication in DNA that replicates within 2 to 3 hr of irradiation than in DNA that does not replicate during this period. This difference may be due to special conformational changes in DNA and chromatin that might be associated with semiconservative DNA replication.


The relationship between the activities of different pools of RNA polymerases I and II during PHA-stimulation of human lymphocytes. Following PHA-stimulation of lymphocytes in culture, it is known that nuclear RNA synthesis and the amount of extractable RNA polymerase activity rise in these cells. The relationship between these two phenomena has been examined. Using an in vitro assay system which discriminates between polymerase activity which is "engaged" in nuclear RNA synthesis and a pool of "free" enzyme, the data suggest that the factors regulating the interaction between these two pools of enzyme activity are different for forms I and II RNA polymerases.


The reactions of mercurated pyrimidine nucleotides with thiols and with hydrogen sulfide. In the presence of thiols, 5-mercuripyrimidine nucleotides are quantitatively converted to 5-thiomercuri derivatives, but these compounds are unstable and decompose at a rate dependent on the nature of the thiol. The decomposition involves three different reactions and proceeds via a symmetrical mercury derivative of the nucleotide. The end product is the unmodified nucleotide. Similar reactions occur in the presence of hydrogen sulfide. Since mercurated nucleoside triphosphates are substrates for RNA- and DNA polymerase only in the form of thiomercuri derivatives, this implies that when DNA is replicated or transcribed in vitro with a mercurated substrate, the latter is rapidly demercurated to the unmodified substrate which is incorporated as well. Hence the product of the in vitro synthesis can only be partially mercurated in any one pyrimidine. Also, formation of cross-links in the resulting polymer is possible.


DNA-methylase from regenerating rat liver: purification and characterisation. DNA methylase has been purified 660-fold from nuclei from regenerating rat liver. The enzyme is able to methylate single stranded (ss) and double stranded (ds) DNA, the only reaction product being 5-methylcytosine. Previously unmethylated double stranded DNA from prokaryotes (M.luteus) as well as from eukaryotes (Ascaris suis) can serve as substrates. The synthetic copolymers (dG-dC)n . (dC-dG)n and (dG,dC)n are also methylated. While SV40 DNA is almost not methylated, PM2 DNA is a good substrate even in the supercoiled form. The enzyme methylates 1 in 17 bases in heterologous M.luteus DNA, but only 1 in 590 in homologous rat liver DNA. The high methylation level of M.luteus DNA, an analysis of the methylated pyrimidine isostichs and a preliminary dinucleotide analysis suggest that all the CpGs in a DNA can be methylated.


DNA polymerases alpha beta and gamma in inherited diseases affecting DNA repair. Fibroblasts derived from patients with diseases affecting DNA repair processes, such as Xeroderma Pigmentosum (classical and variant), Fanconi's anemia, Bloom's syndrome, Ataxia Telangiectasica, Progeria and Werner's syndrome, were assayed for the three DNA polymerases. The specific activities of these enzymes were found within the limits observed in normal human fibroblasts. Also the sedimentation properties of the three polymerases were unaltered.


The inhibition of mitochondrial DNA polymerase gamma from animal cells by intercalating drugs. DNA polymerase gamma from purified nuclei of EMT-6 cells (mice) seems to be identical to the mitochondrial DNA polymerase from the same source following several criteria. These two enzyme activities are strongly inhibited by ethidium bromide and acriflavin, while proflavin, acridine orange, daunomycin and chloroquine inhibition is less pronounced. In the case of DNA polymerases alpha and beta very little inhibition by ethidium bromide was observed. Intercalation of this dye in a poly dA-dT 12-18 template-primer was studied spectrophotometrically under conditions similar to those in the in vitro DNA polymerase assay. The polymerase assay. The inhibition by this drug of the mitochondrial DNA polymerase gamma activity was shown to be competitive at varying concentrations of TTP while the inhibition was of the non-competitive type at different concentrations of poly dA-dT 12-18. We conclude that the drug, most probably in the intercalated form, is able to interact with the active site (s) of mitochondrial DNA polymerase.


Preparation and isolation of covalently closed circular rDNA molecules from DNA of Xenopus laevis. We describe a method leading to the formation of closed circles of rDNA starting from total DNA of Xenopus laevis. Linear DNA molecules were digested with exonuclease 3 and self-annealed. Open circles were enriched and covalently closed by the simultaneous use of polynucleotide kinase, DNA polymerase and polynucleotide ligase. Closed circles of rDNA1 were shown to be alkali-resistant, to have higher density than linear molecules in cesium chloride density gradients containing ethydium bromide, and to have the sedimentation constant expected for a single repeat unit of rDNA comprehensive of its spacer.


Biospecific fractionation matrices for sequence specific endonucleases. Fractionation of several type II specific restriction endonucleases was achieved by separation on two novel biospecific matrices. The matrices are pyran, a copolymer of divinyl ether of maleic anhydride, and Cibacron Blue F3GA, a blue dye commonly used for the calibration of molecular sieves. Both compounds are insolubilized by coupling to sepharose through a cyanogen bromide linkage and in their soluble form inhibit the restriction endonucleases which we have tested. These affinity matrices can be used to obtain restriction endonucleases from crude extracts after removal of nucleic acids. They have also proven to have a high capacity when used as subsequent steps in enzyme purification. Their additional advantage is the rapid development time and reusability of columns packed with the two matrices.Images


Alteration in nucleosome structure induced by thermal denaturation. Mononucleosomes prepared from goose erythrocyte nuclei exhibited limited heterogeneity with respect to number of electrophoretic components, histones and DNA composition. The components differ slightly in ionic strength induced self-association. Thermal denaturation of each component gave only two dominant, highly cooperative, melting transitions, T" and T"'. Urea and trypsin were used to establish the differential lability of these two transitions. Comparison of the morphologies of the mononucleosomes at various stages throughout the melting profile indicated that the 13.3 +/- 1.5 nm diameter mononucleosomes start to disrupt only in the latter half of transition T" and do not unfold until after reaching T"'. The resultant, open ended (17.4 +/- 2.2 nm diameter) toroids are still largely negatively staining and much more uniform in shape if fixed simultaneously with gluteraldehyde.


Nucleotide sequence at the 5' end of ovalbumin messenger RNA from chicken. DNA-sequence analysis of 300 nucleotides from the region of cloned, double-stranded ovalbumin cDNA corresponding to the 5' end of ovalbumin messenger RNA was accomplished using the technique of Maxam and Gilbert (Proc. Nat. Acad. Sci. USA (1977) 74,560-564). The AUG initiation codon was located 52 nucleotides from the AT linkers used in cloning and immediately adjacent to the amino terminal peptide of ovalbumin, indicating the absence of a "signal peptide" in this protein. The nucleotide sequence coding for a phosphorylated peptide from ovalbumin was also found. These results demonstrate that the coding portion of mRNAov begins near the 5' end of the molecule leaving some 600 nucleotides of noncoding information at the 3' end.


Simplified methods for large scale enzymatic synthesis of oligoribonucleotides. We report simplified methods for large scale enzymatic synthesis of oligoribonucleotides using polynucleotide phosphorylase. The main features of the method are use of RPC-5 chromatography, including chromatography at two pH values to deal with the problem of primer phosphorolysis, rapid dialysis for large scale desalting, simplified methods for enzyme removal, and high resolution 1H and 31P NMR for product identification and demonstration of purity. The capacity of the method is adequate to allow beginning with grams of material in the first polymerization step, so that product yields of several milligrams, sufficient for many physical studies, are possible after as many as three separate polymerization reactions.


A method for the recovery of DNA from agarose gels. We describe a quick and versatile method for the isolation of DNA from agarose gels. The DNA is electrophoresed into a trough containing hydroxyapatite, where it is bound. The hydroxyapatite is taken out and the DNA eluted with phosphate buffer. By putting the hydroxyapatite on a small column of Sephadex G50, elution and subsequent removal of phosphate can be performed in one step. The DNA recovered can be used equally well in enzymatic incubations as DNA not purified through agarose gel electrophoresis. Several applications of this technique are described.


A general method for the purification of restriction enzymes. An abbreviated procedure has been developed for the purification of restriction endonucleases. This procedure uses chromatography on phosphocellulose and hydroxylapatite and results in enzymes of sufficient purity to permit their use in the sequencing, molecular cloning, and physical mapping of DNA.


RNA methylation in vaccinia virus-infected chick embryo fibroblasts treated with homologous interferon. Interferon-pretreatment of vaccinia-infected chick embryo fibroblasts resulted in a greater than 50% decrease in ribose methylation of the penultimate "cap" nucleotide in virus-specific mRNA. However, in contrast to results obtained with cell-free systems, in intact infected cells there was (a) no detectable reduction in methylation of the 5'-ultimate m7G of viral mRNA; (b) a virus specificity of the interferon-induced change in mRNA "CAP"-methylation seems unlikely and (c) analysis of the ribosomal and transfer RNA fractions isolated from interferon-treated and control cells revealed identical patterns of methylated nucleotides. Thus, the interferon-induced change in methylation is specific for mRNA "CAPS".


Analysis of terminal structures of RNA from potato virus X. The 5'-end structure of potato virus X RNA was determined following enzymatic methylation in vitro. A single 3H-methyl group was introduced into the 2'-position of the 5'-penultimate residue and the end structure was determined as m7GpppG(m)pAp(Xp)3G. This part of the RNA apparently is involved in binding to ribosomes since it can be partially protected against RNase digestion by wheat germ 40S ribosomes. PVX RNA was not retained by poly(U)-sepharose, indicating that it does not contain a 3'-terminal poly(A) tract.


Theoretical melting profiles and denaturation maps of DNA with known sequence: fdDNA. Differential melting profiles and denaturation maps are calculated for fdDNA whose sequence of nucleotides has been determined recently. The melting profiles for the total DNA and a number of its restriction fragments are compared with experimental data taken from literature. The comparison enables one to correlate a number of peaks on experimental melting profiles with the melting out of concrete regions of the nucleotide sequence. For three fragments very strong end effects are demonstrated on both theoretical and experimental profiles. These anomalous end effects are shown to be connected with a region highly enriched with AT-pairs. A possible influence of the heterogeneity of stacking interaction on the results obtained is discussed in detail.


Measurement of the differential melting profile of a promoter-containing fragment of T7 DNA by means of a microspectrophotometer. A double-beam microspectrophotometer with a 5 microliter cell has been used to study denaturation of DNA in an aqueous solution. This instrument enables measurement of high-resolution differential melting profiles simultaneously at several wavelengths with 0.5 to 1 microgram of DNA. Therefore it becomes possible to study nucleic acids which are difficult to obtain in large amounts. The techniques have been employed to measure the differential melting profiles of T7 DNA and of a fragment of this DNA 1000 base pairs long which contains the four early promoters.


Synthesis of DNA in permeabilized cells of Kluyveromyces lactis. Kluyveromyces lactis cells permeabilized with nystatin, though no longer viable, were able to incorporate 3H-dATP into DNA. Maximum rate of synthesis was obtained when all four deoxyribonucleoside triphosphates were present. For prolonged incorporation of 3H-dATP into DNA rATP or phosphoenolpyruvate were of absolute requirement. DNA synthesis was inhibited by p-chloromercuribenzoate, N-ethylmaleimide, nalidixate, ethidium bromide and distamycin A. The density of DNA synthesized in permeabilized cells grown on non-fermentable and fermentable carbon sources was analyzed on CsCl gradients in the presence or absence of distamycin A. The DNA synthesized by permeabilized cells previously grown on glycerol was essentially mitochondrial DNA; nuclear DNA (30% of total) was also synthesized by cells previously grown on glucose.


Synthesis, DNA-binding and biological activity of a double intercalating analog of ethidium bromide. A bis-phenanthridinium salt has been synthesized and its DNA-binding studied. Evidence provided by UV and CD spectra, by thermal denaturation profiles and by equilibrium dialysis of the drug-DNA complex lead to the conclusion that both phenanthridine moieties intercalate in the helix. The double intercalator appears to be less potent than ethidium chloride as an inhibitor of nucleic acid synthesis in cultured L1210 cells, though it is more potent than a monomeric analog. The low potency may be due to a low cell influx rate.


On the flexibility of the boundaries between the A-form and B-form sections in DNA molecule. The degree of orientation of DNA in a flow has been studied within the interval of the B - A transition induced by ethanol. The orientation of the B DNA (60-65% ethanol, v/v) and that of the A DNA (80-82% ethanol) are nearly identical. This means that both conformations have similar persistence lengths and that there is no aggregation in the course of formation of the A form. Within the transition range (65-78% ethanol) the orientation attains a sharp minimum which coincides with the half-transition point (73% ethanol). The cooperative character of the B - A transition presupposes the existence of boundaries between the alternating sections of the A and B conformations that may entail an increased flexibility of the DNA molecule and a corresponding drop of orientation. Theory predicts an elliptical dependence of the number of boundaries on the proportion of the A form. The experimental degree of orientation follows the same pattern. Quantitative evaluation shows that the flexibility of a boundary is small, so that several dozen of boundaries are required to simulate free rotation.


Highly efficient copying of single-stranded DNA by eukaryotic cell chromatin. Chromatin prepared from S phase hepatoma tissue culture (HTC) cell incorporates in vitro about 11-14 pmoles [3H]dTMP into DNA in 30 min. Single-stranded DNA added to this chromatin stimulates DNA synthesis more than 40-fold whereas activated DNA enhances it about 60-fold. By contrast, stimulation of DNA synthesis by activated DNA in a crude nuclear extract exceeds the stimulation exerted by denatured DNA by a factor of 7. Stimulation of DNA synthesis by denatured DNA is not due to stabilization of either the chromatin or the product of the endogenous reaction. On the other hand, we find that poly(dC) and poly (dT) enhance DNA synthesis by serving as templates which are copied by chromatin in a true complementary fashion. It seems therefore, that eukaryotic cell chromatin is able to copy single-stranded DNA at a high efficiency. Chromatin of G1 arrested cell copies exogenous templates at a considerably reduced rate. The enzyme responsible for the copying of denatured DNA is tentatively identified as DNA polymerase alpha on the basis of its sensitivity to sulfhydril group blocking, its requirements for ions and failure to copy the ribo strand of oligo(dT) poly(A).


Glaucoma. Some practical considerations on a common disease. Chronic simple glaucoma and acute glaucoma are totally different in pathogenesis, symptoms, and treatment. Chronic simple glaucoma is asymptomatic until late in its course, and only by appropriate screening by primary care physicians can the incidence of irreversible visual loss due to this disease be reduced. The symptoms and signs of acute glaucoma are so characteristic that recognition is usually easy and treatment can be begun early enough to prevent permanent angle damage and secondary glaucoma.


Contact lenses. Separating fact from fancy. Contact lenses are a valuable addition to the methods of visual correction and can be used successfully in most cases if patients are properly fitted, instructed, and supervised. The majority of patients can be fitted with conventional hard lenses; soft lenses are preferred in special situations. The most important consideration with either type of lens is proper fitting, which is essential for preservation of normal corneal morphology and physiology.


Visual disturbances in migraine.

Visual disturbances in migraine. Abnormal visual sensations are the most common and characteristic features of migraine. In some patients, they are the only features. The major visual disturbance associated with migraine is scotoma; less common are distortions in size, shape, and color of viewed objects; photophobia; and diplopia and polyopia. Sudden loss of vision occurs in retinal migraine, and paralysis, usually of the third nerve, in ophthalmoplegic migraine. Paresis also may be found with cluster headache.


Clinical enzymology. 1. Enzymes and isoenzymes: sample and patient variables. Enzyme determinations are among the most commonly ordered laboratory tests and are valuable diagnostic aids. For the results to be useful, the sample must be processed and stored properly and patient variables, including age, sex, medication history, and exercise status, must be considered. Isoenzyme determinations are helpful in specific situations.


Case report. Progressive systemic sclerosis presenting as interstitial pulmonary fibrosis. Pulmonary involvement usually is a late manifestation of progressive systemic sclerosis. In the case reported here, dyspnea and pulmonary interstitial fibrosis developed more than a year prior to onset of skin and vascular changes. Open-lung biopsy performed early in the course of the disease failed to yield a definitive diagnosis.


Case report. Plasmacytoma presenting as unilateral proptosis. A 49-year-old man presented with proptosis of the right eye. An x-ray film of the skull showed a lytic lesion in the right frontal bone. No other skeletal lesions were found. Immunoelectrophoretic analysis showed a monoclonal elevation of IgG level. A soft orbital tumor near the foramen of the optic nerve was removed and found to be a plasmacytoma. The patient was given local irradiation. When IgG level increased about four months after surgery, he was treated with chemotherapy. IgG level decreased and no further skeletal lesions were found.


Alternatives to standard cataract surgery. Two alternatives to standard cataract surgery have been developed which have distinct benefits in selected patients. Phacoemulsification, which requires only a small incision and little recovery time, is particularly suited to young patients. Elderly patients, who often cannot wear aphakic spectacles or contact lenses, may benefit from intraocular lens implantation.


Multiple sclerosis. Highlights of studies relating to nature and cause. Multiple sclerosis (MS), a common cause of neurologic disability in adults, most often begins in the early part of the fourth decade of life. Signs and symptoms are the result of focal destruction of myelin in the CNS. An elevated CSF gamma globulin level or evidence of an oligoclonal CSF gamma globulin is helpful in diagnosis. MS may be an uncommon result of early-life viral infection in genetically susceptible persons.


Clinical enzymology 2. Test strategies and interpretation of results. The greatest usefulness of enzyme determinations is in diagnosis and management of hepatic, cardiac, pancreatic, and skeletal muscle diseases. They occasionally are useful in patients with malignant or hematologic conditions. As a rule, enzyme determinations are sensitive enough for normal values to exclude disease but are too nonspecific for abnormal values to confirm disease. Exceptions to this rule are determination of the MB isoenzyme of creatine kinase, the flipped lactate dehydrogenase isoenzyme pattern, and calculation of the ratio of amylase clearance to creatinine clearance.


The cancer-screening dilemma.

The cancer-screening dilemma. Only in cancer of the uterine cervix and in cancer of the breast is there evidence of reduced mortality with early treatment. Screening also enables physicians to detect early cancer of the oral cavity or colon. With regard to cancers at other sites, many questions about screening's potential remain to be answered.


Parkinsonism. Clinical and neuropharmacologic aspects. While the etiology of the most common form of parkinsonism (idiopathic) remains elusive, studies of the regional biochemistry and pharmacology of the brain have led to recognition of the importance of certain pathways, such as the nigrostriatal system. This information evolved from the discovery that the neurotransmitter dopamine is depleted in parkinsonism and that restoration of dopamine by administration of its precursor, levodopa, induces a dramatic therapeutic response in many patients. Such studies have initiated and sustained a major surge in neuropharmacologic advances, but the tangible benefits, in the form of therapeutic results, have undergone some critical reappraisal with the appearance of late adverse reactions to levodopa. One practical approach to this problem is deliberate delay in starting levodopa therapy and the use of lower doses. Use of artificial dopaminergic agonists and selective inhibitors of monoamine oxidase B has also been investigated.


The muscular dystrophies. Clinical update on two major types. The muscular dystrophies are inherited diseases involving skeletal muscle and, to a variable extent, many other organs of the body. Each presents a distinctive clinical syndrome, and each presumably reflects a distinctive inborn error of metabolism. The precise metabolic defect is not known for any of these disorders. However, recent studies suggest that abnormalities in cellular membranes may help explain clinical deficits in two of the most important disorders, Duchenne's muscular dystrophy and myotonic muscular dystrophy.


The assessment of glomerular function: creatinine clearance or plasma creatinine? Plasma creatinine concentration is superior to creatinine clearance for the detection of abnormal glomerular function, of changes of glomerular function in patients with chronic renal disease. Creatinine clearance should be abandoned as the routine assessment of glomerular function.


Anticholinergic drugs, buccal ulceration and mucosal potential difference. Measurement of changes in buccal mucosal potential difference produced by contact with drug formulations may provide a means of predicting their mucosal toxicity and ulcerogenic activity.


Guillain-Barré syndrome after rubella.

Guillain-Barré syndrome after rubella. A case of polyneuropathy (Guillain--Barré syndrome) developing only 6 days after rubella infection in a 26-year-old woman is described. Serological confirmation of the viral infection by detecting the specific IgM antibody has not been previously reported in any of the rubella cases associated with the syndrome.


The insidious presentation of the juvenile form of metachromatic leucodystrophy. Certain progressive cerebral diseases can present with emotional and behavioural disorders. The juvenile form of metachromatic leucodystrophy is one of these. The histories of two children with this condition are given to demonstrate the insidious form of onset.


Therapy of Candida peritonitis: penetration of amphotericin B into peritoneal fluid. Candida albicans peritonitis developed in a 48-year-old man with a perforated gastric ulcer who subsequently was treated with intravenous amphotericin B. The drug penetrated well into the inflamed peritoneal cavity and eradicated the organism from the peritoneal fluid. Nevertheless, at post-mortem, Candida organisms were demonstrated in a gall-bladder empyema and within the gall-bladder wall. Because intra-abdominal organs may be involved in Candida peritonitis, the use of high dose amphotericin B administered either intravenously, intraperitoneally, or both intravenously and intraperitoneally is recommended.