Comparison of methicillin, nafcillin, and oxacillin in therapy of Staphylococcus aureus endocarditis in rabbits. Methicillin (M), nafcillin (N), and oxacillin (OX) (400 mg administered intramuscularly every 8 hours) were compared in the therapy of left-sided endocarditis in rabbits infected with two different strains of Staphylococcus aureus. The three antibiotics were equally effective in eliminating staphylococci from cardiac vegetations. N and OX were four to eight times as active against the staphylococci as M in broth but had equivalent activity in serum. The peak M and OX levels in serum were at least twice the peak N level, but the half-life of N in the serum (2.1 hours) was about three times that of M (0.6 hours) and twice that of OX (1.1 hours). Serum bactericidal activity tests demonstrated essentially equal activity with the three antibiotics 1 and 2 hours after injection; however, at 4 and 6 hours N had an advantage over M and OX. Therefore, despite clear differences in vitro activity, protein binding, and pharmacodynamics, M, N, and OX were equally effective in therapy of staphylcoccal endocarditis in rabbits.


The depressant influence of extracellular fluid hyperoxia on liver slice oxygen uptake. The effect of oxygen tension (Po2) on oxygen consumption (Vo2) of rabbit liver slices was investigated to determine the relationship between extracellular fluid Po2 and liver slice Vo2. Seventy rabbits, 5 kg each, were sacrificed with air embolism. Liver slices (0.3 gm) in Krebs-Ringer's-phosphate (KRP) dextrose were placed in a constantly agitated, 37 degrees C, closed cuvette, and Po2 was continuously monitored down to 10 torr. The system was reoxygenated and closed, and observations were repeated. Hemoglobin concentration was measured on the liver slice homogenate, and a P50 was measured on autologous blood. The presence of small amounts of hemoglobin in the supernatant was confirmed by electrophoretic, spectrophotometric, and morphologic studies. The pH decreased from mean 7.47 to mean 7.37 during each run. The resultant increase in P50 was recalculated and included in the determination of each deltaO2 content/min (Vo2). Vo2 at Po2 30 torr was greater than Vo2 at Po2 90 torr (p less than 0.0001 in each case). Vo2 at Po2 30 torr was not significantly different in the first vs. the second run (p greater than 0.85). The critical oxygen tension for hepatocyte respiration appears to be 30 torr.


Lymphoproliferative responses to antigens mediated by human pulmonary alveolar macrophages. We evaluated the ability of human pulmonary alveolar macrophages (PAMs) to mediate (3H)-thymidine incorporation by blood lymphocytes severely depleted of monocytes when stimulated with soluble microbial and allogeneic lymphocyte antigens. Low (less than 2%) concentrations of PAM's from nonsmokers or blood monocytes did not support optimal responses. Over all, at greater than or equal to 10% concentrations, PAM's from nonsmokers supported higher responses than monocytes. At less than or equal to 10% concentrations, PAM's from heavy cigarette smokers mediated significantly less incorporation than did similar concentrations of PAM's from nonsmokers (p less than 0.05). The findings indicate that PAM's from healthy nonsmokers are functionally competent macrophages in terms of mediating lymphoproliferation in cultures stimulated with antigens. This classical macrophage function is impaired with cigarette smoking.


A simple hypoxic chamber.

A simple hypoxic chamber. A simple, normobaric hypoxic chamber constructed of easily obtainable parts is described. Important features include small size, low cost, simple construction, and easy maintenance. The chamber accommodates 50 mice and can be used for rats as well. Although designed to provide animals for the in vivo bioassay of erythropoietin, it is also useful for experimental studies requiring the acute induction of hypoxia.


Laryngeal tetany: an unusual presentation of chronic renal failure. The presenting features and subsequent management of two adult patients with chronic renal failure complicated by laryngospasm are described. Possible mechanisms to explain this uncommon phenomenon are discussed but its rarity remains unexplained.


H incision--method of choice for radical neck dissection. To prevent skin necrosis, fistula formation and rupture of the carotid arteries after RND, vascularization of the skin of the neck has been considered. The neck vessels (in cadavers) were injected with coloured media and specimens of the skin were cleared (Spalteholz method). The arteries supplying the skin of the neck followed in general an obviously longitudinal course: one group of cutaneous arteries descending from the branches of the external carotid; another group ascending from the branches of the subclavian artery. The upper and lower groups of arteries joined approximately in the middle of the neck. The density of cutaneous arteries in the neck was much poorer than in the facial skin. On the basis of these anatomic data, an incision for RND has been proposed in the form of an H or three-quarter H, in which the transverse line of the incision follows the least vascularized skin region of the neck, without interrupting the great skin vessels. Incisions in the form of a Z or a double Y, OR McFee's incision, do not fulfil this requirement. The authors also report the results of wound healing after RND in 184 patients who were operated in the period fron 1968 to 1975 at the E. N. T. clinic of Ljubljana, where the H incision or one of its modifications was used.


Nasal and paranasal pathology in experimental bilharziasis. The heads of ten white mice experimentally infested by bilharziasis were processed to examine the nasal and paranasal cavities. Five normal littermates served as controls. The incidence of pathology in these cavities was exceptionally high in the diseased group (100 per cent). Lymphoid hyperplasia was noticed in many cases while one case showed bilharzial eggs in relation to the nasal walls. The significance of these findings and their relationship to human bilharziasis is discussed.


The deformity produced by a palsy of the marginal mandibular branch of the facial nerve. It is a common misconception that damage to the marginal mandibular branch of the facial nerve causes drooping of the corner of the mouth. In fact the opposite is true, as a consideration of the anatomy confirms.


The nasal chondroma. 2 case reports and a survey of the literature. Two cases of nasal chondroma are recorded and the past literature reviewed. The importance is stressed of wide surgical excision for these lesions.


Chondrosarcoma of the nasal septum.

Chondrosarcoma of the nasal septum. A rare case of chondrosarcoma of the nasal septum is presented. Wide excision of the tumour including the right orbit and part of the anterior cranial fossa was undertaken. Review of the literature shows that this is the treatment of choice and the radiotherapy does not prevent recurrence.


Fatal haemorrhage due to ruptured inferior thyroid artery aneurysm. A rare case is reported of an aneurysm of one of the branches of the inferior thyroid artery presenting as a thyroid swelling compressing the trachea, oesophagus and left recurrent laryngeal nerve, and complicated by erosion of the tracheal wall through which a sudden attack of bleeding into the trachea suffocated the patient immediately.


Cellularity of porcine adipose tissue: effects of growth and adiposity. Adipose tissue, from two depots in pigs of three breeding groups with different propensities to fatten, was characterized in terms of weight of the adipose tissue organ, adipose cell number, and mean cell volume as determined by electronic counting of adipose cells fixed with osmium tetroxide. Perirenal and extramuscular adipose tissue growth was accompanied by progressive adipose cell enlargement along with an increase in cell number. By approximately 18-20 weeks of life, adipose tissue growth in both lean Hampshire x Yorkshire and fat Minnesota 3 x 1 pigs occurred exclusively by cellular hypertrophy. By 24 weeks of life (37 kg), hyperplasia was complete in Hormel Miniature pigs, which contained about one-third as many extramuscular adipose cells as the conventional pigs. Adiposity in the pig was due to cellular hypertrophy rather than cellular hyperplasia, since during growth, the leaner conventional pigs (30.6% extramuscular fat) contained more adipose cells than the fatter pigs (46.6% extramuscular fat). The number of adipose cells per animal or per adipose organ was directly related to the true body size (weight of fat-free carcass) of the animal. Fat Minnesota 3 x 1 pigs had fewer adipose cells than lean Hampshire x Yorkshire pigs at an equivalent live weight due to the smaller true body size of these animals. In young animals (28 and 54 kg), growth rate was positively correlated with adipose cell number. However, growth rate was unrelated to the total number of cells in the more mature animals (83 and 109 kg). Therefore a slow, normal growth rate may delay but not alter the final cell number.


Determination of less than a nanomol of cerebrosides by high performance liquid chromatography with gradient elution analysis. A gradient elution high performance liquid chromatography method with detection at 230 nm for the analysis of perbenzoylated cerebrosides containing hydroxy and nonhydroxy fatty acids is described. The quantitative range of the method is 0.5-10 nmol of cerebrosides. The limit of detection for injected sample is about 10 picomol. The analysis time by liquid chromatography is less than 5 minutes and prior purification of the cerebrosides from other lipids in brain lipid extracts is not necessary. The cerebrosides are first perbenzoylated with 50 micronl of 10% benzoyl chloride in pyridine and then separated on a chromatographic column of Zipax. The gradient elution is with 2.8-5.5% of dioxane in hexane. This gradient elution micromethod is at least 10 times more sensitive than isocratic elution methods with detection at 280 nm. The method is applicable to other biological materials containing minute amounts of cerebrosides if the glycolipid fraction is first isolated from the lipid extracts. A further fourfold increase in the sensitivity is achieved by replacing air in the reference cell of the detector by gradient elution solvent.


Sterol synthesis in intestinal villi and crypt cells of rats and guinea pigs. The villi of the small intestine of rats and guinea pigs have been demonstrated to be capable of as rapid synthesis of sterols as the crypt cell fractions. This finding is not in agreement with the generally accepted belief that the crypt cells are responsible for essentially all of the synthesis of sterols in the intestine. Three methods of measuring synthesis were used: incubation with [(14)C]-acetate of villi, crypt cell, and muscle fractions obtained by the method of graduated scraping; incubation of whole intestine pieces followed by fractionation into the same fractions; and in vivo studies in rats injected with [(14)C]-acetate and killed 7-40 min later, after which the intestine was fractionated by scraping or by serial sectioning of frozen tissue. All methods were in agreement in showing sterol synthesis in villi to be as active per mg protein as in crypt cells. Measurements of the isotope content of the total nonsaponifiable lipid fractions led to the same conclusions as did the isotope content of the digitonin-precipitable sterol fractions. For a given period of incubation, the ratio of the two values was the same in villi and crypts, ruling out the possibility of synthesis of sterols in crypts prior to transfer to villi. The fractionation into villi, crypts, and muscle fractions by scraping greatly reduced the total sterol synthetic activity in rat but not in guinea pig small intestine, indicating the hazard of using only this in vitro technique to make quantitative estimates of the sterol synthetic capacity of tissue fractions.


Short- and long-term effects of ethanol administration in vivo on rat liver HMG-CoA reductase and cholesterol 7alpha-hydroxylase activities. Short- and long-term effects of ethanol on HMG-CoA reductase (EC 1.1.1.34) and cholesterol 7alpha-hydroxylase activities in rat liver have been investigated. Neither the reductase nor the hydroxylase activity as measured in vitro was significantly affected within 2 hr after a single intraperitoneal injection of ethanol (7 mmol per 100g body weight), whether tested at the diurnal low or the diurnal high point of activity. Although chronic ethanol feeding for 21 days did not affect the diurnal rhythm of either of these enzyme activities, it caused a 29% decrease in HMG-CoA reductase activity and a 56% decrease in cholesterol 7alpha-hydroxylase activity at the diurnal high point. The same chronic ethanol feeding caused a moderate increase in serum cholesterol and a significant increase in hepatic cholesterol concentration. On the basis of these findings, it is suggested that the decreased rate of cholesterol degradation to bile acids may play a significant role in the accumulation of cholesterol in the liver after chronic ethanol feeding.


Analysis of metabolic profiles of bile acids in urine using a lipophilic anion exchanger and computerized gas-liquid chromatorgaphy-mass spectrometry. A method is described for quantitative analysis of bile acids in urine. Urine is acidified and bile acids are extracted on an Amberlite XAD-2 column. Bile salts are converted to acids on an Amberlyst A-15 column and are separated into groups of unconjugated, glycine, taurine, monosulfated, and polysulfated conjugates using the lipophilic anion exchanger diethylaminohydroxypropyl Sephadex LH-20 (DEAP-LH-20). After solvolysis and hydrolysis, the deconjugated bile acids are purified on DEAP-LH-20, and are converted to methyl ester trimethylsilyl ether derivatives. Identification and quantitation of the individual bile acids is accomplished by computerized gas-liquid chromatography-mass spectrometry. The daily excretion of bile acids in urine from healthy subjects was 6.4-11 micro moles. The mixture of bile acids was quite complex and differed from that in bile. About 30 bile acids were identified or partially characterized. Three of these were monosubstituted: lithocholic, allolithocholic, and 3beta-hydroxy-5-cholenoic acids. Fourteen disubstituted bile acids included epimers of deoxycholic, allodeoxycholic, chenodeoxycholic, allochenodeoxycholic, and hyodeoxycholic acids. 3alpha-Hydroxy-12-keto-5beta-cholanoic acid was the major ketonic bile acid and 3beta,12alpha-dihydroxy-5-cholenoic acid was the major unsaturated bile acid in this group. Nine trihydroxy bile acids included cholic and allocholic acids, epimers of these compounds, hyocholic acid, and a 1-hydroxylated bile acid tentatively characterized as 1,3,12-trihydroxycholanoic acid. Cholestatic subjects excreted tetrahydroxycholanoates carrying hydroxyl groups in positions 1, 3, 6, 7, 12, or 23. All monohydroxy and the predominant part of dihydroxy bile acids were present in the monosulfate fraction. Exceptions were 3alpha,12beta-dihydroxy- and 3alpha-hydroxy-12-keto-5beta-cholanoic acids, which were found mainly in the glycine conjugate fraction. Most of the trihydroxy bile acids were nonsulfated, and cholic and norcholic acids were the major unconjugated bile acids. The tetrahydroxy bile acids and hyocholic acid were present mainly in the taurine conjugate fraction, while 1,3,12-trihydroxycholanoic acid was predominantly found in the glycine conjugate fraction. Sulfation of trihydroxy bile acids was increased in patients with marked cholestasis. All bile acids in the monosulfate fraction were conjugated and carried the sulfate ester group at C-3. Significant amounts of di- and trisulfates were not found. The results indicate selective mechanisms for sulfation, hydroxylation, and renal elimination of bile acid conjugates. Analysis of metabolic profiles of bile acids in urine may be a useful method in studies of the function of organs involved in bile acid metabolism.


Experimentally caused proliferation of lysosomes in cultured BHK cells involving an increase of biphosphatidic acids and triglycerides. When cultured hamster fibroblasts (BHK 21 cells) were incubated in a synthetic serum-free medium up to 4 days, they developed signs of a progressive proliferation of lysosomes. The cells became filled with vacuoles that contained polymorphic debris and showed acid phosphatase activity. The specific activities of acid protease and acid phosphatase in the cell cultures increased three- to fourfold. The process was accompanied by a marked decrease in the contents of protein, deoxyribonucleic acid, and total phospholipids of the cultures. The concentration of lysobisphosphatidic acid increased during the incubation from about 1.5% to 3-6% of the cellular phospholipids. The concentrations of two related lipids, bisphosphatidic acid and semilysobisphosphatidic acid also increased substantially. The triglyceride content of the cells increased several fold, whereas the concentration of phosphatidylcholine decreased markedly. Lysobisphosphatidic acid did not increase upon induction of vacuolization by exogenous sucrose, nor when there was an accumulation of triglyceride due to addition of oleic acid to the growth medium. These findings suggest that the formation of the bisphosphatidic acids may be specifically linked to the autolysis of the phospholipids of the cellular membranes and the formation of triglycerides associated with this process.


Interaction of uncharged bile salt derivatives with the ileal bile salt transport system. Two series of uncharged conjugated bile salt derivatives, N-conjugates of ethanolamine and 3-amino-1,2-propanediol were studied for interaction with the ileal bile salt transport system. Evidence for interaction is threefold. 1) In everted gut sac experiments more material was removed from the mucosal compartment when ileal sacs were used. 2) These derivatives inhibited the in vitro transport of taurocholate. 3) In vivo intestinal perfusion demonstrated greater absorption from ileum than from jejunum. Number three demonstrates that such interactions are followed by transmucosal movement. Their uphill transport was less than taurocholate transport. The Na(+) requirement for cholyl-3-amino-1,2-propanediol interaction with the system was greater than for taurocholate. This observation is similar to that previously observed with taurodehydrocholate, which had a greater Na(+) requirement for transport than taurocholate. Therefore removal of the anionic charge, as well as distortion of steroid shape, increases the Na(+) requirement for substrate interaction with the transport system. These observations support our hypothesis that this interaction involves two recognition components; one includes the steroid moiety, the other a coulombic interaction between the anionic bile salt and a cationic membrane site. Additionally the membrane would have an anionic group to accomodate the Na(+). Both factors (steroidal and coulombic) operate for optimal substrate attachment. Simultaneously the system's affinity for Na(+) increases and active transport then proceeds.


An improved synthesis of 24-13C-labeled bile acids using formyl esters and a modified lead tetraacetate procedure. An improved synthesis of 24-13C-labeled bile acids has been achieved using formyl derivatives of bile acids and a modified lead tetraacetate procedure. The formylated bile acides were degraded by lead tetraacetate and lithium chloride to formylated 23-chloronorcholanes in 72-83% yield. Formylated 23-chloronorcholanes were converted to nitriles in dimethylformamide, which were then hydrolyzed to obtain C-24 labeled bile acids in yield of 80-90% of labeled sodium cyanide used. This method results in a higher yield and a purer product with less manipulation than previously reported procedures for synthesis of labeled bile acids.


An improved procedure for the synthesis of glycine and taurine conjugates of bile acids. Glycine and taurine conjugates of 5beta-cholanic acids have been synthesized using improved procedures based on the peptide coupling reagent, N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline. The conjugates are obtained in chromatographically pure form in yields higher than 90%. The use of this procedure in the large scale preparation of cholyl[1,2-13C2]glycine is described.


The quantitative assay of 3-hydroxy-3-methylglutaryl coenzyme A reductase: comparison of a thin-layer chromatographic assay with a rapid chloroform extraction assay. Two assays for the quantitative measurement of HMG-CoA reductase, the major regulatory enzyme in hepatic cholesterol biosynthesis, are described. The first of these procedures employs thin-layer chromatography (TLC) of the reaction product on plastic-backed silica gel G strips impregnated with ammonium carbonate. The TLC strip is then cut into 14 segments and each segment is assayed for radioactivity. Extraction efficiency and exact chromatographic mobility are monitored by the use of authentic [4-(3)H]mevalonolactone as an internal reference. A wide and complete separation is achieved between HMG and mevalonolactone. Also the radiochemical purity of biosynthetic [3-(14)C]mevalonolactone can be assessed by measurement of the (3)H/(14)C ratio across the mevalonolactone peak. While the TLC assay is accurate and sensitive, it is laborious. Therefore a second assay procedure was developed using chloroform extraction of an incubation mixture saturated with solid equal molar KH(2)PO(4)-K(2)HPO(4) at pH 6.8. Extraction efficiency was monitored by the addition of authentic [4-(3)H]mevalonolactone as an internal reference. The chloroform assay procedure was compared with the TLC procedure over a wide range of enzyme activities, both for rat liver microsomal HMG-CoA reductase and for solubilized enzyme. Excellent correspondence (r = 0.999) between the two assays was observed. TLC performed on the chloroform extract demonstrated that biosynthetic [3-(14)C]mevalonolactone was the only (14)C-labeled compound present in the extract. The chloroform extraction assay is rapid; 20-30 samples can be processed in 2-3 hr. This procedure should facilitate studies concerning the nature and regulation of HMG-CoA reductase.


Hormonal content and ultrastructure of the hypothalamo-neurohypophysial system of the rat after injection of vinblastine into the median eminence. The effects of an injection of vinblastine (Vbl) into the median eminence on the structure, fine structure and antidiuretic hormone (ADH) content of the hypothalamo-neurohypophysial system in the rat is reported. The animals were studied on days 3, 8 and 25 after the injection of 1 or 5 mM-Vbl (3micronl). Significant changes were observed only in the 5 mM-Vbl-injectecd animals. Their median eminence extracts showed a progressive accumulation of ADH whereas ADH depletion occurred in the neural lobe extracts. On day 8 after injection, the animals exhibited strong polidipsia although considerable amounts of ADH still remained within the neural lobe. The ADH content of the plasma samples was consistently below the sensitivity of the method (5 micronu). The light microscopic analysis showed accumulation of Gomori-stainable products in the median eminence and a striking depletion of this material from the neural lobe. Electron microscopy revealed accumulation of neurosecretory vesicles and other inclusions proximal to the site of injection in the median eminence together with some evidence of nerve fibre degeneration. Few neurosecretory terminals were found in the neural lobe of the 8-day experimental rats. They had been engulfed by pituicytes for digestion. Recuperation of the normal ADH content of both median eminence and neural lobe was found to occur on day 25 after the Vbl injection. Simultaneously, the neural lobe refilled with Gomori-positive materials and neurosecretory terminals reappeared. The results suggest (1) reversible blockade of axoplasmic transport at the site of the Vbl injection; (2) reversible degeneration of neurosecretory terminals and (3) reversible blockade of ADH release in the surviving terminals of the neural lobe.


Caprine placental lactogen: levels of prolactin-like and growth hormone-like activities in the circulation of pregnant goats determined by radioreceptor assays. Radioreceptor assays for prolactin-like (lactogenic) activity and growth hormone (GH)-like activity have been used to study concentrations of caprine placental lactogen (PL) in the circulation during pregnancy. Both lactogenic and GH-like activities from less than 100 ng/ml (ovine prolactin- and human GH-equivalents) about 60 days after mating to reach peak levels (400-1600 ng/ml) between days 110 and 130 of pregnancy. The levels of both activities increased in essentially the same fashion but during the last 15 days of pregnancy, lactogenic activity declined less than GH-like activity. This divergence was most pronounced at parturition when levels of lactogenic activity increased (approximately 700 ng/ml) despite very low (less than 200 ng/ml) levels of GH-like activity being measured and this probably reflected increased secretion of pituitary prolactin near parturition. When serum from a pregnant goat or a simple alkaline extract of placental cotyledons was fractioned on a column packed with Sephadex G-100, lactogenic and GH-like activities eluted together with distribution coefficients of approximately 0-5-0-6. The possibility that caprine PL serves physiologically as a luteotrophin and/or mammotrophin during pregnancy in goats is discussed.


Prolactin and luteinizing hormone levels before and after parturition in rats bearing either single or multiple embryos. Levels of prolactin and LH were determined in serum and pituitary during the last days of pregnancy and post partum in rats bearing single and multiple embryos. In rats with a single embryo serum prolactin and LH levels were significantly lower during the last 2 days of pregnancy and post partum than in rats bearing multiple embryos. While large increases were recorded in serum prolactin and LH levels in the rats with multiple embryos between days 21 and 22 of gestation, in the group with single embryos changes occurred in LH level only. Throughout the experiment pituitary prolactin was lower in rats with a single embryo than in those with multiple embryos in spite of the sharp drop in prolactin level in the group with multiple embryos from day 21 to 22. No differences were observed in the pituitary LH levels of either group during the days preceding parturition, but in the rats with multiple embryos there was a sharp drop in LH level post partum. It seems that the reduced serum prolactin level in the rats with a single embryo was associated with inhibition of pituitary prolactin synthesis and release, whereas the decreased serum LH level resulted from impaired release but not synthesis. These results support the hypothesis of a regulatory role for the placenta in pituitary prolactin and LH synthesis and release, either by hypothalamus-pituitary stimulation, or perhaps by way of the ovaries, through regulation of ovarian steroid production.


Relationships among bioassay, radioimmunoassay and disc electrophoretic assay methods of measuring rat prolactin in pituitary tissue and incubation medium. Relationships among bioassay, radioimmunoassay (RIA) and disc electrophoretic assay methods of estimating rat prolactin in pituitary tissue and incubation medium were determined. Highly significant correlations were obtained between disc electrophoretic and RIA estimates of prolactin in tissue and between bioassay and RIA estimates of prolactin in medium. Less significant relationships were obtained between disc electrophoresis and RIA (medium) and between bioassay and disc electrophoresis (tissue and medium). The relationship between bioassay and RIA of prolactin in the incubated tissue was not significant. Regression analysis disclosed the following: the RIA measured slightly more, and the bioassay detected substantially more prolactin in tissue and medium than did disc electrophoresis; the bioassay detected about five times more prolactin in medium than did the RIA. No significant relationships were found within or among the assays for depletion and release of prolactin. The results indicate that secreted prolactin has increased bioassay activity relative to its detectability by disc electrophoresis and RIA.


Purification and radioimmunoassay of chicken growth hormone. Chicken growth hormone has been isolated from adenohypophysial tissue from which the glycoprotein hormones had been removed. The procedure entailed alkali extraction, ammonium sulphate precipitation and ion-exchange chromatography on DEAE-cellulose. The resulting fraction was homogeneous, active in the rat tibia bioassay and had a similar isoelectric point, molecular weight and amino acid composition to mammalian growth hormone. A specific homologous radioimmunoassay has been developed using the avian growth hormone.


Effect of limb ischaemia and scalding on the concentrations of growth hormone and corticosterone in rat plasma. In post-absorptive rats in a 20 degrees C environment, bilateral hind-limb ischaemia decreased the plasma growth hormone concentration below the very wide range found in control rats. Injection of sodium pentobarbitone increased the concentration in both control and injured rats but did not eliminate the difference between them. A 20% dorsal scald also decreased the variability of plasma growth hormone concentration but did not reduce it below the normal range. Thus growth hormone is probably not responsible for the insulin resistance seen in the severely injured rat. The plasma corticosterone concentration markedly increased after both injuries but was not altered by pentobarbitone.


Ovulation in prenatally androgenized ewes. The ovarian activity of prenatally androgenized ewes was studied by measuring plasma progesterone concentrations in daily samples of peripheral blood, and by examining the ovaries at laparotomy. Ewes that were exposed to testosterone between days 30 and 80, 50 and 100 or 70 and 120 of foetal life by implanting their mothers with 1 g testosterone, failed to show regular overt oestrous cycles, although some of them ovulated, whereas ewes exposed to testosterone between days 90 and 140 of foetal life had normal oestrous cycles. The incidence of ovulatory failure appeared to increase with age in ewes treated between days 50 and 100 or days 70 and 120 of foetal life.


Suppression of IgE antibody production in SJL mice. III. Characterization of a suppressor substance extracted from normal SJL spleen cells. SJL mice were immunized with 1 microng dinitrophenylated keyhole limpet hemocyanin in 1 mg Al(OH)3. The mice were infected 21 days later with 750 third stage larvae of Nippostrongylus brasiliensis. On day 35, 14 days after infection, they were injected with 1 microng DNP-N, brasiliensis extract (Nb) in 1 mg Al(OH)3. In order to obtain high titer and persistent anti-DNP IgE antibody the mice were irradiated (540 R) 1 day after injection of DNP-Nb. Suppression of anti-DNP IgE antibody production was induced by spleen cells from normal SJL mice. Suppression of IgE antibody response is also obtained by an extract from normal SJL spleen cells. The suppressor substance from normal SJL spleen cell extract is a heat-labile protein, and is not absorbed by anti-mouse immunoglobulin. The mol wt of this substance is larger than 300,000 daltons as determined by gel filtration on Sephadex G-200, but after ultracentifugation, the supernate still has suppressive activity on IgE antibody production.


[A method for the determination of bromide in urine with an ion-sensitive electrode (author's transl)]. A potentiometric method for determining the concentration of bromide in human urine is described. On account of its specificity and precision, this method is especially suited for the determination of slightly elevated bromide concentrations due to occupational exposure to alkyl bromides. The rate of recovery is 102.5 to 112.5%, and the variability coefficients lie between 5.8 and 8.6%. The detection limit is about 0.013 mmol/l. The concentrations of bromide in the urine of a group of normal persons lie between 0.059 and 0.162 mmol/l.


[Simultaneous determination of free cholesterol and total cholesteron on an AA I Technicon autoanalyzer (authors transl)]. A procedure for the simultaneous enzymatic determination of free cholesterol and total cholesterol on a 2 channel AA I Technicon autoanalyzer system is described. The quantitation of free cholesterol is compared with the determination by gas chromatography. The investigation reveals a high correlation between both methods. In contrast to classical procedures the proposed quantitation of free cholesterol can be performed easily and quickly for routine analyses.


Kinetic determination of glucose concentrations with glucose dehydrogenase. A manual version and mechanized versions for several types of analyzers are described for the kinetic determination of glucose with glucose dehydrogenase. Results of glucose determinations with and without deproteinization of samples are discussed. The correlation of results with the hexokinase method is shown.


Citrulline as a diagnostic parameter and a major amino acid constituent of cerebrospinal fluid in hepatic coma. Free amino acids of cerebrospinal fluid and serum in hepatic coma have been studied. Citrulline was found to form about 80% of the total free amino acids in cerebrospinal fluid, whereas serum contained slightly higher levels of tyrosine, methionine, phenylalanine and glutamine. The higher level of citrulline in cerebrospinal fluid may be attributed to the inhibition of argininosuccinic acid synthetase in this disease.


An improved method for the simultaneous determination of individual 17-oxosteroids and of pregnanediol in urine by gas-liquid chromatography. An improved method for the simultaneous gas-chromatographic determination of individual 17-oxosteroids and of pregnanediol in the same sample of urine is described. The method involves the following steps. The urinary sample is chromatographed on Amberlite XAD-2. The fraction containing the steroid conjugates is evaporated; the residue is dissolved in n-heptane and the organic phase extracted with water. The steroid glucuronides are hydrolysed by a bacterial beta-glucuronidase; subsequently, the steroid sulphates are solvolysed in ethyl acetate. Free 17-oxosteroids and pregnanediol are separated by two-dimensional thin-layer chromatography. The zone containing the steroids to be investigated is eluted; after evaporation, the residue is treat with N-methyl N-trimethyl silyl trifluoroacetamide. The reaction mixture is injected into a gas chromatograph; the trimethyl silyl ethers of the individual 17-oxosteroids and of pregnanediol are quantitated by measuring the peak heights.


[New methods of coagulation analysis using chromogenic substrates]. The available assay systems for the determination of coagulation factors based on clotting methods are unsatisfactory, despite efforts to stabilize and to standardize them. Analysis by means of chromogenic peptide substrates offers new possiblities for routine diagnostics, and for fundamental research. The development of these new methods, however, is at an early stage.


[Clinical chemistry and preventive medicine (author's transl)]. In a workshop conference of the German Society for Clinical Chemistry, clinical chemical parameters, which are important in preventive medicine, were discussed for three common diseases, diabetes mellitus, gout and chronic liver diseases. In addition the analytical and diagnostic reliability was evaluated for each of these parameters.


When face recognition fails.

When face recognition fails. Two studies investigated recognition of pictures of faces, focusing on the effects of changes in appearance of the face from presentation to test and type of processing or encoding. Experiment 1 demonstrated that (a) previously seen faces changed in pose and facial expression were discriminated from "new" faces essentially as well as pictures identical at presentation and test; (b) major changes in the appearance of a face ("disguises") reduced recognition almost to the level of chance; and (c) subjects encoding faces in terms of personality characteristics showed better recognition performance than subjects whose processing was based on physical, facial features. Experiment 2 expanded on result (b), utilizing photographs with systematic variations in pose and in the presence/absence of glasses, wig, and beard. The design required subjects to learn names for target faces and then to identify those targets in a series of test photographs. The manipulation of pose and disguising features produced effects on probability of identification that were orderly and dramatic in magnitude. Simple changes in appearance can effectively interfere with recognition of faces.


Effects of instructions, biofeedback, and cognitive activities on heart rate control. In a factorial experiment, 90 male and 90 female subjects were given (a) either instructions to increase heart rate (HR), decrease HR, or no instructions to change their HR; (b) either true biofeedback, false biofeedback, or no biofeedback; and (c) either instructions concerning cognitions to help them change HR or no instructions concerning cognitions. The results indicated that (a) for increasing HR, instructions to increase HR were as effective as the combination of instructions and true biofeedback; (b) for decreasing HR, neither instructions nor biofeedback nor the combination of instructions and biofeedback was more effective than simply sitting quietly; (c) although subjects instructed to increase HR showed higher HRs at the end of training than subjects instructed to decrease, the increase subjects showed a decline in HR from the initial period; (d) almost all subjects reported using cognitions to influence HR, and instructions concerning the use of cognitions did not facilitate changes in HR; and (e) women showed higher HRs, which declined more slowly than those of men, but sex did not interact with any treatment variable. It was concluded that increases (or retarded decreases) in HR were due to instructions, and decreases were due to simple adaptation, thus raising serious questions concerning the effectiveness of the biofeedback component of "biofeedback training" for altering HR.


Perturbations of auditory feedback delay and the timing of movement. Among theories concerned with the timing of movement sequences, an important distinction exists between those that assume closed-loop control (in which feedback contingent on one response starts the chain of events that leads to the next response) and those that assume open-loop control (in which feedback does not serve that function). An experiment is reported in which subjects had to make repetitive finger-tapping responses at fixed intervals of 350, 500, or 650 msec. A brief auditory signal was fed back to the subject after each response, and once in each trial, the auditory feedback delay associated with one response selected at random was perturbed by a small amount. It was found that such perturbations affected the immediately subsequent interresponse interval, which is evidence against the simple open-loop model. However, the effects, although in the same direction as the perturbation, were smaller in magnitude, a finding that rejects the simple closed-loop model. In discussing these results it is suggested that subjects operated chiefly in open-loop fashion but monitored the auditory feedback, making compensatory attempts when intervals between auditory feedback events grossly deviated from the desired interresponse interval.


Impact of oculomotor retraining on the visual perception of curvature. Observers viewed a computer-generated display consisting of horizontally oriented, concave-up curved lines. The position of these curves was contingent on the horizontal position of the eye so that, in order to change fixation errorlessly, from one point to another on the curve, the eye would have to execute a purely horizontal movement. In Condition H this was achieved by moving the curves horizontally, so that the minimum point was always at the horizontal eye position location, thus simulating the effect of viewing a line through a wedge prism on a contact lens. In Condition V it was achieved by moving the curves vertically so that the point fixated always had the same vertical location. In both conditions eye movements were reprogrammed rapidly to eliminate the vertical components of the saccades that were present at the start. While a small, but significant, amount of perceptual adaptation was obtained in Condition H, none at all was obtained in Condition V. The results are interpreted as not in support of such theories of perceptual adaptation to curvature distortion as require a close relationship between motor learning and perceptual change.


Optimal allocation of cognitive resources to spatial locations. From experiments showing that subjects differentially attend to parts of the visual field, psychologists have inferred a limitation on human visual information processing capacity. The model presented describes an optimal way to allocate a limited quantity of "cognitive resources," "attention" or "mental effort". For this model, the sense of optimality is maximizing the probability of finding a target. In an experiment to test the model, subjects searched for a single target letter in an otherwise blank field. Two probability distributions were used to select a target location for a trial, but only one distribution was used for a session. For both distributions, the fit of the model was quite good. It is suggested that the model provides a promising way to test the assumption limited visual processing capacity.


Role of feedback in the development and maintenance of complex skill. Three experiments examined the role of various sources of feedback in the development and maintenance of a complex ballistic skill, dart throwing, using extended practice. Even a brief delay of visual feedback initially affected accuracy and consistency adversely, though with practice performance gradually recovered. A total absence of visual feedback impelled subjects to use subtle cues such as crude auditory localization. When these cues were available, accuracy suffered to the same extent as with delayed visual feedback, but consistency in this case was unaffected. When all external feedback was removed, with subjects throwing in the dark at a luminous dot without hearing the dart land, consistency remained unimpaired, but accuracy suffered. However, on returning to full visual feedback both accuracy and consistency were found to have improved when compared to a control group. The independence of accuracy and consistency is discussed in terms of fixed and variable parameters of the skill. The effect of delayed visual feedback is attributed to the failure to integrate visual information with the fading proprioceptive trace. Central importance is attached to improvement in compentence when no external feedback is available, and possible underlying mechanisms for this improvement are described.


Serial reaction time as a function of the nature of repeated events. Past research into the phenomenon of reduced latency to repeated events in serial reaction time tasks resulted in attempts to partition reaction time into components attributable to separate cognitive processes. These attempts focused on many-to-one condensing paradigms, which permitted direct assessment of the effect of response-only repetitions but not stimulus-only repetitions. The three experiments reported in the present study used a technique designed to overcome this limitation. It was found that repetition of only the symbolic content of the total stimulus-response event was a sufficient condition for a reduced response latency and that response-only repetitions tended to be facilitative only when stimulus-response relations were compatible. These and related findings were discussed with respect to their bearing on contemporary issues concerning the analysis of cognitive operations into separable and additive components.


Control of attention in the processing of temporal and spatial information in complex visual patterns. Eighteen stimuli were created by orthogonally varying the area (A), perimeter (P), and exposure duration of checkerboard patterns. Subjects judged either the area and duration of the presented shapes (area-time group) or the perimeter and duration (perimeter-time group) of the same figures. Perceived duration, area, and perimeter varied with changes in the uninstructed an the instructed stimulus dimensions. The discussion focuses on the ability of subjects to control the allocation of attention to instructed stimulus dimensions, as well as on the evidence in the data in favor of detailed sequential or fast holistic processing. It is suggested that the concept of stimulus complexity, defined as P2/A, is useful in describing the temporal and spatial illusions obtained in this study.


Threshold conditions for binocular rivalry. A series of three experiments was performed to determine the minimum contrast necessary for a grating pattern to engage in binocular rivalry with a dissimilar pattern presented to the other eye. It was found that a pattern at its own contrast threshold can suppress temporarily a contralateral pattern, regardless of the contrast of the latter. In a fourth experiment it was found that a near-threshold pattern is as effective, in terms of the duration of visibility, as one that is four times greater in contrast; only the average duration of suppression varied with pattern contrast. This last set of data extends the findings of others to near-threshold conditions and poses difficulties for models of binocular rivalry based on the notion of reciprocal inhibition.


Relation of split apparent motion to metacontrast. The apparent suppression of the target in metacontrast is often accompanied by "split" apparent motion. In Experiments 1, 4, 5, and 6 "neighboring stimuli" (similar to and flanking the mask stimuli) were added to the display, and subjects rated both metacontrast and split motion. Under some conditions, both split motion and metacontrast were completely eliminated (Experiment 1), supporting the assumption that apparent motion is necessary for metacontrast. However, under other conditions, neighboring stimuli caused a much stronger depression of metacontrast than of split motion (Experiments 4 and 5), sometimes even enhancing the latter (Experiment 6), supporting the assumption that the mechanisms underlying the two phenomena are essentially independent. Further, peripheral presentation and close spacing of target and mask with no neighboring stimuli (Experiments 2 and 3) gave strong metacontrast while completely eliminating split motion, showing clearly that apparent motion is not necessary for metacontrast. Results are interpreted in terms of a "fusion" process underlying metacontrast and a "direction-sensitive unit" underlying apparent motion. Interactions between these two processes that might account for the common co-occurrence of motion and metacontrast are proposed.


Semantic and perceptual processes in symbolic comparisons. This article studies the processing of pictures and words as symbols. Pictures lead to faster and more accurate responses than words when the task is to decide which member of a pair of pictures or words denotes the larger or smaller object. The present experiments show that the superiority of pictures results from the fact that pictures are interpreted more quickly than words, but that after the interpretation is made, processing is the same. These experiments also give evidence that pictures and words are both processed in terms of linguistic codes rather than mental images. The results are well accounted for by an information-processing model that is based on two general assumptions: (a) The stimuli and the instructions are represented as discrete codes, and (b) processing proceeds until one and only one of the stimulus codes is the same as the code for the instructions.


Feature analysis and the growth of a percept. Twelve trigrams divided into four sets, the members of each set varying systematically in the feature configuration at each letter position, were repeatedly exposed at brief durations in a random order to subjects who were asked to report after each exposure those letters that could be recognized with certainty. The set of three trigrams that had the same features for all letters in a given ordinal position was identified with fewer exposures than were necessary to permit identification of sets for which the featural characteristics varied within a spatial position. The results were interpreted as being consistent with a constructive model of letter recognition in which the observer tests hypotheses regarding the presence of a given letter based on the presence of relevant features in a spatial position.


Bisensory stimulation: inferring decision-related processes from P300 component. Three experiments were conducted to evaluate the P300 component of the human evoked response as an index of bisensory information processing. On different blocks of trials, subjects were presented with auditory stimuli alone, visual stimuli alone, or with audiovisual compounds. In each series there were two possible stimuli, one of which was presented less frequently than the other; the subjects' task was to count the infrequent stimuli. In the first two experiments the information in the two modalities was redundant, whereas in the third the modalities provided nonredundant information. With redundant information, the P300 latency indicated bisensory facilitation when the unimodal P300 latencies were similar; when the unimodal latencies were dissimilar, the bisensory P300 occurred at the latency of the earlier unimodal P300. Reaction times paralleled P300 latency. When the information in the two modalities was nonredundant, both P300 amplitude and reaction-time data indicated interference between the two modalities, regardless of which modality was task relevant. P300 latency and reaction time did not covary in this situation. These data suggest that P300 latency and amplitude do reflect bisensory interactions and that the P300 promises to be a valuable tool for assessing brain processes during complex decision making.


Reaction times in a bisensory task: implications for attention and speech perception. Reading reaction time (RT) to visual stimuli was shown to vary according to the nature of simultaneous auditory stimuli. In Experiment 1, simultaneous different digits produced slower RTs than a burst of speech noise, while identicaly digits produced faster RTs. In Experiments 2 and 3 the stimuli were phoneme pairs which differed on either zero, one, or two articulatory features. Identical phonemes resulted in the fastest RTs. The RTs to non-identical phoneme pairs were not directly related to the number of differing features but were dependent upon the specific feature involved. A two-stage model was proposed to explain the results in which parallel processing of simultaneous input occurs prior to a decision-making stage.


Inhibition of the human eyeblink reflex: an evaluation of the sensitivity of the Wendt-Yerkes method for threshold detection. In two experiments, human subjects showed a reduced eyewink reflex to an airpuff (S2) if it was preceded by a light flash or a noise burst (S1). The first (N=6) showed that a light inhibited the blink maximally at a 100-msec lag. In the second (N=8), thresholds for noise pips were established with the method of limits. Then the pips were presented in multiples of threshold values as S1 100 msec before S2. Sujbects pressed a button whenever they heard the sound, on S1-S2 pairs, on S1 alone, or on S2 alone trials. Eyeblinks to S2 declined in amplitude and increased in latency as S1 intensity increased. The threshold S1 (approximately 2 dB over a 50-dB background) produced reliable inhibition in 7 of 8 subjects, and a weaker S1 which never evoked a button press was sufficient to produce reliable inhibition for the group as a whole. Inhibition in any particular trial was unrelated to button pressing. The sensitivity of the reflex technique and its relative invariance to task demands suggest its usefulness as a behavioral psychophysical procedure.


Time, capacity, and selection between perceptual attributes. Three experiments were run to determine whether time and central-processing capacity are requried to select between perceptual attributes. A same-different matching task was employed for all experiments. In Experiments 1 and 2, three sets of stimulus pairs were used, each of which varied along only one relevant perceptual dimension (color, size, or form). In Experiment 1, reaction time on the matching task was shown to be faster when the stimuli were presented in blocks in which all stimulus pairs came from the same set (blocked presentation) than when stimulus pairs from each of the three sets were randomly intermixed (random presentation). In Experiment 2, reaction time on a secondary probe task was faster during the encoding stage of a sequential mathcing task with blocked presentation than with random presentation. Experiment 3 indicated that this outcome could not be attributed to a difference in the number of possible stimulus alternatives. Thus, the results support the hypothesis that time and central-processing capacity are required to select between perceptual attributes.


Prevention of some complications of essential hypertension. The major reason for treating hypertension is to avoid complications of the disease as it affects "target organs." Treatment of the blood pressure is not the only way to avoid these complications, but it is part of the total practice of preventive medicine. Hypertension lasts for several decades in most patients, and there is time to destroy the patient through target organ effects or to save the patient through treatment. Diabetes, atherosclerosis, and other illnesses and operations pose special hazards to the patient with hypertension. Patients take many other drugs as well, and some of them react adversely with antihypertension medicines. Complications from blood pressure drugs involve nearly every organ system, more than most physicians can remember. These may be dose-related and can often be avoided by using smaller doses of more than one drug. Certain problems occur so frequently that they should be learned well. The physician should bear in mind that whatever develops may be due to the antihypertensive therapy. On the whole, however, medications for treatment of hypertension are remarkably safe and free from side effects.


Hepatitis A.

Hepatitis A. There are exciting new developments in the serology of hepatitis A. These new studies will lead to the development of diagnostic tests comparable to the Australia antigen (HBsAg) for hepatitis B. Although active immunization is not likely to be available in the near future, passive immunization is effective. Most patients with clinical disease will recover uneventfully with good diet and ad lib activity. Severe restrictions and hospitalization are rarely indicated.


Patient compliance: the effect of the doctor as a therapeutic agent. This paper is a review of the available literature on patient complicance with medical regimens. An effort is made to focus on those features or characteristics associated with compliance or noncompliance that are clinically relevant for the practicing physician. These include the intelligence of the patient, the patient's knowledge of his disease, the complexity of the medical regimen, the influence of the family, the health belief model, and the doctor-patient relationship. From this review of research data, 12 concrete suggestions are presented for the purpose of enhancing patient compliance and enabling the doctor himself to be more effective as a therapeutic agent.


Undergraduate medical education in geriatrics: nursing home experience. Preclinical medical students undertook an elective course in geriatrics which combined instruction in history taking, physical diagnosis, and problem-oriented assessment of elderly patients in a nursing home. A drug utilization review and specific drug therapy plans were formulated by pharmacy students. The project identified general problems susceptible to institutional as well as individual remedy. The students were led beyond their initial preoccupation with "physical complaints" to interest in pertinent psychological, social, and economic factors. A model of geriatric education for health science students can productively link the health science center and community nursing homes with benefits for the student, the patient, and the nursing home.


Extramural training of medical students: lessons from Southeast Asia. Several medical schools in Southeast Asia have identified deficiencies in their undergraduate medical education that result in inappropriate training of students for the health-care problems that exist in their respective countries. Curriculum changes have been made that take students out of the laboratory and the subspecialty-oriented university hospital and place them in extramural programs in the community. Both the deficiencies identified and the solutions developed merit study by North American medical educators, especially those teaching primary care in family practice.


Human relations training for family practice residents: a four year retrospective review. The Family Practice Center of Akron has developed and implemented a human relations training program as an integral part of the family practice residency curriculum. Following two years of planning and experimenting, a 12-month course of study was formalized in July 1975. Two full-time behavioral scientists are responsible for planning, coordinating, and teaching the curriculum. The curriculum includes a variety of learning experiences throughout the three years and represents approximately ten percent of educational programming and costs.


A competency-based curriculum in business practice management. Business management skills are an essential part of an efficient medical practice, but they are largely neglected or ignored in residency training programs. In order to realistically prepare physicians for their future community practices, the Family Practice Residency Training Program at the University of California, Los Angeles, includes a business practice management curriculum based on 12 behavioral objectives. Through observation, seminars, consultation, and practice design, the resident becomes competent in the skills and behaviors necessary for effective management. Over the three-year period, the resident completes a handbook with research findings, and designs elements of his/her own future practice. The instructor's manual is included to illustrate and clarify methods of implementation and evaluation of the curriculum.


House call patterns of New Jersey family physicians. House call attitudes and practice patterns of New Jersey family physicians were studied in order to assist residency programs in curriculum development. House calls were offered by 82 percent of the 290 physicians in the sample; no difference was noted between rural and urban or between younger and older physicians. The average number of house calls per week was 6.05, of which 4.71 and 1.34 were scheduled and emergency respectively. Patients who were elderly, home-bound, had suffered a stroke, had cancer or congestive heart failure made up the majority of those receiving house calls. This survey also showed that many of the physicians who stated that they do not "offer" house calls to their patients, did in fact perform them. These study results support the thesis that family practice residencies should develop criteria and a protocol for house calls. Among the results which may be expected following such an innovation are increased satisfaction for patients and physicians alike.


Doctor's other office, an alternative to the emergency room. Doctor's Other Office (DOO), a group of ten family physicians, offers after-hours and weekend health care to non-critical patients who might otherwise go to a hospital Emergency Room, even though their medical problems do not require expensive, elaborate facilities of the Emergency Room. Advantages to patients include less expense than the ER, care that is appropriate to their needs, and comprehensive, continuous care through dealing with physicians who will follow through with referral to a regular physician, often the patient's own family physician. DOO physician members enjoy a rational division of after-hours and weekend coverage among colleagues that permits more free time, yet assures that patients receive good quality, continuous care. The methods of operation are discussed, including personnel schedules, consultants, hospital coverage, and finances. The DOO income just meets office expenses, however, life insurance and other fringe benefits that physician members receive through the corporation aid in making this organization more financially attractive.


An integrated medical record and data system for primary care. Part 1: the age-sex register: definition of the patient population. This is the first of series of articles which describes an integrated system for recording medical data. The age-sex register is described in detail. Uses of the register include enhanced capabilities for office management, assessment of postgraduate educational needs, outreach, audit, and research. The problems encountered with definition of the practice size are discussed. Subsequent articles will describe a classification of health problems, a diagnostic index, family folders, filing patients records by geographic location, problem-oriented medical records, encounter forms, and various record forms.


Elevated blood pressure in the young adult. This paper discusses elevated blood pressure, particularly as related to young adults, and suggests that this problem be considered in two subgroups. The first subgroup is termed "labile blood pressure" and not "labile hypertension". In this subgroup are those patients in whom the diastolic blood pressure is normal most of the time and elevated only occasionally. Such patients only require reassurance, although they should be followed to be certain that they do not develop hypertension. The second subgroup includes those who are found to have consistent mild elevations in diastolic blood pressure. Treatment is recommended for this subgroup. An outline of the evaluation and management is presented.


Cytodifferentiation in the accessory glands of Tenebrio molitor II. Patterns of leucine incorporation in the tubular glands of post-ecdysial adult males. The tubular accessory gland of male mealworm beetles undergoes rapid and progressive terminal differentiation in the 8-day period after ecdysis to the adult. Total protein and RNA content are maximal at five and eight days respectively. Rates of leucine incorporation rise gradually through the first four days and then increase abruptly in the 5-to 7-day interval. SDS-polyacrylamide gel electrophoresis demonstrates a variety of proteins; two classes with high mobility (Class A and B) appear prominent in homogenates of 5- to 8-day glands. Double-label procedures show that as the glands mature, an increasing proportion of the total leucine incorporation passes into Class A and B proteins, until at eight days, Class A and B proteins account for 50% of the total for the gland. The relative incorporation into A vs. B also changes linearly over this interval. The developmental program of the tubular gland includes both a linearly biosynthetic increase in the proportion of differentiation-specific proteins and an abrupt change in the overall rates of leucine incorporation.


Relationship between net 45calcium influx across a perfused isolated eel gill and the development of post-stanniectomy hypercalcemia. The net 45calcium influx was measured in perfused isolated individual hemibranchs taken from Anguilla rostrata L. at various intervals following the surgical removal of the Corpuscles of Stannius. Total plasma calcium concentrations were recorded at the same time. A relationship between the development of post-stanniectomy hypercalcemia and the net rate of 45calcium uptake in the isolated gills is suggested. The net influx of 45calcium increased rapidly during the first week, peaked at two weeks and dropped back to control levels at three weeks. Plasma calcium levels followed the same trend over the first two weeks but continued to rise through the third week before dropping slightly during the fourth week. We conclude that the corpuscles of Stannius play some role in controlling the branchial uptake of calcium and that the gills are of primary importance in the appearance of post-stanniectomy hypercalcemia.


The resistance of the septum of the median giant axon of the earthworm. It is generally thought that nexuses constitute low-resistance pathways between cell interiors in epithelial, neural, muscular, and even connective tissues. However, there are no reliable estimates of the specific resistance of a nexus. The reason for this is that in most cases the surfaces of nexuses between cells are geometrically complex and therefore it has been very hard to accurately estimate nexal areas. However, the septa of the median giant axon have a relatively simple shape. Moreover, in this preparation, it is possible to make a measuring current flow parallel to the axon axis so that from the voltage difference appearing between intracellular electrodes during current flow, the specific septal membrane resistance could be calculated. The average specific nexal resistance obtained was 5.9 omega cm(2) if one assumes that 100 percent of the septum is nexus. The steady state I-V curve for the septum is linear (+/- 10 mV). Placement of electrodes was validated by septa even though the septa were found to be permeable to fluorescein and TEA. Exposure of the axon to hypertonic saline impedes the movement of fluorescein across the septa. By analogy with other tissues it is concluded that hypertonic solutions disrupt nexuses.A mathematical model was derived which predicts the steady- state transmembrane potential vs. distance from a point source of intracellular current. When the specific nexal membrane resistance is 5.9 omega cm(2), the prediction closely approximates the fall of transmembrane potential vs. distance in an ordinary infinite cable. This is commensurate with the electrophysiological behavior of this multicellular "axon."


Volume regulation by flounder red blood cells in anisotonic media. The nucleated high K, low Na red blood cells of the winter flounder demonstrated a volume regulatory response subsequent to osmotic swelling or shrinkage. During volume regulation the net water flow was secondary to net inorganic cation flux. Volume regulation the net water flow was secondary to net inorganic cation flux. Volume regulation after osmotic swelling is referred to as regulatory volume decrease (RVD) and was characterized by net K and water loss. Since the electrochemical gradient for K is directed out of the cell there is no need to invoke active processes to explain RVD. When osmotically shrunken, the flounder erythrocyte demonstrated a regulatory volume increase (RVI) back toward control cell volume. The water movements characteristic of RVI were a consequence of net cellular NaCl and KCl uptake with Na accounting for 75 percent of the increase in intracellular cation content. Since the Na electrochemical gradient is directed into the cell, net Na uptake was the result of Na flux via dissipative pathways. The addition of 10(-4)M ouabain to suspensions of flounder erythrocytes was without effect upon net water movements during volume regulation. The presence of ouabain did however lead to a decreased ration of intracellular K:Na. Analysis of net Na and K fluxes in the presence and absence of ouabain led to the conclusion that Na and K fluxes via both conservative and dissipative pathways are increased in response to osmotic swelling or shrinkage. In addition, the Na and K flux rate through both pump and leak pathways decreased in a parallel fashion as cell volume was regulated. Taken as a whole, the Na and K movements through the flounder erythrocyte membrane demonstrated a functional dependence during volume regulation.


Enhancement and phototransduction in the ventral eye of limulus. Limulus ventral photoreceptors were voltage clamped to the resting (dark) potential and stimulated by a 20-ms test flash and a 1-s conditioning flash. At a constant level of adaptation, we measured the response to the test flash given in the dark (control) and the incremental response produced when the test flash occurred within the duration of the conditioning flash. The incremental response is defined as the response to the conditioning and test flashes minus the response to the conditioning flash given alone. When the test flash was presented within 100 ms after the onset of the conditioning flash we observed that: (a) for dim conditioning flashes the incremental response equaled the control response; (b) for intermediate intensity conditioning flashes the incremental response was greater than the control response (we refer to this as enhancement); (c) for high intensity conditioning flashes the incremental response nearly equaled the control response. Using 10-mum diam spots of illumnination, we stimulated two spatially separate regions of one photoreceptor. When the test flash and the conditioning flash were presented to the same region, enhancement was present; but when the flashes were applied to separate regions, enhancement was nearly absent. This result indicates that enhancement is localized to the region of illumination. We discuss mechanisms that may account for enhancement.


Beneficial effect of fluorocarbon emulsion media on the function of neuromuscular preparations in vitro. The effects of liquid fluorocarbons as bathing media were determined by use of in vitro neuromuscular preparations. Rat hemidiaphragms were bathed in either oxygenated fluorocarbon (FC) emulsion or standard oxygenated Krebs solution. Contractile force in response to simple supramaximal nerve stimuli as well as to high frequency stimulation was greater, while twitch:tetanus ratio was smaller in FC emulsion. With such medium, post-tetanic potentiation of contraction was also more consistently observed. Indirectly stimulated diaphragms survived longer in FC emulsion. After cessation of oxygenation, oxygen tension (rhoO(2)) of the medium declined more rapidly with Krebs than with FC emulsion; rhoO(2) directly correlated with force of contraction. Similarly, in the chick biventer cervicis preparation, FC emulsion enhanced nerve-stimulated force of contraction; returning the preparation to standard Krebs solution reversed this phenomenon. Dose-resonse curves of muscle contraction in response to acetycholine and KCl administration were shifted upward during FC emulsion superfusion. Frequency of miniature endplate potentials was lower in FC emulsion than that observed in Krebs solution, measured from the same cell of the rat diaphragm. Resting membrane potentials were also greater in muscle cells sampled from FC emulsion-bathed preparations. These data suggest that FC emulsion is superior to standard Krebs solution as a bathing medium for in vitro neuromuscular preparations by virtue of the high solubility of oxygen in it.


Effect of Zinc on tricarboxylic acid cycle intermediates and enzymes in relation to aflatoxin biosynthesis. The stimulatory action of zinc on aflatoxin production by Aspergillus parasiticus NRRL3240 has been investigated by studying the levels of tricarboxylic acid (TCA) cycle intermediates and related enzymes in the fungal mycelium. During the stationary phase of growth, the levels of alpha-keto acids declined in zinc-sufficient cultures compared with those in zinc-dificient cultures. TCA cycle enzymes did not show any significant changes due to zinc availability. In zinc-deficient cultures, enzymes of the TCA cycle had maximum activity on the fourth day, after which their activity declined. In zinc-sufficient cultures, some enzymes showed maximum activity on the fourth day, others on the second day.


The short form test of academic aptitude (SFTAA) as a determinant of minimal brain dysfunction in children. The Short Form Test of Academic Aptitude (SFTAA) has been found to yield results comparable to the Wechsler Intelligence Scale for Children. With this in mind, it was hypothesized that children with minimal brain dysfunction (MBD) would obtain significantly different results on the SFTAA than children without MBD. Two studies (N = 40 and N = 72) using randomly selected MBD and non-MBD third-grade children supported the hypothesis. In Study I, the MBD and non-MBD children were matched on IQ; in Study II, they were not. Study I found that MBD children scored better than non-MBD children on subtest four (memory). Study II illustrated an apparent reversal of this finding and concluded that IQ must be considered in this type of investigation, since it tends to mask aptitude test results.


Extremity of semantic differential ratings in deaf and hearing subjects. A comparison was made separately by sex of 19 deaf and 19 hearing Ss on mean semantic differential ratings of contradictory concept-pairs. There were nine deaf males, 10 deaf females, 11 hearing males, and eight hearing females with mean ages of 23.00, 21.90, 20.73, and 19.75, respectively. It was hypothesized that the deaf would make less extreme ratings of concept-pairs than hearing Ss and that they would shift their ratings of contradictory concept-pairs closer to the mean of the original ratings of the single concepts comprising the pairs. It was found that both predictions were true only for deaf males. Deaf females did not differ from hearing Ss.


Relational discrimination of hue by young children. Performance-acquisition of relational discrimination of the greener member of pairs of hues from among four blue to green hues and from among four yellow to green hues was related to presence or absence of instructions to choose the greener member of a pair crossed with presence or absence of information about correctness of choice. The Ss were younger (X = 49 months, N = 32) and older (X = 63 months, N = 32) white middle-class boys and girls from among those then attending a private suburban nursery school. Through 48 trials under the four combinations of instructions and information, the relational discrimination was most complete or acquired fastest with instructions to choose the greener member, regardless of presence or absence of information. Relational discrimination was less complete or acquired less rapidly with information alone, and did not occur in the absence of instructions and information.


Effects of methylphenidate on avoidance learning in the aged rat. Twenty Sprague Dawley rats, aged 22 to 26 months were given subcutaneous injections of 4.5 mg/kg methylphenidate or distilled water. Twelve minutes after the single injection was given, rats began 90 trials of avoidance conditioning. Drug animals made significantly more correct responses than did the control animals. tresults indicate that use of methylphenidate in aged rats improved avoidance learning.


Judgment of emotion in human face stimuli: an individual differences analysis. Comparative judgments of the pleasure and anger dissimilarity between 80 face pairs were made by 100 male and female college students. The 80 face-pair stimuli were constructed by a systematic interchanging and deletion of four regions for anger and neutral face poses and for pleasure and neutral face poses. An individual differences analysis of the scaling data resulted in five like-perceiving subgroups of Ss. These subgroups were characterized on the basis of their differential use of face regions in making anger and pleasure dissimilarity judgments. The study illustrates the necessity of the individual differences approach to the study of cue utilization in the perception of emotion in human face stimuli.


The explanatory value of the idea of reincarnation. The idea of reincarnation is presented as having considerable explanatory value for several features of human personality and biology that currently accepted theories do not adequately clarify. Reincarnation is not offered as a substitute for present knowledge derived from genetics and understanding of environmental influences; it may, however, usefully supplement such knowledge. The present paper does not present evidence from cases suggestive of reincarnation. It does, however, cite cases of subjects who have claimed to remember previous lives, most of whose statements have been verified in the course of detailed investigations. For each case, a reference is provided to a detailed published case report furnishing the evidence in that case. The idea of reincarnation may contribute to an improved understanding of such diverse matters as: phobias and philias of childhood; skills not learned in early life; abnormalities of child-parent relationships; vendettas and bellicose nationalism; childhood sexuality and gender identity confusion; birthmarks, congenital deformities, and internal diseases; differences between members of monozygotic twin pairs; and abnormal appetites during pregnancy. Empirical studies of cases of the reincarnation type have so far not provided any evidence that justifies using reincarnation as an explanation for the occurrence of child prodigies of the large inequities in socioeconomic conditions of humans at birth.


Endogeneity and reactivity as orthogonal dimensions in depression. Endogeneity and reactivity have long been considered polar opposites of a major dimension of depression. The present factor analytic study examines 35 distinct depressive symptoms in three depressed samples and supports the conceptualization of D. F. Klein (Endomorphic depression. Arch. Gen. Psychiatry, 31:447-454, 1974) that endogeneity and reactivity can be construed as orthogonal, independent dimensions. Symptoms consistently loading on an endogeneity factor are: 1) lacking in reactivity to environmental changes; 2)showing no interest in life; 3) retarded (slow, feeling tired, etc.); 4) feeling unable to act; 5) considering self lazy; 6) feeling helpless and powerless; and 7) perceiving depression as qualitatively different from ordinary sadness. Symptoms consistently loading on a reactivity factor are: 1) feeling that he or she is bearing troubles; 2) presence of precipitating stress; 3) crediting problems to excessive family and/or job responsiblitiies; 4) expressing concern for welfare of family and friends; 5) visceral symptoms; 6) feeling at "end of rope"; 7) having middle-of-the-night insomnia; and 8) showing self-pity. The results suggest a methodology for identifying depressives who are high-high, low-high, high-low, and low-low on the endogeneity and reactivity factors.


Premorbid social competence and paranoid-nonparanoid status in female schizophrenic patients. The relation between premorbid social competence and paranoid-nonparanoid status was examined in a sample of 300 female schizophrenic patients. The subjects were drawn from the same state hospital employed in an earlier study conducted with male patients. The female paranoid patients were found to have better premorbid adjustment histories than the female nonparanoids. Tentative evidence was presented suggesting that the difference in premorbid social competence between paranoid and nonparanoid groups was greater for first and second admission patients than for patients with three or more admissions. The results were discussed in the context of their relation to previous research in this area. Differences between the female and male studies were noted, and the implications of sex differences in social competence were discussed both in terms of conventional measures of social competence and of the competence construct itself.


Incidence of the 14 and 6 per second positive spike pattern in an adult clinical population: an empirical note. Although 14 and 6 per second positive spiking in children and adolescents  has received extensive investigative attention resulting in conflicting results and opinion, efforts to study this finding in adult populations have been almost totally neglected. The present study attempts to contrast the incidence of this EEG finding in an adult clinical psychiatric sample with similar incidence data derived froma historical normal adult control series. From 10 years of laboratory data, the presence or absence of positive spikes was noted in the waking and sleep EEGs of 2888 psychiatric patients aged 20 and above. These incidence figures were contrasted with similar data derived from the EEG'S of 619 normal adults of similar age collected in a previously published control series. A differentially higher incidence of positive spiking in the adult clinical population as contrasted with the adult normal control population occurred with a high level of statistical significance. Methodological and technological aspects of electroencephalographic recording for the current clinical group and the historical control population are felt to be virtually identical and the possible effect of differential recording or interpretive practice confounding the present results does not seem plausible. The present results offer no solution or resolution of the positive spike controversy. They do, however, suggest that additional focus on this EEG signal in adults may possibly have merit.


Opium and heroin addicts in Laos. I. A comparative study. Students of narcotic addiction have believed that heroin addiction is more debilitating than the "traditional" opium addiction. Access to both opium and heroin addicts in a Laotian treatment facility provided an opportunity to test this hypothesis. All subjects were volunteer narcotic addicts seeking treatment at an inpatient detoxification facility over a 12-month period. The research format consisted of five demographic characteristics, four aspects of past narcotic usage, and three aspects of current narcotic usage. Fifty-one heroin addicts were compared to 438 opium addicts. Many of the demographic differences in the two groups reflected the urban residence of most heroin addicts and the mixed urban-rural residence of opium addicts. Heroin addicts had more frequent daily doses of drug, spent considerably more money for their drug, and required higher initial methadone doses for detoxification. It also appeared that heroin addicts might have "deteriorated" faster and thus sought treatment earlier than opium addicts. Since the heroin and opium addicts in this study differed significantly on most demographic characteristics, it was difficult to know whether these observed differences were due to drug factors or demographic factors. Thus, a study of pairs matched for age, sex, and ethnicity was subsequently undertaken to test the hypotheses generated by this study.


Opium and heroin addicts in Laos. II. A study of matched pairs. Fifty-one Asian heroin addicts in Laos were matched for sex, ethnicity, and age with 51 opium addicts. All subjects were voluntary patients at a treatment facility for addicts. The two groups were compared for demographic characteristics, past narcotic history, current narcotic use, and readmission within 1 year following discharge from treatment. Heroin addicts took more doses of drug per day, spent more money per day on narcotic drugs, required higher detoxification doses of methadone, and sought treatment much sooner than did opium addicts. The two groups did not differ for duration of narcotic use prior to becoming addicted, or for rate of readmission following treatment. Demographic differences in occupation and employment reflected the urban distribution of heroin addicts, and the mixed urban-rural residence of opium addicts. These data suggest that heroin is not per se more or less apt to produce addiction (i.e., is not more "addictogenic") as compared to opium. The type of narcotic drug also does not appear to be an important factor in determining treatment outcome. However, heroin does appear to be more "pathogenic" than opium, since heroin addicts sought treatment much sooner than did opium addicts. This may have been due to economic factors (i. e., heroin addicts took more doses per day, spent more time in phases of intoxication and withdrawal, and spent less time in the middle phase with work and other coping behaviors). Opium addiction is not a "benign" or "social" form of addiction. In comparison to heroin, however, opium does cost less, requires fewer doses per day, and has a less toxic withdrawal (at least in the initial phase). Moreover, opium apparently takes longer to produce life crises that motivate the addict to seek treatment.


Mania during maintenance hemodialysis successfully treated with oral lithium carbonate. A 25-year-old maintenance hemodialysis patient suffered an episode of mania. Oral lithium carbonate given as a single 600-mg dose following each dialytic treatment sustained serum lithium levels in the 0.6 to 0.8 mEq/l range. Clinical remission occurred quickly and was maintained throughout a 6-month follow-up period. No significant side effects were noted.


Depersonalization in accident victims and psychiatric patients. A transient depersonalization syndrome was identified in nearly one third of persons exposed to life-threatening danger (accident victims) and close to 40% of a group of hospitalized psychiatric patients. Although the syndrome was similar in these populations, mental clouding developed more commonly among patients and alertness was more prominent among accident victims. Anxiety was significantly associated with the development of depersonalization among psychiatric patients and was almost certainly a factor in its appearance among accident victims. The findings suggest that this syndrome is a specific response to extreme danger or its associated anxiety.


Psychopathology in children of inpatients with depression: a controlled study. One quarter of 29 parents hospitalized for depression had children with episodes of depression (eight out of a total of 75 children). None of the children in 41 families with well parents had episodes of depression (a total of 152 children). The differences were significant at the .01 level. It is suggested that symptoms "equivalent" to depression such as hyperactivity, deviant behavior, and learning difficulties are not required in establishing clinical depression in childhood. The methodological shortcomings in this study were discussed.


CSF hydrodynamic studies in man. 1. Method of constant pressure CSF infusion. The constant pressure method for the study of the hydrodynamics of CSF is presented. By infusing artificial CSF at constant pressures and recording the resultant flow, it is possible to obtain information about the hydrodynamic conductance of the CSF outflow pathways. By lowering the infusion pressure below the pressure of the sagittal sinus all CSF produced can be collected and the CSF formation rate may thus be calculated. There is a rectilinear relationship between CSF pressure and the flow necessary to maintain the pressure. It is thus concluded that the arachnoidal villi, when once opened, are not further distended by pressure. This method makes possible indirect calculation of the pressure of the sagittal sinus and the pressure difference between the subarachnoid space and the sagittal sinus.


Sump drainage: a palliative manoeuvre for the treatment of craniopharyngioma. A sump system was used as a palliative manoeuvre in the treatment of four cases of cystic craniopharyngioma. Percutaneous needling of the subcutaneous reservoir enabled the fluid contents of the tumour to be evacuated with considerable therapeutic effect. Radiotherapy was combined with this manoeuvre in two cases. The three successfully treated patients have been followed up for 3 1/2, five, and 5 1/2 years. The manoeuvre is not original. It is simple, safe, effective, even in the long term, and worthy of consideration in the treatment of a condition of acknowledged uncertain natural history and surgical difficulty.


Supratentorial intracerebral epithelial (ependymal) cysts: review, case reports, and fine structure. The paper concerns the rare supratentorial, intracerebral or convexity cysts in adults having a wall lined with an epithelium resembling ependyma. The clincopathological aspects of such cysts are reviewed from 15 published cases and two specimens of the authors which could be examined with the electronmicroscope. These cysts manifest at a median age of 46 years as progressive, space occupying lesions with a fairly rapid clinical course of about one to two years. Twelve of 17 cysts were located in the frontal lobes, most were unequivocally intracerebral and none communicated with the lateral ventricle. Microscopic examination of the cyst wall disclosed some variance in structure, the most common feature being a monolayer of ciliated cells sitting on a very thin collagen membrane. One of the present cases was unique in that the compression by the cyst had caused a shell of infarction in the encompassing tissue. The fine structure of the cysts is described and compared with that of potential host tissues from which such cysts may originate. It is concluded that the cysts arise from displaced segments of the wall of the neural tube which correspond to the sites from which the tela chorioidea forms.


Postural changes in plasma renin activity and responses to vasoactive drugs in a case of Shy-Drager syndrome. A male aged 47 years with gross autonomic insufficiency as part of the Shy-Drager syndrome is described. He did not sweat normally when warmed, and his circulatory responses to mental arithmetic, the Valsalva manoeuvre, and head-up tilt were abnormal indicating severe sympathetic failure. During head-up tilt there was a rise in plasma renin activity and plasma aldosterone. It is argued that plasma renin activity is not dependent on sympathetic nervous activity and may be mediated by renal baroreceptors. These rises may help sustain the blood pressure in such patients during repeated head-up tilts. Infusions of L-noradrenaline and angiotension produced greater hypertension, and injections of isoprenaline greater hypotension than in controls. Although it is difficult to exclude the possibility that one factor in this may be hypersensitivity of receptors in blood vessel walls, the principal factor is likely to be the absence of those baroreflexes of which the efferent pathways are in the sympathetic nervous system.


Hypertension and papilloedema in the Guillain-Barré syndrome. Three patients with the Guillain-Barré Syndrome are described, one of whom was relapsing. Hypertension persisted for three to four months in two patients, associated with increased urinary excretion of catecholamines. Baroreceptor sensitivity, although depressed, did not explain the hypertension. It may be due to lesions affecting either central vasomotor control or peripheral sympathetic nerve activity. Two patients had papilloedema. This has been attributed in the literature to defective reabsorption of CSF due to high protein concentration. Normal reabsorption of isotope labelled albumin from the subrachnoid space argues against this explanation in our cases.


A quantitative electrophysiological study of acute idiopathic polyneuritis. The motor unit content and the dimensions of individual motor unit action potentials were studied in 17 patients with acute idiopathic polyneuritis from one week to 9 1/2 years after the onset of the illness. An initial decrease in motor unit numbers is followed by a progressive increase with the passage of time from the onset of the illness. The latencies, areas, amplitudes, and durations of individual motor unit potentials were increased above normal values. The results suggest the presence of significant axonal damage in the majority of cases of acute idiopathic polyneuritis. The intramuscular nerve fibres are the site of most severe electrophysiological dysfunction in this study.


Plasma DOPA levels and growth hormone response to levodopa in parkinsomism. It has been suggested that the therapeutic response to levodopa in patients with Parkinson's disease may be related to changes in plasma growth hormone concentration. In order to examine this problem, we have determined plasma DOPA and growth hormone levels after a standard oral levodopa load in 32 patients with Parkinson's disease. Levodopa caused an increase in plasma growth hormone concentration in 30 subjects. The magnitude and timing of this growth hormone response was not related to the clinical response, the presence or absence of response swings, or the occurrence of dyskinesias. The growth hormone response to levodopa is normal in patients with Parkinson's disease and not altered by long-term levodopa treatment.


Long chain polyunsaturated fatty acids in endogenous depression. The fatty acid composition of the plasma choline phosphoglycerides (CPG) and erythrocyte ethanolamine phosphoglycerides (EPG) were detemined in a series of patients suffering from endogenous depression, a number of patients from the same ward with non-depressive psychiatric disorders, and a number of age- and sex-matched healthy control subjects. A significantly higher proportion of long chain polyunsaturated fatty acids, in particular eicosapentaenoic acid (20:5omega3) and docosahexaenoic acid (22:6omega3), was found in the subjects with endogenous depression compared with the controls. This change was reflected to a lesser extent in the erythrocyte EPG. The proportions of the two prostaglandin precursors gamma-dihomolinolenic acid (20:3omega6) and arachidonic acid (20:4omega6) were similar in both groups. The fatty acid composition of the plasma CPG and erythrocyte EPG of a number of subjects from the same ward with non-depressive psychiatric disorders did not differ from that of the healthy controls. It is suggested that the analysis of the fatty acid composition of plasma CPG may be of diagnostic value and could be involved in the pathology of endogenous depression.


Effects of oral amines on the EEG.

Effects of oral amines on the EEG. Oral tyramine activated pre-existing episodic EEG abnormalities--namely, sharp waves, spike and wave, and localised theta activity--in epileptic patients. Little change was found in the EEGs of migrainous subjects after chocolate or beta-phenylethylamine. The implications of the findings with tyramine are discussed.


Symptomatic cataplexy.

Symptomatic cataplexy. The case is described of a man who developed attacks of cataplexy, narcolepsy, and sleep paralysis because of microglioma which infiltrated the walls and floor of the IIIrd ventricle and the upper brain stem. The mechanisms by which the pathology is related to the symptoms are discussed.


Painful tic convulsif.

Painful tic convulsif. Painful tic convulsif is a syndrome restricted to paroxysmal dysfunction of the fifth and seventh cranial nerves. It occurs primarily in women over the age of 50 years and is usually associated with an ectatic vertebrobasilar artery--less frequently an arteriovenous malformation or cholesteatoma--which compresses the trigeminal and facial nerve roots in the posterior fossa. In rare instances this syndrome may be caused by disseminated sclerosis. Because of the high incidence of posterior fossa lesions in painful tic convulsif, a complete neurological evaluation including computerised transaxial tomography and vertebrobasilar angiography should be performed in every case.


Why does hydrocephalus progress?

Why does hydrocephalus progress? Experimental results in rabbits support the hypothesis that occlusion of the cerebral subarachnoid space, resulting in an increased strain-stress ratio in the ventricular wall, is the mechanical basis of chronic progressive hydrocephalus within a rigid skull. When the cerebral subarachnoid space was drained through an artificial low-resistance fluid pathway, the wall of the olfactory ventricle showed edema that was indistinguishable from the edema of kaolin hydrocephalus. Increased CSF pressure did not produce edema of this grade when the cerebral subarachnoid space was patent. When the subarachnoid space surrounding the right olfactory bulb was occluded with silicone rubber, the right but not the left olfactory ventricle enlarged; resistance to cerebrospinal fluid absorption remained normal.


The peroneal muscular atrophy syndrome. Clinical genetic, electrophysiological and nerve biopsy studies. Part 3. Clinical, electrophysiological and pathological correlations. This report analyses correlations between clinical, electrophysiological and pathological data derived from a series of families with peroneal muscular atrophy. It was found that the observed differences between families in median nerve forearm motor conduction velocity were unlikely to be due to differences in the age or severity of the cases. Similarly it it was unlikely that the pathological differences between cases were due to age or severity of the case. The conduction velocity in the Hypertrophic Neuropathy Group tended to increase slightly with age, while that in other cases tended to fall slightly. The conduction velocity and total myelinated fibre counts were inversely related to the degree of segmental demyelination. The Hypertrophic Neuropathy Group and the Intermediate Group of cases were found to behave differently in a number of correlative analyses, thus supporting the suggestion that they represent different disease entities.


Serum pyruvate kinase in carriers of Duchenne muscular dystrophy. Five out of 17 carriers of the gene for Duchenne muscular dystrophy had an increased level of serum pyruvate kinase activity, whilst 11, including the same 5, showed an increase in serum creatine kinase.


A case of chronic demyelinating polyneuropathy resembling the Guillain-Barré syndrome. A case of demyelinating polyneuropathy is reported which was clinically and pathologically indistinguishable from the Guillain-Barré syndrome, with the exception that the symptoms progressed steadily for 7 months. Pathologically, the peripheral nerves and intraspinal roots showed selective demyelination with axonal sparing and patchy mononuclear inflammation. The posterior columns of the spinal cord also showed selective demyelination with axonal sparing. The simultaneous destruction of central and peripheral myelin is discussed in relation to the immune theory for the Guillain-Barré syndrome. Numerous anterior horn cells showed severe chromatolysis although there was little axon loss. It is suggested that chromatolysis may occur after severe and longstanding demyelination.