Evoked potential alterations in methylmercury chloride toxicity. The present study was designed to assess the sensitivity of evoked potential techniques to detect alterations in offspring exposed to methylmercury chloride (MMC) at different developmental periods. Recordings were obtained from the visual cortex (VEP) and lateral geniculate (LGP) in 30-day old offspring. Results revealed decreased VEP latencies for peaks N1, P1, and P2 in offspring from mothers exposed either during gestation, or nursing and in offspring exposed directly to MMC for 9 days after weaning. Although not significant, a similar trend was observed in the LPG. It is suggested that the decreased latencies may be a result of compressed brain development.


Effects of carbon monoxide on fixed-consecutive-number performance in rats. Four rats were trained under a fixed-consecutive-number (FCN) schedule to make sequences of 20 or more consecutive responses on one lever followed by a single response on a second lever. When performance was stable, they were exposed to 200, 400, and 600 parts-per-million (PPM) carbon monoxide (CO) for either 30 or 60 min before and during a 45-min session. Decreases in response rate at CO levels as low as 200 ppm were due to both decreased local response rate and extended pauses. A lowered percentage of reinforcement, due to decreases in response sequence length, was also found at CO levels as low as 200 ppm. This decreased sequence length may reflect effects of CO on response rate, or a disruption of discriminative aspects of FCN schedule performance.


Role of experience in acquisition and loss of tolerance to the effect of delta-9-THC on spaced responding. Albino rats were given extensive training in spaced responding, using a DRL 30 sec schedule of food reinforcement (only lever presses more than 30 sec apart were reinforced). All rats then went 12 days without behavioral testing. During this period half the rats received daily intragastric doses of delta-9-tetrahydrocannabinol (THC) and the rest equal volumes of the THC vehicle. On day 13, some rats received THC 3 hr before behavioral testing while others received only vehicle. The former showed a sharp increase in lever press rate over baseline levels, but the vehicle control rats were unaffected. The rats with 12 prior THC doses were no less affected than those with no previous drug history. Continued testing resulted in recovery of baseline performance within 5 sessions, again with no effect of previous drug history. Similar results were obtained with doses of 4 mg/kg and 16 mg/kg, though the drug's effects were more pronounced at the higher dose. These results demonstrate that performance in the drug state can be a far more important determinant of tolerance than mere exposure to THC. Drug administration was then suspended for 1 week. Rats that had become tolerant to 4 mg/kg THC were then redivided into 3 new groups. One group received daily doses of vehicle and DRL sessions, a second received DRL sessions without vehicle, and 1 group received neither vehicle nor DRL sessions for this week. Subsequent DRL testing after THC administration showed that only the groups receiving DRL sessions in the intervening week lost their previously acquired tolerance. Experience thus appears to play an important role in loss of tolerance to THC as well as in acquisition of tolerance.


Intraventricular anti-cholinergics do not block cholinergic hippocampal RSA or neocortical desynchronization in the rabbit or rat. Electroencephalographic (EEG) electrodes and ventricular cannulae were implanted in 8 rabbits and 12 rats. Two anti-cholinergic agents, atropine sulfate and scopolamine hydrobromide, were given systemically (1-50 mg/kg) and intraventricularly (5-800 mug). Systemic but not intraventricular injections blocked sensory stimulation-induced or eserine-induced neocortical desynchronization and hippocampal RSA in rats and rabbits which were immobile and either undrugged or ethanol intoxicated. Systemic injections also blocked hippocampal RSA but not neocortical desynchronization in rats given sensory stimulation under urethane anaesthesia, while intraventricular injections only reduced RSA amplitude. Neither systemic nor intraventricular injections blocked neocortical desynchronization or hippocampal RSA recorded from animals when they walked in a motor driven wheel. These experiments support the hypothesis that there are two types of neocortical desynchronization and hippocampal RSA, one cholinergic and one non-cholinergic. They also suggest that atropine and scopolamine pass more readily to the neural system responsible for cholinergic EEG activity from the capillary bed than from the ventricular fluid.


Interaction of d-amphetamine with pentobarbital and chlordiazepoxide: effects on punished and unpunished behavior of pigeons. Key pecking of two pigeons was maintained under a multiple schedule of food presentation. In the presence of one keylight stimulus responding produced food according to a fixed-interval 5-min schedule. Additionally, during this component, each 50th response produced electric shock. When a different keylight stimulus was present, key pecking resulted in food delivery under a variable-interval 3-min schedule. Responding was suppressed by shock presentation (punishment) but was still positively accelerated throughout each fixed-interval cycle; steady response rates occurred during the alternate component when only the variable-interval schedule was in effect. Overall rates of punished responding were largely unchanged with d-amphetamine (0.1-3.0 mg/kg); unpunished responding was generally either increased slightly or was decreased. Pentobarbital and chlordiazepoxide (1.0-17.0 mg/kg) administered alone increased both punished and unpunished responding at most doses. Combinations of d-amphetamine with either pentobarbital or chlordiazepoxide produced increases in punished responding that exceeded those obtained with either of these drugs alone. The combined effects of d-amphetamine and either pentobarbital or chlordiazepoxide on unpunished responding depended on the individual dose combinations. Combinations of d-amphetamine with pentobarbital or chlordiazepoxide produced effects on both punished and unpunished responding that differed substantially from those obtained when any of these drugs were administered separately.


Dissociation of the effects of scopolamine and d-amphetamine on a spontaneous alternation task. The immediate and carry-over effects of scopolamine and d-amphetamine were evaluated in a free running Y-maze spontaneous alternation task. The immediate effect of scopolamine (1.0 mg/kg) or d-amphetamine (5.0 mg/kg) was to reduce alternation to chance or to levels significantly below chance (perseveration), respectively. On a second, non-drug test day alteration decreased in saline treated animals, but increased among mice which received scopolamine on Day 1. In contrast, upon retesting in the non-drug state, the performance of animals initially treated with d-amphetamine resembled that of saline treated mice. Subsequent experiments revealed that these effects could not be attributed to drug effects on peripheral mechanisms, consolidation, residual drug action or drug dissociated learning. It was concluded that the behavioral effects of scopolamine and d-amphetamine are qualitatively different. Whereas scopolamine disrupts habituation, d-amphetamine induces perseveration independently of any effects on habituation.


Triethyltin toxicity as a model for degenerative disorders. Triethyltin (TET) toxicity in mice was examined as a model for certain degenerative disorders. Spontaneous and elicited behavioral tests, electrophysiological measures and nervous system protein characterizations were used to study anomalies resulting from TET treatments. TET animals exhibited lowered spontaneous locomotor activity levels, increased sciatic nerve excitation threshold and conduction velocities, and increased power levels in the slower frequency components of their electroencephalograms. Performance in an active avoidance task suggest that the gross ultrastructural changes commonly seen in TET intoxication are not primarily responsible for the observed neurophysiological changes. Possible sites of action of TET, in both the peripheral and central nervous systems, that would produce these neurophysiological changes and the relationship of these changes to the behavioral symptoms are discussed.


Effects of intracranial injections of 6-OHDA on food and water intakes, body temperature and body weight regulation in the rat. 6-Hydroxydopamine was injected either intraventricularly (320 mug in 10 mul) or intrahypothalamically (64 mug in 2 mul) into rats kept under either free feeding or body weight reduced conditions. Intraventricular injections caused a temporary aphagia and hypodipsia in free feeding rats but daily measurements failed to reveal any long term effects; body weight reduced rats did not display the temporary aphagia but were initially hyperphagic. Injections into the more rostral hypothalamic areas of free feeding rats also showed only minimal short term effects; however, some of the body weight in both body weight reduced group died within several days of injection. Injections made at more posterior loci again showed very little effect in both body weight reduced and free feeding groups; some temporary disruption of feeding occurred from lesions in the proximity of the zone incerta of some free feeding animals.


Effects of acute and chronic administration of caffeine on schedule dependent and schedule induced behavior. The effects of caffeine (3.125, 6.25, 12.5, 25, 50, and 100 mg/kg) on lever pressing, schedule induced licking and water consumption induced by a fixed interval 1 min schedule were studied. Changes in these dependent variables were assessed when animals were reduced to 80% of their initial body weight by partial food deprivation and when body weights recovered after the animals were returned to conditions of ad lib feeding. Results indicate differential effects of the drug between animals at 80% body weight and when they are permitted to recover. Tolerance was examined for a single large dose only for the same dependent variables in animals at 80% body weight.


Enhancement of effects of dopaminergic agonists on neuronal activity in the caudate-putamen of the rat following long-term d-amphetamine administration. Amphetamine- and apomorphine-induced changes in the activity of neurons in the caudate-putamen of paralyzed, locally anesthetized rats were recorded in animals pretreated with 2.5 mg/kg d-amphetamine sulphate for 6, 18 or 36 days, or in animals pretreated with saline for 36 consecutive days. In saline-pretreated animals, 2.5 mg/kg d-amphetamine sulphate (IP) produced an initial, brief potentiation of neuronal firing that was followed by a marked depression of neuronal activity lasting for approximately 35 to 110 min after injection. In amphetamine-pretreated animals, this depression of neuronal activity to the same dose of the drug was markedly prolonged, especially in animals given 36 consecutive days of d-amphetamine pretreatment. A similar enhancement occurred in response to 0.25 mg/kg apomorphine (IP) in animals pretreated with amphetamine for 36 days compared to saline-pretreated control animals. These results are discussed in relation to the known behavioral and biochemical effects of acute and long-term amphetamine administration.


Simple flow-thru swivel for infusions into unrestrained animals. Infusion of fluids into unrestrained animals requires the use of a flow-thru swivel. A method is described for the construction of a simple efficient swivel assembled from disposable plastic syringes and needles.


Effects of methadone on activity and on brain monoamines in two strains of mice. Two strains of mice (C57BL/6J and DBA/2J) were used to determine the effects of single and multiple injections of methadone on open field activity and on brain monoamines. For the DBA strain, the initial injection of methadone produced an attenuation of locomotor activity. After 7 daily injections, activity increased to that of controls. For the C57 strain, the initial injection produced a slight increase in activity which became more pronounced after further daily injections. Norepinephrine concentration was elevated in brains of DBA mice chronically exposed to methadone. This effect was not observed in C57 mice nor in either strain injected only once with the drug. Serotonin concentration was not altered in animals of either strain whether acutely or chronically exposed to methadone. The results of this study suggest: 1) that activity change following methadone injections is dependent upon genetic factors and previous experience with the drug; 2) that the tolerance develops to the drug produced decreases but not increases in activity; and 3) that chronic exposure to the drug can elevate norepinephrine concentration in the brains of DBA mice.


Lithium-magnesium relationship in red blood cells during lithium prophylaxis. The authors investigated lithium and magnesium levels in serum and RBC in 30 patients with affective disorders during lithium prophylaxis. No differences in magnesium levels were found in relation to diagnosis (unipolar, bipolar), sex and age. Mean RBC lithium index was higher in females than in males, particularly in bipolar patients. Magnesium levels in erythrocytes showed a significant negative correlation with RBC lithium and RBC lithium index. Serum magnesium levels did not correlate of lithium concentrations. It was concluded that RBC magnesium may play a role in lithium penetration of RBC and this was discussed in relation to clinical and pathogenetic factors.


[Comparison of evaluation scales and performance tests for measuring the severity of cyclothymic depressions]. Usually the severeness of cyclothymical depression is assessed by self-or arbiter's evaluation scales. These assessments are influenced by - mainly verbal - disturbing variables that hitherto may hardly be controlled. Measurements of performance provide less falsified results. However, they are influenced by the premorbid level of general intelligence and by the age of the patient. These disturbing variables, however, can be controlled rather well. Empirical investigations show that the assessment of the severeness of cyclothymical depression measured by performance tests of evaluation scales leads to different results. Nevertheless, both types of tests are valid for measuring depressions. Therefore, both are to be taken into account for assessment of severeness.


Planning infant learning programs.

Planning infant learning programs. Based on a review of the literature, a theoretical basis for planning learning programs for infants is presented. The prerequisites for effective programming include attention to the characteristics of the learning environment, the infant or learner, and the stimulus-response mechanism. The goals of such a program include provision of sensorimotor experience and promotion of infant attachment to a mother or mother-surrogate as a basis for establishing a sense of security and competency in the infant. The parent must be taught to recognize the infant's best periods of alertness, develop sensitivity to the infant's signals, and utilize appropriate stimulation routines in interactive patterns in order to create an environment most conducive to cognitive development. Specific program content may be varied within the theoretical framework to fit the needs of special children and their families.


Abnormal postural reflex activity and voice usage deviations in cerebral palsy. A relationship is considered between abnormal postural reflex activity and its effect on vocal processes in infants and very young children having cerebral palsy. Neurodevelopmental treatment concepts are interpreted as they may apply to evaluation and intiial management of hypertonic children who exhibit voice usage deviations. Interdisciplinary team function in the areas of physical therapy, occupational therapy, and speech pathology is suggested.


Controlled environment treatment (CET) for patients with below-knee amputations. This paper describes a new approach to early postsurgical wound management of the patient with a below-knee amputation. The method involves using the Controlled Environment Treatment (CET) machine, which wasdeveloped in England. A brief explanation of the components of the machine and its capabilities are listed. Ambient pressure, temperature, sterility, and humidity are easily controllable; advantages and disadvantages of this device over immediate post-operative plaster and conventional dressings as they relate both to wound environment and to physical therapy are mentioned. The early postsurgical therapy program used at Prosthetics Research Study is outlined.


[Therapeutic indications in 4 cases of hemangioma]. The author presents four cases of flat, diffuse angiomatosis with metameric distribution on the external surface of the leg, with ipsilateral varicosis. The first patient was cured by sclerosis of a sinous network of varicose veins; the second by atypical stripping of an abberant varicose collector on the external surface of the leg. The other two cases presented typical ipsilateral varicosity of the internal saphenous; simple in the third case, complicated by arterio-venous fistulas in the fourth: the latter subject will be cured durably by stripping of the internal saphenous, resection of the arterio-venous communication and permanent support.


[Orthostatic circulatory disorders of the left leg. Angiographic and lymphangiographic evidence]. The author reports in detail one case of unilateral circulatory disorders of the left leg. These disorders gave rise to 4 particular signs: pain, reddening, oedema, and coldness that appeared only in the standing; the only significant finding from all the investigation was a very rapid venous filling during arteriography, which indicated the possibility of an arterio-venous communication. But there was no proof of this. The diagnosis and surgical therapy are discussed.


Acoustic properties of the nasal tract.

Acoustic properties of the nasal tract. Sweep frequency measurements of the transfer function of nasals and nasalized vowels have been found to show a more complex pole-zero pattern than can be predicted with a traditional model of the nasal tract which consists of two parallel tubes coupled to the oral cavities. In this paper, we put forward the hypothesis that the more complex transfer function can be explained with reference to the shunting effect of the sinus maxillares and the sinus frontales. The two maxillar sinuses are situated in the bone symmetrically on the right and left side of the nasal tract. The two frontal sinuses are situated above the nasal tract in the bone of the forehead. These cavities are acoustically coupled to the nasal tract via short channels in the bone. Direct sweep tone data on the transfer function of the nasal tract support this hypothesis.


[Immunopathologic aspects of recurrent phlebitis and nodular vascularitis. Therapeutic applications]. Recurrence of vasculitis is conditioned by 2 factors : a) one is extrinsic (bacteria, mycobacteria, viruses, chemicals) ; b) the other comes from the host. From host-extrinsic factors inter-relationships, depend recurrences of the disease. The role of streptococcosis is of primordial importance : 1) by its exotoxins (Streptolysin O) ;2) by its total exoproteins (highly sensitizing for human beings) ; 3) by an antigenic community with some tissular antigens. Immunotherapy when successful may act by an inhibiting effect on allergy (probably exerted by means of a stimulation of the reticuloendothelial system).


[Aspiration and glottal activity. Experimental test during production of Icelandic consonants]. The results of an experimental research of the glottal activity during the production of Icelandic consonants and consonant clusters are reported. The method of research is the photoglottography. It is concluded from the data examined that aspiration in Icelandic can be described as a function of glottal opening at the moment of release. The last part of the study contains a discussion of the place of phonetics in linguistic  analysis. It is asserted that an analysis of the linguistic form always must precede a phonetic analysis.


[Phlebitis of effort and venous edema of the upper limbs. Compressions of the subclavian vein]. The authors present a series of 18 cases (13 patients) of a venous syndrome of the arm. Three were cases of phlebitis due to effort and 15 were cases of intermittent or permanent oedema of the arms. Four of the patient also presented homo- or contralateral arterial disorders. Dynamics and multiposition phlebography gave evidence on 18 occasions of a branchial compression syndrome. Twelve patients were operated upon. On 16 occasions resection of the first rib was carried out by the axillary route (in 1 case this was combined with the ablation of one cervical rib). All the patients were cured without complications.


Labial-mandibular coordination in the production of speech: implications for the operation of motor equivalence. The purpose of this study was to explore select properties of speech movement coordination. Values of displacement for the upper lip, lower lip and jaw were obtained during repetitive productions of three vowels (ae, i, xi, in CVCVC contexts) by six subjects at two speaking rates. These data were analyzed to determine the relative contribution of each of these articulators to the superior-inferior distance between the upper and lower lips. The results of these analyses provided substantive evidence for the operation of motor equivalence in the speech movement coordination of the labial-mandibular system. The theoretical implications of these findings for the neural control mechanisms underlying speech movements are discussed.


Measuring larynx movement in standard Thia using the cricothyrometer. Vertical movement of the larynx during connected speech was investigated in Standard Thai - a language that has five phonologically contrastive tones. The effects of pitch, consonant phonation-type, vowel quality, tonal categories, and position in the utterance were determined. Utterance position was found to be the factor most clearly associated with variations in larynx movement. The occurrence of an overall rise-fall pattern of larynx movement distributed over utterances of varying pitch patterns leads to the conclusion that larynx height is not a principal factor regulating pitch in connected speech. Implications for models of pitch production, distinctive features for tone, theories on the historical development of tone and the role of larynx movements in the production of consonants and vowels are discussed.


[Relations between the form of the vocal tract and the acoustic characteristics of the French vowels]. The distribution inside the vocal tract of certain acoustic parameters (volume velocity, acoustic pressure, stored energy) is calculated for the French vowels. Calculations are made using a simulated lossy transmission line model of the vocal tract. The obtained results are used to study the relation between the acoustic characteristics of these vowels and the corresponding articulatory dimensions. Three aspects of this relation are developed: (1) the "affiliation degree" of each formant with different sections of the vocal tract; (2) the sensitivity of each formant frequency to small changes of the vocal tract area function, and (3) the contribution of each part of the vocal tract to formant damping for each of the distributed losses. The effects of radiation impedance and wall vibration on these relations are evaluated. Use of these results is possible in the fields of speech analysis and vocal tract modeling.


[Thoraco-brachial outlet venous syndromes]. The name "phlebitis of effort" is often misleading ; effort is often only the precipitating or revealing factor of a venous thrombosis related, in fact, to another cause. In particular, the author draws attention to the local factor of subclavian stenosis : one case is reported in demonstration. In order to detect these subclavian stenoses, a clinical examination is sometimes of little value and phlebography is essential for diagnosis. Identification of this kind of lesion is followed by consideration of the indications for surgery, either to prevent the risk of secondary thrombosis or to decrease the consequences of an existing thrombosis ; in the case reported, the freeing of the vein was combined with thrombectomy.


S-shaped repair of the unilateral cleft lip. A modification of Tennison's operation for closure of a cleft lip is presented. The modification entails the use of X-shaped incision lines and a piece of lead rather than a wire.


Benign inverted nipple: trans-nipple-areolar correction. It is not expected that patients who have this correction for inverted nipples can nurse, but neither could they preoperatively. Their hygiene problems are solved. The deformity, their prime concern, has been corrected through a direct trans-nipple-areolar incision with nipple augmentation by flaps of breast tissue.


Secretan's disease: Post-traumatic hard edema of the dorsum of the hand. Five cases are presented of hard, brawny edema of the dorsum of the hand, typical of Secretan's disease. We now believe splinting and active exercise to be the initial treatment of choice. Only after months of such conservative management should one resort to surgery.


The site of reapplication of microvascular clamps. An experiment was done with albino rats to determine whether the arterial clamp should be reapplied proximal or distal to the anastomosis when revising a venous anastomosis in microvascular surgery. Our findings showed that the reapplication of clamps should be avoided if possible. However, if it is necessary to reapply an arterial clamp, it may be placed either proximal or distal to the anastomosis - with almost the same incidence of patency resulting.


[The importance of occupational therapy in a social therapeutic program]. The author in his present paper attempts to outline some of the more important aspects of, and theoretical and practical problems associated with, the integration of occupational therapy into a large-scale sociotherapeutic program.


[The influence of rehabilitative factors on the behavior and affect of epileptics]. First experience in the occupational rehabilitation of a group of less gifted juvenile epileptics is reported. In this paper, the emphasis is on both psychological and sociopsychological aspects of rehabilitation. The observation and control of processes and reactions is of major importance to the entire program of rehabilitation. Also, the improvement of the occupational situation of a patient will have a positive influence on his social behavior, self-confidence, and emotions. Rehabilitation is a complex process, with the results depending to a very large extent on extremely methodical approaches.


[Participation of spouses of neurotic inpatients on the neurotic's views pertaining to their superiors and place of employment]. In a total of 72 sessions, 40 neurotic patients and their partners in marriage, who were interrogated separately, expressed their views of the superiors and employers of the patients. Statistical analyses showed that there was a great similarity between the comments made by the patients and their spouses. The basic psychodynamic process of identification was considered responsible for this. Six modes of identification with the neurotic partner were described. Also discussed by the author are the value and limits of "objective anamnesis". The need for including the entire family in the program of therapy is pointed out.


[Neuropathologic findings after electrotrauma in dogs]. The authors report the results of morphological studies of the brains of dogs on which transcerebral or peripheral electrotraumata were inflicted and which were killed immediately after completion of the experiment. Subarachnoidal and intracerebral hemorrhages were observed in the two groups of experimental animals. Hemorrhages were much less intense in those cases in which so-called peripheral injuries were inflicted on the animals. However, it is reasonable to expect late and permanent functional and morphological damage to the central nervous system to be produced even in those cases where electric current is not caused to flow directly through the brain. This should be carefully considered in any attempt to determine the consequences of electrotraumata.


[Clinical, psychological, and psychophysiological characteristics of neurotic-functional, cardiovascular and neurotic-depressive syndromes]. A total of ninety women classified into three groups (with cardiovascular, depressive, and other principal symptoms) according to clinical criteria were characterized by clinico-anamnestic, psychological, and psychophysiological data with the goal of arriving at a practically oriented differentiation of neurotic syndromes. The relevant variables were determined by means of a factor analysis. The physiological reaction patterns determined in experiments on psychically strained individuals proved unsuitable for the differentiation of the two syndromes. The problems associated with a symptom-oriented classification are discussed.


Some antitherapeutic effects of the token economy: a case in point. This paper deals with some of the complaints of patients and difficulties in treatment which arose on a psychiatric ward which was administered as a token economy. Most evaluations of token economies have been made by advocates of the technique and have selected specific behaviors as "targets" for reinforcement. I do not wish to engage in polemics regarding the relative worth of behavioral and psychodynamic theories of treatment, but this paper reflects my own misgivings about certain aspects of the token economy and is concerned more with the quality of the ward atmosphere it creates than with specific behavior changes. I will describe the difficulties encountered on a single ward because I suspect that such difficulties, while perhaps ubiquitous to psychiatric wards and mental hospitals, are amplified within the token economy to the detriment of patient care. My purposes in this paper, then, are twofold: to present and briefly analyze several recurrent problems on a token economy within a wider context of events than is typical for such discussions; and to provoke advocates of the token economy system to consider the possibility that their favorite treatment modality may actually limit the potential for therapy. In fulfilling these purposes, I shall also be making reference to some psychiatric literature, now fifteen to twenty years old, which has struggled with similar problems with partial success, and of which psychologists and younger psychiatrists are too often unaware.


Integrative and sealing-over recoveries from schizophrenia: distinguishing case studies. The types of recovery from an acute schizophrenic break are manifold: one patient "returns" to reality and walks away as if untouched; another despairs for months about "losing control" of himself; still another finds his reentrance into the world less attractive than his psychotic exit. Each "copes" with his psychosis uniquely, both during and after the acute regression. Nevertheless, from observing and treating several acutely psychotic and recovered schizophrenics on a National Institute of Mental Health clinical research unit, we have noted that individual recovery styles tend to cluster around one of two distinct types--integrative or sealing-over. Broadly defined, the sealing-over patient prefers not to think about his psychotic experience during recovery, the integrator, by contrast, is interested in the psychotic experience and desires to place it into some coherent perspective. Specific behavioral definitions and dynamic considerations of these concepts have been presented elsewhere (McGlashan et al., 1975; Levy et al., 1975). As recovery "styles," we are talking about dichotomies, such as expansion versus constriction and flexibility versus rigidity of controls over consciousness, which in turn determine the range of feelings, thoughts, and actions that a person permits himself and is reasonably comfortable with. This paper illustrates and further delineates these recovery styles with specific cases of two young women who each experienced a first psychotic break and were treated on our clinical research unit. Though but two of many acute schizophrenics admitted to our unit, these patients demonstrated clinical courses most representative of each recovery style and provided rich material for a greater understanding of the dynamics of integration and sealing-over.


Alternative group foster homes; a new place for young people to live. After a brief historical survey of child placement practices in the United States, this paper will address itself to an innovative form of placement for adolescents, "alternative group foster homes." The origins of two of these homes in "runaway houses" and their ideological underpinnings in the social and political critique of the counterculture will be discussed. The two homes will then be described and their functioning contrasted. One of them, Frye House, has managed to remain faithful to the radically democratic principles which animated its founding, and the other, Markham House, has not; the emphasis here will be on this difference and on its consequences for the homes as a whole and for the young people who have lived in them.


Concurrent sex therapy and psychoanalytic psychotherapy by separate therapists: effectiveness and implications. Since the publication of Masters and Johnson's Human Sexual Inadequacy in 1970, sex therapy has become an established, though controversial, new approach to the treatment of sexual disorders. Masters and Johnson adopted the position that any other form of psychotherapy should be avoided or suspended during the two- or three-week period of sex therapy. Helen Kaplan, in considering sex therapy to be a type of psychotherapy, has stressed that the skillful trained psychotherapist uses his awareness of the psychodynamics and unconscious conflicts of the couple in modifying and tailoring the sex therapy program to their individual needs. In the present study, sex therapy, utilizing a second therapist, was introduced into an ongoing psychoanalytic psychotherapy.


A method for small group training of psychiatric ward staff. On a psychiatric ward for adolescents a change in organizational structure provided more autonomy and responsibility to the ward staff. As part of a program to help staff meet these new responsibilities, training groups were instituted to teach staff how to use their work groups more effectively. A method for staff training was used which promoted the development of group cohesiveness in the work groups and the transfer of insights made in training to job performance. In order to articulate clearly the conceptual rationale for the method, it is analyzed here in three parts: the goals of training and their impediments; the conditions under which learning will occur; and the processes through which learning takes place. In the description of the learning processes, "work" is conceived of as a group problem-solving process, involving the balancing and synthesizing of formal task demands and interpersonal pressures. Ward staff resistance to this form of training is discussed, and examples of improved performance on the job are presented. The training groups are defined in comparison to other types of groups and to more traditional didactic teaching.


The young widow: depressive symptomatology throughout the grief process. The purpose of this investigation was to examine patterns of abatement of depressive symptomatology in 30 young widows at three time periods: immediately following the death of the husband, a year later, and at present. Data on all three time periods were gathered during one interview. The study thus provides retrospective information on patterns of depressive symptomatology. It was expected that such information would enhance understanding of the stages of the grief process described by Glick et al. and by Maddison.


Brainwashing, psychiatry, and the law.

Brainwashing, psychiatry, and the law. Buried as a foreign menance more than twenty years ago, exhumed, examined and reinterred once or twice since then, brainwashing has risen again, this time to take its place on the stage of domestic horrors.


Proverbs and psychoanalysis.

Proverbs and psychoanalysis. Proverbs have much to teach the psychoanalyst. The purpose of this paper is to illustrate the clinical usefulness of viewing certain proverbs as analogous to typical dreams, to discuss some implications of the affinities between proverbs, riddles, and typical dreams in the context of applied psychoanalysis, and to view the proverb as stemming from the same common matrix as dreams, myths, symptoms, and folklore.


Idealization and grandiosity: developmental considerations and treatment implications. Analysis of patients with narcissistic pathology offers an opportunity to study the development of specific distortions of self and object representations. Two cases are presented illustrating the development of idealizations and grandiosity. For one patient these were manifestations of a developmental arrest; for the other, defenses against object-instinctual conflict. Differences in the function of idealizations and grandiosity in the two patients are attributed to the role of aggression and to the degree of separation-individuation attained. Treatment implications with references to the works of Kohut and Kernberg are considered.


The effects of clomiphene citrate on the hypothalamic-pituitary-gonadal axis in anorexia nervosa. Serum luteinizing hormone (LH) responses to a course of clomiphene citrate were studied in eleven patients with anorexia nervosa at different stages of the illness. In malnourished patients basal levels of LH were invariably low. With the resumption of a normal weight a small but definite rise in LH levels was observed but this spontaneous response to weight gain was variable in that many patients continued to exhibit abnormally low LH levels. The response to clomiphene in terms of a rise in basal LH levels after administration of the drug, followed by a second peak of LH and subsequent menstrual bleeding, was clearly dependent in part on the patient's nutritional state. In the malnourished state the response to clomiphene was usually either absent or incomplete. After the resumption of a more normal weight, the patients invariably showed an initial rise in LH after the clomiphene, but the second LH peak and subsequent menstruation were frequently not demonstrated. Six patients maintained a normal body weight for at least six months after a course of clomiphene, but only three of them resumed cyclical menstrual bleeding. It was concluded that factors additional to the nutritional state contribute to the prolonged amenorrhoea in anorexia nervosa and that clomiphene appears to have only a limited role in the treatment and management of patients with the disorder. Some aspects of current knowledge of the endocrine mechanisms that regulate normal menstruation and of the mode of action of clomiphene are outlined. The results of the present study are discussed against this background in an attempt to elucidate further the hypothalamic disorder underlying the amenorrhoea in anorexia nervosa.


The effects of administering lithium carbonate on the balance of Na, K and water in manic-depressive patients. Eleven patients in remission from manic-depressive illness were studied by means of metabolic balances before and after the administration of lithium carbonate. Lithium caused a sharp diuresis of isotonic saline and a smaller excretion of potassium over the course of two days. During the subsequent two days there occurred a compensatory retention of Na, K and water. These short-term changes were not associated with any significant alteration in the patients' mood. There was no significant and systematic retention of Na, K or water over the 14 days of Li administration. The recovery of Li was measured simultaneously. During the first week only a proportion of the administered Li was recovered in the urine and faeces, suggesting that a gradual distribution of Li throughout its body space was occurring. After the first week, nearly all the administered Li was recovered, indicating an equilibrium with an even distribution of the ion throughout its body space. This equilibrium was more complete at this early stage in those patients who had been given a smaller dose of lithium carbonate.


Precursors and metabolites of 5-hydroxytryptamine and dopamine in the ventricular cerebrospinal fluid of psychiatric patients. Tryptophan and 5-hydroxyindoleacetic acid (precursor and metabolite respectively of 5-hydroxytryptamine) were determined in ventricular CSF of psychiatric patients undergoing stereotactic subcaudate tractotomy. Tyrosine and homovanillic acid (precursor and metabolite respectively of dopamine) were also determined. Results suggest an association between affective state and the above precursor amino acids with lower concentrations in primary depression and higher ones when anxiety or agitation predominate. This leads to lower 5-hydroxyindoleacetic acid concentrations in depression and higher concentrations in anxiety and agitation.


Clinical significance of plasma chlorpromazine levels. I. Plasma levels of the drug, some of its metabolites and prolactin during acute treatment. Seventeen acute psychotic patients were studied in the course of chlorpromazine (CPZ) treatment. Blood samples were taken weekly both before and two hours after the morning CPZ dose. Plasma levels of CPZ, CPZ sulphoxide (CPZ SO) monodesmethylated CPZ (NOR1CPZ) and 7-hydroxy CPZ (7OH CPZ) were estimated by gas chromatography. Plasma prolactin, luteinizing hormone, testosterone and oestrogens were measured by radioimmunoassay. Six of the seven patients who showed no clinical improvement had plasma CPZ levels equal to or higher than those of patients who improved. 'Non-responders' has a greater proportion of CPZ SO in pre-dosage samples. The occurrence of parkinsonian side effects was associated with a mean plasma CPZ of greater than 50 ng/ml and a mean plasma prolactin of greater than 30 ng/ml two hours after dosage. The elevation of prolactin preceded the onset of parkinsonian symptoms by 1-2 weeks. There was a significant positive correlation between mean plasma prolactin and mean plasma CPZ levels. The prolactin response may prove a useful index of the central antidopaminergic effect of neuroleptic drugs.


Clinical and social variables which differentiate suicide, open and accident verdicts. A study has been made of cases coming before the Brighton coroner in the period 1970-2. Fifty cases in which a suicide verdict was recorded were specially studied, and relatives and acquaintances of the deceased were interviewed. The information thus obtained was compared with information available to the coroner in considering his verdict in 83 further cases in which he made a verdict of 'suicide'. The reliability of the contemporary information on which the coroner's decision is based was largely validated. A study was made of variables which differentiated 'suicide' from 25 'open' and 33 'accident' cases considered by the same coroner. The prevalence of depression did not differentiate 'suicide' and 'open' cases, and this finding contradicts suggestions that the association of depression and suicide might be an artefact of the method of arriving at a suicide verdict. A number of other demographic and clinical factors did however significantly vary between 'suicide', 'open' and 'accident' cases.


Completed suicide: a taxonomic analysis of clinical and social data. A post mortem enquiry has been made into the social family and clinical circumstances of 50 individuals who, according to a coroner's verdict, killed themselves in Brighton. A dimensional analysis of the 123 variables thus collected suggested the possibility of three distinct types of suicide: "depressive suidice', "sociopathic suicide' and "physical illness suicide'. The reliability of this typology has been checked by the analysis of 55 selected variables for a total of 193 cases considered by the same coroner. A cluster analysis has confirmed that the data contained at least three independent types of suicide. Some implications for the prevention of suicide are discussed.


A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability. A standardized, semi-structured interview for examining and recording the mental state in elderly subjects is described. It allows the classification of patients by symptom profile and can demonstrate changes in that profile over time. It is believed that good reliability is demonstrated between psychiatric raters both for psychiatric diagnosis made on the basis of the schedule findings and for individual items. The Geriatric Mental State Schedule (GMS) consists mainly of items from the eighth edition of the PSE (Wing et al. 1967), together with additional items from the PSS (Spitzer et al. 1964), and extra sections dealing with disorientation and other cognitive abnormalities. Modifications have been introduced to facilitate interviewing elderly subjects.


A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. II. A factor analysis. One hundred geriatric psychiatric patients were examined with the Geriatric Mental State Schedule in New York and London, and a correlation procedure involving both clinical and statistical operations was carried out on the psychopathological data thus collected. Twenty-one factors were produced, including three dealing with cognitive impairment. Although it was found that elderly depressives show a profile of psychopathology quite different from that shown by patients with organic disorder, it was also found that patients with an apparently functional disorder may sometimes be diagnosed as an organic disorder, that subjective complaints of intellectual impairment are not good indicators of organic disorders, and may be associated with a depressive factor, and that complaints that could be dismissed as attributes of aging may actually be indicative of a depressive disorder in the elderly. The methodological implications, as well as the limitations of the sample size, are discussed.


Obsessional scores and subjective general psychiatric complaints of patients with duodenal ulcer or ulcerative colitis. The Leyton Obsessional Inventory (LOI), together with 46 questions taken from Sections M-R or the Cornell Medical Index, were administered to 30 inpatients suffering from duodenal ulcer and to 30 patients admitted for ulcerative colitis to test the hypothesis that the latter have more obsessional traits than the former. The results indicated that although the two groups did not differ much in their obsessive personality traits, the ulcerative colitis patients were significantly more worried and concerned about them. None of the socio-cultural factors measured, which are known from other studies to influence these obsessive scores, was associated with the differences found. An analysis of the individual LOI items between the two groups showed that the ulcerative colitis patients were more indecisive, and also more morose, more rigid and more punctual than the duodenal ulcer patients, i.e. traits traditionally associated with obsessional personality types. The two groups did not differ on the Cornell score.


The prediction of outcome in elderly psychiatric patients. Clinical and psychometric characteristics of a sample of elderly psychiatric patients were established soon after admission and they were then followed for 1 year. An attempt to predict outcome was most successful for an unfavourable type which was predictable by measures related to intellectual impairment.


The value of assessing intent in attempted suicide. Suicidal intent was assessed in a sample of 151 admissions to a general hospital for self-poisoning or self-inflicted injury. Severity of intent was associated with the act's medical seriousness and with the risk of suicide derived from a validated risk scale. Although high and low intent cases were comparable in respect of precipitating factors, patients rated high on suicidal intent were more likely to have experienced depressive symptoms in the previous month.


Rehabilitation of psychiatric patients who stayed in hospital more than one year. Fewer than one half (238) of a cohort of 489 psychiatric patients who had stayed in hospital more than one year (longstay) were still in hospital three years later. One third of these 'old' longstay patients (170) were discharged and resettled-and 81 elderly patients died. During the same three years 1971-3 a further 108 patients became (new) longstay; 57 remained at the end of the study. The discharged patients were neither readmitted unduly often, nor did they become destitute.


Radiological opacities of the knee after intra-articular injections of osmic acid. Unusual radiological opacities have been observed in 29 cases after intraarticular injection of osmic acid in 113 knees of 72 patients under treatment for a chronic exudative synovitis in different types of rheumatic diseases. They are statistically more frequent after the injection of 200 mg than after 100 mg (33.9 and 15.7% respectively). Most of the time, they are located in the suprapatellar pouch. The opacities appear soon after the injection and can last for several years. They do not seem to have an unfavorable influence on the clinical course. They appear to be caused by a deposition of osmium in synovial fat tissue. From here the osmium might stimulate fibrosis. The radiological image has to be differentiated from intra-articular calcifications, synovial ossifications and various periosteal osteogenic processes.


Cerebrospinal fluid (CSF) ex vacuo.

Cerebrospinal fluid (CSF) ex vacuo. CSF ex vacuo is a proposed designation for abnormal collections of CSF replacing brain tissue which is absent or has disappeared as a result of maldevelopment, injury, infection, vascular disturbances, brain atrophy, etc. In the literature, designations such as arachnoidal, leptomeningeal and porencepalic cyst, and hydrocephalus ex vacuo, are commonly used. Even if the neuroradiological findings in CSF ex vacuo are impressive, its clinical significance may be nil or minor. However, CSF ex vacuo may develop expansive tendencies, the cause of which is not yet fully understood. On the basis of schemiatic drawings of the neuroradiological findings of eight cases of CSF ex vacuo the variations in aetiology, localization, diagnostic detectability, clinical significance and surgical implications are briefly discussed.


Rectal injuries following radiation therapy for cervical cancer. Injuries of the rectal wall were examined up to 327 days in patients with uterus cancers after radiation therapy with 60Co gamma-rays. Various types of morphological changes were observed at the end of the therapy and the changes could be seen even 327 days after therapy with doses of 3,240-6,040 rad. The percentage of goblet cells in the rectal wall fluctuated for about 50 days after therapy and then became stable, but was slightly less than pre-irradiation level. The changes in the percentage seemed to represent radiation damages to the epithelial cells in the wall. The late effects in the blood vessels were probably more important than damages to the epithelial cells in the wall.


[Angiographical findings in extra-intracranial anastomoses (author's transl)]. A microsurgical anastomosis between the superficial temporal artery and a cortical branch of the middle cerebral artery was carried out in 11 cases with internal carotid occlusion. This treatment was attempted following angiography of the intra- and extracranial cerebral arteries. After the microsurgical procedure for creating an extra-intracranial arterial anastomosis selective angiography of the homolateral external carotid circulation was performed. The analyses of the serial arteriograms showed, that a) a considerable blood supply from the external carotid circulation through the additional collateral pathway to the territory of the middle cerebral artery is possible, b) the extent of the area of the middle cerebral artery supplied by the superficial temporal artery is not only dependant upon a pressure gradient between the external carotid and the middle cerebral artery circulation, but also by the different anatomical variations of the middle cerebral artery.


[Cortical blindness following arteria vertebralis angiography (author's transl)]. Six patients suffered from cortical blindness following vertebral artery angiography. A connection of the incident with the technical procedure or a particularly great amount of applied contrast material, could not be seen. Vasospasm, stasis of contrast material in the arteria calcarina and a toxic lesion seem possible explanations, because the cortical blindness was fully reversible in all cases within some hours or days. Signs for an arterial embolisation did not exist, a finding, which is consistent with the literature.


[The influence of training on the accuracy of roentgenographic cephalometric tracings (author's transl)]. The accuracy in landmark identification and in the determination of angular and linear measurements used in cephalometric analysis on lateral head film were statistically evaluated comparing operators with different levels of competence. The observed magnitude of methodological error was depending on - prior experience of the investigator - individual radiographic anatomical knowledge - rigour of landmark definition and - accuracy of the tracing procedure. Considering these sources of error some of the variability in the present investigation might be avoided by systematic instructions. In order to decrease the variation in landmark location the reproducibility of some points must be further improved by redefining them in their verbal assessments. From an educational point of view the correlation between individual radiographic anatomical knowledge and the magnitude of error in cephalometric analysis should be considered with particular emphasis.


[Diagnostic and therapeutic results of superselective cerebral angiographies in pathologic lesions in the vascular area of the human external carotid artery (author's transl)]. Technical performance, radiological findings as well as the diagnostic and therapeutic significance of superselective cerebral angiographies, performed with a telescopic catheter system, and consecutive embolizations are described in pathologic lesions in the vascular area of the human external carotid artery. In 46 patients vascular malformations (angiomas, fistulas) and vascular tumors (angiofibromas) as well as other tumors (glomus tumors, meningeomas) were demonstrated by angiographies of distal external carotid branches; in further 16 patients there were normal angiographic findings. It is shown by examples that superselective cerebral angiographies fulfill microangiographic properties. Pathological findings of vascular malformations and tumors were demonstrated which could not have been shown with other examination techniques. Besides the improved and more detailed diagnostic information these superselective angiographies of external carotid branches enabled successful embolizations of pathologic lesions by gelfoam-injections or selective occlusions of branches feeding angiomas or tumors by silicone polymerization. These embolizations were not done in patients with arterio-venous fistulas (9). The clinical application, limitations and further development of cerebral embolization techniques are discussed.


Quantitative measurement of demethylation of 14C-methoxyl labeled DMPEA and TMA-2 in rats. Some reports have suggested that methylation and demethylation of compounds related to 6-hydroxydopamine may be involved in endogenous mental disorder. We report the synthesis of 3,4-dimethoxyphenethylamine (DMPEA) and 2,4,5-trimethoxyphenylisopropylamine (TMA-2) with each methoxyl group separately labeled with 14C. The rate and percent demethylation of these two compounds, with five labeled positions, were determined in the rat. The results suggest that TMA-2 might be metabolized to a hydroquinone in vivo; a similar metabolic intermediate of the psychoactive compound DOM is known to give rise in vitro to an indole.


Suppression of amphetamine-induced hypothermia by the neutral amino acid valine. Pretreatment with valine (0.5-2.0 mmoles/kg) can suppress the hypothermic response of rats placed in a 4degreesC environment and given d-amphetamine sulfate (5 or 10 mg/kg). The amino acid was most effective when given 30 minutes before amphetamine administration, at which time it also significantly lowered brain tyrosine concentration (and, presumably, suppressed catecholamine synthesis). Because dopaminergic neurons mediate the hypothermic response to amphetamine and because amphetamine's ability to produce hypothermia requires, in part, the release of newly synthesized dopamine, these observed effects of valine pretreatment support the hypothesis that treatments which alter precursor (tyrosine) availability also affect brain catecholamine synthesis.


Catecholamines and operant response rates in albino rats. The action of d-amphetamine was studied in rats conditioned on an operant "multiple" schedule of reinforcement. The action of this drug depended on the control response rate of each individual. The turnover of brain norepinephrine (NE) and dopamine (DA) was estimated in the whole brain of the same rats; the steady state level of NE, but not the turnover time, was significantly correlated with the average response rate of each subject. No significant correlation was found between this response rate and the turnover of DA. It is proposed that the response rate dependent effects of d-amphetamine might be related to brain NE levels.


Effects of acute morphine administration on the catecholamine metabolism of three strains of mice. Inbred mouse strains exhibit differences in motor activity and brain catecholamine metabolism after acute morphine injection. The two strains C57BL/6J and Balb/cJ, which increased motor activity after morphine present also an increased noradrenaline turnover in the pons medulla, whereas no difference were found in the DBA/2J strain whose motor activity was unchanged. A correlation seems to exist between motor activity and the noradrenaline metabolism in the brain stem.


Effect of lithium on gastric emptying and absorption of oral chlorpromazine. A recent study suggested that low plasma levels (58-70 ng/ml) of chlorpromazine (CPZ) were achieved by patients concurrently taking lithium, despite ingestion of doses of CPZ (400-1000 MG) which ordinarily produce plasma levels of 100-300 ng/ml or more. We have studied this lithium-chlorpromazine interaction in rats. The plasma and brain levels of [14C]chlorpromazine (CPZ) after an oral dose (5 muCi) were significantly lower (p less than 0.005) in rats treated with lithium, whereas the percent of dose remaining in the stomach (24-30%) was significantly higher (p less than 0.001), than in matched controls. Gastric emptying was measured by [14C]polyethylene glycol and was shown to be inhibited significantly by oral and i.p. lithium. This inhibition of gastric emptying by lithium may be the major cause of the lower plasma levels of CPZ since diminution of plasma drug levels has been shown for L-dopa, chlorpromazine, sulfa drugs, and phenylbutazone in animals and man treated concomitantly with anticholinergics, which also diminish gastric motility.


Effect of chlorothiazide on the pharmacokinetics of lithium in plasma and erythrocytes. The effect of chlorothiazide on the pharmacokinetics of lithium in both plasma and RBCs was studied in normal adult males. This was accomplished by administering single, 300 mg. doses of lithium carbonate alone and concurrently with chlorothiazide (0.5 grams/day for one week). Thiazide administration resulted in increases in plasma and RBC concentrations of 26.2 and 25.4%, respectively, as well as a 26.5% decrease in renal lithium clearance. The data were analyzed in terms of a two compartment pharmacokinetic model as previously reported (8). The results of this analysis showed that the change in renal lithium clearance could be accounted for by a 24.1% reduction in the value of ke, the excretion rate constant. It was also shown that changes in plasma lithium concentration during chronic lithium therapy would be expected to increase by 25-30% when chlorothiazide therapy is employed. The model also predicts that changes in RBC concentrations would parallel those occurring in plasma and thus no change in the RBC/plasma lithium ratio would be expected.


Studies on the metabolism of 5-hydroxytryptamine (serotonin). VII. Effects of haloindoles on cerebral 5-HT in various species. In a comparative study, the effective of intraventricularly or intraperitoneally injected p-chloroamphetamine (p-CA) and some chloroindoles on cerebral levels of serotonin was evaluated. 5-Chloroindole depressed 5-HT levels in the brainstem and telencephalon for three days, 6-chloro-2-methylindole (6-CMI) only during the first day. 5-Chloroindazole had no effect at all. p-CA was more toxic to guinea pigs than to rats. p-CA and 5-chloro-2-methylindole (5-CMI) had no effect on cerebral 5-HT in chicks. Apparently, none of these compounds represented or was converted to a metabolite possibly responsible for the neurotoxic effects of p-CA.


The discriminative stimulus properties of nicotine, d-amphetamine and morphine in dopamine depleted rats. Rats permanetly depleted of central dopamine (DA) via 6-OHDA neonatally were studied in relation to their ability to discriminate various psychoactive drugs from saline using a two-bar operant procedure. DA rats learned to discriminate both morphine (4 mg/kh) and d-amphetamine (0.9 mg/kg) as rapidly as controls and exhibited similar sensitivity when dose-generalization studies were conducted. However, DA rats appeared to tolerate higher doses of the same drug better than controls indicating that they were more tolerant to behavioral disruption. It was suggested that the behavioral disruption. It was suggested that the behavioral disruption usurons. DA rats had more difficulty learning to discriminate nicotine than controls. In fact the peripherally injected nicotine stimulus generalized to hippocampal (Hp) injections in controls but was not observed in DA rats. These data suggest that part of nicotine's discriminative stimulus properties may be contingent upon the integrity of a Hp-DA connection.


Electron capture detection of an apomorphine heptafluorobutyrate derivative at low picogram levels. An electron capturing derivative of apomorphine was prepared by incubating the drug with heptafluorobutyric anhydride (HFBA), triethylamine and heat. Mass spectral analysis suggests that HFBA reacts with both phenolic hydroxyl groups on apomorphine to give a derivative detectable at low picogram levels. This method is sufficiently sensitive for pharmacokinetic studies in the horse and is likely applicable to other dopaminergic analogues of apomorphine.


Identification of some volatile endogenous constituents in rat brain tissue and the effects of lithium carbonate and chloral hydrate. Nine endogenous volatile compounds were found in rat brain tissue, and were identified by mass spectrometry as chloroform, a 5-C-aldehyde, dimethyl disulphide, 2,5-dimethyl tetrahydrofuran, a 8-C-alkane, xylene, 2-heptanone, heptaldehyde and 2-n-pentylfuran. Using gas chromatographic and gas chromatographic mass spectrometric techniques, it was established that lithium carbonate did not induce the production of detectable amounts of any new volatile compounds in brain tissue. However, after administration of chloral hydrate, trichloroethanol, a compound not normally present in rat brain tissue, was found to be present.


Effects of chronic exposure to cadmium, lead and mercury of brain biogenic amines in the rat. Effects of chronic (45 days) treatment with different doses of cadmium chloride (0.25 and 1.0 mg/kg/day), methylmercury chloride (0.4 and 4.0 mg/kg/day) and lead acetate (0.2 and 1.0 mg/kg/day) and of 28-day withdrawal of treatment on the levels of acetylcholine (ACh) and activity of acetylcholinesterase (AChE) in cerebral cortex, and concentration of norepinephrine (NE) and 5-hydroxytryptamine (5-HT) in brain-stem were examined in rats. Exposure to both cadmium and methylmercury produced significant decreases in cortical ACh and brain-stem 5-HT levels. In addition, brain-stem NE concentration was increased in methylmercury-treated rats. In contrast, chronic treatment with lead resulted in enhanced cerebrocortical ACh levels but a decreased brain-stem NE concentration. Treatment with cadmium also produced a transient enhancement of striatal dopamine levels. Cadmium-induced decrease in brain-stem 5-HT and lead-induced accumulation of cortical ACh persisted even after 28 day withdrawal of treatment. The data indicate that chronic exposure to low doses of heavy metals produces differential changes in regional levels of various brain biogenic amines. These changes may represent the early signs of adverse effects on CNS function since they occur before any overt symptoms of neurotoxic effects of heavy metals become apparent.


Contrasting alterations in hepatic drug biotransformation of hexobarbital and p-chloro-N-methylaniline produced by prostaglandins. The effect of prostaglandins (PGs) on the hepatic biotransformation of hexobarbital (Hechi) and p-chloro-N-methylaniline (PCMA) was determined in male rats. PCMA metabolism in slices was decreased by all PGs (PGA1, PGB1, PGE1, PGE2, PGF1alpha, PGF2alpha), ranging in concentration from 1 mu M to 1 mM. PGA1, at 1 mM, produced the greatest degree of inhibition, 39%. PG addition to microsomes, however, failed to alter PCMA metabolism. In contrast to PCMA biotransformation, Hechi metabolism was increased by all PGs in slices but not in liver subfractions. PGs of the E and F series were the most potent, producing a two-fold increase in Hechi metabolism at 1 mM after a 20 min preincubation. The increased effect was observed as early as 10 min and lasted for 4 hr. The relationship of PG metabolism and binding to cytochrome P-450 is presented as a possible mechanism to account for the opposite effects on Hechi and PCMA, type I and II substrates respectively, metabolism.


Effects of ryanodine on the contractile force of potassium-depolarized hearts. The relationship between cellular calcium movements and contractility was indirectly assessed in Langendorff-preparations of guinea pig hearts perfused with either Krebs-Henseleit solution or a high-potassium (22 mM) solution containing 2.4 X 10(-8) M isoproterenol. The addition of either D600 (2.4-24.0 X 10(-8) M) or ryanodine (0.24-24.0 X 10(-6) M) to hearts perfused with Krebs-Hanseleit solution produced a concentration-dependent reduction in contractile force. In potassium-depolarized, isoproterenol-restored hearts, the negative inotropic action of D600 exhibited concentration-and time-dependent changes similar to those observed in Krebs-Hanseleit solution. In contrast, addition of 0.24-75.0 X 10(6) M ryanodine to potassium-depolarized, isoproterenol-restored hearts produce a time-dependent reduction in tension followed by a concentration-dependent rebound in contractile force. These results have been interpreted to be a consequence of the respective actions of D600 and ryanodine on Ca2+ influx and on intracellular calcium stores.


In vitro metabolism of amphetamine: an apparent enantiomeric interaction. The stereoselective formation of the major metabolites N-hydroxyamphetamine and 1-phenyl-2-propanol in incubations of amphetamine with 9,000 X g supernatant fractions of rabbit liver has been studied using deuterium labelling in conjunction with selected-ion-monitoring gas chromatography/mass spectrometry. Comparison of separate incubations of (R)-amphetamine with those of (S)-amphetamine-d3 and of (S)-amphetamine with those of (R)-amphetamine-d3 showed that larger amounts of the two metabolites were formed from the (R) enantiomer. When "pseudoracemic" mixture (R)-amphetamine/(S)-amphetamine-d3 or (R)-amphetamine-d3/(S)-amphetamine were incubated the two metabolites were preferentially formed from the (S) enantiomer. Studies on the disappearance of substrate during incubation gave results in agreement with the findings on stereoselective metabolite formation. It was concluded that (S)-amphetamine or one of its metabolites inhibits the metabolism of the (R) enantiomer.


Inhibition of arylhydrocarbon hydroxylase induction in BALB/C mouse liver by delta9-tetrahydrocannabinol. The effects of single administration of delta9-THC on the induction of arylhydrocarbon hydroxylase activity by phenobarbital and 3-methyl cholanthrene were determined. delta9-THC completely suppressed the induction by phenobarbital and reduced the 3-methylcholanthrene induction from 455% to 177% of control. delta9-THC had no effect on phenobarbital induction when both drugs were administered daily for 2 days and mice killed on the third day. Arylhydrocarbon hydroxylase was not the only enzyme effected as delta9-THC also inhibited the induction of aminopyrine demethylase by phenobarbital. These drugs do not have any interactive effect on microsomal protein synthesis but are potent antagonists in the synthesis of nuclear RNA.


Accelerated assay, preservation and purification (concanavalin A) of plasma kininogen. Plasma kininogen, a labile precursor of bradykinin long considered difficult to characterize, has been assayed and partially purified by accelerated, non-destructive methods. Although heparin minimized premature kininogen consumption better than hexadimethrine bromide, both were ineffective when used in combination. The effects of varying incubation parameters upon kininogen consumption by trypsin were studied. Since trypsin (50 mug/ml) liberated in 10 min at 45degreesC in 0.1 M CaC12 as much bradykinin as in 30 min at 37 degrees C, the former conditions were adopted for assaying kininogen in terms of bradykinin equivalents released, as determined by rat uterus bioassay. The fastest (2-day) and simplest procedure for a routine 10-fold purification of kininogen from plasma consisted of ammonium sulfate precipitation (33-46%) followed by a single passage through a concanavalin A-agarose column. Con A binds glycoproteins (e.g. kininogen) more firmly than other proteins (albumin, gamma-globulins). Kininogen, resistant to killikrein attack while bound, was desorbed with 0.05 M alpha-methyl mannoside.


Metabolism of maltose in perfused rat liver and in isolated hepatocytes. The conversion of 14C-maltose into glucose, lactate and 14 CO2 was studied in perfused livers from fed and fasted rats and in isolated hepatocytes. Maximal glucose production was 30 mM x g-1 x h-1; half-maximal rates were found with 3 mM maltose. About 0.01 % of the radioactivity infused was recovered as 14CO2. The addition of maltose had no effect on rates of oxygen consumption, lactate production or ketogenesis. The data suggest that maltose did not serve as a major substrate for biosynthetic or energy producing processes under the conditions of the perfused rat liver.


The influence of coumarin on blood levels of radio labelled protein and radio labelled poly-vinyl-pyrrolidone in thermally injured rats. The evidence presented in this paper suggests that coumarin is a RES stimulator. An enhanced removal of both RPP and radio RPVP was observed beginning at or before 30 minutes and lasting up to 6 hours. Over this time, RPP removal was enhanced by an average of 40%, while RPVP removal was enhanced by 60%. Since RPVP is non-metbabolizable, its levels may be a more accurate estimate of the stimulatory effect of coumarin. This evidence fits in well previous results which have suggested that coumarin may increase the number of phagocytic cells. Other results have shown enhancement of protein lysis by 74% over similar periods, while enhanced protease activity levels of 50% have been observed to accompany this.


[Investigations with 3H-thymidine and electron microscopical studies in rat livers following thermocoagulation of the thoracic duct at the base of the neck (author's transl)]. Autoradiographic studies with 3H-thymidine were done in 90 male and female white Sprague Dawley rats following thermocoagulation of the thoracic duct at the base of the neck. In the acute stages of these experiments we were unable to find any significant influence of a lymphedema on the hepatocytes and Kupffer cells. In the longterm experiments the labelling indices of the hepatocytes were slightly above those of healthy controls of the same age. In another 14 male and female white Sprague Dawley rats we did electron microscopical investigations of the liver. In the acute phase of the experiment we found an intra- and extrahepatic edema as well as damages of the hepatocytes at the periphery of the liver acini. After 12-15 days these findings have regressed. It seems therefore that an intrahepatic lymphedema does not influence the regenerative capacity of the liver to a marked extent.


Influence of retrograde volume and short time cholestasis on the biliary reabsorption of sulfobromophthalein sodium (BSP) and phenol 3,6 dibromphthalein disulfonate (DBSP) from the rat biliary tree after retrograde intrabiliary injection (RII). The retrograde intrabiliary injection (RII) technique was used to study the reabsorption of equimolar doses (1,2 mumol) of sulfobromophthalein sodium (BSP) and its analogue phenol 3,6 dibromphthalein disulfonate (DBSP) from the rat biliary tree under the experimental conditions established in this study i.e. variation of retrograde volumes injected and of short time cholestasis. RII was performed with a microliter syringe joined to a cannula positioned in the proximal third of the common bile duct. This technique guaranteed accurate administration of microliter quantities, also free bile flow could be reinitiated 3 - 5 sec after RII. Bile samples were collected in 2, 5 min intervals up to the 5th min, then in 5 min intervals up to the 15th min, and the following 15 min up to the 30th min and analysed for compounds administered by RII. No significant differences in the biliary reabsorption of BSP and DBSP after RII could be detected. Increasing retrograde volumes of 20, 40, 60, 110, and 160 mul lead to decreasing percent recoveries in the bile in the first 2,5 min after RII (88,0 +/- 3,8 - 15,6 +/- 3,1) when bile flow was started at once after RII. An inverse correlation between retrograde volume and percent recoveries was found. Increasing duration of cholestasis (bile flow was started at once, 0,5 min, 3 min, 6 min, and 30 min after RII) results in decreasing percent recoveries of BSP and DBSP in the first 2,5 min after free bile flow was reinitiated (52,7 +/- 3,6 - 20,0 +/- 1,2). A time dependent proportional effect could be detected. Furthermore in the case of BSP concomitant with increasing cholestasis increasing amounts of BSP - conjugates were found in the bile supporting the idea of a continuing ductular - hepatocellular circulation even during complete obstruction of the common bile duct.


Inhibition of stress ulcer formation with somatostatin in rats. Prophylactitc effect of somatostatin (Growth hormone inhibiting hormone) on restraint stress ulcer formation was studied in rats. Rats treated with somatostatin before and during stress had only the fifth part of the ulcers of the untreated animals after 9 hours of immobilisation. Pathophysiologic mechanism for stress ulcer production is as well discussed as the prohibiting effect of somatostatin on ulcer formation. Prophylactic clinical use has to be considered.


Improvement of biliary excretion of ioglycamide by pretreatment with phenobarbital. The influence of a phenobarbital pretreatment on the distribution and biliary excretion of Ioglycamide was studied in 6 experiments in the anaesthetized minipig. The phenobarbital pretreatment led to a significant increase of the biliary transportmaximum and the biliary concentration of Ioglycamide. A detailed analysis suggests a phenobarbital induced stimulation of the hepatocellular excretion. The applicability of a pretreatment with phenobarbital in order to improve the opacification of the biliary system during x-ray-examinations with Ioglycamide is discussed.


Structural changes of erythrocyte membranes in muscllar dystrophy. Erythrocytes from dystrophic hamsters and patients with Duchenne muscular dystrophy were examined for structural changes using light microscopical methods. The effects of specimen preparation were also investigated. The proportions present of echinocytes were significantly greater in dystrophic hamsters and humans when compared with their respective controls. In the dystrophic hamsters, the progression of the myopathy caused a significant increase in erythrocyte membrane deformations. With dystrophic patients, age-related changes were seen, but these were not statistically significant. These findings were discussed with relation to specimen preparation and the use of haematological techniques in the detection of carriers of muscular dystrophy.


Time sequence and site of fluid accumulation in experimental neurogenic pulmonary edema. The initial phase of pulmonary edema development following intracranial pressure elevation was studied by means of transmission electron microscopy. Using perfusion fixation and application of a blood tracer (HRP horseradish peroxidase) the time sequence and site of fluid leakage out of pulmonary vessels was demonstrated: - passage of edema fluid through intercellular clefts of alveolar capillary endothelium - edema accumulation in alveolar interstitial tissue - draining of edema fluid from the alveolar septum to the interstitium of terminal bronchioli and to lymphatic vessels. An early interepithelial fluid leakage out of the alveolar wall remains questionable.


Acid-base patterns in lean and obese subjects during total fasting. During prolonged starvation blood gas analyses on 24 lean and 78 obese subjects were performed. A statistically significant sex difference of acid-base status was found in that lean females were more acidotic after 4 - 6 days of fasting than lean males. This sex difference was abolished by severe and long-standing obesity, since females suffering from this condition were not significantly different from lean and obese males. Out of 78 obese patients fasted for 1 - 4 weeks 8 had one or more pH values below 7.30. It is concluded that regular blood gas analyses are indicated in all patients subjected to prolonged total fasting.


A new method for chronic intraventricular measurement of intracranial pressure. A new simple method, which allows rapid access to the ventricular system to monitor intracranial pressure, is described. One of the lateral ventricles is punctured percutaneously, with a hand drill operated by a flash-light battery, and a lumbar puncture needle (20 gauge) attached to a water manometer or to a strain gauge connected to a venous pressure monitor.


Rewarming from immersion hypothermia: a comparison of three techniques. Rewarming from immersion hypothermia has been assessed in sheep by the use of three techniques--hot bath, body insulation and airway warming. Though the hot bath was the fastest of the methods of rewarming studied, consideration of temperature gradients and therefore total body heat diminished its advantage in comparison with central body rewarming via the airway (CBRW), which in turn showed considerably advantage over body insulation alone. CBRW did not have any thermal advantage gained on assisting the ventilation as compared with spontaneous breathing. The results illustrate the importance of adequate insulation of the body to prevent further heat loss and this was found to be true whether or not airway warming was being used. The site of heat uptake with CBRW was determined and observations were made on the physical behaviour of temperature gradients.


The use of intravenous regional anaesthesia for the reduction of Colles' fractures. Intravenous regional anaesthesia in the reduction of Colles' fracture was compared in 70 patients with 55 others who were treated with general anaesthetics. It was found to be easier and to involve a shorter waiting time, not to require patients to be supervised so long during recovery, and after this method it was less frequently necessary for patients to be taken home by ambulance. Its disadvantages were that it took longer, and could not be used for psychiatric patients or children.


[Visual evoked potentials in multiple sclerosis]. A study was carried out of 32 patients suffering from multiple sclerosis the diagnois of which was quite definite according to Mac Alpine's criteria and which had developed over more than two years. Comparison was made with patient suffering from optic neuritis of a different aetiology and with normal subjects. The method of investigation was dynamic electroretinoencephalography : the visual evoked potentials were investigated after stimulation by white and coloured light before and after adapatation to darkness. The specificity of the results was tested by, firstly, electro-retinogram recording for control of the visual system, and secondly, by the recording of auditory evoked potentials for control cerebral function. Abnormalities in visual evoked potentials were found in 77 percent of the cases. In particular, there was delayed latency, that is, a slowing of retino-cortical conduction. The significance of these abnormalities is discussed, by analyzing the electroclinical correlationships according to whether there was obvious or subclinical optic neuritis, and the dissemination, activity or duration of the disease. The incidence of visual evoked potential abnormalities was considerably greater than that in optic neuritis (35 percent). The links between abnormalities in nervous conduction and demyelinisation are emphasized. The role and specificity of electrophysiological investigation in diagnosis of multiple sclerosis are discussed.


[Tardive spino-cerebellar degeneration with amyotrophia, complicating a severe case of pallido-luysian degeneration and diffuse histological lesions of senility. (Anatomo-clinical study of a case with nosographic discussion)]. Anatomo-clinical findings are reported in a case of central nervous system degeneration which began at age 47 and progressed over a three year period. Information obtained prior to the patient's death suggested probable spinocerebellar degeneration with amyotrophies. Postmortem anatomical examination confirmed this diagnosis but also revealed the existence of unsuspected lesions. These clinically non-manifested lesions involved severe pallido-luysian degeneration as well as numerous and diffuse senile plaques. The nosological implications of this case are discussed.


Double ventricular parasystole associated with atrial fibrillation. The case of a 75-year-old man with acute myocardial infarction is presented. Two ventricular parasystolic foci, one in the right bundle branch, the other in the left bundle branch system were demonstrated with the aid of a His bundle recording, in the presence of atrial fibrillation.


Electrocardiographic diagnosis of myocardial infarction in patients with pacemakers. The ECG changes of myocardial infarction during permanent or transient right ventricular pacing were studied in 32 patients with transvenous pacemakers who developed myocardial infarction. During right ventricular pacing the electrocardiogram resembled left bundle branch block in 29 patients, right bundle branch block in two, and in one patient the pattern could not be determined. Myocardial infarction induced new ECG changes during pacemaker rhythm in 20 of the 32 patients. There were only QS complexes in 5 cases, ST segment abnormalities in 4 and T wave inversions in 4, negative Q and T waves were simultaneously observed in one patient, Q wave and S-T segment changes in 3 and S-T segment change and T wave inversion in 3 patients. It is concluded that knowledge of the ECG changes induced by myocardial infarction in most patients under artificial pacing can be useful for diagnosis.


Enterovirus infections in acute pancreatitis - a possible etiological connection. All patients admitted with a preliminary diagnosis of acute pancreatitis during a one-year period were subjected to virus investigations. 142 patients were included in the study and of these 91 were found to have acute pancreatitis. Evidence of enteroviral infection was found in 18 of the 91 patients (19.8 per cent). From 17 of the 18 patients enterovirus was isolated from feces or urine, and in one a significant titer rise (CF-test) against Coxsackie virus B5 was found. A significant titer rise of antibodies against the virus type isolated could be demonstrated in 7 of the 17 patients. Thus in 8 cases there was obvious evidence of an acute enteroviral infection during the episode of acute pancreatitis. The etiological agents in these cases were Coxsackie viruses B2, B3, and B5, and ECHO-viruses 6, 11, 22, and 30.


Plasma volume in chronic arterial hypertension. The plasma volume (PV) was determined in 109 patients with chronic arterial hypertension (AH) by 131I-labeled serumalbumin, expressing the results in ml/cm body height. An attempt was made to establish a statistical correlation between PV and diastolic pressure (DP). In essential AH three types of PV were found: normal, hypovolemic and hypervolemic; in hypertensive patients with stenosis of the renal aorta and in those with pheochromocytoma PV was slightly diminished; in hyperaldosteronism it was increased. In AH due to renal parenchymatous lesions the mean PV values were normal, a positive correlation being found between PV and DP (r + 0.929 and p = 0.05) in contrast to the other types of AH, where r was non significant or negative (stenosis of the renal artery, pheochromocytoma, malignant AH).


Effects of in vivo administration of pentagastrin, secretin, and 13-Nle-Motilin on the in vitro incorporation of 14C-leucine into protein of human gastric mucosa. Under endoscopic control, biopsy specimens were taken from the oxyntic gland area of the stomach before and after administration of pentagastrin, synthetic secretin, and 13-norleucine motilin (13-nle-motilin), respectively. In 29 volunteers, the basal rate of 14C-leucine incorporation into mucosal protein averaged 41.2 +/- 7.7 X 103 cpm/mg protein (mean +/- S.D.). One and 4 hours after s.c. administration of pentagastrin (6 mug/kg body weight), values were significantly increased (p less than 0.05) by 18.9 and 21.8%, respectively, with respect to the basal level. One hour after an intravenous shot of 2 CU per kg body weight of secretin, gastric mucosal protein synthetis was not substantially inhibited, whereas a 1-hour continuous i.v. infusion of 13-nle-motilin (0.4 mug/kg body weight, hr) significantly decreased 14C-leucine incorporation rates by 17.5% (p less than 0.05). In contrast to rats, 1 hour after s.c. pentagastrin, protein synthesis in human duodenal mucosa was not altered. From these results it may be concluded that pentagastrin has a trophic influence on gastric mucosa in man. Moreover, the data presented are compatible with the hypothesis that gastrin and motilin may be involved in the regulation of human gastric mucosal protein synthesis.


The biochemical prerequisites for preventing pathogenic lysolecithin activity in the human gallbladder. Human gallbladder epithelium was disintegrated to complete loss of microscopic structure and incubated at 37 degree C together with unlabelled lysolecithin and 14C-lysolecithin. During each incubation lysolecithin was degraded and stoichiometrically equivalent amounts of free fatty acids formed. The maximum rate of degradation was obtained at pH 7.0 and at 200 muM lysolecithin. With increasing amounts of gallbladder epithelial cell constituents the reaction became faster. After heating the epithelial components at 70 degrees C for 10 min the reaction was inhibited. The results suggest the presence of a heat labile lysophospholipase (phospholipase B) activity in the human gallbladder epithelium. This activity may operate to protect the gallbladder epithelium against potentially pathogenic lysolecithin activity. Its presence in the gallbladder epithelium meets the prerequisites for a local anti-inflammatory mechanism and lends further support to the hypothesis of lysolecithin as a mediator of cholecystitis.


Arterial carbon dioxide tension and dyspnea in chronic bronchitis and pulmonary emphysema. The severity of dyspnea (MRC scale) was confronted to the blood carbon dioxide tension (PaCO2) in 45 patients with chronic nonspecific lung disease having moderate or severe airway obstruction (FEV1.0 of less than 1.5 liters). The patients were classified as "bronchitic", "emphysematous" and "intermediate" using a 10- criterion (clinical, roentgenologic and biological) "emphysema score". No correlation between dyspnea grade and PaCO2 was found in "bronchitic" and "intermediate" patients; in the "emphysematous" subgroup PaCO2 tended to rise as dyspnea was more severe, but the linear correlation coefficient (r= +0.37) did not reach the significance threshold, which is high (0.468) for such a limited number of observations.


Gastric acid and serum gastrin responses to insulin and 2-deoxy-d-glucose in duodenal ulcer patients before and after partial gastrectomy. Gastric acid and serum gastrin (radioimmunoassay) responses to insulin (0.2 U/kg i.v.) and 2-deoxy-D-glucose (2DG) (50 mg/kg i.v.) were determined in 11 male duodenal ulcer patients before and after partial gastrectomy involving complete antral resection. In 8 of the patients the acid response to pentagastrin (6 mug/kg subc.) was also determined. Before operation, 2DG produced higher acid and gastrin responses than insulin. Partial gastrectomy reduced basal acid secretion by 54% but did not alter the basal gastrin level, suggesting that this gastrin is of extra-antral origin. Partial gastrectomy reduced the acid responses to insulin and 2DG by 66% and 78%, respectively; after operation the acid responses to these stimulants were equal. The ratio for the acid response to insulin and pentagastrin was 65% before and 56% after partial gastrectomy; corresponding ratios for 2DG and pentagastrin were 112% and 48%. Partial gastrectomy abolished the peak gastrin response to insulin hypoglycemia and reduced that to 2DG by 64%. The integrated gastrin response to insulin and 2DG was insignificant in the operated patients. Both insulin and 2DG release mainly antral gastrin which appears to be of greater importance for the acid response to 2DG than insulin.


Spontaneous aorta and coronary lesions in mountain mammals. II. The chamois (Rupicapra rupicapra). The study of the aorta and coronary arteries from 25 chamois shot in their mountain natural habitat allowed the observation that this animal is more exposed to liposclerotic lesions than other wild herbivorous mammals which live in the plain or at low altitudes. This observation is supported by both the frequency of the lesions (found in the coronary arteries of 14 animals and in the aorta of 10) and their morphologic and histochemical features. The author discusses the possible role of the relatively hypoxic condition, in which this animal lives at high altitudes, on the etiopathogeny of the above mentioned lesions.


Effect of intrajejunal fat on meal-stimulated acid and gastrin secretion in man. The effect of intrajejunal fat infusion on meal-stimulated gastric acid and gastrin secretion was studied in 8 healthy volunteers. Intrajejunal fat significantly reduced the acid response to a meal, measured by intragastric titration, as compared to intrajejunal infusion of saline. While serum gastrin concentrations rose from fasting levels to a constant plateau after the meal when saline was infused, fat infusion resulted in a transitory decrease in serum gastrin concentration followed by a significant increase. It is concluded that inhibition of gastrin release only plays a minor role, if any, in the observed fat-induced jejuanl inhibition of meal-stimulated acid secretion.


The absorption of vitamin B12 after subtotal pancreatectomy in the rat. Subtotal pancreatectomy in the rat was performed by a new method. Except for a small remnant along the splenal hilus, the gland was completely removed. Exocrine pancreatic insufficiency was confirmed by fat and nitrogen malabsorption. A moderate diabetes mellitus was seen. Insulin substitution or diet restriction was unnecessary. The absorption of vitamin B12 after oral administration of 10 ng 57CoB12 was 5.0 +/- 0.2 (ng 57CoB12 +/- S.E.M.) in unoperated rats and 5.1 +/- 0.1 in pancreatectomized rats (p greater than 0.5). Pancreatic extract (PE) (100 mg) increased the absorption of 57CoB12 in unoperated rats (p less than 0.01), but not in pancreatectomized rats (p greater than 0.2). PE (300 mg) reduced the absorption in unoperated rats (p less than 0.01). The results indicate that an optimal amount of pancreatic secretion may stimulate the absorption of vitamin B12.


Intestinal absorption of vitamin B12 in patients with chronic pancreatic insufficiency and the effect of human duodenal juice on the intestinal uptake of vitamin B12. The mean absorption of vitamin B12 (Schilling test) was 13.1 +/- 1.0 (% +/- S.E.M.) in 21 patients with chronic pancreatic insufficiency and 17.6 +/- 1.4 in 13 control patients (p less than 0.01). There was no correlation between pancreatic bicarbonate production after secretion stimulation and vitamin B12 absorption in the patient group (r = 0.117). Human duodenal juice reduced the uptake of 57CoB12-rat intrinsic factor (IF) by perfused rat small intestinal segments in vivo (p less than 0.01) as well as the uptake of 57CoB12-human IF by purified guinea-pig intestinal brush borders in vitro (p less than 0.01). The results confirm reduced absorption of vitamin B12 in chronic pancreatic insufficiency, but the mechanism remains uncertain.


N-acetyl-beta-glucosaminidase in lymphocytes of patients with Hodgkin's disease, plasma cell myeloma and primary polycythemia. The N-acetyl-beta-glucosaminidase activity was cytochemically determined in the peripheral blood lymphocytes of ten patients with Hodgkin's disease, ten with plasma cell myeloma and ten with primary polycythemia as well as in 20 healthy controls. In all the patients studied a significant decrease in the enzyme-positive cell count with decrease of the intracellular content of enzyme-positive cell count with decrease of the intracellular content of enzyme-positive lysosomal granules was noted. These alterations were more marked in the patients with Hodgkin's disease.


Inhibitory effect of pancreatic juice on the intestinal uptake of vitamin B12. Rat pancreatic juice (RPJ) reduced the mean uptake of 57CoB12 bound to rat intrinsic factor (IF) by perfused rat intestinal segments from 30.1 +/- 2.4 (pg 57CoB12 per cm intestine +/- S.E.M.) to 26.7 +/- 2.4 (p less than 0.05). RPJ activated with enterokinase reduced the uptake from 22.8 +/- 2.8 to 16.1 +/- 1.9 (p less than 0.05). RPJ also reduced the uptake from 15.8 +/- 2.3 to 8.3 +/- 2.0 (p less than 0.01) in segments from partially pancreatectomized rats. Rat bile abolished the inhibitory effect of RPJ. The results indicate that in the absence of bile the exocrine pancreatic secretion is capable of inhibiting the intestinal uptake of vitamin B12.


Serum gastrin and atrophic gastritis in achlorhydric patients with and without pernicious anemia. Forty-two patients with pernicious anemia (PA) and 35 patients with achlorhydria but without PA were investigated by means of serum gastrin determination and estimation of circulating parietal cell and thyroidal autoantibodies. In 38 of the 77 patients, gastroscopic and histopathological examinations of the antral and corpus mucosa were performed. The patient groups were similar with regard to distribution of high and normal serum gastrin levels, the frequencey of autoantibodies and antrum-sparing atrophic gastritis. In the present selection of patients, therefore, the achlorhydria group was supposed to represent a precursor state of the group with PA. A minor proportion of patients with severe atrophic gastritis of the antrum as well as of the corpus mucosa was found in the two groups.


Bile acid metabolism and plasma protein turnover in Crohn's disease. Postprandial duodenal bile acids, intestinal protein loss, and albumin and IgG turnover were studied in 19 non-operated patients with Crohn's disease. A lesion of the terminal ileum was present in 18 of 19 patients, either alone or associated with regional colitis. Identical bile acid studies were made in a control group of 20 patients with chronic diarrhoea of undetermined origin. Duodenal bile acid concentration was decreased in 9 of 19 patients with Crohn's disease, and in 5 of 20 patients with unexplained diarrhoea. The glycine/taurine-ratio was increased in 8 of 17 patients with Crohn's disease, but in only one of the 20 control patients. Abnormal intestinal protein loss was present in 13 of 14 patients with Crohn's disease. The fractional catabolic rate of albumin and IgG was increased in all 17 cases of Crohn's disease studied, except the patient with no protein loss. A statistically significant and positive correlation was observed between glycine/taurine-ratio and fractional catabolic rate of both albumin and IgG. No patient with Crohn's disease harboured an abnormal bacterial flora in the proximal small intestine. It is concluded that, in the absence of abnormal bacterial flora in the proximal jejunum, the glycine/taurine-ratio is more valuable as an indicator of terminal ileopathy than postprandial duodenal bile acid concentration in nonoperated patients with terminal ileitis. Abnormal intestinal protein loss and increased catabolic rate of albumin and IgG are practically always present in active Crohn's disease and are strong evidence of an organic gastrointestinal lesion in patients with normal radiographic findings.