Antigen E content of pollen from individual plants of short ragweed (Ambrosia artemisiifolia). A study was conducted to ascertain how much variation in allergenic potency of ragweed pollen occurs among individual plants and different plant populations in a restricted geographic area. Seeds of the short ragweed (Ambrosia artemisiifolia) were collected from 38 different sites in Champaign County, Ill. Plants from these seeds were grown under similar conditions, and antigen E (AgE) was determined on pollen samples harvested from individual plants. The populations from various sites in Champaign County differed by as much as severalfold with respect to mean AgE values. There were statistically significant differences among population means, although large variations occurred among plants within populations. Further research was conducted to learn whether the level of AgE was determined by genetic factors within the plants. Genetic regulation was indicated by the finding that 3 plants which had unusually low levels of pollen AgE all produced offspring with significantly lower mean AgE levels than those of control plants.


A new method of allergen standardization. Passive cutaneous anaphylaxis inhibition in a mouse-to-rat system in comparison with other methods. Various methods have been employed for standardization of potency of allergen extracts. We used passive cutaneous anaphylaxis (PCA) inhibition in a mouse-to-rat system as a new means of standardization. Several allergen extracts, including mite, short ragweed, house dust, Aspergillus, Candida, and Japanese cedar, were examined. Mouse IgE antibodies were produced after two or three injections of antigen and alum. The potency measured by PCA inhibition in the mouse-to-rat system was compared with that of protein nitrogen (PN) content, end point of prick test in humans, and 50% radioallergosorbent test (RAST) inhibition. Our studies suggest that the mouse-to-rat system could be used to determine allergenic potency and to standardize allergen extracts.


Some diets that meet the Dietary Goals for the United States. Few people in the United States have diets with proportions of complex carbohydrate as high and proportions of protein, fat, and sugar as low as proposed in the second edition of the Dietary Goals for the United States by the Senate Select Committee on Nutrition and Human Needs. Sample diets, including low-calorie diets for adults, were planned to meet the Recommended Dietary Allowances and the Dietary Goals. Two possible "first steps" in modifying diets to meet the Goals explored the use of: (a) Specified ranges rather than specific Goals and (b) some but not all of the Goals.


Strategies for nutritional counseling. Dietitians' attitudes and practice. Responses to a questionnaire distributed to forty-four Midwest dietitians during the development of a program to train dietitians in patient counseling strategies are summarized. Dietitians rated forty-five strategies, divided into five broad categories: Instructional, motivational, behavioral, educational diagnosis, and assessment of compliance. Questions about each strategy included reported use, perceived benefits, and perceived barriers to implementation. Six nutritional consultants rated the relative innovativeness of the strategies. The results provide evidence that strategies currently being developed for training dietitians are compatible with dietetic practice, are often viewed favorably by practitioners, and are "teachable" to nutritionists.


The consultant dietitian in nursing homes. I. Methodology and general information. The functions of the consultant dietitian and the foodservice supervisor were studied by surveying dietitians consulting in nursing homes and the administrators of each dietitian's nursing home accounts. Data were available from consultants and administrators in 297 nursing homes in a twelve-state, midwestern region. Almost 60% of the homes had employed a consultant for three to eight years, and nearly half had employed the present consultant for the same length of time. Generally, the dietitians made one to three visits to the homes a month, for a total of 3 to 12 hr. The administrators listed personnel, cost of department operation, and facilities as problem areas in foodservice. Dietitians reported greater concern than did administrators in all of the rated problem areas except cost. Problem ratings of the two groups reflected differences in interest and expertise.


The consultant dietitian in nursing homes. II. Functions and change effectiveness. Data are reported on functions and effectiveness of consultant dietitians in nursing homes. Key responsibilities of the consultants included: Planning and writing menus, in-service training, nutritional assessment, and discussing diets with physicians. Activities performed on each visit to the nursing home were resident visitation and dietary consultation, nutritional assessment, communication with other departments, and checking foodservice and sanitation procedures. Most important activities of the consultant, as perceived by the administrators, were in three functional areas: Menu planning, modified diets, and education and training. Administrators indicated that the most significant change brought about by consultants involved modified diets, menus, sanitation, and communication between the foodservice department and other departments and with the administration.


A computer-assisted personnel data system for a hospital department of dietetics. I. Development of the data base. A data base was developed for a computer-assisted personnel data system for a university hospital department of dietetics which would store data on employees' employment, personnel information, attendance records, and termination. Development of the data base required designing computer programs and files, coding directions and forms for card input, and forms and procedures for on-line transmission. A program was written to compute accrued vacation, sick leave, and holiday time, and to generate historical records.


A computer-assisted personnel data system for a hospital department of dietetics. II. Labor accounting reports. To provide timely and accurate labor accounting reports for a university hospital department of dietetics, six reports were designed: Monthly analysis of labor costs for biweekly employees, ledger of monthly labor costs, quarterly analysis of turnover, monthly report of unscheduled absenteeism for biweekly employees, labor listing, and seniority listing. Computer programs were written to generate four of these reports; two were generated from a generalized data base management system.


Salad production activities in a residence hall foodservice. The objective of the study was to develop a method of assessing the relationship, rather than the absolute magnitude of the relationship, of production time for salads and the number of servings prepared in a university residence hall foodservice. The intercept, slope, and coefficient of determination relating to preparation time and number of salads were calculated for each salad. Production time was influenced by factors other than quantity of food produced.


Mexican-American views of Anglo medical and dietetic practices. Institutions involved in health care delivery and foodservice to a population with large ethnic communities might increase their effectiveness if they knew the possible influences of the folklore or local customs of these groups on the attitudes of their patients. The observations and survey of Spanish-speaking patients by the Department of Food Services at the University of Arizona Health Science Center should be a stimulus for further study of ethnic groups by health professionals.


Myocardial infarction in the differential diagnosis of dementias in the elderly. The incidence of cerebral lesions in relation to myocardial infarction (MI) was evaluated on the basis of data obtained from medical records and autopsy reports on 269 psychogeriatric patients, in a 13-year retrospective study. Among 84 demented patients with MI, brain infarcts and hemorrhages were found in 42 percent, and Alzheimer's disease in 17 percent; (combination in 8 percent). In contrast, among 70 demented patients without MI, brain infarcts and hemorrhages were found in 11 percent, and Alzheimer's disease in 43 percent; (combination in 6 percent). Therefore, when it is difficult to differentiate senile dementia (Alzheimer's disease) from dementia due to cerebrovascular impairment, data on the presence or absence of myocardial infarction may prove useful.


Chronic and acute disease problems in rural nursing home patients. The patients of a rural nursing home in Iowa were surveyed according to age and sex, plus chronic and acute disease problems. With the use of the International Classification of Health Problems in Primary Care, the diagnoses were organized by major disease category and by specific diagnosis. Of the 66 patients, 76 percent were age 75 or older. Women comprised 61 percent of the group, and men 39 percent. Overall, the mean age was 79.1 years. Senility was the most common diagnosis for chronic diseases, and genitourinary infections for acute diseases. Circulatory system disorders comprised the largest category of chronic diseases, whereas genitourinary comprised the largest category of acute diseases. Overall, there were 4.2 chronic disorders per patient. Although the data compare favorably with those in the National Health Survey of nursing homes, more research is needed to prepare medical personnel for the problems associated with a rapidly expanding population of elderly patients.


Drug utilization and prescribing patterns in a skilled nursing facility: the need for a rational approach to therapeutics. A study was made of 50 patients drawn at random from a Skilled Nursing Facility (SNF) attended by seven physicians. For 59 percent of these patients, polypharmacy was practiced but no substantiating diagnoses were recorded. Approximately half of the drugs were administered pro re nata. More drugs were prescribed in potentially toxic dosages than in subtherapeutic dosages. The risk of an adverse drug reaction (ADR) was most often associated with anticholinergic agents, sedative-hypnotic drugs, and neuroleptics (thioridazine and chlorpromazine), particularly when prescribed concurrently. Risk of an ADR was highest when a drug was prescribed without recording a definite diagnostic indication. Lack of consistency by individual physicians in their approaches to the therapy of similar disease entities in comparable patients tended to support the concept of peer review in SNFs and also the need for teaching a rational approach to therapeutics in SNFs based on clinical pharmacology as applied to the elderly.


Simple primary tuberculosis in an elderly woman. The diagnosis of primary tuberculous infection was made in a 78-year-old woman. The chest roentgenographic findings were remarkably similar to those often seen in children and adolescents with primary infection. Like the majority of adults with this entity, the patient was asymptomatic; the diagnosis was suspected epidemiologically and was confirmed by culture of M. tuberculosis from the sputum. As the incidence of new tuberculosis cases declines, the diagnosis of primary tuberculosis in the adult may be made more frequently.


Senile confusion: assessment with a new stimulus recognition test. There is a need for rapid and convenient assessment instruments to test the aged for senile confusion due to organic brain syndrome (OBS). The Mental Status Questionnaire (MSQ) and the Face-Hand Test (FHT) have certain limitations. A valid instrument must measure short-term memory loss and recognition. Sixty-two patients were examined in 17 different trials of the Stimulus Recognition Test (SRT), which involves 10 items. Each item classified the patients according to staff ratings (P less than .001), MSQ MSQ scores (P less than .005), and FHT scores (P less than .005). The composite MSQ score on a scale of 0--10 also served to separate the patients according to staff ratings (P less than .005). The SRT scores correlated .81 to .67 with the MSQ and FHT scores. The SRT does not show the same false positive patterns as the MSQ and FHT. For that reason, it constitutes a useful diagnostic supplement. Suggestions for further research are made.


Institutionalized older adults and their future orientation. This study hypothesized: 1) that as the duration of institutional living increases, the future orientation of active older adults contracts; and 2) that this constriction in future temporal orientation means less opportunity for interaction in the institutional environment. To test the first hypothesis, 100 active female residents in six institutions for the aged were evaluated regarding future orientation, by means of Cottle's Experiential Inventory. The opportunity for interaction was measured by Pincus's Psychosocial Dimensions in the Institutional Environment. The findings indicated that, irrespective of age, the residents became less future-oriented or their orientation became less recent, as the length of institutional residence increased. The second hypothesis was not supported; in fact, the reverse was true.


Systolic hypertension: occurrence and treatment in a defined community. Systolic hypertension, a disorder occurring predominantly in the elderly, is associated with an increased incidence of stroke and coronary artery disease. Based on the supposition that it is a risk factor, many authorities have urged that it be treated. This report concerns an experience in treating systolic hypertension in a defined ambulatory population of 898 hypertensive subjects in a work-site program. The systolic hypertension group (N = 39) was compared with a matched diastolic hypertension group and with a matched systolic/diastolic hypertension group (N = 39 each). The patients with systolic hypertension responded to standard treatment (chiefly with diuretics), but less satisfactorily than did the patients with diastolic hypertension. Side effects or toxicity were uncommon and did not interfere with the therapeutic regimen. However, the ultimate value of such therapy in the prevention of vascular complications remains to be determined.


The elderly patient in the coronary care unit. I. Acute myocardial infarction. In a Coronary Care Unit (CCU) with no age barrier for admission, 21 percent of the patients admitted in 1976 were aged 70 or older. Myocardial infarction was documented in 55 of 130 elderly patients. The overall incidence of arrhythmias was similar to that for younger patients. The mean  duration of stay in the unit and the CCU mortality (9.1 percent) were similar in both elderly and younger patients, as was the in-hospital mortality rate. Of the patients who survived hospitalization, 75.6 percent were still living 18.1 months after the myocardial infarction. The elderly patient is as likely as the younger one to benefit from admission to a CCU.


A psychogeriatric assessment program. V. Three-year follow-up. In 1974, a 10-month diagnostic evaluation of 80 newly admitted psychogeriatric patients was undertaken. The diagnostic categories were functional versus organic brain disease. The present report deals with results of a follow-up evaluation three years later. To assess the prognostic validity of our measures, the initial 1974 data on survivor and nonsurvivor groups were studied, and some of the tests were repeated in 35 of the 40 survivors. Statistically significant differences between survivors and nonsurvivors were found in both "organic" and "functional" groups, with respect to performance on psychologic and psychophysiologic tests, and the level of social functioning before admission. The death rate was significantly higher in the group with organic disease.


Rheumatoid arthritis in the elderly, presenting as polymyalgia rheumatica. Two elderly patients presented with generalized aches and pains (particularly in the shoulders and the pelvic girdle), stiffness, fatigue, anemia, and an elevated erythrocyte sedimentation rate, but there were no signs or symptoms directly referable to the joints. Two and five months later respectively, pain, swelling, and signs of synovitis appeared in several joints in a symmetrical pattern, and a diagnosis of rheumatoid arthritis was made. Rheumatoid arthritis in the elderly may resemble polymyalgia rheumatica. On the other hand, synovitis in many patients with polymyalgia rheumatica may resemble rheumatoid arthritis. In the elderly, the differentiation of these two entities may be difficult. Moreover, patients initially presenting with the signs and symptoms of polymyalgia may eventually manifest typical rheumatoid arthritis.


Attitudes of health workers toward old people. The Tuckman-Lorge Questionnaire was used to study the attitudes of three groups of health workers toward old people and to test their acceptance of geriatric stereotypes. The health workers tested were medical students, housestaff members, and members of a mobile psychogeriatric screening team. Many significant differences were found between and within the groups tested, as well as between male and female subjects. The female housestaff had extremely high and significantly different scores from all other groups. The geriatric staff adhered least to the stereotypes. The results are discussed in the framework that the attitudes of care givers are directly related to the quality of the care provided. It is hypothesized that female housestaff members have special difficulties with role conflicts that cause them to adhere to stereotypes of the aged. The milieu of geriatric treatment, rather than knowledge of statistics about old people, is the most effective background for positive changes in attitudes toward the elderly.


The elderly patient in the coronary care unit. II. Incidence and treatment of arrhythmias. In 1976, 130 patients aged 70 or older were admitted to the Coronary Care Unit (CCU) at Toronto Western Hospital. Arrhythmias were noted in all but 24 percent. Digoxin was given to 53 patients, lidocaine to 24, propranolol to 28, and quinidine to 11. In 2 patients, cardioversion by direct current was required for supraventricular arrhythmias. In 26 patients, temporary pacemakers were used. Of 13 patients who experienced at least one cardiac arrest in the CCU, 10 survived to be discharged to the ward. In total, only 12 of the 130 elderly patients died in the hospital, and in only 3 of these was arrhythmia the primary cause of death. The treatment of arrhythmias in the elderly is as successful and rewarding as in younger patients. Indications for the various antiarrhythmic drugs are similar. Except for digoxin, the dosages of such drugs for the elderly are the same as those for younger patients. Adverse effects apparently are not more common in the elderly.


Emergency transvenous (subclavian) cardiac pacing in elderly patients. Emergency transvenous cardiac pacing can be performed in elderly patients rapidly, effectively, and with few complications. An experienced physician using the subclavian route usually can achieve effective pacing with equipment priced well within the budget of most community hospitals. Data on 36 patients (age range, 75-94 years) are presented.


Behavioral improvement in long-term geriatric patients during an age-integrated psychosocial rehabilitation program. A study was made of the effects of a psychosocial rehabilitative program on the behavioral functioning of elderly chronically ill patients. High school students served as remotivation and socialization therapists in a supervised structured process designed to improve the quality of life for the participating nursing-home residents. The participants were 12 long-term patients whose ages ranged from 62 to 99 years (mean, 73.2 years). The effectiveness of the program was evaluated by means of the Sickness Impact Profile (SIP), a questionnaire designed to assess the effect of a physical illness on daily activities, psychosocial skills and mental status. The results demonstrated that the rehabilitative program had a significant impact on several dimensions of the lives of the participants. As a consequence of the interaction with the students, there was an increase in social interaction, a reduction in daytime sleeping and an increase in mobility. The results reported here extend the successful use of remotivation techniques to areas of overt behavioral functioning not previously assessed.


Prosopo-affective agnosia as a symptom of cerebral organic disease. A previously described test for prosopo-affective agnosia (impairment of facial affect recognition) had been applied in 14 disoriented elderly patients with chronic organic brain syndrome, 14 fully oriented elderly patients with non-organic psychiatric disorders, and 14 normal volunteers. In this re-test study of 37 of the 42 subjects, after a six-month interval, the test was found to be reliable (r = .75, p less than .001). The test was also more sensitive in detecting organic disorders than were other frequently applied neuropsychiatric tests. Prosopo-affective agnosia (PAA) appeared unrelated to prosopo-agnosia (PA) (r = .082, ns). Some patients who had the ability to recognize famous faces and faces of ward personnel were severely impaired in the ability to recognize facial affect. The deterioration was more pronounced for the recognition of sadness and anger than for happiness, indicating that patients with this impairment had reverted to an infantile mode of facial-affect recognition. This reversal is another example of the neurologic regression that characterizes dementia.


Cardiovascular side effects of long-term therapy with tricyclic antidepressants in the aged. In a study to determine the nature and frequency of cardiac side effects during long-term administration of tricyclic antidepressant drugs in usual dosages in the aged, 32 geriatric patients were followed for an average of 36.6 weeks. Ten of them received amitriptyline in a daily dosage of 20-75 mg for 53 weeks (average); in 2, electrocardiographic side effects developed, viz, inversion of the T waves or evidence of acute coronary insufficiency. Imipramine was administered to 21 patients in a daily dosage of 20-100 mg (average, 66 mg) over a period of 40 weeks; in 3 instances major side effects developed--intermittent left bundle-branch block, acute coronary insufficiency with node dysfunction, or T-wave inversion with sinus tachycardia; in 1 instance there was a minor side effect, viz, tachycardia only. In 1 patient, acute myocardial infarction developed after two 10-mg doses of nortriptyline. Five of the 7 patients with cardiac side effects had prior organic heart disease. It was concluded that the incidence of cardiac side effects in aged persons given tricyclic antidepressant drugs in the usual therapeutic dosages for a prolonged period is great enough to warrant frequent careful monitoring of cardiac status during therapy.


Degradation of pentachlorophenol (PCP) in aerobic and anaerobic soil. Aerobic and anaerobic degradation of 14C-labeled pentachlorophenol (PCP) was examined in nitrogen aerated, moist Hagerstown silty clay loam with or without cellulose amendments. In anaerobic soil, PCP reduced soil respiration in the presence of cellulose; volatilization losses accounted for only 0.5% of the PCP added to soil; no 14CO2 was detected; and organic solvent extractable radioactivity was the same from all treatments. Gas and thin-layer chromatographic analysis of the soil extracts showed the presence of pentachloroanisole in both aerobic and anaerobic soils. 2,3,5,6- and 2,3,4,5-tetrachlorophenols and 2,3,6-trichlorophenol were also detected as degradation products by gas chromatography after methylation. Further degradation of pentachloroanisole was examined in both aerobic and anaerobic soils.


Fluorescence detection and determination of patulin by thin-layer chromatography of its aniline imine. A sensitive and simple procedure is descrobed for the analysis of the mycotoxin patulin. The method involves extraction of patulin from the sample, silica gel column chromatographic clean-up, preparation of the aniline imine, thin-layer chromatographic separation on silica gel, hydrogen chloride hydrolysis of the imine, and fluorophore formation from the liberated aniline with fluorescamine. A linear calibration curve was obtained for the 10-100 ng range and the limit of detection was 5 ng. Recoveries of patulin from samples of apple juice spiked at 50-500 ppb were quantitative.


Occupational effect of phosfolan insecticide on spraymen during field exposure. Phosfolan (Cyolane), 2-(diethoxy phosphinylimino)-1,3-dithiolane is one of the widely used insecticides in Egypt specially to protect cotton plants. The hazard of exposure of the spray workers team in the field was estimated in terms of the amount of Phosfolan insecticide retained on workmen body pads during field spraying. The health effect of such exposure was determined through recording of the AChE inhibition in the red blood cells at different intervals after exposure. The calculated percentage of the toxic dose received per every spraying day for each worker varied with the type of job in the range of 0.008 to 0.03 percent. The body of the mixer received the maximum exposure with 10 to 12 fold that of the assistants. The highly exposed group of workers suffered from 31 to 44 percent RBC's AChE inhibition. About half of the inhibited enzyme activity recovered after 48 hours. Then it took more than 3-4 weeks to reach complete recovery. Thus the RBC's AChE activity can be recommended as a criterion for the level of exposure to organophosphorous insecticides.


Cyanide residue levels in extracted honey, comb honey and wax cappings. Cyanide (CN) residue levels were determined in samples of extracted honey, comb honey and was cappings at 1 hr, 24 hr, and 48 hr intervals after destroying the bees in honey bee colonies with normal (ca. 8.5 g) and twice normal (ca. 17 g) doses of CyanogasR A-dust. Applications of CyanogasR A-dust, administered by means of a dust pump at normal and twice normal doses, gave an average residue of 0.01 and 0.04 microgram CN/g of extracted honey, 0.01 and 0.02 microgram CN/g of comb honey and 0.04 and 0.06 microgram CN/g of wax cappings, respectively. When the CyanogasR A-dust (ca. 17 g) was placed on a tray and placed on the bottom board of the hive, the average residue levels for extracted honey, comb honey and wax cappings were less than 0.004, 0.01 and 0.02 microgram CN/g, respectively. Random honey samples from beekeepers, who used CyanogasR to destroy bees, had a median level of 0.031 microgram CN/g, whereas honey from a packing plant and other commercial samples contained less than 0.004--0.026, median less than 0.004 microgram CN/g. Based on residue data from this study, the temporary registration for CyanogasR, to kill honey bees after crop removal, was revised to a full registration in May 1977.


Sequential participation of glutathione and sulph-hydryl(s) in reductive dechlorination of 2,4-di-, and 2,4,5-trichloro phenacyl chlorides by soluble fraction (105,000 x g) of chicken liver homogenate. The mode of reductive dechlorination of alpha-chloroacetophenones, 2,4-di-, and 2,4,5-trichloro phenacyl chlorides into respective acetophenone by soluble fraction (105,000 x g) from chicken liver homogenate has been investigated. The transformation involved the sequential participation of glutathione and a sulph-hydryl. The phenacyl chloride first reacted with glutathione to yield the phenacyl glutathione, which in turn, in the presence of a sulph-hydryl, was reduced enzymatically to produce the ketone, probably via a disulfide intermediate.


Heavy metals in Ras Beirut prawns and sea urchin eggs. Whole samples of Palaemon elegans Rathke, 1837 and eggs of Paracentrotus lividus Lamarck, 1816 were collected on the coast of Ras Beirut, Lebanon in the summer and fall of 1977 and the spring of 1978. All were analysed for lead, cadmium, copper and other heavy metals. Lead concentrations in both the prawns and sea urchin eggs appeared to be highest in the summer and lowest in the spring, whereas cadmium was low in all seasons with only a few elevated readings. The strongest tendency towards seasonal variation was seen in the copper levels of the prawns, which were high in summer, much lower in fall, and then high again in spring. Results of the analyses for nickel, iron, zinc and chromium are also discussed. Of the various possible sources of heavy metals in the Ras Beirut coastal area, untreated sewage, pesticide residues, and automobile exhaust are the most important.


Studies on saprozoonosis. I. A survey on Aspergillus species with special reference to occupational habits. A comprehensive survey of Aspergillus species has been carried out among different cattle and donkey handlers. A total of 300 pharyngeal swabs of different subjects including 100 control and 100 each from cattle and donkey handlers was investigated. All the subjects were found healthy. Among the species of Aspergillus, the number of A. flavus appeared higher followed by A. fumigatus, still lower number was encountered with other species like A. nidulans and A. glaucus. In order to establish the saprozoonotic relationship, soil and air samples of various animal sheds were also analyzed. It was found that the total number of isolates of Aspergillus species from animal sheds were always higher compared to the control samples. None of the A. flavus strains obtained from air samples produced aflatoxin. Histopathological changes in Swiss mice caused by intratail vein administration of spores of Aspergillus species have been investigated.


DNA synthesis in the human diploid cell strain WI-38 during in vitro aging: an autoradiography study. The percent of cells in a WI-38 cell population which did not incorporate tritiated thymidine (3H-TdR) was determined by autoradiography from the measurement of percent nonlabeled nuclei and the ratio of total cell numbers at the initiation and at the termination of exposure to 3H-TdR. This percentage was minimally affected by factors influencing the proliferation of labeled cells, but was dependent on the population doubling level (PDL). The results suggest the presence, in a proliferating WI-38 population, of subpopulation(s) with an extremely slow rate of S phase entrance. The parameter was useful in estimating, empirically, the doubling potential of a cell population.


Senescent human diploid cells in culture: survival, DNA synthesis and morphology. Senescent human diploid cell cultures (WI-38 and WI-26) were studied during Phase III for survival time, ability to synthesize DNA, and nuclear morphology. Periodic transfers made during a 6-month period of Phase III showed that cultures were maintained with only slight variations in cell number. No sign of spontaneous acquisition of infinite proliferative potential was observed. The increase in the number of multinucleated cells found during the period of observation showed that progressive changes occur in Phase III. A certain proportion of cells maintained the ability to incorporate tritiated thymidine throughout the period of observation.


Apposition of uterine luminal epithelium during implantation in senescent golden hamsters. Closure of the uterine luminal epithelium was examined with light and electron microscopy in 3 to 5-month-old and 14 to 15-month-old golden hamsters at 3 1/2, 4, and 4 1/2 days of pregnancy. Apposition of the uterine luminal epithelium and the subsequent changes occurring during the early stages of implantation were delayed approximately 12 hrs in senescent females. However, the sequence of events and the degree to which the uterine epithelium closed and made contact with implanting blastocysts were similar in both age groups. It does not appear that closure of the uterine luminal epithelium or blastocyst attachment to the epithelium is impaired in 14 to 15-month-old hamsters but that other factors are responsible for the declining litter size.


The aging human cerebral cortex: a stereological characterization of changes in the capillary net. Capillaries in the cerebral cortex of six age groups, ranging between 19 and 94 years (= 34 human brains) were stereologically investigated. Capillary parameters such as diameter, volume fraction, specific surface area, mean intercapillary distances and total length per unit cortex volume in patients older than 75 years were similar to those in young ones, 19 to 44 years old. Aged subjects between 64 and 74 years revealed increased capillary diameter, volume and total length per unit cortex volume, as well as decreased specific surface area. Frequency distributions in the same age indicate a real increase of capillary diameter and volume, as also an increase of these parameters on the level of blood vessels with diamteres greater than 8 micrometer, probably arterioles. The results of this study argue against the wide-spread assumption of a decreased blood supply in the cerebral cortex during old age. On the contrary, the capillary net is able to respond to changed metabolism and blood pressure.


A multivariate study of psychogeriatric readmissions. Clinical, demographic and psychosocial items of information were gathered on two samples of 41 single admission cases and 42 readmissions among a population of psychogeriatric patients. Discrominant function analysis indicated that different variables are predictive of readmission for females and males. A discriminant classification procedure demonstrated that contact with family, age and level of education are significant predictors of readmission (93% classification success) for males in the sample, while different factors, community involvement, type of treatment and follow-up, do not attain significance for women.


A study of age categorization.

A study of age categorization. This study used photo (stimulus persons) to explore age categorization in a sample of 150 subjects of diverse ages: 15 males and 15 females in each of five age groups: 18--21, 22--28, 29--38, 39--55, and 56--76. Two sets of 33 photos each (a male and a female set) were presented to subjects for chronological age estimation, age categorization (as adolescent, young, middle-aged, elderly, and aged adult), and preference. Results indicated considerable overlapping of estimated ages across age categories, suggesting that the boundaries between adjacent age stages are highly permeable. Sex-of-photo exerted a major influence on categorization and preference. Female, relative to male, stimulus persons were assigned to older age categories, were perceived to attain middle-aged and elderly status sooner, and were younger when chosen as most preferred (but only for male subjects). These sex-bias effects were mitigated in the oldest respondent. Relevance of the present research to problems of age stereotyping is discussed.


The effect of deviations from stereotyped expectations upon attitudes toward older persons. Subjects read an interview in which either a 36-year-old or a 76-year-old widow talked about her life and discussed how she had spent the previous day; they then recorded their impressions of the woman and rated her on a number of scales. Contrary to expectations, subjects rated the older woman significantly more favorably than the younger woman, even when her behavior corresponded to negative stereotypes of older person. Evidence from subjects' written impressions and spontaneous comments indicated that an older person who is alert, interesting, and involved is perceived as deviating from stereotyped expectations and is evaluated more positively than a younger person who exhibits these same characteristics. This may account for the fact that perceivers consistently view specific older persons as exceptional, even while they retain negative stereotypes of older people in general.


Adult age differences in free recall as a function of basis of organization and method of presentation. To examine age-related differences in the discovery of intralist relationships, young and elderly adults were presented a free-recall list in either the conventional successive single-item format or in a whole-list display. A list that could be organized by associative or rhyming intralist relationships was used to test the levels-of-processing model of memory as an explanation of age differences in recall. Young adults recalled more base-words, associates, and rhymes than elderly subjects on immediate free and cued tests and on an uncued test one week later. Elderly subjects showed less utilization of both semantic and nonsemantic intralist relationships. Age did not interact with method of presentation. Recall and organization deficits occurred for elderly adults even though they were less anxious than young adults.


The interaction between age and list length in free recall. Using the "delayed-recall" procedure developed by Shiffrin (1970), the effects of list length on encoding, storage, and retrieval processes in different aged subjects were assessed. The length of a list interpolated in the retention interval did not interact with age, while an interaction was found between age and the length of list being recalled. Age differences in the probability of recall decreased as the length of the list being recalled increased. This interaction was replicated in a second experiment with immediate recall. This interaction seems most compatible with the hypothesis that older persons use less spontaneous organization during list learning. List length primarily disrupts the ability of younger subjects to develop adequate organizational plans (2.e., longer lists are more difficult to organize), and because older subjects are organizing less, they are less affected by the increases in list length.


Age effects on event-related potentials in a selective attention task. We used an event-related brain potential (ERP) technique developed by Hillyard et al. (1973) to test abilities to attenuate irrelevant stimuli and to detect target stimuli. Subjects, 12 healthy old (80.3 years) and 12 healthy young adults (22.0 years), heard 1500 Hz tones in one ear and 800 Hz tones in the other ear. Infrequently, the pitch of either tone was raised. During one run, infrequent tones in the right ear were targets, and in the other run those in the left ear were targets. Subjects counted targets. For both groups, an early component of the ERP (N1) was larger to tones in the attended ear than in the unattended ear, and a later component (P3) was largest to the target. This suggests that both groups can attenuate irrelevant stimuli and can use stimulus probability information in this task. That P3 was later for old subjects suggests that they take longer to decide stimulus relevance.


Rotation of mental images by young and old college students: the effects of familiarity. Younger and older college students judged whether letters, rotated from 0 to 180 degrees away from normal, upright position, were standard letters or mirror-images of standard letters. The analysis separated basic speed of response from the rate at which mental manipulations of the images of the letters took place. With letters from the English alphabet, younger (mean age, 21.6 years) and older (mean age 55.9 years) sugjects did not differ either in basic speed or in rate of manipulation. With unfamiliar, lower-case Greek letters, however, the basic speed of older subjects (mean age, 56.5 years) was slower than that of younger subjects (mean age, 21.2 years) while there was no difference in rate of manipulation. The results are inconsistent with an hypothesis of general slowing of central nervous system activity.


Age differences in relationships between crystallized and fluid intelligences and problem solving. One hundred and sixty-two subjects at three age levels were tested to examine the relationship between crystallized (Gc) and fluid (Gf) abilities and three problem solving tasks varying in the abstractness concreteness of their stimuli and emphasis on past experience. It was predicted that the difference in correlations between crystallized and fluid abilities and each of these tasks would increase with increased age. The hypotheses were partially supported in the young and elderly groups of subjects. On tasks using concrete stimuli, emphasizing past experience, where no cross-sectional decline was observed, Gc (relative to Gf) accounted for an increasing proportion of variance in performance with increased age. On tasks using abstract stimuli, de-emphasizing past experience, where significant cross-sectional declines were obtained, Gf (relative to Gc) correlated more highly with performance. Contrary to previous research, relationships between Gf and Bc supported a reintegration of abilities in old age.


Values and self-esteem in three generations of men and women. Similarities and differences in values within families across three generations were examined. The relationship between values and self-esteem was also investigated. Sixty inter-generational triads (30M;30F) rated 14 values on a semantic-differential scale. The hypotheses of generational similarities in long-term, central (in Rokeach's terms, terminal) values and of generational differences in short term, specific (Rokeach's instrumental) values were generally supported. However, the hypothesized interactions of self-esteem and generation with values were only minimally supported by these data. There were no generational differences in the terminal values Equality, An Exciting Life, Freedom, and A Sense of Accomplishment. The oldest generation rated the instrumental values Ambition, Capability, Independence, and Intelligence higher than did the other generations. In addition, they rated the more work-oriented values of Education, Money, Success and Work highest. These findings are discussed as possible cohort rather than as age effects. Women rated Ambition, Education, and Intelligence more highly than men.


Age bias, referral for psychological assistance and the private physician. The responses of 60 physicians to a questionnaire comprised of a brief section for demographic information and eight vignettes describing patients with obvious psychiatric symptoms were analyzed. On alternate forms of the questionnaire, the age of the patient was reversed for each vignette. Old patients were referred for psychological assistance significantly less frequently (p less than .001) than were young patients, although both groups were described as presenting identical symptomatology. For those vignettes that described more severe behavioral disturbances, differences in the referral rates of young and not old patients was most pronounced. The results are discussed in terms of age bias on the part of the referring physician and the effect this may have on the provision of mental health treatment for elderly persons.


Rural-urban differences in the structure of services for the elderly in upstate New York counties. This research examines the impact of federal intervention and local community effort on the development of programs for the elderly. The study was designed, first, to gather longitudinal data on the structure of services for the elderly in 53 upstate New York counties for comparison with a study conducted in 1967 and, second, to measure the effectiveness of 43 counties with a County Office for the Aging (COFA) in mobilizing resources to increase services for the elderly. The findings reveal: (1) federal intervention has had the effect of an overall increase in services while at the same time decreasing rural-urban differences; (2) urban COFAs score consistently higher on the measures of community effectiveness; (3) the educational attainment of COFA directors is not a good predictor of success in mobilizing outside resources in both urban and rural counties; (4) in urban but not in rural counties, directors with administrator/planner experience have greater success in mobilizing outside resources.


The meaning of voluntary association participation to older people. Studies have indicated little association between participation in voluntary associations by older people and well-being. This may reflect self-selection by well-to-do older people who are "joiners" or a lack of truly involving group roles. From interviews with 323 persons over 60, it was found that active group participation yielded more "meaningful" reasons for enjoyment, and card-playing less meaningful reasons. Such reasons for group participation as contacts with others and passing the time were associated with lower satisfaction. On the whole, however, type of activity and reasons for participation had little relationship to life satisfaction, since they largely reflected health and socioeconomic status differences.


Substitution of outpatient care for inpatient care:problems and experience. This paper provides a logical framework for considering possible alternatives to inpatient care. First it presents the concept of a substitute-complement relationship among factors of production (or goods and services in consumption) and examines several problems often encountered when applying this concept. Second, it presents four general sources of substitution: (1) technological innovation; (2) changes in organization; (3) capital accumulation; and (4) the dissemination of knowledge. Third, it examines nine activities which are frequently mentioned as providing alternatives to inpatient care. Fourth, it examines some problems and consequences of governmental efforts to plan substitution. The general thrust of the paper is that the substitution process is complex and often depends upon amorphous variables whose influences are subtle, generally nonquantifiable, and often of overriding importance. These variables introduce a downward bias in estimates of program costs and an upward bias in the estimates of program accomplishments. The result is that government attempts to plan substitution are not well conceived and will generally fall short of announced goals and/or cost significantly more than original estimates.


Children's advocacy and primary health care. Children cannot always articulate their own interests or make their own decisions. Children's advocacy is fundamentally an attempt to improve the lives of children. The advocacy effort may be directed either toward improving the outcomes of the decision or the process through which the decision is made. Children as a class are not well served by the health sector relative to other groups; poor children receive benefits and bear costs unequal to the nonpoor; and there is an unnecessary gap between what our technology is capable of offering and what is actually provided. These facts, in combination with the understanding that child health decisions are frequently made in arenas where the intersts of children are not well represented, strongly suggest that child health care decision making can be improved. Children's advocacy offers opportunities for such improvement.


Nosocomial klebsiellas. I. Colonization of hospitalized patients. The colonization of patients by Klebsiella and several other gram-negative bacteria was studied in a hospital urological ward over a period of six months. Before and during the survey there was no evidence of an outbreak of nosocomial infection and multi-drug resistant strains of Klebsiella were not isolated. Klebsiella were biotyped by nine biochemical tests, which led to the detection of 66 biotypes spread uniformly throughout the survey period. This method of biotyping proved a useful epidemiological tool. The colonization rate of throats, hands, and faeces of patients increased after admission to the ward, especially when antibiotics were used. The effect of systemic antibiotics was greater than that of urinary antibiotics especially on throat and faeces carrier rates. Carrier rates for Klebsiella increased also after catheterization and operation--relationships which could well be multifactorial. During the first two weeks after admission the proportion of antibiotic resistant strains of Klebsiella in carriers increased. The proportion of resistant strains amongst isolations from clinical infections was always greater than among strains isolated routinely from sites of carriage.


Nosocomial klebsiellas. II. Transfer in a hospital ward. During a 6-month period an epidemiological survey of the carriage of Klebsiella was conducted in a hospital ward where no outbreak of nosocomial infection occurred. In this endemic situation the regular sampling of several sites of patients, members of the nursing staff, and the environment, and the biotyping of Klebsiella made it possible to analyse the patterns of transmission between sites. There was abundant evidence for striking transmission of Klebsiella between the throat, hands, and faeces of patients. Transmission between patients seemed to be mainly through hands. The role of nurses' hands in transmission was not evident from this survey, probably due to the relatively long interval (a week) between samplings. Through the hands of patients, wash stands and the surrounding floor were contaminated with Klebsiella. The biotyping of Klebsiella facilitated the epidemiological analysis of the results.


Protection from natural infection after live influenza virus immunization in an open population. Live attenuated influenza vaccine containing the recombinant of A/Victoria/3/75 with A/PR/8/34 virus was administered to healthy adults in a field trial aimed at evaluating protection provided by immunization. The study was designed to measure the effect of vaccination on absenteeism from respiratory disease during a natural influenza epidemic. A total of 2115 male employees of the public transport service of Rome volunteered to participate in the trial, 1050 and 1065 receiving vaccine and placebo respectively, in a randomized blind fashion. Vaccination procedure was completed by the end of December 1976. A small-sized outbreak of influenza, due to a viral strain antigenically homologous to the vaccine, occurred during the month of February 1977. Analysis of absenteeism data, classified according to medical certificate, indicated that morbidity from respiratory disease was reduced in vaccinees compared with controls during the epidemic month; the rate of increase of morbidity compared with that of the preceding month was then three times lower in vaccinees than in controls and the difference in absenteeism between the two groups greatly exceeded the ordinary fluctuation that was observed during non-epidemic periods.


A laboratory model for the investigation of contact transfer of micro-organisms. The model was based on grasping a fabric-covered bottle contaminated with a strain of Staphylococcus saprophyticus, then grasping a sterile fabric-covered bottle and counting the organisms transferred. When the donor fabric was moist 10% of the available cells passed onto the hands, but this fell to 0.05% when the inoculum dried. Transfer from wet hands to the fabric amounted to 85%, but in the complete model only 0.06% of the available cells were transferred. The model was used to assess simple methods of degerming the hands. Washing the hands reduced transfer by 95%, while washing in 70% alcohol reduced transfer by 99.99%. Lesser procedures investigated included applying 0.2 ml of 80% ethanol to the hands, which reduced transfer by 93%.


Brucella abortus in the bitch: subclinical infection associated with urinary excretion. Brucella abortus infection in the bitch, associated with an aborted bovine fetus, is described. Clinical signs were absent, but the organism was isolated from many sites in the body, including the urine, after death. The response of the dog to B. abortus infection and its possible role as a vector of the disease is discussed.


The influence of operating conditions of activated-sludge treatment on the behaviour of f2 coliphage. The behaviour of f2 coliphage during activated-sludge treatment was influenced by the temperature, flow-through-time, concentration of mixed liquor suspended solids and the virus load. The most sensitive way to detect behavioural changes was to examine the regression coefficients for the rate of uptake or loss of virus by the mixed liquor solids. This type of analysis revealed, for instance, high values when the solids concentration was high and even greater values occurred when high inocula were used. At high temperature the rate of loss of virus titre after inoculation had stopped was greater than the rate of uptake of virus during inoculation although in all other conditions uptake occurred at a greater rate than the loss of virus. The coefficients were relatively low when the flow rate was increased, when the temperature was low or when the inoculum was small. The distribution of virus between the solids and liquid fractions of the mixed liquor varied somewhat for all conditions but was notably different when (a) the plant was incubated at 5 degrees C when there was much less virus in the solids fraction than usual, and (b) when the inoculum was low and a much higher proportion of virus was found in the solids. The efficiency with which virus was removed across the plant was the least-sensitive determinant of viral behaviour and the value was about the same for most treatment conditions. However, low or high inocula did result in some increased or decreased removal of virus, respectively.


Ecological effects of antibiotic production by dermatophyte fungi. Antibiotic production by dermatophyte fungi has been demonstrated in vivo in the lesions of patients with dermatomycoses. Patients infected with antibiotic-producing strains more frequently carried cocci resistant to penicillin and other antibiotics than did patients infected with non-producer strains. The total bacterial load was less in lesions caused by producer fungi. In vitro studies demonstrated the selection of penicillin-resistant S. aureus from mixed populations of resistant and sensitive cells.


An inherited mild middle-aged adiposity in wild mice. In a warfarin-resistant population of wild mice reared in the laboratory, a dominant gene for adiposity, Ad, was found to segregate. The onset of obesity is at 4--6 months, and adipose mice suffer from hyperinsulinaemia; the sexes differ in penetrance, males having greater penetrance then females. Linkage backcrosses show the gene to be situated on chromosome 7 with about 25% recombination with the closely linked warfarin-resistance genes War, and frizzy, fr. The finding of adipose in two other wild populations also carrying War is discussed as an ecological and physiological problem.


HLA in populations: an approach for genetical susceptibility to cancer. The geographical correlations between the incidence of various cancers and the HLA and ABO antigen frequencies are studied. There is, for example, a positive correlation between breast and colorectal carcinoma and AI, B8 and B12 antigens, and a negative one between prostate carcinoma and B12. The role of the HLA system itself or other genes involved in these associations is discussed. This study gives some evidence of a possible genetic background of susceptibility or resistance to cancer.


Genetic differences in the mitogenic response of peripheral blood lymphocytes in the chicken. The mitogenic responses of chicken peripheral blood lymphocytes were compared in two partially inbred chicken lines and in their hybrids. The lymphocytes of line P chickens showed a higher phytohaemagglutinin (PHA) response than those of line V chickens and (P X V)F1 hybrids. The Con A responses were of the same magnitude in all chicken lines. The higher PHA response in line P chickens was not sex-linked, apparently was not associated with the major histocompatibility complex and it did not correlate with immunoglobulin G allotypes.


Inhibition of lymphocyte cytotoxicity and mitogen-induced transformation of lymphocytes by human skin homogenates. Limitation of the inflammatory cascade has been demonstrated in man by an inhibitor(s) of the prostaglandin system and by inhibitor(s) for chemotaxis of leukocytes. Other factors may exist in vivo that inhibit other inflammatory sequences. In this report, homogenates from human skin interfered with 2 standard assays of lymphocyte function, mitogen-induced transformation and cytotoxicity while homogenates of human placenta did not. Differential centrifugation studies located inhibitory factor(s) primarily in the nuclear fractions. Therefore, reversible transitory depressions of the cell-mediated immune response that are observed concomitantly with chronic dermatoses may reflect release of inhibitory material dermatitic skin in vivo.


Autosensitization to DNA: evidence for an immunologic basis. A 59-year-old female with spontaneous painful ecchymoses developed ecchymoses after intracutaneous injection of washed autologous whole blood cells and calf thymus DNA. Immunofluorescent studies of the spontaneous lesions revealed granular deposits of IgM, C3, factor B and properdin at the dermal-epidermal junction but no deposits in her normal skin. T cells were decreased in number but responded normally to polyclonal mitogens and did not transform in response to DNA containing antigens. Repair of UV-damaged DNA by her lymphocytes appeared to be depressed. The findings presented here are the first immunologic abnormalities uncovered in this disorder and may help in understanding the pathogenesis of the inflammatory lesions seen in autosensitization to DNA.


Updated in vivo methods for evaluating topical antimicrobial agents on human skin. Updated and expanded in vivo quantitative testing procedures to determine the efficacy of topical antimicrobial agents are presented. The occlusion test measures the ability of an agent to prevent the expansion of the resident microflora which occurs when an impermeable dressing is applied to the forearm. Measurements are made at 24 and 48 hr. The expanded flora test measures the ability of an agent to suppress a dense population of micro-organisms produced by expansion of the resident flora of the forearm by prior application of an impermeable occlusive dressing. Measurements are made at 6, 24 and 48 hr or after 10 min in the case for agents designed for immediate degerming. The persistence test measures the ability of an agent to establish a reservoir in skin and exert an antimicrobial effect up to 3 days after the last application of the test material. The ecological shift test determines any major alteration in cutaneous microbial ecology following several applications of the material under occlusive dressings. The serum inactivation test determines whether the presence of serum proteins interferes with antimicrobial activity.


Ultrastructure of the human mucocutaneous end organ. The ultrastructure of the human mucocutaneous end organ is described. The corpuscle is divided into sublobular units comprising axon terminals surrounded by generally concentric lamellar processes which are derived from laminar cells whose nuclei are situated towards the periphery of the sublobules. Interlamellar substance which contains elastic tissue, collagen and coarse periodicity crossbanded structures intervenes between lamellar processes. Specialized zones of contact resembling desmosomes are found at intervals seemingly connecting adjacent lamellar processes and axons with lamellar processes. The ultrastructural features of this end organ are similar to that of the Meissner corpuscle despite minor differences of the light microscopical appearance, which supports the view that differences in sensory end organs are merely variations on a common organizational basis.


Laboratory induction and clinical occurrence of combined clindamycin and erythromycin resistance in Corynebacterium acnes. Corynebacterium acnes strains cross-resistant to clindamycin and erythromycin were observed following long-term selection or mutagenic treatment in the laboratory. Similar strains were found among clinical isolates from patients using clindamycin or erythromycin topically in the treatment of acne vulgaris. Clindamycin resistance was never observed in the absence of resistance to macrolides or other lincosaminides. It is suggested that this resistance may result from an alteration of the 50S ribosomal subunit.


[A quantitative ultrastructural analysis of fenestrations and basal laminae of the blood capillaries in the knee joint synovial membrane (author's transl)]. Studies were carried out on the materials comprising the knee joint synovial membrane, kidney and lung from 13 young dogs and the knee joint synovial membrane obtained surgically from a 16-year old boy. The number of endothelial fenestrations of the blood capillary in the synovial membrane was 330 per 100 mu2 of the fenestrated vascular bed in 3--4 day-old dogs, 938 in 1 month-old dogs, 570 in 2 month-old dogs and 530 in the boy. The conspicuous peak in the development of vascular endothelial fenestrations seen in the synovial membrane of the dogs at 1 month of postnatal age appears to reflect a rapid increase in the mechanical load for the knee joint about 1 month after birth. A similar peak was absent for the blood capillaries in the renal glomeruli where the endothelial fenestrations continued to increase for the first 2 months of the postnatal period in dogs. The basal laminae of blood capillaries in the synovial membrane were often observed to be multi-layered, and this was remarkable especially in the human material. However, the thickness of the laminae of blood capillaries in the synovial membrane, as well as in the renal glomeruli and the lungs, showed a gradual increase with advance of the postnatal age of puppies up to 2 months.


[Spinal electrogram evoked by peripheral nerve stimulation in man (author's transl)]. Summated evoked responses to peroneal and tibial nerve stimulation were recorded from surface electrodes placed over the lumbar and thoracic spine of twenty normal adults. The responses consisted of triphasic potentials (mainly negative) which progressively increased in latency at more rostal recording sites. These responses were thought to have a common origin with those recorded from the spinal epidural space. The conduction velocity of the responses to peroneal nerve stimulation was 48.5 m/sec from the lower to the upper thoracic recording site. In twenty patients with spinal cord lesions, responses caudal to the lesion were similar to those recorded in normal adults except six patients with cauda lesion. Six completely paralysed patients were examined soon after injuries, and two were noted to have evoked spinal responses above the lesion, followed by returning of the function in the lower extrimities. These suggest that this method is of prognostic value for predicting recovery of neurologic function after injuries.


[A study of the stress distribution of the stem of the total hip prosthesis (author's transl)]. By attaching the strain gauges on the inner and outer sides of the stem of the total hip prosthesis composed of Müller, Charnley and domestic SOM type, the stress distribution was measured. At first, the center of the head of the prosthesis and the apex of the stem were adjusted to be on the vertical line, and a vertical load was placed on the uppermost end of the head, then the stress was measured. Next, the stem was fixed in the hole of a wood-block containing acrylic resin, and the load was placed on the head in neutral, 10 degrees valgus and 10 degrees varus position and in the direction same as the stem before fixation, then the stress was measured of respective position. In comparing the difference in stress distribution between the fixed and the non-fixed stem, the stress in the case of the fixed stem proved to be 17--32% that of the non-fixed one. The site where the maximum stress appeared was at the middle third of the stem in the case of the non-fixed stem, while it was at the neck and at the one fifth of the upper portion of the fixed one. In comparing the stress at the neutral, the valgus and the varus position, the stress at the valgus position was found to be minimum, and taking the stress at the neutral position as 100, it was 60--82, and at the varus position the maximum of 105--131 appeared.


Clinicopathological study of soft tissue tumors. Clinical aspects of patients with soft tissue tumors encountered at the Department of Orthopaedic Surgery, Toho University over a 15 year period between 1961 and 1976 were analyzed. Accurate clinical records and histological findings were available in 91 patients, 80 of whom had benign tumors and 11 of whom had malignant ones. Recurrence was seen in 7 of the 80 patients with benign tumors. The prognosis was poor in those with malignant tumors as expected, especially in those with rhabdomyosarcoma.


[Dermatoglyphic studies on the congenital hand anomalies (author's transl)]. Dermatoglyphic studies were carried out on the congenital hand anomalies. Clinical materials consisted of 94 cases with hand anomalies and 148 of their normal relatives as a control. An analysis of the dermal ridge patterns was based on "the Memorandum of Dermatoglyphic Nomenclature" described by Penrose. The results were as follows: 1) In hypoplastic fingers, a high incidence of radial loops or arches was noted, which were quite rare in normal fingers. 2) In cases with crooked fingers, a high incidence of simian creases on palms was noticed. 3) In hypoplastic thumbs, higher positions of axial triradii were observed in accordance with the advance of their grades. 4) In cases of cleft hands with the loss of a central digit, a rudimental finger pattern was found on the edge of the cleft. In the absence of two digits in cleft hands, two finger patterns were found locating on either sides of the clefts of the palm. 5) In cases of syndactyly, union of the digital triradii was found on the palm between bases of the two syndactylous fingers. In a case of osseous syndactyly, single finger pattern was observed on the palmar side of the digital phalanges. 6) In congenital amputations of the humerus, rudimental digits or finger nubbins were sometimes found on their stumps. I found whorl patterns on the nubbins, which suggested rudimental finger patterns. 7) In unilateral constriction band syndrome, the finger and palm patterns showed no particular changes except coarse ridges on affected fingers. In macrodactyly, there were normal ridge counts and the increased ridge breadths, which might indicate the anomalies occurring after the stage of formation of finger patterns. 8) In families of the arthrogryposis multiple congenita and camptodactyly, total ridge counts were markedly decreased and the incidence of the arches on fingers was marked increased. Conclusions The studies on dermal ridges on the congenital hand anomalies may give important keys for solving the process and time of occurrence of these anomalies in the early embryonal lives.


[Suprasternal bone (author's transl)].

[Suprasternal bone (author's transl)]. Human skeletons have many variations which may occasionally necessitate distinction from pathologic changes. Suprasternal bone is an unfamiliar normal variation in the vicinity of the sternoclavicular joint. It was first described by Béclard in 1820 and thereafter many reports have appeared, mostly in anatomy and embryology. An incidence less than 5% is reported abroad. This report describes the incidence of suprasternal bone in Japanese and a few clinical reference cases. Suprasternal bone is now considered to have derived from the persistent rudiment of epicoracoid which should have normally consisted of the part of manubrium sterni. Suprasternal tubercle is considered to be the osseously fused type of suprasternal bone. The material consisted of two groups: 1) Seventy-four sterna were examined roentgenographically which were removed en bloc from the cadavera. 2) 562 sterna of living subjects were examined roentgenographically by Kattan's method. In the seventy-four cadavera, eight cases had suprasternal bones (10.8%) and fourteen cases had suprasternal tubercles. Among them, three had suprasternal bone and tubercle on each side. In the 562 living subjects, thirty-nine cases had suprasternal bones (6.9%) and eight cases had suprasternal tubercles. Among them, three had both on each side. The incidence of suprasternal bone in Japanese is therefore higher than foreigners' reported previously. Kattan's method employed in this study is simple and excellent to show manubrium sterni and sternoclavicular joint clearly. It is emphasized that suprasternal bone is not uncommon and differential diagnosis from pathologic changes is easy as long as it is kept in mind.


[Prevalence of osteoarthrosis of the hip and other joints in Japanese population (author's transl)]. A population study on osteoarthrosis (OA) was made in Iwata district of Kamitonda Wakayama. In the present survey, 1335 inhabitants aged 30 years and over were surveyed from August 1972 to May 1974. The completion rate was 69.1%. The examinations consisted of measurements of blood pressure, body height and weight, blood and urine test and radiographs of hand, cervical spine and pelvis. Osteoarthrotic changes of wrist and finger joint, cervical spine and hip joint were detected and assessed according to Kellgren and Lawrence's criteria by two observers respectively. The results obtained were as follows. 1) The prevalence of OA of the hip joint in this population sample of 737 persons was 0.94%. 2) Primary OA of hip joint was found in 0.27% of the same sample. 3) Compared with Caucasians, the incidence of OA of hip joint was low and similar to that of the Chinese in Hong Kong. 5) The incidnece of radiological osteoarthrosis of wrist, finger joints and cervical spine was comparable in the British studied by Kellgren and Lawrence. 6) The incidence of OA of the first carpometacarpal joint was very low in Japanese regardless the sex.


[Study of weight-bearing changes of normal and abnormal feet by frontal tomography (author's transl)]. Roentogenographic examination with emphasis upon frontal tomography was applied to clarify the positional relationship between the calcaneus and talus, and to measure weight-bearing changes of these bones on normal and abnormal feet in frontal plane. studied were conducted on 30 left feet of normal adults, 18 left feet of normal children, and 37 feet of 19 children affected with cerebral palsy, and 19 feet with unilateral or bilateral foot disorders other than cerebral palsy. Statistical analysis of the in patients with diseases results gave the following results. The 30 feet of normal adults were without definite trend for internal or external rotation, medical or lateral shift, though the calcaneus in the sinus tarsi was found to lower to an average extent of 1.68 +/- 0.68mm. The 8 feet of normal children were also without definite trend of rotation or shift. The calcanei of some of children's flat feet with cerbral palsy were found to fluctuate markedly up and down and also medialy and laterally. But the weightbearing change was in most cases with cerebral palsy stayed within normal ranges. The 19 feet with disorders other than cerebral palsy were found to lie within the normal ranges of lowering, rotation and shift. The author's modification of Méary's method was able to be used quantitatively and qualitatively. This method showed that feet with calcaneus varus of calcaneus valgus deviate markedly from the normal feet based in the evidence of average precentage. The analysis by this quantitative method was found to agree well with that by frontal tomography.


[A biomechanical study on the fracture treatment--intravital measurement of the strain on an intramedullary nail in the healing process of the femoral fracture in goats (author's transl)]. There have been many biomechanical studies throughout the world on the fracture treatment. However, only a few were performed under intravital condition. The purpose of the present study is to measure the successive strength changes of the callus after a fracture, in vivo in an animal. Specifically designed Küntscher nails were made to meet the anterior convexity and the size of the medullary canal of the femora of goats. Three self-temperature-compensating semi-conductor strain-gauges were glued on the inner surface of the nail and coated with epoxy-resin and silicone rubber. The nail was inserted into the intact femur, and the initial measurement of the strains was performed using a specially designed wooden three point bending jig. Then the femur was transected at the middle. Periodical measurements of the strains were done, first, during walking and, then, with the three point bending jig under general anesthesia. Ten goats were used for the experiments. The measurement was undertaken every two to three weeks. Serial x-rays were taken. The femur was studied histopathologically after the death of the animal. 1. Although the nail with the strain-gauges presented some foreign body reaction and certain difficulties in sterilization, it was well tolerated by the animal, permitting the strain measurement for as long as 18 weeks after the fracture. 2. There was a tendency that the less loosening is found between the nail and the bone, the larger is the strain and the smaller becomes the dispersion of the strains. 3. On the three point bending test, the post-fracture strain changes were not directly proportional to the lapse of time. In the early phase, the strains remained large for about four weeks and tended to rapidly decrease in the middle and late phases in accordance with the development of callus formation on x-ray. 4. A similar strain change was observed on the walking test, although the animal presented with some painful limp. The results suggest that early excessive exercise to be avoided when an intramedullary fixation is not sufficiently rigid.


[An experimental study on repair and restoration of gliding function of the injured flexor tendon of the finger. Part 6: A mode of vascularization of the grafted tendon within the pseudosheath (author's transl)]. The so-called two-stage procedure has been used in the reconstructive surgery for the severely injured flexor tendon of the finger. However, only little has been known as to vascularity of the grafted tendon within the pseudosheath. In order to clarify this problem, a series of experimental studies were carried out using young chickens. First, the flexor tendon of the fourth digit of chicken with its sheath was replaced by a silicone rod. The distal end of the rod was sutured to the stump of the flexor digitorum profundus and the proximal end left free. Then, in ten to sixteen weeks, upon removal of the rod, the flexor digitorum profundus of the third digit was grafted through into the newly formed pseudosheath. The paw was immobilized with plaster case in moderate flexion for three weeks, then the chicken was allowed to walk freely. At the different time intervals, starting from the third day to the fifteen weeks after surgery, a mode of vascularization of the grafted tendon and its surrounding tissue was examined microangiographically. The vessels appear at the area of proximal and distal stump of the grafted tendon a week postoperatively, and additional vessels appear at the contact area of the pseudosheath and the grafted tendon two weeks postoperatively. These vessels formed mutual anastomosis in five to six weeks. With time, the vessels connecting between the epitenon and the pseudosheath gradually enlarge and assemble together to form vascular bundles, so that the appearance of the structure becomes similar to that of the mesotenon. Three weeks postoperatively, the vessels appeared in the grafted tendon, and grew gradually so that these vessels ran through the full length of the grafted tendon in five to six weeks. About ten weeks, the vascularity of the grafted tendon is more abundant than that of the normal tendon, but diminished gradually so as to resemble that of the normal tendon at the fifteeth week. Thus, the growth of the vessels of the tendon grafted by two-stage procedure is delayed by two weeks compared with that by the primary tendon grafting.


Binding of methylfolate and pteroylglutamic acid by the specific serum folate binder. The binding sites for methylfolate of the FABP in serum are fully saturated in the physiological state. When the FABP of serum from pregnant subjects is stripped of its endogenous folate, it is capable of binding an average of 549 +/- 12 pg/ml (range 464 to 723) of 14C-methylfolate, compared with 736 +/- 57 pg/ml (range 491 to 1610) of 3H-PGA. When 3H-PGA is added to untreated serum, an average of 258 +/- 6 pg/ml (range 218 to 325) is bound by FABP; this binding represents sites available to PGA but not to methylfolate, as well as sites from which methylfolate is displaced by 3H-PGA. This displacement averages 71 +/- 10 pg/ml (range 9 to 142), the amount which the standard technique for measurement of the UFBC for 3H-PGA overestimates the true UFBC for PGA.


Equilibration of peritoneal dialysis solutions during long-dwell exchanges. There is an increasing interest in CAPD for the treatment of chronic uremia. This technique uses long-dwell peritoneal exchanges lasting 4 hr or more. We have determined equilibration curves for multiple solutes during long exchanges with commercially available 1.5% and 4.25% dextrose dialysis solutions. For small solutes, rates of change of D/P ratios fall off dramatically after 3 hr of dwell time. For larger solutes, D/P ratios change more linearly. Some concentration gradients for net removal by diffusion persist well beyond 4 hr for all but the most highly diffusible solutes. Previously reported net sieving of sodium and chloride during hypertonic exchanges is still evident after many hours.


Abnormal neutrophil chemotaxis and random migration induced by aminoglycoside antibiotics. Gentamicin and amikacin, administered in therapeutic doses to normal healthy adults, caused a transient decrease in chemotactic migration of their PMNs. In contrast, RM of leukocytes obtained from these individuals was increased significantly. The magnitude of these changes did not correlate with the serum antibiotic concentrations. Separate in vitro experiments with gentamicin, however, revealed an inverse dose-response relationship with chemotactic suppression. The mechanism(s) involved in modifications of these leukocyte functions is not well understood. These findings may be of clinical significance in patients, especially those with altered host defense mechanisms, who require therapy with these aminoglycoside antimicrobial agents.


Splanchnic hemodynamic factors in cirrhosis with refractory ascites. Splanchnic and systemic hemodynamic observations in eight patients with cirrhosis and refractory ascites were compared to those of 25 patients with cirrhosis and responsive ascites. The refractory ascitic group was characterized by less portasystemic shunting from both the superior mesenteric and splenic vascular beds, a lower cardiac output, a higher systemic vascular resistance, a wider arterial-hepatic venous oxygen difference, and a tendency for a lower HBF and higher postsinusoidal resistance. Portal pressures assessed from hepatic vein catheterization were similar in the two groups. The absence of a well-developed portasystemic collateral bed in patients with refractory ascites could in part be caused by the tense ascites but could also be an important factor in the mechanism of refractory ascites.


Platelet survival in patients previously resuscitated from out-of-hospital ventricular fibrillation. Platelet survival times were measured in 11 ambulatory patients within 5 to 21 months of out-of-hospital ventricular fibrillation unassociated with acute myocardial infarction. The mean platelet survival time of 7.7 +/- 2.1 days was shortened when compared with 28 normal controls of similar age (9.0 +/- 1.0 days, p less than 0.03) but not different from 56 other patients with stable angina pectoris (6.85 +/- 1.81 days, p less than 0.2). One patient with a near normal survival time of 7.5 days experienced recurrent ventricular fibrillation without associated acute myocardial infarction 1 month following the platelet survival study. Although one platelet inhibitory agent, sulfinpyrazone, may lower the incidence of sudden cardiac death following acute myocardial infarction, the shortened platelet survival time in the group of patients experiencing out-of-hospital ventricular fibrillation did not distinguish them from others with coronary artery disease.


Oxygen transport in a woman with hemoglobin Hope/beta+ thalassemia. Because their blood may "unload" oxygen more readily than normal, people with hemoglobin of low oxygen affinity might be expected to be anemic. We have studied a woman with hemoglobin Hope/beta+ thalassemia, whose hemoglobin level was 10.4 to 12.3 gm/dl (normal 14 +/- 2) despite a P50 of 41 mm Hg (normal 26). Her cardiac index was normal, yielding a calculated mixed venous PO2 of 51 mm Hg (normal 34 to 49). Oxygen transport in patients with low oxygen affinity can be maintained by a variety of homeostatic responses, only one of which is altered erythropoiesis.


Spontaneous secretion from the dog small intestine in vivo. Forty loops of small intestine in the dog were perfused under control conditions with a balanced electrolyte solution. Most of the loops absorbed sodium and water, but 10 loops were in a state of spontaneous intestinal secretion. Compared to absorbing loops, spontaneously secreting loops exhibited reduced values for lumen-to-plasma fluxes of sodium and chloride and increased values for the plasma-to-lumen fluxes of these ions. Analysis of flux ratios suggested that sodium and chloride were actively scecreted during spontaneous intestinal secretion in the dog. Spontaneous secretion was similar to the secretion induced by CT or VIP, except that the latter were associated with a change in PD whereas the PD in the spontaneously secreting loops was the same as in the spontaneously absorbing loops.


Platelet and fibrinogen production: relative sensitivities to endotoxin. The relative sensitivities of platelet and fibrinogen production to endotoxin were determined in male New Zealand rabbits. E. coli endotoxin was administered in single intravenous doses of 0.1 to 50.0 mu/g/kg body mass. 75SeM was injected 5, 12, or 18 hr after endotoxin, and the percent incorporation into platelets and fibrinogen was used to measure thrombopoiesis and fibrinogen synthesis. Leukopenia occurred after the infusion of endotoxin at all dose levels; the lowest dose that caused thrombocytopenia was 0.5 microgram/kg. Endotoxin was detected with the Limulus test in plasma of animals that received 5 to 50 microgram/kg. The stimulation of fibrinogen and platelet production, as well as the postinfusion decrease in platelet count, correlated directly with the log of the dose of endotoxin infused. The lowest dose of endotoxin that stimulated platelet and fibrinogen production was 0.5 microgram/kg. In animals that received this dose of endotoxin, increased fibrinogen production was detected only when 75SeM was injected 5 hr later. In animals injected 5, 12, or 18 hr later. Increased platelet production was detected at these two doses only when 75SeM was injected 18 hr after endotoxin. The data indicate that fibrinogen and platelet production have similar sensitivities to endotoxin, although the time course of stimulation is different for these two blood components.


Monocyte functional and metabolic activity in malignant and inflammatory diseases. Macrophages or monocytes produce CL upon exposure to ingestible particles such as opsonized zymosan or bacteria. In previous studies, we have demonstrated that activated macrophages from mice produce significantly more CL than do normal macrophages. In the present study, we have utilized the CL assay as well as 14C-1-glucose utilization to assess monocyte metabolic activity in a variety of malignant, infectious, and inflammatory diseases. Monocyte peak CL was significantly increased above control values (20.9 +/- 0.5 (S.E.) X 10(3) cpm) in 25 patients with lymphoma (26.7 +/- 1.5 x 10(3)). Markedly increased CL was also seen in inflammatory processes such as bacterial infections, tuberculosis, and sarcoidosis (32.2 +/- 2.7 x 10(3)). In contrast, monocytes from patients with solid tumors, including carcinomas of breast and gastrointestinal and genitourinary tracts, had peak CL values (22.4 +/- 1.6 x 10(3) which were not significantly different from controls. When studied by determining 14C-1-glucose utilization, hexose monophosphate shunt activity paralleled CL values. Monocyte metabolic activation appears therefore to accompany ongoing infectious or granulomatous processes and may also be present in certain malignancies associated with reticuloendothelial stimulation.


Type IV and type "A-B" collagens do not elicit platelet aggregation or the serotonin release reaction. Human collagens were isolated from kidney, lung, skin, aorta, cartilage, and placenta. Five different types were obtained, including two new molecular species, one characteristic of basement membranes, or type IV collagen, and the other the recently described "A-B" collagen derived from fetal membranes. All the collagens were purified and separated by combination of heat-gelation fractionation and salt fractionation. In neutral solution at 37 degrees neither type IV nor type "A-B" collagen elicited platelet aggregation or 14C-serotonin release. Preincubation of platelets with both types IV and "A-B" collagen did not inhibit aggregation upon subsequent addition of collagen types I, II, or III.


Use of protein A--containing Staphylococcus aureus as an immunoadsorbent in radioimmunoassays to separate antibody-bound from free antigen. Heat killed, formalinized Cowan I strain Staphylococcus aureus (PASA) was examined for its utility as a solid-phase immunoadsorbent in various RIA procedures. Specific antibody could be adsorbed to PASA and then reacted with radiolabeled and unlabeled hormone, or alternatively, PASA could be added to antibody-hormone mixture in order to separate antibody-bound from free antigen. Both methods compared favorably with the more standard double-antibody method in each system tested. Antibodies produced by rabbits, guinea pigs, monkeys, and humans were precipitated equally by PASA and double antibody, whereas antibody raised in sheep was precipitated much less by PASA than by double antibody. Antibody bound to PASA was found to reach equilibrium of binding more slowly than unbound antibody for both rapid (TRH) and slow (rPRL) reactions. Binding of either free of complexed IgG by PASA, however, was extremely rapid, reaching equilibrium in less than 30 sec. This rapid binding was utilized in kinetic experiments which would not have been possible with slower-reacting precipitating agents. The versatility permitted by this propertly constitutes one of the most useful characteristics of PASA. Other important attributes of PASA include its convenience, economy, and wide applicability.


Heparin inhibits PGE1-sensitive adenylate cyclase and antagonizes PGE1 antiaggregating effect in human platelets. PGE1-sensitive adenylate cyclase in human platelet lysates in inhibited (50%) by heparin (10 microgram/ml). Inhibition is of a mixed type when analyzed by double-reciprocal analysis. It is also shown that heparin (2.5 to 10 microgram/ml) effectively antagonizes the antiaggregating effect of PGE1 on ADP-induced platelet aggregation. The possibility that heparin may exert its platelet-aggregating activity through inhibition of PGE1-sensitive AC in human platelets is discussed.


Transferrin binding and iron transport in iron-deficient and iron-replete rat reticulocytes. Three aspects of iron metabolism were studies in reticulocytes from iron-deficient, phlebotomized, and phenylhydrazine-treated rats: (1) the number of transferrin binding sites; (2) the uptake of 59Fe-transferrin; and (3) the ability of cytosol to mobilize 59Fe from 59Fe-labeled reticulocyte plasma membrane. The number of transferrin binding sites, assayed by measuring the binding of 125I-labeled transferrin to reticulocytes, were similar in iron-deficient and phlebotomy-induced reticulocytes, 66,000 and 75,000 binding sites/cell, respectively, but were about doubled, 120,000 binding sites/cell, in phenylhydrazine-induced reticulocytes. Uptake of 59Fe into iron-deficient reticulocytes was about one-half that for phlebotomy-induced reticulocytes and one-quarter that for phenylhydrazine-induced reticulocytes, the rates of uptake being measured as 21,540, 41,233, and 79,600 molecules of 59Fe per minute per cell, respectively. The mobilizing activity of cytosol free iron-deficient reticulocytes was also about one-half that of cytosol from phlebotomy-induced reticulocytes and about one-quarter that of cytosol from phenylhydrazine-induced reticulocytes. These results indicate that instead of a compensatory increase in these aspects of iron metabolism, the iron-deficient reticulocyte had a decreased ability to transport iron.


Platelet membrane glycoproteins in thrombasthenia, Bernard-Soulier syndrome, and storage pool disease. Quantitative polyacrylamide gel electrophoresis has been carried out on patients with Bernard-Soulier syndrome, Glanzmann's thrombasthenia, and storage pool defect in order to clarify the abnormalities in their platelet membrane glycoproteins. Normal individuals had values (expressed as PAS staining units/mg of membrane protein) of 5.11 +/- 0.63 for glycoprotein 1 (Mr 150,000), 2.35 +/- 0.35 for glycoprotein  II (Mr 120,000), 0.89 +/- 0.22 for glycoprotein III (Mr 100,000), and 1.34 +/- 0.64 for glycoprotein IV (Mr 85,000). Total PAS staining of these four major bands was 9.70 +/- 1.26 PAS units/mg of membane protein. Patients with Bernard-Soulier syndrome completely lacked glycocalicin and had about one half (1.90 PAS units/mg) of the glycoprotein I of normal controls. These was no significant reduction in glycoproteins II, III, and IV, but total PASstaining was reduced to 4.40 units/mg, reflecting the importance of the contribution of glycoprotein I to this parameter. Thrombasthenic platelets gave values for glycoprotein II of 0.66, which were about 25% of controls, and the values for glycoprotein III (0.34) were about 40% of controls. Patients with storage pool disease gave values within the normal range with the exception of one family which showed, in addition, small platelets and an associated lipid defect. In thic case of glycoprotein (2.71) was significantly elevated.


Correlation of in vivo and in vitro inhibition of thrombin by plasma inhibitors. Rabbit antithrombin III and thrombin were purified to homogeneity to determine the in vivo relationship of these proteins in an autologous system. These proteins, radiolabeled with Na[125I], were injected into rabbits to determine the circulatory half-life. The mean half-life values were 125I-antithrombin III, 54.75 +/- 3.10 hr; 125I-thrombin, 7.25 +/- 1.49 hr; 125I-thrombin-antithrombin III, 7.25 +/- 1.09 hr; 125I[thrombin-antithrombin III], 11.13 +/- 0.88 hr; and Tos-Lys-CH2Cl-125I-thrombin, 27.75 +/- 3.18 hr. All the mean half-life values were statistically different from that of thrombin alone except for the two forms of thrombin-antithrombin III complex. Following injection of the radiolabeled proteins, plasma samples were obtained and gel-filtered to analyze the molecular weight distribution of the radiolabel. An identical elution position on gel filtration of 125I-antithrombin III with native antithrombin III was observed. The 125I-thrombin distributed into two peaks of radioactivity, with a molecular weight of 100,000 (79%) and a molecular weight greater than 200,000 (21%). The 100,000 dalton peak is consistent with a thrombin--antithrombin III complex, and the greater than 200,000 dalton peak is consistent with a thrombin-alpha 2-macroglobulin complex as confirmed by in vitro immunochemical studies. Thrombin inactivated with Tos-Lys-CH2Cl also showed two peaks of radioactivity on gel filtration, one peak which was excluded from the column and the other peak with an elution volume that was consistent with the position of native thrombin.


Sulfhydryl-mediated depression of ciliary activity: an adverse effect of acetylcysteine. Although N-acetyl-L-cysteine (Mucomyst) is an effective mycolytic, numerous investigations have failed to demonstrate a consistent improvement in pulmonary mechanics following its use. In order to determine whether its beneficial mucolytic activity might be counterbalanced by a deleterious direct effect on cilia, we studied its effect on the activity of ciliated epithelium in the ferret tracheal organ culture system. N-acetyl-L-cysteine consistently caused progressive time-dependent ciliostasis at concentrations clinically employed, with complete ciliary paralysis within 8 hr. The effect was only partially reversed by the removal of the drug. Control preparations retained full ciliary activity for 3 to 12 weeks. In order to determine the active site on the N-acetyl-L-cysteine molecule, we investigated the ciliostatic effects of five of its chemical analogs. Isomolar N-acetyl-L-alanine was not ciliostatic, indicating the necessity of a sulfhydryl group for activity. Ciliostasis was independent of isomeric structure, acetylation, and chain length, as evidenced by the similar ciliostatic effects of L-cysteine, D-cysteine, 2-mercaptoethylamine, and N-acetyl-L-homocysteine. We conclude that N-acetyl-L-cysteine induces partially reversible ciliostasis of tracheal epithelium via its sulfhydryl group; prolonged use of this drug may impair mucociliary clearance.


The effect of INH-inhibited heme synthesis on globin synthesis. In the rabbit reticulocyte cell-free system, optimal globin synthesis is dependent upon an adequate level of heme. The effect of heme is mediated by an inhibitor of globin synthesis initiation termed HCR. In addition to marked inhibition of total globin synthesis, HCR results in a decreased alpha/beta globulin synthesis ratio. We describe here the use of INH as a relatively nontoxic inhibitor of heme synthesis in intact rabbit reticulocytes with a resultant inhibition of globin synthesis. In parallel with the inhibition of globin synthesis in reticulocytes, an inhibitor of globin synthesis in the hemin-supplemented cell-free system is generated. No INH-induced alterations in alpha/beta synthesis ratio could be found in "stress" reticulocytes from phenylhydrazine-treated rabbits, but "normal" reticulocytes from untreated rabbits showed a decreased alpha/beta ratio. Inhibition of heme synthesis and the resulting decrease in globin synthesis and intracellular hemoglobin concentration may have application as a potential treatment of homozygous sickle cell disease.


Relation of fluorescence in lipid-containing red cell membrane extracts to in vivo lipid peroxidation. Previous studies have demonstrated that the abnormal fluorescent peak consistent with the crosslinking of red cell membrane constituents by the lipid-peroxide decomposition product MDA is demonstrable in lipid-containing extracts of red cells obtained from patients treated with the oxidizing hemolytic agent diaminodiphenylsulfone. The present studies were primarily aimed at ascertaining the specificity of this fluorescence as an indicator of in vivo red cell lipid peroxidation. Repetitive injection of phenylhydrazine or acetylphenylhydrazine in rats resulted in gradually increasing levels of fluorescence despite the return in hematocrit toward normal. Chromatography on Sephadex LH-20 of lipid-containing extracts obtained from the red cells of rats and rabbits treated with phenylhydrazine revealed fluorescent peaks similar to those observed in red cell lipid incubated with MDA. In addition, increased levels of fluorescence were observed in the extracts of red cells obtained from three vitamin E--deficient premature infants. These findings suggest that the fluorescence assay is a sensitive indicator of in vivo red cell lipid peroxidation.


Effect of carbon tetrachloride on extrarenal erythropoietin production in rats. Liver regeneration after partial hepatectomy is associated with an increase in extrarenal Ep production; however, this surgical procedure is time-consuming and difficult to standardize. Carbon tetrachloride (CCl4) ingestion in rats is an easy and reproducible way to induce liver damage and regeneration. We therefore studied the effects of CCl4 on extrarenal Ep production in rats. Just as is the case following partial hepatectomy, extrarenal Ep production in response to hypoxia was reduced immediately after ingestion of CCl4. Thereafter it rose to supranormal levels which peaked 3 to 4 days after CCl4 ingestion (at this time Ep titers of nephrectomized, CCl4-fed rats rose to greater than 1.0 U/ml of plasma after exposure to 0.42 atmosphere for 7 hr). Extrarenal Ep production then declined, but was still supranormal 7 days after CCl4. Carbon tetrachloride did not significantly affect extrarenal Ep production in rats nephrectomized 18 hr prior to initiation of hypoxia even if they received injections of renin prior to being made hypoxic, nor did it affect Ep production in response to hypoxia in nonnephrectomized rats under the conditions used in this study.


The effect of complete biliary obstruction on bile flow and bile acid excretion: postcholestatic choleresis in the rat. Bile secretory function was studied in rats subjected to a 7-day obstructive cholestasis induced by complete common duct obstruction. Bile flow and bile acid excretion were examined during bile depletion, following the release of the biliary obstruction, and during the infusion of sodium taurocholate at submaximal and saturating rates. A highly significant increase, greater than 100%, in bile flow was evident in cholestatic rats at any bile acid excretory rate, when compared to control sham-operated rats. 14C-erythritol clearance measurements performed during bile depletion and during the infusion of taurocholate suggest that bile flow was mainly of canalicular origin in cholestatic rats. Estimated taurocholate transport maximum (mumol/min per rat) was not statistically different between cholestatic and control rats. However, significantly greater taurocholate plasma levels at Tm in cholestatic rats suggest a decreased efficiency of the bile acid transport process. In addition, the relationship between bile flow and bile acid excretion was found to be nonlinear at low bile acid excretory rates in cholestatic rats. Thus important changes in bile formation occurred in rats subjected to temporary obstructive cholestatis, which differ from those observed in other models of cholestasis that are associated to a reduction in bile flow and bile acid transport capacity.