Sex and strain differences in the visual evoked potentials of albino and hooded rats. Visually evoked potentials were recorded n male and female rats from albino and hooded strains. Recordings were made at 4 different flash intensities in unanesthetized animals. Clear sex and strain differences were observed. Females had larger amplitude P1-N1 and N1-P2 components and shorter latency N1 peaks than males. Albino rats had larger amplitude P1-N1, N2-Pe and P3-N3 components and longer latency P2 and P3 peaks than hooded rats. Variations in flash intensity produced greater alterations in latencies and N1-P2 amplitudes in hooded rats than in albino rats, but greater alterations in N1, N2 and P3 latencies in albino rats than in hooded rats. Hooded rats are recommended as more valuable for studies of chemically induced change in the visual evoked potential.


A reappraisal of scopolamine effects on inhibition. A series of related experiments was conducted to examine the effects of scopolamine on discrimination performance in the presence or absence of a stimulus signalling non-reinforcement. In Experiment 1, rats trained to respond on 1 of two levers in the presence of a 1000-Hz tone and on the other lever in the presence of a 3000-Hz tone were not reinforced when white noise was added to 1 of the tones. Pairing white noise with the other tone during an extinction session demonstrated that the white noise had become a conditioned inhibitory stimulus. In Experiment 2, scopolamine decreased responding and discrimination accuracy on the excitatory (reinforced) trials, and increased responding on the inhibitory (non-reinforced) trials. The magnitude of the drug's effect was similar on excitatory and inhibitory trials. Using combination of visual and auditory discriminative stimuli, Experiment 3 confirmed the results of Experiment 2. These experiments show that scopolamine disrupts animals' ability to discriminate, and that scopolamine-induced increases in non-rewarded responses cannot be attributed solely to a disinhibitory effect of the drug as Carlton (1969) and others have claimed.


Drug effects under automaintenance and negative automaintenance procedures. Three food-deprived pigeons were initially exposed to an automaintenance procedure in which brief periods of response key illumination were followed by food delivery without regard to the subject's behavior. Keypecking occurred at a high rate while the key was illuminated and was reduced in dose-dependent fashion by acute administration of LSD (0.05--0.45 mg/kg), quipazine (1.0--8.0 mg/kg), haloperidol (0.08--0.32 mg/kg), and pentobarbital (4.0--16.0 mg/kg). The animals were then exposed to a negative automaintenance procedure in which food delivery followed key illumination only if the lighted key was not contacted. Keypecking occurred at a low rate under this procedure, with no responses occurring during the majority of key illuminations and was decreased or unaffected by LSD, quipazine, and haloperidol; pentobarbital increased responding at doses of 4.0 mg/kg and 8.0 mg/kg and reduced responding at a dose of 16.0 mg/kg.


Effects of repeated administration of cocaine on schedule-controlled behavior of rats. The effects of cocaine (4.0--32 mg/kg) on schedule-controlled behavior of rats were determined before and during a period of repeated administration of cocaine. In rats trained to lever press on a fixed ratio 40 schedule for food delivery, cocaine (8.0--32 mg/kg) initially decreased response rate in a dose-related manner. During the period of repeated administration, the effects of cocaine on response rate and running rate were attenuated in 2 rats and did not change in 2 others. When dose-effect functions of cocaine were redetermined, a shift to the right was observed in several measures indicating the development of tolerance to these effects of cocaine on performance. In rats trained to lever press on a DRL 20" schedule for food delivery, cocaine (4.0--32 mg/kg) increased response rates, decreased number of reinforcements per session and shifted interresponse time distributions to the left (shorter IRT's in all rats). During the period of repeated administration, the effects of the daily dose of cocaine (16 mg/kg) on all these measures were attenuated. Tolerance to cocaine was further indicated by a shift in the dose effect function of cocaine to the right during the redetermination.


Chronic effects of methadone on a line tilt generalization gradient in the pigeon. Using an adjusting interval schedule, pigeons were trained to key peck at a relatively constant rate during 45 degrees line tilt presentations and at an extremely low rate in the presence of 0 degrees and 90 degrees line angles. Subsequently, the birds received intramuscular injections of methadone hydrochloride every 8 hr in doses beginning at 3 mg/kg/day and increasing progressively to 90 mg/kg/day. Stimulus generalization tests were run on the first day and on the last day a given dose was administered to assess the development of tolerance. Although chronic methadone treatment was associated with an overall decrement in key peck rate, the gradients of line tilt generalization were indistinguishable from saline control gradients at doses as high as 90 mg/kg/day. Though the birds exhibited gross behavioral incoordination, visual stimulus control appeared unaffected.


Endogenous norepinephrine and serotonin within the hippocampal formation during the development and recovery from septal hyperreactivity. Fluorometric analysis of serotonin (5-HT) and norepinephrine (NE) content of the hippocampal formation revealed that biogenic amines are distributed heterogeneously in the dorsoventral axis, and that NE also exhibits a heterogeneous distribution in the medial-lateral direction while 5-HT does not. Dissection of the hippocampus into its dorsal and ventral halves shows that both NE and 5-HT exhibit higher concentrations in the ventral hippocampus in comparison to its dorsal counterpart. A dissection which separated the cell fields CA 1 and 2 from CA 3 and 4 and the dentate gyrus showed NE to be the highest in the latter region, while 5-HT was uniformly distributed between the two regions. Taken together, these data indicate that NE is more highly concentrated in the CA 3 and 4 and dentate area of the ventral hippocampus while 5-HT concentration differences are apparent only in a dorsal-ventral dissection. Concentrations of NE and 5-HT in the dorsal and ventral hippocampus were also determined at 1, 3, 6, 11, 16, 24, and 30 days following a lesion to the septal nuclei. The results demonstrate that biogenic amine levels in the dorsal hippocampus achieve maximal depletion earlier than do their ventral counterparts, and that percent depletion is greater for 5-HT than NE in both dorsal and ventral areas. On the first day following septal lesions, 5-HT is increased above normal levels. Sixteen days after septal lesion, 5-HT is substantially depleted below normal levels. In addition, by 30 days, 5-HT shows significant return toward normal levels from its earlier depleted state. Behavioral changes related to sensory reactivity correlate with the relative decreases of NE and 5-HT following septal lesions.


Noradrenergic role in the self-administration of ethanol. Involvement of noradrenergic and/or dopaminergic processes of the brain in self-administration behavior toward ethanol was assessed in rats allowed to lever-press for 25 mg/kg intragastric doses on a CRF schedule. Initial access to infusions of saline for establishing an operant baseline was followed by one 10-hr session on acquisition contingencies for ethanol and then one extinction session on saline. Prior to a reacquisition session, rats were treated with either (a) saline, (b) alpha-methyl-p-tyrosine (AMT; 225 mg/kg), (c) 1-phenyl-3-(2-thiazolyl)-2-thiourea (U-14,624; 600 mg/kg or 300 mg/kg), or (d) haloperidol (3.5 mg/kg). Only the saline-pretreated control group and the haloperidol-treated rats reacquired lever-press behavior. Groups treated in like fashion, but pressing for a sweet milk reinforcer, all showed reacquisition. Thus, the effects of AMT and U-14,624 are attributed to an inteference with the reinforcing effect of ethanol infusions. Brain levels of norepinephrine were depleted by both compounds, dopamine was depleted only by AMT, and serotonin was elevated by 600 mg/kg of U-14,624 but unaffected by 300 mg/kg. These results suggest that a cerebral noradrenergic system plays an important role in the reinforcing effect of ethanol without an involvement of dopaminergic systems.


Voluntary drinking of ethanol by the rat: biogenic amines and possible underlying mechanism. The present study evaluates the possible relationship between certain biogenic amine metabolites-produced changes in voluntary drinking of ethyl alcohol (ET) solution by the rat and their in vivo effects on the enzymes primarily involved in the hepatic metabolism of ET, i.e., liver alcohol-(L-ADH) and aldehyde dehydrogenase (L-ALDH). In experiments on voluntary intake of ET solution by the rat, compounds selected were injected, 0.5 mM/kg, IP. Administration of vanillylmandelic acid (VMA) and 5-hydroxyindoleacetic acid (5HIAA) and homovanillic acid (HVA) markedly reduced ET drinking. Similar significant effects were seen after administration of the neutral metabolites of the biogenic amines tested, after injection of metanephrine or 3-methoxy-4-hydroxyphenylpyruvic acid. Threodihydroxyphenylserine but not L-dopa reduced ET intake by the rat. Treatment with peripheral decarboxylase inhibitors, i.e., carbidopa, 50 mg/kg, IP, significantly reduced ET drinking as contrasted with nonsignificant decline in ET consumption following benserazide, 500 mg/kg, IP. In the biochemical study, short-term administration of the compounds selected produced varied effects on L-ADH and L-ADH. It is suggested that alteration of hepatic ADH by the compounds tested might account for the observation reduced ET drinking thereby, indicating the contribution of peripheral sources rather than central factors in mediating the behavioral effects studied.


Beta-endorphin is behaviorally active in rats after chronic intravenous administration. Male Sprague-Dawley rats received 14 daily intravenous injections of saline or human beta-endorphin (2.5 mg/kg). Animals were given one-way active avoidance training on the eleventh day, and analgesia testing on the twelfth (tail-flick) and thirteenth (hot-plate) days. Beta-endorphin had no effect on the number of trials needed to reach the avoidance criterion, but significantly lengthened response latencies. Beta-endorphin had no analgesic effect in either test procedure.


Schedule induced self injections of nicotine with recovered body weight. In a recent series of experiments we have shown that high rates of self injection of nicotine were acquired when rats are at 80% body weight on an FT-1 min food delivery schedule. This rate was significantly higher than that of rats at reduced or normal body weight without food delivery schedules or that of rats injecting saline under three parallel control conditions. In the present experiment naive rats were trained to acquire nicotine self injection at 80% body weight with an FT-1 min food delivery schedule. These rats maintained their self injection rates after they were allowed to regain free feeding body weight. The data indicate that once nicotine intake behavior is established it can be maintained with changing nutritional factors.


Suppression of fixed-interval responding by flavour-amphetamine pairings in rats. Amphetamine is a potent and very effective drug for conditioning taste aversions, but much less is known about the possible effects of flavour-amphetamine pairings on aspects of behaviour other than eating and drinking. Rats were trained to press bars for water reinforcers delivered on a fixed-interval one-min schedule. Flavoured reinforcers were then substituted for the water and post-session injections of amphetamine (1 mg/kg) were given. Even a single flavour-amphetamine pairing produced some disruption of responding for that flavour, whereas 3 pairings almost completely suppressed responding (both bar-pressing and drinking). In the same rats, flavours paired with saline injections did not suppress responding. Amphetamine (1mg/kg) injected before sessions of responding for plain water disrupted the temporal pattern of fixed interval responding without affecting the total numbers of bar-presses or the amounts of liquid consumed. Omitting primary reinforcement (water) throughout a single session also failed to suppress responding. The conditioned effects of the flavour were therefore different from the effects of either the unconditioned stimulus (amphetamine) or of an extinction procedure.


A Mossbauer determination of the iron core particle size distribution in ferritin. The important biological iron bearing molecule ferritin has been studied using the 57Fe Mossbauer resonance. Natural and reconstituted ferritin samples have been studied in the temperature range 4--300 K. At low temperatures six-line magnetic hyperfine spectra are observed but with noticeably asymmetric line shapes, at high temperatures doublets are observed and in an intermediate temperature range (30--40 K) complex spectra characteristic of superparamagnetic behaviour are observed. From a theoretical study of the dependence of the hyperfine splitting parameters on particle size and from the experimental probability distributions obtained for these parameters from the Mossbauer spectra, it has been possible to derive the ferritin micelle particle size distributions for four different samples. It is found that the natural and reconstituted samples have roughly similar distributions except for the sample reconstituted from apoferritin in the presence of a phosphate environment. This sample is shown to have a slightly narrower particle size distribution centred on a smaller mean diameter. The information derived from these Mossbauer measurements are finally shown to be consistent with conclusions reached from separate biochemical experiments.


Electron dose reduction coefficients for seven radionuclides and cylindrical geometry. In determining internal radiation absorbed dose it is frequently not possible to assume a uniform distribution of radionuclide in an infinite, homogeneous, absorbing material. When the source-target geometry is such that the target is source-free, special considerations must be given to the dose contributions from electrons, since the conventional assumption of 100% absorption of non-penetrating radiations leads to overestimation of the absorbed dose. The absorbed dose from electrons determined at a point within the source-free region depends upon the depth within it. Electron dose reduction coefficients determined at appropriate distances from the source surface are multiplied by the electron doses determined from the general absorbed dose equation. This method of correcting for source-free regions has been applied to cylindrical and planar geometry, for spinal cord and nerve root dosimetry in cisternography. Utilising published scaled point kernels for mono-energetic electrons, electron dose reduction coefficients have been determined as a function of depth from the source surface for cylindrical source-free regions of radii 0.5, 0.05 cm and infinity, and seven gamma-ray-emitting radionuclides: 51Cr, 67Ga, 99Tcm, 111In, 113Inm, 169Yb and 203Pb. These values may be used in other internal radiation absorbed dose situations, and similar techniques applied to other source-target geometries.


Performance of a gas target neutron source for radiotherapy. The performance of a compact and efficient neutron generator, using the 3H(d, n) reaction and a gas target, is reported. The target is formed in a windowless, differentially pumped vessel pressurised to 7.5 Torr. An extended source of 15 MeV neutrons is produced when the target is bombarded by a 10 mA beam of 210 keV deuterons. Measurements are reported of the neutron energy spectra, neutron and gamma-ray dose rates, target lifetime and tritium handling. The neutron flux distribution of the extended target was measured and compared with the predictions of a simple beam-gas interaction model. The measured neutron source strength is 1.7 +/- 0.4 X 10(12) neutrons per second. The source output is limited by target beam current, not target power considerations.


Fast neutron sensitivities of Geiger-Mueller counter gamma dosemeters. The sensitivities to 4.2 and 5.5 MeV neutrons of different types of energy-compensated Geiger-Mueller counters used in mixed field dosimetry were measured using a field produced by the 2H(d, n)3He reaction with an isotropic gamma-dose component. Further results are presented on sensitivities to 14.7 MeV neutrons.


A detailed re-evaluation of Clambda and Ce with application to ferrous sulphate G-values. The theoretical basis of Clambda and Ce is re-examined and consistent expressions derived involving the quantity Fwa which is a combination of a stopping-power ratio and an energy-absorption coefficient ratio, thereby taking into account the extent to which the ionisation chamber acts as an 'electron detector' and as a 'photon detector' for a particular radiation quality. An extension of the Spencer-Attix cavity ionisation theory to include energy dissipation due to photon interactions with the cavity wall and gas given in a recent paper by Nahum has been used to calculate values for Fwa appropriate to the Baldwin-Farmer ionisation chamber assuming an air-equivalent inner wall, and new values of Clambda and Ce are presented for this and similarly constructed instruments. Clambda also depends on whether the radiation is produced by a linac or a betatron of a given maximum photon energy. The new set of Clambda and Ce has been used to recalculate the experimental ferrous sulphate G-values of Law and Naylor with the result that the difference between G for high energy photons and electrons disappears.


High LET constraints on low LET survival. Survival curves for biological cells irradiated with gamma rays (and other low LET radiations) cannot be properly interpreted without examining the implications of these interpretations for high LET radiations. The theory of RBE demands that the RBE of any high LET radiation field is at most one when the probability for cell killing as a function of the absorbed dose of gamma rays is linear or sublinear, for homogeneous samples whose radiosensitivity parameters are not altered during the irradiation. A contrary experimental finding strongly suggests that the experimental sample is heterogeneous. Violation of this constraint is not unusual where the survival curve found with low LET radiations has a well defined initial negative slope.


Transport phenomena in laminar flow of blood. Recently it has been shown experimentally that transport of heat and gas (specifically oxygen and helium) are augmented in the laminar flow of aqueous suspensions of polystyrene spheres 50 and 150 micrometer in diameter. In this report, data on heat and gas transport are correlated. Application of this correlation to flowing blood leads to the following conclucions. There is no significant augmentation of oxygen and heat transport in flowing blood even at shear rates much higher than physiological shear rates; an observation which is in accord with the experimental results. The augmentation of the diffusion coefficient of plasma proteins in flowing blood, though not very high, appears to be measurable. Of the total measured augmentation of about 6000--30 000% in platelet diffusivity in flowing blood, quoted from the literature, about 500% is attributable from this correlation to fluid mechanical forces, and the balance is hypothetically attributed to other forces (electrical or biochemical) present in blood.


Thermal design of a heat exchanger for heating or cooling blood. Experimental data, and their correlation with predictions from theory, are presented for the thermal design of a countercurrent heat exchanger for heating or cooling blood. The thermal design considers the influence on the Nusselt number of blood and the heat exchanger effectiveness of variables such as the blood flow rate, tube diameter and length, and the thermal properties of blood. The data presented are compared with data from the literature and with predictions from theory. Insofar as the design of a blood heat exchanger is concerned, flowing blood can be considered a single-phase fluid. Results of the thermal design analysis are applicable to attempts to produce and control blood hyperthermia for applications such as the perfusion of tumours of the extremities, and to efforts to induce hypothermia during open-heart surgery.


The anterior chest approach for obtaining free osteocutaneous rib grafts. Fresh cadaver dissections indicated that the anterior chest approach for obtaining a free osteocutaneous rib graft, based on the anterior intercostal vessels, would be feasible. Following this, a mandibular defect in radiated tissue was successfully repaired in one stage by a free osteocutaneous graft with microvascular anastomoses. A 22-cm segment of rib, with overlying muscle and skin measuring 10 X 30 cm, was transferred. Follow-up, with selective arteriography at 6 months, confirmed the belief that the periosteal blood supply alone could support the rib segment. The anterior chest approach, to obtain a free osteocutaneous rib graft, is easier, faster, and safer than the posterior approach.


Submental rhytidectomy.

Submental rhytidectomy. A technique of submental rhytidectomy is described in which support for the advanced flap of upper neck skin is obtained from the firm tissues near the periosteum along the inner curvature of the anterior part of the mandible.


Subcutaneous mastectomy in small, large, or ptotic breasts with immediate submuscular placement of implants. We present a series of 70 patients who have had bilateral subcutaneous mastectomies with immediate placement of implants under the intact pectoralis major and upper part of the serratus anterior. Twenty-two of these patients have had a simultaneous mastopexy, with a free nipple graft. All 70 patients have both of their implants now (up to 3 years) and have a satisfactory appearance.


Subcutaneous mastectomy: a plea for conservatism. The course after subcutaneous mastectomy is not without problems and the esthetic results, even in the absence of complications, are frequently disappointing. The role of subcutaneous mastectomy in the management of breast pathology remains uncertain at this time.


A new technique for end-to-end anastomosis of small vessels of different diameters. We have developed a new technique to simplify end-to-end anastomosis of small arteries of very different sizes. Our technique can be used without regard to the thickness or the hardness of the wall of the larger vessel.


Square scalp grafts, combined with strip grafts, for the treatment of male pattern baldness. In the treatment of male pattern baldness, the use of square scalp grafts permits one to obtain the same number of larger grafts from a much smaller donor area--with immediate primary closure leaving only one linear scar. Suitable instruments for marking and cutting the square scalp grafts have been a problem, but a new square marker and a square knife (with disposable blades, in either the 5 mm or 3.5 mm size) have been designed and are available.


Cystourethrography as an aid in the evaluation of hypospadias and its complications. We report the use of micturating cystourethrography to demonstrate complications of the urethra in hypospadias. We recommend MCU to evaluate hypospadias, both before and after the surgical repair.


Facial nerve injury secondary to lateral displacement of the mandibular ramus. We describe two cases of facial nerve injury after lateral external dislocation of the mandibular ramus, an event not found in the reviewed literature. We discuss the possible pathogenesis and outline the therapy.


Effects of local instillation of triamcinolone on the capsules around silicone bag-gel prostheses in animals. "Soft" silicone bag-gel miniprostheses were implanted in 103 rats. The experimental animals had periprosthetic instillations of zero, 0.2, or 2 mg of triamcinolone acetonide at implantation. The compressibility, the architecture, and the chemical composition of the surrounding tissues were observed at 10 and at 120 days. The compressibility was also measured by mechanical means at 10 day intervals. At 120 days all capsules were similar. All the capsules gradually became firmer with time after the implantation. After 60 days, the steroid-treated capsules were very slightly more compressible (softer) than the controls. This slight difference in compressibility could not be correlated with the other changes in the capsule properties we examined. It is suggested that the structure of these capsules may be similar to that of immature scar, and that it is kept in this condition by the continued stimulus of the foreign implant.


Correction of enophthalmos by disentrapment of an orbital blow-out fracture: case report. We present a case of enophthalmos from a posterior orbital blow-out fracture. The entrapped tissues were released surgically, resulting in disappearance of the enophthalmos and restoration of ocular motility.


Carcinoma of a minor salivary gland in an 18-month-old child: case report. A child with a cleft palate and mental retardation was found to have a malignant mucoepidermoid carcinoma of a minor salivary gland at the age of 18 months. The management of this case is presented.


Late deterioration of silicone rubber foam breast implants: case report. A case is presented showing disintegration of a solid pair of preformed silicone rubber foam breast prostheses, implanted 16 years ago. The only presenting symptoms were discomfort with extreme hardness and distortion of the breasts.


The surgical management of stiff joints in the hand. Significant and lasting improvement in stiff MP and PIP joints can be achieved by operative management. Operative intervention should be considered only after persistence of stiffness after a vigorous program of nonoperative therapy. In our series of 135 such stiff finger joints, capsulotomy increased the range of motion in MP joints by more than 30 degrees in 68 percent of the patients, more than 50 degrees in 57 percent, and more than 70 degrees in 32 percent. The increased range of motion for the PIP joints was more than 30 degrees in 63 percent of the patients, more than 50 degrees in 41 percent, and more than 70 degrees in 25 percent.


A new method to create a philtrum in secondary cleft lip repairs. We report an additional surgical method to form a philtrum in cleft lip cases. The key point of this new method is to release the skin tension of the upper lip, thus protecting against  the disappearance of the newly-made philtrum. We have obtained better results with this method, in comparison with the other methods previously reported.


Loss of silicone implants after subcutaneous mastectomy and reconstruction. We studied 89 patients who had immediate or delayed placement of implants after subcutaneous mastectomies. The complications of infection, necrosis of the skin or areola, and extrusion of the prosthesis occurred in 28 percent of these patients, and the incidence was the same after immediate or delayed placement. Only one of the 45 patients who received prophylactic antibodies preoperatively developed an infection after insertion of the prosthesis. The late complications in some of these patients indicate the need for long-term follow-up.


Use of a silicone bag-gel prosthesis to fill in a supratarsal depression of the upper eyelid. A technique is presented for correction of supratarsal depression in the upper lids of orientals, using silicone bag-gel prostheses.


Anatomical findings in median cleft of upper lip. We present 3 cases of median cleft lip which occurred in 3 patients of differing racial origins. The anatomical findings are presented in the two clefts we repaired.


Improvement of facial symmetry after operative relief of bony ankylosis of the jaw at the age of 10 years. Case report. We report a case of childhood bony ankylosis of the temporomandibular joint, with satisfactory opening and closing after operation at the age of 10 years, and subsequent improvement in facial symmetry.


Anesthesia technique for serving the pedicle of a tongue flap in the presence of a pharyngeal flap. A technique is described for anesthesia while severing the pedicle of a tongue flap to the palate, in the presence of a pharyngeal flap.


Pregnancy and progeny in rats treated with prostaglandin in F2alpha. The effects of prostaglandin F2alpha on pregnancy and embryonic development were investigated in pregnant rats. The animals were treated with the prostaglandin at a dose of 50 microgram s.c., on gestational days 9 to 11 or 12 to 15. Compared to the controls, only intrauterine growth was significantly altered. The number of viable offspring recovered near term was not affected by the treatment, and the incidence of fetal resorptions and malformations was not significantly increased when compared with the controls. However, the placenta revealed extensive areas of degeneration that are found in placental insufficiency. Also, the fetal adrenal cortex showed morphological changes indicative of intrauterine distress.


Oral contraceptive use alters the balance of platelet prostaglandin and thromboxane synthesis. The ability of platelet microsomes to generate platelet aggregating activity on addition of arachidonic acid was evaluated in women taking oral contraceptives and in controls taking no medication but matched for age, sex, and family history. Oral contraceptive users generated significantly more platelet aggregating activity per 100 ug of platelet microsomal protein than controls. Variation in generation of platelet aggregating activity during the menstrual cycle was also observed with highest activity during the third week. These studies show an altered balance of platelet prostaglandin and thromboxane synthesis in oral contraceptive users which may contribute to their increased incidence of thromboembolic phenomena.


The role of iron in prostaglandin synthesis: ferrous iron mediated oxidation of arachidonic acid. Arachidonic acid (AA) is the essential substrate for production of platelet endoperoxides and thromboxanes. Iron or heme is an essential cofactor for the peroxidase, lipoxygenase  and cyclo-oxygenase enzymes involved in formation of these products. The present study has examined the direct interactions between iron and arachidonic acid. Iron caused the oxidation of AA into more polar products which could be detected by UV absorbtion at 232 nM or the thiobarbituric acid (TBA) reaction. High pressure liquid chromatography, chem-ionization and electron-impact mass spectrometry and nuclear magnetic resonance spectroscopy suggest that the major product was a hydroperoxide of AA. Ferrous iron (Fe++) and oxygen were absolute requirements. Fe++ was converted to the ferric iron (Fe+++) state during oxidation of AA, but Fe+++ could not substitute for Fe++. No other enzymes, cofactors or ions were involved. Conversion of AA to a hydroperoxide by Fe++ was inhibited by the antioxidant, 2, (3)-Tert-butyl-4-hydroxyanisole, the radical scavenger, nitroblue tetrazolium, and iron chelating agents, including EDTA, imidazole and dihydroxybenzoic acid. The reaction was not affected by superoxide dismutase, catalase or aspirin. These findings and preliminary studies of the Fe++ induced oxidation product of AA as a substrate for prostaglandin synthesis and inhibitor of prostacyclin production indicate the critical role of Fe++ in AA activation.


Intramuscular administration of 16 phenoxy omega 17,18,19,20 tetranor PGE2 methyl sulfonylamide for pre-operative cervical dilatation in first trimester nulliparae. A single intramuscular dose of 500 microgram 16 phenoxy omega 17,18,19,20 tetranor PGE2 methyl sulfonylamide was used for cervical dilatation prior to vacuum aspiration in 80 first trimester nulliparae. Three hours after prostaglandin administration the cervix had dilated to 8 mm or more in 60 patients (75%). The uterus was evacuated in these patients without mechanical dilatation of the cervix. In the remaining 20 patients the cervix had dilated 4 to 7 mm. Further mechanical dilatation to 8 mm was carried out easily in most of these patients. Side effects included pain requiring analgesic (3 patients), vomiting (4 patients) and transient pyrexia (greater than 1 degrees C, 2 patients). There were no complications or damage to the uterus or the cervix during evacuation of the uterus.


Ultra-violet radiation and 8-methoxypsoralen have actions similar to those of known inhibitors of thromboxane A2 synthesis in rat mesenteric blood vessels. In the rat mesenteric vascular bed three structurally different agents (imidazole, benzydamine and N-0164) which have been reported to be inhibitors of thromboxane (TX) A2 synthesis at certain concentrations, all have a characteristic spectrum of action. They inhibit pressor responses to noradrenaline and angiotensin with equal potency and the inhibition can be reversed by exogenous PGE2: they do not inhibit responses to potassium. Ultra-violet (UV) radiation has a similar spectrum of action. The main difference between the action of imidazole and that of UV radiation is that the former is rapidly reversible while the latter is not. However, irradiation administered to preparations inhibited by imidazole has no irreversible effect provided that the radiation is switched off before the imidazole is removed. The imidazole protects against radiation damage suggesting that the drug may stabilize the site affected by UV light. 8-methoxypsoralen, a light sensitizing agent used in treatment of psoriasis also inhibited noradrenaline and angiotensin but not potassium responses and seemed to make the preparation more sensitive to radiation damage. It is possible that UV radiation and 8-methoxypsoralen may inhibit TXA2 synthesis but this requires confirmation by direct methods.


Effects of prostaglandin-F2alpha on some reproductive parameters of fertile male rats. Silastic-PVP-PGF2alpha tubes significantly reduced the sperm population in the epididymis and vas-deferens of male rats 14 days after their insertion into the scrotal sacs. A reduction in testis and epididymal weights was also evident. The reduction of sperm population was accompanied by a normal sexual drive and circulating testosterone level and partial sterility. The reduction in sperm population and induction of partial sterility was detected at least 7 days after the total release of prostaglandin F2alpha from the Silastic-PVP tubes. The results suggest that the changes in the reproductive parameters might be a consequence of endocrinological and functional disturbances induced by PGF2alpha and that PGs can be used to induce temporary sterility in the male.


Prostaglandins in blood of diabetic versus non-diabetic humans. We have found a higher concentration of prostaglandins in blood from the diabetic patient under long-term indomethacin therapy as compared with blood from non-diabetics. These findings are generally (qualitatively) similar to previous reports with studies of blood serum from diabetic patients, not on indomethacin treatment, compared with non-diabetics. Certain rationale are presented in an effort to explain the reason why blood prostaglandins in the diabetic are not lowered when the patients are treated with a drug which is clearly established as a blocker of prostaglandin synthesis.


Prostaglandin E1-induced potentiation of the anticonvulsant action of phenobarbitone in the rat. Role of brain monoamines. Prostaglandin E1 (PGE1) significantly potentiated the anticonvulsant action of a sub-effective (EDO) dose of phenobarbitone, against maximal electroshock-induced seizures in the rat. PGE1-induced potentiation of phenobarbitone was significantly inhibited after pretreatment with drugs which are known to reduce brain serotonin activity, but was unaffected by drugs known to decrease brain catecholamine activity. Prostaglandin F2 alpha produced a moderate though statistically insignificant inhibition of PGE1 effect. The results suggest that PGE1-induced potentiation of phenobarbitone is not a direct effect but an indirect one, mediated through an increase in brain serotonin activity.


A defect in thromboxane A2 synthesis may be a factor predisposing to cancer. A failure of thromboxane (TX) A2 synthesis may be a factor in cancer. Such a loss could explain the susceptibility to mutation, the excess prostaglandin production, the glycolytic mode of metabolism and the deranged calcium pumping characteristic of cancers. Ionising radiation and phorbols both have actions similar to inhibitors of TXA2 synthesis whereas colchicine and oxygen have actions consistent with stimulation of TXA2 synthesis. The concept accounts logically for hitherto unexplained features of cancer and suggests new strategies for the prevention and treatment of cancer.


Prostaglandins as regulators in cellular immunity. Guinea-pig peritoneal macrophages have been shown to generate substantial concentrations of E-type prostaglandins during culture in vitro. Partially purified lymphokine preparations stimulate PGE production by macrophages. Exogenous PGE1 and PGE2 are potent inhibitors of lymphocyte activation and secretion of lymphokines causing lymphocyte mitogenesis and macrophage migration inhibition. Also indomethacin augments the secretion of these lymphokines in vitro. It is therefore suggested that production of PGE by macrophages provides a physiological mechanism for the regulation of lymphocyte activation in reactions of delayed hypersensitivity.


Prostaglandin F2alpha induced termination of pregnancy and its reversal by prolactin or progesterone in rats. Intrauterine insertion of a Silastic-PVP tube containing 400 microgram PGF2alpha terminated midterm pregnancy in 100 per cent of the animals. Progesterone (2 mg/day) or prolactin (PRL) reversed the abortifacient effect of PGF2alpha. A dose- and duration-related effect of the PRL on PGF2alpha induced termination of pregnancy was evident. The results suggest that PGF2alpha and PRL are antagonistic to each other and multiple doses of PRL are needed to neutralize the luteolytic action of PGF2alpha.


Selective elevation of circulating prostaglandin concentrations in hyaline membrane disease in pre-term infants. The plasma concentrations of prostaglandins E and F (PGE, PGF) and 13, 14-dihydro-15-keto-PGF (PGFM) have been measured in pre-term neonates with hyaline membrane disease (HMD) and controls. The concentrations of PGF and PGFM were significantly higher in infants having HMD with a disproportionate increase in PGFM levels for the increase in PGF found. The vasoconstrictor nature of PGF may contribute to the morbidity associated with HMD and the possible therapeutic benefit from the use of prostaglandin synthetase inhibitors is discussed.


Circulatory responses of perinatal goats to prostaglandin precursors. The effects of precursors in the prostaglandin synthetic pathway as well as those of analogs of cyclic endoperoxide intermediates upon the pulmonary and systemic circulations of fetal and newborn goats were examined. Exogenous arachidonic acid increased pulmonary vascular resistance and decreased systemic arterial pressure of fetuses and newborns. The effects of dihomo-gamma-linolenic acid on the circulation are qualitatively similar, but quantitatively less, than those of arachidonic acid. The cyclic endoperoxide analogs were strong pressors in both pulmonary and systemic circulations. The responses to the fatty acid precursors, which are totally blocked by indomethacin and meclofenamate, appear to indicate that they give rise to more than one vasoactive product. Furthermore, exogenous arachidonic acid produces effects which appear to be different from those produced by endogenous pulmonary arachidonic acid.


Prostaglandin mediated relaxation of coronary artery strips under hypoxia. Strips of beef coronary branch arteries, maintained in vitro, respond to decreased PO2 in the bathing medium with relaxations which are much attenuated by pretreatment with indomethacin or aspirin. It was determined that these hypoxia-induced relaxations are sustained until strips are returned to an environment of high PO2 and that the mechanism involved does not fatigue readily with repetitive exposure to hypoxic stress (53 mm Hg). It was also established that the reduced relaxations observed in the presence of inhibitors of prostaglandin synthesis were not enlarged with time by the development of an alternate process of relaxation independent of prostaglandins. Other experiments showed that when prostaglandin intervention is blocked with inhibitors the strips maintain a given level of tone to potassium chloride under a PO2 of 53 mm Hg, and do so without significant impairment over an observation period of one hour. Similarly, complete concentration-response curves to potassium did not differ under high (515 mm Hg) or low (53 mm Hg) PO2. This confirms that hypoxia-induced relaxation in beef coronary artery strips is a specific process, apparently mediated by a prostaglandin, rather than any consequence of the failure of the energetics of contraction.


Dietary fat type and ambient oxygen tension influence pulmonary prostaglandin synthetic potential. Chronic hyperoxia produces pathological changes in lung which can be fatal. With an interest in delineating dietary factors which might affect the pulmonary response to hyperoxia, we fed rats a semi-synthetic diet containing polyunsaturated fatty acids (PUFA) as either 5% or 78% of the fat complement. The rats were exposed to pure oxygen at one atmosphere. Half the animals in each diet group were injected with aspirin during the hyperoxic exposure. Radioimmunoassay of lung prostaglandins (PG) F2alpha, E2 and E1 were performed at 0, 24, 48 and 72 hours. The major findings were: (1) Feeding the high PUFA diet elevated lung PG synthetic potential tenfold over that of low PUFA-fed animals. There was no effect of diet on mortality. (2) Hyperoxia significantly increased F2alpha-synthetic potential during the first 24 hours of hyperoxia and moderately increased the synthetic potential of E2 and E1. (3) Aspirin significantly depressed synthetic potential of all three PG prior to oxygen exposure but its effect was overcome during hyperoxia. Aspirin-injected rats showed 80% mortality in oxygen vs. 50% for saline controls.


The effects of some methyl prostaglandin derivatives on the ductus arteriosus of swine in vivo. Three methylated analogues of prostaglandin E1 and E2 were examined for their ability to open the ductus arterious of neonatal piglets in vivo. Fifteen (S) 15 methyl prostaglandin E1 (15-Me PGE1), 15 (S) 1K methyl prostaglandin E2 (15-Me PGE2), and 16' 16' dimethyl prostaglandin E1 (16-diMe PGE1) all opened the ductus when given intravenously, intramuscularly or orally. The effects on ductal patency lasted four hours or more in many instances. Side-effects included apnea with intravenous and intramuscular dosages, and with high oral dosages of 15-Me PGE1. A transient drop in heart rate and blood pressure occurred with each dose. In one animal the ductus was kept open for 19 days with six-hourly intramuscular injections of 3 microgram/kg 15-Me PGE1. Transient sedation occurred with each dose. Death occurred on the 19th day and histological studies showed that the morphology of the ductus wall was similar to that seen in a two day old animal. These studies suggest that maintenance od ductal patency in the infant may be possible with oral administration of methyl prostaglandin derivatives.


Suppression by essential fatty acids of experimental allergic encephalomyelitis is abolished by indomethacin. Experimental allergic encephalomyelitis in Lewis rats was suppressed by treatment with essential fatty acids (EFA) given perorally. This treatment effect could be abolished by administration of a drug (Indomethacin) known to inhibit biosynthesis of certain prostaglandins from EFA. This observation suggests that the suppressive effect of EFA on cell-mediated immune reactions is brought about by EFA-derived prostaglandins.


Ferrous iron mediated oxidation of arachidonic acid: studies employing nitroblue tetrazolium (NBT). The oxidation of arachidonic acid by ferrous sulfate provides a useful model to study the role of iron in lipid oxidation reactions. We have employed nitroblue tetrazolium (NBT) in the present investigation to evaluate the mechanism of this reaction. In the presence of arachidonic acid, Fe +++, and O2, the yellow dye NBT was rapidly reduced to the blue form, NBTH2. The molar ratio of arachidonic acid to Fe++ in this rapid reaction was 1:1, showing an interaction of one fatty acid molecule per iron molecule. Approximately one molecule of NBT was reduced per four molecules of arachidonic acid and Fe++. Reduction of NBT was accompanied by oxidation of Fe++ to Fe+++, suggesting the transfer of four electrons from the Fe++ to NBT to reduce the dye. Arachidonic acid was found to be unchanged when extracted at the end of the reaction, indicating formation of a complex that could dissociate leaving intact arachidonic acid. Evidence for the presence of such a complex which slowly dissociates during the reaction was obtained after longer incubations with small amounts of arachidonic acid. NBT reduction was not inhibited by agents which hydrolyze superoxide, by catalase or by agents which trap hydroxy radicals. We, therefore, propose a model in which NBT traps a radical generated on the arachidonic acid molecule. The proposed model suggests mechanisms for other fatty acid oxidation reactions such as prostaglandin and hydroperoxy fatty acid synthesis.


Role of prostaglandins in human fertility. One function of prostaglandins in semen may be suppression of an anti-sperm immune response.


Therapeutic abortion in late first trimester. Prostaglandin pretreatment compared with primary surgery. One hundred randomly selected nulliparous women, 10-11 weeks pregnant, were submitted to either primary surgery (50 cases) or pretreatment overnight with vaginal suppositories of 15(S)15 methyl prostaglandin F2 alpha methyl ester (50 cases) followed by vacuum aspiration. No peroperative complications were recorded in either of the two groups. Thirtyfive of the 50 pretreated women aborted during the pretreatment period and a variable cervical dilatation was observed in the remaining 15 women of this group. The incidence of early postoperative pelvic infection tended to be less in the pretreated group as compared with the other group.


[Marxist-Leninist philosophical personality theory and the development of the theory and practice of psychiatry]. This is a concise presentation of the essential positions of the Marxist-Leninist philosophical theory of personality. Its consequences to modern psychiatry are discussed. Particular emphasis has been placed on establishing practical relations with mental patients and creating optimum conditions for promoting the distinctive qualities or characteristics of persons within the framework of therapy. Also discussed by the author in his present paper are questions associated with pathogenesis. Integration of clinical and sociopsychological research into the development of psychoses is considered necessary.


[Psychology of relations as a theoretical concept of medical psychology and psychotherapy]. This paper presents the theoretical concept of the "psychology of relations" (A.F. Lasurski, V.N. Myasistchev) which forms the basis for studying the personality of a patient and for finding a suitable treatment of nervous and mental disorders by psychological methods. The author shows that there is theoretical agreement between the psychology of relations and the philosophy of dialetical materialism and Pavlov's theory of conditioned reflexes. Also discussed in this paper is the concept's relation to clinical psycho-neurology, its orientation toward considering personality as a system, as well as the recognition of the primacy of the conscious over the unconscious. Prospects for an evolutional and ontogenetic approach to an analysis of the system of relations and the need for elaborating systematized work programs determined by the investigative goal to be achieved are also considered by the author in his present paper.


[Trends and problems in psychophysiologic research]. Considering the increasing importance of psychophysiological investigations, the peculiar quality of psychological control functions in human organism is stressed. For this reason, specific definition of the initial conditions for psychophysiological experiments is necessary. If we use complex experimental schedules including electrophysiological parameters more and more differentiated results can be obtained. The different ways of information storage within the two hemispheres are considered as very conclusive. By means of a model of motor system the significance of internal feedback circuits is demonstrated. A statement concerning the mutual connections between biological and psychological events is given.


[Problem of abnormal alcoholic intoxication in forensic psychiatric judgment]. The problem of pathological intoxication is discussed. Also considered by the authors in their present paper is the fact that various designations are used in the literature to describe abnormal intoxications of which the intensity is less than that of real pathological intoxication. However, phenomenological or symptomatological classifications provide no information whatsoever about the ability to take decisions and about mental responsibility. An attempt is made to establish criteria for the concept of "pathologically colored intoxication" which is primarily oriented, not in a phenomenological context, but toward a substantially diminished ability to take meaningful decisions.


[Report of experience with a socio- and psychotherapeutically oriented open long-term group of parents of severerly brain injured children treated in an outpatient clinic]. In 1972, we started a discussion group for parents of children with severe brain damage. The emerging group dynamic was dialectically determined, on the one hand, by the heterogeneity of the parents' different personalities and reactions to their experience and, on the other, by the homogeneity of the problem to be borne and solved in common: the handicapped child in family and society.


Defining the therapeutic processes in psychiatric milieus. Clinicians are increasingly required to justify the costs of milieu  therapy. The current variety of milieu types and their competing claims of efficacy can make this a vexsome problem. This paper attempts to conceptualize five major therapeutic processes which commonly exist in a broad range of milieus, independent of size, length of stay, staffing and philosophy. It is hoped these will help provide a reasonable and clear means of developing and explaining therapeutic milieu programs.


Explorations in the uses of language in psychotherapy: simple empathic statements. I submit these ideas with hesitation. They seem to rest on a particular assumption widely at variance with contemporary practice and itself difficult to state. The prevailing assumption has been that the content of a person's mental life, symptoms, or experience lay in that person's mind, and that by asking questions, listening, in various ways making ourselves receptive, we could penetrate that mental life. In this traditional manner of thinking, the language of penetration has been secondary to the material being reached. In contrast, I suspect that the language of investigation and therapy is as important as the matter being investigated or treated--that in fact the two bear a symbiotic relationship to each other.


The nonverbal basis of attraction: flirtation, courtship, and seduction. According to a familiar phrase, the "language" of love is universal. Recent ethological studies of nonlinguistic communication in courtship using facial expression, gesture, posture, distance, paralanguage, and gaze have begun to establish that a universal, culture-free, nonverbal sign system may exist (Eibl-Eibesfeldt, 1975), which is available to all persons for negotiating sexual relationships. The nonverbal mode, more powerful than the verbal for expressing such fundamental contingencies in social relationships as liking, disliking, superiority, timidity, fear and so on, appears to be rooted firmly in man's zoological heritage (Bateson, 1966, 1968). Paralleling a vertebrate-wide plan, human courtship expressivity often relies on nonverbal signs of submissiveness (meekness, harmlessness) and affiliation (willingness to form a social bond). Adoption of a submissive-affiliative social pose enables a person to convey an engaging, nonthreatening image that tends to attract potential mates. This report explores several conspicuous nonlinguistic cues that appear to be used widely in contexts of flirtation, courtship, and seduction. The expressive units are discussed from the standpoint of their occurence in five phases of courtship, and are illustrated by four cases.


A semiotic approach to suitability for psychotherapy. At the beginning of my career as a psychotherapist I interviewed a number of patients in an effort to find one who seemed to be a good prospect for long-term psychotherapy. While interviewing with this purpose in mind, I was struck by the fact that a number of the people I spoke with gave me a sense of being extremely suitable for this sort of therapy, but that others seemed quite unsuitable. An informal survey among my peers as well as among more senior therapists revealed that they were not unfamiliar with the phenomenon. The present empirical study of the semiotic aspects of suitability for psychotherapy grew out of this early experience.


Independent nonprofessionals in the community: a case history analysis of a human relations program. For eight years a group of nonprofessional human relations trainers conducted a community-based Adult-Youth T-Group Program in a suburban community under the auspices of the Board of Education. Their history provides the material for this case analysis, which will focus on two sets of issues. One set of issues surrounds the fact that these group leaders were "independent nonprofessionals": trained but noncredentialed persons performing functions usually reserved for professionals (or performed under professional supervision) and performing them outside of institutional and professional boundaries. A second set of issues, only partially related to the first, surrounds the organizational dilemmas and social-political conflict which beset this team and the program which they conducted.


A comparative study of opinion and knowledge about mental illness in different societies. An extensive survey of two communities in Western Nigeria, one urban and the other rural, was conducted to find out some characteristics of opinion and knowledge about mental illness among the Yoruba. A questionnaire containing descriptions of four different types of mental illness (simple schizophrenia, paranoid schizophrenia, anxiety neurosis/depression, and alcoholism), was administered to 771 respondents, randomly selected. The description of paranoid schizophrenia was more readily recognized as mental illness than the others. Respondents tended to typify persons who fit the other three descriptions in such terms as "shy," "hot-tempered," "queer," "flirt," and "drunkard." Compared with Asian, Australian, and North American studies, lesser proportions of Nigerian respondents viewed the descriptions as symptomatic of psychiatric disorder. The finding that most respondents are still unaware of the range of symptoms and their significance is particularly striking because the catchment area for this study has had a long exposure to modern psychiatric delivery systems. It is suggested that the heightening of awareness of psychiatric symptoms through nationwide mental health education is essential for the full utilization of mental health services.


On hybrid concepts in psychoanalysis.

On hybrid concepts in psychoanalysis. Hybrid concepts that combine observable data with abstract metapsychological constructs have increasingly pervaded psychoanalytic discourse in recent years. For example, the "fear of loss of ego boundaries" combines "fear", which may be directly experienced and observed, with "ego boundaries," metapsychological abstraction. The authors regard the widespread use of these concepts, which are most commonly applied to borderline and psychotic conditions, as a trend which may undermine the usefulness of psychoanalytic approaches to these entities.


Trends in the psychoanalytic theory of treatment. Freud considered understanding, attachment, and integration to be important factors in achieving treatment benefits. Subsequent discussions have not always embraced all three factors. It has been especially difficult to conceptualize the part played by the personal attachment of the patient to the analyst. A new, narrower focus on common, structure-building processes promises to show how all three factors are involved with each other in the treatment process.


Sibling loss as an organizer of unconscious guilt: a case study. A case is described in which the death of a sibling in childhood organized a profound unconscious sense of guilt, a repetitive need for self-punishment, and a negative therapeutic reaction in analysis. The various meanings of the patient's negative therapeutic reaction are discussed, along with the question of why this event came to have such pathologic impact on his character.


The role of attention in depersonalization. Episodes of depersonalization function to keep disturbing preconscious thoughts from becoming conscious. The symptom is conceptualized as a compromise between the wish to be "only dreaming" and the need to maintain a waking state in contact with perceptual reality. Restriction of attention is identified as the central mechanism by which the compromise is effected. On this basis an explanation for the alteration in the sense of reality is suggested. Material from a case is given to support these ideas. The author speculates that early efforts to deal with traumatic experience at a time when the distinction between sleeping and waking states is not secure may lead to the symptom choice of depersonalization.


A learning theory model of chronic illness behavior: theory, treatment, and research. Over 300 patients have been treated on an inpatient psychosomatic service employing a learning model of chronic illness behavior. This model stresses social reinforcement and avoidance of occupational and social activities in the development of a syndrome characterized by somatic complaints and care-eliciting interpersonal behaviors. Preliminary studies showed that patients reinforced others for care-giving responses but showed improved tolerance of experimental pain and lower rates of drug use when care-taking responses were minimized and self-control encouraged. Treatment was designed to involve the patient in his own care, including behavior modification techniques to reduce symptomatology, social skills training, and family therapy. One-year follow-up shows that most patients achieve self-set goals, with generalization of beneficial treatment effects. Patients who return to an intact family show continuing decreases in somatic complaints and increases in achievement orientation. Treatment failures are characterized by lack of an intact family and return to the medical care system.


Life change and psychological distress as predictors of pregnancy outcome. An exploratory investigation was conducted to assess the potential utility of objective measures of life change, anxiety, and personality as predictors of labor complications in a sample of full-term, lower-socioeconomic pregnant women without present evidence or histories of serious medical problems. The results of a linear multiple discriminant function analysis indicated that none of the personality or anxiety measures emerged as reliable predictors, but that scores on a measure of life change were able to discriminate between subjects with and without labor complications at a moderate level of predictive accuracy. This moderate level of discriminability was maintained in a double cross-validation analysis. The relationship between life change and the likelihood of complications was in a negative direction, with lower life change scores indicating a greater probability of complications. The theoretical and practical implications of the findings are discussed, along with directions for future research.


A behavioral strategy for promoting  treatment compliance following myocardial infarction. Seven men who had recently experienced a myocardial infarction were treated for medical noncompliance. Patient selection was based on recent and past noncompliant behaviors, denial of infarct, and degree of job involvement. Treatment strategy included (1) self-planning of a rehabilitation program by the patient (activity hierarchy), (2) self-monitoring of bio-behavioral data, (3) weekly visits to review data and decide on new activities. Results showed that all patients were highly compliant as determined by several criteria. The technique is relatively easy to apply and it seems to have wide appeal to patients who might otherwise be at high risk for self-injurious behavior.


Natural history of male psychological health, IV: what kinds of men do not get psychosomatic illness. This article reports on interrelationships between the medical and emotional health of 95 men who were prospectively followed from age 18 to 53. Fifty of these originally healthy men developed illness patterns sometimes called psychosomatic (ulcer, colitis, allergy, hypertension, musculo-skeletal disorders). These men were compared with the other 45 similarly studied men who never developed such illnesses. Although men who developed "psychosomatic" illnesses were more likely to seek medical or psychiatric attention, they exhibited only slightly more psychopathology. Both as children and as adults they had more physical illness of all kinds. They were less likely to indulge in vacations and athletics and more likely to use tranquilizers and excessive alcohol. Men with "psychosomatic" illnesses experienced a greater variety of somatic symptoms under stress, but the loci of these somatic symptoms shifted over time and were not significantly associated with the sites of psychosomatic illness. Premorbidly, the 20 men who were eventually to develop serious irreversible physical illness of any kind reflected far more psychopathology than the 45 men who developed psychosomatic illness.


Transient polyarthritis associated with familial hyperbetalipoproteinaemia. Forty-one heterozygous patients with familial hyperbetalipoproteinaemia have been studied. Twenty-two of these patients have been observed for four years'. Transient flitting inflammatory joint symptoms were noted in thirteen patients of this group. In six patients clinical, biochemical, radiological and radio-isotope studies have been carried out during the acute episode. These investigations suggest that this syndrome is due to acute inflammatory periarthritis and peritendinitis. Radio-active xenon clearance is not prolonged as occurs in inflammatory synovitis although there is elevation of the ratio-active technetium uptake over the affected joints suggesting that the blood flow to the affected area is increased. This is the largest group of patients with this complication reported to date and the recognition of this may prove to be an important aspect of case finding in this disorder. The treatment of hyperlipidaemia at an early stage may well contribute to a reduction in the morbidity and mortality from vascular disease. No further elucidation of the pathogenesis of the arthropathy has been made but a possible relationship between undue exercise and the onset of joint symptoms was again observed.


Automated peritoneal dialysis for home use. In order to provide an alternative to maintenance home dialysis for patients remotely situated or who had vascular access failure, a parallel peritoneal dialysis (PD) program was developed in March 1972. Over four years, 36 patients started PD with the intention of carrying out home treatments. Thirty of the 36 succeeded and 22 completed at least six months of home treatments, seven have so far been treated for over one year. No neuropathy developed except in diabetic patients. No patient, including four who had undergone bilateral nephrectomy, was depenedent on blood transfusions. Predialysis serum creatinine values were questionably higher (p less than 0.07) in a group of six patients who at another time had been maintained on hemodialysis (HD). In this group serum albumin was (mean +/- 1 S.D.) 3.3 +/- 4 g/100 ml on PD and 3.8 g/100 ml on HD (p less than 0.05). Sixteen of the 36 patients had bacterial peritonitis on 22 occasions; the average incidence was once every 14 months of patient exposure. An epidemic of sterile peritonitis involving 40 episodes in 16 patients was resolved after machine techniques were changed. Catheter failure occurred in 15 of the 22 patients in the long-term group, but catheter replacement was not difficult.


An assessment of laparotomy in the management of patients with Hodgkin's disease. Planned laparotomy and splenectomy has been a safe investigation for sixty patients with clinical Stage I, II or III Hodgkin's disease. Twenty-four of the 60 patients (40%) changed stage and 18 patients had their treatment altered as a consequence of the procedure. Forty-three per cent of patients without a palpably enlarged spleen had unsuspected disease when the organ was examined pathologically, although a false positive spleen was uncommon. Eight of 55 patients (14.5%) had intra-abdominal disease which was not detected by lymphangiography. Intra-abdominal disease occurred with all histological sub-types and was found in two patients who had clinical Stage I disease and lymphocyte predominance in their node histology. Sarcoid-like granulomata were found in ten patients, seven in the spleen, one in the liver and spleen, one in the skin and one in the original node biopsy. In the majority of patients, granulomata were associated with nodular sclerosing or mixed cellular histology. In all ten patients the Hodgkin's disease was suppressed by appropriate chemotherapy and disease has not recurred. No patient has shown any clinical evidence of sarcoidosis and the Kveim test done in three patients was negative. Our experience encourages us to recommend staging laparotomy for all adult patients with Hodgkin's disease which does not show obvious generalized spread beyond lymph nodes.


Renin subgroups in essential hypertension: an analysis and critique. It has been claimed that measurement of renin levels in patients with essential hypertension enables identifiable subgroups of patients to be demarcated and that these subgroups exhibit important differences in prognosis and response to therapy. Accordingly, plasma renin activity (PRA) was measured in 181 patients referred to hospital outpatients for treatment of hypertension. Fifteen of these were excluded from study because of abnormality of renal function, an abnormal pyelogram or incidental disease. PRA of the remainder showed a smooth unimodal distribution with a 'tail' of high values (17%) which lay above the range of values observed in normotensive subjects. Following seven days treatment with bendrofluazide the percentage rise in PRA was much less than that of age-matched controls. A group of 55 patients (33%) fell below the range encountered in normotensive matched subjects treated similarly, although the distribution of PRA was still smooth and unimodal. Patients were divided into 'high', 'normal' and 'low' renin subgroups. Whilst there were significant differences in age between the high, normal and low renin groups, there were no significant differences in basal blood pressure, response to diuretics or beta blockers. It is concluded that renin levels in hypertension are influenced by several factors and that any attempt to subdivide patients into renin subgroups is therefore arbitrary. Measurement of renin does not significantly assist predicting the blood pressure response to either diuretics or beta-blockers combined with diuretics.


Pure red cell aplasia.

Pure red cell aplasia. Complete or near complete remission of acquired pure red cell aplasia, not associated with thymoma, occurred in response to prednisone (six occasions), prednisone and cyclophosphamide (twice), cyclophosphamide alone (once) and splenectomy (once). These results were observed in four patients and confirm the value of cyclophosphamide and possibly splenectomy in patients resistant to prednisone in acquired red cell aplasia. In two of these patients, bone marrow progression from a state of ineffective erythropoiesis with many red cell precursors to that of red cell aplasia was observed. This indicates that some acquired refractory anaemias characterized by ineffective erythropoiesis may have the same pathogenesis as acquired red cell aplasia. The absence of demonstrable antibodies active against erythroblasts may merely reflect the insensitivity of currently available techniques. However it is possible that non-humoral immune mechanisms may be involved in the production of some forms of acquired red cell aplasia responsive to immunosuppressive drugs.


The urinary excretion of radiocopper in presymptomatic and symptomatic Wilson's disease, heterozygotes and controls: its significance in diagnosis and management. Radiocopper (64Cu, 67CU), given intravenously, has been used to study the pattern of excretion of copper in patients with presymptomatic, symptomatic and treated Wilson's disease, together with heterozygotes for the Wilson's disease gene and a control group of patients with a variety of neurological lesions mimicking Wilson's disease. Urine was collected for three periods after injection, 0 to 8 hours, 8 to 24 hours, at which time a test dose of penicillamine was given, and from 24 to 30 hours. Stable (endogenous) copper was also estimated on these samples and specific activity was determined. This was multiplied by a correction factor to allow for variations in dose and body weight. The findings for stable copper in urine were largely predictable. Controls and heterozygotes had the least copper excretion, the amounts rising in the presymptomatic to a peak in the symptomatic patients. Institution of therapy was associated with a fall in copper excretion pro rata with time. The most important radiochemical findings were as follows. Heterozygotes excreted less of the injected copper than controls both under basal conditions and after penicillamine. Presymptomatic patients excreted less radiocopper than heterozygotes after penicillamine although the excretion during the basal 24 hour period was very much greater. Patients with symptomatic Wilson's disease had by far the highest excretion of radiocopper in all three time periods which fell after treatment, pro rata with time, as had been found for stable copper. These results were subjected to computer analysis. There was no overlap between the various groups with the exception of a single control subject who had combined pyramidal and extrapyramidal system degeneration of obscure aetiology. This patient was classified by the computer study as 'heterozygote'. These findings lend further support to the hypothesis that the loss of a single gene for copper balance can be detected with a high degree of accuracy and also that presymptomatic patients can be selected from a sibship for prophylactic treatment without the risk of subjecting healthy heterozygotes to unnecessary and potentially hazardous long-term therapy.


Bridging the gap between clinical medicine and public health: an experimental course for medical students. An experimental course for third-year medical students, held at Columbia University, was aimed at enlisting larger numbers of future clinicians in the identification of public health problems and the development of nonclinical interventions, such as environmental and health education strategies. The course sought to develop a new perspective for the analysis of clinical observations. Students chose clinical problems, identified factors influencing incidence or prevalence, or both, and devised intervention strategies while working in a district of the New York City Department of Health. Students found that they could carry out their responsibilities only by going beyond the limitations of care for individual patients and clinical medicine. Students' perceptions and behaviour were measured during periods of their clinical training. Those who had taken the experimental course perceived public health problems and suggested and took corrective actions much more frequently than students in control groups.


A three-year survey of viral hepatitis in West London. During a total population survey of viral hepatitis in the London Boroughs of Hounslow, Richmond and Ealing, 784 patients were seen in three years from 1 March 1972 to 28 February 1975. A diagnosis of viral hepatitis was accepted in 489. The annual incidence was 24 per 100 000. 455 of the patients were tested for the hepatitis B surface antigen (HBsAg) by a radioimmunoassay technique and 93 (20%) of these were positive. The majority of the patients with type B hepatitis were in their third or fourth decades. None was under the age of 16. The male to female ratio among patients with hepatitis B was 2 to 1 in those under the age of 30 and 5 to 1 in those aged 30 and over. The seasonal distribution of viral hepatitis showed a peak in the spring, solely from an increased incidence of non-B hepatitis, and a second, smaller peak in the autumn. There was no appreciable clustering of patients except for one local outbreak in a housing estate during the first year affecting mainly children going to the same primary school, and their parents. Patients with hepatitis B had a longer pre-icteric illness (p less than 0.05), greater duration of jaundice (p less than 0.001) and higher peak levels of serum bilirubin (p less than 0.0005) and serum alanine amino transferase (A1T) (p less than 0.03) than patients with non-B hepatitis. The finding of the surface antigen was also associated with a higher frequency of skin rash (p less than 0.0005) and a greater duration of arthralgia (p less than 0.03). Among the HBsAg negative patients the incidence of arthralgia increased with age (p less than 0.0005). Abdominal pain (p less than 0.005) and vomiting (p less than 0.005) were more common in the young. The injection experience of patients with hepatitis B showed a high proportion of 'non-therapeutic' exposure such as drug addiction. Significantly more HBsAg positive men were single than in the local community (p less than 0.001) or among the HBsAg negative men (p less than 0.01). There was no significant difference between the proportions of single women among the antigen positive and negative patients. Many of the HBsAg positive single men were either known to be or strongly suspected of being homosexual. The ad subtype of the HBsAg was found more often in males (p less than 0.01), particularly over the age of 30. All eight drug addicts tested for subtype were ay, as were two non-addicted female consorts. The association between addiction and ay subtype was highly significant in the males (p less than 0.001). The ad subtype was found in all 11 of the admitted homosexual HBsAg positive men and in all but one of the 17 strongly suspected of being homosexual.


Microspectrophotometric studies on the visual pigment in the intact retina of the goldfish, Carassius auratus (Linn.). The visual pigments in intact retinas of the common goldfish were examined by microspectrophotometry. Difference spectra free of photoproduct contamination had absorbance maxima at lambda527 nm +/- 2 nm. The average pigment density, about 0.32, was almost invariant with regard to retinal location and specimen size. Traces of a photoproduct absorbing maximally at lambda480-490 nm were found. The normalized "absorbance" curve deviated from standard templates. It was suggested that this was an effect of cross-coupling of energy and among photoreceptors. Finally, known action spectra show a red shift relative to the absorbance spectra measured.


[Histological and morphometric study of the development of the optic part of the compound eye of the Enallagma boreale Selys (Odonata: Coenagrionidae)]. The morphology of the optical part of the Enallagma boreale Selys compound eye remains unchanged during its post-embryonic development. The cornea, composed of the epi-, exo- and endocorne, is in perfect continuity with the larval cephalic cuticle. Consequently these two structures possess the same three layers and have a similar process formation. But, the measurements from cephalic endocuticle and endocornea of the adult differ significantly from each other. The latter has a lamellar aspect. The nuclei cornea reaches its morphometric characteristics as early as the pre-emergence stage. The nuclei of the two primary pigment cells which have maintained their epidermic nature, are located at each side of the apex of the crystalline cone. The nuclei of the secondary pigment cells are uniformly distributed in the optical and photosensitive parts. The larval and adult crystalline cones differ morphometrically. The larval one is longer and narrower and reaches its adult characteristics just before emergence. Statistical tests do not show any significant difference between the dorsal and the ventral parts of the larval and adult compound eye.


On possible involvement of adrenocorticoids in chicken spleen development. The possible effects of glucocorticoids on spleen development were assessed by the determination of changes in mean organ weight and histology in chicken (Gallus gallus) embryos at stages 44 and 45 of Hamburger and Hamilton on days 19.5 and 20 of incubation (N = 10--13). After the administration of 1 to 6  mg of metopirone (an 11-beta-hydroxylase inhibitor) the numbers of white-pulp periarterial nests and red-pulp granulocytes decreased. The changes associated with metopirone treatment were less evident after the addition of corticosterone (20 and 200 microgram). After adding corticosterone alone (200 microgram), the white-pulp nests appeared larger than in control. Mean body and spleen weights or spleen-body weight ratios did not change much after treatment. Possibly glucocorticoids normally direct these aspects of spleen histogenesis in chicken embryos.


Optical characteristics of the eye of the spiny dogfish (Squalus acanthias). On the basis of the failure of attempts to induce refractive accommodation changes electrically and with drugs, it appears that the eye of the spiny dogfish (Squalus acanthias) lacks the capacity to accommodate. Retinoscopic measurements indicate moderate hyperopia (+6D). However, measurements made with light restricted to the short end of the visible spectrum indicate only one or two dioptres of hyperopia and it is possible that the latter measurements are more coincident with natural conditions. In contrast to the somewhat flattened lens of other elasmobranchs the lens of the spiny dogfish is nearly spherical. The fact that its refractive index is high (1.66) suggests that the static optical system of this eye is very similar to that of the teleosts.


Uptake of lysolecithin and other lysins by rat erythrocytes. Lysis of rat erythrocytes by lysolecithin, palmitoyl carnitine and palmitoyl choline is inhibited by albumin and by certain lipids. Albumin rapidly forms a complex with the lysins thereby decreasing their reactivity with erythrocytes. Lecithin and cholesterol are lysis inhibitors that do not prevent the uptake of lysins but decrease their interactions with structural elements of the red cell membrane.


[Reynold's syndrome. A case report (author's transl)]. One case of the association of primary biliar cirrhosis and systemic sclerosis progressive (SSP) is described (Reynold's syndrome). This association has been reported in 21 patients. In our case the signs of liver disease precede two years the appearence of SSP. A review of the patients with Reynold's syndrome reported is done and compared with the present case. Diagnostic approach and management of this association is also discussed.


[Latex agglutination test in amebic liver abscess]. Amebic hepatic abscesses are one of the most frequent and serious complications of intestinal amibiasis. Although many methods exists with which the diagnosis can be made, frequently problems do arise. Serologic reactions play an important role in the diagnosis of amebic hepatic abscess. Among the most useful of the serological tests, is that which evaluates agglutination with latex particles. Latex agglutination was positive in 98.5% of 200 cases of proved amebic hepatic abscess. The pros and cons of the utility of this test compared with other serological tests are discussed. It is concluded that or the especialist as well as the general practicioner latex agglutination can be extremely useful in the diagnosis of amebic hepatic abscess.


[Surgical treatment of amebic liver abscess]. The charts of 50 patients with hepatic amebic abscesses diagnosed during 1976 in the Hospital de Especialidades del Instituto Mexicano del Seguro Social and in the Unidad Hospitalaria La Paz in the city of Puebla, were reviewed: 39 were men and 11 women, with an age range between the third and sixth decade. It was necessary to resort to surgical treatment in 25 (50%) of the patients for one or various of the following reasons: failure of medical treatment, imminent perforation, septicemia, perforation or the occurrence of an extremely large abscess. The total mortality was 2%. In all cases medical treatment was administered in the pre- and postoperative period. The surgical technique as well as its frequency is described and compared with the results of other groups. The mortality in our study was very low probably because the patients with large abscesses or sepsis were operated on an early stage of their evolution.


[Dysgeusias].

[Dysgeusias]. This is a review of multiple pathologic conditions associated with altered taste perception and identification. We stated the steps and the molecular basis of this sense. This paper includes two cases that exemplify two distinct types of dysgeusia; case, 1 a 48 year old man who had clinical manifestations of hypogeusia and dysgeusia for one year, probably secondary to air pollutants. Case 2, a 37 year old man who worked in the same factory and also had dysgeusia; we concluded that it was secondary to thermal and chemical agression of the oropharynx; his plasma and urinary levels of zinc were normal. Many medications and contaminants of air and water are related with changes in serum and urine levels of zinc, which is a determinant at several levels for the correct integration of the taste system. Namely it is important for synthesis of the metalloprotein, gustin, a parotid gland protein secreted into saliva, which in turns is very important to make union of the sapid substance (SS) with its receptor in the surface of the gustatory epithelium a the taste buds. Zinc is also related with neurotransmission of the electrical stimulus generated in the bud cell and ending in the central nervous system. There is an acute zinc loss syndrome, seen in patients treated with histidine, which simulates the steps in which taste sensation is integrated. A clinical approach for diagnosis of hypogeusic or dysgeusic patients must include a careful evaluation of the diat elements, an assesment of hereditary disorders, the type of work and contact with pollutants known to be related with dysgeusia. A special care regarding physical examination must be considered in particular a meticulous review of the oropharynx in order to diagnose inflammatory, neoplastic or neurological disorders. The levels of perception an identification of flavors: sweet, bitter, sour and salt, must be determined using the forced scale triple choice technic. Serum and urinary levels of zinc should be determined in each patient using a flameless atomic absorption spectrophotometer. A quantification of the activity of leucocyte alkaline phosphatase, a zinc metalloenzyme, is a useful aid, liver function tests. 13 and 14 determinations and serum protein electrophoresis are mandatory because many pathologic states of these organ systems are known to be related with disorders of taste. We wish to remark the important function of zinc in the taste system, the role of essential trace elements is receiving increased atention and these alterations are good examples of their clinical importance.


[Endotoxins and liver].

[Endotoxins and liver]. Endotoxins are macromolecules containing lipopolysacharides that form part of the bacteria wall. They are released only when the cell integrity is lost. They are suceptible to be absorved and pass to the portal circulation. However, in normal individuals endotoxins are not detected in peripheral blood, due to a filter effect of the liver. The possibility that liver failure could produce alterations in the detoxification of endotoxins is analyzed as well as the role of endotoxins to initiate or perpetuate liver damage. The biological effects of endotoxins on bile secretion, liver circulation, energy and carbohydrate metabolism in the liver are described.


[Surgical treatment of achalasia. Analysis of 27 cases]. 1. Esophageal achalasia is a rare disease of unknown origin that occurs with the same frequency in both sexes. 2. During the preoperative workup as well as the postoperative time the following studies should be performed: upper GI series, esophageal manometry and endoscopy with biopsy. 3. In most instances conservative treatment with dilations only provides temporal relief of the symptoms and moreover, is not exempt from complications; it should be employed only in incipient achalasia, in patients who refuse to be operated upon and in those whose general conditions make surgery inadvisable. 4. Surgery can provide a permanent cure for the symptomatology in the majority of the patients, with a very low mortality and morbidity; an operation should be performed early in those who retain more than 10 mls. in the esophagus with persistence of the symptomatology as well as in those patients in whom cancer is suspected. 5. A modified Heller type operation, with abdominal approach with gastrostomy, diaphragmatic hernioplasty and an anti-reflux procedure and when necessary a piloroplasty is the treatment of choice for esophageal achalasia yielding good results in 88.8% of the cases. It should be noted that the degree of postoperative gastroesophageal regurgitation is directly related to the extent to which the gastric incisons is extended below the esophageal-gastric junction.


Characteristics of transcellular NaCl reabsorption in the kidney. To examine the characteristics of transcellular, energy-requiring NaCl reabsorption, increased delivery of tubular fluid of different bicarbonate and chloride composition to the outer medulla was achieved by infusion of acetazolamide (30 mg/kg body wt) or 0.9% NaCl in anaesthetized dogs. As an index of energy-requiring NaCltransport, cortical and outer medullary metabolism were determined by the heat production technique. Outer medullary metabolism was correlated to sodium excretion but not to chloride excretion. A rise in sodium excretion up to 20-25% of the filtered load during hydropenia was associated with a 70-80% increase in outer medullary metabolism. Further increments in sodium excretion induced by increasing systemic blood pressure and thereby increasing glomerular filtration rate or by infusing 2.9% NaCl did not significantly increase either reabsorption of sodium or cortical and outer medullary metabolism. By infusion of furosemide (2mg/kg body wt) sodium reabsorption and outer medullary heat production could be reduced below control values. These experiments show that sodium rather than chloride determine transcellular NaCl reabsorption. The maximal capacity of this reabsorption system is approached first at sodium excretion rates beyond the physiological range. Calculations based on clearance studies and heat production measurements, before and after furosemide infusion, indicate that transcellular NaCl reabsorption accounts for more than half of the NaCl reabsorption in the kidney.


Exercise-and post-exercise metabolism of the lower leg in patients with peripheral arterial insufficiency. Exercise- and post-exercise metabolism were studied in the lower legs of six subjects without known arterial insufficiency and in sixteen claudicants. Lower leg blood flow was measured with a thermodilution catheter in the popliteal vein. The catheter allowed blood sampling from the calf before, during and after an exhaustive, stepwise increasing load exercise on a bicycle ergometer. A higher oxygen extraction and higher lactate release during exercise in claudicants than in normal subjects persisted in the post-exercise period (P less than 0.05). Leg arteriopoplitealvenous differences of free fatty acids (FFA) showed an inverse intergroup relationship to that of glucose. Being higher in claudicants than in normal subjects during exercise (P less than 0.05). However, net uptake of FFA was not significantly different in the groups of legs although it appeared increased relative to glucose in claudicants both during and after the exercise. Thus no statistically significant substrate preference was detected although the results suggests a preference for FFA relative to glucose in legs with arterial insufficiency. The study furthermore demonstrated the lag of exercise metabolism into the post-exercise period in such legs and a close relationship between this metabolic delay and the severity of the disease.


Lecithin:cholesterol acyltransferase activity in rats treated with 4-amino-pyrazolo-pyrimidine. Lecithin:cholesterol acyltransferase(LCAT) in rats treated with 4-amino-pyrazolo-pyrimidine (4-APP) has been studied. Treatment with 4-APP decreased the plasma concentration of triglycerides, cholesterol and cholesteryl ester concomitantly with a decreased rate of cholesterol esterification in plasma. The reduced cholesterol esterification was due both to an effect on the enzyme and on the lipoprotein substrate. Plasma prothrombin decreased to the same extent as that of LCAT, indicating that the primary effect of 4-APP is upon protein synthesis and secretion from the liver.


Primary structure of human intrinsic factor: progress report on cyanogen bromide fragmentation. Human intrinsic factor purified by labile ligand affinity chromatography was cleaved with cyanogen bromide and fractionated by gel filtration. Four of the fragments were purified and sequenced to a total of eighty-four amino acid residues. Including the N-terminal amino acids this amounts to one third of the total amino acid sequence of human intrinsic factor. One of the fragments contained a tyrosine labelled only on iodination of intrinsic factor devoid of cobalamin.


A rapid direct determination of cadmium in blood by anodic stripping voltammetry. This paper describes a rapid, sensitive anodic stripping voltammetry (ASV) method for measuring quantities of cadmium in blood. An advantage of this method is the minimal sample preparation required, using a metal-exchange reagent. A sensitivity of 4 nmol/l can be obtained. The results correlate with those obtained by atomic absorption spectroscopy. Within-run, the coefficient of variation (CV) was 8.9% at a cadmium concentration of 32 nmol/l. Between run CV was 5.4% at 37 nmol/l. The reference interval for blood cadmium concentration was 5-60 nmol/l for non-smokers and 5-85 nmol/l for cigarette-smokers. This method of cadmium analysis shows that ASV is a rapid, sensitive method for determination of blood cadmium in the normal range.


Erythrocyte-Zn-protoporphyrin as an indicator of lead exposure. Measurement of erythrocte-Zn-protoporphyrin with a haematofluorimeter on blood samples from eighty-four lead-exposed individuals has been compared with a fluorimetric determination of the extracted porphyrins. The results agreed well, and the interference from bilirubin and unchelated protoporphyrin was low. An exponential increase in erythrocyte protoporphyrin and a linear decrease in blood haemoglobin with increased blood lead was found in seventy-nine males with occupational lead exposure. The haematofluorimeter is recommended as a useful tool in screening for lead poisoning.


An improved competitive protein-binding assay for 25-hydroxy vitamin D. A competitive protein binding assay for 25-hydroxy vitamin D in serum is described using serum from a pregnant woman as source of binding protein. Introduction of a polyvinyl alcohol to the reaction buffer enhanced the solubility of 25-hydroxy vitamin D in aqueous solutions and nearly eliminated loss of material to the walls of reaction tubes. Addition of a protein fraction obtained by gel filtration of human serum, shown to bind only vitamin D, enhanced the specificity and reproducibility of the assay without interfering with the binding properties of 25-hydroxy vitamin D. Serum samples were extracted by chloroform-methanol. Comparison of column chromatography on silicic acid and Sephadex LH-20 showed that both systems gave good separation of vitamin D and 25-hydroxy vitamin D and with a similar recovery of about 80%. The silicic acid columns were less time consuming, either to handle and cheaper in use, and was therefore preferred as the routine separation method. The assay has a detection limit of 0.4 nmol/l in serum, and an intra- and inter-assay coefficient of variation of 6.8 and 8.1%, respectively.


Radioimmmunoassay for melatonin in human serum. Goat antisera raised against N-acetyl-5-methoxytryptophan conjugated to bovine thyroglobulin by 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide is utilized in a radioimmunoassay for melatonin. The raised antibodies are coupled to Sepharose 4B and melatonin in human serum is isolated by affinity chromatography, thereby avoiding the time-consuming extractions by organic solvents. A detection limit of 1.9 pg (8.2 X 10(-15) mol) melatonin is achieved. The antibody specificity has been analysed and none of the common melatonin analogues influence this method of melatonin measurement.


Megathrombocytopenia associated with glomerulonephritis, deafness and aortic cystic medianecrosis. Macrothrombocytopenia associated with glomerulonephritis and deafness has only been reported in a few patients since it was first described in 1972. We present a patient with macrothrombocytopenia, glomerulonephritis, progressive uraemia and progressive sensorineural deafness associated with cystic medianecrosis of the ascending aorta and malformation of the aortic valves. The patient had consistently low platelet counts but no clinical signs of a defect haemostasis. The giant platelets were characterized by their size, averaging 11 micron in diameter, elaborate maze-like membrane formations, abundance of microtubules, and the total absence of very dense granules.


A syndrome of factor VII deficiency and abnormal platelet release reaction. A 15-year-old girl with severe factor VII deficiency and chronic arthropathy showed an excessively prolonged bleeding time. Further studies demonstrated low platelet adhesiveness and abnormal platelet aggregation with ADP, collagen and epinephrine. Release of 14C-serotonin was deficient after aggregation with ADP and epinephrine, but was normal with thrombin. Transfusion of plasma or prothrombin complex concentrate resulted in a partial or complete correction of the bleeding time, respectively, but had no effect on in vitro platelet function tests. Both parents and the only sister had factor VII activities of 42%-72% and factor VII antigen levels of 45%-66% of normal and may thus be heterozygotes with respect to factor VII deficiency. All three had normal bleeding times in spite of abnormal in vitro platelet functions. The observations are interpreted to mean that in this family with factor VII deficiency and abnormal platelet release reaction the platelet abnormality as such was not sufficiently severe to prolong the bleeding time unless the factor VII activity was also very low.


Absorption from iron tablets given with different types of meals. The absorption of iron from tablets given with 5 types of meals was studied in 153 subjects. The meals were: a hamburger meal with beans and potatoes, a simple breakfast meal, a Latin American meal composed of black beans, rice and maize and two Southeast Asian meals composed of rice, vegetables and spices served with and without fish. The groups were directly compared by relating the absorption from the iron tablets to the absorption from a standardized reference dose of iron given on an empty stomach. The composition of meals with respect to content of meat or fish or the presence of large amounts of phytates seemed to have no influence on the absorption of iron from tablets. The absorption from iron tablets was about 40% higher when they were given with rice meals than when they were given with the other meals studied. The average decrease in absorption by meals was about 50-60% based on a comparison when tablets were given on an empty stomach. When tablets from which the iron was released more slowly were used, the absorption increased by about 30% except when they were given with rice meals, where the absorption was unchanged. The differences among the meals in their effect on the absorption of iron from tablets thus disappeared when the slow-release tablets were given.


Platelet accumulation in the myocardium during acute nonthrombotic coronary artery occlusion in dogs. The distribution of labelled autologous platelets in the myocardium was studied in open-chest dogs following a nonthrombotic coronary artery occlusion. A significant accumulation of platelets occurred in the ischaemic and borderline ischaemic myocardium both 15 and 150 min after coronary artery occlusion, most pronounced after 150 min. The small platelet accumulation after 15-min ischaemia might be due to stasis of blood since a similar increase in labelled erythrocytes in that area was observed. The platelet trapping after 150 min most likely represents platelet aggregates. In spite of the marked increase in platelet trapping, the myocardial blood flow in the ischaemic area increased significantly from 15 to 150 min of myocardial ischaemia. It is concluded that the increased platelet trapping in the first hours following a nonthrombotic coronary artery occlusion was insufficient to impair coronary circulation.