The social toll of Crohn's disease.

The social toll of Crohn's disease. Eighty-five outpatients with Crohn's disease who knew their diagnosis and that the disease was subject to relapse were interviewed. The personalities of the women as measured by the Eysenck personality questionnaire were similar to those of a control group, but the men were more neurotic and introverted. Most patients continued to live optimistic, useful lives; they felt well, continued to work, hoped that their disease would not deteriorate in the future, and often had an improved relationship with their spouse despite less frequent sexual intercourse. We found that the successful adaptation of patients to this chronic disease was more closely related to their personality than to the activity or extent of the disease.


Respiratory distress syndrome in infants of Cardiff residents during 1965-75. The incidence of respiratory distress syndrome (RDS) among singleton infants of Cardiff residents was greater during 1970-4 than in the preceding five years. This was consistent with changes in the distribution of gestational age and birth weight. Case fatality rates among infants with RDS fell only slightly during the period examined. Detailed examination of secular trends during 1965-75 suggested (a) that increased use of elective delivery without assessment of pulmonary maturity increases the risk of RDS, and (b) that innovations in the management of RDS during the early 1970s cannot be assumed to have had widespread impact on case fatality rates.


Increasing prevalence of breast-feeding. Two studies were performed to gauge the prevalence of and attitudes towards breast-feeding. Mothers delivered in one month in 1975 and in one month in 1977 were sent a questionnaire one month later to determine whether they were breast-feeding their babies; those that were received a second questionnaire at three months. The prevalence of breast-feeding increased significantly between 1975 and 1977, and in both periods primiparas were more likely to breast-feed than multiparas. A survey of mothers' intentions to breast-feed showed that there were no significant racial differences, but that 82% of women in social classes I and II intended to breast-feed compared with 54% in classes IV and V. These results show that, although the level of breast-feeding was high in 1975, a campaign directed at mothers, doctors, midwives, and health visitors did increase the prevalence of breast-feeding.


Minimum information needed by prescribers. The prescriber needs adequate and concise information about each product that he uses, to allow him to obtain optimal effects while minimising harm. Neither the present UK data sheets nor their equivalents in other countries have succeeded in providing such information clearly or completely. This paper develops the proposals on the arrangement of drug information made in the WHO report "The selection of essential drugs." Three sets of minimum information (on tetracycline, propranolol, and aspirin) which illustrate this approach were compared with the manufacturers' data sheets: the latter were incomplete. The information content of our proposals was worked out with a group of clinical pharmacologists, general practitioners, and specialists, and we suggest that this approach should be extended to other drugs.


Package inserts for prescribed medicines: what minimum information do patients need? The information a patient needs about a prescribed medicine can be determined by considering what responsibilities he can assume in relation to taking medicine. When the medicine has been dispensed the patient needs to know how to take the drug; how to store the drug; how it is expected to help; and how to recognise problems and what to do about them. A guide was designed to specify what information is required to meet these needs. Using this guide, a set of minimum information on tetracycline was prepared that aimed at being brief, specific, and readable. The best format for the information remains to be determined. Since leaflets produced by professional organisations are generally unsuitable for these purposes, information sets should be put together by small independent groups consisting of clinical pharmacologists, clinicians, pharmacists, and consumers. Each country should produce its own sets, adapting model sets to the circumstances of local practice.


The Safety Net and preregistration posts. The Safety Net is a clearing system that collects and distributes information about preregistration posts remaining unallocated after as many doctors as possible have been placed by local efforts. Provided that the local systems operate in the final year, the Safety Net should ensure that each student has a post allocated to him before he sits the final examination.


Clinical examination, xeromammography, and fine-needle aspiration cytology in diagnosis of breast tumours. The diagnostic accuracy of clinical examination, xeromammography, and fine-needle aspiration cytology was compared with definitive histological findings in 255 breast lumps excised during one year. When suitable aspirates were obtained for cytological examination the diagnostic accuracy of aspiration cytology was higher than clinical examination or xeromammography. A diagnostic accuracy of 99% was achieved when all three screening tests were in agreement. As well as confirming a clinical diagnosis of malignancy, cytology is useful in identifying malignancy when clinical findings suggest that the tumour is benign. The availability of accurate cytology has affected patient management in many ways. Xeromammography did not enhance the diagnostic accuracy of clinical examination and aspiration cytology in patients presenting with a breast lump and, as a procedure with potential hazard, the benefit of routine xeromammography is questionable when an efficient cytological service is available.


Early treatment of myocardial infarction in the community. The prehospital management of acute myocardial infarction by general practitioners and emergency-treatment service physicians was analysed in 53 patients. The correct clinical diagnosis was made or suggested before admission in 47 patients. Only 25 patients received analgesics from the general practitioner, and 32 were still in pain and needed diamorphine on admission to hospital. Only one patient received antiarrythmic treatment. The findings suggest that, despite accurate clinical diagnosis of acute myocardial infarction, deficiencies exist in the prehospital phase of management and that education programmes are worth consideration.


Terminal symptoms in children dying suddenly and unexpectedly at home. Preliminary report of the DHSS multicentre study of postneonatal mortality. Terminal symptoms in 145 children who died suddenly and unexpectedly at home were investigated and compared with symptoms in 154 control children. Eighty-five (59%) of the children who died had had terminal symptoms, which in 69 cases (48%) appeared to have been major. Non-specific symptoms were especially common among the children who died. Symptoms were often present for several days before death. Only 12 of the 69 children who died with major symptoms had been seen by a doctor within 24 hours before death. We conclude that many deaths in young children might be prevented if doctors and parents were more aware of the importance of non-specific symptoms as markers of life-threatening illness.


Severe hyponatraemia in hospital inpatients. A prospective study of severe hyponatraemia in adult hospital inpatients showed that 44 patients had plasma sodium concentrations below 125 mmol(mEq)/1. Eighteen cases (41%) were iatrogenic, caused by diuretic treatment or postoperative administration of intravenous 5% dextrose, or both. Chest infection, a seldom-recognised and ill-understood cause of hyponatraemia, proved more common than carcinoma of the bronchus. Thirty-one patients had symptoms attributable to the hyponatraemia, but these were severe in only five cases. Analysis of blood and urine was of no value in distinguishing the different diagnostic groups in an emergency.


Benign postinfection polymyositis.

Benign postinfection polymyositis. Six patients developed persistent muscular cramps, aching pain, and fatigability after an influenza-like illness. Electromyography showed myopathic changes, although results of routine laboratory investigations were normal in all but one patient, whose serum creatine kinase concentration was slightly increased. All but one of the patients improved: three were asymptomatic within one to two years. The syndrome was probably a benign form of polymyositis.


Urodynamic findings in chronic retention of urine and their relevance to results of surgery. Fifty-five consecutive male patients aged 18-77 with chronic retention of urine were investigated urodynamically. All were shown to have obstructed micturition. Inflow cystometry defined two groups, one with high-pressure and one with low-pressure filling. Recent-onset enuresis and upper-tract dilatation as seen on radiography were significantly associated with high-pressure bladder filling. Postoperative studies showed that patients with high-pressure filling on preoperative cystometryhad a better response to outflow-tract surgery. The poor response of the patients with low-pressure filling was due to a high incidence of inadequate detrusor contraction leading to persistent residual urine. Thus urodynamic studies may be used to indicate which patients are likely to benefit from prostatectomy and, after the operation, whether the obstruction has been relieved.


Ethanol-induced increase in drug acetylation in man and isolated rat liver cells. Sixteen healthy volunteers took part in a cross-over study examining the effect of ethanol on the rate of sulphadimidine acetylation (blood ethanol concentration about 1 g/1). In both rapid and slow acetylators the apparent half life of the drug decreased by about 20% after ethanol (mean reduction 39 +/- SE 8 min) and the amount of drug acetylated, measured in blood and urine, increased. In three slow acetylators the rate of acetylation in blood increased so noticeably after ethanol that they would otherwise have been classified as rapid acetylators. Suspensions of isolated rat liver cells showed an increase of about 30% in the rate of sulphadimidine acetylation after the addition of ethanol (2 g/1). Patients' usual alcohol consumption should be taken into account in determining their acetylator status.


Prophylaxis against systemic infection after transrectal biopsy for suspected prostatic carcinoma. Five minutes after transrectal prostatic biopsy 16 out of 21 patients were shown by blood culture to have bacteraemia. Antibiotic prophylaxis--routinely with ampicillin and metronidazole for 48 hours--prevented progression to septicaemia, and four days after the procedure all blood samples were negative. Irrespective of whether antibiotic prophylaxis is used, blood culture should be routine in all patients undergoing transrectal prostatic biopsy.


Drowning risks to epileptic children: a study from Hawaii. The role of epileptiform seizures in causing drowning and near-drowning among children was studied by examining the case reports of all 140 childhood immersion accidents that occurred in an area of Hawaii over five years. Four of the 140 immersion accidents were caused partly by epileptiform seizures, but none were fatal. The combined results of the Hawaiian and Brisbane studies (total population studied over five years 1 600 000) showed that no epileptic children died from accidents in the sea or in swimming pools; and the 2.9% incidence of immersion accidents due to seizures in the Hawaiian study compares well with the incidence found in other series. If an epileptic child is mentally normal, well controlled with anticonvulsants, and supervised in the water then the risk of drowning is very small.


Asymptomatic urethral gonorrhoea in men. Over a period of nine months 203 cases of urethral gonorrhoea were seen in 188 men. In 36 (17%) of the cases there were no symptoms, and in 14 (7%) the symptoms were considered so mild that the patients thought medical care was unnecessary. The symptomless patients and those with mild symptoms were found only as a result of efficient contact tracing. This high incidence illustrates the importance of good contact tracing and careful investigation.


Unsuspected gonococcal infection in female patients. Four hundred and ten female patients attending obstetric and gynaecological outpatient departments were investigated for possible gonococcal infection. All were in their reproductive phase. Forty-two (10.2%) of them harboured Neisseria gonorrhoeae. Of the infected patients, 40.5% had no symptoms at all. Investigation was carried out using a single, endocervical specimen cultured in Chacko-Nair egg-enriched media.


Role of Chlamydia trachomatis in non-acute prostatitis. The possible role of Chlamydia trachomatis in non-acute prostatitis was investigated by cultural and serological techniques in a study of 53 adult males. C. trachomatis was isolated from the urethra of only one of the 53 patients and from none of the 28 specimens of prostatic fluid from the same patients. By means of a modified microimmunofluorescent test, serum chlamydial IgG antibodies at a titre of 1/64 or greater, or IgM antibodies at a titre of 1/8 or greater, or both were detected in six of the patients, suggesting a recent or current chlamydial infection, while IgG or IgA antibodies at a titre of 1/8 or greater were detected in the specimens of prostatic fluid from two of the 28 men studied. In the seven patients with evidence of chlamydial infection, as well as in a further 13 of the 53 patients studied, the presenting symptoms suggested non-gonococcal urethritis (NGU) rather than prostatitis. Thus in this study C. trachomatis would appear to play a minor aetiological role, if any, in non-acute prostatitis.


Efficacy of co-trimoxazole in Donovanosis. A preliminary report. Co-trimoxazole (Septrin, Wellcome) was prescribed in a dose of two tablets twice daily for the treatment of 10 patients with Donovanosis. All the patients responded well to this treatment, and the ulcers healed completely within 10 days in eight patients and within 14 days in the remaining two. Ten days' treatment with 40 tablets of co-trimoxazole is suggested as sufficient to treat Donovanosis. No adverse reactions were noted in any patient.


Carcinoma of the penis developed in lichen sclerosus et atrophicus. Malignant change developing in lichen sclerosus et atrophicus is rare in men. A case is described in a 39-year-old man.


Bilateral tactile aphasia: a tacto-verbal dysfunction. Bilateral tactile aphasia was exhibited by a patient who was operated upon for a left parieto-occipital haematoma. Neuropsychological investigation established the following points: (1) the patient, in whom no expressive or receptive dysphasia could be found, misnamed objects when they were presented to him tactually, whereas he almost always gave the correct name when they were presented visually or auditorily; (2) the naming disturbance was identical when the object was presented to the left hand or to the right hand; (3) not only did the patient have no sensory deficit, but he could give unquestionable proof of correct tactile identification by using the objects presented to him tactually; (4) the defect appeared in the verbo-tactile as well as in the tacto-verbal direction; (5) it was not restricted to the name of the object since the patient was unable to describe, without making dysphasic errors, the morphology or usage of objects presented to him tactually; (6) the tacto-verbal dysfunction did not result from a tacto-visual impairment. Computerized tomography scans showed that: (1) there was no evidence suggesting a lesion of the right hemisphere, nor of the corpus callosum; (2) the left lesion involved the angular gyrus, the posterior part of the second temporal convolution, the inferior longitudinal fasciculus, the geniculostriate fibres and some fibres of the tapetum.


Factors influencing the risk of multiple sclerosis developing in patients with optic neuritis. One-hundred and forty-six patients who had presented with optic neuritis but without evidence of demyelination elsewhere in the nervous system, and in whom no specific cause could be identified, were reassessed clinically between one month and twenty-three years after the onset. Fifty-eight patients (40 per cent) had developed MS. All 146 patients were HLA-typed. Three factors were identified which were significantly associated with the development of MS: positive typing for the HLA antigen BT 101, winter onset of the initial attack of optic neuritis in BT 101-positive patients only, and recurrent attacks of optic neuritis. The application of these results to the individual patient is of limited use. However, recurrent attacks of optic neuritis should be given the same significance in the clinical classification of MS as episodes of demyelination occurring elsewhere in the central nervous system in a patient with a previous attack of optic neuritis. The results suggest that optic neuritis is caused by two different environmental agents or groups of agents and that the agent which is most common in the winter leads to the development of MS in the genetically susceptible individual. The agent more common in the summer is much less likely to cause MS in either suscetible or non-susceptible individuals. The biological role of the HLA system in the handling of foreign antigens is discussed and it is suggested that the presence of the HLA antigens associated with MS confers a specific disadvantage on individuals in the ability to handle infection by the MS causative agent and that this allows damaging immunological processes to develop.


Changes in catecholamine turnover in the anterior part of the mediobasal hypothalamus and the medial preoptic area in response to hyperprolactinemia in ovariectomized rats. High serum prolactin levels in ovariectomized rats were induced by transplantation of additional pituitaries under the kidney capsule. Such high prolactin levels reduced serum LH but not FSH levels 3 days after pituitary transplantion. LH and FSH values were at a control levels at day 15 and above these levels at day 24, although prolactin values were still high. Dopamine (DA) and norepinephrine (NE) turnover in the anterior part of the mediobasal hypothalamus (AMBH) and in the medial preoptic area (MPO) was measured by following the decrease in NE or DA content after synthesis blockage with a-methyl-p-tyrosine. The content was measured using a radioenzymatic assay. DA turnover in the AMBH was significantly increased 3, 15 and 24 days after induction of hyperprolactinemia. Although NE concentration in the AMBH was also increased at these times an increased NE turnover was statistically significant only at day 24. DA as well as NE turnover rates in the MPO were reduced by day 3 after pituitary transplantation and at control values at day 15 and 24. It is concluded that the increased DA turnover in the AMBH depresses pituitary LH release probably by inhibiting hypothalamic LH-RH secretion. This inhibition is counteracted by the somewhat slower increase of NE turnover resulting in normalization of LH levels. The increased gonadotropin levels after long-lasting hyperprolactinemia may be due to desensitization of the DA receptor, which was reported earlier. The reduced NE turnover in the MPO 3 days after induction of hyperprolactinemia may be an additional factor in reducing pituitary LH release acting at the level of LH-RH-producing perikarya.


L-Proline and related compounds: correlation of structure, amnesic potency and anti-spreading depression potency. The effects of L-proline, D-proline, and L-azetidine-2-carboxylic acid (L-A.2.C., the lower homolog of L-proline) have been compared in two systems. L-Proline is more potent than either analog in causing amnesia of one-trial avoidance conditioning of the 2-day-old chick and in preventing mechanically induced spreading depression in the retina isolated from 2-3-week-old chicks. The results suggest that the L-configuration and the proper molecular size are essential for the effects of L-proline upon memory and upon spreading depression. This level of specificity is greater than that involved in protein synthesis because L-A.2.C. is incorporated into protein in place of L-proline, in several protein-synthesizing systems.


Cytochemical localization of 5'-nucleotidase in glial plasma membranes. By means of a cytochemical procedure 5'-nucleotidase activity is demonstrated electron microscopically. The enzyme is present in plasma membranes of astrocytes, oligodendroglial cells and microglial cells, but not in neuronal plasma membranes.


Changes in the synapses of spiral ganglion cells in the rostral anteroventral cochlear nucleus of the waltzing guinea pig following hair cell loss. Between 10 and 60 days of age in the waltzing guinea pig, there is a genetically induced loss of all hair cells in the organ of Corti. About 43% of the spiral ganglion cells degenerate between 30 and 60 days of age. After 90 days of age, there is no further loss of spiral ganglion cells. Both Type I and II ganglion cells remain and are without afferent input. The terminals of these ganglion cells in the rostral AVCN, the end bulbs of Held, are normal until 30 days of age. During the period of ganglion cell loss degenerating end bulbs are seen. After 60 days of age, when most ganglion cell degeneration is complete, the remaining end bulbs have fewer synaptic vesicles and their synaptic junctions are flattened. The channels of enlarged extracellular space, which normally surround each synaptic junction or small groups of junctions, are only infrequently present. In freeze-fracture replicas of the rostral AVCN of waltzing guinea pigs after hair cell loss, the number of large, non-aggregate particles on the external leaflet of the principal cell opposite the end bulb is increased, and the number of perisynaptic aggregates is decreased compared to waltzing guinea pigs 10 days of age. The junctional aggregates are unaltered. These changes in the presynaptic terminal and postsynaptic membrane may be related to the loss of afferent input to the spiral ganglion cells, suggesting that activity is important for maintaining the synapse.


Synchronized rhythmic discharges of the secondary olfactory neurons in carp. (1) Rhythmic and synchronized multiunit bursts of spike discharges, which were superimposed on the peaks of the oscillatory potentials of 4--10 Hz (olfactory tract waves), were induced in the olfactory tract fibers of the carp in response to olfactory stimulation. Suppression of the spike discharges was observed during the interburst periods of discharges. (2) Single-unit analysis revealed three types of discharge patterns in the olfactory tract fibers in response to olfactory stimulation: rhythmic excitation (Type 1), suppression (Type 2) and no response (Type 3). A synchronization of spike discharges was observed among the Type 1 units. (3) Mass potentials were evoked in the olfactory tract by electrical stimulations applied to the olfactory nerve. When the time interval between the conditioning stimulation and the test stimulation was about 200 msec, a transient recovery of the evoked mass response was observed. This interval approximately corresponded to the cycle length of the olfactory tract waves. (4) It was concluded from the results obtained that the olfactory tract waves are the summated action potentials from the axons of the secondary olfactory neurons discharging rhythmically and synchronously. (5) An inhibitory phasing mechanism in the olfactory bulb was suggested which may cause the synchronized rhythmic activity of the secondary olfactory neurons.


Characterization of electrophysiological properties of intracellularly recorded neurons in the neocortex of awake cats: a comparison of the response to injected current in spike overshoot and undershoot neurons. Intracellular recordings were obtained from 212 neurons of the coronal pericruciate cortex of 7 awake, untrained cats. Glass microelectrodes, filled with K+ citrate alone or K+ citrate with either cyclic GMP or 5'-GMP were used for recording and for injecting steady depolarizing and hyperpolarizing currents intracellularly. The effects of rectangular linearly rising (ramp) current pulses were also studied. Results were compared in spike overshoot* versus undershoot recordings. Spike overshoot recordings had action potentials (APs) larger than associated baseline shifts on penetration; undershoot recordings had APs smaller than associated baseline shifts on penetration. Undershoot recordings are more commonly encountered in mammalian neocortex than are overshoot recordings. (1) Except for sizes and slopes of APs and other effects consistent with the penetration of passive dendritic cables remote from regions of active spike initiation or propagation, no differences in response to current injection or in other electrophysiological properties were found between overshoot and undershoot recordings. (2) Injection of depolarizing currents produced de-reases in the amplitudes of APs, decreased rates of rise and fall of APs and increased frequencies of AP discharge. Injection of hyperpolarizing current produced slowing or cessation of AP discharge with little or only slight increases in AP amplitude when the resting potential was greater than 47 mV. (3) An effectively linear relationship was found between changes in AP size and the magnitude of weak injection depolarizing currents. This relationship provides a basis for measuring changes in cortical neuronal input resistance by the differential spike height method. (4) Most neurons showed little or no accommodative response to the injection of linearly rising, depolarizing currents. Simple or ceiling threshold-latency curves rather than minimal gradient curves were obtained in 83% of the cells in which ramp currents were injected. (5) Modal values of resting potentials between 47 and 53 mV, without increased rates of spontaneous discharge, indicate that most cells have a critical firing threshold near that reported for somatodendritic (SD) rather than initial segment (IS) generated spikes. The evidence suggests that undershoot recordings primarily reflect penetrations of passive dendritic regions rather than functional modification of neurocellular properties as a consequence of impalement.


Effect of ischemic anoxia and barbiturate anesthesia on free radical oxidation of mitochondrial phospholipids. The mitochondrial fraction obtained from brains of animals submitted to ischemia shows a decrease of phospholipid level, especially plasmalogens in the fraction of ethanolamine phospholipids and choline phospholipids. There appears simultaneously an increase of free radical oxidation processes of unsaturated fatty acids from these phospholipids. The peroxidation processes of mitochondrial lipids are stimulated by calcium ions and, to a smaller extent, by magnesium ions. Barbiturate anesthesia inhibits the peroxidation of fatty acids and increases the antioxidant abilities of the nervous tissue. Nembutal added in vitro remains without effect on the above processes. The effect of acetylcholine and the antioxidant ability of nervous tissue under barbiturate anesthesia with respect to ischemia are discussed.


Experimental stroke in gerbils: effect on translation and transcription. The effect of cerebral ischemia on polypeptide synthesis with isolated microsomes and DNA-dependent RNA polymerase activity with isolated nuclei was investigated by occlusion of right common carotid artery of gerbils. There was a prompt decline of microsomal polypeptide synthesis already at 30 min after occlusion of the artery, and at 4--5 h the specific radioactivity (dpm per microgram protein) was 50% of the control value. At 24 h, when the animals were only slightly responsive to external stimuli, the specific radioactivity of ischemic brain was only 20% of the control value. DNA-dependent RNA polymerase activity was unaffected for 1 h, and clear suppression did not appear until 3 h after occlusion. However, the extent of suppression was similar between polypeptide synthesis and RNA polymerase activity beyond 3 h after occlusion. Although more selective vulnerability of polypeptide synthesis thus exists in cerebral ischemia, the difference between two biochemical processes was not as striking as seen in cerebral anoxia. Focal progression of cerebral ischemia to diffuse infarction in gerbils was suggested  as a possible explanation for the disparity in comparison to the diffuse effect in cerebral anoxia along with the difference in the magnitude of acidosis and depletion of energy reserve.


Cerebellar inhibition and ICSS from stimulation in the area of the nucleus locus coeruleus. The purpose of this study was to determine the relationship between intracranial self-stimulation (ICSS) and the long-lasting inhibition (LLI) of cerebellar Purkinje cells which are produced by stimulation around the dorsal pontine nucleus locus coeruleus (LC). No strong correlation was found between the dorsal pontine sites which produced LLI and those sites which yielded ICSS. Moreover, ICSS sites were no more effective than non-ICSS sites in producing LLI. LLI of Purkinje cells was produced most effectively by stimulation of an area dorsolateral to the LC where axons arising from the LC collect to ascend to the cerebellum. The LLI produced by stimulation of this dorsolateral region was less often associated with short latency excitations, compared to the LLI produced by stimulation of the cerebellar white matter. This characteristic may be useful as an indication of LC-produced LLI. Sites yielding ICSS were scattered around the LC but were most consistent ventrolateral to the LC. These results indicate that ICSS and LLI of Purkinje cells appear to be independent phenomena which depend on different mechanisms.


Effects of priming stimulation of catecholamine containing nuclei in rat brain on runway performance. Rats were implanted with bipolar fine wire stimulating electrodes in the region of the pontine nucleus locus coerulus (LC) and the pars compacta of the substantia nigra (SN). The reinforcing properties of stimulation of each electrode were determined. Subsequently, rats were run in a two alley runway and the effects of priming stimulation on performance in acquisition, discrimination and reversals were measured. It was found that LC priming caused an increased latency to exit from start box. Also, LC priming reduced running time in the rewarded alley in a reversal task whereas SN priming affected both performance in the rewarded and non-rewarded alley.


Requirement of the hen for sulphur-containing amino acids. The sulphur amino acid requirements of White Leghorn-type laying hens were determined in two 52-week experiments using diets based on maize and soyabean meal providing from 5.0 to 6.5 g sulphur amino acids/kg, 12.35 MJ ME/kg and 8.6 to 8.8 g lysine/kg. There were six replicates of 15 individually-caged hens each per treatment. 2. A requirement of approximately 775 to 800 mg sulphur amino acids/hen d, of which about 390 to 440 mg was methionine, was found for a maximum of 80 to 83 eggs/100 hen d. There were indications that the requirement for maximum egg production was less than that for maximum efficiency of food utilisation. 3. Diets containing 138 g protein/kg supplemented with methionine and lysine supported production and food utilisation as effectively as a diet containing 167 g protein/kg.


Ameliorating effects of hyperbaric oxygenation on experimental allergic encephalomyelitis. The effect of hyperbaric oxygenation (OHP) on survival and quality of survival of guinea pigs afflicted with experimental allergic encephalomyelitis (EAE) was investigated. EAE was induced in Hartley and Strain 13 animals by intradermal injections of whole guinea pig spinal cord in complete Freund's adjuvant. The inoculated animals were divided into control and treatment groups; the treated animals received OHP in a variety of treatment schedules. Clinical signs of EAE were quantitated and mean survival times were measured. When Hartley animals were exposed to 100% O2 at 2.5 atmospheres absolute (ATA) for 2 hr/day from 5--19 days postinoculation, the mean survival time (+/- SE) was 19.1 +/- 1.6 days relative to 15.7 +/- 0.7 days in the control (p less than 0.050). When Strain 13 guinea pigs were treated with 100% O2 at 2ATA for 4 hr/day on 5--16 days, the mean survival time was 21.6 +/- 0.6 days compared to 16.0 +/- 0.4 days for the control (p less than 0.001). Clinical sign measurements demonstrated that the onset of EAE in the treated animals of both strains occurred between 4--6 days after these signs became detectable in control animals. These results suggest that OHP therapy can ameliorate EAE in afflicted guinea pigs.


The effect of ovariectomy on liver metabolism and maintenance energy requirement of hens. Six pullets from each of an egg-producing and meat-producing strain were ovariectomised at 12 weeks of age. Ovarian regrowth occurred in two of the egg-producing and four of the meat-producing strain. 2. Measurements of heat production and energy balance were made after peak lay with ovariectomised and sham-operated laying pullets of both strains. Measurements on the ovariectomised pullets were made before and after implantation with oestrogen pellets. 3. Within each strain the ME requirements for maintenance (per kg W0.75), determined by linear regression analysis, were similar whether or not the starvation heat production data were included. 4. The ME requirements for maintenance decreased substantially after ovariectomy but subsequent implantation with oestrogen pellets did not increase these requirements. 5. Studies of hepatic enzyme activities indicated that the major influence of the mature ovary was on hepatic lipid metabolism. This was exerted through a specific stimulation of lipogenesis rather than a general increase in metabolism.


Effect of progesterone on the magnum proteins during primary stimulation of chick oviduct. The effect of progesterone on the secretion of protein by the magnum of 5-d-old, female chicks was determined. 2. The supernatant prepared by centrifuging an homogenate of the magnum at 105 000g was found, by immunodiffusion, to contain an antigenic component which precipitated the antisera for conalbumin 1, conalbumin 2 and ovalbumin after 5 d treatment with progesterone: there was no reaction to ovomucoid, lysozyme and avidin antisera. 3. Disc-electrophoresis of the homogenate revealed two bands at the site of ovalbumin. 4. Incorporation of 3H-lysine into the magnum proteins of progesterone-treated chicks did not differ from that of controls. 5. The secretion available in the magnum may be only a transudate from the serum and not a true secretory product. Progesterone behaved qualitatively as oestrogen in this study although the action is much less pronounced and was delayed.


Effects of nerve growth factor on behavioral recovery following caudate nucleus lesions in rats. Rats with bilateral lesions of the caudate nucleus received intracaudate injections of either nerve growth factor protein (NGF) on inert buffer immediately following surgery. NGF-treated animals demonstrated a faster recovery of normal appetitive behavior and perseverated less than their buffer-treated counterparts on a spatial reversal task, but both groups were impaired relative to sham controls on acquisition of an active avoidance response. Glia to neuron ratios were significantly increased in both lesion groups when compared with sham controls. However, this increase was less in the NGF-treated animals than in the buffer-treated animals. NGF treatment had no effect on steady-state caudate dopamine levels, measured six months after surgery.


Neuronal receptive field properties in feline nucleus reticularis gigantocellularis. Nucleus reticularis gigantocellularis (NGC) has been shown, using both behavioral and physiological techniques, to be involved in the processing of nociceptive information. However, previous studies of the receptive fields of NGC neurons have utilized only innocuous stimuli. Thus, while neurons in NGC may play an important role in nociception, the receptive field properties of these cells remain to be defined. This investigation was designed to determine the receptive field properties of neurons in NGC using  nociceptive and innocuous stimuli. Receptive fields were determined for 127 neurons in NGC. Eighty-seven percnet of the NGC neurons studied responded exclusively to noxious stimuli, while 13% also responded to innocuous stimuli. None of the neurons studied responded exclusively to innocuous stimuli. The receptive fields of most NGC neurons (63%) were large, discontinuous, and bilaterally symmetrical. Eighty-one percent of NGC neurons received convergent inputs from both spinal and trigeminal systems. These receptive field properties differ from those previously reported using only innocuous stimulation.


Enhanced passive avoidance learning and appetitive T-maze learning with post-trial rewarding hypothalamic stimulation. Experiments were carried out to investigate the effects of post-trial reinforcing stimulation of the lateral hypothalamus on learning in rats. The reinforcing stimulation was always presented for a duration of 20--30 sec (0.2 sec on/0.8 sec off), and was administered either immediately, 30 sec delayed or 300 sec delayed after exposure to the learning situation. In experiment 1 post-trial stimulation led to improved passive avoidance learning of an alcove-avoidance task when presented 30 sec compared to immediately after the footshock. In Experiment 2 reversal learning of a one-way shuttle-box avoidance task was facilitated by 30 sec delayed, but not 300 sec delayed post-trial reinforcing stimulation. In Experiment 3 appetitive left-right discrimination was investigated using a T-maze task. Thirty sec delayed post-trial reinforcing stimulation presented contingent on errors facilitated learning of this task. Together, the 3 studies provide further support for the hypothesis that reinforcers directly influence labile memory processes (such as short-term memory) and thereby improve learning.


Ventricular surface of rabbit hippocampus: a scanning electron microscope study. Portions of the ependyma were obtained from the hippocampus of adult rabbits and processed for scanning electron microscopy. The major part of the ependymal surface was covered with a dense layer of cilia, some of these cilia showed bulbous preterminal enlargements. Irregularly arranged pits of variable diameter were also seen. Pes hippocampi showed fewer cilia and deeper furrows than did the remainder of the hippocampus.


Short-term stressor effects of reserpine. The effects of reserpine on plasma glucose, FFA and cholesterol and on adrenal cholesterol were determined in 1-and 21-d-old chicks over a 24-h period. 2. Irrespective of age, reserpinised chicks became hyperglycaemic and hypocholesteraemic, their stores of adrenal cholesterol were depleted and the mobilisation of the lipid was impaired. The response of the older bird was quantitatively larger than that of the younger bird. 3. Propranolol prevented the increase in plasma glucose concentration seen 1 h after reserpine but it did not affect subsequent changes. 4. It is concluded that reserpine acts as a stressor and it is shown that its effects have not been entirely overcome after 24 h.


The morphology of bone mineral crystals. Electron microscopical observations of the size and shape of bone mineral crystallites have not been in complete agreement with X-ray diffraction findings. The two prevalent viewpoints consider bone mineral crystals to be either rod, or plate like in habit. There appears to be agreement that the smallest dimension of the crystals is about 5 nm, but there is discrepancy in the reported c-axial lengths. The method of dark field imaging is used to obtain a quantitative measurement of the c-axial length distribution in rabbit, ox and human bone: mean c-axial lengths 32.6 nm, 36.2 nm and 32.4 nm, respectively, show no significant difference at the 5% level to the mean c-axial length measured by X-ray line broadening. Both bright and dark field images strongly suggest that bone mineral has a plate like form. Reasons for past discrepancies are discussed.


Changes in organic matrix of bone and of bone and blood ATP in rats fed rachitogenic diets. Vitamin D deficient and phosphate deficient states were produced in young rats by the use of synthetic diets. Whole blood ATP, serum calcium and phosphorus and the ash, phospholipid, hexosamine and hydroxyproline contents of metaphyseal bones of control and rachitic rats were measured after 4 weeks on the diets. There was a decrease in whole blood ATP and serum phosphorus of the rachitic rats, and in the contents of ash, phospholipid and hexosamine of the rachitic metaphyses, while the hydroxyproline contents of the rachitic bones were higher than those of the controls. Subcutaneous injection of ATP or inorganic phosphate in rats, fed a low phosphate diet deficient in vitamin D, caused an increase in serum phosphorus and blood ATP levels and in metaphyseal ash contents. It is suggested that some of the metabolic disturbances in rickets are due to alteration in ATP production.


Changes in the red cell, plasma and inulin spaces and in the total water contents of rat femurs in cortisone induced osteoporosis. Measurements of the bone vascular space by use of 99mTc-labelled red cells and 131I-serum albumin, and of the 3H-inulin spaces and total water contents were carried out in female rats treated for four weeks by daily subcutaneous injections of 15 mg cortisone acetate. Significant decreases in bone vascularity, inulin space and water contents were noted as compared to controls. These changes were not associated with differences in plasma calcium values, or parathyroid gland weights. They were found to be present together with significant decreases in bone density and ash contents of the femoral shafts in the steroid-treated animals. It is suggested that the changes in the vascular and extravascular fluid spaces of bones were probably consequent upon a generally depressed level of cellular activity and bone turnover, which could be found in steroid induced osteoporosis.


Oestrogen binding proteins in bone cell cytosol. Attempts were made to demonstrate the presence of specific oestrogen binding proteins ("receptors") in bone cells. High speed cytosol preparations of bone were incubated with several concentrations of radioactive oestradiol alone and with radioactive oestradiol in the presence of a specific antioestrogen, Nafoxidine. Separation of bound and free oestradiol was carried out by dextran coated charcoal treatment and by sucrose gradient ultracentrifugation. Several types of bones likely to be oestrogen-sensitive were investigated: human femoral heads, human phalanx, rat and rabbit calvaria, humeri and femora of female rats. In all experiments we were unable to demonstrate the presence of specific oestrogen receptors in bone cell cytosol indicating that the direct effect of oestrogens on bone, if present, is not mediated by specific oestrogen receptors.


Fetal rat bone in organ culture: effect of bone growth and bone atrophy on the comparative losses of 45Ca and 3H-tetracycline. Fetal rat bones were cultured in either growth-inducing or resorption-inducing media to study mineral losses during bone growth and atrophy in vitro. Whole radii and ulnae from 19-day-old fetal rats, prelabeled with 45Ca and/or 3H-tetracycline, were cultured intact or cut, and then digested by collagenase to obtain the calcified portion of the bones. Three- to five-fold more 3H-tetracycline than 45Ca was lost from the calcified portion when the bones were cultured for 4 days in growth-inducing media. Similar small amounts of 45Ca were lost from live and killed bones, but more 3H-tetracycline was lost from live bones than from killed bones. More 3H-tetracycline was released into the growth medium with a low concentration of calcium (0.5 mM) than when the calcium concentration was high (1.0 mM); no significant difference was seen in the release of 45Ca into the medium at different calcium concentrations. Larger amounts of both isotopes were lost when the prelabeled bones were cultured in resorption-inducing media than in growth-inducing media. When parathyroid hormone stimulated bone resorption in a resorption-inducing medium, equal proportions of both isotopes and bone collagen were lost. Greater losses of 3H-tetracycline than of 45Ca suggest that 45Ca was conserved locally during the resorption that accompanies bone growth, but not during resorption that accompanies bone atrophy.


Quantitative measurement of fractional bone volume using digital scanning videodensitometry. A method is described for reproducible and rapid quantitative measurements of fractional bone volume in sections of a bone biopsy. The presence or absence of bone is determined at several thousand points over the entire surface area of each specimen by high-speed digitization and computer analysis of video scans of enlarged microradiographic images of bone sections. An operator interactive light-pen assembly permits selective delineation of desired areas of the video image to facilitate computation of regional bone mass within each specimen. Tests of the reproducibility of the method of performed and are described. The results obtained from application of the method to determine the amount of bone in various age groups and in two groups of patients before and after therapy are also presented. These data indicate the potential of this technique for high volume, high resolution measurements of the fractional bone volume in both investigative and clinical diagnostic studies of age dependent and disease dependent processes.


Bone mineral turnover in a patient with osteogenesis imperfecta estimated by fluoride excretion. A child with severe osteogenesis imperfecta was treated with NaF for 8 years, at the end of which time his iliac bone contained 29 mg F/g Ca. Urine F was assayed at intervals for 4.5 years after discontinuing treatment. After the first few days the decline in urinary F excretion can be described by a two component exponential function, with half-times of 5.4 months (10%) and 8.9 years (90%). The latter half-time value is of the same order of magnitude as those observed for F and other "bone-seeking" elements in normal subjects, which suggests that the turnover rate of bone mineral is normal in this disease. Three methods for estimating the attained body F burden at the end of NaF treatment--namely, metabolic balance, bone biopsy, and integration of the exponential function--yielded comparable values.


Effects of morphine, naloxone, d,l-cyclazocine, and d-amphetamine on behaviour controlled by a schedule of interresponse time reinforcement. The separate effects of graded doses of morphine, naloxone, d,l-cyclazocine, and d-amphetamine on responding maintained by a differential reinforcement of low rate schedule of food presentation were examined in rats. Morphine did not alter response rates at doses of 1--5.6 mg/kg; at 10 mg/kg a 57% decrease in responding was observed and behaviour was even more severely depressed by 30 mg of morphine per kilogram. Naloxone did not affect responding at doses ranging from 0.1 to 10 mg/kg. d,l-Cyclazocine at doses of 3 and 5.6 mg/kg induced substantial increases in responding not observed when the dose was increased to 10 mg/kg. Cyclazocine, as well as morphine, produced dose-dependent decreases in the number of reinforcements per session. d-Amphetamine exerted a biphasic effect on responding; small doses increased response rates (0.3--3 mg/kg) and responding was suppressed by the drug at a dose of 10 mg/kg. Behaviourally active doses of d-amphetamine caused a dose-dependent reduction in the number of reinforcements per session. Naloxone at otherwise inactive doses (1--10 mg/kg) was found, in separate experiments, to antagonize the rate-decreasing effects of morphine, and to reduce the rate-increasing effects of d-amphetamine. The latter effect is not easily interpreted but confirms and extends other research employing rats in which naloxone was found to reduce the rate-increasing effects of small doses of d-amphetamine upon locomotor activity and responding maintained by a continuous electric-shock postponement procedure. In additional experiments morphine was given daily for 25 consecutive sessions at a dose of 30 mg/kg, 5 min preceding each test session. Responding was suppressed throughout this period and the dose of morphine given before each session was reduced to 10 mg/kg for 35 further sessions. Tolerance to the rate-decreasing effects of morphine was demonstrated; naloxone given in conjunction with morphine (10 mg/kg) in morphine-tolerant rats restored to control values the number of reinforcements per session without causing significant change in overall rates of responding. Few experiments have dealt previously with the development of tolerance to the behavioural effects of morphine under comparable dose regimens, time-course relationships, or behavioural testing procedures. Systematic analyses of these interrelated variables are needed since it is now evident that the schedule employed to maintain responding itself exerts significant effects.


Time course of mesenteric vasodilatation following hypophysectomy and the stopping of a vasopressin infusion. Hypophysectomy caused an increase in superior mesenteric arterial conductance that reached a new plateau approximately 20 min after removal of the gland in four pentobarbital-anesthetized cats. Intravenous infusion of arginine vasopressin (0.74 +/- 0.21 mU min-1kg-1) caused conductance to decrease to approximately prehypophysectomy control values. Stopping the infusion resulted in an increase in conductance and the time course of this vasodilatation was virtually identical to that which occurred following hypophysectomy. The results are consistent with the interpretation that the effects of acute hypophysectomy on the mesenteric resistance vessels are due primarily to removal of the vasopressin system and the concomitant elimination of circulating vasopressin.


Relationship between analgesia and turnover of brain biogenic amines. The analgesic activity of morphine, delta9THC, and sodium salicylate was studied concomitantly with changes in brainstem and cortex turnover of dopamine (DA), noradrenaline (NA), and serotonin (5HT). The results show that a correlation exists between the presence of analgesia and the increased turnover rates of the three biogenic amines. Morphine and sodium salicylate induced analgesia is accompanied by an increased turnover rate of all three biogenic amines; delta9THC-induced analgesia is accompanied by an increased turnover rate of DA and 5HT only. There is, however, no consistent relationship between the degree of analgesia and the degree of change in the turnover rates. The existence of the endogenous morphine-like substances, endorphines, may explain why morphine analgesia is distinct from that of delta9THC and sodium salicylate. The possible relationship between this morphine-like substance and biogenic amines is discussed.


Increased sensitivity of frog skeletal muscle to procaine in the presence of organic anions. In solutions containing an organic anion in place of chloride, frog toe muscles displayed increased sensitivity to the local anaesthetic action of procaine. Twitch inhibition by procaine in all media was accompanied by suppression of action potentials without change in membrane resting potentials. The twitch depressant effect of procaine was greater in solutions with carboxylate anions than with alkyl sulfonates. The intensity and the rapidity of onset of the effects of organic anions was related to the size of their hydrophobic component. Procaine accentuated acetate-induced reductions in the [K]0 required to produce K contractures and in the time course of submaximum K contractures. These effects were not shared by benzocaine. They were antagonized by increased [Ca]0. The results indicate that separate agents can exert mutually enhancing actions from opposite surfaces of the sarcolemma to facilitate the inactivation of depolarization-induced excitation--contraction coupling as well as that of the potential-dependent sodium channel.


Periodic, short-term heat exposure and reproductive function in male and female rats. Reproductive function of male and female rats was examined in relation to periodic, short-term heat treatment. Daily exposure to an environmental temperature of 38.2 degrees C for 55 min elevated rectal temperatures to 39.9 and 41.2 degrees C in male and female rats, respectively. Heat exposure tended to decrease copulation in males cohabitated with unheated females. The rate of conception was affected similarly, and fetal survival tended to be reduced by paternal heat treatment. Estrous cycles were disrupted initially in heat-exposed females, but the rate of copulation and conception of females cohabitated with unheated males was unaltered by heat treatment. However, maternal heat exposure impaired prenatal survival and growth. During lactation, a high incidence of maternal and pup deaths was observed at approximately 14 days postpartum. Maternal deaths were coincident with a decrease in thermoregulatory ability and rectal temperatures exceeding 42 degrees C.


Labeling of a glucose binding protein in the rabbit intestinal brush border membrane. Using a double labeling method based on the method of Thomas (Thomas, L. 1973). Isolation of N-ethylmaleimide-labeled phloridzin-sensitive D-glucose binding protein of brush border membrane from rat kidney cortex. Biochim. Biophys. Acta, 291, 454--464), with radioactive N-ethylmaleimide ([3H]NEM and [14C]NEM) in the presence and absence of D-glucose, a protein band which is periodic acid--Schiff staining insensitive and which has a relative mobility (Rm) of 0.55 (corresponding to a molecular weight of 51 000 daltons) as determined by sodium dodecyl sulfate (SDS) electrophoresis was labeled preferentially. When radioactive p-hydroxymercuriphenylsulfonate ([203Hg]PCMBS) is used in the presence and absence of D-glucose, as described by Smith et al. (Smith, M. W., Ferguson, D. R., and Burton, K. A. 1975. Glucose- and phloridzin-protected thiol groups in pig intestinal brush border membranes. Biochem. J. 147, 617--619.), a protein band which has a relative mobility of 0.62 and a corresponding molecular weight of 42 000 daltons was labeled. Control experiments have shown that increasing concentrations of nonradioactive NEM (0.1--5.0 mM) do not substantially modify the electrophoretic pattern of SDS-solubilized brush border membrane. Nonradioactive PCMBS (0.1--10 mM), on the other hand, modifies the electrophoretic pattern and especially causes a change in relative mobility of the 0.55 protein band which migrates after 1 mM PCMBS treatment with a Rm of 0.62. The effect of 1 mM PCMBS can be reversed by adding L-cysteine or dithiothreitol. Actin extracted from rabbit muscle migrates with the same Rm as the 0.55 protein band in our electrophoretic conditions.


The electromyographic response to sudden stretches of limb muscles in normal human subjects. The electromyographic (EMG) activity following a sudden stretch applied to wrist flexor or extensor muscles was investigated using a method which enabled the individual records and cumulative results of 30 trials to be observed simultaneously. The results showed that in each case the spinal reflex EMG burst was followed by one or two additional reflex bursts. The second of these latter bursts, when present, occurred in one of two distinct latency ranges. Thus, three distinct latency ranges were observed for reflex bursts following the spinal reflex burst. A possible explanation for these results is that there are three distinct long-loop reflexes, one or two of which may be active following a muscle stretch. The present results do not distinguish whether any or all of these long-loop reflexes are segmental or supraspinal in origin.


Cryoactivation and tryptic activation of blood 'prorenin' in normal man and animals. Plasma and serum of healthy subjects apparently contain a precursor form of renin, or 'prorenin,' which can be activated by the ice-cold temperature at which samples are customarily handled for prolonged periods in laboratories and blood banks. The effect of such prior cryoactivation for 9 days at 4 degrees C is to increase subsequent plasma renin activity (PRA) at 37 degrees C by 108 +/- 16.3% (mean +/- SE) over the nonactivated control value (P less than 0.001). At a lower temperature (-4 degrees C), the cryoactivation effect is considerably greater than at 4 degrees C. Cryoactivation is not obliterated by the prefreezing of plasma, or reduced by inclusion of bacteriostats. Nor is it attributable to any detectable reduction in angiotensinase activity. In rats, cryoactivation at 4 degrees C is much lower than in humans, suggesting a marked species difference either in prorenin concentration or in the rapidity of its spontaneous conversion after blood collection. Trypsin at near optimal concentrations also consistently activates human plasma prorenin, whether at 4, 23, or 37 degrees C indicating that cold is not an essential concomitant of tryptic activation. In excess, the magnitude of which varies among individuals, trypsin at first produces activation and later a decline in PRA, probably due to degradation of the reactants (prorenin, renin, angiotensinogen) and of the initial product (angiotensin I). The identity of angiotensin I in activated and control plasmas can be established by specific radioimmunoassay, and bioassay. Our data indicate that tryptic activation involves little direct production of angiotensin I but rather converts prorenin, thereby enhancing the angiotensin generating capacity of the plasma renin system itself. Tryptic activation in plasma of anaesthetized dogs is lower than in humans, but higher than in conscious or anaesthetized rabbits in whom the effect appears to be slight. In anaesthetized rats there is virtually no tryptic activation, which is in line with the results by cryoactivation. Since the renin--angiotensin systems of dogs, rabbits, and rats have been extensively studied in experimental models of human hypertension, these observed departures from human levels of cryoactivation and tryptic activation of prorenin deserve further investigation.


Effect of renal denervation on the development of hypertension in spontaneously hypertensive rats. The involvement of the renal nerves in the development of hypertension in Okamoto spontaneously hypertensive rats (SHR) was investigated by performing bilateral renal denervation in a group (n = 7) of SHR at 8 weeks of age. A sham-operated group (n = 7) of SHR served as surgical controls. Systolic arterial pressure was recorded twice a week until 14 weeks of age using a tail cuff method. Renal denervation significantly (P less than 0.01) altered the time course for development of hypertension, although both groups eventually developed hypertension. During the 6-week observation period, there were no significant differences in body weight, average 24-h food and fluid intake, urine output, or Na+ and K+ excretion between the two groups. At 20 weeks of age there were no significant differences in systolic pressure, average fluid intake, or urine output between the sham and denervated groups. These results suggest that the renal nerves may be involved in the early phase of development of hypertension in the SHR. The possibility that altered renal function may be the mechanism of the above effects is discussed.


The guinea pig tracheobronchial spiral strip: responses to selected agonists. The guinea pig tracheal spiral strip is a useful preparation for studying bronchoconstrictor and bronchodilator compounds. Employing a simple and rapid modification of this technique, experiments were performed in vitro to quantitate the effects of selected bronchospastic agents on guinea pig tracheobronchial smooth muscle. Three sections of the main airways were prepared from each animal: an upper tracheal, a lower tracheal, and a bronchial segment. The dose-dependent contractile responses of the three tissue segments were determined for carbachol, acetylcholine, histamine, 5-hydroxytryptamine, and bradykinin. Differences were observed amongst the agonists in magnitudes of contraction, effective concentration ranges, and slopes of dose-response curves. ED25, ED50, and ED75 values were calculated from regression analysis of dose-response data. The relative order for these agents to produce maximum contractions was found to be carbachol congruent to acetylcholine greater than histamine greater than 5-hydroxytryptamine greater than bradykinin. Furthermore, it was found that there was no significant difference between the three tissue segments in their responses to the various agonists.


Effects of 16,16-dimethyl prostaglandin E2 on ion transport by isolated rabbit gastric mucosa and rat intestinal epithelial cells. The actions of 16,16-dimethyl prostaglandin E2 (dmPGE2) were investigated on ion transport in in vitro rabbit fundic mucosa and rat isolated jejunal cells. Addition of dmPGE2 (1.3 X 10(-4)M) to the serosal side of the rabbit mucosa resulted in a significant decrease in the transmural potential difference (PD) and short circuit current (Isc). The transmembrane resistance (R) displayed a significant rise over control values. Furthermore, the net serosa to mucosa flux of chloride ion decreased while the net serosa to mucosa movement of sodium remained unchanged. In the rat intestinal cells, increasing the concentration of dmPGE2 from 10(-10) to 10(-4)M caused a fall in sodium efflux. These data indicate that dmPGE2 alters the rate of active transport of the predominant ion pump of the resting rabbit gastric mucosa and the rate of Na efflux from rat intestinal epithelial cells without apparently affecting the membrane permeability.


Enzymatic degradation of somatostatin by rat plasma and hypothalamus. A highly sensitive and specific radioimmunoassay for somatostatin has been used to study inactivation of the neurohormone by plasma and hypothalamic peptidase(s). Specificity of the inactivation process was indicated by the absence of interference by addition of luteinizing hormone releasing hormone, thyrotropin-releasing hormone, oxytocin, or substance P. The inactivating ability of hypothalamic tissue and plasma was destroyed by heating and the protease inhibitor benzamidine prevented plasma activity, thus suggesting the enzymatic nature of the processes involved. The present data suggest that the inactivation of somatostatin by hypothalamus and plasma could be an important factor in the regulation of circulating somatostatin levels.


Metabolism of the isolated perfused rabbit heart. I. Responses to anoxia and reoxygenation. II. Energy stores. Cardiac performance, substrate utilization, and creatine kinase (CK) release were studied in Langendorff rabbit hearts during aerobic perfusion, 25 min of anoxia, and 75 min of reoxygenation. In study I (n = 40), increasing glucose availability during aerobic perfusion enhanced substrate utilization without influencing cardiac performance, and this effect was not modified by insulin. Reoxygenation with glucose decreased CK (milliunits per millilitre) in the coronary sinus effluent but the best early recovery occurred in hearts protected with the 'cocktail' (see Table 1) during anoxia and perfused with glucose and insulin during recovery. This early recovery of performance was associated with transient higher CK loss, an effect that may have been related to one or more of the following factors: squeezing out of interstitial CK, heterogeneous anoxic injury to the myocardium, severe sarcolemmal damage, and preferential energy utilization by the contractile apparatus. In study II (N = 82), increasing recovery of cardiac performance was associated with increasing rate of CK loss (milliunits per minute) during reoxygenation. At 15 min of recovery, creatine phosphate (CP) and ATP stores were 400 and 50% of the aerobic group suggesting the presence of a defect in energy transfer from CP to the cytosolic ADP:ATP system. Thereafter, CP levels gradually declined while ATP reached a peak concentration of 85% of the aerobic group at 30 min. By the end of recovery, ATP stores were low at 23% of control, at a time when cardiac performance and the rate of CK loss were maximal. The significance of these depleted ATP stores remains to be elucidated.


Brain extracellular potassium and general anaesthetics. General anaesthetic agents (halothane, trichlorethylene, methohexital, pentobarbital, and alphaxalone--alphadolone) depress the extracellular accumulations (deltaEk) and associated focal potentials (deltaV) which are evoked in the cuneate nucleus by tetanic stimulation of peripheral nerves. Depressions of deltaV are significantly greater than those of deltaEk; at the same time there is a dissociation of the relation between deltaV and deltaEk. There are no detectable changes in the resting levels of K+ or the small voltage shifts evoked by low-frequency intranuclear stimulation with a microlectrode. When anaesthesia produces severe hypotension, augmentations of [K+]0 occur which can be attributed to depression of electrogenic Na--K pumping. A possible explanation of the reduction in K+ release resulting from afferent fibre activity would be failure of conduction caused by membrane stabilization or hyperpolarization.


Atropine blockade of cholinergic drugs on rabbit stomach muscle. The competition between atropine and a full agonist, carbachol, was tested on dibenamine-pretreated smooth muscle of rabbit stomach. Even after extensive irreversible blockade by dibenamine, atropine blockade of the response to carbachol was still competitive and the atropine affinity constant was unchanged. This differed from the noncompetitive action of atropine in blocking the contractile effects of partial agonists such as pilocarpine or heptyl trimethylammonium. The results thus indicate that it is not possible to convert a full agonist into a partial agonist merely by reducing the number of available cholinergic receptors. The present study compares the competitive effect of atropine on the actions of the full agonist carbachol, under conditions of irreversible blockade, with the competitive effect of atropine on partial agonists such as pilocarpine or heptyl trimethylammonium.


Effect of a local cold stress on peripheral temperatures of Inuit, Oriental, and Caucasian subjects. Male subjects comprised of six Inuit from Igloolik, N.W.T., and five Orientals and six Caucasians from Toronto, Ont., volunteered for tests to determine the effect of localized cold stress on peripheral temperatures. In each subject, skin temperatures of the right index finger, the arm, and the cheek, as well as blood pressure and heart rate, were measured before, during, and after foot immersion in water of 10 degrees C temperature for 10 min. There was an immediate decrease in finger temperature on foot immersion in all three subject groups; however, the Inuit finger temperatures recovered very quickly to control values, the Caucasian finger temperatures began to increase after decreasing for 7.5 min, and the Oriental finger temperatures decreased continuously during the foot immersion and remained cool even 10 min after the removal of the cold stimulus. The cold stimulus did not affect the cheek or arm temperatures of any of the groups. In all subjects, systolic and diastolic blood pressures and heart rates increased on foot immersion, gradually returning towards normal values. No intergroup differences were seen in these parameters.


The effect of clothing on the initial ventilatory responses during cold-water immersion. The effect of clothing on ventilatory responses during cold-water immersion was studied. Subjects were immersed in water at 13.9 degrees C on two occasions wearing either a bathing suit only or clothed with jacket, shirt, pants, and sports shoes. It was found that the initial gasp and subsequent minutes of expired ventilation were significantly attenuated, whereas the changes in end-tidal PCO2 were only significantly different for the 2nd and 3rd min of the immersion. It would appear that the use of clothing may prove beneficial during the first few minutes of a cold-water immersion by decreasing the powerful drive to increased respiration.


Epileptiform seizures in domestic fowl. IX. Implications of the absence of anticonvulsant activity of ethosuximide in a pharmacological model of epilepsy. Acute dose--response studies were conducted to determine if ethosuximide had anticonvulsant activity against seizures evoked by stroboscopic stimulation of epileptic fowl and to correlate the observed effects with the concentration of the drug in the plasma. Ethosuximide, in doses that produced mean plasma concentrations of 366 microgram/ml and signs of sedation, did not reduce seizure susceptibility. Twice daily administration of ethosuximide produced mean plasma concentrations of 430 microgram/ml after 36 h without affecting seizure susceptibility even in the presence of marked sedation. Previous studies have shown that epileptic fowl are sensitive to the anticonvulsant effects of phenobarbital, phenytoin, and primidone at plasma concentrations similar to those required in humans. Since ethosuximide has a high specificity against petit mal seizures in humans, the failure of ethosuximide to provide protection indicates that epileptic fowl represent a relatively specific pharmacological model for drugs effective against generalized tonic--clonic and focal cortical epilepsies in humans.


Purine metabolism and differential inhibition of spore germination in Phytophthora infestans. An analysis of the effect of various purines and pyrimidines on the germination process in three different isolates of the late blight fungus, Phytophthora infestans, revealed increased rates of indirect germination in one isolate by adenine, hypoxanthine, and the riboside of dimethylaminopurine. This observation coupled with the capacity of sporangia of the race affected (1.2.3.4) for the uptake and interconversion of purines, as demonstrated by experiments with labelled purines under in vivo and in vitro conditions, pointed to hypoxanthine as a key intermediate in the purine metabolism directly associated with spore formation and development. This enhanced germination contrasted sharply with the almost complete arrest of indirect germination that occurred when sporangia were incubated with the purine analogue, benzimidazole, or with either of the respiratory inhibitors, sodium azide and 2,4-dinitrophenol. The pattern of differential inhibition exhibited by sporangia versus zoospores upon treatment with actinomycin D, 4-FLUOROURACIL, OR CYCLOHEXIMIDE INDICATED THat continued translation on preformed messenger RNA may be one essential requirement for the formation and release of zoospores, whereas their subsequent germination and development may depend upon renewed transcription as well.


Influence of calcium on the differentiation and growth of aggregated organs in Sphaerostilbe repens. In the ascomycete Sphaerostilbe repens the vegetative mycelium aggregated into structures composed of aerial coremia and rhizomorphs immersed in the culture medium. The morphology and growth of the cultures were examined on a defined medium with and without calcium supplementation. Initiation and growth of aggregated organs occurred only if calcium was present continuously in the culture medium. On calcium-deficient media the fungus produced only vegetative mycelium which retained its ability to aggregate in the presence of the cation. Small concentrations of calcium (less than 1 ppm) stimulated aggregation of the mycelium, but higher concentrations (about 200 ppm) were necessary to obtain optimum development of the aggregated organs. Strontium partially replaced calcium, but lithium did not, as a stimulator of aggregation.


Isolation of Yersinia enterocolitica from surface and well waters in Ontario. Yersinia enterocolitica was isolated from forty-three surface- and well-water samples and one municipal supply. In many cases these samples were negative for coliform bacteria. After incubation of membrane filters on M-Endo agar LES at 35 degrees C for total coliform analysis, filters were held an additional 24 h at room temperature. This method was more productive for isolation of waterborne types of Y. enterocolitica than was cold enrichment in buffer alone or in combination with modified Rappaport broth. Most of the water isolates were atypical in being rhamnose-positive. Eighteen isolates (38%) were serotypable, presenting nine different serotypes with 0:4 occurring most frequently followed by 0:6,30. Water isolates of serotype 0:6,30 resemble human strains of the same serotype.


Early phases of degeneration of mycoplasma-like bodies in plant tissue cultures infected with aster yellows: morphological analogies with Mycoplasma hominis. Several forms of mycoplasma-like bodies (MLBs) were observed in electron micrographs of phloem cells from explants infected with aster yellows disease. The structures were found only in explants 11--25 days old, when the degenerating MLBs were first observed. They resembled those described by Anderson and Barile in 1965 for Mycoplasma hominis. A sequence of events in the degeneration of MLBs is postulated and morphological analogies with degenerating M. hominis are discussed.


The effects of a pesticide program on non-target epiphytic microbial populations of apple leaves. The epiphytic microbial community was quantitatively and qualitatively altered when a standard pesticide schedule that comprised applications of an insecticide, a bactericide, and a fungicide was applied to McIntosh apple trees. Effects on non-target organisms were observed for two seasons by three indirect methods and three direct methods: plating of leaf washings, imprinting of leaves onto five different media, spore fall patterns, light microscopy, scanning electron microscopy, and isolation of propagules from leaves incubated in humidity chambers. Magnitude of reduction of bacteria, filamentous fungi, yeasts, and actinomycetes varied annually and between categories of microflora. Populations from treated leaves were reduced 10- to 1000-fold in 1976 and up to 50-fold in 1977. Qualitatively, fluorescent pseudomonads and lactic acid-type bacteria were among those depressed by pesticide. Fungal populations on treated leaves were less diverse than on control leaves. Aureobasidium was only slightly affected and incidence of Sporobolomyces was substantially higher on treated leaves than on controls. The results suggest that numbers of antagonists to foliar pathogens of apple which may occur as part of the natural epiphytic microbial community may be reduced by current pesticide programs and hence have possible implications for the development of biological approaches to integrated control strategies.


[Identification of actinomycetes with antifungal activity which do not affect Rhizobium meliloti]. Thirteen isolates of actinomycetes that have broad antifungal activity and do not affect two efficient strains of Rhizobium meliloti were identified as: Nocardia autotrophica, Streptomyces antimycoticus, S. anulatus, S. capoamus, S. lydicus, S. murinus, S. roseo-luteus, and S. thermotolerans.


Rapid spectrophotometric determination of Acholeplasma laidlawii membranes. The amount of Acholeplasma laidlawii membranes can be accurately, rapidly, and simply determined by spectrophotometric measurements after solubilization in 0.02 M SDS, 0.02 M Tris-HCl (pH 8.0). Extinction coefficients from the 260- to 300-nm-absorption region are adequate for quantitative membrane determination. The following values were found: E1%1cm,280 = 9.11 +/- 0.63, E1%,S1cm,280 = 8.52 +/- 0.40 (corrected for light scattering), E1%1cm,280--310 = 8.15 +/- 0.35. The last value is the most satisfactory for routine analysis. These coefficients are not affected by large differences in the carotene and flavin contents of the membranes or by spectral changes that occur when the membranes are exposed to light. The precision obtained with this method is comparable with that achieved in spectrophotometric determinations of proteins. As little as 6 microgram of membrane can be measured in 50-microliter samples.


Role of the physician in screening for carriers of Tay-Sachs disease. A screening test for carriers of Tay-Sachs disease has been available in Toronto for more than 6 years. In that time more than 11 000 Jewish residents have been tested. Most had requested testing after hearing about the screening program from friends or the media; few had been advised by their physicians to be tested. To sample the attitudes of physicians in Toronto towards carrier screening, we studied questionnaire responses of 42 physicians whose practices were composed largely of Jewish patients. Only 31% regularly advised their young adult Jewish patients to have a carrier screening test but 76% said they had patients who asked if they should be tested. Of the 14 (33%) who had had one or more patients with Tay-Sachs disease 6 did not advise carrier testing. There was a positive correlation between specialty training and support for the screening program. Methods for increasing physician advocacy of these programs are discussed.


Postural hypotension and diuretic therapy in the elderly. Blood pressures were recorded in 319 ambulatory subjects, largely men, age 50 to 99 years. The mean systolic pressures were maximal in the seventh and eighth decades (136.0 and 132.1 mm Hg with the subjects supine and erect, respectively), whereas the mean diastolic pressures fell progressively after age 69. The distribution of postural changes in mean blood pressure was similar in each decade; a decrease of 20 mm Hg on more was noted in 3.4% of the subjects aged 80 to 99 years and in 4.1% of those aged 50 to 79 years. The frequency of postural hypotension was 4.6% in subjects treated with diuretics and 3.4% in those not so treated. Blood pressures and the frequency of postural hypotension did not progressively increase in age in this elderly population.


Prolonged outbreak of nosocomial urinary tract infection with a single strain of Pseudomonas aeruginosa. Sixty-six hospitalized patients became infected with a single strain of multiply resistant Pseudomonas aeruginosa over a 22-month period. The catheterized urinary tract was the site of the infection in 59 patients (89%). The outbreak was confined to a urology ward until an infected patient from this ward spent 2 weeks in the surgical intensive care unit (SICU). Subsequently patients who acquired the infection in the SICU were discharged to surgical wards throughout the hospital. Urine measuring containers and urometers used in the SICU were the reservoir of the P. aeruginosa; daily sterilization of this equipment terminated the outbreak. Urometers appeared to be the reservoir of the epidemic strain in subsequent outbreaks. Five patients were still infected when they were readmitted 3 to 12 months after the first admission, and therefore represented an additional reservoir of infection.


Hemoglobinopathies in a hospital population in Vancouver. A number of varieties of thalassemia were found to be common in the Vancouver area and in other parts of British Columbia. Of 3117 patients whose blood samples were studied by hemoglobin electrophoresis at the Vancouver General Hospital between Jan 1, 1965 and June 30,1977, 813 had the beta-thalassemia trait, 18 had homozygous beta-thalassemia, 97 had alpha-thalassemia trait, 24 had hemoglobin H disease and 14 had miscellaneous variants. Eight patients had interactions of beta-thalassemia with hemoglobin S,C, D, O arab or Vancouver, and one patient had alpha thalassemia associated with hemoglobin Constant Spring. Twelve other variants were noted. They included hemoglobins B2, E, Q, GHsi Tsou, J Bangkok, British Columbia, KOLN, Lepore, Rampa, Tacoma, St. Claude and an unidentified alpha-chain variant.


[Thalassemia in French-speaking Quebec residents]. Eighty-five cases of beta-thalassemia minor were found between January 1975 and November 1977 in 18 families of French-speaking Quebeckers without Mediterranean ancestry. Most of the families had settled in Quebec more than 200 years ago, largely in Portneuf county. This is the first report of such a number of cases of beta-thalassemia in this population. Thus, beta-thalassemia minor is a relatively common condition in Quebec and must be considered in cases of microcytic anemia without evidence of iron deficiency. The hematologic findings were similar to those reported in the past in other populations. Two cases of delta beta-thalassemia minor (in sisters) are also reported; this is the first report of such cases in French Canadians.


Pancreaticocolonic fistula: a complication of pancreatitis. In three cases of pancreaticocolonic fistula presenting before the stage of exsanguinating hemorrhage of severe sepsis the problem was diagnosed on the basis of the clinical history, visualization of the terminal part of the fistula by roentgenography after a barium enema had been given and, in two cases, demonstration of the communication with the pancreatic ductal system by endoscopic retrograde pancreatography. The lesions were repaired surgically. Pancreaticocolonic fistula should be suspected in a patient with upper abdominal pain who has a history of abdominal pain and excessive alcohol consumption and in whom diarrhea and fever, hematochezia or a disappearing abdominal mass develops. Characteristically barium will collect in the terminal part of the fistula and thus permit a tentative diagnosis; the diagnosis can then be confirmed by endoscopic retrograde pancreatography. With this approach surgical treatment can be carried out earlier and the often fatal course of the disorder can be averted.


Death attributed to ventricular arrhythmia induced by thioridazine in combination with a single Contac C capsule. Phenothiazines are known to produce electrocardiographic repolarization abnormalities. Thioridazine and mesoridazine appear to induce such changes more frequently than other neuroleptics and are also known to induce fatal ventricular arrhythmia. The woman described in this article died after taking her usual dose of thioridazine, 100 mg/d, in combination with a single capsule of Contac. C, a decongestant-antihistamine containing phenylpropanolamine and chlorpheniramine. Phenylpropanolamine, an ephedrine-like drug, was thought to have favoured the initiation by thioridazine of the ventricular arrhythmia that led to the woman's death. It is therefore suggested that ephedrine-like medications not be given to patients receiving thioridazine.


Gonorrhea in homosexual men.

Gonorrhea in homosexual men. Extragenital gonorrhea was seen in 65% of 54 cases of gonorrhea in 43 homosexual men attending a venereal diseases clinic between 1974 and 1977; in 21 cases the infection was extragenital only. This type of gonorrhea was often asymptomatic and was associated with a high rate of failure of initial treatment in 6 of the 50 cases in which the patient returned for follow-up assessment, and in 5 of the 6 the persistent infection was extragenital. Syphillis was seen concomitantly or had previously occurred in 6 of the 54 cases. Fifteen of 28 cases of primary, secondary or early latent syphilis seen in men during the same study period had occurred in homosexuals. Appropriate testing for extragenital gonorrhea and for syphilis is important in homosexual men who present for examination, and homosexuality with the possibility of extragenital gonorrhea should be considered in a man with syphilis of recent onset.


Impaired serum antibody response to inactivated influenza A and B vaccine in cancer patients. The serum antibody response to vaccination with bivalent inactivated influenza vaccine containing A/Port Chalmers/1/73 (H3N2) and B/Hong Kong/5/72 antigens was assessed in 44 patients with cancer and in 27 healthy control subjects. A fourfold or greater increase in antibody titre after vaccination occurred in 16 of the 44 cancer patients and 25 of the 27 controls for the A antigen, and in 14 of the 44 cancer patients and 20 of the 27 controls for the B antigen. Patients with lymphoma, who tended to have hypogammaglobulinemia, responded less well than did patients with solid tumours. Among the latter the failure to show a fourfold or greater increase in antibody titre correlated with a poorer 18-month survival.


Squamous cell carcinoma arising in a meningomyelocele. Squamous cell carcinoma developed in the meningomyelocele of a 25-year-old man. This is the third such case reported. The possibility of malignant disease arising in this congenital defect must be taken into account when treatment is being considered.


Usefulness of three additional electrocardiographic chest leads (V7, V8, and V9) in the diagnosis of acute myocardial infarction. Additional electrocardiocardiographic chest leads (V7, V8, and V9) were used in 117 persons consecutively admitted to a coronary care unit. Among the 46 (39%) with a proven acute myocardial infarction the electrocardiograms (ECGs) of 9 (20%) showed ST-segment elevation or abnormal Q-waves, or both, in the three additional leads. In six of the nine, such changes were associated with signs of anterolateral or inferior wall infarction (in three each) on the standard 12-lead ECG, but in the other three (7% of the 46) electrocardiographic changes diagnostic of acute myocardial infarction were found only on the additional chest leads; the last three had characteristic changes in serum enzyme concentrations. This study showed that additional chest leads are helpful in detecting myocardial injury of necrosis in areas of the heart not properly reflected on the standard 12-lead ECG.


Recent advances in the pharmacologic regulation of fertility in men. An updated review of research into contraceptives for men is presented. New concepts of the pharmacologic effects of chemical agents on germinal stem cells and spermatogenic arrest, and the effect of new compounds that act at the post-testicular level but do not affect androgen production are discussed. The latest results of studies on steroidal compounds that inhibit pituitary secretion of gonadotropin and hence result in suppression of spermatogenesis and testosterone secretion are presented. The newer contraceptive pills for men are also evaluated. The major drawback to the development of chemical contraceptives for men is the fear of genetic damage and impotence. New and continued research into this type of contraception is urgently needed.


Psychiatric services in China: or, Mao versus Freud. Reportedly, the People's Republic of China has made great progress in health care services, particularly at preventive, primary and community levels. Information on their psychiatric services is still scarce. A group of 12 health professionals visited the country for three weeks in July 1977. This paper provides a description and an analysis of the network of mental health services using a sample of one mental hospital, six general hospitals and a number of health units in cities, factories and communes. The basic principles of policy and administration are those of a collective socialism with strong central guidelines and considerable local administrative initiative. Admissions to the mental hospital in Shanghai reveal that 83% are young acute schizophrenic cases and very few are neurotic or non-psychotic. This distribution stands in great contrast with admissions to mental hospitals in the West, as is the case in Canada, where schizophrenics represent only 12% of all first admissions to mental hospitals and non-psychotic or minor conditions amount to two-thirds. An impressionistic survey of Chinese traditional medicine rooms in general hospitals revealed that a good proportion of their cases (60-70%) are diagnosed as suffering from minor organic or vague organic conditions without evidence of organic pathology and which in the West would be considered as neurotic or psychosomatic conditions. Outside the institutions, in the communes of the rural and urban areas behavioural, interpersonal and family problems are not defined specifically as mental health problems, but handled within the moral and political ideology prevalent in the country. None of the general hospitals visited had a psychiatric unit, but every patient in every hospital or health unit in the cities and countryside received a combination of traditional Chinese medicine (herbal preparations, acupuncture and moxibustion) besides the Western or modern type of treatment. Officially mental illness is not considered a major problem and it is given very low priority in medical school curricula or in the planning of health services. It is concluded that psychiatric services in China are concerned primarily with cases of psychosis and severe neurosis, that neuroses are viewed as general health problems, and personality and behaviour disorders are considered social or community matters.


An introduction to holistic primal therapy. Holistic primal therapy is a comprehensive system of therapy where the therapist, while establishing a relationship of trust and mutual respect, acts as a catalyst for regression, the dismantling of defenses and the intensification of feelings. He or she acts as a transference object for the patient but also serves as a model of an ideal parent and normal adult. Through his own vitality he re-energizes the patient and helps him to overcome therapeutic impasse by focusing and integrating. Holistic primal therapy represents an important addition to the existing psychiatric modalities of treatment and suitable candidates should no longer be denied access to it.


Operant management of the behavioural sequelae of Wilson's disease: a case report. An approach to the management of the behavioural manifestations of Wilson's Disease by operant technique is outlined. There was considerable improvement in the patient's ability to perform autonomously on this program. When the contingencies were changed the patient's behaviour deteriorated markedly, thereby suggesting that improvement in behaviour was not due to medication alone.


Basic principles in custody assessments. The paper discusses some of the principles of custody assessments in divorce proceedings. It is felt that such assessments should be undertaken only upon the request of the judge or both lawyers. The assessment should be extensive and should include collecting and collating all available data obtained through interviews or letters. The report should include historical material, the formulation, and the reasons for the recommendations. Clinically, the important issue is to decide under whose care the child's growth and development is enhanced. Factors that help in this decision include the emotional ties between the parent and the child, the capacity of each parent to provide physically and emotionally, the preference of the child, and the need for continuity. The psychiatric and moral "fitness" of parents is critically reviewed. It is maintained that no parent should be given an inherent preference in custody rulings. Finally, it is argued that access should be expected after divorce and should be changed or eliminated only under strict conditions.


The authoritarian family and its adolescents. Authoritarian Families possess characteristics similar to those of the Authoritarian Personality. They are power oriented, tend to have dichotomous conceptions, have emotional and intellectual rigidity and submit easily to authoritarian forces. The adolescents in such families are deprived of their basic needs for stability, flexibility and guidance. Consequently they feel frustrated and angry. Their anger manifests itself in various forms. A large percentage of these adolescents adopt their parents' attitudes and develop similar authoritarian personality characteristics. The second group are those who experience considerable conflict and tend to become aggressive and hostile in their interpersonal relationships. STill, there are adolescents who become withdrawn, depressed and apathetic and display great difficulty in dealing effectively with the ordinary demands of their lives. These adolescents and their families are difficult to treat. Several case histories are provided and brief outlines of a treatment approach are given.


Notes on the treatment of anhedonia.

Notes on the treatment of anhedonia. This paper discusses the concept of anhedonia defined as the inability to experience pleasure. Many authors have noted the presence of anhedonia as a personality feature in patients with schizophrenia and other disorders. Anhedonia apparently begins early in life in relation to pathological reactions within the core family. Many authors feel that anhedonia is closely associated with poor premorbid adjustment, interpersonal incompetence and chronicity, and mediates towards poor prognosis. The authors feel that interpretive forms of psychotherapy and psychoactive medication are not particularly effective in the treatment of anhedonic patients. They propose a selection of intellectual, physical and social activities as a more direct attack on this problem of anhedonia. Through these activities the patients are able to gain a tangible experience of pleasure while developing more effective interpersonal skills. The response of patients to activities also provides material for structured forms of psychotherapy and the combination and interaction of activity therapy and traditional psychotherapy is considered to be effective in many anhedonic patients.


Poppers, a new recreational drug craze.

Poppers, a new recreational drug craze. The study was conducted to obtain information on the recreational use of the vasodilators (RVs) amyl nitrite and butyl nitrite in Toronto. The results of 70 interviews (40 complete) indicate that sniffing these RVs gives a 'high' lasting from a few seconds to a few minutes with headache being the most common side effect. None of the more serious side effects mentioned in the literature were reported. RVs are used chiefly in conjunction with sexual activities and dancing. Their use is currently a craze amongst the male homosexual population.


Monosymptomatic hypochondriacal psychoses: a diagnostic entity which may respond to pimozide. Monosymptomatic hypochondriacal psychoses are akin to paranoia. Although presenting with a variety of delusional complaints in individual cases, the condition appears to represent a relatively dis crete diagnostic entity. It is less rare than usually thought, but those afflicted frequently to to the physical specialties, whose treatment does not benefit them. It is important to recognize the illness, since there is tentative evidence that it may respond to treatment with pimozide.


Treatment of minimal brain dysfunction in a young adult. A discussion of the clinical picture and treatment of minimal brain dysfunction in post adolescence is presented. Small amounts of methylphenidate appear to have a salutary effect on symptoms such as irritability, moodiness, restlessness and poor concentration .


The analytical reliability of the zirconyl phosphate method of plasma carcinoembryonic antigen. We evaluated the analytical reliability of the carcinoembryonic antigen (CEA) method of Hansen. Our experience is based on performing over 23,000 CEA assays in more than 10,000 clinical samples. The sensitivity of the assay is 0.5 ng/ml. The precision must be defined as a function of concentration. In the range 2.6 to 12 ng/ml the coefficient of variation is 4.96 to 7.39%. Long-range studies of the reproducibility of the standard curve, over a period of several years and including 435 standard curves, have shown an overall mean B/Bo of 31.45% which is close to the theoretical optimal of 33%. The long-term 90 and 50% intercepts are 0.55 +/- 0.15 and 7.11 +/- 1.0, respectively. Interlaboratory surveys show good agreement between the means of the survey group and the target values but rather large individual discrepancies. The CEA method studied here is sensitive and reproducible in intralaboratory studies but less so in interlaboratory comparisons. The reagents have performed uniformly and close to specifications over an extended period of time.


Pre- and postoperative uses of CEA.

Pre- and postoperative uses of CEA. CEA plasma levels obtained prior to definitive surgery in patients with colorectal cancer in our hands have predictive ability. An elevated CEA greater than 2.5 ng/ml recorded by our laboratory means an increased risk of subsequent local recurrence or of later metastatic disease. The question as to whether or not this is additive as a prognostic variable when tested against careful histopathological staging remains. As a monitor, CEA will detect recurrence. Again, the problem as to how accurate this is remains. If we use two consecutive elevations of plasma CEA greater than 2.5 ng/ml as a criteria, we encounter about 15% false positives which must be weighed against finding disease significantly earlier in about one-third of the patients followed. Our data for second-look procedures indicate clearly that when used in patients with an elevated CEA laparotomy may be useful and further studies showed the presence of disease in 11 of 14 patients with an elevation following surgery for two consecutive tests were greater than 2.5 ng/ml. Two were operable. The significance of these findings is described.


The use of serial CEA determinations to predict recurrence of colon cancer and when to do a second-look operation. The concept of second-look surgery was introduced by Wangensteen 25 years ago, and 17% of patients were reported to be converted to a cancer-free state. Instead of an arbitrary time interval for reoperation, serial CEA values were used as the indicator of colon cancer recurrence and second-look operation. Twenty-two retrospective and 18 prospective patients were evaluable. There was no operative mortality. The CEA Nomogram was used to determine whether the CEA change was significant. All patient-samples were analyzed in duplicate, stored, and compared with the most recent sample; therefore, each patient served as his own control. The prospective results emphasize the importance of minimizing the time delay between a significant change in CEA values and reoperation. Equally important are the frequency of serial determinations (every one or two months), a thorough understanding of the limitations of the CEA radioimmunoassay, and the clinical condition of the patient.