Influenza of age on chromatin transcription in murine tissues using a heterologous and an homologous RNA polymerase. No gross changes in the compositions of chromatin prepared from liver, kidney and brain were noted with age. A decreased age-dependent in vitro chromatin template activity was observed using an Escherichia coli RNA polymerase. This was paralleled by a reduction in the number of initiation sites on the chromatin for the enzyme. However, using a homologous RNA polymerase definite age-related specificities in template activity were found. When chromatin and enzyme were 'age-matched', maximal activity was observed. This levle of activity was comparable in both 6 and 31-month-old mice, which suggested no impairment of function with age.


The collagenous and non-collagenous protein of the canine intervertebral disc and their variation with age, spinal level and breed. The total nitrogen, collagen and non-collagenous protein (NCP) content of the nucleus pulposus (NP), transitional zone (TZ) and annulus fibrosus (AF) of the beagle (a chondrodystrophoid breed) and greyhound (a non-chondrodystrophoid breed) intervertebral discs have been determined over the age range birth to 124 months. Discs were sampled at three spinal levels - lumbosacral, lumbar and thoracic regions. The beagle NP attains an average NP collagen content of 25% dry weight before 11 months of age, whereas the greyhound NP content is less than 5% collagen for most of its life. The NCP of the young greyhound disc is greater than that of the beagle of corresponding age. Plots of the ratio of collagen/NCP for discal regions at various ages highlight the large differences between the two breeds of dog. It is suggested that these differences in protein distribution are related to the elevated incidence of intervertebral disc prolapse in the beagle.


[Elaboration and standardization of a series of psychometric tests for old people (author's transl)]. We had previously elaborated a series of psychometric tests for old people. The aim of this test series is to assess the effects of brain-stimulating drugs (vasodilatating drugs). A factorial analysis was then carried out which enables us to reduce the number of tests, on the one hand, and to indicate the most fundamental fields of activity in old people, on the other hand. Four factors were distinguished. They assess respectively: watchfulness, memory, fluidity, and precision in the task undertaken. These four factors are strongly correlated. This implies the presence of a general factor, close in kind to the first factor. Watchfulness, attention and concentration are, in fact, necessary but insufficient conditions for the performance of all cognitive activities. A total of 7 tests among the most representative of each factor were retained. They are described in detail: test conditions, instructions, scoring and standardization.


[Research and elaboration of a series of psychological tests for studying the quality of memory in old people (author's transl)]. Two series of mnesic tests were elaborated for experimental purposes by grouping and adapting traditional memory tests. The first set gives an overall study of the individual by assessing his short-term retention abilities. The second set is more specific and measures essentially his learning capabilities and the memorizing processes. These test series were designed to furnish both an instantaneous evaluation of the individual in relation to a group and a longitudinal evaluation of his abilities. Rather than assessing the mnesic capital, the test series evaluate the dynamic forms of memory expression which underlie every mnemonic operation, such as: memory span (or field of apprehension), retention processes, recognition, identification, spontaneous reminiscence, induced reminiscence (or associative memory), learning abilities on the basis of both concrete and practical as well as abstract and verbal material. They represent a psychometric tool permitting comparisons through a range of retests and quantifiable scoring of results. But they are also a clinical instrument, in the sense that the processes of the various intellectual functions can be qualitatively apprehended.


Light and electron microscopy of the ovarian interstitial tissue in the senile rat: normal aspect and response to HCG of "deficiency cells' and 'epithelial cords'. The two components of the interstitial tissue in the senile rat's ovary--deficiency cells and epithelial cellular cords--both contain steroidogenic organelles at a very low level of activity, which can be notably raised by HCG. Deficiency cells and epithelial cords are not the expression of primary ovarian aging, but the consequence of senile gonadotropic hypofunctioning. For that same reason, these ovarian structures become permanent and their possible cellular aging can thus be studied. No ultrastructural signs of senescence have as yet been observed.


Molecular mechanisms of ageing. A critique. Two kinds of evidence, taken in conjunction, indicate that Orgel's theory is inapplicable to a wide range of disorders of senescence in man. The age dependence and the anatomical distribution of the lesions of such disorders imply a Burnet type 'forbidden clone' theory of ageing. We describe the difficulty of establishing Orgel's theory for any disorder of ageing in man.


Death and drug treatment in a psychiatric hospital. 218 deaths occurring in a psychiatric hospital during a 3-year period were reviewed and their drug treatment was compared with that of a control group. 75% of the patients suffered from an organic psychosis. Patients received a mean of 2.4 different drugs on the day of death and only 23.6% of the prescriptions were for psychotropic drugs. 20 patients died suddenly and although more of these individuals had received tricyclic antidepressants and phenothiazines than their controls, these differences were not statistically significant.


Cross-sectional-type weight reference values for village children under five years in Lesotho. Cross-sectional-type reference values for weight attained are described for village children under five years in rural Lesotho (formerly Basutoland). Weight measurements derive from observations on 1317 children attending an Under-Fives clinic; it is estimated that 60-70% of the children under five in the catchment area were represented. 4585 weighings on boys and 4826 weighings for girls are included in the analysis. Figures of weight-for-age of boys and girls are given separately as centile distributions suitable for use on Growth Charts. Lesotho 50 centile approximates to 3 centile of British children and slightly exceeds 80% Harvard standard. Weight attained for age is similar, in both sexes, to reports from other less-priviledged urban and rural areas, emphasizing the relative importance of environmental as compared to genetic influences in determining weight-for-age in early childhood. It is suggested that the construction of locally-derived growth reference values is both appropriate and practicable.


Age-dependence of body weight and linear dimensions in adult Mus and Peromyscus. Head plus body length (HBL), tail length (TL) and body weight (BW) were measured on two species of small myomorph rodents, Mus musculus and Peromyscus leucopus, throughout adult life. Both sexes of Mus show about a 15 per cent increase of HBL and TL between 5 and 24 months of age, and a BW increase of about 47 per cent. There is no age-trend of HBL in either sex of Peromyscus between 5 and 67 months of age, while TL increases about 7 per cent. In both species, cessation of skeletal growth is followed by a steady decrement of body mass, which averages about 0.23 per cent per month throughout adult life for the two sexes of Peromyscus, and over two per cent per month after cessation of skeletal growth in Mus. The weight loss in Mus in the last half of the lifespan is shown to be associated with age, rather than with the duration of subsequent survival. This evidence against the hypothesis that the late weight loss in Mus is due to terminal disease.


Alaskan malamute chondrodysplasia. I. Bone composition studies. Chondrodysplastic Alaskan Malamutes exhibit concentrations of calcium, phosphorus and magnesium in radius, ulna, and humerus bone segments similar to those of non-chondrodysplastic dogs of similar age. Significant differences in extractability of mineral components with 5% EDTA were observed in specific bone segments. Although these data suggest that a primary derangement in calcium and phosphorus was possible the magnitude of the differences strongly suggested it unlikely and stress or mechanical factors may account for some of the observed differences. The possibility that chondrodysplasia provides a model for human disorders such as fibrogenesis imperfecta ossium was discussed. These data presented support a previous hypothesis that the chondrodysplasia is not a vitamin D-resistant rickets syndrome.


Longitudinal growth of skeletal muscle fibres in lines of mice selected for high and low body weight. The effect of selection for increased and decreased body weight on the weight, mean fibre length, mean estimated resting fibre length, mean sarcomere length and mean sarcomere number per fibre of the biceps brachii muscle was studied in 10 week old mice. The expected alterations in muscle weight were present and were due in part to changes in fibre length which was increased in the high line and decreased in the low line. The changes in fibre length were due to differences in sarcomere number per fibre which was increased in the high line and decreased in the low line. The mean sarcomere length of mice in the high and low lines did not differ significantly from control indicating that this parameter is unaffected by selection for altered body weight. It is suggested that genetic factors influence longitudinal muscle fibre growth in two ways. Species differ in the length of their myofilaments whereas differences between individuals and lines within a species are due to the formation of additional sarcomeres.


Serum protein concentrations and enzyme activities, as functions of age and sex, in Sinclair (S-1) miniature swine. Venous blood samples were collected monthly from 60 male and 60 female Sinclair (S-1) miniature swine from 1 through 36 months of age. Serum total protein concentration increased linearly from 1 through 10 months of age and remained stable thereafter with no sex related difference. Serum albumin concentration decreased from 1 through 3 months, increased from 3 through 8 months and decreased from 14 through 36 months. From 2 through 36 months, serum alpha-globulin concentration decreased; whereas, serum beta-globulin concentration increased. Serum gamma-globulin concentration increased markedly from 1 through 3 months and continued to increase through 36 months of age. From 10 through 36 months, males had a greater mean serum gamma-globulin concentration than did females. Serum total globulin concentration increased most rapidly from 1 through 3 months, less rapidly from 3 through 18 months and remained stable thereafter. Serum albumin/globulin ratio decreased sharply from 1 through 3 months and continued to decrease from 6 through 36 months with females having a greater mean concentration than males. Serum glutamic-oxaloacetic transaminase activity decreased from 1 through 30 months with males having a greater mean activity than females from 7 through 36 months of age. Serum alkaline phosphatase activity decreased from 1 through 36 months of age with no sex related difference. Serum lactic dehydrogenase activity decreased from 1 through 30 months with females having a greater mean activity than males from 24 through 36 months of age.


Comparative findings on the skelic index of black and white children and youths residing in South Carolina. This paper pertains to one facet of human body form, the relation of lower limbs to stem as quantified by the skelic index (lower limb height x 100/sitting height). The subjects were North American black and white pupils measured during 1974-1975 at elementary and high schools in Columbia, South Carolina. Females were measured at ages 9 and 13 years, males at ages 11 years and 15 years. At each childhood and adolescent age studied, skelic index means were considerably higher for the black than for the white pupils. Standard deviations and distances between spaced percentiles showed that variability of the skelic index at a given age was similar for white and black school pupils of South Carolina. Supplementary means for components of the skelic index indicated (1) black children and youths were shorter in sitting height than their white age peers, and (2) white children and youths were shorter in lower limb height than their black age peers. The skelic index of both ethnic groups increased between late childhood and mid-adolescence.


Growth of the pig: patterns of changes in electrolytes, water, and protein. In 246 pigs studied from day of birth through week 12, mean plasma concentration of Na was 144.2; K, 3.89; and Cl, 103 mEq/1. Fifty-five pigs were analyzed for total body water (TBW), Na, K, Cl, protein, and fat. TBW was 83% fat-free wet weight (FFWW) at birth and declined, but not significantly, over the 12 weeks. Water content of tissues differed from each other as well as in the rates at which their water content changed. Concentration of electrolytes Na, K, Cl (mEg/100 g FFWW) decreased significantly in whole pig, viscera, brain, and skin; while Na increased and K and Cl decreased significantly in skeletal muscle. Of the tissues, skeletal muscle contributed 32% (fat-free tissue weight as per cent of total FFWW) at birth and 44% at week 12; and viscera, 15% at birth and 21% at week 12. The contribution of skeleton decreased over the same period from 22 to 15%, skin from 14 to 6%, and brain from 2 to 0.5%. The contribution of total water by the various organs changes in the same direction as the contribution to total FFWW. Na, K, Cl, and protein as a per cent of total in skin also show the same directional change. In skeletal muscle there was a decrease in conribution to total Na and Cl, but an increase to total K and protein. In the skeleton, except for protein, there is an increase in contribution of total Na, K, and Cl. There was a correlation of 0.99 and 0.94 between the sum of total Na and K in milliequivalents and TBW in millimeters for the whole pig and skeletal muscle respectively.


Immunological studies in patients with Crohn's disease. An investigation of immunological parameters was conducted in 38 patients with Crohn's disease. The immunological tests employed included skin tests with dinitrochlorobenzene and a battery of common skin test antigens, lymphocyte transformation with phytohaemagglutinin and pokeweed mitogen, serum immunoglobulins, and absolute lymphocyte counts. Crohn's disease patients were divided into two groups, those treated with immunosuppressive drugs and those not receiving immunosuppressive medications. The latter group was subdivided into patients with active and inactive disease. Immunosuppressed patients with Crohn's disease did not develop sensitivity to dinitrochlorobenzene and had mildly depressed skin test reactivity to common skin test procedures. Non-immunosuppressed patients with active Crohn's disease also reacted less frequently to common skin test antigens, but 16 of 17 such patients developed sensitivity to dinitrochlorobenzene. Lymphocyte transformation with phytohaemagglutinin and pokeweed mitogen was normal in all groups of patients with Crohn's disease. However, when suboptimal incubation periods were used with phytohaemagglutinin stimulation, there was a significant difference between Crohn's disease patients and controls. Serum immunoglobulin levels and absolute lymphocyte counts were normal in all Crohn's disease patients. We conclude that immunity in Crohn's disease is qualitatively normal.


Gastrointestinal involvement in systemic mastocytosis. Four consecutive patients with systemic mastocytosis were studied. One patient had a malabsorption syndrome with only minor histological changes of the intestinal mucosa. Another patient with ulcer diathesis had a gastric secretory pattern resembling Zollinger-Ellison syndrome. Serum gastrin and histamine levels were consistently normal in all patients. Endoscopy of stomach and colon disclosed urticaria-like papulae either spontaneously or after topical provocation in all patients. No increase of mast cells was found in multiple mucosal biopsies. A markedly increased gastric tissue content of histamine was found, however, in the three patients studied. The findings suggest that urticaria-like lesions associated with a high tissue content of histamine may be more important that hyperhistaminaemia in causing the various gastrointestinal symptoms.


Hepatitis-B surface antigen and cirrhosis in Iraq. Hepatitis-B surface antigen was found in 58% of 64 patients with cirrhosis in Iraq using counter immunoelectrophoresis (CIE), radioimmunoassay (RIA), and three commercial haemagglutination tests--Auscell (Abbott Laboratories), Hepatest (Wellcome Reagents Ltd.), and Hepanosticon (Organon Teknika). CIE detected about half as many positives as the other methods; RIA was the most sensitive. The number of positive reactions was much higher than in any previously reported series of patients with cirrhosis and seven times higher than in a normal hospital control population.


Hyperamylasaemia after duodenoscopy and retrograde cholangiopancreatography. The salivary and pancreatic isoamylases of serum were determined separately in 234 cases of duodenoscopy and retrograde cholangiopancreatography. Successful pancreatic opacification was associated with pathologically high pancreatic serum amylase activities in 60% of the cases. Extensive opacification was associated with large increases of pancreatic serum isoamylases, the maximal rise recorded was 40 times the initial value. In spite of these striking chemical events only two patients developed clinical acute pancreatitis. There were some variations in pancreatic opacification and in the elevation of pancreatic serum amylase which seemed to depend upon the particular contrast material used. A rise of the salivary serum isoamylases caused pathologically high total serum amylase activities in 7% of the cases. High levels of pancreatic serum isoamylase activity before the time of examination did not result in any different pattern of hyperamylasaemia.


Absorption of propranolol and practolol in Coeliac disease. Plasma concentrations of propranolol and practolol were measured in patients with coeliac disease and normal subjects. The mean plasma propranolol concentration in the coeliac patients was higher throughout the period of study, the differences being significant at one, six, and eight hours. The plasma concentration profile of practolol in the coeliacs followed a similar pattern but lagged behind that of the normal subjects. A possible reason for these differences is an alteration in the rate of drug diffusion across the atrophic mucosa of the upper jejunum in coeliac disease. Analysis of the results of the propranolol study suggests that an increase in the rate of absorption combined with saturation of first pass extraction may account for the increased plasma concentrations of unchanged propranolol found in coeliac disease. These abnormalities of drug absorption do not appear to be related to the duration of treatment with a gluten free diet.


Relationship of serum gastrin response to lower oesophageal sphincter pressure. The role of gastrin in controlling lower oesophageal sphincter pressure (LESP) has been examined by measurement of LESP and serum gastrin response to a test protein solution and a control solution in humans. Both solutions were associated with significant (P less than 0-005) rise in LESP, but serum gastrin rose significantly (P=0-05) only after the protein solution. The rise in serum gastrin after the protein solution preceded the rise in LESP by 30 minutes. These results suggest that the lower oesophageal sphincter response to feeding may be independent of protein and is unrelated to gastrin release.


Function of the anal sphincters in patients with intussusception of the rectum. Patients with intussusception of the rectum--six with anal incontinence and nine continent--were examined with respect to the function of the anal sphincters. Anal pressure was recorded continuously during rest, during maximal voluntary squeezing of the anal muscles, and during gradual expansion of the rectum by means of a balloon inserted into the rectal ampulla. The maximal anal pressure at rest, which is mainly due to activity of the internal anal sphincter, was lower (P less than 0-001) in the incontinent patients (31 mmHg +/- 5-6) than the continent (67 mmHg +/- 4-3) and the former had significantly smaller relaxations of the internal sphincter upon rectal distension (P less than 0-05). The increase in anal pressure during voluntary squeezing, a function of the external sphincter, did not differ significantly compared with healthy subjects in either incontinent or continent patients. On the basis of the above findings, it is concluded that the function of the internal sphincter is impaired in the incontinent patients.


Potassium status of patients with cirrhosis. Whole body potassium measurements were performed on 55 cirrhotic patients in different stages of the disease. They included 34 with alcoholic cirrhosis, 10 with cryptogenic cirrhosis, eight with chronic active hepatitis, and three with haemochromatosis. Serial measurements were carried out in 21 patients. The findings of this study indicate that: (1) the aetiology of the cirrhosis is important in determining the potassium status of cirrhotics, most alcoholics being depleted; (2) ascites and decompensation are usually associated with potassium depletion but compensated cirrhotics may also be depleted even when not receiving diuretics; (3) the initial potassium status, whether a cirrhotic be decompensated or not, is difficult to alter in the short term (six months). Marked changes in potassium status can occur in alcoholic patients studied over longer periods.


Influence of specific dietary sugars on the jejunal mechanisms for glucose, galactose, and alpha-methyl glucoside absorption: evidence for multiple sugar carriers. The effects of feeding glucose, galactose, and alpha-methyl glucoside on the kinetics of absorption of these sugars in the jejunum of the fasting rat were assessed by recently developed chemical and electrical methods for characterizing the electrogenic active transfer mechanisms in vivo. The parameters of 'apparent Km' (an index of carrier affinity) and Vmax (an index of the maximum jejunal transfer capacity) were obtained from the kinetic data to describe quantitatively the active transport mechanisms in rats fed their normal solid diet, in rats deprived of solid food for three days, and in rats deprived of solid food but allowed ad libitum access to isotonic solutions of glucose, galactose, or alpha-methyl glucoside for up to three days. Feeding the sugars to fasting rats produced complex differential effects on the 'apparent Km's' and Vmax's of the various transport mechanisms. The changes, although complex, can best be explained by alterations in the transport mechanisms per se rather than by non-specific changes in intestinal morphology or metabolism. The differential effects induced by the feeding sugars are further evidence for the concept that jejunal enterocytes possess multiple carriers or mechansims for the absorption of actively transported sugars in vivo. The multiple forms of the sugar carriers (isocarriers?) MAY BE INVOLVED IN THE FACULTATIVE RESPONSES OF THE ENTEROCYTES TO CHANGES IN THE DIETARY LEVELS OF SUGAR AND MAY BE IMPORTANT IN UNDERSTANDING THE INFLUENCES OF DISEASE AND NUTRITIONAL STATUS ON ABSORPTION PROCESSES IN MAN.


Haemangioma of median nerve causing carpal tunnel syndrome. A case report of an intraneural haemangioma which occurred in a nineteen year old girl, with an acute clinical course. Intraneural haemangioma is a rare condition, but may be another cause of carpal tunnel syndrome.


The contracting fibroblast as a clue to Dupuytren's contracture. Examination of fibrous tissue from various sites in the palm reveals the presence of myofibroblasts only in the nodules, underlining their primary role in the production of contracture.


Flexor synovectomy in the rheumatoid hand. A review of the types, signs and symptoms of synovitis of the flexor surface of the hand. Indications, contra-indications and the results of surgery are discussed.


Unusual congenital anomalies of the thumb extensors. Report of two cases. A case of rare hereditary anomaly of the extensor tendons of the thumb and a case of congenital duck-neck deformity of the thumb are reported.


Repair of the dorsal apparatus of the finger. This paper describes a simple method of assessing the constituent features of flexion deformities of the proximal interphalangeal joints in Hansen's disease, and a simple operation to correct the anterior displacement of the lateral band and the associated contractures.


Contracture of fingers due to fixation of the flexor profundus digitorum to the ulna. Two cases are reported where limitation of extension of one or more fingers resulted from fixation of the flexor profundus digitorum to the ring finger at the site of a fracture of the ulna.


A complication of distal interphalangeal joint arthrodesis. The authors report the appearance of a swan-neck deformity few months after arthrodesis of the distal interphalangeal joint. The pathomechanics, prevention and treatment of the established deformity are discussed.


Restoration of pinch grip in traumatic ulnar palsy. This paper reports tendon transfers carried out to restore the pinch grip in thirty-four patients with irreparable traumatic ulnar palsy. The advantages and disadvantages of the procedure are discussed. Performed for proper indications the results show improved function in most patients.


Post-traumatic neurodystrophy. Treatment by corticosteroids. This paper reports the results with corticosteroid therapy given to patients with neurodystrophy who failed to improve on other treatment, including intensive physiotherapy.


Bennett's fracture.

Bennett's fracture. A new method of conservative treatment of Bennett's fracture is presented, the thumb being immobilised in moderate adduction rather than radial abduction. Anatomical dissections are outlined to demonstrate the rationale of this procedure.


Subcutaneous emphysema in a finger following an injection injury. This is a case report of surgical emphysema in a finger resulting from a high velocity injection accident.


Observations on the use of silicone rubber spacers in tendon graft surgery. Lessons learned from the use of silicone rubber spacers for the preparation of tendon graft beds in sixty digits are reported.


Thorn-induced granulomata of bone.

Thorn-induced granulomata of bone. A case of thorn-induced granuloma of bone is presented and discussed in relation to the previous eight cases reported. The condition affects the exposed areas, usually the hands, of children. It may be as long as nine months from the initial episode of injury or inflammation to presentation as pseudo-tumour. The radiographic appearance are those of a chronic granuloma with longitudinal cavitation and adjacent perioseal reaction and as such can be differentiated from Ewing's sarcoma, osteoid osteoma, tuberculosis dactylitis, benign osteoblastoma, and stress fracture.


Digital flexor tendon irrigation.

Digital flexor tendon irrigation. A readily available standard intravenous cannular has proved to be a useful conduit for the irrigation of a digital flexor tendon.


The open palm and digit technique in the treatment of Dupuytren's contracture. The authors have used the open palm and digit technique for Dupuytren's contracture in fifty-four patients since May, 1973. The procedure consists in making transverse skin incisions on the palm and fingers leaving the wounds open after limited fasciectomy. The results have been surprisingly good due to the elimination of haematoma formation and finger oedema, and the excellent quality of the final scar.


Reconstruction of the mutilated hand.

Reconstruction of the mutilated hand. The experience gained from the reconstruction of sixty-seven severely mutilated hands is applied to the analysis of the procedures of choice in three groups of injury.


Percutaneous internal fixation of fractures of the proximal phalanges. A rational methods for management of the fractures of the proximal phalanges is presented. By this technique fracture healing and recovery of movement take place concurrently rather than consecutively thereby the morbidity is greatly reduced. It leads to early and complete rehabilitation of the patient in a short period.


Hand injuries due to soccer.

Hand injuries due to soccer. Fifty-two hand injuries due to soccer were seen in one season. Approximately one-third of these were in goalkeepers, due mainly to contact with the ball; two-third were in other members of the team, due to either contact with a player or the ground.


[Diagnosis of breast carcinoma with thermographic methods: tele-thermovision, plate thermography]. The diagnosis of carcinoma of the mamma with the aid of tele-thermovision and liquid-crystal-thermography A review is given on thermographic diagnosis of carcinomas of the mamma with the aid of tele-thermovision and liquid-crystal-thermography. 132 carcinoma cases were microscopically examined with cytomorphological criteria. The microscopic and thermographic results were compared. The thermographic diagnosis "suspicious" is dependent on the diameter of the tumour, the vascularisation, the essential cytomorphological criteria as mitosis, prominence and size of nucleoli as well as deviation of the nucleous/plasma ratio. There was no dependence on the distance of the tumour from the surface of the breast and even on the perifocal infiltration with lymphoid cells. The accuracy rate in diagnosis with liquid-crystal-thermography is about 74%; false negative and false positive results both are about 9%. The accuracy rate for tele-thermovision is about 10% lower. The detection rate of carcinoma stage T1 ranges around 50%.


[Frequency of local recidivism in breast carcinoma]. Frequency of local recidivation in carcinoma of the female breast represents a good parameter for the success of primary surgical treatment. A comparative study on nonselected patients of the Chir. Univ.-Klinik Tübingen showed, that local relapse of breast cancer did not increase after a conservative surgery due to different stages of carcinoma if: 1. the safety distance to the tumor was sufficient, 2. postoperative irradiation had been applied in megavolt technique. According to our results and regarding the 10-year-survival rate as well as the rate of local recidivation it does not seem imperative any longer to see a rigid indication for radical mastectomy.


[Cytological diagnosis of endometrial carcinoma]. Because of increase of endometrial carcinoma the frequency rate of invasive cervix carcinoma and carcinoma of uterine corpus has been changing in the last ten years and at several places in the world it is approaching 1:1. That shows the importance of early detection of endometrial carcinoma. A summary of cytology diagnostic of normal and pathological endometrium is given. Especially it is pointed to the great difference between the cytomorphical cell criteria of endometrial malignancies dependent on the differentiation grade of endometrial carcinoma. The predominance of cell atypia is found by the undifferentiated carcinoma of uterine corpus whereas the cells of frequently found well differentiated endometrial carcinoma often cannot be differentiated from normal endometrium cells. The observation of cells of endometrial carcinoma in normal cellular samples of cervix and vagina is no more than 60--70 percent; at this rate the endocervical aspiration has the greatest chance of detection. To correct the early cellular diagnosis of uterine carcinoma the appearance of normal endometrium cells by screening must be noticed and each finding at an untypical moment, for example in postmenopause, must be an alarm signal. The different intrauterine aspiration techniques obtained more than 90 percent accuracy in the detection of endometrial carcinoma. This method is qualified for special indications in a limited number of cases.


[Leptothrix vaginalis. Morphological studies]. 73 patients with a microscopically confirmed Leptothrix vaginalis-infection were examined clinically and cytologically. 80% of the cases showed Leptothrix alone or together wihh lactobacilli or cocci. 18% had trichomonas- and 2% candida-infections. 26 cases (34%) showed inflammation of the vagina. The majority of infection was found in the age group 26 to 45 years. A microscopical examination of the Leptothrix-filaments revealed a subtile segmentation and sporulation.


[Mental and neurological disorders associated with heart operations. Pre- and postoperative studies]. Long before the era of heart surgery began, "cardiac psychoses" were known and described. They do not differ at all from postoperative psychoses after heart-surgery. On the other hand heart-surgery carries a far higher incidence of psychiatric complications than general surgery (general surgery 0,1--1,0%; heart surgery 10--60%). There is no reason to believe that the intensive care unit plays a decisive role in the origin of postoperative cardiac psychoses. Among 150 patients there were 60=40%, who did not show any psychiatric symptoms after surgery. These were exposed to the same environment of the intensive care unit as were the patients who developped symptoms. There were however correlations of statistical significance between "cardiac psychoses" and 1. an occurrence of endogenous psychoses in the family with first degree relatives or in the life history of the patient himself, 2 higher grade of severity of heart disease, 3. extra corporal circulation, 4. higher age, 5. male sex. Postoperative cardiac psychoses are mainly of the type of exogenous psychoses (akuter exogener Reaktionstyp Bonhoeffer). There is no doubt that psychological, reactive and environmental factors do play a certain role too. This is shown by the character of delusions and hallucinations which frequently reflect the postoperative situation. Persecutory delusions with the fear of being killed and ideas and fears of severe body mutilation are the most common motives. Similar motives are frequently observed in postoperative dreams. The manifestations of mental disease in the family or personal history of the patient is considered a significant presupposition of developing a cardiac psychosis of the type of endogenous depression, acute delirium or with schizophrenia like delusions.


[Anterior cervical intervertebral disk operation without secondary fusion. Clinical and experimental studies]. The problems of the spontaneous fusion after cervical discectomy were studied in 12 patients. An examination after the operation showed an improvement of the neurological-radicular symptoms, but 75% of the patients complained about severe pains in the area of neck and shoulders. The cause of these complaints was found by radiological examination to be an angular kyphosis of the cervical spine combined with the subluxation of the intervertebral joints in the operated segment. The mechanical results of the ventral fusion without using interponates are being experimentally reproduced and evaluated. By comparing both methods, the method using interponates showed better results. Therefore, the discectomy with fusion using interponates should be preferred.


[Preventive psychotherapy for prevention of stealing]. In order to prevent patients from stealing, two categories of delinquents are to be taken into consideration: Those who suffer from somatic diseases and psychoses, e.g. prophyria, hypoglycemia, hebephrenia, schizophrenia, depression, mania or epileptic semiconscious states must be treated according to the basic sickness and by means of a supporting psychotherapy. In court exculpation should be recommended. Other people who fell the urge to steal are psychosocially disturbed. This may begin with lying, bad results at school and during professional or university training, and sometimes with running away from home. As soon as the family doctor observes these or similar phenomena, he should inform the parents, in order to start a preventive therapy of the family together with the prospective thief.


[Hypoglycemia. Part 4. General causes, physiological newborn hyperglycemia, hyperglycemia in various illnesses, metabolic deficiency, and metabolic error]. The possible causes for hypoglycemia are discussed in relation to the biochemical and metabolic basis of blood glucose regulation. The functional tests which are important for purposes of differential diagnosis are described in detail. Most cases of clinically important hypoglycemia are based on disfunctions of the regulatory endocrinological mechanisms necessary for prevention of hypoglycemia in the fasting state. The consequence, therefore, is a "starvation hypoglycemia". Ketosis during hypoglycemia is evaluated as a kind of "glucose-sparing-mechanism". It is observed in all cases, where the nutritional glucose supply is not sufficient. The common therapy in typical cases of starvation hypoglycemia is a carbohydrate rich and protein rich nutrition. Additionally, small and frequent meals are required for avoidance of starvation hypoglycemia. Whereas starvation hypoglycemia is frequently seen, so called reactive hypoglycemia is very rare. The following metabolic disorders lead to reactive hypoglycemia: leucinsensitive hypoglycemia, fructose intolerance, galactose intolerance, fructose-1,6-diphosphatase deficiency. Considering these cases special tolerance tests are required. With the usual routine test methods only leucin-sensitive hypoglycemia is diagnosed.


[Therapy of ulcus ventriculi with Caved-S. Use of the gastrocamera for diagnosis and control of therapy]. 36 patients with a ventricular ulcer demonstrated by endoscopy and secured by histology, were given 2 tablets Caved-S 4 times a day for 4 weeks. Clinical parameters were subjective complaints, such as pain and heartburn, which after a relatively short time, many patients declared to have diminished or ceased completely. Objective parameters were endoscopic explorations before beginning of the treatment, i.e. gastroscopy and biopsy, examinations by gastro-camera and in some cases chromography to exclude a possible malignancy. The control examinations were performed almost exclusively by gastro-camera, and that after 2 and 4 weeks. The ulcer healing stage could be clearly defined after Ohmori and Miwa (1971), its localisation and size were also recorded. Altogether it can be said, that the preparation Caved-S, by a working-principle not as yet exactly defined in all details, effects rapid healing endoscopically provable, but that ulcers with a special localisation, e.g. in the angulus-area of the posterior wall, require a longer healing time according to expectation. Clinically relevant side effects were not observed. Thus it can be concluded that Caved-S is very suitable for the treatment of ventricular ulcers. The preparation has a spasmolytical component leading quickly to freedom from pain, and a protective component effecting a healing tendency which can be demonstrated by endoscopic methods. It must be said, however, that this protective healing-promoter factor has not yet been defined pharmacologically.


Effects of insulin-free plasma on the charcoal-separation method for radioimmunoassay of insulin. Radioimmunoassay of insulin in rat plasma using a popular method (Albano, Ekins, Maritz and Turner 1972) involving charcoal-separation of free and antibody-bound insulin was found to be unsatisfactory despite inclusion in standard tubes of insulin-free plasma prepared in either of two ways. Insulin-free plasma and untreated plasma had different effects on adsorption of free insulin to the charcoal. It was concluded that separation with charcoal is very sensitive to any prior treatment of the plasma. Particular care must be taken to ensure that hormone-free plasma is identical in all other respects to untreated plasma.


Effect of metergoline, a specific serotonin antagonist, on human growth hormone response to arginine and L-dopa. In seven normal subjects the repeated oral administration of metergoline, a specific antiserotonin agent, has enhanced HGH response to arginine infusion. Following placebo administration, arginine-induced HGH release was slightly but not significantly reduced; similarly, in eight metergoline treated subjects, HGH response to oral L-Dopa was slightly but not significantly reduced. HGH response to i.v. L-Dopa was not modified by the drug. These results suggest that serotonin controls HGH response only in response to arginine, not to L-Dopa.


Influences of stress, age and sex on serum growth hormone and free fatty acid levels in cattle. The serum growth hormone (BGH) and free fatty acid (FFA) concentrations of large groups of calves (male and female ranging in age from 8 to 14 days and from 3 to 6 months old), bulls, oxen, heifers and cows under normal conditions were compared with the serum BGH and FFA values of corresponding large groups of animals under stress conditions. Stress was caused by transport, as it routinely occurs, and was further reinforced by a stay of several hours in unfamiliar surroundings. Stress provokes a significant increase in serum FFA in all groups and induced a significant decrease in serum BGH in all groups, with the exception of the non-pregnant heifers. The male and female calves which were 8 to 14 days old, had significantly higher BGH levels than the older animals. The female calves from 3 to 6 months of age, and the heifers had significantly lower BGH levels than the cows. The males had higher serum BGH values than the females, but a significant difference could be demonstrated only between the male and female calves of both age-groups. The oxen, which were 1 to 3 years old, had significantly higher BGH levels than the non-pregnant heifers of the same age. It appeared that gestation had no influence on the serum BGH and FFA levels of both heifers and cows.


Effect of food deprivation and hypophysectomy on in vitro protein synthesis by membrain-bound and free hepatic ribosomes. The protein synthetic activities of membrane-bound and free hepatic ribosomes isolated from intact rats fed ad libitum, and normal rats subjected to food restriction to match that of hypophysectomised (Hx) rats were compared to the in vitro protein synthetic capacity of hepatic ribosomes isolated from Hx rats. Hypophysectomy resulted in decreased protein synthetic ability of bound ribosomes, whether protein synthesis was directed by endogenous messenger RNA (mRNA) (p less than 0.05) or by polyuridylic acid (polyU) (p less than 0.01). In contrast, the protein synthetic activity of free hepatic ribosomes from Hx rats was reduced when protein synthesis was directed by endogenous mRNA (p less than 0.05) but, when polyU was substituted as the messenger, the protein synthetic activity of these free ribosomes was equal to that of control rats. On the other hand the effects of food restriction on hepatic ribosomal function could be clearly differentiated from the effects observed following hypophysectomy. Thus, the reduced protein synthetic activity of hepatic bound ribosomes isolated from food restricted normal rats was not demonstrable, when polyU was used to direct protein synthesis. Further, food restriction had no effect on the protein synthetic activity of free hepatic ribosomes, and this was true when protein synthesis was directed by either endogenous or artificial messenger. It is concluded that hypophysectomy reduces the protein synthetic ability of both bound and free hepatic ribosomes, and this change of ribosomal function of Hx rats cannot be attributed to their decreased food intake.


Control by TSH of protein turnover in thyroid subcellular fractions. The action of TSH on protein turnover in various subcellular fractions has been investigated in dog thyroid slices incubated in vitro. The results suggest a general inhibition by TSH of protein catabolism. Using double labeline (3/ and 14C) of the proteins, an increase of the disappearance of some labeled material from the microsomal fraction in the presence of TSH has been observed. The protein nature of this material has been established by testing its susceptibility to hydrolysis by trypsin. The fact that the microsomal pellet had to be treated by triton X 100 before hydrolysis by trypsin could occur, suggests that the material is probably enclosed in, or protected by membrane vesicles. Its high molecular weight and its ability to be immunoprecipitated by an antithyroglobulin serum suggest that the microsomal protein, the disappearance of which is stimulated by TSH, is thyroglobulin or one of its subunits. It is suggested that our results reflect the acceleration by TSH of the vectorial transfer of thyroglobulin through the membranes of the endoplasmic reticulum to the colloid space.


Effect of glucose on adrenocortical activity of newborn piglets. Adrenocortical function was followed in newborn piglets fasted for 36 hours and in piglets given only glucose or glucoplastic amino acids during this period. The greatest increase in relative adrenal weight, blood plasma 17-hydroxycorticosteroid (17-OHCS) levels and in the production of 17-OHCS by pig adrenals in vitro as compared with suckled controls was found in fasted piglets followed by amino acid-treated animals. The latter showed no significant differences in blood glucose between the initial and final values. The administration of glucose produced a transient hyperglycemia, failed to prevent the inhibition of body growth, resulted in a reduction in liver weight similar to that seen in fasted animals, and had a marked suppressive effect on the elevation of adrenocortical function. There were no significant differences in the production of 17-OHCS by adrenals in vitro per kg body weight between the glucose-treated and suckled piglets.


A seven-year evaluation of a career-escalation training program for indigenous nonprofessionals. A community mental health center in an urban ghetto offers a career-escalation program in which indigenous nonprofessional mental health workers can earn a master's degree in the behavioral sciences. The program allows them paid time off for classes and study and also pays for their tuition and course materials. An evaluation of the first seven years of the program showed that only 56 of the 91 staff members who were eligible for the program entered it, and 23 subsequently dropped out. Only three trainees earned a master's degree, although 24 were pursuing or had received an associate-in-arts degree. The author briefly discusses changes that could make the program more effective, but he believes a community mental health center is not the best setting for a career-escalation program.


The impact of the community mental health movement on psychiatric practice and training. The three basic concepts of community mental health will have profound impact on many aspects of traditional psychiatric theory and practice, the author believes, and must be taken into account in psychiatric residency programs. The catchment-area concept means that psychiatrists are obligated to provide help for far larger numbers of people, including those who have problems and attitudes psychiatrists are not accustomed to dealing with. Psychiatrists must also work in partnership with communities that demand a voice in defining and labeling problems and specifying treatment modalities. The concept of promoting health as well as treating illness means that psychiatry becomes involved with broader concerns about improving the quality of life. The third concept, that behavior has family, community, social-class, and other sociocultural determinants, has already affected psychiatric practice and education, but it continues to generate friction.


Retraining hospital staff for work in community programs in California. In 1972 the California Department of Mental Hygiene offered special courses to retrain for community work those state hospital employees who might lose their jobs when the hospitals were closed. The courses were conducted by the Centers for Training in Community Psychiatry. The author describes the development, implementation, and structure of the Los Angeles course. He also presents findings that show that while participants considered the course valuable, most opted to return to the state hospital instead of taking jobs they had been offered at community mental health centers. Participants who did take community jobs tended to be slightly younger and better educated and had fewer years of experience in state hospital service than did those who returned to the hospital.


A comparative study of neurotics seen in a community mental health center and in private practice. Differences that emerge in comparisons of persons applying for psychiatric care at a mental health center with those applying to the private sector are comfounded by marked diagnostic differences beyond obvious social class differences. To circumvent that problem and to ascertain what differences, if any, persist after diagnosis is held constant, the authors examined demographic and psychosocial characteristics of neurotics in a one-year adult applicant population, the only major diagnostic group treated in large numbers and similar proportions by the center and the private sector. Findings showed that significantly more neurotic applicants in the private sector are medical referrals, are members of intact nuclear families, and do not have previous inpatient experience.


Laboratory diagnosis of fungal infections. Most hospitals do not perform mycologic examinations because laboratory personnel still believe in the "old wives' tale" that mycology is too difficult to do and that the fungi are too infectious to handle. This discussion presents methods suitable for use in laboratories of all sizes. It is hoped that laboratories will take the initiative in offering diagnostic mycology services routinely. Medical mycology can be both a challenge and a rewarding experience to those who choose to become involved.


The gram positive cocci.

The gram positive cocci. Recent changes in taxonomy of the gram positive cocci are discussed. Views on these changes and practical methods of differentiating the staphylococci, micrococci, streptococci, and aerococci are presented. Simplified schemes, using acceptable clinical laboratory techniques, are presented that either differentiate or categorize the pathologically important gram positive coccal species.


The lung in cystic fibrosis. A quantitative study including prevalence of pathologic findings among different age groups. The autopsies of 82 patients with cystic fibrosis were reviewed with respect to pathologic changes in the lungs and their respective prevalence among different age groups. Although bronchitis, mucopurulent plugging, and bronchopneumonia were almost universally present among children of all ages, epithelial metaplasia and bronchiectasis were rarer among infants and progressively more prevalent in older age groups. Emphysema was absent in patients under two years of age and affected 11 per cent of the patients two to six years of age and 40 per cent of the patients older than six years, but was never of a severe degree by the point count method. Pulmonary hemorrhage, although uncommon, was usually associated with prominent arterial vessels in walls of bronchiectatic airways. Quantitative assessment of bronchial glands revealed Reid indices significantly higher in patients with cystic fibrosis when compared to noncystic fibrosis patients, but there was no increase in these indices with the age of the patients. Glandular hypertrophy, predominance of mucous acini within glands, and goblet cell hyperplasia of the bronchial mucosa all suggest an explanation for the copious mucous secretion of patients with cystic fibrosis. However, it was not possible to ascertain whether these findings reflect a general exocrine defect of such patients or whether they were merely a response to chronic airway infection, even though the latter is a more plausible assumption.


Particulate environmental matter as seen in lung sections. A study of particulate environmental matter as seen in lung sections is presented. These particles are blackened and are comparable to particles seen in industrial-urban environments. From the study of histologic sections an attempt is made to determine the tissue reaction to them and their ultimate fate.


Meibomian gland carcinoma: report of a case with electron microscopic findings. Meibomian gland carcinomas compose about 1 per cent of the malignant tumors of the eyelids. They present in a characteristic fashion and are frequently mistaken for chalazia. Considerable time often elapses before a diagnosis is made. Early recognition and treatment are important because these tumors can behave in an aggressive manner. The following case report illustrates these features.


Isolated coccidioidomycosis of the uterus. Coccidioidomycosis rarely involves the female genital tract. This report describes a case of coccidioidomycosis that was incidentally discovered involving the uterus of an asymptomatic 70 year old woman who had squamous carcinoma of the cervix. Reports of the few previously documented examples of coccidioidomycosis of the female genitalia are reviewed. Although the uterine lesion probably resulted from a solitary focus of dissemination from a clinically inapparent and completely resolved primary pulmonary infection, evidence is presented that it may have been a primary uterine infection.


Further delineation of the clinical picture of trisomy for the distal segment of chromosome 13: report of three cases. Three cases of partial trisomy for the distal segment of chromosome 13 are reported. Common clinical features included normal birth weight, postnatal asphyxia, convulsions, severe psychomotor retardation, normal growth, and a distinct pattern of dysmorphias consisting of trigonocephalic head with prominent metopic suture, long and markedly curved eyelashes, a stubby nose, increased distance between nose and upper lip, high-arched palate, misshapen ears with virtually absent lobules and prominent anthelices which are curved in a sharp angle, and hemangiomata. Features present in 2 cases were microcephaly, long and narrow fingers with convex nails, and hexadactyly. Two cousins were unbalanced offspring of a large family of carriers of a 9/13 translocation, whereas the third case exhibited a 13p+ chromosome which was formed de novo. The clinical features in the 3 patients are typical of the syndrome due to partial trisomy for the distal segment of chromosome 13 which shows selected and mitigated signs of full trisomy 13.


Partial trisomy 2q and familial translocation t(2;12)(q31;q24). Report is given of a boy with trisomy of the distal part of the long arm of chromosome 2 (q31 leads to ter) due to a balanced 2/12 translocation in the mother: 46,XX,t(2;12) (q31;q24). Other phenotypically normal carriers of this balanced translocation are the patients sister and grandfather. The patient shows a variety of dysplastic signs mainly of the face.


Association of Duffy blood groups with the sickle cell trait. Among a small group of Saudi Arabs the Duffy blood group (Fy(a-b-)) was found to be associated with the sickle cell trait more often than could be explained by random gene combination thus supporting the concept that African gene flow brought the sickle cell trait to the Arabian peninsula. Based on recent observations concerning the possible role of Fy(a-b-) as a resistance factor against vivax malaria, it is proposed that the gene combination AS FyFy is likely to be selected in areas where falciparum and vivax infections are endemic and mixed infections occur frequently.


Epidermolysis bullosa dystrophica dominans (Pasini)-a primary structural defect of the anchoring fibrils. In epidermolysis bullosa dystrophica dominans Pasini a structural defect of the anchoring fibrils, a structural protein of the epidermo-dermal junction, has been demonstrated by electron microscopy to be constantly present not only in involved skin but also in intact skin of nonpredilection sites of blister formation. These findings render support to the concept that in dominant disorders an abnormality in a non-enzymic structural protein is more likely than in an enzymic protein.


[Antisocial behaviour and variations in length of Y chromosome (author's transl)]. The length of they chromosome has been measured for 50 male criminals in a psychiatric security hospital and for 50 non criminal control men. The distribution was normal for the 2 populations and there was no significant difference between the mean Y/F, Yf/Y values and the number of brightly fluorescent segments. For criminal psychopaths, there was no close correlation between the size of the Y chromosome and the psychiatric or criminal background.


Esterase D polymorphism: description of the "new" allele EsD4. Two "new" phenotypes of the esterase D system, named EsD 4-1 and EsD 4-2, were observed in a father and his daughter, respectively. An additional allele EsD4 is postulated.


A note on suxamethonium sensitivity and serum cholinesterase variants. Sera from 21 cases of prolonged apnoea which showed normal phenotype (UU) on the basis of dibucaine and fluoride inhibition were re-examined by replacing the substrate benzoylcholine with succinylcholine (suxamethonium). 9 samples had normal enzyme activity but low dibucaine number (DN = less than 20) indicating the atypical variant; 6 sera showed no detectable enzyme activity. The remaining 6 samples had enzyme activity and DN comparable with healthy controls. The occurence of new variants of serum cholinesterase sensitive only to succinylcholine is suggested.


Short arm deletion of an X chromosome, 46,XXp-. A 27-year-old patient of short stature with primary amenorrhea and other slight Turner signs showed a 46,XX,del(X) (qter leads to p11:) karyotype, identified by a combination of fluorescence and giemsa-banding technique. By BUdR incorporation the deleted X chromosome was shown to be the late replicating one.


Human colonic adenocarcinoma cells. I. Establishment and description of a new line. A series of human colonic epithelial cell lines have been cultured from a single patient: LS-180 the original adenocarcinoma, LS-174T a trypsinized variant, and normal colonic tissue. The malignant cells, 20 to 40, mum in diameter and oval to polygonal, exhibited characteristics of normal colonic mucosal cells, namely, abundant microvilli prominent in secretory cells, and the presence of intracytoplasmic mucin vacuoles. The cultured adenocarcinoma cells, but not normal, demonstrated neoplastic properties by producing high levels of carcinoembryonic antigen (CEA) and by the ability to be propagated in hamster cheek pouches and in immunodeprived mice. The CEA production by the newly established line LS-180 released 900 times more CEA per cell into the culture medium and bore 30 times more cell-associated material than the established line, HT-29. These cell lines may permit detection of distinctive chemical, physiological, pharmacologic, and immunologic characteristics of neoplastic colonic cells.


Selection and characterization of Chinese hamster ovary cells resistant to the cytotoxicity of lectins. Chinese hamster ovary (CHO) cells selected in a single step for resistance to the cytotoxicity of the lectin from red kidney beans (PHA) behave as authentic somatic cell mutants. The PHA-resistant (Phar) phenotype is stable in the absence of selection; its frequency in a sensitive-population is increased several-fold by mutagenesis; and it behaves recessively in somatic cell hybrids. The activity of a specific glycosyl transferase which transfers N-acetylglucosamine (GlcNAc) to terminal alpha-mannose residues is dramatically reduced (less than or equal to 5% of the activity detected in wild-type CHO cells) in several independent PhaR clones. These clones also exhibit (a) a decreased ability to bind [125I]-PHA; (b) a marked resistance to the cytotoxicity of wheat germ agglutinin (WGA), Ricin (RIC) and Lens culinaris agglutinin (LCA); (c) a 4- to 5-fold increased sensitivity to the cytoxocity of concanavalin A (Con A); (d) an increased ability to bind 125I-Con A; and (e) decreased surface galactose residues - all properties consistent with the specific loss of the GlcNAc transferase activity. The lectins WGA, RIC, LCA and Con A have also been used to select, in a single step, resistance closes from each of two complementary CHO auxitrophic lines. These lectin-resistant clones have been characterized by their ability to survive cytotoxic doses of PHA, Con A, WGA, RIC, or LCA, and 4-5 "lectin-resistance" phenotypes have been demonstrated. Complementation data is being sought by somatic cell hybridization. Preliminary results show that two phenotypically-distinct Con AR mutants are complementary in that hybrid cells formed between them exhibit wild-type sensitivity to Con A.


Hormonal mechanisms for differentiation in plant tissue culture. Cells possess extraordinary powers to organize their molecular processes not only to maintain a cell in a given steady state but also to recognize that state during differentiation. Regulation of these organizational forces appears to be under the control of chemical factors, and a hormonal concept of regulation has evolved. Hormones have been considered to act by reacting with a specific target site. This may be part of their mode of action, 0ut i would like to suggest that a hormone enters and becomes part of a total molecular resonance system. In so doing, the entire molecular system of the cell is modified.


Hormonal control of growth and differentiation of insect tissues cultured in vitro. This paper reviews the effects of insect hormones on lepidopteran imaginal discs cultured in vitro. Beta-ecdysone showed that RNA and protein synthesis was required for evagination and cuticle deposition. In particular, studies with actinomycin D and cycloheximide (at nontoxic levels) showed that RNA and protein synthesis during the ecdysone-dependent period was essential for subsequent development. These findings support the hypothesis that stimulation of macromolecular synthesis is fundamental to the action of ecdysone on imaginal discs. The influence of beta-ecdysone on chitin synthesis was also examined. Beta-ecdysone stimulated uptake and incorporation of tritiated-glucosamine by cultured P.interpunctella wing discs. Addition of hexosamines to the culture medium had no influence on ecdysone-induced cuticle deposition, but inhibition of glucose-uptake by cytochalasin B prevented the formation of cuticle.  The action of ecdysone on particular enzymes in the chitin pathway remains to be elucidated.timulated both evatination and cuticle deposition of wing discs of Plodia interpunctella(Hubner). However, evagination required a shorter exposure to ecdysone than did cuticle deposition. Cuticle deposition was obtained under the following conditions: (a) a 24-hour pulse of beta-ecdysone (0.5-5.0 mug/ml); (b) continuous treatment with 0.2 mug/ml beta-ecdysone; or (c) continuous treatment with 0.5 to 50.0 mug/ml beta-ecdysone in medium conditioned with larval fat body...


Device for holding a variety of tissue culture vessels during microscopy. A device for holding tissue culture tubes, plates and flasks has been designed for use in microscopy of cell cultures, which eliminates changing holders when using varied types or sizes of vessel.


Automatic gas tank switching system for CO2 incubators. The use and construction of an automatic gas tank switching system are described. This device monitors the gas pressure in a CO2 incubator gas system and automatically switches to a reserve tank when the main supply tank is depleted. The unit contains an alarm system that signals either loss of power or gas pressure in the supply system.


Complement activation by interaction of polyanions and polycations. Interactions between heparin and protamine in normal human serum previously were found to activate the primary complement pathway and deplete the early-acting complement components. In the present investigation, the role of heparin-protamine complexes, immunoglobulins, C1q and C1-INH in this interaction was studied. Heparin and protamine, like antibody and antigen, were found to combine in multiple proportions; those proportions which resulted in optimal precipitation also induced maximal C consumption. Complexes formed in serum contained C1q and IgG, but the amount of C1q was insufficient to account for the total depletion of C1 haemolytic activity, and immunoglobulins were not required for  activation of complement to occur: maximal consumption was observed in immunoabsorbed hypogammaglobulinaemic sera in which IgG, IgM and IgA were undetectable (less than 5, less than 10 and less than 7 mug/ml, respectively). Purified C1q aggregated heparin-protamine complexes formed or forming in the presence or absence of serum. The ability to induce maximal C consumption was rapidly lost as heparin and protamine interacted, and complexes preformed either in serum or buffer, or supernates thereof, were relatively ineffective in complement consumption. Thus, the consumption of complement seems to occur via transient reactivity with C1,probably at the level of C1q.  It seems to be limited by the ability of free heparin to potentiate the activity of C1-INH, and perhaps also by its direct effect upon the early acting C components. These experiments support the concept that complement activation by interactions between polyelectrolytes such as heparin and protamine, like interactions between the antibodies and antigens, may have a role in the initiation of inflammatory reactions by direct activation of the complement system.


The mediation of tissue eosinophilia in hypersensitivity reaction. I. Isolation of two different chemotactic factors from DNP-Ascaris extract-induced skin lesion in guinea-pig. In an active cutaneous anaphylaxis induced by DNP-ascaris extract in guinea-pig, tissue eosinophilia manifested two phases; the early and mild phase became maximal in about 6 h, while the delayed and intense phase in 18-24 h. Skin extracts from the lesions exhibited chemotactic activities for eosinophils, respectively comparable to the intensity of tissue eosinophilia in each phase; and two different chemotactic factors for eosinophils of skin extracts were separated by gel filtration on Sephadex G-100. The mediation of the early phase seemed to be associated with a thermostable factor with amolefular weight of less than 1400; this factor seemed to be related to mast cell degranulation. The mediation of  the delayed phase appeared to be associated with a thermolabile factor with a molecular weight of about 70,000, probably independent of mast cell degranulation; the factor was considered to be more significant than the thermostable factor, because the delayed tissue eosinophilia was more intense than the early tissue eosinophilia.


The passive  transfer of humoral immunity from sows infected with Hyostrongylus rubidus (Hassal and Stiles, 1892), the red stomach worm, to their offspring and its significance in the conferring of protective immunity. Sows repeatedly infected with large single doses of third stage infective Hyostrongylus rubidus larvae show an anamnestic circulating agglutinin response to the parasite as detected by the passive haemagglutination reaction. At farrowing the circulating antibody level dropped, whereas the colostral agglutinating antibody level increased for a period of a few hours. The predominant class of immunoglobulin which had agglutinating activity against H. rubidus was IgG. Offspring which had suckled the infected mothers had a demonstrable agglutinin titre 4 days after birth, whereas offspring which suckled non-infected mothers had no demonstable agglutinins. On infection of the offspring, those which suckled infected mothers showed a more rapid and pronounced increase and duration of circulating agglutinins than those which had suckled noninfected mothers. The parasitic burden, as determined by the duration of egg laying and total egg output, was considerably lower for the group reared on the infected mothers. These experiments show that passively transferred agglutinating antibodies, mainly of the IgG class, were associated with protection.


Recongnition by guinea-pig peritoneal exudate cells of conformationally different states of the collagen molecule. Guinea-pig peritoneal exudate cells were tested in vitro in the presence or absence of specific antiserum to native collagen for their capacity to discriminate between native and denatured collagens of various species. Adherent exudate cells bound denatured collagens, regardless of the origin of the collagen or the presence of serum. The binding was reduced if the cells were pretreated with trypsin. Recovery of binding was mediated by a normal serum component resembling an IgM antibody to denatured collagen. In the presence of normal serum, native collagen was only marginally bound, apparently in a non-specific manner. Uptake of native heterologous collagens was greatly increased in the presence of specific antiserum to native collagen with specificity of binding reflecting the type of collagen. Binding of denatured and native collagen occur via independent mechanisms.


In vitro uptake and digestion of immune complexes containing guinea-pig IgG1 and IgG2 antibodies by macrophages. The uptake and digestion of immune complexes by peritoneal macrophages from oil-stimulated guinea-pigs were studied using 125I-labelled guinea-pig IgG1 and IgG2 antibodies to hen ovalbumin. When the IgG1 or IgG2 antibody was incubated with homologous antigen at antigen-antibody ratios ranging from 0-01 to 10, the complexes produced were preferentially taken up by macrophages in the absence of complement and digestion by intracellular enzymes. The uptake and digestion of complexes reached a maximum at an antigen-antibody ratio of 0-1-0-5. In this respect, the IgG1 antibody was indistinguishable from the IgG2 antibody having a cytophilic activity. These observations suggest that some conformational changes in both the IgG1 and IgG2 antibodies or specific molecular arrangement in the lattice work of both the complexes may increase the strength of binding of complexes to macrophages, independently of the difference in biological activities between these two antibodies.


Properties of a mutant of Streptococcus mutans altered in glucosyltransferase activity. A mutant of Streptococcus mutans GS-5 has been isolated as a smooth colonial variant on mitis salivarius agar. This mutant, designated SNG-1, adheres to glass surfaces as well as the parental organism when grown in the presence of sucrose. However, in contrast to the parental organism, glucose-grown cultures of the mutant did not adhere to smooth surfaces when incubated with sucrose under nongrowing conditions. The inability of the mutant organism to adhere to glass surfaces under the latter condition was a result to markedly reduced levels of mutant cell-associated glucosyltransferase activity. In addition, the extracellular activity of the mutant was also severely depressed relative to the parental activity. The reduced levels of mutant enzyme activity appear to be a result of a mutation in a structural gene coding for glucosyltransferase activity since (i) mutant glucosyltransferase activity is much less resistant to heat inactivation compared to the parental enzymes and (ii) the migration patterns of the mutant and parental enzymes differ on polyacrylamide gels and after isoelectric focusing on polyacrylamide gels. However, the kinetic properties of the mutant enzymes are similar to those of the comparable parental activities in terms of pH and temperature optima and Km values for sucrose. The mutant enzyme responsible for soluble glucan synthesis has been purified approximately 300-fold. These results are discussed in terms of the mechanism of glucan synthesis by S. mutans.


Streptococcus mutans dextransucrase: mode of interaction with high-molecular-weight dextran and role in cellular aggregation. The interaction between Streptococcus mutans dextransucrase (EC 2.4.1.5) and high-molecular-weight dextran was studied in both the presence and absence of substrate sucrose. Equivalent weight-percent solutions of primer dextrans that differed 200-fold in molecular weight were found to be equally efficient in priming new dextran synthesis. Sodium borohydride reduction of dextran had no effect on its priming ability. These results suggest that dextran synthesis proceeds by addition of glucosyl residues to nonreducing termini of primer dextrans and that several enzyme molecules simultaneously bind to single high-molecular-weight dextran molecules. Kinetic data suggested that dextransucrase contains only one dextran binding site per enzyme molecule. The nature of the commonly observed highly aggregated state of dextransucrase was also studied. Two types of enzyme aggregates were distinguished: (i) oligomeric enzyme aggregates that formed in the absence of dextran and were dissociated by 1 M KCl; and (ii) dextran-induced enzyme aggregates that were stable to 3 M salt. Oligomeric enzyme aggregates were obtained from supernatants of fructose-grown cultures, whereas dextran-induced enzyme aggregates appeared to be present in glucose-grown cultures. The molecular weight of the smallest species of dextran-free detransucrase observed in solutions of 1 M KCl was estimated to be 40,000 by gel column chromatography. Addition of dextran to primer-dependent dextransucrase resulted in formation of complexes that were stable in CsCl density gradients and exhibited a buoyant density of 1.382 g/cm3 as compared with a buoyant density of 1.302 g/cm3 exhibited by dextransucrase. The enzyme-dextran complexes observed in CsCl density gradients contained about 25% dextran. This corresponded to 150 enzyme molecules (molecular weight, 40,000) per dextran molecule (molecular weight, 2 X 10(6)). The implication of these results to the mechanism of sucrose- and dextran-induced aggregation of S. mutans is discussed.


Comparison of subcutaneous and intraperitoneal staphylococcal infections in normal and complement-deficient mice. From a comparison of the effects produced by injecting different strains of Staphylococcus aureus either subcutaneously or intraperitoneally into normal, complement-deficient, or complement-depleted mice, it was possible to assess the pathogenic significance of various staphylococcal virulence factors and the defensive role of complement components in the two sites of infection. In skin lesions the inflammation-suppressing factor found in the cell walls of strain PS80 played a major role. In contrast, in intraperitoneal infection the antiphagocytic capsule of the Smith diffuse and M strains was more important. All strains used produced alpha-hemolysin, which is the ultimate lethal agent in intraperitoneal infection but is only one factor in the production of dermonecrosis. The severity of the skin lesions was inversely related to the amount of early fluid exudate rather than to the rate of bacterial growth, whereas in the peritoneum increased bacterial growth was associated with increased mortality. Both C3 and C5 were needed in the production of fluid exudate in response to staphylococcal skin infection. C3 appeared to be more important in the increased exudate formed in immune mice. In the peritoneum the opsonic and chemotactic actions for complement were important as shown by the results in cobra venom-treated normal mice and in C5-deficient B10D2 old-line mice.


Comparison of mouse strain skin sensitivities to anaphylactic mediators and susceptibility to passive cutaneous anaphylactic reactions. CFW, ICR, and C57Bl/6J mouse strains were examined and compared for their levels of skin sensitivity to histamine and mellitin (a potent mast cell degranulator) and for their susceptibilities to immunoglobulin E-induced passive cutaneous anaphylactic (PCA) reactions. ICR mice were found to exhibit the highest level of sensitivity to histamine and mellitin, whereas C57Bl/6J exhibited the least. CFW mice proved to be the best PCA recipients, whereas ICR mice were the poorest. On the basis of this evidence, no direct correlation is indicated between level of sensitivity to anaphylactic mediators and degree of susceptibility to immunoglobulin E-induced PCA reactions.


Influenza infection in ferrets: role of serum antibody in protection and recovery. The passive administration of ferret antiserum to Ao (H0N1) influenza virus failed to protect the recipient ferrets from subsequent infection with homologous virus. This susceptibility to infection was observed even when the passively acquired serum hemagglutination inhibition (HI) titer was similar to peak convalescent titers. It is therefore concluded that serum antibody alone is probably not a major factor in the prevention of influenza infection. This does not rule out a possible role for serum antibody in prevention of illness. Subsequent to infection, ferrets that had received passive antisera failed to develop high levels of serum HI antibody. In fact, many had no detectable serum antibody (less than 1:8). These animals shed virus for periods of time quite similar to those of infected control animals, which did develope serum antibody. From these data it was concluded that detectable serum HI antibody does not play a significant role in the recovery of ferrets from influenza infection. Interferon was present in high concentrations in the secretions a few days prior to cessation of virus shedding, but it is not clear whether this was the cause of the recovery or merely a concomitant event. Twenty-one days after initial infection two-thirds of the ferrets that had received passive antibody and all control animals were immune to reinfection with the homologous influenza virus. Since the former group had little or no detectable serum HI antibody but most members were immune, there must be some other host mechanism to account for the immunity.


Influenza virus population dynamics in the respiratory tract of experimentally infected mice. Virus population dynamics in the lungs, trachea, and nasopharynx of Swiss-ICR mice were studied after respiratory challenge with mouse-adapted preparations of strain A2/Aichi/2/68 influenza virus. Markedly higher doses of virus were required to produce infection with nasopharyngeal challenge than with bronchoalveolar challenge. In all of the infections, the highest virus concentrations were observed in the lungs. Peak concentrations in the trachea were lower than in the lungs but higher than in the nasopharynx. Decreasing virus levels were observed by 120 h after challenge and were generally below detectable levels by the end of 10 days. A compartmental model of a single mathematical form was developed which provided close fits of the virus concentration measurements regardless of the challenge dose, site of initial deposition, or respiratory tissue considered. The model includes seven compartments with five associated rate parameters. The application of compartmental modeling techniques and expression of the virus population dynamics in mathematical terms is regarded as a new approach to the study of the pathogenesis of infections.


Virulence factors involved in the intraperitoneal infection of adult mice with Vibrio cholerae. Nonmotile mutants of Vibrio cholerae isolated from Ogawa, Inaba, and El Tor strains were less virulent than parent wild types when administered to adult mice intraperitoneally. The cells were suspended in 5% hog gastric mucin. Antitoxic immunity did not protect mice against this type of challenge, but a ribosomally derived vaccine did. Intraperitoneal injection of 10 50% lethal doses of enterotoxin (based on intravenous doses) was without toxic manifestations as were 10(10) heat-killed vibrios similarly administered, regardless of strain. Virulent organisms killed with formalin or ultraviolet irradiation were significantly lethal at a dose of 10(10) cells. Mice made tolerant to endotoxin were protected from death caused by an injection of 3 X 10(10) boiled cells, but they did not survive an injection of formalin-killed cells. It is believed that the cause of death in this animal model of cholera is dependent, at least in part, on a toxic heat-labile moiety closely associated with the vibrios.


Characterization of an anti-glucosyltransferase serum specific for insoluble glucan synthesis by Streptococcus mutans. An anti-glucosyltransferase serum, which synthesized 96% insoluble glucans, was prepared against a purified enzyme preparation from Streptococcus mutans strain HS6 (serotype a). This serum was examined for its effects on glucan synthesis by crude enzyme preparations from eight strains (four serotypes) of S. mutans and for the ability of these preparations to promote adherence of S. mutans to a smooth surface. Glucosyltransferase activity was assayed by measuring the incorporation of glucose from [14C]glucose-labeled sucrose into water-insoluble and water-soluble (ethanol-insoluble) glucans. Anti-glucosyltransferase serum inhibited insoluble glucan synthesis by crude enzyme preparations from cells of the four serotypes of S. mutans. Enzymes from strains of types a, b, and d were inhibited between 70 to 90%; enzymes from type c strains were inhibited from 45 to 60%. The adherence to a glass surface of heat-killed cells from these four serotypes was likewise inhibited. Soluble glucan synthesis was not inhibited by the serum, and in some cases its synthesis increased as insoluble glucan synthesis decreased.


Reed Neurological Research Center, UCLA School of Medicine, Los Angeles, California. Various clinical, virological, immunological, and morphological aspects of velogenic Newcastle disease were defined in chickens inoculated by natural routes with the Missouri-(H) Len 1950 strain. The disease initially appeared as a severe pneumonitis from which most birds recovered. Several days later, many of these birds developed severe encephalitic signs, largely referable to inflammatory changes in the cerebellum. During the pneumonic stage, virus was easily isolated in relatively high titers from the brains of all chickens, and viral products were easily detected in Purkinje neurons. However, when the encephalitis developed, virus was isolated irregularly and in low titers from brains, and morphological evidence for the presence of viral products could not longer be obtained. The encephalitic disease is discussed in relation to encephalitic syndromes induced by other neurotrophic viruses.


Variability of the immunological state of germfree colostrum-deprived Minnesota miniature piglets. Minnesota miniature piglets obtained by hysterectomy and deprived of colostrum were examined for the presence of immunoglobulin by immunoelectrophoresis, double-gel diffusion, and radial immunodiffusion techniques with specific anti-immunoglobulin chain sera. A large amount of variability existed between different litters of piglets and between different piglets within the same litter, ranging from no detectable immunoglobulin in the serum to very high immunoglobulin levels approaching that of the adult pig. All known classes of porcine immunoglobulin including immunoglobulin G, immunoglobulin M, and immunoglobulin A could be found in the sera from litters where there was extensive placental damage. This contaminating immunoglobulin was shown to have antibody activity to actinophage MSP-2 even when present in very low concentrations. The low level contamination with immunoglobulin G, which was the most frequently encountered type of contaminant, was demonstrated to be similar to sow immunoglobulin G both antigenically and in its molecular size. The data demonstrates that individual piglets must be tested for immunoglobulin content rather than being assumed to be immunologically "virgin" and emphasizes the need for an intact placenta barrier to obtain piglets free from maternal immunoglobulin and devoid of antigenic stimulation.


Purification and characterization of a staphylococcal epidermolytic toxin. A staphylococcal exotoxin that causes epidermolysis when injected into the skin of the newborn mouse and man was highly purified by coventional biochemical techniques. With Staphylococcus aureus EV, the epidermolytic toxin was a major protein component of supernatant culture fluids. The initial step in purification was zone electrophoresis in Pevikon carried out at pH 9.0, the isoelectric point of alpha-hemolytic toxin, which remained near the origin. Fractions containing the epidermolytic toxin, but free of alpha-toxin, were then subjected to cation exchange chromatography on carboxymethyl-Sephadex C-50 to remove trace contaminants. A major highly purified epidermolytic toxin migrated as a single band in polyacrylamide gel electrophoresis, sedimented as a single component in the analytical ultracentrifuge, and elicited a single precipitating antibody after injection into rabbits. A smaller amount of a second epidermolytic toxin, identical in molecular weight and antigenicity but differing in electrophoretic behavior from the major molecular species, was also identified. The epidermolytic factor had a molecular weight of 28,600 +/- 400 by sodium dodecyl sulfate-acrylamide electrophoresis and 32,500 +/- 120 by approach to sedimentation equilibrium.


Social-psychological correlates of drug use among Colombian university students. This paper reports the results of a large-scale study conducted among Colombian college students directed at finding patterns of use of legal and illegal drugs. The subjects reported reasons for use and nonuse of the different substances, use on the part of parents, parent's attitudes toward use, effects, attitudes toward drug use, and a series of sociodemographic variables. The results were later analyzed in relation to social learning variables that could differentiate marijuana users and nonusers. Results are also reported on personality differences between users and nonusers as measured by the Maudsley Personality Inventory.


Drug use among white and American Indian high school youth. Data are presented on a sample of white (N = 391) and American Indian (N = 120) high school youth attending the four high schools in the vicinity of Wyoming's Wind River Reservation. For the most part, the Indian youth were members of either the Arapahoe or Shoshone tribes. The general null hypothesis that no significant differences existed between white and Indian youth in either attitudes toward drug use or in the use of drugs was rejected. The data indicate that Indian youth have a more favorable attitude toward the use of marijuana and other drugs than do white youth. Indian youth were also more likely than white youth to try using marijuana and other drugs, but no more likely than whites to continue using such drugs after having tried them.


Recent trends in the demography of heroin addiction among youthful offenders. Trends in demographic characteristics associated with heroin addiction in successive cohorts of a young offender population over the 5-year period 1968-1972 were examined within the framework of two contradictory views of the social competence of the addict provided by the literature. In general, heroin addicts during this period were found to be older, better educated, and more intelligent than nonaddicts. In addition, the racial composition of both the addict and nonaddict samples became increasingly non-White in composition and better educated; nonaddicts became increasingly older; and no significant trends with  respect to intelligence took place. These findings support the view of the addict as being relatively more socially competent than his nonaddict offender peer. Implications of these findings for a model of addiction and rehabilitation are discussed.


Methaqualone (Mandrax) abuse, urine testing, and identification: clinical correlation between a new mass urinalysis test and a military drug abuse program. A urine test presently based on thin-layer chromatography screening and gas-liquid chromatography (GLC) confirmation has been a practical way of detecting methaqualone use in individuals. A more practical test is the radioimmuno assay for screening and GLC for confirmation.  It appears that the drug methaqualone can be easily detected in the urine up to 72 hr after the last dosage. Individuals evaluated after being identified through the urine testing procedure readily admit to the use of illegal drugs and are most cooperative in giving drug abuse data, whether it is Mandrax, hashish, herion, or alcohol. The majority evaluated in this study were not in any program for drug abuse although all but one admitted to frequent drug abuse. The finding has been generally true of the other urinalysis test for drugs of abuse as the majority of the soldiers in the rehabilitation program have been identified by urinalysis over the past year. Because of the uncertainty of surveys on how prevalent was Mandrax use (anywhere from 5 to 90%, depending on who was consulted), a random selection of urines was done in September/November 1973. A total of 7,545 urine samples were tested those 2 months and the results were 2.9 and 3.9% positive respectively. Since that time and through June 1974 approximately 250 urine samples a week were tested for Mandrax  based on a special request by the commander who suspected an individual of abusing Mandrax, and approximately 20 to 30% of the samples were positive. During June and July all randomly collected urines were tested and the results on a daily basis were from 1.5 to 3.5%. Since July 1974 no urines have been collected or tested. The follow-up indicates that of this number practically all are clinically confirmed as drug abusers and are entered into the Army's Drug Rehabilitation Program.


The culture of youth and drug abuse in some European countries. Old patterns of education are being replaced in some European countries by the different ideological norms of the various groups composing modern society. Youth has lost the sure feeling to belong to a certain culture. Drug abuse primarily represents an attempt to get over this insecurity. In an inquiry in Swiss military schools, recruits were questioned about drug and alcohol use and cigarette smoking, and this was related to the home situation. Juveniles who do not have enough affective support in the primary group seem to be more subject to the conflicts of norms going on in our society. Three general factors seem to be responsible for the drug use among juveniles: (1) the family situation of childhood, (2) the conflicts of norms of the society in which they are involved, and (3) the milieu provocation.


Sex roles and street roles.

Sex roles and street roles. A proposed typology of the street roles of female addicts was tested through interviews with 62 female addicts. Five role types are identified which are distinct from one another and exhaust the range of roles reported by respondents. A number of limitations to the typology are isolated and discussed.


The relative effectiveness of a medical hospitalization program vs a feedback-behavior modification program in treating alcohol and drug abusers. There is a sparsity of studies specifying the relative effectiveness of different types of treatment programs in treating a similar target population of drug and alcohol abusers in the same locale. In this paper, two drug and alcohol rehabilitation programs are described and their relative effectiveness compared in treating similar target populations. The first treatment program evaluated is a medically oriented hospitalization program and the second is a short-term therapeutic community program, called "Feedback" because it is structured on the basis of a collection of feedback and behavior modification principles and techniques. Both programs were implemented by basically the same staff and both treated similar target populations of multiple drug abusers and alcohol abusers during comparable time periods. The results indicated that the feedback program was significantly more effective in rehabilitating multiple drug abusers (nonheroin abusers)  than the hospitalization program with regard to three criteria (return to work for 60 days, perform effectively according to the supervisor, and control drug or alcohol problems). But both programs were equally effective in rehabilitating alcohol abusers (problem drinkers and alcoholics).


Evaluating outcome criteria used in methadone maintenance programs. This report reviews the results of several large methadone maintenance programs and analyzes the outcome measures used. Criteria measures were often vague and sometimes not defined. Many studies base their findings on unverified patient self-report because costs for more reliable and systematic data collection are prohibitive. Available data does not allow for resolution of the pro- or antimethadone maintenance views for treatment of heroin addiction.


Comparison of psychiatric inpatient male and female adolescent drug abusers. Drug-abusing male and female adolescent psychiatric inpatients were compared on a variety of etiological, environmental, and social variables. Results indicated that the frequency, duration, and pattern of abuse did not differ significantly for males and females. Factor analyses, however, revealed that for females, drug abuse and pathology in general were associated with family related variables; for males, patient abuse and patient pathology emerged as factors orthogonal to family drug abuse and family pathology. These findings indicate that female pathology is more reactive to the family situation and hence they raise the hypothesis that when the female separates from the family her pathology will decrease more than the pathology of the male who separates.


Reliability and validity of self-reported illegal activities and drug use collected from narcotic addicts. In follow-up of 1,500 drug-using applicants to the NIMH civil commitment program under Titles I and III of the Narcotic Addict Rehabilitation Act, efforts were made to measure the reliability and validity of self-reported criminal and drug-taking behavior. Various methods to assure reliable and valid responses were developed and implemented. These methods included choice of interviewer, intraquestionnaire safeguards, interview-reinterview procedures, and use of police records and urinalysis reports. Overall, the results indicated that the responses for 829 respondents were reliable. The greatest limitation to the validity study was the incomplete and unreliable police records and urinalysis reports.


Polydrug use by high-school students: involvement and correlates. A hierarchical cluster analysis was performed on 273 self-admitted high-school drug users' descriptions of how frequently they had employed marijuana, stimulants, depressants, hallucinogens, solvents, and opiates during the preceding year. Four types of polydrug users were identified and considered as representing an ordinal scaling of the students along a continuum of overall involvement with drugs, and each user was assigned an index score based on his typal membership. A stepwise multiple regression was then performed to discover which of the students' background characteristics and attitudes were related to their polydrug involvement scores. The search for pleasant sensations, the desire for expanded creativity, and the belief that one would cease taking drugs if they were conclusively shown to be harmful were more powerful predictors of polydrug involvement than any of the sociocultural factors.


Deliberate hydrocarbon inhalation among low-socioeconomic adolescents not necessarily apprehended by the police. Nearly 600 low socioeconomic adolescents were given a 17-item multiple choice questionnaire designed by the authors. Demographic data tended, in some respects, to be consistent with previous research. In other respects there were some differences, e.g., sniffing tends to also be a problem with females. The data suggested that there are differences  between chronic and social sniffers and that these differences should be taken into account when designing treatment/prevention programs. Another suggestion is that sniffing tends to be a social activity that is engaged in because (1) it is readily available and (2) it relieves boredom. Prevention programs have tended to focus on making it more difficult  to obtain access to solvents, but this  has had only limited success. The development of alternatives to neighborhood boredom should also be seen as an integral and important part of drug-abuse prevention.


Diffuse chronic granulomatous mucocutaneous candidiasis. A 3-year-old Thai boy with diffuse chronic granulomatous mucocutaneous candidiasis, recurrent bacterial skin infection and adrenal insufficiency is reported. Candida albicans was demonstrated in the dermal granuloma. He had a defect in cell-mediated immunity and was anemic. Although therapy with topical clotrimazole, oral iron, systemic antibiotic and low-dose of prednisone gave a dramatic result, he died of disseminated cryptococcosis.


Some notes of an aging nail watcher.

Some notes of an aging nail watcher. Growth of deciduous tissues gives us a natural kymograph to record secular trends and in some instances makes the mark on the moving record. For the observant clinician, knowledge of the rate of nail growth may permit an occasional spectacular diagnosis, although much more often it merely adds a small bit to our understanding of simple but basic biological prenciples in health and disease.


Surveillance of smallpox.

Surveillance of smallpox. An intensified global smallpox eradication programme was started by the World Health Organization in 1967. This paper describes the basic techniques employed and the experiences involved in implementing the procedures. Surveillance schemes have varied considerably in detail from country to country according to different health structures, and the emphasis is therefore placed on the more generally used approaches. Finally, important principles in the implementation of the smallpox surveillance programme are considered in relation to the development of such programmes for other communicable diseases.