The menopausal transition: analysis of LH, FSH, estradiol, and progesterone concentrations during menstrual cycles of older women. Studies of menstrual cycle length in large populations demonstrated that there is a striking increase in the variability of intermenstrual intervals just before menopause. The changes in serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), and progesterone (P) during menstrual cycles in a group of perimenopausal women were compared with the findings in young normal women. In 8 women, 46-56 years old with regular cycles, cycle length was shorter and the mean E2 concentration was lower than in younger women. There was a striking increase in FSH concentration throughout the cycle while LH remained in the normal range. In 2 women, 14 cycles of variable length were studied during 2 years of the menopausal transition. In some instances, hormonal changes associated with follicular maturation and corpus luteum function occurred in the presence of high, menopausal levels of LH and FSH with a diminished secretion of E2 and P. In others vaginal bleeding occurred during a fall in serum E2 with no associated rise in P. Cycles of variable length during the menopausal transition may be due either to irregular maturation of residual follicles with diminished responsiveness to gonadotropin stimulation, or to anovulatory vaginal bleeding that may follow estrogen withdrawal without evidence of corpus luteum function. The observation of elevated FSH concentrations and normal LH levels in perimenopausal women emphasizes the complexity of the hypothalamic-pituitary-ovarian regulatory system and suggests that LH and FSH are modulated independently at the level of the pituitary.


Triiodothyronine (T3)-binding immunoglobulins in a euthyroid woman: effects on measurement of T3 (RIA) and on T3 turnover. A 36-year-old woman with nodular goiter, nervousness, and tachycardia was evaluated for T3 toxicosis. Her serum thyroxine level, resin T3 uptake, and thyroidal radioiodine uptake were normal. Her T3 (RIA), by a technique employing charcoal to separate bound and free T3, was reported as indeterminate due to an interfering substance; by a double-antibody method, her T3 (RIA) was 325 ng/dl. Further studies of the patient's serum revealed an abnormal T3-binding protein which misgrated in the beta-gamma globulin zone on paper  electrophoresis and gel filtration chromatography (Sephadex G-200), and was precipitated from serum by rabbit anti-human Fab antibody. The gamma globulin fraction of the patient's serum, separated by a standard technique, showed strong binding activity toward [125I]T3, with an association constant of 4.1 X 10(8) 1/mole (Scatchard plot). In a similar system, labeled T4 was not bound. To avoid artefacts which this T3-binding protein might produce in assaying unextracted serum, T3 (RIA) was performed on an ethanol extract of serum and found to be 191 ng/dl, a slight elevation. However, the metabolic clearance rate of injected [125I]T3, estimated by non-compartmental analysis of the serum decay curve or by the specific activity or urinary T3, was about 16 1/day, a low value, so that the T3 production rate, 31 mug/day, was normal. The patient's symptoms disappeared with the resolution of domestic problems, and she appeared clinically euthyroid. Serum TSH was 5.0 uU/ml and antithyroglobulin titer, 1:16. A test for antibodies to thyroid microsomes was negative. We postulate that this subject was euthyroid, but had a concentration of T3-binding immunoglobulin which was sufficient to produce modest slowing of T3 turnover, borderline elevation of extractable T3 (RIA), and a major artefact in the T3 (RIA) measurement of unextracted serum. A similar abnormality may account for other instances of high T3:T4 ratios in serum.


Aldosterone metabolic clearance is normal in low-renin essential hypertension. The possibility that an abnormality of aldosterone metabolism plays a role in the pathogenesis of low-renin essential hypertension was investigated. Normal subjects and patients with low-renin or normal-renin essential hypertension were evaluated while in balance, ingesting a diet providing 120 mEq sodium and 70 mEq potassium. Aldosterone metabolic clearances were determined by a constant infusion technique using tritium-labeled aldosterone. Aldosterone secretion rates and plasma aldosterone concentrations were measured by radioimmunoassay. Aldosterone metabolic clearance in normal subjects was 1422 +/- 69 (mean +/- SE) liters/24 hours. In patients with low-renin essential hypertension, aldosterone metabolic clearance was 1351 +/- 61 liters/24 hours, and in patients with normal-renin essential hypertension, it was 1412 +/- 66 liters/24 hours. These values were not significantly different from those of normal subjects. Although aldosterone secretion rates in both groups of hypertensive patients were within the normal range, patients with low-renin essential hypertension, under the conditions of this study, had significantly higher secretion rates than patients with normal-renin essential hypertension. We have concluded that the maintenance of plasma aldosterone in low-renin essential hypertension reflects sustained aldosterone secretion despite suppression of plasma renin activity, rather than reduced aldosterone metabolism. The maintenance of normal aldosterone secretion in low-renin essential hypertension appears to be inappropriate and is not explained by alterations of known regulatory mechanisms.


Pituitary-gonadal relations in infancy: 2. Patterns of serum gonadal steroid concentrations in man from birth to two years of age. Testosterone, estradiol, 170H-progesterone, and androstenedione (except in cord samples) concentrations were determined in cord sera (30 male and 14 female) and in peripheral sera from infants (121 male and 110 female), age 1 day to 2 years. Male and female cord serum levels of these steroids were not significantly different. In both sexes levels during the first week were lower than those in cord sera. In male infants serum testosterone and 170H-progesterone levels rose sharply in the second week of life, reached a peak at 1-2 months, and then declined to the range seen in later childhood by 6 months of age; male serum androstenedione and estradiol concentrations were higher during the first 2 months of life, but no distinct pattern of rise and fall was seen. In girls serum testosterone levels fell in the first week to the range seen throughout childhood; serum concentration of estradiol, androstenedione, and 17OH-progesterone in girls were markedly variable, with many values above the childhood range being seen, particularly in the first 6 months. These data provide further evidence of active Leydig cell function in male infants. They suggest that there is also ovarian secretion of sex steroids in some female infants in response to the elevated FSH and LH levels which are seen at this time.


Dual sites of inhibition by metyrapone of human adrenal steroidogenesis: correlation of in vivo and in vitro studies. In a patient with pituitary ACTH-dependent adrenal hyperplasia (AH), the standard oral metyrapone test resulted in a decrease in "apparent 11beta-hydroxylase activity" (-48%) accompanied by an increase in "apparent cholesterol cleavage activity" (+318%). When incubated adrenal mitochondria from this patient were studied, metyrapone inhibited both 11beta-hydroxylation of labeled 11-deoxycorticosterone and cleavage of labeled cholesterol, although at 0.1 and 1.0 mM metyrapone concentrations, depression of cholesterol cleavage (23 and 54%, respectively) was less than that of 11beta-hydroxylation (62 and 84%, respectively). The inhibition of cholesterol cleavage by metyrapone (26 and 62%, at 0.1 and 1.0 mM concentrations, respectively) was also demonstrable in adrenal mitochondria from a patient with hypercorticism resulting from an ACTH-independent adrenal adenoman (AA). Metyrapone administration to AA resulted in a significant depression of both 11beta-hydroxylase (-62%) and cholesterol cleavage (-36%) "apparent activities"; when metyrapone and ACTH were given together to this patient, however, only 11beta-hydroxylase "apparent activity" diminished (-26%), while cholesterol cleavage "apparent activity" was greatly augmented (+231%), thereby simulating the results of the standard metyrapone test in AH. These data demonstrate that metyrapone inhibits both mitochondrial reactions involved in cortisol synthesis--initial cholesterol cleavage and final 11beta-hydroxylation; these effects probably result from interference by this agent with the interaction between substrate and related cytochrome P - 450. Since ACTH has a major stimulatory effect on cholesterol cleavage but not on 11beta-hydroxylation, the outcome of metyrapone administration is thus determined by whether a change in ACTH level ensues: while 11beta-hydroxylation is inhibited by metyrapone under any circumstances, total steroid output rises when a compensatory ACTH increase overcomes metyrapone inhibition of cholesterol conversion into pregnenolone and falls when metyrapone inhibition of this reaction is unopposed.


The influence of age and sex on the metabolism of testosterone. The influence of age and sex on the peripheral metabolism of testosterone was studied by giving intravenous tracers of 14C-testosterone to 21 prepubertal children (13 boys and 8 girls), 39 young adults 18-43 years old (23 men and 16 women), and 10 elderly adults 68-86 years old (6 men and 4 women). Studies were also carried out in 2 sexually immature young adults, one 18-year-old 45 XO phenotypic female with gonadal agenesis and one 18-year-old 45 XO, 46 XX mosaic female with gonadal dysgenesis; the latter was restudied after prolonged estrogen-progestagen therapy. Age and sex influences were observed only with respect to the androsterone/etiocholanolone (A/E) ratio; a sex difference in diol metabolite formation was not observed. Prepubertal children showed no sex difference in A/E ratio, which averaged 1.7 +/- 0.28 in boys and 1.9 +/- 0.42 in girls. Young adult men showed a slightly lower A/E ratio, averaging 1.5 +/- 0.10, while females showed a much greater decrease in A/E ratio, to 0.9 +/- 0.09, so that there was a highly significant (P less than .001) sex difference in this age group. The decreased averages were due to disappearance of the higher end of the ranges seen in prepubertal children; the lower limit of the ranges remained the same. Elderly adult men showed a further fall in the A/E ratio, to 1.0 +/- 0.11, and elderly women also showed a further fall, to 0.4 +/- 0.04; a highly significant (P less than .005) sex difference remained. Once again, the fall in average A/E ratio from young adults to elderly adults was due to disappearance of the higher end of the ranges in the former, the lower limits of the ranges were the same in both groups. Of the 2 sexually immature young women, one showed an A/E ratio of 1.3, just below the upper limit for young adult women, and the other showed a ratio of 1.8, well above that limit and thus typical of prepubertal girls. Estrogen-progestagen therapy of the second girl decreased the A/E ratio to 1.4, the upper limit for young adult women. It was concluded that there is a fundamental aging effect in both sexes which causes a gradual progressive decrease of the mean A/E ratio as a result of progressive disappearance of the higher individual A/E values while the lower end of the range of values remains constant; superimposed on this gradual decrease is an acute pubertal decrease in females, probably mediated by the development of the estrogen-progestagen milieu characteristic of sexually mature women.


Induction of hypertriglyceridemia by a low-fat diet. We have studied the effects of moderate dietary fat restriction on plasma triglyceride, cholesterol, glucose, and insulin response in 27 subjects. Compared with a control diet (45% fat, 40% carbohydrate [CHO], 15% protein) the low fat (higher CHO) diet (30% fat, 55% CHO, 15% protein) produced a 41% increase in fasting triglyceride level (155 +/- 17 to 219 +/- 23 mg%) with no change in fasting plasma cholesterol level. Furthermore, this increase in triglyceride levels; induced by the higher CHO content of the low fat diet, was seen in 26 out of 27 subjects. Postprandial triglyceride, glucose, and insulin levels were also higher on the low fat (higher CHO) diet. Since hypertriglyceridemia is a significant risk factor for the development of coronary heart disease, and since our data indicate that the moderate increase in dietary CHO associated with a low fat diet will elevate plasma triglyceride levels, we believe that more caution is necessary before recommending the wide-spread use of low fat diets for heart disease prevention.


Xylitol: stimulation of insulin and inhibition of glucagon responses to arginine in man. The effect of intravenous xylitol infusions on plasma glucagon and insulin responses to intravenous arginine infusions (30 g for 45 min) or arginine "pulses" (4 g for 2 min) was studied in normal subjects. Intravenous infusion of arginine caused biphasic increases in plasma glucagon and insulin in all subjects studied. The increase in plasma glucagon induced by arginine infusion was significantly reduced by xylitol infusions started at 45 min before arginine infusion, irrespective of virtually unchanged blood glucose levels. Plasma insulin response to arginine was exaggerated by xylitol infusion. Repeated arginine pulses given at 30 min intervals evoked uniphasic and almost identical rises of plasma insulin and glucagon with each pulse. Intravenous xylitol infusions significantly blunted plasma glucagon responses and augumented the plasma insulin response to arginine pulses, despite only slight elevations of plasma glucose. These results suggest that xylitol has an inhibitory effect on both basal and arginine-stimulated glucagon secretion, while it enhances insulin secretion.


Nocturnal elevation of plasma melatonin and urinary 5-hydroxyindoleacetic acid in young men: attempts at modification by brief changes in environmental lighting and sleep and by autonomic drugs. In order to determine whether the human pattern of circulating melatonin resembles that previously described in lower animals, men 19-32 years old were exposed to a light-dark cycle with 14 hours of light per day (L:D 14:10). In whites and blacks, nocturnal (dark phase, sleeping) melatonin levels were almost always elevated to 0.05-0.1 ng/ml plasma compared with lower or undetectable levels during the day, measured by the tadpole bioassay. Thin-layer migration of bioactive material was identical to that for melatonin standard. A rhythm with nocturnal elevation of urinary 5-hydroxyindoleacetic acid (5-HIAA) was observed. Nocturnal (sleep phase) rise in blood melatonin (but not urinary 5-HIAA) continued during 21/2 day-night cycle lengths after the onset of constant light. Though the dark phase plasma melatonin rise was less marked after reversal of the sleep-wake cycle (no change in the light cycle), dark phase rise in urinary 5-HIAA continued. Though marked cardiovascular and other effects were produced by intravenous isoproterenol or scopolamine, no definite effect on melatonin levels was observed after either drug during the light phase in waking subjects.


Obesity and oligomenorrhea are associated with hyperandrogenism independent of hirsutism. Obesity, oligomenorrhea, and hirsutism are frequently associated with high plasma androgen levels and/or low testosterone-binding globulin (TEBG) levels. Studied have been undertaken to determine the extent to which each of these clinical features may be related to this hormonal profile. Indexes of plasma free (unbound) androgen levels were focused upon because this fraction appears to be the biologically active portion of the plasma androgens. The hormonal profile was normal in women with either obesity or oligomenorrhea alone and abnormal in those with severe hirsutism alone. On striking new finding was that subjects with the combination of obesity and oligomenorrhea had elevated plasma total and free androgens and depressed TEBG even in the absence of hirsutism. Furthermore, the androgen levels were higher in obese oligomenorrheic women with mild hirsutism than in severely hirsute women who were not obese. Plasma estradiol concentrations were normal in these obese women. A simple explanation for elevated free plasma androgen levels in obese women who were oligomenorrheic yet had little if any hirsutism is not possible. The data are compatible with the concept that obesity is a variably expressed manifestation of slightly elevated plasma free androgen levels or that obesity is an incidental finding which somehow blunts the effect of high androgen levels on hair follicles. Regardless of the explanation, oligomenorrheic obese women must be suspected of having high androgen production even in the absence of hirsutism.


Circadian rhythms in gonadotropin excretion in prepubertal and pubertal children. Timed urinary collections were obtained during sleep and waking hours from 27 prepubertal children ranging in age from 2-12 years and from 13 subjects in various stages of puberty, 12-18 years old. The urine samples were extracted with acetone and introduced into FSH and LH radioimmunoassays. Results of the study indicate a significant nocturnal augmentation of LH secretion in pubertal subjects, confirming existing reports using blood sampling techniques. Increased LH and FSH excretion during sleep was also found in prepubertal children.


Quantitative determination of sex hormone-binding globulin capacity in the plasma of normal and diabetic pregnancies. Sex hormone-binding globulin (SHBG) capacity was measured in a longitudinal study in plasma samples from normal subjects, diabetics, and gestational diabetics and throughout pregnancy, together with unconjugated plasma estradiol. In normal women SHBG capacity (expressed in ng DHT bound per ml of plasma) increased from 23.7 +/- 13.7 (SD) in the 5-8th week period, to 74.5 +/- 20.7 in the 17-20th week period, and to 102 +/- 24 in the 37-40th week period. In diabetics the SHBG capacity for the same periods of time were respectively: 25.3 +/- 17.2, 83.1 +/- 29.1, and 111.6 +/- 22.6. Plasma levels of unconjugated estradiol were 55% higher in the diabetics than in the normal subjects in the second half of gestation, as reported in detail in another publication. From the imbalance between the close to normal SHBG capacity and the higher plasma levels of unconjugated estradiol in the diabetics, it is suggested that the unbound, i.e., metabolically active, fraction of plasma estradiol reaches higher levels in diabetics than in normal subjects in the second half of gestation.


Citrobacter diversus isolated from clinical material. Forty-seven strains of Citrobacter diversus were isolated during a 12-month period from clinical material obtained from patients in a general hospital in Israel. The majority of cultures (38) were recovered from urine and wound discharges. There was one case of septicemia. The biochemical reactions of all cultures were typical for this species, except one that was anaerogenic, and they could be divided into five biotypes (a through e). Thirty-nine strains were identified serologically and found to belong to one of seven O groups described by Gross and Rowe (1974). All cultures were sensitive to tetracycline and nalidixic acid. All strains were resistant to carbenicillin and ampicillin and produced beta-lactamase.


Application of a gloved-hand model for multiparameter measurements of skin-degerming activity. The application of an established gloved-hand model to multiparameter measurements of skin-degerming activity is described. In particular, appropriate experimental designs are illustrated which allow characterization of performance of topical skin-cleansing preparations in terms of rapid, sustained, cummulative, and persistent skin-degerming effects on the hand. Single-contact studies were used to define the degerming activity profiles of selected commercial surgical scrub preparations, and to establish the optimal post-treatment sampling interval for individual preparations. Rapid and sustained skin-degerming effects were measured and contrasted. Rapid skin-degerming activity, iodophor preparation. Sustained skin-degerming activity, namely, that occurring on the gloved hand during a postcontact interval, was shown and characterized for two hexachlorophene preparations. Multiple-contact studies with a 3% hexachlorophene preparations were used to illustrate cummulative and persistent skin-degerming effects. Cummulative skin-degerming activity was demonstrated in terms of progressive bacterial reductions after repeated contacts within a single day. Presistent skin-degerming activity was shown in terms of the profile of daily pretreatment bacterial counts after multiple contacts over successive days. Uniformity of treatment response was established for a broad range of pretreatment bacterial counts extending from approximatley log 4 to log 7 per hand. The importance of pretreatment bacterial count measurement and of adequate neutralization of hand extract samples is stressed. A randomized-hand experimental design is discussed relative to its versatility and amenability to statistical analysis.


Differential identification of Mycobaterium szulgai and other scotochromogenic mycobateria. Strains of scotochromogenic mycobacteria were studied by using numerical taxonomy methods in an attempt to more clearly define Mycobacterium szulgai and to find tests useful in identifying the species. In this study all strains of M. szulgai were strong reducers of nitrate, were slow in hydrolyzing Tween 80, and gave a high semiquantitative catalase reaction. Results obtained indicate that the use of increased pigmentation after 1 h of light exposure at 25 C and that the use of arylsulfatase activity are of questionable diagnostic value in separating the species from other scotochrompgenic mycobacteria.


Halophilic Vibrio species isolated from blood cultures. The Special Bacteriology Section of the Center for Disease Control has received 38 cultures of a halophilic bacterium which apparently unnamed. On the basis of the minimal characteristics of Vibrio species proposed by Hugh and Sakazaki, this bacterium belongs to the genus Vibrio. The unnamed species can be differentiated from Vibro parahaemolyticus by a lower tolerance for sodium chloride (NaC1) and the fermentation of lactose. The failure to ferment sucrose is an additional characteristic which differentiates these organisms from V. alginolyticus. Of 33 unnamed species strains tested, all were sensitive to penicillin, ampicillin, carbenicillin, cephalothin, chlorapmphenicol, gentamicin, tetracycline, rifampin, nitrofurantoin, and sulfisoxazole by agar diffusion and agar dilution tests. The sources of isolation of the cultures of the unnamed species suggest that it is a clinically important organism. Twenty strains were isolated remaining cultures were isolated from localized infections of the extremities. In contrast, only 2 of 60 cultures of V. parahaemolyticus and V. alginolyticus received in our laboratory as human isolates from extra-intestinal sources were isolated from blood.


Mycobacterium resembling Mycobacterium fortuitum that produces brown pigment. Two cultures of acid-fast bacilli with characteristics most closely resembling those of Mycobacterium fortuitum were recovered as casual isolates from sputa of a patient with an apparent brochogenic tumor. One of the cultures was consistenly cream colored to rosy buff. The other, however, changed from buff to rust to dark brown and had the gross appearance of a fungus culture.


Evaluation of beckman antistreptolysin O and antideoxyribonuclease B (ASO/ADB) test kit. The Beckman antistreptolysin O kit agreed within one-dilution increment for 70% of the specimens tested. The antideoxyribonuclease B kit agreed within onedilution increment for 96% of the specimens tested.


Improved method for production of attenuated Venezuelan equine encephalomyelitis (TC-83 strain) vaccine. Primary chicken embryo cell cultures were evaluated a s an alternate cell system for the production of attenuated Venezuelan equine encephalomyelitis (TC-83 strain) vaccine. The TC-83 strain virus was shown to remain stable during 10 serial passages in chicken embryo cell culture with regard to plaque size and morphology, virus yield, potency, and virulence for mice and hamsters.


Distribution, blood transport, and degradation of antidiuretic hormone in man. The distribution, blood transport, and metabolic clearance of physiological concentrations of antidiuretic hormone were studied in 10 hydrated normal subjects with radioiodinated arginine vasopressin (125I-AVP). At 37 degrees C no binding of 125I-AVP to plasma proteins could be demonstrated, but some metabolites were associated with plasma proteins. 125I-AVP was rapidly distributed into a space approximating the extracellular fluid volume. Metabolic breakdown products became demonstrable within minutes after injection. The mean metabolic clearance rate of 125I-AVP was 4.1 ml/min/kg and the mean plasma half-life 24.1 min. Renal clearance had a mean value of 80 ml/min and accounted for 27% of the total metabolic clearance. It is concluded that in man antidiuretic hormone circulates as a free (non-protein bound) peptide, diffuses readily into the extracellular fluid space, and is metabolized within minutes. A plasma half-life of 24 min is consistent with the duration of antidiuresis after hormone administration or release.


An anomaly of insulin removal in perfused livers of obese-hyperglycemic (ob/ob) mice. Obese-hyperglycemic (ob/ob) mice have the interesting feature of being hyperinsulinemic, thus having some characteristics in common with human maturity-onset diabetics. As the cause of hyperinsulinemia in these mice is not established, and as the liver is known to play a role in determining the amount of hormone that reaches the periphery, it was hypothesized that an anomaly in the hepatic handling of insulin might prevail in obese-hyperglycemic mice. Immunoreactive insulin was therefore measured in the perfusate before and after a single passage through perfused livers of lean and ob/ob mice, permitting. It was found that the removal of insulin by livers of lean mice increased with increasing concentrations of the hormone in the portal vein. The removal process had a limited capacity, however, and as a consequence the percentage of hormone removed by the liver actually decreased when portal insulin concentrations increased. Insulin removal by livers of ob/ob mice had qualitatively the same characteristics but was considerably less efficient than in normal livers. Due to this, more insulin was found in the perfusate leaving the liver of ob/9b mice than in that of controls, at any insulin concentration tested. These observations suggest that in obese-hyperglycemic mice more of the hormone may reach the periphery and thus contribute to hyperinsulinemia. The present study further suggests that the anomaly of insulin removal observed in perfused livers of ob/ob mice might be secondary to hyperinsulinemia, since it was partly corrected upon artificially decreasing the circulating levels of insulin (e.g. via a fast, anti-insulin serum, or streptozotocin treatment) before perfusion. The characteristics of hepatic insulin removal reported in this study, as well as the differences observed between livers of lean and ob/ob mice, may reflect changes in membrane insulin receptors and/or in processes responsible for the degradation of the horomone.


Clearance and acid-stimulating action of human big and little gastrins in duodenal ulcer subjects. Acid-stimulating action and clearance of pure natural human big gastriin (HG-34-I) and little gastrin (HG-17-I) were assessed in four male subjects with inactive duodenal ulcer (DU) disease. Disappearance half-times for HG-17-I after intravenous infusion (5.2 min) or rapid intravenous injection (6.4 min) were six to eight times shorter than those for HG-34-I (41.5 and 37.8 min, respectively). Studies of clearance of synthetic human little gastrin (HG-17-I) were performed in three of these same four DU subjects, eight additional male DU subjects, and eleven normal male subjects. The disappearance halftime of synthetic HG-17-I averaged 6.2 min in both the DU subjects and the normal subjects. These data suggest that clearance of exogenous gastrin is not altered in patients with DU. Acid secretion in response to rapid intravenous injection of HG-34-I reached a higher peak and lasted longer than in response to an equimolar dose of HG-17-I; the total response to HG-34-I was about three times that to HG-17-I. During constant intravenous infusion, acid responses to equimolar exogenous doses of the two peptides were similar but the increment in molar concentration of circulating gastrin was six to eight times greater with HG-34-I than with HG-17-I. Chromatography of serum obtained during infusions of HG-34-I revealed no evidence of conversion to HG-17-I, nor was there any increase in circulating G-34 activity during infusions of HG-17-I. The increment in serum gastrin concentration required to produce half-maximal stimulation of gastric acid secretion (D50) was estimated in each subject for each gastrin from curves relating acid secretion to change in serum gastrin concentration produced by infusion of these peptides. After instilling peptone solution into the stomach, acid secretion was measured by intragastric titration, and increases in circulating G-17 and G-34 were determined by chromatography and radioimmunoassay of serum. Increases in circulating G-17 and G-34 in response to the peptone meal, taken together, were equivalent to 1.5 times the D50 determined from infusions of G-34 and G-17. Acid secretion during the same time period averaged 55% of maximal rates. Although G-34 comprised approximately three-fourths of the total molar concentration of circulating gastrin after stimulation, it was estimated to contribute less than half of the acid-stimulating activity.


Evidence for enhanced distal tubule sodium reabsorption in chronic salt-depleted dogs. In order to assess the renal tubular site(s) at which sodium reabsorption is enhanced in chronic sodium-depletion, seven normal dogs, six salt-depleted dogs, and three normal dogs receiving aldosterone were studied during a steady-state water diuresis under Pentothal anesthesia and during progressive hypotonic saline diuresis. For both maintenance of the water diuresis and progressive hypotonic saline diuresis 0.45% NaCl was used. During the steady state water diuresis delivery of sodium to the diluting segment of the nephron as approximated by solute-free water clearance + sodium clearance/glomerular filtration rate (CH2O + CNa/GFR) was significantly lower in salt-depleted dogs compared to normal dogs with or without aldosterone. During progressive hypotonic saline infusion fractional free water excretion (CH2O/GFR) was similar in all three groups as CH2O + CNa/GFR increased up to 12-14 ml/min-100 ml GFR. Thereafter, CH2O/GFR continued to rise in virtually a straight line in salt-depleted dogs but leveled off in normal dogs with or without aldosterone. These data demonstrate that enhanced sodium reabsorption in the diluting segment of the nephron is an important determinant of the renal sodium retention in chronic extracellular volume contraction in dogs in addition to confirming the presence of increased proximal tubule sodium reabsorption in these animals.


Mixed lymphocyte cultures in rheumatoid arthritis. Random one-way microtiter mixed lymphocyte cultures between 43 rheumatoid arthritis (RA) patients and 45 controls consisting of 26 normal subjects and 19 miscellaneous non-RA patients were performed and results were evaluated as relative responses. Low responses (consisting of relative response less than 38%) were found in 31 out of 43 RA patients in cultures against eight of the RA stimulators. The remaining 35 RA stimulators tested yielded only normal mixed lymphocyte culture reactions. The same RA patients used as responders never produced low responses when stimulated by non-RA lymphocytes. But six of the control subjects gave low responses to two RA stimulators. The low responses did not appear to correlate with intake of aspirin, prednisolone, or gold salts, nor could they be reproduced by addition of RA serum of 7S or 19S fractions thereof containing either polyclonal or monoclonal rheumatoid factors. Short-term culture and washing before mixing with the allogeneic cells did not change the low responses suggesting that in vivo bound autoantibodies against lymphocyte receptors were not involved. Study of the inheritance of HLA and mixed lymphocyte culture determinants in the family of patient A. C. who most frequently elicited low responses indicated she was homozygous for a lymphocyte-defined determinant which has been called R. The low responses to A. C. could be interpreted as typing responses based on sharing of the same or of a similar lymphocyte-defined determinant. This gene appears to be increased in patients with RA with respect to non-RA controls and may reflect an association of genes within the HLA chromosomal region leading to predisposition for the development of RA.


Fate of soluble carbohydrate in the colon of rats and man. The fate of glucose in the colon of rats and man was investigated by measuring breath 14CO2 and fecal 14C after direct instillation of 14C-labeled glucose, acetate, and lactate into the cecum. For the 6 h after administration of as much as 400 mg of [U-14C]-glucose to the rat and 12.5 g to man, 14CO2 excretion was as rapid after intracecal as after intragastric instillation. Less than 20% of 14C instilled into the cecum as glucose was recovered in feces and only about 15% of this fecal 14C was in a dialyzable form. The conversion of intracecally administered glucose to CO2 was dependent upon the presence of the colonic flora, as evidenced by the minimal excretion of 14CO2 after administration of [14C]glucose to germ-free rats. In contrast, acetate and lactate, fermentation products of glucose, were converted to CO2 as rapidly in germ-free rats as in their conventional counterparts. Measurement of O2 availability in the colonic lumen indicated that insufficient O2 was available for the aerobic metabolism of glucose by the colonic bacteria. These experiments suggest that the colon bacteria anaerobically metabolize most of the glucose to short-chain fatty acids, which are absorbed and oxidized by the host. Most of the remaining fecal glucose is converted to a larger molecular form that has limited osmotic activity. Thus, the colonic flora benefits the host by reducing the osmotic load of nonabsorbed carbohydrate and by making possible the salvage of a large percentage of the calories of carbohydrate, which is not absorbed in the small bowel.


Membrane permeability as a cause of transport defects in experimental Fanconi syndrome. A new hypothesis. The injection of sodium maleate (200-400 mg/kg) into rats produces aminoaciduria along with glycosuria and phosphaturia, resembling the Fanconi syndrome. This experimental model was studied by means of microinjections into proximal convoluted tubules of the kidney, stop-flow diuresis, and microperfusion of single nephrons. Our results show that, in maleate-treated rats, competition between amino acids or related structures (L-proline, L-OH-proline, and glycine) possesses the same characteristics, and net influx of amino acids appear normal at the proximal nephron. Data obtained by classical stop-flow techniques and single nephron microperfusions also indicate a normal entry of labeled amino acids (L-lysine, glycine, L-valine, L-proline, L-cystine), and 3-0-methyl-D-[3H]glucose and [32P]phosphate from the luminal side of the proximal tubule cell. However, the efflux of molecules from the cell appears enhanced throughout the proximal and distal tubule; molecules that exit at this site are excreted directly into the urine. Our results suggest that the phosphaturia, aminoaciduria, and glycosuria of the experimental Fanconi syndrome can be explained by a modification of the cell membrane permeability (increased efflux) at distal sites of the nephron rather than by a modification of the membrane transport (decreased influx) at the proximal sites, as is currently accepted. Our data also stress the importance of efflux phenomena in membrane transport.


Adrenergic regulation of blood pressure in chronic renal failure. Previous investigations have suggested that significant hypotension during hemodialysis may result from abnormalities of sympathetic nervous system activity. To further evaluate these phenomena, plasma dopamine beta-hydroxylase (D beta H) and cold pressor test (proposed indexes of efferent sympathetic nervous system activity) and amyl nitrite inhalation (an index of the entire baroreceptor reflex arc) were studied in two groups of patients: group I, patients exhibiting a mean arterial pressure decrease to less than 70 mm Hg during less than 10% of dialyses; group II (hemodialysis hypotension), patients with a mean arterial pressure decrease to less than 70 mm Hg during more than 90% of dialyses. The groups were similar with respect to plasma renin activity, renin response to ultrafiltration, age, duration of dialysis, nerve conduction velocity, plasma protein concentration, hematocrit, dialysis weight change, resting heart rate, sex, race, blood pressure and heart rate response to cold pressor test, and 125I-albumin plasma volume. Supine mean arterial pressure was higher in patients with hemodialysis hypotension than in patients without hemodialysis hypotension (group I) both before and after dialysis. Plasma D beta H activity was significantly higher in patients with hemodialysis hypotension (group II) than in group I both before and after dialysis. Amyl nitrite inhalation, expressed as change in delta R-R interval/mean arterial pressure decrease, was less in hemodialysis hypotension patients. These results suggest that hemodialysis hypotension may result from a lesion in the baroreceptors, cardiopulmonary receptors, or visceral afferent nerves. Furthermore, elevated mean arterial pressure in patients with hemodialysis hypotension may be neurogenic in origin, as reflected by plasma D beta H activity, and appears similar to the hypertension that follows baroreceptor deafferentation of experimental animals.


Degradation of circulating DNA by extracorporeal circulation over nuclease immobilized on nylon microcapsules. Studies were undertaken to determine whether deoxyribonuclease I, (DNase I) once immobilized on activated nylon microspheres, would be capable of degrading circulating DNA in vitro and in vivo in an extracorporeal circulation system in dogs. Nylon microspheres were prepared and after gentle hydrolysis and glutaraldehyde treatment, demonstrated a retention of up to 4.73 mg of Dnase I. In vitro studies showed that DNase I immobilized on microspheres degreded a significant percentage of 125I-native DNA (nDNA) within 15 min. Mongrel dogs were injected with 125I-nDNA and a variation in initial t 1/2 in individual animals was observed. Therefore, for experimental studies, 125I-nDNA was injected and decay was recorded during a control period in which untreated microcapsules were utilized in the extracorporeal system. DNase I microspheres were then introduced into the extracorporeal circuit which resulted in an acceleration of degradation of acid precipitable 125I-nDNA. When 200 mug of unlabeled DNA with 125I-nDNA was injected, a similar augmentation of DNA degradation was noted after extracorporeal circulation over DNase I microcapsules. This effect could not be attributed to release of DNase I from the microspheres since no 131I-DNase was detected in the serum or organs of the dogs at the conclusion of the experiments. 125I-nDNA:anti-DNA complexes were passively injected into dogs and after a similar control period of circulation over untreated microcapsules. DNase I microspheres were introduced. Results showed a rapid acceleration in the degradation rate of 125I-nDNA:anti-DNA complexes precipitable with (NH4)2SO4. Extracorporeal circulation over nylon microspheres resulted in no significant alteration of the host's hematocrit or platelet count, and little residual cellular debris on the microcapsules. These data suggest that DNAase immobilized on nylon microspheres may have a potential role in the specific therapy of systemic lupus erythematosus, when it is desirable to hydrolyze DNA circulating free or in combination with antibody.


The effect of hepatectomy on the synthesis of 25-hydroxyvitamin D3. The metabolism of [3H]vitamin D3 in hepatectomized vitamin D-deficient rats has been studied. Hepatectomy drastically disrupts vitamin D3 metabolism as revealed by prolonged high levels of [3H] vitamin D3 in the plasma compartment even 12 h after dose in contrast to sham-operated controls. Some conversion of [3H] vitamin D3 to [3H]25-hydroxyvitamin D3 was detected in hepatectomized rats, but the amount was small in spite of the high circulating levels of [3H]vitamin D3. Since the liver initially takes up much of an administered dose in normal animals and the conversion of [3H]vitamin D3 to [3H]25-hydroxyvitamin D3 is small in hepatectomized rats in spite of high circulating [3H]-vitamin D3, it is concluded that the liver plays a major role in the metabolism of vitamin D3 to 25-hydroxy-vitamin D3.


Location of phosphatidylethanolamine and phosphatidylserine in the human platelet plasma membrane. The location of phospholipids in the human platelet plasma membrane was probed with 2, 4, 6-trinitrobenzenesulfonate (TNBS). TNBS does not penetrate inintact cells and can label phosphatidylethanolamine (PE) and phosphatidylserine (PS). In tact platelets, PE is not accessible to TNBS during the initial 15 min. However, 6.9% PE reacts with TNBS after 30 min and 17.9% PE is labeled after 90 min. In intact platelets, PS is not labeled even after 2 h. In contrast, in phospholipids extracted from platelets 71% PE and 26.5% PS react with TNBS within 5 min. This indicates that PS is inaccessible and PE is relatively inaccessible to TNBS in intact platelets. After incubation of platelets with thrombin, there is increased labeling of PE but no labeling of PS. The incubation of platelets with thrombin (0.05 U/ml) for 5 min results in 16.2% increase of PE labeling during subsequent 30-min incubation with TNBS. PS does not appear to be a component of the functional surface of platelets. However, exposure of PE may have a critical role in platelet hemostatic function. The implication of the study is that there is asymmetry of phopholipids in the platelet plasma membrane which has considerable physiological significance.


Correction of characteristic abnormalities of microtubule function and granule morphology in Chediak-Higashi syndrome with cholinergic agonists. Chediak-Higashi (CH) syndrome is a genetic disorder of children and certain animal species including the beige mouse. We have previously described a membrane abnormality in CH mouse polymorphonuclear leukocytes (PMH). Whereas normal mouse PMN do not form surface caps with concanavalin A except after treatment with agents such as colchicine that inhibit microtubule assembly, CH mouse PMN show spontaneous cap formation. This capping is inhibited by 3',5 cyclic guanosine monophosphate and by the cholinergic agonists carbamylcholine and carbamyl beta-methylcholine that increase 3',5' cyclic guanosine monophosphate generation. These data suggested that microtubule function may be impaired in CH syndrome perhaps secondary to an abnormality in 3',5' cyclic guanosine monophosphate generation. The cholinergic agonists were also shown to prevent development of the giant granules that are pathognomonic of CH syndrome in embryonic fibroblasts isolated from CH mice and cultured in vitro. In this report it is shown that an extreme degree of spontaneous concanavalin A cap formation is also characteristic of peripheral blood PMN from two patients with CH syndrome. This indicates an abnormality of microtubule function in CH syndrome in man. 3',5' cyclic guanosine monophasphate, carbamylcholine, and carbamyl beta-methylcholine reduce spontaneous capping in CH cells. In addition, it is shown that monocytes isolated from the patients' blood and incubated in tissue culture generate a large complement of abnormal granules. When the same cells mature in vitro in the presence of carbamylcholine or carbamyl beta-methylcholine, the proportion of cells containing morphologically normal granules is significantly increased. These responses can be reproduced in vivo in the beige (CH) mouse. Animals treated for 3 wk and longer with carbamylcholine or carbamyl beta-methylcholline show normal granule morphology and a normal degree of concanavalin A cap formation in peripheral blood PMN leukocytes.


Effects of isoproterenol on regional myocardial function, electrogram, and blood flow in conscious dogs with myocardial ischemia. The effects of coronary occlusion and of subsequent isoproterenol infusion were examined in conscious dogs. Left ventricular (LV) function was assessed by measurements of LV diameter, pressure, velocity and dP/dt/P, and regional myocardial function was assessed by measurements of segment length (SL) and velocity of SL shortening in normal, border, and ischemic zones. Regional myocardial function was measured from the same sites, along with intramyocardial electrograms and regional myocardial blood flow as determined by radioactive microspheres. Coronary occlusion resulted in graded loss of function from the normal to severely ischemic zones with graded flow reductions and graded increases in ST segment elevation. Isoproterenol improved overall LV function, and function in the normal zone. Isoproterenol also improved function in 19 of 21 border-zone segments and in all moderately ischemic segments, while elevating further the ST segments. These changes were accompanied by increases in myocardial blood flow. In contrast, in severely ischemic segments, isoproterenol resulted in a deterioration of function, in that paradoxical motion occurred in segments previously akinetic during systole, while paradoxical motion was intensified in those segments in which it was already present. These changes were accompanied by further ST segment elevation but not by concurrent increases in blood flow. In addition, in 2 of 21 border zone segments, myocardial blood flow fell and these segments responded to isoproterenol with complete loss of function; paradoxical motion developed. Thus, in the conscious dog, a strong inotropic agent can improve function, even in the ischemic myocardium, as long as the required additional blood flow can be provided wither through primary or collateral channels.


Permselectivity of of the glomerular capillary wall. Studies of experimental glomerulonephritis in the rat using neutral dextran. Polydisperse [3h] dextran was infused into eight Munich-Wistar rats in the early autologous phase of nephrotoxic serum nephritis (NSN), thereby permitting direct measurements of pressures and flows in surface glomeruli and fractional clearances for dextrans [(U/P) dextran/(U/P) inulin] ranging in radius from 18 to 42 A. Despite glomerular injury, evidenced morphologically and by a marked reduction in the glomerular capillary ultrafiltration coefficient, the glomerular filtration rate remained normal because of a compensating increase in the mean net ultrafiltration pressure. In NSN rats, as in normal controls, inulin was found to permeate the glomerular capillary wall without measurable restriction, and dextrans were shown to be neither secreted nor reabsorbed. For dextran radii of 18, 22, 26, 30, 34, 38, and 42 A, (U/P) dextran/(U/P) inulin in NSN and control rats, respectively, averaged 0.90 vs. 0.99, 0.81 vs. 0.97, 0.63 vs. 0.83, 0.38 vs 0.55, 0.20 vs. 0.30, 0.08 vs. 0.11, and 0.02 vs. 0.03. Using a theory based on macromolecular transport through pores, the results indicate that in NSN rats, effective pore radius is the same as in controls, approximately 50 A. In NSN, however, the ratio of total pore surface area to pore length, a measure of the number of pores, is reduced to approximately 1/3 that of control, probably due to a reduction in capillary surface area. These results suggest that proteinuria in glomerular disease is not due simply to increases in effective pore radius or number of pores, as previously believed. Using a second theoretical approach, based on the Kedem-Katchalsky flux equations, dextran permeability across glomerular capillaries was found to be slightly lower, and reflection coefficient slightly higher in NSN than in control rats.


Permselectivity of the glomerular capillary wall. Studies of experimental glomerulonephritis in the rat using dextran sulfate. To determine whether the increased filtration of serum proteins after glomerular injury is the consequence of altered electrostatic properties of the glomerular capillary wall, we measured fractional clearances of the anionic polymer, dextran sulfate, in nine Munich-Wistar rats in the early autologous phase of nephrotoxic serum nephritis (NSN). In agreement with previous studied from this laboratory, whole kidney and single nephron glomerular filtration rates were normal in NSN rats despite histological evidence of glomerular injury, and despite a marked reduction in the glomerular capillary ultrafiltration coefficient to approximately one-third of normal. In the companion study (9), it was shown that in NSN rats the mean fractional clearances of neutral dextrans over the range of effective molecular radii from 18 to 42 A were reduced, compared to normla. In contrast, in the present study the mean fractional clearances for dextran sulfate over the same range of molecular radii were significantly greater than those found previously for normal Munich-Wistar rats. The fractional clearance of dextran sulfate molecules of the same molecular radius as serum albumin (approximately 36 A) was increased markedly, from 0.015 +/- 0.005 (SEM) in nonnephritic controls to 0.24 +/- 0.03 in NSN (P less than 0.001). The sialoprotein content of glomeruli, estimated by the colloidal iron reaction, was reduced in NSN rats as compared to normal controls. It is concluded that the abnormal filtration of anionic serum proteins, such as albumin, seen in glomerulopathies is, at least in part, the consequence of loss of fixed negative charges from the glomerular capillary wall.


Spectrofluorescent detection of in vivo red cell lipid peroxidation in patients treated with diaminodiphenylsulfone. In the absence of vitamin E deficiency, red cell lipid peroxidation has not been clearly demonstrated in freshly drawn blood obtained from patients with various hemolytic anemias despite indirect evidence that oxidative decomposition of cell membrane unsaturated fatty acids occurs in these particular hemolytic states. Recent studies have indicated that malonaldehyde, a decomposition product of oxidized polyunsaturated fatty acids, is able to covalently cross-link the amino groups of protein or lipid resulting in a fluorescent compound. In the present study we have utilized spectrofluorescent technique to assess whether such fluorescence is present in red cell lipid extracts in association with lipid peroxidation. In vitro red cell lipid peroxidation produced by ultraviolet radiation or the oxidant gas ozone was associated with the development of a fluorescent peak (excitation maximum 360 nm; emission maximum 440 nm) in lipid-containing red cell extracts Similar fluorescence was observed after incubation of red cells with malonaldehyde or with malonaldehyde-containing extracts of peroxidized red cell lipid. Spectrofluorescent evaluation of chloroform: isopropanol extracts obtained from the freshly drawn red cells of six patients receiving the oxidant hemolytic drug diaminodiphenylsulfone also revealed a peak at 440 nm which ranged from 39 to 78 U. In contrast, the levels in samples obtained from 11 hematologically normal subjects were 17-27 fluorescence U. No evidence for an increase in blood levels of free malomaldehyde was observed using the 2-thiobarbituric acid test which is the most commonly performed assay of lipid peroxidation. Serum vitamin E levels were within the normal range. Density separation indicated that the bulk of the fluorescence was present in older red cells. A similar fluorescent peak was also observed in lipid-containing extracts of red cells obtained from rabbits repeatedly injected with phenylhydrazine. The finding of fluorescent spectra consistent with the cross-linking of aminolid by malonaldehyde in the red cells of patients receiving diaminodiphenylsulfone indicates that in vivo red cell lipid peroxidation does occur in the absence of vitamin E deficiency.


Detection of anti-DNA antibody using synthetic antigens. Characterization and clinical significance of binding of poly (deoxyadenylate-deoxythymidylate) by serum. Virtually all preparations of DNA used to detect antibody to native DNA (nDNA) by binding assays have been found to be subtly contaminated by single stranded DNA. Because recent DNA binding data have directly challenged the unique role previously attributed to these antibodies in systemic lupus erythematosus (SLE), resolution of the consequent ambiguity is of theoretical and practical importance. It is proposed that a synthetic nDNA molecule (dAT) might circumvent this difficulty by being antigenically equivalent to nDNA while, on theoretical grounds, lacking significant contamination with single stranded DNA or other cellular antigens. These expectations were generally confirmed by biochemical and immunological analyses. In clinical studies, sera from 124 pateints with SLE and from controls were examined for their ability to bind dAT. In contrast to results with KB binding, patients with non-SLE rheumatologic disorders were indistinguishable from normals by dAT binding. dAT binding was elevated in 85% of sera from SLE patients with clinically-judged active nephritis but in only 9% of those with inactive renal disease. Active non-renal disease, including cerebritis, was not associated with increased dAT binding. Individual non-lupus sera which bound increased amounts of KB DNA, failed to bind dAT. It is suggested that such binding resulted from contaminating non-nDNA antigens. When elevated, dAT binding, like KB binding, varied with disease activity and might thus be useful as a parameter thereof. In several patients elevated dAT binding led to the finding, on biopsy, of clinically silent, active, diffuse proliferative nephritis. It is concluded that use of synthetic nDNA antigens such as dAT may offer theoretical and practical advantages over naturally-derived preparations in detecting anti-nDNA, both clinically and for investigational purposes. Also, caution is urged in interpreting DNA binding data derived from incompletely characterized systems, particularly with regard to the occurrence of anti-nDNA antibodies in serum.


A comparison of the metabolic response to phagocytosis in human granulocytes and monocytes. Recent studies indicate that oxygen radicals such as superoxide or singlet oxygen may be important in the functional activity of human granulocytes. We have examined the possible importance of these radicals in the functional capacity of human blood monocytes. Monocytes, like granulocytes, generate chemiluminescence during phagocytosis. Chemiluminescence is impaired 50-90% by superoxide dismutase, an enzyme which enhances the dismutation of superoxide to hydrogen peroxide. These results indicate that superoxide is related to the chemiluminescence generated by monocytes. Superoxide dismutase in a concentration which impaired chemiluminescence also impaired the staphylococcal killing by monocytes. Hexose monophosphate shunt activity and hydrogen peroxide production by granulocytes and monocytes were also evaluated. The oxidation of [1-14C]glucose was used as a measure of hexose monophosphate shunt activity and the oxidation of [14C]formate as an estimation of hydrogen peroxide production. The oxidation of both substrates by monocytes was increased during phagocytosis but, in contrast to results in granulocytes, was not further increased by the addition of superoxide dismutase. These data indicate that superoxide may be important in bactericidal activity of human monocytes. Our results also suggest that the metabolism of oxygen radicals in monocytes and granulocytes may be different.


Local effects of acute cellular injury on regional myocardial blood flow. This study was designed to examine local effects of acute cellular injury on regional myocardial blood flow. Studies were carried out in awake dogs chronically prepared with indwelling catheters in the aorta and left atrium and an occluder on the left circumflex coronary artery. Regional myocardial blood flow was measured by using 7-10-mum radioisotope-labeled microspheres after reestablishing inflow to a region subjected to a 2-h complete coronary occlusion. Microspheres were injected 15 s, 15 min, 4 h, and 3 days after reperfusion to assess effects of cell injury at varying intervals after reperfusion. Effects of acute cellular injury on blood flow were assessed by determining the relationship between regional blood flow and the extent of subsequent cellular necrosis measured in multiple tissue samples, weight 1-2 g, from the entire ischemic zone. The extent of cellular necrosis was determined from histological sections of each tissue sample. Prolonged ischemia effected local tissue responses which altered perfusion as a function of the interval after reperfusion and the subsequent extent of myocardial necrosis. Although the net response in each region immediately after reperfusion was vasodilation, the hyperemia in regions which subsequently suffered cellular necrosis was attenuated in direct proportion to the extent of subsequent infarction. Blood flow to acutely injured regions remained equal to, or in excess of, flow to nonischemic regions 15 min after reperfusion, but at 4 h and 3 days after reperfusion, flow was significantly decreased in regions with greater than 50% infarction. Thus, these data indicate that prolonged ischemia initiates tissue responses which progressively reduce myocardial perfusion after reperfusion. These effects on tissue perfusion may result from normal responses to irreversible injury and (or) abnormal responses to reversible and thus, potentially alterable, ischemic injury.


Behavioral and physiological effects of examiner sex on process and reactive schizophrenics. In the physiological (polygraph) data, the sex of the E (ES) interacted with the sex of the patient (PS) or the patient's process-reactive status (PR) in only 1 of 16 analyses. Only in the heart-rate variability data was the ES by PS interaction significant (p less than .001). Sex of the E had an appreciable effect in two of the three measures of associative disturbance. The ES by PS interaction was significant (p less than .025) in the recall measure of instability of though processes, and the same interaction neared significance (p less than .06) in the multiword response measure of associative disturbance. It appears that the sex of the E should be considered in studies that use measures of associative disturbance and perhaps when heart-rate variability measures are used.


Suicidal behavior and childhood onychophagia in hospitalized psychiatric veterans. This investigation of adult suicidal behavior and childhood onychophagia among hospitalized psychiatric male veterans suggests that for only personality disorders does childhood non-onychophagia show a significant relationship to adult nonsuicidal behavior. Otherwise, this study indicates that the presence or abscence of childhood onychophagia is not a significant suicidal or nonsuicidal factor among these veterans with a psychotic, neurotic, or personality disorder classification.


Emotional and social real-life problem-solving thinking in adolescent and adult psychiatric patients. The ability of adult and adolescent psychiatric patients to solve emotional problems such as anxiety and depression as well as problems that arise within the social sphere was examined, as was the question of whether the abilities to solve problems in the emotional and social spheres are related. With IQ partialled out, patients and controls did not differ on emotional problem-solving ability, but did differ on social problem-solving ability. Emotional problem-solving ability was found to be related to intelligence, while social problem-solving ability was not. Emotional problem-solving may require more abstract ability than social problem-solving, and normals may need only social problem-solving for adjustment.


Androgyny and need achievement in male and female psychiatric inpatients. An androgyny (gender identity) and a need achievement (n Ach) test were given to 28 normals, 23 schizophrenic patients, and 23 nonschizophrenic psychiatric patients. The psychiatric groups averaged a little over 3 weeks of hospitalization. There were gender differences for the androgyny and n Ach tests, but there were no significant differences among the three groups and no gender X diagnostic group interactions. There were significant correlations between age and both androgyny and n Ach scores, but no significant correlation between androgyny and n Ach scores.


Spatial vs. nonspatial reasoning ability in chronic schizophrenics. Forty chronic male VA schizophrenics were matched with veterans who were seeking educational counseling, and both groups were tested on a 32-item measure of spatial and matched nonspatial reasoning questions. Schizophrenics were inferior in spatial reasoning not only when compared to controls, but also when compared to their own level of functioning on nonspatial reasoning, which suggests that spatial reasoning may be selectively more impaired than general reasoning ability in male chronic schizophrenics.


Comparison of differential diagnostic discrimination for abbreviated and standard MMPI. MMPI response protocols for 194 psychiatric patients were scored on the basis of the first 168 items and then on the usual 400 items. The MMPI-168 raw scores were converted to estimates of conventional clinical scale scores. The Ss were divided into 10 major categories on the basis of final clinical diagnosis. Multiple discriminant analysis was used to compare the discriminant validity of the abbreviated and standard scoring. The results indicated no loss in discrimination to result from scoring based on only the first 168 items. Conversion tables that can be used to transform MMPI-168 raw scores to standard MMPI clinical scale scores are presented for further research and clinical use.


Personality and suicidal history in psychiatric patients. The study sample comprised 575 psychiatric referrals for whom MMPI data were available. Patients were categorized according to suicidal history. The attempted suicide and nonsuicidal patients were differentiated significantly on the D, PD, MF, DY, ES, NE, EX, HO, SD, IP, ANX, and UNC scales. Important differences between the sexes emerged; whereas for men the profiles of the suicidal ideation and nonsuicidal patients were similar, for women those of the suicidal ideation and suicide attempt were similar. Male and female suicide attemptors correspond closely in the pattern and degree of deviation from the nonsuicidal patients of their own sex. The study indicates that patients who have a history of suicide attempts constitute a more psychologically disturbed group and points to a need for further examination of the meaning of suicidal ideation for men and women.


Acceptance of general personality interpretations prior to and after receipt of diagnostic feedback supposedly based on psychological, graphological, and astrological assessment procedures. There was no difference in the acceptance of a general personality interpretation supposedly based on psychological, graphological, or astrological assessment procedures. Ss told that their general personality interpretation was based on one of the three assessment procedures, however, accepted the interpretation to a greater degree than did Ss told the interpretation was "generally true of people." S faith in all assessment procedures and perceived diagnostician skill increased significantly from before to after receipt of the diagnostic feedback. Ss elicited a halo response after they had received the interpretation, such that they generated a highly consistent positive (or negative) view of the assessment procedures and diagnostician skills. Implications of results from this acceptance paradigm were discussed for diagnosticians and therapists.


Test purpose and test response in psychiatric patients and "normal" students. The paper reports two experiments concerned with the effects of instructions on personality and self-report symptom measures. The first experiment investigated whether newly referred psychiatric patients respond differently according to whether they believe the questionnaires are being completed for research purposes or as part of a diagnostic procedure. Experiment II examined similar instructional effects with "normal" student Ss. Students either were told that the questionnaires were for research purposes or that they were part of a psychiatric screening procedure. Results showed that females in both groups reported more symptoms and had higher neuroticism scores than males. Instructions had no significant effect. It was concluded that such measures may be less sensitive to test-taking bias than often is assumed.


Conformity and modeling in an aversive task. High- and low-conformity groups, as measured by the California Personality Inventory, were exposed to a video-taped model who performed an aversive task (i.e., self-administration of electric shock). Comparable groups performed the task without demonstration by the model. In both groups, the modeling procedure produced significantly higher levels of self-administered shock. However, the conformity variable demonstrated no main effect and no interaction with the modeling variable.


Influence of physical fitness on second- and third-order personality factors using orthogonal and oblique rotations. The study investigated the relationship between physical fitness and personality variables at second- and third-order factor-analytic structures. Further, the stability of the factor structures at pre- and post-physical fitness program tests was examined by orthogonal and oblique rotations. Physical fitness and personality data were collected on 56 middle-aged males. The fitness and personality variables were factor analyzed and rotated orthogonally and obliquely by the principal axis form of solution. As a result, five second-order factors were extracted, both initially and finally. Factor scores were estimated for each S on each of the second-order factors, and data were factor analyzed to extract the third-order factors. The second-order factors closely resembled Cattell's factors, but subtle differences were found to exist between initial and final factor structures that may have been due to the influence of the fitness program. Two third-order factors were extracted initially and three finally when the factor scores were rotated orthogonally and obliquely, and physical fitness was associated with two of these hierarchical factors both initially and finally. The hierarchical factor structures appeared to be comparable to the scales of Eysenck. On the basis of the present findings it was concluded that the problem of rotation was not of importance and scientifically uninteresting and that the hierarchical factor solutions were highly stable. Further, it appears that the hierarchical levels of personality are manifested in two syndromes confounded by "traits" and "states" of personality. These two syndromes are Introversion vs. Extraversion and Neuroticism vs. Stability. The extraction of additional factors, such as Low Superego Strength vs. High Superego Strength, as in this study, is completely dependent upon the treatment or conditions superimposed.


Relationship between sex drive and sexual frustration and purpose in life. Forty-eight college students (18 males, M age = 24.3, 30 females, M age = 23.5) participated in a study that investigated the relationship between one's sense of purpose in life and sexual attitudes and behavior. The test instruments included the Purpose in Life Test (PIL), a Sex Drive and Interest Scale, and a Sexual Frustration and Maladjustment Scale. Correlations were computed between the students' PIL scores and scores on each of the sex scales. The results indicated no relationship between PIL scores and the scores on the sex drive scale, whereas significant negative correlations were found between PIL scores and the sexual frustration scores for males and for the combined group of males and females. The scores on the PIL and the sexual frustration scale were not related to the students' sex. These results support Frankl's theory that sexual frustration may be a manifestation of a more general existential frustration.


Personality deviancy and prison incarceration. This investigation was designed to study personality differences among prison inmates that could be attributed to the number of felony offenses and the length of incarceration. MMPI profiles of 93 inmates of a medium security prison were obtained and analyzed. Special attention was directed to the five MMPI variables K, D, PD, SC, and MA. These five variables taken collectively successfully differentiated first offenders from repeaters and short-term from long-term inmates. The results support the hypothesis that increased incarceration has a harmful effect upon personality.


Child-rearing attitudes of subjects who vary in guilt. The present study sought to determine whether high- and low-guilt Ss differ in their child-rearing attitudes. High-guilt Ss were found to be more likely to prefer an overprotective orientation combined with harsh punitive control. In general, attitudes of the high-guilt Ss were seen as more likely to produce psychological disturbance in their children.


Personality profiles in asthma.

Personality profiles in asthma. One hundred and fifty-five hospitalized asthma patients were administered the Minnesota Multiphasic Personality Inventory (MMPI) in order to evaluate the existence of common personality characteristics. When the full sample was divided into subgroups according to age, sex, and duration of the illness, it was found that patterns emerged that appeared largely explicable by these variables rather than the asthma per se. The single most frequent pattern observed across these subgroups was a V-shaped configuration of a "neurotic triad" (scales 1, 2, and 3). This pattern is not unique to asthma, but is also characteristic of other chronic illness populations and seems to represent a defensive stance in coping with the problems of chronic illness. The findings speak against any stereotypic asthmatic personality. It appears more profitable to investigate individual personality patterns associated with coping styles and their relationship to the illness via behaviors that either maintain or delimit the effects of chronic asthma.


Locus of control as predictive of goal-directed behavior. EEO Upward Mobility Program participants were compared with three different control groups along I-E locus of control dimensions. With this instrument and these Ss, no significant differences were found when participation in the program was used as an indicator of goal-directed behavior.


Hopelessness, internal-external locus of control, and depression. This research examined the relationship between hopelessness, defined as a system of negative expectancies about the future, and two theoretically relevant constructs: internal-external locus of control, and depression. Two samples of 67 and 44 undergraduates were administered the Beck, et al. Hopelessness Scale, the Rotter Internal-External Scale, and the Beck Depression Inventory. The data of both samples supported the predictions that hopelessness would be positively related to external locus of control and to depression.


Internal-external locus of control and guilt. This study examined the relationship between internal-external locus of control and guilt. Ss were 65 male and 137 college undergraduates who completed the Rotter I-E scale and the Mosher Hostility and Morality-Conscience Guilt Scales. Results demonstrated that internals reported a higher degree of hostility guilt than externals. Also, females expressed greater hostility and morality-conscience guilt than males.


Augmenting-reducing and sensation seeking: a test of Sales' hypothesis. Physiologically, augmenters amplify incoming stimulation, while reducers attenuate such stimulation. Sales has theorized that this characteristic is a determinant of an individual's need for stimulation and that reducers require more actual stimulation to reach this perceived optimal level than do augmenters. The theory predicts that measures of these characteristics would be correlated. The absolute auditory threshold was used as a measure of augmenting-reducing and the Sensation-Seeking Scale as a measure of need for stimulation in a study that tested 42 college students. The theoretical prediction was not confirmed. The bearing of these negative findings upon Sales' theory and the possibility that the auditory threshold is not a valid measure of augmenting-reducing were discussed.


Personality characteristics of death-row prison inmates. An analysis of MMPI differences that appeared between a sample of 34 male inmates sentenced to be executed by asphyxiation and a representative prison population sample of 2,551 male inmates revealed that the profiles of both groups were indicative of a behavior disorder. The Death Row inmates presented significantly higher elevations on the PA and SC scales. Further evaluation of the subscale scores for the PA and SC scales demonstrated that the test responses of the Death Row inmates to these two scales were related more closely to feelings of resentment, hopelessness, failure, frustration, isolation and social alienation rather than to any delusional, dissociative or bizarre thought processes. Evaluation of the Death Row inmates' responses to four additional MMPI scales supported the previously made contention that the primary concern was with indices of a behavior disorder associated with the situational stress of being confined on Death Row to await execution rather than with indices of psychotic-appearing thought processes. In light of these findings it is felt that high PA and SC profiles scored by inmates who are awaiting execution should be supported by other MMPI scale, subscale and additional scale configurations, as well as other clinical inferences, before psychosis-related diagnoses are made.


Appreciation of risqué cartoon humor in male and female repressors and sensitizers. Male and female nondefensive sensitizers, defensive repressors and nondefensive repressors were instructed to rate the degree of humor in each of 40 cartoons. The cartoons, which previously had been equated for funniness, either contained sexual themes or were completely devoid of sexual content. As hypothesized, female repressors rated sexual cartoons as less humorous than nonsexual cartoons. In addition, female sensitizers rated sexual cartoons as funnier than did female repressors. No differences were found for male Ss. Results were interpreted according to an approach-avoidance model of repression-sensitization.


The personal beliefs inventory: a factor-analytic study. An exploratory study into the factor structure of the Personal Beliefs Inventory (PBI) was conducted. The Wherry-Wherry hierarchical factor analysis was employed to analyze the 60 X 60 intercorrelation matrix of PBI items. The hierarchical solution revealed a general PBI factor structure that implies low self-worth, an attitude consistent with Ellis's theory of emotional disturbance. In addition, six interpretable lower-order factors were revealed and discussed.


Personality correlates of WAIS performance. The relationships between two of Cattell's second-stratum factors, Cortertia and Temperamental Independence, and WAIS scores were investigated for 122 men and 127 women. For men, both Cortertia and Temperamental Independence were related significantly to WAIS scores. For women, Temperamental Independence, but not Cortertia, correlated significantly with WAIS scores. The variability in the degree of relationship between the individual subtests and the personality factors was noted, and the cross-lagged panel correlation methodology was suggested as a possible approach to investigate the causal connections between personality factors and abilities.


The Bender-Gestalt and the Halstead-Reitan battery: a case study. A single case with severe static left hemisphere cerebral damage was used to illustrate some deficiencies in the Bender-Gestalt (B-G) test and to compare its results with the Halstead-Reitan battery. The B-G did not indicate the existence of any brain damage because visuoconstructional tests evidently are related directly only to the right parietal area. The Halstead indicated the existance of brain damage, the amount of impairment to various mental functions, the location, process status, and general type of pathology and provided an evaluation of residual functions. Used as a screening test, the B-G is useful because it measures nondominant functions and is a "don't hold" test. The Halstead should be used when a more complete evaluation or critical test for brain damage is required.


Ethnicity, socioeconomic status, and pattern of WISC scores as variables that affect psychologists' estimates of "effective intelligence". Psychologists estimated "true IQs" or "effective intelligence" from WISC profiles that varied for ethnicity (black, Mexican-American, or white), social class (lower or middle), profile (three scatter patterns), and direction of Verbal-Performance Scale discrepancy. Psychologists gave higher IQ estimates to black and Mexican-American children's profiles than to the same profiles of white children. Social class was not a significant factor. Profiles with much scatter received higher IQs than profiles with limited scatter. The pattern of subtest scores also affected estimates, while the direction of the Verbal-Performance discrepancy was not significant. Finally, the WISC was judged to be more valid for white than for black and Mexican-American children. Explanations of the findings were discussed.


Cognitive deficits in patients with unilateral war-related frontal lobe lesions. The findings of this study may be summarized as follows: (1) No significant general cognitive impairment occurred in S samples with unilateral frontal lobe lesions; (2) Impairment of cognitive performance was greater in Ss with lesions posterior to the Fissure of Rolondo than in well-matched Ss with frontal lobe lesions; (3) Specific cognitive deficits are infrequent in Ss with frontal lobe lesions; (4) No significant differential impairment of cognitive performance was associated with hemispheric lateralization of frontal lesions; and (5) No significant differential impairment of verbal and nonverbal performance was associated with hemispheric lateralization of frontal lesions.


The expectation-reality discrepancy and premature termination from psychotherapy. The confirmation or disconfirmation of initial client expectation with regard to the psychotherapy process was related to drop out from psychotherapy for clients of a university psychological clinic. Previous hypotheses and research findings emphasized the existence of a linear relationship between expectancy confirmation or disconfirmation and drop out from psychotherapy. Contrary to those findings, the present study revealed significant curvilinear relationships between the two variables in question. Cultural and intellectual differences between the lower-class patient population, which exhibited linear relationships between expectancy confirmation or disconfirmation and drop out, and the present college population, which exhibited curvilinear relationships between the variables under investigation, were discussed as factors that contributed to the divergent findings of the present study.


Presenting problems of students at a university psychological clinic. Previous research in college student mental health indicates that most psychological problems stem from the academic area of the student's life. However, many previous studies focused upon the general college population and did not consider the problems of students who are receiving mental health services. In the present study, college students who sought psychological counseling at a university clinic were asked to rate the severity of their problems in 10 problem areas and to provide written descriptions of specific problems within each area. Clients' disturbance ratings and clinical judges' ratings of the clients' written problems revealed that problems in the area of self and self-satisfaction were the most severe problems for college students who sought psychological services.


Effects of physical training on mood.

Effects of physical training on mood. Thirty-six adult men at high risk of coronary artery disease were assigned to either an exercise or no exercise (control) group. Improvements in physical fitness were accompanied by improvements on two mood measures, anxiety and depression. No change was found on measures of adjustment, self-confidence and body image.


Avowed approval of psychotherapy session content among novice A and B therapists. The present data thus affirm previous research that attributes a more accepting style to A therapists. Specifically, A therapists expressed greater avowed approval of in-therapy discussion of unusual thought and behavior, subjective material such as dreams and fears, and certain nontraditional attitudes toward divorce and feminine roles. Similarly, psychology trainees on the whole expressed greater approval of unusual and subjective material and were more favorable in their attitude toward discussion of certain family difficulties and therapeutic progress than were psychiatry residents.


The Democratic Values Scale and professional affiliation. Therapists from four professional groups--nursing, psychiatry, psychology and social work--were compared on Lerner's Democratic Values Scale. Significant professional differences were found on this scale. The findings raise questions about the predictive power of this scale when a variety of mental health professionals are studied.


Neurotic anxiety, pronoun usage and stress. The use of the pronoun "I" when a speaker refers to his own actions, thoughts, or emotions is appropriate. Omission of the pronoun or the use of "you" or "it" may be taken as an indicant of psychological distantiation. This study examines the effects of stress and neurotic anxiety on pronoun usage. Forty-five male and female undergraduate Ss enrolled at Virginia Commonwealth University were selected randomly from 172 volunteers assessed for neurotic anxiety level as measured by the Maudsley Personality Inventory and Taylor Manifest Anxiety Scale. Treatment consisted of asking 20 emotionally charged questions, 10 of which were neutral baseline questions and the other 10 were either negative, neutral, or positive in stress. Responses were tape recorded and transcribed. It was found that negative stress interacting with medium level anxiety neurotics significantly increased distantiation above baseline levels. A hypothesis to explain the results was offered.


Assessing intertrainer effects on the Empathic Understanding Scale: training the trainer. The purpose of this study was to develop a procedure that would provide a preliminary assessment of the level of intertrainer agreement on the Empathic Understanding scale. To illustrate the proposed procedure, a pilot study was undertaken in which 30 excerpts of helping interactions that included the client's statement, therapist response, and client's subsequent response were rated by experienced raters trained by a Carkhuff trainer and a non-Carkhuff trainer. Results indicated that raters trained by different trainers make significantly different judgments about the level of therapist empathy at high levels of empathy. Results of this study were discussed in light of possible scale reliability and construct validity problems. A detailed description and rationale of the proposed procedure was outlined.


Interviewee matching of interviewer temporal speech behaviors as related to perceived empathy, warmth, and genuineness. The present study used an experimental analogue of the initial interview to examine the relationship of therapist durational speech characteristics to therapist empathy, warmth, genuineness and the state of the "therapeutic relationship" as rated by the interviewee. Cross-validated results revealed a modest direct relationship between interviewee speech modelling (DOU) and all process variables examined, with the exception of genuineness. Efficacy of the automated standardized interview as a research tool also was demonstrated. The results implicate the future examination of the relationship between therapist-client speech and silence measures and process variables.


Fantasy in individuals who smoke, stopped smoking, and never smoked. The present study advanced the hypothesis that individuals who smoke tend to fantasize more than those who have stopped smoking or never smoked. Ninety males and 90 females, with each sex divided into three categories (smokers, stopped smokers, and never smoked) were used. Results of the study supported the hypothesis when applied to male smokers, but not to female smokers. While male smokers tended to fantasize most, the opposite was found for the female smoker, who fantasized least. This was also true in the specific area of achievement.


The efficacy of programmed instruction in the training of paraprofessionals. The authors assessed the efficacy of a self-instructional psychiatric learning program to provide training for paraprofessional psychiatric personnel. The self-regulated learning system, which originally was developed to train medical students, was designed to impart basic psychiatric knowledge and diagnostic skills. Changes along personality dimensions that occurred as a function of participating in the programmed learning project also were examined. Participation in this program was associated with substantial pre-post changes in dogmatism and locus of control for males as well as significant increments in psychiatric knowledge and diagnostic skills for the group as a whole. The benefits derived from this easily administered training procedure suggest its feasible inclusion in paraprofessional inservice training programs.


Longitudinal investigation of changes in interviewing performance of medical students. The purposes were to determine the direction and extent of change in a medical student's ability to relate to patients between the sophomore and senior years, to assess the degree of predicted senior year performance from the sophomore year, and to determine the reliability of two major methods: interaction analysis (IA) and global faculty ratings. Twenty-two students were video-taped conducting two 10-minute interviews with a programmed patient: one as a sophomore, the other as a senior. The results for the interaction analysis method showed that the students were more directive, used more exploratory behaviors, were less supportive and more highly rated by the patients (actors) in the senior year. The physician-evaluators' global ratings indicated the students were more supportive, empathetic and open-ended, had fewer uncommon words, but conducted better overall interviews as seniors. The IA method was more reliable than global faculty ratings.


Are men therapists soft on empathy? Two studies in feminine understanding. A serendipitous finding and a replication among successive populations of clinical-counseling practicum students suggest that the typical female therapist communicates more empathically than her male colleague. In the first study, reactions of 8 women trainees were evaluated as more empathic than those of 10 men counterparts. Despite control for sex-typed handwriting cues in the second study, 8 male novitiates' responses were assessed as less empathic than those of 8 females. The results are consistent with the notion of differential sex-role prescriptions for interpersonal sensitivity.


Expectations, experiencing and change in psychotherapy. The relationships of client prognostic expectations and of level of Experiencing in psychotherapy with three variables of therapeutic change were explored in a correlational study that used 26 volunteer Ss who were in treatment with experienced therapists. A positive relationship was found between prognostic expectation and perceived improvement and a negative relationship between Experiencing and perceived improvement. The data also suggested positive relationships between Experiencing and cognitive change and attitude and cognitive change, while they provided no evidence for a relation between expectations and cognitive change.


A comparison of two treatments for depression: the antidepressive program vs. traditional therapy. This study compared a traditional therapy for depression with Antidepressive therapy, a regime of meaningless, boring work designed to provoke the patient to an assertive expression of anger. The Ss were 32 neurotic and 24 psychotic patients at the Tuscaloosa, Alabama Veterans Administration Hospital. Improvement was measured by scores on the Purpose-In-Life Test (PIL) and the Self-Rating Depression Scale. All patient groups improved significantly within a 1-week period. Neurotics treated on the Antidepressive program improved significantly more than neurotics treated on the Traditional program. However, the data failed to indicate that either program was significantly more effective than the other in the treatment of psychotics.


Jehovah's Witnesses and human tissue donation. Because of their religious beliefs members of the Jehovah's Witnesses sect do not permit human tissue donation, not even such a routine and life-saving procedure as blood transfusion. A group of 30 adult Jehovah's Witnesses was compared with groups of donors and nondonors on a variety of personality measures. Donor status is associated with a well-integrated body image and acceptance of mortality, while nondonor status correlates with a less-well-integrated body image, concern about body integrity, and anxiety about death. However, while Jehovah's Witnesses vigorously oppose human tissue donation they appear to do so on strong religious grounds rather than because of personal anxiety and thus are dissimilar to non-donors at large.


Schizophrenic behavior as a function of role expectation. The hypothesis that the behavior of schizophrenic patients is determined in part by role expectation was investigated. The Holtzman Inkblot Technique and a word association task were administered to the same patients under two conditions: (1) Ss were led to believe that the interviewer was unaware of their patient status and expected them to behave in a normal manner; and (2) Ss were informed that the interviewer was interested in their behavior as mental patients. The results indicated that there was less evidence of pathology on the Holtzman when Ss were told that the interviewer expected them to behave in a normal manner. More specifically, there was less Pathognomonic Verbalization and more Form Appropriateness in the normal expectation condition. The findings are consistent with current views as to the pathogenic effects of labeling and institutionalization.


Reliability of the Koppitz scoring system for the Bender Gestalt Test. This study investigated the test-retest reliability of the Koppitz scoring system with Bender Gestalt protocols of adult retardates. Results of a sample of 74 adult retardates yielded a correlation of .80 over an interval of 8 to 146 months. A directional measure of change between error scores on the first and second administrations was not significant, which suggests that the test-retest reliability coefficient is an accurate estimate of the Koppitz scoring system for adult retardates. Scorer reliability for three independent scorers ranged from .92 to .95, which suggests comparability to other investigations with different populations.


An empirical typology of heroin abusers. The MMPI profiles of 59 participants in a VA Drug Abuse Program were analyzed. A total of eight types were defined by factor analysis. Three of the groups accounted for 60% of the Ss. The three groups had profiles that involved elevations on scales 2, 4, 8, and 9.


Personality characteristics related to treatment decisions among inpatient alcoholics: a non-relationship. A battery of standard personality and experimental research scales was administered to 110 male alcoholic inpatients. No differences were found on the 30 scale scores derived from the tests among three groups with differential treatment dispositions: (1) those who discontinued treatment after a 2-week evaluation period; (2) those who chose to remain for a 60-day treatment program, but discontinued prior to completion; and (3) those who chose and did complete the 60-day program. It was suggested that attrition from an inpatient alcoholism program might be predicted better by a multivariate approach that used demographic, life history, psychosocial and personality variables as predictors.


Comments on the relationship between locus of control and alcohol abuse. Studies that report conflicting relationships between alcohol abuse and locus of control were reviewed. Possible explanations for the results were presented, as were data that indicate that locus of control may be related to age and to social desirability, but not to alcohol abuse. It was suggested that in the absence of a clear theoretical rationale for relating locus of control to alcohol abuse, the contradictory findings are not surprising.


Frequency of MMPI two-point codes in a large alcoholic sample. The MMPI two-point codes of 1,009 male Caucasian inpatient alcoholics were examined. Although the mean profile was 4-2, analysis of individual profiles revealed that 79% of the profiles were classified differently from the mean profile. These findings indicate that alcoholics are a heterogeneous group with respect to the MMPI. Some of the most frequently occurring codetypes seem to be associated with widely different behavioral descriptions, which leads to the inference that alcoholics are heterogeneous with respect to personality characteristics as well.


Discriminating alcoholic and nonalcoholic patients with conventional and factored MMPI scales: a comparison. The factor scales were significantly more accurate than the conventional clinical scales in discriminating alcoholic from nonalcoholic patients. Whereas no single clinical scale emerged as highly important to the discrimination, Factor III emerged as very important to it. The possibility that Factor III represents an "alcoholic" factor was raised. From this study, it appears that the factor scales represent a more refined scoring version of the MMPI item pool.


Exclusion of subjects with F scores at or above 16 in MMPI research on alcoholism. The results of these comparisons that used the MacAndrew and Holmes scales suggest that the practice of excluding Ss with F scores at or above 16 may result in the discarding of data on alcoholic and problem-drinking Ss with no appreciable gain in the statistical differentiation of the remaining Ss. In the case of the Hampton scale, application of the rule results in nonsignificant statistical results. Furthermore, the F scale differentiated the groups more effectively than did the Hampton scale. It is suggested that MMPI investigators who use the MacAndrew and other alcoholism scales reexamine the appropriateness of MacAndrew's exclusion rule for their particular samples.


Changes in perceived and experienced control among inpatient alcoholics. The Locus of Control and Experienced Control Scales were administered to 40 alcoholics shortly after admission to a rehabilitation program and again after approximately 6 weeks of treatment. During the course of treatment, the Ss evidenced an overall shift toward a more internal locus of control, an increase in the magnitude and relative degree of control experienced over interpersonal and intrapersonal pressures, and a decrease in the magnitude of control exerted on them by such pressures. The overall increase in the proportionate control experienced appeared to be accounted for by shifts made by those Ss who entered treatment with an initially internal locus of control.


Isoproterenol sensitivity and total body clearance of propranolol in hypertensive patients. The isoproterenol sensitivity (dose-response curve) and the total body clearance of propranolol were measured in 80 men including 15 normal subjects and 65 essential hypertensive patients (20 borderline and 45 permanent hypertensives). The critical dose of isoproterenol was found to be directly correlated to weight (P less than 0.01), age (P less than 0.001), and basal diastolic arterial pressure (P less than 0.001). A partial correlation coefficient study showed that the diastolic arterial pressure was of greater influence than weight and age. The total body clearance of propranolol was inversely related to the basal diastolic arterial pressure (P less than 0.0001) in hypertensive patients. The study provides evidence that the level of basal diastolic arterial pressure could influence the beta-receptor responsiveness and the beta-adrenergic blockade in hypertensive patients.


Naproxen plasma levels in volunteers after single-dose administration by oral and rectal routes. The bioavailability (plasma concentrations, AUC) of a rectal formulation (suppository) of naproxen was investigated in six healthy volunteers by comparison with an oral preparation (tablets). Plasma half-lives after both formulations were identical 10 hr 15 min+/-25 min (S.D.). Determined by the AUC the bioavailability of naproxen in the suppositories was 94.8%+/-6.3% of the bioavailability of naproxen in the tablets. This paper describes also a new gas-liquid chromatographic method for determining unchanged naproxen in human plasma which is quick, sensitive, and specific.