CPK-MB isoenzyme: use in diagnosis of acute myocardial infarction in the early postoperative period. The diagnosis of acute myocardial infarction (AMI) in the early postoperative period may be quite difficult in certain patients. Electrocardiograms fail to be diagnostic of AMI in as many as one third of patients with myocardial injury found at autopsy. Enzyme patterns commonly used to diagnose AMI in patients admitted to coronary care units are obscured by muscle injury, medications, cardioversion, surgical manipulation, and blood transfusion. The MB isoenzyme of creatinine phosphokinase (CPK) has been described as a specific indicator of myocardial injury. Therefore the CPK-MB isoenzyme level was evaluated as a potential aid in the diagnosis of AMI in the early postoperative period. Thirty patients undergoing cardiac surgery and 7 patients undergoing thoracic surgery not involving the heart were studied. CPK-MB isoenzyme was present in the serum in 10 of 30 patients after cardiac surgery but in none of 7 patients after thoracic surgery. The presence of CPK-MB isoenzyme was found to be a valuable adjunctive indicator in the diagnosis of AMI in the early postoperative period.


Arterial stenosis, pressure, and flow.

Arterial stenosis, pressure, and flow. The interaction between the effects of an arterial stenosis and postocclusion hyperemia was studied in a model of the capillaron system. A capillaron is a module consisting of soft-walled permeable vessels (capillaries) in a compliant capsule. Stenosis reduced flow in accord with arterial cross-sectional area. Addition of a capillaron reduced flow to a basal level. In this basal state, autoregulation and postocclusion hyperemia could be studied. Basal flow and autoregulation give no indication of the severity of the stenosis. The magnitude of the postocclusion hyperemia varied with the arterial pressure and, inversely, with the stenotic orifice area. In the absence of arterial pressure changes, the magnitude of the postocclusion hyperemia indicates the severity of the stenosis.


Disc variance: a potentially lethal complication of the Beall valve prosthesis. During 1975, 4 patients with erosion of the disc in Beall valve prostheses were seen. In one case the eroded disc was found loose in the distal aorta at postmortem examination. In 3 other cases, clinical diagnoses were made and successful reoperations performed. Because disc variance represents a potentially lethal complication, patients with disc prostheses should be examined at frequent intervals. When signs and symptoms of mechanical malfunction develop, the valve prosthesis should be replaced immediately to prevent death.


Intimal changes in arteriovenous bypass grafts. Effects of varying the angle of implantation at the proximal anastomosis and of producing stenosis in the distal runoff artery. Autologous arteriovenous bypass grafts were constructed between external iliac arteries in 20 mongrel dogs to determine the development of intimal fibromuscular hyperplasia. Animals received grafts at 55, 90 or 120 degree angles relative to the proximal anastomosis. Five animals with 90 degree angle grafts were also subjected to 80% stenosis in the runoff artery. All grafts showed the development of a fibromuscular tunica intima. Qualitative or quantitative intimal differences were not observed among grafts placed at 90 degree angles, 90 degree angles with runoff artery stenosis, or 120 degree angles. Grafts placed at 55 degree angles relative to the proximal anastomosis developed a consistently thicker fibromuscular layer in the tunica intima when compared to the other groups. These changes which were segmental in nature, occurred in the proximal and distal grafts and over the distal anastomosis.


Levels of circulating norepinephrine and epinephrine before, during, and after cardiopulmonary bypass in man. Little information is available on the levels of circulating catecholamines during cardiac surgery. A study was undertaken to measure the serum levels of epinephrine and norepinephrine before, during, and after cardiopulmonary bypass in 16 patients. Sampling were drawn before induction, after intubation, before bypass, 2 and 8 minutes after initiation of the bypass, and 20 minutes after bypass. The findings of this study show that the initiation of cardiopulmonary bypass was associated with a significant but transient fall in mean blood pressure accompanied by an increased secretion of adrenal epinephrine and norepinephrine. The cause of the observed hypotension may be due to an initial hemodilution of the circulating catecholamines by the 2 L. pump-priming solution. The secretion of adrenal catecholamines appears to be a compensatory response to the lowered blood pressure as indicated by the rapid return of the blood pressure in the ensuing minutes. Twenty minutes after bypass, both the blood pressure and serum catecholamine levels were observed to have returned to preinduction levels.


Severe stenosis of a viable homograft aortic valve. A case is reported of severe stenosis developing in a homograft aortic valve which was viable at the time of implantation. Calcific stenosis should be considered a potential late complication in viable, as well as biologically inert, homograft aortic valves.


Surgical management of impotence using the inflatable penile prosthesis. Experience with 36 patients. Inflatable hydraulic penile prostheses were implanted in 36 patients who had organic impotence. Selection of patients was based on a series of guidelines that included the historical aspects of the patient's initiative, acceptance of the device by patient and partner, motivations, and psychiatric evaluation. Minor complications after implantation were not associated with the ultimate successful function of the device. Major complications were mainly mechanical in origin and readily corrected by secondary surgical procedures. The single failure in this series was associated with infection around the prosthesis, which necessitated removal of the entire device. A nearly physiologic erection was produced in 375 patients. Functional application of the implanted device was successfully achieved in 34 of 35 patients who retained their device. Patient-partner acceptance has been excellent.


Cystometry and sphincter electromyography. Gas cystometry combined with electronically integrated sphincter electromyography provides a rapid and effective screening technique for evaluation of patients with disorders of micturition secondary to neurologic dysfunction. The most frequent cystometric patterns are (1) detrusor hyperreflexia secondary to interruption of the cortico-regulatory tracts and (2) detrusor areflexia secondary to impairment of the segmental innervation of the detrusor muscle. To observe these patterns it is necessary to perform detrusor reflex activation procedures, including change in posture, administration of bethanechol, and urethral and rectal distention. The two prinicpal sphincter disturbances observed with electronically integrated electromyography are detrusor sphincter dyssnergia and uninhibited sphincter relaxation. The delineation of combination of abnormal cystometric and sphincter responses provides for rational selection of pharmacologic and surgical therapy.


Small-Carrion penile prosthesis. A new implant for management of impotence. More than 75 patients have had excellent results using a new penile implant which consists of a silicone exterior with a silicone sponge interior. The prostheses are inserted into the corpora cavermosa; they feel and look like a normal erect penis. The prostheses are available in several lengths and two diameters, and the proper size is selected for each patient at the time of surgery. Complications have been minimal.


The implantable artificial genitourinary sphincter in the management of total urinary incontinence. The artificial genitourinary sphincter has been implanted in 31 patients with total urinary incontinence. Minor complications associated with implantation of this device were found to be mainly mechanical in origin, resulting in malfunction of the apparatus. Postoperative mechanical malfunction, however, was found to be correctable through a variety of secondary surgical procedures. Major complications, including infection around the prosthesis, vesical neck erosion, vesical-colic fistula, and urethral erosion, were generally associated with problems of cuff placement. In nearly all cases in which major complications occurred, it was ultimately necessary to remove the prosthesis. Overall results would indicate that patients with incontinence after transurethral prostatic resection in whom the inflatable cuff was placed around the vesical neck achieved the best results (70%). In this series of 31 patients, 68% had a normally functioning sphincter with complete correction of their urinary incontinence.


Genitourinary prosthetics of the present and future. Development of implantable prosthetic devices to restore genitourinary function has evolved from applying electrical stimulation techniques for bladder evaluation to adapting fluid energy transfer system for occlusion of the urethra to increase outlet resistance. These hydraulic prostheses have been implanted in several hundred patients in medical centers around the world. The principles behind the operation of this closed-loop system, an some alternative designs that simplify the implant procedure, are described here.


Psychogenic urinary retention in women.

Psychogenic urinary retention in women. There appears to be a spectrum of psychogenic urinary retention that is seen mostly in women. The degrees of psychiatric disorder and bladder disorder do not necessarily coincide. Some patients with psychogenic retention may have one acute episode temporally related to psychologic trauma. Others may present with problems related to large residual volumes such as recurrent urinary tract infection or incontinence. All patients require complete neurologic, urologic, and psychiatric evaluation. Permanent urethral catheterization is avoided if possible. Intermittent self-catheterization should be used during periods of psychotherapy and bladder training. Patients with neurogenic bladder, as determined by urodynamic studies, should be managed by bladder training and the use of pharmacologic agents when indicated.


Psychologic evaluation of impotent men.

Psychologic evaluation of impotent men. Psychologic evaluations have been performed as part of the screening process on men who were candidates for surgical implantation of the inflatable penile prosthesis. Goals and methods of evaluation are discussed, with special attention to the use of interview and psychologic test results. Minnesota Multiphasic Personality Inventory profiles that suggest a psychogenic basis for impotence are presented and discussed.


Bladder retraining. An organized program. The management of neurogenic bladder dysfunction has been associated with a relatively high incidence of upper urinary tract infections and urosepsis. Today, the regular use of modern diagnostic tools in roentgenology and urodynamics is available. Moreover, contraindications to bladder retraining are better defined, and we have available better methods of evaluating urodynamics, superior reconstructive and corrective urologic surgery, judicious use of intermittent catheterization, and prompt detection and treatment of recurrent bacteriuria. We also know that, with an organized program of bladder retraining and follow-up, a substantial decrease in morbidity of patients with neurogenic bladder dysfunction has become possible.


Passive urethral compression with a silicone gel prosthesis for the treatment of male urinary incontinence. Eighty-six patients who underwent implantation of the silicone gel prosthesis for post-prostatectomy incontinence are the subject of this study. The operation entails the implantation of a silicone gel prosthesis in the perineum to provide passive urethral compression. Several modifications of this operation have been implemented in the last 2 years, and analysis of our results indicates that lasting benefit can be achieved in about 70% of patients.


Differences in effect of 6-hydroxydopamine on the right and left atria from guinea-pig. The effect of chemical sympathectomy by 6-hydroxydopamine (6-OHDA) treatment was studied on guinea-pig atria. 6-OHDA treatment significantly reduced the positive inotropic effect of nicotine and tyramine on the left atrium, while similar treatment on the intact atria and the right atrium showed a decreased response to tyramine but not to nicotine. After 6-OHDA treatment the left atrium but not the right atrium showed supersensitivity to noradrenaline. The 6-OHDA induced reduction of catecholamine content and noradrenaline uptake was less effective on the right atrium in comparison to the left atrium and ventricles. After 6-OHDA treatment, tissue catecholamine fluorescence disappeared from all tissue layers of the left atrium but the number of specific fluorescent nerve terminals of the right atrium was only slightly decreased. These results indicate that adrenergic mechanisms of the right atrium exhibit higher resistance to sympathectomy by 6-OHDA than the left atrium.


Quantitative aspects on mitochondrial monoamine oxidase in human platelets. The number of monoamine oxidase molecules in human blood platelets has been estimated by titrating them with the irreversible monoamine oxidase inhibitor pargyline to be about 900 per thrombocyte and 200--300 per thrombocyte mitochondrion. It has also been calculated that monamine oxidase constitutes about 1/5,000 of the platelet mitochondrial outer  membrane surface. Molecular turnover numbers for benzylamine and tyramine have been estimated to be about 1,470 and 720, respectively.


Locus coeruleus: fibre growth regulation in oculo. Locus coeruleus (LC) neurons from fetal and young rats survived homotransplantation to the anterior eye chamber. The outgrowth of LC fibres on sympathetically denervated host irides could be quantified precisely using Falck-Hillarp fluorescence histochemistry and [3H]metaraminol uptake. Fetal LC neurons survive better than postnatal ones and produced fibres for one month in oculo: by then )0-50% of the area of the host iris was innervated. After intraocular maturation of the CNS graft the fibre amount on the iris remained constant. Introduction of an iris graft contacting a mature LC graft immediately stimulated the LC to a complete (100%) reinnervation of the iris graft without any change of the restricted innervated area already formed on the host iris. The outgrowth of LC fibres on irides was not influenced by the presence or absence of sympathetic or parasympathetic nerves or by nerve growth factor or its antiserum. We conclude that an iris transplant offers a specific growth stimulus for the LC graft and that this stimulus is not present in the normal host iris. The nature of this stimulus is unknown but may involve the sensory denervation of the iris graft.


Goniomitosis in rats affected by mycoplasma or macrolides. Infection with Mycoplasm pulmonis caused a slight increase in the incidence of chromosome breaks in goniomitotic cells of the rat testis. No differences existed between healthy and infected rats in the frequency of mitotic divisions, measured as the number of metaphases per slide. The macrolide antibiotics erythromycin and tylosin are widely used as antimycoplasmal drugs. Erythromycin was given to healthy rats intramuscularly at a concentration of 20 mg/kg, and tylosin perorally in the drinking water at a concentration of 0.1%, both for 10 days. Neither drug induced an increase in the incidence of chromosome breaks in the spermatogonia. But both these macrolides caused a definite reduction in the therapy of cell division. With erythromycin, this effect had disappeared 18 days after the end of treatment.


Goniomitosis in rats subjected to ethanol. Prolonged compulsory consumption of ethyl alcohol does not increase the incidence of chromosomal abnormalities in the spermatogonial cells of the rat. This was the result of an experiment in which rats given a nutritionally adequate diet received 10% (v/v) ethyl alcohol as their only supply of liquid for 70 days.


The survival of Toxoplasma gondii trophozoites in changes in osmotic pressure. It has generally been assumed that the trophozoites of Toxoplasma gondii cannot survive long outside the body and they cannot resist even small changes in osmotic pressure, and that toxoplasmosis is transmitted by transplacental infection, cysts and oocysts. In an attempt to demonstrate that trophozoites can resist changes in osmotic pressure, some were preserved in ascitic fluid made hypertonic with 1%, 2%, 5%, and 10% salt excess of sodium chloride and in ascitic fluid made hypotonic by mixing it in the ratio 3 : 7, 1 : 9 and 1 : 49 with distilled water. The trophozoites remained infectious in 1% salt excess for 29 days, in 2% for 15 days, in 5% for 5 days and in 10% salt excess for 2 days and in ascitic fluid diluted 3 : 7 with distilled water for 15 days and in ascitic fluid diluted 1 : 9 with distilled water for 3 days. We suggest that trophozoites, being resistant to changes in osmotic  pressure, may survive outside the body long enough to transmit the disease.


Individual variation in mushroom poisoning induced in the male rate by Cortinarius speciosissimus. The renal toxicity of a homogenate of Cortinarius speciosissimus was studied in male rats after oral administration of 100, 500 and 1,000 mg of dried mushroom/kg body weight. Great individual variation in response to the mushroom toxins was observed. At high doses (500 mg/kg and 1,000 mg/kg) the percentage of treated animals which showed renal damage did not increase in proportion of the dose. 20--30% of the rats appeared to be resistant to the toxins of C. speciosissimus, even after large doses. However, in those animals which were affected the severity of renal damage was dose-dependent. The great individual variation in the response to C. speciosissimus toxins could be explained by genetic variation.


Continuity of medical care: conceptualization and measurement. Continuity of medical care is conceived as the extent to which services are received as part of a coordinated and uninterrupted succession of events consistent with the medical care needs of patients. Two operational measures are proposed, based on the Gini and CON indices of concentration. Examples of their application are provided using the 1970 CHAS-NORC national study of health services utilization. The validity of the proposed measures is assessed in a preliminary fashion, and some commonly held assumptions about the relationship between access, quality, and continuity of care are challenged. Advantages of the proposed measures include their ability to summarize a distribution, the availability of data for construction, the relative ease of computation and interpretation, and their sensitivity to organizational changes in the delivery of health services.


The effects of social characteristics on the utilization of preventive medical services in contrasting health care programs. This study, based on household interviews of employed individuals and their families, examines the effects of type of health insurance program and various sociodemographic factors on patterns of use of preventive medical services. A major concern of the paper is to explore the issue of whether participants in prepaid group practice use preventive services more than those in alternative insurance plans. The results show little differences in utilization among subscribers in a prepaid group plan as compared with a comparable sample of those in Blue Cross-Surgical Care plans. However, children in the prepaid plan, as compared with those in the more traditional Blue Cross plans, were more likely to receive general checkups and tuberculin skin tests in the prior year. Contrary to expectations, we found that in the employed population studied, black adults reported more preventive medical utilization than whites, and the black-white difference was the strongest single sociodemographic correlate of adult utilization of preventive care. The reporting of general checkups for children was highest among single-child families, for children under five years of age, and for those with better educated parents.


Socioeconomic and need determinants of ambulatory care use: path analysis of the 1970 Health Interview Survey data. Path analysis is applied to a subsample of the 1970 National Health Interview Survey data to identify the direct and indirect effects of major socioeconomic determinants of ambulatory care utilization. The recursive model of ten equations is predicated on the notion that the dominant determinant is need, measured as activity limitation caused by chronic conditions and restricted activity days. Age, sex, income, education, and other variables are seen both as direct determinants and as acting through their effects on morbidity. The results demonstrate a complex set of relationships among the variables not identifiable in less complex analyses. Both income and education are shown to have pervasive effects. The measure of chronic disability is shown not only to affect utilization directly but to have an even larger indirect effect through its association with increased incidence of acute conditions.


Psychological and social factors as predictors of medical behavior. Response to illness was studied in a group of 251 low-income mothers who brought a child to a pediatric clinic for treatment. Measures of illness and use of medical care services for the child constituted the dependent variables; social characteristics of the mother, and her health beliefs and attitudes served as the independent variables. The information was collected by means of personal interviews. A major determinant of seeking care was the presence of symptoms in the child. Age, number of children, beliefs about illness threat, and about the benefits of medical care also related to obtaining care. A measure of the scope of services used, however, was unrelated to illness, but positively related to both education and the mother's evaluation of physicians. With illness taken into account, situational barriers plus beliefs concerning illness threat and the efficacy of care become more important predictors of utilization of care. The beliefs are related to the mother's experience, education, and life situation. It was concluded that health beliefs interact with situational demands and constraints in relation to actions taken in the face of health threats.


The effects of an experimental prepaid group practice on medical care utilization and cost. Rates of utilization and costs of medical care by a study group in a prepaid group practice, the Medical Care Group of Washington University (MCG), were compared prospectively over a three-year period with those of a demonstrably similar control group cared for by fee-for-service private physicians. MCG enrollees used twice the ambulatory services control enrollees did (p=less than 0.01), but used 23 per cent fewer hospital days (p=less than 0.01). Cost per diagnostic and therapeutic visit was similar for both groups; MCG preventive visits cost more. Increased numbers of MCG services provided led to increased ambulatory care costs for MCG over controls. Hospital utilization savings did not compensate for these increased costs. Thus prepayment in an organized setting did change hospital and ambulatory care utilization but did not reduce medical care costs. Other changes in medical care besides those which result from a different organization of medical care are discussed which might make control of medical care costs more likely.


The International Classification of Health Problems for Primary Care. Health problems of patients seen in the ambulatory setting are different from those encountered in the hospital, and the particular classification of diseases used should reflect these differences. The International Classification of Health Problems in Primary Care (ICHPPC) was designed for use by primary care physicians. It was tested in multiple sites in several countries for one year and has been approved by the World Organization of National Colleges and Academies of Family Medicine-General Practice and other groups concerned with the classification of diseases. The ICHPPC permits classification of the most important part of an ambulatory data see. Data generated by using this classification facilitate outreach to a practice population, construction of diagnostic profiles of health care providers, design of curriculum and health services research.


Immunotherapy for accessible tumors utilizing delayed hypersensitivity reactions and separated components of the immune system. Courses of repeated delayed hypersensitivity challenge reactions at the sites of tumors have been shown to eradicate malignant and premalignant epidermal neoplasms. Local immunotherapy produces therapeutic responses in malignant and premalignant lesions before they are clinically detectable. This leads to a reduced incidence and prevention of tumors. Immunotherapeutic approaches are effective in controlling the early stages of mycosis fungoides and may aid in the management of the cutaneous manifestations in the late stages of the disease. Immunotherapeutic methods induce regressions of soft tissue lesions of a number of multifocal or metastatic malignant diseases with or without concurrent chemotherapy. Immunotherapeutic effects on tumors are similar with primary and recall antigens. Separated components of the cell-mediated immune system induce regressions of tumors following intralesional or perilesional administration, indicating common factors in host defenses against malignant diseases.


Intralesional immunotherapy of melanoma with BCG. Treatment of recurrent cutaneous melanoma nodules with BCG is an effective and relatively nonmorbid method for eliminating these tumor nodules. Injected nodules can be made to disappear about 90 per cent of the time and in about 20 per cent of patients non-injected nodules in the same drainage area may also regress. Subcutaneous melanoma nodules are far more resistant to melanoma injection. Although cutaneous nodules can be made to regress there is no evidence that a systemic effect against disseminated melanoma exists and no responses of distant visceral disease have been seen following intralesional therapy of cutaneous nodules. The regression of cutaneous nodules following BCG injection appears to be an immunologic phenomenon and is related to the immunocompetence of the patient. The molecular mechanisms of this tumor regression are unknown and are the subject of intensive study. Several new approaches such as the use of BCG for the treatment of poor prognosis primary malignant melanomas, as well as the use of nonviable, nonbacteriologic agents for intralesional treatment are under investigation.


BCG immunotherapy as a systemic adjunct to surgery in malignant melanoma. Results of our study suggest that BCG systemic adjuvant immunotherapy may be effective for improving both the recurrence and survival rates in patients with regional metastases from malignant melanoma. BCG is more effective in patients with small amounts of subclinical disease. It is apparent from results of clinical trials that many of the principles derived from the study of animal tumor systems are applicable to human cancer in that immunotherapy is most effective for a small residual number of tumor cells. BCG treatment fulfills many of the ideal criteria for adjuvant treatment following surgery. It is relatively nontoxic; it is effective for disseminated melanoma; it has systemic activity in the adjuvant treatment of subclinical metastases. Hwever, until clinical trials are complete, this treatment as adjuvant therapy must be considered investigational.


Hazards and complications of BCG immunotherapy. The hazards and complications of BCG immunotherapy, as well as the potential for enhanced tumor growth, make it imperative that the clinician know the clinical setting in which BCG can offer therapeutic benefit. This would include the intratumor injection of localized intradermal tumor deposits of melanoma and breast cancer, chemoimmunotherapy with BCG to prolong remission in acute myelogenous leukemia, and possibly the use of BCG as an adjuvant to control minimal residual disease. Aside from these situations, it is advisable to treat patients only on clearly defined experimental protocols.


Constituents of West African medicinal plants. XIV. Constituents of Piper guineense Schum, and Thonn. Piper guineense Schum, and Thonn. (Piperaceae), a woodsy climber of Ghana and other parts of West Africa, has been used as a condiment and a native medicinal. Chromatography of an extract of the fruits afforded the amides piperine, N-isobutyloctadeca-trans-2-trans-4-dienamide, sylvatine, delta alpha beta-dihydropiperine, trichostachine and delta alpha beta-dihydropiperlonguminine, the last of which is a new naturally occurring amide. In a similar manner, chromatography of an acetone extract of the roots afforded piperine, trichostachine and delta alpha beta-dihydropiperine while an acetone extract of the leaves yielded dihydrocubebin, a new naturally occurring lignan.


Rapid semi-quantitative spot test for determination of thebaine and differentiation of Papaver bracteatum from P. orientale and P. pseudo-orientale. The alkaloids, orientalidine, oripavine, thebaine, narceine, narceine, codeine, papaverine, isothebaine, alpenigenine and morphine react with a solution of sulfuric acid containing molybdate to give specific colors. Using the acid solution permitted the differentiation of Papaver bracteatum latex from P. orientale latex and P. pseudo-orientale latex.


Autoxidation of polyunsaturated fatty acids: II. A suggested mechanism for the formation of TBA-reactive materials from prostaglandin-like endoperoxides. The nature and mechanism of formation of the thiobarbituric acid (TBA)-reaction material produced in the autoxidation of polyunsaturated fatty acids (PUFA) or their esters has been studied. On the basis of chemical studies and spectroscopic evidence, it is concluded that the TBA test detects malonaldehyde which arises at least in part from the acid-catalyzed or thermal decomposition or endoperoxides (2,3-dioxanorbornane compounds). These endoperosides have structures related to those of the endoperoxides produced in the biosynthetic sequence leading to prostaglandins. A mechanism is proposed in which these endoperoxides are formed in a free radical cyclization process operating in competition with hydroperoxide formation during the autoxidation of PUFA or their esters containing three or more double bonds. When 20:3 or 20:4 PUFA undergo autoxidation, some of the natural, physiologically active prostaglandins would be produced, although in very low yield, along with many other stereo- and positional isomers. Thus, it is possible that some of the complex symptoms of lipid peroxidation in vivo could be due to nonenzymatically produced prostaglandins or their steroisomers.


A radical scavenging reaction of alpha-tocopherol with methyl radical. To study a radical scavenging reaction of alpha-tocopherol, it was reacted with methyl radical in dimethyl sulfoxide. Two main products, a geminal dimethyl cyclohexadienone and methyl ether of alpha-tocopherol, were obtained and these structures were determined by 13C nuclear magnetic resonance spectroscopy. The radical methylation data of alpha-tocopherol suggested that a delocalize radical species would be an intermediate.


Comparative antilipidemic effects of various ethyl 5-substituted benzofuran-, 2,3-dihydrobenzofuran-, and 3(2H)-benzofuranone-2-carboxylate analogs of clofibrate in a triton hyperlipidemic rat model. The antilipidemic properties of certain benzofuran-, 2,3-dihydrobenzofuran-, and 3(2H)-benzofuranone-2-carboxylate analogs of clofibrate in a hyperlipidemic rat model are described. The hyperlipidemia was induced by intraperitoneal injection of Triton WR-1339. The results were analyzed in light of structural modifications as well as the lipid solubility of substituted compounds as assessed by a consideration of calculated log P values. Comparisons are made between the activity of these compounds and the activity of related cyclic analogs previously reported. Among the various compounds tested, only the 5-C1 and phenylsybstituted dihydrobenzofurans were selective against elevated serum cholesterol levels in this animal model. The data presented support the hypothesis that the cholesterol and triglyceride lowering activity of clofibrate related analogs in this animal model may be separated through a consideration of log P, conformational, and electronic changes. The proposal is advanced that relatively minor structural modification of clofibrate related analogs may lead to compounds which are not only selective in the Triton model but also to compounds which are likely to exert their effects by differing modes of action.


Biosynthesis of fatty acids by the carp, Cyprinus carpio L., in relation to environmental temperature. Incorporation in vivo of sodium 1-14C-acetate into different lipid classes and fatty acids of total lipids and phospholipids of warm adapted and cold adapted carp livers was studied at 5 C and 22 C, respectively. The fatty acid composition of total lipids and phospholipids was also determined. The level of long chain polyunsaturated fatty acids in both total lipid and phospholipid fraction was higher in cold adapted fish than in warm adapted ones. The distribution of radioactivity among different lipid classes depended only on the actual incorporation of the temperature history of the animals. Livers of fish incorporated a higher percentage of radioactivity into long chain polyunsaturated fatty acids of total lipids and phospholipids in 5 C than in 22 C. The distribution of radioactivity among different fatty acids was dependent on the experimental temperature rather than on the temperature to which the fish were adapted. The results suggest that fish are able to adjust the pattern of the biosynthesis of fatty acids very rapidly to the prevailing temperature and to assure by this way the proper physicochemical properties of their membranes. The possible mechanisms involved in this rapid response are discussed.


Glycodihydrofusidate: biliary excretion and its effect on biliary secretion of the rat. Glycodihydrofusidate, which has the same detergent properties a bile salts, is excreted almost exclusively by the bile duct after intravenous injection in the rat. As with bile salts, it leads to a significant (P less tthan or equal to 0.05) increase in excretion of lecithins and cholesterol (0.15 mumol lecithin and 0.026 mumol cholesterol per 1 mumol of glycodihydrofusidate excreted). In addition, this drug simulataneously inhibits excretion of both endogenous bile salts and bile pigments.


Quantitative determination of organic solvent soluble lipofuscin pigments in tissues. Lipofuscin pigment determination in tissue extracts was quantitated by the use of its property of fluorescence. Chloroform:methanol tissue extracts were purified on Sephadex LH-20 columns before quantitative fluorescence measurements of the lipofuscin pigments. Interfering compounds separated by chromatography were retinol and a lower mol wt fluorescent compound. Irradiation of tissue extracts with ultraviolet light was not sufficient to eliminate the interference caused by retional and the lower mol wt compound. Purified lipofuscin pigments from blood, lung, liver, spleen, brain, heart, and kidney tissues demonstrated distinct fluorescent emission maximum at 435 nm and excitation maxima between 345 and 350 nm.


Effect of lactation on lipolysis in rat adipose tissue. The concentrations of nonesterified fatty acids and glycerol in rat parametrial adipose tissue increased at peak lactation. Adipose tissue from lactating rats showed higher rates of release of nonesterified fatty acids and glycerol when incubated in vitro than did tissue from nonlactating rats, but there was a substantial increase in the esterification of fatty acids during involution. These results support earlier evidence that fat reserves were mobilized during lactation.


Aerobic requirements and maximum aerobic power in treadmill and track running. Treadmill and track running comparisons were made on eight track athletes. Oxygen uptake (VO2) during steady-state and maximum aerobic power (VO2 max) were measured in a discrete series of three speeds, and at maximal effort. Running speeds were always in sequence from slowest to fastest. Expired air was collected from the runner by the Douglas-bag method, and analyzed by the Lloyd-Haldane technique. Neither VO2 max nor aerobic requirements of running were significantly different in track and treadmill determinations. There were several correlations: 1) VO2 max with body weight (r = .83 P less than .02), 2) treadmill and track determinations of VO2 max (r = .95, P less than .01) and 3) VO2 ml/kg with running velocity m/min (r = .91, P less than .01) where the regression was linear and may be represented by the equation Y = 5.36 + 0.172X, where Syx = 2.7 m102/kg. It is concluded that treadmill determinations of oxygen uptake may be validly applied to track running in calm air within the range of 180...260 m/min.


Responses to kayak ergometer performance after kayak and bicycle ergometer training. Ten moderately active male volunteers, age 19-30 years, completed one month of training on either a kayak or a bicycle ergometer (five men in each group). The men completed sixteen 30 minute sessions of continuous work at an intensity which maintained their HR within 85-90% of its maximum, as previously determined on the kayak ergometer. After this training period the kayak group demonstrated significant decreases in VO2, VE, HR and blood lactate in submaximal kayak ergometer work and a significant increase in VO2 during maximal kayak ergometer work. These changes contributed to a significantly higher maximal kayaking work output. The bicycle-trained group did not make any of these improvements on the kayak ergometer. However in their last training session on the bicycle ergometer they were able to work at a higher submaximal load while maintaining the same heart rate as in the first training session. It was concluded that the circulatory and metabolic adjustments to kayak work are greater with kayak training than with bicycle training.


The cardiopulmonary capacities of young hockey players: age 10. The cardiopulmonary capacities of 15 selected 10 year old ice hockey players were determined during a discontinuous steady-state bicycle ergometer test. During the test, heart rates, minute ventilation and oxygen uptake were monitored and the peak values at maximal capacity were recorded. Blood was collected from the median cubital vein after each maximal exercise for lactate analysis. These boys represented a select group of highly successful young hockey players. They had been involved in organized hockey for a mean of 4.4 years, 2.9 of which had been spent in a competitive league. The team has ranked 3rd in the Ontario Championships. The maximal oxygen uptake was 56.6 ml/kg-min, a value much higher than reported for healthy inactive boys and close to values reported for young athletes in other sports. Mean maximal minute ventilation reached 64.5 l/min (1.84 l/kg-min). The tests on these athletes were carried out on two separate occasions, 48 hours apart. The test-retest correlations for VO2 max was high (r = 0.81). Only the reliability of the lactate determinations was low (r = 0.24). None of the differences between the mean values for the measurements made at the first and second exercise tests were significant.


A comparison of myocardial function in former athletes and non-athletes. Heart rate (HR), total electromechanical systole (Q-S2), left ventricular ejection time (LVET), pre-ejection period (PEP), and diastole (D) were compared in 350 former athletes and 156 non-athletes, age 27-74. The two cohorts had been equated according to habitual leisure time physical activity. Former athletes exhibited significantly longer Q-S2 and PEP at rest, and significantly lower HR and lengthened Q-S2, LVET, PEP, and D at one minute following a standard two minute step test (less than 0.05). Significantly differences were observed between athletes and non-athletes in the light and moderate activity categories. There were no significant differences between former athletes and non-athletes currently engaged in strenuous leisure time physical activity. Comparisons were made among the three levels of habitual leisure time physical activity with each group and revealed that HR was lower and Q-S2, LVET, PEP, and D were longer at rest and following exercise as the level of physical activity increased. There were more significant differences among former athletes than among non-athletes. Most of these differences were between light to moderate and light to strenuous levels of activity. The evidence suggests an advantage in myocardial function among former athletes compared to their non-athlete counterparts.


Serum testosterone, body composition, and strength of young adults. The relationship between serum testosterone (ST), body composition, and static strength was studied in 26 college females and 16 male college football players. In addition, the transient effect of weight training on ST was studied in 10 college males (5 skilled and 5 unskilled weight trainers), 12 male high school students, and 5 female college students. ST, measured by radioimmunoassay, ranged from 333.7 to 848.1 ng/100 ml in males, and from 32.8 to 121.5 n/100 ml in females. The high school subjects had significantly lower levels of ST. Correlations between serum testosterone, body composition (measured by densitometry), and static strength (grip and backlift) were nonsignificant in males and females. Comparisons of subjects with the highest and lowest levels of testosterone within each sex showed no significant differences in strength or body composition. Serum testosterone increased 111.4 +/- 96.l ng/100 ml (X +/- SX) following a weight training session in the male college group, but failed to increase in the college females or high school males. There were no significant differences in testosterone increases between the skilled and unskilled male weight trainers. Maximal exertion may be necessary for an increase in serum testosterone to occur. Lack of an increase in testosterone by high school males or college females may have been due to a submaximal effort during the weight training exercise.


A comparison of concentric and eccentric muscle training. Eight male university students served as subjects in an investigation designed to develop strength using two different muscle training routines over a six week period. The subjects trained the arm and leg on one side of their bodies using concentric contractions and the arm and leg on the opposite side of their bodies with identical exercises using eccentric contractions. Concentric movements were against a resistance 80% of one-repetition-maximum (1-Rm) for 10 repetitions and two sets; eccentric movements were against a force of 120% of concentric 1-RM for 6 repetitions and two sets. Both routines produced significant gains in strength in all subjects, but neither training procedure produced dynamic or static strength gains significantly different from the other. Subjective evaluations by the subjects indicated that the eccentric training movements were easier to perform than the concentric training movements.


An early stretching routine for calf muscle strains. Four hundred patients, average age 35 attended for treatment of strains to calf muscles. There was an average delay of 8 days before presenting. The treatment involved several repetitions of a routine involving ice or short wave for pain relief, passive stretching, ultra sound and exercises firstly for the antagonists and then the injured muscle in that order. Quadriceps exercises and correct walking were performed to ensure fitness for sport after cure. The average treatment time was 6 days. Prevention of disability was aided by early treatment, stretching before activity and exercises to increase strength in the calf. The recurrence rate was 1%.


Aerodynamic drag analysis of runners.

Aerodynamic drag analysis of runners. A model is presented for the determination of aerodynamic drag forces on runners. The model consists of a series of conjugated circular cylinders, to stimulate the trunk and appendages, and a sphere to stimulate the head. Results are presented for three runners representing respectively, adult American males in the 2.5, 50 and 97.5 percentiles of the population. It is found that power dissipated in overcoming air resistance for these three runners ranges from 0.33 to 0.49 horsepower at a sprint speed comparable to the current world's record for one hundred yards. In addition an alternate model, consisting of a single circular cylinder, is presented that simplifies the determination of total aerodynamics drag. The accuracy of this model is determined by comparing results for total drag with those found with the more complex model. It is found that the error ranges from 5 to 8.9 percent.


Physiological variables during 10 years of endurance exercise. The reported decline in Physical Working Capacity (PWC) max is from 9-15 percent during the ages of 45 to 55 years. The use of vigorous physical activity to prevent this decline and to possibly protect against fatal myocardial infarction has been suggested. The purpose of this study was to investigate the effect of an endurance type exercise program on the maximal PWC of middle-aged men during a 10 year span. Sixteen men, initially 32-56 years (M-44.6), were trained with running or swimming at an intensity above 60 percent of VO2 max during a 10 year period. The average weekly running distance was 15 miles (25 km). The criterion for PWC was directly measured VO2 using the Douglas Bag/Scholander technique. No changes were observed in body weight, resting heart rate (HR), or resting blood pressure (BP). Maximal HR declined 7 beats per minute in 10 years. Pulmonary ventilation (STPD) increased approximately 18 percent. Mean VO2 max was essentially unchanged, 3.376 and 3.303 1/min STPD. VO2 max related to body weight was 43.7 initially and 44.4 ml/min-kg after 10 years. It was concluded that the usual 9-15 percent decline in PWC or VO2 max from age 45 to 55 years can be forestalled by regular endurance exercise. The results may have implications for protecting against heart attacks.


Energy cost of running and walking in young women. The energy cost of level walking and level and grade running was determined in 7 active women with max VO2 = 50.7 ml/kg-min. Speeds investigated were 4 to 8 km/hr walking and 8 to 14.5 km/hr running. The validity coefficients of several procedures for estimating energy expenditure during locomotion [4 for running (6)(11)(16)(17); 3 for walking (6)(12)(17)] were determined. Correlation coefficients between actual and predicted values were 0.949 to 0.951 with standard errors of estimate 0.79 to 0.80 kcal/kg-hour for walking and 0.856 to 0.975 with standard errors of estimate 0.40 to 0.60 kcal/kg-hour for running. VO2 and kcal energy cost values were similar to those previously reported on men at equivalent walking and running speeds. Efficiency of running based on lift work done was about 25%. Lift work for women was slightly less than values previously reported for men at walking but was slightly more at running. These differences did not appear to have a significant effect on energy expenditure.


The natural history of extramedullary plasmacytoma and its relation to solitary myeloma of bone and myelomatosis. From this study I suggest that extramedullary plasmacytoma (EMP) shows several important differences from  myelomatosis and solitary myeloma of bone (SMB) which can be summarized as follows: 1. A marked preference for the primary tumor to present in a particular site, namely the upper air passages. 2. A high incidence of metastatic spread to soft tissues. 3. Spread to bone occurs frequently but shows no preference for bones containing active hematopoietic tissue and widespread bone-marrow involvement occurs only occasionally. 4. Prolonged survival may be achieved with therapy for local disease. 5. Vigorous treatment for disseminated disease can be given and may result in longer remissions than those usually seen in myelomatosis. Healing of bone lesions has been observed on several occasions. It is concluded also that SMB constitutes a rather unusual presentation of myelomatosis but is essentially the same disease process.


Ischemic necrosis of bone in systemic lupus erythematosus. Twenty-three patients with systemic lupus erythematosus (SLE) and ischemic bone necrosis are reported. All patients had received corticosteroids prior to the onset of ischemic necrosis, although one patient had received none for 13 years previously. Nineteen (83%) patients had multiple bone lesions including the femoral heads in 21 (91%) which were bilaterally involved in 15. In addition, humeral heads were affected in seven patients and the tibial plateaus, in three. The most striking feature of this group was the high incidence of Raynaud's phenomemon present in 14 (61%) of the 23 patients. Furthermore, central nervous system involvement was present in 10 (43%) patients, more prominent in those without Raynaud's (67%) than in those with vasospasm (29%). Thus, 20 of the 23 patients, or 87%, evidenced vascular abnormalities either in the form of Raynaud's phenomenon and/or systemic vasculitis. The pathogenesis of ischemic bone necrosis is discussed. In SLE, vasospasm or vasculitis, or both, augmented by corticosteroid therapy, could impede the microcirculation and result in the ischemic lesion.


Total body sodium and chlorine in normal adults. Absolute levels of total body sodium (TBNa) and total body chlorine (TBCl) were determined in 81 normal adults (39 males, 42 females) by means of total body neutron activation analysis (TBNAA). The ages of the subjects ranged from 30 to 90 yr. The mean values for both TBNa and TBCl remained relatively constant throughout the age span studied for males, but decreased slightly for females over 60 yr of age. In order for the absolute measurements of Na and Cl to be of clinical value, the values must be compared to a predicted value based on the sex and body habitus of the individual. Normalization of TBNa values relative to body dimensions (weight, height, body surface area) were evaluated. In addition, TBNa was related to total body calcium (TBCa), which reflects skeletal mass, and TBK, which reflects muscle, or lean body mass. Normalization in terms of a linear combination of the TBCa and TBK was found to be the most satisfactory of all those studied. Sodium excess, NaES, defined as the amount of body sodium (mEq) in excess of body chlorine (mEq) was determined. Sodium excess correlated well with total body calcium. Values for total body sodium and chlorine obtained in the present study were compared with values previously reported in the literature.


Free serum histidine levels in patients with rheumatoid arthritis and control subjects following an oral load of free L-histidine. A dose of 3.7 g of free-L-histidine was administered by mouth to 26 patients with active rheumatoid arthritis and to 29 control subjects. The patients with rheumatoid arthritis had a statistically significant (p=10(-12)) lower pretreatment concentration of free histidine in serum (1.20 mg/100 ml, SE=0.04) than the control subjects (1.90 mg/100 ml, SE=0.06). However, there were no statistically significant differences between rheumatoid and control subjects with respect to the serum histidine concentrations 1 hr, 3 hr, and 4 hr after the ingestion of L-histidine. The changes in the serum histidine concentrations at 1 hr, 3 hr, and 4 hr (compared to the pretest values) were also not significantly different in the patients with rheumatoid arthritis relative to the control subjects. This study suggests that the subnormal free serum histidine concentration of rheumatoid arthritis is not associated with abnormal serum levels of free histidine following an oral load of free histidine.


Nucleation and growth of brushite and calcium oxalate in urine of stone-formers. The physicochemical factors involved in the formation of calcium-containing renal stones have been elucidated previously and some of the techniques for their quantitation are currently available. Accordingly, urinary activity product ratio (state of saturation), formation product ratio (limit of metastability), and crystal growth of brushite and calcium oxalate in 24-hr urine samples were compared between a control group without stones and stone-forming groups composed of patients with absorptive hypercalciuria, normocalciuric nephrolithiasis, and primary hyperparathyroidism. The activity product ratios of brushite and calcium oxalate were significantly elevated in stone-forming groups, largely because of the high renal excretion of calcium. The formation product ratios were reduced in most stone-forming groups, and the crystal growth was increased in the group with primary hyperparathyroidism. Thus, the physicochemical environment of urine in stone-forming groups was favorable to the nucleation of the nidi of brushite and calcium oxalate; in primary hyperparathyroidism, it may be conducive to the subsequent growth of nidi as well.


Blood D-3-hydroxybutyrate and the regulation of plasma concentrations of free fatty acids in the fasted rat. Acetoacetate or DL-3-hydroxybutyrate were infused into fasted rats at rates comparable to the endogenous rate of ketone body release. Blood samples taken before and during infusion were analyzed for concentrations of ketone bodies, free fatty acids, and immunoreactive insulin. During infusion of acetoacetate or DL-3-hydroxybutyrate, blood concentrations of total ketone bodies doubled. While the HBA/AcAc ratios remained constant in rats infused with DL-3-hydroxybutyrate, the ratios decreased significantly during infusion of acetoacetate, reflecting increases in acetoacetate concentrations without proportionate increases in concentrations of D-3-hydroxybutyrate. Blood concentrations of free fatty acids decreased more rapidly in the rats infused with DL-3-hydroxybutyrate than in the rats infused with acetoacetate. The decrease in free fatty acid concentrations was related to increases in blood D-3-hydroxybutyrate in both the DL-3-hydroxybutyrate-infused rats and in the acetoacetate-infused rats. Plasma immunoreactive insulin concentrations were significantly higher in the DL-3-hydroxybutyrate-infused rats than in the acetoacetate-infused rats. Acetoacetate and DL-3-hydroxybutyrate were infused into depancreatized, functionally hepatectomized fasted rats at rates comparable to those used in the intact fasted rats. Only small decreases in free fatty acid concentrations were observed during infusion. From these experiments it was concluded that increases in blood concentrations of D-3-hydroxybutyrate were more effective than acetoacetate in causing decreases in free fatty acid concentrations in the fasting rat. The pancreas is required for this effect.


[A method of microphotometry with TV-image analysing systems (author's transl)]. In scanning microphotometry only a small spot in the specimen is illuminated at the same time. However, lamp and optical system are designed to transfer 10(5) to 10(6) times more information  at once. It is shown, that correct and reproducible results can be attained with stimultaneous illumination of the field received by a TV-camera. It is necessary to calibrate for stray light. Thus the high speed of measurement of TV-Systems can be used for microphotometry.


Design of an ultrahigh-energy hydrogen thyratron/SCR research defibrillator. The design features of an ultrahigh-energy research defibrillator are described. Three voltage sources are used. The first is a 60-Hz supply of adjustable amplitude and duration for inducing fibrillation. The second source uses an 18.000-joule capacitor bank which can be charged to 800, 1600, or 2400 volts. SCRs in series with the chest are used to initiate the discharge, and SCRs shunting the capacitor bank terminate the discharge. The third source employs another 18,000-joule capacitor bank which can be charged to 5000, 10,000 or 15,000 volts. In this source, large ceramic-enveloped hydrogen thyratrons are used for both initiating and terminating the discharge. In the second and third sources, which can deliver rectangular, trapezoidal, truncated exponential, or untruncated exponential waveforms, capacitor charge time is 10 sec and the duration of the delivered shock is continuously adjustable from 100 musec through 1 sec.


Transthoracic impedance to direct current discharge: effect of repeated countershocks. The effect of repeated countershocks on transthoracic apparent impedance to direct current (dc) defibrillator discharges was studied. Repeated dc countershocks result in a progressive decrease in transthoracic apparent impedance that is dependent upon the time interval between countershocks. This decrease was significantly greater in the group of animals shocked at 3-min intervals compared to the groups shocked at 15-sec intervals (P less than 0.001) or at 1-min intervals (P less than 0.005). Since lowered impedance results in higher delivered current for the same energy setting on a defibrillator, this observation may help to explain the enhanced effectiveness of repeated countershocks in defibrillation. Plots of simultaneous current against voltage during transthoracic dc discharge revealed that the current lagged slightly behind voltage during the rising phase of the recording, but that current and voltage were nearly simultaneous during the falling phase. This effect appears to be similar to an ionization phenomenon in that the effective impedance asymptotically approaches a lower value with increasingly applied voltage. This might explain why transthoracic impedance is highest at low energy countershocks and decreases with higher energy countershock.


Electode catheter for transvenous defibrillation. Development of an implantable automatic defibrillator is dependent on achieving a reduction in the energy required for defibrillation, which is related to an optimal electrode configuration. This study investigated the use of a transvenous catheter electrode utilizing the damped sinusoidal waveform; compared the defibrillation effectiveness of varying the configuration of the four electrode units and of using a catheter/subcutaneous metal plate combination; and determined the lowest energy level necessary for near consistent transvenous defibrillation.


The prediction of the impedance of the thorax to defibrillating current. In this paper a technique for predicting thoracic impedance to defibrillator pulses is described. The impedance to low-current (1.0 mA) high-frequency (10-500kHz) sinusoidal current is used as an indicator of the impedance of the thorax to high-current, damped sinusoidal waveform pulses. Results from 71 dogs to which defibrillator shocks of 4 to 220 A peak current were applied show that thoracic impedance can be predicted by this method. This information indicates that it is possible to design a defibrillator that can automatically measure chest impedance prior to a defibrillation shock and deliver a predetermined peak current to the subject.


Observations on wound drainage with a review of the literature. Observations have been made on the choice of wound drainage in 119 general surgical or urological procedures performed by surgeons in a general hospital. Complications of the drains used are reported. Softer and more pliable drains appear to cause less morbidity than the stiffer, more rigid variety. The literature dealing with drainage is reviewed.


Considerations in the development of the automatic implantable defibrillator. A highly reliable ventricular fibrillation detector and a satisfactory electrode system for delivering defibrillating pulses to the heart play a central role in the development of an automatic implantable defibrillator suitable for clinical use. Among the four implanted electrode designs tested, the combination of an electrode placed in the superior vena cava with a conformal electrode on the apex of the heart provided satisfactory defibrillation thresholds with ease of implantation. A new sensing method is also described for which an electrogram derived from the defibrillating electrodes is used as input. A form of a density function is developed for a filtered version of the input, ventricular fibrillation being characterized by a density curve lacking a large peak occurring at a level corresponding to the baseline of the filtered signal. These ideas are being incorporated into the design of a prototype implantable defibrillator delivering pulses of 24 joules.


Headaches in relation to the eyes.

Headaches in relation to the eyes. An analysis of patients presenting with headache shows that in very few cases is the headache related to refractive error. Similarly in presbyopia and hypermetropia headaches are infrequent. A significant proportion (up to 50%) of those patients presenting with a close relationship of headache to accommodation difficulty can be helped by glasses. It is postulated that ciliary muscle contraction per se is effortless and symptomless and that any headaches produced are due to associated contraction of the scalp muscles.


Infantile autism: the incidence of national groups in a New South Wales survey. In a survey on the occurrence of infantile autism in New South Wales it was found that 21-9% of children had at least one foreign-born parent whose native language was not English. In terms of population incidence for New South Wales, Italy and Yugoslavia were under-represented while Greece and Germany were significantly over-represented. The stresses faced by migrants in a new country were discussed in terms of possible contributing agents and in particular, the cultural traditions of the Greeks and their adjustment problems were highlighted. It was suggested that the stresses of cultural change and the socioeconomic pressures borne by the parents resulted in deprivation of their children who were also exposed to a confused language environment, and that a combination of these variables could lead to decompensation into an autistic state in an already vulnerable child.


House dust mites and infant-use sheepskins. A study of dust mite populations in infant-use lambskin and other bedding has showm more mites present in the latter. Regular vacuuming of the lambskin greatly reduces the mite population on it, but cannot prevent recolonization from adjacent areas.


Cor triatriatum.

Cor triatriatum. A case of cortriatriatum, which is not included in three types of Loeffler's classification, is reported, and a complete description of the anatomy and pathology of the case is given. A successful surgical repair of this malformation is possible; therefore the importance of its recognition is emphasized. The clinical manifestations and the different aetiopathogenic theories are reviewed.


Renal calculi and their management.

Renal calculi and their management. Any patient presenting with renal colic requires the taking of a detailed history-- with inquiries about diet and drugs, an examination of the urine, intravenous pyelography and measurement of the calcium concentration in serum and urine. Any stone passed should be analysed. Recurrent stone formation warrants more comprehensive metabolic investigation. The cause of renal calculi in most patients is still not known. When a cause is found, specific treatment can prevent or control stone formation. For the majority in whom no abnormality is detected, various methods of reducing stone formation have been tried but results are disappointing. The most important points in management are the early detection and effective treatment of urinary tract infection or obstruction and the maintenance of a high fluid intake.


Plasma drug concentrations in therapeutics. The literature describing drugs assay in plasma and its value for optimal therapy for individual patients is expanding rapidly. The present review seeks to clarify the rationale underlying the assay of plasma concentrations of drugs, and it attempts to define principles for judging the likely value of assaying a particular drug. Examples are given of drugs which are being usefully measured in clinical practice. The most commonly used assay techniques are briefly described, and their principal advantages and limitations are  indicated.


Occupational injuries: an exploratory analysis of successful Australian strategies. An examination of occupational injuries in Australia during the 1960's is made. It is shown that the incidence of occupational injuries decreased by about 12% during the decade and that occupational injuries now approximate 200,000 per annum. Although there are approximately six injuries to men for every one to women,types and sites of occupational injury do not differ between the sexes. Occupational injuries occur most frequently on Mondays, and the incidence decreases sequentially during the week. The age distribution for serious injuries (incurring an absence from work of more than 28 days) differs markedly from the equivalent distributions for minor occupational and all road injuries in that the third, fourth, fifth, and sixth decades of life each contribute about 20% of this total. The customary heavy over-representation of young males is notably absent. "Passive" countermeasures (those that are behaviour-independent) are held to have been differentially more successful than those that are "active" (those that require active cooperation). Examples are given.


Infection with Mycoplasma pneumoniae: clinical and serological data on 286 patients. In a 14-month period from January, 1971, 286 patients, referred for investigation of a variety of illnesses, were found to have complement-fixing antibodies to Mycoplasma pneumoniae to a titre of 1:32 or greater. Clinical findings in these patients are presented in a form which relates them to different antibody levels. Patients with central nervous system disease are described in some detail and the occurence of rash, arthropathy and a variety of other syndromes is noted. The suggestion is made that low-titred M. pneumoniae antibody appears as an anamnestic response to infection with other agents.


Cronkhite-Canada syndrome.

Cronkhite-Canada syndrome. The first case in Australia of the rare Cronkhite-Canada syndrome which comprises generalized gastrointestinal polyposis, alopecia, onychatrophia and pigmentation, is described. The patient was initially treated for hypothyroidism, but subsequently developed protein-losing enteropathy and adenocarcinoma of the colon arising in the polyp.


An improved M.B., B.S., "final" examination in surgery. A new final year examination in surgery has been devised. It consists of a clinical assessment made by a surgical tutor over a period of six weeks throughout a student's surgical term, a visual, clinically orientated written examination a "spotter-type" practical examination and a viva-voce examination. Correlation with students' previous performances has been good and the examination appears to have solved many of the problems which necessitated its development.


Severe measles in Vietnam.

Severe measles in Vietnam. The effects of measles epidemic amongst Cambodian refugees who were inadequately housed and fed in a refugee camp on the Cambodian-Vietnam border are described. As the condition of the people deteriorated, kwashiokor became prevalent and from a comparatively low death rate initially, children began to die in quick succession. With the supply of extra high-protein food this trend was soon reversed. However, the mortality figures given are official ones and there is no way of checking them by counting graves, as the Cambodians burn their dead. Therefore, it is more than likely that the real situation is understated.


Complications of amniocentesis.

Complications of amniocentesis. A retrospective survey of 358 consecutive amniocenteses was undertaken. The incidence of failure was 37 (9.6%); most commonly this was due to oligohydramnios. A suprapubic tap was the most likely to be successful, but was accompanied by premature rupture of membranes in 3.8% of the cases. Spontaneous rupture of membranes, followed by delivery of a premature infant, occurred 15 times (4.2%). Blood-stained fluid was obtained on 47 occasions (13%), but, apart from the theoretical risks of fetomaternal haemorrhage and fetal exsanguination, and an association with maternal abdominal pain, there appeared to be no serious sequelae from this complication. Withdrawal of blood-stained fluid was not prevented by prior placental localization and was not related to the site of the tap. There were 14 perinatal deaths (equal to a rate of 50 per 1,000 births) and, although no fetal deaths could be directly attributed to amniocentesis, there were four cases in which the procedure could not be completely absolved. Three patients underwent emergency caesarean section because of severe abdominal pain after anmiocentesis. Two had amniotic fluid peritonism and the third had minor intraperitoneal bleeding. Amniocentesis is not without maternal and fetal complications and should be undertaken with due regard to the risks involved.


Mortality from asthma and bronchodilator aerosols. The mortality rate from asthma in Australia had a transcient rise between 1960 to 1967. There was a remarkably high correlation between the sales of pressurized adrenergic aerosols in each of the four most populated States and the corresponding asthma mortality rate for two triennia, 1961 to 1963 and 1964 to 1966. This relationship was not found after 1966. From 1965 to 1966, Australians were warned repeatedly of the possible dangers of over-usage of the adrenergic aerosols. The sales pattern of the aerosols altered, showing a slackening of the rate of increase of sales in 1966 and 1967. This and other evidence suggests that the warnings may have reduced the prevalence of over-usage of the aerosols and that before this, over-usage of the adrenergic aerosols could have caused the epidemic of asthma deaths.


An appraisal of the treatment of femoral shaft fracture: open versus closed. Results of treatment of 103 femoral shaft fractures have been studied, the complications encountered are described and the final impression of the writer on the methodology of treatment is presented.


Six cases of severe head injury treated by exercise in addition to other therapies. Six cases of severe head injury treated with vigorous early morning exercise in addition to more orthodox therapies are presented. Observations on behaviour and psychometric testing have been used to assess results. Discussion is centred round the benefits of early morning exercise.


Action of tilidine hydrochloride and morphine hydrochloride on ventilatory control in normal subjects. The action of tilidine hydrochloride and morphine hydrochloride on the ventilatory response to inhaled carbon dioxide has been assessed in 10 normal volunteers. In doses of 50 mg and 100 mg given intravenously, tilidine hydrochloride induced less respiratory depression than 10 mg of morphine given intravenously. Side effects were not different or troublesome with either drug. Depending on its relative pain-relieving property, tilidine hydrochloride may have advantages over morphine as an analgesic.


Hypertrophic colonic tuberculosis.

Hypertrophic colonic tuberculosis. A patient who has suffered from hypertrophic colonic tuberculosis caused by the human strain of tubercule bacillus is presented. Despite being an uncommon presentation of tuberculosis, it is of more than academic interest to surgeons practising in tropical countries.


Gout, uric acid and renal disease.

Gout, uric acid and renal disease. Gout may be associated with renal disease in two situations: (i) when the abnormal urate metabolism is the primary phenomenon and renal disease occurs secondary to this; or (ii) when the intrinsic renal disease is primary, and results in secondary abnormalities of renal function. Kidney damage secondary to gout is associated with urate deposits either in the intersitium as microtophi or as uric acid crystals within tubules, and vascular disease and infection are superimposed. Hyperuricaemia is a frequent sequel to parenchymal renal disease, but gouty arthritis develops only when the hyperuricaemia is unusually severe. Urate metabolism alters when renal excretion of urate is reduced. The management of these problems is discussed.


Spiders of the genus Loxosceles in Australia. A previous report of the presence of loxoscelid spiders in Australia is confirmed by a further finding of Loxosceles rufescens at a second suburban locality in Adelaide, South Australia. There is thus a third genus of potentially lethal spiders in Australia.


Sudden death in infancy syndrome in Western Australia. The objects of the Western Australian investigation into the sudden death in infancy syndrome are stated. Evidence is presented which suggests that these children are subject to an asphyxial mode of dying. It is postulated that anaphylaxis, due to hypersensitivity to the house dust mite, and possibly other allergens, is implicated, with the respiratory system as the target organ. A family counselling service is described.


Bennett's fracture in general practice.

Bennett's fracture in general practice. A review of eight cases of Bennett's fracture is presented. The mechanism of injury appears well defined and a simple method of treatment is described. Uniformly good results have been achieved in all eight cases.


Total blood lead levels in petrol vendors. The total blood lead levels of a group of 48 petrol vendors and a comparison group of 47 clerks and students were determined. The mean total blood lead level of the petrol vendors was 32-9 mug/100 ml (S.E.1-73 mug/100 ml). The mean level of the comparison group was 14-3 mug/100 ml (S.E. 0-72 mug/100 ml). The concentrations of lead in the blood of petrol vendors were significantly higher than those of the comparison group, and seven individual values fell above the currently accepted "level of concern". Recent relevant literature is reviewed.


Disseminated intravascular thrombosis as the cause of ischaemic enterocolitis. Disseminated intravascular thrombosis was diagnosed in a woman aged 63 years. At autopsy the typical appearances of ischaemic enterocolitis were found, together with thrombi in other organs. This case illustrates the previously postulated connection between intravascular thrombosis and ischaemic enterocolitis.


Comparison of low doses of haloperidol and diazepam in anxiety states. A clinical comparison was made between a butyrophenone drug (haloperidol), and an established antianxiety agent of the benzodiazepine group (diazepam). Both drugs were highly effective in reducing anxiety symptoms, with few and mild side effects of diminishing intensity throughout the trial period.


Solitary ulcer of the rectum, A report of fiteen cases. Fifteen cases of solitary ulcer of the rectum are described. The patients complained mainly of rectal bleeding, discomfort and passage per rectum of mucus. The lesion is most commonly situated on the anterior wall of the rectum and can be red and granular, nodular or ulcerating. Peolapse was found in nine cases. The histological lesion is similar to that seen in rectal prolapse. The condition can be mistaken for colitis, adenomatous polyp or carcinoma. Reassurance, defaecation reeducation and dealing with the patients'emotional problems alleviated the condition in some cases. Surgery to remove a prolapsing segment was performed in one case only.


Difficulties with the diagnosis of linitis plastica carcinoma of the rectum and anal canal. The early and precise diagnosis of linitis plastica-type tumours of the rectum and anal canal is difficult because of their insidious presentation and anaplastic nature. A case report is documented of a patient with a linitis plastica tumour of the lower rectum and anal canal which arose as a secondary tumour from the prostate. The presentation, clinical features, treatment and pathological findings in this case are contrasted with those from other reported cases of prostatic carcinoma invading the rectum and of linitis plastica carcinoma of the large bowel. The unique features of the case are summarized.


Antibody response to one and two doses of influenza virus subunit vaccine. Antibody studies were undertaken to evaluate the responses after one and two-dose schedules of influenza immunization with subunit influenza vaccine. The responses were studied in two adult population groups after the administration of a vaccine containing the most recent epidemic strains A/Pt Chalmers/73 and B/Hong Kong/8/73. Responses to the A component of the vaccine were greater than those to the B strain. Patients with initially low antibody levels responded better than those with higher levels. There was little additional benefit from the second dose of vaccine.


Definition of an exercise tolerance test. Three hundred subjects undertook a submaximal bicycle ergometry procedure which was terminated at level 19 on the Borg perceived exertion rating scale. The findings indicated that the total work output was an effective reference criterion for each individual. Age and height were considerably more dominant than weight in affecting this output in both sexes. In women, however, the use of the maximum work load/maximum systolic blood pressure ratio gave the best explanation of variation. A numerical relative fitness ranking derived from the work output was developed to achieve comparison among subjects irrespective of age, height, weight and sex. This categorization revealed, interalia, that the average maximum systolic blood pressure was a major limiting factor in performance. Significant changes characteristic of ischaemia occurred in the electrocardiograms of a substantial proportion of subjects, including the apparently well, the proportion being higher in women than in men. There were definite differences between the ranked work load categories. The relative fitness ranking is of value in assessing a variety of factors affecting performance in heterogeneous populations, and also in following population responses to various procedures.


Lithium carbonate and hypothyroidism.

Lithium carbonate and hypothyroidism. A case of hypothyroidism as a complication of lithium maintenance therapy is reported. Clinicians should be aware of this condition and patients receiving long-term lithium maintenance therapy should have their thyroid gland function assessed periodically.


St. Agnes: a study of a health centre in evolution. The growth of St Agnes Health Centre is described, with its transition from simple group practice to a comprehensive health centre over a five-year period. Its position in a rapidly growing suburb is analysed and illustrated by usage and referral patterns. The sucessful integration of general practice, sessional specialists and allied health workers under one roof makes it unique as a primary health care project in Australia.


[CSF-evaluation in unilateral, bilateral and alternant facial paralysis (author's transl)]. Etiology of idiopathic facial paralysis remains mostly unknown because further investigations seem unnecessary being the only symptom. Differentiated evaluation of CSF however for cytological or proteinous abnormalities should be performed aside serological examinations. In 9 patients treated within 8 months in our hospital diagnosis could be made by these procedures. Inflammation, if cause of facial paralysis, can only call pleocytosis, if localised within or next to the leptomeninges; protein of CSF perhaps will increase, if local inflammation of the nerve is more distant to subarachnoid space. "Idiopathic facial paralysis" however will not exclude focal inflammation far from subarachnoid space. Surgical decompression should not be performed without previous examination of CSF in regard of it's uncertain success.


[Distraneurin:not a therapeutic agent against alcoholism (author's transl)]. This notice shall inform general practitioners, that Distraneurin (Chlormethiazol) - beside of being a very successful drug in treating delirium tremens, suppressing withdrawals and therefore helping alcoholics by their attempt to get abstinent - bears a great danger of iatrogenic habit formation, when it is prescribed continuously over more than three weeks. The patient describes the effect of Distraneurin in the same way as the effect of alcoholconsume, wishes tenacious to extend the order of this drug and elevates the dose and gets addicted to it.


[Reduction of smoking hazards by Denicotea filter-cartridges (author's transl)]. In the present study the efficiency of Denicotea filter-cartridges is determined as indicated by change of heart rate, skin temperature, urinary nicotine-content and subjective symptoms. Compared with standard smoking effects the use of Denicotea filters produces smaller increases in heart rate and significant reductions of urinary nicotine-content. The majority of the probands no longer experienced side effects. Thus, the elimination of nicotine from smoke by Denicotea filters is effectively demonstrated. Because only a minority of smokers is actually willing to discontinue their habit, despite medical advice, the introduction of Denicotea filters presents itself as a useful alternative.


[Investigation with the MMPI saarbrücken in patients with ulcerative colitis (author's transl)]. The aim of our investigation was to establish whether certain personality traits of patients with ulcerative colitis could be subjected to verification by means of a controlled psychological test. 30 patients with ulcerative colitis and 30 "healthy" control persons were tested with the MMPI Saarbrücken. The colitis patients differed from the control persons in respect of their significantly higher scores on the hypochondria scale, the depression scale, the paranoia scale and the scale measuring social introversion. These higher scores proved to be independent of duration of illness. On the other scales there were no significant differences.


[Rare fistulation in enterocolitis regionalis (Crohn's disease) (author's transl)]. The transmural inflammation in Crohn's disease, the variable localization of the disease and the tendency to a descending spread, all lead to a multitude of possible fistulae, the presence of which is often difficult to demonstrate. This is a report on 5 unusual fistula systems: in 2 cases entero-enteral (one of which with hydronephrosis), 1 case of rectovaginal fistula, 1 case of a branched fistula system in the right buttock, 1 case of fistulae between an abscess system in the spleen "bed" and the greater curvature of the stomach. A radiological and endoscopic diagnosis is important since surgically opened fistula systems heal only with great difficulty or not at all.


[Spinal cord ischemia (syndrome of the sulcocommisural artery) after oral contraception for seven years (author's transl)]. The pathological history of an 29 years old woman with a partial subacute Brown Sequard syndrome traced to a closure of the right sulcocommisural artery in the Th IX area is described. The disease developed after oral contraception for seven years. The relations to the use of oral contraceptives are briefly discussed.


[Indications and results of cerclage in cervical incompetence (author's transl)]. The results of 79 cerclage operations in gestation are reported. The rate of abortion increased in cases of more severe symptomatics: firstly, without labour and bleeding: 83 p.c. successful operations; secondly, with labour: 77 p.c.; thirdly, bleeding and without labour: 70p.c.; and lastly, with labour and bleeding: 40p.c. Before treatment with tocolytic pharmaca was possible, the period of gestation time could not successfully be prolonged if labour had started. With tocolytic pharmaca 56p.c. patients of this group gave birth to a living child. The rate of premature children was 23p.c. Cerclage operations were most successful after the 25th week of gestation. When applied before the 16th week of gestation, the success rate was below 69p.c. Treatment with tocolytic pharmaca increased the indication for cerclage operations. Cerclage operations together with tocolytic treatment are indicated in cases where labour and bleeding occur in gestation.


[Secondary sterility following cesarean section (author's transl)]. In 98 patients with cesarean section secondary sterility was studied and compared with spontaneous labor in a control group. The rate of secondary sterility in the first group was 48,9% and there was no relation to the age. 25% of the women prevented pregnancy on account of maieusiophobia. Involuntary sterility was found in 29,2% and there was no relationship between secondary sterility and puerperalism.


[Mycoplasms in tumors of patients with carcinomata of the collum and its preliminary stages (author's transl)]. Within one year smears were taken from 190 patients who had not been pretreated in our oncological department. The culture media established were examined with regard to Mycoplasms. A Mycoplasma population was stated in 27 women. In the cases of carcinomata of the collum and in its preliminary stages, Mycoplasma infestation was about twice as frequent as in all other cases of genital carcinomata. Discussion is made if Mycoplasms are possible or promoting factors during the development of carcinomata of the collum.


Genetic analysis of antisuppressor mutants in the fission yeast Schizosaccharomyces pombe. Fourteen unlinked sin genes could be mutated to recessive antisuppressor alleles preventing the expression of suppressors in the fission yeast Schizosaccharomyces pombe. cyh1 alleles, resistant to the ribosomal inhibitor cycloheximide, also have some antisuppressor effect. The genetical and physiological characterization of these mutants is consistent with the hypothesis that they affect components of the messenger RNA translation machinery such as tRNA modifying enzymes or ribosomal proteins.


Molecular weight distribution of ribosomal proteins from several vertebrate species. Two-dimensional polyacrylamide gel electrophoresis of proteins from the separated ribosomal subunits of rabbit reticulocytes, rabbit liver, mouse liver, rat liver, chicken liver, and toad liver was performed using the "pH 4.5/SDS" system previously described (Martini and Gould, 1975), with internal standards to measure the molecular weight distributions. With few exceptions, the patterns were remarkably similar, indicating a high degree of conservation during evolution of both net charge (largely determining mobility in the first dimension) and size (determining mobility in the second dimension). The aggregate mass (sum of molecular weights) of both small and large subunit proteins, about 0.65 X 10(6) and 0.95 X 10(6) daltons respectively, were invariant. These figures are significantly smaller than the hydrodynamically determined mass of protein in the subunits. The implications of this discrepancy, which is opposite that found in the prokaryotes, is discussed.


Regulation of proteolytic enzymes in Podospora anserina: selection and properties of self-lysing mutant strains. Previous results showed that cell disintegration in the fungus Podospora anserina occured through the action of two proteases, enzymes whose messengers were normally latent during the extension stage of the thallus. We selected three mutant strains in which the constitutive activity of the protease messengers was expressed by an arrest of growth early in development (10 to 30 hours after spore germination) and a reaction of cell disintegration, in the thallus, suppressible with beta-phenyl pyruvic acid, a protease inhibitor. The mutant character is recessive in one strain. In the case of the two strains in which the mutant trait is dominant, reversion studies have revealed that the deregulation resulted from the specific interaction between two genes and we have succeded in creating two non allelic incompatibility systems comparable to the non allelic gene interactions responsible for the incompatibility phenomena found between wild type races. We know, on the whole, that 11 loci are involved in the regulation of the proteases: five were revealed as incompatibility loci and six were discovered from investigations on four self-lysing mutant strains. It is suspected that all these genes act at the post-transcriptionnal level of the synthesis of specific proteolytic enzymes. We propose that the products of two genes act as "repressors" to prevent the protease messengers from being constitutively translated and that the products of the nine remaining genes exert a positive control by inducing translation, at the appropriate time, through the action of effectors resulting from specific interloci cooperation.


Surface topography of the Bacillus stearothermophilus ribosome. The surface topography of the intact 70S ribosomes and free 30S and 50S subunits from Bacillus stearothermophilus strain 2184 was investigated by lactoperoxidase-catalyzed iodination. Two-dimensional polyacrylamide gel electrophoresis was employed to separate ribosomal proteins for analysis of their reactivity. Free 50S subunits incorporated about 18% more 125I than did 50S subunits derived from 70S ribosomes, whereas, free 30S subunits and 30S subunits derived from 70S ribosomes incorporated similar amounts of 125I. Iodinated 70S ribosomes and subunits retained 62-78% of the protein synthesis activity of untreated particles and sedimentation profiles showed no gross conformational changes due to  iodination. The proteins most reactive to enzymatic iodination were S4, S7, S10 and Sa of the small subunit and L2, L4, L5/9, L6 and L36 of the large subunit. Proteins S2, S3, S7, S13, Sa, L5/9, L10, L11 and L24/25 were labeled substantially more in the free subunits than in the 70S ribosome. Other proteins, including S5, S9, S12, S15/16, S18 and L36 were more extensively iodinated in the 70S ribosomes than in the free subunits. The locations of tyrosine residues in some homologous ribosomal proteins from B. stearothermophilus and E. coli are compared.


Supra-operonic clustering of genes specifying glucose dissimilation in Pseudomonas putida. The linkage arrangements of genes governing glucolysis in Pseudomonas putida have been determined by transductional analysis. Five genes (gdh, kgtA, kgtB, edd and eda), comprising at least three operons, are contransducible with each other, but not with ggu (glucose and gluconate uptake) nor with genes of a known supra-operonic cluster of genes specifying enzymes of other dissimilatory pathways, nor with a biochemically uncharacterized his marker. It thus appears that P. putida may have more than one chromosomal region in which genes with dissimilatory function are clustered in a supro-operonic fashion.


Effect of protein synthesis inhibition on recovery of UV- and gamma-irridated Schizosaccharomyces pombe from repair inhibition by caffeine. The progress of repair in Schizosaccharomyces pombe may be followed during post-irradiation incubation by measuring, after various intervals, the ability of UV- or gamma-irradiated cells to avoid enhanced lethality when exposed to the repair inhibitor caffeine (Gentner and Werner, 1975). This technique has now been used to investigate the effect of inhibition of protein synthesis on repair of UV- and gamma-irradiation-induced damage in this organism. When protein synthesis was inhibited with cycloheximide in UV-irradiated wild-type cells, only a small amount of recovery from caffeine inhibition occurred; this indicated that post-irradiation protein synthesis was required for repair, and in particular for the recombinational repair pathway, which is a major mechanism for repair of UV damage in this organism. In gamma-irradiated wild-type cells, inhibition of post-irradiation protein synthesis reduced the rate of recovery from repair inhibition by caffeine, but full recovery from caffeine-sensitive damage did occur at longer incubation times. We attribute the reduction in rate to the effect of protein synthesis inhibition on the recombinational repair pathway, because this pathway is known to be involved in the repair of both gamma-ray and UV damage. The recovery that took place at the slower rate must reflect a caffeine-sensitive pathway which is involved only in repair of gamma-ray damage and which does not require post-irradiation protein synthesis for activity.


Gene controlled selection of mitochondria in Paramecium. The slow growing mutant cl1 of Paramecium, previously described (Sainsard, Claisse and Balmefrezol, 1974) differs from wild-type by a single recessive nuclear mutation and by a particular mitonchondrial phenotype (Mcl) that gene cl1 distinguishes from the wild-type mitochondrial phenotype (M+). A further analysis of these nucleo-mitochondrial interactions was carried out by confronting the genes cl1 and cl)+ with mixed populations of M+ and Mcl mitochondria obtained after cytoplasmic exchange at conjugation. The following results were obtained: 1. M+ and Mcl mitochondria introduced respectively into mutant and wild-type cells do not multiply easily; 2. when a mixed population (M+ + Mcl) is established, both mitochondrial types are maintained during the growth of the F1 heterozygous cl1/cl1+ clones; 3. when the nuclear segregation occurs in F2, the formation of homozygotes cl1/cl1 or cl1+/cl1+ is soon followed by the segregation of the two mitochondrial types, Mcl or M+, reconstituting the two parental nucleo-mitochondrial associations.


Biogenesis of mitochondria 44. comparative studies and mapping of mitochondrial oligomycin resistance mutations in yeast based on gene recombination and petite deletion analysis. A comparative study of eight independently isolated mitochondrial oligomycin resistant mutants obtained from three laboratories show a variety of phenotypes based on cross resistance to venturicidin and sensitivity to low temperature. Analysis of recombination between pairs of markers indicate the existence of at least three genetic classes; class A, cross resistant to venturicidin and including the mutations OIII, [olil-r], [olgi-R], [tso-r]; class B, mutations OI, [olil7-r], [OLG2-R]; and class C, the mutation O11. The recombination data is consistent with mutations of each class residing in three separate genes, although mutations of class A and B show very close linkage. Recombination in non-polar crosses had demonstrated that markers of all three classes are linked to the mikl locus in the configuration (AB)-mikl-C. The mapping of this segment with respect to other markers of the mitochondrial genome and the order of classes A and B was established by analysis of co-retention frequenceis of markers in primary petite isolates as well as by analysis of marker overlap of genetically and physically defined petite genomes. The unambiguous order eryl-A-B-mik1-C-par was obtained. DNA-DNA hybridization studies using mtDNA isolated from selected petites confirms this map and estimates the physical separation of markers. A resonable correlation exists in this region of th genome between distances estimated physically by hybridization and genetically by frequencey of recombination in non-polar crosses. It is potulated that the oligomycin-mikamycin linkage group represents a cluster of genes involved in determing a number of mitochondrial membrane proteins associated with the mitochondrial ATPase and respiratory complex III.


Regulation of the D-glucose transport system in isolated fat cells. Recent technical advances have yielded considerable new biochemical insights into the hexose transport systems of both brown and white fat cells. In the present studies a novel filtration method was used to monitor initial rates of 3-O-(3H)methylglucose uptake in isolated white fat cells. Transport of 3-O-methylglucose, a non-metabolizable analogue of glucose, occurred by facilitated diffusion, was inhibited by glucose, phloridzin, cytochalasin B and dipyridamole, and was rapidly stimulated by insulin as well as lectins. Total 3-O-methylglucose uptake in white fat cells could be attributed to two kinetically distinct processes in addition to a certain degree of diffusion. Two important new features of glucose transport in fat cells have been discovered. First, in both brown and white fat cells transport per se does not appear to be necessarily rate-limiting for further glucose metabolism. Thus vitamin K5, which markedly increases glucose oxidation by brown fat cells, did not affect the glucose transport system activity. Glucose utilization can apparently be significantly enhanced in fat cells by agents which either increase transport system activity or intracellular enzyme activity. Second, the transport system itself, whether in the basal state or after activation by insulin, lectins, or oxidants, is resistant to sulfhydryl reagents such as N-ethylmaleimide, while the increase in transport activity due to these agents is exquisitely sensitive to sulfhydryl blockage. N-ethylmaleimide blocks the stimulatory effect of insulin on transport whereas addition of insulin to fat cells prior to the reagent completely protects against this inhibitory effect. Further, N-ethylmaleimide prevents the elevated rates of transport system activity due to insulin (or other agents) from returning to basal levels once the cells are washed free of hormone. These data are consistent with the concept that activation of the transport system involves oxidation of key membrane sulfhydryls to the disulfide form, but alternative models are also possible. In any case, these findings provide a possible biochemical clue for future studies designed to identify the specific component(s) involved in the regulatory mechanism which modulates transport of glucose in isolated fat cells.