The relation of impaired vitamin A and E tolerance to fat absorption in biliary diversion. Eleven patients have been studied after cholecystectomy with exploration of the common bile duct (CBD) and insertion of a T tube for free biliary drainage. Prior to clamping the T tube no significant rise was seen above fasting serum vitamin A and E, or serum triglyceride levels after 6 of the patients had been given these substances in a liquid test meal. In addition no rise in fasting vitamin E levels was seen after 3 subjects had been loaded for 4 days with 0.5 g DL alpha-tocopherol acetate/day. Faecal fat collections performed on 9 subjects indicated that over 70% of the ingested fat was absorbed. All these findings returned to normal when the T tube was clamped and the intraluminal flow of bile re-established. We conclude that deficiency of bile may allow the absorption of fat in the absence of fat soluble vitamins.


A method for the estimation of the vitamin A status of rats.


Prolonged tests with retinoic acid as a source of vitamin A for rats.


Distribution of H3-tocopherol in rat tissues and subcellular particles.


Some aspects of steroidogenesis in the vitamin E deficient rat.


Paracetamol hepatotoxicity and vitamin E.


Lipoperoxides in organs of vitamin E deficient rats fed large amounts of highly unsaturated fats. Rats were fed diets containing 10% cod liver oil with and without a supplement of tocopherol acetate for 32 weeks. The determination of peroxides in lipid extracts of adipose tissue, liver, heart and skeletal muscle by different methods was attempted. High amounts of peroxides were found only in adipose tissue of vitamin E deficient animals. Small values were found in other tissues of both groups. The problem whether the organs contain true lipoperoxides, or some other substances are responsible for the peroxide estimates, is discussed.


Vitamin E--selenium interactions.

Vitamin E--selenium interactions.


Epidemiology of anthrax.

Epidemiology of anthrax.


Chemoprophylaxis in chronic bronchitis.

Chemoprophylaxis in chronic bronchitis.


Diabetes and infection.

Diabetes and infection.


Experimental and clinical pharmacology of metampicillin in the biliary tract.


Scientific research freedom.

Scientific research freedom.


Penetration of ampicillin into brain of rats with chronic renal failure.


Effect of micellization on rate of cupric-ion-promoted hydrolysis of dicarboxylic acid hemiesters. The effect of micellar sodium lauryl sulfate on the rate of cupric-ion-promoted hydrolysis of some dicarboxylic acid hemiesters was investigated at pH 5, ionic strength 0.1 M, and 40, 45, and 50 degrees. The rate of cupric-ion-promoted hydrolysis of sodium n-decyloxalate in the micellar phase is about 50 times as fast as that in the bulk solution. The formation constant of the intermediate chelate complex, cupric decyl oxalate, was decreased in the micellar phase, while the rate of attack of hydroxide ion upon the chelate complex was increased. The overall rate increase is attributed to the increase in the entropy of activation for the reaction in the micellar phase. The rates of hydrolysis of sodium hydrocortisone 21-hemisuccinate and sodium hydrocortisone 21-hemi-(3,3-dimethylglutarate) were unaffected by copper ion.


Optimally predictive in vitro drug dissolution testing for in vivo bioavailability.


Subnanogram assay for pilocarpine in biological fluids. A method for the determination of pilocarpine was developed in which the imidazole ring of pilocarpine was acylated with heptafluorobutyric anhydride, using triethylamine as a catalyst. After cleanup, the pilocarpine derivative was analyzed using GLC with electron-capture detection. The limit of sensitivity was 25-50 pg of pilocarpine, which had been subjected to the derivatization and cleanup procedures. The method was specific for pilocarpine, with the isopilocarpine derivative eluting prior to the pilocarpine derivative.


Circular dichroism spectra of tetracycline complexes with Mg+2 and Ca+2. The study of Ca+2 and Mg+2 complexes of tetracycline in buffered solution was undertaken to determine their stoichiometry and the chelation sites. Circular dichroism was used to follow complex formation. Modified tetracyclines, in which potential complexation sites were blocked, were used to determine the participation of particular sites in complexation. Calcium formed a 2:1 metal-ion to ligand complex, while the magnesium complex formed at a 1:1 ratio. Formation of the calcium complex involved addition of one metal ion to the C-10, C-11 site with subsequent addition of a second metal ion at the C-12, C-1 site. The magnesium chelate occurred at the C-11, C-12 beta-diketone site.


N-Halo derivatives IV: Synthesis of low chlorine potential soft N-chloramine systems. A number of low chlorine potential, soft N-chloramines containing nitrogen-chlorine bonds of different polarity were prepared. These novel N-chloramine systems were based on derivatization of 2-amino-2-methyl-1-propanol.


N-Halo derivatives VI: Microbiological and chemical evaluations of 3-chloro-2-oxazolidinones. Comparative antimicrobial activity of 3-chloro-2-oxazolidinone (I), 3-chloro-4-methyl-2-oxazolidinone (II), 3-chloro-4,4-dimethyl-2-oxazolidinone (III), and N-chlorosuccinimide (IV) was evaluated in aqueous buffers in the absence and presence of 5% horse serum. All four compounds had similar bactericidal activity in the absence of horse serum, but I and III had superior activity relative to IV when serum was present. Compound III was considerably more stable with respect ot loss of positive chlorine and bactericidal activity than I and II when stored in 0.1 M sodium dihydrogen phosphate buffered to pH 7.0 at 40 degrees. Thus, III is potentially the most useful bactericidal agent of those evaluated. The chlorine potentials of I, II, and III, the rate constants for transfer of positive chlorine from I and III to morpholine in aqueous solutions, and the hydrolytic stabilities of I and III with respect to loss of positive chlorine were evaluated. These data, together with previously calculated data for IV, are used to rationalize the observed bactericidal activities.


Effect of storage at specified temperature and humidity on properties of three directly compressible tablet formulations. Direct compression tablets containing sodium starch glycolate, an alginate derivative, or povidone as a disintegrant, magnesium stearate as a lubricant, amaranth as a tracer, and dibasic calcium phosphate dihydrate as the matrix were stored for 30 days at 23 degrees and 75% relative humidity (R.H.), 45 degrees and 75% R.H., and 65 degrees and 40% R.H. Samples were evaluated after 0, 10, 20, and 30 days for size, hardness, and dissolution characteristics. Although no significant changes in the dimensions or hardness of the three tablet formulations, prepared at three different compaction pressures, were observed, the dissolution efficiency of the systems showed significant changes, some systems dissolving more rapidly and some more slowly after storage. In some cases, the changes were so substantial as to indicate the possibility of significant changes of the bioavailability of drugs formulated in such systems. The relevance of this work to the problem of evaluating aging effects on the physical properties of tablets is discussed.


Disaggregation of compressed tablets.

Disaggregation of compressed tablets. Tablets of dibasic calcium phosphate containing varying proportions of intra- to extragranular maize starch were prepared at three compaction pressures. The surface area generated per tablet after 10 and 30 min of disintegration was measured with an automated counter by a new technique. The optimum starch combination that produced the maximum surface area in a tablet formulation was either 2.5% intra-12.5% extragranular or 15% intragranular starch alone. The distribution of starch did not affect the resultant strength of the tablets, and maximum generation of surface area was achieved by compacting the tablets at as low a pressure as practical.


Dissolution characteristics and oral absorption of digitoxin and digoxin coprecipitates. A marked increase in the dissolution rates od digitoxin and digoxin was attained by dispersing the drugs in two inert solid carriers, poloxamer 188 and deoxycholic acid. The 1 and 10% (w/w) drug-carrier solid dispersions were prepared by the solvent method. The former dissolved significantly faster than the latter. The oral administration of 10% (w/w) digitoxin-carrier coprecipitates to mice significantly increased toxicity. This observed increase is attributed to an increase in the rate and, possibly, the extent of oral absorption of the drug. Although a 10% coprecipitate of digoxin in both carriers showed an increase in the dissolution rate, no increase in oral toxicity was observed. X-ray diffraction patterns indicated that both digitoxin and deoxycholic acid undergo crystalline modifications due to treatment by the solvent, but the exact nature of the drug-carrier solid dispersions was not revealed.


Electrochemical evidence for interaction between chlorpromazine hydrochloride and trifluoperazine hydrochloride and the flavin coenzymes. Polarographic and chronopotentiometric methods were applied to study the effects of the phenothiazine tranquilizers chlorpromazine hydrochloride and trifluoperazine hydrochloride on the electrochemical behavior of the flavin coenzymes flavin mononucleotide and flavin adenine dinucleotide. The effects of the drugs were measured mainly by decreases in the diffusion currents, id, developed in the polarographic experiments and by a similar decrease in the chronopotentiometric constant, ior1/2, in the chronopotentiometric experiments when the coenzymes were reduced in the presence of the added drugs. The observed interference with the redox properties of the coenzymes could conceivably be related to the reported ability of the drugs to inhibit respiration and produce their tranquilizing effect.


Dissolution of two-component solids.

Dissolution of two-component solids. The dissolution rates of compressed two-component mixtures were investigated. A good correlation between the composition of the solid and its observed dissolution rate was demonstrated by regression analysis. A model for dissolution was applied to compressed mixtures of aspirin-salicylic acid, aspirin-phenacetin, phenacetin-caffeine, and aspirin and caffeine (the last mixture complexes in solution).


Fluorometric determination of trifluoromethyl-substituted 2,3-bis(4-methoxyphenyl)indoles in biological materials. Interest in the 5-, 6-, and 7-trifluoromethyl-substituted 2,3-bis(4-methoxyphenyl)indoles as potent, orally active anti-inflammatory agents required a method for their determination in serum, urine, and feces to permit studies of their absorption, metabolism, and excretion. A simple, rapid, sensitive, and specific procedure was developed based on an ethyl acetate extraction of alkaline specimens and subsequent fluorometric analysis of ethanolic solutions of the extract residues. The method is sensitive to 0.1 microgram/ml, 0.5 microgram/ml, and 0.7 microgram/100 mg of these compounds in serum, urine, and feces, respectively. Overall mean recoveries and standard deviations of the 5-, 6-, and 7-trifluoromethyl-substituted compounds from biological samples were 102.2 +/- 3.0, 102.2 +/- 5.4, and 100.5 +/- 5.7%, respectively. The procedure was applied successfully to absorption studies with 2,3-bis(4-methoxyphenyl)-7-(trifluoromethyl)indole in the dog.


Effect of nonionic surfactants on percutaneous absorption of salicylic acid and sodium salicylate in the presence of dimethyl sulfoxide. Fifteen nonionic surfactants, 10% (w/w), were each incorporated into white petrolatum USP ointment base containing 10% (w/w) salicylic acid or 11.6% (w/w) sodium salicylate with 10% (w/w) dimethyl sulfoxide. Percutaneous absorption was determined from blood salicylate levels in New Zealand white rabbits at regular intervals for 8 hr following application of the ointment. Percutaneous absorption of salicylic acid was increased significantly when sorbitan monopalmitate, sorbitan trioleate, poloxamer 231, poloxamer 182, polyoxyethylene 4 lauryl ether, polyoxyethylene 2 oleyl ether, or polyoxyl 8 stearate was added to the ointment containing dimethyl sulfoxide, salicylic acid, and white petrolatum. Percutaneous absorption of sodium salicylate was increased significantly when sorbitan monolaurate, sorbitan monopalmitate, or poloxamer 182 was added to the ointment containing dimethyl sulfoxide, sodium salicylate, and white petrolatum.


Potentiometric and spectral investigations of anhydrotetracycline and its metal-ion complexes. The interaction of various metal ions with anhydrotetracycline was investigated. A comparison of the UV-visible and fluorescence spectral characteristics of anhydrotetracycline and its metal-ion complexes with a number of modified anhydrotetracyclines in the presence of metal ions suggested that the C-11 oxygen was involved in metal-ion binding. Secondary binding was observed in the A-ring by circular dichroism when the primary site was blocked.


Lipid-protein interactions: enhancement of enzyme activity of L-glutamic acid dehydrogenase by nonionic detergents. Five nonionic detergents enhanced the activity of L-glutamic acid dehydrogenase [L-glutamate:nicotinamide adenine dinucleotide phosphate oxidoreductase (deaminating) (EC 1.4.1.3)]. These detergents activated the enzyme toward alpha-ketoglutaric acid reduction, causing a decrease in the sensitivity of the enzyme to allosteric regulation by guanosine 5-triphosphate. There was also a diminution of the enhancing effect of the modifier adenosine 5-diphosphate on the enzyme's L-glutamic acid dehydrogenase activity. These detergents may cause a conformational change in the enzyme, and this change could lead to an increase in the binding of the substrates for the alpha-ketoglutaric acid reduction. Accompanied with this conformational change would be a decrease in the binding of the modifier guanosine 5'-triphosphate, with no concomitant change in the binding of the adenosine 5'-diphosphate modifier.


Pharmacology of Quercus infectoria.

Pharmacology of Quercus infectoria. The galls of Quercus infectoria (Fagaceae), a commonly available plant in Iran, were studied pharmacologically. Two fractions were employed, a dried acetone-treated methanol extract dissolved in water (Fraction A) and a subfraction prepared by chloroform-methanol extraction (Fraction B). Fraction A was active as an analgesic in rats and significantly reduced blood sugar levels in rabbits. Fraction B had CNS depressant activity. Data obtained with a treadmill indicated a decreased activity ratio by Fraction B, suggesting a possible interference in motor coordination. It potentiated the barbiturate sleeping time significantly without changing the onset time or the loss of the righting reflex. In addition, Fraction B exhibited a moderate antitremorine activity by causing a delay in the onset and a decrease in the severity of tremorine-induced tremors. The local anesthetic action of Fraction B was evident due to the complete blockade of the isolated frog sciatic nerve conduction.


High-pressure liquid chromatographic determination of chlorphenesin carbamate and the beta-isomeric carbamate. A high-pressure liquid chromatographic assay was developed for the determination of chlorphenesin carbamate and its beta-isomeric carbamate. A single 4-mm i.d. X 30-cm column, prepacked with 10 micrometer fully porous silica gel particles, is used with 3% methanol in 50% water-saturated butyl chloride as the mobile phase. The procedure separates chlorphenesin carbamate from several possible impurities in addition to the beta-isomeric carbamate. The assay was applied to bulk drug and compressed tablets. The relative standard deviations for the assays of chlorphenesin carbamate and the beta-isomer are approximately 1 and 2%, respectively.


Molecular connectivity VII: specific treatment of heteroatoms. The molecular connective index, chi, initially designed for hydrocarbons, has been formally extended to molecules containing heteroatoms. The sigma value of the heteroatom is modified to take account of its number of attached hydrogen atoma, sigmaiv = Zv - hi. These values were successfully tested on boiling points and molar refractions. A table of sigmav values is presented for nitrogen, oxygen, fluorine, chlorine, bromine, and iodine in various bonding situations.


Mechanistic studies on transcorneal permeation of pilocarpine. The mechanism of corneal pilocarpine penetration was studied in the albino rabbit using radiochemical techniques. The apparent rate and extent of pilocarpine accumulation in the aqueous humor and the various cell layers of the cornea were determined for both intact and abraded eyes. For the first time, drug levels were monitored in the epithelium and stroma-endothelium of the intact cornea using a tissue-scraping technique. In addition, a new postinstillation rinsing method was devised to evaluate the rate of corneal uptake. The results demonstrate a dual role for the corneal epithelium, both as a barrier to drug penetration and as a reservoir for drug in the intact cornea. The transcorneal pilocarpine flux is slower than the data appear to indicate, and previous overestimates of the apparent absorption rate constant are due to parallel elimination processes occurring at the absorption site. Pharmacokinetic parameters were determined for each tissue to generate an overall mechanism for corneal permeation.


Trace analysis of 2,4,5-trichlorophenoxyacetic acid, its glycineamide, and their alkaline hydrolyzable conjugates in mouse blood, urine, and feces. Chemical methods were developed for the trace analysis of the herbicide 2,4,5-trichlorophenoxyacetic acid, its glycineamide, and their alkaline hydrolyzable conjugates in mouse blood, urine, and feces. The salient elements of the methods are extraction of the free acids with benzene, methylation, cleanup on a silica gel column, and quantification via electron-capture GLC. Any unextracted conjugates remaining in the substrates are then subjected to alklaline hydrolysis, and the liberated 2,4,5-trichlorophenoxyacetic acid is assayed. Data are presented concerning recoveries of the compounds from the three spiked substrates. The utility of the procedures is illustrated by a preliminary pharmacolinetic study employing parallel electron-capture GLC and radioassays of the three substrates from mice injected with a single intravenous dose of 14C-2,4,5-trichlorophenoxyacetic acid. GLC characteristics and partition values of the the compounds and hydrolysis of the glycineamide under various conditions also are discussed.


Correlation of absorption of sulfamethazine boluses with dissolution using a new dissolution apparatus for veterinary tablets. A rotating-basket apparatus for dissolution testing of veterinary bolus tablets was designed and constructed. Sulfamethazine boluses containing different disintegrating agents were evaluated in vitro and by blood level data following administration to cattle. The dissolution t50 and various pharmacokinetic parameters showed directly compressible starch and carboxymethylstarch to be the most effective disintegrants in the concentrations employed while magnesium aluminum silicate and microcrystalline cellulose were about equal but less effective than the previous disintegrants. A bolus formulation containing no disintegrant gave even less satisfactory results. A correlation was established between the dissolution t50 and the time to peak plasma level and also between the t50 and the area under the plasma-time curve for the first 36 hr.


Determination of cyanocobalamin by thermal decomposition of the cyano group using an ion-selective electrode. A method for the simultaneous determination of cyanocobalamin, cobinamide (Factor B), and hydroxocobalamin in the solid state is described. The method is based on heating at 120 degrees for cobinamide and at 140-145 degrees for cyanocobalamin (15-20 min). The cyano content in the sample is distilled as hydrocyanic acid, trapped in 0.1 M potassium nitrate at pH 12-13, and determined by means of the cyanide ion-selective electrode. The error of this method, statistically established, does not exceed +/-3%.


GLC determination of l-2-hydroxy-N-cyclopropylmethylmorphinan in plasma and urine. A specific method was developed for the determination of l-2-hydroxy-N-cyclopropylmethylmorphinan in plasma and urine by GLC, using flame-ionization detection. The method involves the extraction of the compound into ether from plasma or urine at pH 7.4, followed by back-extraction into 1 N HCl. The acid phase is ether washed and made alkaline, and the compound is reextracted into ether. The ether is evaporated to dryness, the residue is dissolved in methanol, and an aliquot is analyzed by GLC. The same method is applicalble to plasma and urine samples following deconjugation of the compound with glucuronidase-sulfatase. The overall recovery is 93.1 +/- 9.4% SD) in the concentration range of 0.020-2.0 microgram/ml. The method was successfully applied to plasma and urine specimens obtained after administering single 25-mg oral doses to humans.


Steric inhibition of conjugation in lowest excited singlet state of 9-anthramide by hydrogen bond donor solvents: role of solvent in chemical structure. 9-Anthramide has electronic absorption and fluorescence spectra that, in water, are similar to those of anthracene. This result is attributed to steric hindrance of the 9-carboxamido group with the peri-hydrogen atoms in the 1- and 8-positions of the anthracene ring. However, in aprotic solvents, although the absorption spectrum of 9-anthramide is anthracene-like, its fluorescence spectrum is red shifted and structureless. This finding is attributed to excited-state rotation of the 9-carboxamido group into coplanarity with the anthracene ring and indicates that, in water, the hydrogen-bonded solvent cage affects the steric inhibition of conjugation in excited 9-anthramide. These findings suggest that studies of structure and reactivity of drugs in nonaqueous or solid matrixes are probably of only limited value, since in the strongly interacting aqueous media the aqueous solvent cage plays a substantial role in determining molecular structure and reactivity.


Effect of variation in compaction force on properties of six direct compression tablet formulations. The effect of variation in compaction force on six direct compression tablet matrixes was investigated. An instrumented tablet press allowed direct measurement of applied and ejection forces. Hardness, apparent tablet density, and disintegration times also were determined. The disintegration time of spray-dried lactose tablets was essentially independent of compaction force. However, in the other systems investigated, the properties studied showed varying types of dependence on compaction pressure. A direct compression formula was developed and exhibits a decrease in disintegration time as compaction force is increased.


The nature of immunity.

The nature of immunity.


Influence of steroids and stress on toxicity and disposition of tetraethylammonium bromide. In female rats, pretreatment with dexamethasone acetate or triamcinolone reduced the toxicity and plasma concentrations of tetraethylammonium bromide while increasing its level in urine. Pretreatment with corticosterone acetate or pregnenolone-16alpha-carbonitrile shared none of these effects. Although starvation or restraint neither diminished the tetraethylammonium bromide concentrations in plasma nor accelerated its urinary excretion, its toxicity was diminished by the stress induced with spinal cord lesions, heat, cold, hydrocortisone, or reserpine as well as starvation or restraint. The protection offered against the toxicant by stress and by the potent glucocorticoids seemed to be mediated, at least partly, via different mechanisms. Stress-induced resistance to tetraethylammonium bromide could not be attributed to elevated plasma corticosterone levels, whereas glucocorticoid-induced resistance could be partially ascribed to increased urinary excretion of the toxicant.


Determination of the nonnutritive sweetener sodium cyclopentylsulfamate and three of its metabolites, cyclopentylamine, cyclopentanone, and cyclopentanol, in urine of rats and rabbits. The nonnutritive sweetener sodium cyclopentylsulfamate was fed to Wistar albino rats and New Zealand White rabbits. Urine was collected for 3 days after feeding, combined, and examined for the metabolites cyclopentylamine, cyclopentanone, and cyclopentanol and for sodium cyclopentylsulfamate was assayed by hydrolysis in acidified dioxane-water and subsequent measurement of the absorbance of the product formed (lambdamax = 490 nm) by the liberated amine with p-benzoquinone. The average conversion to cyclopentylamine, cyclopentanone, and cyclopentanol was 0.103, 0.171, and 0.054% in the rabbit and 0.057, 0.016, and 0.008% in the rat, respectively.


Effect of pentagastrin on blood sugar, serum amylase, lipase and calcium in normal control and duodenal ulcer subjects.


A comparative study of central nervous system depressant effects of some of the disubstituted piperazine compounds--part I.


Factors influencing the age of menarche.


Serum lipoproteins, phospholopid and cholesterol levels in normal children.


Language of the English-speaking coloured child.


A therapy programme for pre-school language impaired children.


Mass generalised learning applied to the problem of carry-over in articulation therapy.


Articulation in apraxia of speech.

Articulation in apraxia of speech.


A filtered speech test for an aging population.


A comparison of the SISI and the stapedius reflex test in the differential diagnosis of choclear pathology.


Properties and electron microscopy of a Vigna-virus belonging to the Cucomovirus group.


Hair transplantation. The use of hairbearing compound grafts for correction of alopecia due to chronic discoid lupus erythematosus, traumatic alopecia, and male pattern baldness. In this study 8 patients with alopecia due to chronic discoid lupus erythematosus (CDLE), 10 patients with traumatic alopecia (TA), and 12 patients with male pattern baldness (MPB) were treated with the punch graft method (PGM). Stastistical evaluations of the results and factors influencing the results were careied out. The mean survival rate of hairs was 72% in CDLE, 97% in TA, and 104% in MPB. The mean number of hairs in a 4 mm graft before transplantation in 30 patients and 752 grafts was found to be 18.2. This is far more than the number reported in previous publications concerning PGM owing probably to the difficulties of counting several hairs simultaneously emerging from the same pilary canal when the hair is cut to a length of 1--2mm preoperatively. For this purpose the author has developed a special photographical magnifying system. The number of hairs surviving transplantation in MPB in a 4 mm graft was about 19 hairs per graft, which is superior to previous reports. This is possibly due to some modifications of the procedure made by the author. In a control series done with the same technique as that often seen in the literature, about 50% inferior results were obtained. These results were however similar to those reported in the literature. Consequently the modifications of the procedure have been successful. Only one article with a series of 12 patients with TA treated with PGM was found in the literature. The hair survival results of the author exeeded the reported results by about 100%. The size, hardness, and elevation of the scars of the donor holes were checked statistically after various treatments. It was found that the diameter of the scar is the same regardless of type of treatment but that a signifcantly greater risk of hard and elevated scars is taken if the bald grafts are put back in the donor holes. No complications were seen in this series. PGM is a safe method that gives good hair survival results on transplanted hairs in MPB and TA, but the results vary in CDLE. In spite of the good results with PGM the author emphasizes that, although the therory of the method is simple, both the preoperative judement and the performance with its practical difficulties and many cosmetic problems is complex and requires a lot of psychological insight, practice and experience before correct preoperative judgement and a maximally good cosmetic result can be achieved.


Micturition in infants and children with normal lower urinary tract. A urodynamic study.


Effect of insulin on serum lipids in juvenile diabetes. In diabetic children, the effect on serum lipids of insulin by itself and combined with glucose of with Aminosol + glucose has been studied. The level of serum free fatty acids decreased significantly in every case. The cephalin level decreased under the effect of insulin and insulin + Aminosol, whereas it rose after insulin and glucose infusion. The triglyceride level remained unchanged when insulin was applied by itself, and decreased significantly under the effect of insulin + Aminosol, while it showed a rising tendency after insulin + glucose infusion.


Surveillance of congenital anomalies in Hungary. Surveillance of congenital anomalies has various functions viz. monitoring (to detect clusters as soon as possible), registering (to contribute to medical care and to provide material for scientific research) and informative. The Hungarian Congenital Malformation Register records the occurrence of malformed babies diagnosed from birth to 1 year of age. The Register has 3 sources (obstetricians, paediatricians, pathologists) and has registered since 1971 over 4000 malformed infants annually, an occurrence of over 28%. Validity and completeness of notification depend on the type of malformation. A separate Monitor started on January 1st, 1973, is confined to congenital malformations detectable unequivocally and readily during the first seven days of life. So far four real clusters occurred in Hungary but their causes could not be found. Particular stress has been laid upon multiple malformations (syndromes) since all known teratogens affecting humans produce multiple malformations.


Abnormal tryptopham metabolism in congenital erythroid hypoplastic (Diamond-Blackfan) anaemia. Tryptophan loading was performed in a child with Diamond-Blackfan anaemia as well as in his parents and two control persons. There was a fivefold increase of anthranilic acid and kynurenine excretion beside a marked generalized aminoaciduria in the proband; in the parents and the controls no such phenomenon could be demonstrated. The importance of the finding is discussed and investigation of tryptophan metabolism before the first blood transfusion is recommended. The finding cannot be used as a heterozygote test.


Methadone maintenance treatment of narcotic addiction: a unit of medical care based on over 50,000 patient treatment years. The experience with methadone maintenance treatment by two major New York City methadone maintenance treatment programs using the Dole-Nyswander philosophy is reviewed. After more than 56,000 person-years in treatment over a 10-year period of time, a unit of medical experience exemplified by these two programs is evident. There was a high degree of patient acceptance, a small amount of recognized residual illicit drug abuse, and steeply reduced criminal activities of those patients who remained in treatment. A wide variety of other methadone treatment programs are recognized. Many use methadone differently from those in the present study. The treatment results reported herein may represent a standard by which narcotic (methadone and other) treatment programs can be assessed.


Undetected opiate use in the Southwest: comparison of official drug-user files and treatment program patient records. Highly disparate research techniques have been employed to develop estimates of the extent of opiate use. Exclusive reliance upon public health and law enforcement statistics has been supplemented in recent years with data generated by survey research "incidence and prevalence" epidemiological methods. State agencies attempting to measure the extent of opiate use as a requirement for the receipt of federal categorical grant formula funds utilize multiple indicators: opiate treatment, arrest, incarceration, serum hepatitis, narcotics overdose death, and survey data. To address the question of undetected opiate use in a major southwestern city, the authors have undertaken a study measuring the extent of law enforcement recognition of the addictive status of a random sample of patients selected from the city's two municipally operated methadone treatment programs. The results indicate that over one-half of the sample was unknown to the police as addicts. Descriptive attributes of the unknown group were identified through appropriate statistical analyses. These findings are comparable to those of a similar study conducted in 1973 in a major eastern city.


Methadone dispensing by community pharmacies. This study reports 1 year follow-up data of 96 patients who received methadone at selected community pharmacies instead of traditional program dispensaries. Outcomes are comparable to those reported for traditional programs. Security measures were not a problem. The results indicate that most patients can begin methadone maintenance at a pharmacy without a period of stabilization at a program unit. Of several factors studied, arrest record, both preceding and during treatment, based on official police data was the single factor significantly associated with employment and continuation in methadone treatment. Community pharmacy dispensing of methadone is a useful means of operating a methadone treatment program.


A study of addicts' career experiences with methadone. Recent public concern over illicit methadone use has generated considerable interest among both treatment authorities and researchers. Unfortunately, many professional studies on the topic have done little to clear up certain misconceptions surrounding methadone use. In building upon earlier empirical work, the authors sought to explore the role of methadone within the context of addict career experiences as a whole. Interviews revealed considerable differentiation in types of experiences and purposes for use with respect to a variety of demographic and drug career attributes. The findings suggest the need for some rethinking about prevailing conceptions of "the problem" of illicit methadone use.


Methadone maintenance and the problem with alcohol. There is a growing concern with the rapid pace of physical and psychosocial deterioration of methadone patients who abuse alcohol. The need for a sample method for determining the extent of the problem, as well as the presence of an alcohol problem in individual patients, led the authors to test the validity of the Michigan Alcoholism Sreen Test (MAST) in a small urban methadone maintenance clinic (N = 125). The MAST was administered to every patient by their counselors, and the nursing staff was asked to independently rate each patient according to Keller's definition of alcoholism. The authors compared the patients' MAST scores with the global ratings of the nursing staff. Forty-six percent (n = 58) of the patients scored in the alcoholism range of the MAST questionnaire, while 34% (n = 43) of the patients were diagnosed as alcoholics by the nursing staff. There was 75% (n = 94) agreement between the MAST findings and the nurses' global ratings (p less than .001). The authors suggest that the MAST could be an effective screening tool in the area of alcohol abuse in methadone clinics. Going beyond the data, the authors recommend reexamination by psychiatrists of their peripheral role in the treatment of these difficult and multihandicapped patients.


The abuse of multiple drugs. I. Definition, classification, and extent of problem. Drug abusers have historically tended to abuse more than one drug. However, over the past 5 years there has been an increasing tendency to combine narcotics, alcohol, sedatives, and/or stimulants. The statistical increase of such abuse in the United States is documented by national surveys and the findings of drug treatment programs and detoxification centers. To clarify the confusion about such terms as "polydrug abuse" and "multidrug abuse," these terms are defined. A classification of multiple drug abuse is presented which demonstrates recent increases in each of four categories.


The abuse of multiple drugs. II. Psychological hypotheses, treatment considerations. Several basic psychological hypotheses about multiple drug abuse are examined, i.e., social determinants, the effect of availability on extent of abuse, that drug abuse is a symptom rather than a disease, the relationship of social class to psychopathology, the lack of specificity of psychodynamics or psychopathology to drug choice, and the use of drugs to facilitate or obliterate concern with assertion, relieve neurosis, or provide homeostasis. There is a need for a variety of comprehensive, directive treatment approaches from which an individual treatment plan can be chosen. Such plans must consider which of the complex factors that can lead to multiple drug abuse are most prominent and can be remedied in each case.


Variables related to length of stay in day programs for drug abusers. In a study of client variables related to length of stay in two types of drug-free day treatment programs, results varied according to program structure and sex of the clients. In the more loosely structured Youth Centers, in which the programs differed from center to center and the populations were heterogenous, there were no clear-cut results. However, within the more tightly structured Ambulatory Treatment Units, the programs and the populations were more homogeneous, and the results showed a significant pattern related to length of stay, but for males only.


Clinical guidelines for the cross-cultural treatment of chemical dependency. Clinicians should be skilled in work with their ethnic peers before attempting cross-cultural treatment. Acquiring cross-cultural sensitivity involves regression to childlike openness for new values, attitudes, and behaviors. Members of the ethnic group can orient the clinician by discussion, suggested readings, and invitations to their homes and ritual events. Work should begin slowly, with regular consultation from ethnic peers of the patient. Special transference issues involve parent-child transactions and the "Messianic countertransference." Clinicians must maintain their primary commitment to the patient and to the patient's social resources, rather than to an institution not responsible to the patient population.


An epidemiological description of the development of drug dependence: environmental factors and prevention. The "agent," "host," and "environment" of drug dependence are examined relative to their potential as effective foci of efforts in the areas of primary secondary and tertiary prevention. Factors associated with the agent and the host are shown to be of extremely limited value when it comes to the primary prevention of drug dependence. Results of prior rewards are reviewed and they serve as the basis for the conclusion that the manipulation of environmental factors holds the greatest promise relative to the primary prevention of drug dependence.


Relationship of neonatal withdrawal to maternal methadone dose. Neonatal withdrawal is described for a sample of 70 infants born to addicted women treated with methadone and comprehensive prenatal care. Although symptoms were manifested by over 90% of the infants, those born to women receiving near-term average doses of less than or equal to 20 mg/day had significantly less symptomatology, weight loss, and need for pharmacologic treatment than those of mothers still on higher doses. Reduction of methadone dose levels during the last 6 weeks of pregnancy to less than or equal to 20 mg/day appears to reduce the severity of neonatal withdrawal.


Further comments on the communicable disease model of heroin addiction.


Medical implications of marijuana use.

Medical implications of marijuana use. The effect of marijuana smoking was studied in 28 healthy young adult men who had previously smoked marijuana for approximately 5 years each. The subjects were hospitalized on a closed research ward for 31 days during which comprehensive psychological, physiological, and medical observations and tests were done. Physical examinations, neurological examinations, chest X-rays, electrocardiograms, and clinical laboratory tests were all within normal limits. Marijuana produced inconstant changes in pulse rate and blood pressure in these studies. Six subjects were found to have significant reduction in resting vital capacity during the baseline period of the study which were felt to be related to their prior marijuana smoking. In contradistinction to these findings, 12 of 15 subjects had statistically significant increases in peak expiratory flow rate immediately following marijuana smoking. Body temperature tended to be slightly reduced during marijuana use.


A note on the A.I.D. test and the youthful drug abuser.


Employment and social disability among opiate addicts. This study examines the relationship between employment and social disability. It is based on admission data for 296 opiate addicts who enrolled in New York Medical College's Multitrack Abstinence Program during 1974. Social disability is defined here as an attribute of the patient which may count against him or her in the job market. Employment rates are examined in the light of an index comprised of three specific disabilities: minority group status, lack of a high school degree, and presence of an arrest record. It is found that the proportion of addicts employed upon admission to the program varies inversely with the number of disabilities. Furthermore, it is found that the proportion of addicts who rely on illegal acts for their main source of income varies directly with the number of disabilities.


Narcotic use in an inmate population at three points in time. Studies on new jail admissions conducted in 1969, 1971, and 1973 indicated a sharp decrease in heroin use among male inmates in the District of Columbia in 1973. In the jail study conducted in 1969 among 225 inmates, 45% reported to be addicted to heroin, in 1971, 47% of the 150 inmates reported to be addicted, as compared to only 22% of the 200 inmates in 1973. Only 38% of the addict-inmates in 1969 reported ever receiving treatment for their addiction, while 62% in 1971 and 64% in 1973 reported receiving treatment.


Drug dependency: some etiological considerations. In an effort to illuminate etiological aspects of drug dependency, some findings from genetics are examined for meaningful connections with psychological areas, particularly with regard to the contribution of Object Relations theory. The latter is described in some detail, using methadone maintenance treatment as an illustrative context. Connections between the two areas are described which increase an understanding of the relevance of each and which raise questions about the artificiality of the usual separation of biological and psychological approaches in this area.


An analysis of psychedelic drug flashbacks. Psychedelic drug flashbacks have been a puzzling clinical phenomenon observed by clinicians. Flashbacks are defined as transient, spontaneous recurrences of the psychedelic drug effect appearing after a period of normalcy following an intoxication of psychedelics. The paper traces the evolution of the concept of flashback and gives examples of the varieties encountered. Although many drugs have been advocated for the treatment of flashback, flashbacks generally decrease in intensity and frequency with abstinence from psychedelic drugs.


A follow-up study of 300 ex-clients of a drug-free narcotic treatment program in New York City. This article deals with an attempt at evaluating the success of a drug-free narcotic treatment program in New York City through a follow-up study of 300 ex-clients of the program. Two hundred ex-clients out of the 300 target population were actually interviewed. The number of months the clients had remained in the treatment program was found to be a key factor in the outcome of the program. The length of time in the program was itself highly dependent upon the client's background: the higher the pretreatment pathology the lower the chance of treatment success.


The epidemiological approach to drug abuse: its relevance to the teaching of future professionals. In most areas of the medical curriculum it is far more important to teach students the approach to problems, rather than to encourage rote learning of the specific diagnostic and therapeutic regimen indicated in every conceivable circumstance. This is especially true in the field of substance abuse, in part because there simply are no clear-cut answers which can be universally applied. Nevertheless, dogmatism has been all too common in the teaching as well as the treatment of addiction, and there is a general tendency to view the problem simplistically and to advocate a specific modality as the solution. Teaching new professionals to apply the holistic perspective of the epidemiologist will enhance the likelihood of establishing realistic program goals, and adopting a comprehensive, balanced approach.


Use of a social indicator system to assess alcoholism among Indian people in Minnesota. A social indicator system was used to assess alcohol-related problems among American Indian people in Minnesota. Instead of counting "cases," the method involved using "events" that were recorded by various social institutions in the course of their work. The system showed that Indian people commonly encountered alcohol-related "events" that led to death or to social institutions with a poor record of problem resolution (foster homes, jail, prison, welfare agencies). However, they infrequently appeared in psychiatric facilities with alcohol-related "events."


Sex differences in alcoholics: a comparison of male and femal alcoholics' self and spouse perceptions. Self-perceptions of male and female alcoholics and the perception of them by their respective spouses were investigated in an attempt to study sex differences in alcoholics. The subjects were 20 male and 20 female hospitalized alcoholics and their spouses. Subjects were administered a modified Katz Adjustment Scale and the NIMH Mood Scale applied both to states of sobriety and intoxication. The results indicated that the female alcoholic is more likely to characterized by her spouse as guilty and depressed both in states of sobriety and intoxication than is the male alcoholic. The therapeutic implications of these and other findings are discussed.


Reported drinking among posttreatment alcohol abusers: a preliminary report. Posttreatment drinking behavior and job effectiveness ratings by supervisors are compared at 6, 12, and 24 months follow-up for young (age 25 and younger) and old (age 26 and older) male alcohol abusers admitted to Naval Alcoholism Rehabilitation facilities. Follow-up results indicate that: (1) large percentage of subjects were rated effective at their work following treatment; (2) effective subjects drank significantly less than noneffective subjects; (3) young subjects tended to drink significantly more than old subjects; (4) of those rated effective at their work, young subjects drank more and abstained less than did old subjects; (5) drinking behavior and work effectiveness ratings appear to remain consistent over the three follow-up periods. Some implications and limitations of the present study are discussed.


Drug abuse in junior high school populations. Illegal drug use in a population of 3,807 junior high school students in a suburban area appeared strongly correlated with family instability, student personal problems, and low academic performance. Use of tranquilizers, amphetamines, and sedatives was often motivated by attempts at self-medication to reduce painful feelings. Over 14% of illegal users took an overdose with about half of them intentional. Illegal users and nonusers agreed that drug education programs and the threat of legal penalties had little influence in their decisions about drugs.


The spread of addiction-the role of the "average addict". A survey of an accidental sample of 100 addict-clients indicates that approximately two-thirds of addicts induct others into the heroin culture. Typically, the number of new users recruited in this way is no more than one or two new users contacted by each experienced addict. The problems of interdicting the transmission process is complicated not only by the large numbers of persons involved in that process, but is further complicated by the fact that new users are recruited relatively early in the experienced users' careers when they are least likely to be known to treatment or law enforcement officials. The work of interdicting the spread of phenomenon is still further complicated by the fact that heroin is transmitted between friends under circumstances the experienced user can characterize, if with some possible exaggeration, as involving an effort to share a pleasurable experience and/or to meet others' requests.


The black addict: I.Methodology, chronology of addiction, and overview of the population. One hundred ninety-two Black, male heroin addicts in various phases of treatment and nontreatment, including never-treated active addicts and actively addicted treatment dropouts, were systematically interviewed for early life events, psychosocial variables, and natural history of addiction. This report presents the chronology of the addiction problem from childhood as well as evidence of significant early antisocial activities predating drug use in this population. Data on family characteristics, arrests, problems in formal schooling, and adult activities are summarized. The current work is compared to earlier data on comparable populations.


A national follow-up study to evaluate the effectiveness of drug abuse treatment: a report on cohort 1 of the DARP five years later. Preliminary findings for the first cohort of a national follow-up study of drug users admitted to treatment in the Drug Abuse Reporting Program (DARP) during 1969-1971 are reported. From a sample of 1,853 selected for follow-up, 87% were located and interviews were completed for 77%. Gross tabulations are shown comparing several outcome measures based on pre-DARP treatment, the posttreatment period, and for the 2 months before interview. Sixty-one percent of all patients returned to treatment at some time after DARP termination. Decreases in drug use, expecially of opioids, were substantial and were generally accompanied by improvements in other outcome measures as well. Plans for more detailed and informative analysis of these and related DARP data are addressed.


The structure of heroin communities (in relation to methadone maintenance). The sociocultural structure of contemporary urban heroin-using communities is delineated using the dimensions "being hooked," "scoring," and "hustling" on "the street." A concentric ring model is constructed with four rings: (innermost) the street dealing network, other criminal hustles, employed addicts, and a peripheral "recruitment" area (outermost). The model is used to define differential intentions toward and responses to methadone maintenance treatment among members of the heroin community.


Drugs, Vietnam, and the Vietnam veteran: an overview. Highlights are presented on the issue of drug use among servicemen in Vietnam and its aftereffects. Two stages of Vietnam drug use are identified-a period of increasing marijuana use followed by the 1970 influx of highly potent heroin to which 1/5 of the enlisted troops were addicted at some time during their tour. The major contributing factors appear to be: (1) the need of troops in stressful combat situations for self-medication, escape, and hedonistic indulgence; (2) the relaxation of taboos against drug use in the United States; and (3) the availability of illicit drugs at low cost, which was apparently the result of profiteering by a number of South Vietnamese officials. Related to the above was the growing disenchantment with the war and the progressive deterioration in unit morale. These drugs are seen as serving many of the functions performed by alcohol in earlier millitary conflicts. There is no hard evidence that duty performance in Vietnam was seriously affected by drug use. Since 95% of those who were addicted to narcotics in Vietnam have not become readdicted, the situation does not appear to be as severe as originally supposed. Myths as to the persistence and intractibility of physiological narcotic addiction were dispelled. A major negative effect has been the difficulty that soldiers with less-than-honorable discharges due to drug abuse have had in obtaining jobs. Other long-term effects from drug use are less clear and are difficult to separate from the overall effects of the war.


Drug overdose emergency room admissions. The incidence and patterns of drug overdose admissions to the University of Michigan Medical Center Emergency Suite were studied for the first 3 months of each year from 1956 to 1970. Among variables investigated with regard to age, sex, and time comparisons were types of drugs used, purpose of ingestions, medical condition on arrival, disposition after emergency care, and history of treatment for emotional problems. The continuing escalation in drug overdose emergencies, primarily related to intentional self-poisoning, reflects the growing social health problems of drug use proliferation and rise in suicide attempts over the past two decades. Emergency room resources are being increasingly taxed by the psychological and medical care needs of these cases. Renewed effort toward primary prevention is essential.


Research on the chemical composition of the vascular wall. XV. collagen and elastin of the aorta wall of persons who died of vascular complications in the course of diabetes mellitus.


Research on the chemical composition of the vascular wall. XVI. Glycosoaminoglycans of the aorta wall of persons who died of vascular complications in the course of diabetes mellitus.


Coronary blood flow and oxygen consumption by the heart following a hemorrhage.


Fetal cephalometry. An improved method and an evaluation. A method of fetal cephalometry is described which is an advance on the combined A and B scan technique previously used. A flow chart has been prepared which clearly specifies the procedure to be followed. The criteria used when making an estimation are reported. The method is applicable to various types of machine and it can be taught to a good degree of accuracy in a short time to people with limited obstetric knowledge. There may be a significant difference between operators but this difference is roughly the same from patient to patient and decreases with training. It is considered that the chief source of variation is the failure to measure the same diameter on each occasion.


Serum oestriol in normal pregnancy.

Serum oestriol in normal pregnancy. Serial measurements of serum oestriol (E3) were made in 56 normal pregnancies from 10 to 40 weeks gestation using a radioreceptor assay. Several parameters of the assay and its intrapatient variability were examined. The mean curve for pregnancy E3 levels and limits of normal variation have been identified and compared with those of other series. A positive correlation was found to exist between infant birth weight and the last E3 value in normal pregnancies prior to the onset of labour. Advantages of serum E3 assays over urinary E3 determinations are discussed.


The cause of the fall in serum folate in normal pregnancy. Study of a complete antenatal population, a group of normal primigravid singleton pregnancies, and a group of normal twin pregnancies, suggests that the fall in the serum folate concentration which occurs in normal pregnancy is due principally to plasma volume expansion and should therefore be regarded as physiological.


Carbohydrate metabolism in pre-eclampsia. Intravenous glucose tolerance tests were performed on 30 primigravidae with pre-eclampsia and 15 normal primigravidae in late pregnancy. The groups were matched for age, height and weight and had no stigmata of potential diabetes. Plasma glucose, plasma immunoreactive insulin and plasma placental lactogen (HPL) levels were measured before (fasting) and at timed intervals after the glucose challenge; the glucose response was expressed as the increment index. The patients with severe pre-eclampsia had significantly lower fasting plasma glucose levels than those with mild pre-eclampsia and normal pregnancies. The mean increment index in both the severe and mild pre-eclamptic groups was significantly lower than that of the normal pregnant group. Fasting HPL levels were significantly lower in patients with severe pre-eclampsia than in those who had mild pre-eclampsia or a normal pregnancy. Both the fasting plasma insulin and insulin response following glucose injection were lower in patients with severe pre-eclampsia than in those with mild pre-eclampsia or a normal pregnancy. The differences however were not statistically significant. The results of this study suggest that carbohydrate metabolism in severe pre-eclampsia is altered to an extent similar to that in patients with chemical gestational diabetes, and this alteration may be due to maternal beta-cell anoxia caused by the vascular changes in pre-eclampsia.


Plasma solute concentrations during gonadotrophin-induced ovulation. The effects of ovulation induction on some plasma solute concentrations were investigated serially in eleven women, nine of whom conceived in that cycle. Increasing oestrogen output during the follicular phase was associated with decreasing levels of osmolality, urea, total protein and the albumin free protein fraction. Smaller decreases in the concentrations of sodium, potassium, chloride, carbon dioxide combining power (CO2CP) and albumin were not statistically significant. The luteal phase was marked by a rise in osmolality and a fall in CO2CP but no other significant changes. Levels of osmolality, sodium and potassium fell in early pregnancy when oestrogen output was further increased. These results appear consistent with an oestrogen induced expansion of the extracellular fluid compartment by retention of water in excess of solute, which might also account for the similar changes in pregnancy.


Haematological changes during ovulation-induction by gonadotrophins. The oestrogen response to ovulation-induction by gonadotrophins initiates a preovulation rise in total leucocytes and promotes fluid retention. In consequence of the latter, cyclic changes occur in blood haemoglobin and the haematocrit. The level of oestrone excretion in the follicular phase of induced cycles indicates that multiple follicular development probably occurs, and this also appears to affect the luteal phase. It seems likely, therefore, that the data present a rather exaggerated picture of the situation which obtains in normal menstrual cycles.


The fetal membranes as a possible source of amniotic fluid prostaglandins. Biosynthesis and metabolism of prostaglandins was studied in human amniotic and chorionic membranes obtained at term. Using specific in vitro methods it was demonstrated that the fetal membranes contain an organization of enzymes regulating both synthesis and degradation of prostaglandins. Differentiation between amnion and chorion showed that virtually all of the biosynthesis and metabolism occurred in the chorion, whereas enzymatic activities in the amnion were negligible or low. The results suggest a high turnover of prostaglandins in the chorion, and its importance as a source of prostaglandins found in amniotic fluid is discussed.


The use of a computer in an obstetric department. Experience with a computer in an obstetric department is presented. A regular statistical analysis of the work of the department was readily available and computer printed summaries were produced for 86 per cent of the patients within one week of their discharge home. Solutions to problems encountered are discussed. It is concluded that a computer can be used economically and advantageously in this way even in hospitals without a computer on site. Future developments in the use of the computer are outlined.


Prostaglandin dehydrogenase in the placenta before and after the onset of labour. Inactivation of prostaglandins in the placenta was studied using an assay for 15-hydroxy-prostaglandin dehydrogenase (PGDH). Forty-four patients with normal single pregnancies between 38 and 42 weeks gestation were studied. Placentae were obtained before the onset of labour in 9, after spontaneous labour in 18, and after oxytocin-induced labour in 17 cases, PGDH-activity ranged from 54 to 495 nanomoles PGF2alpha/g placenta/minute, with a mean +/- SEM of 207 +/- 18 nanomoles/g/minute. The results indicate that the PGDH content of the human placenta does not change markedly with the onset or during the process of labour. The length of either spontaneous or oxytocin-induced labour was not influenced by the PGDH content of the placenta.


Intestinal gangrene due to giant-cell arteritis. Report of a case.


Placental pathology in midtrimester pregnancies interrupted by intra-amniotic injection of hypertonic urea. The histological appearances of 52 placentae from patients who had a urea-induced second trimester abortion were studied. Extensive subchorionic intervillous fibrin deposition and swollen degenerated stromal cells (probably Hofbauer cells), were found both in the placenta and membranes. Between urea injection and abortion, serial vaginal smears showed signs of progesterone deficiency. The urea-induced placental and fetal damage was similar to that seen with hypertonic saline.


Arterial reconstruction to the profunda femoris artery.


The scope of modern anatomy.

The scope of modern anatomy.


The effect of daily norethisterone (0.35 mg) on cervical mucus and on urinary LH, pregnanediol and oestrogen levels. The effect of 0.35 mg of norethisterone daily on cervical mucus and on urinary LH, pregnanediol and oestrogen levels was studied during two treatment cycles in five subjects who had been observed during a control cycle. Variable changes in hormone excretion patterns were found and are discussed. The effects of .35 mg of norethisterone/day on cervical mucus and on urinary luteinizing hormone (LH), pregnanediol, and estrogen levels were studied during 2 treatment cycles in 5 healthy women who had been observed during a control cycle.   LH was measured by radioimmunoassay, total estrogens by a semiautomatic rapid method, and pregnanediol by a gas chromatographic method.  There was some effect on the LH excretion patte rn in all the treatment cycles.  Pregnanediol levels suggested ovulation in 3 cycles.  In all 3 of these cycles the LH peak was lower and not as pronounced as in the respective control cycles.  A patient with some initial suppression of LH and estrogens became pregnant during the trial.  Cervical mucus was scanty, thick, opaque, and impenetrable to sperm throughout treatment.  Spotting occurred in 4 of the treatment cycles, 2 of which were ovulatory.  3 possible ways in which norethisterone might exert its contraceptive effect are listed.


Gosumecs' contribution to helminthiasis.


The nature of immunity: part II.

The nature of immunity: part II.


Niflumic acid in the management of rheumatoid and osteoarthritis.


Asymptomatic bacteriuria in school children.


Some aspects of social obstetrics.

Some aspects of social obstetrics. The effects of socioeconomic factors on reproduction were studied using data from 664 patients at a free general hospital and 207 patients at 2 private hospitals.  Women were divided into 5 classes based on income.  Those in the upper 2 classes were all private patients, those in the lower 2 were all general hospital patients.  There was no difference in the mean age of the mothers, but private patients married an average of 4 years later.  Previous reproductive loss increased significantly as income decreased, and mortality of the offspring to 1 year was 15.5% in general hospital patients as compared with 8.7% in private patients.  No difference in spacing of children was found.  While the difference in incidence of low birth weight was only marginally significant between the 2 groups, type of family, housing, density and type of work done by mother had a significant effect on birth weight.  Stillbirth and neonatal death rates showed a highly significant increase in general hospital patients, and were affected by type of family, density, and type of work.  Complications associated with pregnancy occurred twice as often in general hospital patients, but instances of difficult labor as well as forceps and Caesarian deliveries were higher in private patients.  There was a good awareness about family planning in all but the least educated of these women.


Study of socio-psychological aspects of burns in females.


Recurrent arthritis: unusual presentation of leprosy.


Studies on the mechanism of hypotensive action of a disubstituted piperazine derivative (part II).


Acute renal failure and methaemoglobinaemia due to copper sulphate poisoning.


Poor acceptability of "Pill-a-month" contraceptive. High pregnancy and drop-out rates in a small sample.


Chlorpromazine poisoning with abnormal electrocardiogram (a case report).


Infantile polymyoclonia.

Infantile polymyoclonia.


Congenital contractural arachnodactyly.

Congenital contractural arachnodactyly.


Hemoglobin-E, disease with mitral stenosis (a case report).


An unusual case of papillary carcinoma of the thyroid; intraglandular dissemination associated with perifocal infiltrations by lymphocytes and lymph follicles.


Effects of electrical acupuncture on human somatosensory evoked potentials.


Studies on the early receptor potential in the human eye. VI. ERP in the fellow eyes of patients with idiopathic retinal detachment.


Electrophysiological and histological studies on the sensibility of the bone marrow nerve terminal.


The effect of hypoxia on the rabbit uterine activity.


Effects of psychotropic drugs on monoamine oxidase activity in individual nuclei of hypothalamus and amygdala in rat.


Echocardiographic features of primary pulmonary hypertension.


Switch-off behavior and stage of sleep: a preliminary report.


A case of the duplicate palmaris longus muscle.


Is viviparity the best means of reproduction? Successful reproduction in the context of evolution demands no more than perpetuation of the species, but an ideal system of reproduction should also aim for high efficiency. Two basic systems have predominated: egg laying and viviparity with placental attachment of the embryo to the mother. Egg-laying is inefficient in allowing huge losses and greatly limits the size of the newborn, although it has the advantage of causing little physiological upheaval to the mother. Viviparity, on the other hand, allows the growth of a much larger fetus, offers great protection and is highly efficient. Its major disadvantage is the enormous disturbance of the mother's physiology in the interests of ensuring that the fetus will not be rejected immunologically and that a continuous supply of nutrients can be provided and waste products removed. Only the marsupial seems to have achieved a sensible compromise by producing the young at a very early stage when it is living as an egg embryo without the need for placentation, and then giving it continuous nourishment and great protection by milk feeding in an external pouch.


Serum concentrations of individual monocarboxylic short-chain fatty acids C2-C6 in underweight children. The serum concentrations of individual short-chain fatty acids containing 2-6 carbon atoms were studied in 12 underweight children. Mean n-butyric and iso-valeric acid levels were significantly elevated in underweight children, while those of n-valeric and iso-caproic acids were not significantly higher than in the control group. The level of total free fatty acids was also increased in the underweight group. A reduced enzymatic activity in fatty acid synthesis is supposed to be the factor underlying the impaired lipogenesis.


Diagnostic aspects in 117 patients treated surgically for thyroid carcinoma.


Lyell's syndrome: histological, immunohistochemical and serological observations. Observations of Lyell's syndrome in two girls, one 2 and the other 7 years of age, investigated serologically, histologically and by immunofluorescent technique, are reported. In both cases. the disease had been preceded by a prolonged or repeated treatment with acetylsalicylic acid, in the first case in combination with sulphonamides and antibiotics and in the second in combination with mephenytoin. Immunofluorescent staining revealed immunoglobulins in subepidermal blisters and along the dermal vessels. Acetylsalicylic acid has been assumed to have been one of the causative factors of the violent progression of toxic epidermal necrolysis, probably by an antigen-antibody reaction. This has been supported by serologic demonstration of antibodies to acetylsalicylic acid in both cases.


Peritoneal lavage with doxycycline in acute diffuse peritonitis.


Results of regional portal infusion of 5-fluorouracil in patients with primary and secondary liver cancer. The survival of 47 patients with liver malignancies treated with continuous portal infusion of fluorouracil (5-FU) has been studied. 18 of them had been treated initially by hepatic artery ligation. Total mean survival was 9.4 months. Patients treated with hepatic artery ligation + 5-FU lived longer (mean 10.8 months) than those treated with 5-FU alone (7.4 months). The survival was longer than could be expected for patients treated for primary liver cancer or for liver metastases from  colo-rectal cancer, when compared with the "untreated" group. It is concluded that continuous portal infusion of 5-FU appears to prolong survival in some groups of patients with malignant liver tumours. However, the influence of "unspecific, general" therapy is difficult to evaluate.


The aetiology of acute pancreatitis.

The aetiology of acute pancreatitis. The most common aetiological factors of acute pancreatitis in an unselected group of 215 consecutive surgical patients were biliary tract disease (40.0%), alcoholism (20.0%) and gastroduodenal ulcer (4.2%). In women, biliary tract disease was by far the most common cause (61.3%), but in men considerably high frequencies of alcoholism (48.3%) and gastroduodenal ulcer (15.7%) were noted as at least one possible aetiological factor. This deserves a special notation when contemplating prophylactic measures to prevent recurrences of acute pancreatitis.


Intestinal blind pouch- and blind loop- syndrome in children operated previously for congenital duodenal obstruction. A follow-up study of 27 children operated for congenital duodenal obstruction (CDO) in the years 1953--71 is presented. Nine children belonged to the intrinsic and 18 children to the extrinsic group of CDO. A total of 7 retrocolic, isoperistaltic, side-to-side duodeno-jejunostomy, 7 Ladd's operation, 8 duodenolysis, 2 reduction of midgut volvulus, 2 duodenostomy a.m. Morton and one gastro-jejunostomy were performed at the age of 1 day--15 years. The clinical and radiological examinations were performed 3--21 years (mean 10 years 2 months) after these operations. In 3 cases there was a moderate duodenal dilatation, but reoperation was not necessary. During the follow-up period, one boy, now aged 8 years, developed a blind pouch-syndrome in the I portion of the duodenum containing a 5 x 5 cm phytobezoar 4 1/2 years after duodeno-jejunostomy. The frequency of blind pouch-syndrome after duodeno-jejunostomy was thus 1:7 or 14%. One girl, now aged 9 years, developed a blind loop-syndrome in the ileocaecal segment 3 months after side-to-side ileotransversostomy, which was performed from adhesion-obstruction after duodenolysis for malrotation I and CDO. Both the blind pouch- and the blind loop-deformation were resected and the children recovered well. To avoid blind-pouch- and blind loop-deformations in the intestines, the anastomosis must be made wide enough, and especially in the surgery of the jejuno-ileo-colic region an end-to-end anastomosis is preferable.


Short-stay varicose vein surgery.

Short-stay varicose vein surgery. From 1967 patients attending for varicose vein surgery at the Meilahti Hospital, Helsinki University Central Hospital, have been operated on on the day of admission, spend the following night in the bed ward and are discharged the morning after the operation. The operation is performed under general anaesthesia with as radical approach as possible stripping the long saphenous vein and, if required, the short saphenous vein, excising the superficial side branches and ligating incompetent perforators. In the study a follow-up examination was carried out on 2334 patients. Wound infections occurred in 1.8%. Two patients had transient arrhythmia, and one a late haemorrhage. More serious complications were absent. During the follow-up period 5.2% of patients were operated on for recurrent varicose veins. 84.6% were subjectively satisfied. The number of hospital days per patient averaged 1.2. It was possible to follow the above planned course of action in 93.4%. The organization and surgical technique can be recommended in order to achieve savings in hospital days and to produce permanent and good surgical results.


A comparison of dicloxacillin and ampicillin in the antibiotic prophylaxis of total hip replacement. The effect of two semi-synthetic penicillins, dicloxacillin and ampicillin was compared in systemic antibiotic prophylaxis in total hip replacement patients. The drugs were given in routine oral dosage for eight days to two patient groups each consisting of 50 patients. There was no fatality. In the ampicillin group there were three staphylococcal infections but no infections in the dicloxacillin group. Two of the infections occurred in reapplication cases leading to the loosening of the prosthesis. One infection appeared after a primary operation with a superficial recurrence 10 months later. In the ampicillin group, side effects were diagnosed in 12 cases and in the dicloxacillin group in one case.


Amniotic fluid removal prior to saline abortion. To evaluate whether removal of the amniotic fluid prior to the instillation of 200 ml of 20% hypertonic saline has any effect on the success, speed, and safety of the abortion process, 192 patients at 15--20 weeks' gestation were aborted according to one of the following procedures: 1) instillation of 200 ml saline without removal of the amniotic fluid (92 subjects), 2) removal of 100 ml of amniotic fluid prior to saline instillation (46 subjects), and 3) removal of 150 ml of amniotic fluid prior saline instillation (54 subjects). The study indicated that there are no apparent advantages to the removal of the amniotic fluid prior to the instillation of 200 ml of hypertonic saline. The median times from instillation to abortion and rates of incomplete abortion were similar for the three groups of patients. Rates of specific complications, except for fever, were similar for the three groups. The value of amniotic fluid removal for the success, safety, and speed of saline solution abortion was assessed in 192 patients at 15-20 weeks' gestation. 92 subjects received 200 ml of 20% hypertonic saline, 46 underwnet removal of 100 ml of  amniotic fluid prior to saline instillation, and 54 underwent removal of 150 ml of amniotic fluid prior to saline instillation. All 3 groups had similar rates of incomplete abortion and median times required for abortion.  The rates of complications, except for fever, were also similar.  The results indicate no apparent advantages of amniotic fluid removal prior to instillation of hypertonic saline.


Complications in acute pancreatitis.

Complications in acute pancreatitis. In a group of 260 non-selected cases of acute or subacute pancreatitis, severe complications occurred in 60 (23.1%). Long lasting shock and/or massive internal bleeding (5.4%), severe renal problems (anuria, tubular necrosis, nephrosis) (5.4%) and frank hepatic failure due to extensive liver necrosis or other severe destruction (5.0%), invariably lead to death. The clinical group of findings pointing to a fatal course usually manifested themselves during the first three days. Severe renal and hepatic lesions were in many cases secondary to shock in fulminant rapidly deteriorating cases. Preventing and efficient management of shock are thus essential prerequisites for saving the patient. Other important complications included severe intra-abdominal suppuration and abscesses, peritonitis and sepsis (3.9%), pseudocysts of the pancreas (5.4%) and biliary statis (18.4%). Severe obstruction to bile flow with associated jaundice occurred in only 4.6% of cases; unselected operative biliary decompression does not therefore appear indicated. If an early laparotomy is performed, efficient debridement and drainage are of utmost importance. Fatal panreatitis was associated with extensive necrosis of the pancreas in about 80% of cases; possibly subtotal pancreatic resection at an early laparotomy would have given better results in these most severe cases, as recently reported in the literature.


Ocular signs and local treatment in myasthenia gravis.


Self-management treatment of smoking behavior.


Choice, determinism and value in the light of biological knowledge.


Serum pseudocholinesterase activity in acute myocardial infarction.


Learning of leg position by the ghost crab Ocypode ceratophthalma.


Promoting mental health in school.

Promoting mental health in school.


Persistent and atypical lobules in the human breast may be precancerous. Persistent human mammary lobules (PL) remaining after the menopause, and certain atypical lobules (ALA) are morphologically similar to the common preneoplastic hyperplastic alveolar nodule (HAN) of mice of strains having a high incidence of mammary carcinoma. This and other evidence suggest that like the HAN of mice human PL and ALA are precancerous.


The effect of embryo extract on the types of collagen synthesized by cultured chick chondrocytes.


Medical history questions predictive of myocardial infarction. Results from the Kaiser-Permanente epidemiologic study of myocardial infarction.


Control of mating preferences in mice by genes in the major histocompatibility complex. When a male mouse is presented with two H-2 congenic two female in estrus, his choice of a mate is influenced by their H-2 types. The term "strain preference" is used to describe the general tendency of the male population of one inbred strain to prefer two female of one H-2 type rather than another. The term "consistency of choice" is used to describe the added tendency of particular two males of one inbred strain, in sequential mating trials, to prefer two females of the H-2 type they chose in previous trials. Statistical analysis showed trends in the data that support the following conclusions: (a) The choice is made by the male, not the female. (b) The strain preference of two males may favor two females of dissimilar H-2 type (four of six comparisons), or of similar H-2 type (one of six comparisons). (c) Consistency of choice does not always correspond with strain preference. In one of six comparisons of H-2 genotypes there was no strain preference but pronounced consistency of choice by individual two male. This suggests memory, but fortuitous bias is not excluded. (d) Strain preference of the same male population may favor two male of the same or a different H-2 type, depending on which different H-2 type is offered as the choice alternative to self. These findings conform to a provisional model in which olfactory mating preference is governed by two linked genes in the region of H-2, one for the female signal and one for the male receptor. These mating preferences could in natural populations serve the purpose of increasing the representation of particular H-2 haplotypes or of maintaining heterozygosity of genes in the region of H-2.


Comparison of metabolism of free fatty acid by isolated perfused livers from male and female rats. Livers from normal, fed male and female rats were perfused with different amounts of [1-14C]oleate under steady state conditions, and the rates of uptake and utilization of free fatty acid (FFA) were measured. The uptake of FFA by livers from either male or female rats was proportional to the concentration of FFA in the medium. The rate of uptake of FFA, per g of liver, by livers from female rats exceeded that of the males for the same amount of FFA infused. The incorporation by the liver of exogenous oleic acid into triglyceride, phospholipid, and oxidation products was proportional to the uptake of FFA. Livers from female rats incorporated more oleate into triglyceride (TG) and less into phospholipid (PL) and oxidation products than did livers from male animals. Livers from female rats secreted more TG than did livers from male animals when infused with equal quantities of oleate. The incorporation of endogenous fatty acid into TG of the perfusate was inhibite) by exogenous oleate. At low concentrations of perfusate FFA, however, endogenous fatty acids contributed substantially to the increased output of TG by livers from female animals. Production of 14CO2 and radioactive ketone bodies increased with increasing uptake of FFA. The partition of oleate between oxidative pathways (CO2 production and ketogenesis) was modified by the availability of the fatty acid substrate with livers from either sex. The percent incorporation of radioactivity into CO2 reached a maximum, whereas incorporation into ketone bodies continued to increase. The output of ketone bodies was dependent on the uptake of FFA, and output by livers from female animals was less than by livers from male rats. The increase in rate of ketogenesis was dependent on the influx of exogenous FFA, while ketogenesis from endogenous sources remained relatively stable. The output of glucose by the liver increased with the uptake of FFA, but no difference due to sex was observed. The output of urea by livers from male rats was unaffected by oleate, while the output of urea by livers from females decreased as the uptake of FFA increased. A major conclusion to be derived from this work is that oleate is not metabolized identically by livers from the two sexes, but rather, per gram of liver, livers from female rats take up and esterify more fatty acid to TG and oxidize less than do livers from male animals; livers from female animals synthesize and secrete more triglyceride than do livers from male animals when provided with equal quantities of free fatty acid.


High-pouch imperforate anus treated by electromagnetic bougienage and subsequent perineal repair. Four male infants with imperforate anus were treated by electromagnetic bougienage and subsequent perineal anoplasty with division of rectourethral fistula. Each had high-pouch imperforate anus of the supralevator type, with rectourethral fishtula at or above the level of the membranous urethra. Perineal anoplasty was accomplished in all four, with division of the rectourethral fistula, avoiding the need to do a sacral-abdominal-perineal procedure, as had been customary previously in similar cases.


Pharmacokinetics of chlorpromazine-induced miotic response in rabbits. The time variation of changes in the chlorpromazine-induced pupil diameter decrease was studied following varying bolus and slowly infused intravenous doses administered to rabbits. The observed pharmacological response data were coverted, via, the use of a dose-effect curve, to values theoretically corresponding to relative biophasic drug levels. These values were, in turn, used to construct a linear pharmacokinetic model of the drug bioavailability input equilibrium pharmacological response output dynamics of the system. The use of a time domain, MULTIFIT, computerized method of fitting the data to obtain a pharmacokinetic model was compared to the use of a frequency response, PLTEST, approach. The fidelity of the model in quantitatively relating the time course of systemic drug bioavailability to observed pupil response was verified by the satisfactory agreement obtained by directly comparing experimentally known amounts of drug intravenously infused with corresponding values computed from observed changes in pupil size. The applicability of using pharmacological data for quantitative bioavailability and pharmacokinetic analysis of chlorpromazine is demonstrated. This finding is particularly significant because no suitable chemical or radiological direct assay technique exists for determining levels of chlorpromazine, except for high doses, in body fluids.


Humoral reponse to neuraminidase-treated tumor cells. L1210 leukemia cells grew progressively and caused tumor deaths in all recipient mice. However, when these cells had been treated with Vibrio cholerae neuraminidase (VCN) prior to injection, tumor deaths did not occur. Both untreated and VCN-treated L1210 cells elicited a humoral response, as manifested by an increasing percent of cells in the spleen and peritoneal cavity, with various types of membrane-associated immunoglobulins. Progressive tumor growth was associated with a large percent of peritoneal exudate (PE) cells bearing membrane-associated IgG, a late increase in the percent of PE cells with IgG, and only a small percent of PE cells with IgM on their surfaces. Conversely, PE cells from mice given VCN-treated L1210 cells were characterized by a small percent with IgG, an early increase in percent of cells with IgG, and a large percent with membrane-associated IgM. An injection of VCN-treated L1210 cells into mice with progressively growing L1210 tumors caused frequent tumor remissions, with a corresponding alteration of the ongoing humoral responses. Both the degree of alteration and the number of cures depended on the tumor burden at the time VCN-treated tumor cells were injected. The humoral response in mice with tumor remission following immunization was comparable to the response detected after an injection of VCN-treated cells only.


Choline loss during hemodialysis: homeostatic control of plasma choline concentrations. Endogenous concentrations of free choline in plasma were measured in azotemic subjects receiving repetitive hemodialysis and excretion of free choline into the dialysate was determined. Chemical choline in plasma and dialysate was measured by adding choline kinase and measuring the production of radiolabelled phosphorycholine in the presence of radiolabelled adenosine triphosphate (ATP). Mean free choline concentration in plasma of azotemic subjects receiving hemodialysis was found to be 37 muM, which is about twice that of normal persons. The total excretion of choline into the dialysate during 360 min averaged 730 mumoles +/- 69 (SEM). Levels of free choline in plasma fell during hemodialysis at two hours but recovered toward predialysis values at six hours. The return of plasma choline concentrations toward control values during dialysis suggests that a feedback mechanism exists which was activated rapidly to produce homeostasis of plasma choline concentrations. In these patients, the degree of peripheral neuropathy as judged by measurement of nerve conduction velocities showed a significant inverse correlation with levels of free choline in plasma.


New percutaneous caval filter device for pulmonary thromboembolism.


Elemental analysis of biological specimens in air with a proton microprobe. The unique capabilities of the proton microprobe in an atmospheric environment as a biological tool are illustrated in studies of arsenic and mercury distributions in siingle strands of hair from poisoning victims and of the distributions of several abundant elements in frozen hydrated eye and kidney specimens from rats.


Atopic dermatitis and IgE. Relationship between changes in IgE levels and severity of disease. At the Mayo Clinic, atopic dermatitis was evaluated in a series of 28 patients to determine whether, during the course of the disease, serum IgE levels fluctuated with changes in the severity of dermatitis. The study covered a 1- to 11/2-year follow-up period. Previously, it had been shown that, at initial examination, serum IgE levels were positively related to the extent of disease. Although notable fluctuations in serum IgE levels and in extent of dermatitis were seen in more than half of the cases, no relationship was found between the two factors during the period of study.


Effect of hypoxia on small vessel blood content of rabbit brain.


2-Deoxyglucose selectively inhibits Fc and complement receptor-mediated phagocytosis in mouse peritoneal macrophages. I. Description of the inhibitory effect. Incubation of normal or thioglycollate-elicited mouse peritoneal macrophages with 2-deoxy-D-glucose (2-dG) inhibits the capacity of these macrophages to phagocytize IgG- or complement-coated particles via their Fc and C3 receptors. 2-dG has no inhibitory effect on the capacity of these macrophages to phagocytize latex or zymosan particles, which are ingested in the absence of specific opsonins, and it does not inhibit binding of IgG- or C3-coated particles to their respective receptors on the macrophage's plasma membrane. 2-dG exerts its inhibitory effect on the macrophage and not on the opsonized particle. The inhibition is independent of particle size, occurs within 15-30 min of addition of this glucose analogue to the medium at 37 degrees C, cannot be overcome by supra-agglutinating amounts of opsonizing antibody, and is completely reversible by substitution of 5.5 mM glucose for 50 mM 2-dG in the medium. Addition of equimolar amounts of glucose or mannose, but not of fructose, galactose, fucose, or glucosamine, to medium containing 50 mM 2-dG results in substantial reversal of the inhibitory effect of 2-dG on Fc and C3 receptor mediated phagocytosis.


An improved isolation procedure for the gas chromatographic analysis of urinary polyamines. The isolation of polyamines from urinary hydrolysates in a sufficiently pure state for subsequent analysis by gas chromatography has proved to be difficult. However, by using columns of Porapak-Q and ion-exchange resins, urinary hydrolysates are readily purified and formation of trifluoroacetyl derivatives of polyamines proceeds in high yield without carryover of artifacts in the gas chromatographic elution profile. Good yields from the trifluoroacetylation reaction are not achieved if large quantities of salts or urinary pigments are present. By obtaining the polyamine carbonates in the final stages of the method described, the trifluoroacetylation reaction yields excellent derivatives of nanogram or microgram amounts, particularly after standing over-night at room temperature. The procedure described in detail should permit routine urinary polyamine analysis where rapidity, ease of handling many samples, freedom from complications and artifacts are a consideration.


The infectivity of adenovirus 5 DNA-protein complex.


Tay-Sachs screening: social and psychological impact. Participants in two Tay-Sachs screening programs were generally satisifed with the organization of the tests and the results. There was no evidence of adverse impact on reproductive  plans or interpersonal relations, and the respondents professed to believe in the value of screening. While the carriers discussed their condition freely with others and were no less favorable to the idea of screening than the noncarriers, about one-half of their number expressed discomfort in being told they were heterozygotes. These feelings were allayed by counseling, but there was evidence of some residual unease. It is suggested that this anxiety would be less prominent and more easily reduced if screening were done under conditions of ordinary primary medical care rather than outside the conventional system. 2 studies (1 retrospective and 1 prospective) were conducted on participants in Tay-Sachs screening programs to assess the personal impact of the experience and their sense of fulfillment of the program's promise.  All of the noncarriers felt relief on learning of the results of the test;  48.8% of the carriers and 42% of the carrier's spouses reported a sense of anxiety.  4 kinds of concern were expressed by the carriers and their spouses:  1) a sense of being "singled out" and having an imperfection, 2) dismay that children might inherit the gene, 3) anxiety which was allayed by instruction, and 4) distress  in pregnant couples, eased by instruction.  There was no evidence of adverse impact on reproductive plans or interpersonal relations.  The participants professed to believe in the value of screening.  While the carriers discussed their condition freely, 90% recommended premarital testing, 50% of those before the potential age of marriage.  94% of the participants said the program had lived up to their expectations.  It is suggested that anxiety would be reduced if screening were conducted under conditions of ordinary primary medical care than outside the conventional system.


Ion dependence of the tarsal sugar receptor of the blowfly Phormia regina.


The relation between total finger ridge-count and variability of counts from finger: genetic implications of racial variation. The measure of ridge-count diversity, S/square root 10, was computed for a sample of American Whites, American Blacks and African Blacks, and the regression of S/square root 10 on total ridge-count was determined for each group. The shapes of the regression lines differed considerably. The American White curve was very similar to that obtained by Holt in an English sample, while the two Negro curves generally showed lower lower S/square root 10 values for ridge-counts over 80. The American Negro curve was found to behave like a mixture of the White and African Negro curve to a degree approximating to the fraction of White genes in their gene pool. Holt's parent-child data are used to construct a simple test of the hypothesis that that S/square root 10 reflects zygosity in total ridge-count genotypes. The preliminary results support this hypothesis.


mRNAs containing and lacking poly (A) function as separate and distinct classes during embryonic development.


Production and fate of Balbiani ring products.


In vitro sensitization and induction of syngeneic tumor--specific cell--mediated cytotoxicity.


Cellular immune deficiency in patients with glioblastoma.


Concentration-dependent mutation of diploid human lymphoblasts by methylnitronitrosoguanidine: the importance of phenotypic lag. The mutation of diploid human lymphoblasts by methylnitronitrosoguanidine (MNNG) was measured over the range of 0--45 ng of MNNG/ml of of medium. We found a 12-day lag in the phenotypic expression of 6-thioguanine resistance; the occurrence of this lag was independent of MNNG concentration. We hypothesize that the unexpectedly long lag period reflects a requirement for the loss of previously existing molecules of the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT) after mutation at the HGPRT locus.


In vitro synthesis of rat pre-proalbumin.


Anti-inflammatory and anticonvulsant properties of some natural plant triterpenoids.


Components and control of ribonucleotide reductase system of the rat.


A model for reinforcing mental health facilities: a student's view. Present mental health care facilities are not reinforcing either to work in or to utilize. A new approach to agency design, in order to provide client self-respect and situational relief, to increase availability and accessibility of services, and to attract highly skilled staff should be adopted. The criteria for a reinforcing agency should be based on a client, staff, and community needs. Changes can be implemented by building new facilities or modifying old ones. The resulting facilities would enhance the treatment process, reinforce behavioral change, and reinforce productivity.


Diabetes mellitus: clinical features in 404 Ethiopians.


Serum alkaline phosphatase levels of some fresh water teleosts.


Cognitive changes during the adult years: implications for developmental theory and research.


Drug deaths involving propoxyphene-an assessment in metropolitan Detroit.


Sheehan's syndrome with psychosis.

Sheehan's syndrome with psychosis.


Proton vs. electron scanning transmission microscopy: the ratio of elastic to inelastic cross-sections.


Noise exposure and prevalence of high blood pressure among weavers in Iran. 821 weavers working in three textile mills were examined in this survey. It was found that 8.5% of the workers were hypertensive and 12.4% borderline. All these rates are significantly different from those of the control groups. Also there is a clear increase in the prevalence of hypertensive and borderline cases in the weavers in relation to the length of employment. These findings emphasize the need for, at least annually, periodic examination of the entire work population in order to detect early such adverse health effects and to consider suitable medical care.


Effect of a phorbol ester on a transformation-sensitive surface protein of chick fibroblasts.


Isolated regional perfusion in the treatment of soft tissue sarcomas of the extremities.


The TRIC agent in the female genital tract; a cytologic and virologic study in a trachomatous hyperendemic area.


Comparative efficacy of the stained blood-film and counting-chamber technique for the diagnosis of Wuchereria bancrofti.


Investigations of delayed-type hypersensitivity in rabbits experimentally infected or sensitised by vaccinia virus.


Intrascleral gonio-trepano-iridencleisis.


Comparative study of the dark adaptation time in the normal Egyptians.


Serum proteins and transferrin levels in diabetic patients.


Pathology of Brenner tumours.

Pathology of Brenner tumours.


Hiatus hernia: a comparison between two methods of fundoplication by evaluation of the long-term results. This paper presents a comparative study of two methods of fundoplication, a Belsey-like procedure and a Nissen-Rossetti operation in the management of 283 cases of hiatal hernia from 1962 to 1974. The methods, history, and preoperative findings are described, and the mortality and morbidity rates, particularly related to recurrence, are discussed. A short historical review is included in the discussion, which also deals with the anatomic and physiologic factors thought to be involved in the maintenance of the competence of the cardia. The author's reasons for preferring a Nissen operation are outlined. The management of peptic stricture and of shortening due to periesophagitis by modification of this technique is described.