Hemodynamics of essential hypertension in young subjects. Cardiac output was determined in 42 young essential hypertensives (15 to 25 yrs); values ranged from 3.86 to 10.30 L./minute. These differences were not related to magnitude of volemia. Correlation of output to weekly blood pressure average (BPav) was not significant; its relationship to intraarterial pressure (BPia) was not significant in 21 patients aged 20 to 25 and of borderline significance in 13 aged 15 to 19. Blood pressure changes associated with the study (BPia--BPav) were also not consistently related to cardiac output. Six patients had systolic hypertension; only one had elevated stroke volume. These results outline as complex a picture in young essential hypertensives as in older subjects.


Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node. In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway. In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.


Towards more selective resuscitation.

Towards more selective resuscitation.


Nitroprusside reversal of ergotamine-induced ischemia.


Evaluation of the hemodynamic effects of hyaluronidase in patients with acute myocardial infarction.


Testing antianginal therapy: in favor of current practice.


Prolonged repolarization and hypomagnesemia.


CPK MB elevations in hypothermia.

CPK MB elevations in hypothermia.


Potential hazard of the programmable pacemaker.


Heart rate correction of pre-ejection period.


The management of ruptured intracranial aneurysms.


Essential drugs for developing countries.


The diagnostic value of the biopsy.

The diagnostic value of the biopsy.


Three siblings with ataxia telangiectasia.


Leptospirosis in West Malaysia--epidemiology and laboratory diagnosis.


Noonan's syndrome with mitral valve prolapse.


Leptospirosis in the Malaysian army.

Leptospirosis in the Malaysian army.


Leptospirosis in animals in West Malaysia.


Toxoplasmosis with special reference to peninsular Malaysia and Singapore.


Corynebacterium haemolyticum. An uncommon cause of throat infection.


Systemic lupus erythematosus presenting as intermittent intestinal obstruction.


The relationship between birth weight and maternal weight.


Amyloidosis in Malaysian aborigines (Orang Asli).


DNA polymerase activity: a method of determining the infectivity of blood positive for anti-HBc.


Trichomoniasis--incidence in pill users and associated Pap smear abnormalities. The occurrence of Trichomonas vaginalis in pill users and nonusers was studied by examining 1163 cervico vaginal smears.  There were twice as many pill users as nonusers and a significant number of asymptomatic carriers.  The cytologic findings ranged from normal through inflammatory and dyskaryotic changes to those with malignant features.  The majority, however, belonged to the benign end of the spectrum of epithelial atypias.  Significant observations are that the greater incidence of Trichomoniasis in pill users and the presence of persistent epithelial dyskaryosis in about 8% of the cases.


Salmonella serotyping by the coagglutination method using protein A rich Staphylococcus sensitized with specific antibody.


Falls from trees.

Falls from trees.


Clinical features and management of leptospirosis in Malaysia.


Malignant melanoma metastases in chorionic villi: a case report.


The granulocyte: function and clinical utilization. The American Red Cross eighth annual scientific symposium. Washington, D.C., May 12-13, 1976.


Problems and solutions with filtration leukapheresis.


The role of histocompatibility testing in granulocyte transfusion.


The familial component in longevity--a study of offspring of nonagenarians: III. Intrafamilial studies. The effect of parental longevity on the length of survival of offspring has been examined according to selected demographic and environmental characteristics. The present study is based on 7,103 progeny, 20 years old or older. They were the sons and daughters of 1,766 men or women, 90 or more years old, who were alive in 1922-1930 at the time of ascertainment. The age at death of the other parent of the offspring is the basis of classification used in this analysis. A positive relationship was found between age at death of the non-proband parent and the age at death of the offspring. This relationship existed regardless of similarities or differences in the characteristics analyzed.


Familial correlations of longevity: an isolate-based study. Familial correlations for age at time of death have been computed in a French Canadian isolate. We show that parent-offspring correlations as well as sib correlations are of the same order of magnitude as that between spouses for various age groups at death. It is suggested that heritability of survival is nearly zero. Observed variability in survival is interpreted as the effect of environmental differences acting upon age-dependent genes.


The G and BBB syndromes: case presentations, genetics, and nosology. Hypertelorism and hypospadias are described in four unrelated boys; bilateral cleft lip and cleft palate were also present in two of the boys and mild mental retardation in another. These features are compatible with both the G and BBB syndromes. When present, laryngotracheoesophageal anomalies or respiratory and swallowing difficulties are characteristic features of the G syndrome; otherwise facial features may be useful in distinguishing the G and BBB syndromes. Cases 1 and 2 had anteverted nares and a broad and flat nasal bridge, and Case 1 had shortened palpebral fissures, all consistent with the G syndrome. In contrast, Cases 3 and 4 had a high and broad nasal bridge as previously described in the BBB syndrome. The father of Case 1 had mild hypertelorism and first-degree hypospadias, demonstrating autosomal dominant inheritance in the G syndrome. The mothers of Cases 2, 3, and 4 all had mild hypertelorism consistent with autosomal dominant inheritance and partial male-sex limitation, as previously proposed for both the G and BBB syndromes.


Phenotypic overlap of the BBB and G syndromes. Three males with similar malformations including hypertelorism, telecanthus, cleft lip and palate, and hypospadias, have been evaluated. One also had a laryngotracheoesophageal cleft and therefore was considered to have the G syndrome. The other two had no stridor, aspiration, or difficulty swallowing, and were considered to have the BBB syndrome. Both disorders are associated with multiple malformations and can be most readily distinguished by the presence of laryngoesophageal abnormalities in the G syndrome and differences in facial features evident later in childhood. The BBB syndrome appears to be inherited as an X-linked disorder with the affected female showing only telecanthus and hypertelorism. The G syndrome exhibits autosomal dominant inheritance with males more severely affected, although a few few females have had serious malformations in addition to telecanthus and hypertelorism. In the family with the G syndrome evaluated for this report, the mother of the affected infant had telecanthus, hypertelorism, and anosmia, the latter a feature not previously noted in this disorder.


Alkaptonuria in the Trencín District of Czechoslovakia. For several years the Clinical Genetics Research Laboratory at Martin, Czechoslovakia, has been studying alkaptonuria (AU) in the northern part of the District of Trencín in Slovakia. These affected individuals are part of a group of 103 alkaptonurics originated mostly in the mountainous parts of Slovakia. We report results of pedigree analyses; population and affected-family biochemical urine screening; estimation of inbreeding coefficient, of exogamy rate and of average marital distance and of calculation of the frequency of the AU allele, and of homozygotes and heterozygotes in this portion of the Trencín District. Twelve homozygotes were found, but seven originated from a single hamlet in which a founder effect - genetic drift and inbreeding - are thought to account for the high prevalence of AU.


Cystinuria genotypes predicted from excretion patterns. Genotypes of 17 patients with cystinuria were predicted from data based on excretion rates of the families' obligate carriers. The methodology differed from that used by other investigators as it did not employ intestinal biopsy studies or loading dose measurements. The Type I form was more common than either Type II or Type III and frequently occurred in combination to give compound heterozygous genotypes with the Type III form.


Normal intelligence in two children with Carpenter syndrome. Previous reports have noted a constant association between the Carpenter syndrome (acrocephalopolysyndactyly, type II) and mental retardation. We report two patients with this condition with normal intelligence. These observations indicate that mental deficiency is not necessarily a component of the Carpenter syndrome and that early surgical correction of the craniosynostoses may improve the chances of normal mentality.


Cerebral gigantism and primary hypothyroidism: pleiotropy or incidental concurrence. An 8.5-month-old baby girl had cerebral gigantism and primary hypothyroidism with generalized large muscles (the Kocher-Debré-Semelaigne syndrome). The significance of this association remains to be determined.


X-linked mental retardation: transmission of the trait by an apparently unaffected male. A pedigree is presented in which an apparently unaffected man transmitted the gene for X-linked mental retardation to at least four of his 12 daughters. None of his 12 sons was mentally retarded. These findings may be explained by a somatic mutation and germinal mosaicism in the father or by a half chromatid mutation in maternal gametes.


Autosomal dominant Fanconi syndrome with early renal failure. The "idiopathic" Fanconi syndrome occurs mostly sporadically, occasionally as an autosomal recessive trait. However, few instances of autosomal dominant inheritance have been reported. We described a father and son with the Fanconi syndrome, ie, with renal glycosuria, generalized aminoaciduria, phosphaturia, metabolic acidosis, and bone disease. No other causes of the Fanconi syndrome were found. Both father and son developed end stage renal disease. Aminoaciduria in excess of that seen in renal insufficiency is shown by comparison with published data for amino acid excretion in uremia. Renal transplantation in the father has improved kidney function with no evidence of Fanconi syndrome. This family is unique in that there are no other reports of autosomal dominant Fanconi syndrome with progression to early renal failure.


Spreading of inactivation in an (X;14) translocation. In the KOP translocation, t(X;14)(q13;q32), virtually the entire long arm of the X has been translocated to the end of the long arm of chromosome 14. Meiotic secondary nondisjunction in a female balanced carrier of the translocation has led to a son with two der(14) or 14-X chromosomes. The normal X chromosome is late replicating in the mother. One of the two 14-X chromosomes is late replicating in the son, with heavy terminal labeling of all but the centromeric end of the chromosome. This suggests that genetic inactivation has spread from the Xq segment of the translocation chromosome to at least two thirds of the segment derived from chromosome 14, and that the remaining proximal segment of chromosome 14 is possibly still genetically active. These findings provide an explanation for the phenotype: Klinefelter syndrome plus a few mild malformations that are sometimes seen in this syndrome but are also seen in duplication of the proximal portion of chromosome 14. Although the proband has a duplication of virtually an entire chromosome 14, 14(pter leads to q32), the phenotypic effect of the autosomal duplication has been mostly nullified by the spread of inactivation.


Genetic aspects of the BOR syndrome--branchial fistulas, ear pits, hearing loss, and renal anomalies. A pedigree of branchio-oto-renal dysplasia (the BOR syndrome) is reported, including the documentation by serial audiometric studies of the onset and rapid progression of hearing loss in the twin sister of an affected child. The literature on this syndrome is analyzed to derive some figures for use in genetic counseling of such families. Branchio-oto-renal dysplasia is an autosomal dominant disorder in which affected individuals may have preauricular pits, lachrymal duct stenosis, hearing loss, branchial fistulas or cysts, structural defects of the outer, middle, and inner ear, and renal anomalies, which may range from mild hypoplasia to complete absence. Not all features of the syndrome are expressed in all carriers of the gene, but few carriers lack all the features, and the pits, branchial clefts, and hearing loss, are frequently expressed. Those offspring of affected persons who have pits or fistulas are likely (about 80%) to have hearing loss of varying degrees of severity. A minority of heterozygotes (about 7%) may have hearing loss without pits or fistulas. The risk of severe renal malformation is probably fairly low. Whether families that show dominant inheritance of pits, clefts, and deafness without renal anomalies represent variants of the BOR syndrome or a separate entity (the BO syndrome), is still not clear. At present, any individual with preauricular pits and branchial clefts deserves both otologic and renal investigation.


Mental retardation and osteosclerosis.

Mental retardation and osteosclerosis. We report a girl with profound mental retardation who, at 3 years of age, began to show a progressive osteosclerosis on bone roentgenograms. The bony changes were slightly suggestive of osteopetrosis from which they differed by a number of unusual features.


Anatomical analysis of the developmental effects of aneuploidy in man--the 18-trisomy syndrome: II. Anomalies of the upper and lower limbs. We report the anatomical variations of the limbs in eight infants with the trisomy-18 syndrome that were dissected and studied in detail. In each case, the upper limbs showed defects which further define the specific influence of this aneuploidy on the development of its preaxial (radial) component, and the tendency towards reduction defects. Abnormalities included muscle variations concentrated along the radial margin of the forearm and hand, the absence of the definitive musculocutaneous nerve in all of the limbs, and reductions of the radial artery in four of the bodies. Pathogenetic mechanisms explaining the observed defects are discussed, and include: 1) a defect in peripheral nerve development; or 2) tissue necrosis. The characteristic flexion deformities of the fingers seem to be due to a displacement of the tendons of extensors digitorum and digiti minimi. The lower limbs did not show a consistent pattern of defects, except for the absence of some muscles (psoas minor, the tendon of flexor digitorum brevis to digit V), and the presence of several supernumerary muscles. These variations are discussed as possible nonspecific effects of 18-trisomy on development. The additional anatomical data from this and the first paper in this series [Bersu and Ramirez-Castro, 1977] provide a more detailed picture of the trisomy-18 phenotype which may be useful in corroborating an unconfirmed clinical diagnosis of the syndrome.


The Rieger syndrome.

The Rieger syndrome. Fourteen patients with hypodontia and the ocular features of the Rieger syndrome were examined for the presence of systemic anomalies. A periumbilical defect that consisted of failure of the periumbilical skin to involute was seen in ten of the thirteen evaluated for the defect. Three others had scars over the umbilical area and had a history of surgery for herniation. In addition, four males in one family and one male from another family had hypospadias. None of several other anomalies reported to be components of the Rieger syndrome by other authors was detected in the fourteen patients. The mode of inheritance in the familial cases studied was compatible with autosomal dominance. The results of this study indicate that the Rieger syndrome is an autosomal dominant syndrome whose cardinal features are hypodontia, goniodysgenesis, and failure of the periumbilical skin to involute properly.


Genetics of acheiropodia ("The handless and footless families of Brazil"): X. Roentgenologic study. The main radiologic findings from four unrelated cases and two sibs with acheiropodia are presented and discussed. On the basis of such analysis, a clinical and radiologic description of the anomaly is given. The presence of one or more fingers and of a small bone (Bohomoletz bone) in the upper stumps is discussed. These unusual findings in bone structure were assumed to be due to a variability in the expression of the acheiropodia gene. Radiologic studies of some of the acheiropods' normal parents failed to reveal even mild manifestations of the gene in the heterozygous state. No recognizable pattern was found in the dermal ridges on the end of the acheiropods' upper or lower stumps.


Size and pericentric inversion heteromorphisms of secondary constriction regions (h) of chromosomes 1, 9, and 16 as detected by CBG technique in Caucasians: classification, frequencies, and incidence. Eighty normal Caucasians were studied by CBG technique for estimation of size and inversion heteromorphisms of chromosomes 1, 9, and 16. Size heteromorphisms were classified into one of five sizes using 16p as a reference standard: very small, small, intermediate, large, and very large. Inversion heteromorphisms were also classified into 5 categories - eg, no inversion; partial inversion - minor; half inversion; partial inversion - major; and complete inversion. The frequencies of size heteromorphisms for chromosomes 1, 9, and 16 were 11.3%, 47.5%, and 7.5%, respectively. Thirty-four chromosomes were found to have inversions. Of these, 16 were in chromosome 1, and 18 were in chromosome 9. No inversions were found in chromosome 16. An increase in the size of the h region was more frequently associated with inversion, suggesting that there is a possible relationship between size and inversion. For example, there were 118 chromosomes that were classified as "intermediate" by size; 23 (19.5%) had inversions. In contrast, there were 225 that were "small" in size, and only 10 (4.4%) had inversions. There was no significant difference between males and females for size and position heteromorphisms.


Hypoplastic left heart in a patient with 45,X/46,XX/47,XXX mosaicism. Recurrence risks for primary congenital heart lesions are well defined. An infant with hypoplastic left heart syndrome is observed to have a short neck with a full skin fold on the right side, unilateral single palmar crease, and whorls on all ten fingers. She was found to have the Ullrich-Turner syndrome with mosaicism 45,X/46,XX/47,XXX. We believe the cardiac malformation was secondary to her aneuploidy. This could have important implications for prediction of recurrence risks to the parents. Chromosomal tests may be indicated for infants were severe congenital cardiac lesions, based on subtle clinical findings.


The X-linked syndrome of macroorchidism and mental retardation: further observations. We report six males with the syndrome of macroorchidism and mental retardation. The trait is inherited as though X-linked, or possibly autosomal dominant male-limited. We also found no evidence of gonadal dysfunction. Associated abnormalities were abnormal EEG (3/4), seizures (2/6), and one instance each of cervical vertebral fusion, cataract, esophoria, and abnormal cutaneous pigmentation. One woman with a 50% a priori risk of bearing the mutant gene had mental retardation and seizures. Results of Xg blood-group typing were uninformative for the purpose of linkage analysis.


Prenatal diagnostic studies in a case of twins discordant for anencephaly.


Is there a place for corticosteroids or immune modulation in treating Reiter's syndrome and ankylosing spondylitis?


Workshop IV. Aetiopathogenetic factors in Reiter's syndrome. Adjuvant disease: pathology and immune reactivity.


Pathogenesis of chlamydial polyarthritis in domestic animals: characteristics of causative agent.


Radiological manifestations of Reiter's syndrome.


Yersinia-induced arthritis and Reiter's syndrome.


Cell-mediated immunity to U. urealyticum (Mycoplasma) in patients with Reiter's syndrome.


Prognosis and natural history of Reiter's syndrome.


Reiter's syndrome: long-term follow-up data.


Scintigraphic evaluation and prognosis of patients with Reiter's syndrome.


Reiter's syndrome: long-term follow-up in relation to development of ankylosing spondylitis.


Workshop I. Features and prognosis of Reiter's syndrome. Clinical aspects of Reiter's syndrome.


Reiter's syndrome versus seronegative rheumatoid arthritis.


Comparative study of gonococcal arthritis and Reiter's syndrome.


Psoriatic arthropathy and seronegative rheumatoid arthritis with psoriasis: distinguishing features from Reiter's syndrome.


Workshop III. Management of Reiter's syndrome.


Reiter's syndrome: evaluation of proposed criteria.


Antibiotic treatment in Reiter's syndrome.


Association of serum antithyroid antibodies with lymphocytic infiltration of the thyroid gland: studies of seventy autopsied cases. Postmortem histological examination of the thyroid gland and measurement of serum antithyroid antibodies were performed in 70 patients without overt thyroid disease. Lymphocytic infiltration, antithyroglobulin hemagglutination antibody (TGHA), and antithyroid microsomal hemagglutination antibody (MCHA) were found in 12, 2, and 9 cases, respectively. The incidence of lymphocytic infiltration in females was three times that in males. Ten of the 12 cases with lymphocytic infiltration had positive antibodies (either TGHA or MCHA), while 10 of 11 patients with positive antibodies showed lymphocytic infiltration. Thus, the correlation between morphological and serological findings was highly significant at P less than 0.001. The incidence of a small thyroid gland of less than 15 g in weight was higher in patients with lymphocytic infiltration and/or positive antibodies than in patients with a normal thyroid gland. These data suggest that positive serum antithyroid antibodies in subjects without overt thyroid disease may indicate the existence of lymphocytic infiltration in the thyroid gland, that is presumably subclinical autoimmune thyroiditis.


Effect of protein binding on transfer and metabolism of cortisol in perfused human placenta. The transfer and metabolism of cortisol and cortisone and the effect of protein binding on these processes have been investigated in vitro in the perfused human placenta. The clearance of cortisol in buffer, expressed as a fraction of the antipyrine transfer rate (clearance index), was 0.50 +/- 0.05 SEM in either direction. Extensive conversion to cortisone (85%) occurred during transfer. Addition of corticosteroid-binding globulin (CBG) in amounts sufficient to bind 50% of the cortisol reduced the clearance (0.40 +/- .026) insignificantly, whereas human serum albumin (HSA) in amounts sufficient to bind 50% of the cortisol reduced the clearance to 0.28 +/- 0.012 (P less than 0.001) even though the association constant for albumin is approximately 1000-fold less. The percent of conversion to cortisone did not change significantly with protein binding. The clearance index of cortisone from a protein-free perfusate was 0.74. With CBG and albumin in the same concentrations as used in the cortisol experiments, the binding of cortisone to CBG was 23% and its clearance was 0.70; with albumin, the binding was 45% and the clearance index was 0.45. The addition of albumin and CBG to the same perfusate resulted in a cortisol clearance equal to that obtained with perfusate containing only albumin. Binding to albumin may be more significant than binding to CBG in controlling the transfer rate of cortisol to the fetus.


Riedel's struma associated with subacute thyroiditis, hypothyroidism, and hypoparathyroidism. Riedel's struma with dense fibrous invasion of surrounding muscle and fat was found in a patient who had clinical subacute thyroiditis superimposed on primary hypothyroidism. Riedel's struma may sometimes be an uncommon stage in the more common subacute form of thyroiditis, although in our patient an unusual coincidence of subacute thyroiditis and Riedel's struma is also possible. Of interest in our patient was the development of spontaneous primary hypoparathyroidism; parathyroid function returned to normal concomitant with the spontaneous resolution of the goiter after partial resection. This patient also represents another instance of hyperthyroidism developing in a previously hypothyroid patient.


Subhourly variability of circulating third trimester maternal steroid concentrations as a source of sampling error. Seven plasma samples from five normal third trimester pregnant women, drawn every 5 and 15 min at similar times on 2 days, 2 days apart, were measured in quadruplicate for estradiol (E2), estriol, progesterone, 16 alpha-hydroxyprogesterone, and 17 alpha-hydroxyprogesterone (17P). The mean of the 22 samples obtained from each subject for each steroid was used as a reference mean. Individual determinations were converted to percentages of the reference mean which was normalized to 0%. All pregnancies were uncomplicated, and all mean values were within the normal range for gestational age. Variability about the reference mean for single samples, however, range from a low of -80% to a high of 150%. The single sample, 95% confidence intervals for individual steroids pooled from the five subjects (110 determinations) range from +/- 36% (E2) to +/- 60% (17P). Mean percentage coefficients of variation between 5-min and 15-min sampling sequences were compared by analysis of variance. There is no significant difference between the mean percentage coefficients of variation of a 5-min as opposed to a 15-min sampling sequence for any of the hormones measured. The 95% confidence interval width around the reference mean is a function of the number of samples obtained. Because the 95% confidence interval width from 110 measurements decreases approximately as 1/ square root n with increasing sampling size, the decrement progressively diminishes. For E2, the least variable steroid, a one-sample 95% confidence interval width of +/- 36% decreases to approximately +/- 18% with four samples or approximately +/- 12% with nine samples. For 17P, the most variable steroid, a one-sample 95% confidence interval width of +/- 60% decreases to approximately +/- 30% with four samples or approximately +/- 20% with nine samples. Multiple sampling with plasma pooling is required for the accurate study of steroid concentrations in individual subjects in late pregnancy.


Evidence that triiodothyronine and reverse triiodothyronine are sequentially deiodinated in man. We have demonstrated that in patients given a single iv injection of T3, rT3, or, to a lesser extent, T4, all labeled with 125I in the outer or phenolic ring, chromatography of serum on columns of Sephadex G-25 superfine revealed the presence of a labeled material, separate from the administered hormone and from both iodide and iodoprotein. This peak has been termed pre-T3 because it elutes just before the T3 peak. Identification of the various compounds in pre-T3 was carried out by cation exchange chromatography. Pre-T3 generated from [125I]T3 consistently contained labeled compounds with the chromatographic behavior of 3,3'-diiodothyronine and 3'-monoiodothyronine, while pre-T3 generated from [125I]rT3 contained labeled products with the chromatographic mobility of 3',5'-diiodothyronine, 3,3'-diiodothyronine, and 3'-monoiodothyronine. In addition, pre-T3 also contained the glucuro- and sulfoconjugates of these several labeled products. These studies demonstrate that T3 and rT3 undergo progressive and probably sequential deiodination in the peripheral tissues, resulting in the formation of a variety of diiodothyronines and monoiodothyronine, as well as their glucuro- and sulfoconjugates.


Appearance of labeled metabolites in the serum of man after the administration of labeled thyroxine, triiodothyronine (T3), and reverse triiodothyronine (rT3). Chromatography of serum on columns of Sephadex G-25 superfine after the iv administration of 125I-labeled T4 consistently yielded labeled iodide, iodoprotein, T3, and a labeled peak that eluted from the column before the T3, termed "pre-T3." Much larger quantities of pre-T3 were generated after the iv administration of 125I-labeled T3 and rT3. The ratio of [125I]pre T3:[125I]T3 and [125I]pre T3:[125I]rT3 plateaued at approximately 10 h and 2 h, respectively, after the iv administration of the labeled hormone, and averaged approximately 15% in euthyroid subjects. As pre-T3 behaves like its precursors in the TCA precipitation-ethanol extraction or anion exchange chromatographic procedures used to separate labeled iodide and iodoprotein from administered labeled T3 and rT3, concentrations of labeled hormone measured by these techniques will be in error, because pre-T3 will be included. Thus, the MCR of labeled T3 and rT3 measured by Sephadex chromatography will always be higher than values obtained by the other two separative techniques and the magnitude of change will be similar to the ratio of pre-T3 to precursor T3 or rT3. The Sephadex chromatographic technique is laborious, but appears to be the method of choice where greatest accuracy of measurement is required. As the generation of pre-T3 from labeled T4 is sufficiently slow, the present chromatographic technique is not necessary in studying peripheral T4 turnover.


Contribution of human somatomedin activity to the serum growth requirement of human skin fibroblasts and chick embryo fibroblasts in culture. Although purified human somatomedins and related peptides have been shown to stimulate growth-related processes in cultured human skin fibroblasts, it is unknown whether the serum macromolecules required for the routine growth of human fibroblasts in culture include the somatomedins. To evaluate this question we have obtained sera from five GH-deficient patients before and after GH treatment and have compared these pre- and post-GH sera for their ability to stimulate [3H]thymidine incorporation into DNA and cell multiplication in the patients' own fibroblasts in culture. Subconfluent human fibroblasts demonstrated a dose-dependent increase in thymidine incorporation and cell number when exposed to human sera. Pre- and post-GH sera were equipotent. Partial purification of somatomedin activity by boiling sera at pH 5.5 diminished the level of thymidine incorporation to 10-20% of the level achieved with unboiled sera but did not unmask a difference between pre- and post-GH sera. In contrast to the results in human fibroblasts, boiled post-GH sera were 2- to 5-fold more potent than pre-GH sera in stimulating thymidine incorporation in chick embryo fibroblasts. Mixing experiments failed to demonstrate inhibition of thymidine incorporation by boiled pre-GH sera. Boiled post-GH sera also were twice as active as boiled pre-GH sera in stimulating multiplication of chick embryo fibroblasts and confirmed that thymidine incorporation reflected DNA synthesis. GH added directly to chick embryo fibroblasts did not stimulate thymidine incorporation. We conclude that despite the presence of specific receptors for somatomedin-like peptides on human skin fibroblasts, somatomedins are not a major component of the serum macromolecules required for the routine growth of human fibroblasts in culture. In contrast, in chick embryo fibroblasts, somatomedins do appear to constitute an important part of the serum macromolecules supporting cell growth.


Plasma concentrations of prostaglandins during late human pregnancy: influence of normal and preterm labor. Highly sensitive and specific RIA procedures have been used to measure prostaglandin concentrations in the peripheral circulation of late pregnant and parturient women. The concentrations of prostaglandin E (PGE) and prostaglandin F (PGF) in plasma samples assayed within 4 weeks of collection were not significantly different among the groups studied, the levels (mean +/- SEM, picograms per ml) were: late pregnancy (n = 13): PGE, 4.8 +/- 1.0; PGF, 6.2 +/- 0.5; early term labor (n = 5): PGE, 6.8 +/- 1.5; PGF, 7.9 +/- 0.7; late term labor (n = 5): PGE, 5.4 +/- 2.2; PGF, 12.4 +/- 3.5; and preterm labor (n = 7): PGE, 4.4 +/- 0.4; PGF, 6.9 +/- 1.4. The concentration of 13,14-dihydro-15-keto-prostaglandin F (PGFM) in late pregnancy was 59.0 +/- 7.8 pg/ml. During spontaneous term labor, the concentration of PGFM was significantly elevated (P less than 0.01) to 142.8 +/- 32.3 pg/ml in early labor and 282.7 +/- 55.3 pg/ml in late labor. The concentration of PGFM in plasma from patients in preterm labor (62.7 +/- 17.4 pg/ml) was not significantly different from that found during late pregnancy, but was significantly lower than levels found at term during early labor (P less than 0.05). The concentration of PGE increased significantly in frozen plasma samples stored for more than 4 weeks in all groups studied; the concentration of PGF was significantly elevated after storage only in the late pregnancy group (P less than 0.01). The plasma concentration of PGFM in all groups studied was unaffected by storage. It is concluded that measurement of PGFM concentrations is the most reliable method available of monitoring prostaglandins in the peripheral circulation and that great care must be exercised in the assay and interpretation of prostaglandin levels in human plasma.


Longitudinal studies of plasma aldosterone, corticosterone, deoxycorticosterone, progesterone, 17-hydroxyprogesterone, cortisol, and cortisone determined simultaneously in mother and child at birth and during the early neonatal period. I. Spontaneous delivery. In order to obtain the still lacking reference data of individual plasma steroids in the immediate postnatal period needed for the assessment of adrenocortical function in various neonatal maladaptation syndromes, aldosterone (A), corticosterone, deoxycorticosterone (DOC), progesterone (P), 17-hydroxyprogesterone (17-OHP), cortisol, and cortisone were simultaneously followed in the same human newborn in a single 250-500 microliters peripheral plasma sample obtained at constant times during the first week of life using a mechanized Sephadex LH-20 multicolumn chromatography and standardized RIAs. Mean concentrations in 12 spontaneously delivered full term newborns of either sex and in paired umbilical (UV) and peripheral maternal (MV) venous plasma are given in the table. Besides significant maternoumbilical gradients in each steroid, DOC, P, 17-OHP, and cortisone, originating predominantly from the fetoplacental unit, disappear rapidly with steadily increasing half-lives. A, corticosterone, and cortisol, however, remain elevated in comparison with later infancy, with the exception of a marked "glucocorticoid dip" in cortisol and corticosterone levels between 2 and 12 h after birth.


Ethical issues related to research involving elderly subjects.


Criminal victimization of the elderly: the physical and economic consequences.


Environmental programming for the socially isolated aging.


Content of chorionic gonadotropin in human fetal tissues. As part of a study on the physiological role of hCG in the human fetus, the hCG concentrations in homogenates of various fetal tissues were measured using a hCG beta subunit RIA. The mean concentrations (picograms of hCG per mg wet tissue +/- SEM; n greater than 10, unless otherwise indicated) found in human fetuses of 12-20 weeks were: ovary, 46.9 +/- 4.3; testis, 8.2 +/- 1.7; kidney, 20.3 +/- 2.8; thymus, 11.5 +/- 1.2; adrenal, 2.6 +/- 0.4; lung, 3.4 +/- 0.7; liver, 1.8 +/- 0.2; spleen, 1.4 +/- 0.4 (n = 5); muscle, 2.4 +/- 0.8 (n = 6); and meconium, 356 +/- 104. That the immunoreactive material measured behaved like hCG was determined by RIA of the supernatants. Parallelism was demonstrated between dilution curves for the tissue homogenates and the hCG standard for all tissues except meconium. A rat Leydig cell in vitro bioassay was used to demonstrate that there was hCG biological activity in the supernatants in ovarian, thymic, and renal tissues. The mean ratios of biological to immunological activities were 5.3 in kidney (n = 4), 1.6 in thymus (n = 3), and 1.3 in ovary (n = 2). Blood content of the tissues was determined from measurements of hemoglobin levels and it was found that for the ovary, testis, kidney, and thymus, hCG concentrations were higher than could be explained by the presence of circulating hCG in the tissues. These results, together with our previous results of the binding and effects of hCG in the human fetal testis, support the fact that the fetal testis is a target organ for hCG in the stimulation of steroidogenesis. The presence of high levels of hCG in the ovary, thymus, kidney, and meconium poses questions for further study of the possible physiological role of hCG.


Alternative modes of outreach: an experimental comparison.


The underutilization of nursing home facilities by Mexican-American elderly in the Southwest.


Sexual expression of the elderly in nursing homes.


Research on middle age: an assessment.

Research on middle age: an assessment.


Factors contributing to older persons' satisfaction with their communities.


Comment: an examination of Palmore's Facts on Aging Quiz.


Split xenon detector for tomochemistry in computed tomography. The design of a split high-pressure xenon detector array for tomochemistry in computed tomography (CT) is described. Each detector produces a signal from the front primarily due to low energy photons and a signal from the back primarily due to high energy photons. Two methods are described whereby these signals are used to determine the photoelectric and Compton coefficients. From these, the electron density and average atomic number can be determined for each pixel in the image. These methods were tested by computer simulations of scans of a simple phantom, and the resulting Compton and photoelectric images are presented and compared with a conventional CT image. It was found that electron density and atomic number can be determined to an accuracy of better than 4%. The sensitivity to noise was studied, and it was found that the standard deviation of the mean of a 5 X 5 pixel region in the conventional image is about a factor of 3 lower than in the same region in the Compton image and about a factor of 40 lower than in the photoelectric image.


Computed tomography scanning for the measurement of bone mineral in the human spine. An investigation into the feasibility of using X-ray computed tomography (CT) to measure disease induced changes in bone mineral content of the human spine is described. A theoretical study of this type of measurement has been made using a mathematical model of osteomalacia. The measured EMI number changes linearly with the mineral content, and the sensitivity is shown to be 1.2 EMI units (EU: 500 scale)/1% change in mineral content in vertebral bone. The physical sensitivity to an equal mineral change in cortical bone is found to be 8.6 times greater. The mineral selectivity of the CT method is such that only about half the change in the EMI number arising from progressive osteomalacia reflects change in actual mineral content, while half is due merely to changes in bone density that accompany demineralization. In addition, the perturbing effects of beam hardening on measurement accuracy are evaluated and shown to be significant. Finally, an experimental measurement indicates that in practice the reproducibility of such measurements would be about 1 EU, and it is shown that the measured parameter correlates well with the calculated total linear attenuation coefficients.


Measurement of lung density by computed tomography. Computed tomography scanners can be calibrated to provide reproducible measurements for a quantitative analysis of lung density. Typical histograms for inspiration and expiration are presented. The reproducibility of the method is demonstrated as well as the limitations caused by artifacts and incomplete inspiration. This method is suggested for follow-up studies of patients with diseases affecting the entire lung. Early detection of interstitial lung disorders also seems possible.


Detection of subcutaneous metastases by computed tomography. Subcutaneous fat provides excellent contrast for water density tissue. Five patients with subcutaneous metastases visualized on computed tomography (CT) scans are presented. In some cases, CT proved to be the optimal diagnostic modality for visualizing these lesions and documenting their response to therapy.


Computed cranial tomographic findings in cerebral sinovenous occlusion. Eleven patients with angiographically and/or pathologically verified cerebral sinovenous occlusions not directly caused by trauma were studied by computed cranial tomography (CCT). Static radionuclide brain scans and dynamic radionuclide flow studies were also obtained in four patients; in two, findings diagnostic of lateral sinus thrombosis were noted. These comprised a "negative on dynamic, hot on static" image, as well as a "hot on static with nonfilling on angiography." Computed cranial tomography findings included visualization of the thrombosed vein ("cord sign") or sinus ("empty triangle" or "delta sign"), multiple focal bilateral parasagittal hemorrhages, intense tentorial enhancement, gyral enhancement indistinguishable from infarct, solitary intracerebral hematoma, small ventricles, and normal scan. Excluding the patients with underlying meningioma, all three of whom survived, seven of the remaining eight patients expired during the acute phase of their illness, an 88% mortality. This group includes one patient who had normal CCT findings, albeit without contrast enhancement, who was diagnosed as pseudotumor cerebri. The need for full neuroradiological evaluation, including angiography, is thus stressed if this highly fatal yet treatable condition is not to remain undiagnosed.


Malformation of the cerebral cortex with heterotopia of the gray matter. Developmental malformation of the cerebral cortex with heterotopia of the gray matter is a rare condition. It can present as unilateral megalencephaly, a localized mass, or focal cortical dysplasia. Four histologically confirmed cases are described in this report, and the findings from computed tomography as well as from other radiological diagnostic procedures are discussed.


The value of computed tomography in the diagnosis of intracranial lipomata. Intracranial lipomata can be found in both symptomatic and asymptomatic patients. The tumors, which are rare, can be diagnosed by computed tomography without further investigative procedures.


Quantitative estimation of tumor volume on computer assisted tomography. With the use of computer assisted tomography (CAT), the volume of intracranial hemorrhages can be calculated. The present work outlines a method that, based on EMI scan printouts, makes possible a calculation of the volume of hemorrhages, tumors, or other pathological changes detectable on CAT with a high degree of accuracy, even when the pathological changes are irregular in shape. Thus, there have been divergences between the estimations of volume of meningiomas using this method and the measure of the volume of the enucleated meningiomas within the range of 0 to +5%. An example of such a meningioma, and the calculation of its volume, is presented.


Giant intracranial aneurysms simulating brain neoplasms on computed tomography. Giant intracranial aneurysms (GIA) may simulate brain neoplasms on computed tomography (CT) scans. We present three cases in which a GIA was mistakenly diagnosed as a brain neoplasm on the basis of CT findings. The correct diagnosis was made in each case by cerebral angiography. The possibility of GIA must be considered when a nonenhanced CT study shows a well circumscribed mass without edema at the base of the brain and contrast infusion reveals homogeneous or inhomogeneous enhancement.


The use of coronal sections in evaluating lesions of the sellar and parasellar regions. Nine cases from a series of 12 are presented to illustrate the value of coronal sections in delineating the borders and origins of extraaxial sellar and parasellar masses. In this projection, the presence or absence of suprasellar extension is demonstrated, and two important signs are discussed. A rim of cisternal cerebrospinal fluid termed the "cap" is seen over the superior border of masses extending into the suprasellar region defining their extraaxial location. The broad base of a lesion will define its origin. The limitations of the method are also discussed.


Contrast enhancement: diagnostic significance from a statistical viewpoint. Contrast enhancement attenuation units were calculated from 13 tissues and organs of 20 rats at five different times after bolus 125I-diatrizoate administration. Percent distribution volume of diatrizoate was calculated from these results. The statistical significance of differences in contrast enhancement between each of 72 tissue pairs was determined at each of the five times. A similar treatment of percent distribution volume for 60 tissue pairs was determined. The time elapsed after contrast medium injection appears to be of pivotal importance in contrast enhancement diagnosis. Calculation of percent contrast distribution volume is of potential diagnostic importance, since it reveals contrast medium behavior not evident from a visual perusal of scans. The above methods can be readily adapted to computed tomography scanning.


Comparative efficacy of contrast agents in computed tomography scanning of the brain. Various contrast agents with either sodium or meglumine cations and iothalamate and diatrizoate anions are compared in a series of patients with malignant gliomas. There is no difference in the ability of these agents to enhance tumors in cranial computed tomography.


Peripheral contrast enhancement in chronic epidural hematomas. Three cases of chronic epidural hematomas with contrast enhanced margins on computed tomography (CT) are presented. The CT findings in epidural hematoma are discussed, and two possible mechanisms for the enhancing margin of the chronic epidural hematoma are suggested.


Image quality in cranial computed tomography. Image quality in cranial computed tomography (CT) was evaluated with phantom and patient studies on both a first (single beam) and a second (multiple beam) generation scanner. When comparable radiation doses were used, there were only minor differences in resolution, low contrast detectability, and noise level. The pattern of noise relative to the size of the area in which it was measured was somewhat different. On patient studies, no differences were found when contrast-material-filled vessel visibility and gray--white matter distinction were analyzed. A lesion was obscured by streak artifacts in one scanner in one of 22 patients scanned on both machines. The major factor in image quality as seen in the two scanners seemed to be in the production of artifacts. This was apparent in artifacts from motion, high contrast discontinuities, beam hardening, and edge enhancement. Multiple factors must be considered in assessing CT image quality. In particular, further studies to quantitatively evaluate noise quality and artifact production are needed.


Transsphenoidal encephalocele associated with agenesis of corpus callosum: value of metrizamide computed cisternography. Transsphenoidal encephaloceles are rare congenital malformations that are classified among the medial dysraphias and that are therefore associated with an agenesis of the corpus callosum. Clinically, the diagnosis is difficult, but hypertelorism and weakening eyesight should be of suggestive value. Diagnosis is basically radiological. In the past, it was founded on roentgenography, tomography of the base of the skull, pneumoencephalography, and angiography when necessary. Today, metrizamide computed cisternography using axial transverse and coronal sections, supplemented by sagittal reconstructions, allows for a complete examination of bony, meningeal, and cerebral abnormalities.


A device to indicate anatomical level in computed tomography. A device was designed that makes possible direct anatomical correlation between the computed tomography scan and radiographic scout films. The acrylic-air groove approach used here eliminates the possibility of producing image degrading artifacts as is common with catheter type markers.


An inexpensive color display for computed tomography scanners and other imaging systems. The use of color pictures and displays for interpreting images obtained from computed tomography scanners, scintillation cameras, and ultrasound equipment is an interesting possibility. As currently supplied, color television monitors may add significantly to the cost of a system. A relatively simple way of converting an entertainment grade color television receiver to color monitor operation is described. The display system is significantly lower in cost than vendor supplied monitors and produces images of similar quality.


Anomalies of the systemic venous return. Anomalies in the course and drainage of systemic veins, in particular the inferior vena cava, markedly complicate or even prevent cardiac catheterization and some surgical procedures. Such anomalies have been observed in 32 out of 1,266 children subjected to catheterization and angiocardiography, i.e. 2.5 per cent. Severe anomalies of a superior vena cava were observed in six children, one of them having an associated anomaly of an inferior vena cava. Anomalies of the inferior vena cava were observed in 27 children. The latter included persistent paired development of the inferior vena cava, aplasia of suprarenal portion with azygos or hemiazygos continuation, its persistence at the side of the cardiac apex and combination of these findings. In 19 of the children with an anomaly of the inferior vena cava there was a visceral situs indeterminatus associated, often with severe congenital heart disease and with a large intracardiac shunt (e.g. transposition of the great arteries and stenosis or atresia of the pulmonary artery). Suspicious of such combinations of visceral situs indeterminatus with anomalies of the inferior vena cava and severe congenital heart disease can be suspected on plain chest films, but the diagnosis can be definitely determined only by angiocardiography.


The relationship between chest radiographic scores and respiratory function tests in children with cystic fibrosis. Chest radiographic scores and respiratory function on 80 sets of results from 50 patients with Cystic Fibrosis were analyzed. Chest radiographic scores were assessed independently using the method of Chrispin and Norman. Respiratory function tests were found to correlate well with the chest radiographic score, the best correlation being with the forced expiratory volume in 0.75 sec. to forced vital capacity ratio F.E.V. 0.75/ F.V.C. (r = -0.674 n = 80 p less than 0.001).


Cervical neurogenic tumors presenting as thoracic apical masses in infants and children. Seven cases of cervical neurogenic tumor presented in an almost identical manner roentgenographically; a polypoid extrapleural mass at the lung apex. The association of neuroblastoma with Horner syndrome and heterochromia of the irides is mentioned. Characteristic roentgen appearance should be appreciated due to good prognosis of cervical neuroblastoma with prompt therapy.


The telltale triangle: use of the supine cross table lateral radiograph of the abdomen in early detection of pneumoperitoneum. The most sensitive method for detecting a small pneumoperitoneum depends upon directing a horizontal x-ray beam tangential to the collection of free air. We have observed in the detection of small amounts of free intraabdominal air that the supine cross table lateral abdominal view is most valuable. Such small amounts of free intraperitoneal air collect between loops of bowel at the highest points in the peritoneal space forming typical small triangular lucencies with their bases at the peritoneal reflection.


The incidence of pelvic phleboliths in pediatric patients. During a seven year period in a pediatric x-ray department 15 patients with pelvic phleboliths were encountered in a total of an estimated 12,000 pelvic roentgenograms, an incidence of 1 case per 800. The age range was from 9 to 17 years (average age 13 years), there were 10 girls and 5 boys, and 6 patients had more than 1 phlebolith.


Upper calyx reno-vascular obstruction in children: Fraley's syndrome. Intrarenal vascular obstruction of the upper calyceal infundibulum has been distinguished by Fraley as an entity separate from an asymptomatic vascular impression. Clinically, this form of intrarenal vascular obstruction presents as nephralgia or hematuria. This infundibular obstruction is caused by normal renal vessels, usually the upper segmental artery: radiologically, the vessels produce a constant well-defined filling defect in the infundibulum at IVP, and, the upper calyx group is distended and shows delay in emptying. We found this condition in 14 children from 1968-1975. Control studies showed no progression in the radiological findings, even over a long period. In one of our cases angiography was indicated to exclude tumour or cyst; in another case, surgery was necessary. Complications are urinary tract infection or stone formation. Therefore, children with Fraley's syndrome require regular clinical examination.


Pelvis-shoulder dysplasia.

Pelvis-shoulder dysplasia. Pelvis-shoulder dysplasia is rare skeletal dysplasia characterised by symmetrical hypoplasia of the iliac wings and scapulae. It may be associated with unstable hips in infancy, a prominent lumbar lordosis and a waddling gait. Symptoms tend to lessen with increasing age. A child with this condition who has been followed up to the age of five years is described. Her pelvic dysplasia is milder than in previous cases and has caused no disability. Minor skeletal abnormalities are also present in the lumbar spine, femora and rib cage. Radiography of other members of the family was normal.


Dosimetric studies in the radiological examination of the hips in young infants with a special fenestration method of gonad protection. A special lead shield of 1,5 mm Pb, with a fenestration was used for gonad protection during X-Ray of the hips for detection of dysplasia. The window allows the delineation of all parts of the skeleton required to make a correct diagnosis and check the standardized position of the pelvis, while all other parts, especially the gonads are safely shielded. The scattered radiation for the testes was further reduced by a trough-shaped lead shield behind the scrotum. The effectiveness of this gonad protection was measured by direct dosimetric studies on the infant with LiF and CaF2: Dy dosimeters at different adjustments of the X-ray generator and with medium and ultra high speed screen-film combinations.


Peroral removal of a sewing needle and attached thread from the esophagus in an infant. The authors describe a simple Seldinger Catheter technique by which they removed a metallic sewing needle with attached thread from the esophagus of a 5 month old infant.


Multimodal approach to diagnosis of hamartoma of the spleen. Splenic hamartoma is a benign, primary neoplasm which usually causes a mass in the left upper quadrant of the abdomen. If radionuclide studies show a space-occupying lesion in the spleen that appears solid on the ultrasonogram, and selective abdominal arteriography reveals a richly vascular splenic tumor, hamartoma of the spleen should be the preoperative diagnosis.


Postinflammatory pseudotumor of lung in a child: diagnosis by angiography. A case of postinflammatory pseudotumor of the lung with unusual clinical features is presented. Radiological investigation, with particular emphasis on the angiographic diagnosis, is described.


Infantile hepatic hemangioendotheliomas associated with hemihypertrophy. An infant presented with congenital hemihypertrophy, hepatomegaly, and a low thoracic paraspinal mass. Liver scan showed multiple defects in the uptake of radioisotope. Surgical exploration revealed multiple infantile hemangioendotheliomas of the liver and a paraspinal hemangioendothelioma. In review of 69 reported cases of infantile hemangioendothelioma of the liver and viscera, there has been no previous note of hemihypertrophy associated with this abnormality.


Further studies on BL-3912A: effects on avoidance behavior of rats with low baselines and on reaction thresholds to electric footshock. Rats selected for their low performance baselines in an active avoidance shuttle box task were given various doses of R-(-)-2-amino-1-(2,5-dimethoxy-4-methylphenyl) butane (BL-3912A), S-amphetamine or piracetam. BL-3912A at 1 mg/kg IP had no significant behavioral effects, while 5 and 10 mg/kg significantly increased the number of avoidance responses without affecting responses during the intertrial interval (ITI). Statistically reliable effects on behavior were not observed following 20 mg/kg of BL-3912A. S-Amphetamine at 0.5 and 1 mg/kg IP also facilitated avoidance responding, but could be differentiated from BL-3912A in that the S-amphetamine significantly increased shuttles during the ITI. S-Amphetamine at 0.1 mg/kg was not effective, while 2 mg/kg increased ITI activity. Piracetam (50 or 200 mg/kg) had no significant effects on avoidance or shuttles during ITI. Using an electric shock titration procedure, BL-3912A at 10 and 20 mg/kg IP had no significant effect on reaction thresholds. Animals receiving 100 mg/kg of p-chlorophenylalanine po for 3 days and tested 2 days later showed hyperalgesia to the electric shock. In summary, BL-3912A facilitated shuttle box avoidance responding of rats with low performance baselines. Behavioral facilitation occurred without concomitant increases in noncontingent activity or apparent changes in reactivity to electric footshock.


Comparison of the cycloheximide and food satiation effects on a discrimination task. The effects of intraventricular cycloheximide (CHX) pretreatment were examined on the ability of rats to recall a light position discrimination task. The CHX pretreatment used inhibited brain protein synthesis at the time of training by 71%. Following treatment with CHX the animals demonstrated no retention of the task 18 hr later. Free feeding for 24 hr prior to treatment with cerebro-spinal-like fluid (CSF) produced similar effects as CHX. It is proposed that the amnesic effect of CHX in this behavioral paradigm may be a nonspecific action resulting from decreased motivation. Both the CHX-treated and satiated animals exhibited low responding levels during training, despite comparable behavioral activity levels for the CHX- and CSF-treated groups.


Specificity of cholecystokinin satiety effect: reduction of food but not water intake. The C-terminal octapeptide of cholecystokinin (CCK) was injected into water-deprived rats to observe the effect on water and milk intake. The doses used were 0, 20, and 40 Ivy dog units/kg. The data indicated that milk intake was suppressed in a dose-related fashion within 2-4 min of injection but water intake was not suppressed. This satiety hormone is thus specific to food intake.


Discriminable effects of antimuscarinics: dose response and substitution test studies. In a shock escape T-maze task, rats were trained to turn right following one drug treatment and left following a second drug treatment. The specific drug and dose conditions were the only discriminative cues available to the animals. The number of training sessions before criterion performance indicated the discriminability of the two training conditions. Drug vs no drug training showed that discriminability was proportional to dosage for low doses, but was constant over a range of higher doses. Such an asymptote of discriminability was observed with scopolamine, atropine, benactyzine and Ditran (JB 329), and was shown not to result from tolerance. High dose vs low dose discriminations involving scopolamine were learned very slowly if both doses were within the asymptotic range; this indicates that similar discriminable effects were produced by high and low doses. To compare various drugs, substitution tests were administered to trained rats. The four antimuscarinic drugs generally substituted for one another but did not mimic and were not mimicked by drugs in other pharmacological classes. Some exceptions to this pattern were noted. The discriminable effects of scopolamine were partially antagonized by physostigmine. The results indicate that the antimuscarinic drugs share discriminable actions probably produced by their anticholinergic actions. The asymptote of action at high doses appears genuine, possibly reflecting receptor saturation.


Effect of GABA-transminase inhibition on rectal temperature in mice. gamma-Acetylenic GABA (amino-4-hex-5-ynoic acid) and gamma-vinyl GABA (amino-4-hex-5-enoic acid), two catalytic irreversible inhibitors of GABA-transaminase, produce marked sustained elevations in brain GABA concentrations. Associated with these biochemical changes is a decrease in the rectal temperature of mice. This hypothermia can be reversed by increasing ambient temperature. The results suggest GABA plays an important role in mammalian central thermoregulation.


Time-action and behavioral effects of amphetamine, ethanol, and acetylmethadol. As time increased between drug administration and the start of experimental sessions, effects of drugs on food-maintained responding in rhesus monkeys increased to a maximum and then decreased. d-Amphetamine, ethanol, and alpha-l-acetylmethadol (LAAM) generally decreased high response rates in one component of a chain schedule, while very low response rates in another component were increased reliably only by ethanol. The time of peak LAAM and ethanol concentrations in blood or plasma corresponded with or overlapped the time of maximal behavioral effect, while the time of maximal behavioral effect with d-amphetamine occurred somewhat prior to the time of peak plasma-amphetamine concentration. With d-amphetamine and perhaps with ethanol, effects on operant responding were greater after 30-min pretreatment intervals than after six-hr pretreatment intervals despite higher plasma or blood concentrations at six hours than at 30 min.


Characteristics of beta-phenethylamine self-administration by dog. Phenethylamine (PEA), a biologically active amine found in the brain, maintained intravenous self-administration behavior by dogs previously trained to respond for amphetamine. Systematic changes in the unit dose of PEA (1.5 to 6.0 mg/kg/infusion) were negatively related to the number of infusions (91.3 to 29.5, respectively) per 4hr session. The mean intake of PEA was 165 mg/kg/session. Pretreatment with chlorpromazine (0.5 to 2.0 mg/kg, IV, 30 min prior to the session) produced a dose-dependent increase in the number of self-administered PEA infusions. However, there were no changes in responding for PEA following pretreatment with either the dopaminergic antagonist pimozide (5 to 40 micrograms/kg, IV, 30 min prior to the session) or the adrenergic antagonist phenoxybenzamine (1 to 8 mg/kg, IV, 30 min prior to the session). These data suggest that the reinforcing properties of PEA are not dependent on either a dopaminergic or adrenergic system.


Amphetamine effects on brain slow potentials associated with discrimination in the rat. Slow potentials were recorded from the anterior cortex of rats during discrimination conditioning and the effects of various doses of d-amphetamine on these responses were examined. In the discrimination paradigm one tone (Sd) was followed at three see after the onset by food reinforcement while another tone (S delta) indicated that no reinforcement would follow. Slow potential (SP) responses were measured during the three-sec period following onset of the stimulus. For the first several training sessions the SP responses demonstrated a phase of generalization during which responses were the same to both stimuli. Thereafter, the responses to Sd were significantly greater than responses to S delta. d-Amphetamine produced a dose-related depression of SP responses to the reinforced stimulus in doses of 0.25 to 2.0 mg/kg. The effect of amphetamine on SP responses to S delta was biphasic; the lower doses (0.25 and 0.5 mg/kg) enhanced responses, no change was seen after 1.0 mg/kg and the high dose (2.0 mg/kg) depressed responses. This study demonstrates that the rat develops differential slow potential responses to reinforced and nonreinforced stimuli in a discrimination paradigm and that d-amphetamine produces a differential and dose-related alteration of these SP responses. It is suggested that the actions of amphetamine may be produced through interference with mechanisms of discrimination, by an effect on subcortical activating systems involving norepinephrine, and/or by activation of inhibitory dopamine receptors on cortical neurons.


Effects of angiotensin II on schedule dependent and induced behavior at recovered body weight. The effects of 4 doses of angiotensin II, 0.4, 0.8, 1.2 and 1.6 mg/kg, injected subcutaneously on schedule dependent lever pressing and schedule induced drinking and licking were studied in rats who had recovered body weight under ad lib eating conditions. Prior to this experiment rats had been maintained at 80% body weight and were tested under the usual conditions producing schedule induced drinking. Animals were then returned to the home cage and allowed to recover body weight. Results were analyzed for both the first 15 min of the 1 hr session and for the total 1 hr session. Data indicate that all four doses decreased lever pressing during the first 15 min and for the total 1 hr session. The three highest doses produced increased licking during the first 15 min. Only the highest dose augmented licking throughout the total 1 hr session. Water intakes were significantly increased by the three highest doses only during the first 15 min of the session. Peripheral effects of angiotensin II were discussed and a central pharmacological action on drinking was suggested.


Subcutaneous injections of apomorphine, stimulus generalization and conditioning: serious pitfalls for the examiner using apomorphine as a tool. This report shows that stimulus generalization occurs in rats conditioned by a single injection of apomorphine. The data suggest that apomorphine initially acts as an unconditioned stimulus (UCS) of an unconditioned response (UCR) that, in turn, produces stimuli which become conditioned stimuli (CS) of a conditioned response (CR) having a nature identical to that of the UCR. The study also shows that behaviour elicited by a subcutaneous injection of apomorphine depends on the part of the body selected for administration. The mentioned properties should be taken into account when apomorphine is used as a tool in studies on brain and behaviour.


Food deprivation-induced alcohol ingestion in the mouse: calories versus primary sensory preference. Random bred Swiss mice showed preference for water over 10% ethanol solution when unlimited food was available. When partially food deprived, the preference was reversed in 5 out of 8 animals. About half of the naive mice, however, ingested substantial amounts of this ethanol solution at the very first exposure when partially food deprived for 12 days. It is suggested that while the caloric value of ethanol is reinforcing, food deprivation might make the sensory effects of ethanol also reinforcing.


31st annual scientific meeting of the Gerontological Society. Dallas, Texas, November 16-20, 1978. Abstracts.


30th annual meeting of the Gerontological Society. San Francisco, California, November 18-22, 1977. Abstracts.


Open letter.

Open letter.


The "graying" of the federal budget and its consequences for old-age policy.


Cross-national trends in mortality rates among the elderly.


Older Americans and market work.

Older Americans and market work.


Profiling the shopping behavior of elderly consumers.


Life events and decision making by older adults.


Family structure and the use of agency services: an examination of patterns among elderly Native Americans.


Characteristics of elderly Pueblo Indians in New Mexico.


Geriatric suicide: the Arizona study.

Geriatric suicide: the Arizona study.


Donald P. Kent memorial lecture. Can we invalidate negative stereotypes of aging?


Growing older male: heterosexual and homosexual.


Short-term counseling groups for people with elderly parents.


Discriminators of loneliness among the rural elderly: implications for intervention.


Palmore's Facts on Aging Quiz: a reappraisal.


Information and referral services for elderly welfare recipients.


Evaluating information and referral services.


The Robert W. Kleemeier Award lecture. Social myth as hypothesis: the case of the family relations of old people.


Socialist organization and economic development in China: latent consequences for the aged.


Issues in retirement research.

Issues in retirement research.


Male social scientists: lives after sixty.


Older women in single room occupant (SRO) hotels: a Seattle profile.


Assessing the social environments of sheltered care settings.


Discriminating between survivors and nonsurvivors among working class aged living in the community.


Hazards of drug use among the elderly.

Hazards of drug use among the elderly.


Genetic and evolutionary fitness.

Genetic and evolutionary fitness. The advantages and disadvantages of evolutionary fitness (probability that a single mutant line will not become extinct) and genetic fitness (mean fecundity) are compared. For deterministic processes the two are equivalent, but for stochastic branching processes they may be totally unrelated except that an absolute genetic fitness of unity or less implies an evolutionary fitness of zero. To know the variance as well as the mean family size does not in general uniquely determine the evolutionary fitness. Except where genetic fitness is close to unity, the impact of selection is shown to be rapid for the binomial, Poisson, negative binomial, and truncated negative binomial distributions. Evolutionary fitness, though somewhat cumbersome, has greater relevance to evolution, genetic counseling, and voluntary population control; but genetic fitness which is much easier to handle is the more appropriate measure where a large number of mutants is involved. Some empirical data on the transmission of various types of characters from parent to child are analyzed to allow comparison of genetic fitness, Crow's index, and a Malthusian parameter, with evolutionary fitness. There is a fair, but far from perfect, agreement among them. Multiple correlation of evolutionary fitness with mean and variance of family size taken jointly suggests a much more satisfactory approximation. It thus appears that, at the least, the population geneticist cannot afford to ignore the variance (which is not adequately represented in Crow's index). These relationships, based on two sets of data only may be accidental and should be invoked with caution. It seems more than likely that other aspects of the distribution of family size (eg, even higher moments) may contain relevant information in certain cases.


A goodness-of-fit test for the polygenic threshold model: application to pyloric stenosis. A new test of goodness of fit for the polygenic threshold model is proposed. This test, when applied to disorders showing different incidence rates in males and females, is designed to account for ascertainment in more detail than previously done by other investigators. This is accomplished by computing the expected distribution of nuclear families with more than one affected sib conditioned on several family-dependent variables, including whether each family was ascertained via only affected boys or via at least one affected girl. A direct measure of the probability of observing a data set is thereby derived. The test, when applied to data on pyloric stenosis, exposes the critical nature of the ascertainment procedures. Different levels of statistical significance are obtained when mode of ascertainment is taken into account than when the mode of ascertainment is ignored.


"ADAM complex" (amniotic deformity, adhesions, mutilations)--a pattern of craniofacial and limb defects. We report eight patients with the craniofacial defects and limb anomalies of the (amniotic deformity, adhesions, mutilations) ADAM complex. Facial abnormalities comprise clefts and distortion and dislocation of craniofacial structures; limbs show various combinations of amputation, secondary syndactyly, and constriction. From previous reports and our cases it is obvious that the clinical picture of the ADAM complex varies enormously; a less severe type combines cleft lip and palate with amputations or amniotic bands. Clinical and experimental data suggest that these malformations are of symptomatic (exogenous) origin. Nosologic differentiation from other conditions phenotypically similar but of genetic etiology is important for genetic counseling. Observation of the ADAM complex in two members of a family suggests that genetic factors might operate in some cases.


Improved hospital environment on behaviour patterns of mentally handicapped patients.


Psychiatry: meaning and purpose: an answer to Dr Bebbington.


Family and social factors in the course of schizophrenia.


Alcoholism and psychiatric disorder: some further data.


Management of affective disorders.

Management of affective disorders.


Haloperidol in normals.

Haloperidol in normals.


Relocation and its effect on mortality.

Relocation and its effect on mortality.


The Administration on Aging as an advocate: progress, problems, and prospects.


The management of research in aging: a case study in science policy.


A network model for leadership development among the elderly.


Barriers to effective outreach in Title VII nutrition programs.


The family as a social support system in old age.


Issues involved in the development of a prepaid capitation plan for long-term care services.


Perceived risk and elderly perceptions of generic drug prescribing.


Using survey data in the study of social stratification in late life.


Survey research in the study of aging and adult development: a commentary.


Advantages of aging.

Advantages of aging.


Cranial computed tomography of epidermoid and congenital fatty tumors of maldevelopmental origin. The computed tomographic and clinical findings in 17 patients with fatty intracranial tumors and in 10 patients with epidermoid tumors, all of maldevelopmental origin, are presented. Fat was found in lipomas (the most frequent), dermoids, and teratomas. Differentiation between these tumors is discussed on the basis of density, calcification, location, and symptomatology.


Hemodynamic studies using a CT scanner.

Hemodynamic studies using a CT scanner. New CT software programs allow rapid-sequence images to be obtained. During a period of 12 sec, multiple CT images can be produced, so that the progression of contrast flow at intervals of 1 sec or less can be followed. In addition, as many as 16 consecutive 3-sec scans can be performed, or arbitrary time intervals inserted between scans. The rapidity with which the contrast medium enters and leaves a specific tissue may be a valuable, non-invasive diagnostic tool in differentiating enhancing lesions. Other potential applications are mentioned.


Computed tomography in the evaluation of patients with bilateral retinoblastomas. Six patients with histologically proven retinoblastomas were examined by computed tomography, two at the time of initial diagnosis and four from 2 to 30 years following treatment, which consisted of radiation therapy alone or with surgery. The spectrum of computed tomographic findings includes: calcified retinal tumor, intracranial subarachnoid spread of tumor, radiation-induced tumors (papillary adenocarcinoma and undifferentiated sarcoma) in the field of prior radiation, and second, primary central nervous system tumor, a pineoblastoma.


Acute bilirubin encephalopathy induced with sulfadimethoxine in Gunn rats.


Posterior fossa intra-axial tumors: a comparison of computed tomography with other imaging methods. Fifty patients with posterior fossa intra-axial tumors were evaluated by computed tomography and the results compared with routine skull films, radionuclide brain scanning vertebral angiography, and cerebral air studies. The routine skull series was found to be of little benefit. Computed tomography was more sensitive than the radionuclide brain scan in detecting all of the lesions except astrocytoma, for which sensitivity was comparable. Angiography was the most sensitive means of detecting hemangioblastoma, and was the only reliable radiographic method of differentiating hemangioblastoma from astrocytoma. Cerebral air studies were the most sensitive and specific means of evaluating brainstem gliomas.


Liquid diffraction analysis of the model membrane system. Egg lecithin + myelin protein (N-2). The scattering from the model membrane system, egg lecithin + myelin protein (N-2), has been analyzed by liquid diffraction methods. It is found that by manipulating the protein-lipid ratio, the scattering domains of the protein and lipid can be identified. The multilayer contribution can also be identified by its position and concentration behavior in both the intensity pattern and its Fourier transform. When the multilayer and protein components are subtracted, the phospholipid scattering and an interaction term are left: these two can be resolved by a reasonable assessment of their relative magnitude in the boundary region where they overlap. The interaction term can then be used to determine the most probably position of the protein in the membrane. The deconvoluted protein and lipid transforms can then be combined in the proper way to obtain the electron density profiles. The resolution of the interaction term is not yet complete, but a method for accomplishing this is discussed.


The effect of added protein on the interchain x-ray peak profile in egg lecithin. The effect of added protein on the phospholipid interchain peak profile has been measured. The results indicate that the basic organization of the bilayer is preserved, and that the added protein affects only the arrangement of the lipid hydrocarbon chains in the first few adjacent layers.


The model membrane system. Egg lecithin + myelin protein (N-2). Effect of solvent density variation on the X-ray scattering. The electron density contrast method has been applied to the membrane system egg lecithin + myelin protein (N-2). The case treated here is for a low protein concentration. As theory predicts, the scattering from the different regions of the membrane (protein, hydrocarbon, and polar head group regions) are modulated differently by changing the contrast. It is then possible to separate out the electron pair correlation functions for the different regions, and from these to determine the membrane election density distribution for an external electron density p0 = 0.


Structural studies of synthetic filaments prepared from column-purified myosin. Synthetic filaments prepared from column-purified rabbit skeletal myosin by slow dialysis exhibit characteristic bipolar organization and 14-nm axial subunit spacing. Backbone substructure can be discerned in high resolution micrographs in the form of striations of 3--4-nm width and slight angular tilt from the direction of the filament axis. Filament backbone diameters vary over the population, although remaining relatively constant for a single filament. Approximately 25% of the filaments appear poorly stained and frayed, which may be due to collapse on the electron microscope grid. Optical diffraction studies reveal a 43-nm axial repeat as well as the 14.3-nm subunit repeat, indicating a structural homology with natural filaments. A model for synthetic filament aggregation is presented that is consistent with observations of backbone diameter variation, absence of bare zones, and the presence of fraying filaments.


Mechanisms in the suppression of delayed hypersensitivity in the guinea pig by 6-mercaptopurine. II: Kinetic and morphologic studies on the monocyte-macrophage component. The effect of 6-mercaptopurine on the development and expression of delayed hypersensitivity was studied in the guinea pig. Results indicated that 6-MP produced its suppressive effects primarily by action on cells of the monocyte-macrophage series. Suppression could occur under conditions of both developing and pre-established delayed hypersensitivity. The defect primarily involved newly synthesized, bone marrow-derived monocytes. Marked alterations in monocyte macrophage generation and distribution, especially the T1/2 of circulating monocytes were demonstrated. Suppressive effects were associated with the appearance of a unique morphologic microscopy. Finally, the in vivo expression of delayed hypersensitivity correlated better with a variety of parameters relating to qualitative macrophage function and distribution rather than those relating to quantitative macrophage levels.


Complete neglect of differential overlap study of the binding of salts to N-methyl acetamide. The complete neglect of differential overlap method is used to investigate the binding of LiF, LiCl, NaF, and NaCl to N-methyl acetamide (NMA) as a model for these ions binding to a peptide moiety. The cation (formula: see text) anion interaction is shown to result in a net residual charge on NMA, which becomes less positive as the difference in electronegativity between the anion and cation of the salt present increases. A residual charge of smaller magnitude is also found on a water molecule in the analogous system cation (formula: see text) anion, which displays this same dependence.


Experimental staphylococcal mastitis in the mouse: the persistence of chronic infection from one lactation to the next. Chronic staphylococcal mastitis was established in 50 mammary glands of 25 mice. The mice were mated and in the subsequent lactation there was alveolar mastitis in one of 50 glands. A further five glands had abscesses that contained staphylococci but there was no alveolar mastitis. The results are discussed in relation to the large number of infections that persist from one lactation to the next in cows not subjected to mastitis control measures.


The effects of subcutaneous injections of sodium selenate on blood composition and milk yield in dairy cows. Three groups of four lactating cows received a subcutaneous injection of 0 . 05, 0 . 10 and 0 . 15 mg Se/kg body weighty respectively administered as sodium selenate. A fourth group was injected with saline. In all the cows injected with sodium selenate, the concentration of Se in blood increased rapidly and was significantly higher than in control cows for two days in the group receiving the lowest dose and for 182 days (the duration of the experiment) in the two other groups. The activity of glutathione peroxidase in blood increased slowly in all cows injected with sodium selenate and was significantly greater than in control cows after 15, 22 and 29 days respectively, and remained significantly greater for 63, 91 and 182 days respectively. In a second experiment a single subcutaneous injection of 0 . 15 mg Se/kg body weight had no effect on the mean milk yield of 37 animals (19 . 1 kg/day) compared with the milk yield of a similar group of control animals (19 . 1 kg/day) during 70 days. The concentration of Se in milk was significantly higher on the first (168 microgram/litre) and second (69 microgram/litre) day after injection than in control animals (mean 26 microgram/litre).


Multivariate behavioral genetic analysis of twin data on scholastic abilities. Multivariate behavioral genetic analyses may employ either genetic and environmental correlations or phenotypically standardized covariances to assess the structure of genetic and environmental influences. Correlations and phenotypically standardized covariances answer different questions--correlations are appropriate for understanding the nature of genetic and environmental influences, whereas covariances are appropriate for determining the etiology of phenotypic correlations. The ratio of the genetic and environmental covariances to the phenotypic correlation yields estimates of bivariate heritability and environmentality, measures of the extent to which observed phenotypic covariance is due to genetic and environmental influences. Multivariate analyses of genetic and environmental correlations and covariances are illustrated with twin data on scholastic abilities. Factor analyses of correlations suggest that the same set of genes affects the major areas of academic achievement and that the environmental influences are similarly structured. Analyses of phenotypically standardized covariances indicate that the structures of genetic and environmental influences as they contribute to phenotypic resemblance among scholastic abilities are both similar and simple: there are one general genetic factor and one general environmental factor. Bivariate heritabilities and environmentalities are similar in magnitude, indicating that the strong phenotypic relationship among scholastic abilities is due roughly equally o genetic and environmental influences.


A multivariate twin analysis of within-family environmental influences in infants' social responsiveness. Observational measures of social responsiveness were obtained for twin infants. The structure of within-family environmental influences was assessed by correlating identical twin pair differences for 13 behaviors in seven social settings. Factor analysis of the difference score matrix yielded one interpretable factor. This factor indicated that within-family environmental influences were not completely random but may exert a systematic effect on social behavior in several situations.


Perinatal morbidity & mortality in South East Asia.


Twin method: defense of a critical assumption. Since Galton's time, critics of the twin method have rejected the evidence of genetic differences in human behavior, because the twin method assumes that identical and fraternal pairs have equally similar environments. Twins whose genetic similarity is misperceived by themselves and others provide a critical test of the adequacy of this assumption. The relative effects of perceived and actual genetic similarity on cotwin differences in cognitive, personality, and physical development were assessed in a sample of young, adolescent twins whose genetic similarity was often misperceived. Twins' responses to questions about their own and others' judgments about their zygosity and physical similarity, and the ratings of similarity by eight judges, were used to estimate the perceived similarity of the twins. Actual zygosity was established by matching cotwins on 12 or more blood group loci. Perceived zygosity and perceived similarity by self and others were found to be insignificant biases in the twin study method.


Correlated characters in selection for aggressiveness in female mice. II. Maternal aggressiveness. The present study investigated whether maternal aggression has shown a correlated response in a program of artificial selection for isolation-induced interfemale aggression in housemice. Females from the first replicate of lines (H1, C1, L1) and the second replicate of lines (H2, C2, L2) from generation S5 were given daily aggression tests for 20 consecutive days following the birth of their first litter. Evidence of a correlated response was found for replicate 2, but results for replicate 1 provided no evidence of a correlated response. In generation S10, when better separation of the lines on isolation-induced aggression had occurred, the study was repeated. In S10 there was clear evidence of a correlated response in both of the replicates.


An exponential model for adaptation in taste.


A cross cultural study of cases of functional sexual disorders among arabs.


Age, thymic involution, and circulating thymic hormone activity. Circulating thymic hormone activity and thymic histology were studied in patients undergoing open heart surgery. Plasma thymic hormone activity was measured using a bioassay based upon thymocyte antigen induction on null mouse lymphocytes. Activity was highest at 15-30 yr of age and declined thereafter, being negligible after the sixth age decade. The age-related decline of circulating thymic hormone activity correlated, in general, with progressive thymic involution. However, hormone activity was detected in plasma from some cases with advanced involution, suggesting that the normal young thymus may have considerable functional reserve.


Organic causes of female sexual dysfunction.


Cortisol production and inactivation by the human lung during gestation and infancy. The enzyme which interconverts the active hormone cortisol (F) and its biologically inactive analog cortisone (E), viz. 11 beta-hydroxysteroid dehydrogenase, is known to be present in many tissues. In this study, its possible role as a regulator of cortisol concentration in the human lung was investigated. Small amounts of minced tissue were incubated for 2 h at 37 C in the presence of tracer F or E. After extraction, the steroids were chromatographed using Sephadex LH-20 column chromatography. From 11-21 weeks of gestation, inactivation of F to E occurred (54.7 +/- 8.0%), while in 11 premature infants there was no conversion in either direction and in 9 infants (4 months to 2 yr of age) there was slight conversion of E to F (7.0 +/- 3.4%). Activity in children was negligible. Lung tissue from 4 anencephalics (35-40 + weeks) retained the ability to inactivate F to E (21.3 +/- 4.3%), though to a lesser extent (P less than 0.01) than fetuses up to 21 weeks. The validity of these in vitro studies was borne out by assays of the endogenous steroids in lung tissue and serum. These results suggest that there is an alteration from rapid inactivation of F to E in early fetal life to slight F production in infancy and that this change is advanced by pituitary or other factors which are decreased in anencephaly. This decreasing inactivation by the lung during late gestation results in higher intracellular F levels which probably act to promote lung maturation in preparation for birth.


Increased aldosterone plasma protein binding in women on combined oral contraceptives throughout the menstrual cycle. Plasma aldosterone concentration and the percentage of the fraction bound to a specific plasma aldosterone-binding globulin (ABG) were measured throughout the menstrual cycle in 26 healthy women aged between 19 and 38 yr who were receiving estrogen-containing oral contraceptives (OC), Midafternoon upright levels of total plasma aldosterone were similar in control and OC subjects and showed normal cyclic fluctuation in both groups. The percentage of ABG-bound aldosterone was markedly higher in OC subjects than in controls at all stages of the cycle and showed a positive correlation with the mean blood pressure when all OC subjects studied were considered. In addition, when the plasma ABG levels were measured 6 months or more after the start of medication, they appeared to be related to the dose of estrogen in the OC, but not to the length of time of its administration. The identity of plasma ABG in OC subjects with that in control subjects was also established.


Serum immunoreactive somatomedin-C is elevated late in pregnancy. The concentrations of immunoreactive somatomedin-C (Sm-C) in the sera of women with uncomplicated pregnancies were found to be progressively higher as the duration of gestation increased. Between 19 and 42 weeks of gestation, there was a significant correlation between serum Sm-C concentration and duration of gestation. A striking decline in Sm-C was observed following delivery. While the data are too preliminary to elucide the mechanisms for the raised Sm-C, the concurrent increase in Sm-C and human placental lactogen (hPL) raises the possibility that hPL may mediate the increment in Sm-C.


Repair of uterine perforation through minilaparotomy.


The role of recanalization in tubal pregnancy after sterilization. Recanalzation at the site of tubal ligation is one of the causes of the failure of such a procedure. The underlying factor could be a pre-existing proliferative disease of the tube, i.e. salpingitis isthmica nodosa. The plexiform type of re-canalization that resulted in the presented case might the cause of the tubal pregnancy. The presence of amenorrhea and /or irregular uterine bleeding in a patient with tubal sterilization requires meticulous investigations to avoid the high morbidity rate associated with missed ectopic gestation. The use of HCG assays and laparoscopic evaluation could improve diagnostic ability in similar cases.


Comparison of [125I]somatomedin A and [125I]somatomedin C radioreceptor assays for somatomedin peptide content in whole and acid-chromatographed plasma. The placental membrane radioreceptor assay was used to measure the levels of somatomedin (SM) peptides in plasma. Displacement of both [125I]somatomedin A ([125I]SM-A) and [125I]somatomedin C ([125I]SM-C) by normal whole plasma, the peptide fraction of acid-chromatographed plasma, and a partially purified, insulin-free SM preparation were compared. The peptide fraction of plasma was isolated by acid chromatography over Sephadex G-50 in 0.25 M formic acid with a yield of greater than or equal to 90%, as determined by bioassay and [125I]SM. In the case of [125I]SM-A, the dose-response curves for whole plasma, acid-chromatographed plasma, and the standard SM preparation were parallel (P less than 0.2). In contrast, for [125I]SM-C, the dose-response curves for acid-chromatographed plasma and the purified SM preparation were parallel (P less than 0.2), but both differed significantly from that of whole plasma (P less than 0.001). In addition, there was less variability in the assay of acid-chromatographed plasma compared to whole plasma. The results indicate that radioreceptor assay of unextracted normal plasma using [125I]SM-A is a valid measure of SM peptide concentration, while radioreceptor assay of unextracted normal plasma using [125I]SM-C, in our hands, is not. Acid chromatography of plasma before its assay is an uncomplicated procedure which allows valid and precise measurement of SM peptide content using either [125I]SM-A or [125I]SM-C.


Neurogenic galactorrhea-amenorrhea.

Neurogenic galactorrhea-amenorrhea. Neuroendocrine function in two women with galactorrhea-amenorrhea arising from abnormalities in the PRL reflex arc was compared to that of normal women. Basal gonadotropins were lower than normal, and one patient lacked episodic secretion of LH; however, the serum gonadotropin rise after iv LRH was in the normal range in both patients. Mean basal PRL levels were slightly elevated in one patient and were normal in the other, and the PRL levels after TRH, chlorpromazine, and levodopa testing were similar to those seen in normal women. Breast stimulation did not increase PRL levels in either patient. PRL levels fell with bromergocryptine therapy, galactorrhea ceased, and normal menses resumed. These studies indicate that chronic afferent impulses originating in the PRL reflex arc can result in galactorrhea and amenorrhea and that bromergocryptine therapy in such patients can restore normal menses.


The Dubowitz syndrome.

The Dubowitz syndrome. The Dubowitz syndrome is an autosomal recessive condition of intrauterine growth retardation, postnatal growth retardation, microcephaly, characteristic facial appearance, high-pitched hoarse voice, and borderline intelligence or mild mental retardation. Cleft palate may occur as well as hypospadias, cryptorchidism in affected males, and mild limb defects. The 13 cases reported in the European literature and eight personally examined patients are reviewed.


Sex hormone-binding globulin and estrogen receptor in breast cancer: technique and preliminary clinical results. The binding capacities of SHBG (sex hormone-binding globulin) and ER (estrogen receptor) were measured by agar gel electrophoresis with dextran-coated charcoal treatment and also by sucrose density gradient ultracentrifugation in the sera from 19 women with breast cancer to assay the correlation between SHBG and ER in breast cancer. SHBG levels were also measured by agar gel electrophoresis with dextran-coated charcoal treatment in control sera from 20 normal women. Two kinds of 17 beta-estradiol-binding substances were recognized in the cytosol of breast cancer cells and they were confirmed to be ER and SHBG. Out of 13 postmenopausal patients with breast cancer, the SHBG levels in 6 ER-positive cases (66 +/- 13 pmol/ml plasma, mean +/- SD) were significantly higher than the levels of 10 controls (35 +/- 7.6 pmol/ml; P less than 0.005). SHBG levels in 7 ER-negative patients (34 +/- 7.9 pmol/ml plasma) did not significantly differ from the levels of the controls, but differed significantly from the levels of ER-positive patients (P less than 0.005). Out of 6 premenopausal breast cancer patients, the SHBG levels in 5 ER-positive cases (63 +/- 7.5 pmol/ml plasma) tended to be higher than the levels in 10 controls (55 +/- 4.7 pmol/ml plasma), but did not achieve statistical significance (P greater than 0.05). The findings suggest that correlation between SHBG and ER in postmenopausal breast cancer is possible, but no significant difference was noted between the SHBG levels in ER-positive premenopausal breast cancer patients and premenopausal normal women.