An approach to working with the "placed child". This paper presents an approach to working with the diagnostic and therapeutic challenges posed by the "placed child". A thorough knowledge of child development, combined with awareness of the basic tenets of crisis intervention, offers the child mental health professional guidelines to assist placed children in coping with their uncertain environment. Parents and agencies are guided toward stabilizing the child's environment, while the child is maintained in play therapy to assist him in coping with the confused and frightening emotions that attend the experience of placement separation. Three clinical cases are presented that illustrate an active short-term therapy, a form of primary prevention attempting to forestall the potential damage of unresolved placement separation crises.


The stress of parenting.

The stress of parenting. The ongoing process of parenting is examined with respect to the following: the dyadic versus triadic relationship; change in familial structure; cultural trends; problems of individuation; and other environmental influences.


Autism and attention: theoretical considerations and a pilot study using set reaction time. We have presented an attentional model that may have value in the pathophysiology of autism. We have presented data that suggest attentional dysfunction and an attentional hypothesis that may explain autism's multisensory clinical appearance and natural history. Only further studies will be able to evaluate this hypothesis and hopefully provide us with something more promising to offer parent and child in the way of therapy.


Emotionally disturbed children in special schools: an analysis of ratings of disturbed behavior and perceptual handicaps. The relationship between perceptual handicaps and adjustment was studied among 573 emotionally disturbed children from Massachusetts. Little relationship was found between perceptual handicaps and overall adjustment. Antisocial behavior was the most prominent factor related to removal from regular classrooms and placement in special residential and day schools.


A mother instruction program: behavior changes with and without therapeutic intervention. Mother-child behavior changes over therapeutic intervention and no-contact periods were compared. Fifteen dyads had 8 weeks of instruction followed by no contact; 15 followed a reversed schedule. Overall change was about the same in both groups, and both changed more during instruction than during no-contact periods. Mothers receiving immediate instruction showed greater and more systematic immediate changes following instruction. Children in the group with later follow-up exhibited a greater proportion of behavior change during that no-contact period than during instruction. Thus, no-contact periods cannot be considered no-change periods, though immediate intervention probably ensures more systematic change than intervention preceded by waiting-list experience.


Latency-group art therapy: teaching socialization skills through art. An art therapy experiment involving 10 weekly sessions for six latency-age emotionally disturbed boys produced marked improvements in peer relationships and socialization skills.


Home visiting with family day care providers. The benefits and problems of home visiting with agency-sponsored family day care providers are illuminated in a study of the perceptions of both agency visitors and the providers.


Family life education: a treatment modality. Family life education is a long-established form of help that continually ramifies into new areas. It aims at healthier family living, and reduction of family breakdown and child placement. Most child welfare personnel know about family life education, and some are practitioners in it. Many, however, may not be familiar with its present extensiveness or method of organization and operation. This personalized account of one agency's program, presented at the CWLA Central Regional Conference in Detroit, 1975, provides useful information.


Optical studies of the interaction of 33258 Hoechst with DNA, chromatin, and metaphase chromosomes. The interaction of the bisbenzimidazole dye 33258 Hoechst with DNA and chromatin is characterized by changes in absorption, fluorescence, and circular dichroism measurements. At low dye/phosphate ratios, dye binding is accompanied by intense fluorescence and circular dichroism and exhibits little sensitivity to ionic strength. At higher dye/phosphate ratios, additional dye binding can be detected by further changes in absorptivity. This secondary binding is suppressed by increasing the ionic strength. A-T rich DNA sequences enhance both dye binding and fluorescence quantum yield, while chromosomal proteins apparently exclude the dye from approximately half of the sites available with DNA. Fluorescence of the free dye is sensitive to pH and, below pH 8, to quenching by iodide ion. Substitution of 5-bromodeoxyuridine (BrdU) for thymidine in synthetic polynucleotides, DNA, or unfixed chromatin quenches the fluorescence of bound dye. This suppression of dye fluorescence permits optical detection of BrdU incorporation associated with DNA synthesis in cytological chromosome preparations. Quenching of 33258 Hoechst fluorescence by BrdU can be abolished by appropriate alterations in solvent conditions, thereby revealing changes in dye fluorescence of microscopic specimens specifically due to BrdU incorporation.


Electron microscopy of whole mount metaphase chromosomes. Whole mount metaphase chromosomes, from cultured L cells, have been centrifuged onto grids and examined by electron microscopy. Compact and dispersed chromosome forms provide extensive ultrastructural information. Condensed chromosome arms appear as packed fibers with centromeric heterochromatin identifiable because it stains more intensely than the rest of the chromosome. Kinetochores are readily visible in these preparations. Under appropriate isolation conditions, it is possible to obtain mitotic spindles in which bundles of microtubules remain attached to kinetochores, suggesting that the kinetochores retain basic structural integrity throughout the isolation procedure. Dispersal of metaphase chromosomes by treatment with formalin and distilled water shows that these chromosomes are composed of a basic fiber that is normally highly condensed. This fiber is made up of regularly repeating 70-90 A diameter nucleoprotein granules separated from neighboring granules by a 20-40 A diameter fiber whose continuity is maintained by DNA. This structural arrangement is totally analagous to that reported for interphase chromatin from a variety of sources.


Biological rhythm experimentation: a longitudinal design and analysis. Certain experiments exploring the relationship between biological rhythms and external factors such as pharmacologic agents are typified by the particular importance of interaction and conditional effect parameters. The category of biological rhythm experiments presented here also necessarily involves a deliberate confounding of periodicity rooms and biological rhythm stages (time points). These features, together with the longitudinal nature of the observations, require special precautions in the experimental design and analysis.


Behavior of calf blood flow in normal subjects and in patients with intermittent claudication during a 24-h time span. Calf basal resting and reactive hypercemia blood flow were measured at 4-h intervals during a day in fifteen healthy subjects and in fifteen patients with intermittent claudication by means of a venous occlusion plethysmograph. Mathematical-statistical analysis of the data failed to demonstrate circadian periodicity of calf blood flow in healthy subjects, but proved the existence of a 24-h rhythm of calf basal resting and reactive hyperemia blood flow in patients with intermittent claudication. This different behavior of calf blood flow can be understood if one considers that in healthy subjects the voluntary muscles in the extremities have a blood supply which can be instantaneously adjusted over a large area. In patients with peripheral arterial disease, on the other hand, the vascular responses in voluntary muscles of the limbs to various endogenous or exogenous stimuli are impaired and reduced. The circadian rhythm observed in patients with intermittent claudication has early evening peaks and a nocturnal trough with a nadir occurring after midnight and before 0400. This rhythm displays marked similarities with those of all other circulatory values. As to the mechanism of rhythm, it is hard to decide whether or not it has an independent endogenous origin. It is known that many of the circulatory variables are interrelated and that some are clearly related to other circadian rhythms. Perhaps the rhythmic reduction of limb blood flow which occurs during the night is the mechanism underlying the nocturnal pain of subjects with limb ischemia by peripheral arterial disease.


Re-entrainment of circadian rhythms after phase-shifts of the Zeitgeber. To describe anabrupt shift of the Zeitgeber sufficiently, it is necessary to indicate whether the phase has been advanced or delayed, for how many hours it has been shifted, and what part of the Zeitgeber has been lengthened or shortened respectively. The entrained circadian system usually follows a shift of the Zeitgeber in the same direction and by an equal amount. However, there can be exceptions to both of these rules: a) an instantaneous 12-h shift of a (symmertric) Zeitgeber always represents a delya (= doubling of one-half of its period). In contrast to this, the gradual re-entrainment of the circadian system can be accompalished by either advances or by delays (Fig. 2), it can occur in both dirctions simultaneously by splitting the rhythmic variable (Fig. 1),or it can represent an apparent advance not distinghushable from a delay ( Fig. 6); b) after complietion of re-entraiment, the phase-angle difference psi between organism and Zeitgeber an differ systematically from the pre-shift psi-value...


Evaluation of the barium-enema examination and colonoscopy in diagnosis of colonic cancer. The diagnostic value of colonoscopy was investigated in 123 patients with certain or questionable cancer of the colon as demonstrated by an ordinary barium-enema examination. The diagnosis was revised by laparotomy or clinical follow-up studies in cases of patients having no operation. The following conclusions were deduced: 1) The number of unnecessary laparotomies may be reduced by doing colonoscopy in patients with certain or questionable cancer of the colon as demonstrated by ordinary barium-enema studies. 2) The gain in diagnostic value of adding a colonoscopy to a barium-enema examination is more pronounced in patients with questionable than in those with certain cancer as visualized by the barium-enema studies. 3) The risk of missing a cancer of the colon during colonoscopy is very small if an experienced examiner looking for cancer performs the colonoscopy. 4) Colonoscopy is of little diagnostic value in cases of patients who have radiologic evidence of stenosis of the sigmoid colon. 5) The number of patients selected for colonoscopy on the basis of radiologic evidence suggesting cancer probably can be reduced by refinement of the barium-enema examination.


Intestinal and peritoneal tuberculosis: report of two cases. One hundred and seven cases of abdominal tuberculosis were analyzed. There were no specific laboratory or x-ray findings pathognomonic of abdominal tuberculosis. Leukopenia was often found, but was nonspecific. An abdominal tumor was often palpable.  A great rarity in our series was profuse hemorrhage from a jejunal tuberculous ulcer; the patient had to be subjected to an emergency operation. In another case tuberculosis appeared in a side-to-side small intestinal anastomosis and in its blind ends, which had developed as a late complication. The diagnosis of abdominal tuberculosis must be confirmed by histologic examination of biopsy specimens; if the results are inconclusive, acid-fast bacilli must be seen or culture should be positive. Guinea-pig inoculation is rarely positive, probably owing to the low virulence of the tuberculous bacteria in abdominal tuberculosis. Good results are obtained with chemotherapy in both intestinal and peritoneal tuberculosis. The complications, obstruction being most usual, must be surgically treated. Resection of the affected segment is the best surgical procedure. For ileocecal tuberculosis, right hemicolectomy was performed. According to the authors, roentgenographic evidence of tuberculosis in the abdomen must always be confirmed by operation, because differentiation from carcinoma and other inflammatory lesions is impossible. For good results after operation, anti-tuberculosis chemotherapy is mandatory.


Sexual behavior and affective disorders. One hundred and fifty four consecutively evaluated new and return psychiatric outpatients were examined by the same interviewer using a detailed, precoded questionaire based on the diagnostic criteria for psychiatric research proposed by Feighner, et al. Sexual behavior manifested as prostitution involvement, promiscuity and extramarital sexual experiences was studied for groups of patients with unipolar and bipolar primary affective disorders, secondary affective disorders and non affective disorders. Results and conclusions are reported.


The effect of modified ECT on serum creatine phophokinase, I. With intravenous atropine. Interpretation of serum creatine phosphokinase (CPK) levels is frequently difficult because of complicating circumstances known themselves to raise CPK; for instance, intramuscular injections. One such circumstance among psychiatric patients is said to be administration of electroconvulsive therapy (ECT). In a series of 22 patients who received drug modified ECT, four had CPK elevations beyond the normal range. These findings indicate that CPK elevations among patients receiving ECT should be interpreted cautiously.


The effect of modified ECT on serum creatine phosphokinase. II. With subcutaneous atropine. In the previous study, the effect of modified ECT on serum CPK was investigated. In that study, atropine was administered intravenously two minutes prior to ECT being given. In this study, the more usual clinical procedure in which atropine is administered subcutaneously is investigated. In a series of nineteen patients, four had CPK elevations beyond the normal range. These findings resemble the findings of the previous study closely, and indicate again that elevations of CPK in patients receiving ECT should be interpreted with caution.


Inflammatory colorectal disease and pregnancy: report of a case. A retrospective study of women in the child-bearing age with inflammatory disease of the bowel seems to suggest that these women become pregnant as often as other women in the general population. In this small study it was 100 per cent. The incidence of subjective difficulty with conception is likewise small. Patients with Crohn's disease appear to feel better in pregnancy with regard to their intestinal problems, while more than 60 per cent of the patients with ulcerative colitis appear to do poorly. The live-birth rates for both conditions in our series were approximately 80 per cent. An unusual complication in two of our patients with Crohn's disease was a postpartum, postepisiotomy rectovaginal fistula. This may indicate a possible danger of episiotomy in patients who have Crohn's disease.


Evaluation of the electrosleep machine.

Evaluation of the electrosleep machine. Seven dogs were intensively studied to determine the clinical, physiological, biochemical, and pathological effects of the electrosleep machine. Both the normal dose and a high dose of current was studied. The most notable finding was an increasing number of histologic findings with increasing current dose. There is some question regarding the true nature of these findings. Other changes which were less definite included: EEG slowing and depression of the amplitude of the B-wave in the ERG. Suggestive changes included a chronic increase in pulse rate. Because of the small number of subjects, further studies are indicated to investigate further the findings of this study.


The psychoanalyst and the state hospital. The experience of a psychoanalyst functioning as a consultant to a state hospital has been reported. Some reference was made to other such projects. The objectives and goals of this affiliation were then delineated. Next a description was given of the setting in which the work took place, of the process, of the reactions of the staff to the consultant, and of the consultant to the staff. Finally there was a description of the results and the conclusions.


Socioathy and drug use in a young psychiatric population. Recent studies have consistently demonstrated a higher-than-expected proportion of heavy drug users among young psychiatric patients. Careful reading of these reports fails to adduce what might account for this constant finding. In order to examine this question more closely, one hundred young psychiatric inpatients (aged 15 to 25 years) were studied in detail. The following extensive data were obtained for each patient: demography (sex, age, race, marital status occupation), clinical characteristics (prior psychiatric care, presenting complaint, duration of hospitalization, diagnosis, treatment, disposition), prior social problems (truancy, runaway, pregnancy out of wedlock, divorce or separation, vehicular accident while intoxicated, felony), and social resources on admission (employment, friends, family-of-origin). An extensive drug history consisted of types of drugs, duration and frequency of usage, and pattern of use over the previous twelve months. Based on specific criteria patients were divided into abstainers, occasional users, regular users, and heavy users. Forty-nine of the patients were tabulated as heavy users. Compared to the other patients, heavy users were found to have more unemployment, more divorce and separation, more characterological and fewer neurotic diagnoses, more problematic prior social events, and fewer social resources at the time of admission. Unexpectedly, the two groups did not differ significantly for all other demographic and clinical parameters. The implications of these findings for our psychopathologic categorization and for our management of young in-patients are noted.


Progressive spinal muscular atrophy in a case of hypokalamic periodic paralysis. A 47-year-old man with well-documented hypokalemic periodic paralysis demons-rated permanent myopathy as shown by biopsy. In addition there was clinical and biopsy evidence of progressive spinal muscular atrophy. The feature of the combination of these diseases is reported in a case and discussed.


Hospitalization rates for alcoholism in the Navy and Marine Corps. Hospitalization rates for alcoholism were determined for Navy and Marine Corps male enlisted personnel during the period Fiscal Year 1966-Fiscal Year 1969. Overall rates were 74 and 44 per 100,000 for the Navy and Marine Corps, respectively. These rates were high compared with male civilian populations of the same age range; the high incidence may be secondary to such factors as separation from families, a social milieu that encourages drinking and close sjrveillance by superiors and associates. The rate of first hospital admissions is a gross under-estimate of the total alcoholism problem. Alcoholic cases probably are often given other diagnoses early in the course of their illness. Actual prevalence of alcoholism cannot be determined directly at the present time, but reasonable estimates would be in the range of 2-3% of all naval personnell. Admissions for alcoholism show wide seasonal variations, suggesting the importance of administrative factors such as bed space, staff availability, and possibly diagnostic inexperience and inaccuracy.


[The significance of endoscopic retrograde cholangiography (ERC) in biliary stasis and the postcholecystectomy syndrome (author's transl)]. In a group of 103 patients with biliary tract disease only 27% had findings of ERC which were concordant with the operative observations. False-negative results were present in 20%, while in 55% conventional cholangiography did not provide enough opacification for exact diagnosis. The size of the common bile-duct lumen correlated with the degree of biliary stasis. It can, therefore, be used as a good diagnostic indicator. The normal lumen diameter as measured by ERC was 6.29 +/- 1.29 mm in the suprapancreatic part of the common bile-duct. All cholecystectomised patients had a dilated lumen, the borderline value for biliary stasis being at 13-14 mm.


[Transcutaneous measurement of partial pressure of oxygen in paediatric intensive care (author's transl)]. The method of measuring oxygen partial pressure transcutaneously has provided an opportunity for continuous monitoring of patients on long-term resporator treatment. It has been convincingly demonstrated that serial samples obtained by arterial puncture are inadequate for controlling oxygen supply. An ideal correlation between arterial and transcutaneous pO2 was obtained when the control arterial sample was taken via an indwelling arterial catheter and artefacts, e.g. reaction to the needle puncture, had been eliminated. The necessary percentage of oxygen in the inspiratory mixture can be accurately gauged by continously measuring arterial pO2, as can changes brought about by the application of positive end-expiratory pressure in children on long-term ventilation. The transcutaneous measurement makes it possible to improve continuous monitoring of critically ill patients, and to carry out sparingly and safely long-term ventilation in them.


[Angiographic diagnosis of paraduodenal hernia (author's transl)]. The case is reported of a 26-year-old man who had several episodes of subileus which responded to spasmolytics. Mesenteric angiography revealed a paraduodenal hernia, with displacement of several jejunal arteries towards the mesenteric root and compression of intestinal vessels at about the level of Treitz' ligament. The angiographic findings were confirmed at operation, which consisted of repositioning the jejunal loop and closing the hernial orifice. The patient has since been free of complaints.


[131I-cholesterol scanning of the adrenals: results in various adrenal diseases, especially unilateral adrenal turmours (author's transl)]. 133I-cholesterol scanning of five patients with primary hyperaldosteronism due to adrenocortical adenoma, gave correct lateralization and localization in three, while in two cases lateralization was not definitively determined. In two patients with phaeochromocytoma unilateral localization was clear-cut in the scan. In two patients with hormone-producing adrenal carcinoma the adrenals were localized poorly or not at all on both sides, because of the size of the tumours and suppression of the healthy contralateral adrenal by the autonomous hormone production. In case of retroperitoneal tumour with destruction of the adrenal the scan demonstrated a hyperplastic but healthy adrenal on the other side. Because 133I-cholesterol scanning exposes the steroid-producing gonads to high radioactivity, the method should only be used for diagnosing which side a unilateral adrenal tumour is on. It should not be used to complement a diagnosis of bilateral adrenal disease achieved by other means.


[A prognostic index in acute myocardial infarction: discrimination analysis of clinical parameters on admission to hospital (author's transl)]. In 301 patients admitted to an intensive-care unit because of acute myocardial infarction a prognostic analysis was undertaken, based on 21 parameters (history, condition on admission, laboratory results) and related to ultimate outcome. Although some parameters were singly of prognostic value, discrimination analysis markedly improved predictive value. A prognostic index was constructed from seven easily available parameters: age, pulmonary congestion, leucocytosis, peripheral vasoconstriction, systolic blood pressure, site of infarct and hypertension. For those in a low-risk class (index less than 60, death-rate up to 5%), duration of stay in the intensive-care unit may be shortened and rehabilitation measures accelerated. Those at moderate risk (index 60-90, death-rate up to 25%) require careful monitoring. The highest risk classes (index 90-120, death-rate up to 90%; and index more than 120, death-rate more than 90%) require specially intensive and long-term monitoring, and various procedures for assisted circulation and possible cardiacsurgical intervention should be considered from the outset.


[Simple method of residual urine determination without bladder catheterization (author's transl)]. A simple photometric method for determining residual urine by means of a nomogram is described. Suprapubic puncture is employed (if necessary on an out-patient basis), and bladder urine can also be obtained for testing sensitivity to antibiotics. The results obtained correlated well with those achieved by bladder catheterization.


Seasonal and sexual variations in the responsiveness of rabbit hearts to prolactin. Rabbit hearts perfused by the Langendorff technique were studied. The addition of ovine prolactin (NIH-P-S-10) to the perfusate in a concentration of 50 ng/ml produced rapid increases in both the amplitude and rate of contraction in 33 adult male hearts studied in winter. Prepubertal male animals showed no response, and only 1 out of 12 adult females responded. Pretreatment for 10 days with 2.5 mg/day testosterone propionate led to minimal inotropic but not chronotropic responses in 2 out of 4 prepubertal males and 2 out of 4 adult females to prolactin. Clear responses to prolactin were seen in 5 adult males pretreated with reserpine. Propanolol consistently reversed both the inotropic and chronotropic actions of prolactin. The original experiments were performed in January and February. When tested in May, adult males failed to respond to prolactin and this situation, persisted until October when responsiveness again appeared. The same prolactin preparation and procedures were used throughout indicating that the changes must have been due to seasonal variations in the cardiac responsiveness to the hormone.


Interaction of parathyroid hormone with membranes of kidney cortex: degradation of the hormone and activation of adenylate cyclase. Plasma membranes prepared from rat renal cortex contain both a parathyroid hormone-sensitive adenylate cyclase and a potent proteolytic activity which degrades the hormone into peptide fragments. The degree and pattern of degradation was determined by subjecting incubation mixtures to gel filtration and ion exchange chromatography. Estimation of the degree of degradation by acid precipitation of the intact hormone was inadequate since metabolism of the hormone apparently generated acid-insoluble fragments. When parathyroid hormone was incubated with membrane fraction, the capacity of its stimulatory effect on adenylate cyclase decreased steadily. This decrease of PTH activitiy could be closely related to the degradation of intact hormone by the same membrane preparation. The adenylate cyclase and degradative activity appeared to exist in similar membrane structures since they could not be separated by centrifugation through sucrose density gradients. The degradation of the hormone could not be inhibited by Trasylol and pancreatic or soybean trypsin inhibitors and was only slightly inhibited by ribonuclease and benzamidine. Histone (1 mg per ml), on the other hand, was able to decrease the degradation of the hormone and prevent the loss of its activity. Radioimmunoassay of the incubation mixtures showed that the rapid degradation of both amino- and carboxy-terminal regions of the hormone was prevented by histone. The oxidized, inactive hormone was also degraded to the same extent by the renal cortical membrane. Furthermore, the degradative activity was also found in plasma membrane preparations of renal medulla and liver. This lack of hormone and tissue specificity suggests that similar degradative activity exists in all tissues and that caution should be exercised in estimating hormonal potency based on activation of adenylate cyclase.


Serum cortisol binding capacity and cortisol concentration in the pregnant baboon and its fetus during gestation. The cortisol binding capacity of serum from 11 pregnant baboons (38 samples) and from 7 baboon fetuses delivered prematurely or at term was measured after removal of endogenous steroids. Values for maternal serum collected between 60 and 120 days after mating (59.0 +/- 6.4 mug/100 ml, mean +/- SD) were greater than those for serum collected at term (42.3 +/- 4.9 mug/100 ml). The cortisol-binding capacity of fetal serum collected between 100 and 132 days' gestation was similar to that of the corresponding maternal sample, but at term was only 50% of the maternal value. The rate of clearance of cortisol from both fetal and maternal serum may therefore increase progressively during the last trimester of pregnancy. This effect is likely to be more marked in the fetus. The cortisol binding capacity of 15 serum samples from 9 non-pregnant baboons was 33.4 +/- 5.5 mug/100 ml. Mestranol2 (administered 200 mug/day im for 15 days) significantly increased the serum cortisol binding capacity. The concentration of cortisol in maternal serum from 7 pregnant baboons (10 samples) was 44.0 +/- 8.4 mug/100 ml and was independent of the state of gestation. In fetal serum the cortisol concentration was 4 mug/100 ml before 168 days' gestation and reached 49 mug/100 ml after normal delivery at term. These findings suggest that the mechanisms for production of cortisol by the fetus mature as gestation progresses. The physiological significance of the marked difference between the cortisol concentration and the cortisol binding capacity of fetal serum awaits elucidation.


Volume control of plasma antidiuretic hormone concentration following acute blood volume expansion in the anesthetized dog. Acute volume expansion was produced in 9 dogs by infusing a lactated Ringer's solution at 1 ml/kg/min in a volume estimated to increase blood volume by 20%. Volume expansion was maintained by replacing urinary fluid losses with equal volumes of the Ringer's solution. Following volume expansion, the effects of a slow, nonhypotensive hemorrhage on plasma antidiuretic hormone concentration (PADH) were determined and compared to a group of 9 normovolemic dogs subjected to the same hemorrhage procedure, in order to determine if volume receptor control of ADH release would adapt to acute increases in blood volume. Ringer's infusion significantly increased blood volume to 95.2 +/- 3.1 ml/kg (mean +/- SE; P less than 0.01) when compared to a mean normovolemic blood volume of 77.6 +/- 3.4 ml/kg. Volume expansion was associated with a significantly lower PADH (3.2 +/- 1.6 muU/ml) than that in normovolemic dogs (5.7 +/- 1.2 muU/ml; p less than 0.05). Significant increases in PADH (P less than 0.05) occurred in both groups of dogs after 20 and 40 minutes of a continuous, nonhypotensive hemorrhage (0.40 to 0.45 mg/kg/min. Hemmorrhage was also associated with significant decrease in effective left atrial pressure in both groups of dogs after 5, 10, 20, and 40 minutes of hemorrhage (P less than 0.01). There were no significant differences between the two groups of dogs nor were there any significant changes during the experiment within each group for mean arterial blood pressure, arterial pulse pressure, plasma osmolality, plasma sodium concentration and plasma potassium concentration. Effective left atrial pressure and PADH were found to be exponentially correlated with blood volume in bothy hypervolemic and normovolemic dogs. Analysis of covariance of these correlations suggested that the hypervolemic dogs exhibited the same exponential changes in PADH and effective left atrial pressure with decreased blood volume as in the normovolemic dogs. It is concluded that acute volume expansion does not alter volume control of plasma ADH concentration.


Influence of estrogen-progesterone combinations on gonadotropin secretion in castrate female rats(1). In order to study the effect of progesterone in modulating the secretion of gonadotropins, various doses of progesterone were administered to castrated immature and mature female rats. Progesterone did not prevent the postcastration rise of FSH and LH in these animals. Various amounts of progesterone were then administered to castrated rats that were treated with a constant low dose of estradiol. In animals given doses of estradiol that were able to decrease serum FSH and LH below castrate levels, but not to prevent the post-castration rise, the effect of progesterone was dose-dependent. A very low dose of progesterone lowered serum gonadotropins, an intermediate dose brought about an increase in secretion, and high doses were suppressive. The modifying action of progesterone appears to be dependent upon the level of estrogen, the dose of progesterone, and the time of administration.


Steroid hormone effects on sonatomedin. I. Somatomedin action in vitro. The effects of cortisol, estradiol, and testosterone on somatomedin action on cartilage incubated in vitro have been examined. The addition of hormones in the absence of serum had no effect on the incorporation of sulfate by cartilage from hypophysectomized rats, embryonic chicks, or normal young pigs. Normal human serum provided a source of somatomedin which stimulated the incorporation of sulfate by cartilage in a dose-response relationship; the potency of serum with and without added steroid hormone was determined after formal parallel-line analysis. Moderately supraphysiologic levels of cortisol, 17 beta-estradiol, and testosterone generally had little effect on somatomedin action in the test systems. Very high levels of serum cortisol (100-1000 mug/100 ml) inhibited somatomedin action on pig cartilage, but had little effect on rat or chick cartilage. A 20 ng/100 ml increase in serum estradiol had no effect on somatomedin action on chick cartilage, but appeared to enhance somatomedin action on pig cartilage. A 5 mug/100 ml increase in serum testosterone did not affect somatomedin action on either chick or pig cartilage. These studies suggest that the alteration of somatomedin action is not a major mechanism in the effect of steroid hormones on growth. In addition, since modest increases in serum levels of cortisol, estradiol, and testosterone had little effect on somatomedin action in our assay systems, these systems should be satisfactory for the study of hormone effects on somatomedin generation.


Simultaneous determination of testosterone, 5alpha-androstan-17beta-ol-3-one, 5alpha-androstane-3alpha,17beta-diol and 5alpha-androstane-3beta,17beta-diol in plasma of adult male rabbits by radioimmunoassay(1). A simultaneous radioimmunoassay procedure for plasma testosterone (T), 5alpha-androstan-17beta-ol-3-one (DHT), 5alpha-androstane-3alpha,17beta-diol (3alphaol), and 5alpha-androstan-3beta,17beta-diol (3betaol) is described in this report. Peripheral plasma concentrations of T, DHT, 3alphaol, and 3betaol were 1.16 +/- 0.26, 0.49 +/- 0.15, 0.17 +/- 0.03, and 0.24 +/- 0.04 ng/ml, respectively, in adult male rabbits. In contrast, T, DHT, 3alphaol, and 3betaol peripheral plasma concentrations in dexamethasone-treated castrate rabbits were 0.07 +/- 0.01, 0.02 +/- 0.01, 0.07 +/- 0.01, and 0.05 +/- 0.01 ng/ml, respectively. These results represent the first simultaneous measurement of T, DHT, 3alphaol, and 3betaol in peripheral plasma of any male vertebrate. Moreover, we suggest that DHT, 3alphaol, and 3betaol represent the unidentified immunoreactive material found in peripheral plasma of male rabbits by Falvo and Nalbandov (1).


Radioimmunoassay of plasma relaxin levels throughout pregnancy and at parturition in the pig. Relaxin concentrations in peripheral plasma have been measured throughout pregnancy and immediately following parturition in the pig by radioimmunoassay. Gestation ranged from 114-117 days. Relaxin concentrations remained below 2 ng/ml during the first 100 days of pregnancy and then rose gradually to a mean of 11.9 ng/ml by 3 days before parturition. At this time, relaxin levels began to rise more rapidly and over the next 2 days increased to a mean concentration of 44.0 ng/ml by 30 h before parturition. Relaxin concentrations then increased sharply to a mean of 145.6 ng/ml by 14 h before parturition. This maximum was followed be a rapid decrease to a mean of 42.4 ng/ml by 2 h before parturition. At one day following parturition, relaxin levels were less than 1 ng/ml.


The luteotrophic action of decidual tissue: the stimulating effect of decidualization on the serum progesterone level of pseudopregnant rats. On day 5 (4th diestrous day), pseudopregnant rats were arranged in pairs, one member of which was subjected to hysterectomy (H-ect) and the other to uterine scratching to induce formation of decidual tissue (DT). Blood samples were collected from each pair of rats immediately before and at various intervals after operation until day 13, and with very few exceptions were assayed for progesterone by CPB in the same assay. From 21 such pairs, the following findings emerged: During the period from day 7-day 11 inclusive, a DT-bearing rat's serum progesterone level was higher than that of its H-ect paired control in 79% of the paired comparisons; the mean serum progesterone level of the DT-bearing rats was higher than that of the H-ect rats on each day during this period; and the progesterone level group mean for all the DT-bearing rats during this period was at least 25% (P less than 0.05) higher than that of the H-ect rats. On days 6, 12, and 13, however, no significant differences were found between the 2 groups by any basis of comparison. Ordinary pseudopregnant rats (subjected only to 1aparotomy on day 5) and rats subjected to uterine scratching which failed to form DT had progesterone levels below or similar to, respectively, those of the H-ect members in the pairs. The findings were interpreted as evidence that DT increases the rate of progesteron secretion.


Effect of inhibitors of prostaglandin synthesis on gonadotropin release in the rat. To study the effect of blockade of prostaglandin (PG) synthesis on gonadotropin release in the rat, inhibitors of PG synthesis were injected by various routes in various experimental conditions. The injection of 5-, 8-, 11-, 14-eicosatetraynoic acid (TYA) into the third ventricle (3rd V) significantly decreased plasma LH of ovariectomized (OVX) rats 1, 2, and 4 h following its injection; however, TYA failed to alter plasma LH in OVX rats when administered as a single sc injection and also failed to prevent the post-castration rise in plasma LH when administered sc once daily for 4 days to short-term OVX rats. None of these treatments altered plasma FSH concentrations. Indomethacin (Id) injected into the 3rd V or implanted into the medial basal hypothalamus (MBH) of OVX rats depressed plasma LH 1--6 h later. This effect was no longer observed 24--72 h following its implantation in the MBH. When different doses of Id were administered as single sc injections to OVX rats, plasma LH titers were depressed 24--32 h later, whereas plasma FSH remained either unaltered or was slightly increased. Similarly, the post-castration rise of plasma LH but not that of FSH in male rats was suppressed by a single sc injection of Id given 6 h before orchidectomy. Id administered acutely iv failed to modify the pulsatile release of LH in OVX rats, but it effectively inhibited this release when injected sc 20--30 h before the initiation of blood collection. Moreover, Id blocked the progesterone-induced LH and FSH release in OVX estrogen-primed rats when given sc 24 h before progesterone, but not when it was injected either sc or iv shortly (2 h) before or shortly after (1--3 h) progesterone treatment. Rats treated with Id showed a decrease in BW 24--32 h afters its sc injection. However, the effects of Id on LH release could not be explained by lack of food intake since fasted controls showed LH titers similar to fed rats. Id did not significantly inhibit the LH release in response to synthetic LH-releasing hormone (LHRH) in OVX rats, but partially blocked the response in OVX estrogen, progesterone-treated (OEP) rats. Surprisingly, in OEP rats, Id appeared to potentiate the FSH release in response to LHRH. The results of this study indicate that inhibitors of PG synthesis administered at high doses can inhibit LH release in the rat and that this effect is mainly due to a direct effect of the drug or drugs on the central nervous systen. Consequently, the results of this study give further support to the hypothesis that PGs play a physiological role in the control of gonadotropin secretion.


Proestrous hormone surges dissociated from ovulation in the estrogen-treated hamster. Hamsters injected sc with 50 mug estradiol cyclopentylpropionate (ECP) at 0900 h on day 1 (metestrus) of the cycle show the normal "postovulatory" vaginal discharge 4 days later but do not resume ovulation until 14--18 days later. After ECP injection ovarian histology reveals that the follicles normally destined to ovulate at the end of the cycle (developing follicles) are healthy on the afternoon of day 1, but atretic by day 2. Developing follicles (8--12 granulosal layers) reappear by the afternoon of day 3; follicular development is still retarded by the afternoon of proestrus (day 4). Serum hormone levels were determined by RIA in ECP and oil treated hamsters. ECP fails to affect the normally high levels of FSH present throughout day 1; however, by day 2 both FSH and LH levels are usually undetectable. On day 3, a "rebound" phenomenon occurs and FSH and LH are now detectable in the ECP treated groups. The preovulatory increase of LH occurs on day 4 between 1200 and 1400 h in both groups whereas FSH increases at 1400 h in the ECP group but not until 1600 h in the controls. The elevated levels of FSH, usually observed throughout day 1, occur in the oil treated but not in the ECP group. This most likely accounts for the long delay before ovulation is resumed in the ECP group. Luteal function is unaffected by ECP; circulating levels of progesterone (P) are approximately 12 ng/ml on days 1 and 2 in both groups. The normal secretion of P on day 4 occurs in ECP and oil groups and in the absence of large antral follicles in the former animals. In the ECP group estradiol levels on days 1, 2, 3, 4 at 1500 h are 250, 263, 255, and 273 pg/ml respectively, compared to 34, 80, 105, and 297 pg/ml for the controls. These experiments demonstrate a) that the preovulatory release of anterior pituitary hormones on day 4 is normal in the ECP group but there are no follicles competent to respond by ovulating; b) that the continued functional activity of the CL in the face of elevated estrogen levels accounts for the maintenance of the 4 day "cycle"; and c) the extreme resistance to exogenous estrogen of the hamster as compared to the rat.


Potentiation of suckling-induced release of prolactin by inhibition of brain catecholamine synthesis. The effects of a catecholamine synthesis inhibitor, alpha-methyl-p-tyrosine (alpha-MT), on the accumulation of newly synthesized brain catecholamines and plasma prolactin concentration were studied in lactating rats. [3H]tyrosine was administered to rats 10 minutes before decapitation, and the rate of its incorporation into [3H]dopamine and [3H]norepinephrine was measured in whole brain. Injection of alpha-MT (3.15--12.50 mg/kg) via a carotid cannula increased plasma prolactin levels and decreased the accumulation of newly synthesized brain catecholamines in nonsuckled, lactating rats compared to rats injected with .9% saline solution. Mother rats pretreated with saline solution were suckled for 20 minutes by pups which previously were separated from the mother rats for 5 hours. This treatment resulted in significantly increased plasma prolactin levels compared to nonsuckled controls. In rats pretreated with alpha-MT for 20 minutes, suckling resulted in a further increase in plasma prolactin levels which was significantly greater than the increase caused by suckling or alpha-MT alone. These results suggest that inhibition or catecholamine synthesis had a facilitatory effect on the brain mechanisms responsible for prolactin release in response to suckling.


Changes with age in levels of serum gonadotropins, prolactin and gonadal steroids in prepubertal male and female rats. Radioimmunological determination of serum LH, FSH, and estradiol concentrations in prepubertal female rats demonstrates the temporal coincidence of increased serum levels of these hormones between days 9 and 21. Serum FSH and estradiol levels are continuously high during that time, whereas interindividual fluctuations in LH levels were enormous. No high LH, FSH, and estradiol levels were observed between day 21 and puberty, during which time serum prolactin and progesterone gradually increased. Serum testosterone in the female immature rats stayed uniformly low. It is suggested that increased serum estradiol levels in the presence of low prolactin levels (between day 10 and 20) act in a positive feedback fashion on the CNS-pituitary axis. The resulting increased gonadotropin levels are later (between day 20 and puberty) decreased by an inhibitory action of prolactin and/or progesterone on pituitary gonadotropin release. In male rats serum FSH and prolactin, which were low during the first 3 weeks, increased later to reach high levels during puberty. Serum LH was slightly elevated during the 2nd and 3rd week of life at which time serum progesterone also increased to reach the highest levels in the prepubertal period. Serum testosterone was higher in male than in female rats for the first 3 weeks of life; the difference between both sexes was significant but not striking. Between day 21 and the prepubertal period the testosterone levels were relatively low, but they increased again during puberty. Sex differences in androgen levels (measured with a less specific antibody) were more pronounced whereas estradiol levels in males showed the same pattern between birth and puberty as in the female littermates. These results suggest that not only testosterone but also other, not yet identified, androgens may be involved in the masculinzation of the brain.


High-affinity binding of tetraiodothyroacetic acid by a prealbumin in normal rabbit serum. A protein that binds tetraiodothyroacetic acid (tetrac) with high specificity has been detected in normal rabbit serum. Scatchard plots revealed the protein to have a principal binding site with both high capacity and high affinity for tetrac (KA 4.8 X 10(10) M-1. Binding of tetrac by the protein is partially inhibited by barbital. During polyacrylamide gel electrophoresis at pH 8.0, the tetrac binding protein has a mobility characteristic of a prealbumin. As judged from competitive binding studies, the protein also binds tetraiodothyropropionic acid (tetraprop) firmly, but less so than tetrac. The apparent affinity of the protein for the triiodinated analogues of tetrac and tetraprop is only about 1% that for tetrac, and that for thyroxine (T4) only 0.6% that for tetrac; 3,5,3'-triiodothyronine is not bound at all. The protein can be utilized in a competitive protein binding assay for tetrac in human serum, after removal of cross-reacting T4.


Acute effects of thyroxine, triiodothyronine, and iodide on thyrotropin secretion. Rats fed a Purina or low-iodine diet (LID) for varying periods were serially sampled before and after a single iv injection of T4, T3, iodide or saline. Suboptimal replacement doses of T4 and T3 were given to rats fed LID for 2 months or 1 year (basal TSH, approximately 1000 and 2000 muU/ml, respectively). Both 1 mug T4 and 0.25 mug T3/100 g BW dropped plasma TSH to 70% of the initial level at 15 min and to 10--20% at 4 h. By 12 h TSH had begun to rise in 2-month LID rats, followed by a secondary decline 3--5 days after injection. Statistical comparison of the slopes of the initial TSH decline indicated there was no significant difference between the effect of T4 and T3. There effect of graded doses of T3 (0.01--0.3 mug/100 g) was also examined. There was a highly significant correlation of the magnitude of TSH suppression with the dose of T3 administered. Saline had no effect but 0.65 mug iodide/100 g BW (equal to that in 1 mug T4) had a delayed effect, depressing TSH to a minimum of 25% of the initial value at 48 h in 2-month LID rats. There was no difference in the effect of these doses of T4, T3, or saline in purina-fed rats (basal TSH, 170 muU/ml). T4 or T3 in physiologically equivalent doses thus produces an identical prompt rate of decrease in plasma TSH, indicating that both hormones possess intrinsic hormonal activity. The delayed effect of iodide is presumably because it must first be incorporated into T4 and T3 and secreted by the thyroid gland. The similarity of depression of plasma TSH by thyroid hormones or saline injection in Purina-fed rats is believed due to a nonspecific stress effect in these animals with a low basal rate of TSH secretion. The non-specific inhibition of TSH secretion is minimal in the iodine-deficient rats with a much higher basal rate of TSH secretion, presumably because of relative vectorial influences.


Sequential stimulation of nuclear RNA polymerase activities in livers from thyroidectomized rats treated with triiodothyronine. A single ip injection of triiodothyronine (T3; 30 mug/100 g BW) to thyroidectomized rats markedly stimulates RNA synthesis in isolated liver nuclei. The increased level of RNA synthesized in vitro by isolated nuclei does not depend on a reduced degradation of the nascent RNA molecules, since ribonuclease activities are not affected by the administration of T3. In addition, our results have confirmed previous findings of Tata et al. that the increase in nucleolar alpha-amanitin-resistant RNA polymerase I activity at low ionic strength always preceded the rise of the nucleoplasmic alpha-amanitin-sensitive RNA polymerase II activity at high ionic strength. Moreover, it has been found that a significant increase in an alpha-amanitin-resistant activity at high ionic strength occurs as early as 10 h after hormone injection. This enzyme, which forms RNA with a U to G ratio significantly higher than that of RNA synthesized by the nucleolar alpha-amanitin-resistant enzyme, is probably nucleoplasmic RNA polymerase III which is though to synthesize 5S and transfer RNAs. The possible role and the mechanism(s) of the early and concomitant increase in nucleolar and nucleoplasmic alpha-aminitin-resistant activities, and of the subsequent rise of RNA polymerase II activity following T3 administration are discussed.


Specific, high-affinity binding of 17beta-estradiol in cytosols from several brain regions and pituitary of intact and castrated adult male rats. Specific 17beta-estradiol binding capacities of cytosols from several brain regions and pituitary were determined in intact and castrated adult male rats. The binding capacity of the pituitary was approximately 10 times higher than that of any of the 5 brain region studied. Of these brain regions, the highest 17beta-estradiol binding capacities were present in the anterior hypothalamus followed by progressively lower capacities in the posterior hypothalamus, amygdala, midbrain, and cerebral cortex. The specific 17beta-estradiol binding capacity of cytosol from the anterior hypothalamus was significantly higher in castrated males than in intact rats. No such difference was found in any of the other tissues studied. Using sucrose gradient ultracentrifugation, an 8S sedimentation coefficient was found for the specific estradiol binding macromolecules present in cytosols from pituitary as well as anterior and posterior hypothalamus of castrated rats. The affinity for estradiol of cytosols from anterior and posterior hypothalamus was very high, with the mean association constants being 2.9 and 2.4 X 10(10) M-1, respectively. In competition experiments the 17beta-estradiol binding molecules present in cytosols from pituitary and anterior hypothalamus showed a higher affinity for 17beta-estradiol than for either estrone or estriol. In both tissues these 17beta-estradiol binding molecules showed a moderate affinity for the anti-estrogens MER-25 and cis-clomiphene citrate as well as for the androgen 3beta-androstranediol, but almost no affinity for 3alpha-androstanediol, 5alpha-dihydrotestosterone, testosterone, or corticosterone. These findings suggest that a true cytoplasmic receptor for estradiol exists in the male rat brain and pituitary which may play an important role in regulating reproductive function.


Autoradiographic localization of slow turnover iodocompounds within the follicular cells of the rat thyroid gland. In addition to thyroglobulin, several low molecular wt iodinated glycopeptides are present in the thyroid gland. Some of these compounds are considered to be slowly metabolized remnants of intracellular lysis of engulfed colloid droplets. In this paper we present autoradiographic evidence obtained by light microscopy, suggesting that breakdown products of thyroglobulin digestion can indeed be located within the thyroid cells. The thyroid glands of rats were labeled with 125I to approach isotopic equilibrium. The tracer was then withdrawn from the otherwise unchanged high-iodine diet, and thyroidal radioactivity was washed out for 80 days. Autoradiographs of glands containing 10% or less of the tracer present at equilibrium showed the bulk of 125I within the follicular cells while the colloid was only slightly labeled. An additional finding was the presence of dense radioactive inclusions in the lumina of many follicles. They are assumed to represent clusters of thyroglobulin molecules not readily available to pinocytosis. In addition to autoradiographic evidence, the identity of intracellularly located radioactivity with slow-turnover enzyme-resistant iodocompounds is supported by double labeling experiments, using 125I as the "old" tracer, accumulating within the cells, and 131I as the "new" label representing intraluminal 19 S thyroglobulin. Experimental manipulations which tended to deplete the thyroid of thyroglobulin, increased the 125I/131I ratio in the gland as predicted by the working hypothesis. Thus, this paper describes a new kind of autoradiographic ring reaction due to a hitherto barely considered intracellular organic iodine pool.


The mobilization of bone mineral by 1,25-dihydroxyvitamin D3 in hypophosphatemic rats. Administration of 1,25-dihydroxyvitamin D3 to thyroparathyroidectomized, hypophosphatemic rats on a low-phosphorus diet increases serum inorganic phosphorus and calcium concentrations. Experiments utilizing such rats treated with 45Ca and 32P ten days before use revealed that the rise in serum phosphorus in response in 1,25-dihydroxy-vitamin D3 is derived at least in part from bone mineral. This suggests that under conditions of hypophosphatemia, 1,25-dihydroxyvitamin D3 can mobilize bone in the absence of parathyroid hormone.


The use of activable tracers in the evaluation of the performance of wastewater treatment plants. The use of stable, activable tracers has been studied in applications to establish the performance of waste treatment plants and detect causes of irregular or improper functioning of individual plant processes. Various soluble tracers were evaluated, among them indium, scandium, and bromine. The inert tracers were compared with dye tracers and were found to be superior in turbid liquids and to give more quantitative information. On the other hand dye tracers are more convenient for rapid visible indication of their arrival whereas activable tracers require collection and removal to a neutron source, such as a reactor, for indication. Activable tracers are relatively simple to apply and the cost per test is reasonable.


Locating nuclear power plants underground. This paper reviews some of the questions that have been asked by experts and others as to why nuclear power plants are not located or placed underground. While the safeguards and present designs make such installations unnecessary, there are some definite advantages that warrant the additional cost involved. First of all, such an arrangement does satisfy the psychological concern of a number of people and, in so doing, might gain the acceptance of the public so that such plants could be constructed in urban areas of load centers. The results of these studies are presented and some of the requirements necessary for underground installations described, including rock conditions, depth of facilities, and economics.


Are nuclear shipments really safe?

Are nuclear shipments really safe? The transportation of nuclear materials is on the increase. Although nuclear shipments are only a very small fraction of the Nation's hazardous materials shipments, they attract a great deal of public attention. Shipments of spent nuclear fuel and nuclear wastes are a particular concern. One of the many fears that people have about nuclear energy is the possibility that a nuclear shipment might somehow go awry and cause a serious public hazard. Primarily, they are worried that a shipment of spent reactor fuel or highly radioactive waste could be involved in serious rail or highway accident and dump its contents all over the countryside. Is that really possible? How safe are those shipments? How many are there? What do they look like? Are the packages tested? These and other questions are answered in this paper. Since public risk is the product of the consequences of an accident and its probability, both aspects are presented so that each of us can make up his own mind whether the risk from nuclear shipments is acceptable.


Development of the solid waste resource. This paper describes the waste processing and boiler feed facilities which serve as the prototype for Union Electric Company's proposed Solid Waste Utilization System for recycling essentially all the solid waste generated in the metropolitan St. Louis area. The recently announced system, capable of processing up to 8,000 tons of raw refuse per day and estimated to cost $70 million, will be built and operated without government subsidy. Solid waste will be processed for the recovery of recyclable noncombustibles and use as a supplementary fuel to electric utility boilers.


History of SO2 removal system at the Meramec plant of union electric. In line with the then emerging air pollution control regulations Union Electric installed a limestone injection wet scrubber sulfur dioxide removal system on an intermediate size coal-fired utility boiler at its Meramec Power Plant on an experimental basis in September, 1968. Approximately 3 years of operation many difficulties were encountered with plugging and scaling of various system components by calcium sulphate. As a result of this experience along with related experiences by other utilities employing similar systems, the experiment was terminated in June, 1971. As a result of the experiences gained, however, second generation experiments in sulfur dioxide removal have been initiated elsewhere with the hope of improved performance. A number of experimental projects are still under tests. Costs in resources, reliability, and disposal of residual by-products are matters of great concern. The ture cost of sulfur dioxide removal systems in dollars and resources is not well known and perhaps a reevaluation of current and future SO2 removal projects is in order at this time before additional resources are committed.


An environmental and energy information system. The Environmental Information System Office (EISO) at Oak Ridge National Laboratory (ORNL) provides information support for researchers and administrators involved with energy and environmental policy and progress. Multiple EISO activities for various governmental agencies have resulted in establishment of compatible data bases concerned with energy environmental information, methods for effectively developing these, development and computer display of numerical daya summaries, and reports evaluating published information. Direction is provided by continuing dialogue between users and information system staff.


Pituitary hormones and growth retardation in rats raised at simulated high altitude (3800m). Growth and the endocrine status of the pituitary and thyroid glands were studied in rats born and raised in a hypobaric chamber at a simulated high altitude of 3800 m (SHA); comparisons were drawn with similar rats at sea level. From birth until 40 days of age, SHA rats weighed significantly less than controls with the most striking growth impairment found in female SHA rats. Relative organ weights of anterior pituitary glands, ovaries and uteri from 40-day-old female SHA rats were significantly less than controls. Pituitary content of growth hormone (GH) was reduced in 40-day-old female SHA rats while the content of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were significantly increased over sea level controls. Plasma levels of GH, LH, FSH and thyrotropin (TSH) and pituitary TSH levels did not differ from control values. However, thyroidal uptake of 131I and plasma protein-bound 131I were significantly reduced in SHA rats as compared with controls. It is suggested that (1) the continuous exposure of developing female rats to hypoxia significantly impairs pituitary function and reproductive maturation, and (2) that despite other environmental factors acting on the developing organism at high altitude, growth retardation in rats born and raised at high altitudes is primarily a consequence of hypoxia.


Distribution of lactic dehydrogenase in X-irradiated tissues. Exposure to whole-body X-irradiation in rats causes a marked increase in total lactic dehydrogenase (LDH) activity and decrease in H-LDH/M-LDH ratio in serum and tissues, the maximum effect being observed on the 8th post-irradiation day. While there is an elevation of M-LDH isoenzyme, H-LDH remains relatively constant. Studies on incorporation of DL-leucine-l-14C into heart LDH isoenzymes also revealed increased biosynthesis of M-LDH isoenzyme. This indicates that an adaptive mechanism is operative in the X-irradiated rats, whereby, in order to augment anaerobic glycolysis, synthesis of M-LDH is stimulated. Administration of the radioprotector cystamine does not alter the effects of X-irradiation on serum LDH activity.


Effect of diazinon in male rats. Histopathological and biochemical studies. Mild structural and functional changes were observed in liver and testes of rats after a single intraperitoneal administration of diazinon (21.6 mg/kg). Kidney, however, showed no pathological lesion. Attempts are made to correlate the pathological changes in these organs with the activity of succinic dehydrogenase, adenosine triphosphatase and alkaline phosphatase.


Changes in the kidney peroxidase activity in fish exposed to some industrial pollutants. Fish under abnormal environmental conditions suffer from retarded growth and other physiological dysfunctions related to thyroxine deficiency. In teleosts lacking a definite thyroid gland the kidney plays a very important role in biosynthesis of the thyroidal hormone, in which peroxidase has an indirect action. Effects of some industrial pollutants and factory effluents on fish kidney peroxidase activity were recorded in Ophicephalus punctatus and Clarias batrachus. At concentrations of the pollutants at which 70-100% of the fish survive the exposure, peroxidase activity was greatly inhibited, indicating that even sub-lethal doses of toxicants may cause drastic changes in the physiological systems. The peroxidase activity increased well above the control levels at 5-h and 27-h exposures in some cases, but declined towards the end of the test.


Cytogenetic investigations on leucocytes of workers from a cadmium plant. Chromosome analysis has been performed on workers from a cadmium plant who were exposed to fumes and dust of cadmium and lead. The 35 workers were classified, according to the type and duration of exposure, into a group (cadmium service) exposed to high levels of lead and cadmium in the absence of zinc (23 people) and a group of rolling-mill workers subjected mostly to zinc but also to lower levels of lead and cadmium (12 people). A higher yield of severe chromosome anomalies (chromatid exchange, disturbance of spiralization, chromosome translocation, ring and dicentric chromosomes) together with a total lower number of structural aberrations was observed in the cadmium workers when compared with the rolling-mill group.


Placental transfer of halogenated benzenes (pentachloro-, pentachloronitro-, and hexabromo-) in rats. The present study was carried out to provide information on the placental transfer of three organohalogens of environmental concern. Pentachloro-, pentachloronitro-, and hexabromobenzene were administered per os to rats daily on days 6 through 15 of gestation at level of 40, 100, and 200 mg/kg body weight. On day 22, the dams were killed and fetuses removed by caesarean section. Maternal brain, heart, kidney, liver, spleen and adipose tissue as well as whole fetus, fetal liver and fetal brain were analyzed for organohalogen residue by GLC. Pentachlorobenzene accumulated in the fetus to a greater extent than hexabromobenzene. In maternal tissues pentachlorobenzene accumulated to the greatest extent in adipose tissue, followed by liver, spleen, brain, heart and kidney. With hexabromobenzene, the greatest accumulation was observed in adipose tissue, followed by spleen, liver, heart, kidney and brain. Pentachloronitrobenzene was not detected (0.05 p.p.m.) in any maternal or fetal tissue.


A comparative study of the effects of aflatoxin B1, alpha-amanitin and actinomycin-D on RNA synthesis by rat liver. The effect of different combinations of aflatoxin B1, alpha-amanitin and actinomycin-D on the incorporation of orotic acid-6-14C into RNA was investigated using rat liver slices. The results support the view that the mode of action of aflatoxin B1 and alpha-amanitin are similar in some respects, and that aflatoxin B1 and actinomycin-D act according to different mechanisms. Evidence was also obtained about the formation of an active metabolite of aflatoxin B1 in this system.


Mercury accumulation in placenta and foetal membranes. A study of dental workers and their babies. To investigate the hazards of exposure to levels of elemental mercury lower than the present TLV value (0.05 mg/m3) a group of dental workers and a nonexposed group were studied. The amount of mercury in blood from mothers and babies at the time of delivery was similar. The exposed group had increased mercury content in placenta and foetal membranes. Mercury accumulation in these organs might serve as a protection for the foetus against mercury exposure. Since exposure to sub-TLV concentrations of elemental mercury during pregnancy will not be reflected in blood mercury content at the time of delivery, the amount of mercury in placenta and foetal membranes might serve as a biological indicator of such exposure.


Inhibition of hepatic drug-metabolizing enzymes by thiophaophate insecticides and its toxicological evaluation. Thiophosphate insecticides, fenitrothion, diazinon and methylparathion, inhibit hepatic drug-metabolizing enzyme activity which was assayed using aminopyrine and aniline as substrates. About 50% inhibition was observed 4 hrs after the injection of fenitrothion into mice in a dose of 25 mg/kg. The addition in vitro of thiophosphates into a reaction mixture of drug metabolizing enzyme also produced an effective inhibition and IC50 was around 10(-5)M for fenitrothion. DDVP and oxygenated metabolite of fenitrothion did not show any inhibiting effect either in vitro or in vivo. The inhibition of thiophosphates in vitro was competitive while the kinetics of in vivo inhibition was shown as non-competitive. The drug metabolism in the rat liver preparation was also inhibited by thiophosphate in vitro, but in vivo treatment to male rats resulted in only slight inhibition. Female rats exhibited the similar response as mice. The administration of fenitrothion to mice prolonged the hexobarbital sleeping time and, consequently, suppressed the oxidative metabolism of parathion in liver preparation. These effects reveal that the biological half life of thiophosphate insecticides could be altered by the mode of administration or by co-existing thiophosphates.


Degradation of organophosphorus pesticides in soils with special reference to unaerobic soil conditions. Organophosphorus pesticides are generally transformed by the reactions including oxidation, reduction, hydrolysis, hydroxylation, dehydrochlorination, dealkylation, methylation, isomerization, and conjugate formation. Although the degradation process of pesticides in soils is complicated, main factors may be soil constituents, soil microflora, and chemical structures of pesticides. Chemical structures are especially important for soil metabolism of organophosphorus pesticides, because the priority of the reactions mentioned above is decided. Although organophosphorus pesticides are generally hydrolyzable, the order of hydrolysis varies with chemical structures. It might be said that the slower the hydrolysis rate of the molecule, the more the possibility to be attacked by reactions other than hydrolysis. In such cases, oxidation and reduction are primarily important for the degradation of organophosphorus pesticides. Flooded soils in paddy fields give a favourable environment for the reduction of organophosphorus pesticides having labile substituents such as nitro groups. The threshold of reduction in-flooded soil is expressed as redox potential. Eh, the Eh of paddy soil fluctuates to a great extent, depending on seasons and soil types, especially organic matter content. The result of laboratory experiments with fenthion, disulfoton, Kitazin P (0,0-diisopropyl S-benzyl phosphorothiolate), edifenphos (0-ethyl S,S-diphenyl phosphorodithiolate) and amiprophos (0-ethyl 0-(2-nitro-p-tolyl) N-isopropyl phosphoramidothionate) suggested the participation of several factors mentioned above in the degradation of organophosphorus pesticides.


Herbicide metabolism by glutathione conjugation in plants. Glutathione conjugation of foreign compounds is the first step in the mercapturic acid pathway for the detoxication and elimination of toxic compounds in mammals. Plants have been found to metabolize and detoxify some organic herbicides by glutathione conjugation, but the terminal products seem to be different from that in mammals. The terminal product in plants appears to be insoluble residue and not the mercapturic acid derivative which is normally excreted in mammals. The insoluble residue very likely remains in the plant body during the life of the plant. The differences in metabolism between plants and animals may have been necessitated by the lack of an excretory system in plants.


Epidemiological research on cancer risk by aldol and aliphatic aldehydes. This report concerns the frequency of cancers in an aldehyde factory. The epidemiological evidence raises the suspicion that acetaldol is a possible carcinogen. There may be also syncarcinogenic effects of some aliphatic aldehydes, probably in combination with some air pollutants.


[Recent information on air pollution impact in North-Rhine-Westphalia (author's transl)]. Since 1963, air quality in the Rhine-Ruhr-area, one of the largest agglomerations of industry, population, and traffic in Europe, is systematically monitored and the levels are documented in the form of on air pollution cataster. The surveilled area comprises about 5000 km2. Within the first years, measurements were made with the air pollutants sulphur dioxide and dust fall out. Later, the following air pollutants were included into the monitoring program: Hydrogen fluoride, hydrogen chloride, suspended particles, as well as the determination of total organic substances. In smaller regions within the surveilled area, measurements of the following air polutants were made, too: Nitrogen monoxide, nitrogen dioxide, hydrogen sulphide, carbon disulphide, benzene, phenol, carbon monixide, oxidants, as well as determinations of lead, cadmium, and zinc content in suspended particles and dust fall out. Besides the demonstration of the tasks within the air quality monitoring program, the projection as well as the execution of air pollution measurements are discussed. Definitions of impact characteristics and the adjusted legal air quality standards are given in more detail. Finally, an evaluation of the results of this monitoring program is given for each pollutant. Furthermore, the trends of air pollution and its causes since the beginning of air quality monitoring in 1963 are evaluated.


Properties of human placental hexokinase. Human placental soluble and solubilized mitochondrial hexokinase was partly purified by column chromatography and the kinetic properties were determined. Based on this data, on the chromatographic behaviour and on heat stability experiments, it is concluded that soluble and particle-bound hexokinase are of the same isoenzyme type, presumably type I, in placenta.


Types of arginase in rat tissues.

Types of arginase in rat tissues. Significant amounts of arginase activity were found in homogenates of submaxillary salivary gland and epididymis, as well as of liver, kidney, mammary gland, and small intestine. The isoelectric point of arginase solubilized from kidney was at pH 7.0 in contrast to that of pH 9.4 characteristic of hepatic arginase in rat. The isozymic variants of arginase in the different tissues were identified by their electrophoretic migration on polyacrylamide gels and by titration of the enzymes against antibody prepared against purified rat liver arginase. Antibody titrations confirmed the indications obtained by electrophoresis that one type of arginase is limited to hepatic tissues (and possibly submaxillary gland) while the other type is found in all other tissues. The physiological role of arginase in hepatic tissues has been previously associated with the urea cycle; the possible function of arginase in proline synthesis in other tissues remains to substantiated.


Sigmoidal kinetics of glucokinase.

Sigmoidal kinetics of glucokinase. Glucokinases obtained from the liver of several species of mammals and amphibians exhibit sigmoidal saturation functions for glucose. Hill coefficients (nH) are about 1.5, and half-saturation values (K0.5) lie between 1.5 and 8.5 mmol/l. The nH and K0.5 values are constant throughout the purification steps of rat glucokinase. A dimeric form of rat glucokinase appearing in aged preparations exhibits michaelian kinetics. Sigmoidal kinetics is considered as an adaptive feature of glucokinases to increase the efficiency of the liver uptake of glucose at the changeable concentrations in the blood resulting from variations in the amount of dietary glucose.


Rat liver hexokinases during development. The four glucose-phosphorylating isozymes from rat liver were separated by DEAE-cellulose column chromatography at several ages during development. The isozymes exhibited a sequential mode of appearance. The isozymes A, B, and C reached maximal values of activity at days +1, +3, and +7, respectively, decaying afterwards to the low characteristic adult value. Isozyme D activity was detected in very low levels as early as day +3, rising from day +18 to reach constant adult values at day +30. A fraction of the glucose phosphorylating activity was found associated with particulate material in prenatal and newborn rats. From day +15 onwards, no particulate activity could be detected. The particulate activity was found to be composed of three low-Km isozymes as of the corresponding soluble fraction.


Studies on the mechanism of induction of mitochondrial alpha-glycerophosphate dehydrogenase by thyroid hormone. The role of differential gene activation. The electrophoretic characteristics of the hepatic mitochondrial cytochrome-linked alpha-glycerophosphate dehydrogenase (CGPD) induced by thyroid hormone have been examined. Mitochondria, derived from livers of C57BL/6J or BALB/cAnN mice after 3 days of L-3,5,3'-triiodothyronine (T3) (0.1 mumole) or saline administration, were extracted with Triton X-100 (5 ml/l), and the extracts subjected to alkaline discontinuous polyacrylamide gel electrophoresis. The enzyme was located on the gel by means of a histochemical stain. The migration of CGPD from T3-treated mice was identical with that from saline-treated mice in both strains, and differed from that of NAD-linked alpha-glycerophosphate dehydrogenase. This suggests that the induction does not involve the activation of a new gene for a CGPD isoenzyme that is not expressed in the basal state. In addition, enzyme from both strains of mice exhibited identical rates of migration, indicating that the enzymes from both strains are chemically identical. These conclusions must be considered tentative, pending other studies to disprove the presence of new molecular species with no change in net charge or size.


Venous and capillary blood hematocrit at rest and following submaximal exercise. The purpose of this study was to determine if finger tip capillary blood hematocrit is a valid estimate of anticubital venous blood hematocrit at rest and after submaximal exercise. Simultaneous samples of finger tip cpaillary and venous blood were drawn from thirty-one subjects (15 males, 16 females) before and after a 15 min submaximal exercise on a bicycle ergometer. Venous and capillary blood hcts. were 42.0% +/- 3.9 and 42.0% +/- 3.5 respectively before exercise and 43.3% +/- 3.5 and 42% +/- 3.8 after exercise (X +/- s). The regression equation for predicting venous hct. from finger tip capillary blood after exercise was: Hctv = 0.87 Hctc + 6.44 with r = 0.95 (P less than 0.05). The results indicate that the finger tip capillary microhematocrit method is a valid indicator of venous blood hct. following exercise.


Effects of training on maximal working capacity and haemodynamic response during arm and leg-exercise in a group of paddlers. Maximal oxygen uptake and circulatory adaptation to work with legs and arms were studied in a group of 5 paddlers members of the Belgian national squad and a control-group of 9 trained subjects. The results showed that the specific armtraining of paddlers induced changes in the arm-to-leg ration of physiological parameters at submaximal and maximal work. In the group of paddlers maximal oxygen intake and workload during arm-exercise averaged respectively 88.6% and 80.3% of the scores obtained with leg-exercise. In the control group the arm to leg ratio varied between 81.2% and 65.2%. At a submaximal load of 100 W the difference in heartfrequency was 21 beats/min in the canoe group and 35 beats/min in the control group. Oxygen consumption and ventilation during work with the arms was lower in the group of paddlers. The data of our study suggest that the specific training of paddlers do result in a effect on the haemodynamic adaptations to arm work.


Assessment of aerobic and anaerobic capacity of athletes in treadmill running tests. The criteria of max VO2 and max O2D which are traditionally used in studying aerobic and anaerobic work capacity, have the different dimensions. While max VO2 is an index of the power of aerobic energy output, max O2D assesses the capacity of anaerobic sources. For a comprehensive assessment of physical working capacity of athletes, both aerobic and anaerobic capabilities should be represented in three dimensions, i.e. in indexes of power, capacity and efficiency. Experimental procedures have been developed for assessing these three parameters in treadmill running tests. It is proposed to assess anaerobic power by measuring excess CO2, concurrently with determination of max VO2. Maximal aerobic capacity is established as the product of max VO2 by the time of max VO2 maintenance determined in a special test with running at critical speed. The erogmetric criteria derived on the basis of the tests proposed, may be used for systematization of various physical work loads.


[Potential elastic energy and muscular work (author's transl]. The relationship between the integrated EMG of the biceps (Qs) and positive work (W) was examined for isolated and to and fro movements of the elbow. The movements were performed against either pure inertias or against load. 1. In all cases, a linear QB--W relationship was found. 2. For isolated movements, the QB--W curve showed the same slope whether the movement was carried out against an inertia or against a load. 3. When the movements were carried out against an inertia, the slope of the QB--W curve was steeper for isolated movements than for to and fro ones. These results show that: a) for the movements against a load, the extra component of the integrated EMG arising from the initial isometric phase is compensated by the mechanical work resulting from the release of potential elastic energy; b) for the to and fro movements, elastic energy is stored in the stretched series elastic component during the negative work and released during the positive work. However, in this case, the biceps cannot escape from performing negative work which is necessary to decelerate the extension movement and so, it appears less energy expenditure relatively to the isolated movement.


A new formula for estimating oxygen consumption in man and animal. A formula for estimating oxygen consumption in man and animals using outlet volume flow and oxygen fraction of CO2-free outlet air is derived. The formula is simplified and the error induced is evaluated. Two applications are discussed.


Effects of fatiguing isometric exercise upon achilles tendon reflex and plantar flexion reaction time components in man. Effects of three different fatiguing local muscular exercises upon plantar flexion reaction time and achilles tendon reflex time have been studied in 24 normal males. The Exercise Conditions, each involving a series of 30 maximal voluntary isometric contractions (MVC) of the plantar flexors, differed by allowing either 5, 10 or 20 sec rest interval between each MVC. Decrements in strength ranged from 15% to 34% MVC. Trend analysis of the fatigue patterns revealed that a cubic orthogonal polynomial equation was sufficient to describe the profile of MVC decrement for all conditions. Following the fatiguing exercise, simple visual reaction time (plantar flexion), and its two components, premotor and motor time, failed to demonstrate any change from Pre Exercise Conditions. Achilles Tendon Reflex Times, however, demonstrated a marked augmentation, as manifest in reduced total reflex times, contraction times and half relaxation times.  These results may suggest the differential fatigue of motor units employed in the three motor tasks, viz. MVC, voluntary reaction and achilles tendon reflex. A plausible explanation for the augmentation of the reflex contraction resides in the known potentiating effect of elevated intramuscular temperature. Alternatively, one might postulate a neurally mediated increase in gain of the stretch servomechanism. The possibility of both mechanisms being operative is not excluded.


The effects of intermittent warm-up on 7-9 year-old boys. Twelve boys, 7-9 years old, who, by use of questionnaires, were found to be ignorant of the concept of "warm-up", performed maximal aerobic and anaerobic tasks 4 min after completing a 15 min intermittent warm-up (WU) (30 sec treadmill run, 30 sec pause). The WU required some 60% of the individual's VO2max, and raised rectal temp. by 0.52 +/- 0.19 degrees C. The aerobic criterion task (CT) was a one-stage bicycle ride at a load predetermined to exhaust the subject after 4 min. The anaerobic CT was a 30 sec all-out ride against resistance of 35 gm/kg BW. Subjects also performed both CT's without any WU. VO2max (aerobic CT), HRmax, as well as total mechanical work output achieved during the aerobic CT, were significantly higher with WU, compared with the non-WU sessions. During the anaerobic CT total revolutions, total power output, as well as peak HR, were significantly higher following WU. It is suggested that the benefits of intermittent WU, as used in this study in young children, can be attributed to physiological rather than psychological mechanisms.


[The influence of bicycle ergometer work and oral glucose administration on the muscle hexokinase activity in man (author's transl)]. The influence of orally administered carbohydrates and bicycle work on muscle hexokinase activity, blood glucose, and serum insulin levels were studied in 6 young men. Continuously administered glucose of a total amount of 150 g caused a significant increase in hexokinase activity within 3 hrs. Working at a load of 155 to 195 Watt led to an initial increase of hexokinase activity. At the end of the working period hexokinase activity had fallen to resting values. The possible mechanisms of action are discussed.


[Experimental determination of coefficient of evaporative heat loss in still air (author's transl)]. The authors have determined the coefficient of evaporative heat loss of the human body (he) by means of humidity steps in low air movement (Va less than or equal to 0,2 m/s). Such a determination requires a fully wetted skin and this implies therefore some loss of dripping sweat. The collection of this dripping sweat allows the determination of the total evaporation: this evaporation exists on the skin surface and around the drops during their fall from the skin to the oil pan where dripping sweat is collected. An estimation of this dripping sweat evaporation allows to assess the skin evaporation and, consequently, the evaporative coefficient he. In these experimental conditions: E = S - SNE - 0,0005 SNE (PsH2O - PaH2O) where E is the skin evaporative rate (g/h);S = total sweat rate (g/h);SNE = the nonevaporative sweat rate (g/h);PaH2O = the partial pressure of saturated water (at Ts) on skin (mb) and PaH2O the partial pressure of water vapor in ambient air (mb). The coefficient of evaporative heat loss in low air movement thus found, is 5,18 +/- 0,22 W/m2-mb.


The anatomy of the late radiation encephalopathy. The clinico-pathological data and the topography of the lesions were determined in 13 cases of late radiation encephalopathy. In one case the arterial vascularisation was studied by the translucidation technique after filling of the blood vessels with a colloidal barium sulphate solution. The radiation lesions consisted of areas of focal necrosis and of diffuse demyelination and necrosis of the deep cerebral structures and the brain stem. Demyelination was predominantly present in cases of late appearance of the neurological symptoms while necrosis was found in cases with a short latency period. The cerebral cortex and the arcuate fibres were always the most preserved structures. The topography of the focal lesions in the cerebral hemispheres and in the brain stem corresponded well to the vascular supply areas of the deep perforating arteries, while the diffuse lesions always had a predominant distribution in  the periventricular arterial end- and border-zones. These observations were also confirmed by a post mortem angiographic study. The present report argues once more for a vascular aetiology as cause of the late radiation encephalopathy.


Developmental brain damage after chemically induced epileptic seizures. 25 Wistar rats were subjected twice daily to epileptic seizures induced by the convulsant gaz Flurothyl. Compared with littermates of the same sex and birth weight, the brain of seizure-treated rats showed a reduction of 6% (5.2 million cells) after 5 days and 17.6% (33.4 million cells) after 10 days of treatment.


Facial myokymia.

Facial myokymia. 43 patients with facial myokymia were examined clinically and electromyographically over periods of up to 13 years. 18 patients were suffering from multiple sclerosis, 6 patients from brain stem tumour or tumours of the posterior cranial fossa, and 19 from other known or unknown neurological disorders. Duration, recurrences, EMG results of myokymia and its accompanying neurological symptoms are discribed.


Electrophysiological evidence for a neurohormonal dependence in the changes of the late glabellar response in man. In 19 normal adults reserpine administration induced significant changes in the parameters of the second glabellar response (R2): shortening of the latency and duration; decrease of the excitability threshold and complete blockade of the physiological habituation of R2 to the electrical and mechanical stimulation. No changes in the first response (R1) were observed. All the R2 changes disappeared within about 3 days of drug administration. The Parkinson-like effect of reserpine on the glabellar reflex is discussed in the light of a neurohormonal hypothesis in the control of the polysynaptic pathways biasing R2.


Contralateral reinnervation in Bell's palsy. A case report. Congenital lesion of the left facial nerve trunk has been investigated in a 30-year-old woman. Upon stimulation of the left facial nerve, no response was evoked in any of the mimic muscles. The patient was able to perform voluntary contractions of the left corrugator glabellae muscle and of the left corner of the orbicular oral muscle; these contractions were recorded electromyographically. The stimulation of the right facial nerve elicited responses in the referred left mimic muscles. This circumstance indicated their activity to be due to contralateral reinnervation by the intact facial nerve. The blink reflex examination evoked no response on the left side, while the blinik reflex on the right side was elicited with both its components, both upon ipsi- and contralateral stimulation.


Homovanillic acid and 5-hydroxyindole-acetic acid in the csf of patients after a severe head injury. I. Lumbar csf concentration in chronic brain post-traumatic syndromes. Lumbar CSF concentrations of homovanillic acid (HVA) and 5-hydroxyindole-acetic acid (5HIAA) have been determined in ten patients suffering from chronic brain post-traumatic syndromes, at various length of time after the brain trauma. Lower concentrations of HVA (mean 21 +/- 14 mug/ml) compared to controls (mean 46 +/- 10 mug/ml) was observed in 7 cases; 5HIAA levels were within normal values. The 5HIAA/HVA ratio (1.59 +/- 0.66) was significantly higher (p less than 0.001) than the one recorded in controls (0.66 +/- 0.10). Monitoring of lumbar HVA and 5HIAA over time, before, during and after L-dopa treatment, revealed interesting correlations between modification of clinical picture and the levels of monoamines acid metabolites. The data indicate a profound alteration of brain monoamines in chronic syndromes following a severe head injury and suggest that measurements of lumbar HVA and 5HIAA in these patients may be of euristic and diagnostic value.


Homovanillic acid and 5-hydroxyindole-acetic acid in the csf of patients after a severe head injury. II. Ventricular csf concentrations in acute brain post-traumatic syndromes. Ventricular concentrations of homovanillic acid (HVA) and 5-hydroxyindole-acetic acid (5HIAA) were measured in 7 patients a few days after a severe traumatic brain injury. Both acid metabolites were elevated in respect to control patients values, however, the rise was more consistent for 5HIAA (258 +/- 86 ng/ml) with a 5HIAA/HVA ratio of 0.85 +/- 0.35. The data support previous hypothesis on the profound involvement of serotoninergic structures in the early stages of acute traumatic brain syndromes and on the role of 5HT in maintaining edema and vasospasm.


Acute transverse myelopathy caused by penicillin injection. A case of acute transverse myelopathy with anaesthesia and flaccid paralysis of both lower limbs, following intragluteal penicillin injection, is reported. This accident was probably due to a mistaken intra-arterial injection of the drug with retrograde progression through branches of the internal iliac artery up to the spinal cord. The treatment of such events in all the cases reported by the literature has been disappointing. Therefore, particular precautions must be taken in case of intramuscular penicillin injection, according to the present and the previous cases described, in order to avoid such accidents.


The occurrence of phase-4 block in the anomalous bundle of patients with Wolff-Parkinson-White syndrome. Conduction in the Kent bundle was studied in 17 patients with WPW syndrome, before and after administration of ajmaline and amiodarone. Before drug administration, only one patient showed phase-3 block and only one other showed phase-4 block. After administration of ajmaline to 11 patients and amiodarone to 16 patients (each patient received at least one of the drugs and the two drugs were given independently to 10 patients), the occurrence of phase-3 block alone in the Kent bundle was documented in 9 patients of the 17, phase-4 block alone in 1, and phase-3 and phase-4 block together with a typical accodion in 3. In 4 patients conduction in the Kent bundle was not modified. The phase-3 and phase-4 block as well as the accordion effect in the Kent bundle were similar to the same phenomena previously described in patients with diseased or in dogs with injured intraventricular conducting fascicles. The fact that the Kent bundle can show the same physiological and pharmacological behavior as a diseased His bundle or bundle branches is highly significant, first, because it may indicate that the anomalous bundle is also composed of Purkinje or Purkinje-like fibers and, secondly, because it may help to distinguish a normal from a diseased Kent bundle, and this may become essential for determining the prognosis and treatment of patients with WPW syndrome. The Kent bundle can be compared with a normal or diseased extra-His bundle.


Electrophysiologic and pharmacologic studies in a patient with acute myocardial infarction complicated by intraventricular and atrioventricular block. A patient with an acute anterior wall myocardial infarction complicated by bilateral bundle branch block and paroxysmal AV block is presented. The following new, uncommon or unreported phenomena were documented: the simultaneous occurrence of phase-3 block in the right bundle branch and phase-4 block in the left bundle branch; the simultaneous occurrence of phase-4 block in both main bundle branches; phase-4 left posterior hemiblock associated with escape beats arising from the injured posterior division of the left bundle branch; supernormal conduction in the right bundle branck and 2:1 right bundle branch block related to supernormality. Most of these changes were, of course, not simultaneous, and their successive appearance was related to day-to-day and sometimes hour-to-hour variations in the degree and quality of the multifascicular injury caused by the infarct. In addition, the actions of several drugs upon automaticity and conduction were tested. The effects of amiodarone, lidocaine and isoproterenol were similar to those previously reported under comparable circumstances. At a moment when the patient had repeated episodes of paroxysmal AV block with severe Adams-Stokes seizures, the administration of a single i.v. dose of 0.25 mg of strophanthin suppressed totally the Adams-Stokes attacks through a significant enhancement of ventricular automaticity. If rapid implantation of an artifical pacemaker is not at hand, strophanthin may be life-saving in patients with acute paroxysmal AV block.


The clinical features and significance of bifascicular block complicating acute myocardial infarction. Two series of patients with anterior myocardial infarction complicated by right bundle branch block with either left anterior hemiblock (RBBB+LAH) or left posterior hemiblock (RBBB+LPH), have been studied. The first was a retrospective analysis taken from a time when prophylactic pacing wires were not inserted, and the second was a prospective series in whom pacing wires were inserted as soon as the condition defect was seen. The overall prevalence of RBBB+LAH was 3.3% compared to 1.6% for RBBB+LPH, and complete atrioventricular block was seen in 36% of the former and 66% of the latter. From the retrospective data it was apparent that hospital death was usually associated with massive myocardial infarction, although 3 of the 25 patients in this series died in hospital from sudden development of complete atrioventricular block. If the defect was transitory (1-3 days) then the prognosis was that of acute anterior infarction uncomplicated by fascicular block. The policy of prophylactic pacing failed to show any overall change in hospital mortality, and only 3 patients survived long enough to have permanent pacemakers inserted. This procedure has been of benefit to only one of these cases.


Electrolytic phenomena and massive gas generation around pacemaker electrodes. Clinical presentation of an unusual pacing failure. An unexpected clinical presentation of an unusual pacing failure has been observed in two patients who had had recent implantation of a pacemaker model whose electrodes were made of an nonnoble metal alloy. An intermittent current leakage from the output capacitor and possibly from the output transistor accounted for electrolytic corrosion at the anode, premature depletion of the battery, heart muscle damage and for massive gas generation around electrodes, leading to right ventricular perforation, pneumopericardium and subcutaneous thoracic emphysema. The occurrence of this syndrome shows that, if nonnoble metals are used for electrodes, more attention should be addressed to those conditions which add to polarization problems, as is current leakage from the output circuit components.