Acute ischemic changes in intestinal muscularis. A chronologic study of ischemic changes in the mouse intestinal muscularis was done to delineate the morphologic alterations occurring within 24 hours of ischemia. The muscle cells initially contracted with segmental condensation of myofilaments. Subsequently, increasing degeneration and lysis of myofilaments resulted in the formation of dense degenerative bands and nodules alternating with clear segments in the muscle cells. Eventually, the myofilaments disintegrated. Mitochondria were initially swollen and subsequently condensed, shrunken, and fragmented. The plasma membrane showed progressive dissolution and eventually disappeared. These ultrastructural changes were represented by discernible changes in the histologic sections.


The pathogenesis of respiratory syncytial virus infection in infant ferrets. The infant ferret is susceptible to respiratory syncytial virus infection in both the upper and lower respiratory tracts. In the nose, viral replication is restricted to the surface respiratory epithelium in the nasal passages and turbinates. In the lungs, viral replication is of a lower order of magnitude and is localized in the alveolar cells. The pattern of viral replication in nasal tissues is independent of the age of the animal at infection, whereas the pattern in lung tissues shows a striking age dependence, with viral replication progressively decreasing as a function of age. Thes age dependence appears to be due to an intrinsic age-related mechanism yet to be defined. We feel that the infant ferret is an acceptable model for the study of respiratory syncytial virus disease and that the study of age dependence observed in ferrets may allow elucidation of the mechanisms involved in the age dependence seen in humans.


Experimental acute alveolar injury in the dog. Morphologic--mechanical correlations. In 26 dogs, a single subcutaneous injection of N-nitroso-N-methylurethane produced acute lung injury characterized by tachypnea cyanosis, increased static lung recoil, and decreased lung compliance. During the first few days, light microscopic examination revealed widespread interstitial and perivascular edema and alveolar collapse. At the same time, electron microscopy showed the major alteration to be widespread necrosis of both types of alveolar epithelial cells without significant injury to the vascular endothelium. During recovery, new epithelial cells appeared which probably were derived from granular pneumocytes. These cells developed into mature granular pneumocytes through a phase in which they resembled fetal granular pneumocytes. The late stage was characterized by a picture resembling diffuse interstitial fibrosis but which was due to irreversible closure of clusters of small airspaces with no apparent increase in collagen. Elastic recoil of the lungs, as reflected by peak inspiratory airway pressure, increased during the acute phase and showed a return toward normal that was coincident with the appearance of mature granular pneumocytes in the regenerating epithelium. Lung compliance decreased during the acute phase and in most animals returned toward normal during the recovery phase. These observations strongly suggest that the alteration in lung mechanics is related to epithelial necrosis and that recovery is related to epithelial regeneration.


Steroid-induced polycystic kidneys in the newborn rat. The ability of prednisolone, prednisolone tertiary butyl acetate, and tertiary butyl acetate to induce cysts in the kidneys of 8-day-old rats has been examined following single intramuscular injection of the chemicals into newborn rats. The results indicate that only prednisolone tertiary butyl acetate-treated rats developed cysts to any marked extent. The daily injection of potassium chloride (from Day 2 to Day 7) into the prednisolone tertiary butyl acetate-treated rats prevented the formation of cysts. Similar injection of potassium bicarbonate failed to provide protection. Serum and urine electrolyte (potassium, sodium, and chloride) concentrations were also studied on the day of necropsy. The steroid-treated rats did not develop the hypokalemia observed by previous workers. Changes in electrolyte concentrations were noted in a number of instances, but these could not be causally related to cyst formation.


Experimental galactosamine-induced hepatitis. Effect of anticoagulant and antifibrinolytic agents on microclot formation. An experimental hepatitis was induced in rabbits by intravenous infusion of 1 g galactosamine per kilogram of body weight. Galactosamine administration caused microclot formation in kidneys, liver, lungs, and spleen in a low percentage. If, however, animals were infused with the fibrinolysis inhibitor epsilon-aminocaproic acid in addition to galactosamine, microclots were generated in a high percentage. The microclots exhibited typical staining characteristics like those observed in the generalized Shwartzman reaction. Some animals developed bilateral renal cortical necrosis. Heparin treatment prevented the occurrence of microclot fromation after galactosamine administration, but it neither prolonged the survival time of the animals nor prevented or reduced liver cell damage. Increases in serum GPT and bilirubin levels were similar in heparin-treated and untreated rabbits. The experiments indicate that disseminated intravascular coagulation is involved in galactosamine-induced hepatitis but does not contribute to the severity of the liver injury.


Myocardial contractile force as a function of coronary blood flow. The contractile force of the deep and superficial myocardial fibers was examined in the open-chest anesthetized dog as a function of coronary blood flow (CBF). When 1) dogs that failed to demonstrate coronary autoregulation were eliminated from the data base and 2) CBF and contractile force data were both normalized as a percent of their vaues when perfusion was from aortic pressure (autoperfusion), the relationship between them became very reproducible. Contractile force was highly dependent on the flow rate when the CBF was below that chosen by autoregulation (the rate during autoperfusion). Conversely contractile force was relatively independent of flow at higher CBF. The contractile force-CBF curve thus was found to break precisely at the autoperfused CBF. When myocardial metabolism was elevated by paired electrical stimulation this relationship was unchanged. It was concluded that coronary blood flow is tightly regulated to match metabolic needs over a range of metabolic rates.


Effect of acetylcholine on automaticity of canine Purkinje fibers. The effect of acetylcholine on automaticity of Purkinje fibers was studied in isolated canine false tendon preparations with conventional microelectrode techniques. Of 15 preparations with the control spontaneous rate of 12-60 beats/min, acetylcholine in a concentration of 0.5 mug/ml decreased the spontaneous rate by 20-87% in 13 preparations. This decrease in automaticity was due to a decrease in the slope of phase 4 depolarization and an increase in the maximum diastolic potential. The inhibitory effect of acetylcholine could be reversed by atropine in a concentration of 3 mug/ml in six preparations and prevented by pretreatment with atropine in another six preparations. Atropine per se did not have any appreciable effect on automaticity of Purkinje fibers. The results indicate that acetylcholine significantly suppresses automaticity of canine Purkinje fibers through its muscarinic action.


Mechanism of the inhibition of myocardial protein synthesis during oxygen deprivation. Inhibition of protein synthesis during anoxia in the isolated rabbit right ventricular papillary muscle preparation is totally reversible for up to 2 h if glucose concentration is increased during anoxia. The degree of inhibition of protein synthesis during anoxia is, however, not altered by the presence of increased glucose. Thus inhibition of myocardial protein synthesis induced by anoxia need not be related to irreversible disruption of cellular integrity but may represent metabolic regulation of the synthesis. Tissue content of ATP, ADP, AMP, CP, and lactate and phenylalanine incorporation into protein were measured in individual papillary muscles incubated with varying degrees of O2 deprivation and varying substrates and metabolic inhibitors to determine if the inhibition during anoxia could be ascribed to alterations in tissue high-energy phosphate, adenine nucleotide levels, or rate of metabolic flux through the glycolytic and/or Krebs cycle. Protein synthesis was inhibited in muscles incubated in 15 mM glucose during anoxia despite the fact that in the presence of increased glucose, tissue levels of ATP, ADP, and AMP were equal to that of controls. Protein synthesis was normal in muscles made sufficiently hypoxic so that ATP and CP were significantly decreased and lactate increased. Inhibition of Krebs cycle activity with pentenoate failed to effect the rate of protein synthesis. We conclude that anoxic inhibition of myocardial protein synthesis is due neither to high-energy phosphate depletion nor inhibition of Krebs cycle acitivity. The possibility remains that the inhibition may be related to accumulation of glycolytic intermediates or by-products other than lactate.


Correlation of contractions and transit in rat small intestine. A single strain gauge was implanted chronically in the proximal jejunum of the rat to record contractions. FAsted pentobarbital-anesthetized animals received glucagon, caerulein, or isotonic saline control infusions intravenously while contractions were recorded. In control animals, the distribution of contractions in time showed clusters, with peaks at intervals of 14.24 +/-5.6 (SD) min. Glucagon produced dose-related inhibition of contractions. Caerulein at two lower doses produced a more uniform distribution of contractions in time; a higher dose caused inhibition. In other fasted rats, an isotopically labeled bolus was given through a chronically implanted duodenal cathether, and its distribution along the small intestine was examined in animals receiving the same doses of glucagon, caerulein, and saline. Glucagon caused a dose-related delay in transit. Those doses of caerulein that produced a uniform distribution of contractions accelerated transit; the dose that inhibited contractions delayed transit. Doses of glucagon and caerulein known to affect both motility and transit did not significantly affect water movement. The fasted rat resembles the fasted go in respect to the temporal distributions of jejunal contractions at a single point. Both quantitative and qualitative changes in contractions induce changes in transit.


Glucose utilization and recycling in ponies. Variables of glucose metabolism determined by the use of [U-14C]glucose were compared in fed and fasted ponies. Relative recycling of glucose carbon with respect to tritium in fed animals was negligible for 6-T and 3-T and 16% for 2-T studies; in fasted animals relative recycling was 12 and 14% for 6-T and 3-T studies, respectively. Minimal mass of total-body glucose decreased significantly in the fasted ponies. Based on relative recycling of carbon to tritium, a negligible fraction of plasma glucose was produced via the Cori cycle or from glycerol in fed ponies; recycled tricarbon units contributed 12% of glucose produciton in ponies fasted 72 h. In fed ponies, 16% of plasma glucose carbon was recycled via a futile cycle at the glucose 6-phosphate stage. Glucose utilization was best estimated with the use of [6-T]glucose (or 3-T).


Endogenous prostaglandin in guinea pig taenia coli. Prostaglandin (PGE) is synthesized in the guinea pig taenia coli. A low threshold concentration for an effect of exogenous PGE1 or PGE2 on spontaneous mechanical activity was demonstrated. The PG synthetase inhibitors aspirin, indomethacin, and 5,8,11,14-eicosatetraynoic acid, at concentrations that inhibited PGE efflux, had effects on spontaneous mechanical activity, membrane potential, membrane resistance, and evoked and spontaneous action potentials (single and double sucrose-gap methods) that were consistent with an action due to inhibition of membrane PGE concentration. The threshold concentration of indomethacin, which inhibited PGE efflux, was the same as the concentration that inhibited spontaneous mechanical activity. Pretreatment with ouabain (10(-6)-10(-5) g/ml) or elevated extracellular K+ (29 and 126 mM) made the guinea pig taenia coli entirely refractory to exogenous PGE1 or PGE2; the mechanical effects of the three prostaglandin synthetase inhibitors also were absent in the presence of elevated K+ or ouabain. The data are consistent with a hypothesis that, under conditions of our experiments, endogenous PGE has an effect on resting tension and spontaneous mechanical activity and on properties of the surface membrane of the guinea pig taenia coli.


Effect of ionic environment on oxygen uptake and lactate production of myometrium. The present studies were designed to measure the metabolic cost, in terms of oxygen consumption (QO2) and lactate production, of membrane ion transport, and activation of the contractile apparatus of rat myometrium. The normal QO2 of 16.98 +/- 0.84 mumol/g wet tissue per h was reduced to 15.42 +/- 0.66 in the presence of high-K (127 mM) solution. This was further reduced to 14.05 +/- 0.77 and 13.53 +/- 0.76 by the addition of D-600 (10(-5) M), which inhibits Ca influx or in the presence of Ca-deficient high-K solutions, respectively. Ouabain (10(-3) M) reduced QO2 by an amount similar to that produced by high K. Addition of K+ to Na-rich preparations produced an immediate ouabain-sensitive increase of QO2 whose rate was a linear function of [K+]o up to 30 mM in Ca-deficient solution. In all of the above conditions, changes in lactate release paralleled those in QO2. Isoproterenol (10(-6) M), which causes mechanical inhibition of myometrium, had no effect on the QO2 of muscles in normal solution but reduced the QO2 of muscles in Ca-deficient solution. Lactate release was increased by isoproterenol in both normal and Ca-deficient solutions. These results show that the Na pump is an important site of energy utilization in myometrium. Components which can be interpreted in terms of energy utilization for Ca pumping and the contractile apparatus were also demonstrated.


Insulin removal by isolated perfused rat liver. Removal of unlabeled insulin was studied in the perfused rat liver. Insulin removal followed first-order kinetics over the range of concentrations found in the portal vein of postabsorptive rats, but deviated from first-order kinetics in experiments with a wider concentration range. Clearance was more than twice as great at concentrations normally found in the portal vein in the postabsorptive state (0.40-1.1nM or about 60-100 muU/ml) than at concentrations expected after pancreatic stimulation (4.5-7.0 nM). Saturation of the liver's capacity to remove insulin, however, was not observed even at higher levels. Insulin clearance diminished when the flow rate was reduced. It was not significantly altered by prolonged starvation. Our results suggest that when the insulin concentration is high a greater percentage escapes hepatic degradation then when it is low. Hepatic insulin clearance is in part dependent on the portal flow rate. The kinetics of insulin removal by the perfused liver cannot be accounted for by the properties of insulin-degrading enzymes described by others.


Ontogeny of thirst in the infant rat.

Ontogeny of thirst in the infant rat. The development of water drinking in response to thirst stimuli was found to be precocious and sequential in the neonatal rat. It was studied in suckling rats with a technique that took advantage of their vigorous consummatory reflexes and minimized appetitive responding. Responsiveness to the following thirst challenges appeared in the suckling rat with a clear timetable: cellular dehydration at 2 days of age, hypovolemia induced by colloid dialysis at 4 days, and beta-adrenergic activation at 6 days. Responsiveness to deprivation from mother's milk was vigorous at the earliest day tested (2 days) but could not be distinguished from hunger. Rats weaned, isolated, and tested as miniadults responded appetitively to thirst challenges as early as 16 days of age. But they required a warm environment, optimum access to the water source, and sufficient time to respond. As revealed by consummatory responding, the controls of water drinking mature weeks before they are required. They precede the maturation of capacities for sustained appetitive responding. These appear in the last week of the suckling period, yielding animals that are prepared for adult, thirst-motivated behavior at the onset of weaning.


Interplay among carotid sinus, cardiopulmonary, and carotid body reflexes in dogs. Interactions among vascular reflexes evoked from carotid sinuses, carotid bodies, and cardiopulmonary region were examined in anesthetized, atropinized, and respired dogs with aortic nerves cut. The carotid sinuses were perfused at 220, 150, and 40-50 mmHg; the chemoreceptors were stimulated by perfusion with hypoxic hypercapnic blood. Cardiopulmonary vasomotor inhibition was interrupted by vagal cold block. Measurements were made of arterial blood pressure and of kidney and hindlimb vascular resistance. At sinus pressures less than 170-160 mmHg, cardiopulmonary vasomotor inhibition increased with increase in blood volume. At high sinus pressure, interruption of this augmented cardiopulmonary inhibition was as ineffective in changing vascular resistance as interruption of the lesser inhibition present during normovolemia. Chemoreceptor stimulation increased the response to vagal block at intermediate but not at high or low sinus pressure. The studies demonstrate the dominant role of the carotid sinus reflex when the three systems interact and the ineffectiveness of chemoreceptor stimulation when carotid or cardiopulmonary inhibition is maximal.


Comparison of arterial hemodynamics in the mongrel dog and the racing greyhound. This study was undertaken to define certain differences in cardiovascular function between mongrel (M) and greyhound (GH) dogs. In unanesthetized, trained, chronically instrumented animals mean arterial pressure was significantly higher in the GH (118 vs. 98 mmHg). This was associated with a significantly higher cardiac index in the GH (4.3 vs 3.1 liters/min per m2) and a lower calculated peripheral resistance. Central venous renin activity was significantly lower in the GH when unanesthetized (1.51 vs. 2.88 ng/ml per h). Values of vascular impedance at several selected arterial sites were lower in the GH compared to the M, suggesting differences in arterial wall mechanical properties. The hydraulic power delivered to the aorta by the left ventricle in the GH was twice that of the M (1,166 vs. 564 mol wt). Oscillatory power represented a greater fraction of total aortic power in the GH (15.7 vs. 10.8%). Differences were also observed in the hemodynamic response to acute pentobarbital anesthesia. Thus the young adult GH is hemodynamically different from its mongrel counterpart. These differences bear some resemblance to hemodynamic changes seen in various types of experimental hypertension in animals and to those observed in the early phase of essential hypertension in man.


Electrical off response of cat esophageal smooth muscle: an analog simulation. This investigation was performed to define characteristics and to design an electrical model of the slow membrane depolarization, or "electrical off response," that follows stimulation of cat circular esophageal smooth muscle. The electrical off response showed the following characteristics: 1) the response was preceded by hyperpolarization of the muscle membrane; 2) the amplitude of the off-response depolarization increased directly with increasing amplitude of the preceding hyperpolarization; 3) the membrane potential showed varying degrees of oscillation around the resting point; 4) the oscillation period was constant (4-5 s) and was double the time from the point of maximum hyperpolarization to the peak of the electrical off response. These characteristics suggested that the electrical off response could be represented by a linear second-order differential equation with variable damping, and an analog simulation was constructed. By varying the damping ratio and/or the natural frequency of the analog model, the characteristics of the electrical off response of esophageal muscle could be reproduced. The model provides a means to explore the behavior of esophageal smooth muscle contraction under normal and pathological conditions.


Effects of age and hypertension on utilization of glucose by rat aorta. Aortic intima-media was isolated from three groups of rats varying in age from 6.5 to 72 wk and from 16-wk-old rats with renal hypertension and sham-operated controls. Tissues were incubated with [U-14C]glucose for 3 h, and the incorporation of glucose into lactate, carbon dioxide, and total lipids was measured. The amounts of glucose converted to each product, per microgram of aortic DNA, increased with advancing age of donor rats over the entire range of age studied. Effects of hypertension on aortic glucose utilization were in the same direction as the effects of age, but more pronounced. Effects of age and hypertension were greatest on the conversion of glucose to carbon dioxide and least on its conversion to lipids. Significant although less marked increases in aortic glucose utilization with age and hypertension were also revealed when results were calculated on the basis of tissue weight.


Oxygen consumption by human and rodent striated muscle in vitro. Oxygen consumption has been measured in human and rodent striated muscle in vitro with a platinum-silver electrode system. The effects of excess potassium, caffeine, insulin, osmotic shock, halothane, and Na-pump blockade have been investigated and the differences from amphibian muscle responses are outlined. It has been found that normal human muscle, like that of rodents, is relatively indifferent to major surface depolarization and osmotic shock, as far as oxygen requirements are concerned. Surgical damage to muscle fibers causes them to react unpredictably to pharmacological tests. The results in normal muscles may be of use in the further study of certain muscular diseases.


Intramyocardial distribution of blood flow in hemorrhagic shock in anesthetized dogs. In 34 anesthetized, open-chest dogs aortic blood pressure was kept at 35-40 mmHg for 3 h to determine if maldistribution of coronary blood flow (CBF) could contribute to the irreversibility of hemorrhagic shock. Six dogs were pretreated with phenoxybenzamine (PBZ) and 11 dogs (3 with PBZ) received hypertonic mannitol infusions in late hemorrhage. Changes of heart rate, cardiac output, and peripheral resistance were similar to those described by others. In untreated dogs total and left ventricular CBF fell, as did coronary vascular resistance. However, minimal coronary resistance after transient ischemia rose progressively and the ratio of subendocardial:subepicardial flow fell, as did the percentage of diastolic coronary flow. Mannitol infusion returned CBF and steady-state and minimal postischemic coronary resistance to control values and also returned to normal the increased myocardial water content found in late hemorrhage. Phenoxybenzamine delayed but did not prevent the rise of coronary vascular resistance or decreased subendocardial flow. These studies suggest that there may be subendocardial ischemia, possibly due to myocardial edema, in hemorrhagic shock.


Preabsorptive insulin release and hypoglycemia in rats. Peripheral blood glucose and immunologically reactive insulin levels were determined in freely moving normal rats which were submitted either to a free oral glucose load or to a gastric administration of the glucose load. Identical determinations were performed in ventromedial hypothalamic nucleus-(VMH) lesioned and vagotomized rats after the same oral intake. It was demonstrated that: 1) a free oral glucose intake was immediately followed by two peaks of insulun release and a resultant decrease in blood glucose; 2) a gastric glucose load resulted in a single peak of insulin release and the concomitant decline in blood glucose; 3) the recorded blood glucose level was the resultant of the insulin-induced hypoglycemia and the postabsorptive hyperglycemia; and 4) the responses were largely exaggerated in VMH-lesioned rats and abolished by vagotomy. It is concluded that the early prandial insulin release reflexly induced by food-related stimuli temporarily enhances the metabolic conditions which provoke feeding.


Relationship between clearances of Ca and Na: effect of distal diuretics and PTH. One of the objectives of this study was to determine whether or not the absence of parathyroid hormone (PTH) modifies quantitatively the acute action of chlorothiazide (CTZ) to lower the clearance ratio, CCa/CNa. The same group of dogs was studied with standard clearance techniques before and after thyroparathyroidectomy (T-PTX), and after T-PTX during the infusion of PTH. There was no significant difference in the response to CTZ before or after T-PTX, or during the infusion of PTH. The effects of PTH and a maximally effective dose of CTZ were additive. A second objective of this work was to ascertain whether or not two other diuretics which act on the distal tubule, amiloride and triamterene, had actions on CCa/CNa similar to that of CTZ. Amiloride caused a reduction in CCa/CNa which, even at maximally effective doses, was much smaller than the effect of CTZ. Maximally effective doses of amiloride and CTZ had additive actions. Triamterene was evaluated at only one dose; it also lowered the ratio CCa/CNa.


Humoral deficiency and reticuloendothelial depression after traumatic shock. Circulating opsonin levels and reticuloendothelial (RE) phagocytic activity were investigated in anesthetized rats subjected to Noble-Collip drum (NCD) trauma. Reticuloendothelial function was assessed by colloid clearance kinetics and circulating opsonin levels by in vitro tissue slice bioassay. After sublethal shock, both hepatic RE phagocytosis and plasma opsonic activity were significantly (P less than 0.001) depressed in the 0.5- to 6-h posttrauma period. Pulmonary and bone marrow localization of the blood-borne test microparticles significantly (P less than 0.05) increased during hepatic RES depression. Hepatic RE cells from animals during the interval of posttraumatic in vivo phagocytic depression exhibited normal phagocytosis when incubated in normal pretrauma plasma and decreased phagocytic activity when incubated in posttrauma plasma. After sublethal shock, restoration or opsonin levels by 24 h after shock resulted in hepatic RE recovery. Plasma opsonin levels declined in direct relationship to the degree of trauma. Progressive hepatic RE failure was correlated with the progressive decline in circulating plasma opsonic activity. The findings indicate that opsonic depletion may be involved in the etiology of hepatic reticuloendothelial depression after traumatic shock.


Ion-osmotic hyperthermia during exercise in dogs. The influence of intravenous infusions of various concentrations of NaCl solutions on temperature regulation was investigated in dogs at rest and during moderate exercise for 1 h on a treadmill. Infusion of hypertonic solutions either before and during exercise resulted in elevated (P less than 0.05) plasma Na+ and osmotic concentrations and produced higher equilibrium levels (P less than 0.05) of rectal temperature (Tre) during exercise (prehypertonic 40.9 degrees C vs. no infusion 40.4 degrees C; hypertonic 40.8 degrees C vs. isotonic infusion 40.4 degrees C), but not at rest. Increasing the [Na+] and osmotic concentrations above 170 meq/liter and 325 mosmol/kg, respectively, resulted in no additional increase in exercise Tre. Water consumption during exercise decreased (P less than 0.05) plasma [Na+], osmolality, and the equilibrium level of Tre to control levels. There was no effect of changes in plasma volume (PV) of +/- 8% on the time course, equilibrium level, or change in Tre during exercise. At the end of exercise, there were moderate correlations (P less than 0.01) between Tre and [Na+] (r = 0.51) and Tre and osmoti (r = 0.52) concentrations. It was concluded that a) the exercise Tre responses of the dog respond quantitatively like man to elevated plasma [Na+] and osmolality, b) the Tre levels are not influenced by changes in PV, and c) water intake significantly reduces the ion-osmotic hyperthermia.


Modification of stimulated lacrimal gland flow by sympathetic nerve impulses in rabbit. This study was undertaken to determine if sympathetic nerve impulses modify lacrimal gland fluid (LGF) flow, which was continuously recorded from a cannula in the excretory duct of the lacrimal gland in rabbits anesthetized with pentobarbital sodium. The preganglionic trunk of the superior cervical ganglion was stimulated with electrical stimuli during pilocarpine-induced and reflexly induced secretion. Stimuli equal to or 6-8 times stronger than the intensity that produced maximal pupil dilation caused inhibition followed by poststimulus enhancement of LGF flow when the prestimulus LGF flow was greater than 3.0 mul/min. When the prestimulus LGF flow was less than 0.8 mul/min, the stronger stimulation enhanced LGF flow but the weaker stimulation produced inhibition followed by poststimulus enhancement of LGF flow. Although no measurements of lacrimal gland blood flow were made, the alterations in these responses, which occurred during alpha- and beta-adrenergic blockade, were consistent with the changes in sympathetically induced blood flow that occur during alpha- and beta-blockade in other organs.


Role of arterial baroreceptors in mediating cardiovascular response to exercise. The role played by the major arterial baroreceptor reflexes in the cardiovascular response to exercise was examined by comparing the responses of untethered conscious dogs instrumented for the measurement of aortic pressure and cardiac output with those of dogs with total arterial barorecptor denervation (TABD). Moderately severe levels of exercise (12 mph) in intact dogs increased cardiac output from 111 +/- 17 ml/kg per min, increased heart rate from 101 +/- 5 to 265 +/- 8 beats/min, and reduced total peripheral resistance from 0.039 +/- 0.003 to 0.015 +/- 0.002 mmHg/ml per min. Dogs with TABD responded in a very similar fashion; exercise increased cardiac output from 119 +/- 8 to 356 /+- 23 ml/kg per min, increased heart rate from 122 +/- 7 to 256 +/- 5 beats/min, and decreased total peripheral resistance from 0.042 +/- 0.005 to +/- 0.015 +/- 0.001 mmHg/ml per min. The reflex heart rate responses to intravenous bolus doses of methoxamine were also examined in intact animals, both at rest and during exercise. Methoxamine caused striking bradycardia at rest, but little bradycardia during exercise. These results suggest that the arterial baroreceptor reflex is normally turned off during severe exercise and thus does not modify significantly the cardiovascular response to exercise.


Effect of adrenal steroids on bone resorption in rats. Rats labeled with strontium-85 (85Sr) were rejected with adrenocortical steroids for 2 wk. The urinary-to-tibial (U/T) 85Sr ratio was used as an index of bone resorption. The glucocorticoids caused an inhibition of skeletal resorption, as judged by the 50% reduction in the U/T ratio, and decreased excretion of hydroxyproline. Thyroidal calcitonin levels were slightly elevated in glucocorticoid-treated animals, suggestive of a possible retardation of calcitonin release. The U/T ratios of thyroparathyroidectomized (TPTX) rats injected with corticosteroids were 50% of control values. The results indicate that glucocorticoids inhibit bone resorption independent of the action of calcitonin. Cortisol treatment increased the tibial density as measured by a radiographic technique. However, bone density was decreased and the U/T ratio increased in steroid-treated rats fed a low-calcium diet. In TPTX cortisol-treated rats, parathyroid extract (PTE) increased the U/T ratio and serum calcium but not to the degree observed in TPTX PTE-injected control animals. These experiments indicate that in rats glucocorticoids inhibit the rate of bone resorption but this effect can be overcome in part by PTE.


Amino acid assignment to one of three blood-brain barrier amino acid carriers. The percentages of 22 14C-labeled amino acids remaining in rat brain 15 s after carotid injection were measured relative to a simultaneously injected diffusible internal standard, 3HOH. The injected solution also contained a nondiffusible internal standard, [113mIn]EDTA to correct for incomplete brain blood compartment washout. Self-inhibition and cross-inhibition was demonstrated by inclusion of unlabeled amino acids and carboxylic acids. All amino acids tested, excluding proline, alanine, and glycine, could be assigned to one, and only one, blood-brain barrier carrier system. The neutral carrier system transported phenylalanine, leucine, tyrosine, isoleucine, methionine, tryptophane, valine, DOPA, cysteine, histidine, threonine, glutamine, asparagine, and serine. Affinity for a basic amino acid carrier system was demonstrated for arginine, ornithine, and lysine. A third, low-capacity independent carrier system transporting aspartic and glutamic acids was demonstrated.


Effect of carbachol on 45Ca uptake and protein secretion in rat lacrimal gland. Carbachol stimulates 45Ca uptake and protein secretion in rat lacrimal glands. At low concentration (10-8 M) atropine inhibits these effects but phentolamine and propranolol (10-5 M) are ineffective. The optimum response in both processes is obtained at the same concentration (10-6 M) of the cholinergic agonist. Vinblastine (10-4 M) reduces protein discharge induced by carbachol without modifying the uptake of 45Ca stimulated by the parasympathetic mediator. Calcium influx is proposed as the primary effect of cholinergic inducers in secretory processes.


Current trends in the training of family therapists. The author describes and compares training programs for family therapists at 15 centers in 9 major U.S. cities, using a scale that reflects the spectrum of theoretical approaches to family therapy. At one end of the spectrum are the centers with an experiential orientation, at the other end are those with a structural orientation, and in the middle are those which combine these orientations. He concludes that although creative theoretical advances are being made at a few of these centers, the quality and design of training at the remaining centers suffer from the absence of an adequate diagnostic nomenclature for family therapy and from an insufficiently designed conceptual framework.


Crime and violence among mental patients. The authors studied the arrest rates of 867 patients from the Bellevue catchment area who were discharged from the psychiatric division of Bellevue Hospital. They found that the arrest rates of these patients for two years preceding and two years following their admissions to the study were higher than the arrest rates for the general population of the Bellevue catchment area as well as those for 4,601 cities in the United States. They discuss the implications of this finding for the post discharge care of mental patients, particularly in the light of current discharge policies.


Cluster analysis profiles of suicide attempters. The author reports the results of a three-stage cluster analysis of data on 298 patients who attempted suicide. Patients were allocated by the analysis to seven identifiable profile types that correlated with six outcome variables. These profiles include data on the social setting and the seriousness of the attempt and judgments about overall functioning and interpersonal conflict as well as the input of the patients' significant others. The author states that these profiles have prognostic significance as well as implications for the treatment of suicide attempters and the education of emotionally involved significant others.


Psychiatric aspects of dwarfism.

Psychiatric aspects of dwarfism. Sixteen adult dwarfs - 11 with achondroplasia and 5 with hypopituitarism - were studied by means of psychiatric interviews and psychological tests. There were no significant differences between the two groups; in general, the subjects had achieved a satisfactory life adjustment despite the stress of having bodies uniquely different from those of the general population. They had secure identities as "little people" and successfully used coping mechanisms such as a sense of humor and a pleasant interpersonal style. Male dwarfs tended to experience more emotional distress than female dwarfs.


The interaction of social class and other factors in the etiology of schizophrenia. Epidemiological evidence clearly indicates an especially high rate of schizophrenia at the lowest social class levels of urban populations. The author suggests that this relationship between class and schizophrenia exists because the conditions of life experienced by people of lower social class position foster conceptions of social reality that are so limited and rigid as to impair their ability to deal resourcefully with the problematic and the stressful. Such impairment does not in itself result in schizophrenia; however, in conjunction with genetic vulnerability and great stress, it could be disabling.


Estimating the genetic contribution to schizophrenia. The authors discuss the limitations of the concept of heritability in schizophrenia and, using reported incidence figures, assess two alternatives--the multifactorial and single major locus (SML) models. Both models predict genetic heterogeneity in schizophrenia. For some parameter values, the SML model indicates that homozygotes are rare but at very high risk. According to the multifactorial model, 9.1% of the schizophrenic population has a genetic risk of 99% or more. The authors conclude that neither model adequately accounts for the data but that predictions from both can be used to design sampling procedures which will increase the probability of selecting for study individuals whose illness is highly genetically determined.


Serum creatine phosphokinase in schizophrenia. The author notes that increased serum creatine phosphokinase (CPK) activity is found in the majority of hospitalized acutely disturbed schizophrenics and patients with affective psychoses. It is probable that some of these increases do not result from nonspecific factors such as activity, trauma, or stress, which do cause increases in some cases. Those patients who show increased CPK activity have more florid psychopathology and tend to have higher CPK levels in nonacute periods than those without increases. First-degree relatives of psychotic patients with elevated serum CPK have high-normal or slightly increased serum CPK. There is also evidence of other neuromuscular dysfunction in psychotic patients. The author concludes that the investigation of CPK may have considerable heuristic value for the study of schizophrenia and other psychoses.


The dopamine hypothesis of schizophrenia: focus on the dopamine receptor. Alleviation of schizophrenic symptoms by phenothiazines and butyrophenones is associated with blockade of dopamine receptors, while exacerbation of symptoms by amphetamines appears to result from enhanced synaptic activity of dopamine and/or norepinephrine. The author suggests that biochemical labeling of the dopamine receptor with 3H-dopamine and 3H-haloperidol may clarify mechanisms of drug effects on the dopamine receptor.


The educational objectives of a psychiatric residency program. The authors present a statement of the specific educational objectives of their psychiatric residency program. This statement is designed to help residents keep in focus the central tasks of their training and to provide the faculty with an organizing matrix for curriculum development. Through such specific delineation of their objectives, residency programs can also contribute to a clarification of the specialty.


The effect of marijuana on carbohydrate metabolism. The authors observed the effect of marijuana on carbohydrate metabolism in fed and fasting states in chronic marijuana users. They found no hypoglycemia in 7 patients who were given marijuana after fasting for 24-72 hours. They also found no significant difference in carbohydrate tolerance and no hypoglycemia during an oral glucose tolerance test in 10 patients who smoked placebo or marijuana on alternate days. They conclude that marijuana has no effect on carbohydrate metabolism in the fed or the fasted state in well-nourished chronic marijuana users.


Joint admission as a treatment modality for problem drinkers: a case report. Joint hospital admission of a married alcoholic and his/her spouse can facilitate treatment of the problem drinker. A case report illustrates the advantages of this approach in giving the staff an opportunity to observe and provide the couple with feedback about their patterns of interaction and to provide specific therapeutic interventions during the joint admission.


Chronic hashish use and mental disorder. The authors compared 47 long-term users of hashish with a control group of 40 subjects matched for age, ethnic origin, education, etc., in order to determine whether they differed significantly on psychiatric, physical health, and demographic variables. There was a significantly higher incidence of personality disorders, unemployment, and prison sentences in the group of chronic users. However, in contrast to the findings of other researchers, the hashish users did not have organic psychoses, nor did they differ from control subjects in neurologic signs or EEG and echo encephalogram patterns.


Mania and bromism: a case report and a look to the future. Mania has not been reported as a manifestation of bromism. This paper describes a manic patient who had an elevated serum bromide level. The author suggests that the possibility of bromide-induced mania should be considered when patients who manifest manic symptoms are evaluated. The implications of the bromide-mania relationship for a better understanding of manic-depressive illness are also discussed.


Breaking into the prison: conducting a medical research project. Three major tasks face the researcher in a medical experiment employing prisoners as experimental subjects. Understanding the nature of the subject, crossing the territorial boundary, and obtaining informed consent are prerequisites for the successful implementation of research in the prison and rely heavily on the personal integrity of the invesitgator.


An evaluation of emergency room services during the New York City house officer strike. A chart audit of emergency services provided by attending staff during the New York City House Officers' strike is compared to an audit of work previously performed by house staff. The usual quality of services provided in this institution was maintained during the strike. However, deficiencies in quality noted in house staff charts, continued to be noted in the charts of attending staff. Failure to improve quality of medical records when trained staff substitute for trainees suggests that the central strike issue of poor working conditions contributes to low quality of care.


State level comprehensive health planning: a retrospect. A questionnaire survey of the 50 state CHP agencies and a case study of a single state CHP agency were conducted to contrast the concept of comprehensive health planning with the practice of health planning at the state level. Both the survey and the case study evidenced a substantial disparity between concept and practice. For example, the survey indicated that the following tasks had not been completed by the following percentages of the responding agencies: defining the system of interest (64%), ranking problems (50%), setting targets (74%), thoroughly analyzing intervention alternatives (71%), selecting criteria and procedures for intervention evaluations (57%). The state CHP agencies were found to be lacking in the following areas: (a) technical analyses, (b) explicitness, (c) priority setting, (d) attention to health status indices and preventive interventions, and (e) integration of planning activities. The implications of these findings are discussed.


Extramedical factors in the decision to hospitalize medical patients. This study assesses the importance of extramedical factors in the decision to hospitalize medical patients. Residents in a municipal hospital's emergency room completed a questionnaire on 252 consecutive patients at the time of admission. Extramedical factors contributed to the admission decision in 54 patients (21 percent); for twenty of these patients (8 percent of total) extramedical factors were the primary reason for admission. Factors noted most frequently related to patient behavior, such as being unlikely to follow instructions, and to home situations, such as social isolation. For 16 percent of the admissions, physicians felt that treatment outside the hospital was possible if realistic alternatives existed. Results suggest that extramedical factors are important contributors to the need for hospitalization. Attempts to develop quality assurance criteria, such as in utilization review or admission certification, must take such factors into account.


A preliminary study of circulating vitamins in a Puerto Rican migrant farm population in New Jersey. A preliminary survey of circulating vitamin B12 biotin, folate, thiamin, riboflavin, vitamin B6, pantothenate, nicotinate, and vitamin A & B-carotene of 53 Puerto Rican migrant farm workers was undertaken. Results indicate that hypovitaminemia existed particularly for vitamin B12, vitamin B6 and vitamin A.


Failure to detect hepatitis B surface antigen (HBsAg) in certified shellfish from New England. In this study, hard- and soft-shell clams harvested during a one-year period from state approved (certified) clam beds in Maine, Massachusetts, and Rhode Island were tested for HBsAg by radioimmunoassay. HBsAg could not be detected in clam viscera. The role of bivalve mollusk ingestion in transmission of Hepatitis B remains speculative.


Serosurvey of dogs for Brucella canis infection in Memphis, Tennessee. Following occurrence of a rare case of human Brucella canis in Memphis, Tennessee, the free roaming and confined dog populations of that community and a similar geographical location were surveyed for B canis positivity to identify the foci of infection and to compare positivity rates. Three hundred and two dogs were sampled. Positivity was found only in free roaming dogs in both communities. It is concluded that presence of B canis positivity in free roaming dogs may pose an additional medical threat to communities, thus providing one more sound reason for controlling strays and confining dogs.


Effect of gastric bypass on gastric secretion. Gastric bypass as a 90 per cent gastric exclusion operation was used in 393 patients with massive obesity to limit food intake. Stomal ulcer has occurred in 1.8 per cent of such patients or one ulcer per 140 man years of observation. The studies of indwelling fundic pH and of gastric acid secretion from the excluded stomach indicate that acid secretion is reduced after gastric bypass but that the acid, unbuffered by food in the excluded stomach, results in a lowered gastrin secretion after a meal. Thus, gastric bypass in inhibitory to acid secretion in most morbidly obese patients who do not have known acid peptic disease.


Bypass enteritis. A new complication of jejunoileal bypass for obesity. Four patients who had jejunoileal bypass for morbid obesity had increased frequency of diarrhea, diffuse abdominal tenderness and distention, and fever to 104 degrees F. Roentgenographic studies disclosed multiple distended loops in the bypassed bowel with few air fluid levels. Two of these patients underwent operation for suspected peritonitis from abscess or obstruction. No abscess or mechanical obstruction was found. The bypassed bowel contained many subserosal gas-filled blebs. The remaining two patients were treated with antibiotics and showed prompt improvement. "Bypass enteritis" must be considered in the postoperative period in patients undergoing surgery for morbid obesity. It responds to antibiotics and appropriate electrolyte therapy. The presumed factor is overgrowth of enteric bacteria in the distal portion of the bypassed bowel. Accurate diagnosis will obviate the need for surgical exploration to exclude peritonitis.


Altered serum gastrin levels in achlorhydric states. Hypergastrinemia occurs in achlorhydric states if the antrum is not diseased, and evidence has been presented that suggests that antral gastritis diminishes gastrin levels in achlorhydric patients. There is a dramatic gastrin response to calcium challenge in patients with pernicious anemia. Only minimal response was observed in patients with atrophic gastritis. Unlike the response observed in the Zollinger-Ellison syndrome, secretin challenge suppresses gastrin in achlorhydric states. These findings add a new dimension to the utility of serum gastrin determinations.


Routine subclavian vein catheterization in abdominal surgical practice. Ninety-four routine subclavian vein catheterizations in patients with abdominal surgical procedures were performed by the resident surgical staff at the Medical University of South Carolina Hospital over a ten month period. This was done primarily to have ready access to large veins during surgery and to free the patients' extremities from uncomfortable immobilization and the risk of superficial thrombophlebitis in the postoperative period. The procedure is safe, and complications can be kept to a minimum if experienced personnel place and then care for the catheter.


Abdominal exploration as a diagnostic procedure. Diagnostic laparotomies performed during a five and a half year period in a 400-bed hospital were reviewed. Positive findings on physical examination, laboratory results, or x-ray findings were given one point each, making possible a range of points extending from zero to three for each patient. The number of positive laparotomies (those truly diagnostic) increased in a "linear" fashion with the point rating of each patient. No patients with a zero score had a laparotomy that was diagnostic, whereas 97 per cent of those with a score of three had positive laparotomy.


Fate of the retained rectum after subtotal colectomy for inflammatory disease of the colon. Of forty-nine consecutive patients who underwent subtotal colectomy for inflammatory disease of the colon, 73.5 per cent required subsequent combined abdominoperineal resection of the retained rectum and only two patients had successful ileoproctostomy. For the patient whose rectum is substantially diseased along with the rest of the colon, one-stage total proctocolectomy is the preferred operation.


Abdominal pain. An analysis of 1,000 consecutive cases in a University Hospital emergency room. In the majority of patients in this series of 1,000, acute abdominal pain was due to conditions that required neither surgical intervention nor hospitalization. Eleven of the 1,000 patients had an early missed diagnosis in the emergency clinic for which a subsequent operation was needed, and twenty underwent an operation which subsequent diagnosis showed was not required. All false-negative evaluations occurred in patients with early appendicitis or small bowel obstruction. Most false-positive results were due to acute infections of the female genitourinary tract in patients operated on to exclude appendicitis or a tubo-ovarian abscess. The following factors help identify the high risk patient with an acute surgical abdomen: (1) pain for less than 48 hours; (2) pain followed by vomiting; (3) guarding and rebound tenderness on physical examination; (4) advanced age; (5) a prior surgical procedure. The presence of these features demands careful evaluation and a liberal policy of admission and observation. White blood cell counts, body temperature, and abnormal abdominal roentgenograms may add confirmatory evidence but are not particularly helpful as screening devices.


Ileal loop ureteroileostomy in patients with neurogenic bladder. Personal experience with 54 patients. (1) In a six year experience with ileal loops in patients with neurogenic bladder, 49% of the patients were paralyzed, 30% had multiple sclerosis, and 91% had recurrent or persistent urinary tract infection. Reflux, incontinence, retention, and bladder calculi were additional indications for supravesical urinary diversions. (2) All loops were performed in a similar manner, most of them placed retroperitoneally, and a vigorous program of postoperative care was followed. There were no postoperative deaths, and a moderate number of complications occurred in 51.8% of the patients. (3) The participation of the enterostomal therapist is the preparation of the patient and in the immediate and long-term stomal care has been invaluable and is strongly recommended.


Transcystic duct operative cholangiography. Personal experiences with 500 consecutive cases. Of 500 consecutive cholecystectomy patients, sixty-nine had clinical indications for common bile duct exploration and twenty-nine of these yielded stones for an overall accuracy rate of 42%. Of the 431 remaining patients, thirty-six demonstrated abnormal cholangiograms and in these, twenty-six yielded stones within the common duct, representing and incidence of 6% of unsuspected stones. Of the total series of 500 patients, sixty-one showed cholangiographic indications for common duct exploration and fifty were positive for stones for an overall accuracy of 82%. The overall incidence of common duct stone recovery was 11%. It is concluded that transcystic duct operative cholangiography should be performed routinely during cholecystectomy when feasible.


Gallbladder disease in the young male.

Gallbladder disease in the young male. Eighteen of 2,614 patients undergoing cholecystectomy in two large general hospitals were males between the ages of two and twenty years. The great majority presented with a typical symptoms of cholecystitis. Ten of the eighteen had idiopathic cholelithiasis, with no predisposing factors generally associated with an increased incidence of this disease. This diagnosis must be kept in mind in dealing with patients of this age group.


Hepatography.

Hepatography. A method of hepatography in dogs is described in which contrast medium is infused via the external jugular and superior and inferior venae cavae and hepatic veins. Hepatograms taken by infusing different contrast media in the normal liver and in the liver subjected to parenchymatous damage are also analyzed in detail.


Improving trends with pancreatoduodenectomy. This paer stresses the complete change in outlook associated with pancreatoduodenectomy at the Ellis Fischel State Cancer Hospital since 1963, the year that marks the implementation of step-wise surgical principles espoused by Newton regarding the performance of pancreatoduodenectomy with the minimizing of morbidity and mortality factors. Since 1963 only one hospital death has occurred at Ellis Fishcel State Cancer Hospital after pancreatoduodenectomy and this case was atypical.


Intraluminal, lymph node, hepatic, and serum levels after intraluminal and intramural injection of 5-fluorouracil in the dog colon. The tissue levels of 2-14C 5-fluorouracil were compared after three routes of administration in the colon of fifteen dogs. "Simple" submucosal injection resulted in higher levels in the colonic wall, abdominal lymph nodes, and liver than did rapid intravenous injection. Intraluminal administration demonstrated that the appearance of 5-FU was prompt and that significantly higher levels continued in the colonic wall and liver, but nodal levels were markedly lower.


Computer controlled muscle relaxation: a comparison of four muscle relaxants in the sheep. Computer control of anaesthesia has been extended to include muscle relaxant drugs. Injection of d-tubocurarine, gallamine, alcuronium or pancuronium was controlled by computer to reduce the integrated electromyogram to a preset level (40 per cent of control) for one hour. A programmed level of muscle paralysis is therefore possible for use in physiological and pharmacological experiments, and in clinical practice where precise control of the degree of paralysis together with minimal dosage is advantageous.


Continuous flush system for radial artery cannulation. A prospective study of 50 radial artery cannulations was carried out using the Intraflo continuous flushing device. Functional patency was maintained in all cannulations. No serious complications were seen. It is concluded that this method of continuous flushing is preferable to intermittent manual flushing.


Computer controlled studies in surface cooling hypothermia: the effect of carbon dioxide on brain temperature. A computer controlled ventilation system was employed to maintain a constant end-expired CO2 percentage (FECO2) during a series of studies on young dogs aimed at measuring brain temperature differences during surface cooling hypothermia. The conclusion is that an FECO2 of six per cent or more is desirable if brain temperature differences are to be minimized. Additional experiments showed that ethyl alcohol and sodium nitroprusside infusions during cooling did not decrease brain temperature differences.


The effect of halothani-nitrous oxide anaesthesia and spontaneous ventilation on arterial blood oxygenation and physiological deadspace. Arterial blood, inspired and expired gas samples were taken from seven patients anaesthetized with halothane (1-2 per cent) and nitrous oxide in oxygen and who breathed spontaneously. Over a two hour period, the average arterial oxygen tension was 75 mm Hg and carbon dioxide tension 49 mm Hg. No significant deterioration of either blood gas value occurred during the two hours. The dead-space/tidal volume ratio and alveolar-arterial oxygen tension difference did not alter significantly during the period of the study.


The fat embolism syndrome, results of a therapeutic regime. Results of a therapeutic regime for the fat embolism syndrome are presented. The basis of this regime is to prevent hypoxia by use of oxygen and if necessary intermittent positive pressure ventilation. Prophylactic oxygen therapy in patients likely to develop the fat embolism syndorme is suggested.


Six unusual cases of drug overdose.

Six unusual cases of drug overdose. Six patients out of a total of 1,137 adults treated for drug overdose died during the period May, 1968 to June, 1973. Their case histories are summarized, and the conclusion drawn that, whilst death from drug overdose is unusual, increased vigilance particularly for the unsuspected secondary diagnosis or complication, is needed if there is to be any further reduction in the already small mortality rate.


Solubility and partial pressure: a simple demonstration of their relationship. This simple apparatus demonstrates that when a quantity of volatile agent is added to a solvent system the partial pressure exerted is inversely proportional to the solubility of the agent in the solvent.


The growth of the chick retina after hatching. In autoradiographs of the retina from two-week old chicks injected with tritiated thymidine during the first week after hatching, the labelled cells were found mainly in the extreme periphery of the retina and the ciliary epithelium of the pars plana. The pattern of labelling in the extreme periphery resembles that observed (Fujita and Horii, '63) in retinae exposed to tritiated thymidine during embryonic development. The mechanisms underlying the histogenesis of retinal cells during growth at the extreme periphery in young stages may be the same as those which operate during embryonic devolopment.


Cellular mechanisms involved in cyclic stroma renewal of the uterus. III. Cells of the immune response. The principal cell types associated with the humoral immune response (monocyte-macrophages, lymphocytes, and plasma cells) are numerous in the endometrial stroma of the uterus during the first four postpartum days in two types of mammals, the marsupial North America opossum and the eutherian albino rat. This transietn cellular differentiation coincides with the physiologic period of rapid uterine regression which includes massive reduction in the amount of extracellular stromal material. In addition, heterophils and eosinophils, cell types also known to be associated with phagocytic and immunologic activity, appear in the stroma during the first two postpartum days; their presence may, however, be associated more directly with the postpartum estrus that occurs on day 1 postpartum than with endometrial regression. Thus, the five cell types, which are known in pathologic conditions to be components present in the inflammatory response to a foreign antigen, are conspicuously present in the normal regressing endometrium. Furthermore, there is ample ultrastructural evidence of frequent macrophagic-lymphocytic interaction, transformation of lymphocytes, and active secretion by plasma cells during this early postpartum period. An hypothesis has been derived by uniting this new description of endometrial stromal cell differentiation with the existing literature on uterine collagenase activity, an important feature of postpartum regression (reviews of Gross, '74; Harris and Krane, '74). It is based on the assumption that during regression the extracellular action of neutral collagenase (and possibly other extracellular proteases) release new antigenic sites in proteins located in the ground substance. In the case of collagenase, these transient antigenic sites would arise at the locus of enzymic cleavage as well as from the subsequent denaturation of the fragments of the collagen molecule. This endogenous antigenic stimulus would be strong and temporary, and would lead to the cellular manifestations of the transient humoral immunologic response which are evident in the regressing stroma of these two mammals. This humoral immune reaction may be one of the regulatory mechanisms involved in the cyclic renewal of the extracellular compartment of the uterine stroma.


Cellular mechanisms involved in cyclic stromal renewal of the uterus. I. The opossum, Didelphis virginiana. At the close of a uterine cycle, the remodelling of the endometrial stroma of the North American opossum involves removal of extracellular material by macrophages. This study provides cytochemical and ultrastructural evidence which indicates that the laden macrophages are eliminated from the endometrium through emigration across the glandular and luminal epithelia. During diestrus or the early postpartum period, the abundant uterine glands relinguish their secretory function to acquire a transient function in the transportation of emigrating stromal cells. During the first three postpartum days endometrial regression in the stroma is marked by sudden appearance of monocytes, macrophages, lymphocytes, and plasma cells. Ultrastructural and cytochemical evidence indicates that the macrophages engulf the extracellular macromolecular material which, in the opossum, consists primarily of ground substance. Macrophages filled with ingested extracellular material aggregated beneath the glandular and luminal epithelia, where they acquire an extracellular coat that resembles the material of the basal lamina elsewhere. A fibroblast-like cell closely invests the macrophage at the time the extracellular material appears. Simultaneously, the secretory glandular epithelium is being converted to a highly ciliated one. Macrophages, often accompanied by lymphocytes, acquire intraepithelial positions in the glands. From here these stromal cells gain entrance to the glandular lumens. At this time the luminal contents are rich in acid phosphatase activity which most likely reflects the high lysosomal content of the emigrating macrophages. Evidence suggests that these intraluminal macrophages and lymphocytes are swept, by the recently differentiated ciliary lining, toward the glandular orifices and into the uterine cavity. It is hypothesized that this cyclic appearance and transepithelial elimination of macrophages is a cellular mechanism for removing large amounts of extracellular material without disruption of the endometrium.


The fine structure of the interhemal membrane of the rat chorioallantoic placenta during prolonged pregnancy. In placentas from viable rat fetuses which surgically had been retained beyond term in lactating animals for as long as four days, the fine structure of much of the interhemal membrane was quite like that of full-term placentas. Moreover, contrary to what has been reported previously (Jollie, '64a), in retained placentas which were autopsied at term there were few changes in the four cytoplasmic layers of the membrane which could be interpreted as degenerative. With prolongation of the placenta beyond normal delivery the number of pericytes which were associated with the allantoic endothelium increased; the basal lamina separating the endothelium from trophoblast III progressively became more focally split; and the apposed plasma membranes between this latter layer and trophoblast II appeared to dissociate. Trophoblast II became regionally divided in its cytoplasmic organization, its more superficial zone becoming highly infolded and/or vacuolar. As a consequence, the intertrophoblastic space between layers I and II became more extensive and complex. Within this space, a flocculent material appeared; and there was ultrastructural evidence of massive pinocytosis from the space by trophoblast II. With increased prolongation of gestation, a variety of lysosome-like inclusions appeared within this layer of the membrane.


Comparative ultrastructural analysis of two tortoise bladders, Testudo graeca and Geochelone carbonaria. Urinary bladders from the desert tortoises, Testudo graeca and Geochelone carbonaria were removed at specific times during the year and species in all bladders examined: (1) granular cells, (2) mitochondria-rich cells, and (3) basal cells. Cells analogous to these three types have also been observed in amphibian bladders (from toad Bufo marinus and bullfrog, Rana catesbiana) and reptilian bladders (from Pseudemys scripta and Clemmys caspica). Both tortoises have an incomplete layer of basal cells so that the granular and mitochondria-rich cells extend from the lumen to the basement membrane: something was not observed in bladders from bullfrog or turtles. A flask-shaped light cell was observed in the Geochelone carbonaria bladder obtained in April. No counterpart of this cell was seen in the same species sacrificed in January, or in any of the Testudo graeca bladders, although a similar cell has been described in the turtle, Pseudemys scripta (Rosen, Expt. Molec. Path., 12: 286-296, '70). This study was undertaken to characterize the cell types present in tortoise bladder and to compare them with cell types in the bladder of the turtle, bullfrog and toad.


Airway closure during mechanical ventilation. A nitrogen-dilution technique for measurement of airway closing volumes (CV) and functional residual capacity (FRC) not requiring subject cooperation was tested in five healthy, awake, spontaneously breathing subjects and subsequently used in 20 patients during anesthesia with mechanical ventilation. Incomplete exhalation before inhalation of oxygen did not significantly alter CV. Inspiration of a volume of oxygen equal to 75 per cent of vital capacity (VC) did not affect CV, whereas inspiration to 50 percent VC resulted in a 20 per cent decrease in CV. Expiratory resistance tended to reduce CV. By means of this technique, the validity of which had been thus demonstrated, airway closure could be shown to occur at lung volumes larger than FRC (and thus within a normal tidal volume) in six patients prior to anesthesia, and in a further 11 (total 17 of 20) during anesthesia with mechanical ventilation. FRC decreased by an average of 0.5 liters during anesthesia with mechanical ventilation and was only 0.2 liters above residual volume. Significant hypoxemia was observed in association with airway closure.


Gestational differences in lidocaine toxicity in the fetal lamb. Effects of lidocaine on arterial pressure, heart rate and electrocortical activity were studied in nine fetal lambs at 0.77 to 0.92 gestation (116 to 138 days of gestation; term in sheep is 150 days). Lidocaine was administered into a fetal femoral vein either as a continuous infusion or as a bolus injection. Epileptiform activity was observed in all fetuses both after continuous infusion and after bolus injection of lidocaine. Fetal arterial concentrations of lidocaine at the time of the first epileptiform discharge during continuous infusion ranged from 6.9 to 40.0 mug/ml, and correlated negatively with gestational age (Y equals -1.727 x +242.7; r equals -0.94). The increases in fetal mean arterial pressure during epileptiform bursts correlated directly with the gestational age (Y equals 1.27 x -150.0; r equals 0.91). The convulsive doses of lidocaine injected as a bolus ranged from 8.0 to 34.1 mg/kg, and correlated negatively with gestational age (Y equals -0.991 x +144.9; r equals -0.88). The increased sensitivity to lidocaine of the fetal central nervous system with advancing gestation probably reflects differences in fetal brain development. The increase in cardiovascular responses to epileptiform activity with advancing gestation could be related to differences either in the strength of epileptiform discharges or in permeability of the blood-brain barrier to lidocaine, or to immaturity of the autonomic nervous supply to the cardiovascular system in young fetuses.


Acupuncture analgesia and radiant-heat pain: a signal-detection analysis. Responses to radiant-heat stimulation to the back of the hand were obtained during baseline conditions and during acupuncture sessions. Signal-detection methodology and analysis were used to determine whether acupuncture affects d' (changes physiologic processes) relative to pain report. A binary rather than a rating-scale procedure was used to obtain more accurate measures of sensitivity. Results indicated that acupuncture decreased sensitivity only at intensity levels that were never described as painful.


Failure of nitrous oxide to inhibit transformation of lymphocytes by phytohemagglutinin. Nitrous oxide, in an incubator concentration of 70%, failed to inhibit nuclear enlargement of lymphocytes stimulated to transform by phytohemagglutinin (PHA).


Hydroxocobalamin therapy of cyanide intoxication in guinea pigs. The efficacy of hydroxocobalamin (vitamin B12a) as a specific, nontoxic antidote in acute cyanide poisoning was tested. Guinea pigs receiving lethal intravenous NaCN injections were treated with either vitamin B12a or saline solution. There was a statistically significant antidotal effect of the vitamin. No toxic effect was observed with large doses of the vitamin.


Cytomorphological variations and blood histamine in bronchial asthma. The absolute counts on basophil and eosinophil leucocytes, percentage of vacuolated eosinophil cells and whole blood histamine were determined in 30 controls and 34 patients with bronchial asthma. The basophil counts rose from the quiescent to pre-attack stage and then fell in the acute stage of bronchial asthma. The eosinophil counts, the percentage of vacuolated eosinophils and the blood histamine content increased significantly during an asthmatic attack. An attack of bronchial asthma was precipitated if the blood histamine rose to or above 200 ng/ml or a 50% rise occurred from its quiescent level. The inter-relationship between cytomorphological variations and blood histamine content in various stages of bronchial asthma is discussed.


IgE-mediated adverse reactivity to a radiographic contrast medium. In a patient with a previous history of a serious reaction after intravenous injection of the cholangiographic agent ioglycamic acid (Bilivistan), intravenous cholangiography appeared to be necessary. Therefore intradermal tests were performed in the patient and four controls with three radiographic contrast media closely related in chemical structure. In addition a Prausnitz-Kustner test with heated and unheated patient serum was performed. These tests demonstrated the presence in this patient of selective immediate-type reactivity to ioglycamic acid which was probably IgE mediated. Intravenous cholangiography with iodipamide seemed justified and resulted in no adverse reactions. Although this case may be exceptional, the results suggest that intradermal skin tests at proper concentrations may be useful in choosing the administration of radiographic contrast medium to patients with a history of prior adverse reactions.


The effects of propranolol on the bronchoconstriction by histamine, acetyl-beta-methylcholine and anaphylaxis in inbred guinea pigs in vivo. Propranolol enhanced the anaphylaxis reaction more than the reaction to histamine and mecholyl in inbred strain guinea pigs. These results suggest the presence of beta receptors on mast cells and that there are genetic differences in the reaction to mediators and antigens among these strains of guinea pigs.


Eosinophils and the integrity of the hypothalamic-pituitary-adrenal axis. The level of blood eosinophils was studied in patients with adrenalectomy and/or hypophysectomy and in patients with asthma and eosinophilia. In the latter group was a patient who had asthma associated with hypopituitarism, which is cited in detail. It is concluded that blood eosinophils are independent from the integrity of the hypothalamic-pituitary-adrenal axis.


Treatment of allergy to house dust with pyridine-extracted alum-precipitated extracts of the house dust mite. Two preliminary trials in which patients with respiratory allergy to the house dust mite were treated with pyridine-extracted alum-precipitated extracts of house dust mites are described. In the first, using an extract of D. farinae, twenty-two of twenty-eight asthmatic patients improved. In the second, using an extract of D. pteronyssinus, fifteen of eighteen asthmatic patients improved.


Respiratory disorders and allergy skin-test reactions. This study examines the relations of allergy skin-test reactivity, assessed by prick testing, to a variety of respiratory symptoms, findings, and diagnoses in a general population sample consisting of more than 3000 subjects. The independent and combined relations of skin-test reactivity and cigarette smoking are reported. Prevalences of asthma and allergic rhinitis are closely related to the severity of skin-test reactions; all of the 39 subjects with the largest skin-test reactions observed have had one or both of these conditions. A variety of other respiratory findings, not generally considered allergic in nature, are also related to skin-test reactivity, especially in children and in young to middle-aged adults. In subjects 15 to 54 years of age, an atopic predisposition, as manifested by reactions to allergy skin tests, appears to be associated with an increased susceptibility to the bronchoconstrictor effects of cigarette smoking and to recurrent chest infections. It is suggested that an atopic predisposition relatively early in life may be a risk factor for the later development of chronic obstructive lung diseases.


Granulomatous hepatitis, increased platelet aggregation, and hypercholesterolemia. Two young patients presented with an unusual liver disease, granulomatous hepatitis with postnecrotic cirrhosis, and both underwent a splenorenal shunt procedure. Each developed an arterial embolic episode probably related to increased platelet aggregation. This represents the first report of a liver disease associated with increased platelet aggregation that was clinically significant, a myocardial infarction in one and a posterior cerebral infarction in the other. Also, unexpectedly, both patients became hypercholesterolemic after the splenorenal shunt was established.


Use of a computer to detect and respond to clinical events: its effect on clinician behavior. A computer was used to prospectively detect and suggest responses to simple, medication-related events as reflected in a computerized record in a prospective, randomized study of a diabetes clinic with primary-care responsibility. There were two categories of event/suggestions: when the last observation of a test required for medication control was too old, the computer suggested a repeat; and when an abnormality with therapeutic implications was detected, the computer suggested a specific change in therapeutics. Clinicians responded to 36% of events in the first category with computer reminders and 11% without (P less than 0.0001); they responded to 28% of events in the second category with computer assistance and 13% without (P less than 0.026). For the most clinically significant of these second category events, the difference was even greater: 47% with and 4% without computer assistance (P less than 0.0004). I believe that computer detection and response (in the form of reminders) to simple clinical events will change clinician behavior.


Periodic apnea, exercise hypoventilation, and hypothalamic dysfunction. Periodic apnea and exercise hypoventilation were observed in a 14-year-old boy. Hyperphagia, obesity, serum hyperosmolality without diabetes insipidus or appropriate thirst, and retardation of growth and sexual development indicated a hypothalamic disorder. Neurologic evaluation was normal except for electroencephalographic changes induced by apnea. Pulmonary function tests, resting arterial blood gases in the wakeful state, and ventilatory response to inhaled CO2 were also normal. Acute hypoxemia and respiratory acidosis occurred with apnea during sleep and with insufficient ventilation during exercise. The central origin of sleep apneas was shown by esophageal pressure monitoring. The hypothalamic dysfunction and exercise hypoventilation distinguish this patient from others with obesity and periodic apnea.


Some ionic and dilution effects in the measurement of urinary oestrogens in pregnancy. The estimation of oestrogen in aqueous solutions and pregnancy urines using an automated procedure is affected by the presence of certain ions, and by dilution. These effects have been studied by calculating regression equations from the values obtained with urines to which ions have been added with and without urine dilution. The results suggest that the ionic effect is chemical rather than physical and that there is no advantage in including a predilution step in the analysis. Other means of removing the ionic effects have so far proved unsuccessful.


Quality control of serum alkaline phosphatase assays: project report and discussion of some factors affecting the assay. The factors which affect the standardisation and quality control of serum alkaline phosphatase assays are discussed. A quality control project was designed to test the performance of seven Birmingham laboratories in the assay of sera with alkaline phosphatase activities outside the range normally tested by the National Quality Control and Wellcome schemes. The results showed that the precision of individual laboratories was satisfactory. Differences between the results of the laboratories were considerable and could be accounted for by differences in methodology. Auto-Analyzer methods employing phenyl phosphate as substrate would best be standardised by adopting the optimised reaction conditions of Buch and Buch (1939); but the borate buffer of these authors should be replaced by the carbonate-bicarbonate buffer of Moss et al. (1971). To avoid the confusion which may arise in future if alkaline phosphatases are reported in U/l irrespective of the substrate, it is suggested that some substrate--indicative nomenclature may be advisable.


Recent advances with thyrocalcitonin.

Recent advances with thyrocalcitonin. Thyrocalcitonin (TCT) is a 32 amino acid peptide hormone similar, but not identical, in structure from fish to man. Mammals produce the hormone in non-follicular thyroidal "C-cells" which can be identified visually using recently developed immunocytochemical methods. Although TCT exerts effects on the gut and kidney, bone seems to be the primary target tissue. The ability of TCT to restrict calcium fluxes from bone to blood and to inhibit bone resorption explains its utility for treating certain metabolic bone diseases, e.g. Paget's disease. The bone effects also account for the ability of TCT to combat a hypercalcemic challenge. Recent work suggests close relationships and a possible closed-loop feedback system between the gut and thyroid. In animals, gastrin is a potent TCT secretagogue; studies in man indicate that TCT, in turn, can effect gastric acid secretion and intestinal secretion of water and electrolytes. This gastrin-TCT relationship may help control levels of blood calcium during intestinal absorption of calcium following feeding. The ability of gastrin to stimulate TCT release has been applied clinically for the early diagnosis of medullary thyroid carcinoma (MTC), a C-cell tumor. Subclinical or questionable cases of MTC have been identified reliably using a simple, rapid provocative test involving pentagastrin injection and evaluation of blood samples by radioimmunoassay for elevated levels of TCT.


The ultrastructure of striated muscle.

The ultrastructure of striated muscle. Striated muscle is a tissue in which the major cytoplasmic components are spatially arranged to produce directional motion. This orientation is seen at all levels of structure, beginning with the molecular placement of characteristic proteins into 2 dissimilar types of filaments, and proceeding ultimately to the alignment of muscle fibers in the heart or an anatomically defined skeletal muscle. Generation of contractile force is accomplished by the enzymatic interaction of the 2 dissimilar protein filaments, which results ultimately in the utilization of energy (in the form of adenosine triphosphate) and the production of directional motion.


Cytology of cerebrospinal fluid: technical and diagnosis considerations. The usefulness of cerebrospinal fluid cytology in the diagnosis of malignancy has been enhanced in recent years by the development of new techniques for increasing cellular yield. Micropore filters and a specially adapted cytocentrifuge have been used for this purpose with a resulting increase in cell concentration and in diagnostic accuracy. Cerbrospinal fluid examination has been found to be of particular value in the diagnosis of metastatic carcinoma, lymphomatous and leukemic involvement of the meninges and certain primary central nervous system tumors. Cytologic criteria for the differential diagnosis of the principal types of tumors encountered in cerebrospinal fluid are discussed.


Advances in the detection of amino acids in biological fluids. New methods and modifications of existing methods for the determination of amino acids in biological fluids are reviewed. The application of classical ion exhcange, gas chromatography, and combined gas chromatography/mass spectrometry methodology in the clinical biochemistry laboratory are examined and the advantages and disadvantages are noted for these techniques.


Tired blood and rusty livers.

Tired blood and rusty livers. Iron deficiency is one of the most serious nutritional problems confronting the United States and the world today. An understanding of the mechanisms operative in the control of uptake and utilization of iron is essential to develop suitable prophylactic and therapeutic strategies. Iron excess can also be a serious health hazard. Studies on Bantu siderosis, hemochromatosis and other overload pathologies also provide insight into the intake and storage of this metal. Several models for iron transport across the mucosal membrane are developed. The most satisfactory seems to involve chelation of the iron to provide solubility diffusion passively across the gut membrane, and equilibrium binding to various storage sites within the tissue. Both ferric and ferrous forms are available. The solution chemistry of iron governs its biological behavior. Low-molecular-weight compounds present in normal dietary foodstuffs, as well as those prepared synthetically, can enhance the uptake of oral iron. Suitable application of complexes of iron with fructose, nitrilotriacetate, citrate and other molecules should be efficacious in the treatment of iron deficiency anemia. Potential dangers of food fortification with iron are acknowledged, and application of immunoassay techniques for measuring circulating ferritin suggest it as a rapid and inexpensive monitor for overload.


Determination of erythrocyte adenosine triphosphate by liquid chromatography. A method for measuring erythrocyte adenosine triphosphate utilizing anion exchange high-pressure liquid chromatography is described. The method is not subject to interferences inherent in methods involving hexokinase or the firefly system. The method is highly sensitive, reproducible and rapid. Adenosine diphosphate and adenosine monophosphate can also be analyzed if desired.


The electron transport to nitrogenase in Mycobacterium flavum. 1. Two ferredoxin-type iron-sulfur proteins have been isolated from Mycobacterium flavum 301 grown under nitrogen-fixing, iron-sufficient conditions. No flavodoxin was observed. 2. These ferredoxins are apparently soluble: they were present in the supernatant fraction after disrupting by decompression. Only small amounts were present in particulate fractions. 3. The two ferredoxins were separated by chromatography on DEAE-cellulose, Sephadex or electrophoresis. 4. Both ferredoxins mediated the transfer of electrons from illuminated spinach chloroplasts to a nitrogenase preparation to reduce acetylene. Ferredoxin II was specifically about five times more active than ferredoxin I. Ferredoxin II was also active in the photosynthetic NADP+-reduction whereas ferredoxin I was not. 5. Both ferredoxins were reversibly reduced by either sodium dithionite, illuminated spinach chloroplasts or hydrogen plus hydrogenase from Clostridium pasteurianum. 6. Attempts to determine the primary electron donor for nitrogen fixation in Mycobacterium flavum were unsuccessful. Acetylene reduction in Mycobacterium extracts was obtained only with sodium dithionite or illuminated spinach chloroplasts as electron donors. The reduction of the electron carrier (e.g. ferredoxin) rather than the transfer of electrons from the reduced carrier to nitrogenase was rate-limiting.


Anaerobic degradation of benzoate to methane by a microbial consortium. A stabilized consortium of microbes which anaerobically degraded benzoate and produced CH4 was established by inoculation of a benzoate-mineral salts medium with sewage sludge; the consortium was routinely subcultured anaerobically in this medium for 3 years. Acetate, formate, H2 and CO2 were identified as intermediates in the overall conversion of benzoate to CH4 by the culture. Radioactivity was equally divided between the CH4 and CO2 from the degradation of uniformly ring-labeled [14C]benzoate. The methyl group of acetate was stoichiometrically converted to CH4. Acetate, cyclohexanecarboxylate, 2-hydroxycyclohexanecarboxylate, o-hydroxybenzoic acid and pimelic acid were converted to CH4 without a lag suggesting that benzoate was degraded by a reductive pathway. Addition of o-chlorobenzoate inhibited benzoate degradation but not acetate degradation or methane formation. Two methanogenic organisms were isolated from the mixed culture; neither organism was able to degrade benzoate, showing that the methanogenic bacteria served as terminal organisms of a metabolic food chain composed of several organisms. Removal of intermediates by the methanogenic bacteria provided thermodynamically favorable conditions for benzoate degradation.


Altered phospholipid metabolism in a temperature-sensitive mutant of a thermophilic bacillus. The phospholipid metabolism of a temperature-sensitive mutant of a thermophilic bacillus was studied after the shift from a permissive (58 degrees C) to a restrictive (65 degrees C) growth temperature. During the short period of growth of the mutant at 65 degrees C, the proportions of cardiolipin and its 3-acyl derivative (lyso-cardiolipin) increased, and the proportions of phosphatidylglycerol and phosphatidylethanolamine decreased on cell dry weight basis. In 32P incorporation and turnover experiments, phosphatidylglycerol showed the most rapid uptake and loss of the label. Turnover of cardiolipin, limited to a short period, ceased 18 min after the shift, as did the turnover of phosphatidylethanolamine. In the absence of net phospholipid synthesis, there was a quantitative conversion of phosphatidylglycerol to cardiolipin and an increase in the proportion of lyso-cardiolipin. Chloramphenicol, added to the medium at the time of the shift, reduced the rate of phospholipid synthesis, prevented the increase in the proportions of cardiolipin and lyso-cardiolipin, and slowed the decrease in the proportions of the other two phospholipids. The results indicated a defect in the regulatory mechanism(s) of phospholipid metabolism in the mutant at the restrictive temperature.


The cryopreservation of Chlorella. 1. Interactions of rate of cooling, protective additive and warming rate. The cryoprotective additives glycerol and dimethylsulphoxide were found to be toxic to Chlorella cells at concentrations greater then 2.5% w/v. Polyvinylpyrrolidone, was not damaging up to a concentration of 15%w/v. Chlorella 211/7a had a recovery rate greater than 95% at all rates of cooling studied. With Chlorella 211/8h the survival was lower than 0.1% at all rates examined. The addition of dimethylsulphoxide (5% w/v) to Chlorella 211/8h increased the recovery, particularly at the faster rates of cooling; with polyvinylpyrrolidone (10% w/v) there was an optimum range of cooling rate. Cells of Chlorella 211/7a from the exponential phase of growth were found to be damaged both by a temperature reduction from 25 degrees C to 0 degrees C (thermal shock) and by freezing and thawing. In contrast cells from the stationary phase of growth were resistant to these stresses.


Tubular structures of Vibrio psychroerythrus. The marine bacterium Vibrio psychoerythrus, an obligate psychrophile, contains uniformly dense rod-shaped organelles 10-15 nm wide and up to 1.3 mum long. These structures were frequently seen crossing the septum of dividing cells.


Physiology and fine structure of sporangiospore germination in Piptocephalis unispora prior to infection. Germination of the sporangiospore of Piptocephalis unispora Benjamin, observed by means of light and electron microscopy, involved the formation of a new inner wall which became continuous with the inner layer of the wall of the germ tube. The outer wall layer of the germ tube was continuous with the original inner wall layer of the dormant spore. Preliminary details of appressorium structure were noted. Nutritional experiments indicated that sporangiospores required external sources of utilisable nitrogen and carbon compounds for maximal swelling and germ tube production. Limited development occurred when either nutrient was supplied singly. Comparison of germination of the asexual spore with that in other Mucorales, especially the Kickxellaceae, has been made, and the merosporangial status in P. unispora discussed.


Society, culture, and mental disorder.

Society, culture, and mental disorder. The central objective in this article is to effect a critical examination of these theories and hypotheses that purport to explain the process by which selected sociocultural factors make their ingression into the personality and emerge as mental symptoms and/or mental disorders. The difficulties of isolating these specific factors stem from two unresolved methodological concerns. One is the uncertainty as to whether functional mental illness can be differentiated into several qualitatively distinct syndromes or whether it forms a unity of a more generic character. The other is the failure to formulate a valid social-psychological theory that can demonstrate that selected sociocultural factors contribute to the molding of a mental illness observed in the phenotype. Finally, 15 propositions summarize the factual knowledge that emerges from the several social-psychological, epidemiological, and cultural studies examined.


Institutional alternatives to psychotherapy. A study of growth center users. Are growth centers used as alternative institutions to traditional mental health facilities? Survey methods compared growth centers (N=426) and National Training Laboratories (N=108) participants with clinic patients (N=89). Symptoms, life stress, motivations for participation, process expectations, and various attitudes toward authority, time, and help were assessed prior to participation. Comparisons on degree of psychological distress and avowed motivation indicated that most who attend such activities do so for "psychotherapeutic purposes." Growth centers were found not to be an alternative to traditional psychotherapy, but rather an addition. Eighty percent of the growth center sample had previous or current psychotherapeutic experience. Of the people studied, most go to both rather than to one or the other, and from the perspective of the participants, the institutions do not differ greatly in what they offer, how long the process will take, or what goals will be met.


A consideration of legal issues in child custody contests. Implications for change. The author reviews the criteria by which courts award custody of children and determine visitation rights. In the case described there have been repeated attempts by the noncustodial father to obtain visitation and to modify custody arrangements. A review of literature pertaining to the effects of divorce on children reveals an absence of the type of empirical studies that would be most effective in influencing the courts. The practices outlined in the Uniform Marriage and Divorce Act, model legislation recently approved by the american Bar Association, are discussed in relation to the case, and are not found to improve appreciably on current practice. The author suggests that the condition of children in the courts can be considerably improved by the involvement of child psychiatrists in consultation, education, and empirical research.


Psychopathology in adolescence.

Psychopathology in adolescence. A cumulative psychiatric case register was utilized to examine patterns of psychopathology in 1,334 adolescent patients. Consistent with studies of adult patients, seriousness of disorder was weighted toward being seen in an inpatient rather than outpatient settling; schizophrenia and personality disorder were relatively more common amoung lower-class patients and neurosis and situational disorder among middle- and upper-class patients; neurosis was more commonly diagnosed among female patients, and personality disorder more commonly diagnosed among males. A ten-year follow-up revealed 54.1% reasonable diagnostic stability on subsequent contacts and 62.2% complete subsequent agreement among patients originally diagnosed as schizophrenic. Aspects of the data demonstrate continuity in adolescent and adult psychopathology, the mythical nature of "normative adolescent turmoil," and what appears to be excesive use of situational disorder in diagnosing adolescent patients.


The communication of suicidal intent. A reexamination. Verbal expressions and nonverbal indicators of suicidal intent have been frequently regarded as pleas for rescue and help. We investigated the clinical and empirical significance of verbalizations of suicidal ideas, putting one's affairs in order, and previous suicide attempts as forms of "communication of suicidal intent." The patient sample consisted of 211 suicide attempters: 71 "communicators" and 140 "noncommunicators." The results indicated the following: (1) there is no clear evidence that verbal communication, final acts, and previous suicide attempts are justifiably labeled together as ways of communicating suicidal intent; (2) prior verbalization of suicidal ideation or intent bears little relationship to the extent of the wish to die experienced at the time of the suicide attempt; and (3) "talking" or "not talking" about suicidal plans may be a manifestation of personal style rather than an index of despair or hidden motives.


Suicide by persons with and without psychiatric contacts. A two-year sample of 179 consecutive suicides in Monroe County, New York, was divided according to the presence or absence of previous psychiatric contacts based on a country-wide psychiatric case register (PCR). After a brief description of the total suicide group, the 45% of suicides with PCR contacts are compared to the suicides without such contacts and to the total PCR population. Findings suggest that there are some important differences between psychiatric patients at high risk for suicide compared to other groups. The PCR suicides were almost equally male or female, had a median age of 42 years, had high proportions of persons divorced or widowed, and unemployed or retired. Persons diagnosed as alcohol abusers, or as having affective psychosis, depressive neurosis, or schizophrenia were especially at risk.


Memory functions in depression.

Memory functions in depression. In an attempt to elucidate the memory deficit in depression, short-term memory and long-term memory were examined by means of a memory test battery in 26 hospitalized depressed patients. Their performance was compared with a matched control group and with the performance of those 20 patients who improved after 26 days of treatment with antidepressants. Results indicate that depressed patients show marked impairment in short-term memory without an impairment in long-term memory. The greater the improvement of the clinical state, the greater the improvement in short-term memory, whereas long-term memory was not influenced by the therapeutic success.