Acute newcastle viral infection of the upper respiratory tract of the chicken. II. The effect of diets deficient in vitamin A on the pathogenesis of the infection. Keratotic and squamous changes characteristic of vitamin A deficiency were minimal even in chicks which were malnourished and growth stunted and had no vitamin A in their diet. However, when these chicks were infected with Newcastle disease virus (NDV), keratotic changes appeared, most markedly in areas regenerating after infection. In chicks raised on full nutrient diets lacking only vitamin A, keratotic changes appeared in several areas of nasal mucosa but were absent from the mucosa of the inner (under) surface of the maxillary turbinate. Following NDV infection, such changes did appear in the inner lining epithelia. It is suggested that depletion of vitamin A causes regenerating epithelial cells to keratinize. Other effects of combined lack of vitamin A plus NDV infection were exhaustion of lymphoid cells from cranial bone marrow and exhaustion of lymphoid cell systems locally from the nose and paranasal glands.


Adaptive changes in muscle fibers infected with Trichinella spiralis. Ultrastructural changes which occurred in infected skeletal muscle fibers after infection with larvae of Trichinella spiralis were followed on a daily basis utilizing synchronous infections. No changes were observed in muscle fiber architecture during the first 2 days of intracellular infection. However, on Day 3, a space containing various sarcoplasmic elements developed between the plasma membrane and myofilaments. Widening near the regions of triads was also observed at this time. On Day 4 the space at the outer edge had increased, as did the ones at the triads. In addition, the myofilaments throughout the infected fiber were in a state of partial disarray. Finally, the nuclei were enlarged and had migrated to the central portion of the infected cytoplasm. On Day 5 day, sarcomeres were highly disorganized, and an increase in sarcoplasmic reticulum (SR) was noted. By Day 8, only the extreme periphery of the infected fiber contained Z bands with actin filaments attached. Proliferation of the t tuble system was also evident. At Day 10, myofilaments were completely replaced with SR. Further, the plasma membrane became hyperinvoluted and was associated with a 36-fold increase in the thickness of the glycocalyx. No further enlargement of nuclei occurred after Day 10. Finally, a host-derived double membrane completely surrounded the larva.


Lipid accumulation in smooth muscle cell lysosomes im primate atherosclerosis. Cytochemical and ultrastructural examination of the developing atherosclerotic lesion in hypercholesterolemic rhesus monkeys reveals that lipid is sequestered within lysosomes of aortic smooth muscle cells. A common pathway in the development of sclerotic arterial disease appears to be overloading of vascular smooth muscle cell lysosomes with a variety of metabolites. This may occur as a consequence of an excess of substrate or because of a congenital deficiency of a lysosomal hydrolase.


An ultrastructural study of nutritionally induced and reversed retinal degeneration in cats. Kittens and adult cats fed a semipurified diet containing casein developed a retinal degeneration that initially involved photoreceptor outer segments in the area centralis. By electron microscopy, cone and rod outer segment lamellar discs could be seen to become vesiculated, frayed, disoriented and twisted. Shortening and subsequent disappearance of outer segments was followed by loss of photoreceptor nuclei, primarily in the area centralis but also in the midperipheral retina. The electroretinogram (ERG) indicated progressive reduction in cone and rod amplitudes and a delay in the temporal aspects of the cone response. When dietary casein was replaced by egg albumin in the diets of cats with minimal to moderately advanced degeneration, the degeneration was reversed; rod ERG function and structure returned essentially to normal, whereas some abnormalities of cone outer segment structure and a delay in the temporal aspects of the cone ERG persisted. The data provide strong evidence that dietary casein is a factor in this retinopathy and suggest that an alteration in protein metabolism of the photoreceptor may result from the dietary protein inadequacy.


The dermatoglyphics of American Negroes. Digital and palmar dermatoglyphics of 184 male and 224 female normal American Negroes were evaluated for digital patterns, digital ridge counts, palmar patterns, palmar main line terminations, accessory triradii and palmar creases.  All subjects were seven year olds examined and found free of chronic or other genetic diseases.  The results were presented for the left and right hand separately as well as in terms of bilateral symmetry.  The present results were for the most part comparable to those of the African and other American Negro groups reported earlier.  The distributions of the various dermatoglyphic features among the Negroes taken as a group were compared to those of the other racial groups and their differences were discussed.


The dermatoglyphics of American Caucasians. Digital and palmar dermatoglyphics were collected from 360 male and 360 female seven year old Caucasians from the greater Boston area.  All participants were screened and found to be free of minor anomalies or chronic diseases.  All individuals with I. Q. scores below 70 were also excluded.  The results were presented in such a way as to give information on bilateral symmetry as well as overall frequencies of the various dermatoglyphic features.  The results were compared with those of the corresponding sample of seven year old normal male and female Negroes of the accompanying report.  A review of the distribution of the dermatoglyphic features in different Caucasian populations has also been presented and the overall dermatoglyphics of the Caucasians were discussed in reference to the distribution of the same features in the other major "racial" groups.  The method of collection and selection of the subjects, described in the text, makes this set of data unique and one of the most suitable for use as controls in studying the dermatoglyphics of the individuals with diseases or congenital anomalies.


The hypothenar radial arch, a genetically determined epidermal ridge configuration. A radial arch in the hypothenar area of the human palm is an uncommon ridge arrangement.  It is associated with an ulnar triradius and no axial triradius is present.  The configuration generally occurs on right hands but is sometimes found on both hands.  The frequency in the few European populations studied and in one Canadian sample varies from 0.2 per cent to over 2 per cent of persons.  Hypothenar radial arches have also been reported in patients with abnormal sex chromosomes but are not specific to any karyotype.  Two families are described in which nearly related persons have hypothenar radial arches.  They provide the first evidence that the pattern is inherited.  In one family three out of six sibs have radial arches in the hypothenar area and so have two out of three children of one of them.  In the other family a pair of identical twins and their mother have hypothenar radial arches.  It is suggested that, from the information available, inheritance is probably due to a recessive gene.


Population variation in asymmetry and diversity from finger to finger for digital ridge-count. Population variation in ridge-count asymmetry and diversity from finger to finger has received scant attention in dermatoglyphic studies.  Asymmetry, in particular, has generally been attributed to environmental effects operating during the formation of dermal ridges.  Examination of samples from several groups of diverse racial background revealed the existence of considerable population variation with respect to finger ridge-count asymmetry and diversity from finger to finger.  Patterning along population lines suggests a genetic rather than environmental basis for such variation.  The genetic mechanisms responsible for ridge-counts may also mediate asymmetry and diversity, or the degree of developmental stabiltiy in different populations may itself be under genetic control.


Finger dermatoglyphics of the Bagathas of Araku Valley (A. P.), India. Finger prints of the Bagathas, a dominant endogamous tribal population of Araku Valley in Andhra Pradesh (India) were analysed.  They are distributed in Araku, Paderu and Chintapalli agency areas of Visakhapatnam district of A. P.  Investigations on finger prints of 235 males and 235 females reveal that loops are higher in females (57.58 per cent) than in males (49.19 per cent).  Sex differences in the distribution of the patterns are statistically significant (chi2 equal to 27.8277; d. f. equal to 2; 0.001 greater than P).  The index of pattern intensity shows a higher value in males (14.17) than the females (12.84).  It isevident from the mean ridge counts that there is a clear sexual dimorphism, males showing higher mean ridge counts than females.  Bagathas show greater affinity with the Valmikis in the frequency distribution of pattern types and in the pattern intensity index.  However, a more detailed dermatoglyphic study of all the tribes of Andhra Pradesh yields information of great value in disclosing the pattern distributions among these Dravidian or proto-Australoid tribal populations.


Dermatoglyphics of three Hungarian populations. The dermatoglyphics of 709 individuals from three Hungarian populations living near each other but of different origin were analyzed.  In dermatoglyphic traits the three populations present but slight differences from one another.


The ridge-counts of the interdigital a-b, b-c, and c-d areas in a normal sample and in cerebrally damaged patients of Thuringia, G. D. R. (East Germany). We determined the ridge-counts and their correlations of interdigital area a-b, b-c, and c-d among 300 boys and 300 girls from Jena and 95 male and 79 female cerebrally damaged children from the Mental Hospital of Stadtroda, both in Thuringia, G. D. R. (East Germany).  The mean values of the normals and the patients differ significantly only on the right hand of males in the b-c area (p smaller than or equal to 5 per cent).  Bimanuar comparisons showed significant correlations in the three areas in both sexes in the normal and the abnormal children.  Inter-area comparisons revealed no significant correlation between a-b and b-c areas; correlations were significant between a-b and c-d areas in both sexes in the normal group, but significant for the right hand only in cerebrally damaged children.  Highly significant correlation was found between the b-c and c-d areas only in the right hand of female cerebrally damaged children.  Comparative data from Bavaria and North-Rhine-Westfalia are also presented.


The dermatoglyphics of the Elema people from the Gulf District of Papua New Guinea. The present report deals with the digital and palmar dermatoglyphics of the Elema peoples from the Gulf District of Papua New Guinea.  The samples involved 91 males and 134 females from the areas of Iokea, Sepoe and Karama.  The Elema dermatoglyphics, compared to those of other peoples in New Guinea, were found to have a high pattern intensity index and frequency of whorls, and the highest frequency of ulnar type C line, complete simian creases and patterns in the IV interdigital areas of the palms.  On the other hand, their 11/7 ratio of the D line, the main line index, and the frequencies of patterns in the hypothenar, thenar/I and II interdigital areas were lower than most other groups on the island; they also have the lowest R/U ratio.  All dermatoglyphic features considered, the frequencies in the Elema group were for the most part found to be near the extremes of the range of the dermatoglyphic frequency distributions in New Guinea populations.  The dermatoglyphic distributions of New Guinea as a whole are discussed in terms of those of the other Australian populations with comments on the dermatoglyphic comparisons between the Australasians and the other major human groups, Amerindians, Orientals, Asian Indian, Caucasians and Negroes.


High pattern intensity indices and ridge counts from the Milne Bay district of Papua-New Guinea and their bearing on the origin of the Australian Aborigines. A population sample from the Milne Bay district of Papua-New Guinea was found to have extremely high pattern intensity indices and total ridge-counts.  These fell into the range of certain Australian Aboriginal tribes, and so argue for a possible connection between this region of Melanesia and the Australian Aborigines, although equally strong connections with other regions of Melanesia are known.


Epidermal patterns of the hands and feet of the pygmy Chimpanzee (Pan paniscus). The characteristics of the epidermal ridge system were studied in a series of eighteen lesser or pygmy chimpanzees (Pan paniscus).  The general ridge alignments are very similar to those of the chimpanzee (Pan troglodytes); Biegert ('61).  On the average the pattern intensity (P. I.) of the palm configurations is considerably higher in the pygmy chimpanzee than in the chimpanzee, thus representating the highest total palm pattern intensity of all species of the hominoidea.  The sole configurations show parallel main results to those of the palm; however, the decreased sole pattern frequency of the pygmy chimpanzee is of a smaller predominance only as compared to the values of the other species of this superfamily.  The preliminary data on the finger tip patterns, translated into P. I. values, are much higher than in chimpanzees and within the range of the mean values of gorillas (Brehme, '73), while those of the toes of pygmy chimpanzees seem to possess the lowest P. I. values of the African apes.


Ridge course of the whorls: classification and methods. In dermatoglyphic methodology the system of gross classification of digital pattern types needs modifications.  More attention should be focussed on the study of minute morphological variations among pattern types in order to understand fully the genetic mechanisms involved in pattern variations.  A systematic classification to record many of the morphological peculiarities is lacking.  The paper proposes a classification and methods of identification of the direction of the course of the ridges inside the pattern area of true whorls.  In all, nine ridge course types are identified, named and described.  Data analysed on the basis of the above methods and classification reveal significant bilateral differences for clockwise and counter-clockwise types of ridge directions.  Mode of inheritance, bisexual differences, etc., of the polymorphic course of these ridges should be studied.  Its usefulness in the field of personal identification, population genetics and medicine should also be evaluated.


Dermatoglyphics of Easter Islanders analyzed by pattern type, admixture effect, and ridge count variation. The adult Easter Island population was fingerprinted in 1965 as part of an overall study of their human biology.  Major findings of the dermatoglyphic analysis are as follows.  Digit and bimanuar percentages of patterns (arches, loops, and whorls) were similar to those observed in Europeans.  However, in terms of total pattern type distributions, the Islanders had many more whorls and a correspondingly much higher Pattern Intensity Index than those found in European groups.  This difference was even present, although in lesser magnitude, in Easter Islanders known to be admixed with Europeans.  Corresponding to a high occurrence of whorls, Mean Total Ridge Count (TRC) was also notably high.  An association between TRC as a measure of pattern size and incidence of patterns was clearly evident in several groups available for comparison.


Sex and side differences and correlations between quantitative palmar characteristics in a sample Sardinian population. Defferences between the sexes and between the sides and the correlations between four quantitative characteristics of palmar dermatoglyphics in a sample population of 809 individuals (418 males and 391 females) from the city of Cagliari, Sardinia, are tested.  Males have a greater number of ridges than females, shown by a greater a-b ridge count and A-d ridge count, and a more transverse slope of the main lines, shown by a greater main line index and papillary number.  The left palm shows a greater number of ridges than the right palm between the A line and the triradius d and between the triradii a and b, with a lower main line index and papillary number.  The a-b ridge count has a negative correlation with the main line index and with the papillary number and a positive one with the A-d ridge count; these correlations are greater in the left palms, especially in the males.


Dermatoglyphic traits in patients with cardiovascular disorders. Dermatoglyphic studies were carried out on 800 Japanese subjects.  Digital dermal pattern types were classified into true whorls, double loops, ulnar loops, radial loops and arches.  Both total and absolute ridge count were recorded.  Subjects with hypertension, angina pectoris and myocardial infarction were compared with the remaining group of others who had not yet developed any of these disorders.  Individuals with myocardial infarction had a significantly higher frequency of true whorls and a correspondingly lower frequency of ulnar loops than the control group.  Total and absolute ridge counts were also significantly higher in myocardial infarction.  Individuals with hypertension and angina pectoris were not significantly different in most dermatoglyphic traits from the controls.  These observations suggest that antenatal factors may contribute to the etiology of myocardial infarction in man.


Localization of rapidly exchangeable calcium in mammalian heart muscle. Two new methods were used to calculate net labeled Ca++ compartmental influx into rabbit myocardium: 1) continuous measurements of arteriovenous differences in 45Ca levels are corrected for longitudinal mixing and for varying transit times by a double-isotope technique with the relatively impermeant 131I-labeled albumin as the referent substance; 21 tritiated sucrose and 45Ca contents were measured in ventricular muscle after perfusion with the doubly labeled perfusate and washout of aqueous perfusate with fluorocarbon 80. Both methods yielded similar results. Only 52% of the Ca++ efflux from the vascular bed during the rapid flux period can be accounted for as Ca++ in interstitial water under control perfusion conditions. Contracture induced by substituting K+ for Na+ in the perfusate brings the fraction not accounted for as Ca++ in interstitial water from 48 to 60% of the total in 5 min. When irreversible contracture is induced by return to normal [Ca++] after short periods of excitation-contraction uncoupling due to zero [Ca++] perfusion, the fraction not accounted for as Ca++ in interstitial water is 68% in 5 min.


Rat brain regional uptake and decarboxylation of L-DOPA following carotid injection. Using the carotid injection technique, the regional uptake and decarboxylation of L-DOPA at the blood-brain barrier in the rat was studied. After a single intracarotid injection in the rat followed by decapitation 15 S later, the uptake of L-DOPA was measured relative to tritiated water injected simultaneously as a diffusible internal standard. Decarboxylation was investigated with an injection mixture of L-[carboxy-14C]DOPA and L-[2,3-3H]DOPA. Uptake of L-DOPA studied over the range of 15-5,076 nmol/ml appeared to be a composite of two separate mechanisms. The saturable component had a half-maximal velocity transport value, K-t, of 336 muG. A diffusional, nonsaturable component had a diffusion constant of 0.018. A regional study showed that uptake operated at approximately the same rate in the various brain areas despite marked regional variation in catecholamine concentration. The decarboxylation of L-DOPA also occurred at a similar rate in all regions. Even when L-DOPA was injected at a concentration of 3 mM, 33-51% was decarboxylated within the 15-S period. These results support the hypothesis that L-DOPA movement into the brain occures via a neutral amino acid transport mechanism common to cerebral capillaries of different regions of the brain.


Positive staircase effect in the rat heart. The apparent lack of a positive staircase effect in ray myocardium may reflect inadequate metabolic support. Isolated rat hearts (n equals 10) were perfused at 37 degrees C with Krebs buffer containing 5 mM glucose. In 10 preparations increases in heart rate from 240 to 480/min resulted in twofold increases in left ventricular pressure and dP/dt. Pacing at a rate of 480/min resulted in mechanical deterioration of the preparation and in 50% decreases of myocardial ATP concentration within a 10-min period. Hearts of open-chest rats driven at the same rate for the same period maintained normal ATP stores. In isolated papillary muscles contracting isometrically at a rate of 30/min, peak stress 15g/mm2 (mean plus or minus SE, n equals 8) and was not changed by increasing the concentration of glucose from 5 to 30 mM. When frequency was raised from 30 to 300/min, stress declined to 5.0 plus or minus .15 g/mm2 in the presence of 5mM glucose (P smaller than .001) but increased to 8.8 plus or minus .21 g/mm2 (P smaller than 0.001) in the presence of 30 mM glucose. Thus, rat ventricular myocardium exhibits a positive staircase effect at physiological heart rates when metabolic support is adequate.


Effects of coronary hypotension on myocardial substrate utilization. Changes in myocardial substrate utilization were studied after experimental coronary hypotension in the isolated dog heart perfused with the blood of a large donor animal. After a control period (100 mmHg) the afterload of the isolated heart was adjusted to 50 mmHg and kept at that level for 4 h. After this period, a second control observation was made at a 100-mmHg afterload. Coronary sinus blood flow and oxygen consumption decreased during hypotension and returned to normal during the second control period. Myocardial free fatty acid (FFA) uptake and oxidation did not change significantly. Lactate uptake and the percentage of CO2 derived from myocardial lactate utilization were both diminished during hypotension. These changes were not present during the second control period. Glucose uptake and myocardial respiratory quotient were decreased during the hypotensive period. Half the hearts exhibited elevated end-diastolic pressure after hypotension, but no metabolic differences were detectable between the failing and nonfailing hearts. Thus, prolonged severe hypotension caused a relative preference of FFA oxidation and diminished lactate and glucose uptakes by the myocardium. These changes were quite different from those obtained during experimental hemorrhagic or endotoxic shock.


Methods for serial study of renin-angiotensin system in the unanesthetized rat. Micromethods for measurement of plasma renin concentration (PRC) and plasma renin-substrate concentration (PSC) have been developed for rat plasma with radioimmunoassay of angiotensin I. An improved technique for aortic implantation of plastic cannulas was developed for use in experiments 1-2 wk in duration. The effects on components of renin system of anesthesia and tail cutting were studied. Arterial blood was sampled through cannulas without animal manipulation. PRC varied little in unanesthetized rats, was moderately and variably increased during pentobarbital anesthesia, and was markedly and consistently elevated during ether anesthesia. PSC was unchanged during anesthesia. PRC was increased in blood obtained by tail cutting within 1-2 min after cutting. With the use of the methods and techniques described here serial studies of the renin system in plasma of unanesthetized rats are shown to be feasible. A role for the sympathetic nervous system in the mediation of renin secretion by ether is proposed.


Plasma hormone and renal function changes in unrestrained dogs exposed to cold. Renal clearances and plasma antidiuretic hormone (ADH), 17-hydroxycorticoids, and norepinephrine were measured in unrestrained dogs before and during exposure to ambient cold (minus 4 to + 4 degrees C). Some dogs were treated with an inhibitor of cortisol biosynthesis, Metopirone, either alone or combined with dexamethasone, a potent glucocorticoid suppressing ACTH release. Plasma ADH increased in the Metopirone-treated group (P smaller than 0.02) but changed little in other dogs. Plasma 17-hydroxycorticoids in untreated dogs rose from a control value of 14.4 plus or minus 1.9 (SE) to 1.82 plus or minus 1.2 mug/100 ml after 20 min of exposure (P smaller than 0.01), an increase comparable with that previously observed in restrained dogs. Plasma norepinephrine increased from 0.98 plus or minus 0.07 to 1.15 plus or minus 0.08 mug/liter (P smaller than 0.01) after 20 min of exposure. Urine flow, C-Cr, and C-PAH tended to increase spontaneously in nonexposed control dogs. Exposure to cold abolished or reversed this tendency, most distinctly in the Metopirone-dexamethasone group. The urine concentration, measured as T-c-H2O/C-Cr, did not change in cold, in contrast to a decrease previously observed in restrained dogs. The data do not support the key role of plasma cortisol elevation in the mechanism of urine-concentration defect in cold and demonstrate important differences between responses of restrained and unrestrained animals.


Regulation of arterial blood pressure in the common green iguana. Arterial blood pressure (ABP) responses to graded hemorrhage and passive head-up tilt were studied in restrained, anesthetized, and unanesthetized iguanas. The ABP fell slowly in response to hemorrhage up to a critical deficit of 35 plus or minus 19% of the estimated blood volume; the rate of ABP fall then increased nearly 40-fold to continued hemorrhage. Increased heart rate and decreased femoral arterial blood flow accompanied progressive hemorrhage. Propranolol (2-3 mug/kg) did not appreciably alter arterial pressure-hemorrhage curves but hemorrhage-induced increases in heart rate were diminished nearly 50%. Atropine had little effect on either the blood pressure or heart rate changes induced by hemorrhage. During passive tilts of 0-90 degrees carotid arterial pressure fell 33% before returning to control levels (2 min). Heart rate increased and femoral arterial blood flow and central venous pressure fell in response to head-up tilts. It is concluded that hemorrhage and passive head-up tilting can induce reflex cardiovascular changes that assist ABP regulation in iguanas.


Neuroendocrine conditioning: conditioned feeding after alterations in glucose utilization. We have demonstrated that it is possible to condition the feeding behavior induced by either 2-deoxy-D-glucose (a chemical that induces glucopenia) or tolbutamide (an oral hypoglycemic agent). Such behavioral conditioning is also accompanied by a conditioning of neuroendocrine responses. A model for both overt and covert conditioned responses is proposed.


Central nervous system control of cardiorespiratory nasopharyngeal reflexes in the rabbit. The role of different central nervous regions in the reflex apnea, bradycardia, and mesenteric vasoconstriction evoked by nasopharyngeal stimulation with cigarette smoke was examined in unanesthetized shamoperated, thalamic, and pontine rabbits with intact and sectioned carotid sinus and aortic nerves (CS and AN). Apnea occurred in all preparations. In pontine animals with intact CS and AN, the heart rate response was reduced but not the mesenteric vasoconstriction. The role of suprabulbar and bulbospinal regions became more apparent when individual components of the input profile were examined in animals with controlled ventilation. The bradycardia and mesenteric vasoconstriction evoked by apnea without smoke, but not by smoke without apnea, were reduced in pontine animals. Prior section of the CS and AN attenuated the response in all neural preparations but to the least extent when cerebral hemispheres were intact. The data indicate that the respiratory reflex is predominantly integrated at bulbospinal sites, but the cardiovascular reflex is integrated at both bulbospinal and suprabulbar sites, or is integrated at bulbospinal and modulated from suprabulbar sites.


Endotoxin-induced prostaglandin E and F release in dogs. Prostaglandin E and F (PGE and PGF) levels in sequential blood samples obtained simultaneously from the renal and portal veins and aorta during endotoxin shock in dogs were determined by radioimmunoassay. Four groups of dogs were studied. In five control dogs in which no endotoxin was given, PGE and PGF levels did not change significantly at 0, 15, 30, 60, and 90 min. In eight dogs given endotoxin alone, PGE and PGF levels did not change in the aorta. In samples taken from the portal vein there was a significant rise in PGE and PGF 15 min after endotoxin, whereas renal vein PGE and PGF did not become significantly elevated until 60 and 90 min after endotoxin. In six dogs pretreated with acetylsalicylic acid and six dogs pretreated with indomethacin, PGE and PGF levels did not change after endotoxin. Indomethacin modified the delayed hemodynamic effects of endotoxin whereas acetylsalicylic acid did not. Neither drug blocked the immediate hemodynamic effects of endotoxin. Endotoxin-induced PGE and PGF release is probably due to increased synthesis. The mechanism whereby synthesis is stimulated and the extent to which vasomotor tone is influenced by PGE and PGF during endotoxin shock cannot be determined from our data.


Creatinine, potassium, and calcium flux from chicken cerebrospinal fluid. Brains of methoxyflurane-anesthetized chickens were perfused from a lateral cerebral ventricle to cisterna magna with an artificial cerebrospinal fluid (CSF) containing trace quantities of radioiodinated human serum albumin (RIHSA) or inulin (1.0 mg/ml) to measure CSF bulk absorption. In addition, it contained either trace quantities of 22Na, 42K, 45Ca or [14C]creatinine; the concentrations of the latter three were varied to determine permeability coefficients (K-D's) as a function of concentration. A mass balance for the tracer molecules was calculated to determine their movement into brain or blood. K-D's for 45Ca, 42K, 22Na, and creatinine (Cr) were unaffected by perfusion time and the latter two were larger than previously reported (3). The lack of effect of time on K-D and the large values for K-D22Na and K-D-Cr are attributed to anesthetic effects on brain blood flow. K-D-Cr and K-D42K were larger than K-D22Na or K-D45Ca and K-D's for 45Ca, Cr, and 42K were independent of their inflow concentrations. An active transport process is suggested for potassium and creatinine, but one that is located at sites other than the ependymal wall. Bulk flow clearance accounted for RIHSA movement from CSF, whereas nonbulk clearance  accounted for 50% of 22Na and 45Ca movement and 90% of 42K clearance. Fifty percent of 42K and 25% of 22Na and 45Ca were found in brain. The large recovery of 42K in brain supports the hypothesis that intracellular potassium serves as an exchangeable pool for the tracer.


Kidney function of the American eel Anguilla rostrata. Urine formation in the eel, acclimated to freshwater (FW) and seawater (SW) was studied. SW eels maintained higher plasma and urine osmotic and ionic concentrations than FW eels. Polyethylene-1,2-glycol-14C (PEG-14C) clearance was 29% greater than methoxy-inulin-3H clearance. PEG-14C clearance was considered to be the glomerular filtration rate (GFR). The GFR of SW and FW eels did not differ. Urine flow rate in SW eels was one-third of that in FW eels. The primary urinary solutes in both groups were Na and Cl. Apparently, tubular fluid secretion occurred in FW and, to a lesser degree, in SW eels. With the assumption that water reabsorption was secondary to Na reabsorption in the kidney, the clearance data were used to evaluate all possible explanations for what appeared to be fluid secretion. The data were inconsistent with the possibility that GFR had been underestimated due to glomerular sieving of PEG or active or passive reabsorption of the marker, but consistent with tubular fluid secretion. Furosemide caused diuresis in both groups of eels apparently by inhibition of Na reabsorption in the distal tubule, but it had no effect on the apparent tubular fluid secretion. Tubular ion secretion could not be conclusively implicated as a driving force for fluid secretion. However, the possibility of K, Ca, or Mg secretion in a proximal segment followed by reabsorption in a more distal part of the nephron was not ruled out.


Modulation of leucine transaminase activity by dietary means. The specific activity of leucine transaminase was measured in supernatants of liver, skeletal muscle (gastrocnemius), and kidney homogenates obtained from fed, starved, and protein-deprived rats. After 12 h of starvation, there were slight reductions in leucine transaminase activity of both muscle and kidney tissues. When starvation was prolonged to 1 full day, the activity of this enzyme increased by approximately twofold in both muscle and kidney. Prolongation of fasting to 5 days resulted in an additional increase in specific activity of leucine transaminase in muscle. During the entire 5 days of starvation, leucine transaminase activity remained unaltered in liver of starved rats. Protein deprivation for 1 or 5 days resulted in significant reductions in specific activity of leucine transaminase in skeletal muscle. Protein deprivation did not produce a remarkable effect on the activity of this enzyme in kidney or liver tissue. The results of this study, together with those previously obtained, indicate that within our experimental conditions increased oxidation of leucine in skeletal muscle of starved rats is not initially related to an alteration in activity of leucine transaminase. When caloric deficiency is prolonged, the potential for transamination is also increased. These adaptive changes increase the ability of skeletal muscle to use leucine as a metabolic fuel.


Uremic inhibition of purine uptake by rat hepatic slices. Measurements were made of the production of allantoin by liver slices prepared either from bilaterally nephrectomized rats or from normal, control rats in flasks containing either a) no added substrate, b) hypoxanthine, or c) xanthine. Uremic liver slices showed a 72.3% inhibition of augmented allantoin production with hypoxanthine as substrate and a 68.3% inhibition with xanthine as substrate. Next, uremic rat serum was added to liver slices prepared from normal rats along with either a) no added substrate, b) hypoxanthine, or c) xanthine. Normal rat serum replaced uremic rat serum in control experiments. In these paired experiments, uremic serum exerted an inhibitory effect on allantoin production of 78.0% when hypoxanthine was the substrate and of 83.6% when xanthine was the substrate. Studies on possible underlying mechanisms showed that the observed uremic inhibition of allantoin production by hepatic slices, in the presence of substrate (e.g., hypoxanthine), represents a decreased production of uric acid, secondary to the decreased hepatic uptake of substrate.


Branchial effects of epinephrine in the seawater-adapted mullet. II. Na+ and Cl- extrusion. Injection of epinephrine into Mugil capito adapted to seawater is followed by a 40-60% inhibition of the Na and Cl effluxes. Simultaneously the Na influx is decreased by 30%, the overall result being a reduction of the net sodium extrusion rate by the gill. The change in Na influx is in part explained by a 75-80% decrease of the oral ingestion of seawater. This branchial adrenergic response is sensitive to alpha-blockade by phentolamine and tolazoline and insensitive to beta-blockade by propranolol. Both alpha-blockers are ineffective when injected alone. Propranolol injected alone mimics epinephrine while simultaneous injection of phentolamine blocks the response to propranolol. Rapid transfer experiments suggest that epinephrine inhibits the branchial Cl pump and its associated Na/K exchange mechanism. The leak pathway for these ions remains insensitive to epinephrine.


Placental diffusing capacity in unanesthetized rabbits. The purpose of this study was to determine the placental diffusing capacity of CO in unanesthetized rabbits. A standard dose of CO was administered to 18 near-term rabbits, and at time intervals varying from 5 min to 4 h maternal and fetal blood samples were analyzed for carboxyhemoglobin saturation (HbCO). Following administration of CO, the maternal HbCO rose rapidly within the 1st min and remained nearly constant for the remainder of the experiment. The fetal HbCO after CO introduction to the mother rose as CO crossed the placenta from maternal to fetal blood. After 15 min the fetal HbCO rose to equal the maternal HbCO averaging 18.5%. The fetal HbCO after 1 h averaged 33% saturation, 1.7-fold greater than the maternal HbCO at 1 h. Thereafter there was little further fetal rise and apparently equilibrium was reached. The average placental diffusing capacity for CO was 2.3 ml/(min times mmHg times kg), a value fourfold higher than has previously been reported in anesthetized sheep and dogs. Possible reasons are species difference, effects of posture, influence of anesthesia and surgery, and effects of an open versus intact uterus.


Intestinal transport of tryptophan and its analogs. A comparative study of the intestinal transport of DL-tryptophan and its 1-methylindole (tryptophan-l-Me) and benzo[b]thiophene (tryptophan-S) analogs has been carried out in vitro, using the everted intestinal sac of the rat and hamster. Both tryptophan and tryptophan-S are actively transported across the intestine, while tryptophan-l-Me is not actively transported. The active transport of tryptophan is competitively inhibited by tryptophan-S, suggesting a similar carrier, while tryptophan-l-Me is not an inhibitor of tryptophan transport, suggesting little or no interaction with the carrier. The transport of tryptophan and tryptophan-S is depressed at concentrations (10 mM), and all three amino acids produce subtle alterations in the barrier properties of the sacs, as evidenced by increased tetraethylammonium bromide-14C diffusion.


A proposed mechanism of zinc absorption in the rat. Studies were conducted at the cellular level in an attempt to describe the processes involved in zinc absorption from the intestine. A low-molecular-weight zinc-binding ligand was identified in the pancreas of rats and pancreatic secretions from a dog. The whole-body absorption of 65Zn in rats in which the common bile duct was ligated was significantly less than the absorption of 65Zn in rats in which the hepatic bile duct was ligated. The uptake of 65Zn by epithelial cells from everted intestinal segments was markedly increased in the presence of the zinc-binding ligand fraction from pancreatic secretions. Following in vivo labeling, 30% of the 65Zn in the epithelial cell was associated with the partially purified basolateral plasma membrane. When labeled basolateral plasma membranes were incubated in a medium that contained zinc-free albumin, approximately 96% of the 65Zn was transferred to the medium while less than 30% of the isotope was released to media that contained either no albumin or a 3:1 zinc: albumin complex. In rats fed a zinc-deficient diet, 65Zn absorption was inversely proportional to the serum zinc concentration, and both zinc and copper injections produced a marked decrease in 65Zn absorption. These results suggest that zinc absorption consists of interactions among a low-molecular-weight ligand, recpetor sites on the basolateral membrane, and metal-free albumin.


Comparative evaluation of the specificity and sensitivity of isometric indices of contractility. It is generally held that a useful mechanical index of contractility is one that is unchanged by changes in initial muscle length, but that changes in appropriate direction and magnitude with a change in contractile state. A number of isometric indices were measured in vitro in isolated cat papillary muscles to quantitate their relative dependence on initial muscle length and contractile state. Results indicate that no one isometric index completely fulfills the definition of an ideal index of contractile state. In particular, indices that change considerably with alterations in contractile state (e.g., maximum dF/dt) are also moderately dependent on preload. Conversely, indices that are moderately insensitive to changes in contractile state (e.g., time-to-peak force) are also insensitive to changes in contractile state. Changes in extrapolated maximum velocity and peak VCE were similar and were less sensitive to changes in contractile state than maximum dF/dt. The most sensitive in vitro index of contractility appears to be maximum dF/dt at a constant preload.


Nature of aortic smooth muscle responses to changes in venous return in intact dogs. A response of the aortic smooth muscle to reduction in venous return was demonstrated previously. The present experiments were performed to determine whether these responses were of a reflex origin rather than being attributable to viscoelastic mechanisms. Viscoelastic mechanisms could not account for changes seen in the aortic pressure diameter relationship curve. On the other hand, it was demonstrated that the response was abolished by eliminating sympathetic input to the aorta via spinal cord transection. This and other evidence demonstrate beyond doubt that the aortic response to reduction in venous return is of neurogenic origin and constitutes a well-integrated reflex. However, experimental evidence is presented which clearly indicates that the receptors for the aortic smooth muscle response are not located in either the carotid sinus or aortic arch but must be located elsewhere in the system.


Modification of vagal depressor reflex by CO2 in spontaneously breathing rabbits. The control of hindlimb and renal vascular beds by vagal afferents was studied, in anesthetized spontaneously breathing rabbits in which the carotid sinus and aortic depressor nerves were cut, by measuring the increase in vascular resistance (constant-flow perfusion with autologous blood) during bilateral vagal cold block (VCB). The effect of hypercapnia was studied with both increased ventilation (caused by inspiration of mixtures of CO2 in O2) and decreased ventilation (caused by infusion of gallamine during O2 breathing). The increase in hindlimb resistance with VCB was correlated with respiratory minute volume but not with PCO2; the reverse was true for the increase in renal resistance. Without VCB the renal vessel constriction caused by the hypercapnia was markedly attenuated, provided that there were minimal respiratory movements; the resistance increased dramatically when these movements were abolished or with VCB. Thus, the powerful central effect of CO2 on the renal vessels can be counteracted by vagal afferents activated by lung movement; even minimal respiratory activity can cause this effect.


Intratubular hydrostatic pressure in testis and epididymis before and after vasectomy. A method is described for the measurement of intratubular hydrostatic pressure in the testis, caput epididymidis, and cauda epididymidis of the golden hamster. Pressures in these locations in normal animals ranged from 3 to 6 cmH2O. Mean pressure in the tubules of the caput was significantly higher than that in the seminiferous tubules (P smaller than 0.05) and in the proximal caudal tubules (P smaller than 0.02). There was a small, significant increase in pressure from the proximal cauda to the distal cauda (P smaller than 0.04). Two weeks after vasectomy, the mean pressure in the seminiferous tubules of 3.3 cmH2O was significantly lower (P smaller than 0.004) than the mean pressure in the normal seminiferous tubules of 4.4 cmH2O. Pressures in the cauda at 2 wk of 10-18 cmH2O were significantly greater than normal (P smaller than 0.0005) and reflected the accumulation of sperm and fluid. The high incidence of spermatic granuloma formation and/or rupture of the epididymis observed after vasectomy emphasized that there are definite limits to both distensibility and reabsorptive capacity of the epididymis in some species. Pressures at 1 mo after vasectomy were similar to those at 2 wk in animals that were still obstructed and comparable to normal in animals with granulomas and/or large epididymal leaks. Testicular weight was slightly but significantly decreased 2 wk after vasectomy. At 4 wk, there was no detectable effect of vasectomy on the weights of the testes.


Secretion of salt and water into the medullary collecting duct of Ringer-infused rats. Using a microcatheterization technique, the contribution of the collecting duct to the renal response to extracellular fluid volume expansion was studied in anesthetized rats. During intravenous infusion of Ringer solution (0.25 ml/min per 100 g body wt), urinary excretion of fluid, sodium, and potassium was 365 mul/min per g kidney wt (V), 52.6 mueq/min per g kidney wt (UNaV), and 3.86 mueq/min per g kidney wt (UKV), representing 23, 24, and 65% of filtered load, respectively. Analysis of collecting duct fluid from cortex and outer medulla indicated continued net reabsorption of ions and water in these nephron segments; in contrast, in inner medulla net secretion of Na, K, and fluid into the collecting duct was demonstrated. Addition of sodium and water was equivalent to approximately 10% of filtered load. It is concluded that under the stress of extreme intravenous fluid loading tubular secretion of salt and water into the inner medullary collecting duct contributes importantly to diuresis and natriuresis. The mechanism of such secretion remains undetermined.


Metabolic responses of unanesthetized rats to manipulation of skin temperature. Body temperatures of albino rats are highly variable compared to those of larger mammals. This paper demonstrates that much of that variability can be attributed to shifts of body temperature thresholds for metabolic response accompanying disturbance or arousal. It also shows that the open-loop gain (OLG) of the metabolic temperature-regulating system is as high as that in larger mammals, ruling out low gain as the source of the variability. Skin temperature (T-sk) of shaved rats was controlled by immersion to the neck in a water bath. Metabolic rate (M), measured during step changes of T-sk and during more gradual changes of colonic (T-c) and hypothalamic (T-hy) temperature, was proportional to deviations of both T-c and T-sk below their respective thresholds. The absolute values of the coupling function (alpha) relating M to T-c were proportional to T-sk; the absolute values of the coupling function (beta) relating M to T-sk were proportional to T-c. Thus, the gain of the system changed systematically with body temperatures. The thresholds of T-sk and T-c below which M increased were inversely proportional to T-c and T-sk, respectively, as well as shifting in response to some unknown variable designated arousal.


Nonelectrolyte permeability of the paracellular pathway in Necturus proximal tubule. Micropuncture experiments were performed on Necturus proximal tubule using stationary microperfusion and microrecollection techniques. The transepithelial movement of the extracellular marker, sucrose, was used to investigate the passive permeability of the paracellular shunt pathway under steady-state conditions, during spontaneous reabsorption and water flow induced by an external osmotic gradient. Measurements were made of the sucrose permeability (P-s) efflux, net flux, and of net volume flow. True P-s determined in the absence of net volume flow and transepithelial gradient was 0.96 10-6 cm s-1. Both ouabain and isotonic volume expansion decreased shunt P-s. During reabsorption, solute-coupled water flow increased apparent P-s and net sucrose flux equalled efflux. Osmotic water flow from lumen to plasma decreased apparent P-s, with net sucrose flux equal to efflux; whereas osmotic flow from plasma to lumen increased apparent P-s but no net flux was observed. It is concluded that changes in P-s can be interpreted as relative alterations of the tight junction and the lateral spaces and that a portion of the volume flow from lumen to plasma proceeds via the tight junction.


Effect of hypothalamic lesions on immediate hypersensitivity. Bilateral electrolytic lesions were placed in the anterior basal hypothalamus of male Hartley-strain guinea pigs. The animals with anterior hypothalamic lesions and a group of sham-operated controls were sensitized 5-10 days postoperatively with ovalbumin in modified Freund's adjuvant. At 18-22 days following sensitization both groups were randomly divided into three subgroups and challenged by intrajugular injections of three different antigen doses. Anaphylactic death and the severity of anaphylaxis in the survivors were recorded. Antibody titers were determined prior to challenge with use of the passive cutaneous anaphylaxis technique. Serial sections of each brain were made for lesion localization. Significant protection against anaphylaxis was found in guina pigs with symmetrical lesions in the anterior hypothalamus. No significant differences in antibody titers were observed between the lesion and sham-operated groups. There were no significant differences in the response of isolated muscle strips from anterior-lesioned and sham-operated guinea pigs to exogenous histamine. Anterior hypothalamic lesions of size and location comparable to those that provided protection against lethal anaphylaxis did not modify the anaphylactic response of isolated ileum from actively sensitized animals or following passive sensitization in vitro.


Renal function in the hibernating, and hypothermic hamster Mesocricetus auratus. Plasma and urine concentrations of Na+, K+, and urea were examined in hibernating, hypothermic, and normothermic hamsters. Plasma Na+ and K+ appear unaffected by 48 h of hypothermia (T-re 7 degrees C); however, plasma Na+ increased (P smaller than 0.05) from control values of 125.8 plus or minus 10.2 to 173 plus or minus 9.2 meg/liter in hibernators. Plasma K+ of the hibernator increased to 9.6 plus or minus 3.2 meq/liter from control values of 5.5 plus or minus 0.8 meq/liter (P smaller than 0.05). Plasma urea concentrations were increased (P smaller than 0.05) in both metabolically depressed groups from a control value of 0.5 plus or minus .05 to 0.8 plus or minus .16 and 7.2 plus or minus 2.8 mM in hypothermic and hibernating groups, respectively. Urine concentrations of solute for the hypothermic animals showed no detactable change from control values for Na+ and a decrease for both K+ and urea. Concentrations from hibernators showed a decrease from control values for both Na+ and K+ with no detectable change in urea. Renal tissue slice analysis demonstrated a marked corticomedullary solute gradient for Na+ and urea in normothermic control animals which is eliminated in hamsters hypothermic for 48 h and reduced in animals hypothermic for 15 min. Rewarming animals did not show a return of the solute gradient at T-re 18 degrees C. However, animals that had rewarmed to T-re 37 degrees C demonstrated a complete return with no difference (P greater than 0.05) from control values. Hibernators showed a slight (P smaller than 0.05) gradient for Na+ and no gradient for urea. Animals in all instances demonstrated a decrease in K+ concentration from cortex to papilla. A greater concentration of K+ was found in the renal cortex of animals hypothermic for 15 min and in hibernators (P smaller than 0.05).


Effects of catecholamines on myocardial endogenous substrates and contractility. The effects of epinephrine and norepinephrine on triglyceride and glycogen metabolism and contractility were studied in isolated perfused working rat hearts. Hearts with lipids prelabeled in vivo with [1-14C]palmitate were perfused with bicarbonate buffer containing 5.5 mM glucose, with or without 0.6 mM palmitate (3% albumin), and varying concentrations of catecholamines. Direct evidence for catecholamine-stimulated myocardial triglyceride lipolysis was obtained and, for the first time, was shown to be concentration-dependent. Also, catecholamines enhanced heart triglyceride fatty acid oxidation in concentration-dependent fashion. Stimulation of lipolysis and oxidation was observed only in hearts perfused with buffer containing glucose as the sole substrate, and was inhibited in the presence of 0.6 mM palmitate. Palmitate inhibited net glycogenolysis in the absence of catecholamines, but had little effect on epinephrine-stimulated glycogenolysis. Therefore, with free fatty acids present, mobilization of endogenous triglycerides to meet the increased metabolic demands of catecholamine stimulation is minimized; this is due, possibly, to enhanced utilization of exogenous free fatty acids and to inhibition of net lipolysis.


Effect of tetraethylammonium on tonic airway smooth muscle: initiation of phasic electrical activity. We have previously shown that in the presence of tetraethylammonium (TEA, 6.7-67 mM) phasic mechanical activity and a myogenic response (MR) to quick stretch are produced in normally multi-unit tracheal smooth muscle. The present studies were designed to investigate the electrophysiological basis for these changes in the mechanical properties of the muscle. Intracellular recordings showed that in the presence of TEA the membrane was partially depolarized and trains of small (8-20 mV), decrementally conducted action potentials were produced spontaneously at a frequency of 15-20/min. Action potentials could also be stimulated by external electrodes, and the conduction velocity over short distances was 0.84 plus or minus 0.2 cm/s. Membrane conductance and rectification, as measured by the magnitude of electrotonic potentials in response to external stimulation, were reduced in the presence of TEA. The length constant was increased from 1.6 plus or minus 0.1 to 2.8 plus or minus 0.2 mm. These results are consistent with the notion that TEA produces phasic membrane electrical activity by reducing P-K.


The kidney in regulation of plasma choline in the chicken. Exogenous choline was administered into the wing vein of chickens until steady-state plasma choline levels were achieved. Both plasma and urine were analyzed for free choline by a choline kinase, radiochemical microassay that did not require prior extraction of choline from the biological fluids. Choline was infused at rates from 0.5 to 20.0 mumol/kg-min. Total and urinary clearance were assessed at the steady state reached in each experiment. At the endogenous level of plasma choline of 0.019 mM, total clearance of choline from the plasma was about 50 ml/kg-min and urinary clearance was 0.06 ml/kg-min. There was no significant increase in urinary clearance of choline produced by infusion loads from 0.5 to 1.0 mumol/kg-min. However, as the infusion of choline was increased further, extraurinary clearance decreased while the contribution of the kidneys to total clearance of choline from the plasma increased. At the choline infusion rate of 12.5 mumol/kg-min, plasma choline was 0.5 mM and urinary choline clearance had reached a maximum value of 18.5 ml/kg-min for two kidneys, removing more than 70% of the infused choline.


Effect of vagotomy on electrical activity of the small intestine of the dog. The effect of bilateral thoracic vagotomy on the myoelectric activity of the small intestine was determined in conscious dogs. Animals were implanted with electrodes spaced 25 cm apart along the serosal surface of the small intestine, and a cannula was placed in the most dependent portion of the stomach. Recordings were made with dogs in the fasted and fed states. Two distinct patterns of myoelectric activity were recorded: one typical of the fasted state (the interdigestive myoelectric complex) and one typical of the fed state. After completion of the control recording periods, a truncal vagotomy was performed on each animal. Completeness of vagotomy was confirmed by lack of a gastric secretory response to insulin. Gastric stasis occurred after vagotomy; therefore, the animals' stomachs were emptied via the gastric cannula to obtain a fasted condition. Vagotomy had little to no effect on the fasted pattern of myoelectric activity. The fed pattern was significantly altered in two of the three animals. This alteration could be due to the effect of vagotomy on gastrin release. We conclude that nervous pathways within the vagus may exert some influence on intestinal myoelectric activity but that other neural-humoral pathways are probably involved.


Metabolic responses to varying restrictions of coronary blood flow in swine. An in situ working swine heart preparation is described in which total coronary perfusion was controlled. At normal rates of coronary flow, oxygen, glucose, and fatty acid utilization were stable for at least a 60-min perfusion period. With a 50% reduction in coronary flow, oxygen and glucose consumption were reduced during 30 min of perfusion and fatty acid extraction  was lower at the end of 30 min. Glycogen utilization was increased, but tissue levels of creatine phosphate, ATP, and lactate were similar to those in hearts receiving normal flow. With a 60% reduction in coronary flow, uptake of oxygen, glucose, and fatty acids were further decreased. Tissue levels of high-energy phosphates and glycogen were decreased and ADP, AMP, and lactate increased. Mechanical performance progressively deteriorated in these hearts, and ventricular fibrillation developed after about 20 min (19.8 plus or minus 3.0 min). The data indicate that this preparation is suitable for the study of myocardial metabolism during mild and severe ischemia and may be useful for the evaluation of pharmacological interventions designed for the treatment of myocardial ischemia.


Some characteristics of psychiatric residency training programs. The author summarizes responses to a major questionnaire survey of psychiatric residency training programs. In addition to providing objective data on residents, training staff, and on the training institution and its related facilities, the author presents information drawn from the narrative responses to questions on major issues facing psychiatry. These include training for dealing with critical social problems, recruitment of minority group trainees and faculty, and training in interdisciplinary collaboration and preparation for work with paraprofessionals. It is hoped that these data will facilitate answers to questions about the training psychiatrists should receive in the future by providing information about training programs in the immediate past.


Short-term analytically oriented psychotherapy versus behavior therapy. Ninety-four outpatients with anxiety neurosis or personality disorder were randomly assigned for four months to a waiting list, behavior therapy, or psychoanalytically oriented therapy. The target symptoms of all three groups improved significantly, but the two treated groups improved equally well and significantly more than those on the waiting list. There were no significant differences among the groups in work or social adjustment; however, the patients who received behavior therapy had a significant overall improvement at four months. One year and two years after the initial assessment, all groups were found to be equally and significantly improved.


Short versus long hospitalization: a prospective controlled study. II. Results for schizophrenic inpatients. The authors compared treatment results for 141 schizophrenic patients randomly assigned to short-term or long-term hospitalization. The patients received intensive treatment and were on partially fixed drug dosage schedules. Test results indicated that the short-term group was functioning better at four weeks. However, at discharge (21 to 28 days for short-term patients; 90 to 120 days for long-term) the long-term group showed significantly better functioning. There were no significant differences between the groups on symptomatology at discharge. The authors discuss the implications of these findings for decisions regarding length and type of hospitalization for schizophrenic patients.


Intellectual and neuropsychological functions in young men with heavy and long-term patterns of drug abuse. The authors attempted to determine the long-term effects of heavy drug abuse in 87 male prisoners. The sample was divided into the following groups: 1) nondrug users; 2) users of cannabis and hallucinogens; 3) users of cannabis, hallucinogens, and amphetamines; and 4) users of cannabis, hallucinogens, amphetamines, and opiates. Intellectual and neuropsychological tests sensitive to brain dysfunction revealed no intergroup differences. This finding casts some doubt on other reports suggesting that long-term drug abuse results in neuropsychological disorders. However, the authors caution that one should not conclude that no organic changes occurred in their sample.


Psychiatric resident suicide: an analysis of five cases. The authors present case histories of five psychiatric residents in a large metropolitan area who committed suicide during an 11-year period. Although they found no single precipitant or predictor, they noted striking similarities in the cases, including a high incidence of psychopathology manifested in marital problems, absence of close personal relationships, previous psychotherapy, drug and/or alcohol abuse, etc. The authors suggest an interaction of personal, peer, and institutional factors as casual in all of these suicides and recommend such improvements in residency programs as providing individual faculty preceptors for each resident and facilitating psychotherapy for troubled residents.


Outpatient alcohol detoxification: initial findings on 564 patients. The authors report on a large-scale outpatient alcohol detoxification program, presenting a clinical rationale for outpatient detoxification, describing the program method, and giving initial evaluation data on the first 564 patients. Only 47 percent of the patients required detoxification, and only 19 percent of these required inpatient care. The majority of the patients successfully completed outpatient detoxification; half of these continued in the related rehabilitation program. There were no fatalities. The authors believe the results support the utility of outpatient detoxification as a cost-effective alternative to inpatient detoxification for the majority of acute alcoholics.


The pregnant psychotherapist in training: some preliminary findings and impressions. With more women entering general medical and psychiatric training, the more that supervisors and staff can understand the impact of the resident's pregnancy on the resident and others, the more helpful they can be to her and she to herself. The authors' work was done at what was formerly the Woman's Medical College of Pennsylvania, which has had a larger percent of women in psychiatric training than most programs. This report is derived from a pilot study on the pregnant therapist.


Psychological dimensions of internation dependency. The author analyzes the psychological consequences of international dependency, advancing 13 propositions as clues for a heuristic understanding of the dynamics of dependent relationships between nations. He believes that these relationships must be understood before they can be improved. The author proposes coequal alliances and multinational aid as desirable alternatives to existing political-economic-military strategies.


Childhood chemotherapy and later drug abuse and growth curve: a follow-up study of 30 adolescents. The authors studies the correlation of methylphenidate medication in childhood with later drug abuse and growth in height. Thirty adolescents with histories of minimal brain dysfunction who had been treated for at least six months with chemotherapy were compared with 30 adolescents who had not been so treated. The findings do not indicate that methylphenidate prescribed in childhood contributed to later drug abuse or seriously interfered with growth in height.


Platelet monoamine oxidase activity in acute schizophrenia. The authors found normal monoamine oxidase (MAO) activity in 40 acute schizophrenic patients, in contrast to previous reports of a genetically linked platelet MAO deficit in chronic schizophrenia. Variations in MAO activity were not significantly associated with the 65 clinical variables analyzed, although there was a tendency for patients in the low-MAO group to have more severely impaired reality testing, more paranoid and grandiose delusions, better prognostic scores, and less restlessness.


The postdivorce clinic.

The postdivorce clinic. The authors describe a clinic that evaluates court-referred families who have child custody or visitation problems in the postdivorce period. A multidisciplinary staff uses interviews, auxiliary sources of information, and psychological testing to arrive at recommendations that often address issues not specifically mentioned in the legal proceedings, particularly regarding treatment for disturbed children. The authors suggest that the clinic is an example of an appropriate interaction between law and psychiatry.


Alcoholism and forcible rape.

Alcoholism and forcible rape. Data collected from detailed autobiographies of 77 convicted rapists revealed that 50 percent of them were drinking at the time of the rape and that 35 percent were alcoholics. This strong association between alcoholism and forcible rape highlights the importance of follow-up treatment programs for the alcoholic sex offender; such programs should focus on adequate control of his drinking behavior as well as on his sexual adjustment.


Similarities between parents and offspring on a personality inventory. The authors administered a personality inventory that has been used as a psychiatric screening test to 28 children and their natural parents. By intercorrelations between the tests of parents and offspring they attempted to find out whether the offspring resembled the parent of same sex, the parent of the opposite sex, or a composite of both parents. They found that the offspring resembled their peer group more often than either parent or a composite of both parents.


Indian children and tribal group homes: new interpretations of the Whipper Man. The authors describe a community-based children's home and child welfare program among a tribe of Plateau Indians. The program has been effective because it is compatible with this Indian culture, which accepts extended family and community responsibility for child care. The authors feel that the program demonstrates principles of primary prevention in community mental health.


Dangerousness and civil commitment of the mentally ill: some public policy considerations. The author discusses "dangerousness to others" as a ground for involuntary civil commitment of the mentally ill, suggesting that there is often a confounding of legal/public-policy concerns and mental health concerns in issues related to this concept. The questionable nature of the presumption of dangerousness in mental patients and the overprediction of dangerous behavior for this group indicate that such commitment processes may circumvent legal safeguards designed to ensure due process. The author recommends that psychiatrists and other mental health professionals assume greater responsibility for the ways in which their services are used in these proceedings.


Token programs in an acute psychiatric hospital. The author has used individually prescribed token economies with about 5 percent of his acute psychiatric inpatients. Previous reports have dealt primarily with chronic patients. Case reviews indicated that patients chosen for these programs fell into four categories (which are illustrated by case histories): depressed complainers, apathetic and withdrawn patients, agitated psychotics, and impulsive, acting-out nonpsychotics. The author recommends techniques for patient selection, goal setting, and determination of reinforcers, and suggests that use of token programs may forestall the social breakdown syndrome in very disturbed patients.


Cardiovascular malformations with lithium use during pregnancy. The 143 cases of lithium use during pregnancy collected by the Register of Lithium Babies show that infants exposed to lithium appear to have a higher than expected ratio of cardiovascular anomalies to all anomalies and may have an increased risk of congenital heart disease. The authors believe that these findings justify a conservative policy on the use of lithium with fertile and pregnant women.


Drug-induced dystonia.

Drug-induced dystonia. Among 1,152 psychiatric inpatients who received a phenothiazine, a butyrophenone, or a thioxanthene, 116 developed dystonia attributed to one or more of these drugs. The highest frequencies of dystonia occurred among recipients of haloperidol and the long-acting injectable fluphenazines. For all patients at risk, dystonia was more common in men and in younger patients. For chlorpromazine, high doses, male sex, and low age were each positively associated with dystonia.


Atypical tardive dyskinesia.

Atypical tardive dyskinesia. The author reports an atypical case of tardive dyskinesia in a 19-year-old male who had been given relatively low dosages of neuroleptic medication for less than 6 months. The symptoms cleared within 3 months after the medication was discontinued. The author reviews the literature regarding similar atypical cases and suggests that increased reporting and careful description of such cases might be useful in furthering our understanding of this syndrome.


Electrocardiographic monitoring of enuretic children receiving therapeutic doses of imipramine. The authors studied the monthly electrocardiographic tracings of 27 children with normal cardiovascular function receiving imipramine therapy for enuresis. They found no substantial EKG changes in any of these children, who were receiving doses of 25 to 75 mg of the drug. They conclude that electrocardiographic monitoring may be essential only when more than 25 to 75 mg of imipramine is given and that it should be established that the patient's cardiovascular function is normal before the drug is administered.


Imipramine and electrocardiographic abnormalities in hyperactive children. The authors report seven cases of electrocardiographic abnormalities occurring in 7- to 10-year-old children receiving imipramine pharmacotherapy for behavior disorders. Three of the children evidenced a first-degree atrioventricular block. The abnormalities were less pronounced in the other four children. Imipramine plasma levels during steady state were not found to be directly related to the extent of the electrocardiographic changes within the obtained plasma values. The authors emphasize the necessity of careful clinical surveillance of children receiving imipramine pharmacotherapy.


Imipramine dosage in children: a comment on "imipramine and electrocardiographic abnormalities in hyperactive children". The authors asked that this paper be published as a comment on the preceding article by Dr. Winsberg and associates, who approved the suggestion.


Allergic conjunctivitis due to diazepam. The author reports on four patients, all women, who developed conjunctival hypersensitivity during diazepam treatment. This hypersensitivity is self-limited after diazepam treatment is discontinued. The author suggests that conjunctival hypersensitivity could be mistakenly attributed to contact lens irritation rather than to diazepam.


The impact of the psychiatric intensive care unit on patients and staff. Inpatient crisis intervention units have many of the characteristics of medical/surgical intensive care units. The author believes that the environment of these psychiatric intensive care units serves as an important source of stress and may increase the patient's symptomatology and impair the therapeutic effectiveness of the staff. He suggests some modifications in the environment that may ameliorate these effects.


Depression in thyrotoxicosis.

Depression in thyrotoxicosis. The author describes the case of a middle-aged man who was admitted twice to a psychiatric hospital with depression. On the second admission, his mental state improved following treatment for thyrotoxicosis. The author emphasizes the importance of recognizing such atypical presentations of thyrotoxicosis and postulates a possible depression-producing mechanism in predisposed individuals.


Suicide attempted by self-immolation.

Suicide attempted by self-immolation. The authors found that 14 individuals who had attempted suicide by self-immolation all had psychiatric illness (most were psychotic), and many had religious preoccupations. There was a reversal of the usual male to female ratios for burn injury and for successful suicide--all 5 completed suicides were women. Although self-immolation as social protest was widely publicized during the years surveyed, the authors note that these individuals all attempted suicide for personal and irrational rather than morally idealistic reasons.


An investigation of calendar calculating by an idiot savant. Three mechanisms (eidetic imagery, high-speed calculation, and substitute compensation for normal learning) were investigated and rejected as possible explanations for the calendar-calculating ability of a particular idiot savant. Reaction times for calendar calculations indicated that he used neither an idiosyncratic nor a calendar-based system. Rote memory and a special ability to concentrate for extended periods of time were postulated to explain this individual's performance.


Quality assessment of restorations in a population of school children. An index to measure quality of dental restorative care was devised and utilized on a population of 838 Caucasian school children in a large midwestern city. Quality was measured using a four-point scale. All restorations present were considered as part of the entire mouth. Quality was tested in relation to socioeconomic status. Based on this index the problem of poor quality dental restorations is significant and not necessarily related to socioeconomic status as represented by income or education. Evidence of high quality dentistry as evidenced by stainless steel crowns, space maintainers, and orthodontic appliances was limited to children whose families reported incomes over $6,000. Further use of this quality index is recommended to improve and refine measurements in the area of dental care.


Lymphangiography in ovarian cancer.

Lymphangiography in ovarian cancer. Lymphangiography can be of assistance in pre-treatment staging and thereby influence management of patients with ovarian cancer. The distribution of lymph node metastases was related to the histologic type of ovarian neoplasm. Tumors of germ cell origin more frequently spread to para-aortic lymph nodes, while epithelial neoplasms of the ovary metastasized to the pelvic and para-aortic lymph nodes, apparently in continuity. In this series, lymph node metastasis from ovarian cancer was seldom associated with ascites.


Preoperative irradiation in renal cancer. Evaluation of radiation treatment plans. 1. Analysis of radiation treatment plans of a preoperative irradiation study of the kidney indicates that the primary cancer has been treated to levels of 4,500 rads plus or minus 10 per cent in 90 per cent of the instances. 2. The major problem, from the point of view of the radiation therapist's treatment planning, is the delivery of adequate doses to the regional nodal volume. Only 25 per cent received the prescribed dose. Special booster fields are required. 3. Surgical resection of regional lymph nodes and renal vein thrombus, if present, is recommended, since the deliverance of full radiation doses is not likely without exceeding tolerance of vital normal tissues.


Surgery and postoperative radiotherapy in the treatment of soft tissue sarcomas in adults. A retrospective review of 100 selected patients with soft tissue sarcomas treated by conservative excision and postoperative radiation therapy shows the following: 1. In extremity lesions, a functional limb can be preserved. The 5 year survival rate free of disease is 62 per cent (23/37). 2. The control rate of the soft tissue sarcomas is related to the anatomic site of origin rather than histologic type of the tumor except rhabdomyosarcomas. In lesions of the extremities, the control rate is 82 per cent (51/62). 3. The first manifestation of spread is usually distant metastasis rather than regional lymph node metastasis. 4. The complications can be minimized if sufficient attention is given to the placement of the surgical scar and the radiotherapeutic technique.


Selective intra-arterial embolization of bone tumors. A useful adjunct in the management of selected lesions. Our initial experience with therapeutic selective arterial embolization of 3 highly vascular bone tumors is discussed. In 2 benign lesions embolization of Gelfoam particles through a large bore selective catheter facilitated complete resection by limiting hemorrhage at the time of surgery. Embolization of a vascular malignant tumor provided temporary palliation.


The tumbling bullet sign in a post-traumatic bone cyst. Various hypotheses for the etiology of unicameral bone cysts are discussed. The unique documentation of a lesion which developed as a result of a bullet wound appears to lend credence to trauma as an inciting agent.


Irradiation of stage I and II Hodgkin's disease. One must conclude on the basis of the above analysis that tumor doses in excess of 3,600 or 4,000 rads add only to morbidity, and not to local control. Secondly, the technique of irradiating involved lymph node groups only, leaving other areas to be treated "later," apparently denies the possibility of cure to a significant number of patients with early stage Hodgkin's disease. Recurrence or extension almost uniformly leads to eventual death from disease despite retreatment. No case of second primary cancer has been documented in the patient population included in this report. However, the number at risk is relatively small and chemotherapy was reserved only for generalized recurrence. Since the reported 20 times expected incidence occurred with the combination of total-nodal and multple-agent chemotherapy, one would not expect an increased incidence of second primary lesions in this series.


Iodine 125 source in interstitial tumor therapy. Clinical and biological considerations. Our clinical experience with interstitial tumor therapy is presented in 2 groups of patients: 98 patients with metastatic carcinoma in neck lymph nodes implanted with iodine 125, iridium 192 or radon 222 encapsulated sources, and 105 patients with primary unresectable lung tumors, which were implanted either with radon 222 or iodine 125 seeds. The local tumor control rates with iodine 125, radon 222 and iridium 192 were 78 per cent (38/49), 65 per cent (15/23) and 58 per cent (7/12), while the local complication rates were 17 per cent, 35 per cent and 43 per cent, respectively. An analysis of the tumor control rate as a function of the implanted tumor dose shows that the iodine 125 implants with a delivery of the minimal effective tumor dose of 16,000 rads have a higher therapeutic effect than either radon 222 or iridium 192. The results of the patients with unresectable lung tumors similarly show that the implants with iodine 125 sources are superior to those with radon 222. The advantages could stem from the better spatial dose distribution, and from radiobiologic considerations associated with low dose rates, continous irradiation, and possibly gains in RBE. There present clinical data clearly demonstrate that iodine 125 seeds have a higher therapeutic ratio than radon 222 seeds. There are, in addition, distinct physical advantages making iodine 125 an attractive substitute for radon 222 for the interstitial implantation of malignant tumors.


The therapeutic use of fractionated subtotal body irradiation. A technique is presented for the treatment of generalized radiosensitive malignancies. The results of fractionated STBI (subtotal body irradiation) in a group of 41 patients are at least as satisfactory as those achieved by any other therapeutic modality. Eight of 9 patients with generalized Stage III and IV nodular lymphocytic lymphoma, both well and poorly differentiated, are living without evidence of disease, from 15 to 82 months since treatment.


The radius-dose relationship in linear source therapy. The rationale and physical data are presented which support the hypothesis that the tolerance dose on the surface of a cylindrical applicator containing a central linear source is inversely proportional to the cube root of its radius.


An "instantaneous" display linear accelerator field flatness monitor. A beam flatness monitor is described which consists of 16 iron chambers and amplifiers, the outputs of which are sequentially sampled and displayed as a series of dots or lines on a conventional CRO, giving an instantaneous display of beam flatness variations. The device is used routinely for checking the beam flatness of our Linacs. The device involves no new principles, but represents a radical change in approach to the checking of Linac beam uniformity.


Basal ganglia calcification as a late radiation effect. Basal ganglia calcification following radiation therapy has rarely been documented in the literature. A case of diffuse bilateral basal ganglia calcification developing 6 years after irridiation of a hypothalamic glioma is presented. Review of previous reports and other causes of basal ganglia calcification are discussed.


Magnification angiography. Identifying the capsular vasculature of acoustic neuromas. Five cases of acoustic neuromas studied angiographically are presented. Magnification techniques enhance the visualization of the fine capsular vessels of these tumors. When shown, these abnormal vessels are probably pathognomonic of a neuroma.


Dosimetry of spherical Sr-90-Y-90 beta ray eye applicators. A modification of the conventional extrapolation chamber to perform absolute dose measurements from surfaces of spherical beta applicators (type SIA.I, SIA.3, SIA.6) is described. A stack of Ilford N 550 films has been used in a spherical geometry to obtain the variation of surface dose, the depth dose data and the isodose curves. The results obtained are compared with data available in the literature.


Control by irradiation alone of nonfixed clinically positive lymph nodes from squamous cell carcinoma of the oral cavity, oropharynx, supraglottic larynx, and hypopharynx. The records from 1948 through 1967 of 344 previously untreated patients with squamous cell carcinoma of the oral cavity, oropharynx, supraglottic larynx and hypopharynx who had clinically positive cervical lymph node metastases staged N1, N2A, or N2B, and whose initial neck treatment consisted of external radiation therapy alone were reviewed. After appropriate exclusions the study group consists of 183 patients. The dose to the lymph node(s) was calculated retrospectively. The control rates for N1 lymph nodes are 91.5 per cent (76/83) and for N2 lymph nodes 78.5 per cent (55/70) in the patients whose lymph node(s) were well included in the irradiated volume and received a known dose. A dose response analysis shows that doses in the range of 6,500 rads to a single lymph node, 3 cm. or less in diameter, produce 90 per cent control. When a nonfixed metastatic lymph node of 3 cm. or more in diameter of multiple lymph nodes are present or there is questionable coverage, external irradiation alone cannot be relied upon for control and a neck dissection should follow.


Hyperuricemia in cancer of the larynx. Preliminary report. Serum uric acid values were obtained in 94 patients with cancer, prior to and upon completion of radiation therapy. Hyperuricemia was persistent in all of the patients with carcinoma of the larynx. Explanation for this finding is uncertain. Serum uric acid levels for all other cancers, in this series, were not impressive.


Computer-assisted thyroidal technetium uptake measurement using a short pinhole-to-surface distance. The close pinhole view of the thyroid presents some important measurement problems. Possible errors due to gland, neck and set-up geometry are accentuated due to the effects of the inverse square law, and care is needed to control these. The nonuniform response inherent in the use of the pinhole collimator has a significant effect, but with computer processing this is readily eliminated. ENR subtraction may become difficult in certain circumstances, as insufficient "background areas" may be viewed, but it has been shown that the use of a "universal" (for the particular system) ENR subtraction may give, if anything, more accurate results. With these precautions in use, important errors will be of the same order of magnitude as those involved in more distant views, and may thus be kept within the realms of clinical significance. On the other hand, considerable improvements in both resolution and sensitivity make the use of the closer view an asset to both the research laboratory and the small department involved mainly in routine service work.


Late recurrence in medulloblastoma.

Late recurrence in medulloblastoma. The authors present 3 cases of recurrence of medulloblastoma at 6 years, 6 years 7 months, and 7 years 4 months disease-free intervals from the time of diagnosis. Two of these cases have violated Collins' rule of survivorship; i.e., an interval longer than the patient's age plus 9 months being equivalent to cure. Two of the cases were biopsy proven recurrences of medulloblastoma and in the third, the recurrence was diagnosed on the basis of clinical and roentgenographic data. Other than for these late recurrences, our series is similar to other series reported in the literature.


Metastatic carcinoma simulating inflammatory colitis. Metastatic carcinoma to the colon may be mistaken for inflammatory colitis, particulary Crohn's disease, both clinically and roentgenologically. Characteristic changes include mucosal thickening, nodular masses, multiple and eccentric strictures, asymmetric involvement, pseudosacculations, and spiculations of contour. This report, based upon experience with 12 cases, establishes the distinctive roentgen features of metastatic disease to the colon from a variety of primary sites. It is shown that these changes are dependent upon pathways of spread, growth characteristics, and local tissue response. The clinical importance of making this differential diagnosis is two-fold. A patient with an occult or a known primary malignancy may present clinically with metastatic disease to the colon masquerading as inflammatory colitis. Recognition of the characteristic roentgenologic changes immediately either leads to a search for the primary neoplasm or establishes the diagnosis of widespread disease.


Carcinoma of the cervix: a time dose analysis of control and complications. The use of 3 dose assessment systems is compared. The Manchester approach which measures a dose to Point A and Point B; the Paris approach using rads and mgh; and Ellis's NSD approach appear to have equal value in predicting probability of pelvic control and the likelihood of complication over the dose range employed at this hospital. Control increases with higher dose schemes, but complications appear to be influenced by other variables not accounted for in the 3 systems.


Indications for adjunctive conservative extrafascial hysterectomy in selected cases of carcinoma of the uterine cervix. The survival rates for a selected group of patients with large central lesions, either squamous cell carcinoma or adenocarcinoma and managed by combining irradiation and a conservative extrafascial hysterectomy, are comparable to those of carcinoma of the cervix in general. Death is caused much more often by distant metastases and intercurrent disease than by failure within the irradiated volume.


Numbers of Giardia in the feces of infected children. Estimates were made of the number of Giardia in 1,090 stools from 15 infected children over periods of 1 to 3 months. Three patterns of excretion were observed: 1) high, with the parasite abundant in nearly all stools; 2) low, with the parasite detectable in only 40% of the stools and scanty when present; and 3) mixed, with periods of 1 to 3 weeks of high excretion alternating with generally shorter periods of low excretion, and an overall average of about 60% of stools positive. The presence and relative numbers of Giardia in the feces apparently were unrelated to either the consistency of the stools or frequency of defecation. Attempts to increase parasite excretion with purgatives were, on the whole, unsuccessful.


Evaluation of the skin test for hookworm as an epidemiological tool. The usefulness of a skin test with larval Necator americanus antigen for assessment of hookworm prevalence was evaluated in an endemic area of Costa Rica. In comparison with standard coprologic techniques employed to survey the population, the skin test detected 83% of infections, showing a fairly satisfactory sensitivity. The overall specificity of the test was 50%, i.e., random. No correlation was found between skin reactivity and hookworm burden. The sensitivity of the test increased moderately with age, but its specificity decreased significantly at the same time. False positive reactions were more numerous among persons formerly infected with hookworm who had been negative for as long as 5 years. There was an indication of cross reactivity with intestinal nematodes other than hookworm. The test was used to detect hookworm infected persons in the community for selective treatment, in comparison with mass treatment of all the people in another village. The selective administration of an anthelminthic drug to only skin test positive persons did not achieve the same drop in community hookworm prevalence as did the indiscriminate treatment of the whole population.


Infection of the mastoid bone with a Paragonimus-like trematode. Three unusual cases of mastoid abscess are described. Case histories and the clinical, laboratory, radiological, surgical, and histopathological findings in the patients are reported. Operculated eggs measuring about 60 mu times 40 mu were seen in pus obtained from two cases, but no adult worm was recovered. The findings suggest that the infections could have been caused by either Paragonimus species or Poikilorchis (Achillurbania) species.


Renographic studies in vesical schistosomiasis in children. Renal function in children infected with Schistosoma haematobium and in uninfected controls has been studied with the I131 hippuran renogram. The results suggest that renographic abnormalities which persist after a water-load are more common in infected children who have heavy egg-output in their urine, and abnormal pyelograms. Specific chemotherapy restored the renogram to normal within 3 weeks in several cases. It is suggested that the renogram is useful for the assessment and followup of patients with vesical schistosomiasis, and further work should be done to more clearly define the renal function of such patients.


Studies on schistosomiasis in Somalia.

Studies on schistosomiasis in Somalia. A survey was made on the prevalence and intensity of schistosomiasis in 14 localities in 4 areas in Somalia has revealed the presence of urinary bilharziasis among the inhabitants of all these localities, this being much higher in the two areas where water development has been accomplished. The mean prevalence of infection was found to be 27.2% and 58.1% in the two areas where water development has only been planned, while it was 58.7% and 75.6% in the two areas where the extension of irrigation was achieved years ago. Snails were collected from the habitats visited and these were identified. The role of Bulinus abyssinicus in the transmission of infection was proven.


The relation of worm burden to passage of Schistosoma haematobium eggs in the urine of infected patients. Patients scheduled for cystectomy for bladder carcinoma or exstrophy of the bladder were studied. The number of eggs per day passed in the urine preoperatively was compared with the number of worms recovered from the cystectomy specimen by dissection. A mean of 203 embryonated Schistosoma haematobium eggs per day per worm pair were recovered from the urine of active, untreated cases. The relation between the number of S. haematobium females recovered and the number of living eggs passed in the urine was questionably significant. The correlation between S. haematobium females and all eggs (living and dead) passed in the urine was somewhat better. Several S. mansoni females were recovered from one specimen. This patient passed 139 embryonated S. mansoni eggs per day in the urine for each female worm recovered. Only one active case, treated 6 weeks before operation, might have been missed on routine parasitological examination of the urine.


Chiropteran rabies in Florida: a twenty-year analysis, 1954 to 1973. Chiropteran rabies in Florida is analyzed for the 20-year period 1954 to 1973. The examination of 6,447 bats between 1954 and 1961 yielded 55 (0.85%) positive animals. From 1962 to 1973 however, 2,293 bats examined yielded 236 (10.3%) positive. The yellow bat, Lasiurus intermedius floridanus, accounted for 183 (63.1%) of all cases of chiropteran rabies. Sporadic cases occurred throughout the state with more being reported from the central portion of the state. Cases have been reported every month of the year, peaking in July and August. There were no significant differences in the distribution of rabies in colonial or noncolonial bats by sex or age. There were also no significant differences in the number of reported human and dog contacts made by rabid and non-rabid bats. Clinically ill bats found negative for rabies had a significantly higher contact rate with cats than did rabid bats.


Liver abscess due to ascarid in Iran.

Liver abscess due to ascarid in Iran. A deep 3-cm liver abscess with resulting exogenous cholecystitis, pericholecystitis and adhesions caused by an adult Ascaris was discovered by laparotomy in a 63-year-old man in northwest Iran. Though Ascaris infection rates are high in most major areas of the country, this apparently is the first case of liver abscess caused by Ascaris to be reported from Iran.


Exchange transfusion in hepatic coma: factors affecting results, with long-term follow-up data. 1. Exchange transfusion in our experience has produced a response in 42 per cent of the patients. 2. Complicating factors, primarily sepsis, have been responsible for a 50 per cent mortality in those patients who initially respond, yielding a survival rate of 21 per cent. 3. In a select group of patients with infectious hepatitis under the age of twenty-five years, the survival rate was 37.5 per cent. 4. Excess bilirubin and ammonia rebound after exchange transfusions indicates a grave prognosis. 5. All survivors have normal results on liver function studies.


An electron microscopic study of the effects of portacaval shunts on the ultrastructure of the rat liver after partial hepatectomy. The normally quiescent stable adult liver has a generous capacity for reparative hypertrophy and hyperplasia after loss of functional tissue. The large reserve of the liver's functional capacity permits survival of the animal even if over 70 per cent of its liver is removed. It retains an inherent capacity for regenerative growth which subsides once the original organ deficit is restored. This study attempted to resolve the question of whether alteration in hepatic hemodynamics affects the regenerative stimulus of the liver after partial (70 per cent) hepatectomy. It has shown that the liver remnant regenerates after reduction of portal blood flow by construction of a portacaval anastomosis. The diversion of blood from the liver exerts its own histologic and electron microscopic effects on the liver. Reduction of portal blood flow affects the temporal patterns of regeneration after partial hepatectomy but does not prevent completion of the regenerative process. Correlation of this study with the biochemical data available in the literature indicates that the structural changes in the cellular organelles during the process of regeneration reflect dynamic biochemical events that are based on a predetermined genetic code representing the key to life that is uniquely found in the liver.


Analysis of gallbladder bile in morbid obesity. Thirty-seven per cent of our grossly obese patients selected for gastric bypass had cholesterol gallstones. To document the composition of the biliary lipids prior to weight loss, the bile taken from eleven obese patients at the time of gastric bypass was analyzed and the results compared with those in eleven nonobese patients undergoing elective surgery. There was extreme supersaturation of both gallbladder and hepatic bile in all obese patients. The gallbladder bile of all obese patients fell well outside the micellar zone whereas the bile from all but one of the controls fell within the micellar zone. These data provide biochemical support for the clinical association of obesity and cholesterol gallstone formation and are evidence against the possibility that gastric bypass is a lithogenic operation.


Prognostic evaluation of regional lymph node morphology colorectal cancer. Histologic sections from 143 patients treated with surgery for infiltrating adenocarcinoma of the distal large bowel were studied with emphasis on the morphologic characteristics of the regional lymph nodes. Lymph nodes were classified into four groups designated lymphocyte predominance, germinal center predominance, lymphocyte depletion, and unstimulated. Results were correlated with the extent of disease and five year survival data. There was no significant association between the histologic pattern of the lymph nodes and the extent of the primary lesion. There was a higher survival rate in patients whose nodes showed germinal center predominance (71 per cent) compared with those whose nodes showed lymphocyte predominance or the unstimulated pattern (both 54 per cent), but these results were not statistically significant.