Pregnancy-terminating effect of human chorionic gonadotrophin in rats. A single intramuscular dose of HGC(50) i.u. or more per rat) was able to induce fetal resorption and eventual termination of pregnancy when injected on Day 4 or between days 7 and 11 of pregnancy. This dose was inactive when administered on Day 12 of pregnancy. A single large dose (500 i.u./rat) induced fetal resorption when administered even on Day 12 of pregnancy. In intact rats treated with HCG, daily doses of progesterone were unable to maintain normal implantation; in ovariectomized rats treated with HCG, daily preges. Terone did succeed in maintaining pregnancy in many of the animals. It is suggested that fetal resorption and the eventual pregnancy-terminating effects of HCG in rats are mediated through the alteration of normal ovarian steroidogenesis.


Hormonal requirements of the different cycles of the seminiferous epithelium during reinitiation of spermatogenesis in long-term hypophysectomized rats. Restoration of testicular function in long-term hypo-physectomized rats given different hormonal treatments during the various cycles of the seminiferous epithelium was evaluated on the basis of the weights of testes, epididymides, and other accessory sexual glands, histological examination of testes, and determination of the numbers of spermatozoa/epididymis. The staput fractionation technique for the separation of classes of germinal cells was employed to provide a measure of the advancing front of pulse-labelled cells following the intratesticular administration of (3-H)thymidinemthe results suggested that during the first two cycles, in which spermatogonia develop into pachytene spermatocytes, either LH or testosterone alone was sufficient for partial restoration. During the third cycle of the seminiferous epithelium, LH and FSH were required to allow previously labelled pachytene spermatocytes to progress efficiently to stage 7 spermatids. Administration of LH alone during the final cycle was sufficient to permit stage 7 spermatids to develop into spermatozoa, provided LH plus H had been given during the previous three cycles. Injection of LH during the entire period and of FSH during the third cycle of the seminiferous epithelium was required to achieve Staput profiles characteristic of a normal advancing front of pulse-labelled cells, and to allow partial restoration of spermatogenesis. More complete restoration was obtained in rats given FSH and LH during the first three cycles but, with the doses employed, the number of spermatoza/testis remained subnormal. Efficient completion of each cycle of the seminiferous epithelium appeared to be hormone-dependent. The data are discussed in relation to the possibility that hormones may affect the general development of germinal cells in an indirect manner by their influence on Sertoli cell function.


Effects of a protein-free diet on amino acids and sex hormones of rats during the early postimplantation stages of pregnancy. In rats, the effect of a protein-free diet on the maintenance of gestation was investigated during the early postimplantation stages (days 7 to 10). The growth kinetics of the implantation site, the concentrations of free amino acids in the implantation sites as well as in the maternal liver and the levels of sex hormones in the maternal serum were determined. The results of these studies showed that in the whole implantation site, the absolute amounts of DNA, RNA and nitrogen were significantly lower in the rats fed a protein-free diet, the concentrations of essential amino acids decreased in the whole implantation site to the same extent as in the maternal liver. In the case of the non-essential amino acids, however, a significant increase in the concentrations of some of the amino acids was observed in the maternal liver. With regard to the essential amino acid pool, it appears that the liver and decidua can be regarded as being in a dynamic equilibrium. Peripheral prolactin and progesterone concentrations significantly decreased on day 8 of gestation, while the amounts of LH and total oestrogens remained unchanged.


Immunological aspects of gynecological malignancies. The intricate aspects of cell mediated immunity in patients with squamous cell carcinoma of the cervis and adenocarcinoma of the ovary are demonstrated with an in vitro system. Presensitized lymphocytes from patients with these two gynecologic malignancies demonstrated immediate cytocidal effects on analogous tumor cells in culture. This was not true of lymphocytes from normal health individuals. Some cross-reactivity between surface antigens in fetal gut cells and malignant epithelial cells is suggested by other experiments. These studies are used to formulate a hypothesis that tumor associated antigens do exist in gynecological malignancies.


Basal body temperature recordings in ectopic pregnancy. Basal body temperature charts taken during the cycle of conception of tubal pregnancies suggested the presence of luteal phase defect in the background of ectopic implantation and the recurrence of an apparent menstruation at the expected time of the next period. The temperature changes were compatible with the occurrence of a "superovulation" shortly before the occurrence of tubal abortion.


Intrapartum hypertension and intravenous saline. Four hundred women in labor were given, on a random basis, either 5 per cent dextrose in water or 5 per cent dextrose in normal saline infusions. Normotensive parturients receiving saline showed an increased incidence of elevated blood pressure during labor or postpartum while hypertensive parturients showed no significant increase in mean arterial blood pressure. Fetal serum sodium levels were not affected by whether the mother had received either the dextrose or saline intravenous solution.


Effect of water on the thermal death of a hydrocarbon bacterium in a nonaqueous fluid. A bacterium that grows in oil was tested for survival at elevated temperatures in menstruums of varying water content. For each doubling of the water concentration, the surviving fraction decreased by a factor of approximately 3.0. A minimum value of 0.02% water is required before enhanced killing occurs.


Preparation of 14C-labeled sterigmatocystin in liquid media. 14C-labeled sterigmatocystin was prepared from surface cultures of Aspergillus versicolor A-18074 maintained in liquid media by multiple additions of (1-14C)acetate to the cultures. The highest yield of 7.75 mg/10 ml was found with a sucrose-asparagine-ammonium medium in which more than 3% of the radioactivity of the added (1-14C)acetate was recovered ithe purified (ring-14C) sterigmatocystin. The method offers an easy way to prepare 14C-labeled sterigmatocystin for studies of this mycotoxin.


Pathogenic leptospiras isolated from Malaysian surface waters. Pathogenic leptospiras (1,424) isolated from natural waters and wet soils in Malaysia comprised 29 different serovars (synonym serotypes). All except two of the serovars had been found previously in Malaysia. The exceptional serovars were werrasingha, an Autumnalis serogroup member originally isolated in Ceylon, and a new serovar designated evansi. Serovar evansi had serological affinities with serovar ranarum which was isolated from the kidney of a frog in Iowa. The large variety of serovars found in jungle areas was consistent with similar previous findings of diverse serovar infections in troops who had operated in Malaysian jungles.


Characterization of Bacillus pumilus E601 spores after single sublethal gamma irradiation treatments. Eighteen survivor strains of Bacillus pumilus E601 have been isolated after single sublethal irradiation treatments with 60Co. Primary isolation was based on the loss of motility and pellicle formation. However, with subsequent subcultivation, eight isolates reverted back to the standard of exhibiting motility and pellicle formation. Characteristics of the isolates include alterations in space radiation resistance and in the amino acid requirements for spore germination and outgrowth. Other alterations in cultural and physiological characteristics were found. Three of the isolates were asporogenous.


Incidence of aflatoxin in California almonds. In a survey of California almonds, aflatoxin was found in 14% of 74 samples of unsorted, in-shell almonds as received by the processor in 1972, but it occurred at very low levels (below 20 parts per billion (ppb)) in 90% of the contaminated samples. The overall proportion of individual nuts contaminated was especially low and is estimated with 95% probability to have been in the range of 1 nut/55,300 nuts to 1 nut/14,700 nuts. Aflatoxin contamination is not restriced to any particular section of the almond-growing region of California. Commercial sorting procedures are effective in removing most aflatoxin-contaminated nutmeats, since none of 26 samples of processed, whole nutmeats contained aflatoxin. In contrast, 13 of 27 samples of diced almonds were contaminated, but nine of these 13 samples contained less than 20 ppb. Only one of 25 samples of sliced nutmeats contained aflatoxin (4 ppb). Thus, aflatoxin incidence in almonds varies greatly with the category of finished product. The apparent high incidence in diced nutmeats is probably due mostly to the more uniform distribution of aflatoxin occurring in this product (because of its small particle size) than that occurring in the other products. Sample size requirements for monitoring aflatoxin in almonds are discussed.


Four hundred consecutive patients with permanent transvenous pacemakers. Between April 1, 1965, and May 1, 1973, we inserted permanent transvenous pacemakers in 400 consecutive patients. Patients considered for this type of pacing were those with any episode of heart block and those with other types of bradyarnhythmias who had unexplained vertigo or syncope. There was one operative death and one instance in which the primary unit became infected. Problems with catheter dislocation, electrode fracture, and exit block were few and were easily corrected. We believe transvenous permanent pacing to be the best method of cardiac pacmaking in these patients. It is well tolerated by largely avoidable and easy to correct.


Simultaneous mitral valve replacement and ligation of persistent ductus arteriosus; a case report. The successful simultaneous closure of a persistent ductus arteriosus and mitral valve replacement in a 65-year-old woman with pulmonary hypertension is reported. The approach through a left thoracotomy gave good exposure and momentary cessation of cardiopulmonary bypass made ligation of the calcified ductus possible. Although this seems to be a rare association, when mitral valve disease is significant the simultaneous closure of the duct and mitral valve surgery is the treatment of choice.


Complications of cloth-covered prosthetic valves: results with a new mitral prosthesis. During a 12 year period 5,103 cardiac prosthetic valves in 4,193 patients have been evaluated for performance and incidence of complications. As a result of our experience, the advantages of fewer embolic phenomena, associated with epithelialization in completely cloth-covered valves and those with cloth-covered seating rings, are outweighed by the problems of cloth wear, hemolysis, and hemodynamic obstruction from tissue overgrowth. A valve has been designed which incorporates the desirable features of full-flow orifice, low-profile, self-washing principle, polished contact surfaces, durable materials, and a large eccentric sewing ring into a new mitral prosthesis. Clinical evaluation in 394 patients from Aug. 1, 1971, through Dec. 31, 1973, has demonstrated excellent hemodynamic function and a low incidence of thromboembolic phenomenon.


Coronary collateral blood flow in acute myocardial infarction. The evolution and transmural distribution of coronary collateral blood flow in acute myocardial infarction was determined in 24 trained, unanesthetized dogs by injection of radioactive microspheres into the coronary circulation. Acute coronary artery occlusion resulted in a greater decrease in subendocardial flow than subepicardial flow in both the central and marginal zones of the infarct. Coronary collateral blood flow was distributed primarily to the marginal zone and to the subepicardium of the central zone of the infarct. The greatest increase in collateral flow occured between 12 and 18 hours after coronary artery occlusion. By 24 hours after coronary occlusion, blood flow to all areas of the infarct except the subendocardium of the central zone had returned to near control levels. This dispropotionate distribution of coronary collateral blood flow during the early stages of myocardial ischemic injury helps to explain the apparent lack of protection of the subendocardium by collateral flow.


Interrupted aortic arch and ventricular septal defect. Direct repair through a median sternotomy incision in a 13-day-old infant. A type B interrupted aortic arch was successfully repaired in a 13-day-old infant during profound hypothermia and circulatory arrest. Through a median sternotomy incision it was possible to resect a patent ductus arteriosus and mobilize the descending thoracic aorta for anastomosis to the side of the ascending aorta. At the same time a large ventricular septal defect (VSD) and a small atrial septal defect were closed through the right atrium. Cardiac catheterization 5 months after operation showed a small persistent VSD with a pulmonary to systemic blood flow ratio of 1.1/1. The systolic gradient between the ascending and descending aorta was 20 mm. Hg.


Blood platelets and extracorporeal circulation; kinetic studies on dogs on cardiopulmonary bypass. Platelet kinetics and functions were studied in dogs during extracorporeal circulation. A transient platelet sequestration in the liver occurs during the bypass. This reversible disappearance is accompanied by a loss of the ability of platelets to adhere or aggregate. The platelets which return to the circulation have normal functions and a normal life span. The irreversible damage is mainly due to the direct blood-gas interface. Impairment of lung function by platelet aggregates is discussed and the importance of an in vivo model to study the factors which affect the platelets, such as antiaggregating agents, is pointed out.


Selection of the candidate for myocardial revascularization; a profile of high risk based on multivariate analysis. A survey of 60 patients who died from cardiac related causes after vein or artery bypass operations alone (1967 to 1973) was made with respect to 26 clinical, angiographic, and operative variables. These factors were compared with identical characteristics of 1,188 survivors operated upon in 1973. Through discriminant analysis, the various characteristics, isolated or multiple in any combination, have been converted into risk related to operative death. The distinctive features of the mortality group were vastly different from those in the surviving group. Ten patients (16.67 per cent) of the mortality group were in the ninety-ninth percentile of risk, whereas these factors or variables of similar weight produced an equivalent risk of only 0.34 per cent of the survivors; thus, operative death in these circumstances could be predicted with an estimated 98.0 per cent assurance. Each of 6 patients with mortality risks above 0.99999 had (1) marked cardimegaly, (2) uncompensated congestive heart failure (CHF), (3) triple vessel coronary artery disease and/or obstruction of the left main coronary artery, (4) generalized impairment of left ventricular contraction or segmental left ventricular scar, and (5) evelated left ventricular end-diastolic pressure. As a single factor, congestive heart failure (CHF) exerted the most influence on the probability of dying. A new and more desctiptive statistical interpretation of the factors presumed to affect risk is presented.


Myocardial revascularization in patients with poor ventricular function. Eighty patients with evidence of impaired ventricular function by ventriculography were reviewed. On the basis of the ejection fraction, these patients were divided into three groups. Those with ejection fractions less than 0.2 were considered in very poor condition, those with ejection fractions of 0.2 to 0.4 were considered in poor condition, and those with ejection fractions with between 0.4 and 0.6 were considered fair. Suitability of vessels for bypassing and the presence or absence of collateral cirulation on the cinearteriograms was also noted for possible influence on result. Operative mortality rate in patients having complete repair, defined as bypassing all major vessels with significant obstruction, was 7 per cent. In 26 patients having incomplete repair, the operative mortality was 30 per cent. However, the late mortality rate was not favorably influenced by complete repair, 75 per cent are in improved or good clinical condition, as compared with 65 per cent in the incomplete repair group. As patients with impairment of ventricular contractility are at high risk, it is believed that they should continue to be evaluated on an individual basis for bypass surgery and not categorically denied treatment.


The advantages of transthoracic placement of permanent cardiac pacemaker electrodes. To determine the effect of stimulation site on cardiac pacing thresholds, identical, small-surface area, cathodal, Elgiloy electrodes were placed intramyocardially on the left and right ventricular apices and transvenously into the right ventricular apex of 20 dogs in complete heart block. At seven stimulus durations, threshold voltage and current were  measured directly with an oscilloscope and current probe. Left ventricular intramyocardial pacing required less threshold stimulus energy than right ventricular intramyocardial or right ventricular endocardial pacing. Previous studies that determined lower thresholds with transvenous right ventricular endocardial leads than with directly placed myocardial leads used stimulating electrodes of differing configuration, surface area, and materials at the different sites and/or used epicardial rather than intramyocardial electrodes. These factors biased the results in favor of the endocardial site. When all clinical and electrophysiological facotrs are considered, direct intramyocardial placement of electrodes deserves a much wider acceptance and application than it now enjoys.


A new radioisotope-powered cardiac pacer. A small lighweight nuclear pacer is described. The unit weighs 6) Gm. and occupies a bolume of 33 c.c. It is a standard, R-wave inhibited, demand pacer and has been shown to be insensitive to electromagnetic interference. The unit has met all United States and Foreign Atomic Energy Commission (AEC) safety specification requirements, including cechanical shock, industrial fire, accidental crush, cremation, impact, and corrosion. Its calculated life is in excess of 20 years. Extensive dog testing has been completed and will be described in detail elsewhere. The United States AEC has been issued a license to conduct extensive clinical trials. These began in October 1974, and will be the subject of a later report.


One 25 day survivor with total artificial heart. One calf, which weighed 87 kilograms, survived for 25 days with a total artificial heart (TAH) implanted orthotopically. All hemodynamic parameters stayed normal except the right atrial pressure (RAP), which increased gradually toward the end of the experiment. The cardiac output was maintained between 8.0 and 11.0 L. per minute. Kidney function was well maintained, and no pulmonary insufficiency was noted. Infection became obvious after 2 weeks of pumping although it was controlled to the extent that the calf was able to eat, to several factors, amont them mechanical damage to red blood cells, infection, malnutrition, and liver damage. The calf was standing until 30 minutes before its sudden death from cerebral thromboembolism. The calf's activity throughout the postoperative course convinced us of the feasibility of clinical application and of immediate application to studies of cardiovascular physiology and pharmacology.


Acoustic neuroma and the suboccipital approach (1967-1972). The goal of successful acoustic tumor surgery is to totally remove the tumor and preserve neurologic function. This paper reviews 132 patients, with particular emphasis on the hospital mortality rate, total removal of the neoplasm, and preservation of facial function and, in 3 instances, hearing.


Multiple myeloma: review of 869 cases.

Multiple myeloma: review of 869 cases. A review  of 869 cases of multiple myeloma seen at the Mayo Clinic from 1960 through 1971 revealed that 98% of patients were 40 years of age or older and that 61% of them were males. Inital findings were bone pain in 68% of patients, anemia in 62%, renal insufficiency in 55%, hypercalcemia in 30%, a palpable liver in 21%, and a palpable spleen in 5%. Proteinuria was noted in 88% and Bence Jones proteinuria was identified in 49%. Skeletal roentgenographic abnormalities were seen in 79%. Serum protein electrophoresis showed a spike in 76%, hypogammaglobulinemia in 9%, and minor or no abnormalities in 15%, and a globulin spike was seen 75% of the urinary electrophoretic patterns. Immunoelectrophoresis of the serum revealed a monoclonal heavy chain in 83% and a monoclonal light chain in the serum, in 8% (Bence Jones proteinemia). Three patients had no monoclonal protein in the serum or the urine ("nonsecretory"). Amyloidosis was found in 7% of the patients. Follow-up information was obtained in 99.7% ; 82% of the 869 patients have died. Infection and renal insufficiency were the most common specific causes of death. The median survival was 20 months; 66% of the patients were alive at 1 year and 18% at 5 years.


Bilateral adrenal medullary hyperplasia in multiple endocrine neoplasia, type 2: the precursor of bilateral pheochromocytoma. An asymptomatic 12-year-old girl with multiple endocrine neoplasia, type 2, had high urinary levels of vanillylmandelic acid that suggested pheochromocytoma; she also had bilateral medullary thyroid carcinoma and hyperparathyroidism. Her mother and maternal aunt and uncle  had bilateral pheochromocytoma (metastatic in the former two). Bilateral adrenalectomy was performed. Diffuse, non-nodular adrenal medullary hyperplasia was present. This hyperplasia was characterized by increased medullary mitotic activity, decreased corticomedullary ratio, increased total adrenal weight, and increased total catecholamine content (left adrenal). The results in this case suggest that diffuse hyperplasia of the adrenal medulla may be the precursor of pheochromocytoma in patients with this syndrome.


The spatial distribution of urban pharmacies. Pharmacists are thought to play a central role in providing information and advice on health to lower income and other socially disadvantaged groups. However, recent evidence suggests that social biases exist in the spatial distribution of urban pharmacies. Such biases would severely limit the accessibility of the poor and the nonwhite to pharmacy services. To test the general nature of this evidence, we used multiple regression techniques to assess the simultaneous influence of several ecological and socioeconomic variables on the location of pharmacies in Pittsburgh and Omaha. After controlling for the influence of physicians, hospitals, commercial activity, population, and other variables thought to affect pharmacy location, we were unable to detect any evidence of a direct association between pharmacy location and the socioeconomic or demographic (other than total population) characteristics of areas in either city.


Health and economic development: the example of China and Cuba. The unprecedented accomplishments reported from China and Cuba in providing health care to their populations question the assumption that economic development along the model of Western nations is a sine qua non for developing effective health care systems among nonaffluent developing nations. Equal distribution of resources, emphasis on preventive public health measures, and attention to improving overall quality of life have been concepts employed to great advantage by both countries. When it is realized that improved standards of living have far overshadowed modern medical technology in upgrading the health of populations, the policies employed in China and Cuba become especially relevant to other nations, both developed and developing.


Survival, and a modicum of indulgence in the sick role. Serendipitously occasioned, interim findings from an exploratory study "which-as Whitehead once said of William James's pragmatism-'chiefly starts a log of hares for people to chase.'"3 The data, collected in a 1965 community survey of health, show that no indulgence in the sick role apparently entails greater mortality risk than does a modicum of such indulgence.


Metabolic effects of propranolol in thyrotoxicosis. I. Nitrogen, calcium, and hydroxyproline. The effect of propranolol on the hypermetabolism of thyrotoxicosis was investigated in eight subjects with diffuse toxic goiter. After equilibration on a constant nitrogen, calcium, and hydroxproline intake, nitrogen balance was determined before and during propranolol therapy prior to subtotal thyroidectomy and compared to similar data obtained in seven of the patients following surgically induced euthyroidism. Propranolol administration was associated with clinical amelioration and a rapid, statistically significant, improvement in nitrogen retention. A slight additional improvement in retention was noted in the postoperative euthyroid state. Oxygen consumption, measured serially in four patients, was not significantly changed by propranolol. Urinary loss of calcium, phosphorus, and hydroxyproline was unaffected by propranolol, but excretion of these substances was sharply reduced in the subjects restudied postoperatively. These data offer a evidence of a previously unreported nitrogen sparing effect of oral propranolol during its short-term administration in thyrotoxic man.


Effect of lipids on glucagon secretion in man. Animal experiments have suggested a FFA control mechanism for glucagon secretion. In man, the potent effect of FFA on HGH secretion and the similarity of the secretory control mechanisms for HGH and IRG also support a role of FFA in IRG secretion. Our studies in man in which plasma FFA were elevated by either an oral lipid emulsion (Lipomul) or an intravenous lipid suspension (Intralipid)suggest only a minor role of lipids in control of IRG secretion. Plasma FFA and triglyceride elevations did not suppress arginine- or hypoglycemia-induced plasma IRG elevations, but an inhibitory effect of Intralipid on basal plasma IRG concentrations was observed. Although nicotinic acid administration, which caused a depression in plasma FFA, did elevate plasma IRG, the IRG elevation was considered more likely a consequence of stress induced by the drug. The failure of lipids to inhibit IRG secretion at FFA concentrations inhibiting HGH secretion indicates a dissociation in the secretory control mechanisms of the two hormones.


Effect of intravenously administered glucose on glucagon and insulin secretion during fat absorption. The intravenous infusion of glucose was found to alter profoundly the response of insulin and glucagon to an intraduodenally administered fat meal in conscious dogs from that of dogs given only intravenous saline as a control. In the latter, insulin rose only 4 muu/ml and glucagon rose from 142 SEM plus or minus 8 to a peak of 221 pg/ml SEM plus or minus 50. When glucose was infused, raising plasma glucose above 173 mg/100 ml, the administration of fat was associated with a rise in mean insulin to 344 muu/ml, and glucagon remained suppressed by hyperglycemia to below baseline level, despite the fat meal. The peak insulin response to a fat meal plus glucose infusion was more than three times the peak level observed when glucose was infused alone without a meal or with a nonabsorbable intraduodenal volume load in the form of mineral oil. This suggests that the absorption of fat elicits an entero-insular signal that is greatly potentiated by exogenous glucose. These glucose-induced changes in the hormonal response to a fat meal may mediate certain of the metabolic effects of carbohydrates.


Inhibition of sucrase by tris in rat and man, demonstrated by oral loading tests with sucrose. In the course of work concerned with the inhibition of small intestinal carbohydrate digesting enzymes, experiments were performed on rats and two healthy volunteers using tris as a sucrase inhibitor. The following results were obtained: (1) Tris does not lower the blood glucose in fasting rats after oral or subcutaneous doses up to 500 mg/kg, when administered as neutral solution (pH 7.0). (2) Tris reduces reduces the glycemia in rats and human subjects after a sucrose load. In addition, the insulinemia caused by administration of sucrose is reduced in man. This smoothing effect on both curves is dose-dependent. A delay of gastric emptying by tris could be excluded. (3) After a glucose or matose load in rats, tris has no effect on the blood sugar curve. (4) The marked smoothing effect of tris is after sucrose loading is probably caused by its well-known in vitro inhibitory effect on intestinal sucrase activity of pigs and humans.


Exertional dyspnea and cough as preludes to acute attacks of bronchial asthma. Although wheezing is believed to be a cardinal manifestation of asthma, some patients with this disorder may not present with wheezing, but rather with either exertional dyspnea or cough. In 14 such patients with dyspnea, there was peripheral airway dysfunction with markedly elevated residual volumes, frequency dependence of dynamic compliance and depressed flow rates in the middle-vital-capacity range, whereas specific conductance and one-second forced expiratory volumes were normal. Circumstantial evidence suggests that mucosal edema or mucous secretions may have been responsible. In seven patients with cough, studies revealed a more severe obstructive pattern that appeared to be the result of increased large-airway resistance, and the patients' response to isoproterenol indicated that contraction of bronchial smooth muscle may have been principally responsible. Thus, intermittent episodes of cough or breathlessness may represent variant aspects of asthmatic attacks.


Comparison of ventricular ectopic activity during 24-hour monitoring and exercise testing in patients with coronary heart disease. The exposure of ventricular ectopic activity (VEA) by maximal exercise testing and 24-hour ambulatory monitoring was compared in 100 unselected patients with coronary heart disease. The arrhythmia was noted with exercise in 56 patients and with monitoring in 88. Repetitive forms such as couplets and ventricular tachycardia were found to be twice as frequent (40 vs. 20) with monitoring than with exercise. Patients with prior myocardial infarction had more frequent ventricular ectopic activity of a more advanced grade with both exercise and monitoring than patients with angina pectoris. Exercise exposed the grades of ectopic activity that recurred during two or more hours of the monitoring session. Of seven patients with ventricular tachycardia on exercise only four exhibited this grade with monitoring. It may be that these two methods divulge different information regarding the electrophysiologic state of the myocardium.


The training of manpower needed for biomedical research. Increased federal interest in the health of the American people implies federal support not only of biomedical research but also of training the personnel competent to carry out that research. Mechanisms to implement support biomedical research training include institutional training grants, individual fellowships, training grants, training as part of research grants and contracts, and self-support with assistance by federal loans when necessary. Of these, the institutional grants provide the best mechanism since they are most likely to produce stable, high-quality scholarly programs that are continuously under peer review, and since they allow central direction of the mix of disciplines based on monitoring of current and projected requirements.


Identification and measurement of plasticizer in neonatal tissues after umbilical catheters and blood products. Because of concern about tissue uptake of pasticizers used in medical equipment, di-(2-ethylhexyl) phthalate was measured by gas chromatography-mass spectrometry in neonatal heart and gastro-intestinal tissue. Seventeen infants who had umbilical catheterization alone or with administration of blood products, and 13 stillborn or older controls were studied. The mean levels of the plasticizer for heart residue and pressed extract in the study group --1.27 plus or minus 0.42 and 0.66 plus or minus 0.22 mug per gram respectively--were significantly (pgreater than 0.005) higher than the corresponding control levels (less than 0.07 plus or minus 0.03 and less than 0.07 plus or minus 0.04 mug per gram). Higher levels were associated with larger amounts of blood products, more extensive use of catheters, and early death. Levels in gastrointestinal tissue from three infants who had died of necrotizing enterocolitis were significantly (less than 0.05) higher than those in gastrointestinal tissue from infants without this disease. Thus, plasticizer from medical use of plastics does accumlate in tissues of critically ill infants.


High blood acetaldehyde levels after ethanol administration. Difference between alcoholic and nonalcoholic subjects. Blood actaldehyde and ethanol levels were measured in 11 subjects, six with chronic alcholoism and five nonalcholic controls, after alcohol had been given intravenously. Despite a progressive fall in blood ethanol over a range of 54 to 33 mM/acetaldehyde did not decrease in any of the 11 subjects. The mean acetaldehyde plateau level was significantly (p less than 0.001) higher in alcoholic (42.7 plus or minus 1.2 mum) than in nonalcoholic (26.5 plus or minus 1.5 mum) subjects. When the mean blood ethanol concentration reached 24 mM,the acetaldehyde plateau ended abruptly in each subject. The ethanol concentration at which this fall of blood acetaldehyde occurred suggests desaturation of an ethanol oxidizing system other than alcohol dehydrogenase and indicates that at high ethanol blood levels, such a system contributes to ethanol oxidation. The highet acetaldehyde levels in alcholism may result from both greater activity of this system and mitochondrial damage, and could contribut to the neurologic, hepatic and cardiac complications of alcoholism.


Treatment of the syndrome of inappropriate secretion of antidiuretic hormone with lithium carbonate. Lithium, an established inhibitor of antidiuretic hormone action, was used (as the carbonate salt) to treat a patient with the syndrome of inappropriate secreation of antidiuretic hormone. The patient was studied by balance technics, and after  a stablized hyponatremic state developed, 0.9 g of lithium carbonate was administered daily. A prompt water diuresis ensued, with correctionof hyponatremia in two days. Discontinuation of the drug resulted in a gradual return of the hyponatremic state. No change in urinary cyclic AMP occurred during the period of lithium effect. Lithium carbonate may be an effective treatment for both the acute and the chronic forms of the syndrome.


Serum lysozyme in Crohn's disease and ulcerative colitis. Serum lysozyme (muramidase) concentrations were determined in patients with different types of inflammatory bowel disease and in normal subjects. The mean (plus or minus S.E.M.) lysozyme concentration for each group was as follows: controls, 8.8 plus or minus 0.3, ulcerative colitis, 9.3 plus or minus 0.6, Crohn's disease, 26.3 plus or minus 1.4. a and bacterial and nonbacterial enteritis, 8.9 plus or minus 0.7 mug per milliliter. Thus, mean enzyme levels were significantly greater in Crohn's disease than in ulcerative colitis (p  smaller than 0.001), bacterial and nonbacterial enteritis (p smaller than 0.001) and healthy volunteers (p smaller than 0.001). The elevation of serum lysozyme in Crohn's disease may be related to tissue macrophages because no correlation was found between either the serum lysozyme concentration and the white-cell counts or the absolute numbers of circulating granulocytes or monocytes. Our findings suggest that serum lysozyme may be useful in the differential diagnosis of Crohn's disease from other types of bowel inflammation.


Women in health care.

Women in health care. The occupational, class, and sex structure of the United States Health Labor Force is similar to the competitive sector of the economy (i.e., it is predominantly female, poorly paid and poorly unionized). Upper-middle-class men compose the great majority of medical professionals, whereas lower-middle and working-class women form the greatest proportion of all middle-level, clerical and service workers. This division of labor is due to the role of women both in the family and as a reserve of labor for the economy. There is a virtual absence of the majority of producers--lower-middle-class and working-class women-- in the decision-making bodies of the health institutions. The political strategy for change is to introduce institutional democracy in the health sector, with control on the institutions by those who work in them--and those who are served by them.


Extension of cervical carcinoma to lumbar spine. Carcinoma of the cervix is a lesion in which involvement of the spinal column is not generally considered. Two recent cases attest to the fact that this lesion may compress the lumbar vertebrae and cause paralysis, due to aorta iliac node metastases. Laminectomy with decompression, followed by radiation therapy, only temporarily alters the course of the lesion. With present technics the portals of irradiation are inadequate to prevent this lesion.


Use of prostaglandin E2 vaginal suppositories in intrauterine fetal death and missed abortion. Twenty patients with either missed abortions or intrauterine fetal death were induced with prostaglandin (PGE2) vaginal suppositories. The uterus is surprisingly responsive to PGE2 in cases of intrauterine death, yielding a short treatment-delivery interval. Blood coagulopathies which can develop after intrauterine death can be avoided through early diagnosis and treatment. Eighteen patients completely delivered and there were no serious complications. The remaining 2 patients required curettage. Side effects were mild in nature, consisting of occasional gastrointestinal symptoms. This method is now a standard procedure in cases of intrauterine fetal death and missed abortion at Yale-New Haven Medical Center.


Oxytocin challenge test in monitoring high-risk pregnancies. Eighty-nine pregnancies, at risk for placental insufficiency, were monitored with serial oxytocin challenge tests (OCT) and estriol determinations on 24-hour urine collections. Intraamniotic catheters were used to accurately record intrauterine pressure in 63% of the tests; 114 of the 116 tests (98%) were adequate for interpretation. Thirteen positive tests were recorded; however, in only 2 cases did the positive OCT predict a dysmature-postmature infant when estriol determinations were normal. Prompt delivery following a positive OCT can significantly reduce the incidence of fetal wastage.


Obstetric aspects of the Guillan-Barré syndrome. Two additional cases of Guillain-Barre syndrome complicating pregnancy are reported and the 25 previously published cases reviewed. While fetal prognosis is generally favorable, the occurrence of the disease in late pregnancy is a high-rish maternal condition. Respiratory failure and aspiration pneumonitis may result in premature labor and maternal mortality.


Introduction of labor after intrauterine fetal death: A comparison between prostaglandin E2 and oxytocin. Medical induction of labor was attempted in 30 women after intrauterine death of the fetus. Labor was induced in 15 patients with oxytocin and in an additional 15 patients with prostaglandin E2. The results suggest that prostaglandin has some advantage over oxytocin in these circumstances, and that prostaglandins may be especially useful in this difficult clinical situation.


Suction curettage: therapeutic effectiveness in dysfunctional uterine bleeding. A group of 60 patients between the ages of 30 and 45 were randomly selected to have either a suction curettage or dilatation and curettage. The criteria used for patient selection was that they had dysfunctional uterine bleeding, a normal gynecologic examination, and were receiving no hormonal therapy. These patients were followed up for at least 3 months. Although the number of patients is relatively small, the results showed that, therapeutically, suction curettage was equal to dilatation and curettage in alleviating dysfunctional uterine bleeding.


Effect of PGF2alpha in pseudopregnancy.

Effect of PGF2alpha in pseudopregnancy. Eleven normal female volunteers received human chorionic gonadotropin (HCG) intramuscularly to induce a pseudopregnant state. Twenty-five milligrams of prostaglandin F2alpha (PGF2alpha) was administered intravenously at selected times during the luteal phase to demonstrate a luteolytic effect, or a local effect upon the endometrium producing early vaginal bleeding. Careful comparison of hormone levels and clinical details in these cycles showed that a) 1000 IU HCG daily does not consistently prolong the luteal phase; b) 2500 IU HCG daily does significantly prolong the luteal phase; c) HCG administration significantly increases progesterone and estradiol output in the treated luteal phase; d) prostaglandin administration at selected times during the luteal phase does not consistently decrease estradiol or progesterone output from the corpus luteum or induce early vaginal bleeding; e) prostaglandin F2alpha, a known stimulant of uterine contractility probably causes vaginal bleeding by mechanical means, as evidenced by show of menses in patients with progesterone levels elevated above normal; f) although variations in progesterone and estradiol output occurred during the hours of prostaglandin infusion, no consistent change was observed except for a compensatory rebound in progesterone output; g) prostaglandin F2alpha, in the dose utilized, is not a luteolytic agent.


A new method of promoting fertility.

A new method of promoting fertility. It has been demonstrated that in selected cases of subfertility in men, the first portion of the split ejaculate is superior to the specimen considered as a whole with regard to sperm density, sperm motility, and sperm morphology and also in those cases where there is increased seminal viscosity in the whole ejaculate. The use of a new coital technic, in which the husband practices coital withdrawal after the deposition of the better first portion of the ejaculate during the fertile time of the wife's cycle, has resulted in rapidly achieving pregnancy in many instances where the marriages had been barren for years. A documentation of 33 instances of pregnancy ascribed to this coital technic in the past 4 years, with detailed analyses of whole and split ejaculate semen, is presented.


Effect of intrauterine device on histology of endometrium. Endometrial biopsies were performed in asymptomatic IUD wearers on specific days of the menstrual cycle, and the histologic features were compared to those expected for the day of the cycle. Normal women who had endometrial biopsies performed as part of a sterility workup were used as controls. Endometrial asynchronism (defined as histologic delay or advance of 3 days or more) was observed in 33.5% of 113 biopsies performed on 79 women with IUD'S; 30% showed a delay in endometrial development during the secretory phase. Our findings give further support to those who claim that contraception with the IUD is not achieved through one single process but that a number of mechanisms are possible. Endometrial asynchronism may constitute one of such modes of action.


Actinomycosis infections associated with intrauterine contraceptive devices. A series of 10 instances of genital actinomycosis infection complicating the use of intrauterine contraceptive devices is recorded and its pathogenesis described. The likelihood is suggested that this complication is more frequent than is generally appreciated. A pathway of infection extending upward from the patient's anus, across the perineum, and up the vagina and cervix is suggested as the route of infection. The traumatizing effect of the device and a previously existing or intercurrent infection as additional contributing factors to the development of actinomycotic infection in the female genitalia is also postulated.


The value of radiation therapy in uterine sarcoma. Fifty-eight cases of leiomyosarcoma of the uterus and 47 endometrial sarcomas of the uterus are reviewed based on the pertinent information related to recurrence patterns. The following conclusions are made: 1) Cases of endometrial sarcoma should receive preoperative pelvic irradiation, or postoperative pelvic irradiation if a diagnosis is not made until the postoperative period. This plan will probably be of most benefit, if at all, in stage 1 disease. 2) A case for pelvic irradiation as an adjuvant to surgery in leiomyosarcoma cannot be made from a review of this material, either from a viewpoint of recurrence patterns or radio-responsiveness.


Complications of dermoid tumors of the ovary. There were 253 dermoid tumors of the ovary studied. Torsion of the pedicle with hemorrhagic infarction proved to be the most frequent complication; malignant change was the most lethal. Nine patients with malignant dermoid tumors, most of them with locally advanced disease, were treated with conservative surgery, radiation, and/or chemotherapy. The longest known survivor lived 3 years; most patients died within a year. It was concluded that a more aggressive surgical approach might salvage some patients with locally advanced malignant disease.


Disappearance of serum progesterone: after normal delivery and removal of hydatidiform mole. Serum progesterone was measured by competitive protein binding  assay at regular intervals up to 24 hours after delivery in 4 normal pregnancies. In 6 cases of hydatidiform mole, serum progesterone was assayed before and at regular intervals up to 48 hours after uterine evacuation or hysterectomy. Serum progesterone dropped rapidly by more than 50% during the first hour postpartum, and it was less than 25% of the predelivery levels 24 hours after parturition. In all 6 cases of molar pregnancies, serum progesterone fell rapidly within the first few hours after uterine evacuation. In the presence of theca lutein cysts (2 cases), serum progesterone fell much more slowly than in the absence of theca lutein cysts after removal of the mole tissue. Serum progesterone was less than 5mg/ml after total hysterectomy of uterine evacuation in moles without theca lutein cysts. These findings suggest that while the placenta is the principal source of elevated serum progesterone in normal pregnancy, the molar trophoblast is the principal source of elevated serum progesterone in hydatidiform mole, with the theca lutein cysts making a contribution when they are present.


Enzymatic alterations in Reye's syndrome: prognostic implications. Serial studies on serum enzyme and isoenzyme abnormalities in seven cases of Reye's syndrome were found to segregate patients into three categories of organ involvement. The patients with both extensive hepatic and previously unrecognized skeletal muscle involvement died despite therapeutic measures. The other two groups were characterized by enzyme and isoenzyme changes consistent with either predominantly muscular or hepatic involvement. The prognostic value of these abnormalities has been substantiated in subsequent cases of this syndrome. These findings suggest that those patients at greatest risk may be identified early, thus improving evaluation of the efficacy of specific therapeutic interventions in this disease.


Macroglossia, transient neonatal diabetes mellitus and intrauterine growth failure: a new distinct entity? A newborn infant, small for her gestational age with macroglossia and transient insulinopenic diabetes mellitus is described. Two similar cases have been found in the literature. Flat glucose tolerance test results were found in the mother, the mechanism of which was not disclosed; there was no evidence of hyperinsulinism or malabsorption syndrome and the response of plasma growth hormone, and cortisol, and of urinary epinephrine to insulin-induced hypoglycemia was adequate. It is suggested that the triad of intrauterine growth retardation, macroglossia, and transient neonatal diabetes mellitus constitutes a distinct clinical entity. The link to the maternal abnormalities of carbohydrated homeostasis remains speculative.


Newborn screening for Duchenne muscular dystrophy. Duchenne muscular dystrophy (DMD) occurs in about 1 of 3,000 to 4,000 boys. Laboratory evidence of the disease, notably elevated creatinephosphokinase (CPK), is present already in the newborn infant. Unspecific CPK elevation occurs in the newborn as well, yet disappears shortly thereafter, while in DMD patients the CPK remains high throughout infancy. A new method to reliably determine CPK in a drop of dried blood is described. The method fulfills the criteria given for a suitable screening method in the newborn infant. Although DMD is an incurable disease, early diagnosis has benefits. The latter include early beginning of supportive treatment and particularly recognition of heterozygous carriers of the mutant gene before other affected children are born in a stricken family. It is proposed to adopt the method as a new screening procedure for male newborn infants.


Endogenous and exogenous insulin responses in patients with cystic fibrosis. Eight male patients with cystic fibrosis, normal nutrition, normal physical activity, relatively mild pulmonary disease, no evidence of liver disease and no family history of diabetes mellitus underwent a series of carbohydrate tolerance tests in comparison with a group of 18 normal male subjects matched for age and body weight. Compared with the normal group, the patients with cystic fibrosis had significantly impaired glucose tolerance and significantly lower serum immunoreactive insulin levels during oral and intravenous glucose tolerance tests; serum insulin levels were also significantly lower after intravenous administration of tolbutamide in the patients with cystic fibrosis, but the reduction in blood glucose concentration in each group was not significantly different. During an intravenous insulin test, the decrease in blood glucose concentration was the same for both groups, in spite of significantly lower serum insulin levels in the patients with cystic fibrosis .The percentage fall in plasma free fatty acids was at least as great in the patients with cystic fibrosis as in normals during the test procedures; while a significant decrease in plasma alpha-amino nitrogen after intravenously administered insulin was seen only in the patients with cystic fibrosis. These studies suggest that the carbohydrate intolerance of cystic fibrosis is consequent upon an impaired insulin response to glucose, but that this insulin deficiency is partly compensated for by increased peripheral tissue sensitivity to insulin.


Recurrent acute pancreatitis in patients with cystic fibrosis with normal pancreatic enzymes. Ten adolescent and young adults with cystic fibrosis (CF) have had well-documented recurrent attacks of acute pancreatitis. The diagnosis of CF in each patient was delayed because they did not have pancreatic insufficiency. The diagnosis of CF was documented by the typical pulmonary involvement and elevated sweat sodium and chloride levels in all cases and a positive family history in six of the ten patients. Two patients were diagnosed as having acute pancreatitis before the diagnosis of CF was made, thus indicating that acute pancreatitis may be the presenting complaint in the young adult with CF. The diagnosis of acute pancreatitis was based on the presence of severe abdominal pain, usually with vomiting, tenderness in the mid-epigastrium, elevated serum and urinary amylase and serum lipase. Attacks were precipitated by fatty meals, alcohol ingestion; postcholecystectomy and tetracycline administration. In some patients no precipitating event could be elicited. Intravenous secretin-pancreozymin stimulation tests revealed a diminished bicarbonate secretion with little effect on the secretion of the zymogen enzymes. A mild attack of pancreatitis occurred after secretin-pancreozymin stimulation. The endocrine pancreatic function tested in four patients was normal as revealed by the glucose tolerance tests and determinations of serum insulin, growth hormone and free fatty acid. Transduodenal pancreatograms were performed in three patients; one showed a normal pancreatic duct, one showed duct obstruction and in the third patient a beady type of narrowing was found. The selenomethionine Se 75 uptake of the pancreas was noted only in the head of the pancreas. This suggests that loss of function occurs initially to a greater extent in the tail and body of the pancreas. Three patients died and showed characteristic lesions of CF.


Cystic fibrosis: comparison of two mucolytic drugs for inhalation treatment (acetylcysteine and arginine hydrochloride). Clinical, bronchoscopic, spirographic, scintigraphic, and chemical analyses were done in 24 children with cystic fibrosis to assess the mucolytic effects of acetylcysteine inhalations versus L-arginine hydrochloride aerosols. The latter drug is less active than acetylcysteine and should not be used to treat children with cystic fibrosis.


Clinical practice--improving instruction and evaluating  performance. The cardiac glycoside, ouabain, normally kills HeLa cells at concentrations of about 10-7 M or greater. By treating a population of HeLa cells with increasingly higher concentrations of the drug, a variant population was obtained of HeLa cells capable of growing in medium containing 10 minus 4 M ouabain. Inhibition of volume regulation of cells subjected to hypotonic shock was used as a measure of inhibition of active transport of Na across the plasma membrane. In that way dose-response curves for the rapid effects of ouabain and other inhibitors of active Na transport were obtained with both the original, ouabain-sensitive (OS) and the variant, ouabain-resistant (OR) cells. Three other cardiac glycosides (digoxin, digitoxin and hellebrin) and two aglycones (digitoxigenin and strophanthidin) were found to be equally as effective as ouabain in inhibiting volume regulation of the OS cells; the concentration which produced half-maximum inhibition, I(max/2), was about 6 X 10 minus 7 M in each case. Similar inhibition of the OR population by ouabain was observed only when the concentration exceeded 10 minus 4 M [I(max/2)2.5 X 10 minus 4 M], and the other steroid compounds had no effect on the variant cells at the highest concentrations tested (2 X 10 minus 5 M). OR and OS cells differed also in their sensitivities to the cardioactive erythrophleum alkaloid, coumingine; I(max/2) for OS and OR cells was 5 X 10 minus 8 M and 6 X 10 minus 7 M, respectively. These results, in addition to results of ouabain binding experiments and measurements of the rates of reversal of inhibition of volume regulation, suggest that a major reason for the differential sensitivities of the two phenotypes to these drugs is different affinities of their sodium pumps for inhibitors of active transport.


Early clinical experience with the ACTA scanner. An alternative method of computed tomography has been devised employing a new instrument, the ACTA scanner. This is a total-body scanner which permits study of virtually all body parts, since a water medium is not employed. Early clinical experience with this new method is discussed, and normal and pathological scans are presented.


Use of cornmeal bolus as an aid in obtaining cranial four-vessel angiograms. In cranial angiography it has always been difficult to visualize extracranial vessels of the cervico-thoracic region, upon one radiograph, by using the same exposure factors for both regions. For this reason, we experimented and found that by applying a dry cornmeal bolus on specific areas of the neck a technically superior radiograph of these regions can be achieved. This bolus simulated added soft tissue to the cervical region. The density of the cervical region is now similar to that of the upper thoracic. As a result, factors set for one exposure will adequately penetrate both areas.


Plain film recognition of the ligamentum teres hepatis. A radiolucent linear shadow can be seen on plain radiographs in the right upper quadrant of 30% of patients. The surface anatomy of the liver and its associated ligaments were studied in the cadaver, clinically, and in surgical patients to determine the cause of this shadow. From these studies it is concluded that the shadow is cast by the fat that normally surrounds the ligamentum teres hepatis. The soft-tissue "mass" that the fat shadow demarcates should not be interpreted as a pathological process.


Collective bargaining for radiologic technologists: organizational vehicles. This is the second in a series of articles written by members of the professional affairs committee of The American Society of Radiologic Technologists. The first article alluded to the analogy of a person who was learning to drive vis-a-vis a person who was learning about collective bargaining. The article suggested that the first step might be to study the rules of the road and in this context discussed briefly some of the federal laws that affect the collective bargaining relationship between employees and their employers. In this article, the analogy is carried still further in a discussion of the various types of organizations or groups that could be used for bargaining purposes.


Peripheral vision, structured noise and film reader error. The ability of film readers to detect a nodular target abnormality with the peripheral vision was studied using a gray structureless background, chest radiographs with a bilateral pneumothorax and chest radiographs with pulmonary vasculature. Peripheral detection of the nodular abnormality was profoundly decreased by the presence of the normal structures even though the nodule properties such as size and contrast were not different and, in the case of the pneumothorax, the nodules did not overlap normal structures. Structured noise is an important and often neglected variable in studies of visual search, film reader error and image processing in radiology.


Retrograde pancreatic venography. An experimental study. To explore the feasibility of retrograde pancreatic venography, transhepatic portal catherization via jugular and hepatic veins was performed in 10 dogs. Coaxially introduced catheters were then used to enter individual pancreatic veins for retrograde venography. Appropriate injection technique led to detailed visualization of the pancreatic venous system without anatomically evident injury to the pancreas. The (readily avoidable) injection of contrast agent through catheters wedged into pancreatic veins caused parenchymal extravasation and hemorrhagic pancreatitis. The detection of pancreatic cancer in patients not approachable by arteriography and the intensified search for small islet cell tumors are possible indications for pancreatic venography when the safety of this method is further demonstrated.


The use of prostaglandin E1 to enhance the angiographic visualization of the splanchnic circulation. Superior mesenteric angiograms were obtained in a series of dogs before and again after the injection of a 1-ml bolus of prostaglandin E1 (0.1-1.0 mug/kg) through the angiographic catheter. The prostaglandin E1 produced, on the average, a 100% increase in the superior mesenteric arterial blood flow with only minimal changes in the heart rate, systemic arterial pressure, and portal venous pressure. Opacification of the portal venous system was consistently enhanced after the prostaglandin E1. The arterial phase was preserved by increasing the rate of contrast administration.


The value of the pulmonary-artery-seeking catheter in percutaneous selective pulmonary arteriography. Selective catheterization of the main pulmonary artery via the percutaneous route using a pulmonary-artery-seeking catheter was successful in 98.4% of 122 consecutive pulmonary angiographic studies in 114 patients. Complications were comparable to those encountered in other studies. Myocardial perforation, a frequently reported complication, did not occur, a factor attributed to the "pigtail" design of the catheter. This catheter was found to offer a distinct advantage in performing percutaneous selective pulmonary arteriography.


Role of the coronary collateral circulation in the preservation of left ventricular function. An angiographic assessment of the coronary arteries, the presence and quality of arterial collateralization and segmental left ventricular (LV) wall motion indicated that (a) in the presence of total or subtotal obstruction of a coronary artery, there was a significantly higher incidence of normal motion (p less than 0.001) if the segment of LV wall was supplied by good rather than poor collaterals, and (b) normal wall motion with good arterial collateralization was not associated with abnormal Q waves. It is concluded that a positive correlation exists between the quality of collateral filling and the preservation of LV wall motion in the area supplied.


Bone fragmentation in the rheumatoid wrist: radiographic and pathologic considerations. A peculiar pattern of bone fragmentation of the wrist was noted in 16% of 50 rheumatoid patients. This involved erosion of the navicular, distal radius and ulna, carpal fusion, demineralization, and the presence of an elongated bony spicule overlying the radiocarpal joint. Additional examples were found in rheumatoid cadavers. Pathogenesis of the alteration was not entirely clear although contributing factors included extensive pannus proliferation, osseous compression and fracture. The fate of the detached spicules, their relationship to "fistulous rheumatism", and the differential diagnosis are discussed.


Hemophilia-like arthropathy of the knee associated with cutaneous and synovial hemangiomas. Report of 3 cases and review of the literature. Three patients with cutaneous and/or synovial hemangiomas demonstrated roentgenographic alterations in the knees, simulating hemophilic arthropathy. In 2 cases, unilateral synovial hemangiomas appeared to be present; in the third patient, who had bilateral abnormalities, the Kasabach-Merritt syndrome was evident, resulting in a consumption coagulopathy and hemorrhagic tendency. The pathogenesis of this unusual arthropathy is discussed.


Multicentric reticulohistiocytosis: a rare cause of destructive polyarthritis. A case is described of multicentric reticulohistiocytosis or lipid dermatoarthritis with early radiographic findings of subchondral erosions of the distal interphalangeal joint space, more marked that the erosions of the proximal interphalangeal joint space. The clinical and pathologic findings are reviewed.


A case of Lipoatrophic diabetes.

A case of Lipoatrophic diabetes. A case of lipoatrophic diabetes with atypical biochemical and radiological features is presented. Scattered areas of increased radiodensity in the region of all major joints were associated with cystic changes at the shoulders. It is postulated that this condition varies from patient to patient in severity as well as in course and progression.


Radiographic changes in the sacroiliac joints in familial Mediterranean fever. In a series of 43 patients with familial Mediterranean fever, six were found to have radiographic changes in the sacroiliac joints consisting of loss of normal cortical definition, sclerosis on both sides of the joint with or without erosions, and fusion. These changes were noted despite the absence of clinically symptomatic joint disease. The explanation for these findings is unknown.


The fascicles of the lateral meniscus: an anatomic-arthrographic correlation. A model of the normal anatomy of the capsular attachments of the posterior horn of the lateral meniscus is developed based upon anatomic dissections. The term "fascicles" is applied to the delicate bands of connective tissue which join the posterior lateral meniscus to the joint capsule around the popliteal synovial sheath. The normal anatomic arrangement is illustrated with double contrast arthrograms. Abnormalities of the posterior horn of the lateral meniscus are then demonstrated, emphasizing disturbances of attachment around the popliteal sheath.


A new dwarfing syndrome with extreme shortening of humeri and severe coxa vara. A previously undescribed form of short-limbed dwarfism is reported in an 86-year-old man. All the long bones were shorter than normal, with extreme shortening of the humeri. Other features included dysplastic humeral heads, coxa vara with dysplasia of the femoral heads and acetabula, platybasia, and small vertebral bodies. In all other respects, including intelligence, the patient was normal for his age.


Intraosseous lipoma of the coccyx. Report of a case. A case of benign intraosseous lipoma in the form of an expansile, non-radiolucent lesion of the distal coccyx is reported. Bony detail was completely obliterated. The anterior and posterior cortical margins were markedly thin and in places appeared eroded.


Excretory urographic localization of adrenal cortical tumors and pheochromocytomas. An excretory urographic evaluation of 124 surgically proved adrenal tumors comprising 65 pheochromocytomas, 36 cortical adenomas and 23 cortical carcinomas is reported. The addition of linear tomography improved the diagnostic accuracy over conventional excretory urography. All types of tomographic examinations demonstrated at least 70% of adrenal tumors. Excretory urographic procedures are relatively safe, simple and economical and should be used as the initial step in attempting to localize clinically suspected and chemically diagnosed adrenal tumors.


Dural fluid collections in infants and children. A successful nuclear medical approach. The authors describe their experience in 94 cases of dural fluid collections. The correct diagnosis was made in 94%, which is attributed to (a) including radionuclide angiography and both an immediate and a two- to four-hour delayed scan for every patient undergoing brain studies, (b) a high index of suspicion, and (c) simultaneous interpretation of the scan and the skull film. The false-positive rate was 10%, as shown by cerebral angiography.


Sequential brain scanning as an adjunctive scanning procedure. Sequential brain scans were performed at various time intervals of up to four hours after injection of 99mTc pertechnetate in 108 patients who had previously undergone "routine" one-hour brain scans which were considered normal or equivocal. Forty-six patients were proved to have a discrete morphologic brain lesion. Pathologic processes were demonstrated by the sequential scanning technique in all but 6 cases. In nearly a third of these 46 patients (28%), careful observation of the progressive and subtle changes in radioactivity in the whole sequential scan series was necessary for detection of the lesions: they could not be appreciated on any single static scan when viewed independently.


Detection of hypertrophic pulmonary osteoarthropathy of skeletal imaging with 99mTc-labeled diphosphonate. In two patients with carcinoma of the lung, abnormal findings on skeletal imaging using 99mTc-diphosphonate correctly suggested the diagnosis of hypertrophic pulmonary osteoarthropathy, which was later confirmed radiographically. A scintigraphic pattern of abnormal tracer localization distinguishes this benign condition of bone from bony metastases.


Bifurcation of the portal vein appearing as a focal defect on the liver image. A focal defect was seen on a gamma camera image of the liver in 2 patients, a 52-year-old woman with abdominal pain and a 46-year-old woman with pancytopenia. Liver function was normal, and no tumor stain was seen. Angiography revealed that the "defect" was in reality the bifurcation of the portal vein. These findings re-emphasize the importance of visceral angiography as a complement to radionuclide imaging in the study of liver disease.


Splenic mobility and its effect on estimates of splenic mass. In 47 patients the posterior radionuclide views of the spleen in supine and prone positions were evaluated for difference in splenic contour and calculated splenic weight as the patient's position was changed from supine to prone. A significant change in splenic contour was found in almost 50% of the cases. Values for the mass of the spleen varied by a mean of 36% with a range of plus 195 to minus 79%. The differences are attributed primarily to changes in the position of the spleen and liver within the abdomen.


Effect of collimator motion on image quality in nuclear medicine. To investigate the quality of gamma camera images obtained with moving collimators, a group of collimators was constructed which could be rotated or sinusoidally oscillated in two dimensions. The date indicate a broadening effect on images in the direction of collimator motion. Moving the collimator during imaging will reduce septal aberrations but will not increase resolution.


Congenital bronchopulmonary foregut malformation with anomalous pulmonary artery. The authors present a case of congenital bronchopulmonary foregut malformation with pulmonary artery blood supply and pulmonary venous drainage in a five-month-old boy.


Arachnoid cyst of the internal auditory canal producing facial paralysis in a three-year-old child. The case of a three-year-old child with facial paralysis due to a lesion within the internal auditory canal is reported. Radiographic studies delineated and localized the mass which proved to be an arachnoid cyst. The etiology and differential diagnosis of facial paralysis in children are discussed and correlated with facial nerve anatomy.


Effect of focal spot distribution on blood vessel imaging in magnification radiography. From a computer simulation study of blood vessel imaging with uniform, triangular, gaussian, and twin gaussian line spread functions (LSF) corresponding to various focal spot distributions, it is found that vessel images magnified less than 6 times are not strongly dependent upon the focal spot distributions when the size of the focal spot is equal to or smaller than the vessel diameter. When the focal spot is larger than the vessel, image distributions vary appreciably with focal spot distributions, except at low magnification. It is concluded that, in many practical cases, the focal spot distribution does not seriously affect magnified image distributions of blood vessels.


Longitudinal magnification in radiologic images of thick objects: a new concept in magnification radiography. New concepts which are useful for evaluating image resolution and distortion in magnification radiography are introduced. It is shown theoretically and experimentally that "longitudinal magnification" defined as the ratio of the magnified image size to the conventional image size for objects located in a plane perpendicular to the film, is given approximately by the square of the conventional magnification. Resolution in the radiographically magnified image of such objects is much higher than that obtained by optical magnification. This is confirmed experimentally by radiographs of square-wave test objects. The related image distortion is also discussed.


The evaluation of high-speed screen-film combinations in angiography. Various high-speed screen-film combinations were evaluated to compare increase in speed, loss of resolution, and increase in radiographic mottle. Results indicate that the rare-earth film-screen system is the fastest and has a higher x-ray absorption efficiency. The Kodax X-Omatic screen has the greater resolving power but is slower than the high-speed calcium tungstate system. A smaller focal spot can be used with the fast speed of the rare-earth system to increase resolution.


The cutoff characteristics of rotating grids. The cutoff characteristics of rotating grids are qualitatively and quantitatively different from those of comparable stationary grids. Rotating grids focus to a point in space so lateral decentering occurs in all directions from the central axis of the grid. Consequently, they cannot be used for oblique radiographic techniques. For any type or amount of decentering, cutoff is approximately one-third less for rotating grids.


Selective catheterization of the portal vein and its tributaries. Preliminary report. The portal vein and its tributaries were selectively catheterized in 90 patients. Only one complication required surgery. This technique not only provides information about the status of the portal circulation and liver parenchyma but can also be used in the treatment of bleeding esophageal varices by selective embolization of autologous clots or inert material.


Antegrade spermatic vein phlebography in testicular tumors. A preliminary report. Phlebography of the spermatic veins may yield valuable information about metastases from testicular tumors. Retrograde venous injection of contrast medium is not always possible but the antegrade approach performed in connection with orchidectomy was successful in all of the 5 cases attempted. If funicular lymphography is performed in connection with the removal of the testis, spermatic vein phlebography may be added with a minimum of additional effort. Whenever orchidectomy for malignant testicular tumor is planned, the possible value of additional diagnostic information from spermatic vein phlebography should be considered.


Scintigraphy of breast masses.

Scintigraphy of breast masses. Patients undergoing bone scintigraphy or about to have breast surgery were studied with either 99mTc-polyphosphate or 99mTc-diphosphonate. Seven of 8 patients with carcinoma demonstrated a focal area of increased uptake. The 9 controls, who were clinically free of breast disease, had normal images. In the benign group, increased uptake was seen in patients with gynecomastia, lactating breasts, or acute inflammation. Most patients showed correlation with mammography and thermography.


Bedside pulmonary arteriography.

Bedside pulmonary arteriography. A new technique of bedside pulmonary arteriography is described, in which small volumes of contrast material are injected manually in order to obtain segmental arteriograms in patients who are too ill to undergo conventional pulmonary angiography. This method is safe and effective and can provide information which is useful in the management of certain critically ill patients.


The use of ROC curves in testing the proficiency of individuals in classifying pneumoconiosis. During a test of the ability to classify the profusion characteristics of pneumoconiosis recorded in chest radiographs, a constant decision criterion level needs to be maintained or false conclusions regarding the observer's receiver operating characteristic (ROC) curve may result.


A laser localizer light for tomographic positioning. The use of a wall-mounted laser localizer light which improves the speed and precision of positioning for fixed-fulcrum tomographic equipment is described. Unproductive scout films are eliminated.


Computed tomography: immobilization of the head by dental holder. Movement of the patient's head during computed tomographic studies with the EMI scanner causes some degradation of the quality of the examination. With sufficient movement, major artifacts appear which may obscure intracranial pathology. A simple method of head fixation, utilizing a dental mold, greatly reduces the incidence of unsatisfactory scans.


The coming crisis in radiological manpower--shortage? The 1966 NACOR Report spurred such a sharp growth in numbers of radiologists that today there is concern about an oversupply. Considering all the factors involved--panic reaction to an undocumented "surplus", sharp diminution of the residents in the training pool, and potantial massive increases in demand for radiological services--the authors believe it not unreasonable to anticipate a real shortage of radiologists in the near future. Any deliberate activity at the present time to reduce the output of radiologists in this country would seem premature and potentially disatrous.


[Differences in the effect on hypoxia and anoxia of the CNS produced by chlorprotixen during ontogeny (author's transl)]. In the present paper the author describes the influence of the psychopharmaceutical preparation Chlorprotixen on the response of the CNS to stagnation anoxia (positive radial acceleration 10 g) and aerogenic hypoxia (15 000 m) in the course of ontogeny of the rat. Chlorprotixen increases the resistance to high altitude hypoxia, while it reduces the resistance to anoxia. The greatest differences were observed in the youngest animals.


[Isotonic contraction and contracture of the isolated right rat ventricle. Effect of La3+, prenylamine, ATP, Mg2+ (author's transl)]. 1. The isolated right rat ventricle was immersed in Tyrode solution (25) ml) and stimulated electrically at a frequency of 60/min. Changes in the amplitude of isotonic contractions and contractures were assessed. 2. Isotonic contractions were reduced (after Prenylamine, ATP, Mg), or suppressed (by LaCl3 = 10 mM). Contracture was caused by Prenylamine (4 mg/25 ml Tyrode solution or more). 3. Addition of 100 mM KCl (NaCl reduced equimolarily to 37 mM did not influence contracture in the presence of the investigated substances with the exception of MgCl2 = 10 to 15mM, where only the rate of development of potassium contracture was reduced. 4. After previous immersion of the tissue in the presence of LaCl3 - 10 mM and Prenylamine 1-4 mg/25 ml Tyrode solution the contracture developed after removal of NaCl (substitution by sucrose 270 mM), which, however, declined after addition of NaCl only when previously treated with Prenylamine and not when treated with La. 5. Addition of 100 mM KCl (naCl reduced to 37 mM) after previous immersion of the tissue in the presence of the investigated substances caused contracture the rate of rise of which was smaller after La than in controls: after the remaining substances it did not differ. 6. Reduction of the contracture after reduction of KCl from 100 to 5.6 mM developed only after previous immersion of the tissue in the presence of ATP and Mg and not after previous immersion in the presence of Prenylamine and La. 7. The results are compared with biochemical findings. They suggest a shift of contractile Ca in the heart.


[Association of thyroxine with subcellular fractions of rat liver and adenohypophysis in vitro (author's transl)]. After incubation of thyroxine (T4) labelled with 125I with liver and adenohypophysial homogenate and differential centrifuging into the "nuclear" fraction (600 g), "mitochondrial" (10 000 g), "microsomal" (105 000 g) fraction and cytosol the authors found a marked preference of association of T4 with mitochondria of rat adenohypophyses; the mitochondrial fraction of rat liver was not preferred. The effect of oestrogens was manifested in addition to the usual increase in weight of the adenohypophysis by increased binding of thyroxine with proteins of adenohypophysial mitochondria of oestrogen-treated animals. In liver this effect was lacking. Subfractionation of mitochondria into a membranous and soluble fraction revealed that a preferential association of thyroxine with membrane proteins of pituitary and liver mitochondria develops, the amount of T4 association protein (per protein unit) was several times (3-6x) higher in membrane proteins, as compared with soluble proteins.


[Inhibition of autohaemolysis in vitro by the action of isolated factors Ac III and Ac IV in so-called autoimmune haemolytic anaemias (author's transl)]. Hyper- and autohaemolysis of red blood cells resp. in vitro by saturation of serum of patients with so-called autoimmune haemolytic anaemia is conditioned by the lack of factors Ac III and Ac IV resp., or both, in serum. When both factors are lacking also in red blood cells, in addition to hyperhaemolysis complexes are formed which in serological tests appear as antierythrocytic autoantibodies and which by a bond with red blood cells inhibit their breakdown. By adding factor Ac III and IV in suitable concentrations to serum the haemolysing effect and formation of pseudoautoantibodies is completely blocked. The results of experiments in vitro bring up the question whether autoimmune haemolytic anaemia is really conditioned by an immunological process, i. e. by autoimmunization with the formation of autoantibodies which exert an autoaggressive action or whether they are a special manifestation of deficiency of the above factors, similarly as other haemulytic syndromes which develop e. g. as a result of some enzyme deficiencies etc.


[Chronic tonsillitis and the upper cervical spine (author's transl)]. The authors investigated 46 patients with chronic tonsillitis. Only in 5 (11% blockage in the craniocervical junction were absent. The most frequently affected segment was between the occipital bone and the atlas (in 36 patients), between the atlas and axis in two and between the axis and C3 in three patients. In 28 treatment was only surgical. There blockage disappeared only in four, in two blockage developed operation. Five patients were treated before operation also by manipulation. There the blockage relapsed only once. In 10 treatment was by manipulation only. During the observation period (from 3-9 months) not a single relapse of blockage or tonsillitis was observed during the winter period.


[Age differences in the reactivity of the organism after administration of isoprenaline in rats (author's transl)]. To three age groups of animals 2, 6 and 12 months old isoprenaline was administered in amounts of 8 mg/kg body weight. In these rats changes in the weight of some organs after administration of isoprenaline were followed-up. In the oldest group of rats were the myocardial lesions were most severe, the authors found the slightest oedematous response of the myocardium. The oedema of their aorta, on the other hand, was most marked. The weight of the adrenals, contrary to younger groups, did not change in the course of the experiment.


The epidemiology of enteroviruses.

The epidemiology of enteroviruses. International and local Scottish data illustrate the epidemiology of enteroviruses in recent years. Polioviruses still predominate as causes of serious paralytic disease, except where controlled by vaccination and require continuing surveillance. Aseptic meningitis is the commonest reported illness due to enterovirus infection, but notable clinical manifestations of certain types (particularly coxsackie group A) involve the skin and mucous membranes and the respiratory tract. Gastrointestinal disturbance has been reported in some echovirus infections, and cardiac disease is particularly associated with group B coxsackie virus infections. Although most enterovirus infections are silent or trivial in severity, the trend towards periodic epidemicity of different enteroviruses involving older age-groups may entail the emergence of new disease problems of which heart disease may be one example.


The work of a rural practice.

The work of a rural practice. Study of the work load in the month of November over some years in a single handed rural practice has revealed several interesting trends, one being the way in which the work is gradually increasing. A more detailed study of the work over 12 months has demonstrated how fallacious impressions about one's work can be--the work being spread over a very much larger proportion of the patients than had been originally suspected.


Assessment of severity of haemolytic disease of the newborn at time of birth. A new cord blood factor has been suggested as a measure of the severity of haemolytic disease of the newborn at birth. One hundred and seventy three cases of Rhesus iso-immunisation have been classified as mild, moderate and severe according to the readings of Optical Density Difference of bilirubin in the liquor amnii and correlated with the cord blood haemoglobin, cord blood serum bilirubin, and the new cord blood factor. The new cord blood factor gave the best correlation.


Three common faults in current practice that influence the validity of data obtained from electronic air pollution instrumentation. Instrumental development is now entering a more logical era, where the former artistic character of electronics is being replaced by cold technology. Because of this, one should be expect more reliability; however, there still exist many weak links in practical application. Digital readout systems and computer processing induce a false sense of security. In reality, it is the sample-measurement relationship that determines an instrument's credibility and not the number of digits on its meter. In describing three faulty practices that greatly influence an instrument's performance, it is hoped that measurement may be more closely related to the sample!


Dust counting. Critical review and presentation of Vermont practice. Counting respirable dust particles using bright field microscopy has been the classic approach for rapid practical evaluation of the dustiness of workplace atmospheres. The technique has been beset with difficulties arising out of variations in the optical systems and the counting cells used by various laboratories. This papar reviews the history of the technique and some of the problems which have been encountered. It also details the method used by the Vermont Division of Occupational Health for the past 20 years to count dust, describing the easily reproducible optical system and the use of a "thin" hemocytometer cell employed.


[Variance of the air sample in air analysis demonstrated on a sample of atmospheric aerosol]. Particulate matter, sampled during 24-h periods from 200 m-3 urban air, was collected on cellulose filters. Each of the four quarters of the filters was analyzed separately by atomic absorption spectroscopy; the concentration of 11 metals was so determined. The residual standard deviation among the quarters of the filter was 10%. In view of this deviation among the results, attributed to the variance of the air sample, it seems rather doubtful that the intercomparison of air sampling instruments, using ambient air as common "standard", will ever give reliable results. It seems likely that air samples, smaller than the 200 m-3 used here, will show an even greater variance, at least with regard to some specific pollutants.


Calculation of the mean yearly mixing height over urban areas, from air pollution data. Conditions for the usefulness of the ventilation-volume or box model in the representation of long-term averages of pollutant concentrations are discussed. It is shown that yearly averages of mixing heights can be calculated from air pollutant concentration data without reference to meteorological observations. With no pretence to high accuracy, average mixing heights thus obtained are adequate to rapidly characterize an urban area in the low, medium or high bracket of pollutant concentrations. Estimates of yearly average mixing heights for six French and two Japanese towns are given.


Mercury and selenium in marine mammals and birds. Information is provided concerning the concentrations of mercury and selenium in tissues of marine animals. In marine mammals a 1:1 Hg/Se molecular increment ratio was found and an almost perfect linear correlation between mercury and selenium. It is suggested that marine mammals are able to detoxify methylmercury by a specific chemical mechanism in which selenium is involved. The results also indicate that the fate of methylmercury in fish-eating marine birds differs fundamentally from that in marine mammals.


Transfer of lead through the rat's intestinal wall. The transfer of 203Pb through the wall of the duodenum, jejunum and ileum in 6- and 26-week old female albino rats was studied by the in vitro method of "everted sacs". The lead transport through, and the lead uptake in the wall was practically the same in all intestinal segments. The influence of age on these parameters of lead metabolism was not observed by the method we used. It seems that active transport of lead in all segments of the small intestine in 6-week old rats is negligible.


Troponin and parvalbumin calcium binding regions predicted in myosin light chain and T4 lysozyme. A computer search of available protein sequences and structures suggests that bacteriophage T4 lysozyme contains one region and that rabbit myosin light chains contain three regions similar, and supposedly homologous, to the calcium binding region of carp muscle calcium binding parvalbumin.


5-methyltetrahydrofolic acid is not a methyl donor for biogenic amines: enzymatic formation of formaldehyde. Contrary to previous reports, 5-methyltetrahydrofolic acid does not mediate the methylation of dopamine to epinine. Instead, this methyl donor is degraded enzymatically to formaldehyde, which condenses with dopamine to form a tetahydoisoquinoline derivative. The latter has chromotographic characteristics very similar to those of epinine, which likely accounts for the original misidentification of the product.


Chromatin fragments resembling v bodies. Fragments of chromatin resembling the spheroid chromatin units (v bodies) have been isolated from formaldehyde-fixed and sonicated chicken erythrocyte nuclei. Ultracentrifugal analyses demonstrated that monomer v bodies have a molecular weight of about 300,000 per particle, exhibit a protein to DNA ratio (by weight) of 1.22:1, and contain a DNA fragment with a molecular weight of approximately 140,000 per v body.


When left-handed mice live in right-handed worlds. Many C57BL/6J inbred mice were tested for paw preference. In unbiased worlds, approximately 10 percent exhibited lateral preferences inconsistent with the world bias, and males were more strongly lateralized. Influences of world bias appear to be superimposed upon an already laterally dichotomized population. Initial left-right sense, it is posited, arises as an outcome of a seemingly random process.


Cyclopentyl ketones: identification and function in Azteca ants. The anal gland secretions of dolichoderine ants in the genus Azteca are fortified with cyclopentyl ketones. Since these compounds, 2-methylcyclopentanone, cis-1-acetyl-2-methylcyclopentane, and 2-acetyl-3-methylcyclopentene, release sustained alarm behavior in ant workers, they constitute a new chemical class of insect pheromones. The ketones probably also function as defensive compounds and thus are part of the ants' alarm-defense system.


2,3-diphosphoglycerate: a physiological inhibitor of platelet aggregation. 2,3-Diphosphoglycerate (2,3-DPG) may inhibit the platelet release reaction and the irreversible aggregation of human blood platelets induced by adenosine diphosphate, epinephrine, or norepinephrine. The effects of 2,3-DPG on platelet aggregation were more pronounced in cases with low hematocrit (less than 30 percent). Dipyridamole and vincaminor potentiated the antiaggregating effect of 2,3-DPG. Erythocytes (10-3 to 10-4 per microliter) exhibited a similar antiaggregating effect, especially when secured from anemic patients.


Heavy cosmic-ray exposure of Apollo astronauts. A comprehensive study of the heavy-particle cosmic-ray exposure received by the individual astronauts during the nine lunar Apollo missions reveals a significant variation in the exposure as a function of shielding and the phase of the solar cycle. The data are useful in planning for future long-range missions and in estimating the expected biological damage.


Self-produced locomotion restores visual capacity after striate lesions. Rats permitted unrestrained movement in a patterned visual environment during the interval between two-stage vilateral lesions of the visual cortex reacquire a preoperatively learned pattern discrimination. Rats passively transported through the identical visual environment do not. This is the first demonstration that interoperative self-produced locomotion is essential for recovery of function in the visual system.


Auditory discrimination and recall in monkeys. The first auditory recall functions have been derived for monkeys; the same animals also demonstrate perceptual abilities closely approximating those of man. An efficient, powerful psychophysical technique is used to specify and force predicted levels of difficulty of task performance across time, animals, and problems.


Dynamic random-dot stereograms reveal up-down anisotropy and left-right isotropy between cortical hemifields. With the use of dynamic random-dot sterograms (which are devoid of all monocular depth cues), the temporal duration for detecting a small, briefly presented test square of different depth than the surround varied as a function of its location in the central portion of the visual field. Test squares presented in the upper hemifield were detectable at consistently shorter durations than those in the lower hemifield when the fixation marker was in front of the surround, and vice versa when the marker was behind. No such anisotropy was found for left and right hemifield. Esploratory studies suggested a similar up-down anisotropy and left-right isotropy in spatial resolution. Thus, the upper hemifield representation at the cortex shows a general superiority over the lower one for vinocular detectors tuned to uncrossed disparitites, and the lower hemifield shows superiority for those tuned to crossed disparities.


Contradiction of auditory and visual information by brain stimulation. Cats with permanently implanted electrodes were trained to discriminate between trains of flashes or clicks at two different repetition frequencies. After substantial overtraining with these sensory stimuli, high levels of stimulus generalization were obtained to electrical stimulation of the reticular formation at either frequency stimultaneously with contradictory flicker or click stimulation at the opposite frequency resulted in control of the behavior by the reticualr stimulus. Lateral geniculate stimulation failed to show this effect.


Sex pheromone of the oak leaf roller: a complex chemical messenger system identified by mass fragmentography. The sex pheromone of the oak leaf roller, Archips semiferanus Walker, is composed of a complex mixture of chemical signals. The attractant component of the pheromone contains a series of tetradecenyl acetates having double bonds in positions 2 to 12. Mass fragmentography of the ozonolysis products of the attractant component was used to locate the double bonds in the various isomer.


Low frequency electric field induced changes in the shape and motility of amoebas. Perpendicular and parallel elongation of the giant amoeba, Chaos chaos (Chaos carolinensis), have been observed in alternating electric fields over a wide frequency range (from about 1 hertz to about 10 megahertz). The characteristics change as a function of frequency. Simple dielectric forces may be important in the production of these effects.


Synaptonemal complex complement of man in spreads of spermatocytes, with details of the sex chromosome pair. Human pachytene chromosome pairs have been characterized electron microscopically in spread preparations on the basis of synaptonemal complex length, kinetochore position and attached nucleoli when present. The X and Y chromosomes can be followed by their filamentous axial cores from partial synapsis, through precocious disjuction and end-to-end attachment, to differentiation of a network in the sex chromosome pair.


Evaporative water loss in box turtles: effects of rostral brainstem and other temperatures. Box turtles were implanted with thermodes astride the preoptic tissue of the brainstem. The rate of evaporative water loss could be transiently increased by heating the rostral brainstem. Heating tissue in the anterior hypothalamus affected evaporative water loss only a high ambient temperatures. The magnitude of the response was proportional both to the change in hypothalamic temperature and to the ambient temperature with which the turtle was in equilibrium. The major fuction of a high rate of evaporative water loss in turtles is probably to protect the brain from overheating during thermal stress.


Dopamine beta-hydroxylase activity in brains of chronic schizophrenic patients. Postmorten brain specimens from nine chronic schizophrenic patients and nine control were assayed for activity of dopamine beta-hydroxylase, the enzyme responsible for the conversion of dopamine to norepinephrine. Unlike the results of previous reports, there was no statistically significant difference in enzyme activity between the patient and control groups. There were, however, significant negative correlations between dopamin beta-hydroxylase activity and the tim spent in the morgue before autopsy, and between enzyme activity of schizophrenics and dosage of chlorpromazine or its equivalent.


Growth hormone: independent release of big and small forms from rat pituitary in vitro. Sequential release of big and small forms of growth hormone by perifused rat pituitaries has been demonstrated by immunoprecipitation. The results suggest that either the two forms are independently synthesized and released, or that a newly synthesized molecule of big growth hormone follows one of two paths: direct release or intracellular processing through the storage compartment with conversion to small growth hormone.


Measles virus: an unwanted variant causing hydrocephalus. Mutagenization of measles virus with proflavine produced a temperature-sensitive mutant capable of inducing hydrocephalus following intracranial inoculation of newborn hamsters. Hydrocephalus was not produced by the parental strain or by other measles virus mutants. Thus, mutants can be the causative agents of disease not associated with the parental strain. The results dictate caution in the use and distribution of experimentally induced virus variants.