Neurogenic control of cerebral blood flow in the baboon. Cerebral chemical vasomotor reactivity and autoregulation were tested in normal baboons before and after the intravenous or intravertebral infusion of atropine sulfate (0.02 mg/kg). Atropine did not appreciably effect autoregulatory response, but intravertebral injection suppressed the increase of cerebral blood flow (CBF) by inhalation of 5% CO2 and enhanced the decrease of CEF induced by hyperventilation. These changes produced by intravertebral injection of atropine were not observed after intravenous injection. Since the vertebrobasilar arterial system supplies the brain stem and diencephalon, this suggests that a central vasodilator tonus of the cerebral vessels is maintained by the innervation of the cerebral vessels by cholinegic neurons which have their central origin in the brain sterm and diencephalic area.


Central cholinergic control of cerebral blood flow in the baboon. Effect of cholinesterase inhibition with neostigmine on autoregulation and CO2 responsiveness. Cerebral autoregulation and vastomotor responsiveness to carbon dioxide (CO2) were measured quantitatively by the use of the autoregulation index and chemical index, respectively, in normal baboons before and after intravertebral and intracarotid infusion of the anticholinesterase agent, neostigmine methylsufate (Prostigmin). Continuous measurements were made of cerebral blood flow (measured as bilateral internal jugular venous outflow), arterial and cerebral venous pO2 and pCO2, cerebral arteriovenous oxygen differences, and endotracheal CO2. The effect of intravertebral infusion of neostigmine (12.5 mug/kg body weight) was compared to intravertebral infusion of neostigmine (25 mug/kg body weight) for assessment of any specific action of the drug on a hypothetical cholinergic vasomotor center, presumed to be located in the territory of the vertebrobasilar supply. No significant or persistent changes in cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) followed either intravertebral or intracarotid infusion of neostigmine. Cerebral vascular resistance (CVR) and cerebral perfusion pressure (CPP), however, decreased significantly after intravertebral infusion. Cerebral autoregulatory vasoconstriction during increases of CCP was significantly reduced following both intravertebral and intracarotid infusion. Cerebral autoregulatory vasodilatation was not altered as CPP was lowered. Cerebral vasodilatory reactivity to CO2 inhalation was significantly enhanced following intravertebral neostigime but not following intracarotid neostigmine. Cerebral vasoconstrictive response to hyperventilation was not influenced by neostigmine. These results support the view that central cholinergic cerebrovascular influences exist, and are vasodilatory in nature.


Regional cerebral blood flow studies following superficial temporal-middle cerebral artery anastomosis. Regional cerebral blood flow (rCBF) studies were performed during the postoperative period on 16 patients with internal carotid occlusions and inaccessible stenoses, and middle cerebral artery occlusion and stenoses, who underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomoses. The intra-arterial xenon method with selective application of the xenon bolus through the internal carotid and the newly established superficial temporal channel has allowed comparison of the flow provided by the pathological input with flow through the new input. The results show that initial rCBF (rCBF1) was globally reduced in all patients to a mean of 28.4 +/- 11.9 ml/100 gm/min at a mean pCO2 of 29.6 +/- 9.55 mm Hg. Patients with transient ischemic attacks (TIA) and minor strokes with minimal residua (RIND) had a mean rCBF1 of 30.4 +/- 11.6 ml/100 gm/min at a mean pCO2 of 30 +/- 10 mm Hg, while patients with completed strokes had a mean rCBF1 of 25.0 +/- 12.4 ml/100 gm/min at a mean pCO2 of 29.1 +/- 8.8 mm Hg. There was no significant difference between these two groups. This finding suggests that in this small group of patients with TIA's and RIND's, the cause of the stroke is probably related more to decreased perfusion than embolus, and may explain why these patients' symptoms improve after STA-MCA anastomosis. The results of this study suggest that in addition to an inaccessible lesion, global or focal decreased rCBF is a necessary criterion in the definition of indications for intracranial revascularization procedures.


Prophylactic antibiotics and wound infections following laminectomy for lumber disc herniation. The authors review 531 consecutive operations for lumbar disc herniation performed on 496 patients by one neurosurgeon to determine the effect of prophylactic antibiotics upon postoperative wound infections. In this retrospective analysis 16 instances of sepsis were found, 11 considered to be major and five minor. In the 128 cases in which no antibacterial agents were given, 11 major and 1 minor infection occurred. Four minor infections developed in the 402 occasions when antibiotics were given in the perioperative period. Men had a significantly greater risk of developing infection than women. These data suggest that pre- and postoperative antibiotic therapy directed at a narrow spectrum of microorganisms reduced the incidence of significant wound infections in patients undergoing laminectomy for lumbar disc herniation.


Management of cervical spinal cord trauma in Southern California. Acute cervical spinal cord injuries were reviewed in 356 patients treated by the neurosurgical community in Southern California. Neurological recovery was compared in operated and nonoperated patients with complete and incomplete cervical myelopathies. The complications of nonsurgical and surgical therapy are identified. No neurological improvement was noted in any patient with a complete lesion who underwent early surgical decompression. In those with incomplete sensorimotor paralysis, it was difficult to document any effect of surgical decompression on neurological recovery. Patients with some degree of sensory preservation had a similar incidence of motor recovery in both surgical and nonsurgical groups. With complete sensorimotor paralysis, anterior cervical fusion within the first week of injury was associated with increased pulmonary morbidity.


Electrospinogram and spinal and cortical evoked potentials in experimental spinal cord trauma. Studies in 28 traumatized cats showed the following acute changes after spinal cord compression in the cord segment below the trauma: 1) increase in size of the spinal cord evoked potential; 2) increase in size of the electrospinogram; and 3) increase in frequency of the electrospinogram.


Infiltrative potentiality of brain tumors in organ culture. The invasive potential of 15 brain tumors (seven meningiomas, and eight astrocytomas) as studied in cultures with Gelfoam used as a substrate. A three-stage system is introduced to classify in vitro invasiveness according to the depth of Gelfoam infiltration after 2 weeks' culture. This system proved to be simple and accurate. Meningiomas revealed greater activity in culture as compared to astrocytomas and infiltrated deeper into the Gelfoam. Dura mater explants were placed next to the culture of the tumors to study their interaction. Dura mater acted as a relatively strong barrier against tumor cell invasion in culture. In the majority of the explants, tumor cells revealed either contact arrest or spread underneath the dura and rarely spread over it. Tumor cells were seen infiltrating the dural explants in three cases, all of which were meningiomas.


Cervical spondylolysis with spondylolisthesis. Case report. The authors describe as case in which cervical spondylolysis was found at multiple levels with spondylolisthesis and associated neurological deficits. Radiographic findings with the absence of history of trauma suggest a congenital etiology.


Ventriculo-orbital fistula in closed head injury. Case report. A ventriculo-orbital fistula developing as a result of closed head injury produced intraorbital compression symptoms including downward deviation of the globe and inability of upward gaze. Percutaneous injection of Conray clearly demonstrated the fustula, which was successfully closed by frontal craniotomy.


Ependymal cyst of the spinal cord. Case report. A case with extramedullary ependymal cyst of the spinal cord is presented. The clinical, operative, and pathological findings are discussed and a review of previous cases and a nosologic classification of ependymal lined cysts given.


Malignant teratoma arising within a lipomeningocele. Case report. The authors report the case of an 11-year-old, neurologically normal girl, followed since birth for lipomeningocele, who developed a malignant teratoma within the lymbosacral lesion and presented with metastases to the lungs and groin. This rare occurrence is discussed from an embryological and management viewpoint.


Vasospastic dystrophy of the hand. Case report. The author reports a patient with a history of left arm pain and wasting of the hand who had absent radial and ulnar pulses. Sympathectomy restored the arterial circulation to the hand with nearly complete return of function.


Enlargement of an arteriovenous malformation documented by angiography. Case report. The authors present a case in which an enlarging arteriovenous malformation was documented angiographically. Enlargement of the malformation concurrent with the appearence of basilar artery insufficiency was ascribed to a sump effect (steal) by the arteriovenous shunt.


Percutaneous lumboperitoneal shunt. Technical note. The authors describe a new catheter for use in percutaneous lumboperitoneal shunting, designed to overcome the problem of kinking. They present their experience with the catheter in 14 patients.


Transsphenoidal selective anterior hypophysectomy in cats for microsurgical training. Technical note. A technique for selective anterior hypophysectomy along a transsphenoidal route in the cat is described in detail. This operation is valuable for advanced microneurosurgical training.


Diagnostic value of renal imaging incidental to bone scintigraphy with 99mTc-phosphate compounds. An assessment of the sensitivity and reliability of renal images obtained incidentally to bone scintigraphy with 99mTc-phosphate compounds is reported, and certain patterns of abnormalities associated with those renal images are described. Renal images in 119 bone scintigrams were reviewed and correlated retrospectively with radiographic procedures done within 2 weeks of the bone images. The detection rate for renal abnormalities was 97.4%; the "false-positive" rate was 8.6% and the "false-negative" rate was 2.6%. Abnormal renal images were categorized as (A) nonvisualization of one kidney (13 cases), (B) asymmetric uptake (11 cases), (C) focal decreased uptake (4 cases), (D) bilateral decreased uptake (6 cases), (E) focal increased uptake (4 cases), And (F) miscellaneous (6 cases). The first three categories were always associated with renal abnormalities. Bilaterally decreased uptake and focal increased uptake were not reliable in detecting disease. Extensive metastatic carcinoma of the prostate was noted in three of four patients with bilateral decreased uptake and normal intravenous pyelography. We conclude that renal imaging incidental to bone scintigraphy with phosphate compounds is a valuable diagnostic test. An understanding of the different patterns of abnormalities described should improve the overall reliability of the test.


The Gamut approach to scintigram interpretation--diagnostic aid and teaching method. A Gamut is defined as a complete list of anything. As utilized here, it indicates a complete list of the possible causes of a particular scintigram finding. The procedure for developing a Gamut is discussed, ant its use as a tool for instructing residents in nuclear medicine is described. Sample Gamuts are presented and the Gamut approach to scintigram differential diagnosis is described.


Increased 99mTc-polyphosphate muscle uptake in a patient with polymyositis: case report. A patient with well-documented rheumatoid arthritis and polymyositis displayed abnormal muscle uptake of 99mTc-polyphosphate during routine bone scanning for occult malignancy. The regions of increased uptake corresponded to the areas of clinically active inflammatory muscle disease. On serial scans the degree of muscle labeling correlated well with both clinical and laboratory indices of disease activity.


Liver-spleen scintiscan in kala-azar: case report. Massive splenomegaly was found in a liver-spleen scan in a young man from Greece. Kala-azar was suggested as a possible cause and was confirmed by culturing Leishmania donovani from the bone marrow aspirate. The differential diagnosis of massive splenomegaly should include kala-azar when a patient has been in an endemic area.


Technetium-99m-sulfur colloid and pertechnetate blood pool scans in hepatic veno-occlusive disease: case report. A liver scan on a patient with biopsy-proven hepatic veno-occlusive disease showed multiple areas of decreased sulfur colloid uptake which were not perfused on the blood pool phase of a pertechnetate bolus study.


Identification of an infected pseudocyst of the pancreas with 67Ga-citrate: case report. A case in which the preoperative diagnosis of an infected pseudocyst of the pancreas was made by 67Ga-citrate scanning is reported. Other approaches to the diagnosis of pancreatic pseudocysts are reviewed.


Accessory thyroid in the anterior mediastinum: case report. A case of accessory thyroid in the anterior mediastinum, physically separated from the thyroid gland, is reported. The mediastinal thyroid was incidentally discovered during the preoperative evaluation of a patient with breast carcinoma. The extreme rarity of the case is outlined.


Technetium-99m-labeled stannous imidodiphosphate, a new radiodiagnostic agent for bone scanning: comparison with other 99mTc complexes. Imidodiphosphate (IDP) is an analog of pyrophosphate and diphosphonate, with a P-N-P bond instead of P-O-P or P-C-P. We have labeled IDP with 99mTc quantitatively (98%) using stannous ions as the reducing/complexing agent in a freeze-dried kit form. Radiobioassay of this compound was carried out in rabbits and the results were compared with those of eight other Tc-labeled bone-imaging agents, using the performance of simultaneously administered 85Sr as a reference standard. The 99mTc-IDP concentrated 20% higher in the bone, and its soft-tissue and blood levels were lower than with 85Sr. By comparison, the concentrations in the bone of the other 99mTc agents were 20% less than that of 85Sr. Regarding blood levels, Tc-IDP performed worse than the Tc-diphosphonate but better than the pyrophosphate and the other technetium complexes. Scintillation camera images of 99mTc-IDP in both rabbits and dogs showed excellent details of the skeleton. In a preliminary human study, images with 99mTc-IDP were somewhat inferior to those comparably procured with 99Tc-methylene diphosphonate, but count rates with the IDP complex were about twice those with the MDP compound. Because of its better bone uptake, however, it is suggested that 99mTc-IDP may be clinically useful in spite of its relatively slow blood clearance.


Time course of 99mTc(Sn)-tetracycline uptake in experimental acute myocardial infarction. The relative concentration of 99mTc(Sn)-tetracycline in infarcted myocardium was determined as a function of time after coronary artery occlusion in mongrel dogs. The concentration ratio (infarct-to-normal myocardium) was highest within the first 2 days after occlusion (6.7 +/- 0.5 at 1 day and 8.0 +/- 1.6 at 2 days). By 1 week after occlusion the ratio had fallen to 1.9 +/- 0.2. In the region of infarction, the concentration of 99mTc(Sn)-tetracycline was homogeneously distributed across the inner three-quraters of the myocardial wall; the outer quarter of the wall had substantially lower concentrations during the first 5 days after infarction. The present study confirms the observation suggested in initial investigations in man that scintigraphy performed with 99mTc(Sn)-tetracycline will distinguish between acute and chronic myocardial infarctions.


Concentration of dopamine analogs in the adrenal medulla. Seven labeled sulfonanilide analogs of dipamine were synthesized and their tissue distribution in rats were determined as a function of time. The methanesulfonanilide derivative, NP-27, showed significant uptake and retention in the rat adrenal, with 0.66% dose/gm at 5 min and 0.27% dose/gm at 24 h. The 24-hr target-to-nontarget concentration ratios for the adrenal versus liver, blood, kidney, and heart were 13, 27, 30, and 60, respectively. These results compared reasonably with the corresponding target-to-nontarget ratios of 23, 45, 8, and 15 obtained for 14C-dopamine. The six other analogs showed considerably less uptake and retention. Further evaluation of NP-27 in dogs indicated selective uptake in the adrenal medulla.


Converging collimation and a large-field-of-view scintillation camera. Three low-energy multihole converging collimators were evaluated in reference to accepted imaging parameters using a prototype large-field-of-view scintillation camera. A substantial improvement in resolution and/or sensitivity with depth was observed. Because of the large detector, the inherent reduction in field size due to convergence was not detrimental to satisfactory imaging of most target volumes. Such collimation should prove to be of significant clinical value.


Clinical efficacy of a large-field-of-view scintillation camera. In evaluating the clinical application of a prototype large-field-of-view scintillation camera, a significant increase in the quality of static and cynamic images was observed. With parallel-hole collimation, imaging time for large areas was reduced by more than 50% and a marked enhancement in resolution and sensitivity of lung images occurred in relation to those obtained with diverging collimation on a conventional camera. Using converging collimation, the prototype camera produced images of brain and other organs with considerably better depth response than comparative studies performed with standard size cameras. These results demonstrate that further clinically relevant improvement in scintillation camera performance is possible.


Analytical study of a high-resolution positron ring detector system for transaxial reconstruction tomography. This paper presents an analytical study of a high-resolution positron ring detector system for transaxial reconstruction tomography. Our goal is a combination of good spatial resolution, high sensitivity, rejection of scattered photons, variable section thickness, and the minimization of the number of photomultipliers and coincidence circuits. A circular ring of 288 NaI(Tl) crystals 0.8 cm wide should provide a resolution of 4--7 mm FWHM over a circular region 30 cm in diameter. Coded light pipes permit readout using only 72 photomultipliers and 12 coincidence circuits. With properly designed shielding and an energy resolution of 30% FWHM, a positron activity of 200 muCi per axial centimeter in a 20-cm-diam cylinder of tissue should provide approximately 7,000 events/sex from a 2-cm-thick transaxial section (including a 5% accidental coincident background and a 26% scattered coincident background). This rate is adequate for both static and dynamic imaging. The device can operate at two to three times higher event rates with increased backgrounds.


Positron ranges obtained from biomedically important positron-emitting radionuclides. Positron ranges were obtained experimentally for several nuclides used in scintigraphic imaging. The nuclides examined were 13C, 13N, 15O, 18F, 68Ga, and 82Rb. The results are discussed with respect to the ultimate spatial resolution obrained in a scintigraphic image.


Iron-induced enhancement of 67Ga uptake in a model human leukocyte culture system. The addition of iron, either as Fe dextran or FeCl3, to leukocyte tissue culture medium (containing 20% fetal calf serum) significantly increased the cellular accumulation of subsequently added 67Ga-citrate. This effect of iron was dose-related and decreased, after the initial increase, with increasing concentrations of elemental iron. There was a significant negative correlation (P less than 0.025) between the concentrations of gallium and iron in the medium indicating competition between the two elements for the same serum binding sites. Although it is not yet justified to begin clinical trials, these experiments suggest the possibility that prior administration of iron may increase the usefulness of 67Ga scanning for the diagnosis of neoplasms or abscesses. Further testing of this hypothesis in animals with such lesions would seem indicated.


Indium-113m perfusion study and the nonfunctioning thyroid nodule. Indium-113m eluate has been used to study the perfusion of 12 patients with solitary thyroid nodules that appeared "cold" in the 131I and 99mTc image studies. Seven patients with colloid nodules showed no perfusion and the remaining five (three adenomas and two carcinomas) showed good perfusion with indium. Histologic confirmation was obtained in all cases. Indium-113m perfusion study may be useful in differentiating colloid nodules from either adenomas or carcinomas.


Modification of a rectilinear scanner to improve 67Ga scans. A simple and inexpensive electrical modification of the pulse-height analyzers of the Ohio-Nuclear Model 84FD rectilinear scanner, which allows the use of wide pulse-height intervals, is described. The modified instrument is applied to 67Ga scanning, in which the increase acceptance of gamma rays produces scans of increased count density and improved image quality.


Simple and efficient system for fast interchange of low-energy collimators. The inconvenience and time required for changing collimators on a scinticamera are major problems in the efficient use of the apparatus. A system is described, based on the lightweight, reversible DIVCON collimator made by Searle Radiographics for the Pho/Gamma camera that solves this problem. The core of a straight-bore, low-energy collimator is adapted to fit the DIVCON outer ring and a low-energy pinhole collimator is constructed to fit the same mounting system. Finally, an adapter using a bayonet-mount slot system is added to make collimator changing by hand possible in a minute or less.


A calibrated dose dispenser for gaseous 133Xe. A device that permits accurate dispensing of individual doses of 133Xe from multicurie ampuls is described. The advantages include economy, flexibility in dose selection, and radiologic safety.


Simplified method for determining the modulation transfer function for the scintillation camera. The modulation transfer function (MTF) has long been accepted as an index of scintillation camera system resolution, but the technique necessary for the derivation of the MTF has discouraged its widespread acceptance because of its tedious and time-consuming nature. We have shown that the generation of LSFs for input into computer programs for MTF generation can be accomplished very easily and in short periods of time by using a simplified method. Establishment of the validity of this simplified procedure should contribute to more widespread utilization of the MTF in routine quality control programs as a check for crystal deterioration, electronic circuitry degradation, and/or collimator damage.


Technetium-99m-human fibrinogen.

Technetium-99m-human fibrinogen. Exogenous fibrinogen has been successfully labeled with 99mTc using a modified electrolytic method. The exact labeling mechanism has not been determined. Experimental data suggest that the labeling process of 99mTc-fibrinogen is quite similar to that of 99mTc-human serum albumin as reported earlier by Benjamin. Technetium-99m-fibrinogen is stable in human plasma or in 1% buffered human serum albumin. A binding efficiency of 76% has been achieved with approximately 25% clottable protein. The entire labeling procedure requires less than 1 hr of preparation time. This short labeling time in a closed system may allow development of a practical method for labeling autologous fibrinogen, thus eliminating the risk of hepatitis transmission.


Calculation of relative weights for nuclear medicine procedures. Relative weights for nuclear medicine procedures have been assigned previously on the basis of subjective estimates of resources expended. Thus, ultimate values frequently have not reflected time and cost of personnel and equipment accurately. Based on computerized data collected on over 8,000 patients, we have attempted to calculate relative weights more objectively by analyzing the following parameters: (A) physician time; (B) technologist time; (C) nurse (or aide) time; (D) equipment time and depreciation; and (E) radiopharmaceutical cost, or cost equivalent. Most major organ scans were found to have quite similar values whereas procedures with low ratings on previous value schedules were found to have high relative values when analyzed objectively.


Comparison of 99mTc complexes for renal imaging. The distribution of 17 different agents for renal imaging was compared in the rabbit by organ radioassay at 1 hr. Similarly, 99mTc complexes of iron-ascorbate, glucoheptonate (GHA) and 2,3-dimercaptosuccinic acid (DMS), and 203Hg-chlormerodrin were compared in the dog. The distribution of 99mTc-GHA and DMS was assessed in the human by blood and urinary clearance, external renal measurements, and scintillation camera imaging, and compared with older renal radiopharmaceuticals. Radiation dose estimates, based chiefly on human data, were calculated. Technetium-99m-DMS reaches a high concentration in the renal cortex and its urinary excretion rate and blood clearance are slow. It is excellent for imaging the renal parenchyma without activity in pelvocalyceal collecting system. However, it readily oxidizes and must be used within 30 min of preparation. The biologic distribution of 99mTc-GHA is similar to gluconate and iron-ascorbate complex. Its renal concentration is not as great as that of DMS but its blood and urinary clearances are much faster, resulting in lower radiation doses to most organs. Early camera images with this agent usually demonstrate both the renal parenchyma and collecting system. In later images, ther is excellent demonstration of the parenchyma alone, superior to that obtained with 99mTc-Sn-DTPA. It is a very stable complex and may be used for at least 5 hr after preparation. All radioactive renal agents examined to date have a significant concentration in the liver, making an accurate quantitative comparison between the two kidneys difficult.


Technique for producing cardiac radionuclide motion images. Sequential frames of different portions of the cardiac cycle are gated into a minicomputer by using an EKG signal recorded onto digital tape simultaneously with imaging information. Serial display of these frames on the computer oscilloscope or projection of 35-mm half frames of these images provides a cardiac motion image with information content adequate for qualitatively assessing cardiac motion.


Fibrinogen uptake by thrombi: effect of thrombus age. The uptake of radiolabeled fibrinogen in canine thrombi was determined at varying times after thrombus induction by electric current. The greatest thrombus/blood ratio was achieved when fibrinogen was administered 4 hr after thrombus induction but definite thrombus fibrinogen uptake was still observed when the tracer was administered up to 72 hr after thrombus induction. There was continued fibrinogen accumulation despite a decrease in weight of older thrombi suggesting that net thrombus propagation is not necessary for labeled fibrinogen uptake. Our results suggest that the fibrinogen uptake test may be useful for the diagnosis of deep vein thrombosis for several days after the onset of thrombosis.


The effect of contrast lymphangiography on localization of 67Ga-citrate. Oily lymphangiographic contrast material introduced prior to total-body 67Ga-citrate scanning may be responsible for accumulation of the radionuclide within the lungs. The possibility of false-positive examinations suggests caution in the interpretation of the scan which evidences this finding. When possible, gallium scintiscans should be scheduled prior to contrast lymphangiography.


Uptake of a colloid in rat liver following intravenous intrasplenic and intramesenteric injection. Intramesenteric and intrasplenic injections of 99mTc-sulfur colloid in the rat resulted in significant differences between the mean uptakes in only some of the liver lobes. More important were the wider interlobular variations seen in the intrasplenic and intramesenteric routes of injection compared with the intravenous route. It is suggested that these differences result from laminar blood flow in the portal vein. In the light of our findings, previous evidence must be considered inconclusive. Laminar flow appears to vary between individual animals and may also vary from time to time in the same animal. Caution is therefore advised when other than systemic routes of injection are used.


In vivo assessment of liver size in the rat. In vivo assessment of liver mass in the rat was achieved using several parameters obtained by scintigraphy, including one computed using a Nuclear Data 50:50 analysis system. All correlated well with the directly measured liver weight. The simplest parameter, the area of the anterior view measured from the Polaroid scintigraph, was therefore the one preferred. The results so obtained were compared with those derived from the relationship between liver and body weights. It is suggested that this accurate in vivo measurement of liver mass is of value in the study of the pathophysiology of this organ.


NUMEDICS: a system for on-line data processing in nuclear medicine. A multiterminal system --NUMEDICS--has been developed to study the problems of on-line acquisition, processing, and display of scintigraphic data. The hardware-software configuration of NUMEDICS permits simultaneous and independent operation of terminals in the Division of Nuclear Medicine, the Physics Research Laboratory, and the Cyclotron Laboratory of the Massachusetts General Hospital. This paper describes the hardware and software developments in NUMEDICS which have been proven to be of value in clinical and research applications. These features are illustrated by applications to the evaluation of left ventricular performance, three-dimensional imaging, and functional imaging of rCBF.


Autologous radioiodinated fibrinogen, simplified. A method for the rapid preparation of radioiodinated autologous fibrinogen has been improved. Plasma is separated from cells by a single centrifugation. Fibrinogen is isolated in two salting-out steps at a 1:4 dilution of plasma and 22.5% saturated ammonium sulfate. Iodination is accomplished with chloramine T at a chloramine T-to-fibrinogen molar ratio of 12:1. Free iodide is removed by a single dilution and salting-out step at 29% saturated ammonium sulfate. Preparation time is about 1 hr; clottable radioactivity is 90-95%. Denaturation due to storage is undetectable at 6 weeks. Advantages of this procedure are (A) a short preparation time and (B) a purified autologous radioiodinated fibrinogen preparation.


Digital tomographic imaging with time-modulated pseudorandom coded aperture and Anger camera. The properties of a time-modulated pseudorandom coded aperture with digital reconstruction are compared with those of conventional collimators used in gamma-ray imaging. The theory of this coded aperture is given and the signal-to-noise ratio in an element of the reconstructed image is shown to depend on the entire source distribution. Experimental results with a preliminary 4 X 4-cm pseudorandom coded aperture and an Anger camera are presented. These results include phantom and human thyroid images and tomographic images of a rat bone scan. The experimental realization of the theoretical advantages of the time-modulated coded aperture gives reason for continuing the clinical implementation and further development of the method.


A general method for labeling proteins with 11C. A method for labeling proteins with 11C has been developed. The method consists of adding 11C-formaldehyde (derived from 11CO2 by catalytic oxidation of 11C-methanol) to a buffered protein solution, followed by reduction of the resulting formaldehyde-protein adduct with aliquots of sodium borohydride. Separation of the desired product is achieved simply and efficiently using high-speed liquid chromatography or, in the case of fibrinogen, by ammonium sulfate precipitation. This mild technique leads to high yields of labeled protein and is adaptable to the labeling of proteins and peptides or other molecules which contain a free amino group and which are stable at pH 8.


A comparison of 82Rb+ and 13NH3 for myocardial positron scintigraphy. Rubidium-82 (75-sec half-life) is eluted from a 82Sr (25-day half-life) generator and infused into phantom and dog to show that it gives images of myocardial accumulation comparable to 13N-ammonia with the positron camera.


An unusual cause of "doughnut" sign in brain scanning. The "doughnut" sign in brain scanning was originally described in association with certain mass lesions having central necrotic, cystic, or avascular areas. A case in which this pattern occurred as a result of a superficial lesion, a large cephalhematoma, is presented.


Production of cerebrospinal fluid leak artifact by residual 99mTc-pertechnetate. Residual oropharyngeal 99mTc activity was detected on an 111In-DTPA cisternogram creating the appearance of a CSF leak. This can be prevented by employing a spectrometer setting that encompasses only the higher principal photopeak of 111In.


Effects of pyridoxine deficiency on the composition of plasma and liver fatty acids in rats fed low and high fat diets. A study was made of the effect of pyridoxine deficiency on the fatty acids of liver and plasma in rats fed diets containing 1, 10, or 20% fat. Both ad libitum-fed and pair-fed control rats were used. In pyridoxine deficiency, arachidonic acid decreased with a concomitant increase in linoleic acid. Incubation of liver slices with [1-14C]acetate showed no significant alteration of fatty acid synthesis in pyridoxine-deficient rats fed 1 or 10% fat when compared with the ad libitum-fed control rats, but revealed a marked increase in cholesterogenesis compared with either control group. Incubations with [1-14C]linoleate resulted in no differences in the synthesis of arachidonate between the experimental and the ad libitum-fed control rats. Incubations with [5,6,8,9,11,12,14,15-3H]arachidonate showed decreased incorporation of this fatty acid in total liver lipids in pyridoxine-deficient rats compared with ad libitum fed control rats. We concluded that the diminution in arachidonate observed in liver lipids of pyridoxine-deficient rats does not result from a lower conversion of linoleate into arachidonate, but possibly from an increased degradation of this fatty acid.


Ammonia intoxication: a hazard during rehabilitation of protein-deprived rats. The ammonia tolerance of weanling rats raised for 3 to 6 weeks on a protein-deficient diet was compared with that of a group of age-matched control animals raised from weaning on an optimal protein diet. The groups were challenged with a nitrogen load of either ammonium chloride or amino acids. The results of the loading studies indicate that severe protein deprivation increases vulnerability to ammonia poisoning. These observations suggest that ammonia-induced coma may pose a significant hazard during the initial intravenous rehabilitation of malnourished subjects, if replenishment is undertaken too vigorously.


Effects of amino acid imbalance and protein content of diets on food intake and preference of young, adult, and diabetic rats. Effects of histidine or methionine imbalance and dietary levels (3-50%) of casein on food intake and preference of young, adult, and diabetic (2.5 month old) rats were examined. Depressions in food intake and growth caused by ingestion of the imbalanced diet were greatest in young rats and least or absent in diabetic rats. Alloxan diabetes induced hyperphagia and elevated concentrations of plasma branched-chain amino acids and decreased concentrations of tryptophan and tyrosine. The diabetic rats fed the imbalanced diet for 9 days had a higher concentration of the limiting amino acid in the plasma than the adult normal rats fed the same diet. The diabetic rats preferred the imbalanced diet over a protein-free diet when they were fed these diets concurrently. Ingestion of the imbalanced diet by normal rats caused greater changes in plasma and brain amino acid patterns than did the protein-free diet. Unlike the diabetic rats, the normal rats, especially the young rats, strongly preferred the protein-free diet over the imbalanced diet. The normal rats also preferred a 10% casein diet supplemented with L-methionine over a low or high casein diet. It seemed that young rats were able to select a protein diet that supported maximal growth when proportions of dietary amino acids were balanced. It also seemed that the susceptibility of the rats to amino acid imbalance varied directly with the status of overall protein synthesis of the animals.


Food intake regulation in the weanling rat: effects of the most limiting essential amino acids of gluten, casein, and zein on the self-selection of protein and energy. The effects of altering the quality of the dietary protein source on the self-selection of protein and energy by the weanling rat simultaneously offered a choice of two diets differing only in protein concentration were tested. The protein-energy selected was measured when the first limiting amino acid lysine was added to gluten; when lysine, methionine, or the first four limiting amino acids were added to gluten or to casein; or when the nutritional quality of zein was altered by manipulation of the content of tryptophan, lysine, or the four most limiting amino acids. The additions of lysine to gluten caused a decrease in the protein-energy selected and an increase in growth rate of the weanling rat. However, improving the amino acid balance of casein or zein did not have this effect. It was concluded that the selection of protein and energy by weanling rats is not related to the nutritional quality of the protein fed.


Correlation between the plasma tryptophan to neutral amino acid ratio and protein intake in the self-selecting weanling rat. The relationship between changes in blood plasma amino acids and the quantity of protein and energy self-selected by the weanling rat, simultaneously offered two diets varying only in protein concentration, was examined. The changes in the quantity of protein and energy consumed by the rats, which were brought about by the addition of the essential limiting amino acids and groups of essential amino acids to gluten, casein, and zein, were not linearly related to alterations in the total plasma amino acid concentrations or to the accumulation of the added amino acids in the blood plasma. However a consistent relationship between food intake and plasma acids was identified when the plasma tryptophan to neutral amino acid ratio was correlated with the protein intake selected. It is postulated that the ratio of tryptophan to neutral amino acids in the plasma is involved in, or reflects, a mechanism regulating protein intake.


Effects of high carbohydrate, high fat, or high protein diets on glucose oxidation by isolated intestinal epithelial cells of the chick. A parallel study of 3-O-methyl glucose transport by everted intestinal sacs and [U-14C]glucose oxidation by isolated, dispersed intestinal cells was done in chicks (1) adapted to a high carbohydrate (HC), high fat (HF), or high protein (HP) diet for 2 weeks or (2) fasted up to 5 days. HF and HP diets significantly decreased both serosal : mucosal (S : M) distribution ratios of 3-O-methyl glucose by everted sacs and glucose oxidation by dispersed cells. The effects were more pronounced in HF diet-fed chicks. Fasting signficiantly increased the S : M ratio throughout a 5-day fasting period, whereas glucose oxidation was increased after a 1-day fast and was decreased after a 5-day fast. Feeding HC diet for 1 week to chicks adapted to HF diet restored both functions to control levels. Refeeding fasted chicks for 3 days also restored S : M ratio to control levels. Histological examination of tissues from various treatment groups revealed no obvious morphological differences. The results suggest that the functional changes described represent adaptive changes at the cellular level and that these changes are readily reversible.


Relative importance of the two major pathways for the conversion of cysteine to glucose in the perfused rat liver. The effects of dietary treatments and substrate availability on the rate of gluconeogenesis from L-cysteine has been investigated in the perfused rat liver. At an optimal concentration (10 mM) of [U-14C]cysteine, after 40 minutes, 3.9% of the label appeared in glucose. This corresponded to 90% of the net glucose coming from cysteine. Cysteine was then shown to be converted to glucose at a physiological concentration of substrate (0.1 mM) as well as at the optimal concentration. After 40 minutes of perfusion with 0.1 mM [U-14C]cysteine as the substrate, livers of 72-hour starved rats incorporated 1.7% of the label into glucose, and livers of rats perfused without prior starvation incorporated 0.53% of the label into glucose. This suggested that cysteine was glucogenic at optimal and physiological concentrations of cysteine in both fed and starved rats. To determine which, if either, of the two suggested pathways for the conversion of cysteine to glucose was quantitatively more important, livers were perfused with [U-14C]cysteine alone or with [U-14C]cysteine plus cysteine sulfinic acid. The addition of cysteine sulfinate (10 mM) reduced the incorporation of 14C from cysteine into glucose from 3.9 to 2.7%. This suggested that one-third of the cysteine to glucose proceeded via the cysteine sulfinate-dependent pathway.


Zinc deficiency during the latter third of pregnancy: effects on fetal rat brain, liver, and placenta. The effects of zinc deficiency during the last third of gestation on the growth and development of the fetal rat at term were investigated. Zinc deficiency resulted in anorexia and weight loss of the pregnant dams. Fetuses from such dams displayed intrauterine growth retardation when compared with fetuses from pair-fed or ad libitum-fed controls given adequate zinc. Although the brains of the zinc-deficient fetuses were smaller than those of the controls, the brain was relatively spared while the liver was severely affected. The total cell number was reduced and there was an apparent increase in cell size in the brains of zinc-deficient fetuses in comparison with the brains of the controls. The growth failure of the zinc-deficient liver resulted in a smaller complement of total DNA, RNA, protein, and lipid, and there was less incorporation of [3H]thymidine into DNA in the liver. The placenta appeared to be only marginally affected by the zinc deficiency.


Effects of zinc deficiency on the oxidation of retinol and ethanol in rats. The zinc metalloenzyme alcohol dehydrogenase was assayed in subcellular fractions of liver and retina from zinc-deficient and control rats using retinol and ethanol as substrates. When the zinc concentrations of these tissues were reduced because of feeding inadequate dietary zinc, alcohol dehydrogenase was significantly lowered, and the retinol-retinal as well as the ethanol-ethyladehyde conversion was significantly reduced. While in older rats no changes occurred in liver zinc and alcohol dehydrogenase, the retina was more sensitive to the lack of dietary zinc than the liver. Young rats nursed by zinc-deficient dams showed the most severe changes in both tissues. The data suggest that zinc deficiency affects the utilization of vitamin A as well as the catabolism of ethanol.


Protection against zinc deficiency by prior excess dietary zinc in young Japanese quail. Three experiments were designed to determine whether an excess of zinc during the first week of life would afford any protection to young Japanese quail during a subsequent period of zinc deprivation. Day-old birds of both sexes were fed an adequate purified diet containing soybean protein with requirement (25-30 mg/kg of diet) or higher levels of zinc for 1 week. The zinc level was reduced during the second week to the deficient level of 1mg/kg of diet, except for the controls which continued to receive an adequate or higher level of zinc (25, 30 or 75 mg/kg of diet). With this low zinc intake, birds that received an initial level of zinc in excess of requirement grew significantly better (body weight and length of primary wing feathers) than those that initially received the required amount of zinc. Data on zinc content of liver, breast muscle, tibia and whole body retention suggest that bone may store zinc consumed in excess of requirement and that this zinc may be available for utilization during a subsequent period of zinc deprivation in a growing animal that has rapidly remodeling bones.


Metabolism and biological activity of cis- and trans-phylloquinone in the rat. The separation of sufficient cis and trans forms of vitamin K for feeding and metabolic studies was accomplished on silica gel columns eluted with solvent containing n-butyl ether. The lack of biological activity of the cis isomer of phylloquinone was observed. The cis isomer was retained longer in liver, particularly in mitochondria, but had low retention in that portion of the endoplasmic reticulum isolated as the rough membrane fraction. The cis isomer of phylloquinone was a poor substrate for 2,3-epoxidation in vivo and in vitro. These data are consistent with the hypothesis that epoxidation of vitamin K is coupled to the biological activity of the vitamin, and that microsomes are the site of metabolism and function of vitamin K.


Energy wastage in rats given drugs that induce microsomal enzymes. Metabolic efficiency was studied in rats given drugs known to induce hepatic microsomal enzymes. The presence of an increased metabolic rate was indicated by increases in oxygen consumption under various experimental conditions and by changes in body weight. The latter was not accounted for by increased losses of energy in excreta. The results support the hypothesis that hepatic microsomal enzyme induction can significantly alter the body's metabolic efficiency.


Effects of some nutritional deficiencies on parturition in rats. Relation of food consumption to stress at parturition in rats was investigated in three experiments. (1) Females receiving a low thiamin intake during gestation were compared with those receiving a low zinc intake and those receiving either a restricted or ad libitum food intake with adequate zinc. Litter size was reduced in the low thiamin group. Malformed offspring were noted in the other three groups. Little stress at parturition was evident in any of the groups. Serum progesterone concentrations on day 18 were elevated in all three experimental groups relative to ad libitum controls. Urinary hydroxyproline in females with low zinc intakes did not differ from that in ad libitum controls. (2) A 5% protein diet increased food intake only slightly in females with low zinc intake and resulted in death at the end of gestation. (3) Force feeding of pregnant females was unsuccessful, but results with females given the low zinc diet or restricted amounts of the diet plus zinc supported results obtained in the other two experiments. The possibility that stress at parturition was related to the ability of the females to make normal hemodynamic adjustments to pregnancy is discussed.


Calcium kinetics in the Solanum malacoxylon-treated rat. The chronic ingestion of the leaves of the plant Solanum malacoxylon (SM) causes an endemic disease in the cattle of some areas of Buenos Aires province. The animals affected manifest loss of appetite and weight, hypercalcemia, hyperphosphatemia, and ectopic calcifications. In order to study the mechanism of the hypercalcemia provoked by the administration of SM, a calcium kinetic study was performed in control and treated adult intact rats. The animals receiving SM showed higher levels of serum calcium throughout the study. The body excretion of 47Ca and the size of the most rapidly exchangeable calcium pool were also elevated. On the other hand, the bone accretion rate and the urinary excretion of total hydroxyproline were significantly diminished. The results indicate that during the early phase of SM administration in intact rats, bone turnover rate is depressed.


Cardiac structure and function in vitamin B-12-deprived rats. The effect of prolonged vitamin B-12 deprivation in rats on the histological structure of heart and on cardiac linoleic acid oxidation has been investigated. Offspring from pregnant females fed vitamin B-12-deficient diets were fed the deprivation diet for up to 16 months, and the development of B-12 deficiency was monitored by determination of urinary methylmalonic acid levels. These levels averaged 4.2 mg/day by 9 months of B-12-deprivation diet, and 142 mg/day after 16 months. The hearts of these animals were characterized by extensive fibrosis, and electron microscopy revealed cardiac mitochondria that were grossly enlarged and distorted. The metabolic defect of B-12 deprivation in heart muscle was determined in isolated hearts during recirculating perfusion of labeled propionic acid. Both the uptake and oxidation of propionic acid were markedly reduced in hearts from B-12-deprived rats (16 months) compared with controls, and the site of the metabolic block, i.e., accumulation of labeled methylmalonate, was established. Vitamin B-12 deprivation did not affect the extraction of recirculating labeled linoleic acid by perfused hearts, in contrast to the effect on propionic extraction. Furthermore, the oxidation of the extracted fatty acid was markedly increased over controls. Analysis of the circulating media after 45-minute perfusions showed no accumulation of labeled methylmalonate but did contain significantly less succinate than perfusion media from control hearts. The results are discussed with respect to cardiac structure and to the oxidative pathway(s) for polyunsaturated fatty acids.


Labile nitrogen reserves in the ruminant. Metabolic changes in growing cattle employing a nitrogen depletion-repletion treatment. A metabolism study was conducted in which eight growing steers were subjected to a nitrogen (N) depletion-repletion regime. Three consecutive time periods were used to standardize, to deplete, and to replete body N. Diets fed in the respective periods provided by analysis 6 and 16% protein equivalent, respectively, from corn gluten or urea. Metabolic parameters were monitored during weeks 3 and 5 of standardization, weeks 1, 3, and 5 of depletion, and weeks 1 through 7 of repletion. Growth-rate trends started to deviate downward from linearity during the last 2 weeks of depletion; a trend that was not reversed until week 3 of repletion. Apparently digested N was defined by regression equations in which truly digested N was 94 and 83% of ingested N and metabolic fecal N totaled 0.64 and 0.48 g N/100 g ingested dry matter for corn gluten and urea N, respectively. The relationship between total urinary N losses and truly digested N was determined in which biological value equaled 60 and endogenous urinary N losses totaled 0.34 g N/kg0.60/day (equivalent to 0.040 g N/kg/day). Retained N decreased from 1.09 g during standardization to 0.16 g/kg0.60/day after 1 week of depletion. A subsequent improvement in retained N to 0.36 g in week 3 was followed by a decrease to 0.19 g/kg0.60/day after week 5 of depletion. In repletion, lowest and highest retained N occurred during weeks 1 and 4. Changes in retained N were produced by changes in urinary urea N excretion. Ammonia N accounted for 20, 21, and 24% of the total urinary N voided during standardization, depletion, and repletion. Except for urinary urea N losses that were greater and inversely related to fecal losses in urea-fed steers, dietary N source did not influence the excretion of ammonia, creatinine, or residual N.


Labile nitrogen reserves and plasma nitrogen fractions in growing cattle. The existence and magnitude of labile nitrogen (N) reserves were studied in growing cattle using a dietary N depletion-repletion technique. Blood parameters and urinary N excretion patterns were monitored. Blood hematocrit (Ht) did not respond to reduced ingested N until after week 3 of depletion at which time it began to fall. About 3 weeks of repletion regime was required before Ht values increased again. Plasma protein and albumin decreased from 6.05 and 2.70 g during standardization to 5.44 and 2.44 g/100 ml after 5 weeks of depletion and did not approach predepletion levels until week 6 of repletion. Plasma urea N decreased from 16 mg in standardization to 0.08 mg/100 ml in depletion and required 3 weeks of repletion treatment to attain a peak of 18 mg/100 ml. Labile N reserves were determined by integrating the areas from total urinary N excretion curves obtained during depletion and repletion periods. On a live body weight basis labile N represented 5.6% of total body N. When computed on an empty body weight basis (does not include weight of gastrointestinal tract), labile N totalled 6.0%. The magnitude of labile N stroes as a percentage of total body N was 44% greater in steers with a mean body weight of 280 kg compared with animals weighing 144 kg.


Hepatic microsomal enzyme induction in rats fed varietal cauliflower leaves. Leaves from a standard, insect-susceptible cauliflower variety and an insect-resistant strain were formulated at either 10 or 25% into semipurified diets for male and female weanling rats. After 3 weeks, relative liver weights, microsomal protein, cytochrome P-450, and activities of hepatic microsomal aminopyrine N-demethylase, aniline hydroxylase, p-nitroanisole O-demethylase, and N-methylaniline N-demethylase were determined. Growth, feed intake, and feed efficiency of male rats were not affected by the inclusion of the dried cauliflower leaf in the diet. However, female rats exhibited a depressed feed intake and increased feed efficiency with cauliflower leaf supplemental diets. Relative liver weights increased with increasing percentage of cauliflower leaves in the diet. Hepatic microsomal enzyme response to cauliflower leaf supplementation of the diet was greater in males than in females. Only aniline hydroxylase activity remained unchanged by the test diets. Male rats showed significant increases in N- and O-demethylation with both the 10 and 25% cauliflower diets, and increased values for microsomal protein and cytochrome P-450 at the 25% supplemental level. Female rats did not show significant hepatic microsomal induction from cauliflower leaf consumption at the 10% level. However, cytochrome P-450 and the metabolism of aminopyrine and p-nitroanisole were enhanced by consumption of cauliflower leaves at 25% of their diet. None of the parameters tested in this study evidenced a difference between the two cauliflower cultivars fed to either sex.


Nickel deficiency and nickel-rhodium interaction in chicks. Nickel deficiency was produced in chicks under near optimal growth conditions. This judgment is based on the finding that chicks fed the experimental diet supplemented with nickel had a very satisfactory growth rate, over 600 g in 4 weeks. To induce nickel deficiency, chicks were raised in plastic cages located inside plastic isolators and were fed diets (containing 2-15 ng of nickel/g) based on dried skim milk, acid-washed ground corn, EDTA-extracted soy protein, and corn oil. In 2 experiments, controls were fed 3 mug of nickel/g as NiCl2-6H2O. In experiment 3, instead of 1 control group 25, 50, 250, and 2,500 ng/g of supplemental dietary nickel as NiCl2-6H2O were each given to separate groups of chicks. Nickel deprivation resulted in: ultrastructural changes in the liver with the most obvious abnormality in the organization of the rough endoplasmic reticulum; altered gross appearance, reduced oxidative ability, and decreased lipid phosphorus in the liver; altered shank skin pigmentation that was associated with a decrease in yellow lipochrome pigments; and lower hematocrits. Deficiency also tended to increase the thickness of the legs and size of the hock; decrease the length:width ratios of the tibias and femurs; and decrease the plasma cholesterol. None of the signs of deficiency were seen in chicks fed diets containing at least 52 ng of nickel/g. In one experiment, a group of birds was fed 50 mug of rhodium/g of diet as (ClRh(NH3)5)SO4 to ascertain whether rhodium is a metabolic antagonist of nickel. Supplemental rhodium increased the hematocrits and liver oxidative ability of both nickel-deficient and -supplemented chicks, and increased total liver lipids, liver lipid phosphorus, and liver cholesterol in the nickel-deficient chicks alone. Rhodium did not increase the signs of nickel deficiency.


Nickel deficiency in rats.

Nickel deficiency in rats. Nickel deficiency was produced in rats fed diet (containing 2-15 ng of mickel/g) based on dried skim mile, acid-washed ground corn, EDTA-extracted soy protein, and corn oil. Controls were fed a supplemental 3 mug of nickel/g of diet as NiCl2-6H2O. The rats were raised in plastic cages located inside laminar flow racks. Nickel deprivation resulted in several consistent pathological findings. These included: (1) increased perinatal mortality, (2) unthriftiness in young rats characterized by a rough coat and/or uneven hair development, (3) altered gross appearance (color) of the liver, (4) increased rate of alpha-glycerophosphate oxidation by liver homogenates, (5) decreased liver cholesterol, and (6) ultrastructural changes in the liver with the most obvious difference in the amount and organization of the rough endoplasmic reticulum. Nickel deficiency in rats tended to decrease growth, hematocrits, and liver total lipids and phospholipids.


The validity of preemployment medical evaluations. A protocol is described to determine whether a medical preemployment evaluation can be predictive for attendance or work performance. In addition, the dollar benefit and the cost of such a program is assessed. The present analysis is based on 4,936 men and women, who were processed as prospective hires into non-hazardous job assignments. A medical preemployment evaluation was performed on all applicants, identifying factors which could influence attendance or work performance. Sixty-nine per cent of the examined applicants were hired. During the employment process, all applicants were randomly assigned to a control or trial group. Those in the trial group were hired by the employment office without knowledge of the results of the medical preemployment evaluation, whereas these results were fully disclosed for applicants in the control group. Three months after hire, supervisors answered a detailed questionnaire relating to absence and work performance for each hire. No differences were identified between control and trial groups for overall job performance, appropriateness of the job match and work force losses. A small but significant difference, on the other hand, was identified for sickness absence in the trial group between medical evaluation category A (normal risk) and category R (increased risk identified). Omission of a preemployment medical evaluation, as simulated by the trial group, increased the absence cost for the company by $2.30 per year for each new hire. Compared to a $17.50 cost per preemployment health evaluation, the average length of service of new hires would have to exceed 7.6 years to realize a dollar benefit from the medical examination. Examinations performed on applicants who were never hired further increases the cost of a medical preemployment examination program.


Near-maximal ECG stress testing and coronary artery disease risk factor analysis in Los Angeles City fire fighters. Near-maximal ECG stress testing and coronary artery disease risk factor analysis including blood pressure, serum cholesterol and smoking habits were conducted on a randomly selected group (N=90) of Los Angeles City Fire Fighters ranging in age from 40 to 59 yrs. The data obtained from the fire fighters were compared to data previously reported for a group of Los Angeles insurance underwriters of the same age range. Only 12% of the fire fighters had cholesterol values greater than 260 mg% while 18% of the insurance executives fell into this category. Only 2% of the fire fighters had blood pressure values greater than 160/90 mm Hg while 25% of the insurance executives were hypertensive. Thirty-two percent of the fire fighters were smokers at the time of testing as compared to 26% for the insurance executives. Only one fire fighter had all three risk factors elevated and only five had two risk factors elevated. Forty-seven of the fire fighters had no risk factors elevated. Ten percent of the fire fighters had ischemic stress tests as compared to 8% for the insurance executives. Of the nine fire fighters with ischemic stress tests one was hypertensive, one had elevated serum triglycerides, and three were smokers at the time of testing. Since the fire fighters are a medically-selected population with low risk factors for CHD, the observed incidence of ischemic stress tests is surprising and suggests that ischemic heart disease may be job associated.


Professional counseling in a company with a broad dispersion of work locations. Personal counseling by a well trained professional has been available to employees and their families in the Northwestern Bell Telephone Company in parts of the State of Iowa for five years. The service has been available on a voluntary basis at no charge at the work location. The program has been very successful when measured by the acceptance of the service by the empolyees and by the results of the counseling experience as evaluated by the counselor. The service has not been abused. The range of clinical problems presented fills the entire spectrum of case work. It is interesting that few of the problems are directly due to the work situation. There have been very few appointment cancellations, and most of the cases are closed as "improved". The program was started without a model and has developed slowly. The wide geographic dispersion of our employee work locations has added to the complexity of the program's management. We hope to extend this program of personal counseling to employees in other states in our company. We have demonstrated in Iowa that there is a need for this kind of service at the work location. We have shown that a counselor can be of service with credibility away from a medical department if organizational lines to the company medical department are clearly defined. Our humanity directs us to help our fellow man when he is troubled. Good management philosophy respects the need for physical and emotional health in the employee. A personal counseling program is in harmony with both of the philosophic principles.


Immunoglobulins in workers with traumatic vasospastic disease. Twenty-seven rockdrillers of whom 63% had symptoms of Traumatic Vasospastic Disease were examined. The concentrations of IgG, IgA and IgM in serum were determined with immunoelectrophoresis. The immunoglobulins were found not to be significantly raised.


Mortality factors in diabetes. A 20 year mortality study. The life expectancy of well controlled diabetics has been considered to be approximately that of the normal individual. A 20 year prospective study of the mortality of diabetics who applied for life insurance to the Equitable Life Assurance Society did not confirm this. The study population comprised 10,538 individuals with an average exposure of 7.9 years. During the period of the study 1,478 deaths were recorded, giving a mortality ratio of 335%. Mortality decreased with increasing age at diagnosis of diabetes. Mortality increased with increasing duration of the disease. Mortality was lowest in cases treated by diet only. Mortality in cases with poor control was two and one-half times that of cases with good control. Albuminuria on examination was an extremely unfavorable prognostic factor. Hypertension had a particularly adverse effect on the diabetic as compared to the non-diabetic, especially at ages under 40.


An electron-microscope study of the mode of cell death induced by cancer-chemotherapeutic agents in populations of proliferating normal and neoplastic cells. Deletion of scattered single cells by ultrastructurally typical apoptosis was observed to take place continuously in the lining of the small intestinal crypts of normal mice, and in untreated Crocker mouse ascites tumours. Injection of the cancer-chemotherapeutic agents actinomycin D, mitomycin C, cytosine arabinoside and cycloheximide massively enhanced the rate of apoptosis in each situation, the morphology of cell death induced by these drugs being fundamentally different from that of coagulative necrosis, which developed without treatment in the centres of solid nodules that grew after subcutaneous inoculation of the tumour. In the crypt lining, where the predominant cell type affected appeared to be epithelial, the apoptotic bodies were either extruded into the lumen or rapidly phagocytosed and degraded by adjacent viable cells. But bodies in the ascites tumour were rarely ingested by uninvolved cells, presumably because of their wide dispersal in a fluid medium, and the stages in their development were seen more clearly than has been possible in solid tissues, where phagocytosis is ususlly rapid: they eventually underwent a change resembling coagulative necrosis or in-vitro autolysis. Reports suggesting that cancer-chemotherapeutic agents enhance autophagy in solid malignant neoplasms require confirmation, for secondary lysosomes of any sort were found to be uncommon in the treated ascites tumours, and there is little doubt that phagocytosed apoptotic bodies have been mistaken for autophagic vacuoles in the past. The significance of the fact that cancer-chemotherapeutic agents induce a type of cell death that is found in normal tissues is at present unknown.


The response of the newborn rat to injury. I. Vascular and humoral aspects. The development of oedema in response to irritants injected into the skin, or pleural cavity of rats, has been shown to differ according to the age of rat studied. It was found that newborn rats were less responsive, with respect to oedema formation, at certain times after the injection of a particular irritant. Attempts to suppress the reactions of these animals using anti-histamines, anti-serotonin and kinin-depleting agents were less successful than in adults. Analysis of serum, plasma and exudate proteins revealed quantitative and qualitative differences between newborn and adult rats. The ability of various agents to cause increased vascular permeability in the skin of newborn rats was found to vary with the age of animal studied. Thus histamine, 5-hydroxytryptomine, cellulose sulphate and prostaglandin E2, all failed to cause increased vascular permeability in the skin of rats younger than 3 wk of age. However, lymph-node permeability factor induced increased vascular permeability in newborn (i.e., 6-hr-old) rats. An attempt was made to correlate these results with those of oedema formation following the infections of certain irritants.


Studies of the responses of basophil and eosinophil leucocytes and mast cells to the nematode Trichostrongylus colubriformis. II. Changes in cell numbers following infection of thymectomised and adoptively or passively immunised guinea-pigs. The role of the immune response in the generation of the basophilia and eosinophilia found during expulsion of the intestinal nematode parasite, Trichostrongylus colubriformis, by guinea-pigs was investigated by studying cell numbers in animals whose immune responsiveness had been modified by thymectomy and adoptive or passive immunisation. Basophilia, but not eosinophilia, was depressed in thymectomised guinea-pigs. Bone marrow basophil numbers were significantly increased in T. colubriformis-infected guinea-pigs following the infection of mesenteric lymph-node cells from both normal and T. colubriformis-immune syngeneic donors. Bone marrow basophil counts were also increased following the injection of immune lymph-node cells into uninfected recipients. Small intestine eosinophil numbers in adoptively immunised guinea-pigs showed a pronounced increase following infection with T. colubriformis. A smaller increase followed infection of passively immunised guinea-pigs. These results, and other work with this system, suggest that basophilia and eosinophilia during T. colubriformis infection, although associated with the immune response, might not be fully explained as direct consequences of the interaction of parasitic antigens and sensitised lymphocytes or antibodies.


Gaucher's disease associated with chronic lymphocytic leukaemia, gout and carcinoma. A case report of Gaucher's disease associated with chronic lymphocytic leukaemia is described in a patient with gout and carcinoma of the sigmoid colon. This the first reported case of Gaucher's disease associated with chronic lymphocytic leukaemia.


Neuroblastoma in the dog.

Neuroblastoma in the dog. Two malignant canine tumours of peripheral neuronal tissue are described. A mediastinal neuroblastoma was found in a 15-mth-old Boston Terrier with dyspnoea. The tumour compressed adjacent lung and invaded the cervical spinal cord. A retroperitoneal ganglioneuroma was found in a 2-yr-old Labrador with posterior ataxia and atrophy of the muscles of the hind legs. This tumour surrounded adjacent adjacent soft tissues and invaded the overlying vertebrae.


Primary epithelial tumour in the right atrium of the heart and inferior vena cava in NZR/gd inbred rats; pathology of 18 cases. In NZR/Gd inbred albino rats, tumours occurred in the right atrium or inferior vena cava of approximately 20 per cent. of untreated animals, of both sexes, over the age of 1 yr. The tumours were centred in the wall of the right atrium in 15 cases, and in the inferior vena cava in another three cases; they appeared to be primary in these sites. The tumours were slowly growing, but eventually malignant. Light- and electron-microscopic study showed the tumours were composed of epithelial alveoli imbedded in a collagenous connective tissue containing spindle cells and thin-walled blood capillaries. The epithelium varied from flat to low columnar, and often secreted mucoid material into the lumina, or sometimes into surrounding tissue. This tumour, for which the name atrio-caval epithelial mesothelioma is suggested, very closely resembles a rare epithelial tumour of the right atrium previously described in humans under a variety of names. An underlying embryological anomaly had been postulated in these tumours in humans, and the occurrence of pathologically similar lesions in high incidence in hearts of NZR/Gd inbred rats should help test the hypothesis of genetic and developmental causes in the genesis of this rare cardiac neoplasm.


Mixed mesenchymal differentiation in meningiomas. Five intracranial meningiomas showing mixed mesenchymal differentiation are described. Three contained cartilage, three contained bone, four contained hyaline fibrous strands or nodules which in two instances were calcified, three contained angiomatous areas, one contained pericytoma-like areas, four contained pleomorphic and sometimes multinucleate giant cells, and one contained a mucoid matrix including spheroidal cells superficially resembling chordoma. The importance of recognising such tumours is emphasised as they can be misdiagnosed as metastatic deposits, particularly in a frozen section.


The pathology of elastase-induced panacinar emphysema in hamsters. A single dose of crystalline, porcine pancreatic elastase injected intratracheally into hamsters induces widespread alveolar enlargement with subpleural bullae. A uniformly severe lesion is consistently induced by 0-2 mg elastase per 100 g body weight and with negligible mortality. Compared with controls, which showed no lesion, elastase-damaged lungs show a highly significant (P less than or equal to 0-001) increase in alveolar size and a decrease in internal surface area. Taken with the associated physiological abnormalities, these findings closely simulate human emphysema of the panlobular (panacinar) type. Histologically it appears that elastase converts the fine elastic fibres in alveolar walls and pleura into thickened, nodular fibres which may also be broken along their length. With higher doses of elastase, i.e., 0-5 mg/100 g body weight, many pulmonary arteries showed segmental loss of inner and outer elastic laminae, usually with thrombosis on the overlying endothelium. The mechanism of this thrombosis is unclear. These experiments suggest that damage to elastic fibres may be an important element in the development of human panacinar emphysema, and that the damage could be one pathogenetic mechanism which produces damage of elastic fibres.


Squamous metaplasia in the healing of chronic colonic ulcers of the rat. Chronic ulcers of the rat colon were produced by a administering a 3 per cent. hydrogen peroxide enema. Twenty-three per cent. of the animals with chronic ulcers had areas of squamous metaplasia at the wound margins which in some cases covered the defect. Electron microscopy revealed some areas similar to epidermis with the four characteristic cell layers. The cells demonstrated many filaments, membrane-coated granules, keratohyalin granules and keratin. The cells were linked by complex of cytoplasmic bridges and frequent desmosomes. Basal cells often displayed large irregular nuclei with double nucleoli. Other areas demonstrated a grossly irregular surface with marked cellular pleomorphism and defects in the basement lamina. The incidence of squamous metaplasia and squamous-cell carcinoma in the colon of man is discussed. The ultrastructural characteristics of squamous metaplasia in the trachea and bronchi is recorded and compared with those of the colon. It is suggested that as neoplasia has been observed to follow experimental metaplastic lesions in the bronchus, a similar ocurrence could take place in the colon as the squamous cells exhibited similar characteristics.


Pulmonary oedema in rats given dehydromonocrotaline: a topographic and electron-microscope study. Study of cleared, histological and electron-microscope specimens shows that increased vascular permeability plays a major role in the formation of the pulmonary oedema and pleural effusions that occur in rats following the intravenous injection of a large dose of dehydromonocrotaline. There is a latent interval of 6-8 hr between injection of the dehydroalkaloid and the start of increased permeability which appears to be due to a direct damaging effect of the toxin on the endothelium of pulmonary capillaries and small venules. The endothelial injury does not cause permanent disruption of small blood vessels, and 2 days after injury all vessels are patent and lined by a complete layer of endothelium. Large numbers of mononuclear cells are present in the interstitial tissues of the lung 44 hr after injury. These cells appear to be emigrated blood monocytes but the cause of their emigration and their role in the subsequent progression of this type of injury to the lung are not clear.


Localisation and pathology of Mortierella wolfii toxin in mice. Using 125I labelled M. wolfii toxin the site of action in mice was shown to be the kidney. Autoradiographic studies revealed the label to be localised in the proximal convoluted tubules of the kidney, where there was a marked necrosis and degeneration of the epithelium causing the tubules to become considerably distended. Although the distal and collecting tubules maintained their integrity, many contained amorphous casts. An injected dose of 1 toxic unit (10 mug protein) was sufficient to produce damage to the kidney with subsequent anaemia, azotemia and albuminuria. Other organs appeared to be essentially normal and renal failure was the probable cause of death of mice.


Periductal foam cells in benign mammary dysplasia. The morphology and associations of periductal foam cells were studied in an unselected consecutive series of 576 lesions of benign mammary dysplasia. Periductal foam cells were found to all ages in 10-1 per cent. of the lesions. Their copious foamy cytoplasm, associations with giant cells and infiltrates of periductal small round cells, ochrocytes and colostrum cells suggest that they are macrophages. Mammary epithelium was often damaged at the site of periductal foam-cell infiltration.


Sudden death in infancy in Inner North London. All cases of sudden infant death occurring over a 2-yr period in Inner North London were subjected to pathological and sociological analysis, using detailed expert interviewing of the mother soon after the event by doctors and Health Visitors. Of the cases showing no cause of death at autopsy (Cot Death) the great majority were found subsequently to have microscopic pathology sufficient to cause death, mainly respiratory tract inflammation. In addition, the majority of the "Cot Death" group had a clinical history of illness and in many of these cases hindsight suggested that the quality of health care could have been improved. Only a small minority of sudden infant deaths were found to have no history of illness and no microscope pathology. The results suggest that most cases of sudden infant death may result from a combination of respiratory infection with either special physiological or special sociological factors.


Carbohydrate transport in Moniliformis dubius (Acanthocephala). I. The kinetics and specificity of hexose absorption. The uptakes of 14C-glucose, -2-deoxyglucose, -mannose, -N-acetylglucosamine, -3-0-methylglucose, -fructose, and -galactose by female Moniliformis dubius were nonlinear, saturable functions of hexose concentration. Kinetic and inhibition studies indicated that glucose and 2-deoxyglucose were absorbed via a single common transport locus. Mannose, N-acetylglucosamine, 3-0-methylglucose, fructose, and galactose (in decreasing order of effectiveness) inhibited the uptake of glucose in a completely competitive manner; their absorptions appeared to be mediated by the glucose transport locus and, to some degree, by one or more additional transport systems. Kinetic studies suggested that the apparent inhibitions of 14C-glucose uptake by maltose and glucose-6-phosphate were due to free glucose liberated through the action of surface hydrolases. The uptake of 14C-glucose was also inhibited by salicin, alpha-methylglucoside, and beta-methylglucoside, but not by pentoses, L-hexoses, sugar alcohols, disaccharides (except maltose), gluconic acid, glucuronic acid, phlorizin, or ouabain. Glucose uptake was not Na+-dependent.


Morphological variation of Moniliformis moniliformis (Bremser 1811) Travassos 1915 and Moniliformis clarki (Ward 1917) Chandler 1921. A two-way fixed model analysis of variance was used to test Moniliformis moniliformis and M. clarki for inter- and intraspecific differences with respect to 7 morphological characters used to distinguish species of the genus. M. clarki was sexually dimorphic in more characters than was M. moniliformis when specimens from their usual definitive hosts, Spermophilus tridecemlineatus and Rattus norvegicus, respectively, were compared. More characters were sexually dimorphic in both species reared in hamsters, Mesocricetus auratus, than in their usual definitive hosts or M. clarki from rats. Moniliformis clarki and M. moniliformis (n = 25 each sex, each species) from their usual hosts were significantly different at the 1% level in 6 of 7 characters studied. Further M. clarki of either sex from ground squirrels did not differ significantly in any of the 7 characters from those of the same sex from rats. When reared in hamsters, the range in number of longitudinal rows of proboscis hooks of female M. moniliformis included that of M. clarki, but the 2 species were distinct in each of the other features which distinguished them in rats and ground squirrels.


Infants of mothers with a high and of mothers with a low insulin response to glucose infusion. Glucose tolerance, insulin response and clinical appearance during the early neonatal period. Diabetic mothers affect their offspring during pregnancy, sometimes giving rise to the complete symptoms of diabetic fetopathia with the typical appearance of the child high birth weight, hyperinsulinism, etc. Some of these traits have also been reported to appear in the infants some time before the onset of diabetes in the mother, but no prospective study of infants born to truly prediabetic mothers has yet been reported. Thus it is not possible to say whether or not the previously reported effects are related to an undetected, subclinical diabetes in the mother. A prospective study of the insulin reponse to glucose during pregnancy [9] has been previously published, which included 11 women with a low insulin response to glucose infusion (GIT) - a prediabetic type of insulin response according to the definition of Cerasi and Luft [5] -  and a control group of 14 women with a high insulin response to glucose infusion. In the following the neonatal findings in these 13 infants of low insulin responders (ILR) aand 14 infants of high responders (IHR) are reported...


The scope of prenatal therapy in severe rhesus hemolytic disease. Prenatal blood transfusion of a fetus established anemia due to rhesus hemolytic disease can be life saving. In Hamburg-Eppendorf 252 transfusions in 130 babies have so far been carried out. The success rate was 51%. Out of 39 babies who had ascites at the time of the first transfusion, 13 survived. The amount of ascites aspirated at the first transfusion correlates with the prognosis: The chance of producing a living and healthy child is greater when the amount of ascites is under 5 mls than when it is over 5 mls. Babies with amniotic fluid bilirubin values from 0.4 to 0.6 still have a good chance of survival, whereas the prospects of success with values over 0.6 are very small. The technical risk of prenatal transfusion before the 27th week amounts, according to our observations, to about 6%.


Leukocyte alkaline phosphatase in newborn infants after delivery and in the puerperium. Leukocyte alkaline phosphatase (LAP) activity increases progressively during pregnancy, returning to non-pregnant levels 6 weeks post-partum. This enzymatic activity is under the influence of placental steroid hormones, thus reflecting placental function. LAP activity is thus a reflection of the dynamic relations between estrogenic, progestational and corticoid activity during pregnancy. LAP activity was studied in 60 women and in their 61 newborn infants at delivery and during the first five days of the puerperium. The Kaplow cytochemical technique was employed. The average maternal LAP score as well as the average newborn infant LAP score was considerably higher than the LAP score of the normal adult. The level of the enzyme in the maternal granulocytes was significantly higher than that of the newborn (Tab. I). During the first five days after labor, there was progressive decrease in the LAP score in the maternal and the newborn blood; on the fifth day the LAP scores of both were only slightly above the normal adult score (Figs. 1, 2). An inverse relation between the LAP score and the birth weight of the infant was found (Tab. III). These results confirm the view that LAP activity in the fetus in utero, are dependent on placental steroid function. The lower LAP values in the newborn, as compared to those of the mother are probably dependent on the lower newborn hormone levels. The significance of the relation between LAP scores and the infants birth weight is not clear.


Reward and purpose as incentives for children differing in locus of control expectancies. The Intellectual Achievement Responsibility Questionnaire was used to classify 248 fourth- and fifth-graders as internals, mediums, and externals on the internal-external locus of control personality dimension. Subjects were assigned to four treatment groups resulting from the manipulation of intrinsic (purpose vs. non purpose) and extrinsic (reward vs. no reward) motivational conditions and administered a coding task with number of figures coded as the dependent variable. An analysis of variance with IE, reward, purpose, sex, and grade as factors yielded significant purpose, sex, grade, and IE X Reward X Purpose effects. The performance of internals was found to be unaffected by motivational manipulations; purpose together with reward improved the performance of mediums: reward and purpose (individually and together) improved the performance of externals. Implications for future investigation of the IE construct and the social psychology of psychological research were discussed.


False physiological feedback and persuasion: effect of fear arousal vs. fear reduction on attitude change. Two experiments tested the hypothesis that increases in false physiological feedback of fear arousal will enhance persuasion and that reduction in the arousal feedback is unnecessary for increased persuasion to occur. Prior research has usually found a positive relation between level of arousal and persuasion, but support for the drive reduction hypothesis is tenuous. However, Harris and Jellison (1971) claimed support for such a hypothesis. They manipulated subjects' fear arousal cognitively via false physiological feedback while the subjects listened to a persuasive communication. The present experiments used a similar procedure in an attempt to test an "arousal only" against an "arousal reduction" hypothesis. Subjects listened to a persuasive speech while receiving false feedback via a meter concerning their fear arousal. In Experiment I half of the subjects received high arousal and half received moderate arousal information. Within each of these conditions half of the subjects had their arousal reduced, and the other half did not. In Experiment II subjects received either low arousal, high arousal, or high then low arousal feedback while listening. The results of the two studies generally provided support for the "arousal only" hypothesis. An interpretation in terms of Bem's attribution theory was tentatively suggested.


Ego functioning and acute adverse reactions to psychoactive drugs. The relationship between ego functioning and acute adverse reactions to psychoactive drugs was examined using retrospective data. The data were consistent with a causal model in which characteristic use of regression (and to a lesser extent repression) was associated with acute adverse reactions to marijuana and to LSD. Regression also had an indirect effect through increased usage of LSD. Subjects characterized by the use of intellectualization and denial were less likely to report developing acute adverse reactions. A higher score on a general measure of coping was related to avoiding acute adverse reactions to LSD, but not to marijuana. Projection, regression in the service of the ego, and tolerance of ambiguity has no effect on acute adverse reactions.


Face validity of test and acceptance of generalized personality interpretations. After students in different groups took one of four "personality tests" that varied in face validity, they received a generalized personality interpretation. Even though the test lowest in face validity merely required the subject to circle digits, judged accuracy of the interpretation (a) was high for all tests (76-87% of the ratings in the various test groups were good or excellent) and (b) was independent of type of test upon which the interpretation was purportedly derived. From 46-60% of the subjects in the various groups "definitely liked" or "liked" the interpretation; likability was independent of face validity of the test. Judged accuracy and likability of the interpretation correlated positively and significantly. The willingness of individuals to accept generalized statements about themselves is a researchable problem area suggested by the present research.


Self-help with diagnosis (a self-administered semi-projective device). Studied the validity of a self-administered semi-projective packet of tests and questionnaires developed to provide quick, inexpensive information preparatory, or ancillary, to further diagnostic examinations. Brief writeups of inferences derived from the packet of tests were compared to diagnostic inferences based on from one to three psychiatric interviews, and with full examinations, which included psychiatric and social work interviews and extensive psychological testing. Generally, high comparability between the packet and both criteria were shown on questions of global diagnostic impression, character and defense, central conflicts, and basic ego functions; and significant information was often added by the packet to the data collected in diagnostic interviews. The patients filled out the packet forms conscientiously, and their written self-reports indicated that some patients could learn and otherwise benefit just from performing this task.


A criminal offender introspective report. The development of a new scale suitable for research with the criminal offender was described. Based on the factor analysis of an item pool delineating sociopathic personality traits, five factors were derived to compose an 80-item criminal offender introspective report (COIR).


Regression in the service of the ego in young children. Analysis of studies of primary process thinking as manifested in Rorschach and TAT production of young children (ages 6 to 10) indicate that children show approximately the same amount of primary process production as do young adults (48% vs 54%). However, this primary process does not appear to be clearly related to the child's creative, scholastic, or perceptual-motor development as measured by appropriate tests. High levels of primary process appear to be significantly related only to the negative qualities of the personality, that is, to high levels of tension, anxiety, and poor control of aggression. It is possible that young children have not yet learned to use it in the service of the ego, although they do not seem to be encumbered by its presence.


There is an alternative to the IQ.

There is an alternative to the IQ. Another approach was indicated for understanding the intellectual functioning of the person considered to be retarded from the viewpoint of measured intelligence. Rather than utilizing the standard, usually academically-oriented, test, the inkblot method was used to differentiate how the individual deals with familiar and unfamiliar problems. The emphasis was not on the predetermined responses and verbal meanings of the test constructor, but the language and mode of perceiving, organizing, and responding of the individual to the problems presented to him.


Response to cigarette deprivation as a function of oral fantasy. The role of oral fantasy in reactions of heavy smokers to smoking deprivation was studied. Experimental subjects were first evaluated with the Holtzman Inkblot Test to measure amount of oral fantasy. They also evaluated themselves on a number of Semantic Differential continua. Smoking deprivation followed. Retest Holtzman blots and Semantic Differential rating scales were then administered. Subjects also indicated number of somatic symptoms and body image distortions produced by deprivation. Control subjects followed the same paradigm except they smoked throughout the procedure. It was found that the greater the orality of experimental subjects the greater the number of somatic symptoms and body distortions they experienced following deprivation; and the more they viewed self as having shifted in a less favorable and less potent direction. Such relationships were absent in the control group.


The Mini-Mult with criminal psychiatric patients. In order to determine the usefulness of the Mini-Mult with criminal psychiatric patients, 107 MMPI profiles were rescored for the Mini-Mult and compared with the standard MMPI. Correlations between the two test forms were high but eight of the eleven means of the scales on the Mini-Mult were significantly different from the MMPI. A modest correspondence between indexes of psychopathology and scale peaks was found. Results were interpreted as indicating that the use of the Mini-Mult is not justified with this population.


Temporal relatedness: personality and behavioral correlates. The relationships between the tendency of subjects to perceive temporal zones as interrelated or discrete and other temporal behaviors and personality factors were explored in two studies, one using 115 college students and the other 60 college students, employing the Personal Orientation Inventory, the Temporal Orientation Inventory, and the Circles Test. Subjects who obtained higher time-relatedness scores were found to demonstrate greater self-actualization, evaluate the present time mode more positively, over-estimate time intervals in an estimation task, and to perform less accurately in time estimation than low time relaters.


Test-induced anxiety with children.

Test-induced anxiety with children. Thirty-five elementary school children received the WISC, Rorschach, CAT, and Sentence Completion Test in counterbalanced order with a test-test interval of approximately 24 hours. State and trait anxiety measures were assessed immediately prior to and immediately following each test administration. Results indicated that state anxiety measures increased significantly following administration of the more ambigious and school related assessment tests, namely the Rorschach and WISC. In contrast, the more structured, less amorphous CAT and Sentence Completion Test, did not induce any significant changes in state anxiety. In all cases, trait anxiety measures remained relatively stable. Implications for assessment techniques with children were discussed.


Masculinity-femininity in creative college women. The possible relationship between masculinity and creativity in college women was investigated through a battery of masculinity-femininity scales that tapped both manifest and latent masculinity, factorially derived clusters, and an ipsative measure. Two samples (n = 45 each) of women who had scored above the 75th percentile and below the 25th percentile respectively on two measures of creativity were used. High creative subjects scored higher on activity and described themselves as more masculine; indications are that they possess a broader, less stereotyped sex-role identity.


Development of a reaction inventory to measure guilt. The Reaction Inventory-Guilt was developed to isolate, in individuals, the specific stimulus situations which result in guilt. The 50-item inventory was administered to 96 subjects. The estimate of the internal consistency coefficient was .94. The inter-item correlations were factor analyzed by the principle axis method, and rotation to oblique simple structure was accomplished by the Promax method. Four oblique factors were obtained: intentional behavior disrupting interpersonal relations; self-destructive behavior; behavior contrary to moral or ethical principles; and unintentional behavior disrupting interpersonal relationships.


Comparative pharmacokinetics of coumarin anticoagulants. XIV: relationship between protein binding, distribution, and elimination kinetics of warfarin in rats. The relationships between the protein binding, distribution in the body, and kinetics of elimination of warfarin were studied. Individual rats eliminated warfarin by apparent first-order kinetics, with a biological half-life of 5.9-41 hr and a total plasma clearance of 2.4-22 ml kg(-1) hr(-1). There is a strong positive correlation between the apparent volume of distribution (Vd) and the elimination rate constant (kel). There was no apparent concentration dependance of warfarin binding to serum proteins over a wide concentration range, but there were pronounced intersubject variations in protein binding, with the free fraction of drug (f) in serum ranging from 0.172 x 10(-2) to 1.53 x 10(-2). There are strong positive correlations between f and kel, f and Vd, and f and the kidney-serum concentration ratio of warfarin. Consistent with theory, there is an excellent positive linear correlation between f and total plasma clearance of the drug. The intersubject variation in f is not related to variations in serum albumin or total protein concentration. There is a strong correlation between values of f for serum and liver homogenate in individual animals, consistent with the lack of correlation between f in serum and the liver-serum concentration ratio of warfarin. These results show that the pronounced intersubject variation in the elimination of warfarin observed in this investigation was related to interindividual differences in plasma protein binding of the drug. The differences in protein binding cannot be ascribed to differences in plasma protein concentrations and may reflect configurational differences of proteins or the presence of an endogenous displacing agent at different concentrations.


Solvolytic reactions of cyclic anhydrides in anhydrous acetic acid. The reversible reactions of several cyclic anhydrides with acetic acid to form acetic anhydride and the corresponding dicarboxylic acid, catalyzed by perchloric acid at 25degree, were studied. The equilibrium constants, calculated from spectral data, were 4.85 X 10-4, 1.08 X 10-1, and 4.6 X 10-1 M for succinic, trans-1,2-cyclohexanedicarboxylic, and glutaric anhydrides, respectively. Maleic, phthalic, and cis-1,2-cyclohexanedicarboxylic anhydrides did not undergo any detectable reaction with acetic acid under these conditions, suggesting still higher stability. The reverse rate constants were found to be relatively independent of the structure of the attacking diacid, while the forward rate constants were found to parrallel the equilibrium constants. The rate-determining step for the forward reaction appears to be the breakdown of the tetrahedral intermediate formed by the attack of an acetic acid molecule on the protonated cyclic anhydride.