Sodium channel beta1 and beta2 subunits parallel SNS/PN3 alpha-subunit changes in injured human sensory neurons

Voltage-gated sodium channels consist of a pore-containing alpha-subunit and one or more auxiliary beta-subunits, which may modulate channel function. We previously demonstrated that sodium channel SNS/PN3 alpha-subunits were decreased in human sensory cell bodies after spinal root avulsion injury, and accumulated at injured nerve terminals in pain states. Using specific antibodies for immunohistochemistry, we have now detected sodium channel beta1 and beta2 subunits in sensory cell bodies within control human postmortem sensory ganglia (78% of small/medium (< or = 50 microm) and 68% of large (> or = 50 microm) cells); their changes in cervical sensory ganglia after avulsion injury paralleled those described for SNS/PN3 alpha-subunits. Our results suggest that alpha- and beta-subunits share common regulatory mechanisms, but present distinct targets for novel analgesics.

Plasticity of TTX-sensitive sodium channels PN1 and brain III in injured human nerves

Sensory neurones co-express voltage-gated sodium channels that mediate TTX-sensitive (TTX-S) and TTX-resistant (TTX-R) currents, which may contribute to chronic pain after nerve injury. We previously demonstrated that TTX-R channels were decreased acutely in human sensory cell bodies after central axotomy, but accumulated in nerve terminals after peripheral axotomy. We have now studied the TTX-S channels PN1 and Brain III, using specific antibodies for immunohistochemistry, in dorsal root ganglia (DRG) from 10 patients with traumatic central axotomy, nerves from 16 patients with peripheral axotomy, and controls. PN1 showed temporal changes similar to the TTX-R channels in sensory cell bodies of injured DRG. In contrast, Brain III was found only in injured nerves (not control nerves, or control/central axotomy DRG). PNI and Brain III are distinct targets for novel analgesics.

DNA preparation method can influence outcome of transgenic animal experiments

In our continuing quest to improve the efficiency of producing transgenic animals, we have compared the influence of two transgene purification techniques on the efficiency of creating transgenic sheep and mice. Three hundred eighty-seven sheep zygotes and 2,737 mouse zygotes were microinjected with one of four transgenes. Transgenes were isolated from plasmid sequences either by agarose gel electrophoresis followed by gel extraction or by a single step sodium chloride gradient fractionation technique. Four transgenic sheep and 61 transgenic mice were produced. Both sheep and mice embryos responded similarly to transgene preparation methods. Overall, pregnancy rate was higher for recipients that received embryos injected with NaCl purified DNA (mean +/- SEM: 64 +/- 7% vs. 38 +/- 7%). Furthermore, offspring per zygote transferred (NaCl, 22 +/- 3% vs. Gel, 12 +/- 3%) and transgenics born per zygote transferred (NaCl, 3.9 +/- 0.6% vs. Gel, 1.5 +/- 0.6%) were higher when the NaCl purified DNA was used. However, the proportion of offspring born that were identified as transgenic did not differ between transgene purification methods. Transgenes responded differently to methods of preparation. One of the four genes yielded a significantly higher proportion of transgenics when the transgene was prepared by NaCl purification. These data suggest that on average the NaCl gradient purification technique results in a higher embryo survival rate to term for both sheep and mice, but the technique has no influence on rate of transgene integration.

Heparan sulfate: decoding a dynamic multifunctional cell regulator

The heparan sulfates are a family of cell-surface and matrix polysaccharides with an incredible degree of structural diversity that are distributed widely in virtually all metazoan organisms. Recent genetic, biochemical and cell-biological studies have led to increased understanding of the biosynthetic mechanisms that produce these complex molecules, as well as their functional versatility in regulating protein activities. The dynamic expression of heparan sulfates with differing sugar sequences suggests a new concept in which the repertoire of sequences produced by a particular cell or tissue is designated its 'heparanome'. This review discusses recent developments and surveys emerging experimental strategies that hold promise for revealing the functional specificity and mechanisms of action of heparan sulfates as multifunctional cell regulators.

Constitutive nitric oxide release modulates neurally-evoked chloride secretion in guinea pig colon

The role of constitutive nitric oxide (NO) release in enteric neural pathways regulating ion transport was examined in guinea pig distal colon, in vitro and ex vivo. In in vitro studies, 43% of colonic preparations exhibited oscillations in baseline short-circuit current (Isc), which were reduced by tetrodotoxin (TTX). The NO chelator, hemoglobin (Hb), and neuronal NO synthase inhibitor, 7-nitroindazole (7-NI), significantly increased the baseline Isc in these tissues, which was reduced by TTX. In tissues without oscillations in baseline Isc, Hb reduced the Isc, while 7-NI had little effect. In all tissues, electrical field stimulation (EFS; 15 V/10 Hz) caused a biphasic increase in the Isc which was enhanced by both Hb and 7-NI. In the ex vivo studies, basal release of nitric oxide was significantly lower in colonic segments isolated from guinea pigs administered N omega-nitro-L-arginine methyl ester (L-NAME) i.p. compared to control tissues. Moreover, carbachol, caused a 10-fold increase in NO release in control tissues, but had no effect in tissues isolated from the L-NAME group. L-NAME increased tissue conductance and EFS-induced changes in Isc, which were reversed by L-arginine. However, carbachol-induced ion secretion was unaltered in the L-NAME group compared to control animals. The results suggest that, in guinea pig colon, constitutive enteric NO release tonically suppresses submucous neural activity and it is involved in the maintenance of basal epithelial chloride secretion and mucosal permeability. Hence, constitutive NO promotes a delicate balance between pro-absorptive and pro-secretory processes in guinea pig colon.

[Right bundle branch block and ST-segment elevation in right precordial leads: a marker for sudden cardiac death]

The authors present a patient with a specific ECG pattern and a history of syncope and malignant ventricular arrhythmias. Patients without demonstrable structural heart disease and an ECG pattern of RBBB and ST segment elevation in leads V1 through V3 are at risk for sudden cardiac death. They demonstrate the role of cardiac electrophysiology study including programmed ventricular stimulation and pharmacological testing in evaluation of patients with possible Brugada syndrome. The authors emphasize the role of implantable cardioverter defibrillator (ICD) therapy in treatment of patients with Brugada syndrome.

Problem drinking profiles of patients presenting to general practitioners: analysis of Alcohol Use Disorders Identification Test (AUDIT) scores for the Auckland area

AIM

To quantify the prevalence and demography of at-risk and problematic drinkers in the population attending a random selection of general practices and to compare this with similar studies.

METHOD

A study examining the uptake and utilisation of the "DRINKLESS" package to 369 New Zealand general practitioners was conducted during 1995/6. The "DRINKLESS" package was developed with the World Health Organisation collaborative study for brief intervention for at-risk alcohol consumption. The package uses the Alcohol Use Disorders Identification Test (AUDIT). There were 15,670 completed AUDIT questionnaires collected during the study. These were analysed to ascertain the prevalence and demography of at-risk and problematic drinkers attending general practitioners.

RESULTS

There were 16% of patients identified as having either "risky drinking" or "problematic or dependent drinking". This pattern varied according to the occupation, age and gender of patients.

CONCLUSIONS

The data confirm that large numbers of patients presenting to general practitioners experience alcohol problems of varying degrees. This study also suggests that the AUDIT will have satisfactory detection rates in a primary care setting.

Initial results of reteplase in the treatment of acute lower extremity arterial occlusions

PURPOSE

To assess the feasibility and efficacy of reteplase in transcatheter arterial thrombolysis for lower extremity occlusive disease.

MATERIALS AND METHODS

Fifteen consecutive patients with acute lower extremity ischemia due to occlusive disease were treated by means of catheter-directed thrombolysis with reteplase. Following diagnostic angiography, thrombolysis was started either from an antegrade puncture site in cases of femoropopliteal occlusions, or from the contralateral groin in cases of thrombosis of the iliac artery, common femoral artery, or infrainguinal bypass grafts. Reteplase was infused at a rate of either 0.5 U/h (six patients) or 1.0 U/h (nine patients).

RESULTS

Complete thrombolysis was achieved in all of the nine (100%) patients in the 1.0 U/h group and in four of six (66%) patients in the 0.5 U/h group for a combined success rate of 13 of 15 (87%). Clinical success was achieved in 11 of 15 patients overall (73%). Major bleeding complications occurred in none of the 9 patients in the 1.0 U/h group and in one (16%) of the six patients in the 0.5 U/h group for an overall rate of 6%.

CONCLUSIONS

Reteplase shows promise as an alternative to urokinase in the treatment of lower extremity ischemia due to arterial occlusive disease.

Ultrastructural and karyotypic examination of in vitro produced bovine embryos developed in the sheep uterus

This study examined whether development of bovine in vitro produced (IVP) blastocysts in the sheep uterus resulted in morphologically and karyotypically normal elongation stage bovine blastocysts. Seven day IVP bovine blastocysts, resulting from either in vitro maturation and fertilization, nuclear transfer (NT), or parthenogenic activation, were surgically transferred at the blastocyst stage into sheep uteri. Sheep were sacrificed after 7-9 days, and blastocysts were flushed from their uteri. One of each kind of IVP bovine blastocyst was recovered from sheep uteri for analysis by transmission electron microscopy, and nine NT blastocysts were used to establish cell cultures that were analysed for chromosome complement. TEM analysis of in vivo-derived elongation stage bovine and ovine blastocysts was done for comparative purposes. Most ultrastructural features of the 13-19 day blastocysts were similar to earlier stage blastocysts except that distinct alternative mitochondrial morphologies were found between epiblast and trophectoderm cells. Monociliated cells, presumably nodal cells, were observed in the bovine epiblast and hypoblast, and retrovirus-like particles were elaborated by cells in these same areas. Development in the sheep uterus of IVP bovine blastocysts resulted in the presence of crystalloid bodies in the trophectoderm cells, and apoptotic and necrotic cells were observed in the epiblast tissue. Thus, in vivo incubation in the sheep uterus allowed nearly normal development to the elongated blastocyst stage and may be useful for assessment of NT bovine blastocyst developmental competence. Cell cultures derived from the NT blastocysts had normal chromosome complements suggesting that activation by ionomycin and 6-dimethyl-aminopurine did not cause detrimental changes in ploidy in those blastocysts that developed.

Controlled Formation of Low-Volume Liquid Pillars between Plates with a Lattice of Wetting Patches by Use of a Second Immiscible Fluid

We describe a method for forming an array of microdroplets between two plates, at least one of which is patterned with a lattice of wetting patches, using a second immiscible fluid to control droplet formation. The method may be useful for performing multiple, small-volume biochemical reactions in parallel. We analyze the forces responsible for droplet formation, describe results of a computer simulation using Surface Evolver, and derive an analytic criterion for droplet formation in terms of the contact angles of the droplet:second fluid interface on the wetting patches and surrounding surface, the diameter of the wetting patches, the distance between wetting patches, and the distance between the plates. Copyright 1999 Academic Press.

Soul consciousness and human suffering: psychotherapeutic approaches to healing

A clinical approach to the understanding of disturbances of the psyche that otherwise would be regarded as pathological states of mind is described. A parallel is drawn between psychoanalytic object relations theory and "spiritual object relations," working from the premise that mind comes before matter. A number of clinical examples illustrate how both psychological and spiritual interpretations may be applied and that highlight the need for psychiatrists to be open to the transpersonal frame of reference.

Wooden foreign bodies in soft tissue: detection at US

PURPOSE

To evaluate the use of ultrasound (US) for detection of wooden foreign bodies implanted in cadaveric specimens.

MATERIALS AND METHODS

Wooden foreign bodies were randomly placed in the plantar soft tissues of three cadaver feet by using 5-mm-long incisions. Ten foreign bodies were 2.5 x 1.0 mm (length x diameter); 10 were 5.0 x 1.0 mm. Ten incisions were performed without implantation of foreign bodies. Three musculoskeletal radiologists independently performed US in blinded fashion and recorded the presence of a foreign body. Each used 7.5- and 10-MHz linear-array transducers and was informed of the possible presence of a foreign body.

RESULTS

Sensitivity and specificity for detection of 2.5-mm-long foreign bodies were 86.7% and 96.7%, respectively. Sensitivity and specificity for detection of 5.0-mm-long foreign bodies were 93.3% and 96.7%, respectively. Overall sensitivity was 90.0%, with specificity of 96.7%, accuracy of 92.3%, positive predictive value of 98.0%, and negative predictive value of 83.0%.

CONCLUSION

US can be used effectively to locate wooden foreign bodies as small as 2.5 mm in length. Given that many foreign bodies are radiographically undetectable, the accuracy and availability of US make it an excellent modality for evaluation of radiolucent foreign bodies.

Incentives for general practitioners to provide brief interventions for alcohol problems

AIMS

To assess current practices and attitudes of general practitioners towards prevention and intervention with problem drinkers.

METHODS

GPs randomly selected in the Central and Southern Health Regions answered a 134 item questionnaire on their involvement with patients with alcohol related problems.

RESULTS

In all, 136 general practitioners responded representing 85% of those approached. When asked how often they provided interventions with alcohol problems, 86% reported managing under 13 patients per year, indicating an intervention rate of less than 1% of the mean practice size. In terms of disease prevention, 86% rated 'drinking moderately' as important but this endorsement ranked fifth behind other lifestyle behaviours such as 'not smoking' at 99%. When asked about their perceived role, they indicated higher role legitimacy but lower work satisfaction with alcohol problems. In terms of training, three-quarters stated they had received less than eleven hours of postgraduate alcohol education. They also rated their current effectiveness with alcohol problems as substantially less than potential effectiveness. They indicated the main obstacles to be: government funding policies, lack of adequate training and a need for improved resources and support services.

CONCLUSIONS

With research having established the effectiveness of interventions for harmful alcohol consumption, attention has shifted to ways of engaging general practitioners in providing interventions. This study highlighted how changes to government health policy and improved competency and skilled based training could lead to a greater acceptance by general practitioners of the role they could play in reducing alcohol related problems.

Synthesis and secretion of the mouse whey acidic protein in transgenic sheep

The synthesis of foreign proteins can be targeted to the mammary gland of transgenic animals, thus permitting commercial purification of otherwise unavailable proteins from milk. Genetic regulatory elements from the mouse whey acidic protein (WAP) gene have been used successfully to direct expression of transgenes to the mammary gland of mice, goats and pigs. To extend the practical usefulness of WAP promoter-driven fusion genes and further characterize WAP expression in heterologous species, we introduced a 6.8 kb DNA fragment containing the genomic form of the mouse WAP gene into sheep zygotes. Two lines of transgenic sheep were produced. The transgene was expressed in mammary tissue of both lines and intact WAP was secreted into milk at concentrations estimated to range from 100 to 500 mg/litre. Ectopic WAP gene expression was found in salivary gland, spleen, liver, lung, heart muscle, kidney and bone marrow of one founder ewe. WAP RNA was not detected in skeletal muscle and intestine. These data suggest that unlike pigs, sheep may possess nuclear factors in a variety of tissues that interact with WAP regulatory sequences. Though the data presented are based on only two lines, these findings suggest WAP regulatory sequences may not be suitable as control elements for transgenes in sheep bioreactors.

Surgical voice restoration: the Sunderland experience

Surgical voice restoration following tracheo-oesophageal puncture is a well established procedure and the principal means of speech rehabilitation following laryngectomy and more recently laryngopharyngectomy. A valve prosthesis was used in 65 patients, 50 of whom underwent insertion at the time of surgery. Of the 65, 49 were men, 16 women and 15 have since died; the median length of follow-up of valves in situ has been 24.7 months (range 2-46 months). Of the 50 living patients 80% were using the valve at last examination. Complications arose in 52% but were generally minor and easily overcome.

Development of transgenic sheep that express the visna virus envelope gene

The ovine lentiviruses cause encephalitis, pneumonia, and arthritis in sheep worldwide. Visna virus is a prototype of this family and the pathogenesis and molecular biology of the virus has been well characterized. The envelope proteins of visna virus are responsible for binding of virus to host cells and for causing cell fusion. The surface glycoprotein also elicits cellular and humoral immune responses to the virus, the former being thought to be responsible for eliminating infected cells as well as causing inflammatory lesions. In this study, transgenic sheep were constructed that expressed the envelope genes of visna virus under the control of the visna LTR to investigate the role of the env gene in the pathogenesis of lentiviral disease in its natural host. Three transgenic lambs were identified that contain the env transgene and express the envelope glycoproteins. These transgenic animals have remained healthy and expression of the viral gene has had no obvious deleterious effect. Expression of the visna envelope protein was demonstrated by cell fusion mediated by the envelope gene as well as by immunoprecipitation of the envelope proteins with monoclonal antibodies and immunofluorescence analyses of Env protein in cells. The target cell for visna virus replication in infected animals is the monocyte/macrophage. In natural infection, the level of viral gene expression in these cells increases with cell maturation. In the transgenic sheep, monocytes did not express the envelope glycoproteins until they differentiated into macrophages in vitro. Expression of the env mRNA in macrophages was quantitated by an RNase protection assay. In addition to expression in macrophages, the transgene was expressed by fibroblasts isolated from skin of the transgenic sheep. Expression of both the Env and Rev proteins was detected by immunoprecipitation and immunofluorescence. Two of the three lambs responded immunologically to the expression of the transgene by producing binding antibodies to the envelope glycoproteins. Thus, these transgenic sheep provide a model to study whether a lentivirus glycoprotein will prevent infection or modulate disease in its natural host after virus challenge.

Cardiovascular and other physical effects of acute administration of naltrexone in autistic children

ABSTRACT The physical side effects of acutely administered naltrexone (0.5, 1.0, 1.5, and 2.0 mg/kg, orally) were compared with placebo in 13 children (3-12 years old) with autism. Heart rate, systolic blood pressure, mean arterial blood pressure, and axillary body temperature were obtained before and 1 h after placebo or drug administration. Serum concentrations of the liver enzymes glutamic-oxaloacetic transaminase (SGOT) and glutamic-pyruvic transaminase (SGPT) were obtained 1 h and 24 h after drug. In comparison with placebo, no significant effects of any of the four doses of naltrexone were found on any of these measures. Three hours after administration, there were no significant effects of acute naltrexone on EKG parameters (heart rate, axis, PR, QRS, QT, or QTc) compared to predrug values. These data support the safety of acute administration of naltrexone on vital signs, EKG, and liver function in preadolescent children with autism and are consistent with studies in healthy normotensive adults. In view of prior findings that naltrexone can alter cardiovascular function in certain pathologic states (including some that involve increased opioid peptide activity) and findings of increased opioid activity in some autistic individuals, the absence of cardiovascular effects of naltrexone in autistic children is tentatively suggestive of the safety of acutely administered naltrexone. Since chronic high doses of naltrexone can increase liver transaminase levels in adults, it remains advisable for clinicians to monitor liver function in children receiving chronic naltrexone treatment. Other adverse effects of acute naltrexone in these children appeared to be minimal.

Efficacy of a tiered therapy defibrillator system used to treat recurrent ventricular arrhythmias refractory to drugs

OBJECTIVE

To evaluate an implantable tiered therapy defibrillator system that delivered antitachycardia pacing treatment for slower well tolerated ventricular tachycardias and cardioversion or defibrillation for fast tachycardias or ventricular fibrillation.

METHODS

A tiered treatment device (Ventritex Cadence V-100) was implanted in 30 patients with ventricular tachycardia that was refractory to drugs. Efficacy was evaluated by the responses of induced or spontaneous arrhythmias to the treatments delivered.

RESULTS

Antitachycardia pacing successfully terminated 80% of episodes of ventricular tachycardia induced by non-invasive programmed stimulation, but acceleration was brought about by pacing in six patients in 10% of episodes. During a follow up of two to 17 (mean seven) months, 18 patients (60%) had recurrence of ventricular arrhythmias. Antitachycardia pacing terminated ventricular tachycardia in 17 of 18 patients in 87% of episodes. Twelve patients received shocks for ventricular tachycardia or fibrillation. Failure of pacing, with subsequent cardioversion, occurred in nine patients (50%) in one or more episodes. Acceleration of tachycardia by pacing occurred in 10 patients in 5% of episodes. Only two of these patients had experienced acceleration of previously induced arrhythmia. Five patients had spontaneous fast ventricular tachycardia or fibrillation treated by cardioversion or defibrillation. Spurious treatment was delivered in nine patients (30%), during atrial fibrillation in five, sinus tachycardia in two, and because of fracture of the sensing lead system in two patients. The retrieval of stored intracardiac electrograms was of clinical value in assessing spurious treatment.

CONCLUSIONS

Tiered treatment was effective in terminating recurrent ventricular arrhythmias in these selected patients. Most episodes were treated successfully by pacing, and resistant tachycardias, pacing induced acceleration, or haemodynamically compromising arrhythmias were treated by shocks.

Human and rodent fibroblasts - model systems for studying senescence and immortalization (review)

Normal mammalian fibroblasts cultured in vitro will not divide indefinitely but undergo senescence and give rise to cells that can no longer be induced to divide. It is possible to overcome this finite life span by either cellular mutation or by the exogenous introduction of some viral or cellular oncogenes. This review describes the characteristics of senescence and the different ways in which it can be overcome.

Biochemical and physiological characterization of the efrotomycin fermentation

An efrotomycin fermentation was characterized through physical, chemical and biochemical studies. Growth of the actinomycete, Nocardia lactamdurans occurred during the first 50 h of the fermentation cycle at the expense of glucose, protein, and triglycerides. The initiation of efrotomycin biosynthesis was observed when glucose dropped to a low concentration. Upon glucose depletion, cell growth ceased and a switch in the respiratory quotient occurred. Efrotomycin biosynthesis was supported by the utilization of soybean oil and starch. Analysis of triglyceride metabolism showed that no diglycerides or monoglycerides accumulated during the fermentation. The activity of extracellular enzymes (lipase, protease, and amylase) increased during the cell growth phase and decreased significantly after 150 h. The concentrations of DNA, tetrahydro-vitamin K2 (a membrane component), and free amino acids in the supernatant increased dramatically late in the fermentation cycle (225 h), indicating massive cell lysis. During this same time period, a reduction in cellular respiratory activity and efrotomycin biosynthesis were observed.

A Bootstrap Confidence Interval Based on a Correlation Corrected for Range Restriction

The sample correlation coefficient corrected for range restriction was bootstrapped to obtain a confidence interval on the unrestricted population correlation, rho. The technique was evaluated using a computer simulation under different values of rho and four distributions (normal, mixed, positively skewed and negatively skewed). The corrected correlation coefficient yielded accurate bootstrap intervals over the four distributions. On the average, the size of rho did not affect the accuracy of the confidence interval. However, it did affect stability. The interval behaved rather erratically when rho was small (.1) and sample size was small. Sample size was found to be the most important factor in determining accuracy and stability. Overall, the results suggest that bootstrapping the corrected correlation coefficient is a reliable method for obtaining a confidence interval on rho especially when the sample size is moderate to large (n > 50).

Dyskinetic movements, cognitive impairment, and negative symptoms in elderly neuropsychiatric patients

The presence or absence of tardive dyskinesia, cognitive status, and psychopathology were assessed in a group of elderly male psychiatric patients (N = 49) in a nursing home setting. Twenty-five patients were found to have tardive dyskinesia, which was associated with a greater degree of cognitive impairment and negative symptoms. This finding was not related to obvious macroscopic organic pathologies, which were less prevalent in the dyskinetic patients. In fact, patients with frontal lesions (primarily lobotomies) had a significantly lower prevalence of tardive dyskinesia.

Is group psychotherapy feasible for oncology outpatients attenders selected on the basis of psychological morbidity?

Of 120 consecutive attenders at an oncology outpatients department, 108 were screened for psychological symptoms using the Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983). Thirty-nine patients had significant scores indicating moderate anxiety and/or depression. We felt that this warranted an offer of group psychotherapy in the belief that sharing issues and exploring personal concerns may alleviate some of the experienced psychological distress. Only 10 patients consented to and were able to attend this group, with which five patients persisted. Thus in this group of patients with advanced cancer group psychotherapy was applicable only to a limited number of selected patients. The nature of this study and the size of the population markedly limited our ability to comment on the usefulness of group psychotherapy. Many patients, particularly the most severely psychologically distressed, continued to require other forms of support, particularly domiciliary individual therapy.

The five year school medical--time for change

School medical records of 1000 children born in 1981 were studied retrospectively. They showed that once known medical problems and those screened for by the school nurse (hearing, vision, growth) were excluded, only 17 problems requiring treatment were discovered: speech (n = 10), development (n = 3), undescended testes (n = 3), and phimosis (n = 1). This indicates that routine screening by a nurse, backed up by selective medical examination by the school doctor, is efficient and effective.

Infundibular metastasis and panhypopituitarism

A patient with no known history of primary neoplasia presented with panhypopituitarism secondary to metastasis. Complete anterior pituitary failure was documented by pituitary reserve testing. However, at autopsy there was extensive carcinomatous invasion of the hypothalamus and infundibulum but no adenohypophyseal involvement. The possibility of metastatic disease should be considered in patients presenting with panhypopituitarism. The literature covering this topic is reviewed.

Dissecting aneurysm of a right-sided descending aorta with a left-sided aortic arch

A 66-year-old man presented with myocardial infarction. Chest X-ray showed a large mediastinal mass. Aortic dissection was suggested by a past history of chest trauma, but the mass was in a very atypical site. Dissection of an abnormally placed right-sided descending aorta was confirmed by computed tomography. The aortic arch lay on the left side. This rare combination of congenital and acquired heart disease led to diagnostic difficulty.

Adolescents' attitudes about nuclear war

913 students from 6 junior and senior high schools in California responded to a 20-item questionnaire using 4-point Likert-type ratings to indicate their 3 greatest worries, to the State-Trait Anxiety Inventory, and nuclear-war-related items. On forced-choice items concerns were parents dying for 53.5%, getting bad grades for 37.0%, and nuclear war for 31.9%; however, the three greatest worries were parents dying for 54.9%, nuclear war for 32.8%, and bad grades for 25.9%. Older adolescents were less worried than younger ones, but there were no differences for sex or socioeconomic status, or for race on several items. On derived factor scores students classified as high in worry (about nuclear war) scored higher on Social Issues than low worriers but scored lower on Psychosocial Concerns. Implications for education are discussed.

Mineral balances of men and women consuming high fiber diets with complex or simple carbohydrate

Calcium, copper, iron, magnesium, manganese, and zinc balances of 20 men, 19 premenopausal women, and 12 postmenopausal women were determined while they consumed self-selected diets or high fiber diets with either complex or simple carbohydrate. Self-selected intakes of calcium, magnesium, copper and zinc were generally below RDA levels. Iron intakes of premenopausal women were less than two-thirds RDA. Balances during the self-selected intake period of calcium in men and women and of magnesium and zinc in women were negative, but lower-than-usual intakes could have contributed to this. High fiber diets did not adversely affect zinc, copper, manganese or iron balances. Calcium and magnesium balances were generally negative, especially in women, even though intakes were adequate. Excretion of copper was increased in premenopausal women consuming the simple carbohydrate diet. The levels of magnesium and especially calcium needed to maintain balance when consuming a high fiber diet may be above present RDA levels.

Adrenergic receptors in human liver plasma membranes: predominance of beta 2- and alpha 1-receptor subtypes

Adrenergic receptors in human liver plasma membranes were characterized by radioligand binding assays. The binding of [3H]dihydroalprenolol [( 3H]DHA) to partially purified membranes was rapid, of high affinity, saturable, and stereospecific. The binding of [125I]iodocyanopindolol to the same membranes was also saturable and stereospecific, but extremely slow, and at 37 C required about 6 h for equilibration. The maximum number of binding sites from six livers determined with these two beta-receptor ligands was 36-83 fmol/mg protein. Catecholaminergic agonists competed for these binding sites in the order typical for beta 2-adrenergic receptors. IPS 339 [(tertiarybutylamino-3-ol-2-propyl)oximino-9-fluorene hydrochloride], a beta 2-selective antagonist, was at least 3 orders of magnitude more potent in inhibiting the binding of [3H]DHA than the beta 1-antagonist, atenolol. Computer-aided analysis of the competition curves as well as Hofstee transformations of the binding data indicated the predominance of the beta 2-subtype. The GTP analog guanyl-5'-yl-imidodiphosphate, decreased the binding affinity of the agonist, l-isoproterenol, indicating the modulation of agonist-promoted coupling of the receptors to guanine nucleotide regulatory proteins. The maximum number of binding sites for the binding of [3H]prazosin and [3H]dihydroergocryptine were the same (60-70 fmol/mg protein), indicating that the majority of the alpha-receptors are of the alpha 1-subtype. Competition experiments with prazosin and yohimbine confirmed the predominance of the alpha 1-receptor subtype, although the presence of alpha 2-receptors cannot be completely ruled out. These results indicate that adrenergic receptors in human liver plasma membranes are predominantly of the beta 2- and alpha 1-subtypes.

Effects of sugars on indices of glucose tolerance in humans

Ten men and nine women were studied to determine whether replacement of utilizable complex carbohydrate by sugars (mono- and disaccharides) in a high-fiber, low-saturated fat diet would affect indices of glucose tolerance. Diets differed in that the 50% of calories derived from carbohydrate was either 35% complex and 15% sugars (low-sugar) on 15% complex and 35% sugars (high-sugar). Summation of glucose responses 30-180 min following an oral glucose tolerance test was significantly higher in men, but not women, after they consumed the high-sugar diet. Corresponding insulin responses were significantly higher in men consuming the high-sugar compared to the low-sugar diet. Insulin binding was significantly lower during the base line period and after the high-sugar diet compared to the low-sugar diet. Results indicate that sugars adversely affect indices of glucose tolerance when they replace complex carbohydrates even in a high-fiber, low-saturated fat diet.

Relationship of maternal behavioral style to the development of organically impaired mentally retarded infants

The relationship of maternal behavioral style to the cognitive developmental status of 60, 1-, 2-, and 3-year-old organically impaired, mentally retarded children was investigated. Eighteen global maternal behaviors and four child behaviors were rated on a 10-minute video tape of mother-child play. A factor analysis of the maternal behavioral items revealed three major parameters of behavior. Child-Oriented/Maternal Pleasure was related positively, whereas Quantity of Stimulation and Control were related negatively to Children's Bayley Mental Development scores. Maternal behavioral style was not related to either the ratings of the children's behavior or to the children's current health status and family SES, but was related to the amount of time children had been in intervention programs. Findings were discussed in terms of their implications for intervention with mothers and their retarded infants.

Bone grafting: role of histocompatibility in transplantation

The role of histocompatibility matching in bone allografting was studied in two canine bone graft models. In a cancellous ulnar segmental replacement model, frozen bone allografts exchanged between closely matched dogs were significantly better incorporated by radiographic and histologic criteria than were strongly incompatible grafts. Frozen allografts from disparate donors in recipients receiving immunosuppression appeared indistinguishable 6 months later from those in the untreated closely matched groups and from fresh autografts. Fresh vascularized orthotopically placed fibular bone grafts were evaluated by quantitative blood flow assessment, microangiography, and fluorochrome histomorphometry. Revascularized grafts exchanged between untreated closely matched dogs demonstrated preservation of blood flow and a pattern of repair that was delayed but not otherwise different than vascularized autografts. These results suggest that fresh vascularized grafts in the judiciously matched or immunosuppressed recipient offer attractive clinical possibilities.

Autogenous vein graft to restore ureteric continuity in dogs

Free, autogenous vein segments were grafted to restore continuity of partially excised ureters in 12 mongrel dogs. Shortening and stricture formation of the vein graft occurred over the following four weeks. There was external adhesion around the graft but no urinary leakage, pooling or fistula. Intubation of the graft maintained patency but shortening occurred. Once the tube was removed, stricture formation and complete obliteration of the lumen of the graft occurred over the following few weeks. Prolonged splinting by biologically inert material may facilitate luminal patency and urothelial lining of the fibrous remnant of the venous graft. Gradual shortening of the graft eventually allows end-to-end anastomosis, without tension, as a second stage procedure.

Renal hemangioendothelioma

Renal hemangioendothelioma (HE) is an extremely rare malignant tumor. The sixth case is presented and all six analysed. The tumor affects middle-aged persons of either sex with past history of chronic renal disease and very recent onset of renal pain and hematuria. Anemia is common and a renal mass or tenderness is present. Pyelography shows poor function hydronephrosis, filling defect or collecting system distortion. A radical nephrectomy and radiotherapy is indicated and histology establishes the diagnosis. Renal HE appears to take a hurricane course and local recurrence and widespread vascular metastases occur in a matter of days or weeks after traditional cancer therapy. Industrial carcinogenesis is likely while chronic renal disease may predispose.

An overview of a multifactor-system theory of personality and individual differences: III. Life span development and the heredity-environment issue

In Part III of this three-part series on multifactor-system theory, multivariate, life-span development is approached from the standpoint of a quantitative and qualitative analysis of the ontogenesis of factors in each of the six systems. The pattern of quantitative development (described via the Gompertz equation and three developmental parameters) involves growth, stability, and decline, and qualitative development involves changes in the organization of factors (e.g., factor differentiation and convergence). Hereditary and environmental sources of variation are analyzed via the factor gene model and the concept of heredity-dominant factors, and the factor-learning model and environment-dominant factors. It is hypothesized that the sensory and motor systems are heredity dominant, that the style and value systems are environment dominant, and that the cognitive and affective systems are partially heredity dominant.

Immunological basis of close-contact sensitization to osteosarcoma

Normal persons with a history of close contact with cancer patients often given positive responses in tests for specific tumor immunity. The present study was designed to establish the immunological relevance of such reactivity. Leukocyte adherence inhibition analysis was used to test responses of osteosarcoma (OS)-positive donors to extracts of OS. The test system proved highly specific in that positive leukocyte adherence inhibition responses were detected in 35 of 39 OS patients while only 6 to 7% of the controls were positive. Thus, the test system appears useful in the detection of OS. Two persons reactive presumably because of exposure to OS tissue gave booster-like leukocyte adherence inhibition responses on each reexposure. Reactivity was abrogated by treatment of their leukocytes with a goat anti-T-cell immunoglobulin G. Thus, the reactivity of cells from normal donors exposed to OS probably has an immunological basis, since the test system was highly specific, reflected anamnestic reactivity, and depended on lymphocytes (probably thymus dependent). These findings suggest that an OS-associated antigen can be transmitted horizontally, but the relation of immunity to risk remains obscure.

Antigenic specificity and cellular mechanisms in leukocyte adherence inhibition analysis of immunity to simple proteins and hapten-protein conjugates

The hemacytometer leukocyte adherence inhibition (LAI) assay was investigated with respect to immunological relevance, specificity, and cellular mechanisms. Humans were immunized to keyhole limpet hemocyanin, and rats were immunized to dinitrophenyl-bovine gamma-globulin. LAI analysis disclosed classic patterns of immune response kinetics. The LAI response was dose dependent in vitro with no inhibition at relatively high antigen doses. In vitro specificity in rats was restricted to the immunizing conjugate. Cells forming spontaneous E-rosettes were required for LAI reactions. Lymphokine production required the presence of E-rosette-forming cells. E-rosette-forming cells from normal donors lost adherence in the presence of lymphokine. The requirement for T-lymphocytes was confirmed in a human osteosarcoma system using independent criteria. Thus, the hemacytometer LAI depends upon T-lymphocyte collaboration via a lymphokine. It should be distinguished from the tube and microplate variants of LAI analysis because these appear to depend upon different mechanisms.