The Hamilton Anxiety Scale. Evaluation of homogeneity and inter-observer reliability in patients with depressive disorders

In the present study the Hamilton Anxiety Scale (HAS), originally constructed for patients with neurotic anxiety, has been applied to patients with diagnosis of depressive disorders. The inter-rater reliability and homogeneity are evaluated and total scale score has been correlated to the Bech-Rafaelsen Melancholia Scale (BRMES). Twenty-two patients entered the study, 13 with endogenous depressions, and 9 with non-endogenous depressions when classified according to the ICD-8. For both scales the inter-rater reliability was found statistically significant. Concerning the homogeneity of the HAS, statistical significance was obtained for 7 items reflecting psychic anxiety, whereas in the BRMES statistical significance was found in all items apart from 2. Total scale score on HAS correlated positively with total score on BRMES for all 2 patients. However, when the patients were classified according to the ICD-8 this correlation seemed to be due to the endogenously depressed group as no significant correlation was seen for the group of non-endogenous depression. On the other hand, when the patients were classified according to the MULTI-CLAD system no significant intercorrelation of the HAS and BRMES scores was found within the subtypes of depression.

Analysis of the base substitutions found in the Xenopus laevis 5 S RNA pseudogene

A 5 S RNA pseudogene is associated with the major oocyte 5 S RNA gene of Xenopus laevis. X. borealis has several oocyte specific 5 S RNA genes. Gene 1 is the dominant 5 S RNA gene. Gene 3 has sometimes been referred to as a pseudogene. We show that the base substitutions in the X. laevis 5 S pseudogene are non-random with respect to double and single-stranded regions of the 5 S RNA using the chi 2 test of homogeneity with Yates correction for continuity. In addition, conserved positions of eukaryotic 5 S RNAs are predominantly maintained. X. borealis gene 3 is random in mutations.

Bone marrow necrosis. Report of a case and a brief review of the literature

Bone marrow necrosis (BMN) is a rare finding in specimens from living patients. It is most commonly found in patients with neoplastic disorders, severe infections and sickle cell disease. We present a patient with Hodgkin's disease who developed extensive BMN 11 months before death. A concise review of the literature is also presented.

IgD-Fc receptors on normal and neoplastic human B lymphocytes

Lymphocytes from normal peripheral blood and human lymphoid tumours were studied for AggIgD binding. In normal blood, 2.0-3.7% of lymphoid cells bound to IgD aggregates. Using double labelling and, enrichment and depletion experiments, a subset of normal B but not T lymphocytes exhibited IgD binding. In blocking experiments, AggIgD binding was shown to be specific and Fc dependent. Likewise, B but not T derived neoplastic lymphoid clones expressed Fc delta receptors. Fc delta receptors were exclusively present on neoplastic clones that also expressed SmIgD. Neoplastic lymphoid cells expressing SmIgM alone did not express Fc delta. The chronic lymphocytic leukaemia cell which typically bore membrane SmIgM and SmIgD expressed multiple FcR with specificities for IgM, IgD and IgG. In sequential surface redistribution experiments, Fc delta and Fc mu receptor-ligand binding produced the 'co-capping' phenomenon which was bidirectional in nature suggesting membrane association.

Generalized structures of the 5S ribosomal RNAs

The sequences of 5S ribosomal RNAs from a wide-range of organisms have been compared. All sequences fit a generalized 5S RNA secondary structural model. Twenty-three nucleotide positions are found universally, i.e., in 5S RNAs of eukaryotes, prokaryotes, archaebacteria, chloroplasts and mitochondria. One major distinguishing feature between the prokaryotic and eukaryotic 5S RNAs is the number of nucleotide positions between certain universal positions, e.g., prokaryotic 5S RNAs have three positions between the universal positions PuU40 and G44 (using the E. coli numbering system) and eukaryotic 5S RNAs have two. The archaebacterial 5S RNAs appear to resemble the eukaryotic 5S RNAs to varying degrees depending on the species of archaebacteria although all the RNAs conform with the prokaryotic "rule" of chain length between PuU40 and G44. The green plant chloroplast and wheat mitochondrial 5S RNAs appear prokaryotic-like when comparing the number of positions between universal nucleotides. Nucleotide positions common to eukaryotic 5S RNAs have been mapped; in addition, nucleotide sequences, helix lengths and looped-out residues specific to phyla are proposed. Several of the common nucleotides found in the 5S RNAs of metazoan somatic tissue differ in the 5S RNAs of oocytes. These changes may indicate an important functional role of the 5S RNA during oocyte maturation.

Estrogen receptor content and ploidy of human mammary carcinoma

In 46 cases of invasive ductal mammary carcinoma the relationship between estrogen receptor (ER) content and ploidy was investigated. Seventy-one percent of the diploid tumors were ER+ against 40% ER+ tumors in the nondiploid group. Forty percent of the ER+ cases had nondiploid tumors and in several of these more than one tumor cell population could be demonstrated. The results support the hypothesis that multiclonal or mosaic composition of the tumor may explain why 30-45% of the patients with apparently ER+ tumors do not respond to endocrine therapy.

Oestrogen receptors in human breast cancer. Problems of correlation with histopathological features

Histopathological factors which might explain inconsistency in published data attempting to correlate oestrogen receptor content (ER) and pathological features in primary breast tumours have been investigated in 194 cases. It was found, that unequal assessment of tumour type and of histological grading between observers is one important factor. In terms of grading, however, heterogeneity of growth pattern within the same tumour seems to be of greater significance. No significant correlation was found between histological type of tumour and ER content. However, a trend towards a correlation between the extent of tubule formation (as an indication of differentiation) and ER content was observed.

On the phylogeny of Phycomyces blakesleeanus. Nucleotide sequence of 5 S ribosomal RNA

The nucleotide sequence of the major 5 S ribosomal RNA from the lower fungus Phycomyces blakesleeanus has been determined. The sequence is 5' AAUCUACGGCCAUACAGAUAGUAACACACCGGAUCCCGUCUGAUCUCCGCAGUUAAGUCUCUCCUGGUAGCGUCAGUAC UAUGGUGGGGGACCACAUGGGAAUACGCUAUGUCGUAGGUU3'OH. The Phycomyces 5 S RNA sequence has invariant nucleotide positions characteristic of other eukaryotic 5 S RNAs and fits currently proposed secondary structural models. The Phycomyces of 5 S RNA shows relatively low overall sequence homology to the higher fungal (Ascomycetes) 5 S RNAs (56-60%) but shows higher sequence homology to those 5 S RNAs from Tetrahymena thermophila (68%), human KB cells (67%), and Spinacia oleracea (62%). A comparison of individual segments of the RNA also shows that the structure of Phycomyces 5 S RNA has several major differences from structures common to the higher fungi. Positions 2-14 are homologous with those of metazoan and some protozoan 5 S RNAs. At positions 30-45, the RNA sequence is closer to metazoan 5 S RNAs than to the Neurospora of Aspergillus 5 S RNAs. The Phycomyces 5 S RNA shares similar sequences with both Aspergillus and Tetrahymena 5 S RNAs at positions 79-99. Several other important homologies in primary and proposed secondary structures also have been observed in comparing Phycomyces 5 S RNA with animal and plant 5 S RNAs. We conclude that Phycomyces may not be as closely related phylogenetically to the Ascomycetes as previously thought.

Short-term culture of human breast cancer: in vitro effects of hormones related to patient response

Breast-cancer tissue from 60 patients was tested for oestrogen and testosterone sensitivity in vitro by measuring [3H]-dT incorporation in tissue fragments at various times during 48h culture. Hormone sensitivity in test culture was determined as an increase or decrease in dT uptake. In vitro cultures of breast cancer tissue demonstrate that some tumours are hormone-sensitive and others hormone-insensitive, but it cannot be predicted whether cell proliferation is stimulated or inhibited by hormone treatment. The data were related to the clinical stage of the patients, menopausal status, and the degree of anaplasia of the tumours tested. No correlation was observed between these parameters and in vitro hormonal sensitivity. However, when related to the response of patients to various kinds of hormonal treatment, a significant positive correlation was obtained.

Serum concentrations of cis(Z)-flupentixol and prolactin in chronic schizophrenic patients treated with flupentixol and cis(Z)-flupentixol decanoate

Nine chronic schizophrenic patients selected from three hospital departments were treated with flupentixol (orally and IV) and cis(Z)-flupentixol decanoate in Viscoleo (IM) in a three-phase pharmacokinetic study. Oral administration (single and repeated dosage) showed a relatively slow absorption with maximum serum concentration around 4 h after administration. Intravenous injection indicated multicompartment kinetics for cis(Z)-flupentixol. The biological half-lives calculated after the different doses were the same, indicating that the pharmacokinetics of cis(Z)-flupentixol does not differ between single and repeated administration and does not change when moderately higher doses are given. The bioavailability of orally administered cis(Z)-flupentixol was calculated to be about 40% with IV injection as reference. After IM administration maximum serum concentration was seen between 4 and 10 days in most patients. Calculation of a disappearance half-life gave very variable results, indicating that the release of the drug from the oil depot is not a monoexponential process. The intramuscular depot had a much lower bioavailability than IV injection, which means that steady state has not been obtained after 8 weeks of depot treatment. Serum prolactin concentrations were elevated during neuroleptic treatment, but no correlation was found between prolactin concentrations and the serum concentrations of cis(Z)-flupentixol. A correlation between the changes in clinical ratings and concentrations of cis(Z)-flupentixol or prolactin was not found.

The 5S ribosomal RNA of Euglena gracilis cytoplasmic ribosomes is closely homologous to the 5S RNA of the trypanosomatid protozoa

The complete nucleotide sequence of the major species of cytoplasmic 5S ribosomal RNA of Euglena gracilis has been determined. The sequence is: 5' GGCGUACGGCCAUACUACCGGGAAUACACCUGAACCCGUUCGAUUUCAGAAGUUAAGCCUGGUCAGGCCCAGUUAGUAC UGAGGUGGGCGACCACUUGGGAACACUGGGUGCUGUACGCUUOH3'. This sequence can be fitted to the secondary structural models recently proposed for eukaryotic 5S ribosomal RNAs (1,2). Several properties of the Euglena 5S RNA reveal a close phylogenetic relationship between this organism and the protozoa. Large stretches of nucleotide sequences in predominantly single-stranded regions of the RNA are homologous to that of the trypanosomatid protozoan Crithidia fasticulata. There is less homology when compared to the RNAs of the green alga Chlorella or to the RNAs of the higher plants. The sequence AGAAC near position 40 that is common to plant 5S RNAs is CGAUU in both Euglena and Crithidia. The Euglena 5S RNA has secondary structural features at positions 79-99 similar to that of the protozoa and different from that of the plants. The conclusions drawn from comparative studies of cytochrome c structures which indicate a close phylogenetic relatedness between Euglena and the trypanosomatid protozoa are supported by the comparative data with 5S ribosomal RNAs.

Platelet function and survival in patients wit severe hypercholesterolemia

Platelet aggregation and survival were measured in twelve subjects with severe hypercholesterolemia. There was a small increase in sensitivity to epinephrine and adenosine diphosphate among the most hypercholesterolemic patients, but this did not correlate with reduced platelet lifespan. Platelet survival was normal or only moderately reduced in the markedly hypercholesterolemic homozygous subjects. However, the incidence of reduced platelet survival was significantly increased (p less than 0.05) among the older patients with more extensive atherosclerotic vascular disease compared to the younger patients with limited vascular disease. Marked hypercholesterolemia in the absence of atherosclerosis does not appear to accelerate platelet destruction, although a modest increased aggregability is present.

The nucleotide sequence of spinach cytoplasmic 5 S ribosomal RNA

The nucleotide sequence of the cytoplasmic 5 S ribosomal RNA from Spinacia oleracea has been determined. A secondary structural model possessing four base-paired regions can be constructed from the primary structure. This RNA shows 90 to 93% nucleotide sequence homology with other higher plant cytoplasmic 5 S RNAs and 73% homology with that of the lower eukaryote Chlorella. The spinach 5 S RNA has the nucleotide sequence identical with that of Chlorella in two important single-stranded regions, the sequence C10 AUACC and the dodecanucleotide sequence at positions 33 to 44. A nucleotide sequence similar or identical with C10 AUACC is found in most other eukaryotic 5 S RNAs, including the 5 S RNA from human KB cells. In addition, a single-stranded loop of 12 residues corresponding to positions 33 to 44 in the spinach 5 S RNA sequence may be a general feature of eukaryotic cytoplasmic 5 S RNAs, while prokaryotic 5 S RNAs have a 13-member loop for the corresponding residues. Several other important homologies in primary and secondary structure have also been observed in comparing spinach 5 S RNA to other 5 S RNAs.

The nucleotide sequence of the chloroplast 5S ribosomal RNA from spinach

Spinacia oleracia cholorplast 5S ribosomal RNA was end-labeled with [32P] and the complete nucleotide sequence was determined. The sequence is: pUAUUCUGGUGUCCUAGGCGUAGAGGAACCACACCAAUCCAUCCCGAACUUGGUGGUUAAACUCUACUGCGGUGACGAU ACUGUAGGGGAGGUCCUGCGGAAAAAUAGCUCGACGCCAGGAUGOH. This sequence can be fitted to the secondary structural model proposed for prokaryotic 5S ribosomal RNAs by Fox and Woese (1). However, the lengths of several single- and double-stranded regions differ from those common to prokaryotes. The spinach chloroplast 5S ribosomal RNA is homologous to the 5S ribosomal RNA of Lemna chloroplasts with the exception that the spinach RNA is longer by one nucleotide at the 3' end and has a purine base substitution at position 119. The sequence of spinach chloroplast 5S RNA is identical to the chloroplast 5S ribosomal RNA gene of tobacco. Thus the structures of the chloroplast 5S ribosomal RNAs from some of the higher plants appear to be almost totally conserved. This does not appear to be the case for the higher plant cytoplasmic 5S ribosomal RNAs.

Psychogenic psychoses. A retrospective study with special reference to clinical course and prognosis

The study comprises a retrospective evaluation of case records of 220 patients admitted for the first time with psychogenic psychosis with special reference to clinical course and prognosis within a period of 13--14 years. The reliability of the diagnosis at the time of the first admission is about 60% when the evaluation is based on positive criteria for psychosis. If the psychogenic psychoses are divided into subgroups, the reliability of the diagnosis of psychogenic affective psychoses is about 30%, whereas it is over 90% for psychogenic confusional psychoses and psychogenic paranoid psychoses. If subsequent cases of other functional psychoses (manic-depressive psychosis and schizophrenia) are subtracted, the diagnostic reliability is 50% (111 of 220 cases), which represents the number of retrospectively verified psychogenic psychoses. The frequency of recurrence of psychogenic psychosis was 18% (40), corresponding to 36% of psychogenic psychoses verified by retrospective evaluation (111 of 220 cases). The recurrences were mainly homologous, as heterologous recurrences developed only among the psychogenic affective psychoses (slightly less than half of the recurrences in question). Schizophrenia developed in only 10% (23), and subsequent episodes of manic-depressive psychosis occurred in 8% (18). The stability of psychogenic psychosis on recurrence of functional psychosis was 49% expressed in relation to all subsequent cases of functional psychosis. The over-all prognosis for the psychogenic/reactive psychosis is thus good as regards subsequent mental disease. Chronic functional psychosis (schizophrenia) developed in only 10% (and in less than 20% if the prognosis is assessed on the basis of the reliability of the diagnosis at the time of the first admission (about 60%)). However, in the group of psychogenic/reactive psychoses as a whole an overmortality of 100% was observed in the course of the 14 years, highest in the younger age groups.

Anti-depressive treatment in Parkinson's disease. A controlled trial of the effect of nortriptyline in patients with Parkinson's disease treated with L-DOPA

Nineteen patients with L-DOPA treated parkinsonism involving depressive symptoms, the therapeutic effect of nortriptyline was compared to placebo in a controlled trial. The depressive and neurological symptoms were evaluated by rating scales. Nortriptyline had a clinical significant effect with regard to the depressive symptoms, whereas the neurological parameters were unchanged. The authors suggest the depression in Parkinson's disease to be of both reactive and endogenous origins.

Lymph node identification in carcinoma of the colon and rectum. Value of tissue specimen radiography

A method for identifying lymph nodes in tissue specimens from patients with carcinoma of the colon and rectum by soft X-rays is described and assessed. The method seems superior to more time-consuming and possibly tissue-damaging procedures, and it affords a possibility of identifying lymph nodes down to a size 1--2 mm in formalin-fixed as well as in non-fixed tissue specimens.

Unsaturated and cobalamin saturated transcobalamin I and II in normal human plasma

Insolubilized antibody against human transcobalamin I has been used as a specific and precise tool for the separation of transcobalamin I (and III) from transcobalamin II. Range and mean (in parentheses) for the unsaturated binding capacity for twenty samples are 40-190 (90) pmol/l and 220-1170 (560) pmol/l for transcobalamin I (and III) and transcobalamin II, respectively. The similar figures for the cobalamin saturated transcobalamins are 200-549 (320) pmol/l and 75-475 (160 pmol/l. On analyses of the cobalamins attached to each of the transcobalamins, it is shown that methylcobalamin accounts for most of the cobalamins attached to transcobalamin I whereas transcobalamin II carries most of the 5'-deoxyadenosylcobalamin.

Lymph node identification. Specimen radiography of tissue predominated by fat

A method for identifying, by soft x-rays, lymph nodes in tissue specimens predominated by fat is presented. The method is quick and demonstrates lymph nodes as small as 1 to 2 mm in diameter.

Pulmonary function in obese patients scheduled for jejuno-ileostomy

Preoperative pulmonary parameters were evaluated in 37 extremely obese but otherwise healthy patients. They were on average 100.9% overweight. X-ray of the chest, electrocardiograms, and residual volume, vital capacity, total lung capacity, maximum breathing capacity, forced expired volume in 1 second, and related ratios were all within the normal range. The alveolar-arterial oxygen gradient and the arterial carbon dioxide tension were also within the normal range. The only abnormal finding was a substantially reduced arterial oxygen tension. It is suggested that the measurement of functional residual capacity, closing volume, and the slope of the alveolar plateau (phase III in the single breath nitrogen washout technique) might give more valuable information.

Evaluation of impedance cardiography druing anesthesia in extremely obese patients

In three anesthetized markedly obese patients, non-invasive stroke volumes (the transthoracic electrical impedance method) were compared to simultaneously obtained invasively measured stroke volumes (dye-dilution method). Close correlations were obtained (r = 0.90--0.98) between the two methods, although constant lower impedance stroke volumes were found in these patients when the values usually employed for the electrical resistivity of the blood (zeta) were used for calculation of the impedance stroke volume. No statistically significant difference (P greater than 0.10) between the two methods was found when a zeta of 175 ohm X cm was used for the calculations, or when the percentage changes in stroke volumes were analyzed. The impedance method is safe and reliable; it also permits non-invasive measurements of stroke volume during anesthesia in markedly obese patients.

Postoperative pulmonary function in obese patients after upper abdominal surgery

The pulmonary course after jejuno-ileal by-pass operation in six massively obese patients (mean weight 130.2 kg) was followed for the first 5 postoperative days by means of arterial blood gas analysis and measurements of forced vital capacity (FVC), forced expired volume in the first second (FEV1.0) and peak expiratory flow rate (PEFR). The patients were extubated in the operating room and were breathing spontaneously in the postoperative period. Pao2 and FVC reached their minimum values in the first 24 postoperative hours (respectively, 74% and 45% of their preoperative values), but were almost restored in 5 days. PEFR had at this time reached 77% of its preoperative value FEV1.0% (FEV1.0%in per cent of FVC) did not change from the pre- to the postoperative period, but remained about 70%.

High-dose treatment of rats with perphenazine enanthate

Previously we demonstrated an approximately 20% loss of nerve cells in the basal ganglia of rats following treatment with perphenazine enanthate 3.4 mg/kg s.c. every 2nd week during 12 months. If the treatment period was only 2 or 3 months no significant differences were found.