Angiography and peritoneal lavage in blunt abdominal trauma

Records of 123 consecutive patients who underwent abdominal angiography for blunt trauma were reviewed. Twenty-four patients underwent abdominal angiography on the basis of positive physical findings. Seven (29%) required intervention as determined by angiography and the diagnosis was confirmed. Ninety-nine patients had abdominal angiography in association with angiographic evaluation of the chest, pelvis, or extremities. In 14 (14%) the angiogram indicated the need for intervention. In 13 this diagnosis was confirmed at laparotomy. The fourteenth patient was embolized angiographically and did well. Fifty-four patients had peritoneal lavage in addition to their angiograms. Sixteen were positive and 38 were negative. In four patients the lavage was negative and the angiographic findings indicated need for intervention. Three of these four were confirmed at laparotomy and the fourth patient was embolized angiographically. Indications for abdominal angiography in blunt trauma are: 1) incidental to needed thoracic aortography; 2) incidental to angiography when done for pelvic fractures; 3) suspected intra-abdominal injuries when clinical and lavage data are not definitive.

Specific 125I-radioimmunoassay for cholyglycine, a bile acid, in serum

The concentration of the conjugated bile acid, cholylglycine, in serum is a sensitive and specific indicator of hepatic function. We describe a convenient, specific, and precise radioimmunoassay for cholylglycine, in which 125I-labeled cholylglycyltyrosine is used as tracer. In addition, a blocking agent in the buffer system eliminates binding of bile acids to serum albumin. Therefore no extraction is required. We found no interference by (a) abnormal concentrations of albumin or gamma-globulin, (b) lipemic sera, (c) hemolyzed sera, (d) anticoagulants, or (e) various commonly used drugs. The reference interval for fasting subjects is estimated to be 0.0 to 0.6 mg/L. Our clinical studies show that serum cholylglycine concentrations are usually abnormal in most hepatobiliary diseases, such as viral hepatitis, alcoholic liver disease, cirrhosis, and pediatric liver diseases.

Cisplatin nephrotoxicity in rats: defect in papillary hypertonicity

We examined the effects of cisplatin (5 mg/kg BW) on renal function in rats. Three days after administration of cisplatin whole kidney clearance of inulin fell and 24-h urine volume increased. Maximal urine osmolality and papillary solute content were reduced. Superficial nephron glomerular filtration rate measured along the proximal tubule, where no leak of inulin could be demonstrated, was reduced in cisplatin-treated animals. Differences between superficial nephron glomerular filtration rate determined in proximal and distal tubules were greater in cisplatin-treated rats than in control rats. Neither a change in fluid or sodium movement along superficial nephrons nor a reduced early distal tubule transepithelial sodium gradient explain the polyuria. Urea was reabsorbed from, not added to, the loop fluid in cisplatin-treated animals. Morphologic changes were evident in the S3 segment of the proximal tubule in cisplatin-treated animals but the glomeruli were normal. Polyuria occurred despite diminished glomerular filtration rate in cisplatin nephrotoxicity. The diminished concentration of salt and urea in the papilla as a result of abnormal function of the collecting duct or pars recta portion of the proximal tubule contributed to the defect in concentrating ability.

Vitamin A toxicity and hypercalcaemia in chronic renal failure

Serum vitamin A concentrations were measured in 38 patients undergoing haemodialysis, 24 of whom were taking multivitamin preparations containing vitamin A. Vitamin A concentrations were significantly higher in patients undergoing haemodialysis than in 28 normal controls (p less than 0.001). Patients taking vitamin A supplements had significantly higher vitamin A concentrations than those not taking them (p less than 0.05), and hypercalcaemic patients had higher concentrations than normocalcaemic patients (p less than 0.005). Withdrawal of vitamin A supplements in seven patients caused significant falls in serum vitamin A concentrations and plasma calcium concentrations (p less than 0.01 at two and three months in both cases) and in plasma alkaline phosphatase concentrations (p less than 0.01 at two months). Vitamin A toxicity can contribute to hypercalcaemia in patients undergoing haemodialysis, probably by an osteolytic effect. Multivitamin preparations containing vitamin A should therefore be prescribed with caution in these patients.

Complete eradication of squamous cell carcinoma of the esophagus with combined chemotherapy and radiotherapy

Chemotherapy (with 5-fluorouracil and either mitomycin-C or cis-platinum) combined with radiotherapy was used either for palliation or as preoperative therapy in 67 patients with squamous cell carcinoma of the esophagus. In 25 patients having chemotherapy and 5000-6000 rads, good local palliation was obtained in 11 (49%) without surgery. In the remaining 25 patients, swallowing was restored with a variety of procedures (primarily Celestine tube or gastric bypass). The average survival time was seven months and two patients are still alive at 9 and 12.5 months. Of 42 patients receiving preoperative chemotherapy and radiotherapy, 35 had surgery. Of these, 13 (37%) had complete eradication of their tumors with no histologic evidence of carcinoma in the resected esophagus or associated lymph nodes. In another six (17%), the only evidence of tumor was small microscopic foci of cancer cells in the wall of the esophagus. The 6-, 12-, and 24-month survival rates for patients having surgery after the combined preoperative chemotherapy and radiotherapy were 83 per cent, 52 per cent, and 30 per cent, respectively. These results are far superior to those previously obtained.

Selective inhibition of Escherichia coli protein synthesis and growth by nonionic oligonucleotides complementary to the 3' end of 16S rRNA

A series of nonionic oligonucleotide analogues, the deoxyribooligonucleoside methylphosphonates, were synthesized. The base sequences of these compounds, d(ApGpGp), d(ApGpGp)(2), and d[(ApGpGp)(2)T], are complementary to the Shine-Dalgarno sequence (-A-C-C-U-C-C-U-) found at the 3' end of bacterial 16S rRNA. These nonionic oligonucleotide analogues were tested for their ability to inhibit the in vitro translation of mRNAs in cell-free systems of Escherichia coli and rabbit reticulocyte. In the E. coli system, both d(ApGpGp)(2) and d[(ApGpGp)(2)T] effectively inhibited MS-2 RNA-directed protein synthesis but they had much less effect on either poly(U)- or poly(A)-directed polypeptide synthesis. In the reticulocyte system, these compounds had no significant effect on the translation of globin mRNA. The observation that d[(ApGpGp)(2)[(3)H]T)] binds to 70S ribosomes (association constant, 2.0 x 10(4) M(-1), 37 degrees C) together with the specificity of the inhibitory action of these compounds on protein synthesis strongly suggests that inhibition of translation is a consequence of analogue binding to Shine-Dalgarno sequence of 16S rRNA. The oligonucleoside methylphosphonates inhibited both protein synthesis (without concurrent inhibition of RNA synthesis) and colony formation by E. coli ML 308-225 (a permeable mutant) whose cell wall contains negligible quantities of lipopolysaccharide but had no effect on wild-type E. coli B. Our preliminary results on the uptake of oligodeoxyribonucleoside methylphosphonates by E. coli B show that these cells are not permeable to oligomers longer than 4 nucleotidyl units. Although oligodeoxyribonucleoside methylphosphonates are taken up by mammalian cells in culture, this series of analogues had negligible inhibitory effects on colony formation by transformed human cells. This study indicates that this class of nonionic oligonucleotide analogues can be used to probe and regulate the function and structure of nucleic acids of defined sequence within living cells.

The effects of vitamin A toxicity on calcium and lipid metabolism in chronic renal failure

Serum vitamin A levels were high in haemodialysis patients, and were found to correlate with plasma calcium, triglyceride, cholesterol and insulin levels. Vitamin A containing multivitamin supplements were found to contribute to increased serum vitamin A levels, and their withdrawal in seven patients caused a significant decrease in serum vitamin A and calcium levels, with no effect on lipid levels. Vitamin A containing preparations should therefore be prescribed with caution in these patients.

Promalin improves the shape of Delicious apples in Victoria

Results of two experiments and nine orchard trials over three seasons at eight fruit growing districts have shown that fruit shape of Richared, Lalla, Starking, Hi-Early and Common Delicious apples can be improved by applications of the commercial formulation of N-(phenylmethylkl H-purin-61 - 1 amine plus gibberellins A, + A, (Promalin). Promalin at 25 ppm significantiy increased both fruit length: diameter ratio and prominence of calyx lobes. These fruit were considered to have a more characteristic shape and thus said to be more 'typey'. Response varied between strains, and applications during early stages of flowering were more effective than applications after full bloom. The spraying of Promalin with a hand gun caused heavy overthinning and retention of many small fruit on the tree. Applications with air blast spray equipment at spray volumes of 750-1 100 I/ha gave good results. Some air blast applications induced mild fruit thinning, and in several cases seed number was reduced and stem length increased.

Effects of oral choline on human complex partial seizures

We carried out an open study of the effects of large doses (12 to 16 gm per day) of oral choline on medically intractable human complex partial seizures (CPS). Marked increases of plasma choline concentration (75 to 300%) in three subjects were associated with (1) shorter duration of CPS, (2) less postseizure fatigue, and (3) slight increase of seizure frequency. Both the patients and their families considered the patients much improved. No differences in any of these evaluations were noted in a fourth subject who had less of an increase (21%) of plasma choline content. The results suggest that oral choline therapy may be a useful adjunct in the treatment of intractable CPS. A blinded prospective study will be necessary to assess this possibility.

Numbered Knowles hip pins

Knowles pins with incorporated Miller Identification Means have been used on a limited basis by one of the authors. Preliminary experience suggests that numbered pins can lessen the time of operation, the amount of radiation received from X-ray exposure, and the degree of blood loss.

Immunological distinction between guanosine 3':5'-monophosphate-dependent and adenosine 3':5'-monophosphate-dependent protein kinases

A guanosine 3':5'-monophosphate (cGMP)-dependent protein kinase was purified from bovine lung using 8-(6-aminohexylamino)-cAMP-Sepharose. The activity of the purified enzyme was highly dependent on cGMP using histone f2b as a substrate. The self-phosphorylation of the purified enzyme was strongly inhibited by cGMP and not significantly affected by cAMP. A precipitating antiserum prepared in rabbits against the cGMP-dependent protein kinase specifically inhibited the histone kinase activity and the self-phosphorylation of the purified cGMP-dependent protein kinase without affecting the cGMP binding site. This antiserum also specifically inhibited the phosphorylation of the endogenous substrate proteins by endogenous cGMP-dependent protein kinase in smooth muscle membranes, but did not cross-react detectably with catalytic subunit or regulatory subunit of type I or type II cAMP-dependent protein kinase. Conversely, anti-sera against the regulatory subunit of type I or type II cAMP-dependent protein kinase did not cross-react detectably with cGMP-dependent protein kinase. The substantial differences between the immunological properties of the cGMP-dependent and cAMP-dependent protein kinases suggest that these two enzymes have distinct physiological roles.

Migration of the schistosomula of Schistosoma mansoni from the lungs to the hepatic portal system

The pattern of recovery of schistosomula from the lungs of mice, hamsters and rats is described following normal percutaneous infection via the abdominal skin. Peak numbers were found in hamsters and rats on day 5 and in mice on day 6 post-exposure. Schistosomula were recovered from the lungs up to approximately day 20 post-exposure in all 3 species. None were found in pleural washings and only 2 were recovered following mincing and incubation of host diaphragms. The pattern of recovery of schistosomula from the lungs of mice was also described following the injection of a pulse of parasites into the tail vein. Approximately 54% of these injected schistosomula eventually reached maturity in the hepatic portal system. The ability of schistosomula to migrate and mature following their injection into unusual locations was tested. Small numbers reached maturity in the hepatic portal system following injection into the pleural cavity or subcutaneously, more when injected intra-peritoneally and largest numbers following intravenous injection. Small numbers of schistosomula were recovered by mincing and incubation of systemic organs such as the kidney and spleen. Schistosomula injected into the left ventricle of hamsters were able to migrate via the systemic organs to the lungs and 47% eventually matured in the hepatic portal system. The pattern of schistosomulum accumulation in the hepatic portal system of mice, hamsters and rats is described. Following normal percutaneous infection, schistosomula were first detected in this site from day 6 to day 9 depending on the host species. In mice, migration was complete around day 20 but continued in hamsters up to day 40 post-exposure. Following injection of schistosomula into the tail veins of mice, the first arrivals in the hepatic portal system were detected 12 h later and were found to lose their ability to migrate shortly after arrival. However, a proportion of lung schistosomula injected directly into the hepatic portal system were able to traverse hepatic sinusoids and reach the lungs. It was concluded that the route of migration of schistosomula from lungs to liver was entirely intravascular, with potentially several passages round the pulmonary-systemic circulation, before chance entry into arteries leading to the hepatic portal system. The proportion of schistosomula exiting from the pulmonary-systemic circuit was estimated as 0·14/day. A computer simulation produced values of 11 h and 5 h for the duration of migration through pulmonary and systemic capillary beds. The time for 1 complete circuit would thus be 16 h and the proportion of schistosomula exiting per circuit would be 0·095. This approximates to the proportion of cardiac output going to splanchnic organs in the resting rat (0·128). The narrowness of hepatic sinusoids may be one factor contributing to the sequestration of schistosomula in the hepatic portal system.

Treatment of NZB/W ("lupus") mice with 15(S)-15 methyl PGE1

The F1 hybrid of New Zealand black and New Zealand white mice--the NZB/W mouse--spontaneously develops a disease similar to human systemic lupus erythematosus. Male NZB/W mice with established disease were treated with a stable derivative of prostaglandin E1, 15(S)-15 methyl PGE1 (4 micrograms twice daily) from 7 months of age. The pge analog prolonged survival of these mice: At 14 months 7 of 10 control mice had died, whereas 9 of 10 15(S)-15 methyl PGE1 treated mice remained alive. Thus a dose of 200 micrograms/Kg/day 14(S)-15 methyl PGE1 retards progression of murine lupus.

Cat-scratch disease with encephalopathy

A case of encephalopathy complicating cat-scratch disease has been described. Neurologic signs manifested by convulstions and stupor appeared ten days after epitrochlear lymphadenopathy. The clinical course gradually improved over the next few days and recovery was complete. The spinal fluid was normal. The skin test with CSD antigen was positive. In all cases of encephalopathy developing within six weeks following the appearance of unexplained lymphadenopathy, the diagnosis of cat-scratch disease should be entertained. The importance of the cat-scratch disease antigen in diagnosis is emphasized.

Tumorigenicity of embryonal carcinoma as an assay to study control of malignancy by the murine blastocyst

A bioassay, based on tumorigenicity, has been developed to determine the mechanism whereby the blastocyst of the mouse controls malignant expression of embryonal carcinoma. The assay is based upon the incidence of tumors obtained when known numbers of cells of the 402AX strain of embryonal carcinoma are injected into strain 129 mice, compared to the incidence obtained when the same number of embryonal carcinoma cells are incorporated into Swiss-Webster blastocysts that are then injected in strain 129 animals. The results indicate that the blastocyst can regulate one embryonal carcinoma cell consistently; it may have a slight effect on three, but it cannot regulate four or five of them. The position of the embryonal carcinoma cell in the blastocyst is important. Regulation occurs if the embryonal carcinoma cell is placed in the blastocoele cavity, but enhancement of tumorigenicity is obtained if it is placed between the zona pellucida and the trophectoderm. By contrast, the blastocyst is unable to regulate a single B-16 melanoma cell placed in the blastocoele cavity, indicating a degree of specificity for the regulatory process.

[Aberrant course of the intrapetrous internal carotid in the eardrum. Analysis of a personal case. Review of the literature (author's transl)]

A new case of aberrant course of the internal carotid artery in the eardrum described, with the particular features of being associated with progressive chronic otitis and a picture of multiple malformations. Diagnosis of the abnormality of the course and its topographical limits, using tomography and angiography, led to a successful antroatticotomy. On the basis of a review of the literature, the authors describe the main criteria of the clinical and radiological diagnosis and present the current pathogenic theories of the mechanism of this congenital abnormality.

Physico-chemical studies of isolated chromatin compared with in situ chromatin after partial hepatectomy in the rat

Chromatin was isolated from rat liver cells at 0, 3, 5, 11, 18 and 24 h following partial hepatectomy. Consistent with findings in cultured cells stimulated to proliferate, there was an increase in chromatin molar ellipticity measured at 276 nm, and a decrease in thermal stability 3 to 8 h after surgery. These events occured prior to the onset of DNA synthesis. These early changes be­ tween non-proliferating (G0) and proliferating (G1) cells, as well as later chromatin conformational changes observed at S and G2 phases, mimic changes in template activity.

Results with sheared and unsheared chromatin (both with in vitro and in vivo systems) prove that structural and functional changes can be caused by even the slightest shearing during chromatin preparation, suggesting the loss of native chromatin organization. To eliminate this problem, experiments were also conducted using chromatin in situ. A flow cytometer (FCM) was used to study unfixed liver cell suspensions stained with ethidium bromide (EB). Fluorescence was mea­ sured in the green spectral range after addition of increasing amounts of EB. Experimental evidence is provided that the same alteration in chromatin conformation can be best detected using low molar ratios of EB per unit DNA due to greater fluorescence emission in G1 respect to G0 cells.

These correlated studies demonstrate that the same changes controlling chromatin organization in situ are detected also in the tertiary-quaternary structure of “isolated” chromatin. These changes in chromatin conformation are macromolecular events related to cell proliferation both at the G0 -G1 and G1 -S transitions.

Physical properties of DNA and chromatin isolated from G1- and S-phase HeLa S-3 cells. Effects of histone H1 phosphorylation and stage-specific nonhistone chromosomal proteins on the molar ellipticity of native and reconstituted nucleoproteins during thermal denaturation

To help delineate how changes in chromatin organization are related to DNA replication and transcription during the HeLa S-3 cell cycle, we have extended previous studies of the composition and structure of chromatin in synchronized G1- and S-HASE CELLS. By analyzing changes in molar ellipticity at 276 nm ([theta 276]) during thermal denaturation, it was found that double-helical DNA molecules in native chromatin have different optical activities and thermal stabilities at these two stages of the cell cycle. Furthermore, profiles of d[theta 276]/dT vs. T indicate that native G1- and S-phase chromatins contain different families of DNA superstructures. To help determine the causes and functional significance of these chromatin reorganizations during the cell cycle, we compared the optical activities and thermal stabilities of DNA in native chromatin with protein-free DNA and DNA in nucleoproteins reconstituted in vitro by NaCl-urea gradient dialysis. In addition, we examined levels of histone phosphorylation, histone acetylation, and types of histone and nonhistone chromosomal proteins (NHCP) found in G1- and S-phase cells and in purified hydroxylapatite, (HAP) fractions of these nuclear proteins which were used for in vitro reconstitution. The results of the present studies indicate that changes in H1-DNA-NHCP interactions occur in vivo, are associated with the phosphorylation of histone 1 molecules, and appear to be responsible for the relaxation of compact G1-phase chromatin superstructures into more open S-phase configurations during the HeLa S-3 cell cycle.

Videotaping epileptic attacks during stereoelectroencephalography

Relating the onset of clinical attacks as recorded on a videotape to surface and depth electrographic events improves our ability to define the local or diffuse origin of seizures. In two patients with complex partial seizures, all 14 attacks appeared 3 to 6 seconds after focal discharges began in the amygdala or hippocampus. This meant that the spread of focal electroencephalographic (EEG) paroxysms caused the eventual clinical seizure. In two other patients with 392 generalized seizures and secondary bilateral synchronous paroxysms, a significant number of clinical attacks preceded the first depth or surface electrographic event. This suggested that the attacks originated from brain regions remote from the recording electrodes.

Migration of the schistosomula of Schistosoma mansoni from skin to lungs

The number of schistosomula recovered from abdominal skin declined exponentially with time after infection. However, this decline was shown to be an untrue reflection of the numbers present because of changes in recoverability on days subsequent to infection. Digestion of skin by the enzymes collagenase and hyaluronidase produced a small increase in the number of schistosomula recovered. The number of schistosomula present in abdominal skin and capable of reaching maturity was estimated by exciting the area to which cercariae had been applied, from groups of hosts at daily intervals after exposure. The number of worms maturing in each group of hosts was then determined. The mean duration of stay of schistosomula in mouse, hamster and rat abdominal skin was estimated at 88, 64·5 and 70 h, respectively. The fluid content of abdominal skin to which cercariae had been applied, increased following infection but it was concluded that this alone was not the predominant factor controlling exit of worms. The stimulation of a delayed hypersensitivity response not directed against schistosomes (in mice previously sensitized with 1-chloro,2–4-dinitrobenzene (DNB)) 1 day after exposure to cercariae, produced a significant increase in the number of schistosomula leaving the skin and reaching maturity. Schistosomula can be recovered from the axial lymph nodes of mice, hamsters and rats. If the schistosomula from mice are injected into the tail vein of uninfected mouse hosts, they have the same chance of maturing as comparable skin schistosomula. They are therefore apparently unharmed by their passage through the nodes. Interference with lymphatic drainage by surgical removal of lymph nodes has no effect on the number of schistosomula recovered from the lungs, but the peak recovery is delayed by 24 h. The hamster cheek-pouch, a site with no afferent lymphatic drainage, was also used to investigate the importance of the lymphatic exit route. There was no reduction in the number of adult worms recovered following infection at this site compared with the normal abdominal skin site. The migration of schistosomula to deeper tissues and their entry into blood vessels was followed using the cheek-pouch preparation. It was concluded that the major route of exit from the skin is the blood vascular system.

Schistosoma mansoni: the activity and development of the schistosomulum during migration from the skin to the hepatic portal system

The activity patterns and changes in shape of schistosomula recovered from various locations during migration, are described. There is no significant increase in length during the period which worms remain in the skin. Rhythmic cycles of extension and contraction of the worm body are established soon after penetration. Worms newly arrived at the lungs are identical with skin worms of the same age. Within the lungs their maximum length increases to four times that of skin worms, an adaptation which is believed to facilitate migration through the lumina of blood capillaries. Worms recovered from the lungs and systemic organs on, and subsequent to, day 8 post-infection retain this capacity for elongation. When worms arrive at the hepatic portal system they undergo a process of shortening and there is a transient doubling in the duration of cycles of activity. It is suggested that this shape and activity change terminates migration by preventing escape of worms from the hepatic portal system via the liver sinuses. The stimulus which triggers the response is thought to be the high nutrient levels present in hepatic portal blood, but not in peripheral blood. The stimulus which terminates migration also probably initiates growth. Worms cultured in vitro undergo some increase in length, but have a significantly lower maximum length than lung worms of a corresponding age. Although cultured worms were active, the cycles of extension and contraction were much more erratic than those of in vivo worms. The worms shortened spontaneously after 8–10 days in culture. This shortening occurred marginally later than in the most rapidly migrating worms in vivo.

Preoperative information and recovery of open-heart surgery patients

Postoperatively, 19 adult open-heart surgery patients were interviewed as to information, included or not included in preoperative instruction, they identified as important to recovery. It was found that subjects desired details of all aspects of their conditions and treatment--preoperatively, operatively, and postoperatively. They had the greatest difficulty with pulmonary aspects of their care postoperatively. Subjects indicated a specific need for more information about the endotracheal tube, the ventilator, mucus, suctioning, deep breathing and coughing, and chest tube removal. Subjects experienced transient, primarily depressive, nonpsychotic postoperative mood changes unrelated to preoperative information, physical manifestations, and/or behavioral manifestations. Subjects regarded the nurse as an important provider of information and found the content of preoperative information satisfactory but wanted more individualization of instruction. They also indicated a need for more family involvement in preoperative instruction to provide them with information of the patient's progress throughout hospitalization. Questions and hypotheses for future research were generated.

Time courses of the anti-anaphylactic and anti-inflammatory effects of dexamethasone in the rat and mouse

1 The time course of the activity of dexamethasone has been studied in a variety of anaphylactic and inflammatory reactions in the rat and the mouse. 2 The times of peak activity of dexamethasone, expressed as time between oral dosage and induction of response, and the approximate ED50 values (mg/kg) found were: anaphylactic bronchoconstriction in rats, 12-24 h, ED50 1.8; passive cutaneous anaphylaxis in rats, 6 h, ED50 0.04; cutaneous reactions to histamine in rats, 4 h, ED50 0.01; carrageenin-induced paw oedema in rats, 4 h, ED50 0.03; pinnal anaphylaxis in mice, 6 h, ED50 0.82; histamine-induced pinnal reactions in mice, 6 h, ED50 0.05. 3 In rats, the characteristics of the inhibitory effects of dexamethasone indicate a differential activity against anaphylactic and inflammatory reactions and between different types of inflammatory reactions. Possible reasons for these differences are discussed. 4 In mice there was little difference between the inhibition by dexamethasone of cutaneous allergic and histamine-induced reactions. 5 Pinnal anaphylaxis in mice was potentiated by dexamethasone given 1-2 h before challenge.

Maternal hyperthermia as a possible cause of anencephaly

Mothers of anencephalic infants were asked about febrile illness and sauna bathing during their pregnancies. In 7 of 63 affected pregnancies (11%), a history of maternal hyperthermia near the presumed time of anterior neural-groove closure was given. 5 had fever with a maximum recorded temperature ranging from 38.9 to 40.0 degrees C, each case being secondary to a different type of illness. The other 2 had possible hyperthermia episodes as a consequence of sauna bathing, with no infectious agent involved. The frequencies of hyperthermia at the same period of gestation in two control groups were 0% and 0.1%. This excess frequency of maternal hyperthermia at the period of anterior neural-groove closure, and the differing natures of its causes, imply that hyperthermia itself may be an aetiological factor in anencephaly.

Proglonged epileptic twilight states: continuous recordings with nasopharyngeal electrodes and videotape analysis

Confusion, speech arrest, automatic behavior, and amnesia characterize the prolonged twilight states of both petit mal and psychomotor status. However, in psychomotor status two electroclinical phases were differentiated: (1) A continuous twilight state with partial responsiveness and reactive automatisms interrupted by (2) staring, total loss of responsiveness, and stereotyped automatisms. During the first phase, with reactive behavior, the EEG showed bilateral diffuse slowing. During the second phase, with stereotyped automatisms, there were spreading right temporal 4- to 12-Hz discharges. Petit mal status had one continuous twilight state, during which both stereotyped and reactive automatisms merged as 1.5- to 4-Hz spike-wave complexes, and bimedial temporal 4-Hz discharges' appeared in the EEG.

Inhibition of experimental immediate hypersensitivity reactions by a novel xanthone, RU 31156

RU 31156, the tris-(hydroxymethyl)-aminomethane salt of 7-(S-methylsulphonimidoyl)-5-(n-hexyl)-xanthen-9-one-2-carboxylic acid has been found to be a potent inhibitor of experimental immediate hypersensitivity reactions in vivo. In the IgE-mediated rat PCA test, RU 31156 had an ED50 of 0.0046 (00037--0.0057) mg/kg which compared to a figure of 1.21 (1.04--1.42) mg/kg for disocium cromoglycate (DSCG), both compounds being administered intravenously. RU 31156 was also active when administered orally, having an ED50 of 0.19 (0.07--0.30) mg/kg when given 10 min before antigen. RU 31156 partially inhibited an IgG-mediated PCA reaction in the rat. Both RU 31156 and DSCG inhibited anaphylactic bronchoconstriction in the rat, giving bell-shaped dose-response curves. From the upward part of the curves, approximate ED30 values of 0.02 and 2.0 mg/kg were obtained for RU 31156 AND DSCG respectively. Anaphylactic bronchoconstriction in the guinea-pig was not affected by RU 31156 and pinnal anaphylaxis was inhibited at only relatively high doses of 1--10 mg/kg i.v. The effects of both histamine and 5-hydroxytryptamine in the mouse pinna were not affected by RU 31156. In PCA experiments, RU 31156 showed self-tachyphylaxis following both intravenous and oral administration. It also showed cross-tachyphylaxis with DSCG, indicating that these compounds are likely to share a similar mode of action.

Role of solute excretion in prevention of norepinephrine-induced acute renal failure

Infusion of 0.75 μ g/kgbw/min norepinephrine (NE), for 40 minutes, into one renal artery in anesthetized dogs, induced acute renal failure (ARF). Subsequently there was nearly complete reversal of function within 8 weeks. Isotonic saline volume expansion, or renal vasodilation plus diuresis by acetylcholine (into renal artery: 20 μg/min) did not protect against this type of ARF. Volume expansion with either 5 or 20 percent mannitol partly prevented the fall of GFR 3 hours after NE, this protection being correlated with the magnitude of the osmolar clearance at the time of the insult. IV furosemide (10 mg/kg + 10 mg/kg/h; fluid losses replaced) afforded an even better protection. Proximal tubular necrosis in the "protected" kidneys was as severe as in non-protected kidneys. Glomerular cell morphology (scanning electron microscopy) was not altered by the 40-minute NE infusions. Functional "protection" appeared to depend on solute diuresis at the time of insult.

Crypt cell isolation in the small intestine of the mouse

A successful method has been developed for isolating viable single cell suspensions of intestinal crypt cells from the small bowel of the mouse. The lumen of the intestine was perfused with a 0.2% trypsin solution that dissociated the lining epithelial cells. Crypt cell isolation, which proves to be extremely critical, occurred under optimal mechanical and chemical configurations about 75 min after the beginning of the procedure.

Thermal denaturation of sheared and unsheared chromatin by absorption and circular dichroism measurements

Thermal denaturation of chromatin is observed by simultaneously monitoring absorption and circular dichroism at 276 nm as functions of temperature. Either observation indicates that sheared chromatins shows less thermal stability than native chromatin. The temperature-dependent ellipticities at 276 nm of these chromatins show features not seen in the absorption curves: the ellipticity of unsheared chromatin increases with temperature, while this increase is abolished or greatly reduced in the same chromatin after shearing. After its first thermal transition (prior to the helix-coli transition) the unsheared chromatin achieves the same ellipticity as sheared chromatin.

Pinnal anaphylaxis in the mouse. Mediating antibodies and rhythmic variations in the response

The anaphylactic reaction in the pinna of a mouse actively sensitized to horse serum is mediated by IgG1 and IgE antibodies. Anaphylactic sensitivity is subject to diurnal variation, peak sensitivity occurring at 16.00 hours and minimum sensitivity at 10.00 hours. Anaphylactic sensitivity also varied with the season of the year, being lower during June and July than in the rest of the year, when the reaction was fairly constant.

Effect of thiol-oxidation of glutathione with diamide on corneal endothelial function, junctional complexes, and microfilaments

Intracellular-reduced glutathione (GSH) was removed by thiol-oxidation with diamide during in vitro perfusion of the corneal endothelium. By 15 min the normal mosaic-like pattern of the endothelial cells was disrupted by serpentine-like lines of cell separation at the cell juntions. After 45 min of perfusion, infividual clusters of cells formed cup-shaped islands. The resultant exposure of Descemet's membrane to the perfusion solution resulted in corneal swelling. Transmission electron microscopy revealed that the endothelial cells separated at the apical junctions and that the microfilaments in the apical cytoplasm of cells formed dense bands, whereas the other subcellular organelles were normal in appearance. The change in cellular shape may be due to loss of cellular adhesion which results in the condensation of the microfilaments or contraction of the microfilaments. The addition of glucose to the perfusate prevented the diamide effect, and the diamide effect could be reversed upon removal and perfusion of a glutathione bicarbonate Ringer's solution. These results suggest that the ratio of reduced to oxidized glutathione in the endothelial cells plays a role in the maintenance of the endothelial cell barrier function.

Sequential release of histamine and 5-hydroxytryptamine during pinnal anaphylaxis in the mouse

Histamine and 5-HT have been demonstrated to be involved in pinnal anaphylaxis in mice. Each predominates at different stages during the 30-min development of the reaction. The main mediator of the early stage of the reaction (0-10 min) is histamine, that of the middle stage (10-20 min) is 5-HT, and that of the final 20- to 30-min stage is, again, histamine. The source and mechanism of release of the 5-HT and the late histamine are, as yet, unknown but under investigation.

Evaluation of amniotic fluid for aerobic and anaerobic bacteria

Studies of 117 pregnant women, 83 at term, were instituted to determine the bacteriologic state of amniotic fluid, utilizing both standard aerobic and anaerobic technics. A high association of postpartum infection was found in women who had long periods of premature reptured membranes and many vaginal examinations. Significant organisms including anaerobes, were isolated in many of these instances. Based on the findings of these studies, it is recommended that amniocentesis for aerobic and anaerobic cultures be done when membranes have been ruptured for 8 hours or more, and when the patient has had seven or more vaginal examinations during the course of labor.