Metabolic bone disease in alcoholic cirrhosis: a comparison of the effect of vitamin D2, 25-hydroxyvitamin D, or supportive treatment

In a study of 56 alcoholics with liver cirrhosis, 18 (32%) had decreased bone density and low levels of serum 25-hydroxyvitamin D (25-OH-D) (less than 20 ng per ml). To compare the efficacy of vitamin D2 and 25-OH-D treatment in correcting the metabolic bone disease in alcoholic cirrhosis, the 18 patients were randomized in the following manner, in groups of six patients each: Group 1, control (received no supplemental vitamin D treatment); Group 2, given vitamin D2 (50,000 IU p.o.) two to three times weekly, and Group 3, treated with 25-OH-D (20 to 50 mg p.o.) daily as required to attain normal serum 25-OH-D levels. The study period lasted 6 to 12 months (mean, 10.7 months). Initial histomorphometric study of transiliac bone biopsy with double tetracycline labeling in nine patients in whom biopsy was feasible showed only osteoporosis without evidence of osteomalacia. By the end of the study, serum 25-OH-D levels in the control group (Group 1) raised slightly while showing marked improvement in Groups 2 and 3. Bone density results remained unchanged in control patients but demonstrated a significant increase in both treatment groups. Vitamin D2 and 25-OH-D were equally effective in increasing bone density measurements. Posttreatment biopsies were performed in three patients of Group 2 and two patients of Group 3. While the histomorphometric results in Group 3 were not conclusive, in Group 2 improvement in static measures of bone remodeling was noted. Osteoporosis is the usual form of bone disease in alcoholic cirrhosis and a response to either vitamin D2 or 25-OH-D treatment is suggested.

Chlormethiazole in the treatment of neonatal status epilepticus

A pre-term neonate with status epilepticus resistant to conventional treatment but who responded to a chlormethiazole infusion is reported. Nineteen days of continuous infusion was required before treatment could be discontinued and oral phenytoin substituted. Chlormethiazole should be considered in the treatment of resistant convulsions in the newborn.

Intracellular bile acid transport in rat liver as visualized by electron microscope autoradiography using a bile acid analogue

The role of hepatocyte organelles in the intracellular transport and secretion of conjugated bile acids has not been defined. Therefore we studied the transport and observed the subcellular localization of the bile acid analogue 125I-cholylglycyltyrosine by electron microscope autoradiography to further understand the possible compartmentation of bile acids within the hepatocyte. 125I-cholylglycyltyrosine, which retains a net negative charge, exhibited transport properties similar to native bile acids. After portal vein injection, the compound was recovered intact from bile, and the pattern of excretion paralleled that of [14C]cholylglycine. In addition, cholylglycyltyrosine uptake by isolated hepatocytes was sodium dependent. For autoradiography the analogue was injected into the portal vein, and the liver was perfusion fixed after 30 or 300 s. Light microscope autoradiography performed 30 s after isotope injection demonstrated a steep periportal-to-centrilobular gradient for 125I-cholylglycyltyrosine uptake. At 30 s quantitative grain analysis of electron microscope autoradiographs showed predominant labeling of the plasma membrane and the smooth endoplasmic reticulum (SER). The grain distribution over the region of the plasma membrane decreased from 15% at 30 s to 7% by 300 s and was associated with a sevenfold increase in labeling of the Golgi apparatus and a sixfold increase in labeling of the pericanalicular region. Grain distribution over the SER at 300 s was the same as that noted at 30 s. The hypothesis is presented that bile acids move from the sinusoidal plasma membrane to bile via a pathway that includes the SER and Golgi apparatus.

Cortical and papillary absorptive defects in gentamicin nephrotoxicity

Renal function was examined in rats given daily injections of gentamicin (100 to 150 mg/kg) for 10 to 14 days. Whole kidney inulin clearance fell and urine volume increased. Single nephron GFR of surface nephrons varied. Some nephrons had no filtration, some had low rates, and some had high rates. Abnormal renal tubular epithelial inulin permeability was demonstrated by microinjection. Micropuncture of individual nephrons early and later in their course demonstrated reduced fluid reabsorption along the proximal convoluted tubule of superficial nephrons. Rates of fluid delivery to the late proximal and distal tubule were elevated. The rate of fluid reabsorption in the superficial loop of Henle was increased. Maximal urine osmolality and papillary tissue content of urea was reduced. The polyuria, therefore, results from decreased fluid reabsorption by proximal tubules and, probably, by papillary collecting ducts. The decrease in proximal fluid reabsorption is probably secondary to impaired solute reabsorption. A decrease in collecting duct fluid absorption can be attributed to the observed decrease in papillary solute concentration.

A system for obtaining large numbers of cryopreserved human monocytes purified by leukapheresis and counter-current centrifugation elutriation (CCE)

A system has been developed for the isolation of large numbers of unfractionated mononuclear cells from single, well characterized normal individuals and for the separation by elutriation of these cells into populations of greater than 90% pure monocytes and greater than 99% pure lymphocytes. The total number of monocytes obtained from a single donor averaged about 550 million. After cryopreservation and thawing of these cells, the viability remained greater than 90%, 80% of original cells were recovered, and the ability to ingest antibody-coated targets was comparable to that of fresh monocytes. The cells remained sterile without the use of antibiotics and were suitable for long-term culture. The monocytes that were isolated and cryopreserved by these procedures functioned reproducibly as inhibitors of tumor cell growth and in an assay of responsiveness to monocyte migration inhibitory factor (MIF).

Protein-energy malnutrition and liver dysfunction limit the usefulness of the relative dose response (RDR) test for predicting vitamin A deficiency

The relative dose response (RDR) test was examined for its value in predicting vitamin A nutriture among chronically ill patients with protein-energy malnutrition and among patients with varying degrees of liver dysfunction. The RDR test was elevated (ie greater than 14 per cent) and, thus, predictive of vitamin A deficiency in only 4 out of 9 patients with combined vitamin A deficiency and protein-energy malnutrition. Among 27 patients with liver dysfunction who had vitamin A determinations performed on liver biopsy material, there was no correlation found between the RDR response and the hepatic vitamin A level. Of 12 patients with low hepatic vitamin A levels (less than 100 micrograms/g wet weight), the RDR test was normal in 9 (75 per cent). Inability of the RDR test to predict vitamin A nutriture in patients with protein-energy malnutrition and in patients with liver dysfunction may, in part, be due to inadequate synthesis or release of retinol-binding protein.

Combined modality therapy for esophageal squamous cell carcinoma

Of 55 patients with esophageal squamous cell carcinoma, 30 with localized disease were treated with a combined modality for curative intent. Treatment consisted of mitomycin C (10 mg/m2 day 1) and continuous infusion 5-FU (1000 mg/m2 day, days 1-4, 29-32) (CT), radiation (XRT) (3000 rad, days 1-21) with nutritional support, and surgery (days 49-64). Surgery consisted of celiotomy, esophagectomy and esophagogastrostomy +/- postoperative ventilatory support. Postoperative CT plus an additional 2000 rad XRT was restricted to patients with histologic positive tumor. Since five resected patients with subclinical metastatic tumor had an inferior survival equal to 25 patients treated essentially for palliation, pretreatment celiotomy seems warranted to identify patients with an inferior prognosis. Of 18 resected patients without disseminated tumor evaluable for this combined modality: six were tumor free, three had intramural and nine transmural tumor; the median survival is 76 weeks and five of six living patients are disease free at 95-190 weeks; and local recurrence occurred in two and in two of seven unresected patients. Since toxicity was minimal except for postoperative pneumonitis (13%) and local recurrence low (13%), two courses of chemotherapy and 5000 rad XRT perhaps obviates the need for resection.

Most cited authors and publications in health education journals for 1970-79

This study attempted to answer the following questions about the journals Health Education, Health Education Monographs and the Journal of School Health. What authors have been cited the most in health education journals during the decade of the 70s? What authors have been cited the most in each health education journal? What articles and books have been the most cited in health education journals? What have been the most cited articles and books in each health education journal? It was found that the most cited author was L. W. Green, the most cited articles were L. W. Green "Toward Cost-Benefit Evaluations of Health Education: Some Concepts, Methods and Examples." Health Education Monographs and S. V. Kasl "Health Behavior, Illness Behavior and Sick-Role Behavior." Archives of Environmental Health and the most cited books was School Health Education Study, Health Education: A Conceptual Approach to Curriculum Design. Most cited authors, articles and books varied across the three journals.

Pseudoepileptic seizures: methods and video analysis to aid diagnosis

The purposes of this study were to obtain a detailed description of the clinical features of pseudoepileptic (PE) seizures, to try to reproduce these events in the laboratory during a single recording, and to establish a framework useful to the clinician for evaluating patients whose behavior suggests physiological seizures, but about which doubt remains. We analyzed 37 episodes of PE seizures recorded in 30 patients during a single three-hour video/EEG recording. The PE seizures occurred spontaneously or were induced by sequential activation procedures. The historical information together with behavioral observations show that the PE seizures mimicked primary generalized seizures in 15 episodes, elementary partial seizures with secondary generalization in 21 episodes, and complex partial seizures in a single episode. Our data underscore the usefulness of the video/EEG recording method and suggest activation techniques which, combined with detailed historical information, aid in establishing the diagnosis of PE seizures.

Frozen tissue sections as an experimental system to reveal specific binding sites for the regulatory subunit of type II cAMP-dependent protein kinase in neurons

Specific binding sites for the regulatory subunit of type II cAMP-dependent protein kinase (RII) were revealed in neurons by an immunohistochemical approach. Fixed frozen sections of several regions of the rat central nervous system were incubated in the presence of bovine RII. Bound bovine RII was subsequently detected by an immunofluorescence procedure using antibodies that recognize bovine but not rat RII. The results indicate that RII binds with high affinity to neurons. Binding is prominent in dendrites and almost undetectable in axons and axon terminals. The morphological distribution of the RII binding sites is almost identical to that of microtubule-associated protein 2 (MAP 2) immunoreactivity. Preadsorption of RII with a MAP preparation highly enriched in MAP 2 completely abolished binding of RII to tissue sections, suggesting that the binding is mediated by MAP 2. Our results indicate that frozen sections of fixed tissues are a suitable experimental system for study of specific interactions of cellular macromolecules at a morphological level.

Stress, symptom proneness, and general adaptational distress during pregnancy

Symptom proneness (SP), the 20 psychiatric items of the Cornell Medical Index, here called the Cornell Psychiatric Items (CPI), and a test developed partially from the Schedule of Recent Experiences called the Utah Stress Scales (STRESS) were used to predict general adaptational distress (GAD) symptoms during pregnancy on a sample of 1306 primigravidas. The causal model explored in seven path analyses developed for months 3-9 of pregnancy is that SP and STRESS affect CPI, and that SP, STRESS, and CPI directly affect GAD symptoms. Results suggest that CPI is most predictive of GAD symptoms until the ninth month when SP and STRESS become more predictive. It is suggested that GAD pregnancy symptoms are affected by situational stress, symptom proneness, and level of psychological upset and that this system of relations changes over the course of pregnancy. This information should have important implications for anticipating potential problems and improving the quality of nursing care of pregnant women.

Development of a health attitude scale

A tool was developed to assess attitudes of patients with cardiac disease toward performing prescribed behaviors of their medical regimen. Two groups of subjects with heart disease were used to examine validity and reliability of the Miller Attitude Scale. One group included 480 members of Mended Hearts, Inc., and the second group consisted of 35 patients diagnosed with a first myocardial infarction. The second group repeated the attitude scale six months post-hospitalization. Performance of the medical regimen by this group was verified at the six-month follow-up period. Using Spearman Rank Correlation, there was a significant relationship between attitudes and adherence behaviors for three of the five subscales. Alpha reliabilities revealed a high degree of internal consistency of scale items for all five subscales when testing both groups. A factor analysis resulted in eight factors accounting for the majority of the variance. Each of the five behaviors of the medical regimen clearly defined a factor supporting used of the Miller Attitude Scale for assessing attitudes of heart patients toward behaviors of their medical regimen.

Familial pericentric inversion of chromosome 11 detected prenatally

A pericentric inv(11)(p12q25) was detected by prenatal diagnosis and subsequently found in four other family members. There was no apparent evidence of clinical consequences caused by this inversion.

Eradication and palliation of squamous cell carcinoma of the esophagus with chemotherapy, radiotherapy, and surgical therapy

Between April, 1977, and March, 1981, 86 unselected patients with proved squamous cell carcinoma of the esophagus were treated with a combination of chemotherapy and radiotherapy followed by operation whenever feasible. The preoperative chemotherapeutic agents used initially were 5-fluorouracil, and mitomycin C. After December, 1979, cis-platinum was used instead of mitomycin C. Radiotherapy (3,000 rads) of the tumor was begun at the same time as the chemotherapy. An esophagectomy was performed on suitable candidates 3 to 4 weeks after the chemotherapy and radiotherapy were completed. The mucosal lesion disappeared in 69 of the 86 patients, and dysphagia was relieved at least temporarily in 57 of 62 patients. Recurrent dysphagia resulting from fibrosis at the tumor site caused a secondary stenosis in 11 patients. Excellent palliation was obtained in five patients with bronchoesophageal fistulas who had an initial substernal gastric bypass followed by chemotherapy and radiotherapy. Of the 48 patients who had an esophagectomy, 15 (31%) had no tumor in the resected specimen. Eleven of these 15 patients are still alive with no evidence of disease. All patients with a lesion less than 5.0 cm in length had complete regression of the tumor. We believe that this combination of chemotherapy, radiotherapy, and surgical therapy provides excellent palliation, increases resectability, and has a potential for cure.

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.

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.