Suicide in pregnancy: the Hedda Gabler syndrome

A review of forty-seven suicides in women of child-bearing age revealed that two women were pregnant, two were within the first year post-partum and two falsely believed themselves pregnant. The search revealed two additional pregnancy-associated suicides which had not been reported as suicide. Previous studies asserting that pregnancy protects against suicide would seem to be challenged by these data. Pregnancy-related suicides are similar to each other and to the literary suicide of Hedda Gabler and fit into a continuum of pregnancy-related disorders.

Behavioral, compound action potential, and single unit thresholds: relationship in normal and abnormal ears

Comparisons were made for two species (chinchilla and mongolian gerbil) among mean behavioral audiogram, mean just detectable action potential (AP) responses to tone bursts, and single-fiber response thresholds at the characteristic frequency, averaged in one-octave bands. In normal animals and in a group of Kayamycin-treated chinchillas, these mean measures appear to have a well-ordered relationship. Unit and AP thresholds are within 10 dB from one another throughout the frequency range. Behavioral thresholds are usually 15--20 dB more sensitive, but the three curves are roughly parallel except at the highest frequencies, where the behavioral threshold begins to increase approximately one-half octave above the physiological ones. Individual examples for four gerbils and four chinchillas having hair cell losses due to Kanamycin intoxication reinforce the notion based on mean data that in most cases AP thresholds can serve to predict the behavioral threshold configuration.

Survivorship from large bowel cancer among Caucasians and Japanese in Hawaii

From 1960 through 1973, the Hawaii Tumor Registry identified 781 Caucasian and 1073 Japanese cases of large bowel cancer. Survivorship analysis revealed that Japanese patients had a 32% higher 5-year relative survival rate than Caucasians. Further analyses showed that colon cancer cases did better than rectal cases, and patients diagnosed before 65 years of age fared better than cases diagnosed at an older age. As expected, patients with localized disease lived much longer than those who had more advanced disease. Men and women were similar in their survival from large bowel cancer. Histologic grade of the lesion, socioeconomic variables, behavioral practices and other factors which may affect survivorship by race could not be included in this study. Until such factors are also incoporated in the analyses, the observed results are only suggestive of a racial difference in survivorship.

Properties of auditory nerve responses in absence of outer hair cells

1. Recordings were made from chinchilla auditory nerve fibers after portions of the cochlear outer hair cell (OHC) population were destroyed with the antibiotic kanamycin. In most cases the inner hair cell (IHC) population was completely preserved as determined by phase-contrast microscopy. We presume that the remaining IHCs are functionally normal, and thus that recordings obtained from fibers originating from the lesioned cochlear segment reflect IHC behavior. 2. Behavioral thresholds were measured for all animals both before and after the production of the cochlear lesion. The audiograms and the histological evaluation of the ears were the basis for assessing whether a particular fiber originated in a normal, pathological (shifted threshold; IHC only), or border region. These criteria also identified the animals that sustained IHC damage together with the destruction of part of the OHC population. Only the data obtained from those fibers which probably originated from the OHC-free segment of the cochlea are considered in detail. 3. Fibers whose characteristic frequency (CF) identified them as belonging to the normal (audiometrically and histologically) region, were found to be normal in all respects. 4. Fibers from the border region (where the audiogram has a steep slope between normal and hearing-loss regions probably corresponding to the segment where OHC loss progresses from less than 10% to more than 90%) had very complex response patterns. Their frequency threshold curves (FTC) showed great variability. In general, the closer the fiber was to the fully developed lesion, the more abnormal its FTC became. 5. Those units that were concluded to have originated from the OHC-free part of the cochlea could be divided into three categories on the basis of the shape of their FTCs. A small fraction had very broad tuning (9%). The majority (53%) had approximately normal tail segment, normal bandwidth of the tip segment, and highly elevated threshold at CF. A group of fibers (38%) could not be assigned a CF. Probably the FTC of most of these latter fibers are similar to those of the previous group, but the sharply tuned short tip segment was either missed or was not reachable on account of its extremely high threshold level. 6. Such indexes of fiber response as latency, spontaneous rate, and time pattern (PST histograms) were not affected by the loss of OHCs. 7. On the basis of the data and of the assumptions made it was suggested that outer hair cells provide a frequency-dependent sensitizing influence to the inner hair cells. The frequency dependence could best be expressed as a flat-topped band pass characteristic.

Immunologic tolerance to heterologous immunoglobulin: its relation to in vitro filtration by macrophages

The cellular and molecular basis for the difference in ability of BCG to induce tolerance in BALB/c and DBA/2 mice has been examined by in vitro biofiltration. It was found that incubation with the adherent cells from BALB/c but not DBA/2 spleens could remove the material from BGG which inhibited tolerance induction in BALB/c mice. This material was shown to represent only a trace component in BGG, was present in only certain commercial batches of BGG, and was apparently unrelated to the presence of aggregates or endotoxin.

Patterns of cystine reduction by fibroblasts from normal and cystinotic children

The possibility that the enzymatic reduction of cystine involves a multi-enzyme system led to re-evaluation of cystine reduction by fibroblasts from normal and cystinotic patients. Lineweaver-Burk plots of data with extracts of a normal cell line, representative of seven normal cell lines, under conditions of increasing cystine with variable levels of reduced glutathione (GSH) resulted in a two-limbed curve above 100 micronM cystine. Two cell lines from children with nephropathic cystinosis containing 1-6 micronmol half-cystine/g protein gave a family of curves similar to those of the normal. With six fibroblast lines containing more than 6 micronmol half-cystine/g protein, increasing cystine resulted in a family of lines without two-limbed curves. Plots of the data as activity against increasing cystine concentrations at ratios of cystine to GSH of 1:2 and 1:1 showed that two of the three lines from cystinotic subjects reduced cystine at a faster rate than the normal line. The third line from a cystinotic patient reduced cystine at a slightly slower rate when the substrate concentration in the assay was less than 80 micronM cystine. When the cystine to GSH ratio was maintained at 2:1, normal cells showed a linear increase in the rate of cystine reduction up to 100 micronM cystine, no increase in the rate between 100 micronM and 200 micronM cystine, and an increase again when the concentration of cystine was raised above 200 micronM. Such a stepwise phenomenon was absent with six cell lines containing more than 6 micronmol half-cystine/g cellular protein. A possible mechanism of control of cystine reduction is discussed.

A computer-assisted, goal-oriented psychiatric progress note system

The authors describe a computer system that develops a structured progress note for inclusion in the medical record. The progress note system reflects a goal-oriented patient treatment process and also provides for retrospective analysis of progress note information to accommodate research and review objectives. The system, which has met with a high degree of clinician acceptance, has resulted in improved case documentation, more timely and comprehensive notes, a higher level of objectivity, and a considerable reduction in the time required to organize and record progress note data.

Effect of ionizing radiation on liver microcirculation and oxygenation

Platelet aggregation and adhesiveness, as well as TPO2 responses to hypoxia were measured as microcirculation parameters in beagle dogs subject to Co60 ionizing radiation to a dose of 4600 rads in 5 weeks. Simultaneously, changes in blood chemistry and coagulation were also determined. Marked changes in all studied parameters in the post radiation period lead to the conclusion that radiation liver damage is at least in part mediated through microcirculation disturbances.

Prenatal diagnosis of cystinosis

Cystinosis was diagnosed in a small quantity of cultured amniotic cells from a 22-week-old fetus by a modified pulse-labeling technique in which intracellular 35SL-cystine retention was measured. As a result of the above finding, the pregnancy was terminated by administration of prostaglandin. The diagnosis was confirmed when the nonprotein-free cystine content of the kidney, liver, placenta, spleen, thymus, and gut, as well as that of a large amount of cultured amniotic cells, was found to be 100-fold higher than normal levels.

Uptake and utilization of exogenous cystine by cystinotic and normal fibroblasts

The uptake of l-[(35)S]cystine was studied in six cystinotic and six normal fibroblast lines grown for five days either on cover slips or in 32-oz plastic flasks. Cystinotics showed greater uptake than normals. The apparent K(t) for cystine entry in both types of cells was 0.043 mM but cystinotic cells showed a higher maximum velocity of entry. A comparison of the fate of l-[(35)S]cystine incubated for 20 min with monolayers of cells showed 30% and 15% of the intracellular (35)S to be l-cystine in cystinotic and normal cells, respectively. The (35)S effluxed more slowly from cystinotic than from normal cells after a 20-min preloading with l-[(35)S]cystine. Identification of (35)S compounds in efflux media after 3 min showed 75% of the total (35)S was l-cystine with the remainder in cysteine and acidic sulfur metabolites of cystine with no essential difference between cystinotics and normals. In paired experiments, the specific activity of the effluxed l-[(35)S]cystine after both efflux periods was the same as that entering the cell, thus indicating that the free l-[(35)S]cystine had not exchanged with the pre-existing pool in the cystinotic cells. During 3 min efflux, the l-cystine pool in normal cells was depleted mainly by loss of free cystine. In cystinotic cells, a new steady state was attained after 21 min of efflux and the intracellular l-[(35)S]cystine had the same percentage of total radioactivity seen after the initial 20-min uptake. After the rapid efflux of l-[(35)S]cystine from normals, [(35)S]cysteine and other labeled cystine metabolites appeared in the efflux media. By the end of a 3-min efflux, cystinotic cells had incorporated more label into reduced glutathione than had normal cells. However, when the new steady state was attained in cystinotics, the amounts of (35)S in glutathione were not markedly different in the two types of cells. Approximately 95% of the total label could be accounted for in free sulfur compounds. The data show an increased uptake and decreased efflux of cystine from cystinotic cells. However, it is not possible to conclude if these differences are due to primary changes in membrane function or to the reflection of metabolic defects without further investigation.

Colloid osmotic pressure in erythroblastosis fetalis

Measurements were made of total proteins, albumin, and colloid osmotic pressure on cord blood samples from 15 infants with erythroblastosis fetalis (six of whom were hydropic) and from 151 non-rhesus non-hydropic control infants. The erythroblastotic infants had levels of total protein and albumin which fell within the normal range for gestational age, but their colloid osmotic pressures were abnormally low. It seems that low colloid osmotic pressure may provide a reasonable explanation for the occurrence of hydrops fetalis.

Child-resistant medicine containers: experience in the home

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Surveillance of abortion program in New York City

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Nurse-midwifery in New York City

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Cardiac screening by computerized auscultation

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