Polymorphism in chromosome 4

Chromosomal analyses were performed on 302 individuals, using QFQ banding techniques to determine the occurrence of heteromorphism of chromosome 4. Two type of heteromorphism were observed, one showing an intensely fluorescent band in the centromere region and the other an intensely fluorescent band in the proximal area of the short arm. No one individual possessed both type of heteromorphism. A higher frequency of chromosome 4 heteromorphism was found in patients with schizophrenia, mental retardation, hyperactivity, developmental delay and speech impediments than in normal individuals.

Serum concentrations of the iodothyronines in elderly subjects: decreased triiodothyronine (T3) and free T3 index

In four groups of subjects free of thyroid disease, the following determinations were made: serum concentrations of thyroxine (T4), triiodothyronine (T3), reverse T3(rT3) and diiodothyronine (T2), and calculated indices of free thyroxine (FT4) and free triiodothyronine (FT3). Group A comprised healthy subjects aged 16-64; Group B, 24 healthy elderly subjects aged 68-95; Group C, 23 elderly patients with mild well-controlled chronic illnesses, aged 70-85; Group D, 40 nursing home residents aged 66-100. Serum T4 and T2 concentrations and the FT4 index were not affected by age; the rT3 concentration was slightly but significantly elevated only in Group D patients. Serum T3 concentration was significantly lower in all groups of elderly subjects and decreased FT3 index measurements were detected after age 75. It was concluded that old age, without complicating illness, is accompanied only by a decrease in the serum level of T3 and the FT3 index; values for other iodothyronines are unchanged. Clinicians should consider the age-related changes in T3 and FT3 values when interpreting thyroid function tests.

Operative risk factors in patients with left main coronary-artery disease

To identify the factors associated with operative mortality, we evaluated clinical, angiographic, and surgical variables in 1172 patients with left main coronary-artery stenoses of at least 50 per cent, who underwent coronary-bypass procedures in the Collaborative Study in Coronary Artery Surgery (CASS). The operative mortality was 4.2 per cent overall and was less than 3 per cent in seven of the 15 participating hospitals. Historical variables associated with an increase in operative mortality were age, female sex, and duration and severity of angina. Other variables associated most closely with poor survival were urgency of operation, left coronary-artery dominance, severity of left main coronary-artery stenosis, and impairment of left ventricular contraction. The results of this multicenter study show that aortocoronary bypass surgery in patients with left main coronary-artery disease can be performed with a low mortality and that patients at high risk can often be identified before surgery.

Compressive myelopathy in Maroteaux-Lamy syndrome: clinical and pathological findings

A 41-year-old woman with Maroteaux-Lamy syndrome developed spastic tetraparesis due to a compressive cervical myelopathy. There was substantial improvement following laminectomy and excision of the markedly thickened dura. Light and electron microscopic studies showed extensive accumulations of balloon cells in the dura.

Interaction of separation discomfort with contact comfort and discomfort in the dog

This experiment concerns 2 issues: the time of onset of the process of social attachment in the dog, and the nature of the interaction between the emotion of separation distress and that caused by discomfort. The subjects were 48 puppies from 4 genetic backgrounds: beagles, Telomians, and their reciprocal F1 hybrids. Puppies were divided into 4 groups nd isoalted for short periods under comfortable and uncomfortable conditions beginning at 3, 11, 17, and 25 days from birth. The dependent variable was distress vocalization during a 10-min period. Separation distress did not occur before 11 days and remained at a low level until 21 days, when it rose rapidly. The process of attachment is thus initiated in the transition period but does not reach a high level until some 2 weeks later. Interaction between the 2 kinds of affect is compatible and additive.

Acquired carbohydrate intolerance and cow milk protein-sensitive enteropathy in young infants

Sixty infants with acquired carbohydrate intolerance, 19 with protracted diarrhea, and 41 with features indistinguishable from acute infectious enteritis, were maintained on a lactose-free and cow milk protein-free formula for about eight weeks, after which jejunal biopsies were performed before and after oral provocation with cow milk protein. Following provocation, 43 infants showed mucocal abnormalities associated with marked reduction in the levels of all three disaccharidases. In one infant, mucosal change was unaccompanied by enzyme depletion. Six infants had enzyme depletion without visible mucosal changes. In ten infants the intestinal mucosa remained normal and there was no consistent pattern of change in the enzyme levels. The findings suggest that cow milk protein has a deleterious effect on the small bowel mucosa of young infants recovering from enteritis and may be an important contributing cause of acquired carbohydrate intolerance in these infants. In the management of young infants with acquired carbohydrate intolerance both the offending sugar and protein should be excluded.

Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS)

Data were collected prospectively on 7553 consecutive patients undergoing coronary arteriography. The studies were performed at 13 clinics of the Collaborative Study of Coronary Artery Surgery (CASS) using brachial and femoral techniques. There were eight deaths 0--24 hours and seven deaths 24--48 hours after arteriography (2/1000). There were 15 non-fatal myocardial infarctions (MIs) 0--24 hours and four MIs 24--48 hours after arteriography (2.5/1000). Of 657 cases with left main stenosis greater than or equal to 50%, five died and three had MI. Left main disease increased risk of death by 6.8 times (p less than 0.001). Other factors increasing risk were unstable angina, congestive heart failure, multiple premature ventricular contractions, and hypertension. Of the 1187 patients studied from the brachial artery, six died (0.51%) and five had MIs (0.42%). In 6328 patients studied from the femoral artery, nine died (0.14%) and 14 had MIs (0.22%). The brachial artery technique increased the risk of death 3.6 times compared with the femoral approach (p less than 0.05). This result did not apply when analysis was restricted to laboratories with 80% or more brachial procedures. Risk was not altered by heparin. Thus, a prospective, multicenter analysis of complications reveals low risk of coronary arteriography but significant difference between two techniques.

Clinical and radiologic remission in reticulum cell sarcoma of the brain

Two patients with cerebral reticulum cell sarcoma (CRCS) are reported in whom neurologic abnormalities and radiologic (computerized tomographic [CT] scan) evidence of tumor remitted. In one patient, remission followed craniectomy and corticosteroid therapy and lasted for eight months. In the other patient, at least four remissions occurred over a span of seven years, each in conjunction with the administration of corticosteroids. Corticosteroids may favorably alter the biologic activity of tumor tissue in some cases of CRCS, predisposing to clinical remission and disappearance of tumor on CT scan.

Cows' milk protein-sensitive enteropathy: an important contributing cause of secondary sugar intolerance in young infants with acute infective enteritis

The effect of cows' milk protein (CMP) on the mucosal disaccharidases was investigated in 23 infants with acute infective enteritis. Jejunal biopsies performed before and after cows' milk provocation were subjected to histological examination and to mucosal disaccharidase enzyme (lactase, sucrase, and maltase) analyses. After milk challenge, changes in mucosal histology were observed in 18 infants, in 17 of them the levels of all 3 mucosal disaccharidases were much reduced. 10 of these infants developed diarrhoea and, in 6, the stools were positive for reducing sugar. It is concluded that CMP has a deleterious effect on the jejunal mucosa of young infants recovering from infective enteritis, so that in the management of young infants with sugar intolerance secondary to infective enteritis, CMP and lactose should be excluded from the diet.

Culture conflict and coping in a group of aboriginal adolescents

Critical incidents adapted to presentation in picture form were used to investigate responses of Aboriginal adolescents from Elcho Island mission in the Northern Territory of Australia in conflict situations arising from culture contact. These Aboriginal youths are part of a complex environment where choice behaviour is mediated by specific and broader situational characteristics of the social environment. Results showed a relationship between conflict responses and orientation to traditional values and skills, but no apparent relationship between conflict responses and modern value orientation or psychopathology variables. Adolescents who attended high school in Darwin were seen as more mission and academically oriented than locally educated youth. Contary to expected patterns, males appeared to be less involved in both mission and traditional activities and more restricted by traditional social expectations than were females.

Thyroid function tests in elderly hyperthyroid patients

Several tests of thyroid function were performed in 35 hyperthyroid patients over the age of 65 (elderly). The results were compared to those of similar tests in 48 hyperthyroid patients under the age of 65 (young). Total serum thyroxine (T4) was within the normal range in 14 percent of the elderly and 11 percent of the young hyperthyroid patients. The free thyroxine index (FTI) was within the normal range in 11 percent of both groups. The triiodothyronine uptake (T3U) proved to be a poor test in both groups. Although elevation of the triiodothyronine (T3) level allowed a diagnosis of "T3-toxicosis" in 2 elderly and 3 young hyperthyroid patients, the T3 level was normal in 34 percent of the elderly and 13 percent of the young subjects. Correction of the T3 range for age reduced the number of normal T3 values to 12.5 percent in the elderly hyperthyroid patients. The 24-hour uptake of radioactive iodine was normal in 12 percent of the young hyperthyroid patients, 27 percent of the elderly patients with Graves' disease, and 70 percent of the elderly patients with toxic nodular goiter, despite recent readjustment of the normal range for the test. It is concluded that the diagnosis of hyperthyroidism in the elderly may be difficult and that no single test can be relied upon to exclude the diagnosis.

Computer processing of CT images: advances and prospects

Computerized tomography (CT) images are created by computer and as such are inherently amenable to computer image processing techniques. Advances have been made in the areas of alternative visualization (coronal views, etc.), image enhancement, feature extraction, and computer analysis of the extracted information. Further advances await imaginative application of these techniques and time; others will depend upon necessary advances in image processing methods.

Cytogenetic studies of three true hermaphrodites

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The use of a written summary in group psychotherapy supervision

Clinical supervision is an important feature of the education of the group therapist. The authors describe the application of a summary written by trainee cotherapists in their supervision. They found that the summary, which is supplied to the patients as well as to the supervisor, serves several functions that contribute to improved quality of clinical supervision and training of group therapists.

Hypercalcemia and neoplasia. Biologic, biochemical, and ultrastructural studies of a hypercalcemia-producing Leydig cell tumor of the rat

A localized, transplantable testicular tumor of the Fischer rat regularly produces hypercalcemia and increased phosphorus clearance in host animals. Light and electron microscopic examinations of the tumor indicate that it is of Leydig origin. There is no evidence that the tumor secretes any biologically active sex steroids, judges by weights of target tissues, when the tumor is grown in castrated or spayed rats. No radioactive steroid hormone formation in vitro was detected using 1-14C-acetate as a precursor although 14C was incorporated into the "C27" sterol fraction. Mass (micrograms) amounts of sex steroids were not detected after purifying large amounts of tumor extracts. The phytosterols, beta-sitosterol, stigmasterol, campesterol, were tentatively identified in tumor extracts but were also found in other tissues and in tumors not associated with hypercalcemia. Administered in vivo, human chorionic gonadotropin caused an acute rise in serum calcium in 3 to 5 hours in tumor-bearing hypercalcemic rats. Only trophic hormones with luteinizing hormone activity were found to compete with 125I-human chorionic gonadotropin for binding to the tumor homogenate in vitro indicating the tumor possessed luteinizing hormone receptors. When the tumor was transplanted intrasplenically, hypercalcemia did not occur unless adhesions formed, suggesting that the tumor hormone was rapidly metabolized by the liver and was probably of small molecular weight. Secretory granules, usually thought to be associated with peptide hormone secretion, were not detected at the ultrastructure level. Cortisol, conjugated estrogen, and an inhibitor of sterol biosynthesis (AY-9944) were effective in lowering the elevated serum calcium. Definitive identification of the agent causing lethal hypercalcemia has not been accomplished. The available data suggest it is not parathyroid hormone or vitamin D. The Leydig cell origin of the tumor, its response to human chorionic gonadotropin in vivo, the lack of secretory granules at the ultrastructural level, and biologic characteristics, all lead to the speculation that the secretory product of the tumor is a new hormonal substance, possibly a steroid precursor or related substance not previously described or is a known substance of small molecular weight whose calcium-mobilizing properties have not been fully characterized. This transplantable tumor may represent a model for one form of neoplastic hypercalcemia occurring in man and may have important implications in the general area of calcium and phosphorus homeostasis.

Aspirin and lymphocyte transformation

Twelve healthy subjects were placed on aspirin in a dosage of 600 mg five times daily for 14 days. The capability of their lymphocytes in culture to incorporate 3H-thymidine in response to phytohemagglutinin and allogeneic lymphocytes (one-way mixed lymphocyte culture) was measured before and after the course of aspirin. The results were compared with those obtained simultaneously from non-aspirin-treated control subjects. Statistical analysis showed no significant differences between lymphocyte response in the pretreatment and posttreatment periods or between aspirin-treated and non-aspirin-treated subjects. In contrast to previous reports of lymphocyte suppression resulting from addition of aspirin directly to lymphocyte culture and from orally administered aspirin, we conclude that comparable dose ranges in vivo do not suppress lymphocyte responsiveness to either phytohemagglutinin or allogeneic lymphocytes, at least within a 2-week period of treatment.

Serum folate and vitamin B12 levels in hypothyroid and hyperthyroid patients

We measured the levels of serum folate and vitamin B12 in newly discovered hypothyroid (n =56) and hyperthyroid (n =47) patients and in age- and sex-matched control subjects (n =103). Except for one patient with latent pernicious anemia, serum folate and vitamin B12 levels did not differ greatly in our patients and in our control subjects. Another patient was receiving monthly injections of cyanocobalamin for previously diagnosed pernicious anemia. We conclude that abnormalities of thyroid function per se did not alter serum folate or vitamin B12 levels in our patients.

Attitudes toward Sunday and their relation to depression

An attitude scale toward Sunday containing behavioral preferences with the dimensionality exciting-boring was constructed, based on the performance of 76 alcoholic patients, to investigate the effect weekends might have on patients. Positive or elated patient attitudes reflecting the psychological status of activation correlate negatively with measurements of depression, and positively with judgments of social desirability.