Incidence of thyroid disease in cases of hypertrophic cardiomyopathy

The investigative findings of patients considered to have possible hypertrophic cardiomyopathy were examined, and 31 of these fulfilling defined criteria for the disease were reviewed in detail, with emphasis on thyroid abnormalities. Four patients had a history of thyroid disease (13%). Explanations considered for the apparent association were the effects of hyperthyroidism on normal, or more probably, incipiently abnormal myocardium.

Some uses of the continuous flow blood separator in the myeloproliferative syndrome

A continuous flow blood separator was used for leucapheresis in two patients with chronic myeloid leukaemia, complicated by pregnancy and leukastasis respectively, and for thrombocytopheresis in a patient with megakaryocytic myelosis. The cases described, outline some of the clinical uses of this machine in the myeloproliferative syndrome.

The mental status examination

The mental status examination evaluates appearance and behavior, attitude, perception, orientation, judgment, cognition, abstraction and insight. It can be administered quickly and repetitively. This examination provides information to distinguish organic from "functional" illnesses and also provides objective data regarding the patient's improving or deteriorating sensorium. It helps substantiate clinical decisions on competance, potential for danger and hospitalization.

The current approach to cancer treatment

The therapeutic armamentarium in the treatment of cancer is now expanded to include surgery, radiotherapy, chemotherapy and immunotherapy. The aim is to achieve cure where possible. For some cancers the concept of cure can be questioned, and for many patients, cancer must be regarded as a chronic disease. A vigorous approach to palliation, particularly in regard to special problems such as hypercalcaemia, yields good dividends. Human values remain of paramount importance, and active antitumour treatment with attendant side effects must not be continued where there is no expectation of worthwhile response.

High-dose methotrexate therapy

Eighty-six adults with malignant disease were given high doses of methotrexate with folinic acid rescue, with acceptable toxicity. Protocal violations in two cases led to death. The results of therapy in some diagnostic groups are encouraging.

Diminished reaction to a novel stimulus during amphetamine withdrawal in rats

This experiment determined whether reaction to a novel stimulus was diminished in a dose-dependent fashion following 8 consecutive days of d-amphetamine administration. Thirty-two male rats were injected with saline, 0.5, 2.5, or 5.0 mg/kg of d-amphetamine (each N = 8). On the ninth day, all animals received saline injections and were tested (a) in the presence of a novel stimulus, or (b) in the absence of a novel stimulus. Reaction to the novel stimulus varied inversely with the dose of d-amphetamine which had been received during the drug administration period. This reduction in reaction to the novel stimulus did not seem to depend on (a) the level of amphetamine-induced sterotypy at the end of the drug administration period (b) general reduction of activity, or (c) interference by drug-conditioned responses.

Characteristics of the macrophage uptake of proteinase-alpha-macroglobulin complexes

Complexes formed between labelled proteolytic enzymes (trypsin, subtilopeptidase A) and the alpha-macroglobulins of plasma are rapidly and selectively taken up by rabbit alveolar macrophages. The uptake occurs over a narrow zone of pH. Kinetics of the uptake is affected by temperature; in particular, incubation of macrophages at 37 degrees C before the addition of the labelled complex reduces the capacity to take up complexes. EDTA prevents the association of labelled complexes with macrophages, and can dissociate previously bound label. The effect of EDTA is reversed by the addition of calcium or magnesium or both. Iodoacetamide does not prevent the uptake of complexes but causes them to remain available for dissociation from the cells by EDTA. Incubation of complexes with macrophages at 37 degrees C with no iodoacetamide results in the appearance of trichloroacetic acid soluble products of the enzyme in the supernatant fluid. These observations indicate that the selective uptake of proteinase-alpha-macroglubin complexes by rabbit alveolar macrophages can be resolved into three phases: (1) membrane binding which depends upon divalent cations and is pH sensitive, (2) endocytosis inhibitable by iodoacetamide and (3) temperature-dependent hydrolysis of the contained labelled enzyme.

Self-image and emotional stability of Oedipal and non-Oedipal male homosexuals

The past several years have brought about some changes in the legal status of the homosexual in USA. In some states, the homosexual is labelled as a criminal; in others, homosexuality is not a legal affair. Psychological theories tend to consider the homosexual from two general positions: the Oedipal and the non-Oedipal. The present study was conducted to try to determine how Oedipal and non-Oedipal male homosexuals perceived their self-image and emotional stability. Significant differences were found between the two groups. Considering self-image, Oedipal subjects were found to be more negative. They had less self-worth, self-confidence and self-acceptance than non-Oedipal. They had more negative self-concepts, self-attitudes, and self-motivation. Oedipal homosexuals had less emotional stability. They had more emotional problems, shame, guilt, withdrawal, and depression than non-Oedipal subjects, as well as less success in sexual activity and commitment to the homosexual partner.

Uptake of proteinase-alpha-macroglobulin complexes by macrophages

Complexes of labelled proteinases (subtilopeptidase A, trypsin) with serum alpha 1-macroglobulin or alpha 2-macroglobulin are rapidly taken up in vitro by rabbit alveolar macrophages and peritoneal macrophages but not by mixed rabbit peripheral blood leukocytes. Enzyme, not bound to alpha 1- or alpha 2-macroglobulin, does not become associated with alveolar macrophages. Chemically inactivated subtilopeptidase A does not bind to alpha 1- or alpha 2-macroglobulin; chemically inactivated subtilopeptidase A in mixtures with alpha 1 - or alpha 2-microglobulin, does not interact with alveolar macrophages. Blocking experiments confirmed that the interaction of proteinase with alveolar macrophages is complex specific; uptake of labelled complex was prevented by the simultaneous addition of macroglobulin complexes formed with non-labelled subtilopeptidase A, subtilopeptidase B, trypsin or chymotrypsin but not by macroglobulin alone. The findings demonstrate a complex-specific interaction between proteinase-alpha-macroglobulin complexes and macrophages.

The role of alpha1-antitrypsin and alpha-macroglobulins in the uptake of proteinase by rabbit alveolar macrophages

Proteinases in plasma bind largely to alpha1-antitrypsin and alpha-macroglobin. The latter is represented in humans by alpha2-macroglobulin and in the rabbit by alpha2-macroglobulin and alpha1-macroglobulin. There is a selective and rapid uptake of proteinase-macroglobulin complexes by rabbit alveolar macrophages. It was found that complexes of labelled trypsin or subtilopeptidase A with rabbit alpha1-antitrypsin do not become similarly associated with rabbit alveolar macrophages. Moreover, proteinase-alpha1-antitrypsin complexes failed to inhibit the uptake of labelled proteinase-macroglobulin complexes. Thus, the interaction with macrophages of proteinase-macroglobulin complexes represents a pathway of proteinase metabolism distinct from that involving proteinase bound to alpha1-antitrypsin.

Characteristics relevant to cardiovascular disease among adults of African and Indian origin in Guyana

Characteristics relevant to cardiovascular disease, including anthropometry, arterial blood pressure, serum cholesterol levels, chest radiography and electrocardiography, were investigated in a survey of 843 men and women aged 35-54 years of African and Indian origin living in 2 communities in Guyana. Clinical experience suggested a high incidence of hypertension and a low incidence of ischaemic heart disease.Africans were taller and heavier than Indians but their other characteristics were, in general, similar except that their mean blood pressure levels and R amplitudes in certain ECG leads were consistently higher. Hypertension was common and was significantly correlated with obesity and, probably independently, with body size. Serum cholesterol levels, with mean values of about 200 mg/100 ml, were strongly correlated with factors associated with obesity in men but not in women. Cardiothoracic ratios, measured from chest films, were greater than values regarded as normal for Europeans because of a relative narrowness of thoracic diameters.Prevalence of S-T-segment and T-wave defects in ECGs classified by the Minnesota Code was as high as reported from communities where ischaemic heart disease is clinically more frequent. Hypertension, cardiac enlargement, obesity and cholesteraemia were more prevalent when defects involved lateral leads (I, aVL, V5 and V6) than in subjects with normal ECGs, suggesting that the majority of important abnormalities occurred primarily in the left ventricle and were probably related to hypertension rather than to coronary insufficiency without hypertension. Analysis of S-T and T-wave defects, both by blood pressure and by lead position, might show meaningful differences between populations which, by present methods of presentation, appear to have surprisingly similar prevalences of ECG abnormalities.

XYY sex chromosomes in a Jamaican with orthopaedic abnormalities

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Versuche zur Identifizierung der bei der 191Ir (n, γ) 192Ir-Kernreaktion entstandenen chemischen Folgeprodukte im Na2lrCl6 • 6H2O

Im System Na2IrCl6 · 6H2O konnten auf elektrophoretischem Wege zahlreiche individuelle Rückstoßverbindungen, die auf Grund des 191Ir (n, γ) 192Ir-Kernprozesses entstehen, getrennt werden. Diese haben vornehmlich anionischen Charakter, doch werden auch zwei 192Ir-markierte Kationen beobachtet. Es wurde das chemische Verhalten dieser mit wenigen Ausnahmen in trägerfreier Form vorliegenden Produkte während des Alterns in In HCl-Lösung und bei Reduktion des IrlV zum IrIII studiert. Zum Verständnis des Hydrolysevorganges der 36Cl und 192Ir markierten Hexachlorokomplexe des 3- und 4wertigen Iridiums erwies sich die gleichzeitige Anwendung von aktivierungsanalytischen Methoden als sehr nützlich. Diese Kenntnisse ermöglichten es, die Natur der im Pherogramm auftretenden 192Ir-Rückstoßverbindungen weitgehend zu klären. Der überwiegende Teil ist auf oktaedrische Komplexe des 3wertigen Iridiums mit wechselnden Anteilen an Cl-, H2O- und OH--Liganden zurückzuführen. Von Bedeutung ist die Mitwirkung der 6 Kristallwassermoleküle, welche über Ionen und Radikale die Kombinations- und Stabilisierungs- Reaktionen beeinflussen und so auch die Entstehung von bisher zum Teil noch unbekannten Iridium- Komplexverbindungen verständlich machen.