Autoradiographic analysis of alpha-adrenoceptors and muscarinic cholinergic receptors in the hyperplastic human prostate

Radioligand receptor binding and autoradiography were used to characterize, localize and compare alpha-1 and alpha-2 adrenoceptors and muscarinic cholinergic receptor populations in human benign prostatic hyperplastic tissue. The binding of selective alpha-1 and alpha-2 ligands, [3H]-prazosin and [3H]-UK 14,304, to homogenates of human central and peripheral prostate was saturable and of high affinity. Scatchard analysis produced an equilibrium dissociation constant (KD) of 0.51 +/- 0.10 nM for alpha-1 adrenoceptors, and 2.34 +/- 0.40 nM for alpha-2 adrenoceptors. The mean densities, Bmax, of alpha-1 and alpha-2 adrenoceptors identified in the human adenomatous prostate were 65.9 +/- 12.9 and 36.1 +/- 7.0 fmoles/mg. protein respectively. Receptor autoradiography was used to examine the distribution of muscarinic cholinergic receptors [( 3H]-QNB), alpha-1 adrenoceptors [( 3H]-prazosin]), and alpha-2 adrenoceptors [( 3H]-rauwolscine) on consecutive sections of benign hyperplastic prostatic tissue. Although both subtypes of adrenoceptor were seen in the stromal component of the hyperplastic prostate, there was a substantial predominance of alpha-1 adrenoceptors. A densitometric computer-assisted analysis was performed on the autoradiographic slides to determine the mean ratio of specific alpha-1: alpha-2 adrenoceptors in the stromal compartment of the hyperplastic tissue. The ratio, expressed as % grain occupancy/unit area, was 3.9 +/- 0.75, which is in agreement with a functional alpha-1 adrenoceptor predominance shown in previous studies. Although sparsely distributed in the stroma, a dense alpha-2 adrenoceptor population was seen in association with blood vessels, and in close proximity to the base of some of the [3H]-QNB-labelled prostatic glandular epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)

A trace-enrichment technique for the loading of gel-permeation high-performance liquid chromatography columns

Gel-permeation high-performance liquid chromatography (GP-HPLC) columns provide rapid high-resolution separations but are frequently limited to analytical tasks because the injection volumes must be small. The reduction of volume required for the loading of solutes can often be impractical and lead to poor recoveries. We have developed a trace-enrichment technique to circumvent this problem. By placing a Waters Guard Pak within the loop of a Valco injector and connecting a pump to the injection port it is possible to concentrate proteins and peptides onto the guard column from relatively large volumes. Enrichment onto a reversed-phase guard column insert is achieved by loading solutes in an aqueous solution or one of low organic solvent concentration. Provided that the GP-HPLC is mean-while equilibrated with a solvent system of sufficiently high organic solvent concentration (i.e., 40% acetonitrile containing 0.1% trifluoroacetic acid) it is possible to elute material that has been loaded in this manner by simply placing the injection loop in line with the column. The solvent strength abruptly increases and the peptide or protein sample is loaded onto the column in a very small volume. We have applied this loading principle to both analytical and semipreparative problems. The amino-terminal fragment of pro-opiomelanocortin (POMC) has been extracted from a single human fetal pituitary (18 weeks gestation) and characterized in terms of its molecular weight. This study indicated that no proteolytic processing of the amino-terminal fragment of POMC takes place at this stage in development. In a larger scale application the amino-terminal fragment of POMC was purified from bovine anterior pituitaries.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterisation of human prostatic adrenoceptors using pharmacology receptor binding and localisation

Benign prostatic enlargement is a common cause of bladder outlet obstruction. Recent work has demonstrated the important role played by the sympathetic nervous system in the control of prostatic muscle tone. Although isometric muscle strip studies and clinical trials have highlighted the influence of alpha-1 adrenoceptors, radioisotope ligand binding studies have demonstrated a relatively increased density of alpha-2 adrenoceptors in the muscle within prostatic tissue, the significance of which is as yet unexplained. Forty patients entered a study using pharmacological muscle strip experiments, radioligand binding assays and receptor autoradiography. Pharmacological data from these studies confirmed that contraction of prostatic muscle is mediated predominantly by alpha-1 adrenoceptor stimulation, with no evidence of significant alpha-2 adrenoceptor or cholinergic mediated effects. Radioligand binding studies confirmed that there is a higher concentration of alpha-1 binding sites as contrasted to alpha-2 within normal prostate, but that this relationship approaches equity in adenomatous prostate. Autoradiographic localisation demonstrated that alpha-1 adrenoceptor binding is predominant within prostatic stroma with only a small component of alpha-2 adrenoceptors in this compartment. This comprehensive study supports the suggestion that prostatic muscular contraction is controlled by the influence of the sympathetic nervous system acting via alpha-1 adrenoceptors. These findings support the therapeutic use of specific alpha-1 adrenoceptor blockade in the management of benign prostatic hyperplasia.

Neuropeptide Y-like immunoreactivity in intramural ganglia of the newborn guinea pig urinary bladder

Immunoreactive neuropeptide Y (NPY) was demonstrated in neuronal elements in the urinary bladder wall of the newborn guinea pig. Numerous intramural ganglia were found lying among the smooth muscle bundles and in the submucosa, and NPY-like immunoreactive nerve cell bodies were demonstrated within all of these ganglia. Nerve fibres containing NPY were also richly distributed in the detrusor muscle, submucosa and around blood vessels. In dissociated cell cultures from newborn guinea pig detrusor muscle, a subpopulation (70-85%) of both mononucleate and binucleate intramural neurones was shown to contain NPY-like immunoreactivity. A low percentage (1-6%) of the intramural bladder neurones contained dopamine-beta-hydroxylase. In conclusion, while some NPY-containing nerve fibres in the wall of the bladder are of sympathetic origin, especially those supplying blood vessels, the results of this present study establish that many of these NPY-containing nerve fibres originate from non-adrenergic cell bodies within the intramural bladder ganglia.

Investigation of cremations and severely burned bodies

Among the most difficult cases for law enforcement and medicolegal investigators to investigate are those in which victims have been deliberately burned to cover up a crime, or those in which cremation has resulted from an accident or suicide. This difficulty arises from the fact that the bodies may be destroyed or fragmented. The major objective in these investigations are twofold: The first task is to identify the body using every means available, including the aid of such experts as forensic pathologists, forensic anthropologists, dentists, toxicologists, and serologists as well as fire investigators, who can contribute to the investigation by providing information about the course of the fire.

Autoradiographic localization of binding sites for 125I-substance P on neurones from cultured rat superior cervical ganglion

Using an autoradiographic receptor binding technique, the distribution of substance P (SP) receptors on cells cultured from the superior cervical ganglia (SCG) of newborn rats was investigated. Binding sites for 125I-Bolton-Hunter-SP were observed on a subpopulation of 35-50% of the ganglion neurones. The percentage of labelled neurones remained constant whether the cultures were seeded densely or sparsely. Variation in the density of labelling was observed on different neuronal clusters. Neuronal cell bodies were often densely labelled, but neuronal processes were rarely labelled. In contrast with the neuronal cells, specific labelling was not associated with other cell types found in this culture preparation, including fibroblasts, glial cells and other non-neuronal supporting cells. These results are interpreted to suggest that there is a subpopulation of SCG neurones which, by virtue of their expressing SP receptors, are responsive to SP and have a physiological role within the ganglion.

Simultaneous monitoring of coronary blood flow and 31P NMR detected myocardial metabolites

We report a method of dynamically measuring coronary blood flow in lambs, while simultaneously monitoring cardiac phosphate metabolism with 31P NMR at 81 MHz. This method uses an ultrasonic transit time probe in conjunction with a 4.7-T CSI spectrometer with a 33-cm magnet bore.

Increase in P50 with the use of bicarbonate hemodialysis

We studied the effect of bicarbonate and acetate on oxygenation during dialysis in ten male chronic dialysis patients. The dialysis delivery system and dialysate constituents were identical except for the use of either bicarbonate or acetate. We found no hemodynamic differences between the two kinds of dialysis. Blood PO2 fell by a similar amount, but blood PCO2 was higher during bicarbonate dialysis. The blood pH became alkalotic by the second hour of bicarbonate dialysis and remained so throughout the dialysis, whereas blood pH became alkalotic only at the end of acetate dialysis. The P50 increased significantly only during bicarbonate dialysis, but 2.3 DPG concentration did not change. Red cell volume, assessed by the mean corpuscular hemoglobin concentration, was unchanged. Without changes in the red cell volume we cannot explain the observed changes in P50 in the absence of concomitant changes in 2.3 DPG concentration.

Increase in P50 with the use of Bicarbonate Hemodialysis

We studied the effect of bicarbonate and acetate on oxygenation during dialysis in ten male chronic dialysis patients. The dialysis delivery system and dialysate constituents were identical except for the use of either bicarbonate or acetate. We found no hemodynamic differences between the two kinds of dialysis. Blood PO2 fell by a similar amount, but blood PCO2 was higher during bicarbonate dialysis. The blood pH became alkalotic by the second hour of bicarbonate dialysis and remained so throughout the dialysis, whereas blood pH became alkalotic only at the end of acetate dialysis. The P50 increased significantly only during bicarbonate dialysis, but 2.3 DPG concentration did not change. Red cell volume, assessed by the mean corpuscular hemoglobin concentration, was unchanged. Without changes in the red cell volume we cannot explain the observed changes in P50 in the absence of concomitant changes in 2.3 DPG concentration.

Small-bowel disease: categorization by CT examination

Fifty patients with no small-bowel disease were evaluated by CT to determine the normal appearance of the small bowel and mesentery. Subsequently, the CT findings in 95 patients with proven small-bowel disease were analyzed to determine which CT observations correlated with neoplastic, inflammatory, or edema-producing processes. Thirty-three (83%) of 40 patients with wall thickening or mesenteric masses greater than 1.5 cm had a neoplastic process. Twenty-eight (82%) of 34 patients with normal mesenteric fat attenuation, wall thickening less than 1.5 cm, or mesenteric masses less than 1.5 cm had inflammatory disease. Fourteen (67%) of 21 patients with no mesenteric mass, increased mesenteric fat attenuation, and wall thickening less than 1.5 cm had noninflammatory edema. Overall, CT assigned 75 (79%) of 95 patients into appropriate categories; use of ancillary CT findings led to correct categorization in 83 (87%). CT is helpful in correctly assigning a disease category to patients with small-bowel wall thickening.

Induction of protective immunity against Schistosoma mansoni by a nonliving vaccine. IV. Fractionation and antigenic properties of a soluble adult worm immunoprophylactic activity

An aqueous buffer-soluble, nonparticulate fraction of adult Schistosoma mansoni worms (SWAP) was separated by gel filtration on Ultragel AcA-34, and portions of the eluate were tested for their capacity to induce protective immunity against cercarial challenge when administered intradermally to mice in combination with the adjuvant BCG. All of the immunogenic activity was found in a single peak of protein excluded in the void volume of the column. This same fraction was determined by SDS-PAGE and Western immunoblotting to be unique in that it contained a component of Mr (X 10(-3) 97 (97,000) recognized monospecifically by antibodies from mice vaccinated with unseparated SWAP plus BCG. Similarly, the protective fraction was unique in possessing the capacity to elicit 24 hr delayed footpad swelling responses, as well as lymphokine production, in SWAP-BCG-immunized mice. These results suggest that the immunogenic activity of SWAP resides in a restricted population of molecules, and possibly in the 97,000 antigen detected with antibodies from vaccinated animals. Because both the protective capacity of unfractionated SWAP and the serologic reactivity of the 97,000 antigen are sensitive to digestion with protease, it is likely that the immunologic activity of these molecules is dependent on peptide-bonded structural elements.

Induction of protective immunity against Schistosoma mansoni by a nonliving vaccine. IV. Fractionation and antigenic properties of a soluble adult worm immunoprophylactic activity

An aqueous buffer-soluble, nonparticulate fraction of adult Schistosoma mansoni worms (SWAP) was separated by gel filtration on Ultragel AcA-34, and portions of the eluate were tested for their capacity to induce protective immunity against cercarial challenge when administered intradermally to mice in combination with the adjuvant BCG. All of the immunogenic activity was found in a single peak of protein excluded in the void volume of the column. This same fraction was determined by SDS-PAGE and Western immunoblotting to be unique in that it contained a component of Mr (X 10(-3) 97 (97,000) recognized monospecifically by antibodies from mice vaccinated with unseparated SWAP plus BCG. Similarly, the protective fraction was unique in possessing the capacity to elicit 24 hr delayed footpad swelling responses, as well as lymphokine production, in SWAP-BCG-immunized mice. These results suggest that the immunogenic activity of SWAP resides in a restricted population of molecules, and possibly in the 97,000 antigen detected with antibodies from vaccinated animals. Because both the protective capacity of unfractionated SWAP and the serologic reactivity of the 97,000 antigen are sensitive to digestion with protease, it is likely that the immunologic activity of these molecules is dependent on peptide-bonded structural elements.

Use of reversed-phase and ion-exchange batch extraction in the purification of bovine pituitary peptides

Bovine posterior pituitaries were extracted with an acidic medium designed to maximize solubilization of peptides while precipitating high-molecular-weight protein. The supernatant was then extracted with C18 reversed-phase cartridges to generate a peptide-enriched fraction. Cartridge eluates were subjected to ion-exchange extraction, using a batch procedure which fractionated the peptides into basic, acidic, and neutral pools. Amino-terminal fragments of bovine pro-opiomelanocortin were found to be resolved into separate pools by this method. The 1 to 49 fragment was eluted in the acidic pool while the 1 to 77 fragment was eluted in the basic pool. The 1 to 77 fragment was purified by reversed-phase high-performance liquid chromatography. Amino acid analysis of the fragments, generated from trypsin and V8 protease digestion of the 1 to 77 fragment, permitted assignment of cystine bridges between residues 2 and 24 and between residues 8 and 20. Results from amino sugar analysis were consistent with the presence of an O-linked oligosaccharide at threonine45 and an N-linked oligosaccharide at asparagine65.

The respiratory burst is not required for killing of intracellular and extracellular parasites by a lymphokine-activated macrophage cell line

The macrophage cell line, IC-21, was found to be incapable of producing the oxygen products associated with the respiratory burst. However, IC-21 cells were activated by lymphokine (LK) to kill intracellular (Leishmania donovani amastigotes) and extracellular (Schistosoma mansoni larvae) parasites, as well as tumor cells. In each case, the cytotoxicity exhibited by activated IC-21 cells and activated peritoneal macrophages was indistinguishable. However, nonactivated IC-21 cells were unable to kill L. donovani log-growth phase promastigotes, while nonactivated peritoneal macrophages destroyed greater than 90% of the initial infection. These results indicate that amastigotes and schistosome larvae are susceptible to killing by nonoxidative cytotoxic mechanism induced by lymphokine activation but, on the other hand, support the concept that the killing of log-growth phase promastigotes by nonactivated cells is dependent upon the respiratory burst. We propose that the IC-21 cell line may be a useful model for studying nonoxidative killing functions of activated macrophages.

Effect of intravenous bovine growth hormone or human pancreatic growth hormone-releasing factor on milk production and plasma hormones and metabolites in sheep

Although it is well known that exogenous bovine GH (bGH) increases milk yield in ruminants it has not been possible to determine whether an increase in endogenous GH secretion has the same effect. The recent isolation of human pancreatic GH-releasing factor (hpGRF-44) has enabled this comparison of the effects of bGH and hpGRF-44 on milk production in sheep. Three pairs of Dorset ewes underwent three 4-day treatments according to a Latin square design. Treatment 1 involved: 2-hourly i.v. injections (approximately 3.0 ml) of bGH (15 micrograms/kg; 1.8 units/mg); treatment 2: 2-hourly i.v. injections (approximately 3.0 ml) of hpGRF-44 (0.6 microgram/kg); treatment 3: 2-hourly i.v. injections (3.0 ml) of the vehicle. Treatment periods were separated by 10 days. Sheep were milked twice daily and the milk was analysed for fat, protein and lactose. Blood samples (5.0 ml) were taken before and at 15, 45, 75 and 100 min after every third injection throughout the 4 days. Plasma was analysed for insulin, glucose, urea and non-esterified fatty acids (NEFA). The changes in plasma GH stimulated by hpGRF-44 were consistent and repeatable throughout the 4 days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of different growth hormone-releasing factors on the concentrations of growth hormone, insulin and metabolites in the plasma of sheep maintained in positive and negative energy balance

Three experiments were conducted to compare the ability of different preparations of growth hormone-releasing factor (GRF) to stimulate GH secretion in sheep maintained in positive and negative energy balance. In experiment 1 five sheep were injected (i.v.) with three preparations of human pancreatic GRF (hpGRF-44, hpGRF-40, hpGRF-29-NH2) and one preparation of rat hypothalamic GRF (rhGRF-29-NH2) all at 98.0 pmol/kg, or control vehicle, in a Latin square design when the animals either had free access to food or were fed half their maintenance requirements. Analysis of plasma samples, obtained before and for 150 min after injection, revealed that the reduced food intake resulted in the expected changes in body weight and circulating GH, insulin, glucose, urea and non-esterified fatty acids. The maximum post-injection concentrations of GH did not differ between either the two levels of feeding or the four GRF preparations but the mean post-injection concentration of GH was significantly higher for all GRF treatments on the restricted ration (P less than 0.001). The mean post-injection response to rhGRF-29-NH2 was less than that obtained with hpGRF-44 for sheep with food available ad libitum (P less than 0.05) and was clearly more persistent for all GRF treatments in animals fed the reduced diet (P less than 0.001). In experiment 2 the same five sheep were injected i.v. with rhGRF-29-NH2 (98.0 pmol/kg) when they had free access to food and after food had been withdrawn for 3 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Transferrin receptor induction is required for human B-lymphocyte activation but not for immunoglobulin secretion

Transferrin receptors are expressed on proliferating cells and are required for their growth. Transferrin receptors can be detected after, but not before, mitogenic stimulation of normal peripheral blood T and B cells. In the experiments reported here we have examined the regulation of transferrin receptor expression on activated human B cells and whether or not these receptors are necessary for activation to occur. Activation was assessed by studying both proliferation and immunoglobulin secretion. We have determined that transferrin receptor expression on B cells is regulated by a factor contained in supernatants of mitogen-stimulated T cells (probably B-cell growth factor). This expression is required for proliferation to occur, since antibody to transferrin receptor (42/6) blocks B-cell proliferation. Induction of immunoglobulin secretion, however, although dependent on PHA-treated T-cell supernatant, is not dependent on transferrin receptor expression and can occur in mitogen-stimulated cells whose proliferation has been blocked by antitransferrin receptor antibody. In addition, we have demonstrated that IgM messenger RNA induction following mitogen stimulation is unaffected by antitransferrin receptor antibody. These findings support a model for B-cell activation in which mitogen (or antigen) delivers two concurrent but distinct signals to B cells: one, dependent on B-cell growth factor and transferrin receptor expression, for proliferation, and a second, dependent on T cell-derived factors and not requiring transferrin receptors, which leads to immunoglobulin secretion.

Effect of intravenous administration of growth hormone-releasing factor (hpGRF-44) and Tyr-D-Trp-Ala-Trp-D-Phe-NH2 on plasma hormones and metabolites in goats

It has recently been demonstrated that human pancreatic GH-releasing factor (hpGRF-44) and Tyr-D-Trp-Ala-Trp-D-Phe-NH2 (subsequently referred to as 'the peptide') release GH from rat pituitary glands maintained in vitro and, in the former case, increase circulating GH in rats and man. The commercial importance of discovering an agent capable of specifically enhancing GH secretion in ruminants stimulated the present study which examined: the intravenous administration of both peptides on plasma GH, prolactin, insulin, glucose, urea and non-esterified fatty acids in goats and the effect of the peptide on the release of GH from sheep pituitary glands maintained in vitro. The peptide was injected into the jugular vein of goats in three different forms and at several concentrations (dispersal by shaking, 0.07 microgram/kg; 0.7 microgram/kg; ball-milled, 7.0 micrograms/kg, 70 micrograms/kg; dimethyl sulphoxide (5%), 7.0 micrograms/kg, 70 micrograms/kg). None of the treatments stimulated a significant increase in circulating GH. Nevertheless the peptide (20 micrograms/ml medium) was found to stimulate a 50-60% increase in the production of GH from sheep pituitary glands maintained in vitro. The effect of intravenously injecting hpGRF-44 (1.0 microgram/kg) was investigated in the present and absence of passive immunization with sheep anti-somatostatin immunoglobulin G (IgG) (a bolus of 600 mg, 3 h before treatment with hpGRF-44). Plasma GH was increased (P less than 0.001) within 15 min of treatment and the magnitude of the response was the same for both the immunized and non-immunized goats. A second peak was measured after approximately 75 min which was only significant (P less than 0.05) in the immunized group.(ABSTRACT TRUNCATED AT 250 WORDS)

Total parenteral nutrition in pancreatic disease

Total parenteral nutrition (TPN) was given to 121 patients admitted with severe pancreatitis (73), chronic pancreatitis (23), or pancreatic malignancy (25) over 104 months. No adverse effects on the pancreas were detected from the TPN, including the provision of intravenous (IV) fat. Nutritional status was maintained or improved in all groups, including patients undergoing surgical procedures and those experiencing marked stress. No significant impact on the clinical course of pancreatitis was observed, although the death rate in acute pancreatitis (15.2%) and complicated pancreatitis (18.5%) compares favorably with other published series where early surgical intervention was undertaken. There was an increased risk of catheter-related sepsis in patients with complicated pancreatitis (14.8%) and with chronic pancreatitis (17.4%). No increase septic risk was seen in patients with acute pancreatitis or pancreatic malignancy. Eighty-two per cent of patients with acute pancreatitis required an average of 87 units of insulin per day while 78% of patients with chronic pancreatitis required an average of 54 units per day. In summary, TPN proved to be safe, effective, and well-tolerated in those patients with disorders of the pancreas.

The decreasing incidence of pneumothorax and improving survival of infants with congenital diaphragmatic hernia

In the 6-year period between 1977 and 1982 inclusive, 75 newborn infants with congenital diaphragmatic hernia of Bochdelek underwent corrective surgery during the first 24 hours of life. A total of 40 infants (53%) survived. Beginning in January 1980, a standardized approach to care including early use of mechanical ventilation and paralysis with pancuronium as well as dopamine use prior to any Priscoline infusion, was instituted. To determine whether these approaches improved outcome, term infants without malformations from the years 1977 to 1979 were compared with a similar group treated after institution of standardized care between 1980 and 1982 inclusive. The infants were comparable in all respects, but survival improved from 45% to 82% between the two periods (P less than 0.03). There was an associated decrease in the incidence of pneumothorax (45% in first period; 14% in second period) paralleled by a concomitant increase in pancuronium use (18% and 85%, respectively). Although factors responsible for the improved survival are multifactorial these data indicate the detrimental effect of pneumothorax on outcome and the beneficial effect of a standardized approach to care using conventional intensive care techniques.

Mechanisms of protective immunity against S. mansoni infection in mice vaccinated with irradiated cercariae. VI. Influence of the major histocompatibility complex

Inbred mouse strains develop different levels of resistance to challenge infection with Schistosoma mansoni in response to vaccination with irradiated cercariae. The role of the major histocompatibility complex (MHC) in determining this genetic polymorphism in acquired resistance was investigated. Previous studies suggested that inbred mice bearing either the b or d MHC haplotypes develop a higher level of vaccine induced resistance than do mice with other MHC haplotypes. An analysis of an F1 cross between an H-2b strain (C57BL/6) and an H-2k strain (C3H/HeJ) indicated that the ability to develop high levels of immunity is inherited in a dominant fashion. In order to confirm that the development of high resistance is an MHC associated trait, B10, C3H, BALB and B6 congenic mice bearing different H-2 haplotypes were compared. On either the B10, B6, or BALB background, substitution of b or d with k or a MHC alleles resulted in a decreased level of vaccine induced immunity. The observed decreases were more pronounced in BALB and B6 than in B10 congenics suggesting an influence of background (non-MHC linked) genes on protective immunity. Similarly, C3H.SW (H-2b) mice developed a significantly higher level of acquired resistance than C3H/HeSn (H-2k) mice. Cross and backcross experiments between H-2b and H-2k B6 congenic mice confirmed the dominant inheritance of high resistance as well as the MHC linkage of the trait. These data indicate that the MHC locus exerts a quantitative influence on vaccine induced resistance in certain inbred mouse strains and provide further support for the concept that the protection elicited by irradiated cercariae is the manifestation of a specific host immune response.

Maternal depression in an urban pediatric practice: implications for health care delivery

A scale to measure depressive symptomatology was administered to mothers attending an urban pediatric primary care center. Over 50 per cent of the female heads of households were Black or low income and depressed. This suggests that the provider of pediatric primary care should recognize depression and make appropriate referrals or intervention, since depressed mothers may have a diminished ability to respond to the emotional needs of their children.