Energy cost index as an estimate of energy expenditure of cerebral-palsied children during assisted ambulation

The energy expenditure of cerebral-palsied children ambulating with bilateral quad canes and wheeled walkers was estimated, using average heart rate and speed of walking. An energy cost index (average number of heart rates per unit distance walked) was derived to allow for varying speeds among patients. Children were then categorized into those who had a lower energy cost index when using quad canes and those who had a lower index when using walkers. This made it possible to offer treatment recommendations based on objective data.

Failure to thrive associated with chronic ulcer disease in a 9-year-old boy

Chronic peptic ulcer disease is not generally considered to cause failure to thrive. We are reporting a 9-year-old child who suffered from chronic recurrent abdominal pain and failure to thrive. Investigation revealed that the child also had bacterial overgrowth and evidence of malabsorption. These findings were considered to be due to chronic peptic ulcer disease which caused intermittent small bowel obstruction and gastric outlet obstruction. Successful treatment of the ulcer alone resulted in catch-up growth and an end to the chronic recurrent pain. Recurrent abdominal pain when associated with atypical features or failure to thrive should be adequately investigated. Although rare, chronic peptic ulcer disease with its sequelae should be considered in the differential diagnosis of failure to thrive.

Treatment of primary undifferentiated sarcoma of the liver with surgery and chemotherapy

Primary undifferentiated sarcoma of the liver is a rare tumor with survival reliant on total excision of the tumor. The authors report such a tumor, initially nonresectable, in a 7-year-old girl whose tumor was successfully excised following treatment with cisplatin and Adriamycin (doxorubicin). The light and electron microscopic details of this patient's tumor are presented.

Long-term assessment of cerebral perfusion following STA-MCA by-pass in patients

A prospective study of mean hemispheric cerebral blood flow (CBF) correlated with clinical status has now been completed for the past 54 months. Thirty-eight patients underwent superficial temporal to middle cerebral artery (STA-MCA) by-pass. They were compared with 22 patients with similar arteriographic lesions and clinical symptoms, treated medically throughout the same interval of time. Assignment to either treatment group was not randomized but depended solely on choice of patient or treating physician. Both groups were matched for age, clinical symptoms, angiographic abnormalities, and CBF values. All patients had proximal occlusion of one internal carotid artery or intracranial occlusive disease of the internal carotid or middle cerebral arteries. CBF measurements and clinical evaluations were repeated at regular intervals up to 54 months following surgery or institution of medical treatment. Mean follow up interval after STA-MCA by-pass was 28.7 months and for medical treatment was 29.7 months. Mean hemispheric CBF values for STA-MCA patients became significantly increased 2 weeks after operation. After that, CBF flow values decreased. At 24 months after surgery, flow values for surgically treated patients were significantly higher than among those treated medically, although there were no differences in flow values between the two groups at 3, 6, 12, 36 and 48 months. Prospective clinical evaluations after STA-MCA by-pass were as follows: 12 (32%) improved with cessation of TIAs and/or neurological improvement, 16 (42%) remained unchanged, 7 (18%) deteriorated (due to new or recurrent strokes) and 3 (8%) expired. Clinical results were the same for medical treatment: 6 (27%) improved, 10 (46%) unchanged, 4 (18%) deteriorated due to new or recurrent stroke, and 2 (9%) expired.

The effects of photoperiod and melatonin on serum prolactin levels of mink during the autumn molt

An experiment was conducted to determine the effects of a reduced daily photoperiod and exogenous melatonin on serum prolactin levels of mink during the autumn molt and growth of the winter pelage. During the last week of June, adult standard dark female mink (Mustela vision) were exposed to natural changes in daylength (controls), a reduced photoperiod of 6 h light: 18 h dark (6L:18D) or exposure to natural changes in daylength and treated with melatonin (10 mg) in a Silastic implant inserted subcutaneously over the scapular area. Beginning July 2, and continuing through October 22, blood samples were collected at nine biweekly intervals, and serum prolactin concentrations were quantified by a heterologous double antibody radioimmunoassay. Both reduced photoperiod and exogenous melatonin caused serum prolactin levels to decline rapidly after mid-July, resulting in concentrations that were significantly lower than those of controls 6 to 8 wk earlier. These data suggest that growth of the winter pelage of mink is strongly associated with declining prolactin levels. It appears that part of the photoperiodic-induced effects on fur growth of the mink are mediated through melatonin and its effects on prolactin synthesis and/or secretion.

Social and emotional loneliness: an examination of Weiss's typology of loneliness

This study examined Weiss' conceptualization of social and emotional loneliness. Using data from an extensive survey of undergraduate and graduate students at the University of Iowa, we measured social and emotional loneliness, students' affective and behavioral reactions to loneliness, students' social relationships, and their judgments of the degree to which their relationships supply the six social provisions described by Weiss. As expected, we found differences in the subjective experiences of social and emotional loneliness, although both forms of loneliness were also characterized by a common core of experiences. The results generally supported Weiss's ideas concerning the determinants of social and emotional loneliness. Predictions concerning the affective and behavioral consequences associated with each type of loneliness, however, were only partly supported, although the two forms of loneliness were associated with different affective reactions and coping behaviors. The implications of these findings for Weiss's typology of loneliness are discussed.

Social and emotional loneliness: an examination of Weiss's typology of loneliness

This study examined Weiss' conceptualization of social and emotional loneliness. Using data from an extensive survey of undergraduate and graduate students at the University of Iowa, we measured social and emotional loneliness, students' affective and behavioral reactions to loneliness, students' social relationships, and their judgments of the degree to which their relationships supply the six social provisions described by Weiss. As expected, we found differences in the subjective experiences of social and emotional loneliness, although both forms of loneliness were also characterized by a common core of experiences. The results generally supported Weiss's ideas concerning the determinants of social and emotional loneliness. Predictions concerning the affective and behavioral consequences associated with each type of loneliness, however, were only partly supported, although the two forms of loneliness were associated with different affective reactions and coping behaviors. The implications of these findings for Weiss's typology of loneliness are discussed.

Responses to leukotriene C4 in the perfused rat lung

The isolated rat lung was used to study both the effect of leukotriene C4 on pulmonary perfusion pressure and the synthesis and release of cyclooxygenase products in the pulmonary circulation. A cell-free perfusate was passed only once through the pulmonary circulation or was recirculated. During single transit, leukotriene C4 produced dose-dependent increases in pulmonary perfusion pressure that were abolished by FPL-55712, a leukotriene receptor antagonist, but were not altered significantly by indomethacin. The duration of the pulmonary pressor response to leukotriene C4 was markedly prolonged during recirculation compared to single transit. Leukotriene C4 also induced dose-dependent increases in effluent levels of 6-keto-prostaglandin F1 alpha and thromboxane B2 that were attenuated by indomethacin or FPL-55712 pretreatment. We conclude that leukotriene C4 directly constricts the pulmonary vasculature independent of cyclooxygenase products, is not rapidly degraded by the pulmonary circulation and stimulates the release of cyclooxygenase products in the pulmonary circulation that can be attenuated by pretreatment with indomethacin or FPL-55712.

Induction of winter fur growth in mink (Mustela vison) with melatonin

Adult and kit standard dark male and female mink were treated with 0, 5 or 10 mg melatonin, or a reduced photoperiod of 6 h light: 18 h dark (6L: 18D, initiated during the last week of June) to determine the effects of treatment on winter fur growth. Melatonin was administered in a Silastic implant inserted sc over the scapular region during the last week of June. Regardless of sex or age, mink treated with melatonin or a 6L: 18D photoperiod molted the summer pelage and grew the winter pelage earlier than controls (P less than .001). Winter pelage was fully prime by mid-October, 6 wk earlier than normal. Weight gain of mink, regardless of sex or age, was not affected by melatonin treatment. These findings indicate that photoperiodic effects on the growth of winter pelage in mink may be mediated through the pineal gland and its secretion of melatonin.

A comparison of characteristics in the families of patients with anorexia nervosa and normal controls

The present study compared families of patients with anorexia nervosa with families of non-anorexic adolescent daughters of a similar social class. All anorexics and adolescent comparison girls and their parents were studied using a variety of psychometric measures. Body size estimation and physical anhedonia were also measured. Family characteristics were assessed using the Family Assessment Measure (FAM). Contrary to the hypotheses, no abnormalities were found in terms of parental attitudes to weight control or dieting. The mothers of anorexics displayed no increase in psychopathology on any of the measures. The fathers scored very similarly to controls but with higher degrees of conscientiousness. Neither fathers nor mothers displayed abnormalities of their own body size estimates or body satisfaction. On the FAM the anorexic families reported an increased pathology on several sub-scales. It is not possible to say whether these disturbances are part of the pathogenesis or are sequelae to the illness.

Xenon-enhanced CT CBF measurements in cerebral AVM's before and after excision. Contribution to pathogenesis and treatment

Unlike neurological deficits resulting from intracranial hemorrhage in patients with cerebral arteriovenous malformation (AVM), which have well defined etiology, the pathogenesis and treatment of progressive and/or fluctuating non-hemorrhagic neurological and psychological deficits require clarification. Values for local cerebral blood flow (LCBF) and local partition coefficients (L lambda) were measured by the method using stable xenon (Xe)-computerized tomography (CT-CBF) scanning, and were compared to 133Xe inhalation values using external probes in 16 patients with cerebral AVM's. Values were measured by both methods before and after total excision of AVM's in five cases. Neurological and mental status assessments were compared with LCBF results. Clinical improvement was most evident after total excision of AVM's. Other procedures, such as clipping of vessels, partial excision, and ventriculoperitoneal shunting for hydrocephalus, were associated with frequent complications. Embolization carried risks of cerebral infarction and was not efficacious unless combined with excision. Medical treatment resulted in poor or unsuccessful seizure control, with neurological deterioration despite anticonvulsant therapy. Compared with age-matched normal individuals, LCBF values in patients with AVM's were significantly reduced, particularly adjacent to the AVM's. Mean L lambda values for gray and white matter were normal. After excision, LCBF values in gray and white matter increased significantly up to normal. Due to overestimation of CBF by shunt flow with the 133Xe method of measurement, no correlation was found with results of the CT-CBF method before AVM excision, but significant correlation of the two methods resulted after excision. If accurate LCBF values are obtained by high resolution, direct measurement of tracer clearance from brain tissue, progressive and/or fluctuating neuropsychological deficits correlate with the degree of cerebral steal.

Prolactin binding sites in the uterus of the mink

The present study was conducted to determine if specific binding sites for prolactin (PRL) are present in the uterus of the mink. Uteri of anestrous mink were homogenized and subjected to differential centrifugation into three particulate fractions, 1500, 15 000 and 50 000 X g. Binding of [125I]oPRL to membranes in an aliquot (200-400 micrograms protein) of the 50 000 X g particulate fraction was quantified. Time and temperature for optimal binding were 18 h at 25 degrees C. Scatchard plot analysis revealed a single set of binding sites for PRL with a Kd of 8.25 X 10(-11) +/- 0.68 M. The maximum amount of [125I]oPRL bound was 28 fmoles/mg protein. Prolactin binding sites were detected in both the uterus and kidney of mink, but not in skeletal muscle, spleen, diaphragm or lung. These data indicate that uterine cell membranes of the mink contain sites that bind prolactin with high affinity.

Effects of prednisolone and medroxyprogesterone on corneal wound healing, ulceration, and neovascularization

Albino rabbits were treated four or six times daily with 1% prednisolone acetate, 1% medroxyprogesterone acetate, or a control vehicle, after one of three conditions. First, after 3-mm linear perforating stromal incisions; drugs were given for seven days, and wound bursting strength was determined. Prednisolone suppressed wound tensile strength by 20%; medroxyprogesterone suppressed it by 11%. Second, after trephination, drug administration for 14 days decreased collagen formation in the scar buttons by 43% in the prednisolone-treated group and 39% in the medroxy-progesterone-treated group. Third, after thermal burns; when drug application followed the burn immediately, deep ulceration or perforation developed in 85% of the controls, in none of the prednisolone-treated group, and in 17% of the medroxyprogesterone-treated group. When drug delivery was withheld until day 6, severe ulceration developed in 44% of both groups. In both experiments, stromal neovascularization was markedly suppressed by prednisolone, but only moderately decreased by medroxyprogesterone.

The metabolism of tertiary amines

The metabolism of tertiary amines is mediated primarily by cytochrome P-450 and MFAO, leading to alpha-C oxidation and N-oxidation, respectively. We have discussed how lipophilicity, basicity, steric hindrance, and stereochemistry can effect the outcome of metabolism as well as species, sex, and age. The proposed oxidation of tertiary amines to iminium ions by cytochrome P-450 may explain the isolation of various intramolecular and cyanide-trapped metabolites. N-oxides may represent a smaller percentage of the overall in vitro metabolism of tertiary amines due to the postmortem inactivation of MFAO. In addition N-oxide reducing enzymes present in vivo and in vitro may influence the extent of N-oxide formation. In general, definite conclusions about substrate requirements have been difficult to formulate because of the numerous biological and physical parameters affecting the outcome of metabolism. More singularly directed research on a single species of animal and a wide variety of substrates or vice versa would greatly increase our understanding of the potential metabolism of tertiary amine xenobiotics.

Redistribution of cerebral blood flow following STA-MCA by-pass in patients with hemispheric ischemia

Regional cerebral blood flow and vasomotor reactivity were measured in 33 patients with surgically remediable hemispheric ischemia by the 133Xe inhalation method prior to superficial temporal to middle cerebral artery (STA-MCA) by-pass. Thirteen patients also underwent LCBF and L lambda measurements by the stable xenon CT method for comparison. Twenty-four had proximal occlusion of one or both internal carotid arteries, 9 had intracranial occlusive disease (4 internal carotid, 5 middle cerebral). Measurements were repeated at intervals up to 30 months following surgery and compared to measurements in a similar group (N = 13) treated medically. In the surgically treated group 22 patients had recurrent TIAs, of whom 12 also had minor residual neurological deficits from recent small cerebral infarctions with potential for recovery (RINDs) while the remaining 11 had RINDs without TIAs. After surgery 28 improved with cessation of TIAs and/or neurological recovery, 3 remained unchanged, 2 cases worsened. Compared to age-matched normal hemispheric F1 (gray matter) values, pre-operative F1 values in the STA-MCA group were reduced in both ischemic and opposite hemispheres. Ischemic regions showed imparied vasomotor reactivity to 5% CO2 or 100% O2 inhalation. After surgery, mean hemispheric F1 values increased + 12.8% on the by-pass side and + 10.5% on the contralateral side. Mean F1 increases reached a maximum 3 months after by-pass, most evident in ipsilateral frontal regions (+ 24.2%). Vasomotor reactivity did not significantly improve. Medically treated cases did not show similar F1 increases. Thirteen with carotid occlusive disease (8 with TIAs, 5 with small recent infarcts) underwent CT LCBF and L lambda measurements before and after STA-MCA by-pass. Cases with recent infarcts showed reduced LCBF and L lambda values which increased significantly after STA-MCA by-pass, however the total group operated upon showed only trends for CBF increases, probably due to large standard deviations encountered in serial measurements.

Plasminogen activator (urokinase) causes vascularization of the cornea

The presence of a peripheral zone of (presumed intracellular) plasminogen activator in the normal rabbit cornea has suggested that activator, once released, might regulate the permeability of limbal vessels and angiogenesis, by plasmin-dependent pathways. Plasminogen activator (urokinase [UK]) in rabbit serum albumin (RSA) was injected once (20 microliter, 3.7 CTA U) into the corneal stroma, 2 mm from the limbus. Sprouts arose from the engorged circumlimbal vessels (16 of 20 corneas) beginning on the third day and grew into the cornea over the next several days. Histologically, PMNs were observed in association with growing vessels. Contralateral corneas injected with UK (in RSA) previously inactivated by 99.7% with the specific active site inhibitor, Phe-Ala-Arg-chloromethyl ketone showed minimal vessel engorgement or stromal edema and no vascularization (0 to 20 corneas). Injuries to the so-called (plasminogen activator-containing)"critical zone" of the cornea which elicit neovascularization possibly do so by causing extracellular release of endogenous plasminogen activator. Thus, in addition to initiating the destructive events of ulceration, activator might initiate increases in vessel permeability and also neovascularization, which would result in the eventual arrest of ulceration.