Relationship of hunger, use of a shopping list and obesity to food purchases

Shopping with a list and shopping after a meal are two commonly employed behavioral weight loss guidelines designed to reduce food purchases and therefore food consumption. A survey of 596 female shoppers, which analyzed purchases on the basis of caloric value, failed to support either of these guidelines. Analysis of kilocalories (kcal) purchased indicated that overweight shoppers purchased more total kcal, with a greater percentage of their kcal coming from fat and correspondingly lower percentage of kcal coming from carbohydrates.

Elementary body envelopes from Chlamydia psittaci can induce immediate cytotoxicity in resident mouse macrophages and L-cells

Isolated, purified Chlamydia psittaci elementary body envelopes at a high multiplicity of infection (1,000:1) are capable of inducing immediate cytotoxicity in resident mouse macrophages and 929 L-cells.

Metabolism of dihydrouracil in Rhodosporidium toruloides

Previous studies, including those done with a similar species, have indicated that dihydrouracil is formed by the breakdown of uracil and is degraded into N-carbamyl-beta-alanine. (Fink et al., J. Biol. Chem. 201:349-355, 1953; S. R. Vilks and M. Y. Vitols, Mikrobiologiya 42:567-583, 1973; O. A. Milstein and M. L. Bekker, J. Bacteriol. 127:1-6, 1976). In the present work the conversion of dihydrouracil to uracil is studied in Rhodosporidium toruloides, and the growth characteristics of mutants that have lost the ability to use dihydrouracil as a source of nitrogen are examined. It is concluded that dihydrouracil must be converted to uracil before catabolism of the pyrimidine ring can take place.

Myocardial infarction following regional anaesthesia for carotid endarterectomy

From 1969 through 1982, 185 carotid endarterectomies were performed under regional anaesthesia on 153 patients. Of these patients, 38 (25 per cent) had suffered a previous myocardial infarction, 63 (41 per cent) had documented coronary artery disease, and 115 (75 per cent) had hypertension. Anaesthesia was provided by a superficial cervical plexus block. Monitoring consisted of measurement of direct arterial pressure and continuous display of the electrocardiogram. Oxygen was administered by nasal cannula throughout the procedure. Mean arterial pressure was elevated when necessary by infusion of phenylephrine. No patient in this study suffered an acute myocardial infarction. The only cardiac complications consisted of eight episodes of non-life-threatening dysrhythmias. We conclude that regional anaesthesia for carotid endarterectomy is associated with a low risk of perioperative myocardial infarction.

Spinal blastomycosis--case report

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ACTH-producing pituitary adenoma in an infant with cysts of the kidneys and lungs

The light microscopical, electron microscopical and immunohistological features of a rare ACTH-producing chromophobe adenoma of the pituitary gland in an 11-month-old infant are presented. An unusual histological feature was the presence of numerous follicles. These follicles may develop secondary to necrosis of individual tumour cells. There is only one previous report in the literature of a pituitary adenoma occurring in infancy and that tumour also produced ACTH and showed a follicular histological pattern. It is of interest that our patient also had a combination of medullary cysts of the kidneys and congenital peripheral cysts of the lungs. The association of cysts in lungs with cysts in kidneys also has been reported only once previously. We conclude that the occurrence of cysts in kidneys and lungs and a pituitary tumour in infancy represents a bizarre coincidence although an unknown common embryonic insult to these organs cannot be ruled out.

Chlamydia psittaci elementary body envelopes: ingestion and inhibition of phagolysosome fusion

The cell surface of Chlamydia psittaci seems important for establishing infection since (i) UV-treated elementary bodies (EB) attach to and are ingested by L cells and (ii) heat or antibody treatment decreases attachment to L cells and promotes the fusion of chlamydiae-containing phagosomes with lysosomes in macrophages. In the studies reported here, [3H]uridine-labeled UV-treated EB also persisted in mouse resident peritoneal macrophages and L cells, suggesting that phagosome-lysosome fusion is inhibited. We therefore chose to investigate the ingestion and internal fate of isolated purified EB envelopes in both nonprofessional and professional phagocytic cells. EB envelopes are internalized by target host cells as efficiently as are whole EB. Transmission electron microscopy of macrophages whose lysosomes were marked with ferritin revealed the persistence of individual envelopes in phagosomes devoid of ferritin for the 3-h observation period. In contrast, EB envelopes heated to 56 degrees C for 15 min were consistently found in ferritin-labeled phagolysosomes as early as 30 min. As another index of persistence, isolated EB envelopes were radioisotopically labeled with a Bolton-Hunter analog, [3H]N-succinimidyl propionate, and their fate as trichloroacetic acid-precipitable material was followed. A third probe, employed to detect the persistence of non-biodegradable antigen, was indirect immunofluorescence. Fluorescein-positive antigens were brightly visible for 7 days in both macrophages and L cells when they were inoculated with untreated EB or EB maintained in penicillin. But L cells inoculated with EB envelopes or EB treated with UV or chloramphenicol, all of which prevent the conversion of infectious EB into the metabolically active reticulate bodies, displayed reduced internal fluorescence by 2 days and the appearance of fluorescent material on the cell surface. This release of EB envelope material occurred in the absence of phagolysosome fusion. The data add credence to the belief that the spontaneous breakdown or autolytic enzyme release of EB envelope components must occur preparatory to the conversion of EB to reticulate bodies.

Familial brain tumors: studies of two families and review of recent literature

We studied two families in each of which three or more individuals were affected by brain tumors. In the first family, which had no evidence of neurofibromatosis or tuberous sclerosis, a man, his sister, and her son developed histologically proven gliomas; the man's great uncle was historically reported to have died from a brain tumor, but the exact nature of the tumor was not known. In this family two of the tumors were low grade astrocytomas of the cerebrum, whereas the third was a mixed glioma of the cerebellum. Karyotypic analysis of this tumor showed no marker chromosomes. A second family had a history of an unusual concentration of brain tumors. In one patient the tumor was a histologically verified glioma. Four other patients had historically reported brain tumors, the descriptions of which suggested gliomas. Both families showed involvement of individuals in adjacent generations, although in both instances there were skipped generations. Twins, siblings, or parents and children are the kindred groups affected in most other reported families with multiple brain tumors. The mode of inheritance of brain tumors in these two families and recent literature on the conditions associated with familial brain tumors are discussed.

Extradural aerocele. Case report with 20-year follow-up results

✓ The 20-year follow-up results of a case of extradural aerocele (pneumatocele) are reported.

Intraventricular hemorrhage from pituitary apoplexy

The case of a patient with a massive intraventricular hemorrhage arising from a pituitary chromophobe adenoma is described. This rare and disastrous complication was ascribed to the large suprasellar extension of the tumor and its close proximity to the floor of the third ventricle. Hemorrhage in the tumor extended along the path of least resistance and ruptured into the third ventricle. A partially treated hyperviscosity syndrome and chemotherapy for an unrelated malignancy (multiple myeloma) may have predisposed the patient to the necrosis and hemorrhage in the pituitary tumor.

Cerebellar astrocytomas in children and young adults

A clinical and pathological review of 43 cases of cerebellar astrocytomas in children and young adults was undertaken. Thirty-one of the 36 surviving patients were examined by computed tomography. Twelve patients with asymptomatic tumour were detected. Histology was necessary to identify the higher risk "diffuse" group, but no histological features helped to identify tumours liable to recur. Improvements in the prognosis may occur with long term CT scanning.

Posttraumatic bilateral vertebral artery occlusion: case report

✓ A case of bilateral vertebral artery occlusion following trauma in a 25-year-old woman is presented. The patient had minimal subluxation of C-2 on C-3 without neurological deficit. Her neck was immobilized for 16 days, and then a posterior fixation of C-1 through C-4 was performed with Kirschner wires and methyl methacrylate. Occlusion of the vertebral arteries has persisted, but collateral vessels are adequate and the patient has remained neurologically normal.

Metastasis of carcinoma to meningioma and glioma

A case of frontal meningioma harbouring a metastasis from a previously treated breast carcinoma, and a case of metastatic carcinoma into a frontal glioma are reported.

Intervertebral disc space infection in a child presenting as a psoas abscess: case report

Intervertebral disc space infection in children is usually a benign, self-limiting process. We report on what is, to our knowledge, the first case of discitis in a child that developed into an anterior paraspinous abscess. This 13-year-old girl had a 3-month history of low back and leg pain and low grade fever. Roentgenograms of the spine showed collapse of the L-5, S-1 interspace with destruction of the L-5 vertebral body and, on the lateral lumbar view, an anterior soft tissue mass. Computed tomography showed a paraspinous mass to the right of the L-4 and L-5 vertebral bodies. Access to a right psoas abscess was gained through a retroperitoneal abdominal approach; draining of the abscess revealed necrotic disc material extruding from the L-5, S-1 interspace. Her recovery was uneventful. The causative organism proved to be Staphylococcus aureus.

Anterior sacral meningocele: two case reports and discussion of surgical approach

Virtually all patients with anterior sacral meningocele have a pelvic mass with symptoms and signs relating to pressure of the mass on adjacent structures. Constipation is a universal complaint; urinary incontinence is common. A headache often develoips when the patient stands, due to lowered spinal fluid pressure as the meningocele sac fills. A scimitar-shaped sacrum on anterioposterior plain roentgenograms of the spine is pathognomonic. The coccyx may be absent, and the lower sacral laminate may be absent or incomplete. Myelography confirms the diagnosis and should be done with large volumes of iophendylate in order to fill the sac. Only approximately 130 anterior sacral meningoceles have been reported in the literature. This article presents 2 more cases, both seen at the North Carolina Baptist Hospital. The surgical approach to both was through a sacral laminectomy; the communicating stalk was ligated and the meningocele was removed. One patient was 11 years old and had a large suprapubic pelvic mass found on routine examination. She is neurologically normal postoperatively. The other was 7 years old and had had fecal incontinence since birth. That incontinence is less severe postoperatively and the patient is neurologaically normal.

Gunshot wounds to the spinal cord

A series of 59 patients with gunshot wounds to the spinal cord is presented. Seventeen injuries were cervical, 30 were thoracic, 11 were lumbar, and one was sacral. Twenty-nine patients had immediate complete sensorimotor loss of function, 18 had sensory or motor sparing below the cord lesions, and 12 had injury of the cauda equina. Thirty-nine patients were treated with decompressive laminectomy, four with local wound debridement only, three with cervical traction and subsequent anterior cervical fusion; 13 had only conservative therapy. Eleven patients had return to normal function and 20 patients had some degree of improvement. There was no significant difference in the outcome between patients operated on and those treated conservatively.

Ophthalmic findings in dural arteriovenous shunts

Five cases of dural carotid arteriovenous shunts in the region of the cavernous sinus are reported. Discussion of the specific carotid angiographic features stresses the pathophysiologic characteristics of these shunts in relation to the ophthalmic findings. In all cases, the meningohypophyseal artery was involved as the sole or predominant source of the afferent arterial supply, and the degree of proptosis, epibulbar congestion and secondary glaucoma correlated with retrograde filling of the superior ophthalmic vein from the cavernous sinus. The ophthalmologist's early recognition of this entity as a "spontaneous" pathologic occurrence is important, since he is intimately involved in its diagnosis and long-term management.

Urea: obligate intermediate of pyrimidine-ring catabolism in Rhodosporidium toruloides

Urea has been shown to be an obligate intermediate in and the penultimate product of the catabolism of pyrimidine-ring nitrogen in Rhodosporidium toruloides (Rhodotorula). One of a series of mutants selected for its inability to utilize uracil as a sole source of nitrogen was unable to utilize urea also. The mutant accumulated urea and failed to form 14CO2 during supplementation with [2-14C]uracil. Radioautograms from the resulting cell extracts and media failed to reveal expected intermediates. Cell-free extracts of the mutant were shown to lack urease activity. Revertants of the mutant were essentially wild type in all tested attributes. Elements of the reductive pathway for pyrimidine catabolism are present in Rhodosporidium (O. A. Milstein and M. L. Bekker, J. Bacteriol. 127: 1-6, 1976), but is has not been determined whether this pathway is involved with production of urea.

Posterior cervical fusion in chidren

Six cases of posterior cervical fusion with rib grafts in children are reported. Four of the children had sustained cervical spine injuries in accidents, and two had congenital absence of the odontoid. Three-level fusions (C1-3) were done in four children, and four-level fusions (C1-4) in two. One child died of unrelated causes 3 months after the operation. The other five children have been followed for 5 to 13 years. All are doing well and each has a remarkably supple, stable neck and no neurological deficit.

An interaction between diet and blood group upon serum alkaline phosphatase activity in lambs

Serum alkaline phosphatase activity was studied in groups of lambs fed diets containing different amounts of wheat grain and lucerne hay with different levels of supplementation with formaldehyde treated casein-sunflower seed. Total serum alkaline phosphatase activity increased more in groups fed 100 per cent wheat or 67 per cent wheat 33 per cent lucerne than in those fed 33 per cent wheat 67 per cent lucerne or 100 per cent lucerne. Supplementation of the diets with the casein-sunflower seed preparation resulted in an increase in the heat resistant proportion of serum alkaline phosphatase activity. This effect was more apparent in lambs of the r blood group (R-r-i blood group system) than in R lambs. These finds are discussed in relation to the relative heat resistance of tissue isoenzymes of alkaline phosphatase.

Intracerebral schwannoma

A case is reported in which the authors describe a rare example of an intracerebral schwannoma in a 63-year-old woman having a clinical history suggesting the presence of the tumor for 40 years. Such an unusually prolonged course is ascribed to extensive regressive changes in the tumor. The occurrence of intracerebral schwannoma indicates the existence of schwann cells deep within the brain substance, although the precise source of these cells remains obscure.

Recurrent and multiple suture closures after craniectomy for craniosynostosis

✓ Six cases of craniosynostosis are reported in which recurrent and multiple closure of cranial sutures occurred after craniectomy and insertion of polyethylene film. In all patients there was closure of a second and sometimes a third suture as well as reclosure of the treated suture. In four children the second operations were done before the age of 18 months; none had increased intracranial pressure preoperatively and three who are living have normal intelligence. In two children, the second operations were not done until after the age of 3 years; both had increased intracranial pressure preoperatively, and both are now mentally retarded.