Lymphotoxin and tumor necrosis factor-alpha production by myelin basic protein-specific T cell clones correlates with encephalitogenicity

Lymphokine activity in seven myelin basic protein (MBP)-specific T cell clones was examined. All of the clones recognize MBP peptide 1-9 in the context of I-Au. A strong positive correlation was found between levels of lymphotoxin (LT) and tumor necrosis factor alpha (TNF-alpha) mRNA and biological activity on L929 cells and their capacity to induce paralysis, the clinical hallmark of experimental allergic encephalomyelitis (EAE). No correlation was found between interleukin-2 or gamma interferon production and encephalitogenicity. LT and/or TNF-alpha may play a central role in the pathogenesis of EAE.

Phencyclidine and violent deaths in St. Louis, Missouri: a survey of medical examiners' cases from 1977 through 1986

A survey of 104 deaths involving phencyclidine (PCP) occurring from 1981 through 1986 in metropolitan St. Louis, Missouri, is presented. Four black males (22-33 yr) died from fatal PCP intoxication. PCP was detected in an additional 100 deaths: 81 homicides, 13 suicides, and 6 accidental deaths. Seventy-five of these deaths were homicides of Black males (mean age 27 years) typically dying from gunshot wounds, 64 cases. In 50% of deaths where PCP was detected, other drugs were co-administered: ethanol (35%) and cocaine (20%) being the most common mixtures. A dramatic continuous increase in PCP abuse from 1984 through 1986 was demonstrated by drug abuse indicator data: treatment admissions, emergency room episodes, police exhibits, and driving under the influence of PCP arrests. Increased abuse of PCP in St. Louis has been associated with increased medical emergencies and violence against persons.

Intermediate-dose intravenous methotrexate and mercaptopurine therapy for non-T, non-B acute lymphocytic leukemia of childhood: a Pediatric Oncology Group study

Methotrexate (MTX) and mercaptopurine (MP) are the mainstays of continuation therapy for acute lymphocytic leukemia (ALL). These drugs are stored in tissues as active metabolites. Relapse in ALL might reflect failure to achieve adequate intracellular drug levels. Assured (parenteral) delivery of higher doses of MTX and MP should maximize tissue levels of these drugs by overcoming individual variations in absorption, metabolism, clearance, and compliance. Fifty-nine children with ALL at lower risk of relapse received 12 intensive MTX/MP courses immediately after 4 weeks of standard vincristine, prednisone, and asparaginase induction. Each 2-week intensive course included: MTX, 200 mg/m2 intravenous (IV) push then 800 mg/m2 IV over 24 hours on day 1; MP, 200 mg/m2 IV push then 800 mg/m2 IV over 8 hours on day 2; MTX, 20 mg/m2 intramuscularly on day 8; and MP, 50 mg/m2 orally daily on days 8 to 14. After the 6 months of intensive therapy, continuation therapy was weekly MTX/MP (as on days 8 to 14) for 1 or 2 years. Age-based MTX was given intrathecally (IT) for CNS prophylaxis. All patients entered remission. Three patients relapsed: bone marrow (at 24 and 37 months), and bone marrow and CNS (at 34 months). There were no isolated CNS relapses or deaths in remission. Event-free survival at 4 years is 94% (SE, 7%) by Kaplan-Meier analysis. Toxicities (infection, mucositis) occurred in less than 10% of intensive MTX/MP courses. However, a child with Down's syndrome withdrew after three courses because of recurrent severe mucositis. Further studies of this regimen are in progress.

Trace element deficiencies in inflammatory bowel disease

Since the institution of successful parenteral nutrition, much has been learned about malnutrition and the effects and complications of nutritional therapy. A variety of patient groups suffer from malnutrition, and clinicians accept the fact that an extremely high incidence of hospitalized medical and surgical patients are malnourished. Perhaps the group we most frequently see suffering from malnutrition are patients with inflammatory bowel disease (IBD). This is especially true in Crohn's disease, in which a variety of nutritional disturbances have been described.

The use of lymphoscintigraphy in treatment planning of primary breast cancer

A technique is described for the use of lymphoscintigraphy in treatment planning of primary breast patients. During simulation of the treatment fields, the positions of the internal mammary nodes are projected back toward the source onto the patient skin surface and are marked by radio-opaque markers for visualization on films. Exact solutions for the coordinates of these surface projection points are derived. Approximate solutions are also given which are independent of the isocenter location and primarily dependent on the treatment field gantry angle. If a typical couch angle and field size are assumed, the projection points can be calculated for various gantry angles prior to simulation. Generally, a decision can then be made beforehand whether it would be better to use deep tangents or a separate field to treat the internal mammary nodes. During simulation, the surface projection points serve as visual and fluoroscopic guides to field design and optimization. A method is also presented for projecting the internal mammary node positions onto a single transverse patient contour for conventional 2-dimensional treatment planning. By accurately showing the projected location of the node with respect to the field edge, adequate treatment margin can be assured.

Circulating lymphocytes, neutrophils and immune complexes in pigs after feeding

There are reports in the literature claiming that pigs experience a lymphopenia after feeding. This is not observed in other species. We set out to investigate this phenomenon because of the unusual route of lymphocyte recirculation in pigs. for it suggested that this might be a specific response to dietary antigens. We were unable to confirm this phenomenon. A lymphopenia was observed in both test and control groups as a non-specific response to restraint and blood sampling. In contrast, feeding was associated with a significant neutrophilia (mean 58%, P less than 0.002). There were no increases in circulating IgA, IgG or IgM immune complexes after feeding but IgG immune complexes remained at a higher level than in the control group.

Hypercholesterolaemia and a silent MI

Results of investigations in extraordinary patients should be dealt with cautiously; it is often prudent to repeat tests. Though the aims of treatment in such cases are often the same, differences in approach to the problem are illuminating.

Leukemic retinopathy. Relationship between fundus lesions and hematologic parameters at diagnosis

The authors examined 117 consecutive patients with acute leukemia within a few days of diagnosis. Sixty-six patients had acute nonlymphocytic leukemia, and 51 had acute lymphocytic leukemia. Forty-two percent of the patients had abnormal ocular findings related to leukemia. The authors found an association between the presence of intraretinal hemorrhages and thrombocytopenia for all patients. In addition, patients with acute lymphocytic leukemia and intraretinal hemorrhages had lower hematocrit levels than did those without such hemorrhage. The presence of anemia was related to the findings of white-centered hemorrhages in patients with acute nonlymphocytic leukemia. The presence of cotton-wool spots was not associated with hematologic parameters. Intraretinal hemorrhages, white-centered hemorrhages, and cotton-wool spots were all found more frequently in adults than in children.

Screening for raised cholesterol in a small suburban town

Raised serum cholesterol (above 7.8 mmol/l) occurs as frequently as diabetes mellitus. A voluntary screening programme to identify people with raised cholesterol has proved popular.

RglB facilitated cloning of highly methylated eukaryotic DNA: the human L1 transposon, plant DNA, and DNA methylated in vitro with human DNA methyltransferase

In vitro methylation of Bluescribe plasmid DNA (pBS) with human placental DNA methyltransferase to 6% 5-methylcytosine (mC) reduced transformation efficiencies in rglB+ host strains C600 and DS410 by almost 2 orders of magnitude. By contrast, the rglB- derivative of DS410 showed no reduction in transformation efficiency with methylation while the rglB- derivative of C600 was partially tolerant to methylation. Further, we show that the 1.8 kilobase (kb) and 1.2 kb KpnI fragments derived from the human L1 repeat have respectively 18.3% and 2.3% mC in vivo. Using these hyper- and hypo-methylated genomic segments ligated into the pBS plasmid, transformants with the highly methylated 1.8 kb L1 insert were recovered at 17 to 40 fold higher frequency with the rglB- host strains than with the rglB+ hosts. In addition, recombinant phage (lambda 2001) containing inserts of plant genomic DNA with 26.7% mC (from Petunia hybrida) when plated on rglB- hosts gave titres up to 222 times higher than on the rglB+ strains.

Ultrasound screening for clinically occult abdominal aortic aneurysm

In a review of the records of 74 patients who had undergone repair of an abdominal aortic aneurysm at a community hospital between 1977 and 1983 we found that the aneurysm had been undiagnosed before rupture in 35%; these patients had an operative death rate of 50%, whereas elective repair carried a death rate of 4%. The characteristic patient was an obese man over the age of 55 years with hypertension, coronary artery disease, cerebrovascular disease or peripheral vascular disease. Ultrasound examination was performed in 45 patients with these characteristics, and six aneurysms were diagnosed. Either surgery or computed tomography confirmed the diagnosis. The rate of false-negative results was estimated by review of the charts of 100 men over the age of 55 years who had undergone abdominal ultrasonography for other indications: no undetected aneurysms were discovered over 3 years of follow-up. Routine screening in this high-risk group would improve the rate of diagnosis of this potentially fatal condition before rupture and offer the patient the lower mortality rate associated with elective surgery.

Nevus cell aggregates in the placenta. A histochemical and electron microscopic study

This is a report of the histochemical and ultrastructural analysis of nevus cell aggregates in the placenta from a neonate with a giant pigmented nevus. Although the distinction between aberrant migration of neural crest elements and blood-borne metastasis from the giant pigmented nevus is not readily resolved, the authors favor the former as an explanation of this unusual placental lesion.

Non-Hodgkin's lymphomas

The non-Hodgkin's lymphomas are a group of diseases for which substantial progress has been made in understanding tumor biology and effectiveness of treatment during the last few years. These advances may provide insight into the development of neoplasms because of recognized association of lymphomas with viral infections and immunodeficiency. The prognosis for patients with non-Hodgkin's lymphomas continues to improve. As a result, current studies on treatment of lymphomas in certain favorable stages have concentrated on reducing the intensity of therapy. For patients with advanced disease, further improvements in treatment are being sought.

The evolution and outcome of cavitating periventricular leukomalacia in infancy. A study of 46 cases

Forty six infants with the ultrasonic diagnosis of cavitating periventricular leukomalacia (CPVL) have been reviewed. Follow up examination results allow correlation between the ultrasound appearances and subsequent neurodevelopmental and neurological deficits. The highest incidence of this condition was found in infants at and below 27 weeks gestation, and occurred in 15% of very premature infants surviving 14 days or more. Cavities developed 15 days after the onset of periventricular echodensity (median time). Ventricular dilatation occurred in 24% of the infants who developed cavities. Follow up information was available in 27 infants and 18 of these (67%) had significant neurodevelopmental handicap. The location of echolucent cavities were described as involving anterior, middle or posterior cerebral zones or any combination of these. Cerebral palsy was closely related to the presence of cavities, but there was little association between cavities and developmental delay. Four factors were found to predict cerebral palsy: cavities within the occipital zone, the involvement of multiple regions of the brain, lesions greater than 1 cm in diameter and cavities associated with subcortical leukomalacia. Lesions confined to the anterior or middle zones were unlikely to be associated with significant handicap. The presence of cavities per se was not associated with a higher incidence of severe developmental delay.

Prediction of cerebral palsy in very low birthweight infants: prospective ultrasound study

The value of regular cerebral ultrasound scanning in predicting cerebral palsy (CP) was assessed in very low birthweight infants. The infants were scanned before discharge, and their vision and hearing were assessed at age 9 months and neurodevelopment was assessed at 18 months. Ultrasound abnormalities, defined before the study, were periventricular haemorrhage (PVH), "prolonged flare" (echodensity persisting in the periventricular white-matter for more than 2 weeks without cavitating), and cystic periventricular leukomalacia (PVL). The incidence of these three conditions in surviving infants was 49%, 15%, and 8%, respectively. 158 infants survived to be discharged from hospital and 156 had neurodevelopmental assessment at 18 months of corrected age. All infants with PVH alone and confined to the lateral ventricles were normal at follow-up. The presence of cysts accurately predicted abnormal outcome (94%) and was highly specific (96%). Prolonged flare predicted adverse outcome but the accuracy (79%) was less good than for cystic PVL. 12 infants had CP, and 10 of these had ultrasound evidence of PVL. 8 of the 13 infants with cysts had spastic CP. 4 of these were walking independently and had mild CP. No infant with ultrasound evidence of a single cyst or with cysts confined to the frontal region or centrum semiovale had severe CP. Cysts involving the periventricular white-matter in the occipital region were associated with a poor prognosis. Echolucent cystic lesions detected by ultrasound in the neonatal period accurately predict adverse outcome, and if multiple and present in the occipital region, confer a very high risk of severe CP.

The solubility of oxygen in physiological salines

The oxygen solubility coefficient (αO2) of several different physiological saline solutions was measured over a broad range of temperatures (0 to 25‡C). Distilled water had a higher value than a physiological salt solution (similar to Cortland's saline). Plasma expanders (polyvinylpyrrolidone, dextran, albumin) lowered the αO2 value of the physiological salt solution. A salt solution with a 4% (w/v) mixture of protein substitute had a lower αO2 value than the corresponding 1% mixture. The solubility of oxygen was inversely related to temperature.

The indirect flight muscle of Drosophila accumulates a unique myosin alkali light chain isoform

Mapping of the 5' and 3' ends of the Drosophila myosin alkali light chain (MLC-ALK) mRNA by S1 nuclease and primer extension assays has shown that the primary transcripts are identical irrespective of the time in development that the RNA was prepared. As shown by S1 nuclease experiments these transcripts are alternatively spliced in a tissue-specific fashion generating mRNAs that encode tissue-specific protein isoforms. Antibodies were raised to synthetic peptides identical in sequence to the unique portion of each protein. Western blots of one-dimensional polyacrylamide gels using the type-specific antibodies confirmed and extended the results obtained from the S1 nuclease experiments. The indirect flight muscle is the only tissue in the adult that accumulates the alternatively spliced mRNA. The choice between splicing pathways involves the use of a nonconsensus 3' splice junction in larvae and in the tubular muscles of adults, whereas in the indirect flight muscle of the adult only consensus sequences are utilized. The involvement of a trans-acting factor to activate the nonconsensus splice site in the myotubes of larvae and the tubular myotubes of adults is proposed.

Chromosome 8 breakpoint far 3′ of the c-myc oncogene in a Burkitt's lymphoma 2;8 variant translocation is equivalent to the murine pvt-1 locus

The 2;8 variant translocation of human Burkitt's lymphomas is closely related cytogenetically to the t(6;15) of murine plasmacytomas; both involve a reciprocal exchange between the Ig kappa locus and a band region indistinguishable from that bearing the c-myc oncogene. To define their molecular relationship, we have compared cloned chromosome 8 DNA from the t(2;8) breakpoint in the human Burkitt's lymphoma JBL2 with cloned DNA from the murine pvt-1 locus, the major chromosome 15 breakpoint region in murine t(6;15). DNA sequencing and Southern blot analysis shows that these two regions are homologous. Thus the t(2;8) in JBL2 is the molecular equivalent of many murine t(6;15). The murine pvt-1 locus lies an unknown distance 3' of c-myc; analysis of DNA from several tumours with c-myc amplification reveals that pvt-1 is co-amplified in at least one case, placing pvt-1 approximately 100-500 kb 3' of c-myc. The significance of these results with respect to the role of pvt-1 in tumorigenesis is discussed.

Proviral integration site Mis-1 in rat thymomas corresponds to the pvt-1 translocation breakpoint in murine plasmacytomas

Two loci independently implicated in T-and B-lymphocyte neoplasia are shown to be equivalent. The Mis-1 locus is a common proviral integration site in retrovirally induced rat T lymphomas, while the pvt-1 locus on murine chromosome 15 frequently translocates to the kappa locus in plasmacytomas bearing 6;15 translocations. By comparing cloned sequences, we show that pvt-1 is the murine homolog of Mis-1.

An inexpensive microcomputer digital imaging system for densitometry: quantitative autoradiography of insulin receptors with 125I and LKB Ultrofilm

This article describes a video digitizing system designed for measuring film optical density. The system, which is based on a 6-bit (64 gray level) digitizer, solid state video camera, and Apple II microcomputer, digitizes a rectangular area selected by the operator and converts the gray level values into preselected standard units. In order to develop autoradiographic standard curves for quantitative autoradiography with 125I-insulin, liver slices labeled with 125I-insulin and plastic sections containing known amounts of tritium were apposed to the same sheet of LKB Ultrofilm for exposures of 1-7 days. The results indicate that 3H plastic standards can be used to calibrate QAR of 125I-labeled ligands with LKB Ultrofilm. The Apple system was also used to measure binding of 125I-insulin to the external plexiform layer (EPL) in slices of the rat olfactory bulb. Results suggest that the EPL has two binding sites for insulin, a high affinity site with Kd = 1.0 X 10(-8) M and a low affinity site having a Kd = 1.4 X 10(-5) M.

An unsuspected arsenic poisoning murder disclosed by forensic autopsy

An unsuspected case of homicidal arsenic poisoning, clinically thought to be a primary hematopoietic disorder, was uncovered by an expanded toxicologic screen which is performed in all medical examiner's cases in which the decedent displays gastrointestinal symptoms prior to death. Arsenic concentrations were: blood, 7.2 mg/liter; liver, 15 mg/kg; and kidney, 6 mg/kg.

Disposition of cocaine in fatal poisoning in man

A fatal case of intravenous (IV) cocaine administration is presented. Cocaine tissue concentrations (mg/kg) in descending order were: kidney, 26; spleen, 22; brain, 14; heart, 6.1; skeletal muscle, 6.1; lung, 3.4; liver, 1.6; and adipose, 1.0. Body fluid cocaine concentrations (mg/L) were: urine, 39; bile, 10; vitreous humor, 2.4; and blood, 1.8. These results are in excellent agreement with cocaine tissue distribution in the dog following IV administration and limited tissue data in previously reported cocaine fatalities in man.

Murine T lymphomas with retroviral inserts in the chromosomal 15 locus for plasmacytoma variant translocations

The frequent trisomy of murine chromosome 15 in T lymphomas suggests that it bears one or more genes conducive to T-cell neoplasia. One such gene seems to be c-myc, the oncogene frequently activated in B-lymphoid tumours either by retroviral insertion, as in the avian bursal lymphomas, or by a translocation to the immunoglobulin heavy-chain locus, as in the predominant t(12; 15) of murine plasmacytomas and the analogous t(14; 8) of human Burkitt lymphomas. The c-myc gene was strongly implicated in T-cell neoplasia when 15-25% of T lymphomas arising in AKR mice, a strain prone to leukaemia, were found to have retroviral inserts near c-myc. Proviruses near c-myc were also found in several T lymphomas induced by murine leukaemia viruses (MuLV) in both mice and rats, but many of the rat thymomas bear an insert instead at one of several other common sites, at least two of which have murine homologues on chromosome 15. We show here that some murine T lymphomas contain proviral inserts in the recently identified chromosome 15 locus for plasmacytoma variant (6; 15) translocations, which we have denoted pvt-1. Although 6; 15 breakpoints map cytogenetically to the same chromosome band as c-myc, the alterations of pvt-1 in tumours occur at least 72 kilobases (kb) from the c-myc promoters. The insertions in T lymphomas suggest that an altered pvt-1 locus is conducive to neoplasia in T cells as well as B cells, possibly via long-range effects on c-myc expression.

Diamond-Blackfan syndrome in adult patients

Two adults with pure red cell aplasia are described. No extrinsic etiologic mechanisms were identified. Evidence of anemia was long-standing and varied in severity. Musculoskeletal abnormalities (webbed neck, Sprengel's and Klippel-Feil deformities, and hand abnormalities) were similar to those seen in the congenital form of red cell aplasia (Diamond-Blackfan syndrome). As in the congenital variety, adrenal cortical steroids resulted in hematologic repair. These observations suggest that congenital (Diamond-Blackfan) pure red cell aplasia may be first recognized in adulthood and that steroids provide a potential therapeutic modality.

Variant (6;15) translocations in murine plasmacytomas involve a chromosome 15 locus at least 72 kb from the c-myc oncogene

The variant (6;15) translocations in murine plasmacytomas join the myc oncogene-bearing band of chromosome 15 and the immunoglobulin kappa band of chromosome 6. We recently cloned a region from chromosome 15 linked to C kappa and have now used probes from that region to define the major locus of plasmacytoma variant translocations, which we denote pvt-1. In five of nine plasmacytomas we analysed, the 6;15 translocation resulted from reciprocal recombination between the C kappa locus and a 4.5-kb region of pvt-1. Moreover, nearby we located the region shown by others to have undergone a complex (15;12;6) translocation in plasmacytoma PC7183. All the chromosome 6 breakpoints fell between 1 and 3 kb 5' to C kappa but only two were near J kappa genes. Thus the J kappa -C kappa region appears to be a recombination 'hot spot' in lymphocytes, but the breaks are unlikely to be mediated via V/J recombination enzymes. Comparison of a cloned 108-kb region across pvt-1 and another of 52 kb across c-myc established that the pvt-1 breakpoints lie at least 72 kb from the c-myc promoters. Since c-myc is expressed at a substantial level, the 6;15 translocation apparently activates c-myc. Activation may occur directly, at a remarkable distance along the chromosome, or indirectly, via a putative pvt-1 gene product.

Double pituitary glands with partial duplication of facial and fore brain structures with hydrocephalus

A female term infant was born with multiple bony and facial abnormalities involving the mandible, palate, tongue, nasopharynx, vertebrae, ribs and brain. Death occurred at 1 week and a rare combination of forebrain anomalies, were found in a big head, with complete agenesis of the corpus callosum with duplication of the infundibulum, pituitary, anterior third ventricle and aqueduct. The CAT scan was diagnostic of agenesis of corpus callosum. Incomplete twinning or incompetent neural induction with genetic and epigenetic factors have been suggested as possible mechanisms responsible for this rare malformation.

Liver adenosine triphosphate (ATP) in hypoxia and hemorrhagic shock

Reduction of liver ATP in proportion to the severity of shock and hypoxia is well known. We have studied the interrelationships among arterial oxygenation, arterial pH, and liver ATP in experimental hypoxia and in hemorrhagic shock in rats. No significant correlation was found between liver ATP and arterial pH in both hemorrhagic shock and hypoxia and between liver ATP and arterial PO2 in hypoxia. Induction of experimental observations suggest that in this form of hemorrhagic shock, arterial pH may be a sensitive indicator of decreased hepatic perfusion and impaired liver ATP production.

Rate of diffusion of Solu-Medrol across the silastic membranes of breast prostheses-an in vitro study

Many plastic surgeons have used steroids in breast prostheses in augmentation and postmastectomy reconstruction to prevent capsular contracture. The detection and incidence of complications have increased during the last several years. It is probable that the incidence of complications is related to two factors. First, clinicians have used the same doses in the smaller outer compartments of bilumen implants, giving a much higher concentration of steroid. Second, the more recent implants have thinner envelopes. Tritiated Solu-Medrol was placed in the outer lumen of the bilumen Heyer-Schulte, McGhan, and Surgitek prostheses, and in the only lumen of inflatable Mammatech and Heyer-Schulte prostheses. Diffusion of the Solu-Medrol from each of these identically sized prostheses into the surrounding saline bath was measured with a liquid scintillation counter. Diffusion rates provided concentration-dependent, as predicted by Donnan-Gibbs equilibrium. The silicon gel in bilumen implants was found to represent a second Donnan-Gibbs equilibrium and result in a lower diffusion rate because of affinity for the steroid.

Simultaneous and successive contrast effects in the perception of depth from motion-parallax and stereoscopic information

Prolonged inspection of a three-dimensional corrugated surface resulted in a successive contrast effect, or aftereffect, of depth, whereby a subsequently-viewed physically-flat test surface appeared to be corrugated in depth with the opposite phase to the adapting surface. The aftereffect occurred both when the depth was specified by motion parallax, in the absence of all other sources of depth information, and when it was specified solely by stereoscopic information. The depth aftereffect was measured by 'nulling' the apparent depth in the test surface with physical relative motion or binocular disparity until the test surface appeared flat. Up to 70% of the depth in the adapting surface was necessary to null the aftereffect. Simultaneous contrast effects in the perception of three-dimensional surfaces were used to investigate the spatial interactions that exist in the processing of motion-parallax and stereoscopic information. A physically vertical surface appeared to slope in depth in the opposite direction to the slope of a surrounding surface. In this case up to 50% of the slope of the inducing surface was necessary to null the contrast effect. Similar results were again obtained for motion-parallax and stereoscopic depth.

Similarities between motion parallax and stereopsis in human depth perception

Random dot techniques were used to investigate the human visual system's sensitivity to sinusoidal depth modulations specified by motion parallax information. Thresholds for perceiving depth were found to be smallest when the spatial frequency of the depth corrugations was between 0.2 and 0.5 c/deg visual angle. These data were compared with the equivalent thresholds for perceiving depth corrugations specified by binocular disparity using similar apparatus and psychophysical procedures. The similarity between the sensitivity functions is suggestive of a closer relationship between the two systems than has previously been thought.

Staging Meniere's disease and reporting results in Meniere's disease: symposium panel discussion

At its recent spring meeting, the American Neurotologic Society devoted a portion of its program to a symposium on staging Meniere's disease and reporting results. One of the problems discussed, was which preoperative audiogram should be used for reporting results of any treatment. I think that it is very important that we, as otologists, try to look at Meniere's disease or any inner ear dysfunction in a more scientific way. Some of you may feel, on initial evaluation of this material, that it is too cumbersome to be practical in your daily clinical work. However, we feel we have put forth a reasonable staging system and method of reporting results that can be quite helpful once the simple routine of using them has become established. The vertigogram, for example, which is designed to be very simple and not require any sophisticated equipment, should be as easy to read as an audiogram. If we try to approach the vagaries of Meniere's disease or any inner ear dysfunction in a more scientific fashion, I am sure that in several years we will be in a much better position collectively to evaluate our results and to help our patients. This type of comprehensive staging system for all of the components in Meniere's disease or any inner ear dysfunction will enable us to objectify diagnoses and treatment results so that they can be easily compared. We have put forth some of the ideas and methods that we think will help us arrive at a consensus for reporting results. We encourage you to try some of the suggestions presented in this article and welcome your comments and ideas for improving this staging system and method for reporting results.

Tympanosclerosis. An electron microscopic study of matrix vesicles

The ultrastructure of tympanosclerotic tissue has been studied and compared with other processes of fibrogenesis and calcification. Evidence is presented of the presence of large numbers of extracellular membrane-bound matrix vesicles and their role as the site of primary calcification in tympanosclerosis. Calcified spherular structures are formed and fuse into larger structures lined by a lamina limitans indicating the lines of arrested calcification in the collagenous matrix.

Performance characteristics of a commercial ECG gate

A commercial ECG gate was tested to evaluate its ability to predict accurately the time of end-systole. The predicted times followed the manufacturer's specifications quite well. These times were compared with the actual times of end-systole as determined by computer-derived left-ventricular time-activity curves using Tc-99m-labeled red blood cells. Although there was moderate scatter, the predicted times of end-systole correlated well with the actual times (n = 59, r = 0.829). If the left-ventricular ejection fraction was calculated using the predicted time of end-systole, the error would be 0.03, or less, for 95% of the subjects.

Genital cancer in wives of penile cancer patients

We identified the wives or ex-wives of 227 males of the 256 reported with cancer of the penis to the New York State Cancer Registry from Upstate New York from 1960-64. Utilizing the Registry, death certificates, hospital and physician records, we ascertained those wives who developed cancer at any site from 1951-1975. We generated expected numbers of cases of cancer at each site by applying the age specific incidence rates experienced by women of a specific age in a specific year designated by the age of the wife of the index case in each year, estimating withdrawals from age-specific death rates. Thus, our expected numbers are based on the experience of the women in Upstate New York with traits like those of spouses of the men in the same population with cancer of the penis. We found significantly more cases of cancer of the cervix than expected. This was not true for other sites of cancer.

Plasma pentazocine radioimmunoassay

A sensitive and specific radioimmunoassay of dog and human plasma pentazocine is described. Rabbit antiserum and the second antibody method separated bound from free pentazocine. The radioimmunoassay employed an 125I-labeled radioligand and required extraction from the sample prior to quantitation. The method had a detection limit of approximately 200 pg/assay tube (1 ng/ml). The assay was used successfully to measure pentazocine in the plasma of beagle hounds given 0.3 mg of pentazocine/kg iv. The decline in plasma levels fitted a two-compartment body model with a 100-min mean overall half-life and a 3.2-liters/hr mean plasma clearance rate.

Motion parallax as an independent cue for depth perception

The perspective transformations of the retinal image, produced by either the movement of an observer or the movement of objects in the visual world, were found to produce a reliable, consistent, and unambiguous impression of relative depth in the absence of all other cues to depth and distance. The stimulus displays consisted of computer-generated random-dot patterns that could be transformed by each movement of the observer or the display oscilloscope to simulate the relative movement information produced by a three-dimensional surface. Using a stereoscopic matching task, the second experiment showed that the perceived depth from parallax transformations is in close agreement with the degree of relative image displacement, as well as producing a compelling impression of three-dimensionality not unlike that found with random-dot stereograms.

Within-species variation in the development of ultrasonic signaling of preweanling rats

The development of litter and individual differences in the rate of ultrasonic signaling of neonatal rats was studied. Systematic variations among litters and individuals emerged, without differential treatment. These differences were not correlated with variations in general development as indexed by body weight. Two experiments using a cross-fostering design showed that litter differences developed independently of variations in postnatal environment. These results indicate that the variations among litters in ultrasound rate have a prenatal, possibly genetic, etiology and may represent reliable indicants of response to environmental stress.

Glutathione S-transferase in human lymphoid cell lines and fractionated peripheral leucocytes

Glutathione S-transferase activity was identified in cytosol from human lymphoid-cell lines and peripheral leucocytes (polymorphonuclear-leucocyte/monocyte and small-lymphocyte fractions) and compared with human liver enzyme. The findings of closely similar elution volume in gel filtration, substrate (1-chloro-2,4-dinitrobenzene) and inhibitory (probenecid) kinetics indicate that the liver, leucocyte and lymphoid-cell transferases are closely related. The interaction of reduced glutathione and 1-chloro-2,4-dinitrobenzene was shown to occur in intact-lymphoid-cell culture, to be linear with time and quantity of cells and to have kinetics similar to those of the enzyme reaction catalysed by cytosol.