Squamous carcinoma arising in a giant peri-anal condyloma associated with human papillomavirus types 6 and 11

A case is reported of squamous carcinoma of the peri-anal region arising in a giant condyloma. In situ DNA hybridization showed human papillomavirus (HPV) types 6 and 11. These HPV types are commonly demonstrated in ano-genital condylomas but have not previously been reported in association with malignant change at this site.

Determination of morphine in human plasma by radioimmunoassay utilising a preliminary liquid—solid extraction

Numerous assays are available for the pharmacokinetic study of morphine. Two of these methods are compared with a new assay procedure, which involves a solid-phase extraction to clean up human plasma before radioimmunoassay allowing the determination of morphine levels to a sensitivity of 1 mugl(-1). Data are presented to show the importance of correct method choice if clinical studies are to be used in pharmacokinetic interpretations.

Non-traumatic atlantoaxial subluxation in an adult secondary to retropharyngeal abscess

Non-traumatic atlantoaxial subluxation in an adult due to retropharyngeal abscess has been only sporadically reported. This article presents such a case treated non-surgically, with discussion of clinical presentation, diagnosis, pathogenesis, and treatment. The differential diagnosis of non-traumatic atlantoaxial subluxation is presented for review.

The effect of sympathomimetic drugs on bone capillaries

Mineral transport to bone is dependent on an adequate blood supply. Thus, the role of vasoactive agents merits orthopaedic interest. This paper outlines the morphology of osteons and capillaries in cortical bone and discusses the possible morphological effects of systemic phenylephrine on mice tibiae. The frequency of dilated capillaries on histological serial sections did not significantly change. Hence, a postcapillary mechanism is likely to explain previous EM findings: i.e., an adrenaline-induced increase of the lumen diameter and perivascular cell edema.

Assessment of HTLV III screening tests in Christchurch

The Christchurch Hospital blood bank has assessed commercial kits designed to test blood donations for the presence of antibody to the retrovirus responsible for acquired immune deficiency syndrome (AIDS). Twenty of 1002 blood donations have been found to be repeatably, positive by one or more of these commercial kits. None was positive by the Western blot technique. Certain patient groups were found to have an elevated number of false positive reactions. Extreme caution is advised when interpreting screening test kit results from donor populations at low risk of AIDS.

Fecal bilirubin excretion and serum bilirubin concentrations in breast-fed and bottle-fed infants

To assess the rate of excretion of bilirubin in the stools and its effects on serum bilirubin concentrations, we studied 24 breast-fed and 13 bottle-fed infants during the first 3 days after birth. Bottle-fed infants passed significantly more stool (3-day totals, 82 vs 58 gm, P less than 0.001), excreted more bilirubin (3-day totals, 23.8 vs 15.7 mg, P less than 0.05), and had lower serum bilirubin values (day 3, 6.8 vs 9.5 mg/dl, P less than 0.02). Among the breast-fed infants, greater stool output was associated with greater fecal bilirubin excretion (r = 0.56, P less than 0.05) and lower serum bilirubin concentrations (r = 0.66, P less than 0.001). Our data suggest that hyperbilirubinemia in breast-fed infants may be related to a delay in bilirubin clearance resulting from low stool output.

Cefuroxime in CMW bone cement. A clinical study

This paper presents the results of adding the antibiotic cefuroxime to CMW bone cement in a group of patients undergoing total hip or knee replacement, in which the levels of cefuroxime were assayed in the blood, wound drainage fluid, urine and surplus bone cement. It was found that very small amounts of cefuroxime, less than 5%, were recovered in the urine, serum and drainage fluid in the first week following operation, and since it is known that cefuroxime is not metabolised or excreted elsewhere in the body, it must follow that approximately 95% remains in the bone cement as a potential source of prophylaxis against infection.

Clinical disorders in patients with hyperprolactinaemia. Experience with 59 patients

Fifty-nine patients with hyperprolactinaemia and presumed, or histologically proven, pituitary tumours were identified within a seven-year period. The wide variety of clinical presentation, the natural history, and the problems associated with therapy are highlighted in several selected case presentations which include both patients with invasive tumours and those with no radiological abnormalities and minimal symptoms. The special considerations involved in a planned pregnancy in a patient with hyperprolactinaemia are emphasized.

The structure of the mouse immunoglobulin in gamma 3 membrane gene segment

The genomic region containing the mouse immunoglobulin gamma 3 heavy chain membrane (M) exons has been located and sequenced. The exon structure is highly similar to that of the other mouse gamma chains, with strong sequence conservation in the coding regions and the intron 5' to the M1 exon. The intron between M1 and M2 shows moderate sequence homology but very strong conservation of size. RNA blots suggest that gamma 3 membrane exon usage is similar to that seen in other immunoglobulin membrane heavy chain mRNAs. The transmembrane region contains the invariant residues which have been noted in all other heavy chain sequences and which were previously proposed to be interactive in a two-chain model for insertion through the lymphocyte membrane. Conserved residues with similar spacing have been seen in class II histocompatibility antigens, which are also two-chain transmembrane molecules, but not in class I antigens, which span cell membranes with a single chain.

Effect of frequent breast-feeding on early milk production and infant weight gain

To investigate the effects of frequency and duration of breast-feeding on infants' milk intake and weight gain, two groups of mother-infant pairs were studied during the first month after delivery. Mothers in the control group (n = 24) nursed their infants on a 3- to 4-hour schedule. Those in the experimental group (n = 20) were encouraged to nurse frequently. During the first 14 postpartum days, all mothers recorded the length and time of each breast-feeding. On the 15th and on the 35th postpartum day, milk intake per feeding for 24 hours and infant weight gain from birth were measured. During the first 2 weeks after delivery, mothers in the experimental group nursed more frequently (9.9 v 7.3 feedings per 24 hours; P less than .0001). On day 15, their infants took more milk (725 v 502 mL/24 h; P less than .0002), and had gained more weight from birth (561 v 347 g; P less than .02). On day 35, although mothers in the experimental group were still nursing more frequently (9.8 v 6.8 feedings per 24 hours; P less than .01), milk intake and weight gain from birth were not significantly different.

Milk intake and frequency of feeding in breast fed infants

To provide normative data for healthy full term infants in the United States when the mothers were encouraged to feed as often and as long as the infants wished, 46 mother-infant pairs were studied in the first month after delivery. Mothers recorded the length and time of each breast-feeding for the first 14 days postpartum, and weighed the infant before and after each feeding during a 24-48 h period at 1 month. The mean frequency of feeding during the first 2 weeks of life was 9.8 +/- 2.5 feeds/24 h and the mean duration of feeding was 162 +/- 50 min/24 h. Infants heavier at birth demanded significantly more feedings and nursed longer during the first 14 days of life. At one month the infants were nursing an average of 7.2 +/- 1.3 times/24 h and the mean duration of feeds was 158 +/- 63 min/24 h. Although the frequency of feeding during the first 14 days postpartum was significantly higher than at 1 month, the total duration of feeding in 24 h was similar. Daily milk intakes at 1 month ranged from 395 to 1011 ml (mean 681 +/- 136 ml) and were not significantly correlated with either the frequency or duration of feedings.

Puberty: a comprehensive approach

Understanding the physical, physiological and psychological components of puberty is essential for diagnosis and optimal management of problematic growth and development. The relationships between these components should be considered also.

Positive interference by danazol in a testosterone radioimmunoassay kit procedure

We describe a problem in measuring serum testosterone concentrations in the serum of women who are taking danazol. The Diagnostic Products Corporation testosterone radioimmunoassay gives very high apparent testosterone concentrations in these women and the value obtained depends on the volume of serum extracted per assay tube. Chromatography of the serum extracts on Sephadex LH-20, but not on Celite, before radioimmunoassay reduced these high apparent testosterone concentrations to less than that found in normal women.

Positive interference by danazol in a testosterone radioimmunoassay kit procedure

We describe a problem in measuring serum testosterone concentrations in the serum of women who are taking danazol. The Diagnostic Products Corporation testosterone radioimmunoassay gives very high apparent testosterone concentrations in these women and the value obtained depends on the volume of serum extracted per assay tube. Chromatography of the serum extracts on Sephadex LH-20, but not on Celite, before radioimmunoassay reduced these high apparent testosterone concentrations to less than that found in normal women.

A linkage study of manic-depressive disorder with HLA antigens, blood groups, serum proteins and red cell enzymes

Families with a two-generational history of affective disorder and well and ill sibs were selected from a population of bipolar manic-depressive patients and typed for HLA antigens, blood groups, serum proteins and red cell enzymes. Segregation of specific HLA alleles was not associated with affective illness across family pedigrees. Further, no significant associations were found between affective disorder and ABO, Rh, MNSs blood groups or Hp, EsD, C3, Gc or PGM. Using the lod score method of Morton (1955) for determining linkage, these data indicated that close linkage is unlikely for affective disorder and HLA alleles, haptoglobin, Rh factor, or ABO blood groups.

The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction

We studied the effects of a supportive lay woman ("doula") on the length of labor and on mother-infant interaction after delivery in healthy Guatemalan primigravid women. Initial assignment of mothers to the experimental (doula) or control group was random, but controls showed a higher rate (P less than 0.001) of subsequent perinatal problems (e.g. cesarean section and meconium staining). It was necessary to admit 103 mothers to the control group and 33 to the experimental group to obtain 20 in each group with uncomplicated deliveries. In the final sample, the length of time from admission to delivery was shorter in the experimental group (8.8 vs. 19.3 hours, P less than 0.001). Mothers who had a doula present during labor were awake more after delivery (P less than 0.02) and stroked (P less than 0.001), smiled at (P less than 0.009), and talked to (P less than 0.002) their babies more than the control mothers. These observations suggest that there may be major perinatal benefits of constant human support during labor.

Absolute configuration of dolichol

A derivative of dolichol was formed and then chemically degraded to a small fragment containing the sole centre of asymmetry of the original molecule. Polarimetric comparison of this derivative with a standard prepared from (R)-citronellol showed dolichol to have an S-configuration at C-3. To determine the optical purity of dolichol a diastereoisomeric derivative was prepared and compared with standard diastereoisomers, which could be resolved by high-pressure liquid chromatography. Dolichols from pig liver, human liver and hen oviduct were analysed by this procedure and were all found to be greater than 95% S-configuration.

Feedback-stabilized fractional fringe laser interferometer for plasma density measurements

A feedback stabilization technique is described for a fractional fringe interferometer measuring plasma electron densities. Using this technique, a CO2 laser Michelson interferometer with a pyroelectric detector exhibited a sensitivity of 3.4 x 10(-4) fringe on a 1-ms time scale and, due to acoustic pickup, 1.8 x 10(-2) fringe on a 10-ms time scale. The rise time is 45 micros. Stabilization against slow drifts in mirror distances is achieved by an electromechanically translated mirror driven by a servo system having a 0.2-s response time. A mechanical chopper in one of the two beam paths generates the signal which drives the servo system.

Cutaneous blood flow during heating and cooling in the American alligator

Nine alligators, Alligator mississippiensis, were injected with 133Xe and the clearance half times measured in response to heating and cooling. Mean half times for thermostable, heating, and cooling conditions were 12.2, 8.6, and 28.3 min, respectively, indicating cutaneous vasodilation in response to local heating and reduced blood flow during cooling. Alterations of cutaneous blood flow occurred before changes in body temperature or heart rate. Warming portions of the animal while shading the injection site resulted in reduced blood flow when heat loss occurred. Skin thickness (S in cm) was related to body mass (M in kg) as S = 0.08 M0.38. Cutaneous blood flow per unit area was found to increase with increasing body mass from approximately 0.0025 to 0.025 ml blood-cm-2 of skin-min-1 during warming and from 0.0018 to 0.0045 during cooling for the 0.18--8.6 kg animals, respectively.

Sodium pump activity, amino acid transport and long-term memory

Long-term protein synthesis-dependent memory formation is shown to be inhibited by the non-metabolizable amino acid alpha-amino-isobutyrate (AIB) possibly through a process related to competition for uptake with amino acids necessary for protein synthesis specific to long-term memory. Unlike cycloheximide (CXM) which inhibits long-term memory by inhibiting ribosomal protein synthesis, AIB is non-effective when administered 10 min or more after learning, and its effect is overcome by the sodium pump stimulator diphenylhydantoin if the latter is administered 10 min or more after learning. Within the model of memory formation adopted in this paper it is postulated that the amino acids necessary for long-term memory protein synthesis are taken up by sodium pump activity in the first 10 min following learning, when formation of the preceding labile memory phase is occurring.

A reduction in multiple pregnancies following the use of a clomiphene citrate: human gonadotrophin sequence

The results of stimulation with gonadotrophins at the Sterility Clinic (Crown Street) are presented. Two different techniques have been employed involving 86 patients. All patients have similar indications for treatment. All have received the same preliminary investigations and all have been treated previously with a minimum of three cycles of Clomiphene Citrate without satisfactory response (i.e. "clomid failures). Technique (1) involved 51 patients and consisted of daily injections of Human Pituitary Gonadotrophin (H.P.G.) followed by an ovulating injection of Human Chorionic Gonadotrophin (H.C.G.) and a follow up injection of H.C.G. on post-ovulatory Day 7 or 8. This technique had a pregnancy rate of 64 per cent and a multiple pregnancy rate of 34 per cent. Technique (2) involved 35 patients and consisted of 5 days priming with Ethinyl Oestradiol and Clomiphene Citrate together, followed immediately by daily injections of H.P.G., then an ovulating injection of H.C.G. and a follow up injection of H.C.G. on post-ovulatory Day 7 or 8. The results of this variation in technique were a pregnancy rate of 69 percent, a multiple pregnancy rate of 8 percent. It is suggested that the use of Clomiphene Citrate in the latter technique acts as a "buffer" against the more extreme ovarian responses to H.P.G. acting alone and has the apparent advantage of a higher pregnancy rate, a lower multiple pregnancy rate and a reduction in the number of foetuses in each of the multiple pregnancies.