Hysterectomy and psychiatric disorder: I. Levels of psychiatric morbidity before and after hysterectomy

One hundred and fifty-six women with menorrhagia of benign origin were interviewed before hysterectomy, and re-interviewed six months post-operatively (n = 147), and again 18 months post-operatively (n = 148). Levels of psychiatric morbidity were significantly higher before the operation than after. On the Present State Examination, 58 per cent of patients were psychiatric cases before surgery, as against 29 per cent at the 18-month follow-up. Similar post-operative improvements were found on measures of mood (POMS), and of psychosexual and social functioning. Most of these improvements had occurred within three to six months after the operation. Both before and after hysterectomy, levels of psychiatric morbidity were high by comparison with women in the general population, but lower than in psychiatric patients. The pre-operative psychiatric morbidity had been mainly of long duration.

The node of Ranvier in early Wallerian degeneration: a freeze-fracture study

Using the freeze-fracture technique, the sciatic nerve of the rat and rabbit was examined distally at 24 h after crush, with particular reference to the node of Ranvier and paranode. The paranodes, in the majority of myelinated fibres, showed a loss of the cytoplasmic circumferential bands and longitudinal columns and their associated membrane pores which characterise the normal Schwann cell surface. Axonal changes consisting of accumulations of axoplasmic organelles occurred at both the node and paranode. At the nodes large intramembraneous particles in the axolemma (E face) appeared unchanged. Nodal Schwann cell microvilli and paranodal myelin terminal loops were generally unaffected. The findings are discussed in terms of the decrease in amplitude of the action potential which occurs in early Wallerian degeneration.

Schwann cell plasma membrane changes induced by nerve crush. A freeze-fracture study

Twenty-four hours after nerve crush, the Schwann cell plasma membrane and subjacent outer layer of Schwann cell cytoplasm were examined by freeze-fracture in myelinated fibres from the rat and rabbit sciatic nerves. The irregular circumferential bands and longitudinal columns of cytoplasm which characterise the surface of the normal Schwann cell were diminished or had disappeared. Concomitantly, the membrane pores (of micropinocytotic vesicles or caveolae) which are normally present on the bands and columns were also lost. The loss of these specialised features is discussed in terms of the onset of cell dedifferentiation in association with cell division. The Schwann cell plasma membrane acquired a new feature: deep impressions of adjacent collagen fibres, present particularly on the cytoplasmic bands and columns and presumed to be related to a transient increase in fibre diameter.

Enzymic assays for isomers of 2,6-diaminopimelic acid in walls of Bacillus cereus and Bacillus megaterium

An enzymic assay for individual isomers (meso-, LL- and DD-) of 2,6-diaminopimelate was developed. The enzyme 2,6-diaminopimelate decarboxylase specifically attacked meso-diaminopimelate and was used to measure this isomer manometrically. The meso- and LL-isomers were measured together manometrically in a coupled assay with diaminopimelate decarboxylase and diaminopimelate epimerase (which converts LL-diaminopimelate into meso-diaminopimelate). The DD-isomer was not attacked by either enzyme and was measured, as residual diaminopimelate after the coupled assay, by a colorimetric method, which was also used to measure total diaminopimelate before enzymic treatments. The coupled enzymes were also used to prepare pure DD-isomer from chemically synthesized diaminopimelate. A mixture of diaminopimelate isomers was present in walls of four strains of Bacillus megaterium [in each about 75% (w/w) meso-, 18% LL- and 7% DD-] and in walls of two strains of Bacillus cereus (about 85% meso-, 8% LL- and 7% DD-). One strain of B. cereus contained at least 95% meso-diaminopimelate, with only traces of LL- and DD-isomers. Peptidoglycan from Escherichia coli was assayed as containing at least 95% meso-isomer. The proportion of isomers in the wall of a strain of B. megaterium remained constant after growth in a variety of different media.

Therapy of an experimental glioma with systemic or intraneoplastic methotrexate or radiation

An intracranial mouse glioma model was used to study the effectiveness of chemotherapy with methotrexate )MTX) or radiotherapy. Maximum tolerable doses of MTX were established by toxicity studies in nontumor-bearing mice for the intraperitoneal and intracerebral routes of drug administration with and without leucovorin as an antidote. These maximum tolerable doses were then given either by the intraperitoneal route or directly into the tumor to mice bearing intracerebral tumors. The glioma model proved to be extremely useful for assessing the modalities studied, including repeated intraneoplastic injection of MTX. Dosage schedules were successfully developed for administering large amount of MTX and for preventing systemic toxicity by the administration of the antidote. Radiotherapy in single doses and 800 rads delayed the median day of death and produced several long-term survivors. Higher doses were toxic. Intraperitoneal or intraneoplastic MTX was completely ineffective as a chemotherapeutic agent for this tumor, even though very large amounts could be delivered due to the protection from systemic toxicity afforded by leucovorin. It is concluded that MTX is a poor chemotherapeutic agent for this experimental brain tumor, but that the technique of intraneoplastic administration of chemotherapeutic agents is feasible with this model system and should be studied further.

Chemotherapy of an experimental glioma with nitrosoureas

Chemotherapy experiments were performed with 2 nitro-sourea drugs in an experimental mouse brain tumor model. Cell suspensions of a transplantable mouse ependymoblastoma were injected i.c. by means of a stereotactic frame. The drugs used were 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea and 1-(2-chloroethyl)-3-(trans-4-methylcyclohexyl)-1-nitrosourea and were given by either i.p. or by direct intraneoplastic (i.n.) injection on the fifth day after tumor cell implantation. Injections i.n. of drugs were made with the stereotactic frame. Both drugs were highly effective in increasing the median day of death and in yielding large numbers of long-term survivors. Effectiveness was evident after i.p. or i.n. injection. However, with certain dosage schedules such as every 2 hr for 5 injections daily on 2 consecutive days, i.n. injection was more effective and less toxic than i.p. injection. The reason why repeated i.n. injections produced less toxicity than repeated i.p. injections is not definitely known but may be due to local metabolism of the drugs in the tumors and surrounding brain to a less toxic form. This is the first laboratory report of direct i.n. injection of the nitrosoureas, and the authors consider these results encouraging.