On the scene: Stanford University Hospital. Developing nurse managers.
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Biomedical subjects
Publications and source records attributed to J Miller.
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During the first fifty years of historical and biographical commentary on Freud and the origins of psychoanalysis there were three periods of interpretation of Freud's Jewishness. During the first period, extending from the mid-1920s until the 1950s, it was widely assumed, following the works of Wittels, that Freud was essentially Viennese, that his Jewishness was at most incidental. During the second period, extending until the late 1960s, Freud was believed by some, following Bakan, to be essentially Jewish, and to have concealed that important aspect of his life intentionally. During the most recent period, and especially in the early 1970s, psychoanalysis was interpreted as a compromise wrought by Freud to meet the conflicting demands of secular German and scientific modernity and Jewish and other traditions.
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We have exploited the physiologic mechanism for removal of red cells from the circulation to target the iron chelator desferrioxamine to reticuloendothelial iron stores. Compared with free desferrioxamine injected intravenously, the same dose of desferrioxamine entrapped in resealed red blood cell ghosts resulted in a fourfold to fivefold increase in excretion of radioiron in rats with a selective 59Fe radiolabel of reticuloendothelial iron stores. Desferrioxamine in red cell ghosts did not enhance excretion in rats with selective radiolabeling of parenchymal iron stores. In rats with uniformly radiolabeled iron stores, desferrioxamine in red cell ghosts produced an eightfold to ninefold greater loss of iron in the urine free desferrioxamine intravenously or by slow subcutaneous infusion. Desferrioxamine in red cell ghosts resulted in significantly greater fecal excretion of iron than intravenous desferrioxamine, but desferrioxamine in red cell ghosts and subcutaneous desferrioxamine infusion resulted in similar fecal iron excretion. Clinical application of the red cell ghost method for administration of desferrioxamine and other iron chelators may ber useful for improvement of iron chelation efficiency.
Single unit recordings were made in the portion of the lateral pulvinar which forms the lateral aspect of the caudal pole of the thalamus, i.e., PL gamma (Rezak, M., and L. A. Benevento (1977) Soc. Neurosci. Abstr. 3:573; Rezak, M. (1978) Soc. Neurosci. Abstr. 4: 642), of macaque monkeys. PL gamma receives convergent inputs from the occipital cortex and has strong reciprocal interconnections with the visual association cortex, including the inferotemporal cortex (areas 20 and 21). It was found the that PL gamma has a poor or nonexistent retinotopic organization. Many of the neurons had large, unflanked, overlapping receptive fields which often included the fovea. A few neurons could be influenced by a visual stimulus placed anywhere in the visual field described by a tangent screen. The receptive fields could be bilateral or located entirely within the contralateral or ipsilateral hemifields. The majority of units were binocular and exhibited various types of binocular interaction which could be quite complex. The binocular response was not predictable from the algebraic sum of the monocular responses and could be of the opposite sign (e.g., excitatory when the monocular response was inhibitory). Neurons which were also sensitive to the direction of movement of stimuli projected upon the tangent screen formed a major group. Of the units sensitive to tangentially moving stimuli, two special subgroups were found. One group of neurons gave sustained responses to static levels of luminance, while the other group was sensitive to simuli which moved toward or away from the eyes. The nonlinear rate of change of the apparent size of approaching or receding stimuli was described by a mathematical function which also describes the response of the neurons to the same stimuli. For many of these units which were sensitive to tangentially moving stimuli and one other class of stimuli, such as luminance levels of movement in depth, the responses to one class were seemingly unrelated to the responses to the other class. The same statement may be made for monocular and binocular responses. It may be, then, that different wiring diagrams describe these different types of inputs. These physiological results are discussed in terms of the inputs to PL gamma as well as its cortical targets.
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A rapid methof for preparation of membrane fractions highly enriched in nicotinic acetylcholine receptor from Torpedo californica electroplax is described. The major step in this purification involves sucrose-density-gradient centrifugation in a reorienting rotor. Further purification of these membranes can be achieved by selective extraction of proteins by use of alkaline pH or by treatment with solutions of lithium di-idosalicylate. The alkali-treated membranes retain functional characteristics of the untreated membranes and in addition contain essentially only the four polypeptides (mol.wts. 40000, 50000, 60000 and 65000) characteristic of the receptor purified by affinity chromatography. Dissolution of the purified membranes or of the alkali-treated purified membranes in sodium cholate solution followed by sucrose-density-gradient centrifugation in the same detergent solution yields solubilized receptor preparations comparable with the most highly purified protein obtained by affinity-chromatographic procedures.
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Acute isoniazid poisoning is uncommon in children. Only 27 cases, to our knowledge, have been reported in the literature. Often, the first observation is of uncontrollable convulsions. The metabolic alterations are often striking and the treatment has mainly been supportive, with the judicious use of pyridoxine hydrochloride in those cases in which a history of ingestion of isoniazid is obtained. The response to the administration of pyridoxine has been difficult to evaluate.
Reye's syndrome occurred simultaneously in three siblings. All had characteristic changes in liver histology ascertained by light and electron microscopy. The two patients with the most severe disease also had serum that caused marked stimulation of mitochondrial state 4 respiration in vitro. Histocompatibility locus antigen typing showed that no unique haplotypes were shared by all three children. There was no evidence of exposure to aflatoxins, pesticides, or other substances that have been previously postulated to be associated with Reye's syndrome. Influenza A/Brazil/11/78-like virus was isolated from one patient, and all three patients had a fourfold or greater rise in hemagglutination-inhibiting antibody to H1N1 influenza virus.
The mixed leukocyte culture (MLC) of peripheral blood lymphocytes (PBLs) from two prospective kidney transplant recipients and their respective donors, produced a primed cell population that functioned as suppressors. The primed cells suppressed the primary and secondary MLC when added as third components, without demonstrable cytotoxic cells. Suppressor cells were derived from the MLCs of related pairs that were genotyped to be: (1) serologically defined (SD) identical and lymphocyte-defined (LD) nonidentical, and (2) HLA (total MHC) identical. Primed cells derived from MLC of unrelated HLA nonidentical subjects also showed similar effects. Two general patterns of inhibition were observed: a marked specific suppression of the autologous responding cells and, to a lesser degree, nonspecific suppression. The T cell fraction derived from the primed suppressor population was suppressive, the cells with B cell characteristics were not suppressive. The suppressive effect of cells generated in MLC was serially monitored after kidney transplantation. The suppressive activity of the primed cells was absent in the early postoperative period (4 weeks), perhaps because of high dose immunosuppression, but later in the course suppression was evident again (2 to 5 months). Manipulation of this T suppressor cell population may prove to be of value in enhancing graft acceptance.
Vital capacity (VC) rarely may decrease 35-60% in healthy mountain climbers associated with high-altitude pulmonary edema (HAPE). In the age range 58-71 yr, five of six men during a week or more on White Mt. in 1962 had decreases in VC from 20 to 32% without frank symptoms of HAPE, Dill, one of the five, had decreases in VC again on White Mt. in 1977 and 1978. Yet none of 11 young climbers on White Mt. studied by Hultgren (personal communication) had a significant decrease in VC. Dill's arterial O2 saturation at age 87 at 485 Torr was about 79% in rest and 74% when VO2 was 0.74 ml/min.kg. His aerobic capacity at age 87 yr was 18 ml/min.kg at 695 Torr and 15 at 485 Torr.
The virulence of a multiple antibiotic-resistant isolate of Escherichia coli was compared to that of the same isolate 'cured' of its resistance by acridine orange, and to that of the cured bacteria transformed back to resistance by the plasmid DNA extracted from the original resistant isolate. There were virtually no differences in the mouse LD 50 of these three variants of the same organism.
Blood samples, drawn every 15 days (September 1975-September 1976) from four laboratory-housed male mongrel dogs, were assayed by radioimmunoassay for levels of testosterone and LH in the plasma. The mean plasma concentrations of testosterone remained relatively constant for most of the year with the exception of a significant rise in late August and early September. Mean plasma levels of LH showed a cyclic pattern throughout the year which could be represented by a cosine function curve. However, this cyclic pattern of LH was not accompanied by cyclic changes in plasma levels of testosterone and there was no relationship between these two hormones during the period of 1 year. As the cyclic pattern of LH was altered, the plasma level of testosterone began to rise and reached its highest concentration. Since this alteration of the LH cycle occurred before the increased concentrations of testosterone, and since there was no relationship between these two hormones for the period of a year, we have concluded that there may be another hormone(s) involved which either alters the sensitivity of the canine testis to LH or alters the Lh synthesis/release mechanism of the pituitary gland.