Letter from a dental patient.
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Dental Care↗
Biomedical subjects
M Miller
Publications and source records attributed to M Miller.
The physician and the older suicidal patient.
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Aged↗
A psychological autopsy of a geriatric suicide.
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Aged↗
Size and weight of glomeruli isolated from human diabetic and nondiabetic kidneys.
A sieving technique was used to isolate human glomeruli and to fractionate them by size in order to determine whether nondiabetic and diabetic glomeruli can be separated from one another on the basis of size and mass and to observe the effects of diabetes on the physical properties of glomeruli. The kidneys studied were from five diabetic patients and five nondiabetic controls that were age- and sex-matched. About 40 percent of the glomeruli in the samples of renal tissues were isolated for study. The preparations consisted of more than 90 percent glomeruli, and over 90 percent of the glomeruli were isolated whole. The mean diameter of the diabetic glomeruli was 45 percent greater than that of nondiabetic glomeruli. The mean mass of the diabetic glomeruli was 2.5 times greater than the mean nondiabetic glomerular mass.
Adult↗
Unilateral Morgagnian cataract.
Morgagnian cataract is a hypermature lens in which the cortex liquifies and the dense nucleus sinks inferiorly. Aside from the total reduction of vision, serious sequelae may result. This report is of a unilateral Morgagnian cataract of unknown etiology for which a dilated pupil facilitated the differential diagnosis between cataract types.
Adult↗
Ligand-induced spectral changes in cytochrome c oxidase and their possible significance.
1. The spectral shifts induced on the binding of H2S to ferric cytochrome aa3 are similar to those induced by cyanide, reflecting a possible high- to low-spin state change in the a3 haem. Opposite shifts are seen with either formate or low azide concentrations, while high azide concentrations reverse the change induced at lower concentrations. The unusually high Soret band in the half-reduced sulphide-inhibited species (a2+a33+H2S) results from the superposition of cytochrome a2+ and cytochrome a33+H2S peaks. 2. The difference spectra in the visible region for cytochrome a2+ minus cytochrome a3+ obtained with four inhibitors (cytochrome a2+ a3+I minus minus a3+a33+I)are similar, except that azide and sulphide induce blue shifts of the alpha-peak. The trough in the Soret region for the azide complex is much deeper than that for the other complexes, suggesting changes in the cytochrome a33+HN3 centre on reduction of cytochrome a. 3. The "oxygenated" and "high-energy" forms of cytochrome aa3 both involve spectral changes at the a3 haem similar to the changes induced by cyanide and sulphide. The spectrum of partially reduced cytochrome aa3 in the presence of reductant and oxygen indicates the steady-state occurrence of appreciable levels of low-spin (oxygenated) cytochrome aa3. These may be important for energy conservation during the action of cytochrome aa3 in the intact mitochondrial membrane.
Animals↗
A neuropsychological study of polydrug users.
The long-term neuropsychological effects of persistent nonmedical drug use are still unknown. In this study, 22 young men, all extensive "polydrug" users, were examined while free from drugs for an average of 60 days by means of the Halstead-Reitan Neuropsychological Test Battery. Their performance was compared to that of age-education-sex-matched neurologically intact medical patients and a similarly matched group of neurologically impaired patients. Blind independent ratings of test protocols by two experienced clinicians judged 41% to 64% of the drug users, 11% to 26% of the medical patients, and 84% to 89% of the neurologic patients to be impaired. Interpretation of these results suggests that in some individuals, heavy "polydrug" use may be associated with neuropsychological dysfunction, which persists at least an average of two months beyond cessation of drug use.
Adult↗
Cyclic nucleotides, thioldisulfide status of proteins, and cellular control processes.
It is shown that cyclic nucleotides can have a variety of effects on cell division, cell shape, cell adhesion, and cell movement, depending on the cells selected and the conditions under which they are used. For example, while CHO cells elongate under the influence of exogenous dibutyryl CAMP, Y-1 adrenal tumor cells round up and polyoma-transformed 3T3 cells show no change in shape. The totality of experience with cyclic nucleotides suggests that where they have been used by cells as control elements involving the four processes listed above, they are superimposed on basic cellular processes that progress in their absence--that is, they must be acting indirectly. In attempting to understand the inhibitory action of methyl xanthines on egg development, we were forced to abandon the idea that they acted through cyclic nucleotides. We found that methyl xanthines inhibited the activation of glutathione reductase and that glutathione oxidizing agents act as mitotic inhibitors. Further, we found that tubulin polymerizability, NAD-kinase activity, and a mitotic apparatus associated Ca+2-ATP-ase were all inhibited by oxidation of some of their sulfhydryls and were activated by reduction of the resulting disulfides. These results are discussed in terms of reported cycles and activations of glutathione reductase (GR) in cells and reports that mixed disulfides of glutathione and proteins can act as substrates for GR. Using the fact that a CAMP-dependent protein kinase has been reported to be activated by glutathione, we have suggested potential sites where sulfhydryl control processes and cyclic nucleotide control processes and cyclic nucleotide control processes may interact in certain restricted cases.
Adenosine Triphosphatases↗
[Thoughts about the qualification of assessors for sensory testing (authors transl)].
On the occasion of a storage test in order to evaluate the tightness of milk packing materials to permeating flavours by sensory analysis the statistical method for judging the concerned assessors recommended by Römer and Renner was applied. We gained the experience, that this method allows no statement about the assessor's sensory ability at all, but merely fixes his order of precedence in a panel as to his ability to realize sensory differences in the scope of one special problem. The mentioned statistical procedure cannot substitute a selection of assessors aimed at the subject of the following sensory analysis.
Animals↗
Pathophysiologic and pharmacologic alterations in the release and action of ADH.
The physiologic factors involved in vaseopressin (ADH) release and action are reviewed with emphasis on the interaction between osmotic and volume stimuli to the discharge of ADH. Abnormalities in reception of stimuli to ADH release, and in the impaired synthesis and release of ADH, are reviewed in relation to the causes of diabetes insipidus, and information on the biochemical changes which have been described in patients with nephrogenic diabetes insipidus is also discussed. We summarize the pathologic lesions and associated diseases found in 54 of our patients with diabetes insipidus. Criteria for establishing the diagnosis of diabetes insipdus are reviewed with emphasis on the dehydration test, including the importance of measuring plasma osmolality at the conclusion of water deprivation. Treatment of diabetes insipidus is briefly discussed with emphasis on the use of DDAVP and oral agents. The syndrome of inappropriate ADH secretion (SIADH) is reviewed including our experience with 39 patients. The differential diagnosis of SIADH, including the value of water loading and the measurement of ADH levels, is discussed. We comment on treatment of these patients including the use of investigational drugs. Lastly, we review the pharmacologic features and clinical relevance of some drugs which alter the release and action of ADH.
Analgesics↗
Does the rat with hereditary hypothalamic diabetes insipidus have impaired avoidance learning and/or performance?
Avoidance learning and extinction of rats with hereditary hypothalamic diabetes insipidus (Brattleboro strain) were studied in 2 experiments that differed only in shock intensity. In both experiments rats homozygous for diabetes insipidus were more deficient in both escape and avoidance responding than were their heterozygous or normal controls. Although the hterozygous animals showed improved escape performance at the higher shock intensity, their avoidance behavior was not improved. The superiority of normal and heterozygous animals in extinction performance, relative to the homozygous animals, was eliminated or reversed when the differences in terminal acquisition performance were taken into account by analyses of covariance. Deficiency of ADH, therefore, may not result in faster extinction of avoidance behavior.
Animals↗
Epidemiologic studies of diabetes in the Pima Indians.
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Adolescent↗
Drug-induced stated of impaired water excretion.
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Analgesics↗
Inner medullary plasma flow in the kidney with ureteral obstruction.
To test the thesis that ureteral obstruction causes medullary ischemia, we determined inner medullary plasma flow (IMPF) in rats with bilateral or unilateral ureteral obstruction, and after relief of obstruction, by the intravenous 125I-albumin infusion technique. A progressive decline in IMPF was observed during obstruction of 18 h duration, greater in bilateral obstruction (7% of normal at 5h) than in unilateral obstruction (28% of normal at 5 h). The elevation in ureteral pressure was greater and more sustained in bilateral obstruction. After relief of obstruction, IMPF rose to 69-78% of normal in both groups within 2 h. Histologic studies showed tubular necrosis in portions of the inner and outer medulla immediately beneath the renal pelvic epithelium after bilateral or unilateral obstruction of 18 h duration, and India ink perfusion studies showed very poor filling of vasa recta in these areas. The concentrating defect in the postobstructive kidney may be related, at least in part, to damage inflicted by medullary ischemia during obstruction.
Albumins↗
Computer simulation of brainstem respiratory activity.
A mathematical model of the medullary respiratory oscillator, composed of two mutually inhibiting populations (inspiratory and expiratory) of computer-simulated neurons, is presented. Each population consists of randomly interconnected subpopulations of excitatory and inhibitory neurons, is presented. Each population consists of randomly interconnected subpopulations of excitatory and inhibitory neurons. Neuronal coupling is such that either the inspiratory or expiratory population alone is capable of cyclic activity. Weak inhibitory connections between inspiratory and expiratory populations provide satisfactory reciprocating activity independent of the natural frequency of either population alone. Initiation and persistence of rhythmic activity is dependent on a diffused noncyclic excitatory input. Vagal discharge, simulated by phasic inhibition of inspiratory neurons, results in increased respiratory frequency with decreased inspiratory activity. In the absence of simulated vagal discharge, uniform facilitation of synaptic connections increases averaged activities of inspiratory and expiratory populations, with minor effect on frequency. In the presence of simulated vagal discharge, facilitation of synaptic connections increases both frequency and amplitude. The simulated effects of synaptic facilitation, with and without vagal discharge, mimic the physiological response to CO2 in the intact and vagotimized animal.
Computers↗
Antidiuretic action of prolactin in the rat with diabetes insipidus.
Rats with hereditary hypothalamic diabetes insipidus, devoid of endogenous ADH, exhibited a prompt antidiuresis when injected subcutaneously or intraarterially with ovine prolactin. The antidiuresis was accompanied by a decrease in free water clearance and an increase in urine osmolality without a change in osmolal clearance or creatinine excretion. Measurement of PAH and insulin clearances indicated that prolactin had no effect on renal plasma flow or glomerular filtration rate. Prolactin injection caused a transient decrease in urinary sodium excretion, but proximal tubular sodium reabsorption, estimated by lissamine green transit time, was unaffected. The antidiuretic effect of prolactin could not be attributed to ADH contamination of the ovine prolactin preparation. Kidney cyclic AMP content was increased significantly 5 min after injection of prolactin. Thus, prolactin has an antidiuretic effect similar to that which occurs as a result of ADH action on the kidney and does not require either the release or the presence of ADH in order to cause the antidiuresis. Further, the impaired water excretion cannot be attributed to an increase in proximal tubular sodium reabsorption or to alteration of renal hemodynamics. It is suggested that prolactin has a direct ADH-like action on the kidney resulting in antidiuresis.
Animals↗
Normal glucagon response to arginine infusion in "prediabetic" Pima Indians.
To determine whether abnormalities in glucagon secretion might precede the onset of hyperglycemia in diabetes mellitus, 32 prediabetic Pima (American) Indians, 27 normal Pima Indians and 34 normal Caucasians received an infusion of arginine monochloride (5 mg/kg/min for 40 minutes) with measurement of glucose, insulin, and glucagon. [Prediabetes is the period between conception and the development of diabetes. In most studies the term is used to characterize patients who on genetic grounds are believed to be at high risk of developing the disease, including the normoglycemic monozygotic co-twin of a diabetic or the normoglycemic offspring of two diabetic parents. The latter definition is used in the present study recognizing that in the final analysis the true prediabetic can be identified only in retrospect after the development of diabetes.] The three groups had similar mean fasting glucagon levels. During arginine infusion, the prediabetic Indians reached a mean maximum glucagon level of 315 +/- 14 pg/ml (mean +/- 1 SEM) compared with 294 +/- 20 pg/ml in the normal Indians and 292 +/- 25 pg/ml in the normal Caucasians. The calculated mean areas above baseline under the glucagon curves were 5704 +/- 324 pg-min/ml in the prediabetics, 5189 +/- 446 pg-min/ml in the normal Indians, and 4239 +/- 613 pg/min/ml in the normal Caucasians. The differences among the groups in these variables were not statistically significant. Thus, arginine induced hyperglucagonemia could not be identified as a characteristic of the prediabetic state in Pima Indians.
Adult↗
Arginine-stimulated hyperglucagonemia in diabetic Pima Indians.
Groups of 27 nondiabetic Pima Indians, 34 nondiabetic Caucasians, and 12 diabetic Pima Indians with recent onset of their disease received an arginine infusion to determine if (1) nondiabetic Pima Indians and Caucasians had a similar glucagon response to arginine and (2) diabetic Pimas had excessive glucagon response to arginine as reported in other racial groups. The fasting glucagon levels in the three groups were not significantly different. During arginine monochloride infusion (5 mg./kg./minute for 40 minutes) the diabetic Pimas had glucagon levels significantly higher at 10 minutes and at all sampling points thereafter than the normo-glycemic Pimas. Plasma insulin levels also increased during the infusion but, notably, never differed significantly between these two groups. There was no significant difference in the glucagon levels at any sampling point between the nondiabetic Pimas and Caucasians. The differences in glucagon levels between the nondiabetic and diabetic Indians are similar to those differences reported between diabetic and nondiabetic subjects of other racial origins.
Adult↗