Closed mitral valvotomy.

The results of closed mitral valvotomy operations in 359 patients operated on from August 1957 to October 1974 were assessed at July 1975. About 60% of the patients were in good health. These results suggest that there is still a place for closed mitral valvotomy in carefully selected cases.     

Routine neonatal screening for phenylketonuria in the United Kingdom 1964-78. Medical Research Council Steering Committee for the MRC/DHSS Phenylketonuria Register.

From 1964 to 1968, despite a general policy of routine neonatal screening for phenylketonuria that was usually carried out using the Phenistix nappy test, half to one-quarter of all cases reported to the register had been missed in the screening programme and had not been detected before the age of 4 months. In about two-thirds of the "missed" cases no screening test had been carried out, and in one-third a urine test had been performed but had given a false-negative result. In 1968-9 the screening programme was reorganised according to recommendations made in a Government circular (HM (69) 72), which proposed that a specimen of blood should be obtained by heel prick from all newborn infants between the 6th and 14th day of life and be tested in a central laboratory for the presence of raised blood phenylalanine concentrations. The senior medical officers of the various regions were made responsible for ensuring that all infants were tested. By 1974 only 1 to 2% of surviving infants were not being tested for phenylketonuria in the neonatal period, and only five of the 357 cases born between 1974 and 1978 and notified to the register had been diagnosed after the age of 3 months.     

Morphological changes in nodes of the celiac plexus as affected by extensive abdominal surgery

Experiments on 163 dogs were made to study the time course of histological and ultrastructural changes in celiac plexus nodes after resection of the two-thirds of the stomach as well as after some other large operations on the abdominal organs (economic gastric resection, cholecystectomy, resection of the small intestine). It has been demonstrated that since the first days after operation the gangliocytes and neuroglial cells of celiac plexus nodes manifested histological changes detectable at light and electron microscopy levels. These changes were largely reversible in nature despite destructive processes eventuating in the death of some gangliocytes, pericapsular gliocytes and neurolemmocytes. The most overt changes were observed towards the first week after operation, the number of neurons with reversible changes amounting to 42% and that having the signs of destruction to 9.9%. At the later stages the intensity of the histological changes was noticeably reduced. Analogous data were obtained during studies of the time course of the histological changes after other above-indicated operations. However, the intensity of the changes was substantially less than that seen after resection of the two-thirds of the stomach. The evidence obtained allows the conclusion that the pathological structural changes that develop in the celiac plexus after resection of the two-thirds of the stomach play one of the leading parts in the pathogenesis of the post-gastroresection syndrome.     

猫背外侧索中上行纤维的电生理学特征的初步观察

在麻醉猫的脊髓的背外侧索中用显微解剖法剥制出神经纤维细束,研究其传入的单位放电活动。根据对自然刺激的反应共记录到五类性质的不同的单位:肌梭传入单位(n=111),对轻压刺激敏感的低阈值机械感受单位(n=85),对触毛十分敏感的毛单位(n=65),毛—低阈值机械感受性混合单位(n=17),以及仅对伤害性刺激有反应的高阈值机械感受性单位(n=11)。其中肌梭单位最易观察到,可能是肌梭的传入纤维的直径较粗,因而较易完整无损地被分离到。值得指出,所有传递躯体感受信息的脊髓上行纤维均位于背外侧索的外侧三分之一处,而其他纤维则主要分布于背外侧索的内侧三分之二的区域。     

Mortality among drug addicts in Greater London.

During January 1970 to December 1974, 134 deaths in people aged 10-50 years investigated by coroners in Greater London were recorded as being due to drug addiction. Over three-quarters of the addicts were under 30, and 105 (78%) were male; 55 (41%) were unknown to the Home Office. Barbiturate overdose accounted for over half of the deaths, though two-thirds of these were in people registered as addicts to notifiable drugs. Since the Home Office index is concerned with addiction to one class of drugs only, it fails to reflect accurately the prevalence of all serious forms of addiction. Owing to the continuous change in drug-taking behaviour, however, probably no one method of assessment can provide a complete picture, and thus complementary research methods are essential.     

Head injuries in three Scottish neurosurgical units. Scottish head injury management study.

The organisation of care for patients with head injuries in Scotland was investigated by studying retrospectively 785 patients admitted in 1974 and 1975 to neurosurgical units in Glasgow, Aberdeen, and Dundee. The reasons for the injuries and the patients'' clinical conditions were similar in each unit. The referral practices at the hospitals containing the units were compared and found to be different from that of the unit in Edinburgh. It is concluded that patients in the Glasgow, Aberdeen, and Dundee units, which operate a similar policy for head-injured patients, are in general similar. Transferring to a neurosurgical unit only selected patients rather than all patients with head injuries is safe practice only if policies are agreed with primary surgeons and patients can be transferred without delay.     

Structural investigation of a fucoidan containing a fucose-free core from the brown seaweed, Hizikia fusiforme

A fucoidan, obtained from the hot-water extract of the brown seaweed, Hizikia fusiforme, was separated into five fractions by DEAE Sepharose CL-6B and Sepharose CL-6B column chromatography. All five fractions contained predominantly fucose, mannose and galactose and also contained sulfate groups and uronic acid. The fucoidans had MWs from 25 to 950 kDa. The structure of fraction F32 was investigated by desulfation, carboxyl-group reduction, partial hydrolysis, methylation analysis and NMR spectroscopy. The results showed that the sugar composition of F32 was mainly fucose, galactose, mannose, xylose and glucuronic acid; sulfate was 21.8%, and the MW was 92.7 kDa. The core of F32 was mainly composed of alternating units of -->2)-alpha-D-Man(1--> and -->4)-beta-D-GlcA(1-->, with a minor portion of -->4)-beta-D-Gal(1--> units. The branch points were at C-3 of -->2)-Man-(1-->, C-2 of -->4)-Gal-(1--> and C-2 of -->6)-Gal-(1-->. About two-thirds of the fucose units were at the nonreducing ends, and the remainder were (1-->4)-, (1-->3)- and (1-->2)-linked. About two-thirds of xylose units were at the nonreducing ends, and the remainder were (1-->4)-linked. Most of the mannose units were (1-->2)-linked, and two-thirds of them had a branch at C-3. Galactose was mainly (1-->6)-linked. The absolute configurations of the sugar residues were alpha-D-Manp, alpha-L-Fucp, alpha-D-Xylp, beta-D-Galp and beta-D-GlcpA. Sulfate groups in F32 were at C-6 of -->2,3)-Man-(1-->, C-4 and C-6 of -->2)-Man-(1-->, C-3 of -->6)-Gal-(1-->, C-2, C-3 or C-4 of fucose, while some fucose had two sulfate groups. There were no sulfate groups in either the GlcA or xylose residues.     

Localization of the medullary respiratory neurons in rats by microelectrode recording.

Neuronal activity has been recorded extracellularly from the medulla of anesthetized rats. Units whose discharge frequency varied in phase with respiratory airflow were located bilaterally between 1.5 and 2 mm lateral to midline, extending from 1 mm caudal to 1.5 mm rostral to the obex, in the ventral two-thirds of the medulla. Expiratory units predominated and were intermingled with inspiratory units. Ten different patterns of discharge were distinguished, varying from a short burst at the beginning of expiration to a resting discharge which increased in frequency during either inspiration or expiration. Evidence was also obtained that fiber tracts from other areas of the brain cross midline just caudally to the obex and pass to the respiratory centers on which they apparently exert and excitatory action.     

Construction of the genetic map of the polyoma genome.

Seven early mutants, three late mutants, and one plaque morphology mutant of polyoma have been mapped by marker rescue using wild-type restriction endonuclease fragments. The early mutants map between 1.0 and 26.4 units from the Eco RI site, a region previously shown to correspond to the 3'-OH termainal half of "early" RNA (Kamen et al., 1974). The late mutants as well as the plaque morphology mutant map between 26.6 and 45.4 map units, a region previously shown to correspond to the 3'-OH terminal half of "late" RNA (Kamen et al., 1974). Analysis of the genotype of rescued virus demonstrated that the modification of the mutant DNA during marker rescue was limited to the region of the genome covered by the wild-type restriction endonuclease fragment tested.     

Hepatitis B in retreat from dialysis units in United Kingdom in 1973. Public Health Laboratory Service Survey.

A prospective study of hepatitis in over two-thirds of the dialysis units in the United Kingdom has continued since 1968. After the introduction of a control and preventive programme in 1970 there was a sustained decline in the incidence of hepatitis B to the low level of 0-3% among patients and 0-1% among staff in 1973--a greater than tenfold decrease in four years. Comparisons with data from other countries suggest that the almost complete elimination of hepatitis B from dialysis units in the UK was due to the preventive programme.     

Pulmonary embolism in surgical patients: 1959-79.

The Edinburgh surgical statistics (audit) have been analysed for the years 1959, 1964, 1969, 1974, and 1979 to determine the trends in pulmonary embolism in surgical patients who died. There was a total of 61,038 operations, 1528 postoperative deaths, 804 necropsies, and 158 reported pulmonary emboli. The incidence of embolism diagnosed clinically and at necropsy fell throughout the period. This fall held good after corrections for necropsy rates, prognosis, and proportions of major operations. Although the overall necropsy rate fell from 58% to 40%, in patients expected to have a good prognosis the rate rose from 68% to 75%. Necropsy-proved embolism in "good prognosis" patients fell from 0.5% to 0.15% per 100 major operations. The main reduction has taken place since most surgeons in the area adopted methods of prophylaxis against venous thrombosis, but a direct relationship is not proved by this study.     

The cardioregulatory system of crayfish: The role of circumoesophageal interneurones.

1. Interneurones located in the circumoesophageal commissures were found to control the activity of the cardioinhibitor and cardioaccelerator regularity neurones. 2. These interneurones (cardiac command fibres) fell into three classes: (1) strong inhibitors, which caused cardiac arrest, (2) weak inhibitors, which caused bradycardia, and (3) accelerators, which caused tachycardia. 3. When the positions of interneurones were plotted collectively, they formed distinct clusters, suggesting that each cluster was represented by one command unit in an individual preparation. Twenty strong inhibitor units and 16 accelerator units were found. Weak inhibitors did not form clusters. 4. Stimulus threshold characteristics were as low as 3.0 V and 3 Hz for the strong inhibitor units (mean range 4.7-7.1 V and 14-30 Hz). Higher values were found for weak inhibitors and accelerators. 5. The strong inhibitor command drives always showed a positive bias toward the contralateral cardioinhibitor neurone, relative to the ipsilateral cardioinhibitor. 6. Plots of command neurone stimulating frequency versus evoked cardio-inhibitor activity displayed steep positive slopes for strong inhibitor command units and shallow positive slopes for weak inhibitor units. 7. Reciprocity between the cardioinhibitor and cardioaccelerator neurones occurred during both inhibitory and acceleratory command drives. This is not likely to be a property inherent in the command units themselves because reciprocity was earlier observed during chemical and tactile reflex inhibition of the heart. (Field & Larimer, 1974a).     

Reconstruction of the external genitalia in the adrenogenital syndrome by means of a personal one-stage procedure

The techniques for correction of the external genitalia in the adrenogenital syndrome, as far as known by the author, are reviewed. The goals of repair and timing of surgery are discussed. The author's one-stage technique, first published in 1974, is described with intraoperative illustrations, and the results obtained in nine patients are discussed. The advantages of the technique are preservation of a clitoral glans with erogenous sensation based exclusively on the deep dorsal neurovascular bundle. The glans of the megaloclitoris is obliquely reduced in size at its base toward the ventral surface and by resection of up to two-thirds of the ventral segment. It is relocated at its anatomic female position. The labia minora and the introitus vaginae are reconstructed at the same stage with the skin of the megaloclitoris displaced in posterior direction after a cutback incision. Dispareunia is prevented by total excision of the corpora cavernosa, including the crura.     

Identification of the homozygous recessive genotype for the deficiency of uridine monophosphate synthase in 35-day bovine embryos.

Holstein-Friesian cattle heterozygous for the deficiency of uridine monophosphate (UMP) synthase have half-normal activity of UMP synthase. The homozygous recessive genotype would result in little or no activity, has not been observed among live animals and apparently leads to embryonic mortality at approximately Day 40 of gestation. Activity of UMP synthase averaged 2.74 +/- 0.61 units/mg protein for 19 obligatory normal embryos (from normal x normal matings). Activity for 18 embryos from heterozygote x heterozygote matings yielded three non-overlapping groups as follows: (i) five presumed normals with greater than two-thirds normal activity, (ii) ten apparent heterozygotes with one-third to two-thirds normal activity and (iii) three putative homozygous recessive embryos with less than one-third normal activity. The distribution among these groups was consistent with the 1:2:1 ratio expected for autosomal inheritance. Conception of embryos homozygous recessive for this disorder was demonstrated.     

First seven years of a new NHS mental handicap service 1974-81.

A new community-focused mental handicap service was started in a single-district area health authority in 1974. Almost 90% of all the severely mentally handicapped people in a population of 250,000 are now known to the service. Although two-thirds of long stay inpatients originally admitted with major behavioural problems have had them resolved, the remaining one-third with persisting problems are noted to have spent many years in large understaffed wards before transfer. Specialist services to mentally handicapped people are not synonymous with beds. The learning opportunities during the waking hours of a mentally handicapped person are where professional help must be concentrated, and extensive support services for those caring for the mentally handicapped at home must be set up. Absence of shared philosophies, policies, and planning among the health and local authorities has produced the problems and frustrations familiar to many professionals in mental handicap. Future developments must be based on clearly defined and declared principles.     

The structures of the carbohydrate moieties of the alpha subunit of human chorionic gonadotrophin.

The alpha subunit of human chorionic gonadotrophin was reduced with dithiothreitol followed by carboxymethylation with iodoacetic acid. The modified glycoprotein was hydrolysed with trypsin to give various peptides, the identities of which were established, and glycopeptides. The glycopeptides were separated by gel filtration and ion-exchange chromatography; they were subjected to component analysis and were found to represent the two carbohydrate moieties in the parent glycoprotein. Sequential removal with glycoside hydrolases of monosaccharide units from the glycopeptides demonstrated (1) that galactose, mannose, glucosamine (2-amino-2-deoxyglucose) and neuraminic acid (5-amino-3,5-dideoxy-glycero-galacto-2-nonulosonic acid) residues possess the D configurations, (2) that the glucosamine units are N-acetylated and (3) the order of the monosaccharide units in the chain, the neuraminic acid units being furthest from the peptide backbone of the subunit and substituting the D-galactose units. Methylation analysis of the glycopeptides by adaptation of the Hakomori technique demonstrated that: (4) D-galactose, D-mannose and N-acetylglucosamine (2-acetamido-2-deoxy-D-glucose) units exist in the pyranose forms; (5) the D-galactopyranose units are linked in the 1 and 6 positions; (6) the D-mannopyranose units exist in several forms, one in a terminal non-reducing position, one as 1,2-linked residues and some as 1,6-linked branch points; (7) the N-acetylglucosamine units are 1,6-linked. On the basis of the results of methylation and enzymic analysis, structures are proposed for the carbohydrate moieties and the assignments are compared with other data previously obtained by periodate-oxidation studies [Kennedy et al. (1974) Carbohydr. Res. 36, 369-377].     

Spatiotemporal association patterns in a supergroup of Rwenzori black-and-white colobus (Colobus angolensis ruwenzorii) are consistent with a multilevel society

Primates display broad diversity in their social organization. The social groups of a few primate species are organized in a multilevel fashion, with large groups composed of multiple, core one-male units (OMUs). A characteristic of multilevel societies is that the higher levels can include hundreds of individuals. The Rwenzori black-and-white colobus (Colobus angolensis ruwenzorii) in the montane forests of Rwanda form supergroups and have been suspected to exhibit multilevel social organization. Here we present the first data on the “anatomy” of a supergroup numbering 500+ individuals. We identified subgroups within the supergroup based on progression data, extracting the social network structure from the time-stamped spatiotemporal distribution of passing individuals identified to age–sex class, and selecting an optimal time window for each network using the two-step approach developed by Uddin, Choudhury, Farhad, and Rahman (2017). We detail the existence of core units—multi-male units (MMUs) with a mean of 1.7 adult males and 3.1 adult females, as well as OMUs, all-female units and bachelor units composed of adult and sub-adult males. More than two-thirds of units are MMUs. These grouping patterns conform to a multilevel society with predominantly multi-male core units, a social system that has recently also been described for a population of the same taxon in Uganda. Individual identification will be required to corroborate these interpretations.     

Feasibility of routine testing for hepatitis B surface antigen in hospital employees and restriction of carriers.

In 1972-73, 48 hospital staff members were tested selectively for hepatitis B surface antigen (HBsAg); 4 (8.3%) were found to be HBsAg-positive. In 1974-75, 1415 staff members were tested routinely before employment and at periodic health examination; 25 (1.8%) were found to be HBsAg-positive. Of the HBsAg-positive staff members 55.2% were Asians, this proportion being significantly (P less than 0.05) greater than that of any other ethnic group, and 31.0% were southern Europeans. Nurses and laboratory technologists were the largest professional groups among the HBsAg-positive staff, each accounting for 20.7%. Our results indicate that it is impractical to carry out routine testing of hospital staff for HBsAg. Selective testing and restriction from work in their units is proposed for staff of the renal and peritoneal dialysis units, the emergency department and the intravenous team and dietary staff who handle food directly.     

Primary motor cortex reports efferent control of vibrissa motion on multiple timescales

Exploratory whisking in rat is an example of self-generated movement on multiple timescales, from slow variations in the envelope of whisking to the rapid sequence of muscle contractions during?a single whisk cycle. We find that, as a population, spike trains of single units in primary vibrissa motor cortex report the absolute angle of vibrissa position. This representation persists after sensory nerve transection, indicating an efferent source. About two-thirds of the units are modulated by slow variations in the envelope of whisking, while relatively few units report rapid changes in position within the whisk cycle. The combined results from this study and past measurements, which show that primary sensory cortex codes the whisking envelope as?a motor copy signal, imply that signals present in both sensory and motor cortices are necessary to compute angular coordinates based on vibrissa touch.     

Conduction velocity of the IXth nerve fibers innervating taste organs in the rostral and caudal tongue region in bullfrog

Sensory impulses elicited by electrical, mechanical and chemicalstimulation of the fungiform papillae in the bullfrog tonguewere recorded at two distant points on the glossopharyngealnerve, and the conduction velocities of different types of sensoryunits in the medial branch supplying the caudal two-thirds ofthe tongue were compared with those in the lateral branch innervatingthe rostral third. (1) Rapidly-and slowly-adapting mechanosensitiveunits in the medial branch had the mean conduction velocityof 23 ± 0.4 (S.E.) and 14.8 ± 0.3 m/sec, respectively,the former but not the latter being significantly (P <0.001)slower than the lateral branch units of the same type by 6m/sec.(2) The velocity of gustatory unit impulses was found to rangefrom 14 to 20 m/sec. Statistical examination revealed that themean conduction velocities of the medial branch units can bearranged in the order of water- > sucrose- > acetic acid-= NaCl- >quinine-sensitive units. Similar order had beenfound in the lateral branch units, which were significantly(P <0.001) faster in the mean conduction velocity than themedial branch units of the respective type by 2 m/sec.