Cultural Aspects of Health and Illness Behavior in Hospitals

Health care attitudes reflect the basic world view and values of a culture, such as how we relate to nature, other people, time, being, society versus community, children versus elders and independence versus dependence. Illness behavior determines who is vulnerable to illness and who agrees to become a patient—since only about one third of the ill will see a physician. Cultural values determine how one will behave as a patient and what it means to be ill and especially to be a hospital patient. They affect decisions about a patient''s treatment and who makes the decisions. Cultural differences create problems in communication, rapport, physical examination and treatment compliance and follow through. The special meaning of medicines and diet requires particular attention. The perception of physical pain and psychologic distress varies from culture to culture and affects the attitudes and effectiveness of care-givers as much as of patients. Religious beliefs and attitudes about death, which have many cultural variations, are especially relevant to hospital-based treatment. Linguistic and cultural interpreters can be essential; they are more available than realized, though there are pitfalls in their use. Finally, one must recognize that individual characteristics may outweigh the ethnic and that a good caring relationship can compensate for many cultural missteps.     

Comparison of stem-cell recovery in autoimmune and normal strains

The capacity of NZB stem cells to proliferate in vivo was evaluated in two systems which required repopulation of peripheral organs. In both types of depletion systems, stem-cell repopulation after cyclophosphamide treatment or adoptive transfer repopulation in lethally irradiated hosts, it was found that NZB stem cells were hyperproliferating. The increase in proliferating cells was most pronounced in the spleens of NZB mice treated with high-dose cyclophosphamide and in lethally irradiated F₁ mice reconstituted with NZB T-cell-depleted bone marrow. Thus, upon a stimulus to repopulate, NZB marrow stem cells will hyperproliferate in peripheral organs resulting in an increase in cell number. The abnormality in the marrow cells can be observed in young NZB mice when their marrow cells are in an environment which requires recovery and division.     

Sexual differentiation of rat liver carbonic anhydrase III

Using radioimmunoassay, the concentration of carbonic anhydrase III in the livers of adult male rats was found to be approx. 30-times greater than that observed in mature females. Castration of male rats led to a marked reduction in liver carbonic anhydrase III concentrations which could be partially restored to control levels by testosterone replacement. Administration of testosterone to ovariectomised female rats induced about a 5-fold increase in liver carbonic anhydrase III concentration. Immunoprecipitation analysis of the products of liver mRNA translation in vitro with antiserum specific for carbonic anhydrase III showed that hormonal control of the levels of carbonic anhydrase III in liver is mediated by changes in the amount of translatable carbonic anhydrase III mRNA. Marked changes in liver carbonic anhydrase III concentrations were also observed in developing and ageing male rats.     

Structure and function in the excretory systems of some terrestrial prosobranch snails (Cyclophoridae)

The excretory systems of terrestrial prosobranch snails of the family Cyclophoridae, collected in Jamaica, Costa Rica and South Africa, have been examined physiologically and as regards their gross and fine structure. The process of urine formation commences in the heart, where fluid is filtered across the wall of the ventricle. Filtration through the auricular wall is believed to be negligible. The kidney, which contains three types of cell, modifies the composition of the filtrate. One type of resorptive cell, characterized by basal infoldings associated with mitochondria, takes up salts. Another type, with basal subcellular spaces, may be responsible for taking up water. The third type of cell is secretory, producing concretions of uric acid and phospholipid which are liberated into the kidney lumen when the cell degenerates.
The rate and mechanism of urine production have been investigated using injections of inulin. The filtration rate at 25°C is 0.5 μl/g/min, and in 100% R.H. the average rate of urine production is 0–39 μl/g/min.
An accessory excretory organ has been developed from the hypobranchial gland of aquatic forms. It is composed of groups of subepithelial tubular glands opening into the mantle cavity by one or a series of pores, and secreting purines, phospholipids and mucus. There is evidence that this organ becomes progressively more complex in forms occupying drier habitats.
The systems of excretion and osmoregulation in the Cyclophoridae are considered to be very similar to those in their aquatic relatives, the Viviparidae and Ampullariidae. Certainly the cyclophorids are not as well adapted to a terrestrial life as are the Pulmonata, and in many respects they may be considered "aquatic" snails living on land.     

Metabolic and physical control of cell elongation rate: in vivo studies in nitella

Several levels of control of elongation rate are revealed through the detailed study of responses of the Nitella internode to abrupt shifts in turgor. The immediate response, which apparently reflects the physical state of the cell, is approximately described by the equation r = (P — Y)m where r is rate, P is pressure, Y is the wall's yielding threshold, and m is related to the wall's apparent fluidity (reciprocal viscosity). Because P and Y are in the range 5 to 6 atmospheres, and (P — Y) is roughly 0.2 atmosphere, elongation rate is initially extremely sensitive to changes in P. A small step-down in turgor (0.7 atmosphere) stops growth, and a similar rise greatly accelerates it. These initial responses are, however, soon (15 minutes) compensated by changes in Y. An apparent metabolism-dependent reaction (azide-sensitive) lowers Y; strain hardening (azide-insensitive) raises it. These two opposing processes, acting on Y, serve as a governor on (P — Y), tending to maintain it at a given value despite changes in P. This ability to compensate is itself a function of turgor. Turgor step-downs are less and less well compensated, leading to lower rate, as turgor falls from 5 atmospheres to about 2 atmospheres where growth appears not to resume. This is the lowest attainable yield value, Y₁. The turgor dependency of compensation reflects a turgor requirement of the Y-lowering (“wall-softening”) process. Thus the relation between steady state, r_s, and turgor is an indirect one, derived from time-dependent alterations of the cell wall. This relationship superficially resembles the instantaneously valid one in that, roughly, r_s = (P — Y₁)m_s. Y₁ and m_s, however, have much lower values than Y and m. The duality of the elongation rate versus turgor relation and the prominent role of Y in regulating rate are the major features of growth control in Nitella.     

The control of the differentiation of female embryonic germ cells in the bird

The left gonad from female chick embryos at 4–12 days of incubation was cultured in vitro as pieces of intact gonad, pieces of isolated cortex, and groups of pure germ cells. All cultures were maintained for a time equal to 17 days in ovo. At the end of the culture period, a cytological and quantitative study was made on the germ cells.The results show that some germ cells in pieces of intact 6-day gonad and pieces of 6-day cortex complete their normal developmental sequence and enter zygotene. This shows that the factors that control the differentiation of the germ cells reside in the cortex of the gonad and their expression does not depend upon the pituitary and the medullary estrogens after 6 days of incubation.Germ cells that are cultured as isolated cells do not attach to the tissue culture substrate, do not divide mitotically, and do not enter zygotene. Evidence is presented that suggests 12-day germ cells do enter zygotene when cultured with pieces of 12-day cortex. These data suggest the differentiation of the female germ cells is regulated by the somatic cells of the cortex.     

Affinity labelling of the binding site of rabbit antibody. Evidence for the involvement of the hypervariable regions of the heavy chain

The binding sites of rabbit antibodies with affinity for the haptenic group 4-azido-2-nitrophenyl-lysine have been specifically labelled by photolysis of the hapten-antibody complex. The extent of covalent labelling was 0.5-0.9mol of hapten bound/mol of antibody and, by using an immunoadsorbent, antibody with 1.3mol of hapten/mol was obtained. The antibody was specifically labelled in the binding site and the ratio of labelling of heavy and light chains was in the range 3.3-5.0. The labelled heavy chains were cleaved by CNBr treatment and after reduction and alkylation of the intrachain bonds, were digested with trypsin. Evidence is presented that two regions of the heavy chain, positions 29-34 and 95-114, together contain about 80% of the label on the heavy chain; these two regions respectively include two of the hypervariable regions of rabbit heavy chain.     

Design and physical characteristics of a multistage,continuous tower fermentor

A multistage tower laboratory fermentor has been constructed consisting of eight compartments separated by sieve plates. Flow of substrate and air is concurrent from the bottom to the top of the column. It, was hoped that this system could be used to reproduce, simultaneously on a continuous basis, eight distinct phases of a batch growth curve. It was believed that the extent of batch curve simulation would depend upon the character of hydraulic mean residence time of broth in the column and in the individual compartments. The expected relationship did not occur. Rather it was found that growth in the column involved residence time characteristics not only for the fluid but also for the microorganisms, and for the growth limiting substrate. Depending upon the column operation, these could be distinct and different. The purpose of this investigation was to study the residence time distribution (RTD) of the continous (fluid) and dispersed (microorganisms) phases for model systems as well as for a yeast fermentation. Various degrees of flow nonideality, i.e., fluid blackflow and dispersed phase sedimentation, were noticed. The former seems to be due to interaction of the concurrent gas and liquid flow; it is particularly dependent upon void area of the sieve plate holes. Sedimentation is probably a function of plate design as well as cell size and density. It wa concluded that for a particular plate design the gas hold-up wass controlled by superficial air velocity and was the main parameter governing the differences between dispersed and continous phase(Rt1). This conclusion was supported by a computeraided styudy utilizing a mathematical model of fluid flow to fit the growth kinetics and cell distribution observed experimentally throughout the fermentor. Some advantages of foam control in the tower fermentor by surface active compounds are mentioned. Also, suggestions are made for carrying out fermentations that have two liquid phases, such as a hydrocarbon fermentation. The possibility of closely approximating plug-flow conditions in the multistage tower fermentor, a necessary condition for batch growth simulation, is discussed from a practical point of view.