Overseas doctors and the staffing structure of hospitals.

The introduction of the new immigration rules will considerably reduce the number of overseas doctors available for junior hospital appointments over the next five years. To offset this sponsorship schemes should be offered by universities and colleges comprising training courses, entry to examinations, and hospital appointments, and training programmes should be adapted to make objectives attainable in the four years available to overseas doctors. Employment of overseas doctors can ease the transition within the staffing structure to fewer juniors and more consultants, but planning is urgently required, and in particular the service and manpower needs of the National Health Service must be considered.     

Mapping space by NMR using susceptibility changes at phase boundaries

A technique for differentiating high-resolution NMR signals from different regions of small objects is outlined and some initial results on model systems are given. This method uses inorganic paramagnetic or diamagnetic ions to create magnetic field gradients at phase boundaries.     

Interactions of the neurotoxic amine 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine with monoamine oxidases.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), a thermal breakdown product of a meperidine-like narcotic used by drug abusers as a heroin substitute, produces Parkinsonian symptoms in humans and primates. The nigrostriatal toxicity is not due to MPTP itself but to one or more oxidation products resulting from the action of monoamine oxidase (MAO) on this tertiary allylamine. Both MAO A and B catalyse the oxidation of MPTP to the 1-methyl-4-phenyl-2,3-dihydropyridinium species (MPDP+), which undergoes further oxidation to the fully aromatic 1-methyl-4-phenylpyridinium species (MPP+). These bio-oxidations are blocked by selective inhibitors of MAO A and B. Additionally, MPTP, MPDP+ and MPP+ are competitive inhibitors of MAO A and B. The A form of the enzyme is particularly sensitive to this type of reversible inhibition. Both MAO A and B also are irreversibly inactivated by MPTP and MPDP+, but not by MPP+. This inactivation obeys the characteristics of a mechanism-based or 'suicide' process. The inactivation, which is accompanied by the incorporation of radioactivity from methyl-labelled MPTP, is likely to result from covalent modification of the enzyme.     

Assessment of non-mydriatic fundus photography in detection of diabetic retinopathy.

Non-mydriatic retinal photography with later interpretation of the photographs was assessed as a screening method for the detection of diabetic retinopathy; when compared with an ophthalmologist''s clinical assessment in a random group of 62 diabetic patients it was accurate (false negative 6.8%, false positive 2%) and sensitive (sensitivity 96%, specificity 98%). The assessment of further management required based on analysis of the photographs was 96.5% in agreement with the further management suggested by the ophthalmologist after direct clinical assessment of the patient. If this technique were used to screen patients in a typical diabetic clinic the predicted positive accuracy rate would be 84% and the predicted negative accuracy rate 99.5%.     

Maintenance of ovulatory menstrual cycles in chronically cannulated monkeys: a vest and mobile tether assembly

We report maintenance of apparently normal ovulatory menstrual cycles in cynomolgus monkeys up to 3 months after their placement in a vest and mobile tether assembly, with or without chronic cannulation via a femoral to vena caval catheter. Since menstrual cyclicity and characteristic hormonal profiles of the principal ovarian steroids remained normal in these monkeys, use of the vest and mobile tether apparatus described here permits long-term study of the hypothalamic-pituitary-ovarian axis during chronic cannulation without introducing overt aberrancies as a part of the experimental model.     

Reparative growth in the rat thyroid

This study was designed to investigate the mitotic response to wounding in the rat thyroid. The spatial distribution of mitotic activity 48 hr after incision of the thyroid isthmus, or mere exposure of the gland (sham-operation), was assessed using a stathmokinetic technique. Incision resulted in a 66-fold increase over normal in metaphase index adjacent to the wound, falling over 2 mm to a stable 13-fold elevation. Sham-operation produced a smaller response with a complete return to normal levels over 1-1 X 5 mm. The results demonstrate that there is a dramatic localized mitotic response to wounding in the thyroid together with a smaller generalized response. Further, the response to sham-operation indicates that thyroid follicular cells respond to a diffusible 'wound hormone'. We suggest that this may be a major mechanism mediating reparative growth in this gland.     

Thermal shock hemolysis in human red cells. I. The effects of temperature, time, and osmotic stress

Thermal shock is a form of hemolysis which occurs in human red cells exposed to greater than a critical level of osmotic stress of 1.4 Osm and subsequently cooled from above about 12 degrees C to below that temperature. Higher concentrations and higher cooling rates each increase the amount of hemolysis, within limits. Incubation for varying periods in hypertonic solutions and varying temperatures of incubation affect the amount of thermal shock. The effect of cooling rate on thermal shock is independent of the period of exposure to hypertonic solutions. Thermal shock is not the cause of freezing injury in human red cells, at least above -10 degrees C.