Scent organ development in creatonotos moths: regulation by pyrrolizidine alkaloids.

7-Hydroxy-6,7-dihydro-5H-pyrolizine-1-carboxaldehyde is the major volatile component of the scent organs in males of two species of Creatonotos (Lepidoptera, Arctiidae). The biosynthesis of this presumed pheromone depends on the presence of pyrrolizidine alkaloids in plants that are ingested by the larvae. In addition, these secondary plant substances control the morphogenesis of the scent organs. This morphogenetic effect of an alkaloid has not been observed previously.

In vitro O-demethylation of the psychotomimetic amine, 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane.

The possible relationship between metabolism and psychotomimetic activity among the methoxylated 1-phenyl-2-aminopropanes led to our investigation of the in vitro O-demethylation of 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane (1, DOM, STP). Employing a sensitive and highly selective stable isotope dilution assay, we observed that rabbit liver homogenates biotransform the amine 1 to its 2-O-demethyl, 5-O-demethyl, and bis (O-demethyl) metabolite metabolites. Both monophenolic metabolites are enriched in their S enantiomers. The bis(O-demethyl) metabolite has structural, chemical, and electrochemical similarites to the sympatholytic agent "6-hydroxydopamine". The possible significance of metabolic O-demethylation in terms of the psychotomimetic properties of amine 1 is discussed.

Effects of relocation on chronically ill geriatric patients of a medical unit: mortality rates.

The entire general medical unit of Ste. Anne's Hospital for disabled elderly veterans was moved into a new modern building on July 13, 1971. Roughly, about 350 patients were involved. In anticipation of the move, a program of preparation of the patients was organized to prevent if possible the dramatic increases in the mortality rate reported in some earlier studies of relocated geriatric populations. The principal finding with regard to mortality was a significant decrease of 6.82 per cent after the relocation when compared with mortality rate for the previous year. The highly appreciated air-conditioning system in the new building, representative of modern improvements, may have helped to a minor degree. A much more important factor was the well organized program for preparation of the patients, skillfully carried out by a conscientious staff.

Mortality fluctuations among chronically ill medical geriatric patients as an indicator of stress before and after relocation.

The effects of mass transfer of a sick geriatric population of war veterans were evaluated to determine the resultant change in mortality. A comparison of mortality patterns by months during this interval made over a six-year period, centered around the month of the move, July 1971. Analysis of the mortality fluctuations in the 24-month interval surrounding the move indicated that the course of mortality during this interval was periodic, with four distinguishable phases making up the complete cycle. An attempt was made to link stress-inducing events before, during and after the relocation with the ensuing mortality. It is important to use planned, low-key, stress-prevention measures and continue them for some time after the move, to offset adverse mortality effects from anticipatory anxiety and from the postrelocation release of anxiety-generated stress.

Relative mortality of chronically ill geriatric patients with organic brain damage, before and after relocation.

Elderly patients in whom mental impairment is associated with organic brain damage (chronic brain syndrome) usually bear a higher mortality risk than do other sick geriatric patients, especially under the stress of relocation. When Ste. Anne's Hospital moved, the patients with chronic brain syndrome had the highest mortality rate during the following year. Apparently these brain-damaged subjects failed to cope with the situation until it became real (after relocation). Thus, in a stress prevention program adopted when a geriatric institution plans to move, special attention should be paid to the subpopulation with chronic brain syndrome in the period immediately following the relocation.

Biofeedback for disorders of initiating and maintaining sleep.

Sleep disturbances are a frequent reason for pediatric consultation. When the disturbance persists in the form of delays in entering or maintaining sleep (DIMS), a vicious cycle develops. As part of the cycle, vigilance or arousal occurs, further inhibiting sleep occurrence. Persistent DIMS requires treatment to interrupt this self-perpetuating sequence. Interruption requires reduction in psychophysiological arousal and deconditioning of the events surrounding sleep. Electromyographic (EMG) and thermal biofeedback in conjunction with relaxation training were used with three children who maintained high levels of arousal resulting from stresses common to their developmental stages. Within seven sessions, all three patients showed attenuation of arousal and symptom abatement marked by uninterrupted sleep.

Stability-indicating analysis of injectable estrogen-androgen combinations in formulations containing corn oil.

A method was developed for the analysis of testosterone 17-enanthate 3-benzilic acid hydrazone, 17-beta-estradiol 3,17-dienanthate, and estradiol benzoate combinations dissolved in an oily vehicle. Testosterone 17-enanthate 3-benzilic acid hydrazone was separated from the other drugs and vehicle components by chromatography on an acetonitrile-infusorial earth column followed by quantitation using UV spectroscopy. The estradiol esters were separated from the oil by an additional chromatographic step using a heptane-silanized infusorial earth column prior to quantitation by GLC. Subjecting formulations to elevated temperatures resulted in detectable losses for testosterone 17-enanthate 3-benzilic acid hydrazone and 17-beta-estradiol 3,17-dienanthate. For both drugs, degradation was due to hydroxysis; the degradation products, testosterone 17-enanthate and 17-beta-estradiol 17-enanthate, did not interfere with the intact drug determination. Methods also were developed to estimate degradation product levels in the formulation.

Identification of canine urinary metabolites of the antiprotozoal agent 3a,4,5,6,7,7a-hexahydro-3-(1-methyl-5-nitro-1H-imidazol-2-yl)-1,2-benzisoxazole .

Metabolite fractions from the urine of a dog dosed with 3a,4,5,6,7a-hexahydro-3-(1-methyl-5-nitro-1H-imidazol-2-yl)-1,2-benzisoxazole (MK-0436) were obtained by the use of high-performance liquid chromatography. These fractions were of suitable purity for structural elucidation. Data obtained by mass spectrometry and NMR spectroscopy allowed the identification of seven major metabolites of this drug. Biotransformation in each case involved hydroxylation (mono or di) of the hexahydrobenzisoxazole ring.

Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea: a meta-analysis.

OBJECTIVES/HYPOTHESIS: Trauma and surgery are the most common causes of cerebrospinal fluid (CSF) rhinorrhea. Surgical repair is recommended for patients with CSF leaks that do not respond to conservative measures, traumatic CSF leaks that require transcranial surgery for associated brain injuries, and iatrogenic defects that are discovered intraoperatively. The purpose of our study was to ascertain the outcome after transnasal endoscopic repair of CSF leaks and to identify factors regarding the patient, CSF fistula, and treatment that may influence the results of the repair. METHODS: We performed a meta-analysis of all studies published in English between 1990 and 1999 that reported a minimum of five patients with CSF fistulae that were repaired using an endoscopic approach. We analyzed data that included type of graft and technique used during the repair, surgical complications, the use of packing, and the use of lumbar drains and antibiotics. The success rate was monitored and correlated with the other variables. The meta-analysis database was compared with and added to a database comprising our own patients. RESULTS: Fourteen studies comprising 289 CSF fistulae met the inclusion criteria. Endoscopic repair of CSF leaks was successful in 90% (259/289) of the cases after a first attempt. Seventeen of 30 persistent leaks (52%) were closed after a second attempt. Thus ultimately 97% (276/289) of the leaks were repaired using an endoscopic approach. The success rate of repairs using any of the reported techniques and materials was high and not statistically different. The incidence of major complications such a meningitis, subdural hematoma, and intracranial abscess was less than 1% for each complication. CONCLUSION: The endoscopic approach is highly effective and is associated with low morbidity. The literature supports the endoscopic approach using a variety of techniques and materials for the repair of CSF leaks.

Thermal biofeedback in the treatment of symptoms associated with reflex sympathetic dystrophy.

A 12-year-old male, unresponsive to therapy for symptoms associated with reflex sympathetic dystrophy, was treated by thermal biofeedback techniques. Within the first four treatment sessions, transfer of training from digital warming to warming the affected knee area produced skin temperature elevation around the gastrocnemius and patellar areas. Attenuation of localized vasospasm and cold intolerance resulted, followed by total abolition within ten sessions. After symptom alleviation, a return to premorbid activity levels was reported. Implications for use of thermal biofeedback as a primary noninvasive technique for treatment of symptoms associated with reflex sympathetic dystrophy are discussed.

Endoscopic repair of cerebrospinal fluid leaks to the sinonasal tract: predictors of success.

INTRODUCTION: Cerebrospinal fluid (CSF) leaks may arise as a complication of endoscopic sinus surgery, trauma, or hydrocephalus, or they may occur spontaneously without any identifiable cause. Despite general agreement that CSF leaks should not be left untreated, their initial management, the surgical indications, and the technique of repair are controversial. OBJECTIVE: We undertook this study to ascertain whether a particular surgical technique or material was more successful for repair. Additionally, we tried to identify which specific characteristics of the patient, the CSF fistula, or the adjunctive treatment influenced the result of the repair. STUDY DESIGN: We completed a retrospective review of all patients undergoing endoscopic repair of a CSF leak at our academic hospitals. RESULTS: Forty-eight patients with 53 CSF fistulas were included in the study. Fifty sites were successfully repaired endoscopically on the first attempt. Three persistent leaks were repaired successfully on the second attempt. Location and size of the leak, cause, technique, and choice of material used for the repair did not significantly affect surgical outcome. However, the presence of hydrocephalus had a statistically significant negative influence on surgical outcome. All patients with increased intraventricular pressure required a ventricular shunt in addition to a second endoscopic repair. CONCLUSION: If the surgical technique is sound, endoscopic repair of CSF leaks is highly successful, independent of the choice of the material and technique used in the repair.

The relationship of acculturation and gender to attitudes toward counseling in Italian and Greek American college students.

This exploratory study examined attitudes toward professional psychological services and help provider characteristics among 232 self-identified Italian and Greek American college students in 3 Northeast colleges. Regarding general attitudes toward psychological services in the Italian American sample, women had a greater recognition of personal need for help and higher confidence in the ability of mental health professionals to meet these needs than did men. With regard to preferred counselor demographic characteristics, regardless of gender, lower acculturated Italian American students had a stronger preference for seeing an ethnically similar counselor. With the Greek American sample, there was an interaction effect between acculturation level and gender on attitudes toward services. Among the higher acculturated Greek students, women were more open regarding their personal concerns than men; however, within the lower acculturated cohort, no gender differences were found. With regard to counselor characteristic variables, and similar to Italian Americans, regardless of gender, lower acculturated Greek Americans had a stronger preference for seeing an ethnically similar counselor to discuss a personal problem. Limitations and implications for further research are noted.