T cell acute lymphocytic leukemia terminating as malignant histiocytosis.

Less than 200 cases of malignant histiocytosis (histiocytic medullary reticulosis) have been reported in the literature. Five previously reported cases and the case reported in this article have been preceded by acute lymphocytic leukemia. All of these cases have had similar courses characterized by prompt response of the leukemia to chemotherapy followed in three to six months by the onset of rapidly fatal malignant histiocytosis. The leukemic lymphoblasts in the two cases studied for lymphocyte surface markers had T cell markers. No residual leukemia was identified at autopsy in four of the six cases.

Catenoidal shape of the interventricular septum acquired secondary to myocardial infarction.

A catenoidal, or saddle-shaped, configuration of the interventricular septum, concave toward the left ventricular cavity in the transverse plane, but convex toward the left ventricular cavity in the apex to base plane, occurs in idiopathic hypertrophic subaortic stenosis and possibly may lead to septal hypertrophy and immobility. The authors also have observed catenoidal shape of the interventricular septum in hearts with myocardial infarcts. They reviewed 1,415 hearts examined after postmortem arteriography and fixation in distention from patients autopsied at The Johns Hopkins Hospital. Among 586 hearts with myocardial infarcts, there were 54 (9%) with a catenoidal shape of the interventricular septum. The infarcts, 45 anterior septal and 9 inferior and lateral, appeared to account for the reversal of normal apex to base curvature, although coexistent idiopathic hypertrophic subaortic stenosis could not be excluded in 3 patients. There was moderate or marked infarct expansion in 25/54 (46%) and septal or free wall rupture in 8 (15%) hearts. Reduced average net septal curvature in the 54 hearts, highly significant compared with that in 80 hearts without infarcts (P less than 0.001), would reduce the septum's contribution to left ventricular function and may contribute to the observed postinfarct congestive failure, 30/54 (56%), and hypoperfusion, 7/54 (13%). The results suggest that some myocardial infarcts may produce a catenoidal shape of the interventricular septum that could reduce the functional activity of the surviving uninfarcted basilar portion of the septum and thereby contribute to postinfarction cardiac dysfunction.

Personality and treatment effectiveness in anorexia nervosa.

Compared pre- and posttreatment MMPI profiles of 12 female inpatients with anorexia nervosa using a scale-by-scale analysis of variance. Significant changes in clinical scales and a validity scale confirmed observed behavioral change after treatment. In addition, pretreatment profiles obtained at a different hospital were remarkably similar, which suggests a common constellation of personality characteristics in anorexia nervosa.

Analytic inaccuracy and imprecision in reticulocyte counting: a preliminary report from the College of American Pathologists Reticulocyte Project.

Precision and accuracy of reticulocyte counting appears to require significant improvement. Several poorly controlled analytic variables affect reticulocyte count performance including sample size, use of an ocular insert, interobserver variation in reticulocyte definition, and possibly the type of blood smear evaluated. These sources of imprecision and inaccuracy are discussed, and new data from the initial phases of the College of American Pathologists assessment of reticulocyte counting are presented. Recommendations for analytic goals for both manual and automated reticulocyte counting are provided.

Glycogen levels and peripheral mechanisms of glucose-induced spppression of feeding.

Rabbits deprived of food for 0, 2, 4, 6, 8, 16, and 24 h were assessed for glucose-induced feeding suppression, refeeding after deprivation, and liver glycogen. In previous research, we hypothesized a relationship between liver glycogen and the transition from duodenal to hepatic glucose suppression. In duodenally cannulated rabbits, the infusion of 10 ml of isotonic glucose in awake, free-feeding animals significantly suppressed food intake but did not do so in those food deprived for 2, 4, 6, 8, or 24 h. In hepatic-cannulated rabbits, similar amounts of glucose significantly suppressed food intake in 4-, 6-, 16-, and 24-h-deprived animals. Also, refeeding after deprivation increased as a function of continued deprivation until 6 or 8 h, when refeeding reached asymptote, or decreased through 24-h deprivations. In agreement with these observations, liver glycogen showed a sharp decline between 4, 6, and 8 h of deprivation (depending on circadian cycle). It is proposed that liver glycogen depletion, or some correlate, alters liver glucostatic regulation and determines refeeding after deprivation.

Personality and criminality: a review of the California Psychological Inventory.

Presents review of studies that use the California Psychological Inventory (CPI) with delinquents and criminals. Studies listed fit categories that illustrate the ability of the CPI to measure: (a) personality differences between delinquents and non-delinquents; (b) personality typologies and classifications; and (c) personality variables that predict future criminal or social behavior. In addition, studies are listed that describe the (d) historical development of the CPI and its application to criminality, as well as (3) the CPI's ability to measure and quantify aspects of criminal behavior. Methodological concerns, profile interpretations, and suggestions for future research are discussed.

The association of floppy mitral valve with disjunction of the mitral annulus fibrosus.

Floppy mitral valve is usually attributed to connective-tissue degeneration. However, we have observed several instances in which both a floppy mitral valve and an abnormal mitral annulus fibrosus were present at autopsy. To study this association, we examined 900 hearts (after postmortem arteriography and fixation in distention) from autopsies of adults at The Johns Hopkins Hospital. Twenty-five (3 percent) of the hearts had a morphologically typical floppy mitral valve; in 23 of them (92 percent), the mitral annulus fibrosus showed disjunction--i.e., a separation between the atrial wall-mitral valve junction and the left ventricular attachment. In 42 other hearts (5 percent), which were from significantly younger patients (mean age [+/- SE], 60 +/- 2 years vs. 68 +/- 3; P less than 0.05), there was mitral annulus disjunction but no floppy mitral valve. Two hearts had a floppy mitral valve but no disjunction of the annulus; both of them had old infarcts of the papillary muscle. Our results show that floppy mitral valve is significantly associated with disjunction of the mitral annulus fibrosus (P less than 0.001). We suggest that floppy mitral valve develops from hypermobility of the valve apparatus, and that it is usually secondary to disjunction of the mitral annulus fibrosus, an anatomic variation in the morphology of the annulus.