Notes and quotes

NOTES

AND

QUOTES

Cryopathies. The man put one finger in a gIass of ice-water and withdrew it in severe pain. In twenty seconds the pain rose up his arm, past his eIbow and into his shoulder. The pain disappeared immediateIy when the finger was placed in warm water. The woman dietitian reached into the refrigerator, grasped an ice tray and watched with annoyance as a great red rash spread over her hand and arm. The rash went away in haIf an hour. Drs. Stephan E. Ritzmann and WilIiam C. Levin of the University of Texas MedicaI Branch have given these diseases a name, cryopathies, which is Greek for coId diseases, classified them, described them, outIined simpIe diagnostic tests and found an effective treatment for one group of them. This was reported recentIy by the American Cancer Society which heIps support the work. UntiI now, medica books have not considered coId diseases as such; the textbooks discuss some of the many kinds of them separateIy under other headings. They are reIatively common; in many of them the dramatic reactions to coId are reflected in abnorma1 bIood chemistry. Some of the sensitivity reactions to coId are painless, miId and transient. Many of them are serious and disabIing. Sometimes they can lead to sIow or sudden death.

to the University of Wisconsin for study and treatment. In two families, the metabolic imbalance was detected after routine urine testing with ferric chloride and Phenistix at tbe University Hospitals. Tbe sixth family was discovered when urine tests at tbe Southern Wisconsin Colony produced positive results for two institutionalized siblings, wbose mother was pregnant at the time. Another affected infant was born to this mother subsequently. Tbe socioeconomic level of the six families was higher than that of the general population and the I.Q. levels of the una$ected children also were high (mean I.Q. of 117 with a range from 92 to ry5). In this study, the mean intelligence of the treated children was signilficantly higher than that of their untreated siblings. This was true both for the two children given a special diet at two years of age and for tbose treated earlier. The children treated before six months were signi,ficantly more intelligent than those treated at two years. Neurologic findings paralleled the results of the intelligence tests. Althougb the intelligence in the treated children was higber than tbeir untreated siblings, tbe investigators found that all treated children were significantly less intelligent than their unafected siblings. This di$erence, tbey believe, is the result of brain deterioration which may start prenatally and accelerates during tbe rapid growth period immediately following birth. The diet, they point out, only serves to prevent a further decline in intelligence, and rarely results in a gain in I.Q. over pretreatment levels. If it is true that intelligence level in children with PKU is a decelerating function of age, they state, “then the brain may be especially SUSceptible to damage in the first few weeks and montbs of life and treatment should be instituted as early as possible.” According to the Wisconsin scientists, “Unfortunately, urinary tests for the disease cannot be relied on shortly after birth because of tbe variable renal thresholds for phenylketones in diqkrent bomozygotes. A more reliable test for early diagnosis in this disease is the phenylalanine concentration in plasma. “If pbenylalanine analysis of blood is not available to the practitioner, weekly urinary tests fo;espLenylketones can be made in suspected

When we accept a challenge and deal with it creatively, we lose our anxiety and begin to feel secure. John Davis Phenylketonuria. A study of children witb pbenylketonuria (PKU) treated witb a pbenylalanine diet jurtber substantiates tbe belief that early treatment will prevent tbe impairment of intelligence wbicb would be expected to occur in an untreated child. Tbe mean I.Q. of five children wbo bad begun treatment before the age ojoneyear was eigbty-tbree, compared with the mean Z.Q. of twenty-four for tbree untreated children in this study. The study, publisbed in Pediatrics, December 1961, compared tbe physiologic and neurologic status of eigbt treated PKU children with that of eleven una$ected children and three untreated siblings witb PKU. All twenty-two children were from six families. In tbree of tbe families PKU was detected by a private physician, and tbe child was referred 54

CONTINUED

ON

PAGE

56

NOTES

AND

QUOTES

CONTINUED

Metopirone. A drug to Cal&ate a patient’s probabIe response to severe stress, such as major surgery, has been developed by CIBA PharmaceuticaI Company. The drug, which took research scientists four years to deveIop, is calIed methopyrapone (Metopirone). AIthough it has a very limited market, Metopirone is the first practical agent avaiIabIe to determine the status of pituitary function. The Metopirone test is a safe, simpIe test of residua1 pituitary function assisting in the diagnosis of suspected hypopituitarism. The test is used to determine the pituitary reserve of adrenocorticotropin (ACTH). PartiaI hypopituitarism may be diffIcuIt to diagnose because the patient may appear norma and a state of insufficiency noted onIy under conditions of stress. The main danger to these patients is the deveIopment of adrena crisis under stress, therefore, the evaIuation of residua1 pituitary ACTH reserve is important. To test residua1 pituitary function in patients with suspected hypopituitarism, Metopirone may be given either in tabIet form or by intravenous infusion. The action of Metopirone on the adrena cortex permits indirect estimation of pituitary ACTH. Today there is no practica1 method for directIy measuring circulating ACTH. Metopirone wiI1 be utilized mainIy by endocrinoIogists in hospitals and teaching institutions.

many. Among tbe most characteristic and readily observable symptoms of aging are changes in connective tissue and changes that produce wrinkled skin, bent backs and creaky joints. The chemistry of connective tissue, present in tendons, ligaments, skin and blood vessels, is probably the most obvious approach to tbe aging problem, tbe report states. With aging, connective tissue changes and tbe total amount in tbe body increases. Collagen fibers, tbe principal constituent of connective tissue, become tougber, more crystalline in nature and less soluble in certain liquids. Cbemists can tell a rat’s age by the chemical nature of its collagen and its elastin and by its content of byaluronic acid. Both of the latter constituents decrease witb age. Perhaps the most widely debated tbeory of aging says tbat tbe body’s proteins and vital nucleic acids age tbrougb tbe formation of chemical “cross-links” between their molecules. Tbese linkages immobilize the molecules into “a frozen metabolic pool tbat clogs cells and ultimately destroys tbem.” Tbis tbeory developed out of research on the cross-linking of gelatin films. Proof is still lacking, tbe survey indicates.

Anyone who thinks he knows all the answers isn’t up to date on the questions. Frank Lawrence

New Anti-Ulcer Drug. The treatment of patients with ulcers with a pi11 which combines two antacids, a nerve-blocking agent and an antiphobic drug, has proved successful in 97 per cent of patients over a period of up to five years, a New York physician has reported. The physician is Dr. Louis A. RosenbIum of Forest HiIIs. The drug is known as ModutroI. The great majority of the patients, 326 in aI1, “had previousIy tried other anti-uIcer therapy with unsatisfactory resuIts,” Dr. Rosenblum wrote in the American Journal of

The moment we feel angry in controversy, we have ceased striving for truth and begun striving for Thomas Carlyle ourselves.

Forty million dollars a year and more tban a tbousand research projects are now being directed toward tbe problem of buman aging, according to ChemicaI and Engineering News. Wbat makes bair turn gray, skin wrinkle and bones become brittle? As the body ages, wbat changes take place in organs, cells and molecules? Wbat causes tbe changes? How may they be delayed? Biochemical answers to tbese questions are sougbt by bundreds of researchers in tbe United States and hundreds of otbers abroad. New theories are emerging to belp guide tbe research, wbicb ultimately may lead to tbe extension of buman life (possibly up to 140 years) and to a more vigorous and enjoyable old age for

Aging.

Gastroenterology.

With the new combination drug, Dr. RosenIesions heaIed and stayed bIum reported, heaIed, with no specia1 attention to diet. Moreover, he stated, the emotiona factor in patients with uIcers was controIIed without causing sedation or other side effects. 56

CONTINUED

ON

PAGE

58

NOTES

AND

QUOTES

CONTINUED

World’s

Largest Helium Plant. The world’s largest helium plant is expected to be built at Liberal, Kansas. The United States Government has signed a twenty year contract for the plant’s production. Originally, helium was used primarily as a light-weight gas in dirigibles and balloons. Today, it bus become important in transmitting sound and electricity, for use in missiles and nuclear reactors, and in various new scientiJc developments. In medicine helium is added to oxygen for use in patients with respiratory diseases. It is also added to breatbing mixtures for deep sea divers.

great amount of vitamin Blz binding is due to a specia1 protein pecuIiar to the disease or to abnormal increases of ordinary proteins. Vitamin B,z is readily absorbed on bone charcoa1, and scientists have exploited this property in deveIoping a simpIe and rapid way of measuring the binding capacity in blood sampIes. With radioactive cobalt incorporated in the vitamin, they use a counter to determine how much Blz protein is in a bIood sampIe passed through charcoa1. The onset of Ieukemia is so subtIe that it is diff&uIt to teI1 preciseIy when it starts. It often is preceded by a long period of minor persistent infections, weakness, Iack of appetite and other vague genera1 compIaints. The group now are using the technic as a test on peopIe with preIeukemic symptoms but with no conventiona signs of the disease. They hope to learn at what stage the test wiII show up chronic myeIogenous leukemia. Some scientists have beheved that if the disease couId be detected in its earIiest stages it might be arrested or cured by vigorous treatment. This possibility has never been tested in human beings because myeIogenous Ieukemia is fuII-bIown and irreversibIe when it is diagnosed. Very earIy detection might resoIve the question of whether its earIy stages are controIIabIe. The Washington University scientists aIso are attempting to determine whether the abnorma1 blood proteins represent a cause or consequence of the Ieukemia.

The spark that sets latent powers aflame is a great ideal, purpose, or aim in life. Megiddo Message Chronic Myelogenous Leukemia. Specific proteins with great avidity for vitamin B12 have been shown to abound in the bIood of patients with chronic myeIogenous Ieukemia. Dr. HaroId L. RosenthaI, Associate Professor of Physiologica Chemistry at Washington University, has been studying this phenomenon as a cIue to the biochemical cause of this kind of Ieukemia. A bIood test, based on this characteristic, has been developed in the hope that it might show up the disease even before symptoms appear. This was reported recentIy by the American Cancer Society in an account of the research studies by Dr. RosenthaI, Paul R. Myers and GIoria O’Brien. MyeIogenous Ieukemia is common, most prevaIent among men and women between twenty and forty years of age, and is incurable. It arises from destruction of the bone marrow, which manufactures blood, and it gIuts the circuIation with young and useIess white bIood celIs. Every living anima1 and human being has bIood proteins which take up vitamin Blz. Patients with myeIogenous Ieukemia have more than five times as much of these proteins as normal people do, the RosenthaI group found. In a few other conditions, notabIy in heart attacks, nephrosis, iron deficiency anemia and a few other forms of cancer, the IeveIs of these proteins are high, but onIy about one-haIf as high as in myeIogenous Ieukemia. The Washington University scientists do not know whether in myelogenous leukemia, the

We never too little.

repent

of having eaten Jeflerson

Thomas

Antiradiation/Postradiation

Drugs. Because of tbe great interest in radiation drugs, there are hints that major progress in radiation armor is in progress, according to ChemicaI Week. Approximately 2,000 compounds are said to have been tested to date. About a dozen bave shown radioprotective activity, while some 100 have shown slight to moderate effect. In addition to the search for antiradiation drugs, tbere is interest in the development of postradiation therapeutic treatments such as bone marrow grafting and the administration of chelating agents such as etbylenediamine tetra-acetic acid (EDTA) to remove radioactive isotopes from tbe blood. 58