Studies on iodoproteins and thyroid hormones in ascidians

Iodoproteins in the ascidian Molgula manhattensis were labeled in vivo with ¹²⁵I. The proteins were extracted with water and surfactants and analyzed by gel filtration and by polyacrylamide gel electrophoresis. They were found to be composed largely of small subunits with molecular weights of approximately 22,000 in the tunic and 14,000–15,000 in the endostyle and pharynx. Radioimmunological evidence was found for small amounts of thyroid hormones in the tunics of Molgula, Ciona intestinalis, and Styela clava. Values of 88–220 ng thyroxine (T₄)/g of tissue and 8–16 ng 3,5,3′-triiodothyronine (T₃) were obtained. Seventy five percent of the T₄ in the tunic was in protein-bound form. Trace amounts of T₄ (3 ng/g) and possibly T₃ were found in the endostyle of Molgula, primarily in free form. Evidence for T₄ was found in the blood of Ciona where it may be noncovalently linked to serum proteins. On the basis of molecular size, the endostylar proteins are distinct from proteins in the surfactant-solubilized fraction of the tunic, and protein subunits at both sites are smaller than those of vertebrate thyroglobulin. Whether the iodothyronines found in the tunic, endostyle, and blood are formed within proteins at each of these sites or are synthesized at one site and then transported to another remains to be determined.     

Long-term Implications of Tracheostomy in Cardiac Surgery Patients: Decannulation and Mortality

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Arch vessel injury during pulmonary artery catheter placement

We have observed seven instances of unintentional cannulation of major arteries with 8F sheaths during preparation for open-heart operation. When the sheath was removed and the operation delayed, there were no complications; in the two instances in which the open-heart operation was performed immediately after arterial cannulation, there was 1 death due to hemorrhage and 1 false aneurysm of the carotid artery. Elective open-heart operations should be delayed if unintentional cannulation of a major artery occurs.     

A comparison of low back pain patients in the United States and New Zealand: Psychosocial and economic factors affecting severity of disability

One hundred and ninety-eight patients suffering from chronic low back pain seen at the University of Virginia (U.S.) Pain Center and 117 similar patients seen at the Auckland Hospital, Auckland, New Zealand (N.Z.) Pain Clinic completed a self-report questionnaire prior to beginning comparable outpatient treatment programs. Approximately 55% of the sample from each country returned a follow-up questionnaire 1 year later. Analyses of the results indicated that despite nearly similar between-country reports of pain frequency and intensity, the U.S. patients, both at pre- and post-testing, reported greater emotional and behavioral disruption as a correlate of their pain. U.S. patients consistently used more medication, experienced more disphoric mood states, and were more hampered in social-sexual, recreational, and vocational functioning. Patients from both countries demonstrated a nearly equal degree of pre- to post-improvement; however, the relative initial differences favoring the New Zealanders remained constant across both questionnaire administrations. At the onset of treatment, 49% of the U.S. sample and only 17% of the N.Z. patients were receiving pain-related financial compensation. At follow-up, patients from both countries receiving pretreatment compensation were less likely to report a return to full activity, although the relationship appeared more pronounced in U.S. patients. Seemingly, compared to the U.S., the N.Z. compensation-disability system is used less, or for shorter durations of time, resulting in less severe life-style disruption than appears to be the case in the U.S. patients. Seemingly, compared to the U.S., the N.Z. compensation-disability system is used less, or for shorter durations of time. resulting in less severe life-style disruption than appears to be the case in the U.S.     

Isolated xanthomatosis of the small bowel

A case of xanthomatosis of the small bowel is described. Beginning with the proximal jejunum, an 85-cm segment of small bowel was distorted by regularly spaced nodular accumulations of lipid-laden macrophages that expanded the submucosa and muscularis and extended to the serosal surface. The conditions often associated with xanthomatosis were not found in this patient.