Pituitary tumors in patients with secondary amenorrhea

A new semisynthesis of human insulin starting from porcine insulin is described. NalphaA1, NalphaB1-di-Boc-desoctapeptide-(B23-30)-insulin bearing 6 free carboxyl groups is coupled with the suitably protected human insulin-(B23-30)-octapeptide. The preferred reaction site is the carboxyl group of ArgB22. Side products are eliminated by extensive chromatographic purification.     

Mycotoxicosis in chicks produced by toxins from Phomopsis sp. or Diaporthe phaseolorum var. sojae

The possibility of producing toxic effects in day-old chicks with mycotoxins from Phomopsis sp. or Diaporthe phaseolorum var. sojae isolates was studied. Evidence was found that Phomopsis sp., but not Diaporthe, produces hepatic necrosis with high mortality in chicks. Enzymatically, the hepatotoxin produced by Phomopsis sp. caused an increase in the level of liver glucose-6-P dehydrogenase. Mycotoxicosis caused by Phomopsis sp. was compared with lupinosis.     

In Trinidad: angular stomatitis and pregnancy

Riboflavin deficiency is endemic in Trinidad. A syndrome is observed peculiar to pregnancy. It occurs in the second trimester in women with low blood riboflavin levels. Treatment with riboflavin gives clinical improvement in mothers and raises fetal blood levels. Early biochemical diagnosis and treatment of subclinical deficiency is of value to the Trinidadian mother but protection to the fetus is doubtful. This is because of the effect of multiple limiting factors in which the mother is deficient.     

Electron conversion coefficients in 127Ba and 130La

A sensitive method has been developed for extracting and analyzing heparin from plasma after intravenous and subcutaneous administration in humans and rabbits. The glycosaminoglycans are precipitated from the biological fluid as cetylpyridinium salt, and heparin is cleaved with heparinase. The reaction products are analyzed by polyacrylamide gel electrophoresis and visualized by staining with Azure A/ammoniacal silver. With this method 12 ng of heparin can be detected.     

Treating major depression in primary care practice: an update of the Agency for Health Care Policy and Research Practice Guidelines

The Depression Guideline Panel of the Agency for Health Care Policy and Research in 1993 published recommendations for treating major depression in primary care practice that were often based on studies of tertiary care psychiatric patients. We reviewed reports of randomized controlled trials in primary care settings published between 1992 and 1998. This evidence indicates that both antidepressant pharmacotherapy and time-limited depression-targeted psychotherapies are efficacious when transferred from psychiatric to primary care settings. In most cases, the choice between these treatments should depend on patient preference. Studies to date suggest that improving treatment of depression in primary care requires properly organized treatment programs, regular patient follow-up, monitoring of treatment adherence, and a prominent role for the mental health specialist as educator, consultant, and clinician for the more severely ill. Future research should focus on how guidelines are best implemented in routine practice, since conventional dissemination strategies have little impact.