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The electrocardiogram is often used to gauge the severity of hyperkalemia. We present a case of severe hyperkalemia associated only with pseudonormalized T waves and sinoatrial exit block.

Uptake studies of the potential endoradiotherapeutic agent, 6- 125 I-iodo-2-methyl-1,4-naphthoquinoI bis(diammonium phosphate) have been carried out in vitro on a wide range of normal and malignant human cells. In general, for a standardized dose of 0.1 μCi/ml, the uptake of the compound into normal cells was 0.0015–0.135 pCi/cell. Uptake into malignant cells was significantly higher than normal cells; uptakes of 0.89–11.3 pCi/cell were noted for melanoma, teratoma of testis, osteosarcoma and adenocarcinoma of colon and pancreas. Comparative uptake ratios formelanoma: Chang liver cells and testicular terastomamormal testis were 29 and 23, respectively. Larger uptake ratios are usually observed with higher doses.

Using an intramyocardial pH needle probe (21 gauge) to monitor myocardial metabolism during ischemia, we determined the effect of potassium cardioplegia at both moderate and deep hypothermia. Five groups of 5 dogs each were placed on cardiopulmonary bypass and the pH probe was inserted approximately 10 mm into the left ventricular free wall. Cardiac ischemia was achieved by cross-clamping the ascending aorta at 37 degrees C (Group 1), 27 degrees C (Group 2), or 17 degrees C (Group 3). In the remaining two groups, aortic cross-clamping was followed by the infusion of 600 to 800 ml of potassium cardioplegic solution adjusted to cardiac temperatures of 27 degrees C (Group 4) or 17 degrees C (Group 5). In each group, myocardial temperature was maintained constant, electrical and mechanical activity observed, and pH recorded until a plateau was reached or for 3 hours. Our results show a progressive and significant decrease in the metabolic rate with reduction in temperature over the 37 degrees to 17 degrees C range. By abolishing contractile activity, potassium cardioplegia markedly reduces the rate of hydrogen ion accumulation at 27 degrees C, but at 17 degrees C the additive effect of cardioplegia is much less pronounced. These observations support the principle of reducing contractile activity to a minimum during elective arrest of the heart but indicate that potassium cardioplegia does little to further reduce the rate of anaerobic metabolism, as shown by the measurement of intramyocardial pH, under conditions of deep hypothermia.

A study of treatment practices of pediatric centers managing hereditary fructose intolerance and a review of recent literature on this subject were undertaken in an attempt to establish the degree of dietary liberalization allowable with age and the acceptability of foods containing trace amounts of fructose. The information was needed to plan optimal therapy and thus avoid the consequences of the disorder, namely intestinal dysfunction, metabolic imbalance, and hepatic and renal damage. Fifty responses to 113 letters to centers in Canada and the United States, as well as data from The Hospital for Sick Children, Toronto, Ontario, identified only 29 affected children and provided information on their care, including food lists and literature references. Major principles of treatment were similar, but the approach to allowing and quantifying dietary fructose differed. In response to the apparent need for standardization of treatment, the authors formulated improved recommendations for the control of dietary fructose (less than 1.5 gm/day). Only a few foods of vegetable origin are allowed, including a limited selection of vegetables and cereal products from grain endosperm. Repeated dietary counseling is advocated with regard to allowed foods, sweeteners, and medications to ensure long-term dietary compliance.

During 1974-1977, 158 infants of birth weights less than 801 gm were referred from outlying hospitals. The survival rate was 25% for the whole group and 35% for those weighing 700 to 800 gm. Many were in a poor condition on arrival. One hundred and nineteen died. The most common causes of death were intracranial hemorrhage (39), RDS (26), and infection (13). Thirty-seven of the 39 survivors were followed until 18 months postterm. Growth failure was common--57% were below the third percentile in weight, 37% in length, and 17% in head circumference. Three had retrolental fibroplasia. Five children (14%) had major neurologic sequelae. Eight were severely handicapped with a Bayley score of less than 70 and ten were moderately handicapped with a Bayley score between 70 and 84, resulting in a neurodevelopmental handicap rate of 49%. Significant factors correlating with survival and intact outcome were birth weight greater than or equal to 700 gm, gestation greater than or equal to 26 weeks, the absence of asphyxia, and good condition on arrival at the NICU. There was no intact survival below 700 gm birth weight. The handicap rate of survivors between 700 and 800 gm was only 39%. Although intensive care in a referral unit may not be justified for those less than 700 gm, every effort should be made in the care of those 700 to 800 gm.

A syndrome of supravalvular pulmonary stenosis and an abnormal facial appearance is described in 15 children. The auscultatory findings suggest stenosis of the pulmonary valve. The presence of an abnormal facial appearance consisting of hypertelorism, a flat nasal bridge, a prominent upper lip, and low-set ears should suggest the correct diagnosis. Angiocardiography shows a constant, thin, “diaphragm-like” radiolucency in the main pulmonary artery. Physical retardation and left-axis deviation on the electrocardiogram are frequently present. Additional cardiac defects were also noted in one third of this group of children. No etiologic factor could be determined.

A modified double lumen perfusion method has been used to study dibasic amino acid absorption in human jejunum. Results using this method have been compared with those from oral load studies. Using the perfusion method, kinetic constants (Kt and Vmax) for lysine were: Kt 4.9 mM; V max 51.3 μmoles min-1 30 cm and for arginine were: Kt 3.8 mM, V max 46.3 μmoles min-1 30 cm Lysine absorption was compared in normal and cystinuric subjects. A significant difference was seen between these groups when studied by perfusion but not using the oral load method. Furthermore, oral load studies using mixtures of lysine, ornithine, and arginine showed a difference between the groups for arginine but no difference for lysine and ornithine. All three dibasic amino acids appeared to be well absorbed in the cystinuric patients. Possible explanations for these differences and the failure of oral tolerance tests to demonstrate the known transport defect in cystinuria are discussed.

cytes forming rosettes with sheep erythrocytes and HTL antigen negative lymphocytes interacting with antigenantibody-complement complexes, Clin EXp lmmunol 14:319, 1973. 2. Yata J, and Tsukimoto I: Maturation of cell surface structure of human B. lymphocytes, Lancet 2:1435, 1972. 3. Darzynkiewicz Z, and Jacobson B: HEPES-buffered media in lymphocyte cultures, Proc Soc Exp Biol Med 136:387, 1971. 4. Lar~dolt RF: Das Knochenmark bei Pertussis, Helv Med Acta 2:153, 1945. 5. Morse SI: Studies on the lymphocytosis induced in mice by bordetella pertussis, J Exp Med 121:49, 1965. 6. Morse SI, and Riester SK: Studies on the leukocytosis and lympbocytosis induced by bordetella pertussis. II. The effect of pertussis vaccine on the thoracic duc~ lymph and lymphocytes on mice, J Exp Med 125:619, 1967. 7. Morse S!, and Riester SK: Studies on the leukocytosis and lymphocytosis induced by bordetella pertussis. I. Radioautographic analysis of the circulating cells in mice undergoing pertussis-induced hyperleukocytosis, J Exp Med 125:401, 1967. 8. Miale J B: Laboratory medicine: Hematology, ed 4, St. Louis, 1972, The C. V. Mosby Company, p 906.

Oil pollution has been causing damage to bird populations for half-a-century. Owing to increasing precautions that are being taken, it is not clear that despite a vast increase in traffic the position is any worse now than it was before World War II. Information on the full scale and character of the damage is still inadequate, however, and the first need is for many more data. Meanwhile it seems very doubtful whether any bird species in northern Europe is threatened with reduction in numbers on more than a local scale, although locally the damage may be severe. It is argued that the most effective way of combating such reduction is by the further control of pollution and by conservation of the breeding stock to enable it to repair the damage—rather than by the rehabilitation of oiled birds, as it seems doubtful whether this can ever be carried out on a sufficient scale to influence the outcome markedly. The main argument for rehabilitation appears to be a humanitarian one, for the relief of suffering and to avoid the unnecessary slaughter of birds that could be saved. It is suggested that if birds are rehabilitated it is unsatisfactory to release them immediately, when they have become tame and accustomed to be fed, and that the best method of disposal for them may be not to attempt to return them directly to the wild state but to try to establish breeding populations of tame semi-captive birds in protected situations, where they might provide useful objects for study and an ornament to the countryside.