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Steers (n = 59) produced from the mating of Braford, Simbrah, Senepol, and Simmental bulls to Brahman- and Romana Red-sired cows and Brahman bulls to Angus cows were used in this study. Effects of sire breed and age at feeding on muscle tenderness in the major muscles of the chuck when steers were fed to 1.0 cm 12th rib fat were determined. There were no muscle tenderness effects due to sire breed group, with the exception of the serratus ventralis muscle, which was more tender in Brahman- and Braford-sired steers than in Simmental-sired steers. Additionally, the supraspinatus muscle from the yearlings was lower in shear value than that from the calves. The Brahman-sired steers had serratus ventralis muscles with higher percentages (P less than .05) of intramuscular fat than those of Braford-, Simbrah-, and Simmental-sired steers. Fat deposited within the muscle or between muscles in the chuck was not related to muscle tenderness as measured by Warner-Bratzler shear values. Also, percentages of intramuscular fat of the triceps brachii, serratus ventralis, or supraspinatus muscles were not influenced (P greater than .05) by age at feeding.

Activities of acidic proteases (cathepsin B + L) and neutral, calcium-dependent proteases (CDP) were quantified to determine whether differences in proteolytic activity could explain differences in meat tenderness among breed types. Steers (n = 32) of known percentage Angus (A) and Brahman (B) breeding were used to establish differences in meat tenderness (A; 3/4A-1/4B; 1/2A-1/2B; 1/4A-3/4B). Samples were removed from the longissimus muscle within 1 h postmortem and within 2 h were frozen for subsequent determination of cathepsin B + L, CDP-I, CDP-II and CDP-inhibitor activities. Warner-Bratzler shear (WBS) was assessed after 1, 5 and 10 d of postmortem aging. Taste panel evaluations, conducted on steaks that were subjected to 5 d of aging, detected no differences. At d 1, WBS did not differ among breed types; however, by d 10 of aging, steaks from Angus steers were more tender (P less than .05) than steaks from 1/2B and 3/4B steers. The Angus and 1/4B steaks had significantly more (P less than .05) cathepsin B + L activity than the 3/4B. The CDP had no relationship with WBS; however, CDP-inhibitor was positively related to d-1 WBS (r = .41, P less than .05). Cathepsin B + L activity was negatively related to WBS at d 10 (r = -.44, P less than .05). These data suggest that differences in meat tenderness among breed types may be explained partially by differences in proteolytic enzyme activity.

Angus (A), Brown Swiss (S) and A X S reciprocal F1 (AS) dams were mated to A, S and AS (also reciprocal F1) sires resulting in nine breed groups of progeny with varying proportions of Angus and Brown Swiss breeding. Breed group of dam and of sire significantly influenced birth weight, preweaning daily gain, weaning weight, 205-d weight, condition score and frame size. The means for birth weight and weaning weight were 33 and 213 kg, respectively. Brown Swiss bulls sired calves with the heaviest birth and weaning weights. Calves produced by S dams likewise were heavier at birth and weaning. Pregnancy rates were influenced significantly by year, age and breed of dam and averaged 79, 95 and 92% for S, AS and A cows, respectively. Survival rate averaged 97% and was not influenced significantly by any of the effects examined. Because survival rates were similar for all breed groups, the results for weaning rate paralleled those for pregnancy rate. Genetic influences on preweaning growth traits and survival rate were partitioned into additive breed differences (B) and heterosis (H) effects for direct (d) and maternal (m) components. Pregnancy and weaning rates were examined using similar analyses except that genotype of service sire of dam replaced that of the offspring for the direct additive breed and direct heterosis components. The Bd values indicated that the Angus breed was inferior (P less than .01) to the Brown Swiss breed for all preweaning growth traits except for condition score, in which the Angus breed surpassed (P less than .01) the Brown Swiss. The Bm values also showed an advantage for the Brown Swiss breed for all preweaning growth traits. The additive maternal effect (the genotype of the females exposed), Bm, was important for pregnancy rate and weaning rate (P less than .001 and P less than .05) but not for survival rate (P greater than .10). The direct additive breed effect was not important for any reproductive trait. Direct heterosis did not affect any of the preweaning or reproduction traits; however, maternal heterosis (Hm) significantly affected all traits except birth weight, frame score and survival rate. The Hm estimates were 12.0 and 8.4 kg for weaning weight and 205-d weight, respectively. The Hm estimates for pregnancy rate, survival rate and weaning rate were 10, 2 and 13%, respectively.

Six patients with sickle cell anemia developed extremely high levels of serum bilirubin. In 4 instances, the elevated levels occurred during an episode of viral hepatitis. Two cases occurred at the time of common bile duct obstruction. The heavy burden of pigment resulting from increased red cell destruction was thought to lead to extreme hyperbilirubinemia, when combined with acute hepatic damage or common bile duct obstruction. Under similar circumstances, increased hemolysis from any cause may lead to markedly elevated levels of serum bilirubin.

Summary A patient with scleroderma whose presenting problem was diarrhea and malnutrition and whose disease seemed to be confined to the small intestine is reported.

Increasing interest in intestinal lipodystrophy (Whipple's disease) has been shown during the past year, with two series of six and seven cases, respectively, having been reported.1These represent about one-fifth of the accepted cases reported in the world's literature since the original description of this disease by George Whipple in 1907.2Evidence suggests that intestinal lipodystrophy is more than a local disease of the small intestine. Typical pathological changes may be found not only in the intestinal mucosa and mesenteric lymph nodes but in peripheral lymph nodes as well.3Indeed, serous cavities may be involved, and bacterial vegetations in the endocardium are not rare.4 A highly characteristic clinical picture usually is present. This includes diarrhea, steatorrhea, arthralgia, lymphadenopathy, abdominal pain, and weight loss. One or more of these manifestations may be absent, but, generally, all will develop during the course of the disease. The patient reported

The purpose of this article is to discuss recent advances in the treatment of diarrhea, both acute and chronic. Acute and chronic diarrhea generally have quite different causes and different treatments; therefore, they will be discussed separately. ACUTE DIARRHEA The major advances in this area in the last decade have been an understanding of some of the mechanisms that are involved in the pathogenesis of acute diarrhea and the development of improved classifications. Treatment has not changed greatly. Most individuals in the United States who have diarrhea improve spontaneously in one or two days and do not seek medical attention. Often treatment is not indicated. Therefore, if a patient consults a physician because of recent onset of diarrhea, the first decision to be made is whether or not to treat it at all. Minimal or no treatment is needed in instances of mild acute diarrhea in which the volume of

To determine the incidence and importance of folate deficiency in uremia, we studied 41 patients who had chronic uremia but who were not receiving hemodialysis. Serum folate level was assayed by microbiological, whole serum radioassay, and heat-extracted radioassay techniques. Mean serum folate level, as determined with theLactobacillus caseimethod, was 6.9 ng/ml (normal, more than 3.0 ng/ml). The mean heat-extracted radioassay serum folate level was 6.6 ng/ml. Only 10% of our patients had subnormal serum folate values, as determined with these techniques. No cases of megaloblastic anemia were discovered, and the hematologic profiles correlated withL caseiand heat-extracted radioassay serum folate values. The mean serum folic acid binding protein (FABP) level was significantly greater for the uremic patients than for control patients (26% vs 9.9%, respectively;P=.0005). Our results show that elevated levels of serum FABP spuriously depress the serum folate level, as determined with the whole serum radioassay technique, but apparently do not retard delivery of folate to the tissue in vivo. (Arch Intern Med136:756-760, 1976)

WITH modern chemotherapy, the mortality rate for amebic abscess of the liver is low. Complete recovery without permanent functional or anatomical abnormality is the rule. 1 We have had experience with a patient who had an amebic abscess of the liver in 1967, 1968, and 1972. Such recurrence or reinfection of the liver after proper chemotherapy is unusual. 2 Report of a Case A 34-year-old man was admitted in March 1967 because of intermittent fever (to 38 C [100 F]) for one month and a 5-kg (10-lb) weight loss. For several days there had been cough, dyspnea, and right pleuritic chest pain. Pedal edema developed one week before admission. There were physical signs of a right pleural effusion and the liver was enlarged to the level of the umbilicus. A right thoracentesis on the day of admission yielded 250 ml of bloody fluid and a pleural biopsy specimen showed necrotic

The purpose of this case report is to present a sixth patient with the functioning carcinoid syndrome due to a metastasizing bronchial adenoma of the carcinoid type. A review of the literature is not intended, since the first four such cases are included in the recent review on serotonin by Sjoerdsma; 1 a more recent fifth case was reported by Schneckcloth, Mclsaac, and Page. 2 Report of a Case History.— A 59-year-old man was admitted to Duke Hospital for the first time on Nov. 19, 1959, with the chief complaints of weakness and irrational speech of three days' duration. The patient had been in excellent health until one year prior to admission, when he noted increasing fatigability. Although the fatigue was gradually progressive, he continued working without any specific complaints until three and one-half months prior to admission, when he noted the onset of intermittent, nonradiating left shoulder pain, which

A common anatomic abnormality leading to meat impaction of the esophagus is hiatal hernia, which is often associated with a ring or stricture. Intermittent dysphagia is a predisposing factor. Many patients either have no teeth or use dentures. There is often a history of overindulgence in drinking alcoholic beverages at the time the bolus is swallowed. Enzymatic digestion of impacted meat generally is a safe and effective method of therapy and is to be preferred initially to direct endoscopic removal. At times it may not be effective, especially when other types of food have been swallowed with the meat. Esophageal lavage helps to resolve this problem. Complete roentgenographic and endoscopic studies should be performed at some stage of the management to insure accurate diagnosis of the cause of obstruction. Periodic follow-up evaluation is recommended in every patient.

IN 1957 Citrin et al1demonstrated that the stomach of a patient with giant rugal hypertrophy could be the site of protein loss sufficiently large to cause hypoalbuminemia. Subsequent studies revealed that a number of diseases affecting various portions of the gastrointestinal tract could be responsible also.2-4A syndrome of enteric leakage of protein associated with characteristic dilated small intestinal mucosal lymphatics (intestinal lymphangiectasia) was described by Waldmann and associates.5Later Pomerantz and Waldmann6demonstrated widespread involvement of lymphatics in this syndrome. Hypoplasia of the lymphatic vessels of the lower extremities, abnormalities of the pelvic and abdominal lymphatics, and anomalies of the thoracic duct were found. Generally, it is held4,5that corticosteroids have no effect on the clinical course of patients with intestinal lymphangiectasia. The present case appeared to be benefited by long-term corticosteroid therapy. Report of Case A 13-year-old white school girl was seen at Confederate Memorial Medical Center