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The diagnosis of hormonally active acromegaly has been aided by the radioimmunoassay for human growth hormone (hGH). We report a case in which baseline plasma hGH levels were elevated minimally and partial suppression during the glucose tolerance test occurred. Subsequent hGH assay of the cerebrospinal fluid, however, confirmed active acromegaly and correctly predicted suprasellar extension of the tumor.

A reduction of red cell SA in patients following acute myocardial infarction is reported and the effects of SA-depleted red cells on cardiac index and alveolar capillary blood flow in the dog are described. The mean red cell SA in 26 patients following acute myocardial infarction was 0.021 +/- 0.001 compared with a mean of 0.031 +/- 0.002 mumol./0.1 ml RBC in 12 normal subjects (p less than 0.01). In five dogs injected with neuraminidase, an enzyme which removes SA from the red cell membrane, a 43% decrease in mean cardiac index from 2.3 +/- 0.22 to 1.3 +/- 0.16 (p less than 0.01) occurred. In films of the pulmonary microcircuation the mean widths of typical alveolar capillary beds decreased 42.6% +/- 5% (p less than 0.01). In three other dogs, autotransfusion with SA-depleted stored blood resulted in a 25% decrease in mean cardiac index from 2.0 +/- 0.21 to 1.5 +/- 0.21 (p less than 0.2), and a 21.7% +/- 0.9% (p less than 0.01) decrease in mean widths of typical alveolar capillary beds. We conclude that a reduction of red cell SA follows acute myocardial infarction and that SA-depleted red cells decrease cardiac index and alveolar capillary blood flow in the dogs.

This is the report of two children who had prominent arachnoid granulations that were mistaken clinically for dermoid cysts. These lesions appeared in the midline, primarily posteriorly. During surgery, the lesions extended through the dura connected by a stalk. A pathologic examination confirmed the lesions to be arachnoid granulations.

A helpful clinical sign of ruptured cervical disc is pain relief upon arm abduction. When the disease process is spondylosis with foraminal stenosis, changing arm position does not relieve pain. Anatomical considerations are discussed.

The major 70,000- to 80,000-molecular-weight envelope glycoproteins of the squirrel monkey retrovirus, Mason-Pfizer monkey virus, and M7 baboon virus and the related endogenous feline virus, RD114, were isolated and immunologically characterized. Immunoprecipitation and competition immunoassay analysis revealed these viral envelope glycoproteins to possess several distinct classes of immunological determinants. These include species-specific determinants, group-specific antigenic determinants unique to endogenous primate type C viruses, and group-specific determinants for type D viruses such as Mason-Pfizer monkey virus and squirrel monkey retrovirus. In addition, a class of broadly reactive antigenic determinants shared by envelope glycoproteins of both type C viruses of the baboon/RD114 group and type D viruses of the Mason-Pfizer monkey virus/squirrel monkey virus group are described. Other mammalian oncornaviruses tested, including isolates of nonprimate origin and representative type B viruses, lacked these determinants. The demonstration of antigenic determinants specific to envelope glycoproteins of type C and type D primate viruses indicates either that these viruses are evolutionarily related or that genetic recombination occurred between their progenitors. Alternatively, endogenous type D oncornaviruses may be replication defective, and acquisition of endogenous type C viral genetic sequences coding for envelope glycoprotein determinants may be necessary for their isolation as infectious virus.

A group of 6 patients with malignancies involving the pancreas is presented, with a range of diagnosis from primary reticulum cell sarcoma to probable anaplastic carcinoma. Even with adequate biopsy and autopsy material, it may be difficult to provide a definitive tissue diagnosis in these patients. Although this entire spectrum of tumors is uncommon, it is important to try to establish a diagnosis whenever possible. Biopsy of the tumor should be performed, even from the pancreas itself, if necessary, particularly when the initial presentation of the disease is unusual or if the pattern of metastasis is different from that usually seen with carcinoma of the pancreas. It is suggested that a therapeutic trial of appropriate radiotherapy and chemotherapy be instituted in patients of this type even if a diagnosis of lymphoma is not firmly established. The possibility exists of survival of some of these patients for periods of one year or more as a result of successive therapy.