David R. Weir

The desoxyribosenucleic acid (DNA) content in spermatozoa of fertile and infertile human males

SummaryMicrospectrophotometric studies were made on the amounts of DNA in individual spermatozoa of 21 human males with proven fertility and on 18 human males who are partners in sterile couples. The results were as follows:1.The amount of DNA per spermatozoon of the 21 fertile males is very constant and uniform within each individual and among the 21 different individuals. The mean amount of DNA in arbitrary units is 1.22±0.005 per sperm and is approximately one-half that of human somatic cells which is 2.66±0.05.2.In contrast to the uniformity of DNA in the sperms of fertile males, the sperms from the 18 males under examination for “suspected sterility” showed greatly varying amounts of DNA.3.6 of this suspected group had DNA values close to, but not exceeding that of the fertile males. But for 4 of these 6 males this normal DNA amount conformed to the clinical diagnosis that not the males, but their female partners were responsible for the infertility. The remaining 2 males had sperms with impaired motility, a manifestation which may involve a different factor than that of deviations in the amount of DNA.4.5 males represented a category of borderline cases in which the mean DNA was slightly lower than that of the normal group, but many individual measurements overlapped those of normal sperms. So far as the clinical diagnosis was concerned, 4 of these 5 males were on the borderline for male fertility while 1 male had been diagnosed as infertile because he had sperms with impaired motility.5.7 of the suspected group carried sperms with DNA in decidedly lower amounts than those of normal, fertile sperms. In 5 of these 7 males the clinical diagnosis ascribed the infertility to the males. In the remaining 2 cases where the DNA was also found to be low in the spermatozoa, no cause could be given clinically for the sterility either in the male or in the female partner.6.These data suggest a correlation between a deficiency of DNA in the sperms and one type of male sterility, but this cannot be considered as established until further data (such as more information on the female partner) become available.

Long-term changes in gross body composition of paraplegic and quadriplegic patients

1. The body composition of groups of 14 paraplegic and six quadriplegic patients were compared with those of groups of other chronically ill patients, judged clinically to be either ‘Weil-nourished’ or “poorly-nourished’.The spinal-cord injured patients had values of sodium space (expressed relative to body weight or lean body mass) similar to those of the poorly-nourished group, while in nine other parameters of body composition they resembled a well-nourished group of patients. The increased sodium space in the spinal-cord injured patients is consistent with erosion of their lean body mass. 2. The changes in body composition of three quadriplegic and four paraplegic patients were followed for varying lengths of time up to 51 months. Although many of the changes were significant in individual cases, there was no consistent trend in body composition. Both gains and losses of weight were observed, the largest factor in these being changes in body fat. Ten paraplegics showed a tendency to decrease their sodium space after 12 weeks of controlled dietary intake with significant changes in three cases.

Primary sarcoma of the heart

Abstract This case of primary sarcoma of the heart brings to seventy-six the total number of cases of this disease now on record. This includes two cases in which the tumor was regarded as an angioreticuloendothelioma. Various signs and symptoms led to a correct clinical diagnosis of cardiac neoplasm.This case of primary sarcoma of the heart brings to seventy-six the total number of cases of this disease now on record. This includes two cases in which the tumor was regarded as an angioreticuloendothelioma. Various signs and symptoms led to a correct clinical diagnosis of cardiac neoplasm.

An evaluation of the variability in measurement of some body composition parameters.

Summary The variability in observation of some parameters of gross body composition was assessed by paired observations one week apart in 26 chronically ill subjects. The results of this study permit statistical evaluation of the significance of changes in these parameters observed in other subjects, using the same experimental techniques.

BODY COMPOSITION OF “WELL NOURISHED” COMPARED TO “POORLY NOURISHED” CHRONICALLY ILL PERSONS*

In order to assess the variable of nutritional state in relation to the presence of or progress of chronic illness, nutritional state must be defined objectively. Objective definition implies measurement that is valid, reliable, reproducible, and subject to estimations of intrinsic technical or observer variation. Furthermore, the definition must be related to the problem at hand. Nutritional state may be considered “good or “poor” or relative to these extremes. If the frame of reference is a chronic illness, “good nutritional state would prevent, cure, or delay the progress of disease; the reverse would be true of a Measurement of nutritional state to meet the criteria for objective assessment mentioned above would depend on physical or biochemical techniques. Validation of these techniques depends on an independent definition of nutritional state. In addition, the independent definition should permit a dichotomy of nutritional state into ”good” and “poor” with all questionable decisions as to nutritional state discarded. If the measures selected discriminate between good and poor they may be useful in those instances where the criteria for the independent judgment cannot be applied with accuracy. This is particularly true when a decision must be made between two individuals as to which is better nutritionally than the other. In the study of the role of nutrition in chronic illness it is not always enough to establish that means for a particular value are different in two groups of people. Frequently, one must study small numbers of patients, pairs of patients, or two points in time in the same patient. In these instances placement on a scale of relative goodness of nutritional status is desirable. We have investigated the possibilities of using gross body composition as a measure of nutritional state that would satisfy the foregoing considerations for an objetcive measure. For an independent evaluation of nutritional state we selected “clinical” judgment. This was done in the full knowledge that this was a precarious choice on which to classify individuals. For one thing, it is almost impossible to define without bringing into the judgment the very factors that we would be assessing by body composition studies. However, in the absence of a good way of defining nutritional state from the standpoint of good or poor we felt we could achieve the dichotomy by selecting patients who, by clinical judgment, were in much poorer nutritional state than were those patients with the same disease, and within five years of the same age, selected as good. Poor nutri-

Metabolic deviations of polymorphonuclear leukocytes in rheumatoid arthritis

SummaryPolymorphonuclear leukocytes of normal individuals and of patients with rheumatoid arthritis were incubated in serum containing14C-labeled propionic acid. The overall metabolism was studied by determination of radioactivity in the respiratory CO2, lipids, proteins, amino acids and lactate. The metabolism of polymorphonuclear leukocytes of the arthritic group differed from that of normal individuals in the following respects. They converted less14C-propionic acid into metabolic products, particularly CO2 and protein. Leukocytes of normal subjects convert14C-propionate into aspartic acid and glutamic acid, while leukocytes of patients with rheumatoid arthritis also convert propionate into β-alanine.It appears that polymorphonuclear leukocytes of patients with rheumatoid arthritis and of normal individuals possess aKrebs cycle. Leukocytes of the arthritic group and of normal subjects show a similar14C-distribution pattern in the lactate when incubated 2-14C-propionate. It is concluded that the formation of lactic acid from 2-14C-propionate may proceed to a small extent by an alternate pathway (acrylyl-CoA). The identification of labeled β-alanine was found only in the arthritic group and may be unique for rheumatoid arthritis.ZusammenfassungPolymorphkernige Leukozyten von Normalpersonen und von Patienten mit primär chronischer Polyarthritis wurden in Serum inkubiert, das14C-markierte Propionsäure enthielt. Der Gesamtstoffwechsel wurde mittels der Bestimmung der Radioaktivität in respiratorischem CO2, Lipoiden, Proteinen, Aminosäuren und Laktat untersucht. Der Stoffwechsel von polymorphkernigen Leukozyten in der arthritischen Gruppe unterschied sich von dem der Normalpersonen in folgender Hinsicht: Sie setzten weniger14C-Propionsäure in Stoffwechselprodukte um, insbesondere CO2 und Protein. Leukozyten von Normalpersonen setzen14C-Propionsäure in Asparaginsäure und Glutaminsäure um, während die Leukozyten von Patienten mit primär chronischer Polyarthritis Propionsäure auch in β-Alanin umsetzen.Es scheint, daß die polymorphkernigen Leukozyten von Patienten mit primär chronischer Polyarthritis und von Normalpersonen einen Krebs-Zyklus besitzen. Leukozyten der arthritischen Gruppe und von Normalpersonen zeigen ein ähnliches Verteilungsschema von14C in Laktat nach Inkubation mit 2-14C-Propionat. Es wird daraus geschlossen, daß die Bildung von Milchsäure aus 2-14C-Propionat zu einem geringen Grade auf einem anderen Weg erfolgt (Acrylyl-CoA). Die Identifizierung von markiertem β-Alanin war nur in der arthritischen Gruppe möglich und kann für primär chronische Polyarthritis spezifisch sein.

Serum proteins and blood vitamins in anemia of the chronically ill: Possible role of protein undernutrition☆

Abstract Chronic anemia not associated with malignancy, infection, uremia, arthritis or liver disease occurs frequently in hospitalized chronically ill patients. Evidence is presented that the anemia is not due to deficiency of iron, folic acid, vitamin B 12 or pyridoxine. It is associated with underweight, with decreased serum albumin, and with increased alpha I and gamma serum globulin. With supporting evidence from animal studies done by others, it is proposed that the anemia is due to prolonged protein calorie undernutrition.