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Showing papers by "University of Colorado Denver published in 1982"


Journal ArticleDOI
TL;DR: The life quality of patients with COPD was found to be impaired relative to healthy subjects on all dimensions; depression was the preponderant emotional disturbance reported; difficulties with home management and reduction in social interaction were the primary social-role deficits.
Abstract: • Two hundred three patients with hypoxemic chronic obstructive pulmonary disease (COPD) and 73 healthy control subjects matched for age, sex, race, and neighborhood of residence were administered three self-report inventories concerned with the following four dimensions of life quality: emotional functioning, social-role functioning, activities of daily living, and recreational pastimes. An additional inventory was administered to a spouse or another close relative of each patient. The life quality of patients with COPD was found to be impaired relative to healthy subjects on all dimensions. Depression was the preponderant emotional disturbance reported; difficulties with home management and reduction in social interaction were the primary social-role deficits. Ambulation, mobility, sleep and rest, and a variety of recreational pastimes were also severely affected. Life quality exhibited moderate but significant relationships to neuropsychological, pulmonary, and cardiac functioning and to exercise capability. Age and socioeconomic status were found to be possible moderators of the relationship of COPD to life quality. A model to integrate these findings is proposed. Implications for the management of COPD and for the evaluation of medical treatments of chronic disabling conditions are described. (Arch Intern Med1982;142:473-478)

449 citations


Journal ArticleDOI
TL;DR: It is concluded that cerebral disturbance is common in hypoxemic COPD and may be related in part to decreased availability of oxygen to the brain.
Abstract: • As part of a six-center clinical trial of the effectiveness of continuousvnocturnal oxygen in the management of hypoxemic chronic obstructive pulmonary disease (COPD), we performed detailed neuropsychologic assessments of these patients prior to their beginning treatment. The 203 patients (age, 65 years; Pao2, 51 mm Hg; forced expiratory volume in 1 s, 0.74 L) performed significantly worse than controls on virtually all neuropsychologic tests. Moderate to severe test impairment suggestive of cerebral dysfunction was found in 42% of the patients, as compared with 14% of controls. Higher cognitive functions (abstracting ability, complex perceptual-motor integration) were most severely affected, although half the patients also showed decrements in motor speed, strength, and coordination. Low-order significant inverse correlations were found between neuropsychologic impairment and Pao2, resting arterial oxygen saturation and hemoglobin levels and maximum work. It is concluded that cerebral disturbance is common in hypoxemic COPD and may be related in part to decreased availability of oxygen to the brain. (Arch Intern Med1982;142:1470-1476)

373 citations


Journal ArticleDOI
TL;DR: If microvillar cells prove to be sensory cells, the current concept of the human olfactory epithelium will have to be revised to include two morphologically distinct classes of receptors.
Abstract: This report gives a detailed description of the fine structure of the olfactory mucosa in man. Using a special biopsy instrument and technique, fresh biopsies of olfactory epithelium were taken under local anaesthesia from eight normal volunteers. Transmission electron microscopy reveals that human olfactory epithelium has four major cell types: ciliated olfactory receptors, supporting cells, basal cells and microvillar cells. The ciliated olfactory receptors, as in other mammals, are bipolar neurons; the dendrite tip, modified to form the olfactory vesicle, bears 10–30 cilia that lack dynein arms. The supporting cells, markedly different from the goblet cells of respiratory epithelium, are not specialized for mucus secretion. Instead they are equipped to contribute materials to, and remove materials from, the surface mucus. The basal cells are stem cells that serve to replace epithelial cells and receptors lost during normal turnover or injury. In addition to ciliated olfactory neurons, supporting cells and basal cells, the human olfactory mucosa contains a distinct fourth cell type, the microvillar cell, of unknown function. The apical pole of the cell sends a tuft of short microvilli into the nasal cavity; its basal pole gives rise to a slender cytoplasmic process that resembles an axon. If microvillar cells prove to be sensory cells, the current concept of the human olfactory epithelium will have to be revised to include two morphologically distinct classes of receptors.

246 citations


Journal ArticleDOI
TL;DR: The data collected thus far suggest that children who have their food sensitivity diagnosed at older ages tend to outgrow the problem, even in subjects who could consume the sensitizing food without symptoms.
Abstract: The natural history of food sensitivity has long been the subject of anecdotes about children "outgrowing" their problem, but prospective systematic studies are not easily found that document these opinions. Children who had had adverse reactions to foods during double-blind food challenges 1 to 7 yr prior to this study were evaluated. In children over 3 yr of age, 19% of the previously positive food challenges were negative at the time of the follow-up; in children 3 yr of age or younger, 44% of the food challenges that had been positive were negative. The data collected thus far suggest that children who have their food sensitivity diagnosed at older ages tend not to outgrow the problem. Skin testing was performed over a period of years on some of the subjects, and skin sensitization was found to be markedly persistent, even in subjects who could consume the sensitizing food without symptoms.

239 citations


Journal ArticleDOI
TL;DR: Fasting, residual, and average hourly volume were increased in all trimesters of pregnancy, but tended to return to normal in the postpartum period, and two distinct rates of emptying after breakfast, an early and a late one, were identified.

214 citations


Book ChapterDOI
01 Jan 1982
TL;DR: It should be self-evident that experimental animal and human field studies must interdigitate if any conclusions are to be reached before the end of the present interglacial period.
Abstract: Other contributors to this volume have described intriguing evidence about possible biological substrata for attachment and affiliative behaviors. Such evidence suffers from being of necessity correlational. A statement of John Dobbing’s (1968) in reference to research on the behavioral effects of malnutrition is applicable here: Even the most sophisticated multifactorial analysis is no substitute for the experimental testing of hypotheses, and this can only be done with animals. It should be self-evident that experimental animal and human field studies must interdigitate if any conclusions are to be reached before the end of the present interglacial period. (p. 294)

190 citations


Journal ArticleDOI
TL;DR: There is a remarkable similarity in neonatal survival rates, indicating that continuing communication between obstetric perinatologists and neonatologists is a prime factor in reducing mortality, rather than specific new therapeutic procedures at any single clinical center.

176 citations


Journal ArticleDOI
15 Apr 1982-Nature
TL;DR: The results suggest that a pure antagonist becomes an agonist when it is capable of bringing two receptor molecules within a critical distance, d, and indicate that formation of the receptor microaggregate itself is sufficient to stimulate a transmembrane response system.
Abstract: Gonadotropin-releasing hormone (pyroGlu1-His2-Trp3-Ser4-Tyr5-Gly6-Leu7-Arg8-Pro9-Gly10 amide, GnRH) stimulates pituitary luteinizing hormone (LH) release. An antagonist, D-pyroGlu1-D-Phe2-D-Trp3-D-Lys6-GnRH (GnRH-Ant), binds to the pituitary GnRH receptor and inhibits GnRH-stimulated (10−9 M) gonadotropin release from pituitary cultures (IC50 = 2 × 10×7 M). GnRH-Ant has no measurable agonist activity at concentrations up to 10−6 M. The presence of the D-Lys6 both affords protection against proteolysis and includes an amino group which may be used for derivatization without loss of receptor-binding activity. Formation of the GnRH-Ant dimer by cross-linking of the (lysyl) amino groups of two molecules with ethylene glycol bis(succinimidyl succinate) (EGS) results in a GnRH-Ant dimer joined by a 12–15 A chain. As the amino terminus on GnRH-Ant is blocked, leaving the D-Lys6 amino group the only reactive group1, the reaction of EGS with GnRH-Ant does not lead to larger polymers. Like the parent compound, this dimer is purely an antagonist. We now show, however, that when antibody (AB) to D-Lys6-GnRH (which cross-reacts with GnRH-Ant) is incubated with excess dimer, a product is formed which consists of a divalent antibody with a GnRH-Ant dimer attached to each arm: AB–((GnRH-Ant)–EGS–(GnRH-Ant))2. In contrast to the parent compounds, this conjugate is an agonist, stimulating LH release from pituitary cultures. Our results suggest that a pure antagonist becomes an agonist when it is capable of bringing two receptor molecules within a critical distance, d (15 A

174 citations


Journal ArticleDOI
TL;DR: Severe thromboses and hemorrhages occurred in 18 children receiving vincristine, prednisone, and asparaginase therapy for ALL, with symptoms of headache, obtundation, hemiparesis, and seizure common for the intracranial events.

167 citations


Journal ArticleDOI
15 Oct 1982-Cancer
TL;DR: This lesion may represent a clinically “borderline” variant between the better known benign (adenomatoid tumor) and malignant mesotheliomas of the peritoneum and the recurrence rate in patients followed for two years or more is 50%.
Abstract: Five cases of the recently characterized cystic mesothelioma of the peritoneum are presented. The patients, all women, ranged in age from 23-50, and were seen with large, solitary or multiple, multicystic masses involving the abdominal and pelvic peritoneum. Histologically, they consisted of interconnecting cystic cavities lined by a single layer of flattened to cuboidal cells with variable nuclear atypia. These cells in one case showed ultrastructural features consistent with mesothelial origin. In follow-up periods ranging from 1-13 years, two patients have had recurrence of disease, but all patients are still alive. When these cases are combined with the ten previously reported, the recurrence rate in patients followed for two years or more is 50% (four of eight). This lesion may represent a clinically "borderline" variant between the better known benign (adenomatoid tumor) and malignant mesotheliomas of the peritoneum.

140 citations


Journal ArticleDOI
TL;DR: In this article, a technique for measuring one aspect of infants' motivation to master the environment (persistence at tasks) is described, and significant relationships were found between goal-directedness, an index of directed persistent behavior, and both cognitive functioning and infant competence on the mastery tasks at 13 months.
Abstract: A technique for measuring one aspect of infants' motivation to master the environment—persistence at tasks—is described. Forty-four 13-month-old infants engaged in persistent, task-directed behaviors about 60% of the time during 11 mastery tasks. As a measure of concurrent validity, persistence during a Bayley examination was rated by another examiner; a moderately high correlation ( r = .48) was found. Significant relationships were also found between persistence at the mastery tasks and Bayley MDI, suggesting considerable intertwining of cognition and motivation in infancy. In a subsample of 25 infants tested at 6 months, significant relationships were found between goal-directedness, an index of directed persistent behavior, and both cognitive functioning and infant competence on the mastery tasks at 13 months. Several aspects of the 6-month environments of these 25 infants, especially maternal kinesthetic and auditory stimulation, maternal responsiveness, and responsiveness of toys were related to persistence and competence at 13 months.

Journal ArticleDOI
TL;DR: The role of the volume of blood cultured in the detection of clinically important bacteremia and fungemia in adults and the yield and speed of detection of microorganisms from 5,317 paired 2- and 5-ml samples of blood is evaluated.
Abstract: To evaluate the role of the volume of blood cultured in the detection of clinically important bacteremia and fungemia in adults, we evaluated the yield and speed of detection of microorganisms from 5,317 paired 2- and 5-ml samples of blood The same kind of medium (supplemented peptone broth with 003% sodium polyanetholsulfonate) and atmosphere of incubation (open venting units) were used for all blood cultures Only adequately filled (less than or equal to 80% of stated volume) sets (20-ml tube and 50-ml bottle) were compared statistically Significantly more bacteria (p less than 001), Pseudomonas spp In particular (P less than 005), were isolated from the 5-ml samples of blood We conclude that the volume of blood cultured is a critical factor in the detection of septicemia Consequently, valid evaluation of other factors influencing the detection of septicemia must be based on comparisons in which equal volumes of blood are cultured

Journal ArticleDOI
TL;DR: The authors speculate the microvillar cell represents a second morphologically distinct class of chemoreceptor in the human olfactory mucosa and its ultrastructure suggests it may be a bipolar sensory neuron.

Journal ArticleDOI
TL;DR: Measurement of MPO activity in ocular tissues could provide a useful tool to quantitatively evaluate the severity and time course of inflammation.
Abstract: Myeloperoxidase (MPO) activity was measured in rabbit cornea and iris-ciliary body to quantitate the infiltration and accumulation of polymorphonuclear leucocytes (PMN's) following an inflammatory stimulus.Following injection of clove oil into the cornea, MPO activity could be detected in the cornea at 6 hr, reaching a maximum at 12 hr, and falling to non-detectable levels at 72 hr., MPO activity was only detected in the iris-ciliary body 24 hr after intracorneal clove oil injection.MPO activity in the iris-ciliary body increased in a dose-dependent manner following intravitreal injection of endotoxin. No MPO activity could be detected in cornea.Topical administration of dexamethasone inhibited MPO activity in cornea and irisciliary body 24 hr after intracorneal clove oil and intravitreal endotoxin injection, respectively.Measurement of MPO activity in ocular tissues could provide a useful tool to quantitatively evaluate the severity and time course of inflammation.

Journal ArticleDOI
TL;DR: Precipitating antibodies to cellular antigens, designated SS‐A(Ro), were found in the sera of seven of eight infants with lupus erythematosus, but they were not found in seventy‐one control infants.
Abstract: SUMMARY Precipitating antibodies to cellular antigens, designated SS-A(Ro), were found in the sera of seven of eight infants with lupus erythematosus, but they were not found in seventy-one control

Journal ArticleDOI
01 Sep 1982-Peptides
TL;DR: Results suggest that certain central actions of SP are mediated by receptors which recognize the amino-terminal part of the SP molecule, and SP may be metabolized to this active fragment prior to its action at these receptors.

Journal ArticleDOI
TL;DR: Ierythromycin promptly eradicates C. jejuni from the faeces but does not alter the natural course of uncomplicated campylobacter enteritis when therapy begins 4 or more days after the onset of symptoms.

Journal ArticleDOI
TL;DR: The present studies have quantitated under well oxygenated, steady-state conditions, the rapid placental metabolism and production of lactate, the net fetal consumption of lactates, and the rapid endogenous fetal lactate production from glucose and nonglucose substrates.
Abstract: Lactic acid represents a major exogenous nutrient for the developing fetal lamb in utero. Our study was undertaken (a) to quantitate the net consumption of lactate by the fetus, (b) to quantitate the net lactate production and metabolism by the placenta, and (c) to compare the net fetal lactate consumption with fetal lactate use, measured simultaneously with radioactive tracers. 14 pregnant sheep were prepared with catheters in the maternal femoral artery and uterine vein and in the fetal aorta and umbilical vein. By simultaneous application of the Fick principle to the uterine and umbilical circulations, placental glucose consumption and placental lactate production were rapid, averaging 39.8 +/- 5.1 and 11.8 +/- 0.7 mg.min-1. Net lactate umbilical uptake averaged 1.95 +/- 0.16 mg-1.kg.min-1. During infusion of L-[14C(U)]lactate, fetal lactate turnover was much more rapid, averaging 6.5 +/- 0.8 mg.kg-1.min-1, and lactate utilization within the anatomic fetus was 5.9 +/- 0.7 mg.kg-1.min-1. During infusion of tracer glucose, endogenous fetal lactate production from glucose and nonglucose substrates averaged 3.0 and 1.5 mg.kg-1.min-1, respectively. The present studies have quantitated under well oxygenated, steady-state conditions, the rapid placental metabolism and production of lactate, the net fetal consumption of lactate, and the rapid endogenous fetal lactate production from glucose and nonglucose substrates.

Journal ArticleDOI
TL;DR: It was concluded that suppressed immunological functioning may be included among the pathophysiological consequences of maternal separation in infant monkeys.

Journal ArticleDOI
TL;DR: It is concluded that DPU is more common than previously appreciated and likely involves mediators other than histamine, possibly the prostaglandin system.
Abstract: Delayed pressure urticaria (DPU) is a poorly understood syndrome. We describe 17 patients with DPU. Chronic urticaria was present in 94%. All had negative challenges for immediate demographism and cold urticaria. DPU was induced with a pressure challenge on the shoulder of 15 pounds for 15 min. Average onset of pressure lesions after challenge was 6.5. Lesions were painful, not pruritic, peaked at 9 hr, and disappeared by 24 to 48 hr. Fever, chills, and/or arthralgias occurred in 78%. Positive laboratory abnormalities included leukocytosis in 20% and elevated erythrocyte sedimentation rate in 37.5%. Skin biopsies of lesions showed perivascular round cell infiltrates and negative immunofluorescence. Urticaria responded to antihistamines, but not aspirin, in 100% of patients, while pressure lesions improved with nonsteroidal anti-inflammatory drugs (NSAID), but not antihistamines, in 80% of patients. Both urticaria and DPU were controlled with prednisone, which was necessary in 87.5% of patients. A severe nonremitting course was noted in 7%, 40% had a moderate remitting course requiring intermittent prednisone, and 53% had a mild remitting disease requiring no medication or antihistamines and/or NSAID only. We conclude that DPU is more common than previously appreciated and likely involves mediators other than histamine, possibly the prostaglandin system.

Journal ArticleDOI
TL;DR: A recently described immunofluorescence mounting buffer containing para-phenylenediamine prevents fading of specific staining in skin sections during microscopic examination, and allows better appreciation of morphological detail.

Journal ArticleDOI
TL;DR: The results indicate that use of the new AVP antagonist clearly implicates AVP in the impaired water excretion of both glucocorticoid- and mineralocortioid-deficiency in the conscious rat.

Journal ArticleDOI
23 Apr 1982-Science
TL;DR: Administration of a potent gonadotropin-releasing hormone (GnRH) antagonist as a single subcutaneous injection to castrated adult male rats reduced, by more than 90 percent, both serum luteinizing hormone concentrations and specific pituitary GnRH receptor binding.
Abstract: Administration of a potent gonadotropin-releasing hormone (GnRH) antagonist [Nac-L-Ala1,pCl-D-Phe2,D-Trp3,6]GnRH as a single subcutaneous injection to castrated adult male rats reduced, by more than 90 percent, both serum luteinizing hormone concentrations and specific pituitary GnRH receptor binding. This effect persisted for 24 hours. The dissociation rate of the antagonist from pituitary membrane homogenates was fourfold slower than the dissociation rate of a potent agonist. The prolonged in vivo inhibition of pituitary GnRH receptor binding and luteinizing hormone secretion by the GnRH antagonist may be mediated by the slower dissociation rate of the antagonist from its specific pituitary membrane receptor site.

Journal ArticleDOI
TL;DR: Recommendations include a mandatory trial of labor in patients with only one previous low-transverse cesarean section and no current indication for cESarean delivery and a more liberal management policy regarding patients with two or more previousLow-Transverse cedarean sections also seems warranted.

Journal ArticleDOI
TL;DR: The results described here strongly support the hypothesis that the cerebellar Purkinje neuron is one important locus for the acute soporific effects of alcohol.
Abstract: In the present study, we compared phenotypic differences in behavioral and neurophysiological responses to acute ethanol administration among eight inbred strains of mice. Genetic variation for behavioral sedation, as measured by loss of the righting reflex (sleep time) after a hypnotic dose of ethanol, was shown to be present among the inbred strain population. In addition, a large genetic component of variation in the depressant action of ethanol on the spontaneous discharge of cerebellar Purkinje neurons was found. Results from an analysis of covariance of the behavioral and electophysiological trophysiological phenotypes, measured on each mouse among the inbred strains, provided strong evidence for a high genetic correlation between sleep time and inhibition of cerebellar Purkinje neuron discharge in response to acute ethanol administration. Taken together with our previously reported data on ethanol-induced electrophysiological changes in selectively bred lines, the results described here strongly support the hypothesis that the cerebellar Purkinje neuron is one important locus for the acute soporific effects of alcohol.

Journal ArticleDOI
TL;DR: Monitoring of catecholamine release in male Sprague-Dawley rats trained to circle for sucrose/water reward provided evidence that dopamine is released asymmetrically from caudate in unlesioned rats during voluntary behavior.

Journal ArticleDOI
TL;DR: Both proteins had similar stoichiometry of binding with 1 mol of folate bound per mol of protein, identical and higher affinities for pteroylglutamic acid than stable folate derivatives, and shared antigenic determinants indicated by single precipitin lines of identity on immunodiffusion with chicken antisera raised against either purified protein.

Journal ArticleDOI
TL;DR: Data are presented which suggest that the synthesis of phospholipase C from pGV26 and pVB81 is directed from the tetracycline resistance gene promoter, and the level of enzyme activity produced by E. coli(pGV26) is slightly higher than the levels produced by P. aeruginosa(pMW79) under repressed conditions and approximately 20-fold higher than those produced by the latter under derepressed conditions.
Abstract: Phospholipase C (heat-labile hemolysin) of Pseudomonas aeruginosa is a phosphate (P(i))-regulated extracellular protein which may be a significant virulence factor of this organism. The gene for this hemolytic enzyme was cloned on a 4.1-megadalton (Mdal) fragment from a BamHI digest of P. aeruginosa PAO1 genomic DNA and was inserted into the BamHI sites of the multicopy Escherichia coli(pBR322) and P. aeruginosa(pMW79) vectors. The E. coli and P. aeruginosa recombinant plasmids were designated pGV26 and pVB81, respectively. A restriction map of the 4.1-Mdal fragment from pGV26 was constructed, using double and single digestions with BamHI and EcoRI and several different restriction enzymes. Based on information from this map, a 2.4-Mdal BamHI/BglII fragment containing the gene for phospholipase C was subcloned to pBR322. The hybrid plasmids pGV26 and pVB81 direct the synthesis of enzymatically active phospholipase C, which is also hemolytic. The plasmid-directed synthesis of phospholipase C in E. coli or P. aeruginosa is not repressible by P(i) as is the chromosomally directed synthesis in P. aeruginosa. Data are presented which suggest that the synthesis of phospholipase C from pGV26 and pVB81 is directed from the tetracycline resistance gene promoter. The level of enzyme activity produced by E. coli(pGV26) is slightly higher than the levels produced by P. aeruginosa(pMW79) under repressed conditions. In contrast, the levels produced by P. aeruginosa(pVB81) are at least 600-fold higher than the levels produced by P. aeruginosa(pMW79) under repressed conditions and approximately 20-fold higher than those produced by P. aeruginosa(pMW79) under derepressed conditions. The majority (85%) of the enzyme produced by E. coli(pGV26) remained cell associated, whereas >95% of the enzyme produced by P. aeruginosa(pVB81) was extracellular. Analysis of extracellular proteins from cultures of P. aeruginosa(pMW79) and P. aeruginosa(pVB81) by high-performance liquid chromotography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the phospholipase C gene was cloned intact, and it is likely that several additional genes were cloned on the 4.1-Mdal fragment of DNA. It was also found that some of these genes encode proteins which are the same molecular weight as some previously described P(i)-repressible proteins of P. aeruginosa. The existence of a P(i) regulon of P. aeruginosa is proposed. It is likely that one of these genes also regulates the level of pyocyanin production by P. aeruginosa and that one or more play a role in transport or binding of P(i). The availability of the hybrid plasmids described herein will be useful in further studies on the role of this hemolysin in the virulence of P. aeruginosa and in the study of the genetics and physiology of P(i)-regulated proteins.

Journal ArticleDOI
TL;DR: Evidence is presented to support the hypothesis that lung growth is advanced in mammals born at a relatively mature stage and that structures resembling the primitive pre-alveolar saccules of newborn rats were never seen in even the youngest fetal animals.
Abstract: Morphological and morphometric evidence is presented to support the hypothesis that lung growth is advanced in mammals born at a relatively mature stage. The lungs from fetal and postnatal guinea pigs ranging in age from gestational age 56 days (normal gestation is 68 days in this species) through 16 days postpartum were fixed in situ by intratracheal glutaraldehyde. Morphometry included measurements of lung volume (VL), tissue and air-space volumes, fraction of respiratory parenchyma, alveolar (SA) and capillary (SC) surface areas, and the arithmetic mean thickness of the tissue barrier (tau t). VL, SA, and SC all increased monoexponentially versus body weight (W) from birth to adulthood; the lungs appeared to be in the equilibrated growth phase, with no postnatal period of pronounced tissue proliferation as reported in the newborn rat and mouse. The prepartum value of tau t was 1.96 micrometers; this value decreased by parturition of 1.27 micrometers and did not change significantly with additional age. At the light-microscopical level, respiratory bronchioles could be visualized giving rise to alveolar ducts by a gestational age of 58 days (10 days preterm) with well-developed alveolar septal partitioning evident. Structures resembling the primitive pre-alveolar saccules of newborn rats were never seen in even the youngest fetal animals. Elastin fibers were also evident at this age, both in bronchiolar and duct walls, as well as in alveolar septa. Using electron microscopy, the air-blood barrier appeared mature by a gestational age of 61 days and thereafter, double capillary layers were only rarely seen in septal walls.

Journal ArticleDOI
TL;DR: This case illustrates the transient central neurotoxicity and persistent peripheral neurotoxicity of podophyllin.
Abstract: A young woman presented with podophyllin intoxication following topical application of podophyllin resin to genital condylomata acuminata. The disorder was marked by hallucinatory psychosis, bone marrow depression, and mild hepatic dysfunction. The psychosis and systemic disturbances resolved within 3 weeks, but were followed by autonomic and sensorimotor peripheral neuropathy. This case illustrates the transient central neurotoxicity and persistent peripheral neurotoxicity of podophyllin.