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Stop-flow studies were done in three dogs before and after a parathyroid hormone (PTH) infusion. The urine cyclic adenosine 3\m=' \,5\m=' \-monophosphate (cyclic AMP) to inulin U/P ratios did not change during the control stop-flow but with PTH rose sharply and significantly in the proximal tubular samples. The rise in cyclic AMP to inulin U/P ratios was correlated with the fall in phosphorus concentration in the same samples. The PTH induced urinary cyclic AMP enters the tubular fluid in the same proximal area of the tubule in which PTH is known to affect phosphate reabsorption.

Physiologically complete cervical spinal cord transection results in motor and sensory quadriplegia and interruption of the sympathetic neural pathways; this condition leads to metabolic deficiencies suggestive of abnormal endocrine function. An investigation of the non-stimulated secretion of some of the hormones influencing metabolism was undertaken by evaluating thyroxine, iodothyronine binding index, testosterone, growth hormone, calcitonin, and parathyroid hormone in venous blood of fasting healthy subjects and quadriplegic patients. The effect of the duration of the paralysis was examined by repeating the evaluations at different periods after onset. The results show that 1) thyroxine was low for 2 months after onset in 21 patients and normal thereafter in 53 patients, 2) testosterone was low throughout the study in 62 patients; the decrease is greatest during the first 2 months, 3) growth hormone was often increased in 46 patients for 8 months after onset, and nearly normal afterward in 25 patients, 4) calcitonin was normal in 22 patients throughout the study, and 5) parathyroid hormone was normal in relation to normal serum calcium as early as 6 days after onset in 79 out of 83 patients. These data do not preclude a parathyroid hormone increase at onset or alterations in the patterns of circadian secretion and in the responses to specific stimulation for the hormones evaluated. Therefore, it may be concluded only that the steady state secretion of these hormones is not altered by traumatic quadriplegia per se, but is temporarily modified by the original insult to the nervous system, and by changes in life pattern and the heavy sedation that follows. The results suggest that the minor endocrin changes occurring in quadriplegic patients during the early period of paralysis will be rapidly overcome by rehabilitation to an active life pattern.

The recent data concerning the relationship between psychosocial factors and the incidence of cancer have been reviewed covering life events, personality factors, psychiatric diagnoses, and loss-separation-hopelessness. The multiple methodological and design problems in this area of investigation are the factors that stand out and make interpretation difficult. Nevertheless, an association between oncogenesis and a number of factors such as extraversion, neuroticism, and lack of closeness to family is suggested. Many studies raise additional questions without providing definitive answers. A long term prospective study which has been designed to look at cancer outcome and multiple psychosocial factors is needed to determine if such factors add to the risk of oncogenesis.