Invisible labours: mill work and motherhood in the American South.

With an almost total lack of access to contraceptive information before the mid 1930s, a high percentage of married women working in the textile mills of the American south were or rapidly became mothers. Without the financial resources to provide their families with wholesome food, medical care, and adult supervision, these women, who bore many children and shouldered most domestic duties in addition to their mill jobs, presumably had particular health care needs. This essay intially questions the usefulness of traditional categories that label physical ailments and accidents as either job-related or lifestyle-related. A group of female physicians in Greenville and Spartanburg Counties in South Carolina, all of them southern natives, worked during the 1930s to address some of the most immediate medical needs of the region's working women. These physicians had no appreciable effect, however, on workplace conditions and did not question the social and economic relationships that led so many working mothers to depend on their services. This essay also provides a partial analysis of public health services available to working mothers in Carolina mill villages during the Depression decade and explores reasons why the region's female medical professionals failed to challenge a form of social organization that left working mothers' particular health care needs unaddressed.

Import of stably folded proteins into peroxisomes.

By virtue of their synthesis in the cytoplasm, proteins destined for import into peroxisomes are obliged to traverse the single membrane of this organelle. Because the targeting signal for most peroxisomal matrix proteins is a carboxy-terminal tripeptide sequence (SKL or its variants), these proteins must remain import competent until their translation is complete. We sought to determine whether stably folded proteins were substrates for peroxisomal import. Prefolded proteins stabilized with disulfide bonds and chemical cross-linkers were shown to be substrates for peroxisomal import, as were mature folded and disulfide-bonded IgG molecules containing the peroxisomal targeting signal. In addition, colloidal gold particles conjugated to proteins bearing the peroxisomal targeting signal were translocated into the peroxisomal matrix. These results support the concept that proteins may fold in the mammalian cytosol, before their import into the peroxisome, and that protein unfolding is not a prerequisite for peroxisomal import.

Go tell it on the mountain: Hilla Sheriff and public health in the South Carolina Piedmont, 1929 to 1940.

As director of the South Carolina units of the American Women's Hospitals and as the state's first female county health official, Hilla Sheriff combined elements of the Progressive Era's social gospel; the New Deal notion that concerned, public-spirited officials could make a difference; and a nascent feminism that led her into the controversial fields of family planning and nutrition. Sheriff's responses to endemic pellagra, innovative maternal and child health campaigns, and contraceptive research for the Milbank Memorial Fund attracted national attention and spawned programs based on her models throughout the South. Her ability to tailor programs to diverse communities--mothers who bore double burdens as textile workers, isolated farm families, mountaineers, and African Americans denied access to most health care facilities in the Jim Crow South--serves as a timeless example for those committed to community medicine.

Import of microinjected proteins bearing the SKL peroxisomal targeting sequence into the peroxisomes of a human fibroblast cell line: evidence that virtually all peroxisomes are import-competent.

Peroxisomes import virtually all of their membrane and matrix proteins post-translationally. It is presently unknown whether, in mammalian cells, their exists a pool of mature peroxisomes which have received their complement of proteins and are import-incompetent. Previous work has shown that fibroblasts are capable of importing microinjected peroxisomal proteins into peroxisomes. This report describes the import of a hybrid peroxisomal protein into virtually all peroxisomes of the microinjected cell. The peroxisomal import was uniform in both short and long incubations. Pretreatment of the cells with cycloheximide did not affect the import of the peroxisomal protein, nor was there any difference in the distribution of the imported protein. Sequential microinjection experiments demonstrated that peroxisomes that had imported luciferase were capable of importing another peroxisomal protein injected 24 hours later. These results suggest that, in fibroblasts, all peroxisomes have associated protein-import machinery; this evidence does not support the hypothesis that there exists a pool of import-incompetent peroxisomes.

Atrial sounds and endocardial electrograms recorded during coarse atrial fibrillation.

Hearing atrial sounds is unusual during atrial flutter and rare during atrial fibrillation. We report a patient with hypertrophic cardiomyopathy and coarse atrial fibrillation in whom atrial sounds were recorded phonocardiographically during endocardial atrial electrography. The atrial sounds were recorded phonocardiographically at the same periodicity as the atrial electrograms, and both had beat-to-beat variability in morphology, amplitude, and cycle length. These observations suggest that atrial sounds originate from the atrium and that organized electrical and mechanical activity occur in some types of atrial fibrillation.

Orthostatic hypotension following right ventricular myocardial infarction corrected with mineralocorticoid therapy.

Severe hypotension while standing became a problem in a patient after discharge from the hospital following right ventricular myocardial infarction. Hemodynamic studies showed that right ventricular systolic function did not maintain adequate left ventricular preload and that the patient did not compensate for cardiac dysfunction by increasing blood volume. Volume expansion by mineralocorticoid therapy corrected the orthostatic hypotension and ameliorated symptoms. Hypotension eventually resolved and therapy was stopped four months after the myocardial infarction.

Complications of permanent transvenous cardiac pacing: a 14-year review of all transvenous pacemakers inserted at one community hospital.

Five hundred and eighty-nine consecutive transvenous pacemakers implanted between January 1, 1971 and January 1, 1985 were reviewed. A complication incidence of 17% early in the study period (1971-1977) was caused by electrode displacement and perforation. As of 1975, smaller-sized electrodes with endocardial fixation were used and were associated with a significant decrease in this complication incidence to 2% by 1985. All other complications occurring during the entire study period (1971-1985) occurred at a frequency of 3% (20/589). Infection occurred in 3 of 589 cases; there were no extrusions or erosions. No mortality was attributed to pacemaker insertion. The "twiddler" syndrome seems to be increasing in frequency. Transvenous permanent pacing can be accomplished today with a low complication rate of 5% or less. The majority of these complications are minor and can be corrected easily. Our studies suggest that the reduced complication incidence is mainly related to improved technology.