[Epidural systematic double-catheter venography in the diagnosis of lumbar disc herniation; mysterious vein in the vertebral canal (author's transl)].

Epidural venography should be regarded as a very accurate, relatively simple method of demonstrating disc herniations in the lumbar region. This procedure is especially recommendable in cases that are clinically suspect but have a negative or dubious myelogram. Systematic double-catheter venography has to be considered as an important addition to the existing diagnostic procedures for lumbar disc disease, especially when the more conventional methods have failed. This method should be considered at least as reliable as myelography, and even more reliable in the diagnosis of lateral disc herniations. However, small midline herniations may be missed. In some cases it is possible to detect a trapped root, not caused by a disc herniation. In our experience in 120 cases, systematic use of 2 catheters and simultaneous injection of contrast provides excellent, homogenous visualisation of the epidural venous plexus and surrounding veins. The reliability of the X-rays is definitely superior to the single catheter method. The Seldinger technique is used; the approach is via the right and left femoral vein. The cathetertips are selectively introduced from both sides either into a lateral sacral vein, an internal iliac vein or into a lumbar ascending vein. This can be performed as well on the homolateral or on the heterolateral side. This results in six possibilities from each groin, providing a fairly large number of procedures to obtain adequate filling of the epidural and surrounding veins. The position of choice of the cathetertip(s) can vary during the examination, dependent on diagnostic problems or technical catheterisation problems. The risk of complications is very small. It is possible to perform the examination on outpatients. The adequate demonstration of the epidural veins enables us to visualise frequently a small straight vein in the midline of the vertebral canal, that is unknown in the anatomical literature until now.


Diffuse enthesopathic hyperostosis--anatomical and radiological study on a macerated skeleton.

Anatomico-radiological study of a macerated skeleton in a 43-year-old diabetic woman. An important spondylosis with hyperostosis of the cervical, thoracic and lumbar vertebrae was seen. There were associated changes of insertional hyperostosis at various levels, particularly at the iliac crests. Paget's disease of the left iliac crest was also noted in the corresponding hyperostosis. This case presentation offers an opportunity to discuss local mechanical factors (observed at the tendinous insertions) as well as generalized considerations on the "terrain" of diabetes and perhaps malnutrition. It also demonstrates the interest that an anatomico-radiological comparison on macerated specimens can have for certain osteoarticular research, teaching and paleopathology.


[Behaviour of the sella turcica in juveniles with severe iron deficiency (author's transl)].

In juvenile patients with a severe and longstanding iron deficiency disease several abnormal features such as delayed growth, retarded development and maturation are displayed. The roentgenological examination of the sella turcica in 81 patients and the determination of the sellar size in 73 cases, including 40 men and 33 women, by employing the method of Haas with a slight modification and the following comparison of the results with the values obtained by this author in normal individuals of the same sex and age revealed that in the iron deficient patients the sellar area is considerably reduced. In addition, it could be shown that in the patients the normal augmentation of the size with the advancing age is likewise diminished and comes to an early standstill. It could be, moreover, demonstrated that in men the sellar size and growth are more reduced than in women and that the difference in the patients is much larger than the difference existing normally between both sexes. The reduced size of the sella turcica in the patients indicated that the pituitary gland placed in the sellar cavity is likewise diminished and that the activity of the gland, as far as the function is related to the volume, is equally decreased. This assumption is in good keeping with the clinical findings in the patients being attributed to a low and failing hormonal activity. The close relation between volume and function of the pituitary gland, is proved by the observation made in the patients after the administration of iron showing that the size of the sella is considerably augmented during a relatively short space of time and that at the same time a definite amelioration of clinical symptoms occurs. Thus the X-ray examination of the sella turcica and the determination of its area is a suitable method for a comparative investigation of the size and function of the pituitary gland. It offers a valuable tool for studying the disorders of growth, development and maturation in juvenile patients with a severe and longstanding iron deficiency disease and for investigating the relation of these clinical features to the pituitary function.


[Multicentric reticulohistiocytosis as a cause of an erosive, destructive arthropathy (author's transl)].

Multicentric reticulohistiocytosis is a special form of an erosive, destructive arthropathy. It can be distinguished from other forms of erosive polyarthropathies by the characteristic x-ray appearances, although the final proof of the diagnosis is histological in association with the clinical features and the presence of nodular skin lesions. A case of multicentric reticulohistiocytosis is described. The typical radiological appearances are discussed and the differential diagnosis from other forms of chronic polyarthritis, such as gout, psoariatic arthropathy, Reiter's disease and erosive osteoarthritis is considered.


[Cystic changes in the femoral neck following decompression (author's transl)].

Routine radiographs on Caisson workers have shown a rare form of osteopathy in the femoral neck due to decompression and which is not associated with symptoms. The changes appear on the radiograph as a cystic area with a sclerotic surround.


[Haemophilic pseudo-tumours and iliac haematomas: radiological and clinical findings (author's transl)].

Between 1971 and 1977, 648 patients with haemophilia were seen; of these 38 had pseudo-tumours and 163 iliac haematomas. Amongst the latter 153 were cured by the administration of the appropriate factor. In ten the symptoms persisted. In the early stages the diagnosis cannot be made radiologically. Large haematomas produce indirect evidence of their presence by displacing the bladder. Particularly with small haematomas, computer tomography has proved a reliable and accurate diagnostic measure. Without treatment, a haemophilic pseudo-tumour may develop. Its radiological differential diagnosis includes malignant and benign bone tumours, inflammatory and parasitic disease. Therapy includes conservative measures (factor concentrates) or operative intervention (removal of the haematoma).


[Malignant metastases to the periphery of the skeleton (author's transl)].

Metastases from malignant tumours beyond the knee and elbow are uncommon and represent only 1 to 2% of all bone metastases. Four cases of peripheral skeletal metastases are described, with primaries in the cervix, epipharynx, parotid and breast.


Neonatal death dwarfism. (A further report).

Seven cases of rare "Neonatal Death Dwarfism" observed recently in three major Children's Hospitals in Australia are reported. These include Diastrophic Dwarfism, Achondrogenesis II, Lethal Form of Hypophosphatasia, Homozygous Achondroplasia, Minor Form of Asphyxiating Thoracic Dystrophy, Achondrogenesis II (?) and Unclassified Lethal Bone Dysplasia. In all the patients the clinical diagnosis was uncertain or incorrect, whereas a conclusive radiographic diagnosis could be made after X-ray examination in all but one of the cases. Skeletal survey should be performed in each case of neonatal death dwarfism.


[Mucoviscidosis: dysporia entero-broncho-pancreatica congenita familiaris (Glanzmann): Anderson syndrome (author's transl)].

The features of dysporia entero-broncho-pancreatica familiaris (mucoviscidosis) are described and the course of the disease over ten years is recounted. The cases are probably patients with true mucoviscidosis but in whom not all the symptoms develop in early childhood (Doerr). In the present case the symptoms only developed at the age of five years. From this time on there was increasing pancreatic insufficiency, chronic recurring bronchitis, with increasing destructive bronchitis and resulting respiratory insufficiency, dyspnoea and orthopnoea, right heart strain, sodium and chloride loss in the sweat, changes in the duodenum and the development of aganglionic megacolon.


[Xeroradiography in the diagnosis of skeletal diseases (author's transl)].

The value of xeroradiography in the diagnosis of peripheral skeletal lesions is illustrated by some typical examples and compared with standard radiographic procedures. The advantages of xeroradiography depend on its convenient format, easy appreciation of structural changes and easy viewing. On the other hand, density gradations are flattened. Compared with a technically satisfactory film examination, there is no increase in diagnostic information. Xeroradiography can therefore only be regarded as complementary to conventional radiography for the diagnosis of skeletal conditions.


[Favorable effects of estrogens and progesterones on general diseases].

Estrogens and progestagens exert positive effects on some general diseases as iron deficiency, anemia, premenstrual syndrome, intermenstrual migraine, akne, seborrhoea, hirsutism, androgenetic alopecia, slerodermia, rheumatoid arthritis, osteoporosis and depressive disorders. The mechanism of action and the mode of treatment in such cases are discussed.


Exercise testing as a predictor of heart disease and sudden death.

Analysis of data obtained from symptom-limited exercise testing and standard clinical evaluation has identified certain variables as having marked prognostic significance in coronary disease, making it possible to separate patients at highest risk of sudden death from the vast majority. The way is thus opened for focusing aggressive preventive efforts upon the group most likely to achieve the greatest benefit.


Modulation of immune response by killed Brucella abortus organisms: comparison of the effects of smooth and rough strains on T-dependent responses.

Inactivated Brucella abortus organisms of the smooth (S) or rough (R) strain were tested comparatively on two T-dependent immune responses: mixed-lymphocyte reaction and delayed-type hypersensitivity. The intravenous injection of S organisms depressed the two tests, whereas R organisms increased mixed-lymphocyte reaction and did not alter delayed-type hypersensitivity significantly. This observation may be helpful in understanding the differences in adjuvant properties of S and R brucellae.


The adipocyte volume in human adipose tissue: 1. Lipid space, normal and maximum values, and the relation to body weight index.

The volume of isolated adipocytes in specimens from the subcutis of the abdomen was measured using the pulse counter technique. The lipid content was determined as esterified fatty acids. (1). Adipocyte enlargement is mainly caused by lipid deposition, despite a slight increase in the lipid free volume. (2). Two cell populations were detected in some cases, with the smaller fraction having a volume between 0.024 and 0.129 nl, which is lower than the common range for human adipocytes. (3). An analysis of large numbers of cells in single specimens revealed the lognormal type to fit the volume distribution better than the normal type. (4). Standard deviations of the lognormal distributions decrease with the mean cell volumes. Calculation by extrapolation shows the maximum adipocyte volume is of the order of 1 nl. (5). Normal curves of the adipocyte volume vs body weight index were set up for 142 test persons. They approach maximum volumes and differ with sex. (6). The normal adipocyte volume is ideal weight persons without metabolic disease is in the order of 0.3 nl.


Isolation and properties of two fragments from plasmin digests of human choriomammotropin.

Two fragments have been isolated and characterized from plasmin digests of human choriomammotropin. It was shown that these two fragments were derived from the cleavage of the Arg-Arg (positions 133-134) and the Lys-Gln (positions 140--141) bonds of the hormone: one has 133 amino acids and the other 51 amino acids. Both fragments were biologically and immunologically inactive.


Enzymes of the carbohydrate metabolism in salivary glands from rats submitted to excess of vitamin A.

Male albino rats of the Wistar strain were submitted to daily doses of 15 000 I.U. of vitamin A. Enzymes of the carbohydrate metabolism were assayed in the salivary glands after 1,2, 3 and 4 doses. Phosphofructokinase showed decreased activity in the submandibular gland while it was not affected in the parotid. Glucose-6-phosphate dehydrogenase activity was higher in the submandibular glands of all experimental groups and only in the group of 1 dose for the parotid gland. Hexokinase activity did not alter in the submandibular gland while for parotid it showed higher activity only in the group of 1 dose. Pyruvate kinase activity was different only in the group of 3 doses for both glands.


Nuclear division cycle in germinating conidia of Neurospora crassa.

A temperature-sensitive mutant has been shown to be blocked at a specific point in the nuclear division cycle: just before the initiation of DNA synthesis at the time when the spindle pole bodies have duplicated but not separated. The metabolic activities of conidia of this mutant strain at the nonpermissive temperature have led us to conclude that the nuclei in a population of dormant conidia are arrested at various points in the nuclear division cycle. This conclusion is substantiated by the activities of conidia in the presence of the inhibitory drugs cycloheximide and hydroxyurea. In each inhibitory situation we observed that some, but not all, of the conidia were able to accomplish DNA synthesis and/or nuclear division.


Method for isolation of Escherichia coli mutants with defects in the proton-translocating sector of the membrane adenosine triphosphatase complex.

A technique for selecting mutants of Escherichia coli in which the proton-translocating sector of the adenosine triphosphatase (ATPase) complex has been inactivated is reported. The procedure uses a strain of E. coli (NR-70) lacking the extrinsic (F1) sector of the ATPase complex and which in consequently permeable to protons (B. P. Rosen, J. Bacteriol. 116:1124--1129, 1973). After growing strain NR-70 under noninducing conditions for the lac operon, cells were mutagenized and plated on minimal medium containing low concentrations of lactose. Several mutants of strain NR-70 were isolated as large colonies on these plates, apparently because they could concentrate lactose more efficiently. A description of one of the mutants, strain KW-1, is reported here. The most distinguishing difference in growth properties of the two strains was that, when transferred to medium containing low concentrations of lactose, strain KW-1 induced the lac operon with a shorter lag time than strain NR-70. The mutation in strain KW-1 leading to more rapid growth on lactose was cotransducible with the asn and unc loci, at 83 min on the E. coli genetic map. Intact cells of strain KW-1 actively transported L-proline as well as did wild-type cells, whereas cells of strain NR-70 were markedly deficient in L-proline transport. The improvement in the transport capacity of strain KW-1 correlated with a marked decrease in proton permeability relative to that of strain NR-70. Based on an acid-base pulse technique that measured the proton conductance of the membranes of intact cells, strain NR-70 was at least 10 times more permeable to protons than was the wild type, whereas strain KW-1 was only 2 times more permeable. The transport properties and proton conductance were also compared with membrane vesicles prepared by osmotic shock. With either D-lactate or ascorbate-N-methylphenazonium methosulfate as respiratory substrates, vesicles of strain KW-1 transported L-proline much more rapidly than did vesicles of strain NR-70, but still at rates less rapid than those of the wild type. The passive proton conductance of the membrane vesicles was quantitated by measuring the rate of H+ influx into vesicles in response to a valinomycin-generated K+ diffusion potential. The proton permeability of vesicles of strain KW-1 was reduced 1.5-fold relative to vesicles of strain NR-70, but these vesicles were still four times more permeable to protons than was the wild type. Vesicles of strain KW-1 corresponded to wild-type vesicles treated with 0.5 micrometer carbonylcyanide m-chlorophenylhydrazone (CCCP) and vesicles of strain NR-70 corresponded to wild-type vesicles treated with 1.4 micrometer CCCP. Treatment of wild-type vesicles with these concentrations of CCCP caused decreases in transport comparable to those observed in the mutants. Strain KW-1 lacked ATPase activity. Cross-reacting material to F1-ATPase was not found in strain KW-1 by double immunodiffusion analysis.


Acceleration of the ATPase activity of glycerol-treated muscle fibers by repeated stretch-release cycles.

Glycerol-treated muscle fiber bundles were fixed at their rest length in 50 mM KC1, 2 mM MgC1(2), and 10 micron CaC1(2) at pH 7.8 and 0 degrees C in the presence of sufficient amounts of ATP, creatine kinase, and creatine phosphate. The fiber bundles were stretched linearly with time for 0.3 s at a constant amplitude, suddenly released, then fixed at the rest length for a constant time interval (alpha seconds). The stretch-release cycle was repeated, and the ATPase activity (the rate of ADP liberation) [EC 3.6.1.3] was measured. It was found that: 1. ATPase was activated by repeated stretch-release. As repetitive stretch-release of 1--2% of the rest length caused maximum activation, we usually selected a value of 2.5% of the rest length. The activation of ATPase was found to be a function of the duration, alpha, of the isometric phase after sudden release from stretching. The ATPase activity of fiber bundles was almost unaffected when they were oscillated by a simple stretch-release without an isometric phase after the sudden release (alpha=0). 2. The ATPase activity of oscillated muscle fibers increased with increase in the value of alpha, reached a maximal level, then decreased gradually with further increase of alpha to a value slightly larger than that of static fibers. At 0 degrees C, the value of alpha for the maximum activation was observed at about 2 s, and the maximum activity was about 2.5 times that of static fibers. At 20 degrees C, the alpha value for maximum activation was about 0.5 s, and the maximum activity was about 1.8 times that of static fibers. 3. The time course of ADP liberation after one stretch-release cycle could be easily calculated from the ATPase activity of the summed durations of the isometric phase, alpha, assuming that the ATPase activation was turned off and on by the stretching and release, respectively, and that the state of cross-bridges immediately after the stretch-release was independent of alpha of the cycle. The rate of ADP liberation after stretch-release thus obtained showed a short lag phase, a sigmoidal increase, a decrease to almost zero, then a return to nearly the original level (the rate of static fibers). About 1.3 mol of ATP per mol of myosin was hydrolyzed at both 0 degrees C and 20 degrees C during one cycle of the changes in the rate of ADP liberation.


Temperature-induced change in the Ca2+-dependent ATPase activity and in the state of the ATPase protein of sarcoplasmic reticulum membrane.

The temperature dependence of the Ca2+-dependent ATPase activity and of the conformational fluctuation of the ATPase molecule has been measured for four kinds of preparations: fragmented sarcoplasmic reticulum, MacLennan's enzyme (purified ATPase preparation), and DOL and egg PC-ATPase (purified ATPase preparations in which lipids are replaced with dioleoyllecithin and egg yolk lecithin, respectively). It has been found that Arrhenius plots of the Ca2+-dependent ATPase activity show a break at about 18 degrees C for all the preparations. Hydrogen--deuterium exchange kinetics of the peptide NH protons were used to measure the conformational fluctuation of the protein molecules. Van't Hoff plots of the conformational fluctuation amplitude of a region near the surface of the ATPase molecule also show a break at about 18 degrees C for all the preparations. It is concluded that the break at around 18 degrees C is not related to a gel-liquid crystalline transition of lipids but to a change in the conformation of the ATPase molecule existing in fluid lipids.


Isolation and localization from chicken gizzard of an inhibitory protein for Mg2+-activated skeletal muscle actomyosin ATPase.

An inhibitory protein for Mg2+-activated actomyosin ATPase from rabbit skeletal muscle was prepared from frozen chicken gizzard and purified by DEAE-Sephadex chromatography and gel filtration. 2. The inhibition by this protein was released by the addition of skeletal muscle troponin C and was independent of gizzard tropomyosin. 3. Localization of the inhibitory protein in gizzard muscle tissue and gizzard thin filaments was demonstrated by immunohistological techniques and immunodiffusion tests.


Ca2+-controlled conformational states of the Ca2+ transport enzyme of sarcoplasmic reticulum.

The fluorescent reagent, S-mercuric N-dansyl-cysteine, reacts specifically with thiols of the purified Ca2+-ATPase of the sarcoplasmic reticulum, producing an increase of fluorescence of fluorescence intensity at 500 nm (lambda ex = 335 nm). The reaction is stoichiometric, and the increase of the fluorescence intensity is proportional to the number of blocked thiols. Twelve reactive thiols per 10(5) daltons of ATPase peptide fall into roughly three classes. Blocking of the most reactive thiol entails little inhibition of enzyme activity. Blocking of the five thiols reacting next (intermediate class) results in almost complete inhibition of both phosphorylated intermediate formation and ATP hydrolysis. The second order rate constants of the reaction of thiols have been determined by stopped flow studies. The most reactive thiol and the six least reactive thiols can each be treated as a single class with respect to the rate constant; five thiols of intermediate reactivity appear to have different rate constants (k2, k3, ..k6). Of these constants, k1, corresponding to the most reactive thiol, does not change with [Ca2+]. Upon increasing [Ca2+] from 10(-9) to 10(-5) M, k2 increase and k7-12 decreases; the changes roughly parallel the activation of ATPase activity and the Ca2+ binding to the high affinity alpha sites (Ikemoto, N. (1975) J. Biol. Chem. 250, 7219-7224). Upon further increase of [Ca2+] k2 decreases and k7-12 increase, in parallel with the inhibition of ATPase activity and with the Ca2+ binding to the low affinity gamma sites.


Canine cardiac myosin with special referrence to pressure overload cardiac hypertrophy. I. Subunit composition.

In studies of myosin from left and right ventricles of normal hearts and hypertrophic hearts at 5 weeks and 13 weeks after aortic banding, polyacrylamide gel electrophoresis shows intermediate molecular weight components which derive from heavy chains fragmented in the presence of dodecyl sulfate. The proportion of degraded heavy chains is greater in myosin from hypertrophic hearts than normal hearts, with comparable degradation in left and right ventricle myosin. The observed fragmentation of myosin results from proteolysis due to contaminant proteases or a thermally activated, heat-stable nonenzymatic process, or both. The susceptibility of heavy chains to crude myofibrillar proteases differs in normal and hypertrophic cardiac myosin; however, the kinetics of tryptic digestion are identical for both myosins. With precautions to minimize proteolytic artifacts on dodecyl sulfate-polyacrylamide gel electrophoresis, preparations of myosin from left and right ventricles of normal and hypertrophic hearts exhibit comparable subunit composition, with approximately molar ratios of heavy chains, light chain L1, and light chain L2. Comparable stoichiometry for the light chain fraction is determined by high speed sedimentation equilibrium at pH 11 and direct fractionation of the different cardiac myosins. We do not confirm reports (e.g. Wikman-Coffelt, J., Fenner, C., Smith, A., and Mason, D. T. (1975) J. Biol. Chem. 250, 1257-1262) of different proportions of light chains in left and right ventricle myosin of normal and hypertrophic canine hearts. The light chains display microheterogeneity, with L1 generating two isoelectric variants and L2 generating two major and two minor variants, but identical mobilities and isoelectric values are obtained in the different myosin preparations.


Morphological and biochemical correlates of skeletal muscle contractility in the cat. II. Physiological and biochemical studies.

Isometric twitch characteristics and biochemical parameters of isolated myosin and sarcoplasmic reticulum have been compared in three cat hind limb muscles. The fast twitch caudofemoralis and the slow twitch soleus are almost pure muscles as judged from histochemical studies. Isolated myosin from the caudofemoralis is not only 2- to 3-fold higher in its ATPase activities than that of the soleus, but also in non-dissociated forms has greater electrophoretic mobility than the soleus myosin. Purified myosins from fast muscles as well as soleus exhibited three light chains upon electrophoresis. However, the intact non-solubilized myosins differed in electrophoretic mobilities. The sarcoplasmic reticulum fraction isolated from caudfemoralis exhibits faster rates of Ca++ binding and uptake than soleus, and when fit to a two component model, the caudofemoralis SR exhibits a higher amount of a fast binding site than does soleus SR, features reflected in differences in the relaxation time of the two muscles. In contrast, the fast twitch tibialis anterior has been shown to be a gradient of fiber types and its isometric twitch may be separated by selective nerve stimulation, into a fast and a slow twitch component. Our findings that myosin fractions, as well as sarcoplasmic reticulum fractions isolated from these two components differ with respect to their biochemical characteristics add support to the possibility of a dual function in this muscle.


The first case of a complete deficiency of diphosphoglycerate mutase in human erythrocytes.

An inherited and complete deficiency of diphosphoglycerate mutase was discovered in the erythrocytes of a 42-yr-old man of French origin whose blood hemoglobin concentration was 19.0 g/dl. Upon physical examination he was normal with the exception of a ruddy cyanosis. The morphology of his erythrocytes was also normal and there was no evidence of hemolysis. The erythrocyte 2,3-diphosphoglycerate level was below 3% of normal values and, as a consequence, the affinity of the cells for oxygen was increased. Diphosphoglycerate mutase activity was undetectable in erythrocytes as was that of diphosphoglycerate phosphatase. The activities of all the other erythrocyte enzymes that were tested were normal except for nomophosphoglycerate mutase which was diminished to 50% of the normal value. The levels of reduced glutathione, ATP, fructose 1,6-diphosphate, and of triose phosphates were elevated, whereas those of glucose 6-phosphate and fructose 6-phosphate were decreased. This report sheds new light on the role of diphosphoglycerate mutase in the metabolism of erythrocytes.


Alternative use of the interposition Dacron grafts in the treatment of portal hypertension. Clinical experience with 28 cases.

Twenty-eight patients suffering from esophageal bleeding due to portal hypertension were submitted to an "H" type shunt utilizing a 12 mm. wide knitted Dacron prosthesis. The series consists of 8 meso-caval, 12 porto-caval 8 spleno-renal shunts. Thrombosis of the spleno-portal axis was the main indication for the mesocaval shunt, while side-to-side porto-caval and spleno-renal "H" anastomoses were carried out in patients in whom enlarged lymphatics, edema of the porta hepatis or a too large gap between the two veins precluded the use of a direct shunt. The overall mortality rate was 7% including one operative and one late death. The long-term follow-up study included 26 patients and ranged from 6 to 34 months. In all patients patency of the shunt was evaluated by barium swallow x-ray and esophagogastroscopy. Four of them were further investigated by angiography. A good patency of the shunt was demonstrated in all cases. There was no recurrence of the variceal bleeding either in the post-operative period nor in the long-term follow-up. On the basis of our results we feel that the use of Dacron grafts as "H" type shunts is an effective alternative method in relieving portal hypertension in patients in whom it is difficult or impossible to perform a direct anastomosis and further this procedure can be extended with encouraging results to side-to-side spleno-renal shunts.


Hapten-specific T lymphocyte activation by glutaraldehyde-treated macrophages: an argument against antigen processing by macrophages.

In this communication the effects of glutaraldehyde treatment of trinitrophenyl-(TNP) modified macrophages on their ability to stimulate TNP-specific guinea pig T lymphocyte proliferation were studied. TNP-modified macrophages briefly treated with glutaraldehyde retained much of their ability to stimulate TNP-primed T cells. In contrast, similar treatment of allogeneic macrophages or soluble protein antigen-pulsed syngeneic macrophages completely eliminated their ability to stimulate a mixed leukocyte reaction or protein antigen-specific proliferation, respectively. TNP-modification did not appear to interfere with glutaraldehyde reactivity since macrophages treated with glutaraldehyde before or after TNP-modification stimulated equivalent T cell responses. However, glutaraldehyde treatment of TNP-modified macrophages that had been cultured overnight dramatically reduced their ability to stimulate TNP-specific T cells. Glutaraldehyde-treated TNP-modified macrophages also expressed the same genetic restrictions of T cell activation as untreated stimulators. Thus, T cells primed with syngeneic TNP-modified macrophages were restimulated only by glutaraldehyde-treated TNP-modified syngeneic, but not by allogeneic, macrophages. These results are discussed with respect to the nature of the TNP-specific immunogen recognized by T cells.


The role of the pedodontist in the multiple-procedure approach to general anesthesia for children: report of four cases.

The combining of elective procedures, including dentistry, in a single hospital admission, under general anesthesia, can be a very beneficial service for those patients, for whom such procedures are indicated. By minimizing the number of hospitalizations and the number of general anesthetic procedures for his patients, the pedodontist is reducing the risk of anesthesia complications, the possibility of psychological trauma, and the financial burden of hospital treatment. In addition, he promotes the role of the pedodontist in the community and in the hospital as an integral member of the child's health-care team.


Thymic macrophages modulate one stage of T cell differentiation in vitro.

We have described a procedure for isolating thymic macrophages and have evaluated their activity in stimulating thymocyte maturation in vitro. The culturing of gradient-purified immature thymocytes on thymic macrophages leads to an increased expression of H-2 antigens and decreased lytic sensitivity with anti-TL and C. The macrophage-stimulated thymocyte also acquires the ability to respond in the MLR. We propose that the macrophage may regulate one stage of thymic differentiation in vivo.


[Hormone effects of the administration of 50 mg of dehydroepiandrosterone (DHEAS) intravenously in pregnant women (author's transl)].

The DHEAS overload test has been regarded by C. Lauritzen as reflecting the conditions of placental function. Some will support and some will oppose that test. We have merely concerned ourselves with conducting an examination into the metabolic outcome of the DHEAS overload.  --by defining the way in which oestriolury variations are best express themselves. --by estimating how reliable such variations are in cases where foetal pain and hypotrophy are diagnosed. --by going through a statistical analysis of other hormonal variations.


Syngeneic mixed lymphocyte reaction in mice: strain distribution, kinetics, participating cells, and absence in NZB mice.

Co-culture of mouse spleen nonadherent (T-enriched cells with mitomycin C-treated unfractionated syngeneic spleen cells resulted in increased DNA synthesis in the responding T cells. The kinetics of this syngeneic mixed lymphocyte reaction (SMLR) showed that peak DNA synthesis occurred on day 5 of culture compared to day 4 for conventional mixed lymphocyte reaction (MLR). Anti-T cell antiserum plus complement treatment of the responding cell population abolished the reaction, and similar treatment of the stimulator population enhanced SMLR. These studies indicate that SMLR represents the response of T cells to non-T cells. Studies on the generation of cytotoxic T lymphocytes (CTL) in parallel cultures of T cells activated by syngeneic or allogeneic spleen cells showed no cytotoxicity of SMLR-activated cells for either PHA- or LPS-induced blasts but did show a good CTL response of allo-activated cells to both targets. Studies on the strain distribution of SMLR revealed that NZB mice manifested poor or no stimulation in SMLR whereas all other strains tested exhibited strong SMLR. This defect in NZB mice may be pathogenetically related to the autoimmune disease that develops in these mice.


Lack of generation of killer cells in the mixed lymphocyte reaction between mitogen-stimulated and unstimulated autologous lymphocytes.

The present study has demonstrated that the Con A-activated cell-mediated autologous mixed lymphocyte reaction (MLR) is not associated with the generation of cytotoxic effector cells that kill autologous targets. Thus, the suppression of antibody production of PWM stimulated lymphocytes by autologous Con A-activated suppressor cells cannot be explained by detectable cytotoxicity. We have further demonstrated that the stimulator cell in this system is a nonadherent non-T cell.


The chemoattractant properties of comedonal components.

Acculation of clusters of polymorphonuclear leukocytes (PMN) along the periphery of the walls of comedones (predominantly of the closed variety), has been described as the first change marking the transition of quiescent, noninflamed lesions in acne, into inflammatory ones. The present study analyzed the chemoattractant properties of different comedonal components for human PMN in an effort to evaluate the potential significance of these  substances in stimulating the chemotactic response of PMN in the initial phases of inflammatory acne. It was found that the lipids extracted from pooled comedones had chemotactic activity for PMN in vitro. Beyond that, all chemotactic activity in comedones was related to bacteria. Propionibacterium acnes produced low molecular weight, dialyzable, heat stable chemotactic factors which were released into culture medium during bacterial growth. In addition to the extracellular cytotaxins, P. acnes whole cells and other extracellular products were strong cytotaxigens and activated heat labile chemotactic factors in human and guinea pig serum.


Analysis of the water soluble extract of comedones.

The water soluble fraction of 713 open comedones, pooled from both the face and back of 47 subjects representing all grades of acne, were analyzed for total protein content, carbohydrate content, and for identification of specific proteins. In the water soluble fraction, the protein content represented 11.5%, and carbohydrate content 0.2% of the total comedonal crude weight. Esterase and hyaluronidase activity was demonstrated. Propionibacterium acnes antigenic material, serum albumin, and serum Zn alpha 2 glycoprotein, a minor serum constituent, were identified by immunodiffusion and immunoelectrophoresis.


Minocycline-induced loss of potassium from erythrocytes: identification of a family with an augmented response.

The effect of several tetracycline antibiotics of human erythrocytes was examined because of previous findings that these drugs bind to erythrocyte membranes. Minocycline and cetocycline, two highly lipid-soluble analogues, but not tetracycline, induced loss of K+ from red blood cells. Loss of K+ increased linearly with time of incubation, concentration of minocycline, and temperature. The effect of minocycline was inhibited by plasma and calcium. The cells from one volunteer consistently showed an augmented response to minocycline; similar findings for family members of the volunteer suggested a dominant autosomal mode of inheritance. The only abnormality noted in the subject was mild reticulocytosis and a slightly reduced K+ content in his red blood cells. Preliminary studies did not demonstrate alterations in protein composition of his red blood cell membranes, enhanced osmotic fragility, or defects in Ca++-dependent or ouabain-sensitive (Na+-K+)-dependent adenosine triphosphatase activity. The exact site of the minocycline effect remains to be determined.


The influence of selective thrombocytopenia on immune complex glomerulonephritis.

Anticoagulation in experimental GN has not uniformly reduced inflammation and prevented functional impairment. The observation that platelet thrombi are occasionally present in nephritic kidneys prompted the suggestions that platelet aggregation may play a fundamental role and that inhibition of aggregation may be of therapeutic value. To test this hypothesis, the effect of selective platelet depletion on acute IC GN in the rabbit was evaluated. IC GN was induced with bovine albumin, and platelet depletion with APS. Platelet depletion preceded proteinuria by more than 36 hr and was sustained for 5 days. Platelet accumulation within the nephritic kidney was quantitated with chromium-labeled platelets. The hemodynamic effect of parenteral administration of APS on the evolution of IC GN was assessed by comparing IV with IP administration. Thrombocytopenia in the absence of hypotension had no inhibitory effect on IC GN, nor was there platelet accumulation within the nephritic kidneys of the platelet-depleted animals. These results indicate that platelet aggregation is not essential in the pathogenesis of IC GN and that inhibition of platelet aggregation may be of little value.


Radioimmunoassay of creatine kinase: studies on the skeletal muscle and cardiac muscle enzyme (MM and MB isoenzymes) in serum and neuromuscular tissues.

A radioimmunoassay, specific for the isoenzymes of creatine kinase containing the M subunit of the enzyme (MM and MB creatine kinase), was employed to determine total creatine kinase concentrations in serum and neuromuscular tissues independently of the state of activity of the enzyme. This technique provides a method for the detection of inactive enzyme, which could be produced by inhibitors of the enzyme or by mutations involving the active site of the enzyme. A series of experiments were carried out to compare the amount of creatine kinase in various samples as assessed by normal enzyme kinetic procedures and by radioimmunoassay. The two techniques yielded equivalent results in all situations tested. Samples included serum from normal subjects and subjects with genetic and acquired diseases of muscle and also extracts from skeletal and cardiac muscle. Small quantities of immunoreactive enzyme were found in nervous tissue and assessed in terms of the incidence of the M subunit.


Centrally mediated hyperglycemia by 6-aminonicotinamide.

Some metabolic changes induced by the intraventricular administration of 6-aminonicotinamide (6-AN) were studied in mice. Five or ten microgram/animal of 6-AN produced a marked hyperglycemia, lowered glycogen content in the brain and liver, and reduced the adrenal epinephrine content. Adrenalectomy or hexamethonium prevented 6-AN-induced hyperglycemia and decrease of glycogen content in the liver but not in the brain. Decrease of adrenal epinephrine content induced by 6-AN was overcome by hexamethonium. Pretreatment with 6-AN (10 microgram/animal) markedly lowered the toxic action, but not the hypoglycemic action, of a large dose of insulin.


Steroid production from 17alpha-hydroxypregnenolone and dehydroepiandrosterone by human granulosa cells in vitro.

Granulosa cells were aspirated 3--4 h before the expected time of ovulation from 10 follicles of 4 patients treated with gonadotrophins: 4 of the follicles were immediately preovulatory. The granulosa cells were cultured for 10 h with 17alpha-hydroxypregnenolone or dehydroepiandrosterone and samples of medium removed at 3 and 10 h were assayed for 6 steroids. Granulosa cells were unable to synthesize androgens from endogenous substrate or undertake conversions via the delta5 pathway, but cells from all follicles were capable of aromatizing exogenous androgens to oestrogens although this capability was reduced in cells from follicles beginning to luteinize. Granulosa cells from preovulatory follicles synthesized more progesterone from endogenous substrate than cells from follicles which had not begun to luteinize. The results provide further support for the two-cell theory of oestrogen biosynthesis whereby granulosa cells aromatize androgens which are synthesized by the thecal cells in vivo.


Dissociation as probable origin of mosaic 45,XY,t(15;21)/46,XY,i(21q).

A patient is described with some features of Down's syndrome and a 45,XY, t(15;21)(15qter leads to 15p13::21p11 leads to 21qter)/46,XY,i(21)(qter leads to cen leads to qter) karyotype. Two mechanisms are proposed for the origin of the mosaicism, one assuming the dissociation of a translocation (15;21) chromosome already present in the zygote, and the other involving a chromatid translocation in a 46,XY zygote. The possible independent origin of the two cell lines is also considered.


Reproductive performance in Macaca fascicularis following repeated laparoscopy.

Mating trials were conducted with 16 adult female M. fascicularis that had been repeatedly laparoscoped. Eight of the females in this study conceived. Of these, six delivered live full-term infants after having had between 38 and 67 laparoscopies prior to conception.


Ionophorous properties of the 20,000-dalton fragment of (Ca2+ + Mg2+)-ATPase in phosphatidylcholine: cholesterol membranes.

The purified 20,000-dalton fragment of sarcoplasmic reticulum (Ca2+ + Mg2+)-ATPase has been shown by us (A.E. Shamoo, T.E. Ryan, P.S. Stewart, D.H. MacLennan, 1976. J. Biol. Chem. 251:4147) to have Ca2+-selective ionophoric activity. The Ca2+-ionophoric fragment has been purified by either SDS-column chromatography or SDS-preparative gel electrophoresis. The Ca2+-ionophoric fragment has been subjected to prolonged dialysis to insure the removal of bound SDS from the fragment. The selectivity sequence of this fragment in black lipid membranes (BLM) formed from either oxidized cholesterol or phosphatidylcholine/cholesterol is the same, PBa greater than PCa greater than PSr greater than PMg greater than PMn. This selectivity sequence is the same as that for the intact (Ca2+ + Mg2+)-ATPase. Treatment of the fragment with cholate to absolutely insure the removal of bound SDS resulted in the fragment having a selectivity sequence as above except that PMn greater than PMg. This and other data indicate that the 20,000-dalton fragment is the site containing the Ca2+-ionophoric activity of the (Ca2+ + Mg2+)-ATPase.


Preparation and characterization of human syncytiotrophoblast plasma membrane.

On the basis of electron microscopic evidence, a preparation of microvilli obtained from the surfaces of placental villi was previously considered by us to represent syncytiotrophoplast plasma membrane. The present investigation was undertaken to obtain independent biochemical evidence on the nature of the preparation. Protein, lipid, carbohydrate, sialic acid, phospholipid and cholesterol concentration were determined and found to be consistent with analyses of membranes obtained from other sources. Enzyme membrane markers (5'-nucleotidase, (Na+ + K+)-ATPase and alkaline phosphatase) were also assayed, and found to be considerably enriched in the microvillous preparation compared to the whole placental homogenate. These findings, together with other evidence, support the contention that the preparation is indeed syncytiotrophoblast plasma membrane.


[Gas chromatographic study of broth cultures of microorganisms as a method of detecting extraterrestrial life].

The method of pyrolysis--gas chromatography was used to study the composition of cultural liquids obtained upon the incubation of desert soil samples in a rich growth medium. The composition of pyrolysis products was found to depend on the time of incubation. Cultural liquids differed in their composition from the original growth medium. This method is a dynamical one, and can be employed to control the activity of microorganisms.


[Nonsymbiotic nitrogen fixation in the podzolic soils of the Kola Peninsula].

Non-symbiotic nitrogen fixation was studied in virgin and cultivated podzol soils of the Kola Peninsula by the acetylene and isotope techniques. The activity of nitrogen fixation varied sharply in cultivated soils due to degradation of plant residues and the action of plant root secretion. No significant changes were observed in the activity of nitrogen fixation within the vegetative period in virgin soils. Less than 1 kg of nitrogen per hectare was accumulated in soils as a result of its non-symbiotic fixation during the vegetative periods of 1976--1977.


[Diagnostic problems of primary amyloidosis].

Surgical liver biopsy specimen of a women aged 58 with "biliary complaints" showed amyloid deposits of unknown nature. After a nearly two-years-course of the disease the patient died of cardiac and renal failure. Clinical findings and laboratory tests without abnormal serum globulins suggested primary amyloidosis. Morphologically amyloid was present in the heart, tongue, striated muscles and in many parenchymatous organs and endocrine glands. By electron microscopy no difference was revealed between the primary and secondary type, respectively. Differenciation between primary and secondary form of the amyloid could only be achieved by the demonstratin of resistance of the deposits against induced proteolysis with trypsin digestion under the polarization microscope. The same result was obtained in two cases of senile amyloidosis. The case presented indicates that increased level of pathologic globulins is not an obligatory phenomenon in primary amyloidosis.


Adult height and fertility in men with congenital virilizing adrenal hyperplasia.

The effects of congenital adrenal hyperplasia on adult height and fertility were studied in 30 afflicted men. The patients' heights ranged from 150.0 to 178.6 cm (mean +/- 1 S.D. of 164.0 +/- 7.6), which is significantly lower than both the mean adult height for American men and that of the patients' parents (P less than 0.005). There was no correlation between adult height and the age at which therapy was begun, possibly because the patients treated before one year of age had the salt-losing form of the syndrome. Therapeutic compliance may also have been involved. Apparently normal fertility, indicated by paternity and normal sperm counts, was found in 18 out of 20 patients evaluated. This group included five untreated patients who were found to be fertile and to have normal plasma testosterone and gonadotropin but elevated androstenedione levels.


Impaired dopamine function and muscular rigidity induced by 6-aminonicotinamide in rats.

In corpus striatum, 6-aminonicotinamide (6-AN), 10 mg/kg i.p. lowered the concentration of dopamine and markedly reduced the disappearance of dopamine after synthesis inhibition with alpha-methyl-p-tyrosine. In the dopamine-rich part of the limbic system, the formation of DOPA after decarboxylase inhibition with 3-hydroxybenzylhydrazine was decreased. In diencephalon, 6-AN altered neither the steady-state level nor the utilization of noradrenaline. The data suggest that the muscular rigidity induced by 6-AN may be associated with disruption of dopaminergic transmission.


Mycoplasma pneumonia associated with acute glomerulonephritis.

An 11-year-old girl who presented with pneumonia, pleural effusion, hematuria, and red blood cell casts is described. Mycoplasma pneumoniae complement fixation titers were elevated. The pneumonia resolved following therapy with tetracycline. Light microscopy of renal biopsy tissue revealed an acute glomerulonephritis; immunofluorescent studies showed deposits of IgG, C3 and mycoplasma antigen along the glomerular capillary walls and in the mesangium; subendothelial and subepithelial deposits were seen by electron microscopy. This is the first report of acute glomerulonephritis associated with M. pneumoniae infection with evidence of mycoplasma-induced immune complex nephritis.


Bicaudate index in computerized tomography of Huntington disease and cerebral atrophy.

Ventricular sizes on computerized tomographic (CT) scans were compared in seven patients with Huntington disease, 20 patients with cerebral atrophy, and 20 normal controls. The bicaudate index--the ratio of the width of both lateral ventricles at the level of the heads of the caudate nuclei to the distance between the outer tables of the skull at the same level--significantly discriminated among the three groups. The bicaudate indices were: Huntington disease 0.209 +/- 0.007, cerebral atrophy 0.121 +/- 0.006, and controls 0.092 +/- 0.003.


Lactic acidosis associated with cerebellar vermal atrophy and cardiomyopathy.

The association of fluctuating neurological signs and congestive cardiomyopathy with chronic lactic acidosis is described in a 5 1/2 year-old-boy who ultimately succumbed to congestive heart failure.  The  autopsy findings included severe atrophy of the anterior cerebellar vermis and a hypertrophied heart with left sided endocardial fibroelastosis. Skeletal and cardial muscle calcification was prominent and probably due to the effect of intracellular metabolic alterations associated with lactic acidosis. A review of the literature shows that the combination of cardiomyopathy, isolated atrophy of cerebellar vermis and muscle fiber calcification have not been reported in association with idiopathic lactic acidosis previously.


Diagnosis and treatment of ocular rosacea.

Eighteen patients with ocular rosacea were treated with oral tetracycline which resulted in marked improvement in all patients. Approximately one half of the patients were able to taper and stop the medication without recurrence of symptoms. The remaining have tapered their medication but could not stop without recurrence of symptoms. The majority of the patients in the series had Staphylococcus aureus on their conjunctiva and lids before and after surgery.


Antibody formation to dog pulp tissue altered by Kerr (Rickert's) sealer via the root canal.

Pulp tissue from three experimental dogs was tested for its antigenicity before and after incubation with Kerr (Rickert's) sealer (KS). Reactions to Arthus skin tests showed an increased response to pulp that had been incubated in KS, washed, and then injected, as compared with the material alone. Hemagglutinating antibody titers (1/360--1/600) were obtained from pulp tissue altered by KS. Inhibition tests showed the specificity of the antibody to be at a dilution of titer of 1:300. Therefore, a mixture of Kerr (Rickert's) sealer altered dog pulp tissue and rendered it antigenically active, and a specific humoral response was produced.


The role of increased Ca++ influx as a possible additional adaptive mechanism in experimental left ventricular hypertrophy (exp LVH).

Membrane potentials, isometric contraction and autohistoradiography with 45Ca in papillary muscle of rats with experimental LVH without cardiac failure as compared with sham-operated animals proved an increased Ca influx per beat and a Ca accumulation at or near the sarcolemma. This phenomenon is regarded as an additional mechanism for the improvement of the cardiac performance in the compensatory stage of the experimental LVH without cardiac failure.


Molecular basis for measurement of circulating fibrinogen derivatives.

Fibrinogen plays a pivotal role in both the humoral and cellular mechanisms involved in hemostasis. In performing its hemostatic function, fibrinogen in turn is acted on by several independent enzyme systems that either modify its structure or cleave specific fragments of the molecule into the surrounding milieu. Measurements of enzymatically modified fibrinogen or its proteolysis products represent a means whereby the action of these specific enzymes can be quantitated both in vitro and in vivo. Advances in such techniques as protein purification, affinity chromatography, peptide synthesis, and radioimmunoassay technology permit the translation of recently acquired primary structural data on this important protein into sensitive and specific assays for its circulating derivatives. These assay systems are important tools for probing mechanisms of hemostasis and thrombosis.


Functional differences of ouabain and ethacrynic acid on renal potassium metabolism in dogs.

Current concepts provide inadequate explanations for the effects of ethacrynic acid (ECA) and ouabain (OUA) on renal potassium metabolism because neither the site of action, nor the tubular effects have been agrreed upon. In the present study on anaesthetized dogs, in vivo inhibitory effects of ECA on mitochondria or Na-K-ATPase were excluded. Firstly, ECA hardly reduced outer medullary metabolic rates in kidneys exposed to OUA  and 2,4-dinitrophenol. Secondly, whereas OUA reduced renal Na-KATPase activity by 78% and induced parenchymal potassium release into the renal vein, none of these effects were observed during injection of ECA. During free flow, sodium reabsorption was equally reduced by the two drugs, but fractional potassium excretion was 0.54 +/-0.04 after OUA and 0.99 +/-0.02 after ECA. OUA alone or combined with ECA inhibited almost all ion transport in the distal 60% of the tubular volume as revealed by stop-flow. During ECA alone, chloride reabsorption was reduced more than sodium reabsorption because sodium was exchanged for potassium. ECA and SO4(2-) infusion produced similar stop-flow patterns. Thus, OUA is bound to Na-K-ATPases functionally located to the peritubular cell membrane. ECA promotes potassium secretion probably by inhibiting cellular anion entry at the luminal membrane.


A comparative study of five groups of handicapped children in vocational rehabilitation.

This study explored the vocational and educational plans, work values, realism, initiative commitment to choice, and awareness of occupational information of five groups of handicapped children compared with a group of normal children in grades 6--12. Handicapped children tested significantly lower on all measures of vocational development. Only the cystic fibrosis group approached the high scores of the normal group. Age, grade, and social class were the best predictors of vocational development in all six groups. The findings confirmed the hypothesis that handicapped children are less prepared for vocational training and placement and consequently require special rehabilitation programs to prepare them for work.


Synthetic arterial grafts. III. The outcome in 22 patients with synthetic axillofemoral bypass grafts.

During the 4-year period 1973--76, 22 patients were operated upon with axillofemoral bypass grafts at the Department of Surgery in Lund. They were high-risk patients with severe ischaemia of the leg or previous graft infections. Fourteen of the 22 grafts were well-functioning after the longest observation time  of 32 months. The operative procedure is described and postoperative compliations are reviewed. The axillofemoral bypass reconstruction is recommended as an alternative for this category of patients in whom the conventional aortic bifurcation graft is unsuitable.


[Broncholytic therapy--beta 2 stimulation and vagolysis from an animal experimental viewpoint].

Continuous recordings of heart rate, respiration rate, minute volume and bronchial resistance were made over a period of altogether 3 h in spontaneously breathing dogs anesthetized with chloralose. At hourly intervals, before and 1 and 2 h after the administration of bronchodilators, bronchial spasm was induced by inhalation of an acetylcholine solution. Terbutaline, a beta-stimulant, was administered by inhalation in doses of 0.5, 0.16 and 0.05 mg/kg. For comparison, an atropine derivative, ipratrapium bromide, was given in doses of 0.04 and 0.01 mg/kg. Controls received normal saline. Terbutaline caused an increase in heart rate, respiration rate and minute volume. Acetylcholine-induced bronchial spasm was inhibited to the extent of 10-70% for 2 h after the administration of terbutaline. The acetylcholine antagonist ipratropium bromide caused only transient changes in heart rate, respiration rate and minute volume. Acetylcholine-induced bronchial spasm was inhibited by 95% and 80% for 2 h after doses of 0.04 and 0.01 mg/kg respectively. Terbutaline had a slight stimulant effect; ipratropium bromide displayed no stimulant activity.


Angiotensin regulates release and synthesis of serotonin in brain.

Angiotensin II released serotonin from neuron terminals and accelerated synthesis of the serotonin. This increase in synthesis depended on the activation of tryptophan hydroxylase. A biphasic effect was observed: at high doses the stimulatory effect depended on conversion of angiotensin II to angiotensin III. At low doses an inhibitory effect was found, possible dependent on an angiotensin II metabolite. These actions represent a subtle regulation of the open-loop serotonin system.


Operative correction of obstructed subclavian or innominate arteries.

We have performed 82 operations on 79 individuals with occlusive disease of the subclavian or innominate arteries during the past 16 years. The left subclavian was occluded in 63, the right in nine, and the innominate in seven. Presenting symptomatology was neurologic in 29, arm ischemia in 24, and combined in 23. Blood pressure was reduced by 30 mm Hg on the involved side in all. An extrathoracic approach was used in 67 and a transthoracic approach in 15. Early mortality (20%) and morbidity (20%) were associated with the transthoracic approach. Long subcutaneous axilloaxillary and axillocarotid grafts are prone to thrombosis and skin erosion. Carotid-subclavian grafts used in 57 remain patent, are associated with a low mortality (1.5%), and do not develop "carotid steal." When associated with vascular insufficiency of the lower extremity (44%) the brachiocephalic lesion should be corrected first.


Repeat surgery after disc excision.

Sixty patients requiring repeat surgery after lumbar disc excision are reviewed. Thirty-one had had their initial surgery performed by the authors and represent a 5.9% frequency of repeat surgery after initial laminectomy for sciatica. Of the 60 patients, 49 suffered recurrent radicular pain, 20 suffered from back pain, and 8 had other problems (infection, extradural cysts, etc.). In patients with recurrent sciatica, perineural fibrosis and recurrent herniation were the most common problems; those patients with the latter pathologic condition responded most favorably to repeat surgery. Of 520 patients who had undergone disc excision, only 9 required secondary fusion.


Pelvic displacement of a cardiac pacemaker following trauma. A case report.

The rate migration of an implanted cardiac pacemaker from the subrectus area anterior to the peritoneum to the pelvis following a motor vehicle accident is reported. Discovery of dislodgement was made by observing a marked increase of pacemaker impulse amplitude in the three standard limb leads as measured on an oscilloscope.


Ineligible spouses of SSI beneficiaries, December 1976.

A study based on program records showd that about 200,000 persons receiving supplemental security income (SSI) payments in December 1976 were living with a spouse who was not eligible for payments. In most cases, the beneficiaries were disabled and the spouses were too young to be eligible. Some spouses were receiving help indirectly from the program through the essential-person increment, State supplementary payments, or the deeming-of-income provision. Fewer than half the spouses had income of their own, however, and even when the income of both partners was combined, 55,000 households had no income other than the SSI payment. A sizable number of families included dependent children and thus may have been eligible for aid to families with dependent children.


Principles and hazards of electrosurgery including laparoscopy.

The understanding of the basic principles governing current flow through the body is necessary for the safe application of electrosurgical technique. They also may provide a guide to the design of laboratory studies which are needed to understand completely the ubiquitous nature of radiofrequency current distribution in surgical procedures.


Failure of Dacron prostheses caused by structural defect.

Intrinsic prosthetic failure is quite uncommon since the advent of Dacron prostheses. Only 24 cases of arterial prosthetic failure have been described in the literature. Our experience consists of two additional failures of knitted Dacron prostheses. The first patient developed aortojejunal fistula due to a defect of the aortic prosthesis 6 years after resection and replacement of an abdominal aortic aneurysm. The analysis of the graft revealed a defect in the form of a dropped stitch, which caused a weak spot where the prosthesis was able to be torn apart longitudinally. The second patient had femoropopliteal bypass and 6 years later developed degeneration with aneurysmal formation of the entire length of the prosthesis. Optical microscopy of this prosthesis exhibited mostly transverse failures which were coincident with valleys of the corrugated prosthesis. This was indicative of a defect that rendered the corrugation root too weak to withstand normal arterial pressures. This presentation emphasizes the seldom and serious complication of prosthetic failure due to defect of the prosthetic material. Details of scanning electron microscopy of the prosthesis, clinical presentation, angiography, and pathological findings with treatment also are discussed.


Optimal methods of aortoiliac reconstruction.

Alternate methods of aortic reconstruction for aortoiliac occlusive disease were reviewed in one author's (R.C.D.) personal series of 582 patients (1,105 limbs) during the 15 year period from 1963 to 1977. To illustrate certain trends, separate analysis was done for periods 1963 to 1969 (interval I) and 1970 to 1977 (interval II). During the earlier period, endarterectomy was performed in 72% of patients, with unilateral operations carried out in 15% of patients. Operative mortality was 5.1% and early failure occurred in 4% of patients. In contrast, in interval II graft procedures were done in 89% of patients, with mortality of only 2% and early failure in less than 1% of patients. Unilateral procedures were utilized infrequently (4%). Our analysis suggests that aortoiliac endarterectomy is still the procedure of choice for a small group (approximately 10%) with localized disease. For more extensive disease, aortofemoral grafts appear to be the procedure of choice. Patency of such grafts in the most recent interval was 91% at 5 years. Superior long-term function of aortofemoral grafts appears to be associated with use of a knitted Dacron prosthesis, end-to-end proximal anastomosis, and distal anastomosis which ensures patency of the profunda femoris outflow. The incidence of infection (0.3%) and false aneurysm formation (1.4%) was extremely low. In view of the low mortality rate and superior long-term success of direct reconstructions, extraterritorial grafts are felt to be rarely indicated.


Injuries to the visceral arteries.

Injuries of the major visceral arteries are among the more difficult to manage and rarely occur without serious associated injuries. Sixty-six patients are presented with injuries to the celiac, superior, and inferior mesenteric arteries. Fifty-three injuries resulted from gunshot wounds, nine from stab wounds, and four from blunt trauma. Operative management included vessel ligation in 11 patients, arteriorrhaphy in 43, resection and end-to-end anastomosis in six, Dacron graft interposition in four, and aortic reimplantation in two. Twenty-three patients died, 16 from failure to control hemorrhage. In two patients failure to restore adequate visceral circulation resulted in bowel ischemia and infarction. The successful management of patients with visceral arterial injuries is dependent upon rapid and adequate exposure followed by primary repair or revascularization utilizing available surgical techniques.


The effect of hypervitaminosis A on rat palatal development.

Retinoic acid or retinyl acetate was administered to pregnant rats in doses sufficient to induce a 90% incidence of cleft palate. In another study, a delay in the reorientation of the palatal shelves was observed to be longer with the more potent teratogen, retinoic acid. On day 16 of gestation, 24 hours after final dosage with vitamin A, the synthesis of DNA and protein was studied in fetal carcass, mandible, and palate, and that of sulfated mucopolysaccharides (S-MPS) and glycoproteins (GP) in fetal head, mandible, and palate. Increases in DNA synthesis in fetal palate and in GP synthesis in fetal palate were found; thus, the mechanism of action of vitamin A in inducing cleft palates in rats may be caused by interference with the normal biochemical synthetic pattern of the palatal shelves.


In vitro disruption of ATP dependent active transport following treatment with aldrin and its epoxy analog dieldrin in a fresh water teleost, Labeo rohita.

Tissue homogenates of brain, gill, liver and kidney of Labeo rohita were subjected in vitro to the various concentrations as 5.00, 1.66, 0.55, 0.18 and 0.06 mu M of 2 organochlorine pesticides aldrin and dieldrin and the disruption of ATP dependent active transport (involving ATPase) was studied. The inhibition of total ATPase, Mg2+ and Na+, K+-dependent ATPase by both the pesticides was quite similar and there was an increased inhibition with increased concentration of the toxicant, however, at the lowest concentrations of both the pesticides stimulation was observed in all tissues except gill Mg2+ ATPase where insignificant inhibition was observed after dieldrin treatment.  Inhibition of ATPase system was noted maximum in brain followed by gill, kidney and liver of the experimental fish, however in each tissue maximum inhibition of ATPase was noted after dieldrin treatment than that of th e aldrin treatment. Therefore, the observed action of these pesticides might be related to the ability of the compounds to alter the cellular membrane configuration by binding with the lipid portion of the membrane and this blocking the movement of substances  by active transport.


Canine testicular 17beta-hydroxysteroid oxidoreductase activity. I. Substrate specificity.

The substrate specificity of 17beta-hydroxysteroid oxidoreductase (17beta-HOR) activity was investigated in microsomal preparations of canine testes. Enzyme activity was measured by quantitating the conversion of radioactive substrates to products. The apparent Michaelis constants were determined to be 1.3 x 10(-6)M for androstenendione, 3--10 x 10(-6)M for dehydroepiandrosterone and 25 x 10(-6)M for estrone. These data are similar to those reported for human testicular 17beta-HOR activity and suggest that the canine activity may serve as an animal model for the study of testicular 17beta-HOR.


Testicular steroidogenesis in the baboon Papio anubis.

We recently reported that the baboon testis converts pregnenolone to testosterone through the delta-4 pathway. The present studies were to determine the metabolism of intermediates of the delta-4 and delta-5 pathway by the baboon testis. Fragments (50 mg) were incubated for 3 hr with 10 muCi of the following tritium-labelled substrates: pregnenolone, progesterone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone, androstenedione, or testosterone. Pregnenolone was converted to testosterone primarily through the delta-4 pathway, with accumulation of progesterone, 17-hydroxyprogesterone and 20alpha-dihydroprogesterone as predominant intermediates. Similar results were obtained in progesterone incubations. 17-hydroxyprogesterone was not efficiently metabolized by the fragments, while 17-hydroxypregnenolone and dehydroepiandrosterone were efficiently converted into testosterone and androstenedione. Androstenedione was metabolized primarily to testosterone, while testosterone was not a suitable substrate. Some 5alpha-androstanediol was identified in each incubate. These results suggest that although testosterone is formed from pregnenolone through the delta-4 pathway, the delta-5 intermediates are more suitable substrates for testosterone synthesis in the baboon testis.


Thromboresistance of pyrolytic carbon grafts.

This study reports in vivo testing of ULTI carbon coated dacron grafts in the dog's 4 mm carotid artery, and showed 97.5% patency at 21 days in 40 grafts compared to 33% in 6 control grafts. Physical properties of the dacron substrates were not altered after ULTI carbon deposition. The carbon coated grafts must be carefully cleaned and maintained in that condition. This initial study with the modified pyrolytic carbon adds a new dimension to vascular prosthetics and artificial organ development.


Stereological analysis of Reinke's crystals in human Leydig cells.

Reinke's crystals in human Leydig cells were analyzed stereologically to assess their functional role. Testicular tissues were taken from seven older men (57--82 years old) with prostatic carcinoma and also from seven younger men (26--38 y.o.) complaining of male infertility. Sections 0.5 micrometer thick, stained with toluidine blue or Heidenhein's iron-hematoxylin were examined by a point-counting method and with a Particle Measurement Computor System (IIMC). When the patients were grouped by age, the mean crystal volume, the number of crystals per cell, the volume of crystals per cell and the volume ratio of crystals to cell were significantly larger in the older age group than in the younger age group. In particular, the latter three variables correlated well with the age of subjects, with correlation coefficients of r = 0.66--0.85. On the other hand, none of these variables had any correlation with the concentration of plasma testosterone. These results indicate that Reinke's crystals can be considered as degenerative products in cell life but not as facultative constituents for testosterone production.


Formation of an atypical collagen and cartilage pattern in limb bud cultures by highly sulfated GAG.

Addition of 1 mg/ml or higher doses of the highly sulfated pentosanpolysulfoester SP54 or the mucopolysaccharidepolysulfoester Arteparon to limb bud cultures from 11-day-old mouse embryos caused a marked reduction in the growth of the distal parts of the cartilage anlagen. The most striking effect, however, was the change in the collagen structure of the cartilaginous intercellular substance. After more than 0.05 mg/ml SP54 or Arteparon no collagen filaments were seen but collagen aggregates with an altered cross-striation occurred. They were produced by an antiparallel arrangement of collagen molecules caused by the highly sulfated substances. By immunofluorescence microscopy it was shown that SP54 and Arteparon did not influence the distribution of the collagen types but only affected the aggregation of collagen type II. From the morphological point of view the production of endogenous PG seemed to be uneffected by SP54 and Arteparon. The effect of SP54 and Arteparon was reversible. After removal of these substances characteristic collagen filaments re-formed. The collagen aggregates were decomposed extracellularly or phagocytosed by chondroblasts and decomposed intracellularly.


[Cerebellar astrocytoma and optic glioma--a comparative ultrastructural study (author's transl)].

An ultrastructural comparison of 8 cerebellar astrocytomas and 4 optic gliomas shows that the morphological patterns of both tumor-groups are identical. The confusion in nomenclature of these tumors is discussed and reasons for a preference for the term "pilocytic astrocytomas" are given. Further, pilocytic astrocytes seem to be a special, phylogenetically older, group of glial cells.


[Effect of protein deficiency on the nucleotide content and ATPase activity in rat tissues].

Exclusion for ration of protein for 21 days leads to a rise in the ATP-ase activity, stimulated by ions both of Ca and Mg. Concurrently, a fall of the protein content in the study organs, particularly in the liver, is noted. Exclusion of protein from the diet resulted in substantial changes in the content of the adenyl system. The proportion of ATP declined in all of the investigated organs, parallel with a rising ADP concentration. The AMP increases both in the liver and heart.


[In vitro testing of human lymphocytes (author's transl)].

The use of surface markers for the characterization of various lymphocyte subpopulation today belongs to the standard techniques of immunological laboratories. Recently, functional in vitro testing of human lymphocytes has met with increasing interest. In this paper some of the relevant in vitro test systems such as the lymphocyte stimulation test, the determination of the B cell differentiation capacity in vitro and the demonstration of suppressor cell activity are discussed. Apart from a discussion of the results obtained by these techniques in normal, healthy individuals, the applicability of these techniques for studies in patients is dealt with.


Altered activity of hepatic mixed-function mono-oxygenase enzymes in streptozotocin-induced diabetic rats.

1. In streptozotocin-induced diabetic male rats, hepatic microsomal aminopyrine N-demethylase activity was depressed, whereas aniline hydroxylase activity and cytochrome P-450 content were increased over control values. 2. In diabetic female rats, hepatic microsomal aminopyrine N-demethylase activity, aniline hydroxylase activity, biphenyl 4-hydroxylase activity, and cytochrome P-450 content were increased over control values. 3. Insulin treatment of diabetic male and female rats antagonized all physical and biochemical abnormalities of the diabetic state; 4. Methyl analogues of streptozotocin did not produce a diabetic state when injected into female rats, and resulted in no changes in aminopyrine N-demethylase activity, aniline hydroxylase activity, or cytochrome P-450 content. 5. Insulin treatment of non-diabetic female rats resulted in slight decreases in aminopyrine N-demethylase and aniline hydroxylase activities, but no changes in cytochrome P-450 content. These observations suggest that insulin primarily influences drug metabolism of diabetic animals through correction of the insulin-deficient diabetic state.


[Experiences with the contrast medium metrizamid in lumbar and thoracolumbar myelographies (author's transl)].

At the orthopaedic clinic in Ratingen we investigated between November 1976 and May 1977 60 patients who were suffering from low back pain by means of myelography in order to verify the type of pathology. As contrast medium we used Metrizamid. All X-rays showed a clear outline of the spinal canal and the roof sheat. In 39 cases out of 60 a prolapsed disk was found. In 9 cases the result was uncertain and the rest was negative. Operation was carried out on 42 patients and the findings in 37 cases were conclusive. No severe side effects were found which were due to the contrast medium.


[Results of the Hak-Hagir bladder replacement].

After conservation of the n. intercostalis XII and the epigastric artery and vein the distal parts of the m. rectus abdominis by their favourable position offer themselves as an ideal substitute material for the urinary bladder, as it is to be established from two-year experimental results and from one operation carried out on man.


[Clinical and bacteriological studies with metronidazol in endodontic therapy (author's transl)].

Metronidazol was employed in the endodontic treatment of 200 gangrenous teeth, with symptoms of acute and chronic periodontitis. In 50 cases aerobic and anaerobic microbiological cultivations have been performed. The number of the necessary treatments was less, symptoms of irritation in the periapical region could not be observed. The favourable clinical and microbiological results in the course of the Metronidazol treatment point to the role of the anaerobic microorganisms in connection with the inflammatory symptoms of the gangrenous pulp.


[Evaluation of the clinical effectiveness of paradentosis therapy (author's transl)].

The x2 test of goodness of fit was used to assess the correlation between empirically determined distributions of a number of characteristics used in parodontology and the model of normal distribution. There was found a more or less pronounced asymmetry in the statistical distributions of some clinical and biochemical tests. It is recommended to use 10g X or square root of x in order to achieve approximation to the normal distribution. Inaccuracies in interpretation of clinical data due to neglect of variations from normal distribution are pointed out.


[Objectification of gingival blood-supply disorders by photoelectric plethysmography (author's transl)].

The measuring method described in this paper is used to photoelectrically detect the volume pulsation of the gingival border. The method, which is remarkable for its ease of application, enables both the original pulse and its first differential derivation to be recorded reliably. Evaluation of the pulse cure is by the time of inclination and by the recently introduced "plateau index". Results of studies conducted by Kötzschke et al. show that the plateau index allows to clearly distinguish between normal subjects and parodontopathy patients including those where the disease is in its early stage. This measuring method may be used for objectifying therapeutical measures. Using the "nitroglycerin test", it was possible to show that parodontopathies are very frequently accompanied by functional blood-supply disorders.


[Ultrastructure and clinicopathology of pleomorphic adenomas of the salivary gland. I. Methods and results].

The observations are a ultrastructural analysis of pleomorphic adenomas with one's own 14 cases. Pleomorphic adenoma is chief representative of the secretory tumour complex of salivary glands. Ultrastructure of three dominate secretory tumor cells and three nonsecretory celltypes are descripted. Ultramicroscopical differentiation of stroma elements an their transformations, henceforth regressive of tumour cells in the pleomorphic adenoma are discussed. The author give instructions for electromicroscopic diagnostic of this adenomas. Lastly there is tried to determine the "dignity" of pleomorphic adenomas by their ultrastructure for purpose of a adequate therapy.


[Masked depression as observed by the dentist (author's transl)].

The clinical picture of masked depression is occasionally concealed by atypical symptoms of pain. Successful treatment is possible through stepwise and specific use of thymoleptic agents and tranquilizers.


[Possibilities of adhesive restoration using the Evicrol composite filling material (author's transl)].

The Evicrol composite filling material made by Spofa-Dental of Prague, which has been used for one and a half years now, is a valuable addition to the range of filling materials. Its principal indication is for Black classes III, IV and V. The material also proved itself extremely useful for milk tooth filling as well as for the treatment of fractures in the enamel and dentin regions. Compared to cast fillings in the region of the front teeth, an esthetically far more favorable result may be obtained. However, the success of treatment will always be dependent upon careful processing of the material as well as on observation of the suggestions or pointers as to the proper treatment of teeth.


[Methods of assessing the toxic properties of polymeric filling materials (author's transl)].

This paper discusses the results of experiments conducted with a view to determining the hidden effects of epoxy composites, which cannot generally be ascertained through the use of various toxicological, biochemical, immunological, allergic, morphological, and cytological methods of examination. To discover possible hidden effects of epoxy filling materials experimental use was made of the following methods: hunger diet, ethylalcohol supply, and composite extract supply. Shifts in functions of the organism were evaluated by the following criteria: weight dynamics of animals, histamine content of the blood, and eosinopenic reaction of the blood. The data obtained by the authors shows that it is possible for functional straining to be used as a method of discovering possible hidden harmful effects of dental polymers.


[Investigation on the correlation of pregnancy, caries and gingivitis (author's transl)].

Authors report the results of the examinations of the teeth, gingiva and oral hygiene conditions of 1130 pregnant women. The caries frequency has been 99,38%, the gingivitis frequency 89,2%. Evaluating the results, the caries intensity has been found to increase with age, and women who delivered one or two times have a higher rate than those who had no child. The irreversibel serious damage of the periodontium is relatively rare. The gingivitis frequency and intensity increases with age, parallel with this the oral hygiene is worse. The gingivitis intensity has the highest values in the third month of the first-, and in the eight month of the second period. The caries intensity increases parallel with the gingivitis intensity.


[The orthognathor--a modification to the accompanying orthodontic treatment of subjects of scoliosis (author's transl)].

The author, after stating precisely the meaning of the term scoliosis and describing its therapy, shows the relation between its and dentural lesions as well as possible methods of preventing such alterations. The most suitable type of orthodontic device to be used in this connection is still a matter for discussion. However, the device described in this paper may be considered a further step in the direction of arriving at an optimum therapy.


[Glossal alterations in old people (author's transl)].

The effects of aging on various syndromes of the tongue are discussed by reference to the results of a cross-sectional study of 1002 persons aged 13 to 97, with due consideration being given to data reported in the literature. A significant increase in the frequency of 1. pilosa, wrinkling of the tongue, papillary atrophy, sublingual venectasia, and an increase in the volume of the tongue were observed with advancing age.


[Clinical signs and therapy of the abdominal aortic aneurysm (author's transl)].

The abdominal, infrarenal aneurysm of the aorta shows a very unfavorable spontaneous outcome. Therefore, every patient should be operated on without delay. The surgical procedure consists of a partial resection of the aneurysm and the reconstruction of the vascular flow by means of a synthetic prosthesis. The most dangerous complication of the aneurysm is its rupture. Emergency surgery of a ruptured aneurysm is accompanied by essentially higher risks: The mortality rate lies between 34 and 90%. The prognosis of the operation varies with the patient's age, coronary sclerosis, and renal insufficiency. The diagnosis of the aneurysm can clearly be made with sonography, angiography, and computer tomography. In the case of a ruptured aneurysm, clinical signs are of primary importance. Angiography is not indicated here. From May 1969 until November 1976, 41 patients were operated on in our clinic: 23 electively and 18 after rupture. The mortality rate of the elective cases amounted to 17% and that of the ruptured to 72%.


[Diagnosis and therapy of acute adnexitis using laparoscopy].

In cases of acute adnexitis laparoscopy is an excellent diagnostic method. By this way we found in 182 patients with clinical symptoms only 50,5% acute inflammatory diseases of adnexa. On the other hand there was a normal genital status in 18,1%, acute appendicitis in 9,9%, ectopic pregnancy in 7,7% etc. Clinical examinations and second-look-laparoscopy 6--8 weeks after ending the treatment cases of salpingitis alone showed the best results. Patients with more extensive inflammatory reactions had more adhesions too. An early diagnosis and treatment under hospital conditions is recommended. We have good experiences with immediately operation in cases of suppurative inflammation of the adnexa, which are only diagnosticate by laparoscopy.


[Use of a balloon catheter for sealing of the cervix in hydropertubation].

It is suggested to use a thin balloon catheter in hydropertubation. The advantages of this method are discussed.


[Clinico-genalogic characteristics of hereditary diseases of the nervous system in the Kuibyshev region].

The report contains data of a clinico-genealogical analysis of 450 observations of hereditary diseases of the nervous system, and the prevalence rates of neurohereditary diseases in the Kuibyshev region. The authors stress the significance of the founder effect as a factor lying at the basis of a concentration of autosome-dominant forms in some of the areas of the region. The role of increased inbreeding in the enlargement of the amount of autosome-recessive forms is being confirmed. The results of the study denote that in the population of the studied region the group of nervous-muscular hereditary diseases is most frequent. The main neurohereditary diseases are being clinically defined with an indication of the type of hereditary transmission. The authors underline the significant clinical intra- and inter-familial polymorphism of such diseases as the Charcot-Marie-Tooth neuronal amyotrophy, scapulohumeral-facial myopathy of Landusi-Dejenrinne, primary pelvic-humeral progressive muscular dystrophy, autosoma-dominant myatrophic ataxia, myotonic dystrophy. The authors indicate the necessity of a screening of patients with hereditary diseases of the nervous system.


Immunodeficiency in Down's syndrome. Titres of "natural" antibodies to E. coli and rabbit erythrocytes at different ages.

"Natural" antibody titres to E. coli O antigens of different serotypes and to rabbit red blood cells were determined in 86 subjects with Down's syndrome and 79 mentally retarded but chromosomally normal controls ranging in age from 10 months to 52 years. Subjects in the two groups were matched for sex, age and socio-environmental conditions. Titres of both antibodies, assessed by haemagglutination, were significantly lower in subjects with DS in the 1 to 5 year old group. E. coli antibodies transiently increased to normal values in subjects with DS during the second 5 years of life, thereafter rapidly declining to levels significantly lower than those observed in controls. The titres of antibodies to rabbit erythrocytes in subjects with Down's syndrome showed a more variable course transiently approaching normal values in the 7-10 year group and after 20 years of age. These data are interpreted as further evidence for the existence of a congenital immunodeficiency in Down's syndrome.


Enzyme histochemical and electron microscopic study of a virilizing adrenocortical adenoma.

Enzyme histochemical and ultrastructural studies of a "dexamethasone-suppressed" virilizing adrenocortical adenoma and the attached cortex revealed that tumor cells showed little activities of some lysosomal enzymes and scarcity of lipofuscins and dense bodies of lysosomal type, forming a marked contrast to the cells of zona reticularis and the virilizing adenomas previously reported. The other findings of tumor cells, such as a pattern of activities of dehydrogenases including 3beta-hydroxysteroid dehydrogenase and the morphology of mitochondria, were those of reticularis cells. The findings showed that scantiness of lipofuscins did not rule out the possibility of adenoma producing adrenal androgen, dehydroepiandrosterone. Most of the tumor cells as well as reticularis cells were positive for alkaline phosphatase, the activity of which was interpreted as the effect of ACTH stimulation.


The reaction of the vascular pattern of the hypertrophied myocardium to increased cardiac volume load. A microangiographical study.

Myocardial stereo-microangiography was performed on 30 rats after swimming exercise for one or two periods with and without a previous operation for production of aortic stenosis. In 8 rats with aortic stenosis no swimming exercise followed, and 10 more rats served as normal controls. Swimming exercise resulted in a higher degree of cardiac hypertrophy than aortic stenosis. Both types of cardiac hypertrophy resulted in vascular adaptive reactions in the myocardium. The adaptive reaction to swimming exercise was found to be persistent, at least to some extent, and to be of use if the exercise was resumed. The adaptive alterations in aortic stenosis were further modified by a superimposed period of exercise, although the nutritive capillary vasculature only showed a slight and focal increase in density.


Protein A reactivity of whole rabbit IgG and of fragments of rabbit IgG.

Approximately 15 per cent of the total IgG in normal rabbit serum reacted with protein A. When this protein reactive IgG fraction was treated with acid at pH 2.7 and then digested with plasmin, thus splitting the rabbit IgG between the CH2 and CH3 domains, both the isolated Facb and the pFc' fragments were protein A non-reactive. This results indicates that at least one intact Fc chain is necessary to fulfil the protein A-fc interaction. Traces of protein A reactive rabbit F(ab')2 fragments isolated from normal IgG were also found. These fragments mixed with normal rabbit IgG precipitated protein A.


Blood velocity in human arteries measured by a bidirectional ultrasonic doppler flowmeter.

Blood velocities in 12 arteries were recorded by an ultrasonic doppler flowmeter in 11 young adults. Two major types of velocity patterns existed at rest. In certain arteries (the common carotid, the external carotid, the superficial temporal and the proper palmar digital arteries) flow was towards the periphery throughout the entire pulse cycle. Other arteries (the common femoral, the popliteal, the posterior tibial and the pedal artery) exhibited retrograde flow in part of the pulse cycle. In each individual a spontaneous variation between these two velocity patterns was observed in the subclavian, the axillary, the brachial and the radial artery. The velocity pattern of each artery is described, and absolute blood velocities at recognizable instances during the pulse cycle are given. The influence of peripheral resistance on the velocity pattern was investigated by reactive hyperaemia of the femoral artery. We find that not only is there an upward displacement of the resting femoral curve relative to the line of zero, but the shape of the velocity pattern is also changed. Our conclusion is that peripheral resistance is of major importance not only for the mean velocity, but also for the shape of the velocity pattern in the artery.


Isometric and dynamic endurance as a function of age and skeletal muscle characteristics.

The aim of the study was to investigate the influence of age on endurance of human skeletal muscle. An attempt was made to correlate muscular performance at various ages with some morphological and enzymatic characteristics of the muscle. Fifty healthy men, 22-65 years of age, with low daily physical activity (clerks) volunteered for the study. Isometric and dynamic endurance were determined under standardized conditions and measured in relation to maximum strength, thereby correcting for individual as well as age differences in maximum strength. Biopsies taken from the quadriceps muscle were used for muscle fibre classification, fibre area determinations, and measurements of some enzyme activities (Mg2+ stimulated ATPase, myokinase (MK), lactate dehydrogenase (LDH),LDH isozymes). Maximum isometric and dynamic strength decreased in the older groups while no significant change was seen in isometric or dynamic endurance. Significant correlations were observed between endurance and fibre type distribution, fibre areas, and LDH isozyme activities.


Deviation of the descending aorta associated with enlarged left atrium.

The deviation to the left of the descending aorta associated with enlarged left atrium was analysed in 96 patients with mitral disease confirmed by angiography and cardiac catheterization. The opinion that this finding may be of value in patients below the age of 50 years was supported. In older age groups it is easily confused with the physiologic unfolding of the aorta, when this occurs  at the level of the left atrium.


Protease inhibitors reduce the reverse passive Arthus reaction.

Trasylol, ovomucoid, tranexamic acid and soybean inhibitor decrease the vascular permeability as measured by extravasation of 131I-albumin when injected with the antibody at induction of a reverse passive Arthus reaction in the rat skin. Trasylol given systemically also had a suppressive effect, similar to phenylbutazone. When the reaction was induced in the pleural cavity, both Trasylol and tranexamic acid reduced the influx of leucocytes.


[Professional allergic diseases in CSSR (author's transl)].

The authors have watched more than 300 workers of various fodder manufactures in allergological, immunological and clinical way. The findings have been evaluated to the part of the exposition, hygiene and professional allergens. The symptoms of the latent sensitisation so as clinical symptoms after longer time of employment give evidence about a great importance and higher biological activity of the most fodders of modern farming and about new possibilities of the professional allergisation.


[Study of C3 and C4 complement components of synovial fluids in connective tissue diseases (author's transl)].

C3 and C4 levels and the relative concentration of C3 degradation products were measured in fifty pairs of synovial fluids and sera of patients who suffered from different connective tissue diseases. Inverse correlation between C4 level and C3 breakdown products were found in synovial fluids of different groups. Compared to the other groups of patients, the highest increase of C3 degradation was found in RA. patients and it occurred in the SF all of these patients. In arthrosis cases we failed to find any degradation of C3. Of the seven investigated ankylosing spondylitis only two showed some degree of activation of C3 in the SF. Our results suggest that the occurrence and degree of degradation of C3 complement component is a valuable laboratory parameter in the study of connective tissue diseases.


Stimulation of fetal spleen cells with lipopolysaccharides.

LPS proved to be good B-cell mitogen for fetal pig spleen cells and induced proliferation as well as differentiation of virgin resting small lymphocytes within 48 hours of cultivation. The LPS-activated lymphocytes and blast-like cells were more intensely labeled with anti-Ig antibodies than control cells, most probably due to an increased density of surface Ig. A lower percentage of LPS-activated cells was found to be labeled with F(ab)2 fragment of anti-L than with anti-L antibodies having an intact Fc fragment. The latter finding suggests non-specific binding of antisera to Fc receptors which appear to be activated on LPS-stimulated lymphoid cells.


[Investigations about the influence of immune complexes on in vitro migration of human neutrophilic blood granulocytes (author's transl)].

We studied the influence of cell-free culture supernatants of human blood mononuclear cells exposed to precipitated immune complexes on the migration of polymorphnuclear leukocytes. During the first phase of incubation supernatants from apparently unaffected control cultures were found to stimulate the spontaneous and chemotactic migration (migration enhancing factor, chemotactic factor). In the further course mononuclear cells spontaneously produced a migration inhibitory activity. The presence of immune complexes increased the production of the neutrophil migration inhibitory activity and of the chemotactic factor. Considering our recently published results the experiments confirm the concept that immune complexe act on granulocyte migration in two ways: they induce a release of mediators from neutrophils as well as from mononuclear cells. Our present investigations deal with the question what type of cells-monocytes or lymphocytes-is responsible for this effect.


[Professional asthma owing to Daphnia-allergy (author's transl)].

Two workers in a fish food store showed a professional asthma bronchiale against Daphnia. The diagnosis was proofed by typical anamnesis, scratch test, skin test and inhalative provocation test.


[Change in the content of T-and B-lymphocytes in experimental benzene poisoning (author's transl)].

Changes in T-and B-lymphocytes content in experimental benzene intotication (BI) of CBA-mice were studied. The content of spontaneously rosette-forming cells, B-lymphocytes with C3 -receptors and T-cells in macro-and microtest was determined. It was shown that BI resulted in disorders in the function of thymus, depression of T-cell system and autoimmune shifts. A number of characteristics in kinetics of various fractions of lymphoid cells due perhaps, to different sensitivity of particular types of lymphoid cells to benzene and compensatory response as well. The significance of described phenomena is discussed.