Blood B and T lymphocytes and in vitro cellular immune reactivity in untreated human malignant lymphomas and other malignant tumors.

Peripheral blood lymphocytes and their in vitro reactivity have been recorded prior to treatment in 18 patients with Hodgkins disease, 11 with lymposarcoma, 13 with reticulosarcoma, 20 with various solid tumors and 37 normal control persons. The mean total numbers of lymphocytes, those of T lymphocytes,and the mean reactivity to PHA and ConA were reduced in all groups except lymphosarcoma, although with varying degrees of statistical significance. The percentages of T and B lymphocytes appeared to be normal in all groups, but the ranges of values were somewhat greater than among the normal controls. The mean total numbers of B lymphocytes were normal in all patient groups. All reductions seemed to be more pronounced in patients with disseminated than in those with localized disease, but none of these differences was statistically significant. All patient groups appeared to have reduced reactivity in MLC, while the ability to stimulate control lymphocytes was nearly normal. The results fail to indicate an in vitro immunological abberation specific to Hodgkin's disease. It seems that human malignant, neoplastic diseases are associated with a relatively selective reduction of the total numbers and reactivity of blood T lymphocytes. Various explanations of the reactivity impairment are proposed. The pathogenesis of the reduction of the total number of blood T lymphocytes remains obscure.


[Distribution of capsular serotypes in Klebsieela strains of enteral origin].

The significant proportion of microorganisms belonging to the Klebsiella genus among the causative agents isolated and subdifferentiation of the genus for epidemiological survey of infantile Klebsiella infections are dealt with in the present paper. The 28 Klebsiella strains isolated from cases of enteritis confirms the enteral tropism of these enterobacteria, especially among the infantile population. A proportion of 13.3% strains were identified in pure cultures obtained from feces and were considered as certainly enteropathogenic. The biochemical behaviour of the strains studied pointed to the ubiquity of the aerogenes biotype (76.9%) followed by the pneumoniae biotype (12.4%) and indol-positive Klebsiella strains (10.7%). Of the total 308 Klebsiella strains typed serologically with 80 OK capsular sera, 284 (92.2%) were listed in 63 serotypes, 13 of which (K7, K35, K47, K9, 530, K16, K1, K11, K18, K20, K37, K80, K i.e. 47.5%) were frequently identified in acute infantile cases of enterocolitis syndrome. Most of these serotypes are also considered endemo-epidemic by authors. Worthy of note among the Klebsiella types isolated in pure cultures from cases of infantile enteritis, was the prevalence of the aerogenes biotype, with a higher incidence of K1, K2, K16, K26, K44 serotypes, and of the indol-positive strains, with serotypes K13, K16, K65, K80.


Repair of incisional hernias and defects in the anterior abdominal wall using dermal grafts. Case report.

The technique and results of using autografts of dermis to repair defects in the anterior abdominal wall is shown. Dermal grafting was used in altogether 15 cases. 7 with extremely large incisional hernias, and 8 with defects after malignant abdominal wall tumours. The surgical method is described and the follow-up 1 to 4 years postoperatively has shown a very satisfactory result in 13 cases. In one case there was a postoperative haematoma with subsequent graft necrosis and in the other there was a residual hernial defect. We recommend this method as one of choice in cases with large abdominal wall defects.


[Therapeutic considerations on severe leptospirosis].

The present paper reports on the results obtained by intravenous administration of furosemide which shortened the period of oliguria in the course of acute renal insufficiency in leptospirosis. The criteria of administration of heparin for preventing the intravascular disseminated coagulation syndrome in leptospirosis are discussed.


Laboratory modalities for assessing hemostasis during cardiopulmonary bypass.

This discussion has outlined several simple and reliable test systems which have been found useful in assessing disorders of hemostasis in the hemorrhaging CPB patient. When these tests are utilized as described in the preceding article, they have been extremely helpful in studying hemostasis in the CPB patient to be reexplored; they are equally helpful to quickly render a differential diagnosis of altered hemostasis when hemorrhage occurs. In addition, several "special" procedures, the AT-III and heparin assays, have been reviewed; these have been found quite useful in special instances of CPB hemorrhage, and community cardiovascular teams may wish them to be available. This paper has not presumed to be "authoritative" with respect to the "best" tests for assessing CPB hemostasis, but rather has offered only an approach helpful to the authors. The intent has, however, been to provide guidelines for instituting simple, reliable, and workable procedures for the community hospital where CPB is now routinely performed.


Long-term effects of laparoscopic sterilization on menstruation.

The menstrual changes after laparoscopic sterilization were assessed in 200 women and compared with changes after conventional tubal ligation. About one third of the patients after laparoscopy had longer and heavier periods, but those women who were using oral contraception before operation fared worst. The reason for the menstrual changes may not be due to operation alone. There was no significant difference between laparoscopy and laparotomy in terms of increase in heavy bleeding or number of days of bleeding.


The diagnosis of genetic disorders before birth.

Genetic disorders account for a significant number of the health care problems in our society. Advances in therapy and educational opportunities for the handicapped have increased both the life span and quality of life for many of those affected by genetic disorders. Recent developments in clinical and laboratory genetics have made possible the better delineation of certain malformation and/or mental retardation syndromes, so that their mode of inheritance can be understood. This information enables the genetic counselor to predict the risk for occurrence of a large number of genetic disorders. Most genetic counseling is done, however, only after the birth of at least one affected individual has alerted the family to their predilection for having children with a genetic disorder. The carrier state of a certain number of genetic disorders can now be detected, so that even before the birth of their first child, a family can be forewarned that they are at increased risk. Previously this knowledge often influenced couples to decide against having any children. The advent of prenatal diagnosis of genetic disease, however, which was pioneered in the 1960s, allows specific diagnoses of inherited disorders in the fetus; parents no longer have only a mathematical risk figure for guidance. The technics which permit a preview of the genotype of the fetus with respect to a certain disorder constitute an exciting new field or medicine. They are not now available for use in routine pregnancies, but in high-risk situations the collaboration of the primary care physician and the medical geneticist can contribute significantly to the prevention of certain severely handicapping genetic disorders. The field is new and promises to offer much more in the future as more of the inherited disorders are biochemically characterized and become subject to prenatal detection.


Erythema nodosum in patients with tinea pedis and onychomycosis.

To document association between erythema nodosum and concomitant fungus infection, we studied seven white women seen during a six-year period in our office practice. Five patients are presented. Unilateral erythema nodosum occurred in three patients on the same side as unilateral tinea. Tests with potassium hydroxide (KOH), cultures of nodules on Sabouraud agar and dermatophyte test medium (DTM), skin biopsy, and clinical examination ruled out nodular granulomatous perifolliculitis of Wilson. Lesions simulating erythema nodosum  were produced when Trichophyton antigen was injected subcutaneously in the lower legs. All nodose and fungal lesions cleared after griseofulvin therapy. Fungus infection of feet or nails should be considered a possible cause of erythema nodosum when no other cause is apparent.


Leukaemogenesis in Down's syndrome.

Due to the fixed karyotype and documented malignancy risk in patients with Down's syndrome, recently described aetiological factors can be assigned to their proper places in a conceptual framework for leukaemogenesis in these individuals. This is a more profitable approach than those in which various types of karyotypic patterns are matched to different malignancies. It seems that viruses may play a special role, but they need interaction with other factors, most of which are present in Down's syndrome. A unifying concept which may be helpful in establishing research priorities is presented.


Preparing children for parental disability.

Based on the recognition that the sudden onset of disability with attendant, often prolonged hospitalization can compromise family integrity, mobilize anxieties in all family members, and lead to major role changes within a given family structure, this paper describes specific techniques designed to minimize family crisis secondary to the disability of a parent through the preparation of the children to understand parental disability within the limits of the child's readiness and to help the child master his feelings about these life events. Methods include the use of "special stories," creative play, and active involvement of the child with the handicapped parent in the rehabilitation process.


Psychosocial aspects of genetic counseling.

A competent and effective genetic counselor must recognize and deal with the psychological defense mechanisms which affected persons and parents of affected children use to cope with the strain of genetic disease in the family. Denial, guilt, hostility, grief and mourning and the psychology of defectiveness are all potent emotional factors that must be dispelled or worked through before parents should make reproductive decisions. If the counseling experience is to be satisfactory, the counselor must help parents meet the immediate and long term social needs of affected individuals in addition to their medical needs.


The social work component in community-based action on behalf of victims of Huntington's disease.

When the Delaware Valley chapter of the Committee to Combat Huntington's disease (CCHD) was formed, the professional social worker involved taught and learned, offered and commanded resources, and was helper and recipient of help. This article describes the outcome of the mix of community volunteerism, professional skills, and client needs and potentials.


Initiating group process with parents of multihandicapped children.

Resistance, tacit and otherwise, should be expected when attempting to introduce group process in a medically oriented setting where concern about the emotional sequelae of physical disabilities is minimal. A "street corner" approach was used to motivate parents of young children with severe handicaps to participate in a "workshop" program addressed to concrete concerns of child care, while at the same time dealing with parental feelings of shame and guilt arising from the birth of a physically defective child.


Autogenous veins and velour dacron in femoropopliteal arterial bypass.

Sixty-five patients treated by femoropopliteal bypass in 1974 were surveyed; the mean follow-up time was 10.4 months. The one year cumulative patency rate for velour Dacron was 50 percent; this was less successful than were the results from a comparable group in which vein grafts were used (79 percent). These poor results were due principally to the high failure rate of velour Dacron in patients suffering from clinically severe ischemia. In these only one in four grafts remained patent. If a less than perfect arteriographic runoff was obtained, only one in three still functioned. These results occurred despite high intraoperative graft flows. It appears that velour Dacron may be acceptable in patients treated for claudication if no adequate vein is available. This prosthesis gives an unacceptably high failure rate in patients with severe ischemia.


Growth inhibition of human embryonic and fetal rat bones in organ culture by rubella virus.

Paired organ cultures of metacarpal, metatarsal, and long bones of previable human embryos of 7 to 12 weeks' gestation and tibias of 17-day rat fetuses with inoculated with live or ultraviolet-inactivated rubella virus or control fluids and the growth of the bones was measured by increase in wet weight. In several cultures the ability of the human bones to incorporate 35S, a measure of rate of mucopolysaccharide synthesis, was tested. Growth of human and rat bones was retarded in cultures inoculated with live virus but not in cultures inoculated with inactivated virus or control fluids. Mean 35S uptake was increased by approximately 25% in virus-inoculated cultures of bones of 9- to 12-week human embryos. No histological abnormalities were seen. These findings suggest that (1) defective bone growth in congenital rubella is a direct effect of viral infection of bone, (2) a disorder of mucopolysaccharide syntheses may contribute to the osseous lesions that occur in this disease, and (3) organ cultures of human embryonic and fetal rat bones may serve as convenient models for studying the pathogenesis of this virus-induced congenital osteopathy.


Thymolipoma simulating cardiomegaly: a clinicopathological rarity.

This report describes a 19-year-old girl with a chest radiograph strongly suggestive of cardiomegaly. Although she did not consent to haemodynamic studies, cardiomegaly wasru led out on the basis of the clinical course. Careful radiological study proved the existence of a large mass in the anterior mediastinum, simulating cardiomegaly. At thoracotomy a thymolipoma weighing 450 g was resected. The pathogenesis of thymolipoma is discussed.


On the reliability of plasminogen measurement employing the proactivator-activator converting method.

A simple plasminogen determination method is presented. It is based upon the conversion of plasminogen into activator by large and constant amounts of streptokinase. The activator contained in a standard coagulum consisting of bovine fibrin, streptokinase, and a 1:40 dilution of human plasma converts the plasminogen adsorbed on bovine fibrin into plasmin. Lysis of the test coagulum is hereby induced. The speed of such lysis is limited by the concentration of the activator incorporated in the test coagulum. The variable component of the activator being human plasminogen, the speed of lysis is directly dependent upon the concentration of human plasminogen in the standard coagulum. Using the thromboelastograph according to Hartert in recording the test clot lysis times, this method of plasminogen determination was shown to be a simple and quick procedure. The standard deviation ranged from +/- 13,2 tp 68%, depending upon the plasminogen value to be measured (lower rates of error were attached to high, and higher rates of error to low, plasminogen concentrations). The biological variation of plasminogen values in a group of 26 men aged from 40 to 65 years was calculated to be +/- 21%. Both plasminogen and plasmin, its activated form, were exchangeable in the test, i.e. plasminogen determinations performed by activator assay did not differentiate between plasminogen and plasmin. There was no influence by varying anti-SK titers in the plasma up to a circulating antibody content of 2 million. Furthermore, plasma antiplasmins did not affect the plasminogen measuring system. Plasminogen tested by activator assay displayed values closely related to those achieved by immunochemical methods. Plasminogen measurements were performed in patients undergoing streptokinase and urokinase infusion treatment. 5,000 u streptokinase per hour, as well as 270,000 CTA-u urokinase per hour, infused over a period of 2 days produced a fall in plasminogen down to 30-60% of normal. In contrast, 100,000 u streptokinase per hour lowered the plasminogen concentration down to values of below 1%. The foregoing data indicate that plasminogen measurement, according to the principles outlined here (activator assay), may be regarded as a valuable and reliable method for the routine control of streptokinase and urokinase therapy.


Studies on activator formation in human plasma with streptokinase. III. Investigation of activator kinetics in undiluted plasma in terms of urokinase equivalents.

A new method is presented for estimating the activator (plasminogen-streptokinase complex) concentration in native plasma of patients undergoing streptokinase infusion. The principle of the method is based on clot lysis time as recorded by the thromboelastograph. The test clot constituents were bovine fibrinogen, bovine plasminogen, EDTA, human plasma (with unknown activator concentrations), and thrombin. In order to obtain a standardization line, urokinase dissolved in NaCl solution was substituted for patients' plasma. Thus, each lysis time could easily be converted into urokinase equivalent (CTA-u/ml). Streptokinase and plasminogen molecules in undiluted patients' plasma were found to exist both in an activator-bound (equimolar plasminogen-streptokinase complex) and in a freely circulating form. This result is in agreement with earlier findings where the activator complex was demonstrated to be a widely dissociated complex in highly diluted plasma of patients, thus displaying an ample proportion of free streptokinase and plasminogen and molecules. Streptokinase treatment using dosage schemes of 100,000 u SK/h, and 200,000 u/h were monitored by quantitative activator, streptokinase, and plasminogen measurements. An average activator concentration of 50-100 CTA-u/ml and a SK-concentration of 7-16 u/ml were recorded during streptokinase infusion. Plasminogen values averaged 0.25%, independent of the amount of streptokinase infused. Each drop in streptokinase was accompanied by a drop in activator during the infusion, and each rise in streptokinase by a rise in activator. There was a strong correlation between streptokinase and activator concentrations in that, on the average, 1 u streptokinase equalled 8.4 CTA-u/ml activator (correlation coefficient r = 0.9) It is concluded that the activator concentration in the plasma of patients undergoing fibrinolytic treatment can easily be adjusted by regulating the hourly streptokinase influx.


Intermittent plasminogen-streptokinase treatment of deep vein thrombosis.

The fibrinolytic response of 12 patients receiving single daily infusions of 600,000 units of streptokinase (SK) and 90 mg of plasminogen for the treatment of DVT has been studied. The mean plasminogen concentration was maintained throughout the treatment period (4-6 days) at between 20-40% the initial value, while mean circulating plasmin concentration rose to only about twice initial plasma levels. The degradation of fibrinogen as indicated by a fall in clottable fibrinogen did not fall below 1 mg/ml and serum FDP rose to greater than 1 mg/ml. Limited fibrinogenolysis occurred in 2 patients, while in another patient who bled there was immediate and extensive depletion to below 0.5 mg/ml. The beneficial clinical results obtained with this regimen (Kakkar et al. 1975), which produces only limited systemic plasminaemia, suggest that thrombolysis may be facilitated by higher levels of plasminogen than those maintained during conventional SK treatment.


Blood pressure changes following chronic administration to rats of 3beta,16beta-dihydroxy-5-androsten-17-one, 3beta,17beta-dihydroxy-5-androsten-16-one and 21-hydroxy-4-pregnene-3,20-dione-21-acetate.

The urinary excretion of 3beta,16beta-dihydroxy-5-androsten-17-one (16beta-OH-DHEA) is increased in patients with low renin essential hypertension. This steroid and its isomer 3beta,17beta-dihydroxy-5-androsten-16-one (16-oxo-A) have also been reported to have mineralocorticoid activity in adrenalectomized rats. These findings have led to the postulate that excessive secretion of 16beta-OH-DHEA may be responsible for the production of low renin essential hypertension. In this study unilaterally nephrectomized salt loaded rats injected once a week with 30 mg of 11-desoxycorticosterone acetate per/kg of body weight for 2 month periods developed hypertension. Rats given similar amounts of 16beta-OH-DHEA or 16-oxo-A and rats given no steroids did not develop hypertension. We conclude that it is unlikely that 16beta-OH-DHEA and 16-oxo-A are direct causative factors in the production of low renin essential hypertension.


Can one mix two non-specific antisera and obtain a specific radioimmunoassay?

Sekihara et al. have proposed that it is possible to combine two antisera, each of which is unsatisfactory for a clinical radioimmunoassay due to cross-reactivity problems, and obtain an assay which is of sufficiently good specificity for practical application. The present report provides a theoretical analysis of this problem in a "reduced" case of minimal complexity. We assume infinitesimal concentration of tracer, equilibrium of reactants, perfect separation of bound and free, and that each of the two antisera contain only a single class of antibody sites which can bind to the desired ligand or to a cross-reacting species. Numerical methods are used to generate "ideal" dose response curves. The specificity is evaluated by three criteria: 1) as the ratio of ligand concentrations resulting in 10 or 50% reduction of binding of labeled ligand to antibody, i.e. %B/BO = 90 or 50%; 2) the %B/BO or %B/T at an arbitrary dose level; or 3) the apparent amount of ligand present, for an arbitrary dose of crossreacting ligand. Results indicate that mixing of two nonspecific antisera (each cross-reacting with a different ligand) results in a radioimmunoassay system with a specificity intermediate between that obtained with either of the antisera used alone. Whether this will provide a "satisfactory" assay depends on the purposes for which it is intended, the expected concentrations of cross-reacting ligands, etc. Computer simulation studies may be utilized to select the optimal ratio of the two antisera being used for the assay.


Laparoscopy in staging and restaging of 95 patients with ovarian carcinoma.

The merits of laparoscopy with inspection of diaphragmatic leaves were studied in 95 patients with ovarian carcinoma. Laparoscopy was positive in 19 out of 27 new cases, 11 out of 47 patients previously treated and in apparent complete remission, and 12 out of 21 patients previously treated and with the disease. Thirty-one out of 95 patients were shown to have diaphragmatic metastases alone and/or associated with other localizations of disease. In 5 out of 27 new cases the stage was modified after laparoscopy. The histologic-endoscopic correlation was correct in 28/36 positive cases (78%) and in 31/32 negative cases (97%). In conclusionall patients with ovarian carcinoma should be subjected to laparoscopy as staging and restaging before undergoing laparotomy.


[Treatment of strangulated postoperative hernias of the anterior abdominal wall in old persons].

Based on the experience with treatment of 16 patients with large strangulated postoperative hernias of the anterior abdominal wall, the authors describe some peculiarities of the clinic, diagnosis and surgical tactics in the given pathology in persons aged over 74 years. A planned surgical therapy for postoperative hernias in senile persons is strongly advocated. The question of the planned operation should be settled only under stationary conditions after a careful detailed examination of such patients.


[Clinical aspects and morphology of acute catarrhal appendicitis in children].

The authors compared the clinical and pathoanatomical diagnoses in 1399 patients, operated upon for catarrhal appendicitis. In 123 children the clinical diagnosis was revised as a result of further observations following surgery. In 1276 patients the clinical diagnosis of catarrhal appendicitis was remained. An exploration of the appendicular process in these patients supported the diagnosis in 748 cases (58.6%). In 16 cases chronic appendicitis was recognized, in 111 -- phlegmonous and gangrenous appendicitis (8.7%).


Intra- and extrarenal vascular changes in the acute renal failure of the rat caused by mercury chloride.

Histologic evidence of intrarenal vasomotor changes were observed in the rat in the course of acute renal failure caused by the injection of HgCl2. Male Wistar rats injected s.c. with 2.5 or 4.7 mg HgCl2 per kg b. wt. developed fibrinoid damage in the media segments of preglomerular renal vessels, mostly in the arcuate and interlobular arteries. The lesions were patchy and irregularly scattered throughout the kidneys. 24 h post-injection the lesions were very rare and of only mild degree, whereas they were fully developed and regularly seen 48 h post-injection. A high percentage of similar changes was found in certain extrarenal vascular areas especially in the mesentery and pancreas. The damaged vascular segments were usually dilated. The results of various thichrome stains and histochemical reactions suggested edema of vascular smooth muscle cells and imbibition of the media by blood plasma substances, sometimes reaching the degree of fibrinoid necrosis. These findings were confirmed by electron microscopy. The imbibition of the smooth muscle cells by blood plasma material was clearly evidenced by the demonstration of intracellular fibrin precipitations. In connection with the degeneration of smooth muscle cells, accumulations of crystal-like fibrin formations could often be shown. Subendothelial fibrin formations were not observed. 96 h after the 2.5 mg injection the changes were already regressing, but edema of the vascular wall and signs of disturbed vasotonia persisted for several days. The maximum of the vascular changes usually coincided with the maximum of azotemia and the formation of debris cylinders in the renal tubules. However, no clear relationship was recognizable in individual cases between vascular damage, extent of tubular necrosis and renal function. The pathogenesis of the vascular changes is obscure, but neurogenic factors, increased release of catecholamines and/or vasoactive agents of renal origin in connection with other factors might play a decisive role. Arterial hypertension was absent. It is assumed that the structural damage of the vascular media is mainly brought about by prolonged or recurring vasospasms, or by alternating spasm and vasodilatation with local ischemia and increased tension of the vascular wall in the dilated segments. The altered function and structure of the vascular wall might, to a certain extent, contribute to renal insufficiency.


The importance of smooth muscle cells in the development of foam cells in the gastric mucosa. An electron microscopic study.

Foam cells in lipid islands of the stomach can develop from both histiocytes and smooth muscle cells. With increasing storage of lipid vacuoles in smooth muscle cells, loosening of the myofilament arrangement and decrease of the dense areas subjacent to the plasma membrane occurs. Endoplasmic reticulum and the cisternae of the Golgi-apparatus dilate, the cell organelles increase initially and the basement membrane of the smooth muscle cells is fragmentarily formed. Only in incompletely formed foam cells can the origin from smooth muscle cells be recognised, in their final state their histiogenesis is seldom apparent.


[Morphology of the paraadenomatous adenohypophysis. A contribution to the pathogenesis of pituitary adenomas (author's transl)].

98 biopsies of the paraadenomatous adenohypophysis in acromegaly, galactorrhea combined acromegaly, isolated galactorrhea, hypothalamic-hypopphysial Cushing's disease. Nelson's syndrome, and in nonfunctional adenomas were studied by light microscopic methods in order to find evidence for a possible hyperplasiogenic origin of the different types of adenomas. It was hoped that the numerical relations and structures of hypophysial cells might provide significant information. Nodular ACTH cell-hyperplasia was found frequently apart from ACTH cell-tumors in Cushing's disease and Nelson's syndrome and on this basis we suggest that the adenomas in both diseases arise from hyperplasia. During their further development these adenomas seem to become autonomous, since the number of paraadenomatous ACTH cells decreased in bigger tumors. Some of the cases with isolated galactorrhea showed hyperplasia of acidophil and chromophobe cells in the paraadenomatous adenohypophysis. It can thus be assumed that porlactin cell-tumors also develop from prolactin cell-hyperplasia. Both the adenomas and the nonfunctional tumors in acromegaly seem to grow autonomously from the beginning, since paraadenomatous hyperplasia is seldom seen.


[The wall in persistent ductus arteriosus (author's transl)].

A light microscopy study of the wall in ductus arteriosus was performed in 13 cases of isolated persistent ductus. The specimens were obtained surgically in 11 cases and by necropsy in 2. Four patients were male, 9 female. The eldest was a 9-year-old girl and the youngest, a 4-month-old girl. Morphologically, a progressive transformation of the duct wall to the elastic-type artery was observed. In this transformation three stages were determined; stage I: laminar elastosis of the intima; stage II: same as stage I plus incomplete elastic transformation of the media; and stage III: fully developed elastic-type artery. A neat correlation between morphologic stages and clinical data was not found. The course of events in this transformation is apparently determined in great measure by individual factors.


[Hairy cell leukemia in the spleen (author's transl)].

Fifteen spleens with hairy cell leukemia are studied with immunofluorescent (7 cases), electron microscopic (5 cases), and usual histologic methods. The findings are: enlargment of the spleen (weight always superior to 400 g), diffuse red pulp infiltration by ambiguous cells with regular repartition of nuclei and clear spaces between them, hairy aspects of the cytoplasmic membrane which are especially observed on semi-thin and ultra-thin sections, presence of particular cytoplasmic inclusion bodies (polysome lamellae complex). The cellular infiltration is accompanied by some vascular modifications: pseudo angiomatosis lesions, nodular formations ressembling splenomas. An important hypertrophy of the splenic macrophages with erythrophagocytosis and siderosis is also observed. These two phenomena partly explain the anemia.


Red pulp of the spleen in hereditary elliptocytosis.

Electron microscopic study of the spleen of an adult with hereditary elliptocytosis demonstrated features of erythrocyte pooling in the splenic cords with decreased red cells in transit through the basement membrane slits between the sinus littoral cells and decreased erythrocytes in splenic sinuses. Cordal reticulum cells, macrophages, and platelets were prominent. Light microscopy demonstrated relatively empty sinuses, and electron microscopy confirmed that the sinuses contained variable numbers of intact red cells. The morphology of the splenic red pulp in hereditary elliptocytosis was found to simulate that seen in hereditary spherocytosis but to a lesser degree.


[Development and function of endocrine cells in the proventriculus of the chicken (author's transl)].

An argyrophil endocrine cell type with typical intraepithelial development is seen initially on the 8th day of incubation in the epithelium of the main lumen of the chicken-proventriculus. During the embryonic period, rapid development of these cells can be observed with a quantitative maximum on the 13th day of incubation. At this time increased digestive efficiency is necessary for the chicken embryo with the start of gastric secretion combined with the first swallowing of albumen. There is a subsequent decrease in the number of endocrine cells in the main lumen epithelium, their function in hatched or adult specimens is largely taken over by cells which appear in the epithelium of the glands of the proventriculus on the 16th and later days of incubation. On the 2nd day after hatching the adult distribution pattern of endocrine cells in the proventriculus is attained.


An ultrastructure investigation of intrafusal muscle fibers in myotonic dystrophy.

Ultrastructure features of muscle spindles from two patients with myotonic dystrophy are described. Intrafusal muscle fibers exhibit extensive splitting with nuclear bag fibers affected more so than nuclear chain fibers. No sensory endings are present on nuclear chain fibers nor on one nuclear bag fiber throughout the equatorial and myotube regions. Small motor end plates are evident on various segments of split intrafusal fibers in the polar region and some of these extend into the myotube region. Satellite cells are numerous on both nuclear bag and nuclear chain fibers. These frequently occupy the cleft space between segments of split intrafusal fibers. The myotonic dystrophy muscle spindle ultrastructure features seem to closely resemble the appearance of developing mammalian muscle spindles as illustrated with opossum fetal tissue.


Correlations between renal interstitium and level of serum creatinine. Morphometric investigations of biopsies in perimembranous glomerulonephritis.

Morphometric investigations in 40 patients suffering from perimembranous glomerulonephritis at different stages showed that there is no certain relationship between the severity of glomerular lesions and the serum creatinine level. In 19 cases in stages I-III, with serum creatinine level less than 1.2 mg/100 ml on biopsy, the renal interstitium was less enlarged than in 21 cases in the same stages, but with serum creatinine level higher than 2 mg/100 ml. There is a significant positive correlation between the relative interstitial volume and the level of serum creatinine. The best congruence was demonstrated in the lin/log-plotting indicating that our values correlate best with an exponential function. We therefore conclude that in perimembranous glomerulonephritis, generally considered to be a glomerular disease, functional impairment cannot be explained by the glomerular lesions alone; interstitial changes have also to be taken into account as a cause of renal insufficiency. The following hypothesis is proposed; that the increase in renal interstitium and possible shrinking of collagen fibres may lead to a narrowing of intertubular capillaries. This may result in slowing of glomerular blood flow and may lead to renal insufficiency.


Ultrastructural aspects of chondrodystrophia calcificans congenita (syndrome of Conradi-Hünermann).

An ultrastructural study of chondrodystrophia calcificans congenita is reported. Foci of initial calcification of cartilage are characterized by coexistence of three different types of crystals, probably due to abnormal proteoglycan composition of cartilage matrix. The calcification process in chondrodystrophia calcificans congenita is apparently not related to 'matrix vesicles' as it is in normal cartilage.


Adenomatous changes and adenocarcinoma of glandular stomach in Wistar rats induced by N-methyl-N'-nitro-N-nitrosoguanidine. An electron microscopic and histochemical study.

Adenomatous changes, and early and invasive carcinomas of the glandular stomach in Wistar rats ingesting N-methyl-N'-nitro-N-nitrosoguanidine were studied. Almost all adenomatous changes and carcinomata were located near the midpoint of the lesser curvature. In electron microscopic and histochemical studies, both changes showed great cytological similarity. Electron microscopically, they were found to consist of predominantly undifferentiated cells with poorly developed cytoplasmic organelles, with some highly differentiated cells present. Histochemically, both showed strongly positive reactions for lysosomal enzymes. For tumor transplantation, five lesions were used and in all cases, the transplants were successful.


[Pulmonal silicone-embolism. Light microscopic, electron microscopic and enzymehistochemical investigations in the rabbit lung (author's transl)].

Artificial silicone-embolism in rabbits was produced by injection of Baysilon-antifoam into the ear vein. Electron microscopic and histochemical observations of the lung were made, concerning the toxicity and elimination of the embolic material. At 13 months after injection the embolic silicone was not significantly reduced in amount. The rabbit lung is unable to eliminate chemically inert silicone by enzymatic degestion. We noted serious defects of endothelial cells and pneumocytes, destruction of capillaries and local atelectases. These defects are preponderantly mechanical in origin, but may be caused by lack of substrate or energy in cells deprived of their blood supply. Atelectases are interpreted as a result of break-down in surfactant-synthesis.


[T-cell lymphoma (author's transl)].

The percentage of T- and B-lymphocytes was determined by means of surface markers in 190 patients suffering from various lymphoproliferative disease. Characteristic T-cell lymphomas were diagnosed in 8 patients: 2 of these patients suffered from acute leukaemia, 2 from lymphoblastic lymphoma, 3 from mycosis fungoides and one from the Sézary syndrome. The clinical course of the disease in these patients, the clinical picture and the results obtained with various surface markers and with unspecific mitogens are described and discussed.


[A case report of bird fancier's lung (author's transl)].

By a case of bird fancier's lung proved serologically by precipitin tests the importance of a detailed case history is being stressed since there is an increased frequency of exogenous allergic alveolitis. The paper shall contribute to an early diagnosis to avoid irreversible professional and non-professional damages. For all cases of manifest disease constistent avoidance of allergens is demanded.


[Laparoscopy--current aspects].

A short survey is given on description and evaluation of progress and developmental trend of laparoscopy. Important technical improvements are the cold light via the glass fibre light conductor, optics of high value, the colour photography with electronic flash-light, colour films and colour television, new accessory instruments and belongings. Now as ever hepatomegaly and splenomegaly, jaundice, ascites, portal hypertension, suspicion of cirrhosis and metastases are regarded as main indications. The laparoscopy deserves a greater consideration in unclear abdominal symptoms, in gynaecological diseases, for the proof of the affection of liver and spleen in lymphogranulomatosis, sarcoidosis, tuberculosis (with aimed liver biopsy). The endoscopic retrograde cholangiopancreatography in the differential diagnosis of the jaundice competes with the laparoscopy, but it is not able to supersede it. The laparoscopic judgment of the pancreas and the importance of visible changes of the fine structed. Among the contraindications of the laparoscopy the hiatal hernia has lost its significance.


[Clinical studies and pathogenesis of hairdresser's dermatitis].

Characteristically, hairdresser's dermatitis arises shortly after occupational exposure and tends to clear quickly following a change of professions. A large number of causative agents are usually found. There is a considerably higher incidence in females. The following factors play a major role in the pathogenesis of hairdresser's dermatitis alkalinity of the substances used, carelessness in handling the chemicals, mechanical trauma and constant wetting of the skin, and constitutional factors such as hyperhidrosis and dyshidrosis.


[The so-called sweat-gland carcinoma of the human breast. A review (author's transl)].

The term sweat-gland carcinoma of the breast is used in widely different meanings. Nonetheless, two histologically well-characterized types may be recognized: 1. The apocrine (oncocytic) carcinoma is composed of large well-delimited cells with finely granular, oxyphilic cytoplasm similar to that of oncocytes of other organs. They resemble the "pale" oxyphilic cells of the aging normal breast whose cytoplasm in part show the same quality. These carcinoma cells are regarded as mammary cells in a state of transition into oncocytes. Any similarity they have to cells of the apocrine axillary sweat-gland is purely superficial and in no way influences the interpretation of apocrine carcinomas. 2. The secreting carcinoma histologically is reminiscent of the functioning, hormonally stimulated breast of pregnancy. It reveals apocrine extrusion of nuclei and an accumulation of neutral fat in cytoplasm and duct lumina. A case of secreting carcinoma is described in detail to exemplify the association with exogenous hormonal stimulation. Both types of differentiation of carcinomas may arise together or with other types of mammary carcinomas, and share the clinical prognosis with them. The term sweat-gland carcinoma of the human breast should be abolished since there exists no proof that they really occur.


Characterization of human malignant melanoma cell lines; V. Heterotransplantation in the hamster cheek pouch.

Seven continuous cell lines of human malignant melanoma were studied in terms of their in vivo growth potential in the cheeck pouch of the cortisonized golden hamster. Progressive tumor growth was noted only among the melanoma lines which were grossly pigmented (10/32 transplants). None of the three amelanotic tumor lines showed progressive growth. The growing tumors could be identified as melanoma on morphological grounds and by histochemical demonstration of melanin granules. Histology of the tumor lesions revealed evidence of a host reaction to the tumor transplants. This was confirmed by demonstration of circulating antibodies directed against the implanted human cells. Correlations between in vivo heterotransplantability and in vitro saturation density of human melanoma cells were not found in the present study.


[Studies on the thymidine-triphosphate synthesis in malignant tumors. I. Effects of thymidine on deoxyribonucleoside triphosphate pools and deoxyribonucleic acid synthesis (author's transl)].

Measurements of the deoxyribonucleoside triphosphate (dNTP) contents, the [14C] thymidine and deoxyuridine incorporation and the "key enzymes" of the thymidine triphosphate (dTTP) synthesis, thymidine kinase and ribonucleotide reductase, in diploid Ehrlich-ascites carcinoma, in Yoshida sarcoma-ascites cells and to a smaller extent in surgically removed malignant human tumours show 1. A distinctly increased dTTP content compared with the remaining dNTP is not a characteristic of tumour cells generally but a peculiarity of sarcoma and a sign of differentiation of a malignant tumour. 2. With simultaneous linear deoxyribonucleoside incorporation the dTTP content and the mix-proportion of [14C] dTTP to total dTTP in ascites tumour cells in short-term in-vitro incubation (120 min) remain constant. 3. Thymidine addition to the medium leads to a distinct rise of dTTP concentration even at a dosage of 3 X 10(-5) M. 4. The dNTP contents of ascites tumour cells are within the range of the endproduct-inhibiting concentrations of thymidine kinase and ribonucleotide reductase.


[Studies on the thymidine-triphosphate synthesis in malignant tumors. II. Effect of hyperthermia, Vitamin K and Cytotoxic agents (author's transl)].

Measurements of the deoxyribonucleoside triphosphate (dNTP) contents, the [14C] thymidine and deoxyuridine incorporation and the "key enzymes" of the thymidine triphosphate (dTTP) synthesis, thymidine kinase and ribonucleotide reductase, in diploid Ehrlich-ascites carcinoma, under the application of hyperthermia, vitamin K and cytocidal agents show: The effect of hyperthermia and menadion (the basic substance of the K vitamins) on the above parameters of dNTP synthesis can explain the labile effects of hyperthemia and vitamin K therapy on cancer growth. Alterations of the dNTP concentrations and demonstrable or absent inhibition of the ribonucleotide reduction with application of fluoruracil, amethopterine, cytosine arabinoside, hydroxyurea, trisethylen iminobenzochinone and daunomycin confirm and supplement our knowledge of the cytostatic action mechanism of these substances. They show moreover by the example of fluoruracil and amethopterine medication that the dTTP concentration estimation after in-vitro incubation of tumour cells with the addition of FU or methotrexat is a better measurement of the therapeutic in-vivo responsiveness of malignant tumours than the previously performed test methods.


On the incidence of malignant tumors in routine autopsies.

The present study taken over a 12-year time period analyzes malignant tumors in a large number of autopsies, with specific consideration of the frequency and location, age and sex group distribution, and histologic classification of the tumors. The tumors were first evaluated in terms of specific organs and organ systems and were then histologically classified. On a total of 23338 subjects who died between the years 1960 and 1971, 17052 autopsies were carried out (73.1%) and only 15384 (65.9%) of these were evaluated for out study. Altogether we located 4911 cases of MT, i.e., 31.9% of the evaluated autopsies. The number of MT in the males slightly exceeded that in the females (2508[51.1%] MT and 2403 [48.9%] MT, respectively.) We calculated over 60% of the MT to be in the 7th and 8th age groups. By comparing the two time periods (1960-1965) and 1966-1971) we calculated a significant increase in the MT rate by 1.7%. This increase was found mainly  to effect  the males (the female group showed only a slight increase). The greatest number of MT were located in the digestive system with an MT rate of 26.2%; next came the urogenital system (23.4%) and then the respiratory system (18.7%). The respiratory system took first position of importance in the males with an MT rate of 30.3% followed by the digestive system with 27.4%. The urogenital system dominated in the females with a rate of 29.0%. The rate of MT of the respiratory system was significantly higher in the males...


[Congestive, hypertropic cardiomyopathy--intermediary form of primary myocardial disease? (author's transl)].

A 43-year-old woman with anginal pain and the electrocardiographic signs of an old anterior infarction presented the clinical, hemodynamic and angiographic findings of congestive cardiomyopathy. Left ventricular (LV) end-diastolic volume was sizably increased, there was generalized hypokinetic wall motion and LV ejection fraction was reduced to 40 percent. The subsequent clinical course was characterized by progressive congestive heart failure and the patient died 4 years after the first appearance of symptoms. Autopsy revealed marked dilatation of all heart chambers and severe hypertrophy of the LV anterior wall. The LV posterior wall and the septum were less markedly hypertrophied. Light and electron microscopy showed the typical findings of hypertrophic cardiomyopathy in the anterior part of the LV wall whereas the septum and the LV posterior wall presented unspecific histological alterations. In conclusions, this case demonstrates that a clinically typical congestive cardiomyopathy may be associated with a localized area characteristic for hypertrophic cardiomyopathy. Thus it is a postulated that the described patient represents an intermediary form of primary myocardial disease.


[Significance of body weight in degenerative skeletal diseases (author's transl)].

An attempt was made to ascertain the influence of body weight on degenerative skeletal diseases in a group of 250 hospitalized patients suffering from gonarthrosis and/or lumbar syndrome. The current average body weight according to age, size and sex (Geigy Tables) were used as the standard. Patients with gonarthrosis were significantly overweight while patients with lumbar syndrome fell within the normal range. A prearthrosis or prearthritic deformity of the vertebral column or knee could be demonstrated in the majority of patients, particularly the younger ones. In most of the older patients, an age-induced reduction in the quality of cartilage and tissue of the intervertebral disk was already present. For the established casual significance of prearthroses, the only possible influence of body weight on the development of alterations is as a contributing factor, to functional strain. A statement cannot be made concerning the importance of this contributing factor for methodological reasons; an essential influence, however, is doubtful. Overweight alone does not tend to induce degenerative skeletal alterations under normal static and occupational conditions.


[Conception and goals of sports for handicapped in Switzerland].

The main objective of sport for the handicapped is the maintenance and improvement of physical performance. Sport for the handicapped is also a social hygienic question. We cannot ignore what is happening to the handicapped during their whole life-time: whether they get more and more stiff, unflexible and clumsy, lose their ability to move and become a burden to the society too early. Regular physical activity can work wonders. Many of them find the relation to the public life and their lost self-confidence returned as a result of participating in physical activity programs. They become happier and motivated for their daily work. They discover a new sense of life in proving to themselves that, in spite of their handicap, they are able to achieve considerable performances, a healthier state, and are generally happier and more flexible up to an old age. In conclusion, sport for the handicapped should achieve the following: give pleasure of life, increase courage, promote comradeship, reinforce self-confidence, improve independence, and take away inhibitions and inferiority complexes.


[Radioimmunological determination of unconjugated plasma estradiol and estriol after administration of dehydroepiandrosterone sulfate in late pregnancy].

In 16 normal and pathologic pregnancies we carried out the dehydroepiandrosterone-sulphate loading test by injection of 50 mg DHEA-S-Na intravenously. The plasma concentrations of unconjugated estradiol and estriol were measured by radioimmun-assay. The level of estradiol increased continuously, rising to a maximum 60 min after the injection. In pre-eclamptic patients and cases of intrauterine growth retardation the rise was significantly reduced. There was a good correlation between result of the test and clinical dates. In plasma concentrations of unconjugated estriol no changes could be observed within 3 hours after the injection.


The ultrastructure of oncolytic spores found on pig skin.

A new type of clostridium spore, derived from melanotic hamster tumors treated with pig skin extracts, was examined in a lyophylized form by electron microscopy (EM). Scanning EM indicated that two out of five preparations contained only spores. The spores exhibited oval forms (1.5 X 1.0 MU)with elongated, sometimes infolded, poles indicating an overlying membrane. These structures corresponded to the exosporium as seen by transmission EM. The size of the spores, including the cortex (350-550 A), inner membranes, and cytoplasm averaged 5100 X 5900 A. Cytochemical findings suggest that acid mucopolysaccharides and polypeptides containing N-acetyl-neuraminic acid are localized within the exterior and interior layers of the exosporium and at the surface of the outer coat, which could have a tumor inhibiting effect.


The effect of temperature change on the kinetic behaviour of yeast phosphofructokinase.

Yeast phosphofructokinase does not exhibit any cold sensitivity. The kinetic properties of the enzyme have been investigated in the range between 10 degrees C and 30 degrees C in dependence on fructose 6-phosphate and ATP. Although a significant increase in the enzyme activity with rising temperature does not occur, the shape of the ATP velocity curves is not markedly altered. With increasing concentrations of fructose-6-phosphate the efficiency of temperature on the catalytic process increases, indicating a small temperature effect on the shape of the fructose-6-phosphate velocity curves. The results are interpreted in terms of an adequate kinetic model.


Experimental auto-alloplastic repair of parietal peritoneum,.

Experiments were carried out on 15 dogs to repair the parietal peritoneum with an auto-alloplastic structure whose internal smooth surface was turned towards the abdominal cavity. Gross and histologic examinations have confirmed adaptation of the implant to the new environment without the formation of adhesions.


Electrocardiographic findings in 24 patients with myasthenia gravis.

Twenty four myasthenia gravis patients, 14 females and 10 males, aged between 5 and 65 years (average 29) were studied electrocardiographically. The abnormalities found in the ECG were: prolonged "Q-T" intervals (10 cases, 44.1%), sinus tachycardias (5 cases, 20.8%), sinus arrhythmias (5 cases, 20.8%), right bundle branch block (4 cases, 16.6%), and non-specific "T" wave changes (2 cases, 8.3%). Among our 24 patients with myasthenia gravis, in contrast to previous reports, only two had non-specific "T" wave abnormalities. But prolonged "Q-T" intervals, right bundle branch block, sinus tachycardias and sinus arrhythmias, when compared to normal population incidence, were found to be quite significant. In pathogenesis, primary myocardial histo-pathological abnormalities, and the role of extracardiac factors in producing the changes were discussed.


[Value of puncture-lavage in abdominal closed trauma. Comparison with the laparoscopy and symptomatology (author's transl)].

In a series of 120 closed abdominal trauma the authors compare the reliability of the abdominal symptomatology (60%), of puncture-lavage with an Intracath (92.5%) or with a Diacath (98%) and of laparoscopy (100%). Laparoscopy and puncture-lavage with a Diacath have the same advantages: rapid execution, safeness, reliability. However the preference of the authors goes to the catheter and peritoneal dialysis because of its simplicity and feasability by the surgeon himself. This technique discloses visceral lesions: if positive it allows an earlier diagnosis and operation; if negative it avoids unnecessary laparotomies especially in cases of multiple trauma.


Transferrin-immune complex disease.

A 71-year-old woman showed a highly unusual pattern of iron distribution in the organism which was associated with iron overload. The hallmark of this disease was an extreme hypersiderinemia, the serum iron reaching about 800 mug/100 ml. There was a pigment cirrhosis of the liver, bronzed skin containing hemosiderin, and diabetes mellitus. Paradoxically, hemosiderin was not detectable in bone marrow macrophages, sideroblasts and erythrocytes were reduced, and there was a decrease in radioiron utilization of erythropoiesis, thus indicating insufficient iron supply. The pathogenesis of this disorder based on the formation of an autoantibody with specificity for transferrin thus producing a circulating immune complex which bound the majority of serum iron. Immunosuppression achieved a partial remission including a recovery of the patient's general state, a rise in free transferrin, a decrease in serum iron, disappearance of hemosiderin in the liver, and a rise in erythrocyte production.


Muscle tone under fentanyl-nitrous oxide anaesthesia measured with a transducer apparatus in cholecystecomy incisions.

Fentanyl is a strong, synthetic analgesic which may cause muscular rigidity when administered intravenously. To obtain a quantitative measure of the possible increase in muscle tone after intravenous fentanyl, the muscular tension of the right rectus abdominis was measured in 20 patients before and after administration of this drug. A traction transducer apparatus was fastened between the anterior and posterior rectus sheath in a right oblique laparotomy incision. Premedication was with pentobarbitone, and the anaesthesia and muscle relaxation were effected by thiopentone or enibomal and nitrous oxide-oxygen with 75% nitrous oxide, and suxamethonium infusion (0.2%) until the measurement of tension was started. Immediately after the action of suxamethonium had ceased, fentanyl, about 0.004 mg/kg body weight, was administered. An increase in tone was found in 15 cases (75%). The mean increase was 9.2 N. The influence of the anaesthesia upon the result is discussed, and it is concluded that fentanyl must be responsible for the increase in muscle tone.


The significance of human chorionic gonadotropin in blood serum for the early diagnosis of ectopic pregnancy.

Determination of human chorionic gonadotropin (HCG) values in the serum by the radioimmunoassay technique, was performed in 23 women with suspected ectopic pregnancies. In 16 cases the values of HCG were high and the diagnosis of ectopic pregnancy was verified by laparoscopy and laparotomy. In 7 cases low HCG values were found and ectopic pregnancy was excluded. The detection of HCG in the serum was found to be an excellent tool for the early diagnosis of ectopic pregnancy, thus helping to prevent the dangerous sequelae which follow the late diagnosis of this condition.


Contractile and histochemical properties of the inferior oblique muscle in the rat and in the cat.

Mechanical and histochemical properties of inferior oblique muscles(IO) were compared in adult albino rat and pigmented cat. The twitch contraction times and the fusion frequencies were about the same in both species indicating similar contractile properties of the fast contracting fibers. Rat IO seemed to contain fewer slowly contracting fibers than cat IO; half-decay time of the twitch was shorter in rat than in cat muscles and fusion started at higher stimulus frequencies. Fatique resistance was lower in rat than in rat than in cat. Post-tetanic potentiation occurred in the cat but not in the rat IO. Almost all fibers of rat IO were rich in myofibrillar ATPase. In cat IO most fibers showed high myofibrillar ATPase activity, but some fibers in the global layer had moderate to small amounts of this enzyme. This correlates well with the physiological differencies between cat and rat IO.


Actions of fenfluramine on glucose uptake in vitro and in vivo.

Fenfluramine stimulates the glucose uptake of the isolated hemidiaphragm from normal and streptozotocin diabetic rats in the presence of insulin. The drug does not cause an increased storage of glycogen. During hind leg perfusion of the dog fenfluramine stimulated peripheral glucose uptake. No increase in lactate or in free fatty acids release was observed during prolonged infusions of the drug. Fenfluramine caused an improvement of glucose tolerance in normal glucose-primed rats. A single dose of fenfluramine significantly lowered the blood glucose levels in streptozotocin diabetic rats and in diabetic dogs treated with insulin. Prolonged treatment with fenfluramine of streptozotocin diabetic rats had no significant effect on blood glucose levels. Additional treatment for one week of insulin dependent diabetic dogs with small non-anorexic doses of fenfluramine resulted in slightly decreased blood glucose levels. The dogs could not be maintained on fenfluramine alone (without insulin).


Effect of a selective 5-HT uptake inhibitor--Lu 10-171--on rat brain 5-HT turnover.

Changes in endogenous concentrations of 5-HT and 5-HIAA as well as the turnover rate of 5-HT was studied in rat brain after treatment with a new potent and selective inhibitor of the neuronal 5-HT reuptake mechanism, Lu 10-171(1-(3-dimethylamino)propyl)-1-(p-fluorophenyl)-5-phthalancarbonitrile). After a single dose of Lu 10-171 the concentration of 5-HIAA was reduced from 1 to 24 hours after treatment, whereas that of 5-HT was practically unchanged, indicating decreased turnover of 5-HT in the brain. This was confirmed using three different methods for measuring 5-HT turnover. Thus the rate of 5-HIAA accumulation in the brain after probenecid was reduced after Lu 10-171. Likewise treatment with Lu 10-171 led to a decreased fall in 5-HT and an increased fall in 5-HIAA after inhibition of 5-HT synthesis with parachlorophenylalanine (PCPA). Unexpectedly Lu 10-171 did not change either the accumulation of 5-HT or the decrease in 5-HIAA after inhibition of MAO with pargyline. By and large the results are consistent with the proposed negative feed-back regulation of 5-HT neuronal firing rate due to the abundance of 5-HT at postsynaptic receptors after inhibition of the reuptake mechanism.


Inner ear morphology in Down's syndrome.

A comparative study was made on four pairs of temporal bones from patients with Down's syndrome (trisomy 21) and 15 pairs of temporal bones from other infants of the same age range. Spiral reconstructions showed chochlear length to be slightly shorter in temporal bones from patients with Down's syndrome than that in the controls. Based upon these dimensional measurements, a developmental anomaly of the vestibular apparatus was found.


Skeletal muscle fiber splitting induced by weight-lifting exercise in cats.

Adult skeletal muscle hypertrophy induced by exercise has been thought to be exclusively related to an increase in cross-section area of individual muscle fibers and not to an increase in the number of muscle fibers. Recent experiments using surgical intervention to cause muscle overload have induced an increase in fiber numbers; however, the muscle also exhibited pathological alterations. The purpose of this study was to determine if an exercise regimen also induced hyperplasia. Cats were trained to lift weights with their right forelimb to receive a food reward. After 19-46 weeks of training, the flexor carpi radialis muscle (FCR) was removed and prepared for histochemical examination. The total number of muscle fibers of the right exercised FCR increased significantly (19.3%) when compared with that of the unexercised left FCR (p less than 0.05). This increase was found to be due to muscle fiber splitting.


Genesis and pathogenicity of anti-DNA antibodies.

The formation of anti-DNA antibodies appears to be under a genetic control similar to that regulating the immune response to complex antigenic compounds. The ability to develop a high immune response to DNA seems to be predominantly dependent on the nature of the B-cell population whereas a major role of the T-cell suppressor population is not evident in this response. The immune response to DNA does not necessarily need the presence of thymus-derived lymphocytes, but in some cases T-cells may exert a helper effect. The development of anti-DNA antibody response may be triggered by various factors: viral, bacterial or parasitic agents, tissue destruction or some drugs. A mechanism that may play an important role is the "nonspecific" triggering of anti-DNA antibodies by substances that, like bacterial lipopolysaccharides, exert a potent stimulatory effect on B-cells and simultaneously induce a release of DNA in extracellular fluids. In lupus diseases as well as in mice injected with lipopolysaccharide, pathogenic effects of anti-DNA antibodies appear to be closely related to the formation of DNA-anti-DNA complexes. The demonstration that injections of lipopolysaccharide lead to the localization of DNA-anti-DNA complexes in kidney glomeruli stressed the possible importance of stimuli responsible for a release of DNA in circulating blood in the expression of the pathogenic effects of anti-DNA antibodies.


[Studies with the NBT test in various clinical forms of juvenile rheumatoid arthritis].

Fifty-six healthy neonates and children as well as 33 patients with juvenile rheumatoid arthritis and other diseases of the locomotor system were examined using a modification of the NBT test. In healthy newborn infants there was observed an increase in the number of NBT-positive cells between the first and tenth days. The test results obtained for the 33 patients with juvenile rheumatoid arthritis were positive in 73%, with positive results being obtained especially in those patients where the disease was in its second stage of activity. Highest values were obtained in patients with a predominantly articular manifestation of the disease. Stimulative effects produced by immune complexes are considered to be chiefly responsible for this. However, this method of examination is of small practical value from a differential diagnosis point of view.


[Age dependent frequency of cytoplasmic antibodies].

In a random sample of so-called healthy blood donors under and over 60 years of age (n=196 of 10,593 donations by about 4254 donors) the frequency of antibodies (antibodies against smooth muscles, mitochondria, microsomes, brush border of proximal rat renal tubuli, connective tissue, and parietal cells) detectable by immuno-fluorescence was determined and compared with the incidence thereof in various groups of diseases. In general, two frequency peaks (up to 30 and over 50 years of age) were observed; however, statistical evidence was obtained for the second peak only (with p less than 0.001). In "healthy" blood donors past 60 there was observed a significantly higher frequency of occurrence of antibodies against parietal cells (p less than 0.001) and against connective tissue (p less than 0.01). An attempt has been made to classify antibodies into four groups depending upon age disease, with due consideration being given to the different clinical valency of antibodies. Different frequencies of occurrence of numerous antibodies are believed to be due not only to immune system aging, but especially to the not-yet elucidated disturbance of regulation of autotolerance by alteration of immune cells, which is subject to endogenous (e.g., genetic) and exogenous (e.g. viral) factors that are dependent on age rather than aging.


[Demonstration of antigens of bone and articular connective tissue in the blood of rats with adjuvant arthritis].

The results reported in this paper clearly indicate the release of osteal antigens of articular connective tissue in response to inflammatory alterations and injuries to the region immediately adjacent to an articulation. Further studies will have to be performed in an effort to find out whether these antigens are of pathological importance and if there is a relationship between the liberation of antigens and the intensity of inflammatory alterations or if the different and often difficult-to-interpret results of the determination of antibodies in the sera of patients with rheumatoid arthritis can be more easily explained by a simultaneous antigen analysis of the corresponding sera.


[Formaldehyde sensitization in occupational respiratory exposure].

The determination in a total of 180 workmen regularly exposed to varying breathing zone levels of for-maldehyde of an index of sensitization as low as 12.2% may be interpreted to mean that formaldehyde exerts only a rather weak effect on the respiratory tract. It was not possible for allergoses to be clinically established even if consideration was given to technical difficulties encountered in the use of provocative tests conducted for diagnostic purposes. Rather, the conditions of exposure and the results of tests may be regarded as suggestion that the nonspecific symptomatology was produced by irritation. What is also of considerable importance in this connection is that extremely wide difference in individual sensitivity were observed.


[Glomerulopathy in rheumatic patients due to penicillamine].

This paper describes four cases (where rheumatoid arthritis is the basic ailment of the patients involved) of immune complex nephritis and stage I membranous glomerulonephritis, respectively. Treatment was by means of penicillamine. Also discussed are light-microscopical, immunohistological, and electron-optical results.


[Frequency and importance of mold sensitization in bakery workers].

Mycological, allergological and immunological, as well as occupational-hygiene investigations were made in a large baking products plant in an attempt to find an answer to the questions as to whether allergic respiratory diseases produced in bakers by mold fungi may be considered occupational diseases. In addition, a retrograde analysis was made of a number of statements made by experts in occupational medicine for bakers, confectioners, and control persons. In the case of bakers, recognition as an occupational illness of an allergic respiratory disease caused by such mold fungi as Aspergillus and Mucor is fully justified in view of the agreement between the increased rate of sensitization of those exposed to the mentioned mold fungi and the results of extensive mycological tests. The results of occupational-hygiene investigations made using a specialized airborne dust sampler showed that bakers working in this large baking products plant were exposed to considerable amounts of dust. The results obtained also show that it is absolutely necessary for remedial measures to be taken under control by occupational hygienists.


[Results and experiences in the immunosuppressive therapy of rheumatoid arthritis].

An analysis of the results of treatment-in five different hospitals and with such immunosuppressants as cyclophosphamide, azathioprine, and trenimone - of 550 patients with rheumatoid arthritis showed an overall rate of improvement of 36%. Cyclophosphamide, because of the relatively small number of side effects and the excellent therapeutical results obtained, proved to be much better than the other two immunosuppressive agents. Also, because the dosage required is comparatively low, patients over procreative age could be included in the program of treatment with immunosuppressants.


[The clinical and prognostic importance of IgM rheumatoid factors].

On a total of 1000 subjects diagnosed as having rheumatoid arthritis it was possible to positively correlate the proportion of seropositivity of IgM rheumatoid factors and/or higher titer values to the following clinical characteristics: Male sex; existence, severity, and symmetry of articular alterations determined by morphological x-ray examinations; unfavorable functional values; high inflammatory activity; involvement of various organs; and high rate of progress. So far as this particular clinical picture is concerned, the detection of rheumatoid factors must, therefore, be considered unfavorable to a prediction or conclusion regarding the course of disease, whereas seronegative forms may be regarded as relatively benign.


[Lectin arthritis--a new arthritis model].

By single intraarticular injection of lectin from Lens culinaris in nosenitized rabbits acute and chronic arthritis was produced. By use of fluoresceinisothiocyanate-labelled lectin binding of lectin could be demonstrated in the connective tissue of joint capsule for 4 weeks. The morphological features of lectin-arthritis were described. The results are discussed with respect to the pathogenesis of the arthritis.


Recognizing and referring neonatal surgical emergencies.

Ultimate survival of the neonate with a surgical emergency depends upon early recognition by the family physician, who may refer the infant to a pediatric surgical center. The family physician must prevent infectious and metabolic insults to the critically ill neonate while preparing him for safe and rapid transport to a specialty institution. In many cases, the final outcome is as often determined by the initial care received at the referring hospital and during transport as it is by the surgical procedures and postoperative management.


Interventricular septal motion and left ventricular function after coronary bypass surgery: evaluation with echocardiography and radionuclide angiography.

To evaluate interventricular septal motion and left ventricular function after coronary bypass graft surgery, 40 patients were studied early postoperatively and serially for up to 16 months with echocardiography and radionuclide angiography. Early after operation mean left septal excursion decreased significantly from 4.6 +/- 0.4 (standard error) to 0.8 +/- 0.6 mm (P less than 0.001), and left septal motion was abnormal in 23 of the 40 patients. Mean right septal excursion reversed from 2.1 +/- 0.5 to -2.1 +/- 0.5 mm early after operation in the 22 patients in whom these measurements could be made, and 15 patients showed paradoxical right septal excursion. At a mean of 4 months after operation, only 7 of 35 patients followed up had abnormal left septal motion, and mean left septal excursion had returned toward normal (3.6 +/- 0.7 mm); mean right septal excursion remained reversed (--1.1 +/- 0.7 mm), and 6 of the 14 patients followed up had paradoxical motion. In the 22 patients whose wall thickness could be measured, mean septal thickening during systole decreased significantly from 35 +/- 4 to 21 +/- 3 percent early after operation (P less than 0.01). During late follow-up septal thickening returned toward normal (32 +/- 4 percent). Mean normalized posterior wall velocity increased significantly after operation from 0.76 +/- 0.03 to 1.01 +/- 0.05 sec-1 (P less than 0.001), but posterior wall thickening remained unchanged. Left ventricular end-diastolic dimension and the radionuclide-determined left ventricular ejection fraction were unchanged postoperatively. It is concluded that (1) echocardiographically detected abnormal septal movement is frequent early after coronary bypass graft operation; (2) both decreased myocardial contraction in the septum and increased anterior movement of the whole heart contribute to this abnormality; (3) the abnormalities in septal movement decrease during late follow-up in many patients but persist in some patients; and (4) posterior wall function tends to increase early after operation and therefore overall left ventricular function remains normal.


Health education literature for parents of physically handicapped children.

Parents, for many reasons, are not always able to understand the nature of their child's handicap. Many physicians recognize that they are not always as effective as they might wish to be in enabling parents to comprehend handicaps. Written hand-out materials as aids to better understanding can be helpful to both physicians and families as supplements to verbal descriptions of the disease and instructions for care. This compilation of currently available literature, grouped by category of disease and with addresses where they may be ordered, should offer the pediatrician and other health personnel a ready source of assistance.


Echocardiography in the differential diagnosis of the large heart.

Echocardiography is an extremely useful noninvasive technic in the differential diagnosis of a large heart. It may show whether a large heart is due to left ventricular hypertrophy or dilatation, or if it is due to a pericardial effusion. The hypertrophied heart may be further characterized by determining whether it is symmetrical, as caused by aortic stenosis or hypertension, or whether it is assymmetrical, which is characteristic of hypertrophic cardiomyopathy. Similarly, dilatation of the heart may be due to volume overload of the left ventricle secondary to valvular insufficiency, congestive cardiomyopathy or ischemic heart disease; these can be distinguished by echocardiography. As certain types of mitral insufficiency are associated with specific valvular dysfunction, the possible etiology of the mitral insufficiency and therefore of the volume overload of the left ventricle may be determined using echocardiography. Finally, mediastinal tumors may simulate a large heart, and demonstration of normal cardiac dimensions and wall motion can exclude a cardiac etiology for the "large heart."


Binding of synthetic double-stranded DNA by serum from patients with systemic lupus erythematosus: correlation with renal histology.

Detection of antibody to double-stranded DNA by direct binding assays has proved useful in clinical management of patients with systemic lupus erythematosus (SLE). Recent confusion regarding specificity of these antibodies for SLE appears to be due, at least in part, to contamination of natural DNA preparations with nondouble-stranded DNA antigens. Measurement of binding of a synthetic, self-complementary DNA copolymer (dAT) rather than of natural DNA (KB) has been shown to obviate some of these difficulties, apparently because of freedom of dAT from nondouble-stranded DNA antigens. Among the advantages found in this way was a higher degree of specificity of antibodies to double-stranded DNA for clinically-judged active lupus nephritis than had been suspected. Since activity of nephritis is difficult to assess clinically, histologic data were sought to confirm these observations. Thirty-two kidney specimens were examined by light and/or electron microscopy. The degree of histologic activity and the amount and location of glomerular electron-dense deposits were semiquantitated blindly. The binding of both dAT and KB DNA was measured by the ammonium sulfate method. Correlation with the amount of electron-defense deposits was highly significant for dAT binding and somewhat less so for KB DNA binding as determined by both parametric and nonparametric statistical methods. Significant correlation with histologic activity was found for dAT but not KB DNA binding. These results are consistent with previous data and suggest that dAT binding may provide a useful, noninvasive means of clinically assessing both nephritis activity and the intensity of glomerular immune-complex deposition as reflected by the amount of electron-dense deposits. If it can be confirmed that the latter provides long-term prognostic information, then dAT binding (and perhaps its reponse to therapy) may also prove of value in this regard.


Sexual functioning and the physically disabled adult.

A person's sexual readjustment following a physical disability has traditionally been ignored by health care professionals. Since the occupational therapist often facilitates a person's resumption of activities of daily living, the therapist is in a special position to provide counseling. Understanding, support, and correct information are needed most. As derived from a search of the literature, sexual functioning is discussed in relation to the following disabilities: stroke, heart disease, diabetes mellitus, muscular dystrophy, multiple sclerosis, renal disease, spinal cord injury, pulmonary disease, arthritis, and alcoholism.


Oxygen requirement of renal Na-K-ATPase-dependent sodium reabsorption.

The oxygen requirement of the Na-K-ATPase-dependent sodium transport system was examined in anesthetized dogs infused with 15% mannitol-Ringer solutions at a rate of 35 ml/min. Because of renal vasodilatation and abolished autoregulation, filtered sodium (FNa) could be varied over a wide range by progressive aortic constriction. Sodium reabsorption (RNa) and renal oxygen consumption (RVO2) varied in proportion to FNa (r greater than 0.9). Ouabain, which inhibits Na-K-ATPases, reduced RVO2 by 45 +/- 6%. During subsequent aortic constriction, the ratio delta RNa/delta FNa averaged 0.45 (glomerulotubular balance) (r less than 0.9), whereas RVO2 was not significantly altered. Comparisons of deltaRNa/deltaFNa before and after ouabain administration, indicate that about half of an increase in sodium delivery to the distal nephron is reabsorbed by the Na-K-ATPase-dependent sodium transport system and that deltaRNa/deltaRVO2 (Na/O2 ratio) of this system averages 14.5 +/- 1.3. This Na/O2 ratio corresponds to 2.4 sodium ions transported per ATP dephosphorylated as found in other tissues.


Monovalent cation and ouabain effects on PAH uptake by rabbit kidney slices.

The effects of K+, Na+, and ouabain on para-aminohippurate (PAH) accumulation by rabbit kidney slices have been further examined. The present studies show that for maximum uptake of PAH to occur in Na+,K+-depleted slices extra-cellular Na+ and K+ ions are required together. Kinetic studies revealed that increasing the external K+ from 0 to 5 mM caused a decrease in the apparent Km of transport. The Vmax values were not changed significantly. In the presence of 5 mM K+, increasing Na+ concentration in the bathing medium from 0 to 145 mM produced an increase in the V max while the apparent Km remained constant. In the presence of 5 mM external K+, ouabain inhibition of PAH uptake was progressively and entirely antagonized by decreasing external Na+. Studies on kidney slices treated with ouabain in a Na+,K+-free medium in order to inhibit active electrolyte transport showed that PAH uptake under anaerobic conditions was specifically enhanced by Na+. This stimulation occurred when cell [Na+] was less than medium [Na+]. This Na+-dependent and energy-independent accumulation of PAH was inhibited by hippuric acid but not by N-methylnicotinamide.


Correlation between chest film and angiographic assessment of left ventricular size.

In 76 adult males quantitative angiographic measurements of left ventricular size were compared to 12 plain chest film measurements of heart size and shape. Of the 18 normal cases, only Rigler's B measurement correlated with left ventricular volume (r = .64). However, this correlation was not statistically significant. Of the 58 patients with isolated aortic valve disease, 19 had increased left ventricular mass (hypertrophy) and 39 had both increased left ventricular end-diastolic volume and mass (hypertrophy and dilatation). In the hypertrophy group, plain film heart volume was the most sensitive detector of an enlarged left ventricle (21% false negative rate) and correlated with left ventricular end-diastolic volume (r = .62). Using stepwise discriminant analysis, the combination of heart volume, leftness of the heart, apex position, and roundness of the left ventricle decreased the false negative rate to 5%. In the hypertrophy and dilatation group, plain film heart volume had the highest correlation with left ventricular volume and mass (r = .66) and a false negative rate of 8%. No single variable or combination of variables could usefully discriminate between the hypertrophy and hypertrophy and dilatation groups. These data support the conclusion that plain film heart volume is the best single measurement for detecting left ventricular enlargement.


Visual assessment of total heart volume and specific chamber size from standard chest radiographs.

Ten radiologists at three levels of training visually assessed total heart and individual chamber size in 95 adults of both sexes with well defined cardiac diagnoses. Overall accuracy was highest for total heart size (82.2% correct), followed by left ventricular size, left atrial size and right heart size 79.6%, 75.0%, and 72.8%, respectively. Right heart and left atrial enlargement had a statistically significant negative effect on visual assessment of other chambers (P less than .05). Attempts to subclassify left ventricular enlargement into hypertrophy and hypertrophy and dilatation groups proved unsuccessful. While 63% of the hypertrophy group was detected as abnormal, only 24.3% were correctly subclassified as hypertrophy. For the hypertrophy and dilatation group, the corresponding values were 82% and 70%, respectively. Oblique views were useful in assessing left ventricular size only when inexperienced observers were included in the group of evaluators (P less than .05). A statistically significant improvement in assessment of normal left ventricular size and overall left atrial size was noted with experience (P less than .01 and P less than .05, respectively).


[The effectiveness of various micropore blood filters (author's transl)].

Recently so-called micropore blood transfusion filters have been introduced. They should decrease the number of microemboli produced by blood transfusion and thus decrease the incidence of postoperative and posttraumatic pulmonary insufficiency. Since these filters are rather expensive and several types and models are offered, it seemed to us important to review their properties and the results obtained with the most commonly used models (Pall, fenwal, Swank and Bentley). The efficacy of the various filters is apparently quite different. Depending on the indication, the use of different filters is possible. There is no filter which fulfils all prerequisites which must be made for an ideal micropore filter. On the basis of our literature review we conclude that filters made of Dacron wool are best suited for all purposes. There are no good reasons to use these micropore filters routinely for all blood transfusions. However, when large amounts of blood must be given rapidly and pulmonary function is already reduced, the use of micropore filters routinely for all blood transfusions. However, when large amounts of blood must be given rapidly and pulmonary function is already reduced, the use of micropore filters seems reasonable.


Follow-up status of patients treated with nerve blocks for low-back pain.

One hundred fifty-one (151) outpatients treated with epidural or subarachnoid blocks for low-back pain not due to malignancy were questioned by mail one to two years after treatment to assess their current functional status as compared with that at the time of treatment. The results emphasize the importance of bothe gender-associated differences in life functioning and the circumstances of pain onset, while supporting the proposition that nerve-block treatment of low-back pain is useful, particularly so since the majority were cases of chronic pain. The findings also emphasize the complexity of factors in the total treatment situation, the operation of psychologic, social and economic forces in determining the outcome of treatment, and the need for detailed criteria in studies evaluating treatment effects. (Key words: Pain, low-back; Anesthetic techniques, therapeutic; Anesthetic techniques, spinal; Anesthetics techniques, peridural.)


Ultrastructural and ultracytochemical cyclic changes in the bovine uterine tube (oviduct) epithelium.

Ultrastructural and ultracytochemical features of the uterine tube (oviduct) infundibulum were studied in 8 Hereford cows, which were slaughtered in pairs on days 1 (estrus), 3, 9 or 10, and 18 of the estrous cycle. Fibrous granules (60 to 80 nm), which are supposedly related to basal body replication, were observed in the apical cytoplasm of ciliated cells. Close association between basal bodies and fibrous granules was apparent, especially during the follicular phase. Cilia were observed throughout of estrous cycle, although degeneration of cilia was not observed at any phase of the cycle. Prominent, striated rootlets were observed during both the follicular and luteal phases of the cycle. Maximum secretory cell differentiation was apparent during the follicular phase, at which time these cells were characterized by having a well-developed, rough endoplasmic reticulum with dilated cisternae, numerous ribosomes, and secretory granules of varied size and density. A prominent feature of the secretory granules was their membranous structure, consisting of concentric lamellae of equal dimensions. During the luteal phase, cytoplasmic protrusions were prominent, and extruded nuclei along with other cytoplasmic organelles were present in the tubal lumen. The presence of a well-developed, rough endoplasmic reticulum and numerous secretory granules during the follicular phase indicates that secretory activity of the uterine tube infundibulum may be stimulated by estrogen. During estrus, the cytoplasm of the stromal cells displayed abundant, rough endoplasmic reticulum with dilated cisternae. The increased and extensively dilated rough endoplasmic reticulum at the time of estrus probably indicates increased protein synthesis by the stromal cells. The presence of adenosine triphosphatase activity on the membrane of cilia suggests that this enzyme is involved in energy-forming reactions related to the vigorous action of cilia. The presence of acid phosphatase activity on the cell membrane of the epithelium, microvilli, and secretory granules may indicate involvement in the secretory mechanism of the cell.


Cardiac work demands and left ventricular function in end-stage renal disease.

Cardiac hemodynamics were assessed by right and left heart catheterizations in nine patients on hemodialysis. Results showed increased stroke work index and left ventricular work indices. Left ventricular end-diastolic pressure was elevated in all patients (markedly so in five) and did not fall with occlusion of arteriovenous communications. Cardiac output was significantly elevated, but fell to normal postocclusion. Myocardial oxygen consumption, indirectly assessed by tension time and pressure rate indices, appeared increased. Six patients died: four from complications attributed to myocardial failure without infarction, one from transplant-related complications, and one from bacterial meningitis. Five had increased cardiac weights at autopsy, but none showed infarction. This study suggests that increased cardiac work is present in chronic renal failure. Myocardial mass increases result in increased myocardial oxygen demand; however, the increased oxygen requirements may not be met because of reduced erythrocyte mass. Persistance of pressure-volume overload and severe anemia are conducive to myocardial failure.


Haemodynamic effects produced by insufflation of carbon dioxide into the abdominal cavity during laparoscopy.

Nine healthy women underwent diagnostic laparoscopy during balanced anaesthesia without halothane. Heart rate, blood pressure and cardiac output were measured before and after insufflation of carbon dioxide in to the abdominal cavity. The cardiac output was measured by a bedside radiocardiographic apparatus using 113Indium as a tracer. There was remarkable stability of the cardiovascular system during laparoscopy with only slight rise in blood pressure.


[Cutaneous manifestations due to acrylic resins used in printing].

In the plant of a large newspaper, the manufacture of printing plates using photopolymer acrylic resins, in the place of lead, resulted in a series of orthoergic and allergic manifestations in the workers. Chemical analysis resulted in the isolation of a tetraethylene glycol diacrylate, the harmful nature of which was proven by allergological studies. Its replacement by tetrathylene glycol dimethacrylate eliminated the problems seen (study based upon 300 allergological tests).


Height correlations between parents and mature offspring in normal subjects and in subjects with Turner's and Klinefelter's and other syndromes.

The correlations for stature between parents and grown-up offspring in 90 normal males and 116 normal females have been compared with similar correlations obtained in 27 adult males with Klinefelter's syndrome, 33 adult females with Turner's syndrome and in 75 adult patients with Down's syndrome. There was close similarity between the findings in the patients with sex chromosomal disorders and in normal subjects, a roughly constant amount of height being gained or lost through the chromosomal abnormalities. However the genetic pattern was lost in patients with Down's syndrome. In males with idiopathic precocious puberty and in untreated females with congenital adrenal hyperplasia, the parent-offspring correlations were not normal. In females with idiopathic precocious puberty they approximated normal values. The first two are pathological conditions of varying severity, whilst the majority of girls diagnosed as suffering from precocious puberty represent the extreme variant of normal.


[Recipient capacity of clinical strains of staphylococci belonging to different phage groups].

The recipient capacity of the strains of Staph. epidermidis and Staph. areus belonging to different phage groups, as well as the possibility of epidemic distribution of the erythromycin resistance marker among the clinical staphyloccal strains on using the defective phage obtained from strain 8325 P IIde was studied. The defective phage P IIde may be the source of epidemic distribution of the drug resistance among the competent strains of Staph. aureus. All erythromycin sensitive strains of Staph. aureus lysed by the phages of groups I and III proved to be competent recipients of the erythromycin resistance marker. The strains of Staph. aureus of phage group II and phage type 80/81, as well as the strains of Staph. epidermidis were not competent recipients under our experimental conditions. It was not possible to transfer the high level of erythromycin resistance (1000 gamma/ml) on transduction to the strains of phage group I with a relatively low level of resistance to this antibiotic (20-50 gamma/ml.


[Streptoverticillium albireticuli var. kokandum, a producer of the new antifungal pentaene antibiotic, kokandomycin].

Morphological, cultural and physiological properties of actinomycete L10-0208 were studied.  It was shown that actinomycete was a new natural variant.  It was named Streptoverticillium alboreticuli var. kokandum.  The physico-chemical characteristics of the pentaenic antibiotic are presented and its originality is shown.  The antibiotic is named kokandomycin.


Serum IgE in dermatitis and dermatosis: an analysis of 497 cases.

Serum IgE values from 497 patients with various forms of dermatitis, dermatosis, and tinea pedis were analyzed statistically and compared with values from 95 normal controls. The median and geometric mean values were significantly elevated (except in acne without atopy, lichen planus, and tinea pedis), even after exclusion of patients with a history of atopy or of cutaneous reaction to food or drugs. Serum IgE levels and atopic dermatitis have a close correlation. A modest positive correlation (p approximately equal to .05) appeared between the log serum IgE level and peripheral blood absolute eosinophil count in 80 cases of atopic dermatitis. A unique group of adult nonatopic patients had acquired generalized dermatitis and markedly elevated serum IgE levels (greater than 12,000 ng/ml). Our results suggest that, in most common dermatologic disorders, elevated serum IgE is a secondary phenomenon rather than a primary causative factor.


REM syndrome (reticular erythematous mucinosis): report of a further case or variant of it.

A 50-year-old woman had cervical lymphadenopathy, swollen and waxy-looking gums, and a diamond-shaped, reticular erythematous eruption on her back of eight years' duration. Histologic examination of the gingival tissue and skin showed round-cell infiltration around the small blood vessels and in the upper part of the dermis, and an extensive eosinophilic amorphous deposit throughout the dermis that stained with Alcian blue. The clinical and histologic features, although not identical, resembled those reported by Lischka and Orthenberger (1972) and later by Steigleder et al (1974).


Relationship of antibody affinity to onset of immune complex disease in New Zealand mice.

Affinity (KR) of antibody to human serum transferrin in New Zealand mice was measured by a globulin precipitation technique. KR was low in mice immunized early in life, increased with age of immunization up to 16-26 weeks, and then fell to low levels. KR in young and old NZB mice was increased by immunization with antigen in Freund's complete adjuvant. The correlation between low affinity antibody production and susceptibility to immune complex disease is discussed.


Sequential circulatory changes in the circumferentially burned limb.

To assess the hemodynamic alterations in the circumferentially burned extremity, Doppler arterial examinations and Xenon-133 washout determinations of muscle blood flow (MBF) were obtained in 27 limbs. In this laboratory normal resting MBF was 2.82+/-0.86 cc/min/100 gm (mean +/- S.E.M., N=26) with no value less than 1.60 cc/min/100 gm. In 27 circumferentially burned limbs, the maximum decrement in MBF occurred by 36 hours following thermal injury. The lowest MBF value in the 11 extremities not requiring escharotomy was 1.50cc/min/100gm. Escharotomy was done in 16 extremities. Mean MBF immediately prior to escharotomy was 1.30+/-0.26cc/min/100gm and improved to 4.43+/-0.52cc/min/100gm following escharotomy (p less than 0.01). Correlation between MBF and Doppler examinations was present in 63% of all studies and in 88% of studies performed immediately before or after escharotomy. The diagnostic sensitivity of Doppler examination required audible recognition of abnormal velocity signals as well as absent velocity signals. Because the intial MBF determination or Doppler examination is not helpful in predicting which extremities will eventually require escharotomy, sequential studies should be done during the first 36-48 hours following thermal injury.


Different degradation pathways for glucose and fructose in Rhodopseudomonas capsulata.

In Rhodopseudomonas capsulata the enzymes of the Entner-Doudoroff pathway and the Embden-Meyerhof pathway have been examined. Fructose-grown cells contained inducible activities of phosphoenolpyruvate-fructosephospho-transferase and 1-phosphofructokinase and only low levels of fructokinase and 6-phosphofructokinase. Although fructose-grown cells contained, in addition, all the enzymes of the Entner-Doudoroff pathway together with fructose-1,6-diphosphatase and phosphoglucose isomerase, the Entner-Doudoroff pathway was not operative in fructose catabolism and served only the degradation of glucose. The functional separation of glucose and fructose catabolism via the Entner-Doudoroff and a modified Embden-Meyerhof pathway, respectively, was confirmed by different approaches: 1. Radiorespirometric experiments with glucose and fructose labelled in positions 1, 2, 3, 3+4 and 6 have been carried out. The pattern of 14CO2-evolution from position-labelled glucose was characteristic for the Entner-Doudoroff pathway, that from position-labelled fructose for the Embden-Meyerhof pathway. 2. In the presence of arsenite up to 50% of glucose- and fructose-carbon was excreted as pyruvate. Using 1-14C-glucose, 86% of the pyruvate was labelled in the carboxyl group, whereas using 1-14C-fructose only 19% of the pyruvate was labelled in the carboxyl group. 3. A glucose-6-phosphate dehydrogenase-deficient mutant was isolated which lacked a functional Entner-Doudoroff pathway but which was unaltered in its ability to grow on fructose.