[Blastogenic response in vitro of lymphocyte acne vulgaris].

32 patients with different degrees of acne and 10 healthy controls were studied. On every one of them the test for lymphocytic transformation was performed looking for the range of blastogenic response, using PHA and CA. The positive findings with CA related to those obtained in normal subject would support the hypotesis that the cellular immunity as a response to CA antigens would be different in each patient according to the host local conditions.


[Laparoscopic findings in chronic hepatic porphyria (author's transl)].

The incidence and significance of gray patches on the hepatic surface found at laparoscopy was investigated in 50 patients with chronic hepatic porphyria. The color change was found in 38 patients; in 28 patients well defined gray dots were found. The incidence is not related to the degree of the metabolic disturbance. The gray patches contained 3-9 times more porphyrine than adjacent normally colored areas. Gray color and histological changes do coincide.


[Rupture of postoperative adhesions and hemorrhage--a rare complication of peritoneoscopy (author's transl)].

A case report is given of a patient, who had been operated upon because of gall stones before; the gall bladder had not been removed. At a later date peritoneoscopy was planned and gas insufflated into the abdominal cavity in the usual manner; the patient did not complain about anything particular during peritoneoscopy. However adhesions apparently having formed after the earlier operation between the spleen and the abdominal wall did rupture during this procedure leading to a continously oozing hemorrhage from the spleen. At surgery 3 1 of blood were found in the abdominal cavity and splenectomy became unavoidable. This case report is given in order to draw attention to this sort of complication of peritoneoscopy.


[Photographic documentation of peritoneoscopic findings with the polaroid camera (author's transl)].

Photographic documentation of peritoneoscopic findings is technically well developped, relatively easy to perform, and should be used, as a routine procedure. There are different methods available. The polaroid method is the method of choice, when a paper copy with adequate technical quality is needed at once; this is especially useful for the pathologist, who may evaluate polaroid copies along with bioptic material. The surgeon as well may preoperatively get some visual information if emergency surgery is to be done. The endoscopist is responsible for the quality of the picture himself; a photo laboratory is not needed. Own results and technical procedures are demonstrated.


[Use of colored samples in the detection of occupational exposure to allergic effects of chromium and nickel compounds].

By using a coloured sample with diphenylcarbazide, chromium content in raw materials and industrial intermediate products was determined. At the same time chromium content was determined quantitatively by atomic absorption. The method was said to be simple and easy to be done in any industrial physician's conditions. The sample's sensitivity was said to be 1:100 000. Results of the determinations indicated that protective leather gloves contained considerable content of chromium, and chromium-free machine oils and lubricants were polluted with chromium's minute quantities as the oils and lubrications were being used. It was stated that coloured samples aiming at the detection of chromium, cobalt and nickel should be routinely used in preventive activity of industrial physicians.


[Unloaded shortening velocity of the myocardium as an index of contractility (author's transl)].

An experimental study attempts to clarify the reasons for a fashionable over- or underestimation of the unloaded shortening velocity of the myocardium (Vmax) as an index of "contractility" in international cardiological literature. Long-term investigations on the isolated myocardial preparation as well as on the heart in situ support our own position: 1. Vmax of the myocardium is, without doubt, a value of greater relevance in muscle physiology independent of the interpretation related to the fundamental processes. 2. Vmax cannot be exclusively regarded as a function of the rate of cross-bridge movements, but is influenced by the Ca2+-concentration and consequently by the conditions of electromechanical coupling. 3. Vmax is not a reliable measure for myocardial power capacity under all conditions as this value on the one hand and the developed tension on the other are influenced to different degrees. 4. If the amount of contractile material per cross sectional unit is changed (changed relation of fibrils/mitochondria), Vmax can give better indications on the contractile elementary process than the developed tension. 5. Increased content of connective tissue and scars influence both the developed tension and Vmax. 6. A reduction in Vmax under long-term increased hemodynamic loading of the heart is not to be considered a priori as an expression of cellular damage.


The three dimensional architecture of the seminal vesical mucosa.

A comparative study of the histological presentation of the seminal vesical mucosa is made insisting on the necessity for a better knowledge of its tridimensional architecture. The use of the scanning electron microscope is completed by a three dimensional model of the mucosa in order to assure an accurate understanding of the histology.


Relationships between specialized cells, capillaries and intermediary cytofibrillary elements. Xth Note. Biological evolution of the emonctory subsystem and stereotype in invertebrates.

The paper points out the importance of homeostasis as the most general system of the organism (Ist order system) and the 2nd order subsystem which composes it, discussing the relations between them and the biological evolution of the emonctory subsystem in protists and invertebrates. The emonctory structures, functions and stereotype and their component parts are studied in protists, spongia, coelenterata and coelomata: lower worms, annelids, their hyponeurian descendents (arthropods, molluses) and epineurian descedents echinoderms and protochordates (Stomochordata, Tunicata, Cephalochordata). The structure, functions and stereotypes of protonephridia and metanephridia and of substitutive (vicarious) emonctory organs (nephrocytes and peritoneal cells) are studied in coelomatic invertebrates. Their evolution appears to be directioned to localize within the limits of the emonctory subsystem. During their evolution, some nephridial functions are performed by the vicarious emonctory organs. The evolution of the subsystem in invertebrates appears to be based on stable characters and their relationships with variable features.


Skeletal alterations induced by chloramphenicol in chick embryo.

The experiment was carried out on 200 Rock hen eggs. Three doses of chloramphenicol, 5 mg/egg, 2.5 mg/egg, and 0.5 mg/egg were administered. At the end of the incubation time the surviving enbryos were processed according to Dawson's method. The differences between some bones from the experimental lot and those from the controls as well as malformations and survivals were studied. The results confirm the teratogenic action, the inhibitory effect on skeletal development and the lethal effect of chloramphenicol. These effects are explained by the interrelation between chloramphenicol and the mesenchymal cell.


Effects of the epoxide hydrase inhibitor, 1,1,1-trichloropropane-2,3-oxide on the genetic activity of aflatoxin B1 metabolites in in vitro activation test systems.

The epoxide hydrase inhibitor 1,1,1-trichloroprophane-2,3-oxide (TCPO) was genetically active to cells of S. cerevisiae and conidia of N. crassa. This genetic activity could be eliminated or reduced to near spontaneous levels in the presence of the S-9 fraction of hamster liver homogenate. The addition of TCPO to an in vitro activation system containing aflatoxin B1 resulted in an increase in the genetic activity of aflatoxin B1, and this increase was dependent on the dose of TCPO. These results are discussed in relation to the possible metabolism of the promutagen aflatoxin B1.


Cytochemical demonstration of folic acid in normal and leukemic granulocytes.

By means of an original cytochemical method, folic acid was demonstrated "in situ" in peripheral white blood cells in acute and chronic granulocytic leukemia. In control blood smears folic acid-relevant granules were found predominantly in the nuclei of neutrophils and basophils. Eosinophils were found positive for folic acid reaction both in nuclei and cytoplasm. In leukemic undifferentiated cells, less marked in acute than in chronic granulocytic leukemia, the cytoplasms contained a great quantity of folate. Nuclei were fewer or nonreactive. Therefore the cytochemical localization may be related to the degree of the white cells differentiation.


Dynamics of regeneration in skeletal muscle following localized heat injury.

Local heat applied to rat skeletal muscle determines sudden and brutal necrosis followed by a process of regeneration which develops in a continuous and discontinuous mode. The complex cytohistological and histochemical modifications have been simultaneously followed up. Results may be summarized as follows: during the first 6 to 70 hours after heat application, a morphologica disorganization occurs at the level of both muscle fibers and muscle intertice. Protein reactions are very low or negative within this interval of time. After 10 days, at the site of the injury there appear regenerative elements: young muscle cells, mononucleated cells (myoblasts) and polynucleated myotubes (sarcoblasts). At the level of these formations and of muscular buds in the regenerating zones the histochemical reactions turn positive. Af 35 days after injury the damaged muscle fibres are reconstructed and the intensity of histochemical reactions equals that in the control. Results are indicative of the unity between reactivity of the morphologicall organized cell structure and that of the protein substrate.


Experimental aerogenic pulmonary berylliosis in rabbits.

The dynamics of pulmonary changes produced by a prolonged daily administration of 1 g per cent solution of BeSO4 in aerosols was pursued by current histopathological methods in periodically sacrificed rabbits. A progressive constitution of beryliosic granulomas involving intralobular and interlobular areas was observed. The epithelioids and giant cells were present in variable proportions. Concomitantly, a cellular thickening of alveolar walls and perivascular cuffs was noted, as well as an intercellular reticulin fibrillogenesis. The intratracheal three-fold administration of a 0.3 g per cent solution of BeSO4 induced a more rapid formation of berylliosic nodules with the same characters. The relation between the cell accumulation and reticulin fibrillogenesis was morphometrically analysed and statistically verified as pertinent correlated phenomena.


Immunomorphological reactivity of the intrapulmonary lymphoid tissue.

Young albino rats were repeatedly stimulated by a pulverized suspension of living pneumococci and others by intramuscular injection of killed microbes emulsified in complete Freund adjuvant. The bronchus associated lymphoid nodules increase in size and number; the proximal nodules contain one more follicle with germinal centers formed of pyroninophilic lymphoblasts and plasma cells at the periphery. The follicular organization and the pyronine - plasma cells differentiation point out the ability of these nodules to elaborate a local immune response to antigenic stimulation.


New directions in the evaluation and education of handicapped children.

The Education for All Handicapped Children Act of 1975, which went into effect last October, ensures the right of handicapped children to free appropriate public education. State and local education agencies are required to identify, evaluate and provide services for all disabled children. This multibilliondollar program will guarantee special education resources for up to 12 per cent of American children. A role for physicians in the program is implied rather than defined in the law. Their involvement will vary somewhat from state to state, but will at a minimum involve counseling parents whose children are under evaluation. The law assumes a sophistication of diagnostic ability and curriculum design that does not yet exist, and therefore places a special burden upon physicians to deal effectively with patients now, while developing better training programs and assessment tools, and makes essential the enhancement of the communication between doctors and educators.


Association of the B-cell alloantigen DRw4 with rheumatoid arthritis.

Previous testing of patients with rheumatoid arthritis showed that one HLA-D type, Dw4, occurred more frequently than in normal controls. B-cell alloantigens closely related to HLA-D can now be identified by a simple serologic procedure. Using this test, I studied 80 white patients with erosive, rheumatoid-factor-positive rheumatoid arthritis. The B-cell alloantigen HLA-DRw4 occurred in 70 per cent of 54 patients, as compared to 28 per cent of the 68 normal controls (P less than 10(-5)). Both groups were also tested for the HLA-A, B and C antigens and for HLA-D. HLA-Dw4 occurred in 54 per cent of the patients and 16 per cent of the controls (P less than 10(-5)). Small differences observed in several of the HLA-A and B antigens were not statistically significant. The results indicate that rheumatoid arthritis in whites is associated with genes of the HLA-D region and that immunogenetic factors linked to HLA have a role in its pathogenesis.


Affective and sensory dimensions of back pain.

Pain words used to communicate suffering were analyzed to identify specific dimensions of back pain. The words were obtained from a group of 131 patients suffering from back pain who described their discomfort on a standardized 87-item pain questionnaire. The results indicate that words descriptive of back pain are not associated in completely random ways. When patients complain of back pain, their report falls into 7 distinguishable patterns. The major pattern accounts for 38% of the variance and refers almost entirely to emotional discomfort. The second pattern accounts for 9% of the variance and is a mixed emotional and sensory factor. The remaining 5 patterns account for 29% of the variance and constitute an entirely sensory class of factors.


Multidisciplinary treatment of chronic pain: long-term follow-up of low-back pain patients.

Thirty-six patients with low-back pain who had been treated in our multidisciplinary pain center returned for 80-week follow-up evaluations by the staff pscyhologist, physiatrist and physical therapist. Statistically significant gains were maintained in the reduction of prescription analgesics and on 4 measures of physical functioning: (a) long-sittimg-to-toe; (b) straight-leg-raise; (c) knee-to-chest; and (d) overall exercise performance. Despite verbal reports of continuing pain, most patients claimed they were coping much better with it, and they displayed a marked reduction in their utilization of medical resources for further pain treatment. These long-term results suggest that a multidisciplinary approach can offer an effective means of treating chronic low-back pain.


[Calcified aseptic abscess due to Dracunculus medinensis (author's transl)].

A sterile abcess of the forearm caused by Dracunculus medinensis is described. Histologically, lysed and partially calcified worms and larvae were found one month after the outset of the swelling, giving a mottled aspect radiologically.


Production of DNA bifilarly substituted with bromodeoxyuridine in the first round of synthesis: branch migration during isolation of cellular DNA.

Incubation of human lymphoid cells with bromodeoxyuridine (BrdUrd) for short periods produces three classes of DNA containing analog: DNAHL (hybrid DNA, density approximately equal to 1.75 g/cm3), DNAint (intermediate density DNA, density approximately equal to 1.71 g/cm3), and DNAHH (DNA with both strands containing analog, density approximately equal to 1.80 g/cm3). Preparations of DNAint yield DNAHH after extensive shearing and/or treatment with single strand specific endonuclease. Cross-linking of pulse-labeled (BrdUrd + 3HdT) DNA in cells by treatment with trioxsalen and near UV light before lysis prevents the appearance of DNAHH.Cross-linking after lysis has little effect. A large fraction of DNAHH is obtained after incubation of cells with caffeine. Extraction of DNA at high salt concentration or cross-linking with trioxsalen and near UV light drastically reduced the amount of DNAHH obtained from caffeine-treated cells. We conclude that most DNAHH arises from in vitro branch migration in isolated DNA growing points.


Case report: primary actinomycosis of external oblique muscle.

A 67-year-old man had actinomycosis with primary involvement of the abdominal wall, which is rare. His chief complaint was an enlarging, hard, nontender mass in the right lower quadrant of the abdomen. The mass had been present for two weeks and measured 11 X 8 cm. An x-ray film of the chest, barium studies of the gastrointestinal tract, and an intravenous pyelogram showed no abnormalities. Excisional biopsy was performed, and the findings were consistent with Actinomyces israelii infection. There was no evidence of underlying bowel disease or break in continuity of the mucous membrane. The patient responded well to a three-month course of penicillin therapy.


Roundworm granuloma of the anterior abdominal wall.

A case of migration of a gravid female roundworm into the peritoneal cavity is reported. The presenting feature, a lump in the anterior abdominal wall, has not previously been documented. Fertilized ova of the worm were found in miliary peritoneal granulomata, and showed development up to the eight-cell stage.


[Incidence of glycosuria among the population of different age groups living in Andizhan and in the Andizhan district].

A total of 10330 persons, residents of the town of Andizhan (5292 persons) and of the rural districts of the Andizhan region (5038 persons) were examined for glucosuria; it was revealed in 306 persons (2.9%), somewhat more frequently in the urban than in the rural residents (3.1 and 2.8%, respectively); glucosuria was more incident in women than in men (3.3 and 2.4%, respectively); it was more frequently encountered in persons of older age groups than in young individuals (0.6--2.8% in persons aged under 30 years, and in 5.1--6.3% in persons aged from 30 to 70 years and older). Diabetic glycemic curves were found in 122 of 306 persons with glucosuria (39.8%); these curves were suspicious for diabetes mellitus in 63 persons (20.5%). Only in one of 149 persons (0.67%) of the control group without glucosuria was a diabetic curve revealed. The incidence of diabetic glycemic curves increased in persons with glucosuria with the advance of age (13.3% at the age of 10--19 years, and 68.4% at the age of 70 years and older). The authors recommend mass examination of the population for glucosuria by means of the glucose tolerance test for a more complete and timely diagnosis of diabetes mellitus. This is particularly expedient in case of persons of older age groups.


Cytotoxicity of 5-fluoro-2'-deoxyuridine: requirement for reduced folate cofactors and antagonism by methotrexate.

Protein in vitro inhibition of thymidylate synthase (5,10-methylenetetrahydrofolate:dUMP C-methyltransferase, EC 2.1.1.45) by 5-fluoro-2'-deoxyuridylate requires 5,10-methylenetetrahydrofolate. The cytoxicity of 5-fluoro-2'-deoxyuridine towards cultured L1210 mouse leukemia cells is reduced when intracellular reduced folates are depleted, either by limiting the source in media or by inhibition of dihydrofolate reductase with methotrexate. Likewise, the intracellular amount of 5-fluoro-2'-deoxyuridylate covalently bound to thymidylate synthase in L1210 cells treated with 5-fluoro-2'-deoxyuridine is greatly diminished when cells are depleted of folate cofactors. The folate requirement for optimal growth of L1210 cells is lower than that required for maximal cytotoxicity of 5-fluoro-2'-deoxyuridine. These findings provide a biochemical rationale that may be useful in designing clinical protocols that use 5-fluorinated uracil analogs.


Biochemistry of actomyosin-dependent cell motility (a review).

Actins and myosins similar to the major proteins of muscle are the major molecular components of intricate mechanochemical systems that perform numerous vital motility and structural functions in all eukaryotic cells. In this article, after a brief summary of the morphological distribution and ultrastructure of actin, myosin, and interrelated proteins of nonmuscle cells, our present knowledge of their biochemistry is critically appraised from the perspective that understanding complex cellular processes depends ultimately on the identification, purification, and biochemical characterization of the proteins involved. Although few conclusions are reached, possible molecular mechanisms for cellular regulation of actin polymerization, filament association, actomyosin ATPase activity, and mechanochemical coupling are discussed and a number of potentially fruitful directions for further research are suggested. These include comparative biochemical investigations and the study of the interaction of heterologous proteins, but particular emphasis is given to the need for quantitative studies at the molecular level of motility proteins purified from a single cellular source.


Postnatal changes in the DNA content of mouse cerebral hemispheres.

Changes in the wet weight of the cerebral hemispheres and in their DNA content and concentration were studied in CBA mice (non-SPF, Velaz, Prague) aged from 1 to 270 days. It was found that hemisphere wet weight rose by 350% between the 1st and 14th day and by a further 11% between the 14th and 180th day. In the next three months it remained stable. The total DNA content rose by 30% between the 1st and 2nd day and by 45% between the 1st and 10th day; changes between the 10th and 180th day were non-significant, but a decrease of 16% occurred by the 270th day. Between the 1st and 2nd day the DNA concentration did not alter, or rose non-significantly (+20%). Towards the end of the 2nd postnatal week it fell exponentially (-75%). Changes in the DNA content and concentration indicate that the rate of cell proliferation in mouse cerebral hemispheres is highest on the first two days after birth, while the general chemical composition of the hemisphere develops fastest between the 2nd and 14th day. The constancy of the DNA content between the 10th and 180th day implies that cell division in the hemispheres of adolescent and adult mice primarily reflects renewal of the non-neuronal cell population.


Age-dependence of succinate dehydrogenase (SDH) in rat liver and its inducibility after barbital and phenylbutazone pretreatment.

SDH activity in liver homogenates increases threetimes from one day before to one day after birth. The plateau till the 13th day of life is followed by a minimum on the 15th day of life, thereafter the increase leads to a maximum on the 120th day. The influence of phenylbutazone and barbital on body and liver weight as well as on hepatic SDH activity was investigated in different age groups. Both drugs were administered in three single daily doses, phenylbutazone additionally 31 days long. Hepatic SDH activity based on liver wet weight or liver protein did not change in any of the experimental groups. But as a consequence of increased liver body weight ratio (mostly non-significant), hepatic activity per gram body weight exhibited a tendency to higher values.


Activation of epileptic electrographic phenomena in the human EEG by nasal air flow.

The activating effect of deep oral breathing (with the nose closed) and nasal hyperventilation (with mouth closed) was examined in 62 patients with three different kinds of epileptic EEG abnormalities: unilateral localized temporal (fronto-temporal, occipito-temporal) abnormalities - group F, bilateral episodic theta-delta abnormalities - group TH, and bilaterally synchronous spike and wave abnormalities - group SW. Nasal hyperventilation was much more effective in group F and TH. Its effect was already significant 30-60 seconds after the start of deep breathing. In the group SW there were no statistically significant differences between the effects of nasal and oral hyperventilation. Unilateral nasal hyperventilation (the other nasal cavity being closed by tamponade) demonstrated a more pronounced activating effect on ipsilateral localized temporal EEG abnormalities. These effects of deep nasal breathing can hardly be explained by metabolic-vascular mechanisms, which probably are involved in the course of oral hyperventilation. On the other hand they are in agreement with animal experiments demonstrating that the mechanical stimulus of nasal air flow operates as a synchronizing impulse for certain rhinencephalic structures.


Stimulation of the thalamus and its effect on electrographic manifestations of the brain in unrestrained rats.

The thalamus was electrically stimulated in unrestrained rats with implanted cortical and subcortical electrodes. Single pulses often triggered rhythmic cortical activity identical with the 8--9/sec spike episodes which occur spontaneously in rats in the walking state. In rhythmic stimulation of the thalamus, self-sustained 3/sec spike-wave paroxysmal activity, with partial clonic jerks, was observed. Specific and non-specific thalamic nuclei participated in the production of these activities.


Stimulation of the hippocampus and its effect on electrographic manifestations of the brain in unrestrained rats.

The dorsal hippocampus was electrically stimulated in unanaesthetized, unrestrained rats with a cobalt-gelatin rod in their cortex. The significance of the hippocampus in the elicitation of both physiological spontaneous rhythmic activity (episodic activity of 8--9/sec frequency bound, in rats, to a state of quiet wakefulness, and "sleep spindles") and pathological rhythmic activity of the self-sustained after-discharge (SSAD) type was determined from the aspect of the EEG and behavioural characteristics. 1. Single electrical pulses (0.1 msec, 1--10 V, 0.3/sec) elicited an evoked potential bilaterally in the somatosensory cortex. Elicitation of rhythmic after-activity (of the type of episodes or sleep spindles) was observed only in some cases in which an adequately strong stimulus was used. 2. Repeated series of rhythmic electrical stimuli following each other at short intervals (2--3 min) led to the formation of SSAD in about one third of the cases and at all stimulation frequencies (3-15/sec), although low frequencies (3--4/sec) were the least effective. The character of the SSAD and simultaneous behavioural phenomena differed fundamentally from those evoked by electrical stimulation of the thalamus (Chocholová et al. 1977). The development of paroxysmal after-activity was signalled by responses of a more or less distinct "recruiting" character during stimulation. On the basis of a comparison of electrographic and behavioural manifestations after electrical stimulation of the thalamus and hippocampus, the possibility of both thalamic and extrathalamic projection from the hippocampus to the cortical region is considered.


The development of oxidative enzymes in rat liver mitochondria.

During early postnatal development there was an increase in the specific activity of a number of oxidative enzymes localized on the outer and inner mitochondrial membrane. The succinic oxidase complex of the inner mitochondrial membrane, whose activity in 1-day-old rats was 50% of the value in adult animals, attained the maximum on about the 10th day after birth. Activity of the choline and the proline oxidase complex, both of which are also localized in the inner mitochondrial membrane, was minimal in 1-day-old rats and went on rising after the 10th day. Rotenone-insensitive NADH-cytochrome c reductase activity, which is localized on the outer mitochondrial membrane, remained stable up to the 10th day, and rose between the 10th and the 90th day. Developmental changes in monoaminooxidase activity, which is likewise localized on the outer mitochondrial membrane, followed a similar course to the choline and proline oxidase complexes. The amount of cytochromes a+alpha3 and cytochrome b in isolated mitochondria did not alter during development. The protein spectrum of the mitochondrial particles, determined by polyacrylamide gel electrophoresis in sodium dodecyl sulphate, likewise displayed no marked changes during postnatal development. The above findings show that the metabolic functions of the mitochondria mature during development and that changes in the different enzymes have their own characteristic time course.


Glutamate dehydrogenase and glutamine synthetase activity in some organs of ruminants and monogastric animals.

A comparative study of glutamate dehydrogenase (GLDH 1.4.1.2) and glutamine synthetase (GS 6.3.1.2.) activity in liver, kidney and spleen homogenates from cattle, sheep, pigs and chickens showed that chicken liver contained on an average 3.5%, pig liver 8.3% and bovine liver 45.6% of the glutamate dehydrogenase activity present in sheep liver. Relatively low trace activity was found in the spleen and kidneys, except for the renal cortex of cattle (32% of activity in the liver). GS activity was the highest in chicken liver; in pigs it amounted to 33.40%, in cattle to 24.2% and in sheep to 19.7% of this activity. No marked interspecies differences were found in the values in the kidneys and spleen. It can be concluded from the results that the relatively high GLDH activity in the liver of ruminants compared with pigs and chicken is associated with the greater ability of ruminants to utilize ammonia. The higher GS activity and lower GLDH activity in chicken liver can be attributed to higher uric acid synthesis from ammonia via glutamine and purine bases and the lower ability of birds to utilize ammonia for protein synthesis. The presence of alanine dehydrogenase was not demonstrated in chicken liver, where the maximum oxidation of NADH after the addition to pyruvate and ammonia substrate was found.


Blood pressure and water and electrolyte intake and excretion in rats (Brattleboro strain) after unilateral nephrectomy.

Using Brattleboro rats with and without hereditary diabetes insipidus (DI, non-DI), blood pressure, water intake and the excretion of water, sodium, potassium and osmotically active substances were measured in intact individuals and in animals subjected to unilateral nephrectomy at the age of 23 or 80 days. The development of blood pressure (BP) changes, determined in unilaterally nephrectomized animals at the age of 4--6 months, depended on the age at which the kidney was removed. After nephrectomy at the age of 25 days, hypertension developed only in DI females given 0.6% NaCl solution to drink. The BP of those which drank water was unaffected. Unilateral nephrectomy at the age of 80 days produced a slight BP increase in females irrespective of whether they drank water or 0.6% NaCl, but in males only if they drank 0.6% NaCl solution. No hypertension was observed in intact animals. No relationship was found between water intake and the blood pressure level. The BP increase in water-drinking females uninephrectomized at 80 days was accompanied by a raised urine flow and raised excretion of osmotically active substances. Sodium losses in DI animals were greater than in non-DI animals and the urinary sodium concentration, in maximum dehydration, attained minimum values in DI and maximum values in non-DI animals. Unilateral nephrectomy at 25 days increased sodium losses in all the animals except non-DI females, but when performed at 80 days, only in DI males. No relationship between these results and BP changes was found. The possible relationship of the extrarenal consequences of absence of vasopressin to the development of experimental hypertension are discussed.


Formiminoglutamate excretion in rat urine after whole body irradiation, histidine administration, starvation and stress.

Formiminoglutamate (FIGLU) urinary excretion was studied in rats subjected to whole body 60Co irradiation with doses of 450, 650 and 850 R. During the first post-irradiation days, FIGLU excretion doubled after both lower doses. From day 3, 450 R led to a decrease, whereas 650 and 850 R were followed by a still enhanced FIGLU excretion. No correlation to the radiation dose was found. A daily intraperitoneal administration of histidine in a dose of 200 mg/kg led to a constant 5-fold increase of FIGLU output and to more distinct differences in post-irradiation FIGLU excretion. Two days starvation or ACTH administration, followed by doubled urinary total 17-hydroxycorticoids, did not interfere with FIGLU excretion.


[Treatment of traumatic sections of the Achilles tendon].

The author maintains that the atrophy of the sural triceps muscle, the retraction of the Achille tendon and the osteoporosis of the calcaneum and of the tarsian bones, occurring after the traumatic sectioning of the Achille tendon, are the results of an inadequate treatment. The cause of these sequellae is the immobilization of the foot in an equinus position, which relaxes the sural triceps and as a result of the lack of mechanical traction factor, leads to local circulatory disturbances followed by a modification in the structure of the bone and of the muscle. On the basis of this pathophysiological concept the author has excluded post-operative immobilization in the equinus position, and in fact any type of immobilization, recommending in contrast a mobilization of the foot from the very first days after the suture of the tendon. The clinical results obtained confirm the value of the hypothesis.


[Surgery of hiatal hernias].

On the basis of a study performed in 141 cases of hiatal hernia that have been hospitalized in the clinic a series of clinico-therapeutical considerations are made, with surgical implications. The most frequently encountered type of hiatal hernia was that occurring through sliding. Very frequently there are morbid associations (in over 60% of the cases) and this indicates the necessity for a complex study of the patients and a careful selection of the predominant affection. Only 81 of the patients that have been examined - that is 57% - had surgical indications. Two types of interventions have been associated: the correction of the diaphragmatic hiatus was always associated with an intervention in view of avoiding the repetition of the gastroesophagian reflux. Good and very good post-operative results have been obtained in 78% of the interventions and mediocre results in 22% of the operated patients.


[Necessary technic. Double ligation of the duodenal stump without plugging].

Gastrectomy with ulcer exclusion, associated to double ligature of the duodenal stump without infundation is a technique easy to perform in ulcers with difficult duodenum. This technique was successfully applied in 34 patients with sub-bulbar chronic duodenal ulcers (with norm- or hypoacidity), complicated by penetrating bilio-pancreatic callous lesions (one case of pancreatic fistula was recorded, that was treated with X-ray therapy). In another 10 patients with complicated ulcers (perforations - 5 cases, bleeding  associated with perforation - 2 cases) the authors used the same technique. Two deaths were recorded: through generalized peritonitis in one case and through duodenal fistula, melena and peritonitis in another case.


[Flexible metallic intramedullary nail, an ideal osteosynthesis material for femoral fractions].

The authors have used modified Ender nails for the treatment of femural fractures. Nails of different sizes are used in different arrangements, depending on the site of the lesion. Thus, for fractures of the femural neck 3 metallic nails, with a diameter of 4 mm are used, introduced through the internal supra-condylian aspect in paralel arcs; two nails, 5 mm in diameter, are introduced in the same way for the correction of the fractures involving the trochanterian massif; for fractures sited under the trochanterian massif (diaphysis, supracondylian, and supra- and inter-condylian), 5 mm diameter nails are used, placed on the internal and external aspects of the condyl in metalic arcs. This type of intervention was demonstrated to be stable, rapid, non-haemorrhagic and with low risk of shock. Supported walking is started in the first week after surgery--in cases with fractures of the trochanterian massif and of the diaphysis--provided these are stable fractures, in the first month when unstable fractures occur at the same level, and after 3--4 months in cases of fractures of the cervical neck. The authors' experience in the treatment of 250 cases is presented.


[Ultrasonic nephrotomography in the differential diagnosis of renal tumors].

Renal ultrasonography was performed in 40 patients. Complex exploration was carried out in 12 patients with renal tumours, such as: urography, renal scintigrams, renal arteriography, ultrasonography and cavography. Laminography was proved to be an useful method in the positive and differential diagnosis of renal tumours, especially of cystic ones. Informations provided by this technique are not absolute, and these are some possibilities for errors which operate both ways: omission of malignancies or affirmation of malignancy when the lesion is benign. The method should be considered as complementary in the field of renal investigations and will be interpreted in the general context.


[Spontaneous sigmoido-vesical fistula].

The colo-vesical fistula, most frequently of diverticular origin, usually occurs at a later age, when the diverticular disease is complicated by local and peri-sigmoidal processes. A characteristic of this disturbance is the fact that, although the causal affection is colical, the manifestation, at least initially, is mostly at the level of the urinary bladder, under the form of repeated bouts of cystitis of an apparently undetermined origin. Such manifestations should prompt, besides exploration of the urinary apparatus, also an exploration of the colon. The exclusively surgical treatment should be applied as early as possible after the identification of the fistular lesion, in view of preventing more severe local complications and ascendent urinary infections.


[Osteoma of abdominal scars].

The authors make a review of etiopathogenic theories and of therapeutic possibilities on the basis of a personal observation of a case with osteoma that developed on the site of a supra-ombilical scar ofter gastrectomy for ulcer.


Measurement of air flow in the maxillary sinus by hot-film technique.

A method of hot-film-anemometry was developed to investigate the velocity of air flow in the maxillary sinus which has hitherto not been detected by other methods. The hot-film-probe can registrate the slow but rapidly changing air flow dependent on the respiratory cycles. This study was performed during sinuscopy. The average of measurement values by quiet respiration was found in the sinus of 8 cm/sec during a velocity in the nose of 5 m/sec. The respiratory fluctuations in the nose induce a movement stream of circulation in the sinus. When inspiration changes to expiration there was still a flow but at a lower degree. No flow in the sinus could be observed between respiratory cycles. After sniffing the velocity peak rises to higher values. The air flow in the sinus depends on the patency of the ostium. In case of a reduced air flow we can distinguish between a partially open ostia and an obstructed one. The measurement demonstrates an injector-effect beside the influence of pressure difference and diffusion on the ventilation of the sinus.


[Intrapancreatic foreign body].

A case is presented, of a patient in whom a foreign body (metallic pin) was imbedded in the body of the pancreas, by penetrating from the level of D3. The case underwent surgery with good results.


[Nondiscal sciatica without organic lesion].

Among 1 800 patients operated on for hernia of the disc, 2% were completely negative on surgical exploration. Since a psychiatric aetiology might be involved, these patients were again given physical examination, clinical psychiatric examination and a personality test (minimult). This psychometric examination yelded pathological results in 68% of these patients. A comparison with two control groups operated on for hernia of the disc permitted a distinction of statistically significant differences. The results are compared with similar studies by other authors on patients with lumbalgia and dorsalgia. A practical approach is defined.


[Acute interstitial nephritis with oliguric renal failure following phenylbutazone medication].

Acute oliguric renal failure due to acute interstitial nephritis developed in a patient after treatment with phenylbutazone. The histological, immuno-histological and serological features in this case are compatible with the involvement of a delayed hypersensitivity reaction in the pathogenesis of this drug-induced interstitial nephritis. Other side effects of phenylbutazone on the kidney and the water and electrolyte metabolism are discussed.


Onychomycosis caused by Aspergillus terreus.

Four cases of onychomycosis caused by Aspergillus terreus are presented. The clinical characteristics consisted of spotted and striated leuconychia, dark spots and fragility of the nails. The mycology is described, and is shown that A. terreus has an inhibitory effect on the growth of dermatophytes and Scopulariopis brevicaulis. Topical treatment with 1% Pimafucin in a mixture of 60% dimethylsulfoxide (DMSO) and 40% water as well as 9% aqueous solution of sodium benzoate were both effective. The literature concerning onychomycosis caused by A. terreus is summarized.


Trichophytosis by double infection of Trichophyton schoenleinii and Trichophyton violaceum.

Chronic generalized trichophytosis in a 44-year-old female is reported. The disease began when she was 15 and gradually spread from the scalp. Surviving hairs on the scalp and eyebrows showed an endothrix invasion. Enlargement and fistulization of the cervical and axillary lymph nodes were also present. Trichophyton schoenleinii was cultured from the scalp while Trichophyton violaceum was isolated from the body skin, the nail and lymph nodes. Griseofulvin produced significant improvement with occasional relapses. The possible role of the basic cell-mediated immune defect, as revealed by the decreased number of the T and B cells, is discussed.


Effect of amphotericin B on the incorporation of neocarzinostatin into human gastric cancerous tissues.

AmB/NCS combination therapy against cancer was evaluated. Seven gastric cancer and 2 gastric polyp cases were treated in this manner and in addition 2 gastric cancer patients were treated with NCS alone, to serve as the control. AmB dissolved in glucose solution was administered intravenously as was NCS, which was given at the onset of gastric surgery. Lesion tissues and healthy tissues were collected from each patient and the NCS titers measured by bioassay. It was shown in the majority of the gastric cancer cases that the NCS levels in the lesion tissues were substantially higher than in the surrounding normal tissues, whereas in the gastric polyp and the gastric cancer patients who received NCS alone, no significant differences were found between the tissues.


Antibodies to donor B lymphocytes and mixed lymphocyte culture blocking in cadaveric renal transplantation.

In 33 renal allograft recipient-donor pairs, B and T lymphocyte complement-dependent cytotoxicity crossmatches and mixed lymphocyte culture (MLC) blocking experiments were performed and the results were correlated with graft outcome. MLC blocking particularly in the unidirectional culture against donor-stimulating cells, was highly correlated with the presence of complement-dependent cytotoxicity antibodies against donor B lymphocytes. Grafts in both MLC blocking and B lymphocyte crossmatch-positive groups fared equally as well as those without positive tests. No difference in graft outcome was noted when the presence or absence of MLC blocking was examined in relationship to positive or negative B lymphocyte complement-dependent cytotoxicity crossmatching.


Viability of T lymphocytes survived in frozen-thawed human bone marrow.

To know immunocompetence of cryopreserved human bone marrow, an optimal condition for cryopreservation of hemopoietic stem cells was determined on the basis of in vitro colony formation. Viability or immune function of frozen-thawed bone marrow lymphocytes was evaluated by spontaneous rosette formation and sheep red blood cells and mixed lymphocyte culture activity. It was demonstrated that the thawed marrow cells could form E rosettes and respond to alloantigens in mixed lymphocyte culture equally or more than those before freezing. Stimulating activity of cryopreserved marrow cells in mixed lymphocyte culture was not altered through a freeze-thawing process. These observations suggest that bone marrow lymphocytes may survive without losing their immunocompetence after freezing as well as hemopoietic stem cells.


Endomyocardial fibrosis in Chandigarh area, India. A study of nine autopsies.

The clinical and autopsy data of nine cases of endomyocardial fibrosis encountered over a period of 11 years are presented. These account for nearly 24% of primary cardiomyopathies and 0.8% of cardiac diseases seen at autopsy. There were four cases with biventricular endomyocardial fibrosis, three with a predominantly left and two with a predominantly right ventricular affection. There was no correlation between the clinical data and the autopsy pattern of endomyocardial fibrosis; all of them presented as congestive cardiac failure.


Flow rate versus bladder volume. An alternative way of presenting some features of the micturition of healthy males.

By transforming uroflowmetrograms from curves of flow rate versus time into curves of flow rate versus instantaneous bladder volume, additional information about the variation of the flow rate during voiding is obtained. These curves show that, within a certain volume range, the maximum flow rate is more or less independent of the voided volume. A second volume-independent parameter is the maximum contraction velocity, which can be calculated from the flow rate and the instantaneous bladder volume. This parameter is presumably a measure of the physiological maximum contraction velocity of the detrusor muscle.


Urodynamic equipment for screening and office use: CO2 cystometry.

A newly available compact urodynamic set-up is presented herein, consisting of a 2-channel CO2 pressure recording unit with flow registration. Flow, bladder and rectal pressure recording are considered the minimal requirements for obtaining sufficient information on functional changes of the lower urinary tract.


[Risk and complications in peritoneoscopy].

The work is based upon the authors' 10 years' experience with more than 1500 examinations. 87 of them were combined with target biopsy of visceral organs and 5--with target cholecystocholangiography. Peritoneoscopy is not free of complications. Being a surgical procedure, it requires a special surgical skill.


An economic appraisal of helminth parasites in sheep.

The economic effects of the common helminth parasites of sheep are described and the current methods of prophylaxis adopted by sheep farmers in the United Kingdom reviewed. More efficient prophylactic programmes are outlined and the economic benefit accruing from two programmes designed to control fascioliasis and parasitic gastroenteritis are presented in detail.


[Immunosuppressive activity of several drugs and their effect on antibody formation in pullorum disease].

Furazolidon given alone or in combination with chloramphenicol, with spectinomycin, with gentamycin or with sodium arsenilate as well as chlorpyrazine, applied alone, suppress the clinical manifestation of pullorum disease in birds both in the experimental and in the spontaneous outbreak of the disease. These medicinal drugs lower the production of agglutinins in birds--mostly the combination furazolidon+chloramphenicol, followed by furazolidon+sodium arsenilate. The same combinations do not prove essentially effective in influencing the development of the morphologic lesions and do not fully exempt the body from the causative agent of pullorum disease.


[Fibromatosis of the thyroid gland region. An electron-microscopic and enzyme-histochemical study (author's transl)].

Two cases of aggressive fibromatosis of the thyroid gland region were studied by histological, immunhistological and electron-microscopic methods. Contractile cells can be found in all tissue preparations using human serum containing antibodies to smooth muscle, especially in the periphery of the tumor. These cells have the characteristics of myofibroblasts by electron microscopy. The central areas of the tumor are composed of hyalin thickened bundles of collagen fibres with few cellular elements. The myofibroblast is thus considered to be the characteristic cell type of the tumor, and the pathogenesis and histogenesis of the lesion are discussed.


The endocrine pancreas in chronic pancreatitis. Immunocytochemical and ultrastructural studies.

The endocrine pancreatic tissue from patients with severe primary chronic pancreatitis (n=6). secondary chronic pancreatitis due to duct obstruction by carcinoma (n=6) and non-diabetic, non-pancreatitic controls (n=4) was studied qualitatively and quantitatively using specific immunocytochemistry and electron microscopy. Grouping of variously sized islets in the sclerotic tissue (sclerosis islets), islet neoformation by ductuloinsular proliferation, and intrainsular fibrosis were the main qualitative findings. Immunocytochemical quantitation of the distribution of insulin (B), glucagon (A), somatostatin (D) and pancreatic polypeptide (PP) producing cells revealed a significant relative increase in the number of A cells and a decrease in the number of B cells of the sclerosis islets in primary chronic pancreatitis ((B-44.1+/-9.3%:A-38.3+/-2.4%:D-8.6+/-5.1%:PP-4.6+/-4.1%) as well as in secondary chronic pancreatitis B-38.0+/-14.3%:A-38.4+/-19.0%:D-9.1+/-5.8%:PP-14.5+/-23.4%) compared with controls (B-71.1+/-8.1%:A-24.3+/-5.5%:D-8.0+/-2.8%:PP-0.5+/-0.4%). The number of PP cells was significantly increased in primary chronic pancreatitis only. It is suggested that scarring of the exocrine pancreas affects islet composition, probably by impairment of the local circulation and of glucose diffusion, thus leading to reduction of the number and glucose sensitivity of B cells. The hyperplasia of A and PP cells appears to be a secondary phenomenon due to the loss of B cells.


A case of heterotopic pancreas in lymph node.

A case of pancreatic heterotopia in a lymph node is described. Small pieces of pancreatic tissue were found incidentally in four lymph nodes located around the common hepatic artery in a 65-year-old man. Both exo- and endocrine elements of the pancreas, together with ductal structures were found to constitute the heterotopic tissue. No authentic case of heterotopic pancreas in lymph nodes has been previously reported in the literature.


Three-dimensional morphology of the liver in cirrhosis and related disorders.

Cirrhotic livers of different types were subjected to three-dimensional graphic reconstruction of nodules, interstitial septa and blood vessels from serial histologic sections. It was found that in all cases adjacent cirrhotic nodules were connected to one another so as to form a nodular network, in spite of their apparent separation in histologic sections. The nodules were linked in the form of chains with abundant anastomoses, and the network was 'conjugate' with the intrahepatic vascular tree, as revealed by its close relationship to blood vessels. A parenchymal network of the same type was also found in livers with subacute or chronic hepatitis, suggesting that this type of structure was common to cirrhosis and its precursor lesions and represents the geometrical configuration of hepatic parenchyma surviving zonal hepatic necrosis. A Re-examination of chronic liver disease in terms of its structural framework provided a new viewpoint from which to analyse the morphogenetic problems of these disorders.


Lack of evidence of chalone activity in used medium and extract of JB-1 tumor cells in vitro. A flow cytometry study.

In cell-free mouse ascites fluid from the JB-1 ascites tumor in the plateau phase of growth low-molecular chalone substances have been found which reversibly and specifically arrest JB-1 cells in the G1 and G2 phase of the cell cycle. The aim of this study was to investigate whether chalones were involved in the regulation of in vitro growth of JB-1 tumor cells. Used medium and cell extract from confluent, stationary JB-1 cell cultures were investigated for proliferation-inhibitory properties. JB-1 cells from stationary cultures were explanted in test cultures and the traverse of cells through the S phase was investigated by means of flow cytometry (FCM). Inhibition--expressed as a delay of the traverse of cells through the S phase--was not observed when a surplus of used medium, concentrated and fractionated used medium or concentrated and fractionated cell extract from JB-1 cells in vitro was added to test cultures. On the contrary, used medium and concentrated and fractionated used medium stimulated growth. Thus, no involvement of chalones in the growth regulation of JB-1 tumor cells in vitro was detected.


[Sex hormone balance in prostate cancer].

In cancer of the prostatic gland of stage II--III in males, 50--60 years, a reduced gonadial endocrine function is observed, that is manifested in a considerably reduced excretion of testosterone and estrogen. Because of the different rate of reduction in the testosterone and estrogen excretion in patients 50--69 years of age, one may observe the state of relative and in 70--80 years old patients--absolute hyperandrogenization of the organism, which is likely to be an unfavorable factor, taking into account the property of testosterone metabolites (dihydrotestosterone in particular) to enhance proliferative processes in the prostatic gland.


An experimental model of analgesic-induced renal damage--some effects of p-aminophenol on rat kidney mitochondria.

1. p-Aminophenol, a known nephrotoxin, has been studied as a model for phenacetin-induced renal damage. 2. Respiration, oxidative phosphorylation and ATPase activity were inhibited in mitochondria isolated from the kidneys of treated rats; this could not be reversed by the addition of exogenous loosely bound cofactors and bovine serum albumin to the assay medium. 3. After treatment the mitochondrial levels of sodium and calcium were increased, potassium decreased and magnesium unaltered. 4. Mitochondria isolated from treated rats showed ultrastructural damage. 5. The results are interpreted to indicate that renal tubular cell mitochondrial injury is important in triggering cortical analgesic renal damage.


Histological and histochemical pattern of phytohemagglutinin (PHA) skin test in patients with sarcoidosis.

Phytohemagglutinin (PHA) is a non-specific stimulant of blastogenic transformation and proliferation of T-lymphocytes in vitro. This material has been used for detection of a reduced lymphoblastic transformation in vitro and, as a skin test, for providing information in the evaluation of cellular immunodeficiency in man (BLAESE et al. 1973). As in sarcoidosis the immunological features are "depression of delayed-type hypersensitivity suggesting T-cell anergy and raised serum immunoglobulins suggesting B-cell overactivity", the authors used PHA skin test in comparison with patients with tuberculosis and M. Hodgkin. PHA positive reactions recorded at 72 hrs. were in 95% for sarcoidosis, 90% for tuberculosis and 5% for M. Hodgkin. But the histological and histochemical investigation of cutaneous biopsies demonstrated three significant differences at 72 hrs. in untreated patients with sarcoidosis compared to the material of tuberculosis patients: formation of lymphatic pseudo-follicles, an increased number of arteriovenous anastomoses and appearance of C-mucopolysaccharide (a histochemical marker of connective tissue in sarcoidosis). There were in sarcoidosis, unlike tuberculosis, blast cells, plasmocytes and a number of lymphocytes at 72 hrs. It is difficult for the authors to explain the different behaviour of the PHA skin test in sarcoidosis and tuberculosis. The appearance of the C-mucopolysaccharide might be a result of the raised serum level of IgM in patients with sarcoidosis.


[Effect of a decrease in the concentration of serotonin in the brain on elaboration and preservation of defensive conditioned reflexes].

Injection of a total dose of 1200 mg/kg of parachlorphenylalanine to mice leads to a 75% drop in the serotonin (5-OT) content in the brain with a subsequent return to the initial level in seven days. The processes of elaboration and reproduction of conditioned defensive active and "passive" avoidance reflexes were studied against the background of reduced 5-OT content. It has been assumed that the observed disturbances in elaboration are linked to the increased fear emotion when the mice are placed in new surroundings. Disturbances in retention of the "passive" avoidance conditioned reflex are in fact disturbances of its reproduction. A conclusion has been drawn that a drop in the 5-OT content in the brain does not prevent the formation and fixation of defensive temporary connections.


[Microelement metabolism in patients with hereditary extrapyramidal diseases].

The author studied 40 patients with hereditary extrapyramidal diseases, including 8 cases with Hallerworden-Spatz disease, 13--with Hutchingtons chorea and 23 with torsion dystonia. For control purposes 20 normals were studied as well. The studies were aimed at determining the iron, manganese and zinc content in the blood plasma in the diurnal urine by means of an atom-absorbtional spectrophotometry on the apparatus "Perkin--Elmer-503" with the use of black lead flasks. These parameters were correlated with the clinical syndrome, severity of the condition and its duration. In order to detect the possible intercorrelations between the trace elements the method of a correlational level with determination of Spearman's coefficient was used.


Electromagnetic blood flow measurement during extended deep femoral angioplasty.

Electromagnetic flow measurements have been made on 53 patients undergoing extended deep femoral angioplasty. Flow measurements were made on the common femoral artery before reconstruction, after reconstruction and following an intra-arterial injection of papaverine. Flow measurements were correlated with the clinical outcome of the operation. The follow-up period varied between 6 and 30 months. There was no significant difference in follow-up period between the success and failure groups. The operation produced a significant increase in volume flow in both the success and the failure group. Flow velocities before and after reconstruction were, however, significantly higher in the success group. The results indicate that flow velocity measurement is preferable to volume flow measurement in assessing the long-term success of extended deep femoral angioplasty. A flow velocity of less than 5 cm per second achieved after reconstruction is likely to lead to failure; more than 10 cm per second indicates the likelihood of success.


Heterotopic bone formation in upper midline abdominal incisions.

Five cases of heterotopic bone formation in upper abdominal incisions within one year are presented. The patients were male, with a mean age of 52 years. The bone formation was diagnosed by palpation and X-ray and in 3 cases verified by operation and histology. The condition is said to be very rare.


Bipolar cautery for laparoscopic sterilization.

Laparoscopic sterilization with a bipolar electrode was performed in 62 patients. The sterilization failed in one patient and was questionable in another. The effectiveness was assessed by hysterosalpingography (HSG) in 51 patients. No complications due to laparoscopy occurred. The method is considered to be advantageous because of the low risk of complications. The effectiveness of the method seems to be acceptable.


Scanning electron microscopic observations of a mucopolysaccharide coating on human corneal endothelium.

Scanning electron microscopic observations of human corneal endothelium revealed a binding of ruthenium red-osmium tetroxide to a material on the inner surface of the endothelial cells on the cornea and the trabecular meshwork. The coating material was partially digested by proteolytic enzymes.


The immunological relationship between filtrable agent, Salmonella and murine leukosis.

Salmonella typhimurium was invariably isolated from our J strain murine leukosis. Immunization of D103 mice with either inactivated Salmonella typhimurium or the cell-free extract of leukosis inhibited the transplantation of leukosis. The adoptive immunization of D103 mice with spleen cells of Strong A mice immunized with either Salmonella or the cell-free extract of leukosis inhibited the transplantation of leukosis. The addition of either Salmonella or the cell-free extract of leukosis inhibited the migration of macrophages of leukosis spleen in tissue culture. Strong A mice is non-susceptible to J strain leukosis. However, inoculation of neonatal Strong A mice with the cell-free extract of leukosis produced a susceptibility to the transplantation of leukosis. These results suggest that both a filtrable agent and Salmonella typhimurium are present in cells of this leukosis and might be etiologically related to the leukosis.


Actomyosin ATPase activity of human laryngeal muscles.

The muscles from seven human larynxes removed by laryngectomy have been examined for actomyosin ATPase by histochemical methods. The various muscles contained a mixture of ATPase low (type I) and ATPase high (type II) muscle fibres. The thyreoarytenoid muscle had the highest proportion of type II fibres (65%) and the posterior cricoarytenoid muscle had the highest proportion of type I fibres (67%). The other laryngeal muscles had intermediate valves. All human laryngeal muscles had a higher percetage of type I fibres than the corresponding muscles in animals so far examined, a finding which may be related to the development of speech.


Use of the halo-pelvic apparatus for treatment of fracture-dislocations of the thoracic and lumbar spines accompanied by paraplegia.

Twenty-five cases of paraplegia due to fracture-dislocations of the thoracic and lumbar vertebrae were treated using the halo-pelvic apparatus. Thirteen of them only needed the apparatus, two underwent laminectomy, and ten had posterior spinal fusion in addition. The advantages of this method are that gentle reduction can be achieved without severe complications, and that posterior spinal fusion can be performed with this apparatus on, thus enabling an early start to the subsequent exercise program and minimal absence from work.


Surgical treatment of gastric cancer with special reference to lymph node removal.

Factors influencing the prognosis in gastric cancer treated by curative resection include lymph node metastasis and the extent of invasion of the gastric wall. Lymph node metastasis can be removed surgically, but the extent of invasion is not amenable to external measures. Of these two factors, the extent of wall invasion has the greatest influence on prognosis in cases undergoing curative resection. With lymph node removal of equal extent the prognosis worsens in proportion to the depth of invasion. Further, lymph node metastasis increases with increasing depth of invasion. Metastasis was seen in Group 2 and 3 nodes in more than 60% of cancer with invasion beyond the Tunica muscularis propria (pm), indicating that wide lymph node removal is essential in cancers with deep invasion of the wall. The effects of extended radical operation on the host as illustrated by the indices of total serum protein and albumin levels were no different from those of less extensive resections. It was confirmed that extensive radical resection did not delay postoperative recovery.


A new nail-plate for treatment of fracture of the neck of the femur.

Operative treatment of fractures of the neck and trochanter of the femur does not always produce a satisfactory result. This is usually due to biomechanical problems with the available internal fixation methods. We studied the anatomy of the neck of the femur by roentgenograms and sectional specimens from 70 cadavers. In addition, various nail-plates were subjected to buckling tests and, by simultaneously attaching a strain-gauge, stress distribution was calculated. The results of these preliminary studies were then used to design a new nail-plate better than those available at present. Testing of this new nail-plate confirmed that it had a strength equal to that of the Holt nail-plate (the strongest of the available nail-plates).


Adenomatoid tumor of the uterus: report of a case and review of the literature.

A case of uterine adenomatoid tumor in a 47-year-old female was studied with both light and electron microscopes. The tumor was circumscribed, 2.5 cm in diameter, and located in the posterior wall of the uterus. In light microscopy, tumor cells showing "signet-ring" appearance arranged in cords or tubules. Hyaluronidase-sensitive acid mucopolysaccharide was present in the cells and luminal surfaces. Mucicarmine stain was negative and periodic acid-Schiff reaction was faintly positive. In electron microscopy, the tumor showed basal laminae, well-developed desmosomes and numerous microvilli. Intercellular spaces were present between adjacent cells. Small intercellular spaces were separated from the large lumens by desmosomes and tight junctions, while large spaces communicated with the tubular lumens. Forty-four reported cases of adenomatoid tumor in females were briefly reviewed.


[Spontaneous transformation in LTT of patients with atopic dermatitis and other allergic skin diseases (author's transl)].

Increased spontaneous transformation rates have been repeatedly found in the LTT of patients with neurodermits or other diseases. We were interested in the question, if they are to induce artificially. On 37 voluntary persons the LTT was performed before, 24, 48 hours and 1, 2, 3 and 4 weeks after an intracutaneous injection of 0,1 ml of Candidin. On 19 test persons a statistically significant and on further 4 a distinct increase of spontaneous transformed cells in the LTT was to record compared with the culture before the injection of the antigen. This phenomenon was only to detect on low levels of spontaneous transformation (to 3%) in the initial culture. The importance of this observation is discussed in regard to immunological processes in the organism during an antigen exposition as well as to its relation with the evaluation of the LTT.


Specific and non-specific skin test reactions with animal dander extract.

Intradermal skin tests have been performed in atopic patients with allergenic extracts of different animal danders at uniform concentration. A high incidence of positive test was recorded which could not be related to the clinical histories, especially with the allergens of horse, cow and dog dander (NR). Better correlation was observed with guinea pig and cat allergens (R). The incidence of NR reactions was highest in the house dust allergy group of patients; with the exception of horse dander allergen, the frequency of R reactions was more pronounced in the grass pollen group. It is suggested that both allergen-specific and non-allergen-specific mechanisms may contribute to positive wheal and flare reactions.


[The kinetics of the humoral and secretory IgA-production at the beginning of an acute respiratory disease (A.R.D.) in infants (author's transl)].

On three consecutive days at the beginning of an acute respiratory disease (A.R.D.) we analysed the concentration of IgA in the serum and in the aspirate of the nasopharyngeal region (N.P.A.) of 13 infants from the age of 3 up to 21 months (average age: 7.4 months). We found, that the absolute concentration as well as the dynamics of the changes of the concentration were higher in the N.P.A. than in the serum. The differences found are statistically significant. On the basis of these pathophysiological facts a screening-method could be developed for the early diagnosis of acute virus diseases of the upper respiratory passages.


Clinical signifcans of longitudinal determination of immunoglobulin values in infants with acut respiratory diseases.

The immunoglobulin values (IgM, IgA, IgG) were determined longitudinally in 73 infant with acute obstructive bronchitis; with acute obstructive bronchitis associated with bronchopneumonia; with bronchopneumonia. The immunoglobulin values were determined by single radial immunodiffusion method. The comparison of time of clinical recovery and x-ray clearing on the one hand and the normalisation of immunoglobulin values on the other hand was done too. It was found that the high immunoglobulin values were maintained  after the clinical recovery and x-ray clearing the longest period of time in infants with acut obstructive bronchitis. In infants with acute obstructive bronchitis associated with bronchopneumonia the high immunoglobulin values were maintained very long but they were normalised on the 34-30th day of clinical recovery and x-ray clearing. In infants with bronchopneumonia the high immunoglobulin values were maintain considerably shorter and they were normalised on the 6th day after the clinical recovery. Whit regard to different time of normalisation of immunoglobulin values in infants with acute obstructive bronchitis associated with bronchopneumonia it was concluded that the longitudinal determination of immunoglobulin values has clinical significance since it can be found which of these two diseases is dominant.


Trend of IgD values during the hyposensitization in children suffering from bronchial asthma.

In 50 children, aged from 3 to 14 years, with bronchial asthma the IgD values were determined before and during the hyposensitization. The estimation of IgD values was made with method of single radial immunodiffusion, using Partigen plates - Behringwerke products. The IgD values were determined in seven serum samples in each investigated child. In 7 cases (14%) IgD was not found before hyposensitization. From 43 cases (86%) in whom the IgD value was found 34 (79%) had IgD values under 50% from the standard value and only 9 cases (21%) had the values over 50%. During the hyposenitization it came to changes in distribution of IgD values and only in 11 cases (29%) it came to real increase of IgD values. All investigated children had positive "skin-sensitive" reaction during the hyposensitization. On the base of the results obtained it could not be drawn a conclusion on relation between the IgD values and the effect of hyposensitization.


Lymph node activating factor from mixed cultures of allogeneic lymphoid cells: effect on the lymph nodes of euthymic and athymic mice.

The action of "lymph node activating factor" (present in supernatants from 4hr cultures of allogeneic lymphocytes) on the lymph nodes of athymic nu/nu mice, nu/+ hybrids and euthymic BALB/c mice was studied. An increase in lymph node weight, cellularity and changes in lymph node morphology, i.e. an increase of the dense lymphatic tissue of the cortex and paracortex and appearance of follicles with light centers, were found in all mice. Lymphocyte activation evaluated by the presence of lymphocytes with RNA synthesizing nucleoli occurred only in nu/nu mice and nu/+ hybrids. Marked changes in lymph node morphology found in nu/nu homozygotes suggest relation of the lymph node activating factor to mediators acting directly on B cells.


[The effect of chloroquine diphosphate upon tissue mast cells in rat's skin (author's transl)].

The number and morphological changes of the mast cells were studied in the skin of three groups white rats. The first group was treated subcutaneously with 5 mg/kg body weight chloroquine diphosphate for twenty days, the second group was treated with saline; the third group was not treated at all. An absolute increase of the number of mast cells in the animals treated with chloroquine diphosphate was established. It was assumed the increase of the mast cells is connected with the activation of the histidine-decarboxylase and the rise of the histamine level in the site of chloroquine diphosphate application.


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

A high concentration of precipiated immune complexes inhibits the in vitro migration of human polymorphnuclear leucocytes. On the other side a low concentration of insoluble antigen-antibody complexes as well as soluble immune complexes were found to stimulate the migration. The immune complexes act indirectly on the migration of neutrophils by a nonspecific release of mediators from neutrophils. Since immune complexes may influence the migration of granulocytes, it is important in leucocyte migration tests used for evaluation of cellular immunity to avoid the presence of immune complexes.


Experimental investigations in guinea pigs on the recognition of the allergic eczematous reaction: A comparison of the macrophage migration inhibition test with the patch test.

1. The patch test as an in vivo test has disadvantages. It is our impression that biologically false reactions occur in approximately 5%. 2. The MIT as an in vitro test is very time consuming, but safe for the patient. It is supposed to give up to 20% false reactions. 3. In 76 and 72% of 156 guinea pigs sensitized with potassium bichromate and sulfasol respectively, both the test methods gave results in agreement. 4. Sensitization by potassium bichromate estimated by patch test only was 30%, and by MIT only also 30%, but the two test methods disagreed in 24%. 5. Sensitization by sulfasol evaluated in the patch test only was 36%, and in the MIT only 48% but the two test methods disagreed in 28%. 6. The differences between the results of the two test methods are not satistically significant and their failure rate does not provide absolutely sure results, but we believe that the patch test is preferrable in recognition of contact allergy because it is in vivo and probably has a lower failure rate in comparison with the MIT in the human.


Erythrocyte membrane Na+ and K+ activated adenosine triphosphatase in protein-calorie malnutrition.

Total, ouabain insensitive and ouabain sensitive Na+ and K+ adenosine triphosphatase activity in the erythrocyte membrane of protein-calorie malnourished children with marasmus and kwashiorkor was compared with the enzyme activity in apparently healthy children (normals). Na+ and K+ contents of erythrocyte and plasma were also determined in these patients. Specific activity (units per milligram of membrane protein) of ouabain sensitive Na+ and K+ adenosine triphosphatase was significantly higher in erythrocyte membrane preparations from children with kwashiorkor but not from children with marasmus. After 4 to 5 weeks of treatment with diets sufficient in protein and calories the specific activity of the enzyme was lower as compared to that on admission. Erythrocyte and plasma Na+ content (microgram/10(6) cells and microgram per milliliter of plasma) in children with kwashiorkor were not different from those in normal children, however, there was reduction in K+ content of erythrocytes and plasma of these children. After treatment, erythrocyte Na+ and K+ and plasma K+ in children with kwashiorkor increased significantly. In marasmic children erythrocyte Na+ was higher as compared to normal but there were no differences in K+ content of either eyrthrocytes or plasma in these children.


"Mitral stenosis" secondary to combined "massive" mitral anular calcific deposits and small, hypertrophied left ventricles. Hemodynamic documentation in four patients.

Certain observations are described in four elderly women with massive mitral anular calcific deposits, small thick-walled left ventricles and diastolic gradients between pulmonary artery wedge position (or left atrium) and left ventricle. All four patients had some degree of obstruction to left ventricular outflow. Examination at necropsy (two patients) or at operation (one patient) disclosed only focal fibrous thickening of the mitral leaflets without commissural or chordal fusion. By auscultation, none had mitral opening snaps, only two had loud first heart sounds and only one had a mitral diastolic rumble. Hemodynamic documentation of a diastolic gradient between pulmonary artery wedge position (or left atrium) and left ventricle in the presence of massive mitral anular calcific deposits and in the absence of diffuse disease of the mitral leaflets has not been demonstrated previously. The diastolic gradients are considered to result from the combination of the large mitral anular calcific deposits and the small, thick-walled, noncompliant left ventricles.


An etiological survey of the severely retarded Hertfordshire children who were born between January 1, 1965 and December 31, 1967.

An etiological survey is presented of all suveryl retarded children living in Hertfordshire, at home and in residential care, born between January 1, 1965, and December 31, 1967. One hundred and forty-six children (87 boys and 59 girls) were ascertained, out of a total population of 46,960, with a prevalence of 1 in 320 or 3.1 per 1,000. Approximately 1/3 (47) had the Down syndrome, 1 per 1,000 population. It was possible to establish a diagnosis in a further 45 cases, which included 1 additional case of autosomal chromosome abnormality and 7 each of autosomal dominant, recessive and X-linked conditions; 17 were associated with presumed multifactorial etiological factors; in 6 the condition was thought to have been caused by an environmental agent. It was not possible to establish a cause in the remaining 54 cases. Recurrence risks of severe mental retardation in cases where it is possible to establish a definite diagnosis are discussed and the potential value, for genetic counseling purposes, of a categorizing such patients into broad symptomatological groups, is suggested.


MA changes in institutionalized Down's syndrome persons: a semi-longitudinal approach.

A semi-longitudinal approach was employed in this partial replication of a larger study of MA changes in institutionalized retarded persons (Fisher & Zeaman, 1970). Curves were fitted to MA data for a Down's syndrome group and a group of retarded subjects matched on the basis of initial Ma and CA. The findings generally replicated those of the earlier study. Specifically, the results of a multiple regression/correlation analysis indicated that the two curves were similar in shape, but differed with respect to height.


Underestimating the educability of Down's syndrome children: examination of methodological problems in recent literature.

For many years, the educational capabilities of Down's syndrome persons have been underestimated because a large number of studies purporting to give an accurate picture of Down's syndrome persons' developmental capabilities have had serious methodological flaws. A close examination of that literature, coupled with a look at findings from two current early education projects for Down's syndrome children, revealed that psychometrically defined educability is far more common in Down's syndrome persons than a cursory review of the literature would lead to believe.


Evaluation of spectinomycin and gentamicin in the treatment of hospitalized patients with resistant urinary tract infections.

Spectinomycin hydrochloride 140 mg/kg/day and gentamicin 3 mg/kg/day were evaluated in the treatment of 50 hospitalized patients with urinary tract infections. Seven patients (28%) in the spectinomycin group had positive urine cultures after 72 hours of therapy due to initial resistance of the organism (5 isolates) or development of resistance to spectinomycin (2 isolates). Response to gentamicin therapy was uniformly satisfactory. Complications of spectinomycin therapy included pain and induration at the injection site (11 patients) and elevated serum creatinine values (2 patients). Ototoxicity was noted in three patients given gentamicin. Peak serum concentrations of spectinomycin (range 55-157 microgram/ml) and gentamicin (range 2.8--8.5 microgram/ml) showed marked interpatient variation. Spectinomycin appears to be of limited value in the treatment of urinary tract infections caused by gram-negative bacilli.


Fostering the object construct: large-scale intervention with handicapped infants.

Parents provided their developmentally delayed infants with sequential experiences intended to foster the development of the object construct. The participants were enrolled in a multidisciplinary early intervention program serving a wide spectrum of impaired infants from a large, rural geographic area. In comparison with infants who were not exposed to object-construct intervention, infants who received training performed moderately but significantly higher on Scale I of the Uzgiris-Hung Ordinal Scales of Psychological Development.


Randomized trial of emergency mesocaval and portacaval shunts for bleeding esophageal varices.

A randomized trial of emergency portacaval or mesocaval shunting was conducted in twenty-four cirrhotic patients bleeding from esophageal varices. The group of eleven patients having mesocaval shunts was comparable to the group having portacaval shunts in age distribution, sex, and preoperative physical condition. Postoperative fatality rates were 46% after portacaval shunting and 73% after mesocaval shunting. Results favor portacaval shunts for the emergency control of bleeding varices in the spectrum of patients seen in an urban hospital.


[The fine structure of the epithelium of the main outlets from the liver and pancreas of the domestic chicken (author's transl)].

Light- and electronmicroscopic and some histochemical investigations on the major excretory ducts of pancreas and liver was carried out on 24 adult chicken. The epithelium of both ducts was shown to include: cells with apical secretory granules, non-differenciated duct cells, ciliated cells and migrating cells. In addition the epithelium of the pancreatic ducts included goblet cells. The distal plasmalemm and the microvilli are covered with surfacecoat, which like the secretory granules produces precipitate with PA-silver. This area of the cell also shows a strong reaction to M++ and Ca++ activated ATPase.


Ultrastructural studies on the formation of myoflilaments and myofibrils in the human embryonic and adult hypertrophied heart.

The myofibrillogenesis in the human embryonic heart is described. The synthesis of thin filaments, which are the first to appear, takes place in close proximity to smooth surfaced SR tubules. Z-band material is closely related to the thin filaments and appears first as irregularly distributed patches in the filamenteous mass. Further cellular differentiation includes an organization of the thin filaments/Z-band material. The synthesis of thick filaments, which follows that of the thin filaments, takes place in ribosome rich areas of the cell. They are rapidly incorporated into the strings of organized thin filaments/Z-band material. The periodic binding sites on both kinds of filaments are believed to play an important role in the precise ordering of the filaments. The formation of myofilaments in the adult hypertrophied human heart is also described. The similarities between this process and that observed in the embryonic heart are striking, and we believe it to be the same process.


Myelinated nerve fiber supply and muscle spindles in the respiratory muscles of cat: quantitative study.

The present study was undertaken to provide quantitative data on the myelinated fibers of the phrenic and intercostal nerves and the number of spindles in the main respiratory muscles of the cat. The myelinated component of the phrenic and intercostal nerves was studied in the cat. Histograms of sequency distributions as a function of nerve fiber diameter were established for normal nerves. Certain nerves were then examined 35 to 40 days after excision of the dorsal spinal ganglia. The muscle spindles of the corresponding muscles were counted and localized, and, on the basis of several morphological criteria, were classified with those usually described in the interosseous muscles. The study of the nerves, as that of the spindles, demonstrates clear differences of proprioceptive innervation among the respirator muscles. The lateral part of the diaphragm and the Triangularis sterni have practically no spindles. The external muscles of the first thoracic spaces are very rich in spindles. Respiratory muscles can be ranged in an almost continuous manner between  these two extremes.


Rapid isolation of chloride cells from pinfish gill.

Enriched fractions of chloride cells with good ultrastructural integrity have been obtained from gill filaments of the euyhaline teleost, Lagodon rhomboides. The branchial epithelium from seawater-adapted fish was dissociated by gentle mechanical means in a Ca++, Mg++-free balanced salt solution. Density gradient centrifugation of the mixed cell suspensions through a Ficoll gradient yielded a fraction containing between 50 and 70% chloride cells. This fraction showed a 3- to 4-fold enrichment over comparable gill homogenate values for sodium plus potassium-activated adenosinetriphosphatase, (Na+, K+ ATPase), an enzyme concentrated in chloride cells. Isolation of chloride cells from fish adapted to one-third seawater was less successful, due to the smaller size and reduced number of these cells, although fractions with at least a 2-fold enrichment of the enzyme were obtained. These results continue to support the belief that chloride cells are responsible for osmoregulatory activity associated with the branchial epithelium of teleosts and that this vital function is mediated through the activity of the transport associated enzyme, Na+, K+-ATPase, the specific activity of which increases with osmotic stress.


Gas embolism death after laparoscopy delayed by "trapping" in portal circulation.

A young woman died suddenly about 1 hour after instillation of CO2 for diagnostic larparoscopy. Post-mortem x-rays revealed large volumes of gas in the portal system, the heart, and the brain. In addition, autopsy revealed gas bubbles in the coronary arteries, pulmonary hemorrhage and edema, and a probe-patent foramen ovale. We postulated the "trapping" of gas in the portal circulation and affirmed this by experiments in 6 dogs. We further postulate the delayed and intermittent release of this gas and of platelet aggregates into the systemic circulation would occur in volumes which would be insufficient to produce hemodynamic signs yet sufficient to produce serious pulmonary insult.


[New species of the genus Nocardia and its antibiotic properties].

A culture of a new species of Nocardia, i.e. N. indigoensis producing an antibiotic close to celicomycins was isolated from a soil sample of Kazakhstan plated on the selective medium with kanamycin. By a number of chemical properties and biological activity the antibiotic differed from celicomycins. Probably it is a new natural substance.


Haemangioma with coagulopathy: sustained response to prednisone.

Two cases of giant haemangioma with thrombocytopenia are described. A satisfactory and sustained response to prednisone was achieved in respect of both coagulation abnormalities and tumour size. It is proposed that prednisone is effective by enhancement of thrombosis and reduction of fibrinolysis within the tumour, thus promoting a natural form of resolution. It is suggested that prednisone therapy should be first-choice treatment of complicated haemangiomas.


Experience with dacron graft arteriovenous fistulas for dialysis access.

The technique, hemodynamics, and results of a new, more successful Filamentous Velour Dacron graft dialysis fistula between brachial artery and axillary vein are described. Hemodialysis has been successfully instituted in 15/16 patients. One graft was removed for infection and one for overlying skin erosion. There have been five episodes of thrombosis, all with successful restoration to function. After a median nine-month follow-up, nine of 16 grafts have been complication-free and 13 of 16 remain functional or functioned until the time of death. Hemodynamic studies revealed that with high flows (even 1900 cc/min), there was no evidence of cardiac failure or peripheral "steal". One patient with low flow (less than 300 cc/min) had transient distal ischemic symptoms and another with similar flow later developed arterial occlusion distal to the fistula after suffering a myocardial infarction. With increased attention to technical details observed in this early experience, it appears that greater than 80% of these grafts should provide long-term dialysis access for this difficult patient population.


The trousers-shaped baffle for use in the Mustard operation.

The trousers-shaped baffle has been found very useful in intraatrial correction of transposition of the great arteries. Reasons are given to explain the particular form of the patch, and details of the operative technique are described.


Intermuscular abdominal implantation of permanent pacemakers in infants and children.

Pacemaker implantation in infants and young children presents technical problems because of the relatively large size of the units. Various implantation sites have been employed to avoid the problems of unsightliness, migration, skin necrosis with infection, and patient discomfort. We are presenting a new technique which obviates these difficulties. The pacemaker generator is located in a space developed between the muscles and fascia of the abdominal wall. This site will accept even the largest of demand pacemakers with cosmetically acceptable results.


Vena cava interruption after pulmonary embolectomy.

Interruption of the inferior vena cava for thromboembolism is occasionally apppropriate following either pulmonary embolectomy or other cardiac operation performed through a median sternotomy. Experience has shown that simple extension of the sternotomy incision to the umbilicus is a quick and practical means of obtaining good exposure for caval interruption.


A new prosthesis for reconstruction of the left ventricular outflow tract.

A new left ventricular outflow tract prosthesis is described. It consists of a tightly woven Dacron graft with one end modified by being wrapped around a thin perforated stainless steel tube to form a rigid left ventricular insertion port and the other end anastomosed to a Hancock xenograft valved conduit for suture to the arterial system. The prosthesis is simple in design and flexible enough to permit anastomosis to any portion of the abdominal aorta. In addition, since the entire blood conduit consists of a porous woven arterial graft and a tissue valve, anticoagulants are not required. The prosthesis has been successfully employed in a 7-year-old boy who had undergone two previous open-heart operations for resection of a subaortic ring but who had persistent evidence of severe residual stenosis. We believe this conduit has advantages over present commercially available units.


Valve placement in the ventricular apex for complicated left ventricular outflow obstruction.

Successful correction of severe valvular calcific aortic stenosis is described in which a stented porcine aortic heterograft was placed in the ventricular apex. Creation of a double outlet is a valid alternative approach to relieve left ventricular hypertension, and indication for such a procedure may be encountered unexpectedly. Intramyocardial placement of a durable tissue valve provides a simple and effective option for the cardiac surgeon.


[Total replacement of the ascending aorta with reimplantation of the coronary arteries. Technic and indications].

Our experience with nine total replacement of the ascending aorta with reimplantation of the coronary arteries has led us to advocate this as the technique of choice for curative treatment of ascending aortic aneurysms when these involve the sinus of Valsalva, and of acute dissecting aneurysms of the aorta when the tear in the intima is situated in the ascending portion. An endo-aneurysmal approach simplifies the operation and considerably reduces the blood loss during surgery.


[Prolactin and thyrotropin after stimulation by thyrotropin releasing hormone a study under long-term administration of oral contraceptives (author's transl)].

The longtime application of oral contraceptives is assumed to elevate serum prolactin levels under non-stimulated conditions. We therefore examined whether oral contraceptives also will augment prolactin secretion after stimulation, e.g. by thyrotropin releasing hormone (TRH). After TRH stimulation the time sequence of secretion both of prolactin (HPRL) and thyroid stimulating hormone (TSH) was determined. Three groups of women were tested in a non-randomized study: group 1 without any hormonal medication (= controls), group 2 taking an oral contraceptives containing cyproterone acetate, group 3 using an oral contraceptive containing d-norgestrel. HPRL secretion was similar in all three groups, the same held true for TSH. A possible correlation between the secretion of HPRL and TSH was examined in the control group. No such correlation was found. The secretion patterns of both hormones also were different. In addition, the basic levels of both HPRL and TSH did not seem to influence the response after stimulation.


[Clinical and biochemical studies in three pregnancies with placental sulphatase deficiency (author's transl)].

Three pregnancies (two I. parae and one II. para) with abnormally low urinary estrogen excretion of less than 5 mg estrogens per day have been investigated in this study. After intravenous injection of 100 mg DHA-S to the mothers no increase of estrogen production was observed. The level of human placental lactogen, was found within normal range. Ultrasonographic measurement of fetal size and monitoring of the fetal heart rate have demonstrated fetal benefit. At the end of pregnancy the cervix of both did not dilate after infusion of Syntocinon. Healthy male infants were delivered by Caesarean sections in both cases. The II. para, however, developed spontaneous labour and delivery at term. Clinical and laboratory tests have indicated the possibility of rare placental sulphatase deficiency. After delivery the placental steroid sulphatase activity was measured as the rate of hydrolysis of (6,7-3H) oestrone-sulphate or (4-14C) dehydroepiandrosterone-sulphate during in vitro incubation with the homogenate or the microsomal fraction from the pathological placentae. In all three cases the specific activity of 3-sulphatase was considerably (more than 80%) decreased when compared to three normal placentas, whereas the activity of the other enzymes (17beta-hydroxysteroidoxidoreductase, delta4/5-isomerase, aromatizing enzyme system) was found within the normal range.


Treatment of necrotizing fasciitis caused by Staphylococcus epidermidis.

Postoperative necrotizing fasciitis with septicemia caused by Staphylococcus epidermidis was documented by cultures of the blood and wound biopsy specimen. Therapy consisted of surgical debridement, topical application of mafenide acetate dressings, and parenteral administration of cefazolin sodium. The combination effectively reversed the progression of infection and necrosis.


Persisting structural abnormalities in liver, kidney, and muscle tissues following hemorrhagic shock.

Hemorrhagic shock-induced abnormalities of liver, kidney, and muscle morphology were studied sequentially for eight days following shock and resuscitation in rabbits. The findings revealed marked structural changes, some of which became more pronounced between one and three days after shock and all of which persisted for at least three days. All of the tissue changes reverted to near normal by eight days. The specific findings included hepatic sinusoidal compression with cellular swelling and vacuolization one day after shock; renal vacuolization and swelling of proximal tubular convolutions, culminating in widespread cellular damage three days after shock; and separation of myofibrils and disruption of the band pattern in muscle tissue. These findings demonstrated the prolongation of the morphological abnormalities induced by shock, previously observed only in the acute phase, and the capacity for structural repair by the tissues after reversible hemorrhagic shock.


Multiple aneurysms in dacron velour graft.

Fomation of an aneurysm in a Dacron graft is a rare complication. It usually occurs within two years from operation. Most cases take the form of a generalized dilation. Multiple saccular aneurysms developed in a patient with a Dacron velour graft. The cause of the complication is not always clear, but multiple defects in the construction of the Dacron graft seemed the most likely cause in this case.


Common bile duct obstruction associated with a dacron H-graft portacaval shunt.

An unusual patient had ascending cholangitis secondary to common bile duct obstruction by stones and a Dacron graft previously utilized in the performance of an H-graft portacaval shunt. Erosion of this foreign body into the common bile duct appeared to be secondary to bacterial contamination of the graft and direct contact of the foreign material with the biliary tree.


The carbohydrates of influenza virus. II. Gas chromatographic analysis of glycopeptides derived from viral glycoproteins and mucopolysaccharides.

Two carbohydrate fractions can be obtained from egg-grown influenza virus after Pronase digestion followed by gel chromatography. One fraction contains glycopeptides (MW ca. 2000--2600) which represent the carbohydrate side chains of the viral glycoproteins. The constituent sugars of this material are fucose, galactose, glucosamine, and mannose, and their position within the side chain has been partially elucidated by methylation studies. The other fraction (MW greatest than 6000) appears to be mucopolysaccharide and is composed of fucose, galactose, glucose, galactosamine, and glucosamine.