Circadian and seasonal variations of some metabolic parameters in the serum of the albino laboratory rat (Rattus norvegicus var. alba).

Total protein (TP), glucose (GL), esterified fatty acids (EFA) and total cholesterol (TC) were determined at 4-hour intervals during the 24-hour cycle in the serum of 270 female Wistar rats, in February, May and July. The results can be summed up under the following points: 1) The differences found between the levels of the given parameters in February, May and July were statistically highly significant. The greatest differences were observed in the TC level, which was lowest in July (0.82 mmol/l) and highest in February (1.87 mmol/l). The highest TP and GL values were found in May (62.5 g/l; 10.69 mmol/l) and the lowest in February (40.1 g/l; 7.8 mmol/l). The smallest differences were observed in the EFA level, which was highest in July (8.09 mEq/l) and lowest in February (6.39 mEq/l). The minimum 24-hour variations in the levels of most of the given parameters during the 24-hour cycle were observed in May (compared with February and July). 2) In a study of TP and GL concentration, the time of day was found to be a very important factor. The maximum TP level during the 24-hour cycle was found most often in the early morning or forenoon, while the blood glucose level was highest at about midday and in some cases in the early morning. The blood cholesterol level was relatively stable during the 24-hour cycle and it is impossible to draw definite conclusions from its fluctuations. Changes in the EFA level during the 24-hour cycle were likewise irregular. 3) Except for cholesterol, interindividual differences in the levels of the given parameters in the various months seem to be statistically non-significant.


[Onset of arthrosis. Physiopathologic, nosologic and therapeutic perspectives].

The author has studied specimens of patellar articular cartilage obtained by drill biopsy during 45 operations for chondromalacia patellae. The samples were examined by electron microscopy. Thirty patients were suffering from early chondromalacia and 15 from long standing chondromalacia. The findings showed that the initial lesions were located in the superficial layer of the cartilage in areas subjected to high pressure. The author considers that a better knowledge of the evolution of the cartilaginous lesion can lead to better treatment, either medical or surgical.


[Functional study of a double arthrodesis of the foot].

The authors have reviewed 190 feet treated by double arthrodesis for a variety of lesions including post-traumatic deformities, flat foot, paralytic lesions, club foot and other conditions. Follow-up was more than two years in 101 cases, more than five years in 73 cases and more than ten years in 30 cases. The importance of obtaining a good correction of both hindfoot and forefoot is emphasized. The long-term results of feet correctly aligned was good. The fate of the neighbouring joints and the functional adaptability of the foot have been studied. Details of surgical technique are given.


[Combination of methylmethacrylate (acrylic cement) and antibiotics. Bacteriologic and mechanical study].

The authors report the results of a study about the association of acrylic cement with antibiotics. Three cements have been tested: Simplex, CMW, Palacos, with 14 different antibiotics. A series of experiments has been carried out in three phases: a macroscopic study of the polymerisation of the mixture; in vitro bacteriological studies; and mechanical studies (trials of resistance to traction, flexion, shock measuring the modulus of elasticity and hardness). In vivo bacteriological testings have been carried out on 10 patients. It has come out from this study that the polymerisation of cement, usually does not destroy antibiotics which remain active and that the mechanical properties of cement are modified in sundry manners. All  additions of tested antibiotics modifie mechanical properties by about 25 p. 100 but some additions seem to be preferable. Improvements must still be made and confirmed by this type of research.


[Aseptic osteonecrosis in the renal transplant patient. Apropos of 27 surgically treated cases].

The authors have treated 27 cases of avascular necrosis of bone in patients following renal transplantation. They have noted some specific features--early onset after transplantation, multiple localization and rapid and severe progress of the lesion. The authors discuss the pathogenesis as it relates to cortico-steroids, bone dystrophy due to renal failure and the effects of dialysis. Surgical treatment requires special care because of the poor general condition of the patient. Operations have been done on 20 hips (12 forages, 1 cup arthroplasty, 2 Moore prostheses, 5 total prostheses) and 7 knees (1 forage, 6 removal of loose bodies). Two procedures were found to be valuable at the hip--forage at a very early stage and total prosthetic replacement. The indications for operation depend on the degree of functional disability. For the knee, necrosis affected both the femoral and tibial component resulting in effusion and locking. The only useful procedure seemed to be removal of loose bodies. In every case, surgical procedures must be conducted under careful and constant medical supervision.


[The use of sulphan blue dye during surgical procedures for bone infection].

Sulfan blue is a vital dye which can be injected intravenously before a surgical procedure and produces a greenish coloration of all vascularised tissues. The authors describe the technique of its use and its toxicity. This technique makes it possible to recognize during an operation all devitalised tissues and to excise them with greater accuracy.


[Conservative treatment of osteoarticular tuberculosis of the elbow].

The authors have applied conservative treatment in 21 cases of tuberculosis of the elbow with 12 months of specific chemotherapy and antibiotics and plaster immobilization for 3 montths followed by rehabilitation. Four elbows were ankylosed at the end of treatment. Seventeen elbows had useful joint mobility. In thirteen cases, there was more than 70 degrees of movement in flexion but the results were not so satisfactory as regards pronation and supination. The authors believe that conservative management gives better results than surgery by arthrodesis or resection.


[Treatment of patello-femoral arthrosis by anterior displacement of the tibial tuberosity (Maquet procedure)].

The authors have treated 71 cases of patello-femoral arthrosis by anterior displacement of the tibial tuberosity to diminish pressure of the patella. In most cases, an osteotomy of the tibial crest was made and forward displacement maintained by the addition of a bone graft. The medial and lateral patellar retinacula were divided, the patellar articular cartilage was shaved and fine drill holes made in chondromalacic cartilage. The results were satisfactory in 75% of cases but the follow-up was short (about one year). It was concluded that the tibial tuberosity should be displaced forward by about 2 centimetres. The surgical technique is fully described.


[Osteotomy of the calcaneus for pes cavus in childhood].

Osteotomy of the calcaneus (Dwyer procedure) was performed in 14 children (26 feet) aged between 5 and 15 years. On four occasions it was associated with an osteotomy of the first metatarsal and on three occasions with tarsectomy. The technique is described and the results are analysed. The authors conclude that the results were good in children under the age of 10 whilst the feet were still supple. In children over the age of 10, in whom the feet were more rigid, the gait was improved but the cavus deformity was not improved. The best age for operation is between 6 and 10 years.


[Fractures of the tibial shaft treated by blind intramedullary nailing. A review of 521 cases].

The authors have studied a series of 521 fractures of the tibia treated by blind intramedullary nailing without reaming. Union by the 120th day was obtained in 93.3% of cases. Malunion was uncommon and was related to an inadequate initial reduction. A secondary procedure was only necessary in two cases of malunion. In closed fractures, no case suffered infection. In compound fractures, 4.3% became infected (5 osteitis, 4 septic non-union) but all cases were cured by secondary procedures. Aseptic non-union occurred in 2.3% of cases. The authors recommend the use of nails of at least 8 mm diameter driven down to the region of the lower articular surface. In patients with a narrow medullary canal, or in fractures of the lower third of the tibia, the authors consider that reaming would have given better results. In other types of fracture reaming is more hazardous than useful.


[Conservative treatment of deformities of the anterior chest wall].

The authors have treated 55 deformities of the anterior chest wall in children. There were 37 cases of symmetrical pectus carinatum, 15 cases of asymmetrical pectus carinatum and 3 cases of pectus arcuatum. Associated lesions of the ribs, scapulae and spine are described. Treatment in every  case was by plaster casts followed by a plaster jacket and exercises. The results were much more satisfactory in deformities associated with prominence than with depression of the sternum. In pectus carinatum, the results were better when the apex of the deformity was more distal. The best age for treatment was between 12 and 13 years. No patient was treated by operation.


[Results and limitations of rehabilitation in cerebral palsy].

The authors have studied 1575 children treated by rehabilitation, splintage and eventually surgery. Some were followed up for 25 years and all were followed up for more than 4 years. The results are described for the upper limb in hemiplegics and quadriplegics and for the lower limb in paraplegics and quadriplegics. An analysis was made of the influence of I.Q., age at onset of treatment, and neurological features (spasticity, athetosis, sensory deficiency, anaesthesia). It is concluded that some attempts to treat must always be made. The authors describe the results that may be expected.


[Planning and building with responsibility towards society].

Comprehensive general provisions in the field of social legeslation and an excellent building programme have provided essential pre-requisites for therapeutic work and rehabilitation procedures for the disabled. Less favourable, however, is the public attitude vis-à-vis the societal responsibilities. In the building sector this is reflected in the poor quality of the architectural environment, e.g., unimaginative layout plans, careless building agglomerations, and town planning developments determined by economic interests, all causative factors to disabilities and fruitless rehabilitation efforts. Depending upon the planners' and architects' understanding of the constructed environment as a decisive influential factor on the individual and society's behaviour the town planning and architectural prerequisites for integration, community living and solidarity will be provided, or not. Also, the individual performance of the building experts determine whether, for the disabled citizens, too, the houses, flats, towns and regions produce a friendly or inhospitable atmosphere, or no atmosphere at all. We must call for an architecture with artistic quality based on the liberal and social principles of our basic civil rights.


[City guides for the disabled - an interim balance (author's transl)].

The following article wants to bring city guides for the disabled into focus, which appeared in rapid succession in the Federal Republic of Germany since 1971. After reflecting about the purpose and effect of city guides upon the consumer, city planners, and the wider public the author surveys hitherto published guides. Based on his own essential contribution to the making of the guide to the city of Ludwigshafen the author retraces the various stages of conception.


[The effects of wheelchair dependency on the self-concept (author's transl)].

The article studies the question whether the self-concept of wheelchair-bound people - as described in a personality questionnaire (Freiburg personality inventory) - differ from that of the non-disabled and other disability groups, and to what extent. The study was performed on 297 wheelchair-bound persons and corresponding reference samples. There was evidence that differences between these groups are existent. The way wheelchair-bound people describe themselves indicates mechanisms developed to compensate for reduced self-acceptance. Furthermore, the study results argue in favour of psychological training methods to be applied in the rehabilitation of this disability group and the development of appropriate measuring instruments.


In vivo responses of alloreactive lymphocytes stimulated in vitro. Skin graft rejection mediated by MLR-Primed lymphocytes.

Mouse lymphocytes that have been primed in vitro against alloantigens show a specific increase in cells reactive to the priming antigens in mixed lymphocyte response (MLR) and include cells that are specifically cytotoxic in vitro. The primed population also contains cells capable of causing rejection of skin grafts when injected into nude mice. Functional enrichment of cells capable of rejecting skin grafts bearing specific alloantigens and depletion of cells capable of rejecting a third-party graft have been shown. Priming the cells a second time in vitro may result in a moderate enrichment of cells capable of rejecting the specific graft and depletion of cells reactive to third-party skin compared with once-primed cells. These findings support the prediction that the MLR is an in vitro model of allograft responses in vivo.


[Therapy of acute gonorrhea].

Since the appearance of totally resistant, penicillinase producing gonococci, penicillin should no longer be considered first choice in the treatment of acute gonorrhea. In order to limit further extension of resistant strains, thiamphenicol (Urfamycin 2,5 p.o. or 0,75 i.m.) or spectinomycin (Trobicin 2,0 i.m.) are suggested as replacements for penicillin.


[Benign acute pericarditis: choice of treatment?].

101 cases of acute benign pericarditis covering a period of 18 years are reported, and it is stressed that 80% of patients who relapsed had been treated with corticosteroids. It was also found that corticotherapy did not favourably influence the evolution of the tamponade risk, the persistence of cardiomegaly or pericardic constriction. It is concluded that, except for a few well-defined indications, corticotherapy is to be avoided in the treatment of acute benign pericarditis because of the high risk of recurrence. Some suggestions regarding the indications for corticotherapy are presented.


In vitro proliferative response of chronic lymphocytic leukemia.

The peripheral blood lymphocytes of 13 previously untreated chronic lymphocytic leukemia (CLL) patients showed a decreased and delayed response in vitro to plant mitogens (PHA and PWM) and specific antigens (PPD and MLC). In addition, the serum of these patients inhibited the mitotic reactivity of both autologous and homologous normal lymphocytes. Since incubation with CLL serum did not affect the SRBC-rosetting capacity of normal lymphocytes, we believe that CLL serum interferes with some metabolic stage in blastogenesis rather than at the level of mitogen membrane interaction. The in vitro transformation of lymph node, bone marrow and peripheral blood lymphocytes in some of these patients was also investigated. Stimulation of peripheral blood cells with plant mitogens resulted in a more serious impairment of the response than that found with bone marrow and lymph node cells. This could be explained by the fact that, although CLL is a widespread lymphoproliferative disorder, some preferential homing of normally reactive cells in the bone marrow and lymph nodes cannot be excluded. Finally, since no stimulation was observed in mixed leukocyte cultures (MLC), our experiments provide evidence that no antigenic differences are detectable in CLL lymphoid populations.


Membrane adenosinetriphosphatase: a digitalis receptor?

The enzyme Na+,K+-ATPase is a good model for receptor studies because of its known functional correlates. The binding of digitalis to the enzyme observed in vitro satisfied the criteria for receptor binding. Studies of the relationship between the digitalis binding and the drug action reveal an impressive correlation between these events but fail to provide proof of a causal relationship. Studies with other Na+,K+-ATPase inhibitors and agents that affect transmembrane Na+ movements (steps that would follow Na+,K+-ATPase inhibition) provide further supportive evidence that sodium pump inhibition and the resulting enhancement of intracellular Na+ transients cause the inotropic action of digitalis.


Mucopolysaccharidosis in a cat with arylsulfatase B deficiency: a model of Maroteaux-Lamy syndrome.

A Siamese cat that presented clinical signs similar to those seen in humans with mucopolysaccharidoses was studied. The animal excreted increased amounts of polymeric glycosaminoglycans in the urine, consisting almost entirely of dermatan sulfate. Electron microscopy of circulating polymorphonuclear leukocytes revealed the presence of many membrane-bound lamellar inclusion bodies. Sulfate incorporation studies with cultured skin fibroblasts indicated defective glycosaminoglycan degradation. These cells showed a deficiency in arylsulfatase B activity. The disorder appears similar or identical to the Maroteaux-Lamy syndrome described in humans.


Aortico-left ventricular tunnel with natal cardiac failure.

Presented is a case of aortico-left ventricular tunnel in a 1-day-old girl who was in shock and severe cardiac failure. The clinical, auscultatory, hemodynamic and angiocardiographic, surgical, and pathologic findings in this case and from the 21 others reported in the literature are described. The diagnosis should be considered in an infant or child with signs of aortic insufficiency. Aortography is diagnostic when a localized supravascular aortic channel communicating with the left ventricle is opacified. Definitive treatment is surgical, though residual aortic insufficiency is common.


Lifetime covered earnings and quarters of coverage of retired and disabled workers, 1972.

This article presents information on the lifetime covered earnings of retired-worker and disabled worker beneficiaries under OASDHI, the year of their first earnings credits, their quarters of coverage, and the relationship of these factors to 1972 benefit levels. Among both groups, relatively more women began earning credits after 1940; they also worked fewer years in covered employment and had lower lifetime earnings overall. Their benefits were thus smaller than those of men. White men tended to have higher lifetime covered earnings than did black and other men, but the latter sometimes had lifetime earnings that exceeded those of white women with equal quarters of coverage. Black women and those of other minority races tended to have the lowest lifetime covered earnings. Both retired and disabled workers whose covered employment began after 1950 were likely to have benefits as high or higher than the benefits of those with earlier credits--a reflection of rising wage levels and higher taxable maximums, as well as the "new start" computation method. as well as the "new start" computation method.


Temporary vascular bypass for perfusion of a renal transplant during abdominal aneurysmectomy.

A temporary vascular bypass was utilized to maintain perfusion of a renal transplant during abdominal aortic aneurysmectomy. The shunt, of polyvinyl tubing, was placed between the upper abdominal aorta and the common iliac artery, where the perfusion pressure was only 15 mm Hg less than systemic pressure.  The transplanted kidney fuctioned normally during 71 minutes of aortic cross clamping, and there was no evidence of postoperative renal failure.


Ventral hernia with a skin-covered Silastic sheet for newborn infants with a diaphragmatic hernia.

The persistently high mortality rate for newborn infants with a congenital diaphragmatic hernia, which is symptomatic and treated in the first 24 hours of life, is due to multiple pulmonary and vascular factors. This demands the exclusion of any additional compromising elements. The effects of increased intra-abdominal pressure due to replacement of the intestine into the abdomen can be avoided by the formation of a ventral hernia. A large hernia can be produced best by suturing a sheet of Dacron reinforced Silastic to the fascia of a midline abdominal incision and covering it with skin flaps. This nonreactive prosthesis will remain in place for several months and later can be removed simply. This technique was used successfully in three infants and should improve the survival rate of precariously balanced newborn infants operated upon during the first few hours of life.


Two-chain subunit structure of HLA-D antigens.

Both F(ab')2 fragments and intact antibody from rabbit anti-B-cell antisera were shown to specifically block the mixed lymphocyte culture (MLC) reaction. The antisera, which were raised to papain-solubilized spleen cell membrane antigens, appeared to block the stimulator cell and not the responder cell. Specificity of the blocking was shown in that antisera to beta2 microglobulin would not block the MLC-stimulating cell. Membrane antigens from acute lymphocytic leukemia cells were labeled with 125I, solubilized with sodium deoxycholate and immunoprecipitated with either human or rabbit anti-B-cell antisera. Both sources of antisera precipitated polypeptide subunits of 27,000 and 35,000 daltons.


Mixed leucocyte interaction suppression generated after alloimmunization.

Utilizing a bone marrow cell immunization protocol designed to actively enhance renal or cardiac allografts, the in vitro mixed lymphocyte interaction has been studied. After immunization with allogeneic cells over a wide dose (10(5) to 10(8)) and time range, the mixed lymphocyte interaction using peripheral blood lymphocytes is reduced, and this reduction is shown in mixing experiments to be attributable to a circulating suppressor cell that has adherence characteristics of T lymphocytes. Specificity for in vivo generation of these circulating cells as well as specificity in the in vitro reaction was shown, although a nonspecific suppression background was observed. Allogeneic thymocytes, splenocytes, and platelets were effective in immunizing to generate these cells also. There was no general correlation with the ability to generate these cells and to actively enhance cardiac allografts, since suppression was seen after alloimmunization in strain combination that cannot be actively enhanced.


Portal versus systemic transplantation of dispersed neonatal pancreas.

It is not known whether the advantage of the portal vein as a transplant site for islet transplantation is caused by the immediate availability of a blood supply or by the localization of the islets in the portal circulation. We transplanted minimal quantities of islet tissue from neonatal rat donors to isogeneic adult rats with streptozotocin-induced diabetes. Transplants were performed to three sites, i.p., portal vein, and systemic vein (i.v.). When four neonatal donors were used for each recipient there were no i.p. cures but 90% i.v. and 100% portal vein cures, which suggests that access to a blood supply is important. As the amount of tissue transplanted was decreased, there were significantly more cures with the portal vein route, which suggests that localization of the islets in the portal circulation is also important to graft survival.


Fibrinolytic activity of in vitro cultivated human bladder cell lines.

Three human bladder carcinoma cell lines, T 24, RT 4, and MANO, a human bladder nonmalignant epithelial cell line, HCV-29, and a human lung fibroblast line, 460 H1, were investigated for their ability to induce fibrinolytic, urokinase and plasmin inhibitory activities in cell culture, using serum-free medium, for up to 36 h. Generally, the non-malignant cell line and the fibroblast line had a greater ability to produce urokinase inhibitor than did the malignant cell lines. The amount produced varied greatly between cells and over the study period. A low concentration of plasminogen activator, immunologically identical with urokinase, and its accumulation in culture supernate were found with RT 4 after 12 h and 24 h cultivations, whereas no plasminogen activator was detected in all other cell lines for periods up to 36 h. No plasmin, non-specific protease or plasmin inhibitory activities were detected in any of the supernates from the cell lines.


[Comparative electrophoretic studies of native myosin and myosin treated with sodium dodecyl sulfate from smooth and skeletal muscles].

A procedure is proposed for electrophoretic studies of skeletal and smooth muscle myosins in 2.2% polyacrylamide gel at high ionic strength (mu = 0.4). When separated by electrophoresis myosin is shown to retain the ATPase activity which was dtermined histochemically directly in the gels. It is established that myosin molecules of the studied types of muscles have different electrophoretic mobility. At the electrophoresis on dodecylsulphate gels two types of light chains were detected in the smooth muscle myosin (their molecular weights being 26,900 and 17,800) in contrast to skeletal myosin which has three types of light chains. The obtained data evidence for existence of isoenzymic forms for myosin.


[Dynamics and kinetics of 14C-nicotinic acid uptake by leukocytes and erythrocytes as an index of vitamin PP transport regulation].

Isolated leukocytes with the presence of 14C-nicotinate in physiological concentrations (1 mg%) uptake it intensely from the dilute plasm for 6h. Dynamics of the uptake is characterized by two maxima (30-50 min and 3-5 h) which might reflect metabolic transformation of vitamin PP in leukocytes. Isolated erythrocytes and blood plasma proteins under these conditions accumulate the labelled vitamin in the largest amounts for first minutes of incubation without subsequent changes, accumulation of the labelled nicotinate by erythrocytes is 20 times as low as that by leukocytes. Kinetics of 14C-nicotinate uptake in increasing concentrations (from 4.0 up to 50.0 mM) by isolated leukocytes indicates to a system of this vitamin intake through the plasmatic membrane ensuring its intensive transport into cells with the present of 3.0-6.5 mM of nicotinic acid and a step inhibition of the label accumulation at higher concentrations which reflects decompensation of the vitamin-barrier function of the leukocytes plasma membranes with a rise in the nicotinate concentration in the medium from 6.5 to 16.3 mM the label accumulation is inhibited not only by leukocytes but also by erythrocytes. However the blood plasma proteins still bind 14C-nicotinate when it is present in the medium in linearly increasing high concentrations (16.0 = 50 mM).


Recent advances in respiratory conditions in cattle.

The study of cattle respiratory diseases during the last decade show that several observations made in the late 1960s are still relevant today. Many of these diseases are shared with other countries in Europe, but the developments discussed will be examined with the respiratory disease problems that occur in Britain in mind. The new information is dealth with as it applies to (i) structure, function and immunology of the lungs (ii) diseases of calves indoors (iii) diseases of young animals grazing, (iv) diseases of adult animals indoors and (v) diseases of adult animals grazing.


En face organ cultures of rabbit aortic segments after a single dilatation trauma in vivo. A new model in the study of endothelial regeneration.

Following an in vivo lesion of the rabbit thoracic aorta, endothelial regeneration was studied in silver-stained specimens from en face organ cultures of aortic segments with and without intercostal arteries. The in vivo lesion had been inflicted by an embolectomy catheter. Our results confirmed that endothelium regenerates from preexisting endothelium around the mounths of the intercostal arteries. A conspicuous observation was the orientation pattern of endothelial cells during regeneration. Transmission electron microscopy suggests that the cell cytoskeleton plays a role in the regulation of regeneration. The organ culture technique described, complementary to in vivo and in vitro investigations with cell cultures, seems to be a valuable tool in further investigations on factors involved in the repair of arterial tissue.


Multiple primary malignancies. A statistical study based on autopsy data from 1943-1972.

Autopsy data from 1943 to 1972 has been analysed for the study of multiple primary malignancies (MPM). It is shown that association between different primaries takes place at random and that there are no favourable combinations. It is further concluded that tumors do not produce either immunity or enhanced susceptibility to any subsequent malignancies of the same or any other organ. The importance of such studies is pointed out.


[Long-term tissue culture of normal and atherosclerotic human arterial explants (author's transl)].

A method for longterm tissue culture of human arterial explants is described. The explants of normal and atherosclerotic femoral arteries, removed immediately post mortem, were kept in culture for up to 14 days in a biochemically active state. Viability was checked by glucose uptake and lactate production, with daily changes of incubation media and sterility controls. Compared to the well established short term incubation systems where metabolic activity decreases progressively after 6 h, glucose uptake, lactate production and uptake of 3H-oleic acid are linear within 4-14 h. The highest incorporation of 3H-oleic acid is found in phospholipids, the lowest in cholesterol ester. But whilst activity, after the pulse label of 24 h, progressively decreases in phospholipids, it constantly increases in the cholesterol ester fraction as a consequence of the persistant cholesterol esterification.


[Enzyme histochemical, histometrical and ultrastructural studies of spleens in vinylchloride-disease (author's transl)].

By means of histometric, enzyme histochemical, and electron microscopic investigations it was demonstrated that the pathological changes in the spleen in vinylchloride-disease are primary. Fibroblastic cells are the only specific splenic cells involved. Fibre-associated reticulum cells of the red pulp and fibroblastic reticulum cells in white pulp are stimulated to produce excessive amounts of the extracellular elements of connective tissue, especially collagen fibrils. The newly formed connective tissue causes obliteration of extracellular blood channels in the red pulp and thus a reduction in the number of pulp-cord macrophages, and scarring of the periaterial lymphatic sheaths. The results of this fibrosing process are characteristic quantitative changes in the splenic histologic structures. These changes are different from those structural alterations occurring in spleens following extrasplenic hemodynamic changes, such as thrombosis of the splenic veins or cirrhosis of the liver.


Familial Hodgkin's disease and the major histocompatibility complex.

Two sisters who developed nodular sclerosis Hodgkin's disease (H.D., N.S.) within 3 months of their 25th birthdays were HLA and MLC identical. All family members possessed the HLA-B7 antigen. The propositi, a third HLA/MLC identical sister, and the mother, shared the maternal B7 and lacked Dw2. The father and a fourth sibling with the paternal B7 were heterozygous for Dw2. In six unrelated patients with H.D., N.S., the presence of B7 and Dw2 correlated precisely. In 69 consecutive patients with H.D., N.S., the frequencies of 23 HLA antigens did not differ significantly from the frequencies in 245 control subjects.


[Diagnostic value of Frank's corrected orthogonal electrocardiogram].

The changes in the corrected orthogonal electrocardiograms of 411 patients were analyzed: 134 with right ventricle loading, 137 with left ventricle loading and 140 with myocardial infarction (chronic phase). On the base of sensitivity and specificity criteria the indices SXmV, SXmsec and QZmV for the patients with right ventricle loading and RXmV and RZmV for the patients with left ventricle loading proved to be with the highest diagnostic value. Sensitivity is within 19% to 61%. Sensitivity is within 85% and 95% in patients with myocardial infarction (chronic phase), for the different indices depending on the infarction zone. The comparative analyses of the indices of the corrected orthagonal Frank electrocardiogram and the standard electrocardiogram (12 leads) give a certain preference to the indices of the standard electrocardiography.


[Virological and serological examination of wild birds during the spring migrations in the region of the Manych Reservoir, Rostov Province].

In accordance with the Soviet-American collaboration program on influenza and ARD, cooperative field studies were undertaken in 1975 in the USSR in order to test the field and laboratory methods for studies on influenza virus ecology. In the Rostov region of the USSR, virological and serological examinations of 321 birds of 25 species were carried out. Virological tests were performed with 678 biological specimens and in various serological tests 308 blood serum specimesn from wild birds were examined. Examinations of specimens of washings and organs of birds revealed no hemagglutinating agents. The paper presents the results of studies of avian blood serum specimens in the HI test, neuraminidase activity inhibition test and the immunodiffusion test.


Some aspects of protein changes in frozen foods.

In the past decades many results on changes of food proteins caused by freezing and their relation to quality changes were found. Recently especially the nutrition physiological viewpoint of these alterations has aroused considerable interest. In the present paper the attempt is made to outline some aspects of these changes which are usually referred to as "denaturation" caused by freezing. After a description of the phenomena observed and their measurement, a survey of the main causes presumed for the "denaturation" of fish muscle proteins by freezing is given. With special consideration of the molecular range it can be said that generally aggregation phenomena prevail and that the participating molecules, or part of them, may still be native or more or less changed in their conformation before or during aggregation. Definite judgement of the nutritional properties of the altered proteins in frozen foods is possible only when convincing results of feeding experiments will be available.


[Influence of water activity on the enzymatic changes in freeze-dehydrated muscle. IV. Change in the activity of glycolytic enzymes during storage (author's transl)].

The influence of water activity (25-65% r.h.) on the changes in activity of glycolytic enzymes during storage (up to 120 days) of freeze-dehydrated bovine muscle was investigated. For this purpose, at different times of storage the decrease of glycogen and the increase in lactate in the rehydrated samples were determined. At 25% r.h. no loss in activity was observed. However, during storage at 40% r.h. and higher the glycolytic activity decreased; this effect increased with rising water activity. The denaturation of the enzyme proteins might be due to Maillard reactions, particularly to the reaction of proteins with the highly reactive glycolytic metabolites glyceraldehyde phosphate and dihydroxyacetone phosphate.


[The pathomorphology of chronic apical periodontitis].

The clinical, roentgenological and histopathological diagnoses of thirty apical processes are compared. The paper also discusses certain histopathological characteristics. As a result of these investigations, a proposal is made to modify the classification of chronic apical processes.


[Clinical-radiological parallel control of a longitudinal study of the anti-caries effect of aminofluoride applied locally for 7 years in a double-blind test].

The determination of anticarious effects of topically administered fluorine compounds is usually based on short-time cross-sectional or longitudinal studies. In a comparison made for a period of more than seven years the anticarious effects of amine fluorides administered to selected groups of test subjects have been studied under controlled clinical experimental conditions.


[Animal experimental studies on the question of chemical prevention of congenital clefts. II. Studies on mouse cleft palates due to cyclophosphamide].

Embryotoxic and teratogenic effects were produced by cyclophosphamide in mice of the AB/Jena-Halle strain. The simultaneous administration of Solcoseryl tended to modify these noxious effects, significantly reducing the incidence of cleft palates to one half.


[Complications in gynecologic laparoscopy].

During the past nine years 2700 laparoscopies with 0,4% complications were performed. By reason of the increasing interest for laparoscopy it is refered to cause and avoidance of those complications. Exact technique, an optimum of equipment of apparatus and increasing experience are very important for the laparoscopic examination with the lowest risk.


[Comparative characteristics of the epidemiology of intestinal coli infection caused by 2d-category Escherichia and of Sonne dysentery].

The authors present the results of a comparative study of Sonne dysentery and of the intestinal coli infection 0124 and 0151; significant differences in their epidemiology shown were chiefly caused by a different degree of pathogenicity of the causative agents of these diseases. A low degree of escherichia pathogenicity, and, in this connection, dependence of the character of the infection manifestation on the dose of the causative agent indicated food factor of the infection spread to be necessary for the origination of the clinically expressed disease. Epidemiological observations and bacteriological data showed that in diseases of escherichia etiology only those persons who had clinical manifestations of the disease could serve as epidemiologically significant sources of infection. In this connection prophylaxis of the mentioned affection should be primarily based on the intensification of the general sanitary measures.


[Biological characteristics of Proteus strains isolated from water sources in the Azerbajiani SSR].

Biological characteristics of 102 Proteus strains isolated from the water bodies is given. The strains studied were referred to Pr. mirabilis, more rarely to Pr. vulgaris; about half of the cultures deviated from these biological types by the signs of indol formation and maltose fermentation. Proteus of groups O3, O5, O13, O23, and O30 were revealed in studying the serological characteristics. All the cultures were polyresistant, nonbacteriocinogenic; most of them were sensitive to the wide colicine spectrum. One strain produced a cytopathogenic action on the tissue culture.


[Study of the incomplete antibodies in a population of different age groups in foci of bovine brucellosis in Kashka-Darya Province].

Antiglobulin Coombs' test was included into the complex of sero-allergic reactions used for selection of the groups of population to be vaccinated by epidemiological indications, for the purpose of studying the incomplete antibodies in age aspect under conditions of the existing foci of brucellosis infection. A total of 1904 persons were examined. Incomplete antibodies were found with equal frequency in the blood serum of children and in adults of the population of the Kashka-Dariya region of Uzbek SSR residing in the foci of cattle brucellosis; it was revealed in 40.3% of children aged from 7 to 10  to 10 years, in 45.6% of children aged from 11 to 14 years, and in 42.3% of adults aged from 31 to 40 years.


Histochemical studies on the mucosubstances in the gill of fresh water mussel, Parreysia corrugata var. nagpoorensis (Lea).

The present paper deals with the characterisation and distribution of the mucosubstances elaborated by the gill in fresh water mussel by employing recent well-established histochemical techniques. The results showed that the gill secretes the mucosubstances consisting of neutral mucins, sulfomucins, sialomucins and atypical high pH azurophilic mucosubstances having alcianophilia at pH = 5.6. Hyaluronic acid could not be detected. The importance of these mucins is discussed with reference to feeding.


[The metallic cations' capture through the external mucopolysaccharide surface coat encompassing the neurons (author's transl)].

Union of several iron compounds and other metallic cations to the duodenum mucines and to the neuronal surface mucopolysaccharides is studied. The results differentiate clearly the behaviour of the duodenum mucosubstances and neuronal surface mucosubstances. The duodenum mucines only attract to certain cations, in such a way that their union seems to be specific. On the contrary the neuronal surface mucopolysaccharides attract to most of the assaied metallic cations. These results coincide with other biochemical ones that prove that cationic attraction by the acid mucopolysaccharides is of electrostatic nature. To reveal the metallic cation union to the mucopolysaccharides is used ammonium sulphide in solution. The physiological role of these perineuronal mucopolysaccharides in relation to nervous impulse transmission and propagation is discussed attending to the obtained results.


Assessment of cor pulmonale in cystic fibrosis by echocardiography.

Thirty-one patients with cystic fibrosis of varying severity were examined by echocardiography. Right ventricular dimension (RVD) was above upper normal limit in 14 patients and right ventricular dimension index (RVD index) was higher than the upper normal limit in 11 patients. Furthermore, there was a significant relationship between increasing RVD index and 1) decreasing forced vital capacity (FVC) both actual test results and average 6 months values; and 2) decreasing peak-expiratory flow rate (PEFR) both actual test results and average 6 months values. This observation suggests a persistent heart involvement. Five patients had either heart failure and/or electrocardiographic evidence of right ventricular abnormality. These patients had increased RVD index and one patient with the highest RVD index died 8 weeks after the examination. The present study has shown the usefulness of echocardiographic measurement of right ventricular dimension and of septal motion in assessing cor pulmonale, before development of electrocardiographic abnormalities and right heart failure.


Ultrastructure and histochemistry of the medullary interstitial matrix of rat kidney.

Medullary tissue of the normal rat kidney was perfused with 3 percent glutaraldehyde (GA), incubated in 0.5 percent cetyl pyridinium chloride and postfixed in 1 percent OsO4. In comparison with the ordinary fixation with GA and OSO4, the medullary interstitium represented abundant matrical substance that is rich in acid mucopolysaccharides (AMPS) and morphologically represents a diffuse reticular structure consisting of 30 to 150 a thick microfibrils and granular structures of 300 to 500 A in diameter. When chondroitinase was applied before OsO4 treatment, the dense granes disappeared and the microfibrils were replaced by loosely textured 30 A thick microfilaments. After hyaluronidase treatment the microfibrils disappeared and most granules changed into a ring-shaped structure with an electronlucent central portion. These results suggest that the reticular structure consists of microfilaments of hyaluronates and amorphous masking substance of chondroitin sulfates. In the dense granule, hyaluronates become concentrated in the central portion and chondroitin sulfate in the peripheral zone. When perfused with a CPC-containing GA, the medullary interstitium was diffusely filled with a large amount of fine granular substances suggesting the presence of water soluble free AMPS filling the reticular space.


Mixed lymphocyte culture reactions at delivery and in the puerperium: effects of parity, HLA antigens and maternal serum.

Mixed lymphocyte culture reactions between maternal and related neonatal cells at delivery, and maternal and paternal cells about a week after delivery, and the effect of maternal serum and HLA antigens on these reactions were studied in 11 families with primiparous or secundiparous mothers and in 13 families with multiparous mothers (six or more pregnancies). Weak or absent MLC response of the mother to her infant was observed in one-third of primiparous and secundiparous mothers and in one-half of multiparous mothers. In some cases the non-reactivity could be due to genetic similarity, i.e. HLA or HLA-D identity between the mother and her infant. In other cases, this was obviously not a valid explanation and no apparent reason for the non-reactivity was found. The MLC suppressing effect of maternal serum on MLC reactions at delivery and about a week later was not correlated with the strength of maternal-neonatal MLC reaction. Four of the ten sera from multiparous mothers studied a week after delivery had an inhibitory effect of 50% or more on MLC reactions involving stimulatory paternal cells. Responding paternal cells and other MLC combinations were also inhibited to varying degrees. None of the sera of primiparous and secundiparous mothers had an equally strong MLC inhibiting effect.


Volume displacement of the tympanic membrane in the sitting position as a function of middle ear muscle activity. A quantitative microflow method.

An open microflow meter system has been worked out for quantitative recording of the volume displacement of the tympanic membrane and its movement direction at stapedius reflex. An acoustically elicited M. stapedius contraction can be recognized by the characteristic response and latency time. The stapedius reflex contraction causes an outward or inward movement of the tympanic membrane. The magnitude of the volume displacement of the tympanic membrane is influenced by the middle ear pressure and in some ears the movement direction of the tympanic membrane changes.


Local lymph node response in rats to allogeneic stimulus: analysis of the in vitro responding cells.

Parental strain rats were immunized in the footpads by F1 hybrid spleen cells. The draining lymph nodes were removed during the first 10 days after immunization and tested for mitogen responsiveness. Cell fractionation was performed by removal of macrophages, surface Ig positive, and F(c)-, and C3-receptor carrying lymphocytes. The depleted suspensions were tested in MLC to test the effect of lymphocyte subpopulations on the accelerated MLC response profile exhibited by the immune lymph node cells. Overall increase in mitogen stimulation was observed, but stimulation indices were slightly reduced as compared to non-immunized cells. Removal of phagocytic cells gave some increase in MLC response which was most pronounced when responder cells were tested during the first days after immunization. Depletion for non-T lymphocytes resulted in lowering of non-stimulated responder cell 14C uptake, whereas the specific accelerated MLC profile was unaltered or tended to improve acceleration. It is concluded from indirect evidence that T lymphocytes are the cell type responsible for the altered MLC kinetics, but that macrophages and non-T cells modify the response.


Inhibitory effect of human mononuclear phagocytes on DNA synthesis in stimulated lymphocytes.

Human mononuclear phagocytes cultured in vitro revealed an inhibitory influence on DNA synthesis, as measured by 3H thymidine incorporation, in lymphocytes stimulated by a lectin (PHA), a soluble antigen (PPD) and allogenic lymphocytes. The inhibitory effect increased with increasing ratio of macrophages to lymphocytes, and was positively related to the differentiation of monocytes to macrophages. The inhibitory ability appeared to have no connection with the histocompatibility gene complex. The culture medium of macrophages cultured with and without lymphocytes showed no inhibitory effect.


Immuno-inductive and immuno-suppressive influence of human mononuclear phagocytes cultured in vitro.

DNA-synthesis, as measured by 3H thymidine incorporation, in immune lymphocytes from human blood stimulated in vitro with PPD was shown to require monocytes. No such requirement was demonstrated for PHA-induced DNA-synthesis under the same conditions. Initial packing of cells by centrifugation was beneficial for the cultures stimulated by antigen, but not for the cultures stimulated by lectin, thus indicating the necessity for contact between monocytes and lymphocytes for antigen stimulation. Monocytes and macrophages preincubated with PPD indced DNA-synthesis in lymphocytes. Monocytes were found to be least as capable of retaining and presenting antigen as macrophages, and autologous macrophages presented antigen more efficiently than allogeneic macrophages. DNA-synthesis in lymphocytes, induced by adding PPD or PHA to the culture medium, was inhibited by a large number of monocytes. Macrophages caused inhibition under the same conditions, even a small number. DNA-synthesis in lymphocytes induced by PPD-preincubated monocytes and macrophages increased with increasing ratio of mononuclear phagocytes to lymphocytes up to a certain value. A further increase in the ratio caused inhibition, thus indicating both an immunoinductive and an immuno-suppressive influence of mononuclear phagocytes.


Muscle adaptation to extreme endurance training in man.

To evaluate the effect of extreme endurance training on muscle fibre composition and activities of oxidative enzymes in different fibre types biopsies were taken from vastus lateralis, gastrocnemius and deltoideus of elite orienteers. Comparisons were made between the (trained) leg muscles and the (relatively untrained) arm muscles, and with leg muscles of 16--18 years old boys. The orienteers had the same percentage type I fibres and vastus lateralis and gastrocnemius as in deltoideus, but higher percentage type I fibres in vastus lateralis compared with the controls. The similarity between trained and untrained muscle in the orienteers suggests that training had not caused the high percentage type I fibres which rather might be the result of selection of individuals with the best prerequisites for high oxidative capacity. However, the distribution of type II subgroups in the leg muscles of the orienteers differed from both their own deltoideus and leg muscles of the controls, the relationship IIA/IIB being altered in favour of the more oxidative IIA. The leg muscles of the orienteers also showed an increased occurrence of the normally IIC fibre. These latter findings point at the possibility of a training induced alteration in the subgroup pattern. Unlike in the controls there was no significant difference in succinate dehydrogenase activity, measured in single fibres, between type I and II fibres in gastrocnemius of the orienteers. Thus, type II fibres have the ability metabolically to adapt to high oxidative demands. This might to some extent be mediated by a conversion from IIB to IIA form.


Experimental cardiac hypertrophy and the synthesis of  poly (A) containing RNA and of myocardial proteins in the rat: the effect of digitoxin treatment.

The synthesis  of poly(A) containing RNA was increased in heart of non-digitalized and digitalized rats after aortic constriction, the increase being of the same degree as that of the RNA lacking this sequence. No differences were found, either  in  the absence or presence of polyuridylic acid, in the incorporation of radioactivity into protein by cardiac ribosomes isolated from animals treated differently. It may be concluded, that after the constriction of the aorta the synthesis of mRNA proceeds at a similar rate as that of the  bulk RNA, and that the treatment of the animals with digitoxin does not abolish the stimulus for hypertrophy.


Primary psychiatric illness in a neurological out-patient department in North East England. An assessment of symptomatology.

A total of 2,716 patients attended a neurological out-patient clinic in North East England between May 1970 and May 1974. The symptomatology of 358 patients with primary psychiatric illness has been analyzed in a retrospective study. There were 172 symptom wordings and these were grouped in 18 headings. The most common symptoms were headache, dizziness and pain in the body. The presenting symptoms were analyzed with reference to age, sex, pattern of referral, diagnostic category and method of disposal. Aspects of non-organic disease in a neurological clinic are discussed.


Cell-mediated immunity against digestive organ cancers : leucocyte migration inhibitory factor activity as an immunological parameter.

The present study was conducted to investigate the usefulness of the direct leucocyte migration agarose method for studying cell-mediated immunity in vitro. Comparative studies of the purified protein derivative (PPD) skin test and the leucocyte migration inhibition test (LMIT) in which PPD was used as test antigen indicated a significant qualitative and a weak quantitative correlation between these two tests. Furthermore a positive correlation was found between the LMIT and the macrophage migration inhibition test (MIT) using ultrasonicated authochthonous tumor antigen. Comparative studies of the LMIT, MIT, PPD skin and DNCB tests on the same patients showed that cases responding positively to the the PPD skin and DNCB tests tended to respond positively to the LMIT and MIT. Patients with digestive organ cancers were examined by the LMIT. With the advance of cancer, decreased positive test test rates were found. After gastric cancer operations the LMIT findings were divided into two groups: one type changed from positive to negative, and the other type changed from negative to positive. The former response was suggestive of a successful operation, and the latter response was suggestive of a non-curative operation. These results indicated that the direct leucocyte migration inhibition agarose test was useful investigating cell-mediated immunity.


The effect of cycloheximide on mouse learning.

Mice were trained in an avoidance learning task. The incorporation of 3H-leucine into the hippocampal regions of trained mice was higher than that of control mice. When mice were injected with cycloheximide, a strong inhibitor of protein synthesis, impairment was evident in acquisition of learning. Cycloheximide produced morphological changes in mitochondria and microtubules of some brain axons. It is suggested that the cycloheximide-induced learning impairment may be due to the blocking of the synthesis of the specific protein necessary of neutral conductivity.


Early diagnosis of acute renal allograft rejection: efficacy of macrophage migration inhibition test as an immunological diagnosis.

1. Three cases of acute rejection were detected by macrophage migration inhibition tests (MIT) conducted directly on seven patients who had received renal allografts. The macrophage migration inhibitory factor (MIF) activity was positive in all cases 1-2 days before the appearance of acute rejection. 2. After the administration of a high dose of Solu-Medrol (1g/day for 3 days) to suppress the acute rejection, MIF activity recovered to its normal level 3 days later. These findings seem to indicate that MIT yields immunologically useful criteria for the early detection of an acute rejection.


Diagnosis of drug induced liver injury using a lymphocyte blast transformation test based on whole blood culture.

Twenty cases of suspected drug induced liver injury (16 cases of which satisfied the criteria for at least a query positive diagnosis as based on the Fourth Congress of "Drugs and the Liver" in Japan) were studied by the whole blood culture technique of lumphocyte blast transformation. The positive rate with this technique was 10%, and no more than 15% even with the addition of one query positive. One reason for the low positive rate was that there was not only an allergic mechanism at work in the study group but that liver injury due to direct cytotoxicity of the drug was involved also. For a drug such as chlorpromazine with strong cytotoxicity for lymphocytes, it was difficult to demonstrate a relationship between allergic mechanisms and the drug with this method.


Purification and some characteristics of liver cytosol cornin, an antimitotic substance from rat liver cytosol.

Further purification and characterization are reported on rat cytosol cornin (RLCC), an antimitotic substance. Fraction I (purified RLCC) was purified more than 10-fold from crude RLCC with Sephadex G-50 column chromatography and showed a remarkable inhibitory effect on division of inseminated sea urchin eggs and mouse fibroblast cells. Fraction I was observed as one spot, and the molecular weight was estimated to be about 25,000 by thin layer gel filtration. Fraction I contained protein (92%) and RNA (8%), but the antimitotic activity was scarcely affected by treatment by pancreatic RNase. The protein of Fraction I was separated into two bands by SDS-polyacrylamide gel electrophoresis, and the molecular weight was estimated as 10,000 and 15,000, respectively. The 50% inhibition dose of Fraction I on the first division of inseminated sea urchin eggs and on proliferation of mouse L cells was about 2.5 X 10(-5) g/ml and 5 X 10(-4) g/ml, respectively. The yield of fraction I was about 35 mg from 100 g rat liver.


[Glucose tolerance abnormalities in mice actively immunized with components of bovine pancreatic hormones (author's transl)].

The relationship between immune insulitis and glucose tolerance was investigated in three groups of mice following active immunization with different components of bovine pancreatic hormone. An abnormal blood glucose level was observed in the three groups ranging from 33.3% to 87.5% of sensitized mice. A relationship was not present between the glucose tolerance response and the presence of insulitis or anti-insulin antibody in the blood of sensitized mice. However, all sensitized mice with a marked decrease in glucose tolerance were found to have insulitis. In animals without established insulitis and with no demonstrable anti-insulin antibody, abnormal glucose tolerance was noted. This latter condition occurred more frequently with recrystallized insulin than with a-component and did not occur with monocomponent insulin. These findings seemed to indicate that two distinct processes involving some circulating antibodies with anti-insulin antibody and insulitis might be involved in the development of the observed glucose tolerance abnormality.


Myocardial scintigraphy as a supplementary diagnostic tool in heart disease.

Myocardial scintigraphy with cesium-131 and thallium-201 was performed in 191 patients. Previous myocardial infarctions localized to the anterior and lateral wall of the left ventricle were correctly diagnosed with both radionuclides. Inferior and posterior infarctions were only detected when thallium was used. In patients with non-informative ECG changes like bundle branch block, non-specific ST-T changes or with atypical symptoms, myocardial imaging made an essential contribution to the establishment of a correct diagnosis. The potential value of myocardial imaging in patients with valvular heart disease and in cardiomyopathy is described.


Percutaneous rhizotomy of the articular nerve of Luschka for low back and sciatic pain.

The results of percutaneous facet rhizotomy for the treatment of low back and sciatic pain in 30 patients are reported. Satisfactory results were obtained in 76% of cases. No complications were found. This procedure should be tried in every patient with low back and extremity pain and no major neurological deficit before resorting to laminectomy.


Precerebral arterial blood flow pattern in intracranial hypertension with cerebral blood flow arrest.

A pulsed echo Doppler flowmeter was used to confirm cerebral flow arrest in patients with intracranial hypertension resulting in a cerebral perfusion pressure of zero or close to zero. The cerebral angiograms showed non-filling. The term brain tamponade is used for this condition. The patient had a mean arterial blood pressure at the time or recording ranging from 70 to 160 mmHg. Under these conditions the transcutaneous recording of internal carotid artery flow velocity immediately distal to the carotid bifurcation showed a reverberating flow pattern with marked pulsations. The forward flow in systole was counterbalanced by the retrograde flow during diastole resulting in a net flow of zero. This flow pattern is basically caused by a combination of intracranial vascular obstruction, the arterial blood pressure at the site of measurement, and finally the compliance of the distal arterial segment as well as the intracranial compliance. This non-invasive method is of potential value in the determination of intracranial flow arrest.


The industrial back problem: role of the industrial hygienist and ergonomics.

This article discusses a major and costly problem in industry today--the industrial back problem. What does industrial hygiene have to do with back accident problems? This article relates the problem to the basic philosphy of industrial hygiene and ergonomics. Information is provided to give the reader a better understanding of the back problem. The role of industrial hygiene and ergonomics is explained as a help to industry in curbing the high costs and workdays lost due to perplexing back problems in industry.


Variations in intrafusal fiber size within histochemically identified types of intrafusal fibers in the pigeon.

The myofibrillar adenosine triphosphatase reaction with acid preincubation allowed the identification of three types of intrafusal fibers in pigeon flexor carpi ulnaris muscle spindles. Measurements of cross-sectional areas at the polar region showed much overlap in fiber size among populations of each type.


A case-control study of uterine perforations documented at laparoscopy.

A case-control analysis was done of 19 cases of uterine perforations which occurred during laparoscopic sterilization at Gardy Memorial Hospital in Atlanta, between February 1, 1974, and January 31, 1976. The over-all perforation rate, 30.4 per 1,000 procedures, is three to 30 times that commonly reported for dilatation and suction or sharp curettage (D&C) of the uterus. Case women were 10.4 times more likely than control women to combine two of the following three characteristics: age greater than 34, parity greater than 4, and obesity greater than 20 per cent above the ideal body weight for height. Surgeons with fewer months of formal Ob/Gyn training were no more likely than their relatively more experienced colleagues to perforate the uterus. No other risk factors were delineated. It is believed that the perforation rate, higher in this study than in earlier ones, reflects better ascertainment of perforations. The bleeding site was always visualized with the laparoscope in this series.


Ion pumps in the renal tubule.

Biochemical studies of renal tissue have so far not shown the presence of any active pump mechanism other than Na-K-ATPase. In this review of possible transport mechanisms for the ions Na, K, H, Cl, and HCO3, it is suggested that transport of these ions can be coupled to ATPase by conductance (uniport) processes or by ion gradients by co-transport (symport) or countertransport (antiport) systems. These may be neutral or electrogenic. Accordingly, the function of any region of the tubule will be determined by the porter(s) present in the apical or basal-lateral membrane, and by the Na-K-ATPase located almost exclusively in the basal-lateral membrane. Future research in this area will probably define these porters in vesicles isolated from specific cell types of the kidney.


Dynamic compliance of arterial grafts.

A cantilever transducer has been developed which allows measurements of diastolic diameter and diameter change in response to pulse pressure in dissected blood vessels during sterile procedures. Preliminary results indicate that it will detect subtle changes in wall elastic properties of arterial grafts at subtle changes in wall elastic properties of arterial grafts at and following implantation, which changes may influence graft function. Compliance, the percentage change in volume per unit pressure, was greater in normal canine femoral artery than in autogenous vein grafts (AVG). Two new graft materials were tested. Mesh-covered modified human umbilical cord vein (DBM) was similar in compliance to AVG but more compliant than double-velour Dacron. Diastolic diameter changes were also recorded. After 2 wk, all three graft materials had increased in diameter: AVG by 8%, DBM by 6%, and Dacron by 5%. After 3 mo, AVG diameter increased by 24%.


Effect of prophylactic digitalization on the development of myocardial hypertrophy.

The effect of prophylactic digitalization on the development of left ventricular hypertrophy was studied in adult rats. Digitoxin, 0.1 mg/100 g body wt or solvent was given daily for 1 wk prior to either aortic constriction or sham operation and was continued until the animals were killed, either 1 or 4 wk after surgery. A hemodynamic study was done in those animals killed 1 wk after surgery; hearts of all animals were examined for evidence of myocardial hypertrophy. Constriction of the ascending aorta had no significant effect on cardiac output but did reduce peak flow velocity and flow acceleration. An increase in left ventricular mass, RNA, and hydroxyproline was found in the animals with aortic constriction. Digitoxin treatment did not alter peak flow velocity or flow acceleration, but did significantly increase isovolumic (dP/dt)P-1. Digitoxin had no effect on body weight, heart weight, RNA, or hydroxyproline in either the sham-operated animals or in the animals with aortic constriction. Therefore, despite plasma digitoxin levels sufficient to affect myocardial contractility, left ventricular hypertrophy still developed after aortic constriction.


Transient postocclusive renal vasospasm in conscious rhesus monkeys.

Transient postocclusive renal vasospasm occurred in nine conscious postoperative monkeys with electromagnetic flowmeters implanted on the left renal artery. During an interval of 5-7 days, beginning approximately 1 wk after the implantation of an electromagnetic flowmeter and pneumatic occlusive cuff on the renal artery, occlusions produced by 2- to 15-s inflations of the cuff were invariably followed by flow reduction of 40%-90%, which began 30-60 s after occlusion and lasted from 3 to 60 min. These flow reductions were not related to changes in heart rate, cardiac output, blood pressure, nor to flow in other branches of the aorta; nor were they affected by papaverine (5 mg/kg), propranolol (1 mg/kg), phentolamine (3-5 mg/kg per min), or dipyridamole (1 mg/kg). This response to renal artery occlusion disappeared after 5-7 days and did not recur. This phenomenon should be kept in mind when planning experiments involving long-term implantation of flowmeters on the renal arteries of monkeys.


Bruch's membrane in pseudoxanthoma elasticum. Histochemical, ultrastructural, and x-ray microanalytical study of the membrane and angioid streak areas.

In a case of pseudoxanthoma elasticum (PXE), Bruch's membrane was studied histochemically, ultrastructurally and by element analysis. Two kinds of calcifications were observed, one composed of hydroxyapatite and the other of CaHPO4. They were seen in the scar tissue of angioid streak areas and in the membrane outside these areas, respectively. Furthermore, a thready material was found in the membrane as well as an increased amount of acid mucopolysaccharides. The genesis of the calcifications and the pathogenesis of angioid streaks are discussed. The author is in favor of a malformed collagen as the basic defect in PXE.


Laparoscopic exposure and sequential observation of the ovary of the cycling bitch.

A method was developed to alter surgically the bursa of the bitch to allow sequential observation of the ovary by means of laparoscopy. Adult anesthetized female dogs of three breeds underwent laparoscopic examinations in which each natural bursa slit was lengthened 1.0-1.5 cm using laparoscopic hook scissors in conjunction with electrocautery. The ovary could be effectively and repeatedly exposed for laparoscopic viewing through the lengthened bursa slit. Neither laparoscopic surgery nor frequent routine laparoscopic examinations of the reproductive organs had an effect on subsequent ovarian activity. All dogs subjected to the laparoscopic ovarian exposure technique exhibited estrus behavior, follicle development, ovulation and corpus luteum formation. Preovulatory follicular development was detected as early as 11 days before ovulation with the most rapid follicular maturation occurring two to three days before ovulation. Follicular collapse and extensive hemorrhage at the rupture site during ovulation did not occur. Release of the cumulus mass from a vesicular follicle was observed in one bitch. The cumulative mass adhered to the follicular wall for an indefinite time following ovulation. The structural size of the bitch corpus luteum was maximal four to eight days following ovulation. Corpora lutea remained visible on the ovarian surface for 16 weeks. No differences in cyclic ovarian morphology were observed among the three breeds of dogs studied.


Muscle spindles in nonhuman primate extrinsic auricular muscles.

Muscle spindles were sought in peri-auricular muscles of several primate species (rhesus monkey, woolly monkey, and baboon). Transverse sections cut at 10 mu and stained primarily by a silver impregnation technique were examined using light microscopy. Spindles were identified on the basis of standard criteria. Posterior and/or superior auricular muscles of each species were found to contain spindles. At least some muscles innervated by facial nerve have classical spindles as component structures.


Isolation and characteristics of bacteriophages from staphylococci of chicken origin.

Lysogenicity in chicken coagulase-positive staphylococci was tested by incubating the strains in the presence of mitomycin C. Of 88 strains tested, 84 (95.5%) were proved to be phage carriers and 81 were susceptible to any of the phages. The lysogenic strains were detected with almost equal frequency from both of typeable and untypeable strains by the international phages. Sixteen phages (CH phages) were isolated from chicken lysogenic strains, and their usefulness for the typing of chicken staphylococci was evaluated. Of 122 strains examined, 101 (82.8%) were found to be typeable with the CH phages at a routine test dilution (RTD). About 82% of strains untypeable by the phages of the international series were lysed by one or more of the CH phages. The phages seemed to be highly specific to chicken staphylococci, because they lysed only a few strains of animal origin other than chicken. Thus, the 16 phages newly established were found to have significant advantages in typing chicken strains.


Efficacy of fenbendazole against adult Dictyocaulus viviparus in experimentally infected calves.

Fenbendazole, methyl-5(phenylthio)-2-benzimidazolecarbamate, a new broad-spectrum anthelmintic, was evaluated against the adult Dictyocaulus viviparus, lungworm of cattle, in artificially infected calves. At a dosage of 5 mg/kg of body weight, fenbendazole removed 100% of the worms if given as an oral suspension, and 99.7% of the worms if given as a feed additive.


[Utilisation of photochemotherapy by UVA and locally applied psoralens (author's transl)].

In the Skin Clinic of Neurnberg about 1,500 patients have been treated since 1972 with blacklight and 8-methoxypsoralen, approximately 120-150 every day. This new therapy has proved very good in psoriasis, acne, bacterial disseminated eczema, parapsoriasis and mycosis fungoides. The technique and the rate of relapses, the side effects and their endogenous as well as exogenous causes will be discussed.


In vitro activity of spectinomycin against recent urinary tract isolates.

The susceptibilities to spectinomycin of 303 recent urinary tract isolates were determined and compared to the susceptibilities of those strains to ampicillin, tetracycline, and gentamicin. Based on minimal inhibitory concentrations, 84% of Escherichia coli, Klebsiella, and Enterobacter, 31% of other Enterobacteriaceae, 7% of Staphylococcus aureus and Streptococcus (including enterococci), and 0% of Pseudomonas aeruginosa were susceptible to concentrations of spectinomycin that are easily surpassed in serum (</=32 mug/ml); 90% of all organisms tested other than P. aeruginosa were susceptible to concentrations that are easily surpassed in urine (</=128 mug/ml). Spectinomycin was active against more isolates than either ampicillin or tetracycline but against fewer isolates than gentamicin. Disk diffusion susceptibility tests did not reliably distinguish susceptible from resistant isolates with any of the four antibiotics studied.


A new technique for resecting the non-inflamed not-adhesive appendix through a mini-laparotomy with the aid of the laparoscope.

A new technique for appendicectomy is described. Following detailed laparoscopic inspection of the abdomen, the appendix is pulled out with a laparoscopic forceps through a small incision in the right lower abdomen; it is then skeletized. Following ligation with catgut and nylon, the appendix is severed using the thermocautery. The stump is subjected to careful after-coagulation or treated with iodine, and repositioned. Only the skin is sutured.


Yeast opsonization defect and immunoglobulin deficiency in severe infantile dermatitis (Leiner's disease).

The defect in Leiner's disease, which presents in early infancy with extensive dermatitis, diarrhoea, and failure to thrive, has been attributed to a defect of the fifth component of complement (C5). We report 2 brothers with extensive dermatitis and dysgammaglobulinaemia. Both died. The older showed symptoms of Leiner's disease: C5 tests were not performed. The younger had extensive dermatitis and was found to have the C5 defect. He developed normally, but died suddenly with pertussis. We postulate that the C5 defect is not the sole cause of Leiner's disease as has been suggested, but that hypogammaglobulinaemia or other lymphoid deficiency is also required for its expression.


Biochemical changes in progressive osteoarthrosis.

Quantitative and qualitative variations in glycosaminoglycan content were studied in fibrillated, intact, and osteophytic cartilage of the human femoral head in osteoarthrosis. Total glycosaminoglycan content was reduced in fibrillated, unchanged in intact, and raised in osteophytic cartilage. In fibrillated and osteophytic cartilage the ratio of chondroitin sulphate to keratan sulphate was high and therefore resembled immature cartilage. Hyaluronic acid was present in reduced amount in all osteoarthrotic material. Proportionally more proteoglycans were extractable by 0-15 M NaCl and 4 M guanidinium chloride from the diseased cartilage than from normal cartilage, and all proteoglycans irrespective of buoyant density were carbohydrate deficient. It is postulated that the changes described are compatible with collagen and matrix disruption due to focal overloading and the general attempt at repair.


Errors and artifacts of Doppler flowmeters and their solution.

Continuous-wave Doppler ultrasound flowmeters are essential instruments for the vascular surgeon. Unfortunately, when used for quantitative purposes, they yield a flow velocity waveform that is substantially in error. Current directional continuous-wave Doppler velocimeters used a O-crossing detector to convert the Doppler signal to a waveform. Unfortunately, there are several inherent problems with this technique, and velocity waveforms are produced that have significant artifacts or errors. In this report, it is shown that a multifilter system is a simple, inexpensive alternative to systems using a O-crossing detector, and furthermore, permits real-time display of the Doppler waveform. The severity of the underlying arterial disease can be quantified by the calculation of pulsatility index. The pulsatility index was calculated from the Doppler waveforms recorded from peripheral arteries in 155 limbs and showed an excellent correlation with the severity of atherosclerosis as assessed by arteriography.


[Histochemical study of experimental burn wound].

A composite histochemical and histoenzymechemical study of an experimental burn wound was carried out. The results indicated that the process of healing of the burn wound differed considerably from that of wounds of different etiologies. The burn wound was characterized by secondary obligate deepening, inhibition of leucocyte and macrophage reactions with a reduced functional activity of the cells, simultaneous existence of alterative-exudative and macrophage reactions, inhibition of granulation development, microbial dissemination in the wound and development of vasculites in the wound.


[Congenital defects of the cerebral vessels associated with cardiomegaly].

A case of cardiomegaly developed due to the congenital malformation--aneurysm of Galen's vein in combination with hemangioma of the right hemisphere of the brain--in a newborn is described; the baby died on the 3rd day after birth of increased cardiac insufficiency.


[Relationship between the myocardial mass and the volume of human heart ventricles in hypertrophy].

The weight and volume values of heart ventricles from patients dying of cardio-vascular and some other diseases were studied. Measuring of sarcomeres in freely fixed and controlled pressure-fixed hearts showed that with the former method of fixation heart ventricles were contracted and the volume of their cavity approached the tidal volume. In freely fixed and "fresh" hearts removed at autopsies within 2-27 hours after death, concentric and excentric hypertrophy of ventricles may be characterized by numeric values of the relative mass: the ratio of ventricle mass to volume of its cavity, and in the left ventricle--by the relative diameter of the cavity: the ratio of the cavity diameter in cross-section to the thickness of the ventricle wall.


[Malignant hypertension. Report of a case].

A case of malignant arterial hypertension, treated with sodium nitroferrecianuro, beta blockers, vasodialators, and hemodialysis with hyposodic baths is presented. It shows the favorable response to this type of treatment, in the cardiac sphere as well as the alteration in the eye grounds. The etiopathogenisis and treatment of malignant arterial hypertension, and indications for the nephrectomy and renal transplant are discussed.


Hemodynamics of hypertension and of hypertensive heart disease.

Therefore, one may look on the hemodynamic changes in essential hypertension as a continuum of greater degrees of peripheral vasoconstriction. In labile hypertension, the mild arteriolar constriction only slightly increases vascular resistance (the "inappropriately" normal level), and the mild venoconstriction serves to redistribute blood to the heart and lungs, thereby augmenting or increasing cardiac output to its increased level. Thus, in this schema it is possible to find mildly hypertensive patients, or even some subjects with labile hypertension, with a normal cardiac output, especially if their circulating volume is already reduced. With advancing disease, arteriolar constriction increases, providing further increases in total peripheral resistance and stress upon the heart, and the coincident venular constriction reduces circulating plasma volume, venous return, and cardiac output.


[A new approach to cataract surgery. Extraction through the pars plana with a phakotribe ("lens gobbler") (author's transl)].

Lens extraction by the posterior route with the phakotribe keeps the complete anterior segment intact. The approach causes no inconvenience to the globe. An account of 18 months experience. The method enables extraction of the most delicate cataracts without subsequent procedures. Vision can be restored rapidly by a contact lens. However the indications must be well evaluated in experimental hands. This technique may be indicated in cataracts in children whether they are congenital or traumatic as well as in traumatic cataracts in adults.


[The processes of osteotomy in ocular surgery. Introduction of a new type of oscillating osteotome (author's transl)].

The authors recall the different technics of bone approach in the dacryocystorhinostomy, the orbital osteosynthesis, the resilient buckling of the lids, the restoration of the medial palpebral ligament and the orbitotomies by temporal way. The processes that utilize a circular oscillating trephine or a saw with oscillatory motion seem to be suitable to most of these operations. A new type of oscillating osteotome is offered.


[Treatment of corneal ulcers by hydrophilic lenses pre-soaked in proteolytic hydrolysates of the corneal stroma (author's transl)].

The faculty of confering to hydrophilic contact lenses the properties of corneal bandage made unable to swell has been investigated by saturating them with calf's corneal hydrolysate. The absorption and storage of the proteolytic hydrolysate (properties and collagenasic hydrolysate's technic of obtention is mentioned) by hydrophilic contact lenses are studied. The treatment of some corneal ulcers is related for 27 eyes from 20 patients. The results appear more suitable for torpic ulcers than for mechanical ulcers.


[The experimental study of the tolerance to suture materials in the sclerocorneal zone of the globe (author's transl)].

The problem of tissue reaction to the presence of sutures in the sclerocorneal zone has been studied experimentally in 60 rabbit eyes. The suture material used was 6/0 thickness produced By Braun/Melsungen, R.F.A. with nontraumatic needles, silk, non-chromic and chromic catgut, and biosutures prepared from rat tails according to the technique of the Filatov Institute in Odessa (U.S.S.R.). Following non-chromic catgut and the biosuture the tissue reaction was generally very mild but they reabsorbed rapidly. By contrast chromic catgut provoked an intensive reaction and absorbed more slowly with the possibility of producing a toxo-allergic reaction. The silk sutures behaved in the same way as the biosutures and the non chromic catgut. If after 11 or 14 days the silk sutures were not eliminated necrotic changes  developed over them more intensively and the suture fell out. This situation could provoke the formation of fistulae.


[Exudative diabetic retinopathy. The use of clofibrate in the treatment of hard exudates using a reduced but prolonged dosage over several years (author's transl)].

Clofibrate is the treatment of choice in exudative diabetic retinopathy. With a low dose the exudates disappear, on the condition to carry on the treatment during several years. 1 or 2 capsules a day (500 or 1 000 mg/day) is enough. At this dose the tolerance is very good, allowing a regular and non-stop treatment.


[Lacrimal physiology (author's transl)].

The althors want to recall the importance of the quality of the lacrymal film. The role of the accessory lacrymal glands is essential. The excretory system is not a passive emunctory but an active pumping system, the walls of the passages absorb most of the lacrymal fluid. Easy tests enable to probe the lacrymal system.


[Cüppers' string operation (author's transl)].

Cüppers' thread operation opens a new chapter in Oculo-motor surgery. This operation aims at reducing the rotational force of the recti muscles innervational impulsion without changing the balance in primary position. This result is obtained by suturing the muscle belly and sclera at least 13 mm behind the original scleral insertion. The indications for this operation are the following: 1. Oculo-motors Paralysis, in acoordance to the Cüpper's principle: "paresis versus paresis" reducing the rotational force of the innervational impulsion of a muscle induces an increasing of innervational impulsion in the yoke muscle. 2. Surgery in excentric fixation: creating a pseudo-paralysis induces a change of fixation in the opposite direction. 3. Nystagmus surgery: the thread allows a reduction of the innervational impulsion in the muscles which create the blockage; the abnormal head posture is thus reduced. 4. Surgery in variable non accommodative squint: the static component of the deviation is treated by classical surgery, the dynamic component by thread operation.


[Changes of the corneal thickness after cataract extration (author's transl)].

A study of changes of the corneal thickness after cataract extraction was carried out on 149 patients. Cataract extraction was performed with partial knife incision or "ab externo" incision. The corneal thickness was measured with a Haag-Streit pachometer prior to cataract extraction and 4 days to 6 months after the operation. The investigation showed that the postoperative increase of the corneal thickness returns as before the operation.


[Vitelliform degeneration of the macula and Leber's amaurosis. Discussion on nosology (author's transl)].

A description of vitelliform degeneration of the macula in 6 year-old child, and Leber's amaurosis in his first cousin aged 7. The evolution has been followed and studied for 18 months from the point of view of slit-lamp examination, function and electrophysiology. The intrafamilial association of these two types of hereditary tapeto-retinal degeneration allows a discussion on their respective nosological character in the light of the small amount of literature available.


[Herpetic keratitis as a cause of disturbance of motility of the globe and upper lid (author's transl)].

The author describes the phenomenon of convergent squint and ptosis of the upper eyelid caused by relasping herpetic keratitis have not been previously reported, although this possibility should be considered. This observation represents a contribution to the better understanding of herpetic eye disease in general as well as the eventual recognition of the toxic effect of the HSH virus on man in vivo. According to the author these ocular disturbances are provoked by the toxic effect of the human herpes simplex virus and are connected to its neurotropism.


[Ultrastructural study of two cases of persistent primary vitreous (author's transl)].

Ultrastructural study of two cases of persistent hyperplastic primary vitreous. Behind posterior lens capsule we find a connective tissue where fibroblasts present an intense activity. Numerous vessels and neuro-ectodermal tissue were noted.


[Vitrectomy through the pars-plana in two cases of persitent primary vitreous (author's transl)].

Two cases of persistent hyperplastic primary vitreous have been managed by the vitreous cutter Sukon "Alternating" with a pars-plana approach.


[Ultrastructural study of a case of molluscum contagiosum (author's transl)].

This is the case of a female child with molluscum contagiosum widely disseminated around the mouth and the eye-lids. Antibiotics were used to stop local staphylococcal superinfection. Follicular conjunctivitis and keratitis punctata disappeared only after complete removal of all cutaneous lesions. Biological diagnosis was done by direct observation of the Poxvirus with the electron microscope, since isolation of the virus itself is impossible. Ultrastructural study of the excised tumor has shown the different stages of the growth of the virus, and the associated cellular lesions.


[Clinical trial of the new percutaneously active antirheumatic etofenamate. Summarising report (author's transl)].

2-(2-Hydroxyethoxy)ethyl-N-(a,a,a-trifluoro-m-tolyl)anthranilate (etofenamate, Rheumon Gel), a percutaneously active antirheumatic containing etofenamate as active principle has been subjected to clinical studies in both hospitalized and out-patients in various types of rheumatic disease. These trials included double-blind studies against placebo gel, controlled comparative studies against two topical commercial products (ointmentI: combination of 2-hydroxyethyl salicylate and p-menthan-3-ol; ointment II: 3,5-dioxo-1,2-diphenyl-4-n-butylpyrazolidine) and open trials for efficacy and tolerance. Of the 760 patients taking part in the trials, 556 were treated with Rheumon Gel.


Prostaglandin E1 treatment of NZB/NZW F1 hybrid mice. II. Prevention of glomerulonephritis.

The F1 hybrid of New Zealand black and New Zealand white mice--the NZB/NZW mouse--spontaneously develops a disease similar to human systemic lupus erythematous, characterized by impaired cell-mediated and enhanced humoral immune responses, development of antibodies to nuclear antigens, and immune complex glomerulonephritis. Because there is experimental evidence that prostaglandin E1 (PGE1) can enhance T-cell function and cell-mediated responses and suppress B-cell activity, NZB/NZW mice were treated with 200 microgram PGE1 subcutaneously once or twice daily from 6 weeks of age. PGE1 treatment of female and male mice prevents giomerular deposition of immunoglobulins and complement (monitored by immunofluorescence), and development of the proliferative glomerulonephritis (determined by light and electron microscopy) characteristic of untreated NZB/NZW mice. After 1 year of treatment, 18 of 19 female mice survived, whereas only 2 of 19 untreated control mice were alive. Male mice treated with 200 microgram PGE1 daily were also protected: 9 of 11 versus 2 of 9 untreated mice were alive at 65 weeks. PGE1 treatment did not prevent development of antibodies to nuclear material in any of the treated groups.


Short-term and prolonged treatment with oral contraceptives and liver function.

Experiments on female rats were performed to observe the effects of progesterone and two synthetic progestens: ethinodiol-diacetate and methylestrenolone on liver function. In acute experiments animals were treated for the duration of one sexual cycle. All three compounds prolonged the hexobarbital biotransformation time. This effect is reversible and normalised 48 h after stopping treatment. The testosterone inducement of microsomal mixed function oxydases remained at the level of controls after methylestrenolone pretreatments and was even higher in the ethinodiol-diacetate and progesterone pretreated animals. Subacute and chronical treatments lasting for two or more sexual cycles resulted in the same slight inhibition of hexobarbital biotransformation when performed with the two progestogens. Chronical progesterone administration prolonged significantly hexobarbital biotransformation time. This impairement is also reversible. Our results pertain to a moderate, transitive inhibition of hexobarbital metabolism during short-term and prolonged progesterone and progestogen treatment. This effect may be easily suspended by interrupting drug administration or inducing microsomal enzymes with a single dosage of testosterone. In our progesterone experiments the inhibition of liver function increased with dosage and exposition time. In case of the two examined progestogens exposition time has not been proven as a predisposing factor for impairing liver function.


Clinical evaluation of D-penicillamine by multicentric double-blind comparative study in chronic rheumatoid arthritis.

In order to evaluate clinical efficacy of D-penicillamine (DP) a double-blind study was conducted by the Metalcaptase Research Group consisting of forty-one rheumatological centers in Japan. A total of 179 patients with rheumatoid arthritis (RA) was divided into two groups; one treated with 5 mg (control group) and the other with 100 mg (drug group) of DP in capsule form. The trial lasted 24 weeks. Global judgment by physicians revealed that improvement was found in 27% in the controls and 65% in the drug group. Adverse reactions occurred in 34% of the controls and 49% of the drug group. Skin rashes, taste disturbances, gastrointestinal upset and proteinuria were frequent in the drug group, but severe or fatal reactions could not be seen in this trial.


A double-blind trial of high versus conventional dosages of gold salts for rheumatoid arthritis.

In a double-blind study, patients were randomly selected for treatment using conventional doses (CD; 50 mg) or high doses (HD; 150 mg) of sodium aurothiomalate given weekly by injection. Twenty-three patients were assigned to the CD group and 24 to the HD group. Neither efficacy nor toxicity correlated with serum gold concentrations. Conventional doses were as efficacious as high doses with respect to both rapidity and degree of response. However, side effects were much more frequent and severe in the HD group. Thus there is no reason to recommend a 150 mg weekly dosage regimen.


A study of the in vitro metabolism of androgens by human scalp and pubic skin.

The metabolism of dehydroepiandrosterone, androstenedione and testosterone was compared in vitro in human scalp, forehead, pubic and axillary skin biopsies. Conversion of testosterone to the metabolite 5alpha-dihydrotestosterone, believed to be the active form of androgen, occurred in all tissues; however 17-oxosteroids such as androstenedione, 5alpha-androstanedione and androsterone were also formed from testosterone and were the major metabolites of scalp and forehead skin. While 17beta-hydroxy steroid dehydrogenase activity was present in every skin sample, it was evident there were differences in the direction of operation of this enzyme in skin from different body sites. Axillary skin readily metabolised androstenedione and dehydroepiandrosterone to active 17beta-hydroxy steroids such as testosterone and 5alpha-dihydrotestosterone, but these compounds were minor metabolites of androstenedione and dehydroepiandrosterone in forehead and scalp skin despite their activity in 17beta-oxidation of testosterone. Pubic skin was intermediate between axillary and scalp skin in its ability to form 17beta-hydroxy products from androstenedione and dehydroepiandrosterone. It is suggested these patterns of metabolism may reflect differences in androgen sensitivity.


An assessment of laparoscopy as the primary investigation in the subfertile female.

Our experience with laparoscopy as the primary means of assessment of the female genital tract is described in 279 women attending a subfertility clinic. Thirty-two per cent of patients with primary infertility and 60 per cent of patients with secondary infertility had significant pelvic disease. We feel that laparoscopy should replace other methods for the routine primary assessment of the genital tract in infertile women.


Reactivity of essential thiols of myosin. Chemical probes of the activated state.

14C-Labeled fluorodinitrobenzene and N-ethylmaleimide have been used as chemical probes of the conformational states of myosin induced by the binding of MgADP and MgATP. The results indicate that in the high-energy conformation, MMgADP-Pi, the essential thiols are protected from modification but their diminished reactivity does not result from depletion of the reagent by reaction at nonessential thiols. The binding of MgADP to myosin exposes the essential thiols as reflected by an increased rate of their modification. The influence of the divalent cations Mg2+ and Ca2+ on the conformation of the M species has also been investigated. By monitoring the incorporation of fluorodinitrobenzene, the conformations of the M state in the presence of these cations can be clearly discerned.


Effect of nucleotide binding on the proximity of the essential sulfhydryl groups of myosin. Chemical probing of movement of residues during conformational transitions.

The reaction of myosin with three bifunctional sulfhydryl reagents of differing cross-linking span is reported. In the absence of nucleotide only p-N,N'-phenylenedimaleimide with a cross-linking span of 12-14 A can bridge between the two essential sulfhydryls of myosin. The other two reagents, 2,4-dinitro-1,5-difluorobenzene and 4,4'-difluoro-3,3'-dinitrodiphenyl sulfone with cross-linking spans of 3-5 and 7-10 A, respectively, react under identical conditions with the SH1 sulfhydryl but do not bridge to the SH2 group. In the presence of MgADP, both p-N,N'-phenylenedimaleimide and 4,4'-difluoro-3,3'-dinitrodiphenyl sulfone bridge across the SH1 and SH2 groups indicating a closer proximity of these two sulfhydryls in the presence of bound nucleotide. These results are discussed in relation to the conformational change induced in myosin by binding of the nucleotide.


Neocarzinostatin: effect of modification of side chain amino and carboxyl groups on chemical and biological properties.

The antitumor protein neocarzinostatin (NCS), isolated from Streptomyces carzinostaticus, is a single chain polypeptide with 109 amino acid residues. Complete acylation of the amino groups (alanine-1 and lysine-20) was observed when NCS was allowed to react with 3-(4-hydroxyphenyl)-propionic acid N-hydroxysuccinimide ester at pH 8.5. Since the ensuing bis[(alanine-1, lysine-20)-3-(4-hydroxyphenyl)]-propionamide NCS was fully active in antibacterial potency and in the inhibition of growth of leukemic (CCRF-CEM) cells in vitro, it appears that the two amino groups in the protein are not essential for biological activity. Radiolabeled NCS was prepared by using a tritiated or 125I-labeled acylating agent. Since the CD spectra of native and bis(alanine-1, lysine-20)-amino modified NCS were indistinguishable, there is presumably no change in the native conformation of the protein due to acylation. Reaction of NCS with ammonium chloride in the presence of 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide at pH 4.75 converted all the 10 carboxyl groups into carboxamides and produced a protein derivative of basic character. This modification caused a change in the native conformation of the protein accompanied by a loss in biological inhibitory activities.