[Sarcomas occurring on fibrous dysplasia of bone. Apropos of a complex hemimelic form, with a review of the literature].

Bone formation by the sarcoma is exclusive, without any cartilaginous component; the pattern of the tumour being sometimes quite similar to dysplasia lesional tissue. It seems to be a tissular transformation rather than an unicellular sarcomatous change. Among the etiological factors, except the part of the radiotherapy, periostal changes enhanced by a surgical procedure with acrylic cement in the femoral shaft are perhaps contributing to the development of a sarcoma whose pattern is quite particular.


[Recent fractures of the humeral diaphysis. Apropos of a continuous series of 200 cases, of which 107 were treated with a hanging cast alone. (Arterial intra-osseous vascularization of the humerus)].

Were reviewed 200 fractures of humeral diaphysis, two cases have been excluded because they were incomplete; 175 patients out of 200 have been reexamined a long time after; 23 have not been reexamined but held a sufficient follow up. Most of the transversal fracture were met among young adults (56 per 100 traffic accidents). The intraosseous vascularisation was studied elucidating partly the greatest frequency of pseudarthrosis in the part 1/3 middle-1/3 inferior especially after exaggerated periostal elevation. Among 107 cases treated by hanging cast were noted 4 pseudarthrosis, 12 shoulder's stiffnesses. Traction or external fixation were rarely useful (comminuted fractures, burns). Surgical procedures were rarely necessary because this type of fracture usually united with good result after conservative treatment. The outcomes of 40 osteosynthesis were examined and non-unions were noted. Vascular (4 out of 200) and nervous (29 out of 200) complications were also noted.


[Formation of the skeleton - growth of a long bone. Growth of the 3d metatarsal bone in the rat].

The authors have studied the longitudinal growth of the third metatarsal bone of the rat. This bone has only one epiphyseal plate at its distal extremity and none at its proximal one. Nevertheless it was demonstrated that the proximal extremity was responsible for 16% of the total longitudinal bone growth.


[Essential bone cysts of the upper end of the femur in children. Our experience with 12 cases].

The authors have operated on 12 children with solitary unicameral bone cysts of the upper femoral extremity. They opened the cysts widely, resecting one third of the bone circumference, reinforcing the bone solidity by a nail plate and filling the cavity with autogenous bone grafts. 11 cysts healed, 1 recurred. Some residual deformities were noted (coxa valga or vara).


[Severely slipped femoral epiphyses treated by the D. Dunn open reduction method].

The authors describe the Dunn's technique that they have followed in 19 cases of severely displaces slipped upper femoral epiphysis. The approach was posterior, subperiosteal for preserving vascularity. The results were good in 15 cases, poor in 4 cases. The indications are detailed.


[Articular fractures of the calcaneum. Therapeutic indications based on a series of 105 cases].

The authors have treated 105 articular fractures of the calcaneum. Three methods were tested: open reduction and fixation, conservative treatment with early mobilization, primary subtalar arthrodesis. The final results were satisfactory in 85% of the cases. However the three above groups were hardly comparable. Details on the radiological study of these fractures are given. The authors conclude that when osteosynthesis obtained a perfect anatomical reduction, functional results were good. But perfect reduction was rarely obtained. Final results could be improved by a better selection of the surgical cases and a better surgical technique.


[Associated homolateral fractures of the neck and shaft of the femur].

The authors have reviewed 25 cases of associated fractures of neck and shaft of the same femur. Some were treated conservatively, others were operated on. They conclude that the best treatment should be surgical on both foci. They recommend nailing of the shaft, the nail being introduced in the anterior aspect of the greater trochanter, and screwing of the neck, the screws being located behind the nail. In cases of low diaphyseal fractures plating was used. However a high rate of non-unions was noted in such cases.


[Traumatic dislocations of the hip with fracture of the femur head. Apropos of 28 cases].

Having reviewed 28 cases of fractures of the femoral head complicating traumatic dislocation of the hip the authors point out that the problems to be solved are the reduction of the dislocation (close or surgical) and the fate of the femoral head fragment. Close reduction succeeded in 12 cases, failed in 12 other cases, was not attempted 4 times. Open reduction was performed 16 times. When the femoral fragment was small, close reduction was attempted and the femoral head fragment neglected (10 cases). In three cases close reduction was attempted despite a big femoral fragment. These cases were complicated by a secondary femoral neck fracture. After open reduction the femoral head fragment should be neglected if small, screwed if important. Eight times a rather big fragment was removed but final results were unsatisfactory.


[Pseudarthrosis of the dorso-lumbar vertebrae].

The authors have observed three cases of fractures at the thoraco-lumbar level which did not unite after ten to twelve months - Dynamic X-rays demonstrated persisting mobility of about 20 degrees. The fracture line of the vertebral bodies was situated in a frontal plane and fragments were separated by the antero-inferior edge of the above vertebral body. The authors conclude that such fractions ought to be treated by internal fixation when recent, internal fixation and grafting when ancient.


[Sequelae of acetabulum fractures treated by total hip prosthesis].

The authors have treated by total prosthesis 39 cases of fractures of the acetabulum, at the stage of severe sequellae. 21 of them had been initially treated conservatively, and 18 had been previously operated on. 23 times they used conventional prosthesis anchored with cement. 8 cases became loose and had to be re-operated on. 16 times an original prosthesis made of highly porous metal was used with no complication at the present time.


[Gonalgia following meniscectomy. Arthrographic fingings. Review of 200 case records and radio-clinical comparison].

The authors have examined by arthrography two hundred knees which had remained painful after meniscectomy. In 170 cases this examination revealed a possible explanation for the pain; residual pathological posterior horn, lesion of the other meniscus, degenerative changes of the cartilages, lesions of the ligaments. 91 patients sustained a second surgical procedure. In 81 cases the arthrographic findings were confirmed, in 10 cases surgical exploration found more lesions than expected.


[Valgus fixation of trochanteric fractures in elderly patients. Early weight-bearing walking. Apropos of 25 cases].

The authors have treated 25 unstable trochanteric fractures in old people by valgus osteotomy and nail-plate fixation. In 6 cases a medial translation was added. Walking with weight bearing was started 7 to 14 days after the operation. The results were satisfactory in only 14 cases. The authors think that this type of fixation is logical on a bio-mechanical standpoint. However they conclude that the procedure is not fiable enough.


[Controlled orthopedic reduction of spinal fractures].

The authors estimation is that malunions are poorly tolerated at the spine level. Therefore they advocate a systematic reduction of fractures at any level of the spine after a review of 100 cases. They describe the closed procedure they used in 63 cases for obtaining reduction without anesthesia, under radiologic and manometric control. Then, in 53 cases, a plaster cast was applied. In 10 other cases, closed reduction was completed by a surgical procedure, either by an anterior or a posterior approach. 15 fractures were surgically reduced and fixed, and 22 cases were treated by rehabilitation only without reduction. An original classification was set up for a precise description of the initial lesions, and the measurement of sequellae and final results.


[Anatomopathological aspects of giant cell tumors of the bone].

The morphological study of Giant Cell Tumors of Bone collected at the Orthopaedic Department of C.H.U. Cochin, with high resolution radiography of macroscopical samples added to topographical cytology allows to report the following facts: --Mononuclear cells have cytonuclear criteria between histiocyte and fibroblast cells, quite apart from Chondroblastoma and Chondromyxoid fibroma. Cytological transitions are observed between mononuclear and giant cells. --Osteoid formation is usually connected with the lysis or the blow-up of the neighbouring cortex. Without secondary changes, collagenisation is reduced. --A vascular network is appearing between the cortex and the tumor, factor of some radiological evolutions, those aspects being nearly similar to aneurysmal bone cyst. --The grading of the tumour has no valuable architectural support ; mitotic activity is equally of no value for the assesment of a recurrence. Nuclear analysis with granular clumping of chromatin, thickening of the nuclear rim and increase in size and number of nucleoli was only a help to identify sarcomas. The latter are primary-associated with quiescent-appearing lesions or merging on multiple tumoral sampling. Giant cell sarcoma, except fibroblastic-like forms, can keep a differenciated cytology with frequent amitosis. --Tumor polymorphism is warrant of some histological pitfalls ; the most rewarding territories for the analysis are in the long bones the upper epiphyseal areas. Whereas, the frequency of secondary changes enhance the additional value of topographical inprint cytology for a correct morphological appraisal.


[Cytologic study of giant cell tumors. Electron microscopy. Cyto-enzymology].

A cyto-enzymologic study of giant cells tumor revealed a high acid phosphatase activity in multi-nuclear cells (as in osteoclasts) and a very low alcaline phosphatase and peroxydase activity. Acid phosphatase was located in lysosom which were concentrated in definite cytoplasmic areas. The blood rate of this enzyme should be raised if it were excreted by the cells. Therefore a study of acid phosphatase blood rate could reinforce a diagnosis based on X-rays and a raising rate after surgery could help for early detection of recurrences.


[Ultrastructural study of giant cell tumors of the bone. Preliminary results].

2 giant cells tumors were examined under electron microscope. The study confirmed that basic cellular population was mononuclear cells which demonstrated a tendancy toward phagocytosis and fibrillar material production. These cells had some appearance of macrophages or fibroblasts.


[Giant cell tumors. Follow-up of 85 cases. Clinical experiences of the Department of Orthopedics at the Cochin Hospital].

The results of a series of 86 cases with a follow-up of 2 to 23 years are presented. Treatment was surgical in all cases except in spine and pelvis. 24 cases were treated by curetage, 51 by resection in some cases after curetage. Block resection nearly suppresses the recurrences and, when used as the first treatment, may avoid secondary malignant degeneration.


[Evolution of myeloplaxic tumors. Apropos of 21 cases].

21 cases of giant cells tumors were observed. Two were malignant primarily. Twelve cases treated by curetage produced 7 recurrences, one being malignant. Seven cases treated by resection produced no recurrence. The authors believe that the prognosis and the indications are based more on clinical and radiological features than on histologic grading studies.


[Giant cell tumors of the long bones. Curettage-filling].

13 cases of G.C.T. were treated by curetage with only 3 benign and 1 malignant recurrences. The authors are in favour of curetage as a routine treatment provided it is performed at the right time.


[Giant cell tumors. Course and treatment].

32 cases of Giant cells tumors. 17 treated by curetage with 6 recurrences, 1 malignant. 9 treated by resection with 9 successes. 7 treated by radiotherapy with 6 recurrences 2 of which were malignant; 2 amputations.


[Recurrence in soft tissues of a giant cell tumor of the femoral condyle].

A case of recurrence with osteogenesis only in the soft tissues of a giant cell tumour is reported.


[Treatment of giant cell tumors. Resection-unicondyle reconstruction].

The authors report 4 cases, 3 involving a femoral condyle one the lower extremity of the humerus treated by resection followed by massive grafting.


[Unusual pulmonary metastases of giant cell tumors].

A case of giant cells tumour treated by curetage recurred locally together with pulmonary metastasis. Amputation and lobectomy disclosed no malignancy. In spite of incomplete removal of pulmonary tumours. X rays picture and general status are normal 4 years later. 5 comparable published cases are reported.


Improvement by chlorine of the intestinal absorption of inorganic and organic Mg compounds and of their protective effect against adrenergic cardiopathy.

Comparative studies on the therapeutic effects of MgSO4, MgCl2, Mg aspartate, and Mg aspartate hydrochloride were carried out in Sprague-Dawlwy rats. In general, the intestinal absorption of Mg and its uptake into bone were improved after oral or intraduodenal administration of the two compounds containing chlorine; however, in these animals, gain in body weight was reduced, especially after MgCl2. Treatment with 9-alpha-fluorocortisol plus epinephrine resulted in cardiac hypertrophy and necroses. All Mg compounds fed in amounts leading to marked hypermagnesemia prevented hypertrophy; as regards the incidence and severity of necroses, however, MgSO4 and Mg aspartate proved ineffective. Significant protective effects were observed only after MgCl2 and Mg aspartate hydrochloride, indicating the central pathogenic role of extracellular hypochloremic alkalosis in metabolic heart necroses.


[Treatment of giant cell tumors of the sacrum. Apropos of an observed case].

A case of giant cells tumor of the sacrum, invading a large part of the sacral body, the buttock is reported. The sacro-rectal space and the sacral canal with the cauda equina were compressed. Complete avulsion was performed, each nerve being closely dissected. Clinical recovery with roentgenographic aspect of bone healing is still present, three years and a half post-operatively.


Membrane alteration in failing hearts of cardiomyopathic hamsters.

Cardiomyopathic hamsters (UM-X7.1) show clinical signs of congestive heart failure and an abnormal EKG pattern. The sarcolemmal fraction obtained from the failing hearts at advanced stages of myopathy exhibited no change in the basal adenylate cyclase activity; however, the activity of this enzyme in the presence of catecholamines or NaF was lower in the failing heart sarcolemma than that in the control. The activities of Ca2+-ATPase, Mg2+-ATPase, and Na+-K+-ATPase in the failing heart sarcolemma were also less than the control values. These results suggest an association of membrane defect with heart failure.


Cellular changes and damage in mechanically overloaded hearts.

The electron microscopic aspects of myocardial cells in several types of mechanically overloaded heart are reviewed. Alterations which may be interpreted as degenerative changes are all the more frequent as the load is more severe. They seem to be the cause of the interstitial fibrosis which often accompanies hypertrophy. Their mechanism is dubious: swelling of mitochondria and intracellular lipidosis, which could signify cellular hypoxia, are rarely present. Other changes are characteristic of an increase of proteosynthesis and of the active growth of the main structures of the cell: myofibrils, mitochondria, T- and L-tubules. Some pictures of myofibrillar growth are not always easily distinguished from those of myofibrillar lesions. The mitochondria/myofibril ratio may be modified or not. The apparent volume of the mitochondria may remain normal while their density increases, which implies a decrease of their average size. In severe and long-lasting overloads, hypertrophy and hyperplasia of the Golgi apparatus and multiplication of granules of the auricular type evoke a regression of the cell toward its fetal type.


Ultrastructural study of nuclear pores in hypertrophied heart cells.

Nuclear pores were consistently found in both spontaneous and experimentally induced hypertrophy. The structure of nuclear pores in hypertrophied hamster, guinea pig, and rabbit heart cells was similar. The morphology of nuclear pores was similar to that previously seen in normal cardiac cells and in other cell types. Each pore complex was composed of a pore sometimes containing a central granule, a pore margin having an octagonal shape, and two rings of annular granules lying upon the pore margin.


Cell number in human heart in atrophy, hypertrophy, and under the influence of cytostatics.

The DNA content was determined in 30 human hearts from different age groups and of different weight classes. Among these cases were included 4 hearts of children and 5 hearts of adults who had been treated with cytostatics. The total DNA content was determined biochemically and the nuclear DNA content was measured by means of Feulgen cytophotometry. By combining both methods, the total number of heart muscle cells was determined. We obtained the following results: (1) The DNA concentration remained the same in all the hearts, while the total amount of DNA rose up to three-fold with increasing heart weights. (2) Cytophotometric DNA measurements revealed that, in hearts of infants up to the age of 7, a diploid DNA content is found in 80% of the muscle nuclei. In children of higher ages and in adults, 60% of the muscle nuclei are tetraploid. In hypertrophied hearts, there occurs an increased polyploidization of the muscle nuclei, with up to 8% of 32-ploid nuclei. Thus, polyploidisation is caused by chronic hyperfunction of the heart. In atrophic hearts, on the other hand, no regression of polyploidisation was observed. (3) The number of connective tissue cells in a given heart increases from 1 x 10(9) just after birth to 5 x 10(9) in adults, reaching its maximum of 10 x 10(9) in extremely hypertrophied hearts. The number of heart muscle cells is 2 x 10(9) in normal hearts of children and adults, and may rise to 4 x 10(9) in excessively hypertrophied hearts. (4) During treatment with cytostatics, the DNA content of the myocardium is reduced only in hearts of children; in adult hearts, no decrease of DNA is observed. Cytostatics prevent polyploidisation of the heart muscle nuclei and exhibit no other influence upon the DNA content of the heart muscle cell nuclei. (5) Cytostatics cause a decrease in the number of connective tissue and heart muscle cells of up to 57% of the original value in hearts of children. The cell number of adult hearts remains the same under cytostatic treatment.


Human heart aneurysm: biochemical and morphological characteristics.

The microscopic structure of left ventricular wall aneurysms and akinetic zones differs markedly. In samples obtained from akinetic zones, dystrophic changes and marked hypertrophy of muscle cells were observed with dispersed  myofibrosis. In 1 case of left ventricular wall aneurysm, a pronounced nonspecific inflammatory reaction in the subepicardial layer was present. In all samples investigated, there were marked morphological signs of activated proteosynthesis, mainly aggregations of ribosomes, both in the muscle cells and in the fibroblasts. Utilization of glucose-14C was highest in samples with a predominant content of muscle cells. Pentose-phosphate shunt activity was highest in samples consisting mainly of fibrous scar tissue. The ability of the tissue homogenate to incorporate glycine-14C into the trichloracetic acid-precipitated protein was higher in samples containing predominantly connective tissue. The highest activity of the pentose-phosphate shunt, together with the highest rate of proteosynthesis, was observed in the sample from the left ventricular wall aneurysm with marked inflammatory infiltration of the tissue.


Cardiomyopathy in crowded rabbits.

Rabbits were crowded 4 to a cage for 2 weeks, then released for 1 week, crowded again for 2 weeks, and so on. Of 44 rabbits subjected to intermittent crowding, only 9 survived for longer than 10 months, 20 died during the 1st month, and 15 died between the 2nd and 9th month of the experiment. Histological sections of the myocardium showed myocytolysis, intersititial edema, and an increased amount of acid mucopoly saccharides in rabbits surviving for 2 weeks and more. The accumulations of acid mucopolysaccharides were apparently unrelated to necrotic foci. Long-term survivors frequently showed myocardial fibrosis and endocardial fibroelastosis, as well as basophilic degeneration of myocardial fibers. The lesions observed were similar to those described in idiopathic endomyocardiopathy in Southern Africa. Therefore, the rabbit may be of some value for research in cardiomyopathies.


Prevention by K+, Mg2+-aspartate of isoproterenol-induced metabolic changes in the myocardium.

Isoproterenol ISO), in a single dose of 7.5 mg/kg body weight, was found to produce alterations of cardiac metabolism in dogs. After 2 hours, high energy phosphate stores and glycogen were reduced, whereas the levels of lactate and pyruvate, the lactate/pyruvate ratio, and myofibrillar ATPase activity were elevated. Ca2+ accumulation by sarcoplasmic reticulum (SR) and mitochondria were increased (p less than 0.01). After 24 hours, a partial recovery in the parameters studied could be observed. Only myofibrillar ATPase activity and the Ca2+ uptake by SR and mitochondria were lowered. When K+, Mg2+-aspartate (K,Mg-ASP) was administered concurrently with ISO, myofibrillar ATPase and Ca2+ accumulation by SR did not differ from controls 2 hours after ISO application; also, the other parameters exhibited a tendency to improve (p less than 0.01), but did not reach control levels. At 24 hours after ISO application, we could observe a similar effect of K,Mg-ASP in the prevention of Ca2+ overload accompanying metabolic changes.


[Epidemiological aspects in the evolution of epidemic cerebrospinal meningitis (ECSM) in the city of Bucharest in the period 1951-1973].

Analysis of the evolution of the main epidemiologic indices showed that epidemic cerebrospinal meningitis evolved during the last two decades in our country according to the general evolution of this disease in most of the developed countries in the temperate zone, however with certain particular elements revealed by the data obtained in the country and in Bucharest. Details are given for the town in Bucharest, during the 1951-1973 period, concerning the general trends of the frequency and gravity indices of the cases, the structure per age groups of the morbidity, the forms of manifestation of the epidemiologic process. Stress is laid on the seasonal character (winter-spring) of the increase in the number of cases and the periodicity of the epidemic waves.


[Characteristics of the course of the last epidemic of epidemic cerebrospinal meningitis (ECSM) in the city of Bucharest].

Active survey of the epidemiologic potential of cerebrospinal meningitis, in Bucharest, starting in 1967, made it possible to carry out a complex study of the last epidemic wave in 1968-1972. Details are given concerning the results of the complex epidemiologic, clinical and laboratory investigations, which revealed the particularities of this epidemic episode, including the frequency and gravity of the cases, territorial distribution, prevalent affection of certain age groups and children's communities, the prevalence of certain clinical forms, antigenic structure of the pathogenic agent and its sensitivity to antibiotics, comparative efficiency of the different methods of laboratory diagnosis, real and apparent contagiousness, etc. The authors discuss the efficiency of present methods applied in the prevention and control of meningococcal infections in general and of epidemic cerebrospinal meningitis in particular.


[Clinical and therapeutic observations on 34 cases of meningococcic meningitis].

The present paper reports on 34 cases of meningococcal meningitis admitted during the last three years to the Clinic of Communicable Diseases of Cluj. The incidence was higher in adolescents and young adults (76%). The clinical form was severe in 10 cases, medium in 19 cases and mild in 5 cases. All the patients recovered, with a mean duration of the disease of 9-12 days. No sequelae or relapses were recorded. The treatment was based upon penicillin G, 15 million U/day. In 17 cases sulfonamides were associated and in 5 cases chloramphenicol and ampicillin. In 29 cases intravenous, intramuscular or oral cortisone was administered and in 5 cases intrathecally. The results obtained in the cases treated only with penicillin were identical to those obtained by an associated therapy. Worthy of note was the decrease of the sensitivity of meningococci to sulfonamides and chloramphenicol and their increased resistance to tetracyclin and erythromycin.


[Data on the use of serological tests for differentiation of exanthematous typhus primary infection from that of recurrences in native cases of Brill-Zinsser disease].

A group of sera from autochtonous cases of Brill-Zinsser's disease, in the early acute phase, were examined by the tests of Murray et al. and Voronova, in the course of a study on the characteristics of the immune response in primary and secondary stimulation with Rickettsia prowazeki. The results obtained both with these sera and those of primary typhus cases from other countries, suggest the possibility of establishing a serologic diagnosis of Brill-Zinsser's disease, with certainty, by identifying the secondary nature of the disease according to the presence of antibodies type 7 S. The authors recommend complement fixation with increasing soluble R. prowazeki antigen concentrations as a method of electron for routine diagnosis.


[Studies of immunoglobulins G in newborn infants, using the immunodiffusion method].

Immunoglobulins G (IgG) were determined in the neonate using immunodiffusion in Hyland Travenol agar gel. IgG values were tested in the umbilical cord and perpheral blood, establishing their relationship with various parameters. Hypogammaglobulinemia does not appear to be so rare in the neonate (4.91%).


[Simple method for production of conditions of general anaerobiosis].

The description is given of a modified method starting from the alkaline pyrogalol technique, described by Béerens and Tahon-Castel, for obtaining anaerobiosis in Petri dishes. The modification consists in: sealing the dishes with paraffin, adding of talcum in the reducing mixture instead of silica, and use of the ready prepared mixture ovar a period of at most 6 months. The method was tested against the reference method using suspensions of C. Oedematiens (species demanding strictly anaerobiosis conditions), C. histolyticum (somewhat less exigent) and C. perfringens spores (mean esigence), seeding on the surface of dishes with Willis-Hobbs medium. The comparative experiment, counting 30,941 colonies on 408 Petri dishes proved the value of the method proposed. The procedure was just as efficient in surface cultures of nonsporulate anaerobic germs.


[Interference of chloramphenicol with some cytoplasmatic enzyme systems].

The activity of alkaline phosphatase was determined in a lot of Wistar white rats which had received during 8 days therapeutical doses of chloramphenicol hemisuccinate, the enzyme being investigated in the circulating granulocytes and the liver. In the neutrophil granulocytes evidence was found of a marked decrease in alkaline phosphatase activity (40% presented a positive activity in the injected animals as against 70% in the controls). In the liver the histochemical test used did not allow for a discrimination between the experimental and control animals. The biochemical test, however, showed depression of alkaline phosphatase activity in the liver of rats receiving chloramphenicol (216.72 muM PO4 mean value as against 267.36 muM PO4).


[Fluorescent antibody method in the study of an antiviral agent: 5-sulfamido--isatin-thiosemicarbazone].

Direct immunofluorescence supplied evidence of the antiviral action of a new synthetic derivative (5-sulfamido-ITSC) against vaccina virus in HeLa cell cultures. The antiviral potential of the new derivative is expressed by a 10-18 delay in the appearance of the viral antigen and by the quantitative reduction of synthesis. Administered in a single dose of 40 uM/ml, after infection of the HeLa cells, 5-sulfamido-ITSC does not arrest the infection and bring about elimination of the virus from the cell, in the course of a single viral multiplication cycle. Direct immunofluorescence is a rapid, specific method for detection of the in vitro antiviral action of synthetic derivatives.


[Serological typing in the study of the transport of strains of Pseudomonas aeruginosa in the hospital environment].

Bacteriologic investigations in an operation theatre in the surgical department of an older hospital building in Bucharest detected 14 Ps. aeruginosa strains (10 strains were isolated on the floor of the operation theatre, from the sterile room and wash basins, two strains from the wheels of stretchers and two from the footwear used during the transport of patients). Serologic typing identified the routes of transport of the Ps. aeruginosa species, making it possible to take the necessary control measures.


[Gastrointestinal disorders caused by non-agglutinable (NAG) vibrios].

In August-October 1973 several NAG vibrio strains were isolated for the first time in our country from clinical cases of acute intestinal disturbances. The patients were admitted to hospital being clinically suspect of dysenteric syndrome or alimentary toxiinfection (nausea, vomiting, abdominal colics, tenesms, mucosanguinolent stools, aqeous stools from 4-5 up to 20 in 24 hours, with signs of dehydration). NAG vibrios were isolated from all the cultures in, practically, pure cultures. Epidemiologic survey in the village of B resulted in isolation of the same NAG vibrio strains from the samples collected from the direct contacts and drinking water sources. Therefore, NAG vibrios can unquestionably cause a diarrheic disease and it will be necessary to extend the bacteriologic diangosis also in this direction in all cases of diarrhea of "unknown etiology".


[Altered morphopathological aspects of Pneumocystis carinii pneumonia].

The present paper reports a study on 27 children who died of interstitial pneumonia due to Pneumocystis carinii in the clinics of pediatrics, Cluj, in the course of 3 years (1971-1973). The incidence was 10% of the children who died from acute pneumonia. The authors show the morphopathologic possibilities of identifying the pictures modified by plasmocytic pneumonia due to association of the disease with bacterial and viral infections. These cases represent a quarter of the authors' cases. The importance of being acquainted with these altered pictures, illustrated in the text, is emphasized.


[Vaccination strategy in influenza].

The present paper deals with the conditions that influenza vaccines must comply with, their efficiency in terms of the route of administration, the major antigenic changes of influenza viruses, that has to be known from beforehand, a basic problem for the efficient control of a pandemic. Vaccination must have in view reduction of the mortality and morbidity rate, a major criterion in establishing a programme for the prevention of influenza by vaccination.


[Characteristics of immunity in influenza].

Immunity in influenza is a complex phenomenon that depends upon numerous factors whose importance is not yet sufficiently known. The following mechanisms of defence are triggered by infection with the influenza virus: (a) The immune secretory system: -- IgA antibodies, --immune response in terms of the vaccinating dose, previous immunologic experience and time (appraised according to the moment in which infection started). (b) Serum antibodies: -- to the soluble antigen, -- to surface particulate antigens (hemagglutinin and neuraminidase), --antihemagglutinin and antineuraminidase antibodies, indicating the degree of protection. (c) Cellular immunity: -- influenza virus inducing the proliferation of lymphocytes in vitro and activating the inhibitory factor of mononuclear migration, -- mediated immunity. These problems of immunity have not yet been fully elucidated.


[Studies of the influenza epidemic of January-March, 1974].

In an epidemiologic, clinical and viral study of several influenza foci in some urban districts of Romania during January-March 1974, 23 influenza virus B Hong-Kong 8/73 strains were isolated. The dynamics of HAI serum antibodies confirmed the viral diagnosis. The epidemic ran a slow course, affecting especially the 14-25 years age group and had an evident benign clinical aspect.


[Details of the evolution of the influenza epidemic process in the city of Bucharest in 1974].

The present paper reports on the results of a complex epidemiologic survey of the epidemiologic potential of influenza in Bucharest in 1974, conducted on the basis of a complete, unitary methodology including; (a) Dynamic survey of the morbidity and mortality from influenza, with statistical-mathematical processing of the data per age group and total population; (b) Monthly sero-epidemiologic survey of the antiinfluenza immunologic profile of the population, determined in lots of 540 sera (annual total 7020 serum samples), with statistical-mathematical processing of the serograms; (c) Serodynamic determinations of 67 paired serum smaples collected from patients presenting influenza syndromes during ascension of the epidemic morbidity from influenza; (d) Complex epidemiologic surveys in representative influenza foci in children, adolescent and adult communities. Based upon the result obtained the authors discuss the evolutive particularities of the epidemiologic process in Bucharest, particularly during the epidemic ascension of the first trimester of 1974, caused by the intensified circulation of influenza virus type B. The orientative value of certain elements for the epidemiologic prognosis is emphasized, such as: the immunologic profile of the population per age group with regard to the circulating influenza virus strains (autochtonous or imported strains), active control of the incidence of influenza in communities (technical schools etc.) or enterprises with a large number of employees, laboratory etiologic determinations in cases of a clinical diagnosis of influenza in a preepidemic season. The authors' ten years experience in the active survey of the active epidemiologic potential of influenza in the town of Bucharest shows that the methodology applied was efficient both for scientific assessing of the epidemiologic situation and for an orientation in the choice of preventive and  control measures.


Abnormalities of peripheral blood lymphocytes in rheumatoid arthritis.

Peripheral blood lymphocytes from some rheumatoid arthritis (RA) patients show a reduced response to PHA when stimulated directly after isolation from blood. Cells which have been preincubated in medium with normal serum for 22 h before exposure to PHA show a relatively enhanced response, which approximates the normal. These findings could be compatible either with the blocking of surface PHA receptors of circulating RA lymphocytes, or with progressive maturation of these cells in vitro. Preincubation does not enhance the relatively reduced response of RA lymphocytes to allogeneic RA lymphocytes in one-way mixed lymphocyte cultures. An increased reduction in response to PHA following irradiation of RA lymphocytes suggests an increased radiosensitivity of the PHA-responsive subpopulation. This abnormally reduced response was not seen if the cells were preincubated in vitro prior to irradiation.


Arthritis in the rabbit knee joint: a quantitated model.

The knee joint in rabbits has been used as an arthritis model for the study of acute immunologic injury. Histologic examination of synovium plus a standardized procedure for irrigating inflammatory exudate from the joint allowed study of damage due to immune complexes, urate crystals, and Arthus type vascular lesions by multiple parameters. With this model Arthus lesions could be abolished with neutrophil depletion and reconstituted with intra-articular injection of neutrophil suspension. The rate and degree of injury could also be diminished by depletion of complement components.


[The use of hemagglutination inhibition tests and complement fixation tests for evaluation of immunity states and diagnosis of recent rubella infections].

Comparative HAI and CF study of German measles antibodies in 575 sera collected from subjects of different age gave positive HAI reactions in 87% of the cases and positive CF reactions in 55% of the cases. The greater sensitivity of HAI and the longer presence of these antibodies justifies the use of this test for investigating the state of immunity in German measles. The combined use of the two tests for the diagnosis of the disease is very useful especially when the first serum sample is collected some time after the onset when the increase in serum antibody titers can only be demonstrated by CF, as HAI antibodies reach a high titer soon after the onset.


The mechanism of trapping of immune complexes in experimental antigen-induced arthritis.

The role of acute inflammation and of specific antibody in the retention of antigen in joint collagenous tissues of immunized rabbits was examined. The role of the acute synovitis occurring immediately after IA antigen injection in the retention of immune complexes was investigated by the concomitant IA injection of trace amounts of 1258-BSA and mono-sodium urate crystals and by the production of an acute Arthus reaction using an unrelated antigen in doubly immunized rabbits. In neither case was more 125I-BSA retained in the inflamed joint tissues compared to the contralateral noninflamed joints 7 days after antigen injection. In addition, immunized rabbits depleted of ciruclating polymorphonuclear leukocytes by previous treatment with nitrogen mustard retained 2.7 times more antigen than control, nonimmune animals. In another experiment, antigen retention in joint collagenous tissues was greatest 30 min after IA injection, before the appearance of acute inflammatory synovitis. These findings suggest that acute inflammation is not a major factor in the retention of antigen in collagenous tissues. To investigate the role of antibody in the retention of antigen, nonimmune rabbits were injected i.v. with purified anti-BSA antibody three days prior to the intraarticular injection of BSA. Over 20 times more antigen was retained irreversibly in collagenous tissues obtained from the injected joints of passively immunized animals as compared to similar tissues of control rabbits. When rabbits were injected i.v. with purified anti-BSA antibody and either killed 20 min or 3 days later, in vitro binding of antigen by joint collagenous tissues was seen only in animals where antibody was allowed to equilibrate with the extravascular space for 3 days. These findings indicate that retention of antigen depends on the presence of extravascular antibody. It is concluded that the trapping of immune complexes in collagenous joint tissues of immunized animals depends on: (1) the presence of antibody in the extravascular space; (2) the diffusion of antigen or soluble complexes into this space; (3) the interaction of antigen or soluble complexes with extravascular antibody with subsequent formation of larger and more insoluble complexes, and (4) the trapping of these complexes in the collagen fiber meshwork.


Physiopathological aspect of Glynn's type of experimental arthritis.

Knee joint arthritis is induced among rabbits previously immunized by intradermal injection with egg albumin (EA) emulsified in adjuvant containing either M. tuberculosis or M. butyricum, then by intra-articular injection with EA. Arthritis evolution involves two phases, an early one during the first 2 months and a late one from 3 months to 1 year. During the early phase, arthritis intensities are similar no matter which Mycobacterium is used. However, during the late phase, only rabbits immunized with M. tuberculosis develop self-perpetuating arthritis. Among more than 50% of arthritic rabbits, immunological lesions of aortic artery and cardiac valvules are found. Among the rabbits immunized with M. tuberculosis, the humoral anti-EA antibody level remains constant during the whole arthritis evolution; but, among the rabbits immunized with M. butyricum, the arthritis intensity decreases from 3 months of evolution. The correlation between arthritis index (AI) and humoral antibody level is only significant among the rabbits with early arthritis. The intradermally immunized rabbits show a positive skin test with EA and tuberculin. The more intense the cutaneous reactions, the greater the chances of developing self-perpetuating arthritis after the EA intra-articular injection. The fluorescent anit-EA antibodies in the synovia and spleen are found only among the early arthritis. After 2 months of evolution, fluorescent antibodies disappear whatever the immunization may be. Among the immunized rabbits, it is probable that antigenic EA does not persist in the synovia. Indeed, the autologous inflamed synovia transplantation, from the donor-challenged knee joint, does not develop an inflammatory reaction in the non-challenged knee joint. The fluorescent immunoglobulins IgG and IgM in the synovium of arthritic rabbits are found with the same percentages as fluorescent anti-EA antibodies. The lymphocyte response to EA, PHA and PWM are positive whatever the immunization and arthritis evolution may be. There is no correlation between AIs and lymphocyte responses to specific and nonspecific mitogens. It is probable that self-perpetuation depends closely on M. tuberculosis whose adjuvant power is much superior than M. butyricum and not on antigenic EA whose essential role would be to trigger the inflammatory process.


[Supplementary data on the theory concerning the cyclic evolution of influenza viruses].

The distribution per age groups of antibodies to influenza viruses A/Hong Kong/1/68, A/England/837/69 and A/England/42/72 in the sera collected in 1970 demonstrates that antigenically similar strains also dominated the epidemiologic picture of influenza in the past century. The results suggest that the pandemic of 1893 and infection in persons born before 1885 were caused by a strain similar to A/Hong Kong/1/68 and in those born in 1895-1897 by the antigenic variant A/England/42/72. The anamnestic response to the A/England/69 variant, following upon vaccination with the Hong Kong strain shows that the primary infection in persons born before 1900 was caused by a strain antigenically similar to the first variant. The data obtained lend support to the hypothesis of antigenic recycling of influenza virus and of the finite character of the antigenic variation of influenza viruses.


[Relations between the principal classes of serum immunoglobulins and serodiagnostic tests in viroses. I. Influenza infection].

The relationship between the main serum immunoglobulin classes (IgM, IgG) and the positive diagnostic serologic tests (hemagglutination-inhibition and complement fixation) followed up in 30 paired serum samples from patients in the course of a primary influenza infection with B virus strain, before and after treatment with 2-ME, showed actual participation of the IgM molecules sensitive to 2-ME in the CF test. HI with the serum fractions of patients and convalescents of influenza B, in the presence of virus strains A and B, that had circulated earlier in the area, showed anamnestic responses by the presence of IgG and IgA antibodies in the patients' sera; HI and CF with the same serum fractions in the presence of virus B/Iaşi/74 of the epidemic, showed the presence of IgM, IgG and IgA in the convalescent sera, as also demonstrated by immunoprecipitation in agar gel with specific IgM, and IgA antisera and by treatment with 2-ME. Separation of these sera on a Sephadex G-200 column revealed filtration of IgM antibodies at the same peak as the IgG and IgA antibodies, possessing a closely resembling molecular weight (7S) and probably being IgM subunits with an immunologic behaviour similar to that of the intact molecule sensitive to 2-ME.


Decreased (Ca2+ + Mg2+)-stimulated ATPase activity in erythrocyte membranes from polycythemia vera patients.

Erythrocytes were hemolyzed in hypotonic phospate buffer containing 0.5 mmol/l Ca2+ and the membranes subsequently washed twice in hypotonic tris buffer. The centrifugation was performed in a continuous flow system, which was necessary to obtain maximal ATPase activity. The Mg2+-dependent Ca2+-stimulated ATPase activity of 14 patients with polycythemia vera was only 67 per cent (P less than 0.001) of the activity of a control material consisting of 10 donors and 11 bank blood specimens. Five patients with secondary polycythemia and four patients with an increased erythrocyte fraction did not differ significantly from the controls. The polycythemia vera patients with the highest leukocyte count showed the lowest ATPase activity. The apparent calcium dissociation constant of the ATPase in polycythemia vera was about 10(-6) mol/l, as in controls. The relation between the reduced ATPase activity and the abnormal hemopoiesis of polycythemia vera patients is discussed.


Congenital stomatocytosis and chronic haemolytic anaemia.

A new case of congenital stomatocytosis associated with haemolytic anaemia, increased autohaemolysis, abnormalities in the erythrocyte metabolism, increased osmotic fragility and shortened erythrocyte survival is described. Intracellular cation concentrations are abnormal: Red cell sodium is high, and potassium is low. The pump rate for monovalent cations is increased.


Inferior olive: its role in motor learing.

Specific chemical lesion of the rat inferior olive by intraperitoneal administration of 3-acetylpyridine prevents recuperation from motor abnormalities generated by unilateral labyrinthine lesion. Moreover, in animals that have recuperated from the balyrinthine lesion, 3-acetylpyridine produces a reversal of the symptoms within 2 hours of administration. These results indicate that the integrity of the olivo-cerebellar system is necessary for the acquisition and retention of this form of motor learning, but that the cerebellum itself is not the seat of such learning.


Infertility diagnosed by laparoscopy: review of 324 cases.

Reproductive biology has developed into a major subspecialty in gynecology. This study is a retrospective analysis of a private patient population in which the major presenting complaint was infertility. The 324 cases reviewed are divided into three groups: group1-congenital lesions (subdivided into anatomic defects and endocrine disorders); group 2-infectious disorders and genital neoplasias; and group 3-iatrogenic causes of anovulation. Direct visualization of the internal genitalia combined with a hysterogram gives positive proof of tubal patency and allows the surgeon to develop a plan of therapy. By visualizing the ovaries, he obtains the information necessary for the proper choice of ovulatory stimulating agents. Laparoscopy is not a new procedure but has been used increasingly in modern medicine. Better optic resolution and new operative instrumentation have been a great help to the fertility specialist. The laparoscope spans the gap between palpation and exploratory laparotomy.


Clinical and electromyographic evaluation after chemonucleolysis for lumbar disk disease.

Results in 200 patients with lumbar disk disease who had chemonucleolysis were evaluated by two means. First, the surgeon evaluated the patients clinically from 6 to 30 months after chemonucleolysis by rating each case as excellent, good, fair, or unimproved. Results were judged excellent or good in 91% of the 153 "clean" cases (without previous operation) and in 53% of the 36 with previous operation; 11 patients were lost to follow-up. No patients were clinically worse than before treatment. Scond, a physiatrist did a repeat electromyogram three months or longer after chemonucleolysis. He judged a patient improved if there was a decrease or disappearance of the positive waves and/or fibrillation potentials noted on initial electromyogram. Based on these objective findings, 90.5% of "clean" cases and 85.4% overall showed improvement. Surgeons' clinical evaluations and the independent physiatrical evaluations based on objective electromyographic findings thus correlated closely.


In vitro fertilisation of human oöcytes.

This paper describes attempts to cure infertility due to irremediable Fallopian tube lesions by the laparoscopic recovery of pre-ovulatory ovarian oöcytes, their fertilisation in vitro, and their subsequent reimplantation into the uterine cavity.


Advances in laparoscopic sterilisation techniques.

Sterilisation by laparoscopic surgical interruption or occlusion of the Fallopian tubes is briefly reviewed. Fourteen cases of an experimental technique for reversible sterilisation by the insertion, either laparoscopically, at laparotomy, or by the vaginal approach, of a Silastic rod into each oviduct, are described.


Primary mesenteric venous occlusive disease.

Primary mesenteric venous occlusive disease is a highly lethal disease. The only way to improve survival is early diagnosis and immediate laparotomy. The disease occurs in the older age group with a higher incidence in women and should be considered in the differential diagnosis of serious abdominal distress. The most helpful diagnostic tests are paracentesis and peritoneoscopy, but above all, the most important diagnostic tool is a high index of suspicion on the part of the examining physician.


Immunologic evaluation of patients with cancer by delayed hypersensitivity reactions.

Testing of delayed hypersensitivity responses to recall antigens, newly encountered antigens and tumor antigens has contributed to the understanding of several immunologic factors in human neoplasia. Patients with Hodgkin's disease tend to have depressed responses to both newly encountered and recall antigens. Patients with solid tumors are more likely to be deficient only in the response to newly encountered antigens. In patients who have intact response to recall antigens, reactivity to antigen preparations from tumor and control tissue may be studied. Tumor-associated or organ-associated antigens have been demonstrated by delayed hypersensitivity responses in leukemia, Burkitt's lymphoma, malignant melanoma and carcinoma of the lung, breast, cervix uteri and intestine. Approaches to a definition of the specificity of these reactions are described. The results with these tumor antigen tests correlate strongly with the clinical course. This is a promising technique for monitoring immunotherapy. The results from tests with recall and newly encountered antigens also correlate with the clinical status and perhaps with prognosis. Various possible interpretations of these changes are discussed. Further work should be directed toward an exact definition of immunologic defects in patients with cancer and toward the use of this understanding for a rational program of immunotherapy.


Inhibition of ATP synthesis associated with 6-aminonicotinamide (6-AN) teratogenesis in rat embryos.

Pregnant rats were injected ip with 6 mg/kg 6-aminonicotinamide (6-AN) at day 12 of gestation. Embryos removed between 1 and 48 h later had reduced adenosine triphosphate (ATP) concentrations, of about 50% of control values. All fetuses examined near term were malformed. Nicotinamide (NAM, 100 mg/kg) given ip 1 h after 6-AN afforded protection: malformations occurred in only 15% of the survivors; and there was minimal ATP reduction, 15% below control values. NAM given 2 and 4 h after 6-AN produced intermediate ATP concentrations and malformation frequencies. Thus, there was a relation between the embryotoxic and ATP-depressant actions of 6-AN in day 12 rat embryos.


[Experiences with the Sparks-prosthesis in the periphery (author's transl)].

According to our own experiences it is not advisable to implant the Sparks-Mandril in an extremity which gangrene. The ideal case for implantation is the patient with short walking distance and an unsuitable vena saphena magna. The prothesis is useful for the femoro-crural bypass procedure. The thrombogenicity of the Mandril can be neglected by heparinization of the patient or after careful perfusion of the prothesis.


Muscle fiber orientation in normal and hypertrophied hearts.

Muscle fiber orientation in the left ventricular myocardial layer was histometrically estimated in normal, concentric and eccentric hypertrophied hearts. The angle of inclination of muscle fibers from coronal section was largest in the innermost and outermost zones and was progressively diminished toward the middle layer in all the hearts. In the inner layer, the inclination was depressed in eccentric hypertrophy, while there was no difference in fiber orientation in the outer layer. Concentric hypertrophy proved to be an intermediate stage between the normal heart and eccentric hypertrophy, and no opposite behavior was found in the arrangement of heart muscle fibers. The results supported the following view on the mechanism in the activity of hypertrophied hearts. Cardiac hypertrophy is a common accommodation process to increased load, regardless of the difference in the macroscopical shape. In hypertrophy, the ventricular cavity is inevitably enlarged. Consequently, the tension exerted on the ventricular wall on account of intraventricular pressure increases, and the contractile force required from a unit thickness of the ventricular wall is enhanced. The muscle fibers meet this increased demand by starting contraction from an over-stretched state and by ceasing its activity after smaller shortening than in the normal heart.


The measurement of cerebral blood flow in the rat.

Cerebral blood flow (CBF) was determined in the rat under 70% nitrous oxide anesthesia and pentobarbital anesthesia. The application of the Fick principle technique of Kety et al. was modified utilizing 133Xe infused intravenously steadily for 30 seconds, at which time the animal was decapitated and the head frozen in liquid nitrogen. A prior femoral artery to femoral vein shunt was led through a polyethylene catheter of 0.13 ml volume. This catheter passed as a coil in a NaI crystal well-counter with the arterial 133Xe concentration curve recorded by a ratemeter-recorder system. The results of the hemispheric blood flow (HBF) were: under 70% nitrous oxide anesthesia in normocapnia (Paco2 38 mm Hg), 86 +/- 15 ml/100 gm per minute; with hypocapnia (Paco2 20 mm Hg), 40 +/- 5 ml/100 gm per minute; with hypercapnia (Paco2 63 mm Hg), 187 +/- 10 ml/100 gm per minute; and with pentobarbital anesthesia (Paco2 38 mm Hg), 41 +/- 8 ml/100 gm per minute.


Coagulation defects in rabbits after infusion of dispersed fluorochemicals.

Coagulation parameters were studied in rabbits during and after intravenous infusion of suspensions of dispersed fluorochemicals. Blood samples from rabbits given dispersed perfluorobutyltetrahydrofurane or perfluorotributylamine showed thrombocytopenia, prolongation of activated partial thromboplastin time, and decreases in Factors X and XI. The possible presence of an inhibitor of coagulation was suggested by the prolongation of prothrombin time when measured with serial dilutions of thromboplastin reagent. These abnormalities were not found in whole blood or platelet-rich plasma after incubation in vitro with dispersed fluorochemical.


In vitro effect of methylprednisolone on protein synthesis of activated canine thymus-derived lymphocytes.

Technics of studying the protein synthesis of canine thymus-derived lymphocytes in vitro have been developed. Activation of these cells by PHA or MLC increases protein synthesis. Methylprednisolone decreases the stimulation of protein synthesis of these activated lymphocytes. The decrease in protein synthesis is not caused by lympholysis. In this respect, the dog, like man, can be considered a steroid-resistant animal. It is postulated that this effect of methylprednisolone contributes to its immunosuppressive action by inhibiting the afferent limb of the immune response.


[Some properties of preparations of Na+ and k+-ATPase treated with deoxycholate].

The treatment of membrane suspension from the guinea pig kidney cortex possessing Na+, + K+ -ATPase activity with 0.20% sodium deoxycholate (DOX : protein equals 12 : 1) leads to lowering of their enzymatic activity. DOX-treated preparation can be divided into two fractions by centrigugation (1 hr - 22 000 g). The pellet has 1.5-fold higher enzymatic activity than the initial preparation and cannot be activated by small amounts of histones. The supernatant has 2-fold lower enzymatic activity than the initial preparation but in presence of small amounts of histones this activity rises to the level of the initial preparation activity. The action of DOX treatment on the membrane structure of Na+ + K+ -ATPase preparations is discussed.


Normal and aberrant neuronal development in the cerebral cortex of human fetus and young infant.

Several approaches utilized in ontogenetic investigations in laboratory animals have been explored in preliminary studies of morphogenetic events in the human cerebral cortex. 1. Golgi studies of dendritic growth cones, filopodia, and other developmental processes have permitted specification of the maximal phase of dendritic growth and differentiation of pyramidal neurons in the hippocampus. This period spans the twentieth to twenty-eighth week of fetal development. 2. Studies of the temporal pattern of appearance of the axonal plexus of the stratum pyramidale suggest that axosomatic synaptic pathways in the hippocampus develop relatively late in respect to the appearance of axospinodendritic inputs. 3. Dendritic spine development is evident at 26 weeks g.a. in the hippocampus but not in the visual cortex. Most hippocampal pyramidal neurons have acquired a full complement of spines by 6 months postnatally. The presence of severe metabolic and cardiorespiratory disturbances and/or chromosomal abnormalities significantly influences dendritic spine morphology and development. 4. The general morphological features of several varieties of neurons in the cisual cortes of a 32-week-old preterm infant are considered in respect to the electrographic characteristics of this infant's visual evoked responses. The observations in this and other cases illustrate the manner in which ontogenetic problems susceptible to inquiry in laboratory animals can serve to guide similar morphophysiological studies of normal and aberrant developmental events in human brain.


[Availability of Mg2+, Na+, and K+-ATPase in the nuclei of the skeletal muscles of rabbits normally and during experimental muscular dystrophy].

A  comparative study was carried out in the properties of ATPase system of the skeletal muscle nuclei in the rabbits in norm and with experimental muscular dystrophy conditioned by E-avitaminosis. It is shown that in the system, containing 1.5 mM of MgCl2, ATPase system of the nuclei is activated by sodium and potassium ions. In norm maximum activation is observed with their presence in the medium, the concentration being 80 and 70 mM, respectively. With experimental muscular dystrophy maximum activating concentrations decrease and are equal for both cations - 30 mM. Activation of the enzymatic system by these ions is specific because the introduction of equimolar quantities of cholin-chloride or lithium, cesium ions instead of sodium ions into the incubation medium evokes no activation of the ATPase system of the rabbit skeletal muscles both in norm and with experimental muscular dystrophy. A simultaneous presence of sodium and potassium ions in optimum concentrations in the incubation medium makes for an increase of ATPase activity to the same extent as the presence of one of these cations. Oubain, a specific inhibitor of Mg2+, Na+, K+- ATPase, taken in the concentrations of 10(-4) and 10(-3) M did not decrease the intensity of ATP hydrolysis and its activation conditioned by the presence of sodium or potassium. A conclusion is made that Mg2+, Na+, K+-ATPase taking part in the work of "sodium pump" is absent in the nuclei of skeletal muscles.


[SH-group and Mg2+-dependent Ca2+-activated ATPase activity of the microsome fraction of the brain].

Mg2+-dependent Ca2+-activated ATPase of microsoma fraction from the grey matter of cerebral great hemispheres determined after the preliminary treatment of the preparation with 0.1% digitonin, while preserved in the medium with 10 mM mercaptoethanol for seven days at a temperature of 4-6 degrees C is inactivated by 10-15% and approximately by 50% while preserved without mercaptoethanol. Mercaptoethanol does not make reactivating effect. SH-reagents at definite concentrations completely inhibit the activity of Mg2+, Ca2+-ATPase. Half-maximum inhibition of the enzyme is reached with the salirgan, p-CMB and NEM concentrations of 5-10(-6) M, 5-10(-6) M and 5-10(-3) M, respectively. Mg2+-ATPase is not suppressed completely, and at high concentrations of SH-reagents the residual activity is 1.3 muM of Pi per 1 mg of protein in 1 hr. ATP in the concentrations optimal for manifestation of Mg2+, Ca2+-ATPase (3 mM) efficiently protects the enzyme from the inactivating effect of NEM. This gives reasons to suppose that the active centre of Mg2+, Ca2+-ATPase contains an SH-group. The quantity of SH-groups readily accessible of the Ellman reactive in the initial preparation of the brain microsomes is 45 + 2.0 nM per 1 mg of protein and in the preparation dissolved in 2.5% sodium dodecyl sulphate, 110 + 7.8 nmM per 1 mg of protein. In the presence of 0.1% digitonin the quantity of SH-groups of the preparation is 55 + 3.5 nM per 1 mg of protein, simultaneously such treatment of detergent results in manifestation of Mg2+, Ca2+-ATPase activity. An inactivating effect of SH-reagents and the protective effect of ATP indicate similarity of the enzyme under study to Mg2+, Ca2+-ATPase of sarcoplasmatic reticulum.


[Solubility of the Mg2+-dependant Ca2+-activated ATPase fraction of the plasma membranes of synaptosomes].

Mg2+-dependent Ca2+-activated ATPase (Mg2+,Ca2+-atpase, EC 3.61.4) in the fraction of synaptosome plasmatic membranes is activated with 0.05-0.08% solutions of digitonin and sodium deoxycholate. At higher concentrations of digitonin the activating effect lowers, sodium deoxycholate in the increasing concentrations inactivates the enzyme. 0.08% digitonin activates Mg2+,Ca2+-ATPase of synaptosome membranes, without demanding for its transition into solubilized state. Separation of non-active 0.08% digitonin extract from the deposit results in a decrease in the enzymatic activity of the latter and addition of the extract to the deposit activates the enzyme. At least two components separable from each other are likely to be necessary for the enzyme activity manifestation. A solubilized preparation of Mg2+,Ca2+-ATPase with the maximum activity and the ratio of total ATPase to Mg2+-ATPase equal to 3.5-4.0 may be obtained by extraction with 0.15-0.20% digitonin solution. Maximum quantily of protein is extracted by means of digitonin in the same concentrations. The extracted protein is divided in 7.5% polyacrylamide gel into eight-ten electrophoretic zones.


[Role of calcium ions and fatty acids in the inhibition of Mg2+, Na+ and K+-ATPases by means of the "direct" hemolysin and phospholipase A of cobra venom].

The influence of calcium ions and fatty acids in the action of direct hemolytic factor and phospholipase A on Mg2+ and Na+, K+-ATPases was investigated. It was established that calcium activates greatly phospholipase A and to a less extent--the direct hemolytic factor. The activity of ATPases is inhibited most effectively by the system consisting of phospholipase A, direct hemolytic factor and Ca2+. Fatty acids can participate in the mechanism of membrane ATPases inhibition.


An ultrasonic fluctuation velocimeter.

A novel ultrasonic velocimeter is described and evaluated with a view to measuring blood flow in vivo. The device is not based on the Doppler principle but operates by analysing the random fluctuations of the echo backscattered by blood. The rate at which the amplitude of the reflected signal passes through its mean level is related (by the dimensions of the resolution cell) to the velocity of the scatterers. Experimental trials in vitro validate the concept although there is a factor of two disagreement with predictions. The device is compared with the conventional Doppler volocimeter and problems on operation in vivo are discussed.


Diagnosis of testicular torsion using Doppler ultrasonic flowmeter.

Thirty-one patients with intrascrotal disease process have been studied with the Doppler ultrasonic flowmeter to determine if testicular torsion can be differentiated from acute epididymitis when clinical characteristics are ambivalent. In all instances of proved torsion there was a loss of blood flow in the involved testes, whereas in acute epididymitis or other epididymal and gonadal diseases blood flow ranged from normal to hyperemic.


[Heterogeneity of protein metabolism and activities of certain enzymes in functionally different structures of nerve tissue].

The article deals with a review of the results of studies conducted at the department which evidence for inhomogeneity of localization, composition and different intensity of intravital renewal of proteins as well as for different activity of some enzymes most important for the nervous system functions in the macro- and microstructural formation of the nerve tissue. On the basis of the experimental data concerning the presence in the nerve tissue of a wide range of rates for intravital renewal of proteins in the structures of different functions as well as of those concerning subcellular and suborganoid localization of intracellular peptid-hydrolases, a conclusion is drawn that catabolism of the protein molecules occurs mainly on the cell membrane structures. The effect of acid peptide-hydrolases is chiefly manifested in the died and damaged cells and neutral ones in the intact functioning cells. As among the proteins most important functionally for the nervous activity ATP-hydrolyzing enzymes occupy a special place, the article provides basic data of studies in the ATPase activity in the nervous tissue, intracellular localization of the enzyme, its sensitivity to uni- and bivalent ions, as well as in the mechanism of interaction with ouabain--specific inhibitor and with melipramine--neurotropic substance.


[Enzymatic properties in muscle membranes].

A study in the enzymatic properties of muscle membranes established that sarcolemma of the rabbit skeletal muscles contains the Ca2+-ATPase system which does not require Mg2+ for manifestation of ions activity. By some kinetic properties it differs from ATPase of myosin. The complex Ca-ATP2+ is a substrate of Ca2+-ATPase. Ions of a series of bivalent metals inhibit the latter as well as the passive transport of Ca2+, that may evidence for a definite relation of Ca2+-ATPase with Ca+2 transport in skeletal muscles. Acetyl cholinesterase and AMP-aminohydrolase are strongly bound with the sarcolemma. The sarcolemma structural organization is shown to play a certain role in manifestation of their activity. On the basis of the data obtained when studying the activity in the ATPase systems and dynamics of formation and decay of the intermediate phosphorylated product in the microsomal fraction of cow and rabbit myometrium certain peculiarities are established for the active mechanisms of Ca2+ transport in smooth muscles. A problem is under discussion on the possible active participation of sarcolemma in regulation of Ca2+ concentration in the smooth muscle cells. Two ATPase systems, Mg2+-dependent and Mg2+-dependent Ca2+ activated are found in nuclei; the role of lipids of the skeletal muscles in manifestation of their activity is studied. AMP-amino hydrolase properties are characterized for different areas of the sarcoplasmatic reticulum membranes. The model of E-avitaminous muscular distrophy was used to show disturbances in the structure of sarcolemma and membranes of the sarcoplasmatic reticulum which are accompanied by changes in their ATPase and Ca2+-transporting properties.


[Solubilization of Mg2+-dependent Ca2+-activated ATPase of brain microsome fraction].

Mg2+-dependent Ca2+-activated ATPase (Mg2+, Ca2+-ATP-ase) of microsome fraction from grey matter of great cerebral hemispheres of cattle is activated by 0.1% solution of digitonin. Simultaneously 30-60% of initial fraction protein is extracted, respectively, with 0.1-0.3% concentrations of digitonin. The Mg2+- and Mg2+, Ca2+-ATPase activities manifest in solubilized protein. The maximal solubilization of both enzymes is reached when treating the fraction of brain microsomes with 0.3% solution of digitonin, the Mg2+, Ca2+-ATPase activity is not manifested in the 0.2% digitonin extract of this fraction. The Mg2+, Ca2+-ATPase activity is not always manifested in the 0.4% digitonin extract of the sediment which was obtained after extracting the initial fraction with 0.2% solution of digitonin. Addition of 0.2% extract to it causes manifestation or increase of the Mg2+, Ca2+-ATPase activity. Thus, minimum two components which are extracted by detergent in different concentrations or one of the extracted components which is an activator of solubilized Mg2+, Ca2+-ATPase may be necessary for manifestation of this activity in the solubilized components of the fraction of brain microsomes. The membrane components extracted with digitonin possess evidently a small molecular weight as they compose 7.5% polyacrylamide gel in which 0.4% digitonin extract of the brain microsome fraction is divided into 7-8 electrophoretic zones.


[Heterogeneous and kinetic analysis of certain properties of Ca2+-ATPase in sarcolemma of rabbit skeletal muscles].

Kinetic properties of Ca2+-ATPase were studied by means of the continuous potentiometric method. On the basis of heterogenous and kinetic ideas it is shown that the experimental data on the effect of ions CA2+ on the Ca2+-ATPase activity may be explained, assuming the chelate complex Ca-ATP2- to be a substrate of the enzyme. The results obtained show that if the chelate complex formed in the aqueous stage is a substrate, then, a competition for adsorption at the active centre is possible between Ca-ATP2- and ATP4- but not between Ca-ATP2 and Ca2+. If the substrate is the chelate complex formed directly at the active centre, then ATP4- and the enzyme must combine through ion Ca2+ according to the scheme: enzyme - Ca2+ - ATP4-.


[Closed complete dislocations of the crus and the result of their treatment].

Based on the analysis of treatment of 22 patients with complete closed crural dislocations, it is emphasized that this trauma is associated with extensive and specific injuries to the articular elements. Concomitant injuries of popliteal vessels were found in 4 (of 22) cases. Timely performed operative restoration of the arterial integrity yielded favourable late results in 2 patients. Two patients admitted in later terms were subjected to a high amputation of the leg. In 15 patients the knee joint instability developed due to ligamental rupture in crural dislocation. Eleven patients from this group were operated upon, plastic reconstruction of ruptured lateral and crucial ligaments and the removal of injured meniscuses being accomplished in them. Persistant good and satisfactory functional results were gained in 10 cases. Only one poor issue was noted.


[Conservative treatment of cicatricial stenosis of the esophagus].

One hundred and eight five patients with an esophageal burn were treated clinically, 53 of them showed already developed strictures. In 31 cases the narrowing could be passed by a bougie 12-14. In 28 of them the esophagus was dilated by means of a routine dilation; in 3 there was perforation of the esophagus necessitating jugular mediastinotomy in the first, transdiaphragmatic mediastinotomy in the second, and resection of the thoracic esophagus in the third, the results being favourable in all of them. In 5 cases dilation was accomplished via an esophagoscope, but in 9 gastrostomized patients a successful retrograde dilation was performed. Eight subjects having nonviable strictures were amenable to surgical therapy.


[External drainage and suture of the bile ducts following choledochotomy].

The authors report their experience with the use of a T-shape drainage in 258 choledochotomies, accomplished in 248 patients, and suturing of the common bile duct in 77 patients. The technic of preparation of a T-shape drainage, its fixation in the common bile duct and the postoperative management of patients with such drainages are described. The complications developed while using a T-shape drainage are analysed. Late sequelae of application of the drainage were taken into account after 219 operations, whereas in 163 patients intravenous cholangiography was performed after such drainage of bile ducts, the terms being longer than 3 years in 140 cases.


[Intestinal plastic surgery in stomach resection].

It is the author's opinion that a primary gastrointestinal plasty in resection of the stomach, performed nowdays by some specialists in reconstructive procedures for late postgastrectomy complications, should be considered to be erroneous, since late complications arising after gastric resection result from somewhat different causes. It is believed that, as a rule, these are the result of various errors and drawbacks of improper gastric resection, the liquidation of which would necessitate a special operative intervention, but not the routine surgery, especially if this operation is as complicated as reconstructive gastrointestinal plasty.


[Dispensary treatment and surgical actions in goiter].

An efficacy of antistruma measures in the Mordovian ASSR was estimated. It is noted that prophylactic surveys of the population for recognition of struma patients would contribute to their early dispensarization, provide the conditions for a timely conducted drug therapy and enhance surgical activity in this affection.


[Effect of coagulated hemothorax and early fibrinothorax on the state of patients after pneumonectomy].

An estimation of the postoperative course after pneumonectomy in 328 patients, depending on the character and rate of distinguishing the pleural fluid, is given. The development of collapsed hemothorax and early (during the first week) fibrinothorax is predominantly related with separation of massive pleural adhesions, it aggravates the postoperative period and predisposes to the development of pleural empyema. Rethoracotomy with the removal of clots especially in later terms fail to prevent this complication. Intrapleural injections of fibrinolytic drugs is found to offer more perspectives.


[Experience in treating staphylococcal destruction of the lungs in children].

An experience with treatment of 278 patients having various forms of staphylococcic destruction of the lung is discussed. Patients with a pneumopleural form of SLD were predominating. The treatment in such patients should be initiated with draining of the pleural cavity in combination with an intensive therapy. Radical treatment should be conducted only on strict indications. An early diagnosis and timely therapy are felt to be of great importance.


[Hermetic closure of liplike fistulas during laparoscopic gastrostomy and jejunostomy].

The author has elaborated the method of additional hermetical closing of labioid fistulas of the stomach and jejunum on the basis of creation of a fibrous ring in edges of an exterior fistular orifice. In case of impaired hermeticity this ring allows permanent bearing of a cannula and hermetic closure of the fistula again. Doubling of the methods of hermetical closure of fistulas provided an opportunity to facilitate the technic of their creation up to a simple bringing out of the visceral wall into the abdominal wall puncture. Thus, 26 fistulas were established in laparotomy, and 60 operations were performed without a wide exposure of the abdominal cavity, using laparoscopy.


[Instrumental method of examination in diagnosis of closed abdominal injury].

70 instrumental investigations were performed (18 laparoscopies and 52 laparocenteses) in closed traumas of the abdomen. Both methods are believed to be of a great diagnostic precision, making 96%. A hazard of damaging internal organs during the investigation seems to be rather exaggerated. The characteristics of both methods are described comparatively.


[Prolonged spasm of the arteries of the base of the brain during experimental fibrinolysis in the subarachnoid space].

An ex tempore mixture of fibrinogen (1%--4 ml) and 0.2 ml thrombin solutions forming a compact clot of fibrin in the subarachnoid space was introduced into the cisterna magna of dogs. To dissolve the fibrin clot 2 ml of a fibrinolysin solution with an activity of 400 units were introduced into the same cisterna 10--15 minutes thereafter. A total of 26 experiments were set up, of which 13 were served as controls with separate introduction of the mixture ingredients. Through serial vertebral angiography with a 50 per cent urotrast solution it was found that following introduction of the fibrinogen and thrombin mixture the lumen of the basilar artery and of its branches contracts on the average up to 89.2 +/- 1 per cent. After introduction of fibrinolysis the diameter of the artery initially increases up to 116.3 +/- 2.5 per cent. In 3 hours time a pronounced spasm of the basilar artery and of its branches is seen to develop up to 80.9 +/- 3.6 per cent and after 24 hours -- up to 73.9 +/- 2.1 per cent. The spasm persists for up to 10 days, but its intensity gradually declines. During subsequent 11--18 days the diameter of the brain base arteries returns back to normal. In control experiments no development of protracted spasm was demonstrated. Hence, it is established that the appearance of fibrinolysis products formed in the spinal fluid consequent upon dissolution of a clot of fibrin containing no blood cells is attended by the development of a protracted spasm involving major arteries of the brain.


[Histological, histoenzymatic and biochemical study of the liver and small intestine of rats during short periods of starvation].

The structure and the activity of acid phosphatase, beta-glucuronidase, alkaline phosphatase and ATP-ase in the liver and small intestine of rats receiving for 20 days a one-time, fixed at a certain time (2 o'clock) feeding was studied morphologically in dynamics in 2, 6, 24 and 48 hours after the last feeding. Furthermore, parallel with this the activity of acid phosphatase, beta-glucuronidase, alpha-glucosidase and beta-acetylglucosaminidase was determined in homogenates by biochemical methods. Alongside the total activity free activity of beta-acetylglucosaminidase and the activity of this enzyme in the blood plasma was defined. It is shown that during fasting, especially by the 48th hour, there takes place a significant activation of lysosomal enzymes both in the liver and in the small intestine (in the cells of the cylindrical epithelium). A significantly increased permeability of lysosomal membranes (mounting free activity of beta-acetylglucosaminidase) in the liver and of plasmic hepatocytes membranes (higher activity of the enzyme in the blood plasma) was also ascertained. The activation of the lysosomal enzymes is considered to be an adaptive reaction of the organism in fasting.


[New protease-inhibitors with broad specificity in the polychaet Sabellastarte indica (Savingny), I (author's transl)].

In this paper we describe new and so far unknown protease inhibitors present in the tentacles of the annelid Sabellastarte indica Savingny. At least five different isoinhibitors with inhibitory activity towards trypsin, plasmin, chymotrypsin and kallikrein can be separated electrophoretically. Our protease inhibitor active material differs from the other well known protease inhibitors found in invertebrates in its high molecular weight, in that it is heat-labile and in the occurrence of the isoelectric point in the weakly acid region. On the other hand, the new protease inhibitors have some similarities to the soybean inhibitor described by Kunitz, and to ovomucoid. We also discuss the possibility that these inhibitors may influence the fibrinolytic system.


The effect of hormone induced stress upon the extent of alkylation of rat liver nucleic acids by N-methyl-N-nitrosourea.

An examination was made of the effect of treatment with methylating agents of varying carcinogenic potency and with stress inducing hormones upon DNA synthesis in the resting liver of the rat. With the methylating agents an early stimulation of DNA synthesis was observed, but this was depressed below the control levels at later times and with higher doses; hormone administration also resulted in a depression of DNA synthesis but, without any initial stimulation at the dosage employed. Under conditions of induced stress it was found that the extent of reaction of N-methyl-N-nitrosourea with cellular macromolecules was enhanced. This appeared to be a general effect upon the liver cell since both DNA and rRNA were affected in a similar manner.


Strand breakage in rat brain DNA and its repair induced by ethylnitrosourea in vivo.

The damage and repair of rat brain DNA was studied in vivo after a single carcinogenic dose of ethylnitrosourea. Fragmentation of the brain DNA produced by this carcinogen was demonstrated on alkaline sucrose gradients. By the 24th hrs after treatment with ethylnitrosourea the single-strand damage to DNA was not completely repaired. As the highly differentiated cells of the central nervous system do not proliferate, it is possible that during brain carcinogenesis delayed repair of DNA of primitive cells might be needed for the formation of tumor anlage.


[Colonization of the mouse liver by transplanted virogenic leukemia cells. Electron microscopic investigations (author's transl)].

Cells of a virogenic, immature myelogenic leukemia were injected in i.p. in one week old mice, strain NMRI, each animal receiving 10(5), 10(6) or 13(7) cells respectively in 0.2 ml Hanks' BSS. Mice were sacrificed at different times between 10 hrs and 21 days p.i. and liver specimens were prepared for electronmicroscopic studies. 10 hrs p.i. the leukemic cells are found in the sinusoids of the liver and after 30 hrs in the periportal fields. The leukemia cells migrate into the Disse spaces from the sinusoids. The leukemic cells penetrate with cytoplasmic digitations between connected endothelial cells. There is no lytic disintegration of the endothelial cells. The leukemic cells multiply by mitotic division of the Disse spaces, thereby compressing the liver cells. The cell membranes of both cell-types remain intact. Electronmicroscopically no evidence is found of a secretion of enzymes from the leukemia cells that destroy liver cells. Destruction of the liver cells is the consequence of the growth-pressure exerted by the dividing leukemic cells. Within the liver of the recipients the leukemic cells produce RNA-viruses. In the cytoplasm - frequently in the area of the Golgi-field - groups of immature A-particles are formed. In the virus fields the ribosomes disappear. The immature A-particles consist of two concentric electron dense shells. On the surface of the liver cells budding particles and immature C-particles develop. Extracellular mature C-particles with a homogeneous nucleoid and an irregular outer shell may be seen. The formation of viruses is found to be independent of the stage of the leukemia.


[Tumour inhibitory N-(bis--(2-chlorethyl)-aminomethyl)-urethanes (author's transl)].

The synthesis of N-[bis-(2-chlorethyl)-aminomethyl]-urethanes (I-VI) and N,N'-di[bis-(2-chlorethyl)-aminomethyl]-urea (VII) and their evaluation on the Yoshida sarcoma of the rat and on the sarcoma 180 of the mouse are described. The antitumor activity of I-VI is based on a reaction mechanism analogous to that of aromatic N-lost-derivatives.


Effect of urethan on the synthesis of nucleic acids in thymus, spleen, and bone marrow.

Urethan, in a single dose of 1 mg/g body weight, exerts a strong inhibitory effect on DNA synthesis in lymphoid organs and bone marrow of rat. The inhibition observed in spleen and thymus is longer lasting than that exerted on bone marrow or regenerating liver, demonstrating a marked sensitivity of lymphoid cells to the drug. This effect can explain the rapid reduction of weight and cell number in thymus and spleen under urethan treatment, in absence of any lymphocytolytic action. The different effect of urethan on the different subpopulations of lymphoid cells therefore appears to be due to their kinetics rather than to a specific sensitivity of some of them.


On the active principles of the spurge family. III. Skin irritant and cocarcinogenic factors from the caper spurge.

The toxic and irritant principles of the seed oil and of the latex of the caper spurge (Euphorbia lathyris L.) were isolated together with several non irritants of similar chemical structure. From the seed oil two irritant Euphorbia factors L5 and L6 and from the latex a mixture of irritant Euphorbia factors were obtained. Euphorbia factor L5 was identified as 3-hexadecanoate of the new tetracyclic, poly-functional diterpene parent alcohol ingenol. Euphorbia factor L6 most probably is the 3-tetradeca-2,4,6,8,10-penta-enoic acid ester of ingenol. The mixture of Euphorbia factors was shown to contain esters of ingenol and of 16-hydroxy-ingenol, respectively, each containing a long chain unsaturated fatty acid, most probably in 3-position. The non irritants from the seed oil comprise ingenol-20-hexadecanoate (compound L4) and several esters of macrocyclic diterpenes of the new lathyrol type (compounds L1-L3, L8, and possibly L7). Compound L4 is a positional isomer of Euphorbia factor L5 and most probably an artefact formed during the isolation procedure. The macrocyclic diterpenes are of interest as possible intermediates in the biogenesis of tetracyclic diterpene parents of cocarcinogenic esters. The parent alcohols ingenol and 16-hydroxy-ingenol are inactive irritants. As compared to croton oil factor A1 (TPA), Euphorbia factor L5 exhibits about 1/10 of its irritant activity on the ear and about 1/10 of its cocarcinogenic activity on the back skin of mice. As an irritant Euphorbia factor L6 shows about 1/5 of the activity of A1. Structure/activity relationships of ingenol and phorbol esters and the possible role of cocarcinogens of plant origin as second order carcinogenic risk factors are discussed.


[On the relation between lobular angiomatosis and angiosarcomas of the breast (author's transl)].

A 38 year old woman showed first a lobular angiomatosis of the breast with regular neoplastic capillaries. After about one year multiple nodules of an agniosarcoma appeared. Their origin from the angiomatosis is suggested by the sequence of the lesions and for topical and histogenetic reasons.


[Malalignment of lumbar spine with lumbar PID (author's transl)].

In 322 cases of lumbar PID proved by myelography the radiologically recognizeable malalignment of the lumbar spine was related to site and direction of the prolaps. Scoliosis towards the side of the prolapse was seen in about 70 per cent. Scoliosis convex towards the normal side was significantly more common with right-sided than with left-sided prolapses. Scoliosis was the more pronounced the higher the site of prolapse. The degree of lumbar lordosis, too, appeared to depend on the level of prolapse. The lower the prolapse the less the lordosis. In the individual case one cannot draw any conclusions as to site or direction of a prolapse from radiologically detectable malalignment.


[Local vitamin A acid therapy in palmar/plantar hyperkeratoses (authors transl)].

Up to date, the treatment of palmar/plantar hyperkeratoses presents a therapeutic problem. The known therapeutic procedures result in short-term improvement only, if any at all. In these investigations involving 68 patients suffering from palmar/plantar hyperkeratoses of different etiology, small doses of vitamin A acid locally applied, produced a striking improvement in hypertrophic lichen planus of palms or soles: the regression was complete and in most cases permanent. The skin texture of patients with genetic keratoses and callosities became normal within a few weeks: but this condition remained free of symptoms only as long as vitamin A acid was used as a maintenance dose once or twice weekly. In hyperkeratotic eczema, pityriasis rubra pilaris, and verrucae plantaris vitamin A acid locally applied was found to be unsuitable for treatment. The possible side effects of this treatment are mentioned. Several possibilities regarding the way of action of vitamin A acid are discussed.


Bacteriophage P13234mo-mediated intra- and intergroup transduction of antibiotic resistance among streptococci.

Numerous streptococcal strains representing serogroups A, C, and G were tested for transducibility to antibiotic resistance by the temperate Group A streptococcal phage P13234mo. The resistance markers carried by Group A donor strains included the ERL1 factor determining inducible resistance to erythromycin, lincomycin and streptogramin-B type antibiotics as well as chromosomally located mutations for streptomycin and spectinomycin resistance. ERL1, presumably of plasmid nature, was transduced to each of the 36 Group A strains, 10 of the 16 Group C strains, and 1 of the 10 Group G strains tested. Transduction of streptomycin and spectinomycin resistance occurred at lower frequencies than ERL1 transduction, the percentage of transducible Group A strains was lower for these markers than for ERL1, and intergroup transduction was not observed. The effective in-vitro dissemination of resistance factors such as ERL1 by broad host range phages like P13234mo may have some bearing on the marked increase of the incidence of erythromycin and lincomycin resistant streptococci of several serogroups in clinical specimens.


[Interrelationships between serum and secretory antibodies in immunization with live influenza vaccine].

A study was made of the accumulation of antibodies in the blood serum and the secretions of the respiratory tracts of persons immunized with the living influenza vaccine. The duration of inductive phase and the dynamics of the antibody accumulation in the secretions occurred irrespective of their initial level in the blood sera, this pointing to the autonomic character of the local immunity system. On the other hand the functional condition of the system of local immunity influenced the intensity of the antibody formation in the system of the general immunity. If before the immunization the antibody titre in the secretions were 1:4 and greater, the antibody accumulation in the blood sera took place less intensively. An analogous phenomenon was also observed when the antibodies were absent in the secretions before the immunization, but their formation took place as soon as the first week after it. The mechanism of this peculiar "competition for the antigen" of the systems of local and general immunity consisted in the neutralization of the influenza virus in the area of the porta of infection.


[Antibodies to the lipoproteinase of group A hemolytic streptococci in the blood of healthy and ill persons].

In examining 170 samples of blood sera of healthy and sick individuals it was shown that with the aid of a simple and express antilipoproteinase test it was possible not only to reveal, but also to determine the titre of specific antibodies to the lipoproteinases of various serological M-types (2, 4, 22/12, 22 and 49) of a hemolytic streptoccus, group A. The antibodies to the enzymes were frequently revealed in the sera of adults and older children. The results obtained were still inadequate for the epidemiological or clinico-immunological analysis, but pointed to the principal possibility of using the antilipoproteinase test for the mentioned purpose.


[Immunoprophylaxis of epidemic parotitis].

Specific prophylaxis against epidemic parotitis is considered to be necessary. It is epidemiologically justifyable at first to conduct selective immunization with the monovaccine of children aged over one year (in creches and kindergartens) and schoolchildren (and 10-year-olds inclusively) who had had no epidemic parotitis, and later to vaccinate children over one year newly-admitted to the creches, kindergartens and schools. In order to bring to the minimum the risk of supervention of the living parotitis vaccine on the asymptomatic infectious process it is necessary to conduct the vaccination at the period between the end and the beginning of the stable seasonal rise, which in Leningrad falls on the period between the second decades of August and October.


A technique for monitoring endometrial or decidual blood flow with an intra-uterine thermistor probe.

A technique is described for studying endometrial or decidual blood flow by introducing a thermistor, mounted in a flexible catheter, into the uterus. The technique was first tested in model experiments and in the pregnant rabbit and was then used to study the blood flow of the human uterus. In pregnant women, the thermistor was introduced between the decidua and fetal membranes, and in non-pregnant women, it was applied to the endometrium of the fundus. Intra-uterine pressure was recorded simultaneously. No complications were encountered in either pregnant or non-pregnant patients. Decidual or endometrial blood flow remained steady over long periods. There were transient fluctuations about the mean level, usually associated with myometrial contractions, but these could easily be distinguished from changes in the level of blood flow evoked by administration of vasoactive drugs.


A case of disseminated hemangiomatosis with cutaneous, hepatic and skeletal manifestations and increased urinary excretion of glycosaminoglycans.

A case of disseminated hemangiomatosis with cutaneous hepatic and extensive skeletal manifestations is reported. The diagnosis was established by means of bone X-ray, hepatic angiography, and skin and bone biopsies. A moderately increased urinary excretion of glycosaminoglycans (GAG) was found. The main GAG fraction excreted was tentatively identified as a heparan sulphate.


Increased lymphocyte ATP-ase activity in patients with carcinomas of the oral cavity and larynx.

Increased mitochondrial ATP-ase activity was found in circulating lymphocytes from 5 out of 8 patients with carcinoma of the oral cavity or oropharynx and from 5 out of 10 patients with carcinoma of the larynx. In a majority of these cases changes in the ATP-ase activity after treatment paralled to the clinical result of treatment. It is suggested that determination of ATP-ase activity of circulating lymphocytes is of diagnostic value in patients with oral, oropharyngeal and laryngeal carcinomas as well as prognostic value after treatment of the patients.


Electrocardiographic and hemodynamic correlations in patients with idiopathic hypertrophic subaortic stenosis.

The ECG and Frank VCG were compared to the hemodynamic findings in 33 patients with idiopathic hypertrophic subaortic stenosis in whom cardiac catheterization had excluded concomitant valvular heart disease, congenital heart disease, or occlusive coronary artery disease. The patients were divided into two groups according to the absence (Group I) or presence (Group II) of left ventricular hypertrophy on the ECG and/or VCG. The 11 patients in Group I were found to have neither mitral insufficiency nor a resting left intraventricular gradient, and only six patients in whom mitral valve movement was visualized demonstrated systolic anterior movement of the anterior leaflet. The papillary muscles and left ventricular wall were either normal or only mildly hypertrophied in 10 of 11 Group I patients. Group II (22 patients) demonstrated either a resting left intraventricular gradient and/or mitral insufficiency in 18 patients. Twenty-one of the 22 patients showed systolic anterior movement of the anterior leaflet of the mitral valve on a cineangiogram and the papillary muscles and left ventricular wall were moderately to severely hypertrophied in 18 patients. These data suggest that specific hemodynamic and anatomic characteristics of hypertrophic subaortic stenosis may be predicted with reasonable accuracy from the ECG and VCG.


Correlation of heart size with clinical and hemodynamic findings in patients with coronary artery disease.

The clinical, hemodynamic, and angiographic findings were correlated with the heart size in 207 patients with proved coronary artery disease. Cardiomegaly was noted in 34 patients and normal heart size in 173. In these two groups, the patients' age range, duration of disease, and history of myocardial infarction were similar. There was no statistical difference in incidence of shortness of breath, hypertension, left ventricular hypertrophy, or abnormal glucose tolerance. Patients with cardiomegaly had a significantly higher incidence of congestive heart failure (26 per cent) as compared to patients with normal heart size (2.9 per cent) (P less than 0.001). Patients with enlarged heart presented a high incidence of anterior wall or multiple myocardial infarction (73 per cent) (P less than 0.001). The cardiomegaly group had a high incidence of elevated end-diastolic volumes, elevated end-diastolic pressures, and diminished ejection fractions when compared to patients with normal heart size (P less than 0.01). Double and triple coronary artery disease was more frequent in patients with cardiomegaly and total coronary score was also higher in this group (P less than 0.005). Asynergy was present in 55 per cent of patients with normal heart size but in 82 per cent of those with enlarged hearts (P less than 0.01). The group of patients with cardiomegaly and documented congestive heart failure had ejection fractions less than 0.30. Cardiac catheterization is probably not advisable in these patients in the absence of associated significant mitral regurgitation, ventricular septal defect, or ventricular aneurysm.