Duration of disability following lumbar disc surgery.

The total duration of disability of 116 patients operated on for lumbar disc prolapse was studied 10 years postoperatively. From the beginning of the observation period 10 years before surgery, the number of days on sick-leave increased continually and no positive effect of the surgical treatment in this respect could be observed. There was a highly significant coincidence between the end-result assessment by the patient and the total duration of the postoperative disability. The following factors were conducive to a short total period of post-operative disability: early surgery (short interval of preoperative sciatica), short total preoperative period of sick-leave and immediate relief of sciatic pain by the operation. The objective changes in the preoperative state of the patient such as neurological and X-ray findings had a less significant influence.


Spondylolisthesis. Treatment by excision of the loose lamina and resection of the pedicle.

Eighty patients were treated by radical arch resection, i.e., removal of the loose lamina and the fibrous tissue in and around the pseudarthrosis and resection of the caudal portion of the ventral part of the pedicle. In 17 patients an additional spinal fusion was performed. The mean observation time was 4.7 years. The forward dislocation increased by 25 per cent in the group without fusion compared with 16 per cent in the fused group. The symptoms of nerve root affection for the most part improved, but the back pain persisted in 28 patients. Fifty per cent of the patients were in full-time employment at the time of the follow-up. A total of 75 per cent were improved and 25 per cent unchanged or worse.


The effects of fractions (chalones) obtained from lymphoid organs on lymphocyte proliferation in vitro.

Aqueous extracts of lymphoid organs were prepared and fractionated by means of gel filtration, ion exchange chromatography, and isoelectric focusing. A protein-containing fraction with a molecular weight of approximately 80,000--90,000 and isoelectric points of 7.6 and 5.3--6.2 was isolated and shown to inhibit reproducibly both thymidine incorporation and proliferation of concanavalin A-stimulated mouse spleen lymphocytes in vitro. This effect appeared specific since proliferation of mastocytoma P-815 and leukemia L-1210 cells remained unaffected. A small molecular weight fraction (500 to 10,000 daltons) was also found to inhibit lymphocyte proliferation in vitro but was without apparent specificity for cell type.


Electromagnetic rheoangiometry: an extension of selective angiography.

A harmless magnetic field produced by an extracorporeal magnet induces in the blood vessels of a living subject electrical signals which carry information about regional blood flows. Loop probes of hairlike consistency equipped with fine electrodes can now be introduced percutaneously and selectively into the vasculature through angiographic catheters to pick up these magnetically induced signals at selected loci. In addition to a continuous record of phasic blood flow, the loop sensors provide signals which measure variations in vascular diameters, thus yielding a continuous record of active and passive vasomotion. Coupled with blood pressure recordings, these data will permit determination of the elastic constants of blood vessels in situ. The manifold capabilities of electromagnetic rheoangiometry for providing continuous records of these vascular parameters are illustrated in dogs with tracings using multichannel recorders which provide continuous information of arterial blood pressures, instantaneous and mean blood flows, and instantaneous and mean vascular diameter changes simultaneously in two nonadjacent arteries.


Ultrasonographic appearance of gas-containing abscesses in the abdomen.

This report describes the sonographic appearance of six gas-containing abdominal abscesses. Gas-containing abscesses may appear as densely echogenic masses with acoustical shadowing, but may also be seen merely as regions of acoustical shadowing or as an echogenic mass. A hypothesis is advanced that the appearance of gas-containing abscesses as echogenic masses may be due to a "microbubble" constrast effect.


Meibomian keratoconjunctivitis.

We evaluated, dermatologically and ophthalmologically, 26 patients who had chronic blepharitis (meibomitis); we also investigated 26 age- and sex-matched controls. All of the blepharitic patients had an abnormality of sebaceous gland function ranging from seborrhea sicca to seborrheic dermatitis or acne rosacea, suggesting a generalized sebaceous gland dysfunction that included the meibomian glands. Sebaceous gland abnormalities most frequently involved the cool areas of the face or scalp. Stagnation of the meibomian glands presumably caused a defect in the tear lipid layer; this resulted in an unstable tear film that produced superficial punctate keratopathy. The break-up time was much lower in these patients than in controls. The break-up time returned to normal or super-normal levels when fresh meibomian secretions were expressed into the tear film. The superficial punctate keratopathy had the characteristics of those seen in conditions with a known unstable tear film and not of those experimentally produced by staphylococcus toxin.


Left atrial ultrastructure in mitral valvular disease.

Light microscopic and ultrastructural observations were made on left atrial tissues obtained from 14 patients at the time of operation for correction of mitral valvular disease. Cardiac muscle cells varied in size but most frequently were hypertrophied. In fibrotic areas, present in all left atria, the muscle cells tended to be isolated from adjacent cells and exhibited degenerative changes of varying severity. These changes consisted or proliferation of Z-band material and cytoskeletal filaments, myofibrillar loss, proliferation of elements of free and extended junctional sarcoplasmic reticulum, variations in size and number of mitochondria, occurrence of abnormal mitochondria, dissociation of intercellular junctions, formation of spherical microparticles, and accumulation of lysosomal degradation products. Hypertrophy was considered to lead to cellular degeneration, with decrease or loss of contractile function. Atrial fibrillation was associated with severe cellular degeneration. The severity of degeneration was greater in patients with mitral regurgitation, with or without associated mitral stenosis, than in patients with pure mitral stenosis.


Effects of carbon tetrachloride on rat liver plasmalemmal calcium adenosine triphosphatase.

Calcium adenosine triphosphatase (Ca-ATPase) activity in rat liver plasma membrane fractions prepared by zonal centrifugation was studied for sensitivity to carbon tetrachloride (CCl4). Levels of Ca-ATPase activity in such membrane fractions from animals given CCl4 by gastric intubation were no different from those in plasmalemmal fractions obtained from control rats. When the fractions were incubated in vitro, however, this enzyme activity was inhibited by the presence of CCl4 in a dose-dependent manner. Moreover, inhibition of Ca-ATPase could be reversed by the removal of CCl4. These results would explain the observed increase in hepatic calcium content following the administration of CCl4 if the Ca-ATPase were capable of actively extruding calcium and if this extrusion mechanism proved sensitive to CCl4 present on or about the hepatocytes.


Dystrophic cardiac calcinosis in mice: genetic, hormonal, and dietary influences.

Mice of five inbred strains (BALB/c, C3H, C3Hf, DBA/2, and C57BL/6) of both sexes, mated and virginal, were examined for the incidence, severity, and location of dystrophic cardiac calcinosis (DCC) at various ages. Three hybrids, B6C3F1, C3B6F1, and CC3F1 of both sexes, all mated, were likewise studied. Excepting DBA/2, females of the inbred strains acquired the lesion at a much earlier age than males; DCC appeared in young DBA/s mice of both sexes. DCC in BALB/c mice was almost exclusively epicardial and occurred with equal frequency and severity in mated males and females, with higher incidence but lesser extent in virginal females. The occurrence was highest, the degree most severe, and the location exclusively myocardial in C3H and C3Hf mated females, irrespective of parity, whereas virginal females of these strains were entirely free of disease even after administration of exogenous progesterone. Involvement of males, also myocardial, was relatively minimal, especially in C3Hf mice. Over half the DBA/2 mice were affected, regardless of sex or mating; calcinosis appeared in the epicardium and/or myocardium, predominantly in the myocardium. Strain C57BL/6 was completely devoid of the lesion, as were the two hybrids thereof, B6C3F1 and C3B6F1. The hybrid of BALB/c and C3H showed a high incidence of minimal involvement, exclusively myocardial and limited to breeding females, indicating dominance of the C3H gene(s). Renal calcinosis was uncommon among BALB/c mice but was frequently found in C3H, C3Hf, and DBA/2 strains. Pulmonary calcinosis was rare and limited to C3H and C3Hf female breeders. Mated C3H females fed increasing amounts of fat showed a concomitant rise in incidence and severity of the cardiac lesions. Progression of the lesion from necrotic myocardial fibers to fibrocalcific masses is illustrated, as is formation of the renal deposits.


Relationship between mineralocorticoids and renal Na+-K+-ATPase: sodium reabsorption.

To evaluate the mechanism responsible for the effect of deoxycorticosterone acetate (DOCA) on renal Na+-K+-ATPase, we compared the relative contribution of this hormone and of increased absolute sodium reabsorption (TNa) to the restoration of the enzyme in kidneys of adrenalectomized rats. In study A, adrenalectomized animals maintained on a salt-free diet received 5 mg/kg per day DOCA i.m., while sham-operated and untreated adrenalectomized rats receiving the same diet served as controls. Absolute TNa and Na+-K+-ATPase specific activity in the cortex and outer medulla of DOCA-treated rats were similar to those measured in untreated adrenalectomized animals, but were significantly lower than in sham-operated controls. In study B, the adrenalectomized rats did not receive DOCA but were fed a high salt diet and received isotonic saline, 50 ml/kg per day s.c. Absolute TNa and cortical and medullary Na+-K+-ATPase specific activity were significantly higher in the salt-loaded group than in both adrenalectomized and sham-operated rats deprived of salt. These results suggest that absolute sodium reabsorption is a major determinant of renal Na+-K+-ATPase activity, and that the effect of DOCA on this enzyme is secondary to its stimulation of absolute tubular sodium transport.


Management of enterocutaneous fistulas and problem stomas with silicone casting of the abdominal wall defect.

Silicone casting of abdominal wall defects around enteric fistulas in six patients and problem stomas in three patients proved to be an effective means of controlling the output of the fistulas, reducing wound care time, and reducing or eliminating parenteral nutrition needs. Outpatient management was possible in seven of the nine patients. It is observed that the wounds healed rapidly with this method of fistula control. Epithelialization occurred more rapidly than expected. This method of management may tend to make the fistulas remain open longer than by other means of care, but the significant increase in patient comfort, the financial savings, and the relative safety warrant continued utilization and observation of this method of management.


Total infrarenal aortic occlusion.

Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for 12 hours preoperatively with 3,000 ml of Ringer's solution containing supplemental potassium. Mannitol (25 g), furosemide (20 mg), and heparin (120 u/kg) were given intraoperatively. Thrombectomy was accomplished by transection of the aorta, with proximal manual control of the aorta after the renal arteries were occluded. With this technic there were no deaths or renal complications, whereas previously, three of the six patients developed renal complications and one died. Ninety-two per cent of the grafts have remained open. We recommend that the direct transabdominal approach be continued rather than the extraanatomic bypass (axillobilateral-femoral), since further propagation of the aortic thrombosis may then lead to infarction of the kidneys or other viscera.


The atherosclerotic popliteal aneurysm: report of diagnosis and treatment in twenty-six cases.

Twenty-six popliteal aneurysms in eighteen patients are presented. There was a 45 per cent incidence of bilaterality and a 33 per cent incidence of extrapopliteal aneurysms. Rest pain and/or gangrene secondary to thrombosis of the aneurysm were the most common presenting symptoms. Eleven reconstructive procedures were carried out with good results and no mortality. All popliteal aneurysms should be repaired when found regardless of size, and due to the high incidence of extrapopliteal aneurysm, these patients should undergo a thorough search for aneurysms at other sites. They may be excised with end-to-end anastomosis with the graft or simply ligated and bypass grafting accomplished. Saphenous vein or Dacron graft may be used with equally satisfactory results. Long-term follow-up is recommended because of propensity for recurrence of aneurysms in the residual popliteal artery and to rule out extrapopliteal aneurysm formation.


Potassium metabolism.

In man, mechanisms for potassium excretion are complex and highly developed, while potassium conservation is potentially inadequate. Potassium balance is regulated by alterations in excretion in the distal renal tubule, where mineralocorticoid hormones and Na-K ATPase are the major regulating factors. The distribution of potassium across cell membranes is influenced by changes in acid-base status, by pancreatic hormones and by the autonomic nervous system. Potassium stimulates insulin and aldosterone secretion and increases Na-K ATPase in the distal nephron, so promoting its own redistribution or excretion. Emergency management of hyperkalaemia is best effected by promoting cell-entry of potassium, rather than renal excretion. The speed of replacement of deficits is always limited by the small extracellular potassium pool.


[The adaptation of the skeletal muscle fiber types to extensive and intensive loading forms--a review (author's transl)].

Hitherto existing findings let us recognize that the adaptation of the skeletal muscle fiber to loading is depended of the type of the single muscle fiber, which is of the other hand caused in the embryological determination.


Effect of albendazole on gastrointestinal parasites of cattle.

The efficacy of albendazole in removing gastrointestinal nematodes and tapeworms was studied in 16 treated and 16 untreated (control) beef calves. The anthelmintic was administered as an oral drench at a dose level of 5 ml/45.5 kg of body weight (5 mg/kg). Percentage of efficacy against the various genera was: Trichostrongylus axei, Oesophagostomum radiatum, and Moniezia-100.0; Haemonchus placei, Cooperia spp, and Trichostrongylus colubriformis - greater than 99.0; Ostertagia ostertagi -98.3; and Bunostomum phlebotomum -96.2. Efficacy against Trichuris was 20.2. Efficacy against immature nematodes in the abomasum and small intestine was high, 91.9 and 86.4, respectively, but total numbers of nematodes were not large. Efficacy against immature stages in the cecum and remainder of the large intestine was 48.5. Signs of toxicosis were not observed in calves treated with albendazole.


Expanded polytetrafluoroethylene as dialysis access grafts: serial study of histology and fibrinolytic activity.

Expanded polytetrafluoroethylene (Gore-Tex) grafts were evaluated as hemodialysis access shunts. A serial study of cellular ingrowth and endothelialization was performed. The development of fibrinolytic activator was sequentially monitored and shown to be consistently higher in the Gore-Tex grafts than in either knitted or woven Dacron prostheses. Functional assessment by repeated needle puncture demonstrated that PTFE grafts were durable, had uniform patency (6 mm ID size) and showed no evidence of degeneration during the time limit of this study. Although these are favorable characteristics, further long-term evaluation of PTFE grafts is necessary before its role as a vascular prosthesis applicable to clinical practice, can be established.


Female sterilization by laparoscopy: a comparative study of tubal occlusion with electrocoagulation and spring-loaded clip with one-year follow-up.

Findings are reported of a study conducted to evaluate and compare the safety and effectiveness of the spring-loaded clip and the electrocoagulation techniques of tubal occlusion via laparoscopy. The study was conducted from June, 1974 to June, 1975 on 300 cases in a Bangkok, Thailand hospital. Only patients who requested sterilization to limit family size were included in the study, and study patients were required to return for 6- and 12-month follow-up visits. To minimize possible patient and physician biases, all sterilization procedures were performed by one author (S. K.). and data were analyzed by the other author (S. P.). The specific operative technique was randomly assigned to the patient immediately prior to surgery, and the patient was unaware of the particular technique used. The findings showed no potentially serious complications for either technique. Neither complication rates nor incidence of pain were significantly different for the two procedures. The presence of adhesions was the most frequent cause of surgical difficulty in both techniques. No mechanical difficulties were reported. No pregnancies were reported within one year of sterilization.


Isolation of putrescine-requiring mutants of Neurospora crassa.

Two auxotrophs of Neurospora crassa have been isolated that give a positive growth response to putrescine, spermidine or spermine. One of the mutants is deficient in ornithine decarboxylase activity and has been designated put-I. Both mutants map on linkage group VR, fail to complement and are infertile when crossed to one another, indicating that they are probably alleles. A putrescine auxotroph is incapable of suppressing a pro-4 mutant. The isolation of the mutants confirms that putrescine is an essential factor the normal growth of the organism, and is synthesized via a single pathway in Neurospora.


Contact dermatitis due to multiple corticosteroid creams.

A patient was allergic to the corticosteroids halcinonide, fluocinonide, desonide, and triamcinolone acetonide. She also was allergic to ethylendiamine hydrochloride, neomycin, thimerosal, formaldehyde solution, and nystatin.


Thyroid neoplasms after radiation therapy for adolescent acne vulgaris.

There is a potential hazard of thyroid cancer after exposure to external irradiation for the treatment of adolescent acne vulgaris. We noted a 60% incidence of thyroid carcinoma among 20 patients with such a history, who were operated on for thyroid nodules during a five-year period. Eighty-three percent of the patients with carcinoma had either a follicular or a mixed papillary-follicular carcinoma; 17% had a papillary carcinoma; 33% had regional node metastases; none had evidence of distant metastases. The interval between radiation exposure and thyroidectomy ranged from nine to 41 years. This association of thyroid neoplasms and a prior history of radiation for acne vulgaris may be coincidental and therefore remains to be proved by retrospective surveys of large numbers of treated patients with appropriate controls.


The role of microorganisms in diaper dermatitis.

A quantitative microbiological survey of multiple sites in the diaper area in 40 normal infants and 100 infants with various forms of diaper dermatitis showed (1) no significant differences between normal infants and those with common chafing form of diaper dermatitis except for a low number of Staphylococcus aureus organisms in 50% of those with chafing dermatitis compared to no S aureus in normals; (2) S aureus occurred in high numbers in every case of atopic dermatitis and was frequently found at much lower levels in psoriasis, seborrheic dermatitis, and chafing dermatitis; (3) Candida albicans occurred in 80% of cases clinically diagnosed as moniliasis localized to the diaper area and in 33% of those suspected of Candida infection with dissemination beyond the diaper area, while C albicans was found in only five of 145 culture sites in 40 normal infants.


Familial balanced translocation 4p+/17q- as a suggested cause of primary trisomy-21 Down's syndrome.

A case is presented in which a 4p+/17q- familial balanced reciprocal translocation in the mother produced a son with primary trisomy-21, as well as the structural chromosomal anomaly. A number of similar situations have been reported, suggesting that the two events are related. In practice, this (as well as other direct risks) should be taken into account when counseling those families in which one parent carries a balanced translocation. A hypothesis, based on experiments in Drosophila, has been put forward by Grell to explain the mechanism which links the balanced structural abnormality to an aneuploidy of chromosomes not taking part in the structural change, and this has been extended to similar human situations.


[Autoradiographic investigations in actinic (senile) comedones (author's transl].

Skin specimens of patients suffering from actinic comedones, young patients with acne vulgaris, and normal controls of the same age groups respectively were subjected to in vitro autoradiography. From the results it can be concluded, that a rise in the proliferational activity in the follicular infundibulum due to actinic stimuli is responsible for the development and growth of actinic comedones.


Musculoskeletal manifestations of bacterial endocarditis.

The records of 180 patients out of 247 with bacterial endocarditis were examined. 50 patients had rheumatic manifestations. In 10 there was arthritis of 2-12 weeks' duration before diagnosis; 19 had myalgia/arthralgia; 17 had back or neck pain; 14 had demonstrable arthritis; and 2 tenosynovitis of the foot. Of the 14 patients with arthritis, 8 had monarticular arthritis and 6 polyarticular. All but one patient had a raised erythrocyte sedimentation rate, and in one patient rheumatoid factor was positive. The rheumatic features responded when the endocarditis was treated. Some of the symptoms undoubtedly resulted from the infection and fever of the endocarditis, and emboli may have caused the transient aches but there was no evidence that they caused the synovitis in the patients with arthritis. The rheumatic manifestations of bacterial endocarditis can mimic other rheumatic diseases and disguise the underlying disease.


Gold-induced immune complex nephritis in seronegative rheumatoid arthritis.

Proteinuria, with or without the nephrotic syndrome, developed in 8 patients with seronegative rheumatoid arthritis after the institution of gold therapy. Light microscope examination of renal biopsies showed normal findings in 7, and a focal increase in the mesangial matrix of one glomerulus in the eighth. In all patients immunofluorescence showed deposits of IgG and C3 along the glomerular basement membrane, indicative of immune complex nephritis. The renal biopsies of 5 patients were studied with the electron microscope and subepithelial deposits were detected in all. The Rose-Waaler test for the detection of IgM-rheumatoid factor (IgM-RF) was repeatedly negative in all patients. These results suggest that the development of gold nephropathy may be related to an absence of IgM-RF in serum.


Surgical management of congenital pulmonary valve dysplasia.

Pulmonary valvular stenosis secondary to congenital valve dysplasia differs markedly from the classic variety of pulmonary stenosis. The reported mortality of patients treated by standard commissurotomy is 38 to 66%. The clinical features and operative management of 14 patients with dysplastic pulmonary valves are reviewed. Three groups of patients were studied. Group 1 consisted of 5 patients treated by commissurotomy. Group 2 comprised 3 patients treated by partial excision of the valve. In neither group were there operative deaths, but 5 of the 8 patients developed recurrent stenosis; 3 required reoperation. In 1975, because of the high incidence of recurrent stenosis, total valvectomy was begun. Ten patients (Group 3) have undergone valvectomy with 1 death. Nine patients were doing well at 3 to 15 months of follow-up. Based on the reported mortality and present findings, total excision of the valve is recommended for relief of stenosis in pulmonary valve dysplasia.


The effects of different amphetamines on copulatory behaviour and stereotype activity in the female rat, after treatment with monoamine depletors and synthesis inhibitors.

The effects of treatment with alpha-methyl-p-tyrosine (alphaMPT), parachlorophenylalanine (pCPA) and reserpine in combination with D- or L-amphetamine on copulatory behaviour and stereotype activity was studied in estrogen + progesterone treated ovariectomized rats. In doses which clearly prevented D- and L-amphetamine-induced stereotype activity alphaMPT or pCPA did not influence the effect of D- and L-amphetamine on lordosis response. Reserpine treatment decreased the enhanced stereotype activity after D- and L-amphetamine but did not decrease the effect on the copulatory behaviour. Pretreatment with pCPA or reserpine clearly reduced the effect of fenfluramine on the lordosis response. It is suggested that different mechanisms of action are involved in the D-amphetamine effect on the lordosis response and on stereotype activity. The present data give further evidence that the lordosis inhibitory effect of fenfluramine is mediated by 5-HT-mechanisms. The mechanism by which L-amphetamine inhibits the lordosis response seems to be different from both the action of fenfluramine and the effect of D-amphetamine.


Peritoneoscopy for the diagnosis of left lobe lesions of the liver.

Peritoneoscopy and direct-vision liver biopsy are simple, safe, and accurate methods for the documentation of focal lesions predominantly involving the left lobe of the liver or the left portion of the right lobe. Focal lesions of the left lobe of the liver constitute a major indication for peritoneoscopy and direct-vision biopsy of the liver when its use is not contraindicated and when blind percutaneous biopsy or biopsies and cytologic examination have failed to establish the diagnosis.


Neurophysiological experiments on intention tremor (author's transl).

During a postural innervation, cerebellar intention tremor can be produced by applying direct stimulus to the muscle. The stimulus is followed by a silent period of 160 to 200 ms, which exceeds the normal variation. Simultaneously, a massive rebound in the antagonistic muscle is evoked due to the tension reflex in the agonistic muscle. Passive shortening or stretching of the voluntarily activated muscle has no effect: there is no silent period in the shortened muscle, no rebound in the stretched muscle, and, consequently, little or no oscillation follows. The spindle apparatus seems irrelevant to the development of intention tremor. The feedback mechanism of the Golgi-inhibition systems is discussed. These findings cannot be explained by assuming a central pacemaker.


Apomorphine hydrochloride-induced improvement in Huntington's chorea: stimulation of dopamine receptor.

Four patients affected by Huntington's chorea (HC) with a well defined family history of the disease were injected intramuscularly with apomorphine hydrochloride in nonemetic doses, ranging from 1 to 4 mg. Soon after treatment, all patients showed a marked decrease in abnormal involuntary movements. Pretreatment with haloperidol (2 mg intramuscularly) or sulpiride (100 mg intramuscularly) 30 minutes prior to apomorphine treatment, prevented the therapeutic effect of this compound. It is suggested that apomorphine-induced improvement in Huntington's Chorea is mediated by the stimulation of a special kind of dopamine receptor, leading to inhibition of the activity of dopaminergic neurons.


[Biometry of the malignant glaucoma (author's transl)].

The survey of a population of 7 patients with malignant glaucoma, whose 3 were bilateral, showed that the total length of these eyes was weaker, the corneal radius shorter, the anterior chamber more shallow and the insertion of the lens more anterior than that of eyeballs with angle-closure glaucoma on the whole. These latter, we must remind, are already smaller than normal eyes. But this lessening of size does not affect the corneal diameter which remains always normal. And the lens, which is greater than normally in the angle-closure glaucoma, in the contrary is normal or smaller in the malignant glaucoma. The authors think that this little size of the lens allows it to be dislocated anteriorly through the limbal ring after the operation, and so is the cause of the post-surgical malignant glaucoma.


[The retro-equatorial muscular strapping. A technical adaptation of Cuppers's Faden-Operation. A preliminary report (author's transl)].

Reckoning up the Balance-sheet of about 300 Faden-operations performed during two years in blocking convergent squints, the Authors note that whether this operation is absolutely appointed in various forms of horizontal incomitances in which the spasmodic factor is prevalent on the other hand in moderate forms it does not seem to give better results than classic muscular surgery. After having detailed the characteristics and technical difficulties of this operation, first they mention that its effects are unforeseeable in spite of a previous careful clinical examination; then moreover, it has a binding character. In many cases reoperations allowed to notice a considerable sclerosis of the formerly operated muscle and neighbouring capsule. To avoid these drawbacks, instead of a muscular fastening, they make a retroequatorial strapping on the sclera. They describe the successive steps in their procedure, which appears having many benefits with regard to the original Faden-operation.


[The influence of the type of monofilament suture on re-epithelialisation of corneal grafts (author's transl)].

We have investigated whether a correlation exists between the quality of graft epithelialisation and three types of suture: triangular sutures, continuous and interrupted sutures. The study concerns 192 randomly chosen keratoplasties, performed by the same surgeon using suture material of 9 or 10/0 monofilament. We used the chi2 test for statistical analysis. No correlation was found to exist between the quality of epithelialisation and the type of sutures. By contrast the aetiology of the corneal disease had a highly significant influence (alpha at 1%) on the quality of this epithelialisation, with this correlation persisting whatever type of suturing was used.


[Soluble therapeutic implants in ophthalmology (author's transl)].

The insertion into the conjunctival sac of a soluble polyacylamide implant (2.A.A.) makes it possible to obtain high and durable concentrations of drugs in the eye.


[Experimental phaco-emulsification in the rabbit. Induced corneal endothelial lesions, regeneration at 24 hours (author's transl)].

The purpose of this study was to evaluate action of the Shock phacofragmentor's tip vibrations; this study was done in rabbit corneal endothelium: 1--Tip in the anterior chamber close to the cornea and iterative entrances by the incision; 2--In order to avoid some endothelial injuries, it appears necessary to introduce the instrument only once and also use the vibrations only inside the nucleus. Then the lens materials can be removed by irrigation and or aspiration.


[The action of instilled physostigmine on the acetylcholine content of the bovine ciliary body (author's transl)].

The authors have compared the content of acetylcholine (ACh) of the two ciliary bodies (150 microgram of tissue) after the instillation of a stimulating dose of a 1% aqueous solution of physostigmine (10 applications of three drops at intervals of three minutes) into the conjunctival fornix of one eye. Kymographic measurements on guinea-pig ileum demonstrated an average elevation of the ACh content in the instilled ciliary bodies (0.48 microgram) against the controls (0.33 micron). The eyes were enucleated one hour after the last application.


Early effects of ethacrynic acid on cochlear histochemistry.

We have investigated the histochemical changes in the succinodehydrogenase (SDH) and adenosine triphosphatase (ATPase) enzyme systems of the guinea pig cochlea at 30, 60, and 240 minutes following the intracardiac injection of ethacrynic acid. In control animals, there is intense SDH activity in the stria vascularis, spiral prominence, and hair cells. At all periods after ethacrynic acid injection, there was decreased activity of SDH in the outer hair cells in the basal turn. The activity of SDH in the stria vascularis and spiral prominence was equally as intense as in control animals at all periods, however. Strong ATPase activity in control animals was demonstrated by dark-brown precipitations in the external sulcus cells, stria vascularis, and hair cells. The ATPase activity was decreased at 60 minutes after ethacrynic acid injection only in the stria vascularis. The importance of these results is discussed.


Protein synthesis during right-ventricular hypertrophy after pulmonary-artery stenosis in the dog.

The rate of protein synthesis in the heart of normal dogs and those with pulmonary-artery stenosis was measured by a continuous intravenous infusion of [14C]tyrosine. The protein-synthesis rate of both ventricles was the same in normal dogs and averaged 7.5% per day. The right ventricle hypertrophied rapidly after the acute imposition of pulmonary-artery stenosis, the wet weight increasing by 84% after 24 days, with the rate of increase being most rapid over the first 5 days. The left ventricle remained largely unaffected and served as an internal control. During hypertrophy there was an increased incorporation of [14C]tyrosine into protein without a significant change in the specific radioactivity of free tyrosine in the ventricles. After 5 days of stenosis the synthesis rate of the total mixed proteins of the right ventricle had increased to 13.6% per day, compared with 6.2% in the control left ventricle. This increase in synthesis was reflected in both the myofibrillar and sarcoplasmic proteins. After 5 days the protein-synthesis rate decreased, but still remained significantly elevated above that in the control left ventricle by 24 days of stenosis.


The catabolism of intravenously injected heparan N-[35S] sulphate in the rat.

The metabolic fate of heparan N-[(35)S]sulphate was studied in rats. Heparan sulphate was obtained from either bovine aorta or lung and labelled with (35)S by desulphation and subsequent resulphation in vitro. Experiments in which heparan N-[(35)S]sulphate was administered intravenously to either free-range or wholly anaesthetized rats with ureter cannulae established that substantial desulphation occurs in vivo, with elimination of inorganic [(35)S]sulphate in urine. Oligosaccharides labelled with (35)S, possible intermediates in heparan sulphate degradation, could not be detected in urine or blood. The general distribution of radioactivity after administration of heparan N-[(35)S]sulphate, as demonstrated by whole-body radioautography, suggested that desulphation was not restricted to one organ in particular. Support for this view was obtained in experiments in which heparan N-[(35)S]sulphate was administered to animals after the removal of kidneys, liver, spleen, pancreas or gastrointestinal tract. In all cases inorganic [(35)S]sulphate was still produced. The ability of rats of desulphate heparan N-[(35)S]sulphate was progressively impaired by increasing concentrations of heparin administered simultaneously. It was concluded that heparan sulphate is metabolized at a number of sites in the body by a sequence of degradative events leading to the formation of inorganic sulphate. It is also concluded that at least some of these events are common to heparan sulphate and heparin.


Characteristics of sarcoplasmic reticulum from slowly glycolysing and from rapidly glycolysing pig skeletal muscle post mortem.

The composition and function of fragmented sarcoplasmic reticulum from pig skeletal muscle was examined in the period immediately post mortem. Muscle was defined as being either slowly glycolysing or rapidly glycolysing on the basis of colour, pH and concentrations of glycogen and lactate. The microsomal fraction was separated on a discontinuous gradient of 35, 40 and 45% (w/v) sucrose into heavy and intermediate fractions which sedimented to the interfaces, and a light fraction which remained on the surface of the 35%-sucrose layer. The sarcoplasmic reticulum from rapidly glycolysing muscle had a lower buoyant density than had that from slowly glycolysing muscle. This was reflected in the consistent lack of material in the heavy fraction and a greater proportion in the light fraction. The latter material had significantly lower ratios (w/w) of protein to phospholipid (2.3:1 versus 3.8:1) and of protein to cholesterol (10.4:1 versus 15.6:1). There were no gross differences in phospholipid content or in fatty acid composition of individual phospholipid classes in the membranes from the two types of muscle. Analysis of membrane proteins by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis showed that ATPase (adenosine triphosphatase) was a major component of each fraction and that its contribution to the total protein content of the membrane was greater in rapidly glycolysing muscle, suggesting a loss of non-ATPase proteins. The two fractions of sarcoplasmic reticulum prepared from rapidly glycolysing muscle had approximately one-third the normal activities of Ca(2+) binding and Ca(2+) uptake in the presence of ATP and one-half the passive Ca(2+)-binding capacity in the absence of ATP of the fractions from slowly glycolysing muscle. However, the (Ca(2+)+Mg(2+))-stimulated ATPase activities were similar. Efflux from actively loaded vesicles, after the addition of EDTA, consisted of a rapid and a slow phase. Vesicles from rapidly glycolysing muscle lost 60% of associated Ca(2+) (approx. 0.10mumol of Ca(2+)/mg of protein) during the rapid phase, compared with 30% (approx. 0.17mumol of Ca(2+)/mg of protein) in those from slowly glycolysing muscle. The efflux rate during the slower phase was comparable in both types of vesicles. Analysis of the temperature-dependence of (Ca(2+)+Mg(2+))-stimulated ATPase activity revealed that a high-activation-energy process operating in the temperature range 31-45 degrees C in the intermediate and light fractions from slowly glycolysing muscle was not apparent in vesicles from rapidly glycolysing muscle. Conditions that result in the prolonged activation of glycogenolysis in pig muscle post mortem primarily affect the protein components of the sarcoplasmic-reticular membrane, giving rise to a loss of loosely associated proteins. The function of the membranes observed under these conditions does not appear to be due to enhanced permeability of the membrane to Ca(2+) and may be the result of a defect in the transport of Ca(2+) into the vesicles.


Effects of noradrenaline on the activation and the stability of brain adenylate cyclase.

At constant 1 mM-ATP, the Mg2+-saturation curves for adenylate cyclase (EC 4.6.1.1) particulate preparations obtained from corpus striatum and cortex tissues of rat brain show that addition of 0.1 mM-noradrenaline increases the apparent Vmax. for Mg2+ by 300% in corpus striatum particles, and by 280% in cortex particles. At 10 mM-MgCl2, the addition of 0.1 mM-noradrenaline increased by 800% the adenylate cyclase activity of corpus striatum particles. At all Mg2+ concentrations, the addition of 0.3 mM-CaCl2 suppressed the noradrenaline-induced stimulation of adenylate cyclase of corpus striatum particles, and even resulted in a strong inhibition of the activating effect of Mg2+ itself on adenylate cyclase of corpus striatum particles, and even resulted in a strong inhibition of the activating effect of Mg2+ itself on adenylate cyclase activity of cortex particles. The addition of noradrenaline during a 3 h preincubation of particle preparations of brain cortex at 38 degrees C decreased by more than 4-fold the half-life of the decay of adenylate cyclase activity. The addition of MgATP protected against noradrenaline-induced inactivation.


The effects of unsaturated fatty acid depletion on the proton permeability and energetic functions of yeast mitochondria.

1. The fatty acid composition of the ole-1 and ole-1 petite mutants of Saccharomyces cerevisiae was manipulated by growing the organism in the presence of defined supplements of Tween 80 or by allowing cells that had first been grown in the presence of Tween 80 to deplete their unsaturated fatty acids by sequent growth in the absence of Tween 80. 2. The transition temperature of Arrhenius plots of mitochondrial ATPase (adenosine triphosphatase) increases as the unsaturated fatty acid content is lowered. 3. Cells require larger amounts of unsaturated fatty acids to grow on ethanol at lower temperatures. 4. Cells that stop growing owing to unsaturated fatty acid depletion at low temperatures are induced to grow further by raising the temperature and this results in a further depletion of unsaturated acids. This is due to a higher rate, but not a greater efficiency, of mitochondrial ATP synthesis. 5. Arrhenius plots of the passive permeability of mitochondria to protons between 4 and 37 degrees C are linear. The rate and the Arrhenius activation energy of proton entry increase greatly as the unsaturated fatty acid content is lowered. 6. Unsaturated fatty acid depletion has the same effects on the proton permeability of ole-1 petite mitochondria, indicating that the mitochondrially synthesized subunits of the ATPase are not involved in the enhanced rates of proton entry. 7. The adenylate energy charge of depleted ole-1 cells is greatly decreased by growth on ethanol medium. 8. The adenylate energy charge of isolated mitochondria is also lowered by unsaturated fatty acid depletion. 9. The results confirm that unsaturated fatty acid depletion uncouples oxidative phosphorylation in yeast both in vivo and in vitro, and is a consequence of changes in the lipid part of the membrane.


Dibutylchloromethyltin chloride, a covalent inhibitor of the adenosine triphosphate synthase complex.

1. The synthesis of dibutylchloromethyltin chloride, a new covalent inhibitor of the mitochondrial ATP synthase [oligomycin-sensitive ATPase (adenosine triphosphatase)] complex is described, together with a method for preparing dibutylchloro[(3)H]methyltin chloride. 2. Studies with the yeast mitochondrial oligomycin-sensitive ATPase complex show that dibutylchloromethyltin chloride inhibits both the membrane-bound enzyme and also the purified Triton X-100-dispersed preparation. 3. F(1)-ATPase is not inhibited even at 500nmol of dibutylchloromethyltin chloride/mg of protein, and the general inhibitory properties are similar to those of triethyltin, oligomycin and dicyclohexylcarbodi-imide, known energy-transfer inhibitors of oxidative phosphorylation. 4. Binding studies with yeast submitochondrial particles show that dibutylchloromethyltin chloride antagonizes the binding of triethyl[(113)Sn]tin, indicating that there is an interaction between the two inhibitor-binding sites. 5. Unlike triethyltin, inhibition by dibutylchloromethyltin chloride is due to a covalent interaction which titrates a component of the inner mitochondrial membrane present at a concentration of 8-9nmol/mg of protein. 6. All of the labelled component can be extracted with chloroform/methanol (2:1, v/v), and sodium dodecyl sulphate/polyacrylamide-gel electrophoresis of the chloroform/methanol extract indicates that the labelled component has an apparent mol.wt. of 6000-8000. However, t.l.c. reveals the presence of only one labelled component which is lipophilic and non-protein and is distinct from the free inhibitor, mitochondrial phospholipids and the dicyclohexylcarbodi-imide-binding protein (subunit 9). 7. Inhibition of mitochondrial ATPase and oxidative phosphorylation is correlated with specific interaction with a non-protein lipophilic component of the mitochondrial inner membrane which is proposed to be a co-factor or intermediate of oxidative phosphorylation.


Inhibition of the membrane-bound adenosine triphosphatase of Escherichia coli by dicyclohexylcarbodi-imide.

The inhibition of the membrane-bound adenosine triphosphatase of Escherichia coli by DCCD (dicyclohexylcarbodi-imide) is studied under conditions of varying KCl concentration. An increase in K+ concentration and in other cations causes an increase in the DCCD sensitivity of the enzyme, as well as significant changes in the kinetic parameters.


Streptozotocin-induced renal tumours in rats.

Forty-six separate renal tumours developed in 36/80 Wistar male rats given a single i.v. dose of streptozotocin (25 mg/kg body wt) to induce diabetes mellitus. Fourteen of the tumours were epithelial in type, 8 were wholly mesenchymal and 24 were largely mesenchymal but also contained epithelial elements. The purely epithelial tumours correspond to the renal adenomas and adenocarcinomas seen in man. The mesenchymal tumours were composed either of undifferentiated spindle cells or of a mixutre of poorly differentiated mesenchyme and epithelial glands. Microscopically, the mixed tumours resembled the nephroblastomas seen in man; both elements appeared to be malignant, but in the absence of metastases this remains unproven. The management of the diabetic state did not influence the incidence of tumours, but insulin appeared to enhance tumour growth.


Intense tumour-cell destruction by syngeneic mice: role of macrophages, complement activation and tumour-cell factors.

When injected i.p. and in large numbers (10(7)) into syngeneic mice, 125IUdR-labelled L1210 cells are rapidly destroyed in a small proportion of animals, while in the other animals the lysis is low. This bimodal distribution is clearly visible 24 h after cell injection. The intense lysis occurs in fewer animals when macrophage-derived lysosomal enzymes are inhibited by trypan blue and if the complement is depleted by high doses of cobra venom factor (CVF). The intense destruction occurs in more animals after adjuvant treatment, if the mice are latently contaminated, after a moderate production of C3b by low doses of CVF, or after the injection of a tumour-cell dialysate. The destruction seems to be the result of positive feedback reaction which involves at least macrophages and complement activation.


Reaction of (Na-K)ATPase with 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole: evidence for an essential tyrosine at the active site.

The reaction of 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole [NBD-Cl] with purified eel electrophax Na+ and K+ stimulated adenosine triphosphatase [(Na-K)ATPase] has been monitored by changes in the (Na-K)ATPase activity, the K+ stimulated p-nitrophenyl phosphatase [PNPase] activity, and the protein ultraviolet absorption spectrum. The NBD-Cl reacts with two tyrosine residues per mol of enzyme (approximately 6-7 nmol/mg of protein), as judged by changes in protein absorption spectra and incorporation of [14C]NBD-Cl. The modified tyrosine groups are located on the Mr = 95 000 polypeptide chain and react at different rates. Only one tyrosine modification is necessary for complete inhibition of (Na-K)ATPase activity, although both must be modified for complete inhibition of PNPase activity. Reversal of these modifications by 2-mercaptoethanol restores 65% of both activities. Na+ increases the rate of tyrosine modification, K+ decreases the rate, and ATP affords the more reactive tyrosine group complete protection. NBD-Cl modification of approximately 6-7 nmol of tyrosine groups/mg of protein results in a large decrease in ATP affinity as judged by equilibrium binding. These results are compared with similar results obtained from NBD-Cl modification of the coupling factors of oxidative phosphorylation and photophosphorylation. A model is presented suggesting an asymmetric arrangement of two 95 000 polypeptide chains with a single tyrosine residue at the ATP site.


Tentoxin. An uncompetitive inhibitor of lettuce chloroplast coupling factor 1.

The interaction of tentoxin [cyclo-(-L-leucyl-N-methyl-(Z)-dehydrophenylalanyl-glycyl-N-methyl-L-alanyl-)] with solubilized lettuce chloroplast coupling factor 1 was characterized by direct binding studies, measurement of the time course of ATPase inhibition, and steady-state enzyme kinetics. Neither substrates, products or Ca2+ competed with the tentoxin binding site, nor did they induce any large change in tentoxin affinity. The inhibition of lettuce chloroplast coupling factor 1 ATPase was found to be the time dependent, and at equilibrium the affinities estimated by equilibrium ultrafiltration and enzyme inhibition were similar (1.8 . 10(8) M-1). The steady-state kinetics best fit an uncompetitive pattern suggesting that the inhibited steps follow an irreversible step occurring after ATP binding.


The extent of mitochondrial F1-ATPase and adenine nucleotide carrier activity with epsilon-ATP.

1. The use of 1,N6-ethenoadenosine 5'-triphosphate (epsilon-ATP), a synthetic, fluorescent analog of ATP, by whole rat liver mitochondria and by submitochondrial particles produced via sonication has been studied. 2. Direct [3H]adenine nucleotide uptake studies with isolated mitochondria, indicate the epsilon-[3H]ATP is not transported through the inner membrane by the adenine nucleotide carrier and is therefore not utilized by the 2,4-dinitrophenol-sensitive F1-ATPase (EC 3.6.1.3) that functions in oxidative phosphorylation. However, epsilon-ATP is hydrolyzed by a Mg2+-dependent, 2,4-dinitrophenol-insensitive ATPase that is characteristic of damaged mitochondria. 3. epsilon-ATP can be utilized quite well by the exposed F1-ATPase of sonic submitochondrial particles. This epsilon-ATP hydrolysis activity is inhibited by oligomycin and stimulated by 2,4-dinitrophenol. The particle F1-ATPase displays similar Km values for both ATP and epsilon-ATP; however, the V with ATP is approximately six times greater than with epsilon-ATP. 4. Since epsilon-ATP is a capable substrate for the submitochondrial particle F1-ATPase, it is proposed that the fluorescent properties of this ATP analog might be employed to study the submitochondrial particle F1-ATPase complex, and its response to various modifiers of oxidative phosphorylation.


Effect of liposomes containing cholesterol on adenylate cyclase activity of cultured mammalian fibroblasts.

Liposomes prepared with cholesterol and dipalmitoyl phosphatidylcholine were incubated with a clone of normal rat kidney fibroblast of cells in culture. The cells took up [14C]cholesterol in proportion to the concentration of liposomes in the incubation medium, and the uptake increased with time over the four hours of study. Two cell membrane enzymes, adenylate cyclase and (Na+ + K+)-ATPase, exhibited decreased activity after treatment with cholesterol-containing liposomes. The decrease in adenylate cyclase activity was directly proportional to the uptake of [14C]cholesterol. When a variety of subclones of NRK 5W were examined some were found to respond to cholesterol treatment and some did not. These data are consistent with the view that membrane cholesterol content plays a role in controlling the activity of some plasma membrane enzymes.


Proteolytic modification of staphylokinse.

There are three types of staphylokinase of different isoelectric points (6.7, 6.1 and 5.7). Staphylokinse of pI 6.7 was converted to that of pI 6.1 and then to that of pI 5.7 by the treatment with trypsin. Heterogeneity of staphylokinase might be the result of post-translational modification by proteolytic enzyme.


Reaction mechanism of erythrocyte phosphofructokinase.

The reaction mechanism of erythrocyte phosphofructokinase (PFK) was investigated by the initial velocity and the product inhibition. Intersecting lines obtained with initial velocity studies are consistent with a sequential mechanism and the formation of ternary complex as an intermediate. The product inhibition studies support an ordered Bi Bi mechanism in which fructose 6 phosphate (F6P) is the first substrate binding and adenosine diphosphate (ADP) is dissociated from the enzyme before fructose-1,6-P2 (FDP).


A new experimental model of hyperphenylalaninemia in rat. Effect of p-chlorophenylalanine and cotrimoxazole.

A new experimental model of hyperphenylalaninemia was proposed. Combination of p.chlorophenylalanine, strongly inhibitor of phenylalanine hydroxylase, and cotrimoxazole, presumably inhibitor of dihydropteridine reductase, produced a good inhibition of phenylalanine hydroxylation in vivo. Thus phenylalaninemia reached values similar to those found in PKU patients, without administration of excess phenylalanine. Tyrosine concentrations remained near the control values and a phenylketonuria occurred.


[Changes in the activity and tertiary structure of beta-amylase from wheat seeds under the effect of salts].

Changes are observed of 1-anylinonaphtalene-8-sulphonate probe fluorescence intensity, connected with beta-amylase in the presence of Ca(NO3)2, Mg(NO3)2, KNO3, NH4NO3 and (NH4)2SO4 at a concentration range within 10(-4)--1 M. Considerable decrease of the fluorescence intensity was observed under the addition of all the salts mentioned at concentration of 10(-3)--10(-4) M. A quantum yield increase of probe fluorescence was noted for Mg(NO3)2 (10(-4) M). High concentrations of Ca(NO3)2 and Mg(NO3)2 (0.25--1 M) also resulted in a sharp increase of the fluorescence intensity. Changes of beta-amylase activity took place simultaneously. The changes of the enzyme activity are suggested to be due to changes in the conformation of the enzyme protein under the effect of salts.


[Osmotic activity and ionic permeability of membrane vesicles from Streptococcus faecalis and Micrococcus lysodeikticus cells].

Membrane fractions containing osmotically active vesicles with sufficiently low membrane permeability for K+, Na+ and Cl- ions typical for the intact cell membrane were isolated from the cells of the glycolyzing bacterium Streptococcus faecalis. In their osmotic properties and ionic permeability the membrane fractions of S. faecalis were found similar to those of the respiring bacterium Micrococcus lysodeikticus, which are capable of the energy-dependent potassium transport. It may be thus assumed that the S. faecalis fractions obtained may be used to study ionic transport. The removal of proton-dependent ATPase of the S. faecalis membrane preparations did not affect the permeability of membranes for K+ ions which is indicative of different mechanisms of proton and potassium translocation.


[Electrophoretic study of muscle extracts of low ionic strength].

The method of Na-dodecylsulfate electrophoresis in polyacrylamide gel demonstrated that the so-called tonoactomyosin of smooth muscles extracted from the muscle homogenate with salt media of low ionic power represented a complicated protein system into whose composition there was included a heavy myosin chain with the mol wt of 210000, premyosin subunit with the mol wt of 230000, actin, and, possibly, a number of other proteins. The extracts of low ionic power possessed Mg2+ and Ca2+ activated by ATP-ase activity. The premyosin subunit was also revealed in the extracts of low ionic power from the skeletal muscle homogenates. It is supposed that premyosin subunit was included into the enzymatic system responsible for the ATP-asic properties of the extracts of low ionic power from the homogenates of different types of muscles.


Light and electron microscopy study on urethral regeneration.

In a series of experiments on dogs, it was feasible to replace a segment of urethra using wide-mesh Dacron. Light and electron microscopy study on the regenerated urethra showed no evidence of muscle, cavernous tissue and nerve regeneration. Although an excess of fibrous tissue surrounded the regenerated urethra, there was no change in the calibre of the new urethra after 7 months' observation.


Myocardial lipid metabolism in cardiac hyper- and hypo-function. Studies on triiodothyronine-treated and transplanted rat hearts.

Lipid composition of the myocardium and in vitro lipid metabolism were studied in hearts from young rats after 30 days of treatment with triiodothyronine (100 microgram/kg per day) and in heterotopically isotransplanted hearts of inbred adult rats 6 days after surgery. The former served as an experimental model of cardiac hyperfunction, while the latter, empty beating hearts, served as a model of cardiac hypofunction. In hearts from hyperthyroid animals the concentration of phosphatidylcholine, phosphatidylethanolamine, cardiolipin, and the incorporation of 14C-labelled palmitic and erucic acid into these phospholipids were increased significantly as compared with controls. In contrast, the triglyceride concentration and the incorporation of palmitate into triglyceride was significantly decreased. In transplanted hearts, the phospholipid concentration and the incorporation of 14C-labelled fatty acids into phospholipids were significantly decreased as compared with the hearts of the inbred host rats of the same age. The results indicate that the mechanical performance of the heart affects the phospholipid composition, which may be a reflection of increased or decreased proliferation of subcellular membranes in sustained cardiac hyper- or hypo-function.


Platelet dopamine uptake in Huntington's chorea and Gilles de la Tourette's syndrome: effect of haloperidol.

Uptake of 14C-dopamine by human platelets has been studied in two diseases, namely Gilles de la Tourette's syndrome and Huntington's chroea, in which abnormal metabolism of dopamine has been implicated. Platelets from untreated Huntington's chorea patients showed a small increase in Km and Vmax.; platelets from patients in all other groups showed an uptake identical with the controls. Haloperidol (10(-5)M) was also shown to be a strong non-competitive inhibitor of 14C-DA uptake by platelets. This property is probably unrelated to the drugs' action in ameliorating the symptoms of Huntington's chorea which is likely related to the increase in cholinergic neuronal activity produced by neuroleptic blockade of dopamine receptors.


Antitryptic property of cancer-related glycoprotein EDC1.

Cancer-related urinary glycoprotein EDC1 inhibits the action of trypsin and chymotrypsin on casein and synthetic substrates. The amino acid and carbohydrate compositions of EDC1 are different from those reported for pregnancy-related urinary trypsin inhibitors.


[Cardiomyopathies].

Cardiomyopathies have been characterized as diseases of the heart muscle of unknown cause. The dilated type [idiopathic cardiomegaly] cannot be regarded as a separate entity, but a uniform final result of myocardial damage due to various factors. Hypertrophic cardiomyopathy [asymmetrical hypertrophy of septum] probably represents a genetically conditioned disease with characteristic clinical and pathological features.


[Neurogenic muscular lesion presenting a picture of "central core disease"].

A neurogenic lesion has been described in mother and son. In the son there was a prevalence of denervation changes whereas reinervation ones prevailed in the mother. In both, "central cores" were present in aggregations of type-1 fibres. In the authors' opinion the findings represent a neurogenic lesion (also verified clinically and electromyographically), less advanced in the son and more advanced in the mother, ultimately stabilizing to yield a pattern resembling that of the "central core disease".


Localization of the membrane perturber adamantylsulfate in sarcoplasmic reticular vesicles.

The properties of a new membrane perturbing agent, adamantyl sulfate (A-1-S) are described. Lobster sarcoplasmic reticular vesicles (SRV) were used as a test membrane system and the activity of the Ca2+--Mg2+-dependent ATPase in conjunction with spin label data was used to determine the location of A-1-S in the membrane. The results suggest that A-1-S perturbs only the polar region of the SRV and that this causes loss of ATPase function. Thus, ATPase activity requires integrity of the membrane polar region.


Voluntary organizations for handicapped children and their families: the meaning of membership.

Two surveys of families caring for very severely disabled children at home reveal that about half the families belong to a voluntary organization. Membership varies by disease, social class, income, family composition and locality. Over half the non-members would like to belong to such organizations and practical obstacles are the most common reason for not belonging. The principal benefits derived by members are the opportunities to share problems and exchange information and advice. In general such bodies hava a role that is different from and complementary to statutory services.


Transcutaneous electrical neurostimulation: a new therapeutic modality for controlling pain.

Transcutaneous electrical neurostimulation relieves chronic and acute pain by blocking the transmission of pain impulses with comfortable electrical stimulation of light touch sensation. The original Gate Control Theory of Melzack and Wall provides a working model to explain the significant pain relief afforded patients. As high as 80% of selected patients presenting with a wide variety of causes could achieve some relief after treatment. This comfortable, safe method is finding wide application in clinical practice.


Meeting the needs of handicapped children and their families. The evolution of Honeylands: a family support unit, Exeter.

A support service for families with mental, physical, sensory or environmental handicap has evolved from a paediatric ward of a District Hospital. Expressed parental needs have been the source of evolutionary change. About 200 families use the various services of specific therapy, day or longer term residential relief, playgroups for those with special needs, school for the chronically ill. The location is a remodelled stately home on large grounds close to the centre of a city of 100 000, and serves a district of 300 000. The demand for permanent residential placement in the age group under 11 years in this area appears to have been reduced by 80%.


Parents of Down's syndrome babies: their early needs.

The paper reports the results of detailed interviews with parents of Down's syndrome infants shortly after their being informed of the diagnosis. It reviews previous studies and confirms a number of findings. 1. The majority of parents wish to be told of the diagnosis as soon as possible and with the spouse present. 2. They do not automatically resent the 'teller'. 3. They wish to be told directly but sympathetically, in private and have access to the baby. 4. Several interviews are needed at short intervals following the initial telling for parents to ask further questions and to assimilate more information about their child's condition.


Physically handicapped children in long-stay hospitals.

Six thousand five hundred handicapped children live permanently in long-stay hospitals, where their needs may not be met because of lack of resources within the hospital, eg. there is a shortage of therapy staff in long-stay hospitals. These children could be accommodated in the community if local authorities were prepared to make adequate residential provision for them. The children are likely to suffer emotional distress in hospital, because there is a grave shortage of nursing staff and very little understanding about the mothering needs of children in institutions. This paper is based on some of the findings of a 2-year study into the care of 223 multiply handicapped children in eight mental handicap hospitals. The study was financed by the Spastics Society, and undertaken from the Thomas Coram Research Unit at the University of London Institute of Education.


Industrial rehabilitation of dermatitis patients.

Industrial rehabilitation is identified as an integral part of the process of patient resettlement. The organization of the Government-sponsored Employment Rehabilitation Service is described. The low incidence of dermatitis as seen by medical advisers in that Service is explained. Ways in which employment medical advisers can provide complementary support to consultant dermatologists is suggested.


Occupational protein contact dermatitis in food handlers.

The preparation of food in restaurant kitchens carries a high risk of occupational dermatoses. Analysis of 33 cases revealed four different etiological types. Simple irritant dermatitis was rare (2 cases), plain contact dermatitis was more common (6 cases). Fifteen patients had relevant patch tests and scratch tests; ten had positive scratch tests only to explain the cause of their dermatitis. The last type was termed protein contact dermatitis. The major type IV allergens incriminated were metals, onion and garlic. The major proteinaceous allergens indicated by history and test results were fish and shell-fish. Open patch tests with the incriminated foods may cause erythema or oedema on normal skin after 20 minutes. Previously eczematous, now normal looking, skin often responds with a crop of dyshidrotic vesicles preceded by erythema and itching 30 minutes after the application of an open test. Examination for specific IgE is not always positive in such cases. Inhalant allergy was rare. The results indicate that food handlers are sensitized by the protein they touch, and then react to later contact with the proteins. Protein contact dermatitis is similarly common among veterinary surgeons, while the importance in other occupational groups remains to be studied.


Cross-reactions between ethylenediamine, diethylenetriamine and triethylenetetramine.

A consecutive series of 1544 patients and 137 patients in occupational contact with epoxy resins were tested with ethylenediamine and/or triethylenetetramine; some were tested with diethylenetriamine. Guinea pigs sensitized to triethylenetetramine were tested with ethylenediamine and diethylenetriamine. The results showed that cross-reactions may occur between triethylenetetramine and ethylenediamine, although the majority of the patients were sensitized to only one of the compounds.


The chamber-scarification test for irritancy.

A procedure has been designed (the chamber-scarification test), which possesses greatly increased sensitivity for assessing the irritancy of topically applied materials. A forearm test site is criss-cross scarified by drawing a 30-gauge needle over the skin with just enough pressure to cleave the epidermis without drawing blood. The test agent is applied in an aluminum chamber once daily for 3 days. The advantages of the method over conventional patch testing are: enhanced capacity to measure mild irritants, reduced time (3 days versus 10 to 21 days), less effort, less cost, less discomfort for the volunteers and greater reproducibility.


Occupational allergy from 1,2-benzisothiazolin-3-one and other preservatives in plastic emulsions.

Two male employees in an industry producing plastic emulsions acquired contact dermatitis from preservatives. One was sensitized to both components in a preservative, i.e. 1,2-benzisothiazolin-3-one and ethylene diamine. The other man acquired a contact allergy to 1,2-benzisothiazolin-3-one and to another preservative, formaldehyde.


The electrocardiogram in aortic valvular atresia.

In a review of the electrocardiograms of 27 patients with aortic valvular atresia,  several showed an unusual pattern. In two, the Wolff-Parkinson-White syndrome was present, and in the third, complete right bundle-branch block was seen. The study also confirms that left axis deviation and left ventricular hypertrophy can occur rarely. No patient showed a Q wave in lead V6.


Silent unilateral pulmonary venous obstruction. Occurrence after surgical correction of transposition of the great arteries.

An 11-year-old girl was found to have completely obstructed left pulmonary veins eight years following corrective surgery for transposition of the great arteries. The patient was acyanotic and asymptomatic. Retrograde flow of arterial blood from the affected left lung accounted for an angiographic appearance that mimicked occlusion of the left pulmonary artery and resulted from a failure of systemic venous development. Pulmonary venous anatomy could only be demonstrated by pulmonary arterial wedge angiographic studies. This experience emphasizes that complete unilateral pulmonary venous obstruction may occur in an asymptomatic patient and underlines the importance of investigating pulmonary venous anatomy in any patient with gross inequality of the distribution of pulmonary blood flow.


Symptomatic osseous sarcoidosis with findings on bone scan.

Twenty-one years after the onset of sarcoidosis, a 51-year-old woman experienced pain in the lower portion of her back, which proved to be the result of sarcoidosis involving the pelvis. The pelvic abnormality consisted of osteosclerotic and osteoblastic lesions. A bone scan showed several other areas of increased uptake, and the diagnosis was confirmed by bone biopsy. The patient improved with treatment with steroids, but the findings on the x-ray film and the bone scan did not change. Sarcoidosis may cause obscure, but symptomatic, osseous lesions.


Synergistic effects of chlorpromazine and perphenazine on several chemotherapeutic agents. I. General profile of the effects measured by the filter paper strip-agar diffusion method with Escherichia coli and Pseudomonas aeruginosa.

The combination effects of chlorpromazine (CPZ) and periphenazine (PPZ) with beta-lactam antibiotics (ampicillin, carbenicillin, cefazolin) and nalidixic acid group compounds (nalidixic acid, piromidic acid and pipemidic acid) have been estimated to be synergistic by the filter paper strip-agar diffusion method (Dye's method) with Escherichia coli and Pseudomonas aeruginosa as test organisms. The observed synergism might be associated with their inhibition of various enzymes including ATPase and DNAase as well as with their specific binding to DNA. Similar synergistic effects of CPZ and PPZ have been shown by the broth dilution method. Based on these findings, it seems to be a fascinating project to devise a new phenothiazine drug without influence in mental disease that will have a greater measure of synergistic effect when combined with the above-studied antibacterial agents.


Vitamin A acid: a review of its pharmacological properties and therapeutic use in the topical treatment of acne vulgaris.

Vitamin A acid (retinoic acid: tretinoin) is a vitamin A derivative used in the topical treatment of acne. It acts by 'unseating' comedones, improvement developing slowly over a period of 2 to 3 or more months, and is also said to prevent the formation of new lesions. About three-quarters of patients with acne vulgaris benefit from treatment. In controlled studies, results achieved after a 3 to 4 months course of treatment were superior to those with sulphur-resorcinol-salicylic acid. When compared with benzoyl peroxide, results were variable and appear to depend on the length of treatment, the types of formulations used, and the concentrations compared. Application of vitamin A acid should be continued until the patient has been free of new lesions for several months. Further continued application at a less frequent interval or using a less active dosage form may help to prevent exacerbations of acne. A systemic antibacterial agent such as tetracycline can be given as well as in patients with moderate to severe lesions. Vitamin A acid is used in conjunction with gentle washing (to remove surface oil) but should be applied to a dry skin to avoid unnecessary irritation. Patient education and encouragement are crucial during the initial phase of treatment when microcomedones may be converted to pustules prior to desquamation.


ATPase activities, Ca2+ transport and phosphoprotein formation in sarcoplasmic reticulum subfractions of fast and slow rabbit muscles.

Subfractionation of sarcoplasmic reticulum from fast-twitch and slow-twitch rabbit skeletal muscles was performed on a sucrose density gradient. Vesicle fractions were characterized by: measurement of (Ca2+,Mg2+)-dependent (extra) ATPase, Mg2+-dependent (basal) ATPase, Ca2+ uptake characteristics, polypeptide patterns in sodium dodecylsulphate polyacrylamide gel electrophoreses, phosphoprotein formation and electronmicroscopy of negatively stained samples. In fast-twitch muscle, low and high density vesicles were separated. The latter showed high activity of (Ca2+,Mg2+)-dependent ATPase, negligible activity of Mg2+-dependent ATPase, high initial rate and high capacity of Ca2+ uptake, high amount of phosphorylated 115000-Mr polypeptide, and appeared morphologically as thin-walled vesicles covered with particles of 4 nm in diameter. Low density vesicles had little (Ca2+,Mg2+)-dependent ATPase but high Mg2+-dependent ATPase. Although the initial rate of Ca2+ uptake was markedly lower, the total capacity of uptake was comparable with that of high density vesicles. Phosphorylated 115000-Mr polypeptide was detectable at low concentrations. Instead, 57000 and 47000-Mr polypeptides were characterized as forming stable phosphoproteins in the presence of ATP and Mg2+. Negatively stained, these vesicles appeared to have smooth surfaces. It is suggested that low density vesicles represent a Ca2+ sequestering system different from that of high density vesicles and that Mg2+-dependent (basal) ATPase as well as the 57000 and 47000-Mr polypeptides are part of the Ca2+ transport system within the low density vesicles. According to the results from slow-twitch muscle, Ca2+ sequestration by the sarcoplasmic reticulum functions in this muscle type only through the low density vesicles.


Siderophores: diverse roles in microbial and human physiology.

Siderophores, defined as high affinity iron(III) ion transport agents, and their cognate membrane-bound receptor complexes, occur in the enteric bacteria Escherichia coli and Salmonella typhimurium. The total system is tightly regulated by iron repression. The transport properties of the specific siderophores enterobactin and ferrichrome (which is not made by these particular enteric bacteria) have been examined in detail. In E. coli the outer membrane receptor for ferrichrome is programmed by the tonA gene; the receptor also serves as the binding site for T1, T5, phi80, albomycin and colicin M. Similarly, in S. typhimurium phage ES18, ferrichrome and albomycin compete for the genetic equivalent of the tonA locus. The ability of ascorbic acid to protect against atherosclerosis as well as rhinovirus infection in humans may be related to the role of the vitamin in iron metabolism. Deferrisiderophores are clinically useful in the treatment of acute and chronic iron poisoning but, on the other hand, they could constitute a natural hazard by transporting actinides, such as 239Pu, through the food chain.


Transport mechanisms in the preimplantation mammalian embryo.

Compaction is associated with major changes in the transport processes in preimplantation embryos. Before this time the processes are homocellular, in which all the component cells exchange materials across their cell membranes with a common environment. After compaction the outer trophoblast cells become organized into a simple, squamous epithelium which is capable of transcellular vectorial transport, that selectively controls the movement of materials into the embryo. Measurements of the intracellular concentrations and membrane permeabilities of Na+, K+ and Cl- in the mouse oocyte and two-cell embryo have demonstrated that they undergo significant changes during this period of development. The development of transcellular transport across the trophectoderm is fundamental in the regionalization of the embryo. These physiological mechanisms are involved in the formation of the blastocoele fluid, and may be dependent on the development of regionally located Na+, K+-ATPase on the juxtacoelic surfaces of the trophoblast cells.


Transport of cytoplasmically synthesized proteins into the mitochondria in a cell free system from Neurospora crassa.

Synthesis and transport of mitochondrial proteins were followed in a cell-free homogenate of Neurospora crassa in which mitochondrial translation was inhibited. Proteins synthesized on cytoplasmic ribosomes are transferred into the mitochondrial fraction. The relative amounts of proteins which are transferred in vitro are comparable to those transferred in whole cells. Cycloheximide and puromycin inhibit the synthesis of mitochondrial proteins but not their transfer into mitochondria. The transfer of immunoprecipitable mitochondrial proteins was demonstrated for matrix proteins, carboxyatractyloside-binding protein and cytochrome c. Import of proteins into mitochondria exhibits a degree of specificity. The transport mechanism differentiates between newly synthesized proteins and preexistent mitochondrial proteins, at least in the case of matrix proteins. In the cell-free homogenate membrane-bound ribosomes are more active in the synthesis of mitochondrial proteins than are free ribosomes. The finished translation products appear to be released from the membrane-bound ribosomes into the cytosol rather than into the membrane vesicles. The results suggest that the transport of cytoplasmically synthesized mitochondrial proteins is essentially independent of cytoplasmic translation; that cytoplasmically synthesized mitochondrial proteins exist in an extramitochondrial pool prior to import; that the site of this pool is the cytosol for at least some of the mitochondrial proteins; and that the precursors in the extramitochondrial pool differ in structure or conformation from the functional proteins in the mitochondria.


Human platelet actin. Evidence of beta and gamma forms and similarity of properties with sarcomeric actin.

Human blood platelet actin was purified using 30% sucrose to extract actomyosin and potassium iodide to dissociate actomyosin and to depolymerize actin. Pure actin thus obtained resembles skeletic muscle actin in its polymerization properties, CD spectra and ability to activate myosin myosin Mg2+-ATPase. Isoelectric focusing gel analysis shows that human blood platelet actin exists in beta and gamma forms. The ratio of beta to gamma forms is of 5 in purified actin, in whole cell extract and in all the fractions studied.


Responses in human pretibial muscles to sudden stretch and to nerve stimulation.

Electromyograms have been recorded from the human tibialis anterior muscle during voluntary contraction. The accessibility of the nerve to this muscle (common peroneal) has permitted a comparison of reflex responses to low threshold electrical stimulation of the nerve with those to stretch of the muscle itself. Nerve stimulation elicited a reflex at monosynaptic latency (V1 at 28-29 ms) and a second response (V2 at 50-52 ms). A tendon tap induced  two responses (M1 at 29 ms and M2 at 50 ms). The responses to a 'ramp' stretch were similar. The homology of V1 with M1, and of V2 with M2 is discussed. V2 and M2 probably correspond to the 'transcortical' reflexes described from other muscles. Neither V1, V2, M1 nor M2 were influenced by anaesthesia of the foot. M1 and M2 were both reduced in amplitude by a selective gamma-efferent block produced by local anaesthetic in the common peroneal nerve. It is concluded, that muscle spindles are the receptors predominantly responsible for M2 ('transcortical') responses. The amplitudes of M1 and M2, but not V1 and V2 were augmented by prior instruction to 'resist' the stimulus. This is interpreted as evidence for voluntary modulation of gamma-efferent activity at a constant force of contraction.


Possible role of intestinal alkaline phosphatase activity in thiamine transport.

Thiamine deficiency caused a marked decrease of intestinal alkaline phosphatase (al-Pase) activity, but had no effect on the Ca++-ATPase activity and Ca++-absorption in rats. The al-Pase activity was significantly decreased 1 h after oral administration of ethanol at 0.5 and 2.5 g/kg. In contrast, Mg++-, Ca++-and (Na+ + K+)-ATPase activities did not change after the administration of ethanol. These findings show that the al-Pase activity, unlike the Ca++-ATPase activity, is not related to Ca++-absorption. A possible role of al-Pase activity in the active transport of thiamine in the intestine was discussed.


Prostaglandin E1-induced fever in rabbits pretreated with p-chlorophenylalanine.

The prostaglandin E1-induced fever was neither potentiated nor attenuated at all levels of the ambient temperatures (2, 22 and 32 degrees C) studied after pretreatment of the conscious rabbits with p-chlorophenylalanine, when compared to the untreated control.


Effects of streptozotocin on early rat embryos grown in culture.

Addition of 1 mg/ml streptozotocin to serum in which 10-day rat embryos are cultured reduces their growth and viability. There is therefore a risk that administration of this drug to pregnant animals to induce diabetes could also have direct, deleterious effects on the embryos.


Erythromycin stearate in acne vulgaris: its effect on the skin surface lipids and on the activity of purified pancreatic lipase.

To study the mechanism of action of erythromycin stearate in acne vulgaris, the composition of the skin surface lipids was analyzed before, during and after treatment (500 mg daily for 1 week, 250 mg daily for 2 months) in 17 patients. Quantitative thin-layer chromatography showed that the fatty acid fraction in the skin surface lipids decreased significantly during the treatment period. The clinical effect was good in 14 of 17 patients. Further investigations were performed on the effect of erythromycin stearate on purified pancreatic lipase. The enzyme activity was not inhibited by exposure to the drug.


[The quantitative cineangiography. Part II. Computerized analysis of the left ventricular volumes in man (author's transl)].

The values of left ventricular volumes (EDV and ESV) were determined in 35 patients with various heart diseases by computerized reading technique utilizying both the area-length and the slice methods. The data thus obtained were compared both with those derived manually and with those obtained following injection of 113mIn into the left ventricle and monitoring by external counting the dilution curve. Good agreement among the data obtained by the various methods was found. It appears, then, in the clinical practice, the computerized method has definite advantages over the others since it allows quick determination of the data and therefore examination of multiple frames.


[Cytogenetic differences in radiation effects on red-haired field mice from different geographic populations].

The paper presents the data on the effect of X-rays on the incidence of chromosome aberrations and on the mitotic activity of bone marrow cells in two geographical populations of Clethrionomys glareolus. It is shown that the percentage of aberrant cells at different intervals after the irradiation (350 r) is higher in the Moscow population than in the Komi ASSR population. The fractionation radiation results in different increase in the number of aberrant cells. The change of the mitotic activity after X-irradiation was also different in these two geographical populations.


[Medico-genetic study of the population of Uzbekistan. I. Incidence and variety of hereditary pathology].

In district of the Samarkand province the screening for families burdened with multiple cases of non-infectious diseases was performed. The principles of the applied screening procedure are described in the present paper. In the course of clinical examination 98 families were detected, 55 of which included more than one person suffering presumably with Mendelian diseases and 43--with multifactorial disorders. Over 30 nosological forms were found, among which orthopaedic and neurological forms were the most frequent. As a rule, identical cases were detected in one or two families. The role of certain genetic processes in the distribution of hereditary diseases in the Uzbek population is discussed.


Hematologic changes in Down's syndrome during infantile and early childhood period.

"Twenty cases of Down's syndrome and 25 age-matched normal controls were subjected to hematologic study including Hb, R.B.Cs, W.B.Cs., HbF., bone marrow, protein electrophoresis and chromosomal study. Peripheral blood and bone marrow showed noticeable increase in granulocytes, increase in staff, and decrease in lymphocytes in mongols as compared to the controls. HbF was lower than normal in 18 cases. The other two showed abnormally high HbF. Protein electrophoretic study showed normal pattern except one case in which a remarkable decrease in the Beta and Gamma Fraction was noticed".


A histochemical study of fibrinolytic activity and inhibition of plasmin in the lungs of some animal species.

Determined by the histochemical fibrin slide technique, the fibrinolytic activity of  lungs decreased in the following order of species: rat, mouse, pig, guinea pig, rabbit, cattle. Examined by the fibrin slide 'sandwich' technique, inhibition of plasmin showed the opposite mode of decrease. The possible role of these differences in the pathogenesis of various disorders of the lungs in the different species is discussed.


[Antiallergic asthma effect of ipatropium bromide (Sch 1000) in dogs (author's transl)].

Antiasthmatic effect of ipratropium bromide (Sch 1000) which is a quarternary ammonium derivative of atropine was investigated in comparison with atropine in anesthetized dogs. Asthmatic responses were provoked with inhalation of Ascaris suum antigen. Sch 1000 (0.1 approximately 0.3%) and atropine (0.1 approximately 0.3%) were given by inhalation for 10 min prior to or after the antigen inhalation. Pretreatment of Sch 1000 and atropine inhibited the increase in respiratory resistance (Rrs) induced by antigen by 55 approximately 75% and 25 approximately 50%, respectively. After treatment with each drug, the enhanced Rrs was reduced by 40 approximately 55% and 35 approximately 40%, respectively. The activity of Sch 1000 was three fold stronger than that of atropine. Sch 1000 and atropine also effectively inhibited the increase in airway secretion produced by antigen, while both drugs in 0.3% solution had no effect on the normal bronchial tone and secretion. The findings suggest that vagal activity is involved in allergy related asthma and inhalations of anticholinergic drugs such as Sch 1000 show promise in the treatment of bronchial asthma.


[X-ray negative pulmonary carcinoma with positive sputum cytology (author's transl)].

The repeated finding of malignant or suspicious cells in the sputum of an apparently normal person must not be ignored. Immediate and intensive attempts should be made to localize the carcinoma. Sometimes, in the presence of a central tumour an early diagnosis can be made radiologically. With peripheral tumours and early diagnosis is more likely. The most successful method for the early localisation of an occult bronchial carcinoma is fibre optic bronchoscopy, with selective bronchial aspiration. Consistent finding of malignant cells in the secretions from a lobar bronchus, provided contamination can be excluded, justifies surgery such as a lobectomy. Delay in instituting treatment while waiting for radiological or bronchoscopic confirmation reduces the chance of successful surgery because of the possibility of metastases or the development of cardiological or respiratory complications.


[Radiological aspects of emphysema (author's transl)].

Radiology is the basic factor in diagnosis of emphysema. Further differentiation is possible by assessment of the concomitant cardio-vascular changes. By these means, the type of emphysema (accompanying emphysema in chronic bronchitis, or primary emphysema) can be established.


[Supravalvular aortic stenosis: Congenital and acquired changes in the ascending aorta near the valve (author's transl)].

Three patients with supravalvular aortic stenosis are described. One was a typical, sporadic-type supravalvular aortic stenosis, another a predominant aortic valve stenosis as part a complex heart lesion and the third inflammatory shrinking of the anulus fibrosus with an inflammatory aortic valve stenosis. The means of diagnosis are discussed. Angiocardiography and aortography are essential in order to demonstrate the pathology, haemodynamics, relation to the coronary arteries and the sinus of Valsalva, and in order to show other abnormalities. The aetiology and pathogenesis of various types of supravalvular aortic stenosis are discussed.


[Special indications for using the whole body scanner (author's transl)].

In addition to the role of the body scanner in the diagnosis of diseases of the body cavity and parenchymal organs, the authors review the scope and indications for using whole body computer tomography in special situations. Examples are given of its use in the diagnosis of tumours in the vicinity of the skull base, in the orbits, the facial skeleton, soft tissue tumours, bone diseases and CT-controlled biopsies.


[The diagnostic value of mammography during pregnancy and lactation (the radiological features of the breast during pregnancy) (author's transl)].

During early and late pregnancy and lactation, there is an increase in the size of the breasts, with increased density of their structure. The moderately dense parenchyma in young women is characterised by a) wavy contours of the subcutaneous zone and b) linear or oval translucencies in the central parenchyma. Our investigations indicate that it usually takes three months after delivery before the breast structure returns to normal and one is able to interpret the mammogram satisfactorily. For this reason mammography should be avoided during these three months and if there is a suspicion of disease in the breast, a biopsy should be carried out immediately.


[A comparison of radiographic and operative findings in lumbar disc prolapse (author's transl)].

Myelography with water soluble contrast is a valuable method of diagnosis for suspected disc prolapse. In our experience complications are rare and therefore the indications for contrast examinations should not be too strict. Only in this way is it possible to localise the level accurately, so that surgical intervention can be confined to the appropriate level.


[Myelography with water soluble contrast for malformations of the conus medullaris and filum terminale (author's transl)].

Contrast demonstration of the distal dural sac and its contents is essential for an understanding of the regional pathology in cases of occult or previously operated non-occult forms of lumbar myelodysplasia. Only in this way is it possible to demonstrate the position of the conus medullaris, the course of the nerve roots, thickening of the filum terminale or other soft tissue abnormalities. Of various methods, the most detailed information can be obtained by the use of water soluble contrast injected after careful, high lumbar puncture (L 2/3). This is illustrated in five cases in which Dimer X was used. In view of its proven low neurotoxicity, Amipaque, which is now available in Germany, will be used in future.


[Abnormal scintigrams in demyelinating diseases of the brain (author's transl)].

In 6 patients with acute or exacerbating demyelinating disease and in 2 cases suffering from adrenoleucodystrophy (Schilder's disease) brain scintigraphy revealed areas with increased isotope uptake. The pathological foci were verified by autopsy in 4 cases and by inspection in 1. These foci are difficult to distinguish from other localized brain diseases causing increased isotope uptake; in addition to the clinical course and to spinal fluid abnormalities reversibility of the scintigraphic lesions indicate demyelinating diseases. The typical pattern of symmetrical lesions within the white matter and the progression of abnormalities from the occipital to the frontal lobe speak in favor of Schilder's disease.


[Gastro-intestinal bleeding and vascular calcification in pseudoxanthoma elasticum (author's transl)].

Pseudoxanthoma elasticum is an hereditary disease of elastic fibres affecting the skin, eyes and the cardio-vascular system. The radiologist should be familiar with this disease; the vascular changes can lead to bleeding from the gastrointestinal tract, which can be elucidated angiographically. There may also be circulatory disturbances in the extremities associated with early and pronounced calcification of the media and intima.


[Radiological changes in glomerulo-nephritis--typical and atypical changes in 368 patients (author's transl)].

Atypical radiological excretory patterns were analysed amongst 368 patients with histologically proven glomerulonephritis. Amongst the functional, i.e. reversible, changes 17% showed radiological abnormalities. In most cases, the clinical features indicated the diagnosis, but in a few it was necessary to add angiography to renal biopsy. The findings are discussed and related to the relevant literature.


[Diagnostic exploration of biliodigestive anastomoses with isotopes (author's transl)].

Using the radiopharmaceutical Solcoscint-Hepatobida (99mTc) and a high definition camera, sequential hepato-biliary scans were performed. Twenty-five patients were used to demonstrate the value of the method for the evaluation of biliodigestive anastomoses and for the recognition of post-operative complications. The method can be recommended in combination with radiological procedures or in situations where radiology cannot be used.


[Sequential hepato-splenic scintigraphy with 99mTc-pertechnetate in experimental post-hepatic block (author's transl)].

Using baloon catheters in the inferior vena cava, post-hepatic blocks were produced in experimental animals. Subsequent liver perfusion scintigraphy showed marked reduction in portal flow. The significance of these findings in the diagnosis of the Budd-Chiari syndrome and its differentiation by scintigraphy from an intrahepatic block in cirrhosis of the liver is discussed.


[A comparison of intravenous and infusion cholangiography with intraoperative and tomocholangiography (author's transl)].

Seventy-four patients are described who were examined by various cholangiographic methods. 1. In the diagnosis of stenosis of the papilla, intraoperative cholangiography was found to be the most reliable. Intravenous and infusion cholangiography were of equal value and provided less information than the intra-operative examination. 2. For stones, intravenous and infusion cholangiography is significantly better than the intro-operative cholangiogram. Tomography provides no additional information. 3. For stones in the papilla, the intra-operative method is best and is superior to intravenous and infusion cholangiography. Pre-operative tomography resulted in a loss of information.


[Programming of a 70 mm. serial technique (author's transl)].

An electronic programme selector for a 70 mm. serial technique is described. Its use is discussed, particularly in its quantitative aspects. The advantages are accuracy, reproducebility and flexibility.


[Modulation transmission function and detail recognition in tomograms (author's transl)].

Tomograms with linear movements and 40 degrees swing have shown that the usual T-modulation transmission function is inadequate and that the I-modulation transmission function is as significant as for plain films. Moreover, several selected modulation transmission functions are necessary. Even if resolution is high, detail recognition is reduced in relation to the threshold contrast. This is particularly true for the level of the cut and its close vicinity. On the other hand, pseudoimages are supressed by the threshold contrast.


[Complaints in the lumbosacral region and their management with Dolo-Neurobion].

Many patients complaining of acute pain in the lumbosacral area suffer from affections of intrapelvic organs (urinary bladder, prostate glands, female genital-organs). The routine diagnosis in such cases is described. In 53 own patients the analgesic and anti-inflammatory effect of Dolo-Neurobion has been evaluated. It is a combination drug consisting of the neurotropic vitamins B1, B6 and B12 and the analgesic metamizole. The treatment was started parenterally in the recommended doses and continued orally. If there were definite signs of infection in the pelvic area, additional antibiotics were administered after bacteriological tests. Dolo-Neurobion showed good or excellent results in 77,4% and moderate effects in 15,1% of the patients. There were no major side-effects or intolerance.


Grandmaternal age at birth of parents of children with trisomy 21.

The authors investigated the age of the parents and grandmothers of 262 children with simple trisomy 21. In cases in which the mother was under 30, the mean grandmaternal age was higher than that of the controls. This might mean that some of these cases, being the children of old mothers, began their lives as trisomic zygotes. The authors assume that not only maternal but also paternal mosaicism might be significant. They evaluate their results in light of genetic counseling and in consideration of practical conclusions that can be used in prenatal genetic diagnosis.