Difference between effects of conjugated estrogen on neurotics and non-neurotics of climacteric women complaining of menopausal symptoms and its clinical application for their screening.

In order to screen the neurotics and non-neurotics of climacteric women with menopausal symptoms, conjugated estrogen was injected intravenously and the reactions were compared. Menopausal symptoms were represented by Kupperman's menopausal index. After estrogen injection the non-neurotics showed a decrease of the index, i.e., alleviation of the symptoms, while the neurotics showed no change of the index. Taking advantage of this difference, a discriminant function between neurotics and non-neurotics was calculated using, as variables, Kupperman's menopasual indices determined before and after administration of the conjugated estrogen. The calculative screening obtained from this discriminant function yielded consistency with clinical diagnosis in about 94% of the neurotics and about 87% of the non-neurotics, suggesting that this test is of value in the screening of neurotics and non-neurotics in the climacteric women with menopausal symptoms.


Effect of nafoxidine (U-11,100A) on the induction of uterine peroxidase.

The relationship between the quantity of nuclear estrogen receptor complex formed and the amount of peroxidase induced by estradiol in immature rat uteri was determined. A good correlation was obtained between the quantity of 3H-estradiol specifically bound to the nuclear pellet and the amount of enzyme present 12 h after treatment with physiological doses of estrogen. Nafoxidine (U-11,100A) administered together with estrogen reduced signficantly the increase in peroxidase activity brought about by estradiol. Pretreatment with nafoxidine was less effective. The possible mechanism of action of this antiestrogen is discussed.


Inhibition of (3H) prostaglandin F2alpha binding to its receptors by progesterone.

The specific binding of [3H] prostaglandin (PG) F2alpha to bovine corpus luteum cell membranes was inhibited by progesterone. Progesterone inhibition of binding was dependent on membrane protein and independent of [3H] PGF2alpha concentrations in the medium. The lower inhibition of binding at high protein concentrations can be overcome by increasing the amounts of progesterone added. Progesterone inhibition of binding appears to be due to a decrease in the receptor number rather than a decrease in the receptor affinities. The kinetic properties (association and dissociation rates) of the remaining receptors were unchanged. The inhibition of [3H] PGF2alpha binding was observed by preincubating the membranes with progesterone or by adding at the beginning but not during incubation. The concentrations of progesterone that inhibited binding by about 50% do occur in bovine corpora lutea of estrous cycle and pregnancy.


Clonorchiasis and hepatic neoplasms.

Thirty-eight subjects from Hong Kong with chronic infestation by Clonorchis sinensis were studied. Ten of the patients died of hepatocellular carcinoma, seven of cholangiocarcinoma, and one each of carcinoma of the common bile duct and lymphoma. The major difference between the patients having cholangiocarcinoma and hepatocellular carcinoma was cirrhosis. Only one patient with cholangiocarcinoma had cirrhosis; whereas all but one patient with hepatocellular carcinoma had cirrhosis. The etiopathogenesis of these two tumors is substantially different.


Hepatocellular carcinoma in the Gambia.

A hospital based study of hepatocellular carcinoma was undertaken in The Gambia. The overall male incidence rate was 12.0/100.000, almost certainly artificially low but putting The Gambia readily into the areas with a high incidence of this disease.


[Localization of several rhodopsin regeneration enzymes in retinal rods].

The distribution of NAD kinase and glucose-6-phosphate dehydrogenase within membranes of both outer and inner retina rod segments was studied by the sucrose gradient centrifugation of crude outer segment preparations. Rhodopsin and retinoldehydrogenase served as markers for outer segment membranes, whereas succinate dehydrogenase was a marker for inner ones. It is shown that NAD kinase and glucose-6-phosphate dehydrogenase are localized within inner segment membranes of the photoreception cell and that the activity of these enzymes in the crude preparations is due to contamination of the inner segments.


[Synthesis of nicotinamide adenine dinucleotide in the nuclei of pigeon erythrocytes].

The nuclei of pigeon erythrocytes are capable of synthesizing NAD from nicotinamid-mononucleotides and ATP. Some data on the kinetics of NAD-pyrophosphorylase have been obtained: the optimal concentration of nuclei and the effect of various incubation time. The pretreatment of nuclei by Triton X-100, or by ultrasonics enhances NAD synthesis. The results suggest that cyclic 3',5'-AMP (Fluka) may have no effect on NAD synthesis. The control of the cell metabolism by NAD formation is considered.


[Enzyme, electron microscopic and polarographic characteristics of isolated rat brain mitochondria. III. Quantitative assessment of their distribution in fractions of the homogenate].

Activities of succinate dehydrogenase, succinate- and NAD-H-cytochrome c--reductases, and cytochrome c--oxidase was compared in 1 g tissue homogenate and homogenate fractions made from 1 g brain tissue using various solutions. Fractionation resulted in the increased activities of NADH- and succinate cytochrome reductases, and in the loss of succinate dehydrogenase activity, cytochrome oxidase was less influenced. These phenomena are regarded as signs of the interrelation between mitochondria and other constituents of brain cell within homogenates. Maximal quantity of mitochondria isolated from homogenates is no more than 20% of all the mitochondrial homogenates (according enzyme data). The electronogram of the brain mitochondrial preparation isolated in the Krebs--Ringer solution without glucose pointed out to a high homogeneity of mitochondria in the residue.


[The effect of ultraviolet radiation of different wave lengths on the concentration of DNA--fuchsin in the cells of Zajdel's ascitic hepatoma].

The cytophotometrical analysis of the relationships between the content of DNA--fuchsin and the duration of acid hydrolysis of the intranuclear DNA (the Feulgen reaction) in the Zaidela hepatoma cells allows to see the degree of the DNA--protein binding. The UV irradiation of different wave-lengths (254, 325 and 365 nm, resp.) irrespective of the degree of absorption by nucleic acids, causes changes in chromatin condensation, thus suggesting the labilization of DNA--protein bounds.


Fasting urine excretion of magnesium, calcium, and sodium in patients with renal calcium stones.

Urine excretion of magnesium (Mg), calcium (Ca) and sodium(Na) was studied in patients with renal Ca stones having normal kidney function (n= 60), and in matched controls (n= 60), on a free diet following an overnight fasting period. In some formers, Mg was lower than in normals, whereas Ca was unusually high resulting in a significantly higher molar Ca/Mg ratio (p less than 0.001). 2. In 3 out of 4 stone groups Na excretion was significantly elevated because of reduced tubular reabsorption. In normals, fractional Na excretion varied between 0.44 and 0.54% of endogenous creatinine clearance, whereas it exceeded 1% in the stone patients. Conversely, the molar ratio Na/Ca was equal in all groups. 3. Fasting urinary cyclic AMP was comparable in both populations supporting the assumption that in the majority of patients Ca- or Mg- wasting via urine may not be responsible for secondary hyperparathyroidism. In small selected groups, losses of divalent cations may act in concert, leading to stimulation of the parathyroid glands. 4. Correlations between minerals and Na reveal a close relationship between Na, Ca and Mg in terms of clearance and excretion rate in patients and controls. Fractional Na and Ca excretion are correlated in patients but not in normals. This suggests that in the absence of phosphaturia, factors other than extracellular volume expansion and/or hyperparathyroidism are operative in stone disease. 5. The origin of fasting natriuresis and relative hypercalciuria may be ascribed to a change, as yet not causally identified, in distal tubular Na reabsorption.


[Peptide hydrolase activity of different sections of the rat brain].

The protamine-splitting peptid hydrolase activity method was modified for using when analyzing the different areas of the rat brain. The tissue weight was 15-40 mg, only 3.5 mg was sufficient for investigation in a test tube. The indexes of neutral peptide hydrolase activity differed thrice and were arranged as follows: auditory and optic cortex--41, cerebellum--60, hypothalamic area and corpus striatum--69, hippocamp--89, corpora quadrigemina--92, pyramides and pons--120, medula--121, and thalamus--122, The deprivation of REM-sleep for 24 and 48 hours or total sleep deprivation for 24 hours did not cause changes in the peptide-hydrolase activity of the investigated brain areas.


[Differences in the enzymatic activity of mitochondria from enriched neuronal and glial fractions].

Studies were performed in the activities of certain enzymes from oxidoreductase group: cytochrome c-oxidoreductase (EC 1.6.99.3), succinate dehydrogenase succinates: cytochrome c-oxidoreductase (EC 1.3.99.1), cytochrome oxidase (EC 1.9.3.1) and malate dehydrogenase (EC 1.1.1.37) in mitochondria from neuronal and glial-enriched fractions. The mitochondrial fraction purity was observed by the electron microscope. The enzyme activity of the glial mitochondrial fraction was much higher than that in the neuronal mitochondria. Malate dehydrogenase from glial enriched fraction consists of three isoenzymes, while neuronal mitochondria had two isoenzymes of malate dehydrogenase. The neuronal mitochondria were found to be more stable to lubrol and digitonin.


[Study of leukocytic enzymes in patients with diffuse peritonitis].

Under observation were 25 patients with grave diffuse peritonitis. Histochemically, the activity of oxidation-reduction enzymes in leukocytes of peripheral blood was determined. It was found that the control of enzymic activity at the cellular level and determination of the concentration of lactic and pyruvic acids permitted the detection of hypoxic alterations in peritonitis, provided an opportunity to judge the dynamics of the pathological process.


[Determination of the content of biogenic amines and their precursors by a thin-layer chromatographic method].

A method is developed for a simultaneous determination of the content of biogenic phenyl- and indolalkylamines and their predecessors. The method includes preparation of a homogenate by cutting the animal tissue and its extraction in acidic butanol, purification of butanol from tissue by centrifugation, subsequent conversion of the substances from the alcohol phase to the aqueous one and lyophilization of the latter. Then thin layer chromatography is performed. For obtaining the neutral separating layer the mixture of the microcyrstalline cellulose JIT and silicagel is used. The mixture ethyl acetate--acetic acid--water (5:1.5:1.5) is used as a solvent. The thin layers of cellulose JIT or ecteolo-cellulose with the solvent 0.01-n HC1 and cellulose JIT with the solvent ethyl acetate--acetic acid-water (5:1.5:1.5) may be used, respectively, for determining the content of the reactions final products, when measuring the enzymic activities of DOPA-decarboxylase and 5-oxytryptophan-decarboxylase.


Serological study of an outbreak of paresis due to equid herpesvirus 1 (EHV-1).

Six cases of paresis occurred in a Swedish stud with 48 mares and a stallion. Complement-fixation tests revealed a recent infection with EHV-1 in most horses of the stud. Serumneutralisation tests showed rapid antibody-titre increases during the course of the disease. This type of antibody response was interpreted as induced by reinfection or, possibly, recurrent infection. Two diseased mares were sacrificed. No virus could be isolated from their central nervous system (CNS), liver or spleen, but there is a presumptive evidence for the presence of an antigen specific to EHV-1 in the CNS and liver. Neutralising antibodies to EHV-1 were demonstrated in the liver and kidneys following elution by acidification of the tissues. No such antibodies could be demonstrated in the brain and spinal cord. A possible reason for this failure is discussed.


[Agar gel diffusion precipitation and immunoelectrophoresis of the Aujeszky virus].

Two virulent and two vaccinal virus strains are dealt with. The study has been carried out by means of the diffusion precipitation reaction in agar gel and the immunoelectrophoresis technique using hyperimmune sera obtained from cocks as well as concentrated and purified antigens. It has been demonstrated that the virulent and the vaccinal (latent) strains of Aujeszky's disease virus cannot be differentiated serologically. The complex of antibodies induced by the virulent and the latent strains has proved to contain absolutely identical products. On the basis of the results obtained it is suggested to find some other means (markers) to differentiate the virulent from the latent strains of the virus.


[Effectiveness of a Bulgarian vaccine against Marek's disease in broilers].

Studies were carried out to establish the effectiveness of the immunization of broilers against Marek's disease using a Bulgarian vaccine produced with strain C3-1 of a turkey herpes virus. The experiments were done under the conditions of an industrial poultry dressing combine with a total of 52,450 day-old hybrid birds vaccinated at the rate of 1000 plaque-forming units (PFU), 39,450 birds vaccinated with 500 PFU each, and 91,564 unvaccinated control birds. After the 60-63-day fattening period was over the average value of the mortality rate was 2.17 per cent and 2.48 per cent in the vaccinated birds and the controls, respectively. The vaccinated groups of birds showed also a comparatively higher weight gain--by 73 g, on an average, recorded prior to slaughter--as against the control groups. No differences were found in these indices between the groups immunized with 1000 and 500 PFU. In a laboratory test with 255 birds divided into four groups immunized with 100, 500, 250, PFU and controls, challenged in the third week with a pathogenic herpes virus it was found that up to the 6th month the first two groups developed Marek's disease as accounted by 1.65 per cent of the birds, while those vaccinated at the rate of 250 PFU were not properly protected, showing a higher morbidity rate--9.23 per cent. It is concluded that the Bulgarian vaccine--strain C3-1--confers solid immunity in a dose of 500 PFU, the vaccination of broilers being economically profitable.


[Experimental infection with bovid herpesvirus 2].

An experimental infection with strain KOS/Haskovo of the Bovid Herpesvirus 2, isolated in Bulgaria, was induced in susceptible heifers through intradermal, intranasal, and intravenous application. Regardless of the route of infection clinically the disease manifested itself as an eczema of an urticarial type, accompanied by a febrile reaction, leukopenia, erythropenia, and oligochromemia. Highest titers of virus-neutralizing antibodies were established on the 30th day following infection in the i/v injected animals. All experimentally infected animals remained resistant to a challenge with a homologous virus on the 80th day after they were infected.


[Study of the immunogenic properties of inactivated vaccines prepared with the infectious bovine rhinotracheitis virus (IBR)].

Tested were the chemical and physico-chemical means for the inactivation of the infectious bovine rhinotracheitis virus. Formalin and saponin were shown to decrease the immunogenic activity of the virus. The inactivation of the virus, preserving its immunogenic properties, was achieved with the use of two inactivating factors (1 and 2), and the concentrated vaccines produced containing an oil adjuvant at amounts of 10 cu. cm per dose in the vaccination and revaccination at a 28-day interval proved highly immunogenic. Neutralizing antibodies in the vaccinated rabbits and calves were demonstrated after the 14th day following treatment. The antibody titers on the 28th day following vaccination, and on the 14th day following revaccination reached their peak levels: log 2.5 to 4.5 and 6.5 to 7.5, respectively. The problem is discussed of the correlation between the circulation and the secretory neutralizing antibodies after immunization with an inactivated IBR vaccine.


[Action of rifampicin on the reproduction of Aujeszky's disease virus].

The study on the effect of rifampicin on the reproduction of Aujeszky's disease virus (strains 2, 5, 7, 10, 12, and 17, which are virulent, and strain MK, which is an avirulent virus mutant) in cell cultures revealed that the formation of plaques is inhibited, though to a slighter extent, at a concentration of the inhibiting agent of 100 mug/ml, the value of their titer lowering by one logarithm. All virus strains have proved equally susceptible to the effect of rifampicin. During the virus multiplication in the presence of rifampicin the diameter of the plaques formed decreases from 2.8 to 0.5 mm, and with the avirulent strain MK it decreases up to 0.2 mm. They have rose tint in contrast to the plaques formed by strain 2, which are colourless. Rifampicin has no effect on virus reproduction when the cells are cultivated 24 hours prior to adding the antibiotic or when the virus adsorption on the cells takes place simultaneously with rifampicin. At lower rates the latter does not alter the reproduction process of the virus, however, at doses higher than 10 mug/ml it becomes toxic for the cells. Rifampicin inhibits the multiplication of the virus if it is added to the infected cell cultures up to the 12th hour following the adsorption of the virus. When 25-diacetyl-rifampicin is added to the nutrient medium the number of the plaques formed decreases but no change in their diameter occurs. However, with the avirulent MK strain both the number of plaques and their size decreases. Rifampicin B and rifampicin SV have no effect on the reproduction of Aujeszky's disease virus.


Fibrous histiocytoma simulating congenital fibromatosis: a light-, electron microscopic and tissue culture study.

The unusual occurrence of a fibrous histiocytoma of subcutaneous soft tissues, bones, and viscera is described in a newborn infant. The clinical and radiologic picture simulated a congenital fibromatosis, but histologic, electronmicroscopic and tissue culture studies indicated a malignant tumor with a bimodal cell population resembling immature fibroblasts and histiocytes. Although less mature and more uniform, it essentially parallels the findings in the adult malignant fibrous histiocytomas.


Ultrastructural and x-ray analytical studies on intranuclear bismuth inclusions.

Parenteral administration of bismuth subnitrate produced intranuclear inclusions in the rabbit kidney tubules. In glutaraldehyde fixed material these inclusions had a homogeneous appearance but in osmicated material some of these inclusions showed a granular and fibrillar substructure. In relatively thick unstained sections prepared from unosmicated tissues, it was found that the inclusions were electron-dense, but they vanished from view when the electron beam was focussed on them. This phenomenon is thought to be due to the presence of bismuth, which is a mental with a high electrical resistance and low thermal conductivity. With the aid of electron-probe analysis the presence of bismuth was demonstrated in these inclusions and it seems possible that sulphur may be present here.


Cellular transformation in vitro induced by herpes simplex virus (HSV). Note III. Oncogenicity of some HSV-2-transformed cell lines.

At high in vitro passage levels HSV-2-transformed hamster and rat cell lines were oncogenic for the homologous animals, inducing fusocellular or round-cell sarcomas. The cell lines obtained by in vitro cultivation of the tumors were free of infectious virus.


[Investigations on the prophylaxis of wound infection by the topical application of a combination of polymyxin-b, bacitracin and neomycin (polybactrin spray) (author's transl)].

A controlled prospective trial was carried out on 100 cases of appendicectomy for a suppurative or perforated apendix, 153 operations on the biliary tract and 25 abdominal colon and rectum resections. The topical administration of Polybactrin aerosol, sprayed once into the open laparotomy wound produced a significant reduction in postoperative wound infection.


[Prognostic assessment in peripheral facial nerve paralysis with particular reference to electroneurography (author's transl)].

Electrophysiological investigations were carried out on 20 healthy controls and 130 patients with peripheral facial nerve paralysis. The aetiology was as follows: idiopathic (Bell's palsy) in 60 cases, viral in 29, traumatic in 18, postoperative in 4, in connexion with chronic otitis media in 6, diabetes mellitus in 4, positive rheumatological tests in 3, disturbed lipid metabolism in 2, the Melkersson-Rosenthal syndrome in 1, as a complication of pregnancy in 2, and in association with a tumour in 1 case. The compound action potential (CAP) of the orbicularis oris muscle was determinedi n 370 occasions in a right/left comparision, the record of the muscle response was intergrated over the time of action (IAR) on 32 occasions and trison of 255 occasions. The normal values are given in the first place and their dependence of the age of the subject. Then, the prognostic sifnficance of the above-mentioned parameters is investigated in cases of peripheral facial nerve paralysis. It is apparent that the determination of the CAP in a right/left comparison is a valuable prognostic guide as early as the 4th day, insofar as a decrease in this parameter of under 50% can be interpreted as a favourable sign and satisfactory reversal of the paralysis can be expected within 6-8 weeks. By contrast, a decrease of over 70% in the CAP is a bad prognostic sign, indicative of presumably only a poor trend to reversal of the paralysis. An intermediate depression of the CAP in the range of 50-70% signifies an expected moderate recovery within 6-8 weeks ahe case of CAP determination at the time of maximum amplitude depression (as opposed to the 4th day), then a decrease of less than 70% is taken to be indicative of satisfactory functional recovery within 6-8 weeks; a decrease of 95-100% signifies a bad prognosis, whilst a decrease amounting to between 70 and 95% carries an uncertain prognosis. The maximum decrease in amplitude was registered on the 8th day on average; the range lay between the 4th and the 14th day. An exception to these figures was the delayed response of the CAP in the case of 6 patients, 5 of whom showed a maximum decrease during the 3rd week and the last patient as late as the 4th week following the onset of facial nerve paresis. Similar reliance can be placed on the prognostic value of the IAR. however, the decrease in the IAR is smaller than that of the CAP measured on the same potential in a right/left comparison, so that a decrease in the IAR of over 60% can already herald a poor recovery. Repeated determination of the latency in cases of facial nerve paralysis showed that the mean latency value for the entire group of patients was slightly prolonged at the end of the 1st week, but the latency values obtained in any one particular patient are of no prognostic significance. A comparison between CAP and latency values obtained with the opposite (i.e...


Tumor inhibiting capacity of spleen and lymph node cells from mice with murine sarcoma virus (MSV-M)-induced tumors.

The direct tumor inhibiting capacity of spleen and lymph node cells obtained from mice in different stages of Moloney sarcoma virus (MSV-M)-induced tumor development was studied. MSV-M producing ascitic tumor cells with a tumor dosis50 of about 10(3) cells and a mean latent period--depending on the amount of transplanted cells--of6-12 days were used as target cells. They were mixed with dilutions of spleen and lymph node cells obtained from mice at various times after infection with MSV-M. The cell mixtures were incubated for 5 hours, then injected into mice, and tumor inhibiting activity was determined after an observation period of 14 days. Tumor inhibiting capacity was demonstrated with cells harvested from mice 8 days after infection with MSV-M, it was strongest with cells obtained at the stage of peak tumor size and during regression, and was still demonstrable with cells taken at the 86th day after infection. Pretreatment of the lymphoid cells with anti-0-antibodies and complement abolished the tumor inhibiting capacity. This result indicates that immune T cells abrogate the capacity of the ascitic tumor cells to induce tumor development.


[New structural components detected in B. pertussis of different serotypes].

The authors present electron microscopic data on the study of morphological peculiarities of the strains belonging to various serological types. All the strains studied had a structure characteristic of Gram-negative bacteria. Two types intracellular membranes and intracytoplasmic crystal-like structures were revealed in a number of strains (No. 222, No. gZ353, No. 475), irrespective of the serological types. Dynamics of formation of the crystal-like structures in the bacterial cell was described. Marked changes occurred in the cells with the formation of crystal-like structures: cytoplasmic membrane became detached from the cell wall with the resultant contraction of the cytoplasm; large periplastic spaces formed.


Synthesis of penicillin analogs, (--)-methyl 6-epi-6-bromobisnorpenicillanate and (+/-)-methyl 6-epi-bromopenicillanate.

The [(4-methoxycarbonylthiazolidino)carbonyl-dihalomethyl]phenylmercury compounds 2a,b and 5a,b have been synthesized. When heated in refluxing bromobenzene they form halogenated penicillin analogs. (--)-Methyl 6-epi-6-bromobisnorpenicillinate (3a) and methyl 6-epi-6-bromopenicillinates (6a,b) have been prepared and isolated.


[Comparative characteristics of the functional state of the adrenal cortex in the dogs and the fox, Vulpes fulvus].

Comparison has been made of secretory activity of the adrenals in silver foxes and dogs. Besides, studies were made of the effect of ACTH and angiotensin II on the production of gluco- and mineral corticoids by the adrenals in these animals. It was shown  that the spectrum and number of main corticosteroids produced by the adrenals in vitro is identical infoxes and dogs. No difference was found between these animals with respect to the reaction of the adrenals to the addition of ACHT and angiotensin to the incubation medium, although in foxes more significant reaction of glucocorticoid part of the adrenals to ACTH was noted.


Radioligand receptor assay of FSH.

The assay of FSH by a radioligand receptor assay (RLA) using homogenates of rat testicular tissue incubated for 17 h at 21 degrees C has been assessed. Chloramine-T or lactoperoxidase were used for iodination. The assay gave linear dose-response lines between 30 and 2000 ng sheep FSH/tube, and there was usually no major interference by LH. Two batches of labelled FSH, however, gave assays in which LH showed a striking interaction with FSH. When these batches were avoided and FSH and LH were mixed in ratios that differed less than fourfold, the assay was combined successfully, in the same tubes, with an RLA for LH, using LH and FSH labelled with 131I and 125I respectively. The RLA for FSH was not suitable for assay of FSH in rat serum because of apparent non-specific interference. Assay by RLA of rat FSH, in pituitary homogenates or released during incubation in vitro, gave results which were not closely correlated with those of either conventional bioassay or radioimmunoassay.


Augmented secretion of TSH in response to TRH after pre-treatment with dexamethasone for six days in rats.

Serum TSH and corticosterone concentrations were measured in rats given TRH or exposed to short-term cold, as well as in intact rats, after pre-treatment with dexamethasone for six days at two different dose levels (25 and 250 mug/100 g body weight). Both doses increased the secretion of TSH in response to TRH whereas cold-induced TSH secretion was not modified by pre-treatment with dexamethasone. In intact rats serum TSH levels did not differ significantly from controls. In all experiments the steroid blocked ACTH secretion. It was also found that administration of TRH produced a rise in serum corticosterone concentrations. Our results support the view that dexamethasone given for six days facilitates TRH stimulation of the pituitary whilst simultaneously inhibiting the secretion of TRH in response to cold.


Breast cancer in the Forbes-Albright syndrome.

A 33 year old woman with persistent galactorrhoea developed breast cancer six years after pituitary radiation for a pituitary adenoma (Forbes-Albright syndrome). The possible role of prolactin in human mammary cacinoma is discussed.


Regulation of the activities of the enzymes involved in the metabolism of steroid hormones in rat liver: the effect of administration of anterior hypophyseal hormones and gonadotrophin preparations to hypophysectomized rats.

A crude human hypophyseal extract (HE), as well as human growth hormone (GH), ovine prolactin (PRL) and commercial preparations of ACTH, TSH, pregnant mare's serum gonadotrophins (PMS) and chorionic gonadotrophin (CG) were tested for their ability to induce the activities of cytoplasmic 17 beta-hydroxysteroid dehydrogenase and microsomal delta 4-5alpha-hydrogenase and to repress the activities of microsomal 3alpha- and 3beta-hydroxysteroid dehydrogenases in the liver of hypophysectomized rats. The activity of 17beta-hydroxysteroid dehydrogenase was not affected by any of the administered hormones. For the other enzymes, only PRL was effective in causing changes in the activities; the repressive effect on 3alpha-hydroxysteroid dehydrogenase activity was highly significant (P less than 0.001). These results indicate that PRL is involved in the regulation of at least some of the enzyme activities of hepatic steroid hormone metabolism.


Inhibition and facilitation of feedback influences of dexamethasone on adrenocortical responses to ether stress in rats with hypothalamic deafferentations and brain lesions.

In order to elucidate the mechanisms and the sites of action of the negative feedback of corticoids in the regulation of ACTH secretion, the effects of systemically administered dexamethasone on adrenocortical responses to ether stress were studied in intact rats and in 11 experimental groups. These included animals with partial anterior, anterolateral, posterolateral, posterior and small posterior deafferentations as well as bilateral lesions in the medial forebrain bundle (MFB), fasciculus longitudinalis dorsalis (FLD), medial and lateral midbrain reticular formation (MRF) and in the ventrolateral pons. In rats with posterior hypothalamic deafferentation the degree of the inhibitory effect of dexamethasone was much smaller than that in intact animals. In animals with lesions in the FLD and MRF, dexamethasone also produced a reduction in the suppression of the response, though the difference was not significant. Bilateral lesions in the MFB and MP have on the other hand very significantly enhanced the effect of the negative feedback of dexamethasone when compared to intact rats. These data would indicate that hypothalamic deafferentations and brain lesions may change the sensitivity of the hypothalamus for the feedback control of corticoids and that there exist two antagonistic systems, an inhibitory and a facilitatory, in the brain which mediate this effect.


Serum and pancreatic immunoreactive insulin (IRI) and proinsulin-like component (PLC), serum IRI and PLC response to different stimuli in normal subjects and organic hyperinsulinism.

The serum levels of total immunoreactive insulin (IRI) and proinsulin-like component (PLC) in the fasting state and following the administration of insulin secretagogues in 5 patients with organic hyperinsulinism and age and sex matched normal subjects are reported. Diagnosis of organic hyperinsulinism could be established in all instances on the basis of the inappropriately high total serum IRI levels for the corresponding blood glucose values; such an abnormal relationship was not seen in normal subjects, and was further enhanced by insulin secretagogues. Unrestrained insulin secretion in organic hyperinsulinism was enhanced following the administration of glucose, tolbutamide, glucagon or amino acids; the last 2 stimuli are known to be ineffective in causing insulin secretion in the presence of hypoglycemia in normal subjects. Four patints had insulinomas and one probably had islet cell hyperplasia or abnormal function of islet cells. Chromatography of serum IRI to quantitate PLC is a useful adjunct to the diagnosis of organic hyperinsulinism as in the fasting state the proportion of PLC is always elevated, above the normal range of 5-22%. Following the administration of insulin secretagogues there was pronounced increase in total serum IRI in organic hyperinsulinism but the proportion of PLC generally decreased, suggesting thereby that mojor increase in IRI was due to release of stored granular IRI which is known to have a low proportion of PLC.


Oocyte maturation and glycolysis in isolated pre-ovulatory follicles of PMS-injected immature rats.

Graafian follicles were isolated by microdissection from the ovaries of PMS-injected immature rats killed at specific times on the day before ovulation. They were incubated in Krebs bicarbonate buffer containing 5 mM glucose and 1% bovine serum albumin. The oocytes were recovered after incubation and examined by Nomarski interference contrast microscopy. The amount of lactate and glucose in the incubation medium was analysed enzymatically. Oocytes recovered from follicles extirpated in the morning, i.e. before the endogenous LH surge, and incubated for 2-10 h were in the dictyate stage, while addition of LH or FSH to the medium resulted in oocyte maturation as revealed by germinal vesicle breakdown (GVB) and polar body formation. The time-course of GVB in vitro was similar to that seen in vivo after exogenous LH. Both gonadotrophins markedly enhanced lactate accumulation in the medium and, as studied for LH, glucose uptake by the follicles. The effects of LH but not those of FSH, on GVB and lactate formation were prevented by the presence of an antiserum against the beta-subunit of LH. The gonadotrophic effects on GVB could be mimicked by the addition of prostaglandin E2 to the medium. When the follicles were extirpated in the late afternoon, i.e. after the LH surge, and incubated in hormone-free medium for 4 h the oocytes showed GVB in a progressively increasing proportion depending on the time of follicle extirpation. Lactate formation by this group of follicles was markedly enhanced compared to that of "morning" follicles, but it could be even more stimulated by in vitro exposure to LH. A preliminary series of experiments on the effect of phosphodiesterase inhibitors showed that theophylline and isobutylmethylxanthine at certain concentrations completely blocked the LH effect on GVB, whereas a newly developed compound, ICI 63.197, in itself induced GVB.


Intramitochondrial crystalline inclusions in the liver of a patient with hyperthyroidism.

The case of a female patient with hyperthyroidism and slightly impaired liver function is described. Histological examination of liver biopsy did not reveal any pathological findings. Electron microscopic examination revealed crystalline inclusions in a great number of the mitochondria of the liver cells, as well as increased size of the mitochondira. Similar findings were obtained upon examination of a liver biopsy performed six months after start of treatment for hyperthyroidism. Examination of the skin, muscle and white blood cells did not show the presence of such inclusions in the mitochondria. The significance of these findings in the liver cells is discussed.


Primary liver carcinoma -- clinical picture and diagnostic possibilities. A review of seventy-five cases.

A study was performed on a group of 75 patients with primary liver carcinoma (PLC) treated at the 1st Medical Department in Prague during past 24 years. The average age of patients when they died was 59.9 years. 86.7 per cent of the patients were men; in 88.0 per cent of cases PLC was associated with liver cirrhosis. It was found that the frequency of PLC incidence is increasing. Case histories, subjective complaints and laboratory findings were analyzed in these patients. The diagnostic contribution of some examination methods was evaluated (laparoscopy with the aimed liver biopsy in 50% of the cases, isotopic methods in 34.6% of cases, roentgenologic methods in 36.0% of cases, detection of alpha-1 fetoprotein in serum in 55.5% of cases). The analysis of causes of death was also performed. Histologic classification proved the hepatocellular carcinoma in 94.6 per cent of patients, the cholangiocellular carcinoma was found only in 4 patients. The agreement of clinical diagnoses with the pathologic-anatomical diagnosis was found in 70.6% of cases.


Perivascular lymphocytic cuffing in astrocytomas.

A series of cases of astrocytoma of differing cell composition and degree of malignancy was examined for the presence of reactive perivascular cuffing. Only surgical biopsy material was used. A correlation was made between perivascular lymphocyte cuffing and the presence of neoplastic astrocytes of the gemistocytic type.


Production of human lens capsule illustrated by a case of chronic lenticular chalcosis.

The osmiophilic  capsular inclusion bodies in a case of  accidental lenticular chalcosis have been used as an in vivo indicator of capsular production. Copper stimulation and hence inclusion impregnation lasted 5 years and was stopped 2 years before removal of the lens by extraction of a foreign body. The amount of capsule produced in the two year period varied at different locations but it greatly exceeded the previously measured quantities. A capsular turnover is postulated with a capsular production by the epithelial cells and a surface resorption process. The production rate is considered to be relatively high in childhood and gradually subsides with increasing age.


Bacteria in hip surgery. A study of routine aerobic and anaerobic cultivation from skin and closed suction wound drains.

One hundred and seven patients with closed suction wound drains after hip surgery were investigated with regard to bacteria in the drain. In one-third of the cases bacterial contamination of the wound was found. In more than half the total number of cases the bacteria in the wound were not identical with those found on the skin, either pre- or post-operatively. Anaerobe bacteria occurred only in one case. Penicillin administration considerably reduced the frequency of positive cultures. These findings support the prophylactic use of antibiotics in the prevention of late infections in endoprosthesis operations even when the early infection rate is satisfactorily low.


Elimination of water-soluble contrast media from the subarachnoid space. Investigation with computer tomography.

Contrast media injected into the subarachnoid space may be eliminated in two different ways, by diffusion through the meningeal membranes or by transport through these CSF pathways. The latter mode of transport may be examined using computer assisted tomography of the head. Diffusion predominants with contrast media of low molecular weight, such as methiodal sodium. The transport through the CSF cihculation increases when contrast media of high molecular weight such as meglumine iocarmate and metrizamide are used.


A variant of Poland syndrome: report of case.

A variant case of Poland syndrome is reported, with the patient presenting major unilateral anomalies in the sternocostal head of the left pectoralis major muscle and a shorter left arm and hand. No pre-natal history of attempted abortion or using toxic or teratogenic drugs could be elicited. The variability of the upper extremity anomalies and the frequency of major ipsilateral defects of the skeletal and genite-urinary systems, the associated diseases, and the diagnosis and management of these patients are briefly discussed.


[Incidence and clinical features of pituitary tumours in cases of central Cushing's syndrome (author's transl)].

Approximately 10% of all patients with untreated central Cushing's syndromes have clinically verifiable tumours of the pituitary. After bilateral adrenalectomy 10 to 20% of patients with apparently normal pre-operative pituitary glands develop clinically and roentgenologically demonstrable pituitary tumours, of the so called Nelson type. These are usually very active chromophobe adenomas which are dangerous because they expand rapidly. They secretee considerable amounts of ACTH and MSH. A typical case is described.


[Postoperative radiological control in space occupying lesions of the sellar region (author's transl)].

Different methods of postoperative radiological examination of space occupying lesions of the sellar region are discussed with regard to early diagnosis of recurrences. The important role of regular controls by lateral radiographs of the skull is stressed in this follow up survey of 164 cases over a period of 23 years. Comparisons of radiographs over a period showed in 80% of our cases whether there was a tumour recurrence or not. Radiological changes in the area of the sella can be demonstrated more clearly by the use of magnified lateral radiographs and a centimetre rule. With regard to frequency and time of recurrence, 40% of first recurrences were found after 5 years, so periodic radiographic follow up X-ray examinations should be carried out six monthly intially, and later at twelve month intervals. Examples are demonstrated. Intraoperative marking of the diaphragm and dorsum sellae with gold foil for later control radiography is evaluated. Today, space occupying lesions, including intrasellar pituitary tumours, can be clearly demonstrated with the CT scan after i.v. injection of contrast medium to intensity the shadow of the tumour tissue.


Phospholipid-induced modifications in the brain of animals fed with cholesterol-supplemented diet.

1) Cholesterol - enriched diet induces changes in the phospholipid fatty acids of particulate fractions and modifications in the membrane-bound enzyme: 2) BC-PL (100 mg/kg i.p., as shown in rabbits) prevent cholesterol-induced modifications at brain level: 3)BC-PL (100 mg/kg i.v., as shown in mice) have a recovery effect on the cholesterol-induced modification at brain level; 4) It is suggested that some atherosclerotic lesions are analogous to those reproduced by anoxia; 5) It is suggested that the effect of BC-PL is a direct action at the level of the brain cellular membranes.


The regulatory role of steroid hormones on the PGF/PGE ratio in target tissues.

Estrogen has been found to regulate cyclic nucleotide and prostaglandin levels in the rat uterus. This action of estrogen is associated with a simultaneous rise in cyclic GMP and PFG levels. Alterations in PG levels are either independent of or secondary to the formation of cyclic GMP. The mechanism by which estrogen induces the rise in uterine PGFs, although not precisely defined, is associated with alterations of the enzymes rather than of the substrates involved with prostglandin synthesis.


Mechanisms by which leukocytes emigrate and induce tissue destruction.

Chronic inflammatory reactions are characterized by emigration of leukocytes to chemotactic stimuli and the subsequent release of intracellular enzymes which propogate the inflammatory reaction and cause tissue injury. The adoptive transfer of isologous 51Cr labeled leukocytes was used as a model to dissect the cellular mechanisms involved in cell accumulation to the site of immune complex or complement mediated inflammatory reactions. An intact microtubular system was necessary only for neutrophil emigration whereas cell membrane integrity was necessary for mononuclear cell but not neutrophil accumulation in vivo. The accumulation of both cell types was inhibited following phagocytosis or in the presence of corticosteroids. Release of protein polysaccharide degrading neutral protease activity from leukocytes in the presence of immune complexes was dependent upon intact microtubular activity and cell membrane integrity since agents affecting these systems inhibited enzyme release. Conversely collagenase activity released from leukocytes under the same conditions was not inhibited by these agents. Evidence will be presented indicating that the emigration of specific cell types and the release of selected enzyme systems are controlled by separate and distinct mechanistic pathways.


Dissociation of phagocytosis, metabolic stimulation and lysosomal enzyme release in human leukocytes.

In this paper studies are reported concerning the relationship between particle binding to the plasma membrane of human polymorphonuclear leukocytes (PMN's), phagocytosis, generation of oxidative metabolites, and the release of lysosomal enzymes by these cells. Superoxide (O2-) generation by, and lysosomal enzyme release from, normal PMN's and cytochalasin B-treated cells were measured. We have found that neither phagocytosis nor lysosomal degranulation are prerequisites for enhanced O2- generation. Cytochalasin B-treated PMN's, incapable of ingesting particles but still able to bind particles to membrane receptors, generated enhanced amounts of O2- when treated with serum-treated zymosan (STZ), a C3b receptor stimulus, or with aggregated IgG (agg IgG), an Fc receptor stimulus. Moreover, the soluble stimulators complement component C5a, phorbol myristate acetate (PMA), and calcium ions in the presence of the ionophore A23187, also increased the O2- production of these cells. In all cases a time and dose-dependent stimulation was found of both the O2- generation and the lysosomal enzyme release, but there was no correlation between ability of any stimulus to provoke enzyme release and its ability to stimulate O2- generation. When PMN's were preincubated with 5 X 10(-4) M hydrocortisone-Na-succinate, lysosomal enzyme exocytosis with the immune reactants was inhibited 16-35%. Hydrocortisone also inhibited O2- generation, except when STZ was used as the stimulus. Thus, in the case of stimulation of functional processes of PMN's via the C3b receptor, hydrocortisone inhibits membrane fusion without interfering with one of the early biochemical events (O2-production).


Collagen in granulation tissues.

Collagen is abundantly synthesized in granulation tissues and reaches a concentration higher than in normal neighbouring tissues. Such newly formed collagen is characterized by an abnormally low solubility and an easy degradation by collagenases and collagenolytic cathepsins. The activities of these two types of enzymes are high (especially collagenases) in tissues of acute inflammations when the granuloma is resorbing. These activities are lower in sub-acute inflammation and the collagen content of the persistent granuloma remains high. The collagen synthesized in granulation tissues is cross linked by hydroxylysino-5-keto-norleucine, the stable cross-link of collagen in embryonic skin. It is progressively replaced by the two aldimine cross links of normal adult skin when the granuloma is resorbed (acute inflammations induced in rats; human normal scars). The cross link of embryonic skin, on the contrary, is permanently present in collagen of tissues of subacute, chronic inflammations (sponge implants in rats, human hypertrophic scars and keloids. Studies of the structure of alpha-chains revealed that type III collagen (embryonic collagen) is present in granulation tissues.


Anti-inflammatory models in animals.

The pleural cavity of rats and guinea-pigs has been utilized to study the inflammatory response to immediate hypersensitivity, delayed hypersensitivity, calcium pyrophosphate and carrageenan. The mediators will be described and their possible interaction with cyclic AMP. Finally the effect of some anti-inflammatory agents on these models will be discussed.


The macrophage as a secretory cell in chronic inflammation.

Although it is clear that macrophages are always present at sites of chronic inflammation their contribution to the evolution of these lesions is not well understood. In vitro studies have shown that macrophages secrete a variety of products on exposure to different stimuli. These include hydrolytic enzymes, active at acid or neutral pH, with known capacity for degrading tissue constituents. Lysosomal acid hydrolases are released from viable cells over a prolonged period of time by various agents known to cause, or are associated with, chronic inflammation. These agents may be nonimmunogenic substances, such as carrageenan and asbestos, which interact directly with macrophages or alternatively the products of immune reactions involving either B or T lymphocytes. These lymphocyte products include immune complexes of certain composition and the secreted products of T lymphocytes stimulated by nonspecific mitogens or specific antigens. In marked contrast biologically inactive substances such as latex particles or digestible substrates such as erythrocytes do not induce the selective release of acid hydrolases from macrophages. It is clear that alghough macrophages secrete abundant amounts of neutral proteinases under certain conditions this release does not occur necessarily during the release of acid hydrolases induced by inflammatory agents. The role played by acid and neutral hydrolases secreted by macrophages during the various stages of chronic inflammatory responses remains to be clarified.


Adjuvant disease induced by mycobacteria, determinants of arthritogenicity.

Genetic, endocrine and immunological factors are probably involved in adjuvant polyarthritis. The nature of the vehicle and of the mycobacterial components administered also has a major influence. It was originally assumed that arthritogenicity and adjuvanticity of mycobacterial fractions such as wax D were intimately related. Our previous findings showed that the water soluble adjuvant (WSA) of M.smegmatis which could substitute for mycobacterial cells in Freund's complete adjuvant and induce delayed hypersensitivity was not arthritogenic in the Wistar rat. We have since observed that auto-immune diseases could be elicited by WSA. Therefore experiments were repeated using the very susceptible Lewis strain. The activity of cord factor and of various mycobacterial preparations suspended in mineral or in peanut oil was also evaluated in mice and in normal or hypophysectomized rats. Our present findings confirm the absence of arthritogenicity of WSA in the Lewis strain. They also indicate that cord factor with WSA does not suffice to induce a generalized adjuvant disease, but that a mycobacterial component which could be susceptible to lysozyme treatment is required also. However, the local inflammation of the injected limb was produced by a preparation of cord factor administered in mineral or even in peanut oil. This was observed in normal or hypophysectomized rats and in Swiss mice which were not susceptible to the generalized disease.


Cardiac dysrhythmias in the conscious dog after surgically induced autonomic imbalance.

The ventrolateral cardiac nerve in the dog is a primary branch of the left sympathetics and represents a direct neural link between the central nervous system and the heart. Its electric excitation elicits characteristic shifts in pacemaker and tachydysrhythmias related to its explicit innervation of the inferior atrial, atrioventricular (A-V) junctional and ventricular tissues. Total denervation of the canine heart, sparing the ventrolateral cardiac nerve, produced a long-term model in which only these portions of the heart retained their sympathetic innervation. The trained unanesthetized model dog was subjected to severe exercise in order to determine the effects of elevated levels of sympathetic tone upon these important regions of the conduction system. Reproducible tachydysrhythmias were elicited in all six animals completing the regimen of periodic testing over a period of 136 to 378 days after operation. The abnormal rhythms consisted of shifting cardiac pacemakers and supraventricular A-V junctional and ventricular tachycardias with frequent premature systoles. Comparable abnormalities were not observed in a similarly tested sham-operated animal or in dogs with a totally denervated heart. The exercise-induced dysrhythmias gradually disappeared with time, presumably in relation to autonomic reinnervation of the heart. The characteristic patterns of ventrolateral cardiac nerve and upon its presumed influence upon Purkinje fiber and A-V nodal automaticity and temporal dispersion of refractoriness in myocardial tissues.


Effect of dietary control and exercise training on daily food intake and serum lipids in postmyocardial infarction patients.

The effects of 12 weeks of exercise training without dietary control (n = 30) and exercise training with dietary control by dietition counseling (n = 30) and exercise training with dietary control by dietition counseling (n = 30) on serum cholesterol, serum triglycerides, and total substrate contents were studied in 60 postmyocardial infarction patients. Both groups showed reductions (P less than 0.01) in mean total daily kilocalories consumed (2867 +/- 82 versus 2088 +/- 77 and 2848 +/- 15 versus 1285 +/- 68, respectively); however, no significant change occurred in total body weight. The dietary control group consumed relatively more kilocalories as protein than the group without dietary control (285 of 1,285 versus 389 of 2,088, respectively) and less (P less than 0.05) as fat (443 of 1285 versus 804 of 2,089, respectively). Both groups had lower (P less than 0.01) mean daily dietary cholesterol after 12 weeks (811 +/- 44 versus 232 +/- 17 mg) versus (325 +/- 18 versus 309 +/- 23 mg, respectively). A reduction in serum cholesterol (P less than 0.05) was seen in the dietary control group (270 +/- 8 versus 243 +/- 7 mg/dl) but not in the group without dietary control (260 +/- 6 versus 261 +/- 7 mg/dl). The dietary control group had a lower mean triglyceride level (P less than 0.05) (229 +/- 24 versus 155 +/- 18 mg/dl)) but no differences were seen in the group without dietary control (189 +/- 15 versus 180 +/- 13 mg/dl). It is concluded that significant reductions in caloric intake and daily cholesterol compliment the effects of exercise training in postmyocardial infarction patients by increasing substrate protein:fat consumption ratio and by reducing serum cholesterol and triglycerides. These effects are not seen with exercise training alone.


Ultrastructure of the human breast and its disorders.

The extant literature pertaining to the ultrastructural features of disorders of the human breast is reviewed and annotated with findings derived from a personal study of 82 patients whose specimens encompassed a wide variety of such lesions. In addition, observations of lesions heretofore undescribed are presented.


Cytodifferentiated renal tumors occurring with Wilms' tumors of the opposite kidneys: report of two cases.

The most common differentiated renal tumor of early childhood is the congenital mesoblastic neophroma. Well-differentiated forms of Wilms' tumor may present a difficult differential diagnosis from these benign neoplasms. The cases of two patients found to have well-differentiated renal neoplasms after being treated for Wilms' tumor of the opposite kidneys are reported. The second neoplasms were composed of a benign-appearing stroma with mature skeletal muscle and completely lacked any embryonal, nephroblastic tissue. These benign-appearing neoplasms may be cytodifferentiated variants of Wilms' tumor. Though tumors of this type may have a malignant potential, there is evidence to indicate that they may be approached more conservatively than the usual nephroblastoma. In cases of bilateral Wilms' tumor, well-differentiated tumors might be treated by partial nephrectomy alone, with careful preservation of functional renal tissue.


A sensitive fluorimetric assay for serum angiotensin-converting enzyme.

A simple, rapid, highly sensitive and reproducible assay for angiotensin-converting enzyme in untreated serum is described. It is based on the conversion of the substrate analog, hippuryl-L-histidyl-L-leucine (5 mM in 0.1 M K phosphate, pH 8.3-0.3 M NaCl) to hippurate and L-histidyl-L-leucine, which is quantified spectrofluorimetrically (lamdba excitation = 360 nm; lamdba fluorescence = 500 nm) by formation of a fluorescent adduct with ophthaldialdehyde. The chloride requirement and inhibition and activation patterns correspond to those for angiotensin-converting enzyme. The Km for hippuryl-L-histidyl-L-leucine was 1.33 mM. The mean value of serum angiotensin-converting enzyme for 58 normal human subjects (mean age, 32 years; range 19-57) was 32.2 +/- 1.30 (SE), with a standard deviation of 9.87 nmol/min/ml serum. The assay is useful for the diagnosis and possible management of sarcoidosis and may have other applications in the future.


Meningitis due to combined infections. Association of Haemophilus influenzae type B and Clostridium perfringens.

Haemophilus influenzae type B and Clostridium perfringens were recovered simultaneously from the cerebrospinal fluid of a patient with purulent meningitis. No antecedent history of head trauma was present to explain the coexistence of the anaerobe with Haemophilus organisms. A review of the literature on mixed meningitis indicates that no previous cases of anaerobes have been reported in uncomplicated meningitis due to multiple organisms. In addition, the recovery of clostridia is extremely unusual in the absence of an identifiable portal of entry. We have identified two additional cases of clostridia infection in the central nervous system and recommend that anaerobic organisms be considered in selected cases of meningitis.


Abnormal vitamin D metabolism in patients with cirrhosis.

To assess the role of hepatic function and alcohol on vitamin D metabolism, serum 25-hydroxyvitamin D (25-OHD) levels were measured in 20 healthy nonalcoholic control subjects, 31 "inactive" cirrhotics whose alcoholism was in remission, 8 alcoholic cirrhotics, and 15 alcoholics with normal liver function. Cirrhosis but not alcoholism, was assoicated with low serum 25-OHD levels. The aminopyrine breath test (ABT) was performed because aminopyrine, like vitamin D3, is metabolized by hepatic microsomes; the ABT correlated highly (r = 0.74, rho less than 0.01) with serum 25-OHD in the inactive cirrhotics. After an intravenous injection of 120 mug vitamin D3, serum 25-OHD rose significantly within 24 hr in 6 healthy controls and 2 patients with celiac disease but not in 6 inactive cirrhotics. The data suggest impaired 25-hydroxylation of vitamin-D impaired in patients with cirrhosis, related predominantly to the degree of hepatic dysfunction.


Vaccine-associated poliomyelitis in the United States, 1961-1972.

Although poliovirus vaccines have led to a dramatic reduction in the incidence of poliomyelitis in the United States, there is evidence that vaccine-related cases have occurred in both vaccine recipients (recipient cases) and their contacts (contact cases) and that the incidence and epidemiologic characteristics of these cases in the 12-year period 1961-1972 have changed. Before 1965, there were 63 recipient cases compared with only 16 between 1965 and 1972. These latter cases were in younger persons and were more frequently associated with trivalent oral poliovirus vaccine (TOPV) than the former cases. Both groups were predominantly male and had intervals between immunization and onset of illness that clustered between 7 and 21 days. Only three contact cases were recognized before 1965, compared with 39 cases in 1965-1972. The increase was in both children and adults. Unlike recipient cases, contact cases were almost as frequent in females as in males. Evidence that the contact cases were vaccine-related included the apparent clustering between 20 and 29 days of the intervals from vaccine administration to onset of illness and the significantly increased frequency of longer intervals for contact cases in non-household members compared with contact cases in household members. The decrease in recipient cases and the increase in contact cases in 1965-1972 compared with the previous 3-year period are explained by the general curtailing of routine vaccination of adults after 1964, a switch from monovalent oral polio vaccine to TOPV, improved recognition of contact cases and a shift in emphasis from mass vaccination campaigns and communitywide programs to routine vaccination of infants.


Renal responses to PTH in patients with hormone-resistant (pseudo) hypoparathyroidism.

Five patients with pseudohypoparathyroidism were compared to normal subjects and patients with hypoparathyroidism in their ability to respond to the infusion of parathyroid hormone (PTH) by altering excretion of calcium, sodium, potassium, phosphate and bicarbonate. In patients with pseudohypoparathyroidism, impairment in renal responses to PTH was more generalized than has been recognized. The patterns of response varied from patient to patient. The most commonly observed abnormality, aside from lack of increase in urinary cyclic adenosine 5'-monophosphate (AMP) was failure to decrease the calcium to sodium clearance ratio, and indication of impaired renal calcium reabsorption. The responses which most closely approximated normal, including a normal decrease in the calcium to sodium clearance ratio, occurred in a patient (Case 1) who had the largest, although impaired, response in cyclic AMP excretion. Conversely, the most abnormal responses occurred in three patients (Cases 2, 4 and 5) who had the smallest increases in cyclic AMP excretion after the administration of PTH. The impaired renal reabsorption of calcium after the administration of PTH (lack of decrease in calcium to sodium clearance ratio) may, when present, be in part responsible for hypocalcemia.


Hydramnion and fetal renal anomalies.

Four instances of hydramnion associated with renal anomalies are reported: two patients had obstructive uropathies and two had a neoplastic type of renal dysplasia. In two infants water concentration tests revealed a defect in water-concentrating ability. It is postulated that the observed hydramnion resulted from fetal polyuria. In patients with unexplained hydramnion a search for renal anomalies is indicated.


Initiation of human parturition. IV. Demonstration of phospholipase A2 in the lysosomes of human fetal membranes.

In this study we sought to define the subcellular localization of phospholipase A2 in human fetal membranes. Others have postulated a role for decidual lysosomes in the initiation of human parturition. We hypothesized that if phospholipase A2 were localized within lysosomes of fetal membranes the accelerated expression of the activity of this enzyme could be prevented until such time as the metabolic events of parturition begin. At parturition a perturbation of the lysosomal membrane within the chorio-amnion could result in an increased release of free arachidonic acid through an accelerated activity of phospholipase A2. The results of this study suggest that at least a portion of phospholipase A2 in the chorion laeve and amnion is localized in the lysosomal fraction.


Reproductive performance of women successfully treated for gestational trophoblastic tumors.

The reproductive performance of 36 women who had been successfully treated for gestational trophoblastic tumors with multiple courses of cytotoxic agents including methotrexate, 6-mercaptopurine, actinomycin D, and 6-azauridine, between 1962 and 1972, has been studied in comparison with 36 patients who had spontaneously aborted a hydatidiform mole but received no treatment and a control group consisting of 36 women attending an antenatal clinic. The majority of patients who wanted further pregnancies following chemotherapy had one or more successful conceptions. The incidence of abnormal pregnancies in the treated group was higher than that of the control group. Similarly, there was a higher number of abnormal pregnancies in the untreated mole patients when compared with the control group. This suggests that patients who develop trophoblastic tumors tend to have a poor obstetric history and that this is not significantly worsened by chemotherapy.


Adrenocorticotropic hormone in human fetal blood at delivery.

Adrenocorticotropic hormone (ACTH) concentrations in umbilical arterial and venous plasma were measured in newborn infants delivered both vaginally and by cesarean section. Mean ACTH was significantly higher in the arterial (602.0 pg. per milliliter) than venous (261.5 pg. per milliliter) plasma in vaginal deliveries (pless than 0.01). Arterial plasma of babies born by elective cesarean section before initiation of labor contained less ACTH (384.7 pg. per milliliter) when compared to those delivered after labor had started (698.7 pg. per milliliter). Serial determinations of ACTH in pooled fetal blood obtained during labor showed that the average hormone titers increased significantly from first stage (295.2 pg. per milliliter) to second stage of labor (440.5 pg. per milliliter), and reached a peak at delivery (645.4 pg. per milliliter). The pituitary gland of the fetus at midtrimester contained ACTH. Possible mechanisms for fetal secretion of ACTH at delivery are discussed.


Pathology of chronic Bolivian hemorrhagic fever in the rhesus monkey.

Gross and microscopic lesions of Bolivian hemorrhagic fever (BHF) are described in 10 rhesus monkeys that survived from 30 to 78 days after subcutaneous inoculation with a dose of 10(3) plaque-forming units (PFU) of Machupo virus, a dose which produces a severe and generally fatal disease. Six of the monkeys had been given low doses of homologous immune globulin when initial signs of infection appeared. Monkeys exhibited clinical signs in two phases. The initial signs of acute infection which began to appear about 1 week following inoculation included: diarrhea, depression, anorexia, dehydration, and skin rash. The survivors of this early phase of the illness usually showed improvement before relapsing into the second (or chronic) phase, which was characterized clinically by central nervous system disturbances including incoordination, tremors, convulsions, paresis, and muscle atrophy. Microscopic lesions were similar in both immune globulin-treated and untreated animals. These included widespread lymphoreticular infiltrates in the walls and adventitia of blood vessels of the brain, spinal cord, pancreas, intestine, liver kidney, adrenal, parathyroid, heart, and skeletal muscle. Diffuse lymphocytic infiltrates not confined to the vascular or perivascular tissues were present to a variable degree in many of these and other organs. Several monkeys exhibited lymphocytic inflammation of the choroid, meninges, peripheral nerves, and ganglia.


Differences in the provision of mental health services by race.

A study of a newly mandated crisis clinic still shows the signs of a different quality of service offered to Third World clients. Black men in the present study had difficulty in obtaining the most needed and most preferred services. Reasons for the disparity in services appear to be institutional.


Aortoenteric and paraprosthetic-enteric fistulas: radiologic findings.

Ten cases of graft-intestinal fistulas occurred in 712 patients who had undergone abdominal aortic reconstructive surgery. Radiographic abnormalities were demonstrated in eight--three by conventional barium gastrointestinal examinations and five by angiography. A high index of suspicion of the condition and an aggressive radiologic workup are recommended.


Angiography of mediastinal parathyroid adenomas.

Two cases with mediastinal parathyroid adenomas are presented. Both patients had undergone previous unsuccessful neck explorations. Angiography correctly localized the parathyroid adenomas in each case, substantiating the value of parathyroid angiography in mediastinal tumors.


Systemic to pulmonary venous communication in the superior vena caval syndrome.

A case of superior vena caval obstruction due to bronchogenic carcinoma is presented. Upper extremity venography demonstrated shunting of contrast media from systemic veins to the right pulmonary veins. This collateral pathway has been previously described in the superior vena caval syndrome. A proposed mechanism for this flow pattern is discussed.


Pseudocavitary granulomas of the lung.

Due to the high lipid content of the caseous material in granulomas of the lung, these lesions may radiographically mimic truly cavitated pulmonary neoplasms or granulomas. Four cases of pseudocavitation within granulomas of the lung are presented along with their clinical, radiographic, and pathologic features. In all four cases diagnosis was made only after surgery.


Percutaneous spot localization of nonpalpable breast lesions.

The spot method of localization is applied to nonpalpable breast lesions detected at mammography. This percutaneous procedure is easy to perform, comfortable for the patient, and highly accurate in facilitating surgical excision of the smallest amount of breast tissue for microscopic examination.


Double-blind comparison of meglumine lodoxamate (Cholovue) and meglumine iodipamide (Cholografin).

A double-blind comparison of two intravenous cholangiocholecystographic agents of similar molecular structure, meglumine iodoxamate and meglumine iodipamide, was carried out in 90 patients. Each produced a comparably high percentage of satisfactory examinations. A similar pattern of excretion speed and intensity was noted for each, though meglumine iodoxamate appeared to be slightly more effective in patients with elevated serum bilirubin. Less evidence of hepatic toxicity and fewer and less serious adverse side effects were observed in patients given the newer agent, meglumine iodoxamate.


Lymphoreticular hyperplasia of the stomach (pseudolymphoma).

Three histologically proved cases of gastric lymphoreticular hyperplasia with long term follow-up are reported. This condition is often confused radiologically with ulcerating carcinoma and pathologically with malignant lymphoma. The presence of a large ulcer surrounded by a mass and associated with thick rugal folds and additional gastric or duodenal ulcers is not diagnostic but should suggest the possibility of this condition.


Cholecystokinetic cholecystography: efficacy and tolerance study of sincalide.

The intravenous administration of sincalide, the C-terminal octapeptide fragment of cholecystokinin, affords safe and effective means for gallbladder contraction with resultant cystic and common bile duct visualization. Intravenous sincalide circumvents the problem of unpredictability of response of the gallbladder to a fatty meal and variability in the rate of release of endogenous cholecystokinin. Peak gallbladder contraction occurs earlier than with a fatty meal.


Colonic changes of herpes zoster.

The lesions of herpes zoster of the colon were observed in three cases. Small polygonal mucosal blebs or small ulcerations involving a short segment of the colon and appearing in a reasonable time relationship with the cutaneous manifestations either in a corresponding or noncorresponding dermatome should enable diagnosis of this unusual condition. Recognition of this entity in the presence of these skin lesions should be obvious and therefore helpful in avoiding more aggressive and invasive diagnostic procedures.


Anomalies of the craniovertebral border.

Pertinent embryology is reviewed as a background for understanding anomalies of the craniovertebral border. These anomalies constitute a variable spectrum due either to incomplete assimilation or abnormal fusion.


An early rim sign in neonatal adrenal hemorrhage.

Neonatal adrenal hemorrhage can usually be diagnosed on excretory urography without resorting to surgical exploration or invasive diagnostic procedures. In the typical case an avascular mass is seen between the liver and kidney. A case is presented in which a vascular rim surrounded the avascular mass, giving an appearance similar to that of an obstructed upper pole renal duplication. This early vascular rim, not as well known as the calcified rim which develops days to weeks after the acute hemorrhage, is probably created by compression and displacement of adrenal tissue by the central hemorrhage.


Autonomic dysreflexia in patients with spinal cord lesions: complication of voiding cystourethrography and lleal loopography.

Autonomic dysteflexia is a pathologic reflex which occurs in patients with a spinal cord lesion above T7. The most dangerous manifestation of this reflex is marked increase in systolic and diastolic blood pressure. The trigger is the distension of the urinary bladder, urethra, rectum, or intestine. It can and does occur during radiological examinations such as cystourethrography, loopography, and probably during the barium enema. Because of possible deleterious consequences of marked hypertension, blood pressures in these patients should be continuously monitored during the examinations and appropriate measures immediately instituted should the reaction occur.


Roentgenologic abnormalities of the urinary bladder secondary to Crohn's disease.

Urinary tract symptoms and signs may result from secondary involvement of the urinary bladder in patients with Crohn's disease. In a small but significant proportion of these individuals, urinary tract symptoms represent the initial or predominant mode of presentation. Such patients may be erroneously treated for primary infection of the lower urinary tract for prolonged periods before the intestinal origin of the disease process is discovered. Roentgenologic abnormalities of the urinary bladder may provide early and important clues to the correct DIAGNOSIS. The various abnormalities of the urinary bladder which may occur secondary to Crohn's disease are described and illustrated, and the roentgenologic differential diagnosis is discussed.


Unilateral hematocolpos and ipsilateral renal agenesis: report of two cases and review of the literature.

Two cases are presented of a partially duplicated vagina characterized by a one-sided hematocolpos associated with renal agenesis on the same side. A review of the English literature reveals 39 previously reported cases. Invariably this complex of anomalies is seen in adolescents and young women with progressively severe abdominal pain, menstrual irregularities, and a pelvic mass. It is important to make an early accurate diagnosis since they are usually managed as having an ovarian mass and submitted to multiple laparotomies and occasionally to mutilating surgery. An analysis is presented of the salient embryologic, clinical, and radiologic features of the 41 cases gathered. The need for definitive preoperative evaluation of both the urinary tract (urography and cystoscopy) and the genital tract (hysterosalpingography) cannot be overemphasized.


Gallium scanning in cerebral and cranial infections.

Eighteen patients with cranial or intracranial infections were studied with technetium and gallium brain scans. Seven of 18 lesions were noted with gallium and not with pertechnetate, while the reverse pattern was not seen. Brain abscesses were visualized with gallium but not with pertechnetate in two of five cases. Osteomyelitis of the skull and mastoiditis showed intense gallium uptake in all cases, meningitis or cerebritis gave inconsistent results.


Pseudocyst formation in acute pancreatitis: ultrasonographic evaluation of 99 cases.

A total of 99 patients admitted with a diagnosis of acute pancreatitis were studied by abdominal A- and B-mode ultrasonography in an effort to detect pseudocyst formation. Positive ultrasonic scans were noted in 52 cases. In three patients with positive sonography, surgical exploration did not demonstrate pseudocysts, giving a false positive rate of 8.3%. Of the negative studies four were proven incorrect at surgery or autopsy , yielding a false negative rate of 8.5%. Approximately one-fifth with cystic lesions underwent spontaneous resolution. Three additional patients with pseudocysts had spontaneous cyst-enteric fistulization demonstrated by radiography. The sensitivity and accuracy of pancreatic ultrasound demonstrated by this study established ultrasonography as the procedure of choice in detecting pseudocyst formation in patients with acute pancreatitis.


Preoperative radiation therapy in endometrial carcinoma: preliminary report of a clinical trial.

A total of 91 patients with stage I endometrial adenocarcinoma who were referred for radiation prior to hysterectomy were randomly allocated to recieve either intracavitary or external bean irradiation. Total abdominal hysterectomy was done 4-8 weeks later. The 53 patients who received intracavitary irradiation had an actuarial 5 year disease-free survival rate of 75%; the survival rate of the 38 patients in the external beam group was 48%. Nine patients in the external beam group had recurrence or metastases compared to two in the intracavitary group. These recurrences were predominantly pelvic. Complications were also more frequent in the external beam group. These results demonstrate that intracavitary radiation is superior to external beam radiation using the regiments described.


The role of postoperative irradiation in the management of stage I adenocarcinoma of the endometrium.

A comparison of treatment protocols for endometrial carcinoma is presented. Valid conclusions regarding optimum approach are virtually precluded because of variability of such factors as clinical staging, incidence of vaginal metastases, patient selection, and histologic grade. While hysterectomy is the established definitive treatement, the superiority of adjuvant irradiation can be demonstrated only by randomized prospective studies.


Fast neutron beam radiotherapy of glioblastoma multiforme.

Twenty-one patients with glioblastoma multiforme were treated with fast neutron beam irradiation of the whole brain. Therapy was well tolerated up to calculated doses of 1.850 radn+y in 12-18 increments over 6 weeks. The survival rate 6 month after initiation of treatment was 62%, not significantly different from conventional photon therapy; average posttreatment survival appears to be shortened compared to photon therapy. No improvement or prolonged maintenance of existing neurologic function was observed. Autopsy findings in seven patients showed replacement of tumor by coagulative necrosis persisting at least 16 months posttreatment, paucity of tumor cells with infrequent mitosis, and suppression of macrophage response. These findings differ from those in conventionally irradiated patients. No treatment-related changes were documented by conventional gross and histologic studies of the irradiated brains distant from the tumors. Thus the deaths of patients in this study appear to be related to unexplained causes other than progressive growth of tumor.


Transformation delay of lymphocytes in patients undergoing radiation therapy.

Two types of assay systems to measure the effect of radiation on immune competence are described. The first, transformation, is measured by blast formation or uptake and incorporation of tritiated thymidine by lumphocytes. This measure is affected by a number of known cell responses to radiation such as division delay and delay in DNA synthesis. The second, called Bactec, is designed to measure lymphocyte metabolic acitivty. Data gathered on 37 patients with lung cancer show that the Bactec system provides a better index of the patient's immune status before and after radiation therapy.


Perforation of the nasopharynx by nasogastric intubation: a rare cause of left pleural effusion and pneumomediastinum.

A case of nasogastric tube perforation of the posterior nasopharynx producing a left pleural effusion and pneumomediastinum is reported. Findings which led to the correct diagnosis were the rapid appearance of a left pleural effusion simultaneous with the initiation of tube feedings, the intrathoracic location of the nasogastric tube, and demonstration of perforation of the posterior nasopharynx. Potentially hazardous intubation techniques are discussed.


Arthrographic diagnosis of synovial chondromatosis.

A case of synovial chondromatosis without plain film calcifications is presented. The arthrographic findings and differential diagnosis are discussed.


Carcinoma of the urachus.

Characteristic roentgenographic and anatomical features of a mucinous adenocarcinoma of the urachus were observed in two patients. Both presented with a midline anterior abdominal mass in the supravesicular area. The tumor contained fine stippled calcification in one case. The cystogram demonstrated an irregular filling defect in the bladder dome in the other case. Ultrasonographic examination in one case was helpful in delineating the nature, size, and location of the mass in detail.


Update on the independent radiation monitor (IRM).

The new independent radiation monitor (IRM), unlike its predecessor, is a reliable and sensitive safetly device for any radiation therapy room. It shows unequivovally that the beam is on, and it is inexpensive and simple to construct.


The risk and accuracy of pancreatic biopsy.

Pancreatic biopsy in 171 patients produced complications in 4.7 per cent and death in 1.7 per cent. The biopsy diagnosis was confirmed in 86 per cent but was falsely negative in 14 per cent of pancreatic cancers. Frozen sections were interpreted correctly in all cases. Wedge biopsy resulted in fewer complications and fewer false-negative results than needle biopsy and is preferable except for periampullary lesions in which transduodenal needle biopsy is best. When the biopsy incision transected a pancreatic duct, suture ligation and drainage avoided complications. Open transduodenal biopsy of periampullary lesions was reliable, but the duodenotomy closure leaked in 10 per cent of the cases. Pancreatic biopsy with confirmation of malignancy should precede pancreaticoduodenectomy in most cases of suspected pancreatic cancer.


Hepatic artery ligation and 5-fluorouracil infusion for metastatic colon carcinoma and primary hepatoma.

Nine patients with extensive bilateral hepatic metastases of colorectal cancer were treated with hepatic artery ligation and continuous infusion of 5-fluorouracil (5-FU). Silastic catheters were inserted into the hepatic artery at laparotomy, and continuous perfusion was effected by a Sigmamotor pump. There was no operative mortality or morbidity, and drug toxicity was acceptable. Dosage averaged 10 mg/kg/day and average time of infusion was sixty-three days. Liver function returned to preoperative values within two weeks in all patients, and four patients had improvement of preoperative liver function for three to six months after perfusion. Two patients had palpable regressions that lasted five months or more, and one patient had a slight palpable regression for two months. Five who are dead had a mean survival of 10.4 months after therapy, with a median survival of 11.5 months. Eight of the nine patients had significant clinical improvement following treatment. Seven patients with irresectable primary liver carcinoma were treated with continuous 5-FU infusion. A Silastic catheter was placed at laparotomy into the hepatic artery via the gastroduodenal artery. Ligation of the hepatic artery was not performed. There was no operative mortality or morbidity. Dosage averaged 10 mg/kg/day and the average time of infusion was 140 days. Significant clinical improvement was noted in six of the seven patients although this did not correlate with improvement of hepatic function. All six responding patients are still living (mean survival, 14 months). Prolongation of life with hepatic artery infusion of 5-FU has been significantly better than with any previously reported chemotherapy for this disease.


Neurological complications of extraspinal.

The anatomy and physiology of the blood supply to the central nervous system from the aorta is outlined. Pertinent cases are reported, to illustrate the effect of impairment of this blood supply in producing ischemia of the brain, spinal cord, and peripheral nerves. In patients with such neurologic disease, especially if sudden in onset, a search for a circulatory basis in lesions of the aorta or its branches may be rewarding and crucial. With regard to reconstructive surgery of the aorta, certain precautions may be taken: maintenance of normotension, gentle dissection, preservation of segmental arteries when possible, bypass shunting, avoidance of prolonged aortic clamping and perhaps heparinization. Unfortunately, depending upon deficiencies in collateral circulation to the spinal cord, occasional cases of postoperative paraplegia will still occur, which are both unavoidable and unpredictable.


[Myelocytic leukaemia with atypical evolution (author's transl)].

A case of myelocytic leukaemia appeared in a four year old boy. The surprisingly benign evolution until now, leds to a speculation on the possible influence exerced by chickenpox virus as a immunologic stimulant.


Viremia with herpes simplex type 1 in adults. Four nonfatal cases, one with features of chicken pox.

Recovery of herpes simplex virus (HSV) Type 1 from the blood buffy coat of four adults is reported for the first time. All of the patients had vesicular stomatitis and facial vesicles; two also had either keratoconjunctivitis or disseminated skin lesions. The infection was not the primary one with HSV in any of them. Two of three patients who had renal failure were receiving immunosuppressive drugs; one patient was normal except for alcoholism and diabetes. None developed signs of visceral organ infection and all recovered within 2 to 4 weeks. The findings demonstrate the occurrence of heretofore unrecognized nonfatal HSV Type 1 viremia in both healthy and immunosuppressed leukocytes, can occur regardless of the presence of serum antibody, and may or may not be associated with the disseminated lesions.


[Insulinomas in children. Histologic and ultrastructural study. (apropos of 2 cases)].

The authors report two case-histories of insulin-secreting tumors of the pancreas in children. They emphasize the rare occurence and the percularity of these tumors with regard to insulinomas in adults. The ultrastructural and histopathological examination showed: --the presence of a "junction area" rich in centro-acinar cells between the pancreas and the tumor, --within the tumor, the existence of exocrine elements i.e. acinar cells and more or less differentiated canalar structures. On behalf of these findings the authors discuss the problem of the histogenesis of these tumors. Is it a matter of endocrine adenomatous hyperplasia of centro-acinar origin, or of real "apudoma"?


[Adsorption of enteroviruses on nitrate cellulose membranes: influence of mineral salts, detergents and calf serum (author's transl)].

The filtration through cellulose nitrate membranes of a poliovirus type II suspension in distilled water alone or with added mineral salts (NaCl, MgCl2, AlCl3) results in adsorption of the virus. The maximal adsorption is obtained with NaCl. A detergent in the virus suspension or a pretreatment of the membranes with calf serum prevents this adsorption. Elution of the adsorbed enteroviruses is achieved with alcaline and proteinaceous buffer.


[Burkitt's disease in the Ivory Coast: anatomo-clinical and epidemiologic considerations].

The authors study the epidemiological conditions of the appearance of Burkitt's disease on the Ivory Coast. This condition represents 4.12% of cancers observed in this country. From a thorough study of the differences in temperature, relative humidity, vapour pressure, hours of sunlight, amount of rainfall, they were able to pick out that equatorial forest zones are more at risk than the savannah zones. The climatic conditions in the forest render intervention by a vector plausible, either directly or indirectly via malaria or other parasitic infestations.


Sever hypertension in a child with Wilms' tumor: a case report.

Problems of management in a child with a large Wilms' tumor and severe uncontrolled hypertension presenting for anesthesia and operation included attempts to determine the etiology of the hypertension; identification of hazards produced by attempted rapid pharmacologic control of blood pressure; need for urgent operative intervention despite uncontrolled hypertension; and choice of anesthetic agent and technic.


[Non-chromaffin laryngeal paraganglioma. Clinical and electron microscopical study].

The authors describe the case of a 51 year-old woman presenting with a very large laryngeal paraganglioma in the aryepiglottic fold which had passed through the cricothyroid membrane and invaled the thyroid. A crico-hyoido-pexy enabled the tumour to by completely removed and anatomo-pathological examination showed degeneration. Under electron microscopy, the ultrastructure of the tumour was similar to that of chromaffin paragangliomas. It is three years since this patient was cured.


Lymph nodes and vessels in primary lymphoedema. Their relative importance in aetiology.

The classification of lymphoedemas is reviewed and the various primary lymphoedemas distinguished from the secondary. The early lymphographic studies of primary lymphoedemas (many of which arise from genetic factors) probably laid undue emphasis on changes in the lymphatic vessels. Oil contrast media in leter use in lymphography have given much information onchanges in the nodes. In 89% of patients reviewed both nodes and vessels were diseased and in the majority the changes were worse in the nodes. This suggests that in many patients with primary hypoplastic lymphoedema the pathological process has arisen first in the nodes.


[Embolization in the jugulo-tympanic chemodectoma. Value, indications and results].

Jugulo-tympanic chemodectomas are usually treated by means of surgical ablation and radiotherapy, these two techniques being used either in isolation or association. The recent advent of embolization, which has undergone considerable development in the field of vasular neuro-radiology within the last few years, open up new therapeutic possibilities for these vascular tumours. A study of three personal cases, followed up after a substantial lapse of time, gives a good idea of the importance of embolization in the therapeutic armoury. In fact, although embolization used alone can cause a reduction in functional symptomatology and even and objective clinical improvement (disappearance of some lesions of the cranial pairs, for exemple), it is regularly followed by repermeabilization of the various pediculi. Embolization used in isolation should therefore be reserved for patients who are inoperable for reasons for extension or associated deficiencies. Embolization appears to be of value before the operation as it results in less haemorrhage and may also be of value before radiotherapy.


[Herpes virus isolated from pigeons (author's transl)].

A virus has been isolated from pigeons with the clinical symptoms of "infectious coryza". The virus produces numerous pocks on the chorio-allantoic membranes; livers from infected embryos have areas of necrosis. Microscopic examinations reveals basophilic and eosinophilic intranuclear inclusions. The virus produces a cytopathic effect of rounded refractile cells after 24 h with rapidly spreads throughout the monolayer. The virus is sensitive to chloroform. Electron microscopy of negatively stained lysed cell preparations shows that the virus is a herpesvirus. The strain is pathogenic for pigeons. Lesions produced by intralaryngeal inoculation consists of small necrotic foci in the laryngeal epithelium and in the liver.


[Chemotherapy in a case of laryngeal chemodectoma].

A case report of chemodectoma of the right aryepiglottic fold accompanied by large homolateral adenopathy, treated by cobalt-therapy and chemotherapy. The patient is clinically cured three years from the beginning of treatment. Interesting results of chemotherapy associated with radiations where the operation is refused by the patient.


Superoxide dismutase (erythrocuprein) and free radicals in clinical chemistry.

Erythrocuprein (superoxide dismutase) has recently been shown to have an enzymic function towards superoxide anions. The discovery of superoxide dismutase, its mode of action, and estimation are reviewed along with a brief introduction to oxygen activation and free-radical chemistry. The formation, activity, and destruction of oxygen free radicals in white blood cells, red blood cells, and subcellular particles are discussed. (a) The production of superoxide anions by white cells during phagocytosis is thought to be advantageous for the overall bactericidal event. (b) Normal red blood cells generate low levels of superoxide anions. Increased levels of free-radical production could play a significant role in accelerating cell ageing (haemolysis). (c) Subcellular particles produce superoxide anions. These as well as organic peroxides have been implicated in drug hydroxylation reactions involving cytochrome P-450.


Mucus gland tumors of the larynx and laryngopharynx.

During the 30-year period from 1939 through 1968, 20 patients were seen who had "minor salivary" tumors arising in the mucus glands of the larynx or laryngopharynx. This group comprised about 3% of more than 600 patients with mucus gland tumors of the upper aerodigestive tract treated at Memorial Sloan-Kettering Cancer Center during the same interval. In each instance the tumor was malignant, and all but three of these patients were men. Location and histology of these uncommon tumors is described. Only 2 of 18 treated cases were "cured." Uncontrolled cervical lymph node involvement or distant metastasis was more often the reason for treatment failure, rather than local recurrence at the primary site.


Evidence for the assignment of the loci AK1, AK3 and ACONs to chromosome 9 in man.

The segregation of human enzymes and chromosomes has been studied in more than 30 independent primary human-rodent somatic cell hybrids and a series of 64 subclones. The results strongly suggest that the locus determining AK1, 'red cell' adenylate kinase, is on chromosome 9 in man, and hence that the locus for the ABO blood groups and that for the Nail-patella syndrome may also be assigned to this chromosome. Evidence is presented indicating that another adenylate kinase, nucleoside triphosphate adenylate kinase, and also the soluble form of aconitase, are probably syntenic with AK1, and that the mitochondrial form of aconitase is probably not syntenic with these loci.


Pathology of lacquer thinner induced neuropathy.

Seven men aged 17 to 22 years developed severe distal symmetrical predominately motor polyneuropathy after repeated inhalation of a commercially available brand of lacquer thinner. Motor nerve conduction velocities were markedly slowed. Fascicular biopsy specimens of sural nerve showed a striking loss of myelinated nerve fibers. Prominent neurofilamentous masses resulted insegmental paranodal distention of axons with secondary thinning and retraction of myelin from the node of Ranvier. Autopsy material from one case revealed central chromatolysis of anterior horn cells in the lumbosacral enlargement and axonal swellings in the fasciculus gracilis. One or more volatile hydrocarbons contained in the lacquer thinner involved may be neurotoxic if inhaled to excess any many cause a neuropathy with characteristic pathological features.


[Mutagenic action of N-nitrosodimethylurea on Actinomyces rimosus and Penicillium chrysogenum].

High mutagenic activity of N-nitrozodimethylurea (NDMU), an agent of the group of the nitrozo compounds not studied in detail was shown with respect to prototrophic and auxotrophic strains of Actinomyces rimosus, an organism producing oxytetracycline and Penicillium chrysogenum, an organism producing penicillin. The rate of direct and back mutations in the auxotrophic strain of Act. rimosus under the effect of NDMU was many times higher than that of spontaneous mutations. NDMU was used at one of the selection stages at which a more active variant of Act. rimosus was obtained. This is evident of a possible use of the mutagen for induction of variation with respect to the quantitative feature of oxytetracycline production. A great number of morphologically changed forms and biochemical mutants of Pen. chrysogenum formed under the effect of this substance. NDMU induced a mutant of Pen. chrysogenum capable of selective synthesis of 6-aminopenicillinic acid without addition of the precursor.


[Pharmacology of gentamicin sulfate].

Pharmacology of gentamicin sulfate prepared at the All-Union Research Institute of Antibiotics was studied. By the paramaters of acute toxicity the drug did not differ from a Bulgarian sample of gentamicin sulfate. Under the conditions of the acute experiment on animals it was found that only high doses of gentamicin significantly exceeding the therapeutic ones induced some decrease in the arterial pressure, respiration suppression, blocking of the neuromuscle transmission in the synapses of the skeletal muscles. The latter may be eliminated by the use of calcium chloride. Under conditions of the chronic experiment with intramuscular administration of gentamicin sulfate to the animals for 4 weeks in doses equivalent to the theraputic ones for humans, impairement of the vestibular function and albuminuria often accompanied by pronounced distrophic changes in the kidney canaliculi were observed in some animals. An increase in the drug dose resulted in more pronounced distrophic changes in the kidney tissue.


[Effect of inorganic phosphorus on the biosynthesis of polymyxin B].

A synthetic medium containing optimal levels of the sources of carbon, nitrogen and inorganic phosphorus and providing satisfactory yields of polymyxin B was developed for 2 strains of Bac. polymyxa 933 and VK-153. The consumption of phosphorus in the medium by the strains and the antibiotic biosynthesis levels depended on the form of phosphorus added to the medium. Optimal biosynthesis of polymyxin B was observed at lower concentration levels of soluble soluble phosphorus in the medium than the bacterial growth.