Cyclic adenosine 3',5'-monophosphate (cAMP) in pregnancy body fluids during normal and abnormal pregnancy.

cAMP levels in maternal urine (MU), maternal plasma (MP), and amniotic fluid (AF) were measured by competitive protein-binding assay in medically uncomplicated pregnancies (Group A) and some abnormal pregnancies (Group B). In Group A, MU values increased from 3.43 +/- 0.3 mu/Moles per gram of creatinine (mean +/- S.E.M.) at 12 to 29 weeks to its peak value, 5.72 +/- 1.03 at 33 to 35 weeks (p less than 0.025). Thereafter, the values decreased until term. In AF, cAMP levels increased from 9.4 +/- 1.02 at 10 to 19 weeks to 32.6 +/- 2.7 picomoles per milliliter between 35 and 42 weeks (p less than 0.005). Mean +/- S.E.M. MP levels between 4 to 20 and 21 to 42 weeks showed no significant difference (14.97 +/- 15.89 +/- 0.57 picomoles per milliliter, respectively). Umbilical cord plasma contained higher concentrations than in MP and AF. In Group B, abnormal MU patterns were observed in hypertensive disorders, chronic renal disease, and postmaturity. In a single patient with hyperthyroidism, abnormal MU and AF (but not MP) levels were observed. Abnormalities in MU and AF concentrations of the nucleotide are thus not specific for one disease entity.


Phosphatidylinositol and phosphatidylglycerol in amniotic fluid: indices of lung maturity.

The minor phospholipids in amniotic fluid from normal pregnancies were correlated with the well-established index of lung maturity, the lecithin/sphingomyelin (L/S) ratio. When the L/S ratio was less than 1.0, the acidic phospholippids phosphatidylglycerol (PG) and phosphatidylinositol (PI) were absent or low in concentration (0.0 to 2.5 per cent of lipid phosphorus). Parallel to the increase in the L/S ratio to 2.0, the content of PI increased 6.0 to 8.5 per cent of lipid phosphorus. PG, the unique phospholipid of lung surfactant, first appeared and PI concomitantly decreased when the L/S ratio exceeded 2.0, indicating the secretion of mature lung surfactant. Analysis of PI and PG in amniotic fluid as markers of surfactant seems to be of value as an additional index of prenatal evaluation of lung maturity and may be particularly useful when the specimen is contaminated with blood.


Serum unconjugated estriol levels in the third trimester and their relationship to gestational age.

Maternal unconjugated estriol levels were measured throughout the 28 to 41 week interval in two groups of accurately dated normal pregnancies. The first group consisted of randomly sampled pregnancies on which 285 unconjugated estriol determinations were performed. The logarithms of the mean values plotted into a positive sloping, relatively straight line which was disrupted by a plateau originating at 31 to 32 weeks and terminated at 35 weeks where there began a steep surge to a point at 36 weeks (surge point) that returned values to fit the previously established straight line. To investigate these findings in individual pregnancies, a second group of nine subjects was studied with serial unconjugated estriol determinations. In all nine of these subjects, the surge point could be identified statistically and occurred at a mean gestational age of 36.0 +/- 0.6 (1 S.D.) weeks. Data from the first group of randomly sampled pregnancies indicate that the surge point occurred around a mean gestational age of 36.0 weeks and was confirmed by data from the second group of serially sampled individual subjects showing the surge point as a statistically definable marker in normal pregnancies.


Limitation of the specific serum radioimmunoassay for human chorionic gonadotropin in the management of trophoblastic neoplasms.

Two cases of recurrent trophoblastic disease are presented in which human chorionic gonadotropin was detected in assays of urine concentrates at a time when serum levels were undetectable by a sensitive and specific beta-subunit radioimmunoassay. The potential greater usefulness of measurements of urinary concentrates is discussed.


The androgenic polycystic ovary.

The polycystic ovary has the capacity to produce excessive androgens (delta4-androstenedione, dehydroepiandrosterone, and testosterone). Whether this disorder is caused by constant pituitary priming of the ovaries due to hypothalamic-pituitary derangement or an ovarian enzyme defect, the end result is the same, i.e., abnormal androgen production. In an effort to explain the syndrome, we offer the hypothesis of an inherently sensitized adrenal secreting excessive androgen which leads to an imbalance in the hypothalamic-pituitary axia. The result is a tonic stimulation of the ovaries eventuating in "the androgenic polycystic ovary."


Assay of estriol-16alpha-(beta-D-glucuronide) in pregnancy urine with a specific antiserum.

A rapid, direct radioimmunoassay for estriol-16alpha-(beta-D-glucuronide) in pregnancy urine has been developed by use of immunogens in which the estriol glucuronide hapten is linked through positions 2 or 4 of ring A to bovine serum albumin or agarose gel. The resultant antibodies cross react less than 1% with other estriol conjugates, estradiol conjugates, or unconjugated estrogens. Pregnanediol-3-glucuronide cross reacts less than 0.5%. This high degree of specificity of the antibodies allows for a 10,000-fold dilution of pregnancy urine to be assayed directly without interference from other steroids or urinary constituents. Good linear correlation was obtained for urinary-estriol glucuronide equivalents measured in the same subjects by our routine colorimetric method which separates and measures free estriol after hydrolysis. With an accelerated antibody-antigen equilibration of 20 minutes at 40 degrees, 10 samples can be easily processed in less than 90 minutes. The method also allows for the evaluation of variations in the excretion pattern of one estrogen conjugate in normal and high-risk pregnancies.


The effects of dipivalyl epinephrine on the eye.

We treated one eye each of ten patients with ocular hypertension with dipivalyl epinephrine (DPE), a congener of epinephrine. Pupil size and intraocular pressure were measured before and at intervals up to 240 minutes after instillation of a single drop of DPE in concentrations from 0.005 to 0.5%. Concentrations of 0.025% DPE and greater significantly reduced IOP, and mydriasis was induced by concentrations of 0.1% DPE or greater. Comcentrations of 0.1% DPE, instilled twice daily for one month, significantly reduced intraocular pressure during diurnal testing on days 2 and 31. No toxic side effects were noted. The DPE produced dose-related increases of cyclic adenosine monophosphate in the aqueous humor of rabbits.


The retina in type 5 hyperlipoproteinemia.

Of two patients with type 5 hyperlipoproteinemia, one exhibited lipemia retinalis with multiple retinal hemorrhages and intraretinal lipid extravasations. Postmortem examination showed hemorrhages in the inner retinal layers and lipid deposits largely in the outer plexiform layer. Lipid within the walls of the retinal vessels was demonstrated by light and electron microscopy. The second patient exhibited visual loss due to progressive obstruction of retinal vessels with white material presumed to be lipid. Findings were confined to one eye.


Atypical retinitis pigmentosa in familial hypobetalipoproteinemia.

Of three patients with familial hypobetalipoproteinemia, a 42-yeear-old white woman, who was homozygous for this autosomal dominantly inherited disease, had no detectable serum betalipoprotein and had a marked retinal pigmentary degeneration characterized by ring scotomas by Goldmann perimetry, extinguished electroretinographic responses, delayed responses and elevated thresholds during dark adaptometry, and abnoramal cone thresholds. A 4-year-old daughter and a 28-year-old niece of the first patient, who wer heterozygous, had reduced but detectable levels of serum betalipoprotein and no significant retinal pigmentary degeneration. Unlike patients with autosomal recessively inherited abetalipoproteinemia (the Bassen-Kornzweig syndrome), none of our patients had significant neurologic of cardiac defects. Although the level of serum betalipoprotein might be correlated with retinal pigmentary degeneration in familial hypobetalipoproteinemia and abetalipoproteinemia, it appears that  neurologic and cardiac defects are dependent on other factors.


Spatial summation properties of goldfish ganglion cells.

At threshold the eye is known to sum quanta as though the total catch were important and not the distribution on the retina. In humans, spatial summation is larger under dark adapted conditions. The extent of this spatial summation is studied in goldfish retinal ganglion cells which are known to receive both rod and cone inputs. The area of summation in single ganglion cells is found to be much larger for rod input compared to cone input. It seems that in single ganglion cells, the spatial summating properties increase markedly in the dark due largely to the neural organization of rod and cone input.


Experimental parturient hypocalcemia in cows following prepartal chemical inhibition of bone resportion.

Cows fed a balanced diet with the required amounts of calcium and phosphorus developed acute hypocalcemia and hypophosphatemia shortly after parturition, even in the presence of the a responsive parathyroid gland, when bone resorption was selectively inhibited by the prepartal administration of disodium ethane-1-hydroxy-1, 1-diphosphonate (EHDP). When serum total and ionized calcium levels declined below 6.0 and 1.0 mg/100 ml, respectively, cows developed clinical signs similar to naturally occurring parturient paresis. The plasma immunoreactive parathroid hormone levels were similar prepartum, at parturition, and 1 day postpartum in cows administered EHDP as in control cows. Parathyroid chief cells were predominately in the actively synthesizing phase of the secretory cycle with a prominent Golgi apparatus and lamellar arrays of rough endoplasmic reticulum. Many chief cells were degranulated of mature secretory gransules. Calcitonin activity in thyroid extracts, determined by bioassay, and the numbers of secretory granules in thyroid C-cells were similar in both groups of cows. EDTA infusion after 60 days of the experiment demonstrated that the immediately available calcium reserves were reduced in EHDP-treated cows. The serum calcium remained significantly lower and did not return to preinfusion levels by 24 hours. Serum calcium in control cows returned to within the normal range by 6 hours after EDTA infusion. The urinary excretion of hydroxyproline was consistently reduced prepartum and following EDTA infusion in cows receiving EHDP. The experimental induction of parturient of parturient hypocalcemia by the prepartal administration of EHDP provides a valuable model for studies to investigate the mechanisms in bone responsible for the development of severe hypocalcemia that occurs in response to the increased calcium demand imposed by parturition and the initiation of lactation.


Motor innervation of the flexor pollicis brevis: an electromyographic study.

Percutaneous stimulation of the ulnar and median nerves at the wrist, with simultaneous recording of action potentials on a standard electromyograph oscilloscope, was performed to observe the motor innervation of the flexor pollicis brevis muscle. Both the deep and the superficial heads of the muscle were studied in twenty-three subjects. Results showed that the most common pattern of innervation was exclusive ulnar nerve supply in both heads, with 52.4 percent of the subjects showing this pattern. Dual supply by both median and ulnar nerves occurred next in frequency with 19.0 percent showing this pattern in both heads of the muscle. Exclusive median nerve supply was observed in only 9.5 percent of the total cases studied. The remaining 19 percent showed varying patterns, with each head of the muscle supplied differently. If no differentiation between deep and superficial heads is made, this 19 percent may be considered as dual innervation of the muscle. In this case, it may be concluded that 38 percent of the muscles studied showed some type of dual innervation.


Effect of prolactin on diluting and concentrating ability in the rat.

The effect of prolactin on free water clearance (C(H2O)) and reabsorption (T(cH2O)) was assessed in hereditary hypothalamic diabetes insipidus (HHDI) and hydropenic Sprague-Dawley rats. Infusion of ovine prolactin (200 nmol/kg per h) ablated C(H2O) in HHDI rats but had no effect on T(cH2O) in hydropenic rats. Additional experiments in HHDI rats employing submaximal infusions of both ovine and rat prolactin indicated that with increasing infusion rates of these hormones, urine osmolality progressively increased with a maximum effect being reached at 30-40 nmol/kg per h with ovine and 15-20 nmol/kg per h with rat prolactin. In similar experiments, using synthetic lysine-arginine vasopressin, maximum effect on urine osmolality was achieved with an infusion rate of 25-75 pmol/kg per h. During infusion of all three hormones, urinary cyclic AMP excretion increased significantly in a similar fashion. These data suggested that prolactin had a direct effect on collecting tubule permeability and acted through stimulation of cyclic AMP production.


Age-dependent mechanical and biochemical responses to glucagon.

The age-dependent relationships between glucagon-induced alterations in myocardial mechanics and adenylate cyclase activity in fetal and newborn lambs and adult sheep were evaluated. Glucagon substantially augmented the force of contraction of ventricular myocardium isolated from the adult but not from the fetus or newborn. Similarly, substantial increases in the spontaneous frequency of contraction and tension were observed in adult atrial strips, but not in the fetus or newborn. Comparable activities of phosphodiesterase were observed in extracts from fetal and adult myocardium and were unaltered by the addition of glucagon. Adenylate cyclase activity in adult myocardial homogenate and particulate fractions was comparable to that of fetal tissue. Glucagon stimulation of the particulate fraction produced no change in fetal adenylate cyclase activity whereas a 43% increase in activity was observed in preparations from adult tissue. Sodium fluoride and epinephrine augmented adenylate cyclase activity in both fetal and adult myocardium. Thus, glucagon produced age-dependent, parallel changes in heart rate, active tension development, and particulate fraction adenylate cyclase activity, suggesting that these chronotropic and inotropic responses are indeed mediated by adenylate cyclase and that lack of response in the fetus reflects the absence of mature glucagon receptor sites.


Pig reticulocytes: I. Transitory glucose permeability and metabolism.

Glucose permeability and metabolism were examined in the reticulocytes of pigs made anemic by daily administration of phenylhydrazine for 5-7 days. Blood samples containing 70-90% reticulocytes were fractionated according to their density by centrifugation. The most immature reticulocytes obtained from the top centrifugal fractions possessed a glucose permeation mechanism. The salient features of glucose transport include a) saturable kinetics with Vm ranging from 0.1 to 0.4 mumol/ml cell X min and with Km ranging from 6.6 to 12 mM, b) inhibition by phloretin, and c) countertransport characteristics suggesting that the glucose entry was mediated by a mechanism involving membrane carrier-type transport. In the course of reticulocyte maturation leading to mature red cells, the glucose carrier mechanism was discarded or rendered ineffective, resulting in nonglycolytic mature red cells. Glucose and ribose consumptions in the most immature reticulocytes were 2.5 and 0.75 mumol/ml cell X h, respectively. Concomitant with the diminishing glycolytic ability, ribose consumption was enhanced slightly as the reticulocytes matured to red cells. Dihydroxyacetone, a potent metabolic substrate for the mature pig red cell, was utilized readily by the reticulocytes.


Do dreams have meaning? An empirical inquiry.

Three judges attempted to sort randomly selected dreams of normal college students and schizophrenic patients according to dreamer, night of occurrence, and sequential order within a night. Sorting was successful at statistically significant levels (which differed for the two groups) for all but the third task. The authors conclude that dreams are, as depth psychologists have assumed, orderly nonrandom events and that they reflect day-to-day changes in the life of an individual. They note that further work is needed to determine whether there is order among dreams of a given night.


Computed tomograpy and neuroradiology: a fortunate primary union.

Computed tomography (CT) has led to extensive reassessment of and alterations in the practices of neuroscientists. Many of these alterations and their implications are described. The progress and problems encountered in the past 36 months are reported as well as the trends of future investigations. The principles evolving should apply in many situations as the benefits of CT are extended to other portions of the body.


The effects of biological motion on CT resolution.

A variety of periodic and aperiodic psyiologic motions affect the quality of CT images. This study was initiated to estimate what an optimal scan period should be in the design of CT units. Ultrashort scan periods were experimentally similated in the heart and liver to approximate the parameters of future technology.


Some limitations of computed tomography in the diagnosis of neurological diseases.

Some of the limitations of CT in the diagnosis of neurologic disease are reported. Problem areas include small lesions; lesions obscured by adjoining structures; small vascular structures and detail of large vessels; cases in which the diagnosis is made but information is incomplete for treatment; cases of incorrect diagnosis; non-nenoplastic lesions mistaken for neoplasms; some subdural hematomas; occasional false negative findings; and misinterpretation due to technical errors. Knowledge and use of the clinical presentation, the performance of other complementary diagnostic procedures, repeat CT scans tailored to the region of interest, and repeat serial scans may assist in reaching the proper diagnosis and diminishing potential error.


Trends in the development of reconstruction tomography in neuroradiology.

Because of the new uses of CT, it is difficult to accurately forecast the future balance between it and conventional radiologic techniques. However, the relatively low frequency resolution of CT makes it unlikely that conventional radiology will be completely replaced. Photon noise and the iodine concentration of the contrast medium limit the size of the cerebral vessels which can be studied by CT. Thus angiography is likely to remain the method of choice for fine-detail study of these vessels. For optimal measurements and comparative studies, improved head fixation is required. Given precisely reporducible positioning, stereotaxic surgery and radiation therapy become a reality.


Computed tomography in infants and children: intracranial neoplasms.

Cranial CT proved exceptionally accurate  in detecting and localizing cerebral neoplasms in children, with only one false negative case in 40 tumors. CT had its greatest diagnostic value in cerebral and cerebellar hemispheric lesions, tuberous sclerosis, and as a screening device for craniopharyngiomas. While CT may provide a definitive diagnosis, additional information form other neuroradiologic studies is often necessary.


Computed tomography; the anatomic basis of the zone of diminished density surrounding meningiomas.

Computed tomography of meningiomas often demonstrates a zone of diminished density surrounding the actual tumor. This zone may be related to widening of the subarachnoid space, cerebral edema, tissue necrosis, or demyelination. A case is presented in which the anatomic basis of the zone of diminished density was shown on pneumoencephalography and at surgery to be an enlarged subarachnoid space.


Computed tomographic evaluation of hemorrhage secondary to intracranial aneurysm.

Angiography in patients with subarachnoid hemorrhage secondary to aneurysm gives precise information on the location and size of the aneurysm and the aneurysm and the presence of spasm but gives incomplete information on ventricular size, size and location of hematoma, and extent of infarction. CT demonstrates precisely brain or intraventricular hematoma and, at times, subarachnoid hemorrhage, indicates the extent of infarction; and rapidly documents the degree of hydrocephalus. Infarction secondary to spasm, hematoma, and hydrocephalus are readily differentiated. The CT examination may be repeated as often as necessary without patient discomfort or morbidity. Serial scans allow rapid assessment of change in ventricular size, development and persistence of infarction, and change in size of hematoma.


Demonstration of purulent bacterial intracranial infections by computed tomography.

Computed tomography is shown to be an important modality in both diagnosis and management of cerebral infections. Representative findings from CT scans of patients with purulent bacterial infection of the meninges, cerebrum, ventricles, and adjacent structures are presented. Material is taken from 2,645 CT scans done in a 1 year period at the Hospital of the University of Pennsylvania. It is hoped that the use of CT will lead to a decrease of morbidity and mortality in entities such as brain abscess and subdural empyema.


Stereotaxic computed tomography.

A method for stereotaxic computed tomography is described. A head fixation system has been devised enabling the exact transfer of information fromthe diagnostic coordinate system of the scanner to other therapeutic or diagnostic coordinate systems.


Picture processing in computed tomography.

Using the EMI scanner system computer, picture processing of various kinds can be performed. Computer programs enabling analysis of regions of interest, subtraction, smoothing, and reconstruction in three dimensions have been designed; they are easy enough to be handled by the regular staff. The potential of the methods is illustrated.


Computed tomography and radionuclide studies in the diagnosis of intracranial disease.

The accuracy of CT and radionuclide studiies in the diagnosis of intracranial disease is analyzed based on experience in 641 patients. Results indicate that both modalities give reasonably similar precision and that a modest improvement in diagnosis can be expected if both techniques are employed. It is emphasized that the radionuclide studies used routinely included what are rightfully considered adjunctive scanning procedures, so that results must be considered in this light.


High resolution computed tomography of the orbit withthe Ohio Nuclear Delta head scanner.

The orbit is an ideal structure to examine by CT because of large differences between absorption values  of retroorbital fat and other structures such as muscle, optic nerve, and ophthalmic artery. Spatial resolution in CT is dependent upon the volume of each pixel (individual picture element). Whereas the pixel volume of the original EMI scanner was 117 mm, that of the Ohio Nuclear Delta head scanner employed in this paper is only 5 mm. Ovver 200 patients have been examined using this scanning instrument, including 32 patients in whom the orbits were specifically examined with a scan plane parallel to Reid's baseline. Representative abnormalities are discussed and illustrated. Orbital tumors such as hemangiomas, lymphomas, meningiomas, and inflammatory pseudotumors can be accurately localized while still very small.


Further progress in CT scanning and computerized radiation therapy treatment planning.

Total body computed tomography has introduced a unique method of obtaining body contours as well as anatomical representations for radiation therapy treatment planning. CT scanning combined with computerized radiation therapy treatment planning has improved accuracy and contributed greatly to the solution of complex treatment problems. CT scans can also be used to evaluate the progress of patients undergoing radiation therapy.


Health planning for computed tomography: perspectives and problems.

Computed tomography has been introduced to the health care system at a time when health care planning is still evolving. Unlike the recent past, final authorization of large expenditures and new services such as CT now lies outside the providers of care and is based on laws and regulations that are not familiar to many physicians. A brief review of the principal federal statutes is presented from the Hill-Burton Act to the National Health Planning and Resources Development Act of 1974. Recognizing the unique problems in certain special service areas such as CT, the state of Indiana has formed committees to collect information and develop recommendations to assist its health planners in their actions and decisions under the federal statutes. The quantitative problems which the Indiana CT committee must address are presented in some detail, problems that other health planners face as well.


Economic analysis of computed tomography units.

All operating CT installations in the United States were surveyed in January 1976; data were obtained from 98 of 140 installations. Although the respondents represented 80 head units and 18 head and body units, the overwhelming experience was with head CT studies. CT equipment was installed in an average of 1.3 months, operated 64 hr per week and examined 50-55 patients per week. A downtime of 7 hr per week was reported. Radiologists are responsible for 92 of 98 installations, and 90% of installations are in a hospital. The scheduling delay averages 1.6 days for inpatients and 11.5 days for outpatients. The delay is increasing in many installations. The estimated total yearly technical cost is +325,000-+371,000 per installation, depending upon patient volume. The estimated technical cost per patient (when 50 patients per week are studied) compares favorably with the estimated net revenue per patient from the average basic technical charge (+130 compared to +138). A separate billing method is used by 59% of installations, and 76% have an extra charge for contrast injection and additional studies; 60% of patients receive contrast. The reported total charges during the last 3 months were higher in installations that (1) charged additionally for contrast, (2) were located in outpatient settings, and (3) had nonradiologists as the responsible physician. It should be emphasized that most CT installations are not independent activities and should be considered an integral part of a diagnostic radiology department or office.


Computed tomography of the body: initial clinical trial with the EMI prototype.

A review of the first 400 cases examined on one of three prototype EMI body scanners is presented. During the initial evaluation phases, it became obvious that computed tomography of the body has tremendous potential in the evaluation of various organs and disease states. The technique has been most useful in evaluating patients with known or suspected abdominal neoplasm, particularly lesions of liver, pancreas, retroperitoneum, and kidney. Too few cases have been studied to realistically quantitate its impact on the total field of medical diagnostic imaging.


Picture quality of computed tomography.

Some limitations that impair the picture quality of computed tomography are presented. Picture grain is analyzed in detail and its relationship to different matrix sizes is demonstrated. The choices of matrix size for viewing various parts of the body are defined, and the need for higher resolution in the future is debated. Comparison is made between two scanning systems: the moving fan beam with rotation and the simple rotating fan beam. Possible artifacts in the picture caused by drift and delay in dector response are discussed.


Computed tomography of the body: early trends in application and accuracy of the method.

Early experience with extracranial CT has shown this diagnostic method to be highly accurate in evaluating the liver, pancreas, kidneys, retroperitoneum, and pelvis. The diagnosis of neoplasm, inflammatory changes, and normal moophologic variants is possible. Initial data indicat that this modality may assume a primary role in the evaluation of the liver, pancreas, and retroperitoneum (e.g., the differentiation of medical from surgical jaundice and the distinction of solid from cystic lesions). In the thorax, the results appear far less dramatic. CT scans rarely surpass the diagnostic accuracy of conventional radiologic studies. Initial results indicate a need for studies comparing CT with radionuclide examinations, ultrasonography, and other conventional radiographic procedures as well as for evaluating its use in radiation therapy planning and follow-up.


Computed tomography of the liver.

This work examines the scope and accuracy of CT in the detection of tumors, abscesses, cysts, and parenchymal disorders of the liver. While CT remains an emerging modality, it is shown to be equal to nuclear medicine in detecting mass lesions. It has also been possible to distinguish obstructive from nonobstructive jaundice. Presently, CT is not well suited to the study of cirrhosis. Technological advances in CT design and contrast agents offer promise of significantly improved resolution.


Computed tomographic evaluation of aortic aneurysms.

Applications of computed tomography are being extended from the brain to other body parts. This report describes CT scanning of abdominal and thoracic aortic aneurysms in 30 patients. CT shows greatest promise in abdominal aortic scanning, where reliable identification of the aorta can be achieved even in the absence of enlargement or calcification. However, current limitations prevent visualization of internal detail such as intimal plaques or mural thrombi. Technical advances are described which should have an important bearing on this.


Computed tomography of the heart.

In an attempt to evaluate the possible usefulness of transmission computed tomography, CT scans of the chest of a series of dead dogs were obtained by means of an EMI body scanner. The sections thus obtained with and without the injection of contrast material reveal a great deal of cardiac morphology. Infarcts of the heart produced prior to scanning were imaged as regions of lower x-ray attenuation. The hearts of a series of live dogs following infarction were imaged by means of a positron  emission transverse tomomograph (PETT) following administration of C-palmitate. The images permitted assessment of the relative size of the infarct. The relative advantages of transmission and emission tomography in cardiac visualization are discussed.


Cardiac reconstruction imaging in relation to other ultrasound systems and computed tomography.

A computer-controlled system is described for the generation of two-dimensional motion images of the heart. A standard B scanner is used to scan the area of interest during 40-50 cardiac cycles, and the computer controls recording of the ultrasound signals, beam position indicators, and physiologic data. The ultrasonic echoes are reformatted by the computer into sequential frames by reference to the ECG. Images are displayed in motion on a large monitor, and hard copy is obtained on 35 mm cine film. Off-line computer-controlled signal processing is utilized for image enhancement of clinical studies. Real-time systems for the production of two-dimensional motion images of the heart are discussed and compared to computer reconstruction of ultrasound cardiac imaging. The advantages of ultrasound imaging of the heart and other body areas are presented, and prospectives are offered by which the present and future roles of ultrasound can be evaluated in respect and future roles of ultrasound can be evaluated in respect to computed tomography. It is concluded that ultrasound will remain the primary noninvasive modality for cardiac motion study and that ultrasound will continue to provide important clinical information in all parts of the body where it is currently employed.


Clinical and serologic responses of volunteers infected with phlebotomus fever virus (Sicilian type).

Twenty volunteers were inoculated with various doses of human serum containing Phlebotomus fever virus (Sicilian type) to determine their clinical and serologic responses as well as the human infectious dose50 of the virus. All infected subjects developed fever which varied in duration from 6 to 74 hours. The most common symptoms during sandfly fever were headache, anorexia, myalgia, photophobia, low back and retro-orbital pain. Infected individuals developed a marked leukopenia characterized by an initial lymphopenia followed by protracted neutropenia. Little complement fixing antibody was detected in convalescent sera but most subjects developed significant rises in hemagglutination inhibiting antibodies. All infected subjects developed specific neutralizing antibodies with titers ranging from 1:40 to 1:2,560. Of the three serologic tests performed, the plaque reduction neutralization method appears to be the most sensitive test for detecting antibodies to Phlebotomus fever viruses.


Japanese encephalitis virus in Northern Taiwan, 1969-1973.

Sentinel pigs were bled and mosiquitoes were collected for isolation of Japanese encephalitis virus (JEV) between 1969 and 1973 in a rural area of northern Taiwan which reported a high annual incidence of human cases. The study site included a farmyard, schools, a bat cave, rice paddies and a heronry. Although Culex annulus was collected in every month of the year, isolations were made only in midsummer and only from Culex annulus and (once) from Culex tritaeniorhynchus. These isolates were usually collected from pig-related sources. Human cases in the vicinity of the study site were reported 3 to 6 weeks following the initial isolations from sentinel pigs. Isolations were made only for 4 to 8 weeks each summer. The isolation of JEV was not related to the availability of susceptible pigs or the spring or summer peaks in prevalence of Culex annulus. Despite periodic draining of rice paddies and the application of insecticides, sufficient numbers of Culex annulus were available to support transmission of JEV in each year of the study.


Isolation of Langat virus from Haemaphysalis papuana Thorell in Thailand.

A strain of Langat virus (LGT), T-1674, was isolated from a pool of Haemaphysalis papuana Thorell collected in the forest of Khao Yai National Park in Central Thailand. The isolated virus was found to have growth and antigenic similarity to the prototype Langat strain (TP-21). This is the first report of a natural infection of Haemaphysalis ticks with LGT and of the isolation of this arbovirus in Thailand. The wide distribution of known vectors of LGT in Thailand suggests that the virus may be present in other areas of the country.


Collagenolysis of rat tail tendons by crude corneal collagenase and clostridiopeptidase A.

An experimental apparatus, which uses freshly collected, nondenatured rat tail tendons as substrate against crude corneal collagenase from alkali-burned rabbit corneas and clostridiopeptidase A, is introduced. The apparatus makes it possible to compare the collagenolytic activity of the two enzymes directly on intact connective tissue similar to intact corneal tissue. It was found that the two enzymes were able to reduce the tensile strength of rat tail tendons to less than 100 g in less than 5 h. The two enzymes attacked the tendons in structurally the same manner, estimated from a statistical model. The conclusion drawn is that crude corneal collagenase can degradate intact connective tissue indicating that it can attack the intact cornea.


Cyclophosphamide-induced amelioration of Marek's disease in Marek's disease-susceptible chickens.

Bursa- and thymus-dependent functions were examined in Marek's disease (MD)-susceptible normal chickens and in chickens treated with 5 and 16 mg of cyclophosphamide (CY) at the time of hatching. Chickens not exposed to Marek's disease virus (MDV) and treated with CY temporarily lost mitogenic response to concanavalin A but regained full response after 5 weeks. Bursa-dependent functions, such as presence of germinal centers in spleen and cecal tonsils, morphologic features of bursa, and sheep red blood cell antibody response were completely lost in chickens treated with 16 mg of CY and only partly retained in chickens treated with 5 mg of CY. In chickens exposed to MDV, the degree of thymus-dependent spleen cell mitogenic response was directly related to frequency and severity of MD. Chickens treated with 16 mg of CY had a mild mitogenic depression and low frequency and severity of MD lesions, whereas those treated with 5 mg of CY and those not treated had marked mitogenic depression and high frequency and severity of MD. Suppressions of bursa- and thymus-dependent functions by MDV alone were also evident when comparing MDV-exposed and nonexposed chickens. The results also indicate that presence of small, residual amounts of humoral factor(s) may enhance MDV oncogenesis.


Effects of swab materials on infectious bovine rhinotracheitis virus.

The recovery rates of infectious bovine rhinotracheitis virus from swab materials were compared. The adsorptive and elutive properties of cotton, polyester, and calcium alginate wool were examined by direct exposure of infectious bovine rhinotracheitis virus to swab materials in buffered tissue culture medium. Calcium alginate wool was virucidal; this was apparent after 2 hours' exposure. Cotton and polyester swab materials exhibited little virucidal effects. The addition of wooden applicator sticks with the swab materials reduced viral titers further.


Murine cytomegalovirus glomerulonephritis: clinical and ultrastructural observations.

This investigation was initiated to study and correlate the clinical and ultrastructural aspects of glomerulonephritis induced in the laboratory mouse by the intraperitoneal injection of a sublethal dose of murine cytomegalovirus. An attempt was made to ascertain the pathogenesis of the glomerular changes and the resultant viremia. Murine cytomegalovirus infection caused an acute transient glomerulonephritis in young female mice of the HA/ICR strain. Mice that survived a sublethal inoculation of homogenized infected gland developed transient proteinuria and excreted tubular casts. The murine cytomegalovirus infection resulted in a glomerular lesion that was selective for the mesangial cell. After entering the mesangial cell by phagocytosis the virus replicated in the nucleus and was excreted into the channel of the mesangial matrix, with extension toward the periphery of the capillary loop and adjacent to the urinary space. Virus particles were rarely found in the glomerulus after the 5th day of infection and chronic renal disease was not observed.


In vitro effects of elastase and collagenase on mechanical properties of hamster lungs.

A previous study of hamsters, 21 days after intratracheal treatment with pancreatic elastase, showed development of emphysema, shift of the volume-pressure curve up an to the left, with both air and saline filling, and increase in quasistatic lung compliance. There was also a striking increase in vital capacity and lung volume at transpulmonary pressure of 25 cm H2O (TLC25); however, 21 days after collagenase treatment, there was only a slight increase in TLC25. The lung volume changes were not consistent with the theory that the collagen fiber network is responsible for limiting distension of the lung. This report considers saline-filled volume-pressure curves studied in excised hamster lungs after incubation with endotracheally instilled pancreatic elastase or clostridial collagenase solutions. Fluid retained in the lungs after the first infusion-withdrawal cycle was significantly greater in lungs treated with elastase than in lungs treated with collagenase or in control lungs. Total fluid volume at full inflation was similar in the 3 groups. Chord compliance of lungs treated with collagenase was greater at high volume range than that in lungs treated with elastase or control lungs; chord compliance of elastase-treated lungs was higher at mid-volume range than that of collagenase-treated or control lungs. The results of these in vitro studies are consistent with the theory of independently functioning elastic and collagen fiber networks, with the latter limiting lung distensibility at high volumes, and the former providing great extensibility at low volumes. Events that are part of the repair process after elastase injury may result in a change in the orientation of collagen in alveolar tissue and appear to account for the differing effects of in vivo and in vitro elastase treatment on the static mechanical properties of the lungs.


Effects of rhinovirus infection of pulmonary function of healthy human volunteers.

The effects of experimentally induced rhinovirus and mycoplasmal respiratory tract infections on the pulmonary function of healthy, young, adult volunteers were investigated prospectively. Before inoculation, 12 volunteers were completely normal, whereas 9 had increased frequency dependence of compliance as their only abnormality of pulmonary function. Rhinovirus infection was induced in 8 of the completely normal volunteers, and 5 developed increased frequency dependence of compliance at the time of illness. These changes returned toward normal during the following 2 weeks and were not associated with concomitant changes in any other parameter of pulmonary function, including "closing volume". Three subjects with increased frequency dependence of compliance as their only abnormality before rhinovirus infection developed no significant change in dynamic compliance or any other abnormality in pulmonary function after infection. No changes in pulmonary function were detected in 3 volunteers with experimentally induced mycoplasmal infection. These finding suggest that although rhinovirus infections are associated primarily with upper respiratory illness, they can produce transient peripheral  airway abnormalities in previously normal young adults; however, closing volumes, as well as routine pulmonary function studies, may not detect these changes.


Recovery from rabies in man.

A 45-year-old woman from Mendoza, Argentina, was severely bitten by a dog that died 4 days later. Before death, the dog was nervous, aggressive, and had occasional seizures. Ten days after the woman had been bitten, rabies vaccine treatment was begun: 14 daily doses of suckling mouse brain vaccine followed by 2 booster doses. Twenty-one days after the biting episode, she developed a cerebellar striatal syndrome, which persisted throughout several months, and severe encephalitic symptoms, which persisted for 75 days. After 13 months, recovery was nearly complete. The patient's serum and cerebrospinal fluid contained rabies-neutralizing antibodies reaching maximum titers of 1:640 000 and 1:160 000, respectively. Titers of this magnitude have never been previusly recorded after suckling mouse brain vaccine treatment. This phenomenon, together with the epidemiologic, clinical, and laboratory data presented, supports the conclusion of a nonfatal case of rabies in man.


Cerebrospinal fluid hormone concentration in the evaluation of pituitary tumors.

Cerebrospinal fluid (CSF) concentrations of corticotropin, growth hormone, thyrotropin, prolactin, luteinizing hormone, and follicle stimulating hormone were measured in 28 patients with various neurologic disorders, in 49 patients with pituitary tumors of whom 22 had suprasellar extension, and in 6 patients with craniopharyngiomas. With the exception of 1 patient with pseudotumor cerebri, CSF adenohypophyseal hormone concentrations were low in patients with neurologic disease and in patients with pituitary tumor without suprasellar extension. In marked contrast, 21 to 22 patients with suprasellar extension of a pituitary tumor and 2 of 6 patients with a craniopharyngioma had elevations of one or more CSF adenohypophyseal hormones. Posttreatment CSF adenohypophyseal hormone levels fell from previously elevated levels in 4 of 5 patients. These data suggest that an elevated CSF adenohypophyseal hormone concentration is a sensitive indicator of suprasellar extension of a pituitary tumor, and posttreatment measurements are useful in determining efficacy of therapy.


[Detection and distriburion of slow pre-betalipoprotein in agar gel electrophoresis of total serum in 204 cases of mixed hyperlipidemia].

The demonstration in certain sera by electrophoresis an Agar gel, according to Noble's technique, of a further band of intermediate pre-betalipoprotein, between the betalipoproteins and the usual rapid pre-betalipoproteins, led to the designation of this fraction under the name of slow pre-betalipoprotein or pre-beta-lipoprotein. To the rare studies so far published on this subject, we bring here our contribution in the form of a routine analysis of the variations, and not only the presence, but also the relative concentration of the slow pre-beta-lipoproteins with regard to the rapid prebetalipoproteins. On the fasting serum, after 12 hours fasting, comparative studies of normal control subjects (104 cases) of essential hypercholesterolemia, with or without tendinous xanthomas, corresponding to type IIa (110 cases), mixed hyperlipidemia of type II + IV or III, on paper electrophoresis, corresponds usually to type IIb (204 cases) and, finally, massive endogenous hypertriglyceridemia, corresponding to type IV (95 cases). These indicate clearly the elective concentration of the band of slow pre-betalipoproteins persisting after 12 hours fasting in cases of mixed hyperlipidemia (73% of cases), whilst it is rare in the other groups (no more than 5% of cases). A more complete study of 204 cases of mixed hyperlipidemia showed that the high frequency of slow pre-betalipoproteins is situated in a fairly narrow range of relatively moderate hypertriglyceridemia, between the lower limit of 1.50 and the upper limit of 6 to 7 g/l: the maximum frequency and intensity is situated within the area of 2.50 to 4 g/l. The cases who have already had cardiovascular accidents are more often found to have this band than the cases without complications in a fairly similar age group. However, longitudinal studies, both midterm in relation to therapeutic correction, and short term throughout the day or between the 8th and 12th hour of fasting, have clearly revealed the potential labile nature of this fraction, and show the pathological nature of its sometimes massive persistence beyond the 8th hour and even beyond the 12th hour of fasting. This is a sign of pathological blocking of its transformation rather than of a constitutional lipoprotein abnormality.


[Familial blepharophimosis (author's transl)].

A typical case of familial blepharophimosis is reported. The genealogical tree is reviewed up to the third generation, finding a total of seven affected individuals, 40% of the studied patients. A nervous pattern in the E.N.G. of the facial nerve was found and its possible implication in the genesis of the facial features is discussed. In the genetic study, there was a normal cariotype, and in the genealogical tree a dominant autosomic transmission, without any evident difference in the transmission related to the primitively involved sex was observed.


[Clinical and developmental aspects of hepatoma].

We have reported here 38 cases of hepatoma observed over a period of 3 1/2 years in a Paris hospital, and recall the main circumstances of discovery of this primary tumour of the liver. Clinically, hepatomegaly with a hard, painful border, increasing rapidly in volume in a patient with a past history of alcoholism and with a poor general condition, remains the best sign. More often, decompensated cirrhosis is the only sign and may lead to the wrong diagnosis, until alphafoetoprotein estimation and laparoscopy are carried out. Unfortunately, the almost constant presence of cirrhosis, usually diffuse, and the pluricentric character of the hepatoma, make any attempt at removal immpossible. Treatment consists simply of the administration of analgesics whilst awaiting a fatal issue within 3 to 4 months. We believe that it is useful to have constantly in mind this terminal complication of cirrhosis as, at present, among the direct or associated causes of death from cirrhosis, hepatomas seem to account for about 20%.


[Reflexions and thoughts about one case of acromegalic gigantism (author's transl)].

Having observed a 22 year old man with a case of acromegalic-gigantism (2,30 m.) whose growth still continued after the ablation of a hypophyseal micro-adenoma, by trans-sphenoidale tract, the authors after making various neuroendocrine comments study from a psychological point of view the myth of the giant which appears to be linked to the myth of origins, from a phylogentical point of view (for example Atlantis) as well as from the ontogenetical point of view (identification to the father). The example is particularly ambivalent: at the same time idealized (the Heros), and rejected (the Ogre)--this is explained by the evolution of the father complex, and by the connections between, on the one hand the ego, and on the other hand the ideal ego and the couple ego ideal-super ego.


Use of conjugated estrogens in eye diseases.

Presomen, a preparation of natural conjugated estrogen has been applied to 81 ophthalmologic patients. Some patients received it as a preoperative measure for the prevention of hemorrhages, others were treated with the drug in order to facilitate the absorption of vitreous and retinal hemorrhages. The effect of the preparation on capillary fragility has likewise been studied. The literature contains contradictory reports on the mode of action of conjugated estrogens. Clinical observations show conjugated estrogens suitable for the prevention of hemorrhages in connection with surgical interventions.


Low postheparin plasma hepatic lipase activity in familial type IIa hyperlipoproteinemia.

A subnormal activity of postheparin plasma hepatic lipase was demonstrated in nine of 16 patients with familial type II hypercholesterolemia. On the other hand, in patients with combined hyperlipidemia (type II b) the hepatic lipase activity was mostly in upper normal range. The postheparin plasma lipoprotein lipase activity was normal in both patient groups. It is suggested that the low hepatic lipase activity may have a role in the patholgenesis of one form of familial hypercholesterolemia.


Glomerular injury in patients with neoplasia.

There is considerable circumstantial evidence relating neoplasia to glomerular injury. Recently, more convincing evidence has been derived from the demonstration of tumor-associated antigen or antibody to such antigen, in relation to glomerular basement membranes in four patients with glomerular injury and cancer. The most common form of glomerulopathy reported in patients with carcinoma has been membranous glomerulonephritis. However, increased mesangial cells and matrix have also been found in some patients with hematuria and progressive renal failure. In contrast, most patients with Hodgkin's disease and glomerulopathy have had the minimal lesion-type nephrotic syndrome, which has usually responded to successful treatment of the Hodgkin's disease. Glomerular abnormalities have also been reported with chronic lymphocytic leukemia, lymphosarcoma, Waldenstrom's macroglobulinemia, and benign tumors. When there is no apparent cause, proteinuria with or without hematuria or impaired renal function should suggest the possibility of associated neoplasia, particularly in elderly patients.


The effects of calcium and phosphorus in hemodialysis.

Combined use of Ca supplements (orally or by dialysis) to circumvent decreased intestinal Ca absorption and aluminum compounds to reduce plasma [Pi] has been demonstrated to decrease plasma [iPTH], to normal or near normal in many patients, and to decrease the percentage of bone surface involved in bone resorption. A highly significant positive relationship between change in plasma [iPTH] and bone resorbing surface has been reported. It seems evident, therefore, that PTH must be a major factor in the bone resorption of chronic renal failure, despite the relative skeletal resistance to PTH. As a result, correction of factors that increase PTH secretion should be considered a prime goal of therapy in these patients. The osteomalacic element of renal osteodystrophy, on the other hand, is only partially controlled by these maneuvers and probably requires the additional use of vitamin D or one of its active metabolites for full correction.


Increased resistance to virus infections of mice inoculated with BCG (Bacillus calmette-guérin).

CD-1 or OF-1 mice were inoculated intravenously with 1 mg per mouse (i.e. about 10(6) live bacilli) of Pasteur Institute BCG and challenged 15 to 31 days later with the following viruses introduced by various routes: encephalomyocarditis, murine hepatitis, type 1 and 2 herpes simplex, foot-and-mouth disease and A0 and A2 influenza viruses. In most cases, BCG-inoculated mice exhibited a significantly higher resistance to these lethal infections than control mice (overall survival in control: 18%; in BCG-inoculated mice: 41%). Enhancement of resistance by BCG was especially marked in infections with encephalomyocarditis, herpes simplex type 1 and influenza A2 viruses. Intercurrent infection of BCG-inoculated mice with non lethal doses of viruses did not abrogate their resistance towards subsequent challenge with lethal doses of an unrelated virus. The possible mechanisms of this enhancing effect of BCG on host's resistance are discussed in the light of the known effects of this immunostimulating agent on the various facets of the immune response and of the respective roles the latter play in the defence against virus infections.


The pharmacology of the pineal gland.

Only recently have a sufficient number of publications been available to legitimize a review of the pharmacology of the mammalian pineal organ. Two decades ago Kitay & Altschule reviewed the world literature on pineal physiology, which comprises several thousand papers, and concluded only that removal of the pineal, or administration of pineal extracts, somehow affected pigmentation in lower vertebrates and gonadal function in mammals (1). As the studies described below demonstrate, much more information is now available concerning the pharmacology of the pineal. This review subdivides present knowledge into two areas: (a) the effects on mammals of administering pineal extracts or pure synthetic or natural pineal constituents and (b) the effects of drugs and hormones on the pineal itself. As might be anticipated, the bulk of studies cited in both categories deals with the pineal hormone, melatonin. Melatonin was first isolated from bovine pineal extracts in 1958 by Lerner and his colleagues (2), who used as a marker the capacity of the hormone to aggregate the pigment granules in amphibian melanophores around the cell nucleus. Five years later, Wurtman et al (3) showed that melatonin affected a physiological function in mammals, that is, the size and secretion of the ovary, and subsequent studies have demonstrated that melatonin administration also modifies the growth, composition, and functional activities of numerous other organs. Only recently an assay was developed that allows quantification of the melatonin in human urine (4). The concentrations of the compound vary with a characteristic daily rhythm, peaking at night. The pineal's apparent role as the sole or major source of melatonin, the presence of melatonin in urine, and the demonstration that physiologic effects follow a pinealectomy or the administration of melatomin seem to justify labeling it a pineal hormone. Melatonin synthesis and pineal biosynthetic activity are generally controlled by the sympathetic nerves of this organ (5,6). Therefore, it should not be surprising that drugs known to modify the synthesis, release, or metabolism of norepinephrine in peripheral organs also affect pineal function. Melatonin is itself a derivative of another biogenic amine, serotonin, whose metabolism and actions are also affected by numerous drugs. Indeed, the pineal has often provided an apt tool for examining monoaminergic mechanisms for pharmacologists not specifically concerned with its particular functional properties.


[Effect of antibiotics on the resistance of white mice to C1. perfringens toxin].

The effect of potassium benzylpenicillin, streptomycin sulfate and chlortetracycline on experimental gangrenous intoxication was studied. When the antibiotics were injected before intoxication, the albino mice resistance did not significantly change. When the antibiotics were injected immediately after the toxin administration, the resistance of the test animals markedly decreased.


Rapid microbiological assay for chloramphenicol and tetracyclines.

An agar diffusion assay for chloramphenicol and tetracyclines is described, using inhibition of hemolysis by Clostridium perfringens as a biological indicator of antimicrobial activity. Well-defined zones formed after a 1.5- to 2-h incubation in an anaerobic chamber or after 3 h using a GasPak system. Serum levels of chloramphenicol as low as 2.0 mug/ml could be reproducibly determined with this method. Concurrent presence of gentamicin did not influence the assay. Levels of penicillin G were also reproducibly determined with this method, although use of stable zones of growth inhibition which would form after overnight incubation were a more convenient end point for this bactericidal drug. The hemolytic assay with C. perfringens is a reproducible, accurate, and rapid method for determination of levels for chloramphenicol and tetracyclines.


Demonstration of solids-associated virus in wastewater and sludge.

Data presented demonstrate the relatively high multiplicity of solids-associated virus in field samples, i.e., wastewater, sludge, and soils. Influent, effluent, and chlorinated effluent samples showed 16.1 to 100% of the total virus demonstrated in samples to be solids associated. Three techniques for freeing solids-associated virus are described and compared. Using sonication of solids and polyethylene glycol concentration, virus was demonstrated in fully digested sludge (60 days at 34 C), sand at the site of a sewer leak, and dried sludge cake and mud 900 m downstream from a sewage disposal site. These data emphasize the inadequacy of virus concentration techniques that do not include the processing of solids. In situ elution failed to free solids-associated virus.


Morphology and ultrastructure of a Penicillium sp. grown on n-hexadecane or peptone.

The morphology and ultrastructure of a Penicillium sp. grown on n-hexadecane or on peptone in shake-culture were compared using transmission and scanning electron microscopy. The fungus grew as hollow mycelial balls surrounding individual hydrocarbon droplets on n-hexadecane and as solid mycelial balls on peptone. A dense layer of fungal mycelium that showed irregular forms, fusion, and increase in hyphal size formed at the hydrocarbon-water interface. Inclusions were present in the hexadecane-grown fungus that were absent when the Penicillium sp. was grown on peptone. Problems of fixation made it difficult to differentiate detailed changes in the cytoplasm when the fungus was examined with the transmission electron microscope.


Growth of Clostridium tertium and Clostridium septicum in chemically defined media.

Defined media for the growth of Clostridium tertium and Clostridium septicum are described. The requirements for growth of these two species are compared with each other and with those of Clostridium perfringens.


Influence of starch source on sporulation and enterotoxin production by Clostridium perfringens type A.

Of 16 different starch preparations tested, Clostridium perfringes NCTC 8798 yielded maximum sporulation and enterotoxin formation when ICN-soluble starch was included in Duncan and Strong sporulation medium. In general soluble starches were better than potato, corn, or arrowroot starch with regard to these two parameters.


Bacteriological quality and shelf life of ground beef.

The bacteriological quality of unfrozen raw ground beef was evaluated after 0, 3, 6, 9, 12, 15, and 18 days of storage at 29 +/- 1 F (-1.7 +/- 0.6 C). At the time of fabrication, all of the ground beef samples contained 10(6) or fewer total aerobic and psychrotrophic bacteria/g; 81% contained 100 or fewer coliforms/g; 94% contained 100 or fewer Escherichia coli/g; and all of the samples contained 100 or fewer coagulase-positive Staphylococcus aureus and Clostridium perfringens/g. Total aerobic and psychrotrophic bacteria increased by 1 log between 3 and 18 days of storage. Coliform and E. coli counts decreased during storage, whereas coagulase-positive S. aureus and C. perfringens counts did not change significantly. These data indicate that meat processors, wholesalers, and retailers could improve the bacteriological quality and prolong the shelf life of ground beef packaged in oxygen-impermeable film if the temperature of product never exceeded 29 +/- 1 F (-1.7 +/- 0.6 C).


Inactivation of poliovirus in digested sludge.

The effect of anaerobically digested sludge on poliovirus during incubation at temperatures between 28 and 4 C was studied. Although virus was fully recoverable from sludge, its infectivity decreased in proportion to the time and temperature of incubation. The rate ranged from greater than 1 log per day at 28 C to about 1 log every 5 days at 4 C. The mechanism of inactivation was studied at the lower temperature where the sedimentation coefficients of most inactivated particles were not detectably modified. The ribonucleic acid (RNA) of these particles appeared to have been nicked and had an average sedimentation value about 70% that of RNA from infectious virus. Since the specific infectivity of RNA from particles recovered from sludge was directly proportional to that of the particles from which it was extracted, loss of infectivity was probably due to inactivation of RNA. Some breakdown was also found in the two largest viral proteins of inactivated particles. Thus, the mechanism of inactivation may be cleavage of viral proteins followed by nicking of encapsulated RNA. Because no virucidal activity was found in raw sludge, this component of digested sludge appears to be a product of the digestion process.


Isolation of Pseudomonas aeruginosa and other bacterial species from ornamental aquarium plants.

Ornamental aquarium plants were demonstrated to carry as many as 10(8) viable mesophilic bacteria per g. Gram-negative organisms predominated among the 19 genera of bacteria identified. Pseudomonas aeruginosa was readily isolated from 53% of the samples tested.


Production of infectious Epstein-Barr virus by using an intermittent culture collection system.

Procedures were developed to produce infectious Epstein-Barr virus in large glass fermentors with limited mechanical agitation by using an intermittent culture collection system. The system appears quite suitable for use in fermentation vessels of 50 liters or larger.


Combinations of antimicrobial agents: II. The in vitro sensitivity of 52 strains of proteus species to sulphafurazole, polymyxins and combinations of sulphafurazole and polymyxins.

The sensitivity of 52 strains of Proteus species to sulphafurazole, polymyxins and the combinations of sulphafurazole and polymyxins was determined by means of discs and trays. It was found that 2 and 6 strains, respectively, were sensitive to discs containing 100 mug sulphafurazole and 300 mug polymyxin B, respectively, 41 strains were sensitive to the combination of discs containing 100 mug sulphafurazole and 50 mug colistin, respectively, and 38 strains were sensitive to the combination of discs containing 100 mug sulphafurazole and 300 mug polymyxin B, respectively. The tray method proved that 2 and 5 strains were sensitive to 25 and 200 mug sulphafurazole, respectively, and that 1, 2 and 3 strains were sensitive to 25, 50 and 100 mug polymyxin B, respectively. Also 41 strains were sensitive to the combination of 100 mug sulphafurazole and 25 mug colistin and 38 strains were sensitive to the combination of 25 mug sulphafurazole and 6.3 mug polymyxin B. There was good agreement between the results of the disc and of the tray studies. The synergism between sulphonamides and polymyxins may offer therapeutic possibilities.


Multiple palmoplantar histiocytomas.

Four patients had multiple histiocytomas involving the palms and soles; we describe the clinical and histologic features of their disorder. Multiple lesions of histiocytoma are rare, and their occurrence on the palms or the soles has not been reported, to our knowledge. Whorled patterns of intertwining bundles of histiocytic cells and fibers were seen predominantly and most frequently on histologic examination. No recurrences were noted during a follow-up period of up to two years after removal of the lesions. They appear to be distinct from juvenile fibromatoses and eruptive histiocytomas.


Recessive hypophosphataemic rickets, and possible aetiology of the 'vitamin D-resistant' syndrome.

Two out of 3 children of a first-cousin marriage presented with severe rickets in infancy and are now adult. Their disease has shown continued activity, marked resistance to treatment with vitamin D, early fusion of cranial sutures, greatly increased bone density, nerve deafness, and life-long hypophosphataemia unaffected by treatment. Both parents and a third sib were normal clinically and biochemically. Blood grouping supported both stated paternity and parental consanguinity. Genetics of this unique disease can only be explained satisfactorily on the basis of autosomal recessive transmission, a mode not previously reported in primary hypophosphataemia. This homozygous disease resembles an exaggerated form of common X-linked rickets, though it is caused by a different gene. Although rare, it is particularly important because of the information it provides on the pathogenesis of both forms. We propose that both syndromes may result from multiple target organ unresponsiveness to 1,25-dihydroxycholecalciferol in intestine, kidney, bone, and parathyroid gland.


[Rapid diagnosis of respiratory viral disease by means of indirect immunofluorescence test].

Indirect immunofluorescence test was employed to detect respiratory virus antigens in pharyngeal secretions. Parainfluenza virus type 1-3 sera gave positive results in 19 out of 40 patients with acute respiratory infections tested, mainly among children affected by "viral croup". The reliability of the test for the rapid diagnosis of respiratory infections is discussed.


Evaluation of "instant" preparation of the colon with povidone-iodine.

The antimicrobial effect of 20 minutes exposure to 10% povidone-iodine solution and to 5% neomycin-erythromycin solution was evaluated in vitro in 6 suspensions of dog feces. Povidone-iodine eliminated aerobic growth (P less than 0.001) and reduced anaerobes 4.01 +/- 1.06 (P less than 0.02); C. perfringens was the only anaerobic organism grown. Forty unprepared dogs underwent resection of the sigmoid colon and primary anastomosis. Twenty received normal saline and 20 povidone-iodine injected intraluminally immediately before resection. The colon contents of povidone-iodine treated dogs grew only 0.07 +/- 0.07 aerobes and 3.74 +/- 0.49 anaerobes (all Clostridia) (log10/ml colon contents) (P less than 0.001). All povidone-iodine dogs survived 3 weeks with no anastomotic leaks; three controls died from anastomotic leak within the first week (P = 0.12). Reexploration of survivors revealed less perianastomotic reaction in the povidone-iodine group. Twenty minutes exposure to povidone-iodine produced a significant decrease in bacterial counts in vitro and in unprepared sigmoid colon. No adverse effects were demonstrated.


[Studies on the physiopathology of cholera in Bari].

During a small epidemic of cholera in South Italy in summer of 1973, the infection showed some peculiarities and differences in comparison with cholera classic picture of Asiatic areas. In this paper epidemiological, pathogenetic, clinical and biochemical data of patients admitted to the Institute of Infectious Diseases of Bari are reported. The age of the majority of patients (over 50) is an important factor for understanding cause of infection; but also preexistent basal diseases are responsible of severe course of infection. In fact, in spite of low mortality (2/70), in many cases the course of disease has been complicated by metabolic disorders. Also cardio-vascular conditions have influenced course of infection. The Authors discuss the causes of this atypic behaviour of cholera in South Italy.


Cyclic AMP.

Cyclic AMP is believed to be the intracellular agent which mediates the action of many hormones on their target cell. The mechanisms by which the nucleotide controls glycogen metabolism in liver and skeletal muscle seem to be firmly established. Data relevant to this area of research are selectively reviewed. In addition, the evidence is reviewed for and against a role for cyclic AMP in the regulation of a variety of other cellular functions including: cardiac contractility, smooth muscle relaxation, platelet aggregation, salivary gland amylase secretion, pancreatic exocrine secretion, and gastric acid secretion.


Identification of the jaundiced infant who is likely to recover without surgical intervention.

A series of 32 infants with persistant jaundice in whom an unequivocal differentiation between intrahepatic cholestasis and biliary atresia could not be made is reviewed. A protocol including Lipoprotein-X (LP-X) determinations before and after a short course of cholestyramine (CSM) was carried out in all. A fall in serum LP-X after CSM indicates the presence of patent extrahepatic bile ducts (even microscopic) which will function without benefit of hepatic portoenterostomy. A rise in LP-X levels after CSM means an atretic biliary system. The LP-X, CSM protocol was not able to differentiate between the anatomical variants of biliary atresia that may respond to hepatic portoenterostomy and those that will not. Patent bile ducts (even microscopic) in the porta hepatis and/or proximal hepatoduodenal ligament, which are in continuity with intrahepatic ducts, must be present if hepatic portoenterostomy is to be successful. None of our 12 infants undergoing hepatic portoenterostomy showed evidence of bile excretion after the procedure. Microscopic study of serial sections taken through the excised hepatoduodenal ligament tissues of these 12 infants revealed that none had anatomical findings conducive to the success of the operation.


Gas gangrene: review of 34 cases.

High morbidity and mortality continue to result from gas gangrene, despite the use of aggressive modes of therapy. Between 1967 and 1973, 34 patients with gas gangrene were seen at the University of Maryland Hospital; 11 (32.3%) died. Clostridium perfringens was recovered from the wounds in 79% of the cases and from the blood in 15%. Eighty-five percent of the wounds contained one or more organisms in addition to C perfringens, with as many as seven organisms recovered from some wounds. Twenty-nine patients received hyperbaric oxygen treatments, as well as the more conventional antibiotic drugs; it was not possible to assess the value of this added therapy. Gangrene of the abdominal wall resulted in a higher (50%) mortality than gangrene of an extremity (24%). Presence of normal or depressed white blood cell counts, decreased platelet counts, and abnormal renal or liver functions all denoted a poor prognosis.


[Late stages in the replicative cycle of human cytomegaloviruses in diploid cells. Ultrastructural study].

An ultrastructural study of late stages of the replicative cycle of human cytomegalovirus (CMV) in human embryo fibroblasts cell cultures has been performed. Nucleocapsids are observed only inside the intranuclear inclusion. They mature apparently by taking the envelope from the structural components of microvescicular systems reaching from the nuclear membrane the periphery of the nuclear inclusion. However, some capsids reach "naked" the cytoplasm and then take the envelope from cytoplasmic membranes. In the cytoplasm homogeneous "dense material" and "dense microbodies" are present; in extracellular space enveloped "dense microbodies" are scattered among virions. The peculiar envelopment of CMV capsids, not yet described in the literature, is discussed and the typical ultrastructural cytopathology of CMV infected cells is indicated as an useful tool in diagnostic virology.


Anti-neuraminidase antibody response in hamsters experimentally infected with Sendai virus.

Investigations were performed to study the behaviour of neuraminidase-inhibiting (n.i.a.) and, by comparison, of neutralizing, hemagglutinin-inhibiting (h.i.a.) and anti-S and anti-V complement-fixing (c.f.a.) antibodies in hamsters inoculated intranasally with a Sendai virus strain of recent isolation. Moreover the distribution of the virus in the respiratory tract was followed. Preliminary experiences were done to assure a correct performance of the neuraminidase-inhibition test. First of all the optimal pH and then the influence of the normal hamster serum on the enzyme activity were evaluated. The n.i.a. as well as h.i.a. and anti-S and anti-V c.f.a. were demonstrable from day 6th after infection, neutralizing antibody from 8th day. The n.i.a. reached the peak of 24 days, that is later than the other types of antibodies, and started to decline after 1 month, together with the drop of the h.i.a and c.f.a. On the contrary the neutralizing antibody persisted at high titres till the end of the observation period (75 days). Detectable antibody response was coincidental with a marked drop in the titers of virus recovered from the respiratory tract. Because of the association of both hemagglutinating and neuraminidase activities with the same Sendai glycoprotein, it is stressed the possibility that hemagglutination-inhibition and neutraminidase-inibition tests titrate the same antibody.


[The inhibitory effect of alkyl-aryl-sulfonate on the swarming of proteus bacteria].

Tests were carried out on 16 strains of Proteus to determine the smallest amount of alkylarylsulfone that prevents complete swarming of the bacteria, restricting it to band only 1-2 mm wide. This was achieved by adding 0.0075% of detergent to Gassner's medium. The result was easily visible on the surface of inoculated plates. It was also shown that this inhibitory effect on the flagellar apparatus of Proteus and also Salmonella was purely temporary being due to a reversible reduction of this apparatus.


Immunization against mucosal disease--bovine viral Diarrhea (MD-BVD) in calves applying lapinized vaccine against swine fever and a modified live virus of MD-BVD.

Calves vaccinated with the modified strain C24V react by creating neutralizing antibodies in high titres and are resistent to infection while non-immunized calves manifest the clinical symptoms of MD-BVD. Calves, vaccinated with the lapinized strain "K" of the SF virus react by creating neutralizing antibodies in low titres against the vius of MD-BVD and manifest no apparent clinical symptoms after challenge with the virulent strain MD-BVD.


[The significance of CELO virus as a hatching egg contaminant with special reference to its oncogenic properties].

A group of young hamsters was injected subcutaneously in the neck region with allantoic fluid containing CELO virus. A second group received transplants of cells from tumours induced by CELO virus. Tumours developed in both groups. The latent period was shorter after transplantation than after virus inoculation. The tumours grew progressively, histologically resembling fibrosarcoma. It is recommended that hatching eggs infected with CELO virus should not be used in vaccine production.


[Immunological correlations between 2 strains of mucosal disease virus diarrhea (short report].

Cross-neutralization tests of the C24V strain and the "Kotschmar" strain provided evidence that the two strains are serological variants. Independenthy of quantitative serological differences, these strains had a better immunizing action in calves against a virulent strain of MD/VD virus. This virulent strain evidently formed a third serological variant, because when calves were infected with it, there was a decrease in the serological differences between antibodies. A practical conclusion is that diagnostic serological testing using only one strain is unlikely to detect all the infected animals, particularly those with low titres of antibody. In the presence of complement the neutralizing capacity of immune serum increased and, in the case of low antibody titres, serological differences between strains decreased. Therefore the complement-dependent neutralization test with at least two strains of virus is recommended for use in diagnostics.


[Isolation of reoviruses from mink].

In this first report of the isolation of reovirus from mink, isolates were obtained from 18 to 26 young mink with viral enteritis, by using cultures of cat kidney cells. The isolated also produced cytopathic changes in cell cultures of mink kidney, dog kidney, piglet kidney, calf kidney, bovine embryonic kidney and calf testis. A characteristic feature was the formation of eosinophilic inclusion bodies in the cytoplasma of culture cells. Haemagglutination tests were negative with erythrocytes from cat, rabbit, pig, horse and cattle. Attempts to infect old and young mink, kittens and ferrets with tissue culture material failed. It was not known to what extent this second infection with reovirus influenced the course of mink viral enteritis.


The development of criteria for evaluating psychiatric education programs.

During the last year, the Psychiatry Education Branch of the National Institute of Mental Health undertook an exhaustive review of 530 training proposals from 205 institutions. The scope of such an endeavor, as well as the desire to maintain peer review, necessitated the recruitment of 90 outside consultants. The need for consistency of judgment among a large group of site visitors gave rise to a document that detailed points of concern in the evaluation of psychiatric training programs. Broader dissemination of this document might be useful in a program's self-evaluation, and might further its understanding of the site-visit process. The result of many such evaluations should be the improvement of psychiatric education throughout the country.


Congenital insulinoma (nesidioblastoma): ultrastructural evidence for histogenesis from pancreatic ductal epithelium.

An insulinoma removed from a neonate with proved hyperinsulinemia was examined with the electron microscope. The tumor was composed of pancreatic ductal epithelium and beta cells in direct contact and in lobular units. The pattern of the tumor, the morphologic evidence of beta cell-type activity in ductal cells, and the similarity of the arrangement of tumor cells to that observed in islet regeneration after subtotal pancreatectomy in the rat indicate that this tumor originated from ductal epithelium.


Necrotizing retinopathy with herpes zoster ophthalmicus: a light and electron microscopical study.

A necrotizing retinopathy following a vesicular cutaneous eruption in the distribution of the right trigeminal nerve developed in a patient who had been receiving systemic corticosteroid therapy one week prior to the onset of herpes zoster ophthalmicus. Seven weeks after the herpetic symptoms began, the patient died of pneumonia following an intracerebral hematoma. At postmortem examination, unexpected multiple focal and confluent lesions, which corresponded to areas of extensive retinal necrosis, were observed in the fundus of the right eye. Intranuclear inclusions with a perinuclear halo were identified within the affected sensory retina. Electron microscopy of the retinal lesions disclosed round to oval enveloped viral particles that were characteristic of the herpes viruses. A mild lymphocytic infiltrate was evident in a demyelinated right Gasserian ganglion. Demyelination and necrosis of the right trigeminal sensory tract and adjacent areas were evident within the brain stem.


Discharge planning in an acute hospital.

To improve discharge planning on an acute medical ward, a nursing "team system" was initiated with clear delineation of responsibility for discharge planning. The head nurse supervised the nurses' actions and supported their communication with attending physicians. To assess the efficacy of this approach, chart reviews and interviews of 60 consecutive patients were performed before and after the implementation of the plan. A plan was labeled adequate if the following criteria were met: all treatable diagnoses were recognized; appropriate treatment regimens were instituted for each diagnosis; the patient's abilities were sufficient for him to function in the proposed environment; and plans were made for follow-up care. Patient knowledge was stated to be adequate if the patient was aware of his diagnosis, treatment regimen and plans for follow-up care. In addition, the patient was questioned concerning his satisfaction with the plans for further care. Seventy-five percent of the patients admitted to this ward required discharge planning. Of those requiring discharge planning, the plan was judged adequate in 55% prior to the program change and in 83% following that change. Eighty percent of the patients required some teaching during their hospital stay. Of these, by the time of discharge, knowledge was adequate in 53% prior to the program change and 51% subsequent to the change. Initially 68% of the patients were very satisfied with the discharge plans but this figure rose to 86% following the program change.


Benign hepatic tumors and their association with oral contraceptives.

The growing number of reports of benign hepatic tumors occurring in young women who have been receiving oral contraceptive steroids has led us to review the 33 patients reported in the literature and to cite two additional case reports. By presenting two reports, one describing focal nodular hyperplasia and the other multiple hepatic cell adenomas, we hope to emphasize the pathological differentiation between these two lesions in order to calrify further reporting. Twelve of the 35 patients had massive intraperitoneal bleeding; two other patients had less severe hemoperitoneum. Five deaths have been reported. Although the frequency of use of these agents has become such that a direct relationship between them and benign hepatic tumors is not proved, the clinician should bear the association in mind when presented with women taking oral contraceptives who have abdominal pain. The review is made in the hope of stimulation further case reporting and microscopical and ultrastructural analysis. We trust that three will clarify the possible role of contraceptive steroids as predisposing or etiologic agents.


Histocompatibility types and viral antibodies.

Serum neutralizing (Nt) antibodies to herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), and histocompatibility (HL-A) types, were determined in multiple sclerosis (MS) patients and in control subjects. Titers of Nt antibodies to HSV-1 and to HSV-2 were increased among subjects bearing HL-A3 or HL-A7 or both, whether they suffered from MS or not. The increases were statistically significant in the MS group. The MS and control groups did not differ significantly in levels of HSV-1 or HSV-2 Nt antibodies.


Prophylactic effects of phenytoin, phenobarbital, and carbamazepine examined in kindling cat preparations.

Prophylactic effects of phenobarbital, phenytoin (diphenylhydantoin), and carbamazepine were examined in amygdaloid kindling preparations in cats. Daily electrical stimulation was delivered at the time of peak plasma levels. Comparative examination of the chronological pattern of the clinical seizure development, after discharge growth, and formation of distant independent spike foci was made between periods of kindling with chronic drug administration and of rekindling without drugs. Both phenobarbital and carbamazepine were effective, but phenytoin was totally ineffective. Prophylactic action of phenobarbital and carbamazepine was mainly through the suppression of the development of motor seizures manifestations in the former and the same with the development of sustained after discharge in the latter. The kindling preparation appears to possess many desirable features as an ideal model of human epilepsy for the purpose of assessment and recruitment of potential antiepileptic drugs and development of a rational pharmacotherapeutic approach for the management and prevention of seizure disorder.


Experimental herpes simplex virus encephalitis. Effect of corticosteroids and pyrimidine nucleoside.

The effects of methylprednisolone sodium succinate and cytarabine have been examined in an experimental herpes simplex virus-induced encephalitis in rabbits. In this model herpes simplex virus (HSV) is normally cleared from the brains of untreated animals. Infected animals treated with large doses of methylprednisolone showed a slight delay in the rate of clearance of virus, and a minimal reduction in the inflammatory process, but did not otherwise differ from untreated controls. Animals treated with cytarabine displayed a notable rise in viral titers in brain at a time when virus had been cleared from untreated controls. Cytarabine-treated animals also showed persistence of intranuclear inclusions in the lesions, and moderate diminution in the extent of inflammatory response. Thus, while methylprednisolone appears to have little adverse effect on the encephalitic process, cytarabine, perhaps because of its immunosuppressive properties, results in a failure of normal clearance of virus from nervous system lesions.


Neuromuscular disorder associated with a defect in mitochondrial energy supply.

A limb muscle biopsy specimen from a patient with a slowly progressive congenital neuromuscular disorder disclosed, by electron microscopy, widespread mitochondrial crystalline inclusions. Biochemical studies of isolated mitochondria showed decreased respiratory rate and respiratory control with both nicotine adenine dinucleotide and flavor-protein-linked substrates. Mitochondrial adenosine triphosphatase (ATPase) activity, both basal and magnesium (Mg++)  or 2,4-dinitrophenol- (DNP) stimulated, was greatly reduced in contrast to normal. The rate and extent of mitochondrial calcium accumulation was normal. These findings are consistent with a defect of the respiratory chain-linked energy transfer at a level common to all three energy coupling sites of the respiratory chain. The defect in ATPase activity may be secondary to replacement of functional mitochondrial inner membrane by crystalline inclusions.


Biochemical abnormalities of erythrocyte membranes in Duchenne dystrophy. Adenosine triphosphatase and adenyl cyclase.

Adenosine triphosphatase (ATPase) activity in erythrocyte membranes from patients with Duchenne dystrophy was inhibited by ouabain less than in normal individuals in assay systems containing high or low contents of salt. Epinephrine and cyclic adenosine monophosphate increased total ATPase activity in all samples, and epinephrine restored ouabain sensitivity to the Duchenne membranes. Basal adenyl cyclase activity in about twice that of controls. Epinephrine stimulated adenyl cyclase activity of normal membranes two to three times, but did not stimulate the enzyme in Duchenne membranes. These differences may reflect a genetic abnormality of the membrane.


Treatment of malignant glioma. A controlled study of chemotherapy and irradiation.

Thirty-three patients with malignant glioma were randomly divided into two groups after extensive tumor resection. Those in group A received, every five to eight weeks, a course of chemotherapy consisting of intravenously administered carmustine, 80 mg/sq m/day for three days, and vincristine sulfate, 1.4mg/sq m on days 1 and 8. Patients in group B were treated identically and received radiation therapy (RT) as well, 4,500 rads whole brain plus 1,500 rads to the side of the tumor. The median survival time of group A was 30 weeks, while that of group B was 44.5 weeks, but the overall survival curves were not significantly different. The median survival times exceeded the 17 weeks reported elsewhere in comparable patients not receiving postoperative therapy. Estimates of the quality of survival suggested (1) the two groups were not comparable following randomization, possibly influencing the results; and (2) postoperative radiation and chemotherapy do not increase morbidity and offer a longer period than other treatments during which patients' conditions remain stable or improve.


[Primary hyperoxaluria. Clinical, histological and crystallographic study of the ocular lesions].

A post-mortem histological examination of the eyes of a case of primary hyperoxaluria revealed the presence of crystals in the ciliary processes and at the level of the retinal pigment epithelium. The crystallography study demonstrated that it consisted of wewhellite. The ocular lesions are compared with those found by other authors in primary hyperoxaluria, after prolonged methoxyflurane anaesthesia, after experimental administration of dibutyloxalic acid or naphthalene, and in the human retina in longstanding detachments. Most of the factors which give rise to the presence in the eye of oxalate and its selective precipitation in the midst of certain ocular tissues remain hypothetical. The retinal lesions observed in primary hyperoxaluria appear to be pathognomonic for hyperoxalaemia.


Herpes simplex virus types 1 and 2: therapeutic response to antiviral drugs.

In vitro studies have demonstrated a relative resistance of herpes simplex virus type 2 to antiviral therapy when compared with herpes simplex virus type 1. The in vivo studies, however, show an excellent therapeutic response to both antiviral drugs in experimentally induced viral keratoconjunctivitis.


The Richner-Hanhart syndrome: report of a case with associated tyrosinemia.

The Richner-Hanhart syndrome with tyrosinemia was recognized in a mentally retarded adolescent boy. The clinical manifestations, including hyperkeratosis of the volar aspects of the hands and feet, thickening of the conjunctival epithelium, and corneal opacities, as well as biochemical aberrations of tyrosine metabolism, responded to specific treatment with a diet low in phenylalanine and tyrosine. Light and electron microscopical studies illustrate the underlying conjunctival pathologic changes.


Malignant optic glioma in a 70-year-old patient.

In a 70-year-old man with glioma of the optic nerves and tracts, the initial symptom was a unilateral loss of vision that progressed rapidly and was followed by amaurosis of both eyes. All diagnostic radiological procedures were negative. Four months after the onset of the disease, the patient developed hemiplegia, became comatose, and died. Post-mortem examination revealed a glioblastoma multiforme of both optic nerves, chiasma, and optic tracts that extended posteriorly into the left thalamus and medial geniculate body. The tumoral thickening of the optic nerves was absent in the intracanalicular part, a finding that concurred with the normal radiological appearance of the optic foramen. Glioblastoma multiforme of the optic pathways should be included in the differential diagnosis of acute visual failure in elderly people, even though the final diagnosis may be possible only at postmortem examination.


In defense of SISIs. The short increment sensitivity index.

We review the Short Increment Sensitivity Index (SISI) in terms of its performance with a variety of sites of lesion and its likely physiologic basis. We conclude that its original schema can be broadened to extend its clinical application if changes are made in the parameters of its routine use. The two major changes involve (1) a presentation level of no less than 90 dB hearing threshold level (HTL) and (2) a bimodal interpretation of results based on the premise that high scores indicate normal cochlear function and low scores indicate extensive cochlear damage or neural dysfunction. We suggest that routine use of the modifications suggested here can provide useful diagnostic information and bring to light a group of neurally impaired patients that has been relatively ignored.


Thalidomide anomalies of the ear.

Eighteen 12- to 16-year-old patients with thalidomide embryopathy were examined otologically and neurotologically to clarify both morphological and functional ear anomalies. Ear anomalies were found in the external, middle, and inner ears. However, the inner ear, especially the vestibular portion of the labyrinth, was more extensively undeveloped both morphologically and functionally. Dysfunctions were concomitant in the oculomotor and the vestibular systems.


Evidence for recombination between two different immunological types of foot-and-mouth disease virus.

Recombination was observed between temperature-sensitive (ts) mutants of two immunological types of foot-and-mouth disease virus which were distinguishable by two marker characteristics in addition to their antigenic type. Putative ts+ recombinants were isolated and the segregation patterns of their marker characteristics examined. The results are discussed in terms of the origin of new sub-type strains.


Coppr deficiency in the rat. Relationship to chronic cyanide poisoning.

Daily administration of increasing doses intraperitoneally of  2.5-4.0 mg NaCN/kg to male Wistar rats for 5 weeks produced acute signs of poisoning immediately post-injection but no sign of chronic toxicity except lower final body weights than in control rats. CN-treated rats had less liver copper than controls, but not below the range of normality, and their liver mitochondrial membranes were 24% less able to bind adenine nucleotides than control membranes. No other biochemical or pathological sign of copper deficiency occurred. Liver cytochrome oxidase activity was normal after the 5 weeks of CN-administration, as was the ability of liver mitochondria to synthesize phospholipids. The ultrastructure of hepatocytes was normal without evidence of the enlarged, misshapen mitochondria produced by copper deficiency. Normal cytochrome oxidase activity of liver mitochondria, together with reduced liver copper levels and reduced binding affinity of mitochondrial membranes for adenine nucleotides, indicate that the membrane binding site for adenine nucleotides is not cytochrome oxidase per se but may involve copper, perhaps by virtue of its cationicity. With repeated exposure to CN- rats develop tolerance to acute poisoning. It is suggested that this may be due to the switch in glucose catabolism towards the pentose pathway at the expense of other pathways.


The role of calcium binding protein in the mechanism of action of cholecalciferol (vitamin D3).

A role has been sought for the calcium binding protein (CaBP) which is synthesised de novo after giving cholecalciferol (CC, vitamin D3) to rachitic chicks. After homogenation of mucosal cells in sucrose media, the CaBP was found in the 78,000 X g supernatant. Therefore, the CaBP is either present in the cytoplasm or in some labile membrane structure, e.g. the microvilli, that is disrupted by homogenation. This intracellular CaBP may facilitate diffusion of Ca into intestinal cells. No secretion of CaBP into the lumen could be detected nor did excess CaBP placed in the lumen increase Ca absorption of rachitic chicks. The mitochondria of duodenal mucosal cells contained most of the Ca being translocated by the small intestine. CaBP caused release of Ca already present in mitochondria and diminished Ca uptake by mitochondria and it appreared to do this by increasing the rate of Ca flux across the mitochondrial membrane. This would explain the greater "turnover" of Ca in mucosal cells of cholecalciferol-treated chicks. These and previous findings have been used to propose a scheme for the effect of cholecalciferol on Ca transport from the small intestine.


Caviation in lung cancers.

This paper examines the incidence of cavitation among tumours of the lung, the various radiological appearances and cellular types of these cavitated tumours, and the resulted of sputum cytology. Over a 46 months' period, histological and or cytological evidence of pulmonary neoplasm was found in 244 subjects whose posteroanterior chest radiographs showed opacities suggestive of pulmonary malignant disease. Of the 244 lung tumours, 220 (90%) were primary and 24 (10%) were secondary. Twenty-seven tumours (11%) were cavitated. Every cavitated tumour but one was a primary lung neoplasm. Twenty-one (81%) of these 26 cavitated primary lung tumours were squamous cell carcinoma. Large cell undifferentiated carcinoma (two cases of 7%), adenocarcinoma (one case or 4%) small cell undifferentiated carcinoma (one case or 4%) and alveolar cell carcinoma (one case or 4%) made up the rest. Sputum was examined for cells on 185 patients with primary solid and in 25 patients with primary cavitated lung cancers. Cancer cells were found in 152 patients (72%). Surprisingly, the finding of cancer cells in the sputum was no more frequent in cavitated tumours than in solid tumours. It is concluded that if a cavitated lesion in the radiograph is maglinant, a primary squamous cell carcinoma of the lung is the most likely cause. Sputum cytology performed by a competent cytologist is a very useful and simple diagnostic tool, but it appears to be no more helpful in diagnosing cavitated than in solid lung cancers.