[Therapeutic approach in the rehabilitation of chronic lower back pain. Comparative study of 3 techniques of lumbar reeducation].

The short-term therapeutic effect of 3 techniques of rehabilitation of the lumbar spine (cyphosis gymnastics, kinebalneotherapy and differenciated rehabilitation) was studied out of 87 chronic lumbalgias selected at random and using one of the three techniques administered by 3 physical therapists. A comparison of these 9 couples (technique, technician) was based on criteria evaluated on a blind basis using the traditional unidimensional analysis and also multidimensional analysis. The cyphosis gymnastic reeducation gives less satisfactory results using 26 criteria out of 27. There is an underlying physical therapy factor. A certain number of prognostic factors with implications for any rehabilitation method and for all of the techniques, were disclosed. The comparative testing methods used in the study of drugs are applicable to rehabilitation techniques. However, it was not possible to carry out a comparative study of a reeducation method with a reeducation placebo.


[In vitro study of the primary antibody response of circulating lymphocytes in patients with chronic inflammatory rheumatism].

We have studied the in vitro antibody response to a hapten of peripheral blood lymphocytes from 26 patients with rheumatoid arthritis and 7 ankylosing spondylitis. These patients had never received immunosuppressor drugs before or corticosteroids during the month before the test. They had failed to receive aspirin or non-steroid anti-inflammatory drugs for 72 hours before blood sampling. The control groups included respectively 38 healthy subjects and 24 patients hospitalized for non inflammatory disease. The antibody response of ankylosing spondylitis patients is comparable to that of controls ; on the opposite the response of patients with rhumatoid arthritis is significantly depressed in comparison with the three other groups. The weak response of lymphocytes in arthritis is not due to increased cell death in culture or to modified kinetics of the antibody response or to the appearance of a IgG secondary type response or a in vivo pre-activation. The lymphocytes of arthritis patients do not inhibit the response of normal lymphocytes when they are co-cultured. The observed response is identical to that obtained when control patient lymphocytes are co-cultured with normal lymphocytes. The function of suppressor T cells induced by Con A seems normal in  spondylitis and arthritis.


LEg venous oxygen saturation in the evaluation of intra-operative blood flow during arterial reconstructive surgery.

In twenty-four patients, undergoing a femoro-popliteal saphenous vein bypass graft for symptomatic atherosclerotic occlusion of the superficial femoral artery, oxygen saturation values for the femoral and popliteal veins were compared to the directly measured blood flows in the common femoral artery and in the bypass graft, respectively. Blood flow and venous oxygen saturation increased significantly after transfusion of 900 ml of blood. Pharmacological vasodilation caused a significant increase in blood flow both before and after transfusion, whereas the changes in venous oxygen saturation were significant only before blood transfusion. A close statistical relationship was found between initial femoral venous oxygen saturation and initial blood flow in the common femoral artery as well as between initial popliteal venous oxygen saturation and initial byapss blood flow. However, especially at low saturation values, the evaluation of blood flow was very uncertain. Whole leg and lower leg oxygen uptakes were not altered by intraoperative changes in blood volume. It is concluded that blood flow in the common femoral artery and the bypass graft can be roughly estimated from analysis of oxygen saturation in the femoral and popliteal veins, respectively. Furthermore, by determining leg venous oxygen saturation both before and after flow augmentation, induced by pharmacological vasodilation, a conception of the load on the vascular system may be obtained.


Lack of suppressor cell activity in rheumatoid synovial lymphocytes.

Lymphocytes were eluted from the synovial tissue of seventeen patients with rheumatoid arthritis (RA) and one with ankylosing spondylitis. In eight of these patients immunoglobulin production by synovial lymphocytes in the presence and absence of pokeweed mitogen was studied. In nine patients T lymphocytes were isolated from the eluted cells, and the T helper and suppressor cell functions were evaluated in an allogeneic co-culture system. Peripheral blood lymphocytes (PBL) from twenty-eight normal donors were also studied for comparison. Immunoglobulin produced by synovial lymphocytes was higher than in PBL of normal donors. However, the stimulation index of synovial tissue lymphocytes was lower. Most of the normal donors had suppressor cell activity in their peripheral blood, whereas in synovial tissue lymphocytes a statistically significant number of patients did not have any suppressor cell activity. In contrast, the synovial tissue lymphocytes showed helper activity not differing significantly from that of the T lymphocytes from peripheral blood of normal individuals.


Evaluation of manipulation and other manual therapy. Criteria for measuring the effect of treatment.

In order to evaluate manipulation and other methods of manual therapy, the literature was reviewed. It was found that the number of publications based on scientific criteria is rather limited. However, with certain reservations it can be concluded that manipulation of the lumbar spine might have an immediate, short-time effect on low back pain in a limited number of patients. The criteria for selection, however, cannot be defined on the basis of the available material. Manipulation has no superior long-term effect as compared to other methods of treatment. The effect of specific, non-manipulative mobilization of the cervical and lumbar spine needs further elucidation. Manual therapy in decreased mobility of the extremity joints has received support from control studies.


[Immunohistologic findings in patients with myocardial hypertrophy].

Heart reactive antibodies have been found with direct and indirect immunofluorescence in patients with congestive cardiomyopathy. The authors therefore investigated by direct immunofluorescence 25 patients with aortic valve disease and 11 patients with congestive cardiomyopathy who underwent diagnostic heart catheterization and left ventricular endomyocardial biopsy. The left ventricular biopsies were fixed by bouin, formaline and freeze-drying. A first analysis was performed to determine auto- or formaline-induced fluorescence. A second analysis was performed to identify myocardial structures with positive fluorescence using 5 different anti-sera or patient's serum. The results showed positive fluorescence with anti-IgG-antibodies in patients with aortic valve disease (23%) and with congestive cardiomyopathy (73%). The immunoglobulin deposits were located mainly in the subendocardial connective tissue. These deposits showed also slight fluorescence with anti-IgM, anti-C1q and anti-C4 antibodies. However, a correlation between the hemodynamic and immunologic findings was not demonstrated. It is concluded that the myocardial immune complexes appear to be reactive and do not play an essential role in the pathogenesis of congestive cardiomyopathy.


[Effect of 2 phosphonates on the osteolysis induced by tumor extracts].

An in-vitro model is proposed to test the potential effect of diphosphonates in treatment or preventing bone metastases. This model involves culturing of neonatal mice calvaria in sterile conditions in an appropriate medium and measuring 45Ca release from bone to medium, the mice being injected with 45Ca on the day of birth. Tumour extracts added to the medium usually increase the bone lysis; this effect is significantly decreased when the mice have been treated with either ethane-hydroxy-diphosphonate (EHDP) or dichloromethylene-diphosphonate (Cl2MDP). These experiments represent a first step in a group of experiments with a view to clinical trials in cases of bone metastases.


Induced pain referral from posterior lumbar elements in normal subjects.

Patterns of pain referral, induced from the posterior elements, have been studied in normal volunteer subjects. A series of intracapsular and pericapsular injections were performed at the L1-2 and L4-5 levels. The areas of pain referral indicate overlap between the upper and lower lumbar spine. It is also shown that the pericapsular and intrafacetal pain referral areas are similar and that the upper lumbar spine is more sensitive than the lower.


The pharmacologic approach in differential diagnosis of chronic pain.

Chronic pain of unknown cause below waist level was evaluated in 100 patients by using the Differential Spinal Block (DSB) in a multidisciplinary pain clinic setting. The classic DSB approach, refined for better control of psychologic variables, was found to be a safe and effective means of differentiating various pain mechanisms. We found that, of all patients tested, 55% had pain of central or psychogenic origin and 30% had sympathetically mediated pain, as compared with 15% who had somatic pain. A long-term follow-up of these patients confirmed this impression. These results substantiated the importance of psychologic variables, in dicating the necessity for use of behavioral-based therapies in conjunction with the routine use of the refined diagnostic DSB procedure in patients with chronic pain.


Plastic reconstruction after bypass surgery and massive weight loss.

In summary, the surgical techniques described can provide substantial benefit to selected patients who have sustained massive weight loss. As in all cosmetic surgery, patient selection must be meticulous. The expectations of the patient must be realistic, and the very real risks of the operative procedures must be understood. Patients who have sustained massive weight loss should be informed of the possibilities of reconstructive plastic surgery.


An analysis of differential epidural spinal anesthesia and pentothal pain study in the differential diagnosis of back pain. Aids in avoiding unnecessary back surgery.

The selection of the proper patient for back surgery is of prime importance and is the topic of this report. An analysis of patients evaluated with differential epidural spinal anesthesia and the Pentothal pain study show these tests to be helpful in separating those patients with primarily organic pain who could benefit from surgery from those patients with primarily functional pain who should not be operated upon. These tests will help one determine whether a disability is related to the severity of pain, to the patient's emotional response to pain, or to a somatic manifestation of a gross emotional breakdown.


Pharyngeal infection with Neisseria gonorrhoeae.

During 1978, 156 patients were treated for pharyngeal infection with Neisseria gonorrhoeae; 115 (74%) returned for a posttreatment culture. Aqueous procaine penicillin G (4.8 X 10(6) units) given im with (19 patients) or without (64 patients) orally administered ampicillin for four days was successful therapy in 86% of instances. All seven patients who received tetracycline hydrochloride orally for five days had negative posttreatment cultures, as did nine of 12 patients who received 2.0 g (four patients) or 4.0 g (eight patients) of spectinomycin hydrochloride, im. Concurrent anogenital infection with N. gonorrhoeae was documented for about 60% of the patients, and, with one exception, was eradicated by these treatment schedules.


Effects of hexachlorobutadiene (HCBD) on renal function and renal organic ion transport in the rat.

1,3-Hexachorobutadiene (HCBD) has been suggested to cause nephrotoxicity. In addition, it is eliminated to a large extent in the urine. This study was designed to examine the effects of HCBD on overall renal function and specific renal transport systems in the rat. A single i.p. dose of 100 mg HCBD/kg caused a reduction in urine osmolality and body weight. Urine flow rate increased slightly and marked increases in urinary protein, glucose and ketones were observed. Renal slices after the same dose showed a reduced PAH accumulation. The transport of other organic compounds was affected only slightly. After daily administration on 4 successive days with various doses a graded response was observed on both transport and overall renal function. Glutathione administered in a 2.5-fold molar excess did not obtund the effects of HCBD on renal function or transport


Occupational exposures to pesticides containing organoarsenicals in California.

The only organic arsenicals used in agriculture are methanearsonic acid (MSMA) and its sodium and ammonium salts and dimethylarsinic acid (cacodylic acid) and its sodium salt. They have an oral LD50 in the rat of 700-1,000 mg/kg and are classified as toxicity category 3 pesticides. During the three-year period 1975, 1976 and 1977 in California there were 34 reports by physicians of injury due to exposure to pesticides containing organic arsenicals of which nine resulted in systemic symptoms and the remainder being eye and skin irritations. There appeared to be prompt recovery from these exposures. They were caused primarily by use of faulty equipment, not using due care in its operation, poor work practices and improper use of protective equipment. There is no evidence that this group of chemicals is carcinogenic in animals or man.


[Our experiences with uroflowmetry].

The uroflowmetry is an essential part of the complex urodynamic examinations. One of its advantages is the non-invasive behaviour; the patient does not suffer any inconveniences. It is suitable for the evaluation of the success in surgical interventions due to obstructions in the lower urinary tracts, for control of results of the medicamentous therapy or after operative procedures, which have as their purpose the improvement of the function of the detrusor and for the general differentiation of diseases which are accompanied by dysuric symptoms. The technique renders possible the registration, the preservation of date and means an unlimited repeatable methody.


[Spastic lock of fallopian tube in laparoscopic representation (author's transl)].

Spastic tubal occlusion was established by laparoscopy, a condition recorded on tubal function tests primarily from patients with genital hypoplasia. These accounted for eight per cent of all patients examined for sterility. Hints are given on the detection of tubal spasm, differential diagnosis for delimitation from organically caused tubal occlusion, and remedial action.


[Histophysiological characterisation of chorion. Histological, histochemical, and electron-microscopic investigations (author's transl)].

Histological, histochemical, and electron-microscopic techniques were used to investigate the chorion in 15 women over the first four to eight weeks of normal pregnancy. Evidence was produced to maximum enzyme activity and lipoid accumulation between the sixth and eighth weeks. These findings were confirmed by ultrastructural observation. Data were collected on active exchange in x-cells. That exchange together with manifest delta 5-3-beta hydroxysteroid-dehydrogenase were found to cause not only oxidative processes, but, with some reasonable probability, synthesis of steroid hormones in the chorion, as well.


A comparative study of DNA-induced transformants and spontaneous revertants of inositolless Neurospora crassa.

Inositolless (inl-) Neurospora crassa strains were treated with DNA (allo-DNA) of wild type N. Crassa. Hyphal fragments of a mycelial suspension of the N. Crassa ragged inl- strain used as recipient in our transformation experiments were found to consist of units containing 100--1000 nuclei. In this strain the inositol-independent (inl+) nuclei appearing after DNA treatment or by spontaneous reversion are present in the cytoplasm together with a large number of inl- nuclei. Thus, both transformation and reversion initially must result in heterokaryosis. Under appropriate conditions the inl- nuclei can be detected in the transformed and spontaneous inl+ phenotype revertant strains. Spontaneous revertants are usually characterized by the loss of their inl+ nuclei after transfers on inositol-supplemented medium. On minimal medium, the growth rate of transformed strains is significantly lower than that of spontaneous revertants. The inl+ gene appearing after DNA treatment or by spontaneous reversion is inherited as a trait bound to chromosomes. In crosses with the transformed strains, there is a significant increase in the number of non-Mendelian (6:2 and 5:3) tetrads in the inl locus.


Kinetic modelling of yeast phosphofructokinase.

Phosphofructokinase from baker's yeast (Saccharomyces cerevisiae) is an octameric enzyme which exhibits complex allosteric behaviour. In contrast to mammalian phosphofructokinase, the enzyme does not show association-dissociation behaviour. A systematic kinetic investigation at pH 7.2 in dependence on the substrates, fructose 6-phosphate and ATP as well as on the effectors AMP and ADP is presented. The results are interpreted in terms of a structure oriented theoretical model. Because the two state model of Monod, Wyman and Changeux proved to be insufficient for interpretation of the experimental data, it was extended to a four state model in which the basic conformations R and T of the enzyme are split into subconformations R1 and R2 as well as T1 and T2, respectively. It is assumed that fructose 6-phosphate and the adenine nucleotides influence different allosteric equilibria. The model permits a precise quantitative description of the experimental data.


Significance of HLA antigens and the mixed lymphocyte reaction in psoriasis.

Human Major Histocompatibility (HLA) complex antigens B13, BW16, BW17, CW6 and  D-MA are increased in frequency in patients with psoriasis. Of these, the strongest association is with HLA-CW6 and D-MA, with a relative risk of 10.4. Since no strong association with any HLA-A locus antigen is seen, it seems likely that the disease susceptibility gene for psoriasis lies close to the HLA-D locus, which is defined by the use of the mixed lymphocyte reaction (MLR). In the mouse, the Immune response (Ir) genes are found in the MLR region and it is thought that Ia antigens lie at a corresponding location in man. Recently, we have demonstrated that human epidermal cells cause stimulation in the mixed lymphocyte reaction. Lymphocyte antigens which stimulate in this reaction are known to be products of HLA genes and anti-HLA-D sera block stimulation by epidermal cells. It is possible that these antigens may be involved in the regulation of cell--cell communication. Psoriasis is a disease characterized by epidermal hyperproliferation. It is possible, therefore, that an HLA-linked deficiency of recognition between epidermal cells exists in patients with psoriasis and that this defect allows abnormal cellular proliferation to occur.


Psoriasis: odd varieties in the adult.

Occasionally we observe particular varieties of psoriasis and in rare cases transitional features with other diseases, which pose problems concerning the differential diagnosis and the nosological classification. This communication deals with the following clinical and histological aspects of psoriasis: 1) Sebopsoriasis. Relationship of psoriasis to pityriasis rubra pilaris. 2) Erythema annulare centrifugum type of psoriasis. 3) Is subcorneal pustular dermatosis an expression of pustular psoriasis? 4) Salient histopathological criteria for the diagnosis of the different atypical forms of psoriasis. 5) Presentation of an unusal case with striated and retiform verrucous psoriasis-like eruptions, which show a relationship to parakeratosis variegata.


Particular clinical features of psoriasis in infants and chidren.

The onset of psoriasis is observed before the age of 10 years in 15% of all patients. The clinical pattern often takes on a peculiar form. Psoriasis guttata--or less frequently nummular psoriasis--is the initial phase during childhood. It is very difficult to establish a diagnosis on the basis of incipient features when childhood psoriasis is located on the head, palms, soles, or on the fingers, toes and nails. Intertriginous or flexural psoriasis, psoriasis spinulosa and oral psoriasis is also described. The onset of napkin psoriasis starts at the age of 3 months. Occasionally, Leiner's disease may develop into a typical, chronic psoriasis. We have concentrated our studies on the less common features of childhood psoriasis: the generalized pustular infantile form, congenital psoriatic erythroderma, acquired psoriatic erythroderma, and infantile arthropathic psoriasis.


Surface features and behavior of the connective tissue cell.

The surface features and behavior of the connective tissue cell in normal areas and in healing incisions of the aponeuroses of the abdominal wall of the albino rat were studied with the scanning electron microscope (SEM). The normal cell is smooth, oval or triangular in outline and has a generally rounded surface and very short or no cell processes. The behavior of the fibroblasts and the condition of the fibers in and around the wounds were visualized. Shortly after the incision, the fibroblasts accumulated around the wound, possibly by increased cell division. At the site of the incision the cells responded by a self-protective mechanism in which they withdrew their processes and acquired a spheroid form. During the maximum period of a fibrillogenesis the fibroblasts enlarged, acquired a fusiform outline and long processes, exhibited a roughened surface and were surrounded with small rounded cell particles polymerizing into fine fibrils. The process of collagen secretion and three stages of collagen maturation were visualized. Some abnormal cells were seen; they could be evidence of merocrine or holocrine mode of secretion or possibly signs of cell senility.


Anticataleptic action of psychostimulating drugs and serotonin in brain.

The effects of drugs changing serotonin activity in rats were studied observing changes in the anticataleptic action of amphetamine and ephedrine. It was observed that: 1) parachlorophenylalanine prolonged the anticataleptic action of ephedrine and, in part also, that of amphetamine, 2) methysergide alone exerted an anticataleptic effect and enhanced somewhat the same effect of both psychostimulating drugs used, 3) d, 1-tryptophan increased the intensity of catalepsy and reduced very significantly or abolished completely the anticataleptic action of ephedrine and amphetamine. These results support the view that the serotonin system exerts a suppressing effect on the central effects resulting from stimulation of catecholamine dependent functions.


Hypercapnia and hyperkalaemia.

Studies in patients undergoing peritoneal laparoscopy, in which carbon dioxide was used as insufflating gas, showed that artificial hyperventilation was an effective means of preventing serious hypercapnia. The hypercapnia caused a rapid hyperkalaemia and there was a linear relationship between the two. Reversal of the hypercapnia caused the serum potassium to fall towards normal but the speed of this fall did not match the speed of reduction in Paco2. It is suggested that the changes in serum potassium following changes in Paco2 may have some clinical relevance in potassium-depicted patients.


"9 + 0" immotile spermatozoa in an infertile man.

In this paper the peculiar case of an infertile man, possessing only normally shaped, but stiff and immotile spermatozoa is described. All the sperm are conventionally structured, with the constant characteristic of the absence of central tubules and projections forming the so-called central sheath. Electrophoretic analysis of the high molecular weight polypeptide chains attributed to dyneins shows the constant absence of one chain. The importance of the central structure, usually belonging to the "9 + 2" model spermatozoa, and the possible localization of a dynein chain in this region are discussed.


[Neuromuscular block control during and after anaesthesia (author's transl)].

During many years the clinician's requirements for neuromuscular blocking drugs are satisfied by clinical investigations. Electromyographic recordings which are a satisfactory method are not useful in current practice. The use of nerve stimulators as Churchill Davidson apparatus modified for train of four impulses must reach the continental theatres, the response to neuromuscular blocking agents varying over a wide range. Five ways of stimulation can be used giving different informations, not only during anaesthesia, but so after particularly to specify the origin of some complications.


[Acute rheumatic carditis. Follow-up (author's transl)].

Thirteen cases with a first attack of acute theumatic carditis are presented, analyzing the clinical picture and long-term follow-up. Although the clinical acute attack was quite benign, incidence and importance of residual heart disease has not changed.


Comparison of the plaque-stimulating and thymocyte-stimulating activities derived from human monocytes.

Human monocytes have been reported to release factors that can elicit distinct responses from a number of different target cells. In this report, it is shown that most of the thymocyte-stimulating activity in supernatants of endotoxin-stimulated monocytes can be separated from the plaque-stimulating factor (BAF) by gel filtration and isoelectric focusing; however, since these activities could not be entirely resolved, the question was addressed whether the plaque-stimulating activity of BAF depends upon the stimulation of T-cells. Several critical experiments are reported which fail to support this hypothesis. On the other hand, these experiments led to the observation that the response to BAF depends on both an IgM-positive B-cell and a G10-adherent, plastic nonadherent, IgM-negative, irradiation-insensitive cell found in nude splenocytes. Finally, the possibility is discussed that this factor may be responsible for many of the physiological sequelae of infection.


Thymosin modulation of suppressor function in mice and man.

The effect of thymosin on suppressor-cell function was evaluated in vivo in a murine tumor system and in vitro on human lymphocytes. In mice, the Lewis tumor system was used. We showed that splenocytes from tumor-bearing animals were able to enhance tumor growth in a syngeneic system. This enhancement was similar when thymocytes from tumor-bearing animals were used and disappeared after anti-Thy 1-2 antiserum treatment, suggesting a T-dependence. Treatment of the tumor-growth-enhancing lymphocytes with corticosteroids or irradiation caused this effect to disappear completely suggesting that the tumor-growth-enhancing T-lymphocytes were suppressor T-cells. Furthermore thymosin (fraction 5)-treated, tumor-growth-enhancing T-lymphocytes were not able to enhance tumor growth and even significantly decreased it. In the human system we showed that Con A-stimulated lymphocytes were able to suppress the response of normal lymphocytes to PHA, PWM, and Con A, and in MLC. This effect was significantly blocked in presence of thymosin fraction 5.


Phosphorylation of streptozotocin during uptake via the phosphoenolpyruvate: sugar phosphotransferase system in Escherichia coli.

Mutants of Escherichia coli K-12, Staphylococcus aureus, and Bacillus subtilis defective in the general components (enzyme I, or HPr, or both) of the phosphoenolpyruvate:sugar phosphotransferase system are shown to be resistant to the antibiotic streptozotocin. It is shown here, employing 32P-labeled phosphoenolpyruvate, that wild-type cells of E. coli phosphorylate streptozotocin, whereas with a phosphotransferase system-defective mutant of E. coli the drug is recovered in an unaltered, free form. The internal accumulation of streptozotocin at the steady-state level was about 70 times that of the concentration in the external medium. The antibacterial action of streptozotocin, as well as the uptake of the drug, was inhibited by N-acetyl-D-glucosamine. The uptake of the antibiotic was extremely sensitive to p-chloromercuribenzoate. It is concluded that streptozotocin is taken up by E. coli via the phosphoenolpyruvate:sugar phosphotransferase system and consequently accumulates in the cell at first as streptozotocin-phosphate.


Zearalenone, deoxynivalenol, and T-2 toxin associated with stalk rot in corn.

The mycotoxins zearalenone (2.8 micrograms/g), deoxynivalenol (1.5 microgram/g), and T-2 toxin (110 ng/g) have been found in the pith of corn stalks standing in the field. Such contaminated stalks may contribute to mycotoxicoses of farm animals.


Mouse epidermal and skin extracts tested for cytostatic activity ("chalones"). Effects on organ and cell cultures.

Crude and fractionated epidermal extracts have been shown to decrease the growth and viability of epidermal cells (mouse ear organ cultures) as well as of murine mastocytoma cells, fibroblasts (L cells) and kidney cells (primary cultures). This cytotoxicity has been demonstrated to be due to the extracts and not to parasitic toxins. Furthermore, extracts prepared from dermis, mammary glands, and liver were likewise cytotoxic. These results do not confirm the presence of tissue-specific growth inhibitors (chalones) which have been claimed by others to be present in epidermal extracts.


Gonococcal urethritis--diagnosis and treatment.

For men with urethral discharge, a simple gram stained smear is 98% sensitive and over 99% specific in detecting gonococcal infection when compared to a single Thayer-Martin culture. The smear is less than 50% sensitive in asymptomatic urethritis. Neither Fluorescent antibody nor various serologic tests offer any diagnostic advantages over smears and/or cultures and they are not cost-effective. Treatment of gonococcal urethritis may be successfully accomplished with a variety of antibiotic regimens. Tetracycline hydrochloride (500 mg four times a day for 5 days) is highly effective, inexpensive, and is active against Chlamydia trachomatis; post gonococcal urethritis (PGU) is therefore uncommon. Aqueous Procaine Penicillin G (4.8 million units IM with 1 g of probenecid) has become the standard in the United States but suffers from higher cost, the need for refrigeration, occasional alarming toxic procaine reactions, and a high incidence of PGU. Spectinomycin 2 g IM remains expensive but is the regimen of choice for treatment failures and for Neisseria gonorrhoeae that produce penicillinase (PPNG). Other antibiotics active against PPNG are cotrimoxozole, cefoxitin, and cefuroxime. PNNG have now been reported from 27 countries throughout the world, but have attained significant prevalence in only a few areas of East Asia and West Africa. Because gonococcal patterns of antibiotic resistance are constantly changing, each region of the world needs to monitor treatment results and maintain some surveillance over sensitivity to antibiotics.


[Mucolipidosis type II. Report of 2 suggestive cases].

The clinical and laboratorial study of two brothers with gargoylism is reported. The examination of the urine showed normal findings of mucopolysaccharides. The authors made differential diagnoses with others mucolipidoses and concluded that mucolipidose type II should be considered in any patient with gargoylism.


[Anatomo-pathological study of the brain in idiopathic cardiomegaly].

The pathological findings in the brain of patients who died with idiopathic cardiomegaly are reported. The major findings in the 38 studied cases were cerebral infarcts (10,5%) and cerebral atrophy (7,9%) besides the nonspecific histological changes represented by neuronal ischemic alteration, satellitosis of nerve cells and swollen and hyperplasia of endothelial cells in capilaries of the cerebral cortex. These findings were considered a consequence of the venous stasis of the congestive heart failure. These data were compared to those seen in the brain of patients with heart failure in the course of chronic Chagas disease. The morphological findings were similar. The frequence of infarcts and atrophy was higher in the cases of Chagas disease and the cerebral atrophy was seen in an younger group of patients compared to the cases of idiopathic cardiomegaly. It seems that there is another factor also responsible for the occurrence of cerebral atrophy in Chagas disease, since from the clinical and hemodynamic point of view both cardiopathies have many similarities.


The current status of home total parenteral nutrition.

The history and current status of home total parenteral nutrition are reviewed. Patients without a functional intestinal tract are able to lead a relatively normal life, infusing their essential nutrients through a Silastic central venous catheter while they sleep at night. The average catheter life is nine months. Suspected sepsis and obstruction of the catheter were the leading causes for catheter removal.


Preparation of parietal peritoneum for measurements of in vitro permeability.

An experimental method for in vitro studies of permeability of parietal peritoneal membrane was developed in rats. Sodium and potassium fluxes across the peritoneum lining two different regions (the diaphragm and the anterior abdominal wall) were estimated and electrical resistance of the isolated membranes were determined. A significant reciprocal correlation was observed between the two indices. Quantitative differences between the two types of membranes were found, the diaphragmatic region being more permeable than the other. It is suggested that a monolayer of mesothelial cells covering the membranes is partially responsible for these differences. The parietal peritoneum was found to be less permeable than visceral peritoneum (mesentery) studied under identical conditions.


[Congenital adrenal hyperplasia due to blockade of 3-beta-hydroxysteroid dehydrogenase].

Five cases of congenital 3 beta-hydroxysteroid deshydrogenase deficiency in children are reported: four boys with perineal posterior hypospadias and one girl with clitoromegaly. The salt losing syndrome was clinically overt in only three patients. The main biological character was the very high level of plasma dehydroepiandrosterone (DHA) with an elevated DHA/delta 4 androstenedione ratio. The 17 alpha-OH progesterone, though in normal biosynthesis of glucocorticoids being produced beyond the enzymatic block, was raised, but this apparently paradoxical observation may assist making the diagnosis. Deficient production of testosterone was demonstrated in the prepubertal boys by absence of postnatal rise in plasma testosterone or a decreased reponse of plasma testosterone to chorionic gonadotrophin. It is concluded that deficiency of 3 beta-hydroxysteroid deshydrogenase, now easily recognizable with the use of plasma steroids radioimmunoassay, is probably less rare than was apparent with the use of urinary steroid estimations.


Determination of cardiac output of the artificial heart from the drive air flow.

An indication chamber, inserted between the right heart drive and the pump proper, was designed to provide continual measurement of the quantity of blood pumped by the pneumatic artificial heart. The flow is evaluated from the motion of a piston provided with a photoelectric transducer. The effect of compressibility of the drive gas on measurement accuracy is eliminated. The indication chamber provides for automatic replenishment of gas that escapes by diffusion and through minor leakage. During testing in an artificial circulation within the range of physiological conditions, measurement in accuracies did not exceed 5%.


Genetic counselling for neurological disorders.

When parents have a child with any problem, they usually become concerned about the chances of this problem recurring if they have further children, or of appearing in their grandchildren. Similarly, persons with any congenital disorder themselves or family history of such disorder, often worry about their future children. Genetic counselling can in most cases provide reassurance that there is little need for concern. In those instances where the risks are real, they can be put into perspective and often effectively circumvented by procedures such as prenatal diagnosis. Pregnant women of advanced age run increased risks of having children with chromosome disorders; it is of benefit to individual couples and to the community to refer such women for amniocentesis.


'Oscopy' in obstetrics and gynaecology.

Endoscopy has enhanced the science and practice of obstetrics and gynaecology immeasurably over the last decade. There is an established place for most of these procedures, especially in the case of laparoscopy. The hazard of laparoscopy should be able to be further reduced. In the case of laparoscopic sterilization, probably the most conservative method should be used, especially in those at risk of seeking reversal. Hysteroscopy has a small but significant place, mainly in diagnosis. Although promising, foetoscopy is still very much in the development phase.


Combined cholinergic antagonist and beta 2-adrenoceptor agonist bronchodilator therapy by inhalation.

The bronchodilator effects of 40 microgram ipratropium bromide (I) and 400 microgram fenoterol (F) by pressurised aerosol and both drugs in combination were compared with placebo (P) in a double-blind study in eight patients with chronic, partially reversible airways obstruction. The four treatments were (1) IP, (2) PF, (3) IF and (4) PP, with the second aerosol administered two hours after the first. Both drugs produced significant bronchodilatation for five hours, the response being greater and more rapid in onset with fenoterol. Both drugs in combination (IF) produced significant additive bronchodilatation from three to six hours after fenoterol. This additive effect may have been due to the improved lung function caused by ipratropium bromide and does not imply a synergistic effect. There were no side-effects reported. The results suggest that both ipratropium bromide and fenoterol are effective bronchodilating agents in patients with chronic asthma.


Studies on poison ivy. In vitro lymphocyte transformation by urushiol-protein conjugates.

The isolation and purification of poison ivy urushiol is described. The preparation of urushiol-ski protein and urushiol human serum albumin is also described. Lymphocytes from eleven donor naturally sensitized to poison ivy and from four non-sensitive individuals have been cultured for 5 days in the presence of urushiol-carrier conjugates. Lymphocytes from seven of the eleven sensitive donors responded with a stimulation index greater than 3.0 to urushiol-albumin conjugate. When urushiol-skin protein conjugate was used as a stimulant, lymphocytes from only three of the eleven sensitive donors responded. The results suggest that urushiol-protein conjugates can stimulate sensitive lymphocytes in vitro, although a response is not observed in every individual naturally sensitized to poison ivy.


Complement C3 and immunoglobulin in inflammatory acne vulgaris.

In patients with moderate to severe inflammatory acne, complement (C3) was detected by immunofluorescence in sixteen early inflammatory acne lesions but in only one of thirteen biopsies of non-inflamed skin from acne sites. C3 deposition occurred particularly in the walls of small dermal blood vessels and at the dermo-epidermal junction. IgM was identified in vessel walls in four of sixteen early lesions. In eight late inflammatory lesions C3 deposition was much less prominent and was present in vessel walls in only two. None of the late lesions showed vascular deposition of IgM. The observations indicate that complement activation occurs in inflammatory acne and it is suggested that this may play a pathogenic role in the inflammation.


The fate of phage lambda DNA in lambda-infected minicells.

The fate of phage lambda DNA in lambda-infected Escherichia coli minicells harboring the plasmid ColE1, and in plasmid-free minicells, were studied. Binding of lambda DNA to the minicell membrane, and formation of the supercoiled covalently-closed circular structure has been demonstrated. Phage infection abolishes plasmid DNA synthesis. Only a very slight, non-replicative lambda DNA synthesis occurs, soon after infection. This synthesis is associated with fragments of lambda DNA arising during, or soon after its penetration.


Effect of crosslinking by glutaraldehyde on interaction of F-actin with heavy meromyosin.

Crosslinking of F-actin by a bifunctional reagent glutaraldehyde resulted in a marked decrease of viscosity and length of F-actin filaments. The extent and rate of superprecipitation of actomyosin reconstituted from the modified actin were lower than those of unmodified actin-myosin complex, but activation of heavy meromyosin ATPase by the crosslinked actin was higher than by unmodified one. Heavy meromyosin ATPase activated by the crosslinked actin was distinctly less dependent on KCl concentration than that activated by unmodified actin. Turbidity of the modified acto-heavy meromyosin in the presence of ATP exceeded the sum of turbidities of actin and heavy meromyosin, whereas in the case of unmodified acto-heavy meromyosin the turbidity was comparable to that for noninteracting system. The difference in activation of heavy meromyosin. ATPase by the cross-linked and unmodified actin, clearly seen at room temperature, significantly diminished when temperature was lowered to 0 degrees C.


General mechanisms of inflammation in rheumatoid arthritis.

Rheumatoid synovitis is characterized by the simultaneous occurrence of two major types of immunologically-induced inflammation. These usually occur concurrently in the same joint. A cellular immune response is present in the sublining layer of the synovial membrane and an immune complex-induced acute inflammatory reaction is present in the synovial effusion phase of the disease. The two reactions are closely related and mutually interdependent. The cellular immune response is reduced in rheumatoid arthritis, but the chronic inflammatory cells of the synovium are active in the synthesis of IgG and probably considerable amounts of IgG rheumatoid factor. Rheumatoid factor complexes, particularly IgG-RF complexes, appear to be responsible for the exudative, immune complex-induced inflammatory phase of the disease.


[Bactericidal effects of macrophages of mice treated with interferon].

The preparations of interferon or virus-inhibiting factor produced in L cell (L-IF) and mouse brain (MB-IF) enhanced the killing of Staphylococcus aureus (S.a.) by the mouse peritoneal macrophage. The L-IF, heat-inactivated at 80 degrees or 60 degrees for 30 min., and mock L-IF could not enhance the killing of S.a. The heterologous human and rabbit interferon preparations didn't enhance the bactericidal activity of macrophage. The L-IF didn't have any effect on the release of lysozyme from the macrophages.


[Effect of interferon on the increased reduction of nitroblue tetrazolium (NBT)].

Human leukocyte interferon (HL-IF) enhanced the NBT reduction of human peripheral neutrophil in vitro. Dose relation between IF activity and the NBT reduction was recognized. Heat-inactivated HL-IF, HL-IF neutralized by anti-IF serum or heterologous IF could not increase the NBT reduction.


[Intrahepatic pancrease in Sparus datnia (Ham. Buch.), a Sparidae of the Persian Gulf].

A fish, Sparus datnia (Ham. Buch.), Sparidae, protandric, is one of the species, which has a diffusing intrahepatic pancreas. The gland is compound of two parts : the exocrine part (follow the branches of the portal vein), and the endocrine part (langerhans islets, more or less abundent in the external side of the endocrine part). Three kinds of granular cells are recognized in the endocrine islets.


[Effects of water intake on variations of plasma renin activity (PRA) and blood aldosterone during physical exercise in man].

In man, increase of renin and aldosterone levels in sera resulting from a brief and heavy muscular exercise on bicyle ergometer is notably reduced but not abolished by massive hydration.


[Transfer of monovalent cations across the isolated human amniotic membrane].

When the conductance and the bi-ionic potential are measured in vitro, monovalent cations are transferred according to a simple diffusion mechanism across the amnion (from the inside to the outside of the amniotic cavity or in the reverse direction) in channels with neutral or negative fixed sites. For equal concentration, the permeability to K+ is superior to that of Na+.


[C-cell hyperplasia in the thyroid of the normal rat].

During life of normal rat, it appears an hyperplasia of thyroïdeal C cells, eventually till tumors, a progressive hypertrophy of parathyroïd glands and a fall of calcemia. Chronological study of these phenomena shows that C cells hyperplasia precedes parathyroïd hypertrophy. This last so appears as a reaction against hypocalcemia provoked by hyperplasia of parafollicular cells.


[Effect of the time of theophylline administration on the intensity of diuresis and natriuresis in the rat].

The present study originates in two experimental data: circadian variations evidence of water, electrolytes and solutes urinary excretion and theophylline diuretic and salidiuretic effects knowledge; we purpose to evidence theophylline-induced water and sodium renal excretion in rats as modified by the time of drug administration. Theophylline single dose is injected in 100 animals (20 lots of 5 rats) at 8 h, 14 h, 20 h or 2 h and urines are collected during a consecutive to injection hours long period: 8 h-14 h (I), 14 h-20 h (II), 20 h-2 h (III) or 2 h-8 h (IV). Diuresis increases in + 40,4 p. cent (I), in + 123,7 p. cent (II), in + 123,3 p. cent (III) in + 65,4 p. cent (IV). So, natriuresis increases in 39,6 p. cent (I), in 223,2 p. cent (II), in 114,3 p cent (III) and in 109,6 p. cent (IV). These results evidence that theophylline diuretic and natriuretic effects change strongly with injection time, being largest if it is injected at 14 h and slightest if injected at 8 h. Such observations prompt to study if the other pharmacological properties of theophylline, especially at pulmonary level, response also with a time-dependant intensity.


[Demonstration of the myotoxic effect of theophylline on the isolated kidney glomerulus of the rat].

After confirmation of the intense and very fast myorelaxant effect of theophylline on isolated glomeruli, xanthic reagent myotoxic effects are shown during more or less long contacts with these glomerular suspensions. We studied isolated glomeruli diameter evolution according to reagent dose (0,25 to 10 mg/ml) and its contact length (1, 5, 10 minutes). If the diameter remains practically constant during all the period for the lowest doses, it begins to decrease after the 5th minute for higher (1 and 2,5 mg/ml) and cracks up in the first minutes for the biggest ones (5 and 10 mg/ml). Pharmacologic and toxic actions are discussed ; hypothesis of a toxic effect at smooth muscular cells level is proposed.


[Immunofluorescence demonstration of somatostatin-containing cells in the digestive tract of the monkeys irus, Macaca Papio hamadryas and Cercopithecus aethiops].

Indirect immunofluorescence technique with antisomatostatin serum has allowed us to detect somatostatin containing cells in the gastro-intestinal tract of three species of monkeys : Macacus irus, Papio hamadryas and Cercopithecus aethiops. These cells are localized only in the stomach, in the duodenum, and in the jejunum-ileum. No somatostatin cells were encountered in the esophagus and in the colon. The maximum of somatostatin positive cells is localized in the duodenum, as well in the Lieberkühn's glands as in the Brunner's glands. These cells are always separated from each other ; they were found only in glandular epithelium ; no immunopositive cells were observed in the surface epithelium. No morphological or numerical differences were noted between the three species of monkeys.


[SAMBA : a cytophotometer coupled to a computer for the purpose of the automatic study of cell kinetics and the recognition of cell types].

The system SAMBA has been designed for automatic analysis of biological images, at the cellular or subcellular level. The examination is performed at the maximum resolution power of the microscope. It enables to discriminate by means of a pool of morphological and densitometrical parameters, between cells in the different phases of the cell cycle, or between cells belonging to various types in heterogeneous populations. Other recognition programs are at present beeing in progress, in order to promote the use of SAMBA in other fields of fundamental research and clinical application. Owing to the minicomputer now in use, SAMBA is an autonomous system, capable of beeing routinely used in diagnostic centers.


[Effects of microwaves on the cellular immune response of Swiss mice].

Biological effects of microwaves (2450 MHz) were studied on cellular immune response of Swiss mouse. The obtained results show an increase of MIF, PFC and Phagocytosis values after microwaves irradiation.


[Diminution of blood and hepatic cholesterol induced by an apple-supplemented diet in the hamster. Trials in man].

The effects of an apple-supplemented diet on plasma and liver cholesterol were investigated in two strains of Hamster, a normal one and another which exhibits a spontaneous accumulation of cholesteryl esters in the liver (FEC animals). Adding of apples to the standard diet promoted a 20 % decrease of cholesterolemia in normal animals and normalized the high level of plasma cholesterol in the FEC animals. Similarly, the cholesterol content of the liver was diminished. The levels of cholesteryl esters were strongly lowered, threefold and tenfold respectively in normal and in FEC animals. Incorporation of labelled mevalonate into cholesterol was increased, but esterification of the neosynthesized sterol was markedly reduced in the liver from FEC animals. In human daily ingestion of apples caused a significative reduction (16 %) of cholesterolemia.


[A postsynaptic type nodal axon].

A node of Ranvier in which the nodal axon is post-synaptic to a terminal axon was found in the cerebral cortex of the rat near by an epileptic focus. This type of synapse is in itself a rare observation but is also worthwile considering because of its vicinity with this focus.


[Effect of vinblastine on the blast population of the thymus subcapsular zone in the mouse].

It is well admitted that blast cells of the thymic subcapsular zone play an important role in murine leukemogenesis. Previous ultrastructural investigations have revealed the morphological heterogeneity of this population which is formed by lymphoblasts, X cells and ring shaped nucleolus cells. These aspects could correspond to different positions in the cell cycle of an unique cell type. After administration of vinblastine, a drug blocking mitosis in metaphasis, the percentage of lymphoblasts decreases whereas the percentage of X cells increases. There is no modification of the number of ring-shaped nucleolus cells. This suggests that at least a part of lymphoblasts gives rise to x cells.


[Orthosympathetic reaction during paroxysmal asphyxia in the rat].

Acute hypercapnic hypoxia provoked by the ligature of the trachea kills the rat in 3 to 5 minutes. Catecholaminemia is immediately increased by adrenaline release from the adrenal medulla for the largest part. Catecholamine contents of the suprarenal glands is not decreased at the time of death.


[Role of host cells in suppression of the in vivo multiplication of Ehrlich's ascitic cancer cells by the virus-inhibiting factor or interferon].

Neither activation nor depression of murine peritoneal macrophages or lymphoid cells modified the suppressive effect of the virus-inhibiting factor or interferon on the multiplication of Ehrlich's ascitic cancer cells in mice.


[Effect of the virus-inhibiting factor or interferon on the division and differentiation of murine leukemic cells].

Myeloblasts of a clone originating from a spontaneous myeloid leukemia in mice were induced to form macrophages by the virus-inhibiting factor or interferon or its inducers such as Newcastle disease virus and double-stranded RNA.


[Purification and comparison of quail and chicken pepsinogens].

Pepsinogens of quail and chick, specific to adult proventriculus, were purified and their properties were compared. These two pepsinogens are similar in regard to enzymological characters, amino acid compositions, and immunological characters.


[Effects of 2 water-soluble contrast media, meglumine iothalamate (Conray) and meglumine iocarmate (Dimer-X), on the electric activity of identifiable giant neurons of the African giant snail (Achatina fulica Ferussac)].

The influences of two water soluble contrast media, meglumine iothalamate and meglumine iocarmate, on the neuronal excitability and on the neuronal sensitivity to putative transmitters were examined in comparison with those of sucrose using two identifiable giant neurones of Achatina fulica Férussac (the TAN and the PON). A relatively low increase of osmotic pressure of the extracellular fluid, produced by the application of contrast media, reversed the Cl- dependent inhibition caused by a putative transmitter. The same increase of this osmotic pressure, however, did not influence the Cl- independent inhibition and the excitation of the neurone examined. The hyperpolarization of neuromembrane was caused by an increase of osmotic pressure of the extracellular fluid. Its relatively high increase was necessary to make spontaneous spike discharges disappear totally. All effects of the two contrast media, observed in this study, were due to the increase of osmotic pressure of the extracellular fluid ; no specific effect of the contrast media containing the iodine on the indicators used was observed.


[Effect of oligopeptides containing L-Phe, L-Tyr, L-Trp, L-His or L-Met on the excitability of the 2 giant neurons of the African giant snail (Achatina fulica Ferussac)].

Effects of about ninety oligopeptides, containing L-Phe, L-Tyr, L-Trp, L-His and L-Met, on the excitability of two identifiable giant neurones (the PON, periodically oscillating neurone ; and the TAN, tonically autoactive neurone) of Achatine fulica Férussac were examined. Three oligopeptides, L-Lys-L-Phe-L-Tyr, L-Phe-L-Tyr and L-Phe-L-Trp, showed an inhibitory effect on the PON. However, this effect on the PON was weaker than that of the same three peptides on the TAN. [The latter has been reported in previous papers (1 to 3)]. Besides the three oligopeptides mentioned, four peptides, L-Phe-L-Phe, L-Phe-L-Phe-L-Phe, L-Tyr-L-Tyr and L-Tyr-L-Tyr-LTyr, still showed a weak inhibitory effect on the TAN in a high concentration.


Chronic immune complex disease in mice: the role of antibody affinity.

Two lines of mice selectively bred for producing high and low affinity antibody to protein antigens were repeatedly injected with human serum albumin and the severity and pattern of immune complex disease induced in this way was studied in the two lines. In low affinity mice, there was a greater intensity of deposits in the glomeruli shown by immunofluorescence, and more antibody was eluted from kidney homogenates compared to high affinity line mice. In the low affinity mice, complexes were mainly on the basement membrane whereas in high affinity mice, the localization of immune complexes was predominantly mesangial. However, no significant difference in glomerular filtration rates between the two lines was obtained. The immunopathological significance of antibody affinity is discussed in the light of these results.


Behaviour of human immunoregulatory cells in culture. I. Variables requiring consideration for clinical studies.

The suppressor function of lymphocytes stimulated with concanavalin A (Con A) provides a potential method for examining disorders of immunoregulation. Clinical application, however, requires definition of the culture conditions that influence the expression of normal suppressor cell activity. In the present studies culture conditions were modified until a sensitive assay for non-specific suppressor cell function was reproducible utilizing the response to varying doses of phytohaemagglutinin (PHA) as an indicator system. Practical conclusions included (1) that sensitivity was not lost if the suppressor cells and responder cells were allogenic; (2) that fresh responder cells were as sensitive as precultured responder cells; (3) that a wide range of Con A concentrations could induce suppressor activity; and (4) that the sensitivity of the assay was much enhanced by using suboptimal mitogen doses of PHA. Twelve percent of normal subjects gave false negative results but these could be avoided by studying cells at more than one time point after stimulation with Con A. Cells resting in culture for 7 days could be induced to suppress after stimulation with Con A and these suppressor cells were very sensitive to pharmacological doses of dexamethasone. Studies utilizing different times of cell pre-incubation before Con A stimulation and different periods of exposure to Con A revealed fluctuation in the induction of suppression that may represent alternating periods of suppression and amplifying activity among stimulated cells in vitro. Such variations will need to be taken into account in the application of this type of assay to clinical studies seeking disordered immunoregulation.


[The diagnostic value of various stiffness indices in the evaluation of the diastolic properties of the left ventricle].

The results are presented of simulated calculations obtained with the aid of a continuum model of the left ventricle in a passive state on the basis of a nonlinear elasticity theory. Various empirical indexes of left ventricular rigidity are calculated from modelled diastolic pressure/volume curves, and are compared with myocardial elasticity indicators. With respect to sensitivity and specificity, as the best there were found the volume-standardized Diamond index (d[lnP]/dV)V0 and the Laird index d(lnP)/d/lnV). The indexes are calculated from two parts of enddiastolic pressure/volume values. An analysis of clinically measured values confirmed the model predictions.


Amino acid analogues: uptake, pool formation and incorporation of phenylalanine and two halogenated derivatives in cultured mammalian cells.

HeLa cells take up Phe and two of its ring halogenated derivatives (pFPhe and pClPhe) with rpaidity, concentrating them against the external medium both at 4 and 37 degrees C. The majority of amino acid (greater than 90%) is accumulated without energy expenditures at 4 degrees C, and can be quickly discharged by normal cell washing procedures in saline. At 37 degrees C the freely-diffusible (FDP) pool is accompanied by another which develops more slowly and cannot diffuse out freely during washings with saline but is extractable with trichloracetic acid (the slowly-diffusible pool, SDP, or more conventionally, the acid-soluble pool). Both of the analogues produced larger pools of the latter type than Phe itself from external concentrations ranging from 10(-5) to 10(-3) M. The incorporation of pFPhe into proteins over these same concentrations ranged from 30 to 90--95% of Phe incorporation, whereas pClPhe showed negligible incorporation. From these and similar analyses it can be concluded that amino acid pools form largely independently of protein synthesis, but bear a close relationship with the external amino acid concentration. The fraction of total uptake into cellular pools entering the SDP was relatively constant over a wide range of external concentrations. pFPhe incorporation into cellular proteins produced the same labelling distribution of Phe. It appears to ener all proteins, the vast majority of which have similar half-lives and turnover rates to Phe proteins. In competition, little or no interference was experienced between the analogue and Phe in uptake and pool formation until excessive amounts of one or the other were present (50--100x). By contrast, incorporation of pFPhe into protein was markedly reduced by the presence of Phe. However, the development of normal or large pools of pFPhe or Phe in cells prior to 3H-Phe incorporation did not affect the linear incorporation pattern of the radioisotope into protein. The relationship of pools to protein synthesis is discussed, and it is concluded that, although the SDP could contain potential precursor molecules for protein synthesis, it does not usually act as the direct supplier of amino acid for protein synthesis. Alternative explanations for precursor supply are discussed.


The predictive utility of the orthopedic examination in identifying the low back pain patient with hysterical personality features.

Physical examination of the patient with low back pain routinely includes a number of tests which are useful clinically to the orthopedist as suggestive of the presence of hysteria or malingering. These include tests of light touch differences medially and laterally in the same foot or leg, vibratory sensation in the lower extremities, forward flexion, straight-leg raising differences between the supine and sitting positions, and the Burns' bench test. The present study examined the specific predictive utility of these tests individually and as a composite battery in identifying low back pain patients with hysterical personality features. Twenty-five postoperative lumbar laminectomy and diskectomy patients were administered the MMPI and evaluated by physical examination. Silight to moderate correlations were found for each of the subtests with a Composite Hysteria Index derived from the MMPI. The predictability was improved by the use of a weighted combination of the individual tests obtained by multiple regression analysis. The results lend empirical support to: the predictive value of these clinical tests in definitively identifying 60% of those low back pain patients with hysterical personality features; decision rules for use in clinical practice were also developed.


Sit-up exercises: an electromyographic study.

The effect of 5 different sit-up regimens on the abdominal muscle activity were investigated by electromyography as well as the degree of lumbar flexion required with each type of sit-up. In the long-lying position the rectus abdominus muscles were only active an average of 34% of the sit-up cycle. The greatest duration of activity (90%) was found in the shoulder lift hook-lying (knees flexed) sit-up in which the subject elevates the trunk to the point where the scapula is lifted from the mat. In addition, this sit-up requires minimal flexion of the lumbar spine (3 degrees versus 38 degrees) and is less likely to result in increased forces across the lumbar disk. The evidence is that this sit-up is the most effective in terms of abdominal muscle activity and the safest in terms of causing lumbar spinal flexion.


The effect of unilateral isokinetic strength training on local adipose and muscle tissue morphology, thickness, and enzymes.

One-leg exercise of 5 weeks duration in 10 healthy middleaged women resulted in a significant increment of muscle force in the exercising leg and in a less, but at some angular velocities also significant, increase in the nonexercising leg. The thickness of subcutaneous tissue measured by ultrasound and skinfold caliper decreased, while muscle thickness increased in the exercising leg only. The increased thickness of muscle tissue was associated with an increase in the relative number and relative fiber area of type II fibers in the exercising leg. The mean fiber area of type IIB fibers increased significantly as well as the activity of lactate dehydrogenase and myokinase. The decrease of thickness of subcutaneous adipose tissue was not associated with a significant decrease in fat cell size and was probably due to geometrical factors secondary to hypertrophy of the underlying muscle. It is concluded that the relationship between lean and fat components of the human thigh is significantly influenced by changes in the activity of the thigh skeletal muscles, but a local dynamic strength training program can hardly be used for local emptying of the fat depot over the exercising muscles.


Lymphocyte response to autochthonous human solid tumor cells: relationship to histological types and tumor load.

Mixed lymphocyte--tumor cell cultures were made with materials from patients with various histological types of cancer. In 25 out of 89 patients, positive lymphocyte response to tumor cells was observed. There appeared to be an inverse relationship between the frequency of positive responses and extent of the disease. Patients with neuroblastoma, however, showed more frequent positive responses in cases of widespread disease. The data obtained may have valuable clinical implications, supporting the possibility of immunotherapy of cancer patients.


Frequency-dependent selection at the PGM-1 locus of Drosophila pseudoobscura.

Frequency-dependent fitness was studied at the Pgm-1 locus of Drosophila pseudoobscura with respect to two fitness components: rate of development and larva-to-adult survival. The Pgm-1 locus is very polymorphic with only two alleles, Pgm-1(100) and Pgm-1(104), occurring at high frequencies. For each of these two alleles, 20 homozygous strains were obtained from a sample of 1,140 wild-inseminated females. First-instar larvae of the two genotypes were combined in a set of eight different frequencies: 0.0, 0.10, 0.25, 0.40, 0.60, 0.75, 0.90, and 1.0. Frequency-dependent fitness effects were observed for the two survival-related fitness components examined: larvae of the less common genotype develop faster and have a higher probability of survival than larvae of the more common genotype. The rate of survival at intermediate genotypic frequencies is similar to that in pure cultures. If selection acted solely as frequency-dependent effects on survival-related components of fitness, the equilibrium frequency of the Pgm-1(100) allele would be 0.615 for a two-genotype system, which fits an observed frequency range for this allele in nature between 0.55 and 0.71. Experimentally created linkage disequilibrium was excluded from the experiment by using a large number of independent strains. It is nevertheless possible that the frequency-dependent selection may not affect the Pgm-1 locus per se, but may reflect a linkage disequilibrium present in the natural population. Even if this were the case, the frequency-dependent selection could affect the frequency of the Pgm-1 alleles in nature.


Some properties of site-specific and general recombination inferred from int-initiated exchanges by bacteriophage lambda.

The site-specific recombination at the attachment site for prophage integration might proceed by two general mechanisms: (1) a concerted reaction without a free intermediate; (2) a sequential mechanism differing from typical general recombination only by an inability of the cross-strand intermediate structure to migrate into the region of nonhomology adjacent to the attachment site. The blocked-migration model predicts frequent genetic exchange in the int xis region near the attachment site if Int-mediated recombination occurs between lambda phage with homologous attachment sites. We find such additional int xis exchanges, but only at very low frequency (1% of the Int-mediated recombination). We conclude that the resolution point only rarely moves away from the initial crossover point specified by Int and, therefore, that the Int reaction is mainly concerted. We interpret the rare additional int xis recombinants as indicative of occasional branch migration from an initial Int-mediated crossover. The frequency of the rare int xis recombinants is not simply related to distance from the attachment site to an int- or xis- mutation, suggesting that the heteroduplex distance is often at least a gene in length. The frequency of these additional exchanges is also not a strong function of distance between two mutations; from this we conclude that the resolution to the observed recombinant structure in the sequential cases occurs often by mismatch repair. We have found no marked effect of mutations in the bacterial recA, recB, recC, recF, or recL genes on the frequency of the int xis recombinants; this may indicate that none of these genes specifies a product uniquely required for resolution of a cross-strand intermediate.


A simple technique for the isolation of deletion mutants of phage lambda.

We describe a simple technique for isolating deletion mutants of phage lambda and use it to dissect a cloned fragment of foreign DNA. The technique is based on our previous finding that the normally essential product of lambda head gene D is dispensible for phage growth if the DNA content of the phage is less than 82% that of lambda wild-type (Sternberg and Weisberg, 1977). A significant fraction of the few phage that form plaques when a D amber mutant is plated on a nonsuppressing host contains deletions that reduce the phage chromosome size to less than 82% that of wild-type. It is possible to isolate deletions ranging in size from less than 1.5 kb to 14 kb (3 to 27% of wild-type lambda), and the size range can be restricted by an appropriate choice of the DNA content of the starting phage. This method, unlike the older EDTA or heat resistance methods, permits the scoring of deletions because of the absence of phenotypic variants. We investigated the effect of several host and phage mutations on deletion frequency and type and have determined that a host polA mutation increases the frequency of deletions about 30-50-fold without changing the type of deletions. A host mutD mutation or thymine deprivation increases deletion frequency about 10-fold. In contrast, a host ligts mutation has no effect on the frequency of deletions. We have also determined that the size of the smallest lambda chromosome packageable in a plaque-forming phage particle is 72-73% that of lambda wild-type.


Site-specific mutagenesis using synthetic oligodeoxyribonucleotide primers: I. Optimum conditions and minimum ologodeoxyribonucleotide length.

A synthetic oligodeoxyribonucleotide mismatched at a single nucleotide to a specific complementary site on wild-type circular phi X174 DNA can be used to produce a defined point mutation after in vitro incorporation into closed circular duplex DNA by elongation with DNA polymerase and ligation followed by transfection of Escherichia coli (Hutchison et al., 1978; Gillam et al., 1979). The present study is an investigation of the optimum conditions required for the oligodeoxyribonucleotide-primed reaction for production of transition and transversion mutations in phi X174 DNA, using the large (Klenow) fragment of E. coli DNA polymerase I. Under optimum conditions up to 39% of the progeny of transfection are the desired mutant and significant mutation is observed using a heptadeoxyribonucleotide.


Site-specific mutagenesis using synthetic oligodeoxyribonucleotide primers: II. In vitro selection of mutant DNA.

A method for the in vitro selection of mutant DNA has been devised as an adjunct to the recently developed method for the use of short enzymatically-synthesized oligodeoxyribonucleotides of defined sequence as site-specific mutagens for circular DNA. The selection method uses the mutating oligodeoxyribonucleotide as a primer for Escherichia coli DNA polymerase I (large fragment) under conditions where there is preferential interaction with mutant DNA template. After ligation using T4 DNA ligase, endonuclease S1 is used to degrade single-stranded non-mutant DNA leaving the desired mutant as closed circular duplex DNA. This paper describes the development of the method using mutants in phi X174 DNA as the model system. Studiies on the changes A leads to G and G leads to A at position 587 of phi X174 viral DNA (am3 to wild-type and its reversal) show that one or two cycles of selection can lead to a population of phage consisting of close to 100% mutants.


[Reliability of double-contrast arthrography in detection of cartilage lesions of the knee joint (author's transl)].

The present work evaluates the method of double-contrast arthrography. To this end, cartilage damage on femoral condyles and tibial joint surfaces was studied in 1566 retrospectively evaluated double-contrast arthrographies. Operation reports and histological results served as control. The results of our own experiments demonstrate that even isolated cartilage lesions as small as 1 mm in diameter can be visualized.


[Sonographic determination of liver volume. Problems, methods and practical significance of liver volume measurements (author's transl)].

A sonographic procedure is described which permits accurate determination of liver volume by simple means. Comparison between the sonographic measurements and volume determinations at autopsy carried out by water displacement of the isolated organ showed a statistical error of +/- 1.58% and for average liver volumes of 1,800 ml and 95% limits of confidence of -84 to +20 ml. Quantitation of liver size may be an important clinical measurement, e.g. in assessing the possibility of shunts in the lieno-portal system in portal hypertension with recurrent bleeding from oesophageal varices due to cirrhosis of the liver, for evaluating liver atrophy after shunts affecting the liver, for demonstrating liver size in right heart insufficiency and congestive states or for the control of the effectiveness of cytostatic drugs in lymphatic or haematological disease.


[Computer tomography of the facial skeleton and pharyngeal space (author's transl)].

Seventy-five patients with histologically confirmed abnormalities of the facial skeleton and pharynx, including the mouth and base of the tongue, were examined by computer tomography. The advantages of simultaneous demonstration of the soft tissues and bones in localised space-occupying lesions are pointed out. Accurate comparison between pre-operative descriptions and findings at operation in 30 cases showed high diagnostic accuracy. Conventional, multi-dimensional film tomography is being increasingly replaced by computer tomography.


[Computer tomographic diagnosis of a mega-dolicho basilar artery (author's transl)].

Four mega-dolicho basilar arteries are described, which were found by computer tomography and confirmed by angiography. Two patients showed additional abnormalities or anomalies of other vessels. The computer tomographic features are described. The elongated vessels can produce so-called normal pressure hydrocephalus by impressing the floor of the third ventricle, although the hydrocephalus cannot be confirmed by computer tomographic cisternography.


[Roentgenological characteristic of pulmonary metastases in thyroid cancer in respect of its biological behaviour (author's transl)].

In metastases of the lung which must be considered as typical in cancer of the thyroid, it is possible to differentiate roentgenologically between fine and coarse nodules, the limit being approximately 10 mm. Metastases consisting of fine nodules are by no means to be considered as representing a fatal generalisation, whereas metastases with coarse nodules are frequently accompanied by other metastases distant from the primary tumour.


Doming of the pulmonary valve after valvotomy.

Doming of the pulmonary valve is considered an important angiographic sign for valvar stenosis. But, this sign cannot be used with similar specificity following valvotomy because at the time of surgery a bicuspid valve is created. Pre- and postoperative hemodynamic data and right ventriculograms are reviewed in 22 patients with simple pulmonary valvar stenosis. There was no correlation between the transvalvar gradient and appearance of the pulmonary valve after surgery.


[Significance of the contralateral kidney for a successful decrease of blood pressure following renovascular surgery in patients with unilateral renal artery stenosis. Angiographic and pharmacodynamic studies in renovascular and essential hypertension (author's transl)].

This study was carried out to improve the diagnostic procedure and preoperative prognosis in patients with unilateral renovascular hypertension. The vascular sensitivity of the non-stenosed kidney was tested by the influence on renal hemodynamics (133xenon washout technique) of dihydralazine applicated intrarenally and was correlated with selective renal arteriograms. Comparative studies were done in patients with essential hypertension including those with and without nephrosclerotic lesions. The results demonstrate that the pharmacodynamic effect of the vasodilator used in this study is obtained only in kidneys without arteriosclerotic lesions of the small vessels. A postoperative normalization of blood pressure in patients with unilateral renal artery stenosis depends on a patent renal bypass and a normal vascular response of the contralateral kidney.


[Renal blood flow, diuresis and isotope nephrogram in experimental stenosis of the renal artery (author's transl)].

After experimental stenosis of the renal artery of the dog, the isotope nephrogram shows a prolongation of the transit-time, when the renal blood flow is reduced to 40--70%. This finding was most significant in low diuresis (0,05--0,2 ml/min), sporadic in moderate diuresis (0,2--2,0 ml/min), no longer demonstrable in forced diuresis (greater than 2,0 ml/min). The diuretic effect of X-ray contrast medium (70% Na-Meglumin-Jotalamat, 0,5 ml/kg i.v.) normalizes a pathologic ING in low diuresis.


[Pseudo tumours of the adrenals--errors in interpretation and their avoidance (author's transl)].

In 13 patients an adrenal tumor was suggested by non-invasive roentgenologic studies (scout films of the abdomen, intravenous urograms, tomograms). The lesions turned out to be misdiagnosed after patients had undergone arteriography. Variations of the spleen, superimpositions of the tail of the pancreas and fluid filled hollow viscus were found to be the reason for this adrenal 'pseudo-tumors'. The possibilities of diagnosing those 'lesions' without doing invasive studies are discussed.


[The lateral projection with an inclined beam for the demonstration of aneurysms of the anterior communicating artery and of the middle cerebral artery (author's transl)].

In addition to the a.p. and lateral projections for the diagnosis of aneurysms of the anterior communicating artery, the literature also recommends oblique views by turning the head to right or left with an a.p. beam. Lateral views, turning the head 20 degrees to the side of injection often provide better demonstration of the origin of the aneurysm and its relationship to surrounding vessels.


[The neuro-radiological anatomy of the normal and abnormal rat brain. I. Radiological techniques for normal anatomy (author's transl)].

In vivo and post mortem techniques for the radiological examination of normal brains have been developed, using 66 white adult rats. Aortic arch injections for survey angiograms (10 animals), selective catheterisation of the internal carotid artery (16 animals) and ventriculography by percutaneous needle puncture (20 animals) were performed in vivo; the animals survived and the examinations could be repeated. The techniques proved useful and accurate methods for the radiological demonstration of the topography and morphology of cerebral vessels and chambers; they also provided information on the function of the cerebral circulation and C.S.F. dynamics. The findings were checked and correlated by post mortem studies (20 animals) using contact radiography, micro-angiography and casts of the ventricles. As a result, extensive topographic and anatomic information concerning the cerebral vessels in the rat was obtained, including some microscopic-radiological findings. The combined use of these methods provided a basis for studying the growth of experimentally induced brain tumours and the effect of various types of treatment.


[Isotope methods in the diagnosis of venous disease. I. Methods of radionuclide venography (author's transl)].

The method of radionuclide venography is best determined by the localisation and type of suspected venous abnormality. The authors describe four methods using 99mTc microspheres and 99mTc-pertechnetate. Correlation of the isotope and angiographic findings in 150 patients indicated an accuracy of 90% for the isotope methods. The risks of radionuclide venography are discussed. Isotope venography is recommended as a simple, non-invasive technique.


[Isotope methods in the diagnosis of venous disease. II. Results of radionuclide venography (author's transl)].

The frequency of scintigraphic findings in the presence of thromboses, post-thrombotic changes and in normal veins, was determined in 150 patients. The results of radionuclide venography and contrast venography in these patients have been compared. Abnormalities in veins can be detected by radionuclide venography with a high degree of accuracy. Differentiation between acute and chronic thrombosis and post-thrombotic changes can only be made by invasive contrast venography.


Comparison of monomer, dimer and non-ionized medium at urography with simulated compression; an experimental study in the rabbit [author's transl].

Density, estimated through renal pelvic volume as calculated according to previous experiments (Owman 1978) and urinary iodine concentration, is suggested to be more accurate than, and complementary to, mere determination of urine iodine concentration and diuresis when evaluating and comparing urographic contrast media experimentally. More reliable dose optima are probably found when calculating density rather than determining urine concentrations. Of the examined media in this investigation, metrizamide and P 268 are by far superior, giving higher density, higher urinary concentrations, and metrizamide also less diuresis.


[A new contrast medium emulsion for lymphography (author's transl)].

A new contrast medium for lymphography has been developed. It is suitable for direct, such as bi-pedal, lymphangiography, and has certain advantages compared with the commercially available contrast medium Ethiodol, such as absence of a lipogranulomatous reaction and less extensive oil emboli in the lungs. It is also possible to use the substance for indirect, retrosternal lymphography. The substance is indirect, retrosternal lymphography. The substance is an emulsion of triglycerides of iodinated poppy seed oil. The method of preparation of the emulsion is described.


[The technic of "open pelviscopy". A new method for increased safety in laparoscopy].

The method of "open pelviscopy" is described and compared with the common performance of gynecological pelviscopy. The "open pelviscopy" combines the advantages of laparotomy--preparation of anatomical layers under view of the operator--with those of pelviscopy--minimal traumatization and optimal view at the intraabdominal organs. This method avoids blind puncture of the abdominal cavity, which otherwise is necessary to perform the pneumoperitoneum and to use the optic instruments. Apart from the well established indications for diagnostic and therapeutic gynecological pelviscopy we prefer this method especially in obese patients and in those who formerly had several laparotomies.


[The value of laparoscopy in gynecology].

There is  a definite place for laparoscopy in gynaecology as a diagnostic tool and for limited operative procedures. Nevertheless, the indication for laparoscopy should be subjected to the same strict criteria as any other operative procedure. The use of laparoscopy and its various indications are discussed. So-called major operative laparoscopy or pelviscopy is rejected. Greatest restraint should be employed to use laparoscopy for obtaining biopsy material from ovarian tumours for diagnostic purposes.


[Necessity of training and safety in gynecological laparoscopy--a contradiction?].

At the Gynaecological University Hospital Göttingen 1659 laparoscopies were performed 1961-1978 by 67 gynaecologists with an average of 24,8 laparoscopies per gynaecologist. Most of the doctors were still in their training period, assistance was always given by a specialist gynaecologist. Only in 5 cases (0,3 per cent) laparotomy was necessary due to complications following laparoscopy or laparoscopicsterilization. Injuries of the transverse colon, the greater omentum and a mesenteric artery-caused by the trocar-were seen, also diffuse bleeding from the parietal peritoneum and from the ramus of the Fallopian tube. No deaths due to laparoscopic complications occurred. The incidence of severe complications can be kept within tolerable limits in a training hospital where the majority of the operations are performed by doctors in training, when the following conditions are strictly adhered to: Careful consideration of the risks involved in laparoscopy/laparoscopic sterilization and other less invasive diagnostic and contraceptive methods, strict attention to the contraindications of laparoscopy and performance of a standardized laparoscopic technique under the supervision of an experienced operateur.


Variation in S phase in synchronous human cell lines.

Growth parameters of diploid and trisomic human fibroblasts were determined. The rate of growth of both classes of cells was examined in asynchronous cultures, and diploid and trisomic cells had similar growth rates. Synchronous cultures were developed using simple mitotic selection. The patterns and length of the DNA synthetic period (S phase) were found to be altered in trisomy 21 cells when compared to diploid human or to heteroploid HeLa cells. Early S-phase synthesis was absent or reduced and the overall length of the S phase was extended. However, the trisomic cells have apparently normal rates of DNA chain elongation and normal replicon sizes.


[Histological differential diagnosis of psoriasis vulgaris and seborrheic eczema of the scalp].

The clinical differential diagnosis between seborrheic dermatitis and psoriasis vulgaris of the scalp can be difficult. We, therefore, tried to elaborate histopathological criteria for a differentiation of the two dermatoses. Forty excisional biopsies were analysed without knowing the clinical diagnosis. The histopathological substrate within the epidermis is characterized in psoriasis by dermatitis-like and in seborrheic dermatitis by psoriasis-like alterations. Therefore, in some cases a definite histopathological diagnosis could not be made. Strong criteria favouring psoriasis are: moderate condensed hyperkeratosis with alternating parakeratosis, PAS-reactive serum inclusions and Munro abscesses within the horny layer, spongiform pustles and neutrophilic leukocytes within the epidermis. Strong criteria for seborrheic dermatitis are: irregular acanthosis with relatively thin condensed orthoor parakeratotic horny layer, spongiosis and spongiotic vesicles, exocytosis of lymphocytes and the lack of any hard criterias for psoriasis. The results may suggest that seborrheic dermatitis of the scalp may transform into psoriasis in patients with a genetical disposition ("psoriatic diathesis", "latent psoriasis") via a Köbner reaction. The existence of the seborrheic dermatitis (Morbus Unna) is not doubted by these investigations.


Hemolysis due to aortic insufficiency following closure of ventricular septal defect.

A two-year-old girl with ventricular septal defect (VSD) developed a severe degree of intravascular hemolysis following VSD closure. The cause of hemolysis was considered to be due to the aortic insufficiency (AI) jet against the VSD patch. The patient was reoperated on the seventh post-operative day. There was a small hole on the right coronary cusp, which was closed by five interrupted sutures. However, a third operation was performed on the following day because of the reappearance of AI. The use of pericardial flap to cover the whole right coronary cusp resulted in disappearance of hemolysis. The patient was discharged in a satisfactory condition.


In vitro assessment of Tc-99m labeled bovine thrombin and streptokinase-activated human plasmin: concise communication.

Bovine thrombin and streptokinase-activated human plasmin have been labeled with Tc-99m using stannous reduction of pertechnetate under physiological conditions (pH 7.4). The binding efficiency of radiotechnetium to these enzymes is greater than 94%, with less than 5% of reduced but unbound Tc-99m (Sn) complex as assayed by ascending paper radiochromatography using ITLC silica gel plate. Free or unbound pertechnetate is less than 1%. In vitro enzymatic analyses of the Tc-99m-labeled enzymes demonstrate no evidence of protein denaturation or significant loss of enzymatic activity after labeling. Both labeled enzymes are biochemically active in vitro with their respective substrates.


Concanavalin A induced suppressor activity in human leprosy.

Peripheral blood lymphocytes from nine normal subjects and 40 patients with leprosy were pretreated in vitro with Concanavalin A (Con A). Cells from normal subjects pretreated for 24 hours showed consistent and effective generation of suppressive activity which inhibited mitogen induced transformation of autologous lymphocytes. Prolongation of Con A pretreatment to 40 hours resulted in maximal suppressive activity. Tuberculoid leprosy patients had lymphocytes in their blood which on 24 hour pretreatment with Con A exerted suppressive effects markedly greater than the maximal suppression noted with 40 hour pretreated normal lymphocytes. In contrast, untreated patients with polar lepromatous leprosy showed a decrease in suppressive activity which could not be altered by prolongation of Con A pretreatment: the loss of suppressive activity noted in this form of leprosy was restored during erythema nodosum leprosum.


Attraction to "good form" in Down's syndrome.

Seventy-five children were examined in tasks involving matching figures in order to establish whether there exists a specific attraction to symmetrical or Gestalt type "good form" displays in mentally handicapped children and particularly in Down's Syndrome or if the tendency was towards image reversal. Twenty-five children with Down's Syndrome were matched on M.A. with twenty-five non-Down's Syndrome subnormals and twenty-five normal children. Symmetrical and asymmetrical displays were presented to the groups for reproduction and reproduction from memory. The results supported the hypothesis that mentally handicapped children have a significant attraction to symmetrical arrangements and that Down's Syndrome children are more significantly attracted than other handicapped children. Evidence is presented to show that what often is mistaken for a tendency to image reversal is in fact an attraction to "monotonicity" and is more related to "good form" than to reversal.


Dermatoglyphic distances and position of 21 trisomy mosaics.

The position of 21 trisomy mosaics with an average proportion of trisomic cells approximating 0.5 in relation to normal subjects and those with complete 21 trisomy has been evaluated by means of dermatoglyphic distances, using samples of 142 mosaics, 302 normal controls and 225 complete 21 trisomics for males and females separately and combined. Distances were calculated by means of the simplified D2k method. Penrose's "size and shape" analysis of variance has been applied for comparison to obtain distance coefficients, C2H, based on pattern intensities. Results indicate that mosaics are not intermediate but much closer to 21 trisomics in spite of the fact that the average proportion of trisomic cells in blood approximates 0.5; secondly, that the degree of deviation from the intermediate position of the mosaic sample is roughly proportional to the degree of cytological mosaicism. The position of mosaics is appreciably more intermediate in respect of finger-tip patterns than in respect of palmar and sole loops and triradii. The results obtained here have thus given evidence for the usefulness of dermatoglyphic distances, which enable all the differences in frequencies or means of the respective characters to be conveniently represented by a single number, in studies of the abnormal development of phenotypic characteristics in cases of incomplete trisomy.


Some characteristics of a population of mentally retarded young adults in a British city. A basis for estimating some service needs.

A population of young people who are mentally retarded is described in terms of the frequency of various kinds and degrees of impairment--intellectual, physical and behavioural. The population consisted of all those born in 1951--1955 who were resident in a city in 1962 and who at any time during the school years had been placed in any mental retardation service. The prevalence of the mentally retarded as defined is sixteen per 1000. Age specific prevalence rates for the same population rise from age five, reach a plateau of fourteen per 1000 from ages ten to fifteen and then drop sharply for the post-school period to a rate of five to six per 1000. Classifications of physical impairment, seizure histories and behaviour disturbances are described. Percentages are given separately for those with each impairment and in combination for each individual. For the survivors at age twenty-two, 44 per cent had physical impairments, 26 per cent had a history of seizures and 46 per cent had experienced behaviour disturbances. Results are discussed in relation to service needs.


Kinaesthetic movement after-effects in children with Down's syndrome.

In order to assess the liability of proprioceptive information, an experiment on kinaesthetic after-effects was carried out. Matched groups of severely subnormal and Down's syndrome subjects were compared with normal children of either the same chronological or the same mental age. No difference was found between the normal and the severely subnormal children, but the magnitude of the after-effect measures in Down's syndrome children suggests that asymmetrical pointing produced kinaesthetic after-effects which disrupted these subjects' total frame of spatial reference.


[Health effects of trichloroethylene in human subjects (author's transl)].

Trichloroethylene has been widely used for the removal of grease in dry cleaning, plate and painting industries, in which approximately 280 thousand workers contact trichloroethylene, for example, in the United States, resulting in acute and chronic poisonings. Based on 203 papers mainly on trichloroethylene toxicity on human beings, the present review covers acute toxicity, chronic toxicity, carcinogenicity, factors modifying toxicity, metabolism, dose-response relationships and maximum allowable concentration of this chemical. 1 figure and 12 tables.


Role of brain amines in the fetal hyperpyrexia caused by tranylcypromine in LiCl-pretreated rats.

Tranylcypromine (TCP), a monoamine oxidase inhibitor, caused a fatal hyperpyrexia in rats pretreated with LiCl once a day for 4 days. Pretreatment with LiCl alone did not alter the level of serotonin (5-HT), dopamine (DA) and norepinephrine (NE) in the brain. In fatal hyperpyrexia caused by LiCl plus TCP, the brain 5-HT and DA levels were increased, whereas the brain NE level was decreased. Reserpine and alpha-methyl-p-tyrosine completely prevented the hyperpyrexia, but FLA-63 did not show any effect. The hyperpyrexia was completely prevented by p-chlorophenylalanine (PCPA) given 72 hours before TCP but not by PCPA given 24 hours before TCP. Haloperidol and chlorpromazine, DA receptor blockers, inhibited the fatal hyperpyrexia, while cyproheptadine and methysergide, 5-HT receptor blockers, did not. These results suggest that DA plays an essential role in the hyperpyrexia induced by the combination of TCP and LiCl in rats, but the involvement of 5-HT is inconclusive.


Circumstantial evidence for increased potassium conductance of membrane of cardiac muscle by 2-nicotinamidoethyl nitrate (SG-75).

The mechanism of action of 2-nicotinamidoethyl nitrate (SG-75), was investigated by the use of arterially blood-perfused papillary muscle preparations of the dog. All drugs were administered intra-arterially. SG-75 shortened the effective refractory period (ERP) and decreased the rate of automaticity and developed tension of the papillary muscle, whereas verapamil failed to change the ERP despite a decrease in the developed tension. SG-75 in extremely high doses induced ventricular fibrillation. Methacholine produced decreases in the rate of automaticity and developed tension, and the actions were abolished by atropine. The SG-75-induced decreases in two parameters were not modified by atropine. These results indicate that the cardiac action of SG-75 differs from that of calcium-antagonistic vasodilators and it is suggested that the basic mechanism of action of SG-75 involves an increase in potassium conductance in the membrane of cardiac muscle, without mediation through muscarinic receptors.


Transport of dextran sulfates to rat livers.

Liver subcellular distributions of three different dextran sulfates (DSs) with average molecular weight (AMW) of 3000, 20,000, and 200,000, and sulfur content of 18%, anticoagulants and antilipemic agents, were examined in rats after intravenous administration of 50 mg/kg. About 20% of the injected radioactivity was taken up by liver 15 min-3 hr after 35S-DS administration, but the uptake of 35S-DS with AMW of 200,000 was slower than that of the other DSs. About half of the radioactivity distributed in livers was found in the cytosol fraction. The cytosol fraction/liver ratio of the radioactivity gradually decreased with the increase in the nuclear fraction/liver ratio. The specific radioactivity of the lysosomal fraction was 5--20 times as large as that of the other fractions. Unchanged forms of 35S-DSs with AMW of 3000 and 20,000 were found in the lysosomal and the cytosol fractions. Administration of DSs with AMW of 20,000 and 200,000 significantly enhanced the Na+-K+-dependent ATPase activity of lysosomal fraction which has been considered to be an index of endocytosis. These findings suggest that DSs are probably transferred into liver cells by transmembrane and endocytotic transports.