Lymphoblastic transformation in response to viral antigens in multiple sclerosis.

The blastogenic response of lymphocytes to pokeweed mitogen and a battery of viral antigens was studied in healthy individuals, patients with multiple sclerosis (MS), and patients with other neurologic disorders. The multiple sclerosis patients exhibited a diminished response to pokeweed mitogen and to mumps, parainfluenza, and poliomyelitis I antigens when compared with healthy individuals. However, there was no significant difference between the multiple sclerosis patients and the neurologic control group, except that the MS patients had a better response to measles antigen. The three groups did not differ with regard to herpes antigen. Blocking factors were found in the autologous plasma of all three groups with approximately equal frequency, but were not responsible for the decreased responses noted. A significant inverse correlation was found between disease severity and the blastogenic response to pokeweed mitogen and herpes, parainfluenza, and measles antigens. These findings indicate that the decreased cell-mediated immune response in some MS patients is not specific for any of the viruses tested, and is probably a nonspecific effect of chronic disease. Patients with the relapsing-remitting form of the disease had a higher response to measles antigen and a lower response to pokeweed mitogen than patients with the chronic progressive form of the disease, suggesting that these variants differ immunologically as well as clinically.


Sterilization of cerebral metastases by radiation therapy.

It is generally acknowledged that radiation therapy (RT) provides effective palliative treatment for the majority of patients with brain metastases. It is less well known that RT can be "curative." In 10 years, we examined five patients with brain metastases treated with whole-brain radiotherapy and with no residual tumor in the brain at autopsy. These five patients represented about 3 percent (5 of 187) of patients treated for brain metastases and later examined at autopsy. Some metastatic brain tumors are eradicated by RT, and all nonterminal patients should be offered such treatment.


Conduction velocities in single fibers of diseased human muscle.

Focal sarcolemmal lesions, segmental degeneration, and fiber splitting are observed in Duchenne muscular dystrophy and have been proposed to be major contributory causes of dysfunction of this disease. The presence of these abnormalities should affect impulse conduction along the sarcolemma. To test this prediction, we measured conduction velocities of the action potential in normal and diseased human intercostal muscle fibers by means of intracellular microelectrodes. The resting potentials of fibers from patients with Duchenne dystrophy, Becker dystrophy, and motor neuron disease were partially depolarized, and conduction velocities in these fibers were slower than normal. When the membrane potential was artifically hyperpolarized, the conduction velocity in Becker dystrophy fibers was not significantly different from normal. However, conduction velocity values in Duchenne dystrophy or motor neuron disease fibers were significantly lower than normal regardless of the level of membrane hyperpolarization. These data are analyzed in light of the presence of morphologic lesions in the diseased muscle fibers.


[Endothyroid (non-chromaffin) branchiomeric paraganglioma. Description of a clinical case].

A case of endothyroid paraganglioma in a 9-yr-old girl is described. Subtotal lobectomy was performed and the tumour was not recognised until a histological examination has been carried out on a section embedded in paraffin. Only two other cases could be found in the literature. An account is given of the diagnosis of this form, and reference is made to its prognostic aspects since there is a remote possibility that metastasis may occur many years after surgery.


[The role of aviation in the epidemiology of smallpox].

The structure and features of the smallpox virus are described and an account is given of the clinical picture of the disease. Tables and graphs are cited to illustrate the progress of the WHO's eradication campaign over the last 10 years. In dealing with part played by the aeroplane in the epidemiology of smallpox, attention is given to the high diffusion potential of the disease owing to increased air travel and the confluence of multi-ethnic and multi-national groups in airports. Prevention should thus be concentrated on airports as opposed to the rest of the country, and both aircrews and ground staff should be vaccinated. Stress indeed is laid on the need for vaccination and the search for further means of preventing its complications.


Effects of isocaloric supplements of glucose or soyabean oil on lipids in tissues and plasma lipoproteins of starved and overfed chicks.

Chicks were overfed a basic diet supplemented isocalorically by soyabean oil or glucose 1, 2 and 10 days after 1 day of starvation. Carcass lipids resumed the prestarvation level 1 and 2 days after overfeeding with oil or glucose, respectively. After 10 days, an equal amount of lipid, mainly triglycerides, accumulated in the carcasses of both supplement groups. In the liver a transient accumulation of lipid was noticed in the oil-supplemented groups while a continuous increase was found in the glucose-supplemented ones. Hyperlipemia, due essentially to very low density lipoprotein (VLDL), was concomitant to liver lipid concentration. After 1 day, oil overfeeding raised plasma VLDL 6-fold, while the same level of VLDL was obtained within 2 days with glucose supplement. After 10 days, hyperlipemia was reduced in the oil-supplemented group, while it increased in the glucose-supplemented one. The fatty acid fluctuation caused by the treatments in liver lipids and plasma VLDL were grossly similar: the level of linoleic acid was reduced by glucose and increased by oil supplementation; the linoleic acid increase in VLDL preceeded that of liver lipids in the oil-supplemented groups. The results indicate a delayed transport of newly synthesized hepatic lipids in glucose-supplemented animals.


[Study of lipid metabolic coefficient K2 in patients with hyperlipoproteinemia type IV before and after reduction of triglyceride level by adapted diet therapy].

An intravenous fat tolerance test (IV FTT) was performed in a group of patients with type IV hyperlipoproteinemia before and after reduction of triglyceride level, the latter is obtained through a diet adapted to the nutritional sensitivity, body weight remaining constant. Before the diet the increase in cholesterol (CT) and triglycerides (TG) was related in both obese and non-obese patients to an increase in very-low-density lipoproteins (VLDL), while other lipoprotein fractions were not affected. In these patients, K2 is significantly lower than in controls whatever the nutritional sensitivity. However, K2 is lower in obese patients than in patients with normal weight, VLDL-CT and VLDL-TG are tremendously reduced by the relevant diet and K2 is constantly and significantly increased, although it does not reach a normal value in obese subjects. There is a highly significant correlation between VLDL-TG levels and K2 in obese and non-obese subjects. Several physiopathological explanations are discussed to account for the variation of K2 according to TG levels. The results obtained support the view that the K2 defect is secondary to the hyperlipoproteinemia.


[Injection of mitochondria into oocytes and fertilized eggs].

The suspension of mitochondria isolated from the loach embryos or the frog heart were injected in the oocytes or fertilized eggs of the loach, newt, toad and frog in the amount roughly equivalent to the content of mitochondria in the egg. After the injection the oocytes did not differ during several days from the normal ones and the fertilized eggs of the loach, newt and South Afican clawed toad developed normally. The activity of cytochrome oxidase in the injected oocytes was kept at a somewhat higher level (1.4 to 1.9 vs 1.0 in the control) during several days. In the developing eggs the activity of cytochrome oxidase began to decrease from the blastula stage and attained rapidly the control level. The decrease of the enzyme activity is due to non-specific degradation of excessive mitochondria or to compensatory inactivation of the enzyme ensuring the maintenance of its normal activity during the development.


[Independence of the (NAD+):(NADH) ratio from the adenylic system in the liver cytoplasm of the developing chick embryo].

No dependence was found between the index of the adenylic system phosphorylated state (ATP) : (ADP) (HPO2-4), the ratios (ATP) : (ADP) and (ATP : (ADP + AMP), on one hand, and the ratio (NAD+) : (NADH) in the cytoplasm, on the other one. The maximum value of the ratio (ATP) : (ADP) (HPO2-4) was observed on the 17th day of development and correlated with the maximum rate of gluconeogenesis. The ratio (NAD+) : (NADH) in the cytoplasm suffered no changes until hatching and decreased twice thereafter.


Oral cancer and herpes simplex virus--a review.

Numerous studies have suggested that patients with oral cancer have an increased immune response to herpes simplex virus. However, the number of cases has always been small, and essential controls have not always been included. Laboratory experiments have shown that herpes simplex virus can be carcinogenic or cocarcinogenic under certain circumstances and so must be considered as a possible etiologic agent in oral cancer. This article reviews past research and suggests priorities for future investigations.


Asymmetrical radical formation in D- and L-alanines irradiated with yttrium-90 beta-rays.

Radical formation in 90Y-beta-irradiated D- and L-alanines was studied using ESR. It was observed that the relative radical concentration by beta-irradiation was distinguishably (13.9-21.5%) more in D-alanine than in L-alanine. Discussion was made on the possible mechanisms for the observed results.


Localization of collagenase in chronically inflamed guinea pig temporal bone.

Bone destruction, commonly associated with chronic otitis media, requires collagen degradation. Collagenase, a neutral protease, appears to be an essential component in the process of collagen breakdown. Collagenase was identified within chronically inflamed and normal guinea pig temporal bones using an immunohistochemical technique with fluorescein isothyocyanate and peroxidase-antiperoxidase labels. Localization of the enzyme identifies sites of matrix resorption. Collagenase was found in osteoclasts, osteocytes, mononuclear inflammatory cells, and at resorbing margins. Inflammation increased the intracellular collagenase content of inflammatory bone osteocytes when compared to normal osteocytes using a microspectrofluorometer. It appears that the inflammatory process directly influences bone destruction through the action of mononuclear inflammatory cells and indirectly by stimulating bone cells to increase their proteolytic enzyme production.


Pathophysiology of Cushing's disease.

The term Cushing's disease is applied to those cases of Cushing's syndrome in which hypercortisolism is secondary to inappropriate secretion of ACTH by the pituitary. Studies on control of ACTH secretion in these patients reveal: (a) that the episodic secretion of ACTH is similar to the normal; however, frequency and amplitude of the secretory episodes lack the normal circadian rhythm; (b) that ACTH release can be stimulated by vasopressin and metyrapone in a normal or above-normal manner; and (c) that it can be suppressed by large doses of corticosteroids. When the dynamic aspects of the ACTH response to corticosteroid administration are studied, it appears that the normally negative differential feedback mechanism is converted into a positive one, whereas the delayed, integral mechanism is undisturbed. Patients with Cushing's disease in the presence of obvious pituitary tumors cannot be distinguished from those without pituitary tumors by studying only the pituitary function. All these and other well-known facts would favor the concept that ACTH secretion in Cushing's disease is under hypothalamic control whether or not a pituitary tumor is present. Moreover, there are observations that suggest that brain centers superior to the hypophysiotropic area of the hypothalamus are involved in the pathophysiology of Cushing's disease. This concept has led to the discovery of neurotropic drugs that are able to induce complete remission of Cushing's syndrome in a cerain percentage of patients. In some patients with severe psychiatric diseases, neuroendocrine abnormalities are present that resemble closely those characteristic for Cushing's disease. With the most refined neuroradiological methods, pituitary microadenomas are demonstrable in approximately 70% of patients with Cushing's disease, and this number compares well with those of earlier autopsy findings (70 to 80%). In a small number of patients (4 to 10%), these tumors are large and can easily be detected by standard roentgenograms of the head. Recent studies on the frequency of these large tumors do not support the hypothesis that adrenalectomy accelerates the progression of these tumors. In this case the term "Nelson's syndrome" would be uncessary. It is established that complete cure of Cushing's disease can be obtained in most patients with selective removal of a microadenoma from the pituitary gland. The current experience with this microsurgical procedure caused a renewed interest in Cushing's original suggestion that the disease is primarily a pituitary disorder. However, there are already a number of enigmatic observations. Possibly, the recent ultrastructural studies using immunocytochemical methods will resolve some of these problems. At this moment it is impossible to decide whether Cushing's disease is primarily a CNS or a pituitary disorder, when all arguments for one or the other hypothesis are taken into account...


Current evidence for the organic etiology of spastic dysphonia.

For over 100 years it has been universally assumed in the literature that spastic dysphonia is a functional or psychoneurotic voice disorder. In the last few years, new data have accumulated that support the concept that spastic dysphonia is caused by an organic, rather than a functional, abnormality. Histologic examination of segments of the recurrent laryngeal nerve removed from patients with spastic dysphonia has revealed myelin abnormalities in 30% of the nerves examined. Neurologic examination indicated brain stem or basal ganglia disturbances in some patients who had no apparent nerve disease.


The biologic significance of the aldosterone concentration in saliva.

Salivary aldosterone measurements can be used to study aldosterone secretion and metabolism noninvasively. Salvia and plasma aldosterone concentration were highly correlated during all periods of study; during adrenocorticotrophic hormone (ACTH) administration, a relatively greater amount of aldosterone appeared in saliva; during dexamethasone administration, a relatively smaller amount of aldosterone appeared in saliva. As plasma cortisol increased with ACTH administration there was an increased relative amount of aldosterone in saliva. DOC (11-deoxycorticosterone) was found in saliva only during ACTH administration. Corticosterone was identified during baseline periods. Salivary aldosterone concentrations were independent of flow. The data indicate that saliva is an accessible bodily fluid which may be used to monitor the changes in nonprotein bound plasma steroid hormone concentration in children.


Development aspects of renal beta-amino acid transport II. Ontogeny of uptake and efflux processes and effect of anoxia.

Renal cortex slices from newborn, 2-week, and 4-week-old Sprague-Dawley rats had reduced initial rates of taurine uptake compared to adult slices after short (less than 30 min) incubation periods. From birth onward, steady-state accumulation occurred by at least two sodium-dependent uptake systems. The first system had an "apparent Km1" = 0.1 mM and a Vmax varying from 1.8 to 5.1 mumoles/ml ICF/120 min at four ages. The second uptake mode had an apparent Km2 = 12-16 mM and a Vmax of 45 mumoles/ml ICF/120 min. Efflux of taurine was reduced in slices from younger animals possibly accounting for taurinuria. Only other beta-amino acids inhibited accumulation. Anoxia inhibited uptake at high concentration ( greater than 1.0 mM) at each age, but taurine accumulation at low concentrations ( less than 0.4 mM) was relatively protected from anoxia in neonatal ( less than 36 hr of age) tissue. Preincubation in taurine-free medium for 120 min enhanced low concentration, but not high concentration uptake in neonatal and 2-week slices. After preincubation in dibutyryl cyclic AMP (dbcAMP) enhanced uptake of taurine was found in adult cortex, but not in neonatal cortex. The ontogeny of renal taurine transport in cortex slices appeared to involve faster initial uptake rates and faster efflux as well as greater dependence on aerobic metabolism with maturation. Age-related differences in the response to preincubation and cyclic nucleotides were also indicative of maturation events in renal tubular amino acid transport.


Effects of viral exposure of the two-cell mouse embryo on cleavage and blastocyst formation in vitro.

The effect of viral exposure of two-cell mouse embryos on their capacity to undergo subsequent cleavage and blastocyst formation in vitro was determined. Exposure to Coxsackie viruses B-4 and B-6, reovirus type 2, influenza virus type A, mouse cytomegalovirus, adenovirus type 5, and mouse adenovirus resulted in statistically significant inhibition of blastocyst formation. Development in vitro was unaffected by exposure to ECHO virus type 11, attenuated poliomyelitis virus type 2, parainfluenza virus type 1, mumps, rubella, and herpes simplex viruses types 1 and 2. Blastocyst formation was also unaffected by exposure of embryos to mouse interferon in a concentration 24 units/ml of culture fluid. Coxsackie virus B-4 was recovered from exposed embryos.


Pain thresholds in rats during recovery from REM sleep deprivation.

Using 30 Sprague-Dawley female rats, threshold to pain was measured over the course of recovery from REM sleep deprivation. Relative to the untreated controls and to their own pretreatment thresholds, the REM-deprived animals showed significantly reduced pain thresholds which were still evident 96 hours after the termination of the REM deprivation. Possible implications of these data for research with analgesic drugs were noted.


Corticosteroids and neuromuscular transmission: electrophysiological investigation of the effects of prednisolone on normal and anticholinesterase-treated neuromuscular junction.

The effect of prednisolone on indirectly stimulated rat muscle twitch was investigated at normal and prostigmine-treated neuromuscular junctions. In vivo, predenisolone up to 150 mg/kg body weight did not affect twitch contraction in normal animals. In neostigmine-pretreated animals, however, doses between 12.5 and 90 mg/kg could entirely abolish the anticholinesterase-induced twitch augmentation. In vitro, prednisolone produced a depressant effect on the twitch of a normal phrenic nerve diaphragm preparation which could amount to 20%. When the preparation was pretreated with neostigmine the augmented twitch could be depressed by 10(-3) to 10(-6) mol/l prednisolone to levels below the untreated control. Part of this effect is owing to a suppression of the neostigmine-induced, stimulus-bound repetitive firing of the motor nerve terminals, but to explain the full effect a further inhibitory action on neuromuscular transmission must be assumed. The latter could be accounted for by a depolarizing interaction of prednisolone and neostigmine on the nerve terminals resulting in conduction block. An action of prednisolone on postsynaptic receptors could also be considered. Such effects of the glucocorticoid might contribute to the exacerbation of muscular weakness occasionally observed in patients with myasthenia gravis at the beginning of steroid therapy.


Effect of physical training on the development of hypertension in the spontaneously hypertensive rat.

The effect of chronic physical exercise on the development of hypertension was measured in spontaneously hypertensive rats (SHR) and their progenitor normotensive wistar-kyoto controls (WK). Starting 4--5 weeks after birth groups of rats were subjected to swimming exercise 1 h x day-1, 4 days x week-1 for a total period of 11 weeks. Control rats were handled daily without exercise. Both in trained SHR and WK a significant delay in increase in body weight was observed. Physical training caused a small, but significant (P less than 0.001) reduction in systolic blood pressure of SHR, whereas it did not affect blood pressure in WK. Heart rate was significantly (P less than 0.001) lower in both trained SHR and WK than in their non-trained controls. At the end of the training period the degree of training was tested by measuring muscle cytochrome oxidase activity and relative heart weight. Cytochrome oxidase activity in gastrocnemius muscle was higher in the trained animals, although the difference was only significant (P less than 0.05) for WK. Training also caused a significant (P less than 0.01) increase in the ratio heart weight to body weight in WK. Both trained and non-trained SHR have a ca. 25% higher relative heart weight than WK controls. SHR hearts did not further hypertrophy as a consequence of physical exercise. These data indicate that swim training induces a trained state in both SHR and WK. Moreover, this form of training causes a slight, but significant attenuation of the development of hypertension in SHR.


Studies on the synaptic interconnection between bulbar respiratory neurones of cats.

In cats anaesthetized with pentobarbital, medullary respiratory neurones of both dorsal and ventral populations were recorded intracellularly with 1 mol.l-1 KCl-electrodes. The neurones were classified according to the projection of their axons to the spinal cord (bulbospinal neurones) or to the vagal nerves (vagal neurones). Those neurones which could not be activated antidromically (NAA-neurones) by either procedure were subdivided into (inspiratory) R beta-neurones, which were monosynaptically excited by lung stretch receptor afferents, and into inspiratory and expiratory NAA-neurones, which did not receive a direct synaptic input, from these afferents. All types of neurone investigated revealed postsynaptic activity during both inspiration and expiration. The periods when synaptic activity was minimal were the periods of transition between respiratory phases. The input resistance of most respiratory neurones varied in parallel with the respiratory cycle. A drastic fall of the input resistance during expiration was observed in R beta-neurones and in some inspiratory vagal neurones. This was not seen in inspiratory bulbospinal neurones. In stable intracellular recordings, periodic postsynaptic inhibition was demonstrated in 52 of 53 respiratory neurones by IPSP reversal following chloride injection. Maximal membrane potential then was generally reached during one of the periods of respiratory phase transition. Reasons for the failure of others to demonstrate these IPSPs are presented and discrepancies between other findings and these are discussed. It is concluded that reciprocal inhibition between bulbar respiratory neurones does exist and is a general phenomenon. It is argued that reciprocal inhibition is the fundamental mechanism underlying respiratory gating of afferent inputs. The probable existence of recurrent inhibition is inferred from the changes in the pattern of membrane depolarization during the active period of neurones.


[Pesticide residues in feed-stuffs in Sweden (author's transl)].

The occurrence of pesticide residues was studied in samples of feed-stuffs produced in Sweden or imported to Sweden during the years 1972--1976. In all, 278 samples representing 37 types of feed-stuffs (components, as well as finished feeds) and 18 countries were analyzed. Residues of chlorinated hydrocarbon pesticides and PCBs were looked for in 224 samples, mostly feed components. The analytical method used involved solvent extraction, florisil-column clean-up, thinlayer chromatographic separation and gas-chromatographic determination. Chlorinated hydrocarbons were found in several samples. DDT and its transformation products were detected in 66 samples (29.5%), lindane in 44 (19.5%), PCBs in 25 (11.2%), alpha-BHC in 22 (9.8%), beta-BHC in 11 (4.9%) and dieldrin in 9 (4.0%). The levels were usually low (Table I). The chloropesticides occurred most frequently and at the highest levels in feed-stuffs of animal origin and in imported oil-feeds. In 25 of the samples the contents of sigmaDDT exceeded the maximum limit accepted by the National (Swedish) Food Administration for grain and bran intended for human consumption (0.05 mg/kg, Talbe IV). The highest residue level of sigmaDDT (0.66 mg/kg) was encountered in a sample of fish meal. The PCB levels found did not exceed the temporary tolerance established by FDA (1973) for finished animal feeds (0.2 mg/kg). One hundred and seven samples were analyzed for phenoxy acid residues using a thin-layer chromatographic and gas-chromatographic technique. Phenoxy acids were detected in only 2 of 62 randomly selected feed samples (0.05 and 0.2 mg/kg, respectively). The residue limit established by the National Food Administration for 2,4-D and MCPA in grain and bran intended for human consumption is 0.1 mg/kg. Fortyfour samples of feeds were submitted because of suspected phenoxy acid contamination. In 12 of the samples phenoxy acid residues were found. The highest level (3.5 mg/kg, MCPA) was observed in a sample of accidentally contaminated molasses. Considering the apparently low level of contamination of Swedish grain with chloropesticides, PCBs and phenoxy acids and the dilution on compounding feed-stuffs of animal origin and oil-feeds, only very low pesticide residue levels can be expected in Swedish finished animal feeds.


BKV splice sequences based on analysis of preferred donor and acceptor sites.

We have determined the DNA sequences which correspond to the splicing regions in the transcripts of human papovavirus BKV, an evolutionary variant of SV40. To precisely localize the excision points in the BKV sequence, we have conducted a preliminary analysis of numerous viral and eukaryotic splice site sequences. This analysis suggests that the preferred sequence for the donor site belongs to at least one of four groups: Pu↓GTAxG, Pu↓GTAxxT, Pu↓GTxxGT, Pu↓GTxAG (↓ = the cleavage site). These four groups derive from the two basic sequences, Pu↓GTxxG and Pu↓GTA. An optimal donor site might be: AG↓GTAAGT. The preferred sequence for the acceptor site is of the form PyPyxPyAG↓; no dinucleotide AG occurs within 13 nucleotides prior to the terminal AG of the 3' end of the intervening sequences. As we have found in this study of BKV splice sites, the sequences for the preferred donor and acceptor sites provide predictive value in localizing RNA splice points when the DNA sequence is known.


Weight and skeletal maturation - a study of radiological and chronological age in an anorexia nervosa population.

The carpal bones of 18 anorexia nervosa patients were radiographed and the X-ray age assessed by 2 different standard methods. The study demonstrates that skeletal development in anorexia nervosa patients is delayed such that there is no association between radiological assessment of age and chronological age. It is strongly suggested that bony development actually ceases when body weight falls sufficiently to stop menstruation. There was a highly significant (P = 0.001) linear relationship between radiological age and the sum of the age of onset of the illness plus any period(s) of re-feeding. Weight gain seems to re-kindle the bone maturing mechanisms: the role of weight thresholds and associated hormone activity being discussed. The findings of this study strongly support the existing evidence that the anorexia nervosa patient is biologically and psychologically immature.


Neutrophil function and diagnosis of pre-leukaemic states.

Haemopoietic dysplasia is a condition which often precedes the development of acute non-lymphocytic leukaemia. Before this event, however, patients are at risk from severe infections even in the absence of neutropenia. This paper describes 3 patients with haemopoietic dysplasias in whom neutrophil microbicidal activity was deficient in vitro. The important abnormality appeared to be defective release of myeloperoxidase into the phagocytic vacuole. Two of these patients suffered from numerous baterial infections.


Trigeminal neuropathy as the presenting symptom of systemic sclerosis.

Three cases of systemic sclerosis in which trigeminal neuropathy was the presenting symptom are described. All 3 patients had progressive diseases and 2 died from its complications. In each case extensive neurological investigation was undertaken before the disease was recognized and it is suggested that earlier recognition of the systemic sclerosis might obviate the need for this. Trigeminal neuropathy in systemic sclerosis was associated with a poor prognosis in 2 of the patients.


Stimulatory effect of chlordiazepoxide on locomotor activity in mice: importance of noradrenergic transmission.

Chlorodiazepoxide (CDP) produces stimulation of the locomotor activity of CD-1 and DBA/2 mice. This effect is strongly pronounced at the commencement of the testing session, and it is followed by a decline of the locomotor activity. The drugs impairing noradrenergic transmission: reserpine, clonidine and alpha-methyltyrosine, depressed or abolished the stimulatory effect of CDP; clonidine, in addition antagonized the subsequent decline of the locomotor activity in CDP-treated mice. Mice receiving reserpine subchronically (in the dose of 0.5 mg/kg daily for 3 days) displayed either motor depression or hypermotility. In approx. 50% of subchronically reserpinized mice CDP produced a strong hypermotility, lasting for at least 1 hr. It can be concluded that a noradrenergic mechanism is involved in the stimulatory effect of CDP on exploratory locomotor activity in mice, and that there exist two distinct subpopulations within the CD-1 strain, reacting differently to chronic reserpine treatment.


Severe orthostatic hypotension associated with carcinoma of the bronchus.

A patient is described who had severe orthostatic hypotension. An account is given of his treatment with a monoamine oxidase inhibitor and tyramine. At post-mortem, 8 months after the illness began, a small oat cell carcinoma of the bronchus was found. It is suggested that the orthostatic hypotension was a nonmetastatic manifestation of the underlying carcinoma.


Bilateral sixth cranial nerve palsy in infectious mononucleosis.

A 15-year-old girl who presented with a bilateral sixth nerve palsy caused by infectious mononucleosis is described. The neurological presentation of infectious mononucleosis is discussed.


Cerebral blood flow after treatment with ORG-2766, a potent analog of ACTH 4--9.

Regional cerebral blood flows (rCBF) were measured in conscious, male rats at 10, 30, 60 min and 24 hr after intravenous administration of a potent, behaviorally active analog of ACTH/MSH 4--9 (ORG-2766). Flows in the basal ganglia, hippocampus, septal area and frontal cortex were depressed significantly throughout the 60 min postinjection period. HYpothalamic and parietal flows were depressed at 10 and 30 min, but recovered by 60 min, whereas flow to the cerebellum was depressed between 30 and 60 min postinjection. The least changed and therefore relatively better perfused area throughout the first 60 min period was the occipital cortex. By contrast, at 24 hr, when perfusion of all brain regions had returned to near control levels, flow to the occipital cortex was elevated. During the first hour after treatment with either ORG-2766 or alphaMSH the patterns of regional circulation in the brain were qualitatively the same. The data suggest that ORG-2766 and, probably, alpha MSH trigger serially linked neurophysiologic changes in the brain lasting at least 24 hr, which organize the behavioral actions of this class of peptides on memory and attentional processes.


A collagen film for microdetermination of collagenase activity.

A simple, rapid, sensitive, and specific film assay for collagenase activity employing a glass-supported, reconstituted collagen gel is described. Digestion of the collagen film results in sharply defined zones of lysis detectable by staining with Coomassie blue. The assay is semiquantitative and suitable for micro enzyme determination in biological fluids.


[Computerized tomography in the evaluation (author's transl)].

CT can clearly demonstrate dilation of intra- and extra-hepatic bile ducts due to mechanical obstruction. Note is made that the intrahepatic bile must not necessarily participate in dilation in obstructive jaundice. The cause in 27 cases observed in our institutions was as follows: 16 pancreatic tumors; 1 stone; 2 extrahepatic bile duct obstructions; 4 liver lesions (tumor and cirrhosis) and 4 with cause unknown. Furthermore, CT is helpful in the evaluation of hepatogenic non-obstructive jaundice such as due to primary liver cell carcinoma (hepatoma), metastases to the liver and advanced cirrhosis of the liver. The value of CT in the evaluation of different types of cholestasis is demonstrated by several exemplary cases; and the problems of differential diagnosis are pointed out.


[Percutaneous transhepatic procedures for diagnosis and therapy in obstructive jaundice (author's transl)].

The techniques of percutaneous transhepatic cholangiography, intubation of the bile ducts for external and internal drainage, application of endoprostheses and removal of biliary tract stones as performed at the Department of Diagnostic Radiology in Lund, Sweden, are described. A flow diagram for diagnostic and therapeutic procedures in patients with obstructive jaundice is discussed.


[Kinetic mechanism of chicken liver mitochondrial malatedehydrogenase (author's transl)].

Kinetic mechanism of chicken liver mitochondrial malatedehydrogenase is established from the initial reaction rates and reaction product inhibition. The results obtained in the reduction of NAD+ (pH 10) allow the formulation of an ordered bi-bi mechanism in which the coenzyme is the first substrate added to the enzyme. Inhibition by the reaction products and by the excess of the very substrates, reveals the formation of the E-oxaloacetate; E-L-malate; E-NAD+-oxaloacetate; E.NAD+-NADH; E-NADH-NADH and E-NAD-NAD+ abortive complexes, the significance of which may be checked under defined experimental conditions. Enzyme inhibition by ATP, ADP and AMP in the reduction of NAD+ (pH10), accords with the proposed mechanism and proceeds via formation of the E-nucleotide and E-NAD+-nucleotide inactive complexes.


[The geriatric day hospital (author's transl)].

The author surveys the development of geriatric care in Great Britain and describes the relationship between geriatric medicine and psychogeriatrics. Both specialties have evolved within the system of progressive patient-care day hospitals. The responsible ministry lays down a norm of two places in both the psychogeriatric unit and geriatric days hospitals to every one thousand people aged 65 and over. The author presents the range of functions of the geriatric day hospital as well as its role within the framework of facilities caring for the aged.


[Experimental acceleration of fracture repair by biochemical media (author's transl)].

The influence of calcitonine, amino acids, ribonucleid acids, kallikrein, growth hormone, and cyclic adenosine 3'5' monophosphate on fracture repair was tested in rabbits. To obtain an objective measurement of callus stability the bones were bent mechanically. The force applied and the degree of bending were recorded continuously. The slope of the curve was taken as a parameter of callus stability. In the series with calcitonine no influence on fracture healing was found. Injections of ribonucleic acids, amino acids, kallidrein, and growth hormone demonstrated a limited effect on bone repair. Callus formation was stimulated by adenosine 3'5' monophosphate. Optimal results were achieved by a combination of adenosine 3'5' monophosphate, amino acids, ribonucleic acids, and kallikrein.


[Contribution of dynamic isotopic tests in the study of algodystrophies].

The authors studied 20 patients suffering from algodystrophy (23 localizations) by triple scintigraphy with technetium, using pyrophosphate to study the importance of bone changes, marked red blood cells to measure the vascular volume, and pertechnetate to measure the interstitial compartment. These tests were done on the average 1.4 months after the outset of the disease. This work made it possible to demonstrate in the algodystrophy: a pronounced bone hyperfixation that was uneven according to the patients; a frank increase in the vascular volume, notably on the capillary level, and a reduction of the circulatory output (calculated on 4 distal localizations), and an increase of the interstitial compartment higher than that of the vascular volume and corresponding to the edema. These results demonstrate a circulatory stasis. In 4 patients treatment with calcitonine reduced the vascular volume but not the bone hyperfixation. In 1 patient, treatment with pindolol reduced the bone hyperfixation and the vascular volume. The authors underline the advantage of such methods in creating a better knowledge of the physiopathology of algodystrophies and effective means of treating them.


Angiographic localization of beta cell tumours.

Angiography was carried out on 28 patients by which a beta cell tumour was verified in 21. One case was excluded as no final diagnosis was established. Angiography correctly localized 14/17 adenomas (82%) and 3/4 carcinomas (75%), in total 17/21 tumours (81%). The adenomas were equally distributed throughout the pancreas. Three false negative diagnoses included an adenoma in the head of pancreas seen in retrospect, a hypovascular adenoma in the head of pancreas and an adenoma in the tail of pancreas which probably was hidden by the spleen. All carcinomas were located in the body and tail of pancreas. Metastases to the liver were demonstrated in two cases, although present in all. One carcinoma was not distinguished from superimposed metastases in the left lobe of the liver. A false positive diagnosis was reported in 3/7 cases (57%). One resulted from accumulation of contrast in the duodenal mucosa, another from a small accessory spleen in the tail of pancreas and the third was probably due to contrast accumulation in the body of pancreas seen 'end-on'. A false positive diagnosis may also derive from contrast accumulation in a hyperplastic lymphnode, a penetrating gatroduodenal ulcer, a pancreatic haemangioma or metastasis. Diagnostic specificity was 0.85, sensitivity 0.43.


Classification of pancreatic endocrine tumours.

Conventional or electron microscopy can contribute significantly to the diagnosis of pancreatic endocrine tumours. These techniques, however, are of limited value for the classification of the tumours, which should take both clinical and morphological findings into account. In this paper a classification based on both the clinical features and on the content of peptide hormone-producing cells in the tumours is presented.


Radioimmunoassay in diagnosis, localization and treatment of endocrine tumours in gut and pancreas.

Pancreas and gut hormones are involved in many endocrine and gastrointestinal diseases. Radioimmunoassays for these hormones have proved particularly valuable in diagnosis, localisation and control of treatment of endocrine tumours, of which many are mixed. An estimate based on ten years experience in a homogenous population of 5 million inhabitants (Denmark) suggests, that endocrine gut tumour-syndromes on an average appear with an incidence of 1 patient per year/syndrome/million. At present six different syndromes are known: 1) The insulinoma syndrome, 2) The Zollinger-Ellison syndrome.3) The Verner-Morrison syndrome. 4) The glucagonoma syndrome. 5) The somatostatinoma syndrome, and 6) the carcinoid syndrome. Accordingly diagnostically valuable RIAs for pancreas and gut hormones include those for insulin, gastrin, VIP, HPP, glucagon, somatostatin, and presumably also substance P. It is probably safe to predict that the need for gut and pancreas hormone RIAs within the next decade will increase greatly in order to assure proper management of tumours producing gastroentero-pancreatic hormones.


The clinical diagnosis of insulinoma.

Based on the literature and on experience and on experience with 23 cases the clinical diagnosis of insulinomas is reviewed. In clinical praxis the diagnostic steps can usually be simplified to a demonstration of fasting, symptomatic hypoglycaemia. Hence, we have used the 72-hour fast as the single diagnostic test for insulinomas during the last 5 years. Pro-insulin measurements may be a valuable supplementary tool. Other diagnostic tests are probably of little importance.


Delay in the diagnosis of insulinomas.

The median diagnostic delay in 32 patients with verified insulinomas was 2 3/4 years (range 1/4--18). The median delay in the 1939--1958 period was shorter (2 years, n = 17) than in the 1959--1978 period (3 years, n = 15). Thus, modern developments with insulin estimations were without noticeable effect upon the diagnostic delay. The findings can probably only be explained by a poor awareness of the insulinoma syndrome in the medical profession.


Strategy in the diagnosis of insulinoma.

A simple diagnostic strategy in the diagnosis of insulinoma in adult subjects is proposed based upon the literature and own experiences. It comprises measurement of plasma proinsulin, insulin and C-peptide as well as blood glucose after an overnight fast. When a low or normal proinsulin concentration is found, organic hyperinsulinaemia is very unlikely, while elevated proinsulin, after exclusion of uremia, hepatic cirrhosis, thyreotoxicosis and surreptitious administration of insulin or sulfonylurea drugs, strongly indicates this condition.


Elevated serum proinsulin in beta cell nesidioblastosis. Report of a case in a newborn.

A newborn infant with severe hypoglycaemia and nesidioblastosis was subjected to subtotal pancreatectomy without any sign of improvement. In spite of very low plasma levels of glucose (i.e. less than 1 mmol/l) plasma insulin concentrations were high (i.e. greater than 700 pmol/l). Plasma proinsulin was considerably enhanced comprising 43% of the total insulin immunoreactivity. Plasma glucagon concentrations were normal. Postoperatively normal to subnormal plasma glucose levels could only be maintained by treatment with frequent meals, diazoxide and intramuscular injections of a long-acting glucagon preparation. With time, signs of mental retardation became obvious.


Possible entries to the diagnosis of a glucagon-producing tumour.

Most, if not all, of the glucagon-producing tumours of the pancreas are malignant. For this reason an early diagnosis is essential. The glucagonoma syndrome is associated with a skin rash, stomatitis, anaemia, glucose-intolerance, hypoaminoacidaemia, weight loss, elevated sedimentation rate and hyperglucagonaemia. The more important and constant findings are the skin lesion, the low level of aminoacids in the blood and the increased glucagon concentrations. The skin lesion is not pathognomonic, but any therapy-resistant bullous dermatosis which microscopically is characterized by epidermal changes should alert the clinician to suspect a glucagonoma. The syndrome can be proved by demonstration of hyperglucagonaemia and a pancreatic tumour.


Verner-Morrison syndrome and vasoactive intestinal polypeptide (VIP).

The clinical features of the Verner-Morrison syndrome are surveyed. This rare clinical entity still needs to be more clearly defined. Especially in relation to the role of VIP and the clinical value of VIP measurements. A case with a good correlation between the activity of the disease and circulating VIP is presented.


Majority and minority cell populations in GEP and bronchial endocrine tumours.

Gastro-entero-pancreatic (GEP) and bronchial endocrine tumours have been studied by immunohistochemistry using specific antisera against a variety of hormonal and neuronal peptides. In gastrinomas numerous tumour cells were found to contain GH-like immunoreactivity. These cells were identical with those storing gastrin. Gastrinomas as a rule were extremely heterogeneous containing a variety of minority cell populations, including CCK immunoreactive cells and neurotensin immunoreactive cells. Glucagonoma cells were found to store GIP-like material in addition to glucagon. In some insulinomas calcitonin-like material was encountered in the insulin producing tumour cells. In both glucagonomas and insulinomas other pancreatic endocrine cell types constituted minority cell populations. One intestinal somatostatinoma contained gastrin cells as a minority cell population. Bronchial endocrine tumours contained scattered cells displaying ACTH-like or enkephalin-like immunoreactivity. Two such tumours in addition contained cells displaying neurophysin immunoreactivity.


Pancreatic-polypeptide (PP) and endocrine tumours of the pancreas.

The role of human pancreatic-polypeptide in endocrine tumours of the pancreas is reviewed. Pancreatic-polypeptide may be involved in 3 different ways: 1. In cases with pure PP producing tumours. 2. In mixed endocrine tumours containing PP cells. 3. In cases with PP cell hyperplasia in normal pancreatic tissue associated with endocrine pancreatic tumours as VIP-omas, insulinomas, and glucagonomas. PP does not seem to serve as a general marker for endocrine tumours of the pancreas, but PP determinations are useful in patients wbith watery diarrhoea syndromes, because such syndromes may be associated with tumours that contain PP cells. Large molecular forms of PP occur in plasma from patients with endocrine tumours and high PP concentrations, but may also be found in other groups of patients. It is suggested that an atropin-suppression test could be of diagnostic value in revealing patients with increased serum concentrations of PP from other causes than vagal stimulation of normal PP cells.


Role of peripheral afferent nerve fiber in acupuncture analgesia elicited by needling point zusanli.

Needling acupuncture point zusanli shows a significant suppressive effect characterized by the response of jaw movement. The afferent analgesic impulses arising from the point zusanli for producing this effect are transmitted largely by A beta gamma fibers in the peroneal nerve. Sufficient amount of A beta gamma fibers brought in to action is an important factor in achieving this prominent analgesic effect. The inhibitory action of the large fibers, such as A beta gamma, mediating analgesic impulses upon the small fibers such as A delta and C, carrying painful impulses, seems to be one of the component parts of the mechanism of acupuncture analgesia.


Calmodulin activation of adenylate cyclase in pancreatic islets.

Pancreatic islets contain calmodulin. The protein binds to a particulate fraction derived from the islets and stimulates adenylate cyclase activity in this subcellular fraction, both phenomena being activated by ionized calcium. A calcium-dependent stimulation of adenylate cyclase by endogenous calmodulin may contribute to the accumulation of adenosine 3',5'-monophosphate evoked by insulin releasing agents in the islet cells.


[Destroyed lung (author's transl)].

The expression of "destroyed lung" is, now, accepted to designate the large destructions of the lung, secondary to pulmonary and essentially infectious diseases, the cure of which is obtained but with important sequelae. The main cause remains tuberculosis, cured by chemotherapy. Some large pulmonary suppurations, treated by antibiotics, can lead to the same sequelae. These "destroyed lungs" can keep an asymptomatic form. But often, about ten years after the initial disease, they cause several troubles such as progressive dyspnea leading to irreversible respiratory insufficiency, repeated pulmonary infectious episodes and hemoptysis, the risk of which is increased by aspergillosis. The radiological aspect of these "destroyed lungs" is made of opacities with multiple cavities or with one unique large cavity. The mechanism of hemoptysis has been understood recently: all destructive lesion of the pulmonary tissue produces as a consequence a development of the systemic blood circulation, bronchial or parietal, with reverse blood circulation from systemo-pulmonary anastomoses-which can produce capillary dilatations-into the pulmonary artery. All these complications can lead to a surgical treatment. Embolization of bronchial arteries is a less aggressive method when hemoptysis is the main symptom. These acquires "destroyed lungs" can be compared to those caused by extensive pseudokystic bronchiectases. For both cases clinical aspects and therapeutic methods are similar, though the lesions are fixed and likely congenital in the last form.


[Carcinoïd heart disease: clinical, light and electron microscopic study (author's transl)].

The authors report a clinical and pathological case of carcinoïd heart disease in a 70-years old man. The primary carcinoïd tumor was ileal with both hepatic and neighbouring lymph node metastases. The clinical history was dominated by a typical carcinoïd syndrom biologically confirmed and accompanied by a tricuspid insufficiency. An autopsy permitted to described with precision the topography and extent of the cardiac affection. The originality of this work is due to the ultrastructural study which has rarely been done. This study permitted us to make some clinical histopathological, histogenetic and pathogenetic comments.


[Supra trochlear femoral erosions. Their relations with gonarthrosis and chondrocalcinosis (author's transl)].

Studying one hundred cases of simple gonarthrosis we found only one supra trochlear femoral erosion (STFE). Such a lesion was discovered in 14 cases among 150 chondrocalcinosis with arthrosic lesions. The cases involving STFE trend to a commun marked chondro-osteolytic evolution. The caracteristic patella sizes show clearly that STFE is not in relation with en anomaly of patella (patella alta...). The upper osteophyte of the patella presents only a minor importance in the formation of STFE. This STFE formation begins probably with a progressive chondro-osteolysis of patella and trochlea. Then, appears a progressive nipping between the upper point of patella and the supra trochlear femoral bone.


[Therapy of chronic autonomous pancreatitis. Results in 147 cases (author's transl)].

The authors summarize their own personal experience acquired in the Department of Pr. Mercadier, concerning chronic pancreatitis. They attempt to define the factors influencing the choice of surgical technic, whilst emphasizing the grave nature of this condition, the long term prognosis of which remains severe in 50 per cent of cases.


[Accidental ingestion of caustic in childhood (author's transl)].

Accidental ingestion of caustic in childhood is not frequent but severe. It result in oesophagal burns progressing to stricture formation. 18 children with severe oesophagal burns were admitted during the six past years in the Intensive Care Unit of "Hôpital des Enfants-Malades" in Paris. The authors report mainly two cases. They recommend oesophagoscopy and they propose a protocol of treating applied since 1974 in France and foreing countries. The present problem consists mainly in a preventive program to avoid kind of accidents and their sequels in children and their families and finally in the community.


[Necrotising enterocolitis. Report of 3 cases (author's transl)].

A review of clinical, pathological findings in 3 cases of necrotising enterocolitis is presented, as well as considerations about pathogenesis. The authors stress the benefits of hyperbarie oxygen in the treatment of the disease.


[Chronic constrictive pericarditis complicating an apparently stable rheumatoid arthritis. Report of a new case (author's transl)].

The authors report a case of constrictive pericarditis complicating an apparently stable sero-negative rhumatoïd arthritis, a rarely described pathological association. The patient had a serious polyserositis due to an extremely marked and inflammatory pericardial constriction. The rhumatoïd origin was confirmed by pericardial effusion, histological and immunofluorescent studies. The inflammatory pericardial process rendered pericardiectomy virtually impossible and resulted in a fatal outcome.


[Duhring's and coeliac's diseases (author's transl)].

An atrophy of villi without digestive troubles is found in a 3 1/2 years old boy with a typical Duhring's disease. This observation proves the interest to research an enteropathy in case of dermatitis herpetiformis, and on the other hand the gluten free diet's efficacity on the cutaneous lesions. The authors consider cutaneous lesions's pathogeny and the antigenic relations between these two diseases.


[Some rare diseases of the esophagus (author's transl)].

Cancer excepted all other diseases of the esophagus are rare. Diverticula, benign tumors, perforations and the pathology of the cardia (hiatus hernia, achalasia and esophageal varices) are not studied here. We took into consideration the following diseases only: spasm of the cricopharyngeal muscle, Plummer-Vinson or Kelly-Paterson syndrome, cervical osteophytosis, dysphagia lusoria, benign and malignant mediastinal lymphatic nodes, Schatzki ring of the lower esophagus and esophageal duplications.


[Histopathological findings in Hodgkin's disease (author's transl)].

The histological classification of Hodgkin's disease, as proposed by Lunkes and Butler, is incomplete and does not include all the morphological findings. The distinction between sub-varieties of the nodular sclerosing type and particular forms of the disease (interfollicular with necrosis, with xanthelasma, or epithelioid pseudo-metastatic cells) clearly demonstrates the large polymorphism of the ganglionic lesions. A study of the different types encountered in the same patient shows that there is probably a form which evolves from type 1 towards type 3 and then type 4, an another form characterized by nodular sclerosis. The distribution of the various varieties and sub-varieties were studied by the author in 442 ganglia and results were similar to those reported in other series: nodular sclerosing form: 38.2%; form without nodular sclerosis: 61.8% made up of H1: 10.6%, H3: 45.5%, H4: 5.6%.


[Retro-peritoneal tumors. Report of 21 cases (author's transl)].

The authors report their experience about 21 cases of retroperitoneal tumors. They emphasise their often late revelation, the frequent malignity and the involvement of the surroundings organs. They insist on the interest of the opacification of urinary tract and angiography and the value of echo-ranging and total body scanner to evaluate the characteristics of these tumors and theirs extensions. Recurrents are frequents and must be operated each time necessary.


[Delayed radionecrosis of the cerebral hemispheres following betatron electron beam irradiation for scalp cancer. Pathological and clinical findings in one case (author's transl)].

Three years following an irradiation by the Betatron's electron beam of an epithelioma in left parieto occipital area of the scalp in a female patient aged 77, early suffering from high blood pressure, a fatal pseudo-tumoral brain necrosis occurs presenting as a rapidly increasing from of Wernicke's aphasia. The necropsy shows intense radionecrosis lesions of the brain and the bone, free of any parenchymatous malignant proliferation note-worthy for the striking density of microvascular changes as previously described in radiation therapy. The case observed some years ago, allows to definite again the limits doses of the extracranial irradiations now estimated at 1760 rets. That is the "Nominal Standard Dose" (NSD) measured by rets and taking into account the number of seances (N) and the duration of irradiation (T) which would be to take the place of "the total dose" (D) (rads). These dosimetric criteria themselves must be adjusted to the age and the vascular features of each patient.


[Bourneville's tuberose sclerosis in children (author's transl)].

In 20 out of a series of 30 children with Bourneville's disease, the diagnosis was made from the association of epilepsy and multiple achromic spots, before the appearance of adenomas. A total of 27 of these 30 children had these spots, and their characteristics are reviewed, as well as the average age of onset and frequency of the other typical cutaneous signs noted in this group: sebaceous adenomas, Koenen's tumors, and leather-grained skin plaques. Severe epilepsy was a constant finding and was often resistant to treatment: West's syndrome (18 cases), and Lennox Gastaut's syndrome (16 cases). Severe mental deficiency was also an almost constant finding and was increased by behavioural disorders: 11 out of the 13 children aged more than 5 years. Other locations of the disease included more particularly the ocular (8 cases), skeletal (11 cases), and renal (1 case) regions. In 5 cases, the disease had been transmitted by a parent, but in 3 of these it had not been recognized.


[Diagnostic problems in the disseminated intraparenchymatous form of cerebral cysticercosis. A report on two cases (author's transl)].

The authors report 2 cases of brain localisation of cysticercosis due to Cysticercus cellulosae. In both cases epilepsy was found but only later was its origin proved by the finding of caracteristic ellipsoidal calcifications of cysticerci on the roentgenogram. The authors also recall the various possible symptoms; insist on the fact that early positive diagnosis is difficult and that the mode of treatment by surgery is exceptional. Though cysticercosis is rare in France, it should be remembered when a diagnosis of epilepsy is made and no apparent cause is found: further research of etiology should thus be made in such cases.


[HLA in psoriasis, population and family studies (author's transl)].

We have detected B13 and BW17, respectively 6 and 20 times, in a dample of 51 psoriasis, versus, respectively 2 and 12 times in a sample of 140 control subjects. Two informative families have been investigated. In the first one, marker transmission and illness heredity were correlated, whereas, in the second one, both were dissociated. These observations allow to consider every physio-pathologic hypothesis linking HLA system and psoriasis vulgaris.


[Pharmacological basis for a fixed association of hydrochlorothiazide, amiloride hydrochloride, and timolol maleate (author's transl)].

The treatment of hypertension requires in many cases a therapeutic combination. This survey, carried out in 96 cases, shows the interest of a fixed combination including a thiazide diuretic (hydrochlorothiazide), a potassium sparing (chlorhydrate of amiloride) and a beta-blocking agent (timolol maleate) as compared to therapy with a beta-blocking agent or diuretic alone. This combination, logical from a pharmacological view point, has proved significantly more effective (81% of patients were normalized) and as well tolerated (none additional side effect) as each of its components. As it simplifies prescription by reducing the number of tablets, it appears a considerable contribution to hypertension therapy.


[Bone in hepatic cirrhosis: morphometric and biological study (author's transl)].

Quantitative bone histomorphometry and evaluation of blood parameters have been performed in 24 patients with hepatic cirrhosis. 13 patients show osteoporosis which, in 8 of them, is associated with osteoclastic hyperactivity but without elevation of blood parathormon. All patients have hypocalcemia and 14 of them hyperosteidosis. These results are compared with data of the literature on bone morphometry and phosphocalcic metabolism during hepatic cirrhosis.


[Hormonal status and hyperthyroidies (author's transl)].

The authors have compared "clinic" and "biology" in order to determine principal tests in vitro in: hyperthyroïdie diagnostic: T3-FT4 rT3; hyperthyroïdie form: TBG; treated greave's disease: FT4-TBG.


[Treatment of alcohol withdrawal symptoms: a clinical study (author's transl)].

A total of 24 patients (20 men and 4 women) were treated for varying degrees of alcoholism. Tiapride was administered orally as 300 to 600 mg/day to 22 patients, the other two cases receiving i.v. injections followed by oral doses. Tiapride was extremely well-tolerated and no side-effects were noted. Withdrawal symptoms were effectively reduced, and a significant action was noted against tremor. Tiapride was also effective against depression and anxiety, and hallucinations disappeared in two cases.


[Management of carcinoma of the kidney with metastasis (author's transl)].

The discovery of pulmonary metastasis is not a contraindication to operation. In the light of 21 personal cases and a review of the literature, the authors give their arguments in favour of surgery. No pronostic criterion is certain except for two facts: 1) the course is capricious; 2) spontaneous remissions do not occur. The results of surgery alone do not seem to be influenced by radiotherapy nor chemotherapy.


Studies on the mechanisms underlying horizontal-bipolar interaction in the carp retina.

Responses of on-center bipolar cells and horizontal cells were recorded simultaneously in the carp retina, and the effect of polarization of horizontal cells on the bipolar cells was studied. Hyperpolarization by extrinsic current of horizontal cells elicited in the bipolar cells a hyperpolarizing response which, unlike the electrical coupling betweeen adjacent horizontal cells, was accompanied by a change in membrane conductance. The bipolar cell responses elicited by polarization of external horizontal cells showed a negative reversal potential, while those elicited by polarization of intermediate horizontal cells showed a positive reversal potential. It was suggested that the external horizontal cells modify the cone-bipolar transmission which involves the conductance change of subsynaptic potassium and/or chloride channels, while the intermediate horizontal cells modify the rod-bipolar transmission which involves the conductance change of sodium channels.


[Eighteen cases of desmomas (author's transl)].

In 14 years the authors have recorded 18 cases of desmomas. Most of the cases were situated in the 3rd and 4th decade. They only found 8 times the usual localization in the abdominal musculature. In five of their observations they found and accidental or surgical traumatism. The histopathological data are given and the ultrastructural examination reveals the fibrillogenetic activity of the tumoral cells. Multiple recurrences were observed in two cases; they concerned lesions localized in the members. No metastatic evolution was to be found.


[Bronchial tumor and paraneoplastic syndrome of antiduresis: a new case of Schwartz-Bartter's syndrome (author's transl)].

The autors reports about a new case of Schwartz-Bartter's syndrome. Its first clinical manifestations are primarily the neuro-psychiatric disorder and the arterial hypertension. These manifestations were attributed to an inappropriate secretion of antidiuretic hormon, in relation with a bronchial neoplasm (oat-cell carcinoma). The tumor was removed surgically; shortly after the operation the biological disorders disappeared completely. But they reappeared 5 months later, indicating recurrence (local and metastatic). This recurrence started to present clinical manifestation, 2 months later. After a brief historical approach, the authors suggested the aetiology, the diagnosis circumstances and the biological criteria of Schwartz-Bartter's syndrome. Then later, the precised the main principles of its management.


Primary mucus-secreting adenocarcinoma of the renal pelvis.

Mucus-secreting adenocarcinoma of the renal pelvis is an extremely rare tumor. It arises from multipotential transitional epithelium which is capable of undergoing metaplastic transformation when subjected to chronic irritation from calculi, hydronephrosis, or pyelonephritis. Women are affected slightly more often than men. Tumor invasion implies a poor prognosis. Long-term survival occurs but is infrequent. In the case reported, preoperative angiography yielded useful diagnostic information.


[Technical notes about radiculosaccography (author's transl)].

We insist about the following notions: contra-indications: epilepsy, papillary stasis, important ethylism, folliculitis in the lumbar punction area; preparation by intra-venous hydrocortisone and Primperan in two different syringes (to prevent lipothymia and vomiting); localisation by TV of the space L2-L3; cytology and albumin in the cerebrospinal fluid; localised X-rays on the suspected intervertebral disk.


[Rupture of an aneurysm of the splenic artery into the pancreas, a rare cause of gastrointestinal bleeding (author's transl)].

In a 73 year old man, repeated gastrointestinal haemorrhages first attributed to peptic oesophagitis, recurred despite anti-reflux surgery. Upper endoscopy being negative, arteriography was performed which revealed the presence of a fissured aneurysm of the splenic artery. This was successfully treated by left splenopancreatectomy. A communication between the aneurysm and wirsung's duct was found in the operative specimen. This a very rare cause of gastrointestinal bleeding. The diagnosis can be made only by arteriography.


[Paralytic shellfish poisoning (author's transl)].

Different diseases as viral or bacterian gastro-enteritis, Tiphoid, viral hepatitis can come from shellfishes. Less known is the shellfish poisoning although recent outbreaks took place in Spain, France, England, Morocco. Toxic poisoning is caused by a poison produced by dinoflagelates of plankton which get developped in shells and make them dangerous, even cooked, to be eaten. A respiratory failure can result from this neurotropic poison.


Endocrine function in sclerosteosis.

Sclerosteosis is a rare autosomal recessive condition which is characterized by excessive skeletal overgrowth, distortion of the facies, cranial nerve abnormalities and raised intracranial pressure. Syndactyly and digital malformation are associated features. Radiological examination reveals thickened sclerotic bone maximally involving the skull, including the pituitary fossa. Sclerosis and hyperostosis are present throughout the skeleton. Biochemical and endocrine tests were carred out on 3 patients with sclerosteosis in an attempt to detect any dysfunction of calcium regulation of the pituitary. Results revealed no abnormality of basal parathyroid or calcitonin secretion. Histological examination revealed quantitatively increased bone resorption in comparison with normal subjects, although the pattern resembled osteosclerosis. Regulation of growth hormone, adrenocorticotrophin, gonadotrophin and thyrotrophin function were intact. We conclude that pituitary function and calcium 'homeostasis' are normal in this disorder.


The role of physical activity in the prevention of ischaemic heart disease. A review.

It has been demonstrated that vigorous leisure-time physical activity and hard physical occupational work protect against ischaemic heart disease (IHD), but the protective mechanisms are not clear. According to most research reports programmes of regular physical activity do not lower serum cholesterol concentrations, but they do lower serum triglyceride levels. Dedicated marathon runners have lower serum low density lipoprotein and higher high density lipoprotein levels than controls, but it has not been proved that this lipoprotein pattern is the result of regular, high-intensity exercise. Regular physical exercise lowers the blood pressure to a greater degree in hypertensives than in controls. An exercise programme plus diet had no greater effect on serum total cholesterol levels than did diet alone on subjects with primary hyperlipoproteinaemia types IIa, IIb and IV. However, in types IIb and IV the exercise programme plus diet was more effective than diet alone in lowering serum triglyceride levels. The results of these studies are not valid for deciding whether regular exercise decreases the IHD risk factors studied. Such judgements must be based upon the results of randomized, controlled trials. The only satisfactory trial of this nature to date was done in Helsinki, and its results were inconclusive.


Transfer of the herpes simplex thymidine kinase gene from human cells to mouse cells by means of metaphase chromosomes.

Thymidine kinase (TK)-deficient human cells were infected with ultraviolet light-inactivated Herpes simplex virus type 1, and "transformed" cells that expressed Herpes TK activity were isolated. Purified metaphase chromosomes were isolated from the transformed human line and incubated with TK-deficient mouse cells. TK+ cells were selected, and it was shown that these cells were gene transferents which expressed Herpes TK activity, identical to that found in the transformed human cells. The gene transferents contained no intact human chromosomes. When removed from selective pressure, the gene transferents rapidly lost the TK+ phenotype. However, upon continued growth in nonselective medium, a subpopulation in which the TK+ phenotype had become more stabilized appeared. These results suggest that the Herpes gene for thymidine kinase has integrated into the genome of the HSV-transformed human cells and that it can be transferred to other cells by means of purified metaphase chromosomes.


Glucagon stimulated plasma cyclic adenosine-3',5'-monophosphate in the differential diagnosis of jaundice.

The amount of plasma cyclic adenosine-3',5'-monophosphate was estimated before and 15 minutes after the intravenous injection of 1 milligram of glucagon in 34 patients with obstructive and in 23 patients with nonobstructive jaundice. After stimulation with glucagon, the median adenosine-3',5'-monophosphate concentration in obstructive jaundice rose fortyfold or more, while in nonobstructive jaundice, the increase was twentyfold or less. The difference was highly significant. The results indicate that this test can be useful in the differential diagnosis of obstructive and nonobstructive jaundice.


Lung cancer in Malaysia.

Between 1967 and 1976, 388 cases of lung cancer were seen at the University Hospital, Kuala Lumpur, with histological confirmation in 72%. Most were aged from 50--80, with a male to female ratio of 2.8 : 1. The patients were predominantly of Chinese origin (82%) and from the lower socioeconomic strata. A history of smoking was elicited in 78%. The chief clinical and radiological features and the diagnostic methods are presented. The incidence of the histological types was squamous carcinoma 34%, adenocarcinoma 25%, large cell carcinoma 12%, small (oat) cell carcinoma 12%, "unidifferentiated/anaplastic" 15%, and others 2%. Malays appeared to have a higher percentage of adenocarcinoma. A comparison between the histologically confirmed group and the rest showed no significant difference in features. Problems pertaining to the management of Malaysian patients are discussed.


Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma.

The accuracy of diagnosis of cell type obtained from sputum cytology, bronchial aspirate, bronchial biopsy, or percutaneous lung biopsy in 161 cases of confirmed primary lung cancer has been examined and the pretreatment histological diagnosis has been compared with the final diagnosis made after surgical resection or necropsy. The yield of positive diagnoses of malignancy obtained by each method of investigation in each cell type showed that cytological examination of sputum was the most accurate method, but a high degree of accuracy was also obtained by bronchoscopic aspiration and bronchial biopsy. Percutaneous lung biopsy was the most effective, but the least accurate, means of obtaining carcinoma cells. The level of diagnostic accuracy was highest in patients with squamous cell carcinoma. Accurate pretreatment diagnosis of patients with adenocarcinoma was particularly difficult, and only 20% of these cases were correctly diagnosed by investigation. Of seven patients with adenocarcinoma and a positive diagnosis of malignancy made on percutaneous lung biopsy, none was correctly diagnosed. The causes of error in diagnosis of cell type of primary lung cancer are discussed.


Peak flow rate records in the diagnosis of occupational asthma due to isocyanates.

Peak expiratory flow rate (PEFR) has been recorded hourly or two-hourly from waking to sleeping in workers with respiratory symptoms who were exposed to isocyanate fumes at work. Twenty-three recordings averaging 33 days duration were recorded in 20 workers. Each worker was also admitted for bronchial provocation testing to toluene di-isocyanate (TDI) or diphenylmethane di-isocyanate (MDI) fumes or both. A final assessment of work-related asthma made from subsequent work exposure was compared with the results of bronchial provocation testing and a subjective assessment of the peak flow records. Both techniques were specific and sensitive. Physiological patterns of occupational asthma were defined from the records of PEFR. The most striking finding was the slow recovery from work-induced asthma. This commonly took several days to start and in one worker took 70 days to complete after leaving work. Several workers developed a pattern resembling fixed airways obstruction after repeated exposure at work. The consequences of these findings for the recording of symptoms of occupational asthma are discussed and recommendations are made for the recording of PEFR in workers in general.


Liquoid induced stasis and the generalized Shwartzman reaction. An electron microscopic study in blue foxes.

The composition of the occlusive material within dilated glomerular capillaries, following intravenous injections of Liquoid in blue foxes, was studied electron microscopically; it was found that it mainly consisted of a debris in which disintegrated red cells constituted the major component. Damaged platelets and necrotic endothelial remnants were other components. These observations were interpreted as a result of glomerular stasis, and it was concluded that stasis in glomerular capillaries is a basic event in the development of the renal lesions accompanying the generalized Shwartzman reaction.


Cytotoxic effect of neocarzinostatin on human lymphoid cells.

Effect of a protein antitumor antibiotic, neocarzinostatin (NCS) was examined on Epstein-Barr virus (EBV)-carrying human lymphoid cell lines and normal human lymphocytes. A marked cytotoxic effect of NCS on umbilical cord lymphocytes freshly transformed by EBV was observed, whereas the cells before transformation were affected only very little by NCS. Majority of long-term cultured cell lines were affected only slightly, while shorter-term cultured lines were more susceptible to the effect of NCS. An uptake of FITC-labeled NCS into cells was examined by fluorescence microscopy. The incorporation by the freshly transformed cells was higher than that by the longer-term cultured cell lines. Normal lymphyocytes or heat-killed cells, however, incorporated FITC-NCS very little. On the basis of the known mode of action of NCS on DNA and the present observation, the cytotoxicity of NCS appeared to be exerted within the cells.


The pattern of liver diseases in Singapore. An autopsy study.

This study is based on an analysis of 1839 consecutive necropsies. Liver diseases are common in Singapore. Of particular importance are cholelithiasis, cirrhosis and primary carcinoma of the liver. Gallstones are mainly of the pigment variety and a significant proportion are present in the bile ducts. The multiracial composition of the population is reflected in a difference in the pattern of liver diseases among the different ethnic groups. Indians are found to have more alcoholic hepatitis and cirrhosis which are often of the micronodular type, while the Chinese have significantly more macronodular cirrhosis and hepatocellular carcinoma. Clonorchiasis and schistosomiasis are confined to the immigrant Chinese. The pattern of liver diseases is changing. Cholangitis and cholangitic abscesses as a result of cholelithiasis are becoming more common while amoebic abscesses and hepatic ascariasis are definitely on the decline. This is attributable to improved sanitary conditions.


Breast cancer in Surinam.

Two hundred forty two breast malignancies, all in women, including 238 carcinomas and four sarcomas, were screened in surgical pathologic materials from 1964-1976 in Surinam (population 385,000). The histologic types were similar to those generally seen. The mean age was 55.1 years and the range 24 to 89 years; 45.8% of cases came from the Creole population. The incidence in this period is calculated at 9.5/100,000.


The natural occurrence of Trypanozoon in domestic chicken in the Ivory Coast.

From a natural infected chicken (Gallus gallus var. domesticus) in the Ivory Coast trypanosomes were isolated using Mastomys natalensis as recipient animal. Trypanosomes were diagnosed as belonging to the subgenus Trypanozoon from its morphology and its infectivity for rodents. The stabilated stock was able to infect a laboratory chicken. The stock proved to be human plasma subresistant and showed electrophoretic patterns of three enzymes (ALAT III, ME I, PEP III) so far only seen in pig and dog originated Trypanozoon stocks from the same region surveyed. The discovery for the first time of chicken harbouring Trypanozoon has to be considered in epizootiology and epidemiology of trypanosomiases.


[Microspectrophotometric study of the crystalline inclusions in different strains of Amoeba proteus].

Using microspectrometric technique, integral extinction and extinction spectra of crystalline inclusions of two amoeba strains, C and Ct, have been studied. The analysis of extinction spectrum form allowed to suggest that the crystals seen in both amoeba strains have identical chemical composition, whereas the morphological differences between cells in their transparency may be due to different mode of the crystal package. The relative amount of the crystals was measured in both amoeba strains on the basis of the integral extinction value. The distinct differences between the strains were detected in the integral extinction value and in the extinction spectra, which allowed us to use these parameters as genetic markers in the experiments on the nuclear transplantation in amoeba.


Mucinous adenocarcinoma of prostate.

Primary mucinous adenocarcinoma of the prostate is rare. The presence of mucin in prostatic carcinoma is usually associated with decreased tumor aggressiveness and increased survival rates. When mucinous adenocarcinoma of the prostate is found, it is necessary to exclude extraprostatic primary sources particularly from the urinary bladder and the gastrointestinal tract.


Border disease: persistant infection with the virus.

Two genetically related sheep that produced border disease-affected lambs from successive pregnancies were identified. These sheep, and some of their progeny, were found to be persistently infected with a virus antigenically related to bovine virus diarrhoea/mucosal disease virus. Only one of the sheep developed detectable serum antibody to the virus, and this animal only produced it 12 months after being detected as infected. The epidemiological significance of sheep persistently infected with border disease virus is discussed.


[Immunological reactivity study of patients with uterine trophoblastic tumors].

By using DNCB delayed hypersensitivity test, the reaction of spontaneous rosette formation (RSRF) and the reaction of inhibition of leucocytes migration the authors examined 55 female patients with different forms of trophoblastic tumors of the uterus and 15 females following the removal of the mole without any signs of the disease concerned. Forty three patients showed a positive DNCB test, 93 of them were completely cured, a negative test was noted in 12 patients, only a 50% cure being observed. RSRF indicated the increased level of rosette-forming cells from 4,7--28% up to 10,3--73% in a successful treatment and its decrease down to 0--5% in the tumor progression, except 7 patients showing reduced RFC levels after the recovery. The reaction of leucocytes migration inhibition has revealed a considerable depression of leucocytes migration (MI--from 0.35 to 0.78) in 18 of 25 patients with manifestations of an acute tumor process (72%). In 7 cases no inhibition was noted, in 6--the treatment being insignificantly effective or time-consuming. In 21 (47.8%) of 27 patients without any signs of the affection there was no inhibitory effect. Leucocytes of healthy donors failed to respond to the tumor extract in either of 24 cases.


[Pattern of lymphogenic metastasizing of soft tissue malignant tumors].

The examination performed indicated metastases in regional lymph nodes in 34 (7.5%) of 453 patients with soft tissue malignancies. The presence of metastases aggravates considerably the prognosis: a 5-year survival was 6.6%. Great risk of metastatic proliferation is especially characteristic of rhabdomyosarcoma, non-classifiable blastoma and synovial sarcoma. Primary tumors develop metastases more frequently than recurrent ones. The probability of lymphogenic spread of metastases is the higher the larger the tumor size in young individuals, and also with skin involvement. Tumor infiltration of bones does not result in an increased percentage of lymphogenic metastasization. The proximity of a tumor to regional lymph nodes is not inherent in a higher risk of their metastatic involvement.


[Prognosis in malignant tumors of soft tissues].

The author reports the data on 348 patients with malignant tumors of soft tissues, operated upon within the period of 1946--70 inclusively, children being excluded from this number. Various factors were studied from the prognostic viewpoint. The data obtained enabled estimating the morphological tumor structures, other conditions being equal, as a factor of great importance. None of the factors should be regarded separately. The accumulation of observations and systematization of prognostic criteria seems to be absolutely essential. Prognostication in malignant tumors of soft tissues may aid in selecting an adequate extent of surgical intervention, in avoiding too traumatic procedures, thus contributing to patients' rehabilitation.


[Diagnosis and treatment of neck chemodectoma].

The work is based on the analysis of clinical data of 10 patients with chemodectoma of the neck, 8 of them being subjected to surgery. The diagnosis in 8 operated patients was confirmed histologically, 2 non-operated patients had angiographic manifestations. It is emphasized that carotid angiography plays an important role in establishing the diagnosis and differential diagnosis of benign and malignant chemodectoma. There were noted no mortality and postoperative complications. The oncological aspects of surgery for chemodectoma are also discussed.


[Effect of adrenaline and hydrocortisone on thiamine absorption in the intestine].

The effect of a single intramuscular injection of adrenalin and hydrocortisone (0.5 mg/kg and 10 mg/kg, respectively) on the thiamine absorption was studied in an isolated part of the intestine in male albino rats. The hormonal action on the Na-K-ATPase activity in the intestinal mucosa was also investigated. The intestinal thiamine absorption rate was shown to increase 10 min after adrenalin and 60 min after hydrocortisone injection. The Na-K-ATPase activity in the intestinal mucosa rose 10 min after the adrenalin injection and did not change after the administration of hydrocortisone.


[Cell proliferation induction in a monolayer chick embryo culture by the Sendai virus].

The response of cells on monolayer chick embryo cultures to infection with Sendai virus was studied. Total infection leads to the death of the cells within 3--5 days postinoculation which permits this system to be considered as lytic. Its significant difference from other systems with the lytic outcome of interaction of non-oncogenic viruses with animal cells consists in marked enhancement of production of proper cellular RNA and proteins in the infected cells and an increase in their division rate preceeding their death.


[Relationship of the characteristics of the chromosome set in human cell cultures to the production and antiviral action of interferon].

The role of chromosomes 2, 5, 16, and 21 in production and effect of human interferon was checked in human diploid cells, human heteroploid cells J-96 and clone J-41 thereof. The J-41 cells were found to have a lower number of chromosomes 2 as compared to the other cells under study; J-41 cells produce less interferon than the other cells. Most J-41 cells lack chromosome 21. Unlike the other two cell cultures, these cells do not produce antivirus state after treatment with interferon. The number of chromosomes 16 is larger in J-96 cells than in diploid ones, and they are less sensitive to interferon than diploid cells. The experimental results confirm the importance of chromosome 2 for coding for interferon production, other chromosomes taking part in the regulation of this process. The gene of sensitivity to interferon is localized in chromosome 21, the regulator gene coding the production of repressor of sensitivity to interferon is in chromosome 16.


[Experimental myocardiopathy caused by the herpesvirus].

Mice weighing 18--20 g were inoculated with herpes simplex virus type I. The rate of pathological changes in the myocardium was found to depend on the route of virus inoculation and the time of heart examinations in the infected animals. The development of myocardiopathies was not determined by the virus dose used in the test. An immunosuppressant drug, imurane, reduced the rate of heart affections. Pathomorphological changes in the heart were of parenchymatous-interstitial nature, with the leading role of lesions of myocardium muscle cells proper and secondary development of microcirculation disorders. The rate of heart lesions increased when herpes and influenza viruses were given to mice simultaneously; staphylococcus toxin had the same effect.


[Possible mechanism of orthopoxvirus preservation in nature].

Until recently, virus carrier state in the absence of overt clinical infection has been known for only one species of orthopoxviruses, namely, ectromelia virus. The paper describes the results of the modelling of asypmtomatic infection caused by monkeypox, cowpox, and ratpox viruses. Persistence of these viruses up to 6 weeks in animals (hamsters, cotton and white rats) with experimental asymptomatic infection as well as in apparently normal naturally infected white rats was established by isolation of virus from the organs of these animals. These results suggest that asymptomatic virus carrier state may occur both with ectromelia and a number of other orthopoxviruses. The mechanism may be of ecological importance, providing for circulation of these viruses and their preservation as biological species in nature.


[Physicochemical properties of the Okhotsky virus].

Purified concentrated Okhotsky virus was prepared. The buoyant densities of its virions were determined in sucrose and cesium chloride gradients and found to be 1.16--1.18 and 1.36 g/cm3, respectively. The experimental evidence indicated the double-stranded nature of Okhotsky virus genome RNA. The study of the above physico-chemical properties confirmed the appurtenance of Okhotsky virus to the genus Orbivirus of the Reoviridae family.


[Virological and serological study of rotavirus gastroenteritis].

Cases of acute gastroenteritis with negative bacteriological analyses were examined. Preparations of feces collected from patients in the acute stage of the disease were found by immune electron microscopy to contain typical rotavirus particles forming specific aggregates in the presence of convalescent sera. Examinations of paired acute and convalescent sera of the patients revealed the presence in convalescent sera of specific antibodies neutralizing simian rotavirus SA 11 antigenically related to human rotavirus. The specificity of the antibody was confirmed by their titrations by immune electron microscopy and HI test. Thus, rotavirus etiology of cases of gastroenteritis in various parts of the country was confirmed, and the possibility of specific laboratory diagnosis of such cases using simian rotavirus SA 11 was demonstrated.


[Human rotavirus in cell culture: its isolation and passage].

Rotavirus was isolated from feces of patients and passaged in green monkey kidney cell subculture using the factors affecting the initiation of infection of tissue culture cells with human rotavirus. The effective factors were found to include the presence of low concentrations of trypsin in the infected culture and virus centrifugation of a cell layer which agreed with the data by Almeida et al. (1978) and Shoub and Bertran (1978) obtained in other cell systems. Immune electron microscopy was used to detect the virus in cell cultures and to prove its specificity.


[New aspects of diagnosis, treatment and follow-up of trophoblastic tumours (author's transl)].

Diagnosis, treatment and follow-up of gestational trophoblastic tumours has become more efficient through the introduction of new methods like angiography, computer tomography and, especially, the determination of specific chorionic gonadotrophin. Exact diagnosis, with differentiation of high- and low-risk patients allows an individual approach to treatment. The results of these new diagnostic and therapeutic methods were studied in a department with a relatively high incidence of gestational trophoblastic disease in a European region, where trophoblastic tumours are generally rare. (Since 1971 16 cases of trophoblastic tumour and 68 patients with hydatidiform mole were treated in the department of Obstetrics and Gynaecology, University of Graz.) Schedules were drawn up for the diagnosis, classification of risk and for treatment. This may help to get good results and to prevent errors in the future. Long-term determination of HCG beta in the serum and also comparative follow-up of LH and HCG in urine led to the formulation of further characteristics of gonadotrophin secretion after hydatidiform mole and treatment of trophoblastic tumours. On the basis of the results a regimen has been formulated which seems to be optimal for the detection of tumour after hydatidiform mole and for the registration of the effect of treatment in case of trophoblastic tumour.


[Immunology and oncology of paraproteins].

Since the first description by Apitz paraproteins were for a long time regarded as biologically abnormal proteins which normally do not appear in the human plasma. According to the modern biochemical knowledge this determination of the notion can no more be acknowledged, since analyses of amino acids did not reveal any differences in the composition of the complete paraproteins and the immune globulins. Apart from the complete paraproteins which consist either of gamma, my, delta, alpha or epsilon heavy chains on the one hand and of kappa or lambda easy chains on the other hand, also molecule fragments and isolated heavy or easy chains, respectively, appear. Like immune proteins paraproteins are formed by B-lymphocytes and their transformation forms, respectively, in which case the monoclonality represents their specific characteristic. Thus exist close relations to malignant changes of the B-lymphocyte system, in particular to the non-Hodgkin-lymphomas. Several functional peculiarities of the paraproteins, such as autoantibody effect, lymphocytotoxicity, aggregation ability and binding affinity to blood cells lead to multiform clinical phenomena. To this belong immune defects, nephropathies, haemocytopenias, amyloidoses and haemorrhagic diatheses. As evoking cause of the alteration of B-lymphocyte system with activation of one or several cell clones (e.g. in double paraproteinaemia) tumour viruses are taken into consideration. After an infection with oncogenic herpes viruses irreversible cell transformations in the lymphatic system have been proved. Thus it is doubtful, whether there are indeed true benign paraproteinaemias. One has rather to speak only of relatively benign forms of the course.


[IgG- and IgA-antibodies to the Epstein-Barr virus in the sera of patients with nasopharyngeal carcinoma in Cuba].

Sera from 24 patients with nasopharyngeal carcinoma (NPC) and from 60 normal subjects were examined for the presence of IgG and IgA antibody to various antigens associated with Epstein-Barr virus (EBV). The results indicate that NPC in Cuba, like in other countries, was accompanied by high titers of EBV-specific IgG antibody the levels of which differed markedly from those in normal subjects. Serological activity of the patients differed depending on the stage of the illness and its duration. Geometric mean antibody titers to the capsid antigen (VCA), D and R components of early antigen (EA) of EBV complex were higher in patients with extensive tumour process (III--IV stages) and in patients with the duration of the disease since the onset less than 3 years. Sera of the most patients contained EBV-specific IgA antibody which were practically completely absent in sera of the control subjects. Alongside with characteristic manifestations of responsiveness to EBV observed by other workers, patients with NPC in Cuba had specific features: higher antibody titers to VCA than in Caucasian subjects in the countries where this disease occurred sporadically, like in Cuba; high levels of antibody to EA, frequently exceeding those in patients with NPC from endemic zones (for instance in Chinese patients); prevalence of EBV-specific antibody to the R component of EA complex.


[Levels of humoral antibodies to Epstein-Barr virus in the population of Cuba].

Indirect immunofluorescence was used to study the levels of humoral antibodies to capsid (VCA) and early (EA) antigens of Epstein-Barr virus (EBV) in sera of 322 normal subjects living in the province of Habana and varying in ages from several months to 93 years. The results suggest that the population of Cuba, like in other countries, is widely infected with EBV, although the pattern of spread of this infection has some specific features. In particular, the infection rate of the pediatric population (3--4 and 5--9 years) is moderately high, 73% and 65%, respectively, whereas in adult population it is rather low (62--86%) despite the tropical location of the country. In all the age groups examined, geometric mean titers (GMT) of antibody to VCA were also lower than in comparable groups of population from other countries. The observed high GMT of VCA antibody in persons over 55 years and a considerable increase in the number of positively reacting sera and sera with high antibody titers (greater than or equal to 1 : 160) agree with the data by other workers and appear to be due to reduced immunological defence of the cellular type in elderly people. Antibody to EBV EA were found in all the age groups examined, although in a small per cent. The subjects with high antibody titers to this antigen (greater than or equal to 1 : 40) were found more frequently in the two youngest age groups (0--2 and 3--4 years) which appears to be due to large amounts of virus usually occuring in the period of primary infection. The analysis of infectious mononucleosis incidence for 5 years (1972--1976) in various age groups of Habana province population indicates a general low level of incidence. Two small peaks in 3--4 and 15--19-year groups corresponded to increased GMT values of antibody to EBV EA in these particular age groups.


[Plasma lipoproteins and apolipoproteins].

In a survey the plasmalipoproteins LDL, VLDL and HDL are characterized and their functions demonstrated. Metabolically they are connected together through the IDL. Their clinical importance lies in the disturbances of the lipoprotein metabolism, which are significant for hyperlipoproteinaemia and arteriosclerotic diseases. Atypical plasmalipoproteins are LP(a), pre-beta-1-lipoprotein and sinking-pre-beta-lipoproteins. The LP-X is of interest for the differential diagnosis of jaundice. The carrier proteins of the plasmalipoproteins, the apolipoproteins, are Apo A, Apo B, Apo C, Apo D, and Apo E. They are differently structured. Their concentration in the individual plasmalipoproteins are also responsible for their function in normal and pathological lipid metabolism.


[The effect of theophyllin on small intestinal structure and function of the diabetic rat (author's transl)].

In order to obtain some information about the role of cAMP in the regulation of cell turnover of the intestinal mucosa it was interesting to investigate whether chronic pharmacologically induced changes in the cellular cAMP levels could cause alterations in mucosal growth in the case of a well defined animal modell, involving increased cell proliferation rate, such as chronic experimental diabetes mellitus of the rat. Since it has been suggested that cAMP levels on the one hand are low in cell division and increased cAMP levels on the other hand inhibit cell division, the aim of the study was to induce a suppression of the cell proliferation rate in the intestinal mucosa by chronic theophyllin application, a well known PDE-inhibitor. The following results could be obtained: Chronic theophyllin application induces a hyperplastic alteration of the small intestinal mucosa of the rat, which is similar to that observed in diabetes mellitus. In diabetic animals theophyllin causes a further increase in hyperplasia. The morphological alterations of the intestinal mucosa are more pronounced than the functional changes. In experimental diabetes mellitus the radioimmunologically determined cAMP level in the intestinal mucosa is rather low. Chronic theophyllin application alone or in combination with experimental diabetes mellitus was unable to increase the cAMP-level continuously. This could be a result of an adaptive change of the cAMP regulating enzyme system. Therefore theophyllin induced mucosal alterations are probably due to systemic effects of this drug.