Molecular properties of T lymphoma immunoglobulin. I. Serological and general physicochemical properties.

Immunoglobulin (Ig) released into the medium by monoclonal continuously cultured murine T lymphoma cells of the lines WEHI-22 and WEHI-7 was isolated by serological precipitation or solid-phase immunoadsorption techniques. The intact immunoglobulin had an electrophoretic mobility on sodium dodecyl-sulphate (SDS) containing polyacrylamide gels comparable to that of IgG (mass 150,000). This mobility was significantly faster than that of '7S' IgM of murine B lymphocyte surfaces. The T lymphoma immunoglobulin consisted of a pair of heavy chains linked by disulphide bonds and light chains non-covalently bound to the heavy chains. The isolated heavy chains migrated slightly faster than the mu chains of MOPC 104E IgM. Some, but not all, antisera directed against mu chains of normal mouse serum IgM bound T lymphoma immunoglobulin apparently via a cross-reaction localized to the Fd fragment. These data indicate that immunoglobulin of T lymphoma cells and, presumably normal T lymphocytes, represents an immunoglobulin isotype which is distinct from those immunoglobulins found on the B cell surface.


An on-line clinical information system in family practice.

An interactive on-line clinical information system is in operation within the residency of the Department of Family Practice at the Medical University of South Carolina in Charleston. This approach eliminates some of the traditional sources of error in collecting clinical information. Particular attention is given to flexibility of data presentation: data may be segregated by time, by disease entity, by age and sex of the patient, by physician, by year of residency, and by disease class. The responsiveness of this on-line technology allows the production of complete, up-to-date practice reports within 24 hours of a request.


An integrated medical record and data system for primary care. Part 6: a decade of problem-oriented medical records: a reassessment.

The Problem-Oriented Record (POR) has had a profound effect upon the medical community. Since its introduction not quite ten years ago, POR has gained remarkable acceptance. A short review of the relatively brief history of POR is given and various facets of its use are outlined as guidelines for more critical reappraisal of its merits. The fact, however, that POR is currently taught in a majority of medical schools and used in ever increasing numbers of hospitals is highly indicative of eventual conversion of all medical recoreds to POR format.


Potassium and the photoreceptor-dependent pigment epithelial hyperpolarization.

Light-evoked changes in pigment epithelial cell membrane potentials and retinal extracellular potassium ion concentration, [K+]0, were measured in an in vitro frog retina-pigment epithelium-choroid preparation. Light stimuli hyperpolarized the apical membrane of the pigment epithelium. Through an electrical shunt pathway connecting the apical and basal membranes, the basal membrane also hyperpolarized, but to a lesser degree than the apical membrane. This differential hyperpolariation of the two membranes increased the transepithelial potential (TEP). This increase in TEP was shown to be the major voltage source of the c-wave of the electroretinogram (ERG). Direct measurement of [K+]0 in the distal retina, made with K+-specific microelectrodes, showed a light-evoked decrease in [K+]0 having an identical time course to the apical hyperpolarization. There was a linear relationship between the light-evoked change in TEP and the logarithm of [K+]0. This exact relationship was also found when the apical membrane was perfused directly with solutions of varying [K+]0. The change in TEP associated with the ERC c-wave, therefore, was explained solely by the response of the pigment epithelium to the light-evoked decrease in [K+]0 in the distal retina.


Modulation of emotion with a brain pacemamer. Treatment for intractable psychiatric illness.

A treatment involving chronic implantation of a receiver that can be activated by an external power source to stimulate specific brain sites has been used in 11 patients with intractable psychiatric illness. All of the patients, a heterogeneous group, had failed to respond to all indicated treatments. Length of illness varied from 6 to 23 years without significant remission. Of the 11 patients, four had uncontrollable violence-aggression (two with no demonstrable organic brain disease and two with brain pathology), five were chronic schizophrenics, and two had lifelong patterns of severe neurosis in addition to the disabling disorder for which the procedure was performed. Three of the 11 patients had seizures in addition to behavioral pathology. Ten of the 11 patients are out of the hospital and functioning without medications or other treatment. Some are symptom-free and others have shown significant improvement. The one patient who failed to respond had an organic lesion over the cerebellar site that was to be stimulated. The rationale for the procedure was based on data gathered during earlier therapeutic studies in patients with depth electrodes and extensive anatomical and physiological experiments in animals. The transistorized stimulator used in treating these patients is similar to stimulators being used for treatment of epileptic and spastic patients.


Chronic abscess of the brain stem.

The incidence of solitary brain stem abscess is less than 4% of all posterior fossa abscesses, and probably less than 1% of all intracranial abscesses. Two cases are reported, both presenting as chronic progressive clinical problems and initially diagnosed as gliomas. It is suggested that aspiration is a more suitable treatment than excision, and that in cases secondary to otogenic disease, radical mastoidectomy might have been an adequate method of prophylaxis.


[5-hydroxytryptophan decarboxylase (5-HTPD) and monoamine oxidase (MAO) activities in the embryonic pineal organ of Lacerta vivipara J. A qualitative and quantitative microscopic study of the uptake of 3H-5-HTP under experimental conditions and the histochemistry of MAO (author's transl)].

Experiments involving combined injections of a drogue (Ro4-4602 or nialmide) and precursor (3H-5-HTP) allowed to determine the best conditions for performing an experimental study of serotonin (5-HT) synthesis and metabolism in the embryonic pineal organ of Lacerta vivipara. Inhibition of 5-HT synthesis at the decarboxylation step using Ro4-4602 significantly reduces the tritiated indolamine rates in the pineal sensory epithelium of embryos of the stages 37-40. In contrast with the embryos of stages 36 to 40 which received injections of 3H-5-HTP only, the secretory rudimentary photoreceptor cells (SRP) of embryos of the same stages which were pretreated with Ro4-4602 do not show a selective radioautographic labeling. After inhibition of the monoamine oxidases with nialomide, the tritiated indolamine rates are significantly increased in the SRP of embryos of stages 35 to 40. Our radioautographic studies show indirectly the early presence of 5-HTPD and MAO in the SRP (stage 35) during the pineal embryogenesis of Lacerta. In the distal part of the pineal, monoamine oxidase activity is histochemically demonstrated at stage 34. During ontogenesis, the reaction becomes increasingly intensive in the apical part of the epithelial cells while it extends to the epithelium of the proximal part of the pineal organ.


An improved procedure for the isolation of suprasterol2 I and II from a photochemical reaction mixture of ergocalciferol (vitamin D2).

An improved procedure for the isolateion suprasterol2 I and II from a photochemical reaction mixture of ergocalciferol (vitamin D2) and their spectral data are described in this paper. When a solution of ergocalciferol in ethanol was irradiated by UV light from a high-pressure mercury lamp, the reaction mixture gave six spots, including suprasterol2 I and II, on the thin-layer chromatogram, while the peaks corresponding to pyro-D2, isopyro-D2,5,b-trans-D2, suprasterol 2 I and II were observed in the gas chromatogram obtained from a capillary column GLC (Suprasterol2 I and II were main peaks). After purifying the mixture by column chromatography on silica gel containing 12% alumina as an absorbent, two main fractins were isolated. The data of their spectra, TLC and GLC showed that the former fraction was suprasterol2 II while the latter was suprasterol2 I and that the both fractions contained the respective compound only. Both suprasterol2 were crystallized as the 3,5-dinitro-benzoates.


On the role of junctional cholinesterase in determining the time course of the end-plate current.

1. The effect of membrane potential on the half-time (t1/2) of the falling phase of the end-plate current was studied both in the absence and the presence of anticholinesterase. 2. In absence of anticholinesterase the relation between log t1/2 and membrane potential was linear at negative, and not linear at positive levels of membrane potential. This relation was not affected by the quantity of the released transmitter. 3. In presence of an irreversible anticholinesterase the relation between log t1/2 and membrane potential was shifted towards higher values of log t1/2. This shift could be counteracted by decreasing the quantity of the released transmitter. 4. It is concluded that in presence of anticholinesterase the decay of the end-plate current is slowed down because in this experimental condition the elimination of transmitter from the synaptic cleft is slowed down. 5. These observations were made in muscles bathed in Tris-HCl buffered Ringer solution. If a phosphate buffered Ringer solution was used, the relation between log t1/2 and membrane potential was linear throughout the range of membrane potentials studied. The reason why different buffers give different results is not clear and should be further studied.


Calcium antagonism of the block in excitation-contraction coupling produced by a urea exposure-removal treatment.

Exposing frog's toe muscles to Ringer's solution made hypertonic with 400 mM urea for 60 min followed by placing the muscles back in Ringer's (urea-removal treatment) completely blocks the twitch without disrupting the surface openings of the T-tubules. The urea-removal treatment also increased the triadic junction width. Placing the muscles in Ringer's with an elevated calcium concentration (5 mM) following exposure to the hyertonic solution prevented the block of the twitch response but not the increase in the triadic junction width. Exposing untreated muscles to Ringer's with 5 mM calcium either had no effect on the twitch on reduced it by 30 percent or less. These results suggest the possibility that increasing the width of the triadic junction decreases the amount of calcium ions reaching the terminal cisternae during an action potential thereby blocking the twitch. Elevating the calcium concentration in the T-tubules would increase the amount of calcium which enters the triadic junction during an action potential and thus antagonize the above effects.


Effects of adrenaline on the action potential of sympathetic ganglion cells in bullfrogs.

The effects of catecholamines (adrenaline, noradrenaline and isoproterenol) on ionic conductance changes during the generation of action potentials of bullfrog sympathetic and spinal ganglion cells were studied with intracellular microelectrodes. In sympathetic ganglion cells, adrenaline (3X10(-5)-1X10(-3)M) reversibly decreased the peak amplitude and positive after-potential of action potentials, and prolonged the duration of spike potentials without changes in the resting membrane potential and conductance in the Ringer solution. The maximum rates of rise and fall of spike potentials were also decreased. The action of noradrenaline was similar to that of adrenaline, but isoproterenol did not show any effects. Adrenaline (3X10(-5)-3X10(-4)M) markedly depressed the peak amplitude and maximum rate of rise of both TEA-potential and Ca-potential produced either in TEA solution containing TTX or in the isotonic CaCl2 solution. Similar actions were observed with noradrenaline but not isoproterenol. In spinal ganglion cells, catecholamines did not show any effects of the action potentials in Ringer and TEA solutions. It was concluded that adrenaline inhibited the increases in Ca2+, K+ and Na+ conductances during the generation of action potentials of sympathetic ganglion cells.


Prolonged sarcotubular regenerative response in frog sartorius muscle.

The sarcotubular system of frog sartorius muscle fibers is found to generate a prolonged depolarizing regenerative response under appropriate experimental conditions. It is shown from a point-voltage clamp analysis that the inward current component responsible for the response lasts on depolarization for hundreds of milliseconds, and reverses its sign when an equilibrium potential is exceeded. The sarcotubular response occurs in F-Ringer solution and is enhanced with EDTA. It also occurs in normal or propionate-Ringer solution containing EDTA without great change in the equilibrium potential. The response is inhibited reversibly with picrotoxin. Partial replacement of Na by K in the propionate-Ringer solution reduces the inward current component which suggests that Na may be the responsible ions.


[Keratoplasty in childhood (author's transl)].

Report on 36 keratoplasties (30 eyes) in children up to 15 years of age. An efficient postoperative care was of critical importance for the final outcome. The specific problems are discussed. Regarding the fact that generally children are only operated on in case of heavy corneal disease which brings about a higher risk of graft failure our results may be judged as "fair": 63% of the transplants were optically clear; 43% exhibited good and 30% fair functional results. The best results were achieved with keratoplasties in corneal dystrophies (keratoconus included). Another group with good results was that with herpetic corneal disease, whereas transplants after heavy perforating injuries mostly failed. A beter postoperative medical collaboration and consultation is needed to improve final results. This is especially true for correcting operative measures (loosening sutures) and for therapy and prophylaxis of graft reactions.


Coronary artery surgery.

This paper assesses the results in 543 patients undergoing coronary artery surgery between 1969 and March, 1976. Indications included angina, acute infarction and ventricular arrhythmia, and there were some angina-free patients. Surgical techniques were constantly reviewed and frequently changed. The mortality in all groups was 4.2%. The mortality in chronic stable angina (424 cases) was 3%, but as from January, 1975, it has been 2%. The perioperative infarction rate in all groups was 10.7%, and this condition was the most significant cause of perioperative mortality. Modern principles of myocardial protection during surgery have helped to lower mortality and morbidity rates.


[Emergency endoscopy: its application in the department of medicine of a city hospital (author's transl)].

In about 90% of cases of active gastrointestinal hemorrage, sources and nature of bleeding can be identified exactly by means of emergency endoscopy. With time passing from the beginning of hemorrhage, diagnosis established by endoscopy is getting less precise. The most common cases of bleeding are peptic lesions, either esophageal, gastric, or duodenal; the most common site of hemorrhage is the stomach. Different potential points bleeding at the same time have to be take in account. A case report of Mallory-Weiss syndrome (13 episodes of hemorrhage) illustrated the method's value in establishing diagnosis of acute gastrointestinal bleeding. Special applications of emergency endoscopy in mental patients are described.


Protection against anaphylaxis in hymenoptera-sensitive patients by passive immunization.

Passive administration of specific immunoglobulin led to a transient rise in antiphospholipase IgG. An observed rise of 2 microgram/ml (twofold in three cases) was associated with a very diminished response to bee venom. This did not prevent the patient's own IgG response to challenge, which was at least as good as that of non-infused patients. The infusion of IgG cannot be proposed at present as a routine mode of therapy in insect allergy. However, we present the results of our study as the best evidence to date that blocking antibody is protective.


[Rehabilitation in various types of heart diseases].

The occasions on which reevaluation, re-establishment, readaptation, and rehabilitation in the true sense should be used are discussed, and the concept of both psychological and physical rehabilitation as an indivisible whole is underscored. It is also made clear that rehabilitation must not be limited to the heart patient himself, but be seen as the reintegration of the subject (and not the object) of rehabilitation in his family, social, occupational and recreational environment. Rehabilitation begins during hospitilisation and short- or long-term programmes are prepared. Full rehabilitation requires readjustment of the patient's surroundings and the removal of preconceptions and misunderstandings that may often make communication dramatically impossible.


Lymphokines of T and B cells. I. Demonstration that T and B cells of tumor antigensensitised mice produce different lymphokines changing surface charge of target cells.

Lymphocytes from MC sarcoma-bearing mice were exposed to a soluble tumor antigen. The lymphokine-containing supernatant thus obtained was fractionated on Sephadex G-75. Fractions were tested for their activity to reduce the surface charge of indicator macrophages by cell electrophoresis technique. When unseparated spleen or lymph node cells were used the charge-reducing activity of the supernatant was found in three regions according to molecular weights of about 100,000, 60,000 - 35,000 and 13,000 Daltons. The appearance of activity was found to be time-dependent. As indicated by tests with separated lymphocytes both B and T cells appear to release charge-reducing activity.


Primary gastric lymphoid proliferations: immunological criteria to distinguish gastric lymphoma from reactive hyperplasia.

A group of six patients with a marked gastric lymphoid "hyperplasia", two of these with generalised lymphoma and the others suspected for primary gastric lymphoma, were investigated to discriminate between simple reactive hyperplasias and lymphomatous proliferations. Microscopical and ultrastructural examinations were not useful for this purpose but immunological data can give evidence of a two-fold nature of gastric lymphoid hyperplasia. Some cases are without immunological disorders, others are met with peripheral blood signs of immunological alterations similar to those observed in malignant lymphomas and in chronic lymphocytic leukemia. Only these latter cases should, in our opinion, be regarded as primitive gastric lymphomas.


Action of humoral factors derived from acute and chronic myeloid leukemic cells on in vitro myelopoiesis.

The experiments described in this paper were performed in order to elucidate a possible regulatory role of acute and chronic myeloid leukemic leucocytes. The influence of these cells on either activated or non-activated mouse bone marrow cells was measured, and the results were compared with the action of the two major leucocyte fractions, mononuclear cells and granulocytes. It was demonstrated that acute leukemic blasts were almost completely unable to activate myeloid committed stem cells (Colony Forming Units, CFUC). In contrast, blasts from patients with chronic myeloid leukemia (CML) in blastic crisis disclosed a variable pattern of activation, in that two out of three cases exerted normal stimulatory capacity. A possible inhibitory action of leukemic cells was the subject of further experiments. Acute leukemic blasts in some cases disclosed inhibitory activity, a few cases appeared to be without influence on normal proliferating CFUC. Granulocytes from patients with CML in the chronic phase showed inhibitory capacity when compared with granulocytes from normal individuals. It is apparent from these experiments that leukemic cells themselves may contribute to the regulatory derangements of leukemias.


Influence of membrane polarization and hormonal stimulation on the action of lanthanum on frog skin sodium permeability.

The effect of mucosal La3+ on short-circuit current (s.c.c.) has been studied on isolated frog skins with normaly polarized or depolarized apical membrane. With skins in "polarized condition", La3+ stimulates transiently the s.c.c. and after a long-lasting presence on the mucosal side (1 h) attenuates significantly the stimulation promoted by oxytocin. With skins in "depolarized conditions", lanthanum stimulates permanently the s.c.c. and does not modifying the oxytocin effect, even over long period of continuous stimulation. In contrast, an inhibitory action of mucosal La3+ develops, when skins submitted to repetitive hormonal stimulation are forced to oscillate from the stimulated to the normal resting state. The significance of this particular mode of action is discussed in terms of a possible electrical potential variation of apical membrane during oxytocin stimulation.


[Upper gastrointestinal haemorrhage after venous bypass in cirrhotics (author's transl)].

In a series of 76 patients who had undergone venous bypass for upper gastrointestinal haemorrhage, the authors noted 13 recurrences of bleeding, six resulting in death directly or secondary to hepatic failure. Repeated rupture of esophageal varices after thrombosis of an anastomosis is well known but in one out of two cases a second bypass involving another part of the portal territory resulted in cure. The important problem remains that of the precise aetiological diagnosis of the haemorrhage, there often being a doubt between esophageal varices and haemorrhagic gastritis. In certain cases there is no good indication for a bypass, as indicated by the absence of further bleeding after certain anastomotic thromboses. Ulcers due to venous bypass are rare. Secondary medical or surgical treatment in patients with a patent anastomosis should be undertaken with caution, in particular in the case of splenectomy for residual hypersplenism.


[A case of analbuminaemia (author's transl)].

A new case of analbuminaemia is described in a 6 month old child of algerian origin. The condition was discovered fortuitously, the clinical manifestations consisting only of slight oedema. Serum albumin concentration was 64 mg/l and its immunochemical behavior identical to that of normal albumin. The body react by an increase in the synthesis of globulins. In the propositus, levels of alpha, antitrypsin, caeruloplasmin, haptoglobin, jalpha2 macroglobulin, transferrin, immunoglobulin M were more than 3 times normal. Analysis of non-esterified fatty acids normally carried by albumin was normal. By contrast, it was shown that the presence of free bilirubin not bound to proteins was detected from 17 micronmol/l. Study of the family showed a normal distribution of albumin and globulins. The genetic origin seen in previously reported cases was confirmed by the co-sanguinity of the parents.


[The heterogeneity of human lymphoid leukemias unmasked by immunological studies of membrane markers (author's transl)].

The immunological analysis of the membrane phenotype of the leukemic cells, by studies of various markers and antigens unmasks some degree of heterogeneity of chronic lymphocytic leukemias and of acute lymphoblastic leukemias. This analysis gives indications of the nature and origin of the proliferating cells. The analysis gives indications of the nature and origin of the proliferating cells. The data provided by these studies are useful for a modern classification of these diseases and allow new nosologic groupings.


[Von Willebrand's syndrome (author's transl)].

The biological syndrome in von Willebrand's disease is presently defined by four parameters: bleeding time, factor VIII coagulant activity (VIII:C), Willebrand factor activity (VIIR:WF) and factor VIII related antigen (VIIR:AG). The study of 48 patients from 25 families confirms the heterogeneity of the von Willebrand's syndrome including both quantitative as well as qualitative defects. Classical von Willebrand's disease results from the quantitative decrease of a plasma protein named "Willebrand factor" which is the primary gene-product of an altosomal chromosome. Both severe and moderate forms can be observed. In very severe forms, the apparent lack of the VIIIR:AG as measured by an immunoradiometric assay suggest the possibility that some patients are homozygous. "Variants" of von Willebrand's disease have been recently described in some patients, based on the discrepancy between the observed subnormal levels of VIIIR:AG and low levels of VIIIR:WF. The qualitative abnormality of the factor VIII/Willebrand protein can be assessed by different methods such as double cross immuno-electrophoresis, or immunoradiometric assay.


[Haemorrhagic oesophagitis: an unrecognised source of bleeding in the post-gastrectomy patient (author's transl)].

Four cases of recurrent upper gastrointestinal haemorrhage occurred in patients who had undergone gastrectomy for ulcer, being secondary to reflux oesophagitis. This cause of bleeding is poorly recognised and the exact occurrence rate can be determined by the general and routine use of fibroscopy during the haemorrhage. The diagnostic and physiopathological problems are discussed. Repositioning of the cardia with the fashioning of an effective anti-reflux mechanism invariably led to the suppression of these haemorrhages.


Calcium and phosphorus metabolism in nephrotic syndrome.

Calcium and phosphorus balance studies were performed on 13 nephrotic patients and eight patients during clinical remission of the nephrotic syndrome. Marked impairment of intestinal absorption of calcium was found among nephrotic patients, in eight of whom faecal calcium equalled or exceeded dietary calcium. The mean faecal:dietary calcium ratio of nephrotic patients, 1-06 +/- 0-23 (SD), was significantly higher (p less than 0-005) than that of patients in remission, 0-58 +/- 0-21 (SD). The mean 24-hour urinary excretion of calcium of nephrotic patients, 0-68 +/- 0-68 (SD) mmol, was significantly lower (p less than 0-005) than that of patients in remission, 3-02 +/- 1-91 (SD) mmol. Calciferol administered to three nephrotic patients in the dosage of 1.25 mg per day did not significantly influence intestinal absorption or renal excretion of calcium. There was no difference between the two groups of patients in intestinal absorption or renal excretion of phosphorus; there was net intestinal absorption in all subjects. Quantitative bone histology was studied in seven of the nephrotic patients. None had osteomalacia or osteitis fibrosa, while only one had evidence of mild osteoporosis.


Liver function in asymptomatic adult individuals with severe alpha1-antitrypsin deficiency (Pi Z).

Eleven adult individuals (aged 24 to 66 years) with severe alpha1-antitrypsin deficiency, Pi Z, and with no clinical signs of liver disease, were investigated with a broad spectrum of liver function tests. Except for low alpha1-antitrypsin levels, no evidence of abnormal hepatic protein synthesis was found. Neither could any biochemical signs of liver cell necrosis or increased liver cell regeneration be disclosed. In spite of the well-known pronounced distension of hepatic endoplasmic reticulum (E.R.) by aggregated asialo-alpha1-antitrypsin in this disease, the function of the E.R. tested with the aminopyrine breath test was not found to be impaired.


Semiquantitative determination of Cc and C3 receptors on human lymphocytes by isotope-labelled marker cells.

The number of Fc and C3 receptors on normal B lymphocytes, isolated from blood, was assessed semiquantitatively by a new method in which the marker cells (pretreated sheep erythrocytes) for Fc and C3 receptors are labelled by 99Tc and 51Cr respectively. The mean number of bound marker cells per rosette was assessed simultaneously by measurements of radioactivity. Control studies showed that a measuring system using 1/4 agglutinating titre of antibody on the marker cells is particularly advantageous: (1) Fc and C3 receptors are not demonstrable on T lymphocytes; thus, B lymphocyte fractions with Fc and/or C3 receptors are well-defined. (2) The binding affinity of the marker cells for normal lymphocytes is so weak that the number of bound marker cells per rosette rarely reaches the maximum which was calculated and measured as about 30 marker cells per rosette; thus, the measuring system is sensitive to changes in the number of receptors. (3) By binding of marker cells to lymphocytes bearing  Fc as well as C3 receptors it has been demonstrated that interference phenomena between the two marker cells are not operative. Studies of blood lymphocytes from normal human subjects showed B lymphocytes carrying either Fc and C3 receptors as well as a fraction of B lymphocytes having both Fc and C3 receptors. The latter maker up about 6% of the lymphocyte mass. Comparative assessment of the quantitative distribution of these receptors indicates a developmental sequence, B lymphocyte with Fc receptors evidently developing, via B lymphocytes with Fc as well as C3 receptors, into B lymphocytes having C3 receptors only.


ATYPICAL SURFACE MAKER CHARACTERISTICS IN A T-cell lymphoma.

A case of T-cell lymphoma with an unusual phenotype is described. The majority of malignant tumour cells did not form E-rosettes, and lacked surface immunoglobulin but reacted with an antiserum to T cells and thymocytes. Localised acid phosphatase and non-specific alpha naphthol acid esterase activities and a prominent, convoluted, nuclear pattern in some neoplastic cells also supported the T cell derivation. The results demonstrate  the importance of using a panel of markers for identification of the cellular derivation of some lymphomas.


Surface antigen changes accompanying lymphocyte activation. Selective reactivity of certain anti-H-2 antisera with activated lymphocytes of unrelated H-2 haplotype.

It is here shown that some noncongenic anti-H-2 antisera produced by using normal spleen cells at the immunogen can contain cytotoxic antibody activity against activated, but not resting, lymphocytes of unrelated H-2 haplotype strains. Reactivity was noted against lymphocytes activated in vitro with T- or B-cell mitogens, or in vivo by antigenic stimulation. Analysis of the results indicated that the anti-activated lymphocyte activity was most likely related to production of anti-Ala-1 ('activated lymphocyte antigen') alloantibodies. This appears to occur as a result of donor lymphocyte activation during production of the anti-H-2 antisera, using Ala-1-incompatible donor and recipient combinations, where the donor cells are competent to recognize and react against host H-2 incompatibilities. These results confirm the finding that lymphocyte activation can be accompanied by the expression of an antigen that is either absent or weakly expressed on resting lymphocytes.


[HL-A D antigens from B-lymphocytes and susceptibility to certain diseases].

The discovery of many associations between HLA and human diseases has emphasized the biologic importance of the main histocompatibility system in man. The recent findings from specific immune response genes (Ir locus) mapping within the H2 region of the mouse have led to systematic study of the similar D locus mapping within the HLA region in man. In this study the frequency of a number of HLA-D antigens has been determined in normal individuals and in patients with four diseases selected in view of their genetic background: juvenile diabetes, multiple sclerosis, grass pollinosis and acute leukemia. In each a significant association has been found with a specific HLA-D antigen: DW3 in juvenile diabetes and grass pollinosis, DW2 in multiple sclerosis, and DW7 in acute lymphoblastic leukemia.


Immunological status of aged subjects with reference to serological evidence of autoimmunity.

When a group of 104 aged subjects was screened for autoimmune reactions, positive reactions for the rheumatoid factor and/or autoantibodies (ANA, anti-thyroid, PCA, anti-smooth muscle, anti-mitochondria) were recorded in 40.4%. Immunological functions were studied in 32 positive aged subjects, 32 age- and sex-matched negative controls, and 32 young subjects. Some differences attributable to the process of aging were quite evident, such as a depression in the percentage of E rosette forming peripheral lymphocytes and in their response to PHA, and an increase in the percentage of IgG-bearing peripheral lymphocytes and in the serum levels of IgA and three complement fractions (C'3, C'4, and C'3-PA). No clear-cut picture was noted when autoimmunity-positive and -negative, aged subjects were compared. However, some differences between sexes suggest that autoimmune reactions are linked to a depressed T cell function mainly in males, whereas the reverse is true for females.


[The perioperative myocardial infarct after aortocoronary bypass].

Two sets of criteria are developed for the diagnosis of perioperative myocardial infarction: 1) new, persistent Q waves and either an elevated 48-hour MB-CPK area or a positive pyrophosphate scan, 2) severe ischemic ST-T wave changes and both elevated MB-CPK area and a positive scan.


[Surgical treatment of myocardial aneurysms. Indications and results].

The long term results of 95 left ventricular aneurysmectomies are presented. In 47 patients simultaneous aorto-coronary bypass surgery was performed. 53 patients presented preoperatively with congestive heart failure; 8 out of these died within the first postoperative month, while 5-year survival rate (actuarial method) was 52%. Two thirds of this patient group improved. None of the 42 patients without preoperative congestive heart failure died early. 5-year survival rate was 93% and subjective improvement was recorded in one half of this subgroup. Comparison of pre- and postoperative angiograms (40 patients) revealed an increase in left ventricular ejection fraction reflecting the removal of the non-contracting segment. The ejection fraction of the contracting segment of the left ventricle improved after aneurysmectomy, especially in patients with preoperative congestive heart failure. In conclusion, aneurysmectomy improves left ventricular function and the symptoms of heart failure; moreover, it prevents perforation of false aneurysms. Its effect on arrhythmias could not be determined conclusively. Angina may be improved by simultaneous aorto-coronary bypass surgery.


Foibles and fallacies in the diagnosis of arthritis.

The diagnosis of arthritis is usually made on a clinical basis, and laboratory and x-ray aids are only secondary and sometimes misleading tools. Set forth are 11 common fallacies which often mislead the physician in his interpretation of laboratory and x-ray findings in the study of a patient with arthritis. Included are references to the role of x-ray findings, joint fluid and synovial biopsy findings, hyperuricemia, rheumatoid factor, rheumatoid nodules, sedimentation rate, antinuclear antibodies, and other peripheral blood and urinary findings. In most cases, the astute physician should be able to make an accurate diagnosis when he first sees the arthritic patient; in others, any and all of the laboratory and x-ray parameters mentioned, despite their obvious shortcomings, may be of help in leading to a proper diagnosis. In a small percentage of cases, only the passage of time and further observation of the patient will establish the correct diagnosis.


Pneumocystis carinii infection.

Over the past decade, P carinii has become an important cause of pneumonia in the compromised host. Progress has been made in clinical awareness of the organism, in methods of diagnosis, and in developing new forms of treatment. However, there is still a lack of basic knowledge about the biology, taxonomy, and epidemiology of P carinii; of specific host immune factors involved in the pathogenesis of the infection; and of a clinically reliable serologic test. With recent advances in P carinii research, progress hopefully will be made in these areas in the future.


Histiocytosis X: abnormal cerebrospinal fluid cytology in extrahypothalamic central nervous system involvement.

The clinical course and long-term survival of a patient with acute disseminated histiocytosis X and extrahypothalamic CNS involement were presented. The clinical significance of histiocytes appearing in the CSF cocomitant with the onset of this neurologic syndrome was discussed. Detailed cytologic examination of the CSF in patients with histiocytosis X and CNS involvement was recommended.


The problem-oriented medical record: modification and simplification for rehabilitation medicine.

A modified POMR has been formulated for use in rehabilitation medicine. It incorporates the concept of the Weed system, modifies rehabilitation problems into seven functional categories, and modifies the problem-oriented progress note. It uses a problem-oriented team conference and a functional status form. These modifications, I believe, improve patient care, medical education, and facilitate the medical audit.


Haemophilia.

The clinical and haematological features of haemophilia are reviewed and the historical aspects, pathogenesis and genetics are discussed. The problems associated with management, such as factor replacement, home therapy, physiotherapy, surgical intervention and the presence of inhibitors, are fully described. Finally, mention is made of the psychological problems of haemophiliacs and of the help given by the South African Haemophilia Foundation.


Maternal lymphocytotoxic antibodies and bilirubin levels in the postpartum offspring.

HLA antigens are present on immature red cells (Harris & Zervas 1969), but disappear from their surface when they become mature and enter into the circulation (Silvestre et al. 1970). Nevertheless some remnants of HLA substance may survive this antigenic switch and possibly persist on adult red cells (Morton et al. 1969, 1971, Doughty et al. 1973). A shortened survival of HLA incompatible reticulocytes has been reported when they are transfused into recipients with circulating anti-HLA antibodies (Zervas et al. 1972). As to anti-HLA antibodies possibly reacting with erythrocytes in cases of fetomaternal immunization, Moulinier (1970) claimed that they would potentiate any hemolytic process in newborns of Rh-immunized women, but successive investigations failed to confirm this (Ahrons & Glavind-Kristensen 1971, Nymand 1975). Also, Nymand (1975) found no association between lymphocytotoxic antibodies in mothers and high bilirubin levels in the umbilical cord blood collected at delivery. On the contrary, when the onset of neonatal jaundice in the postpartum offspring was monitored, newborns of mothers with lymphocytotoxins appeared to become jaundiced more frequently than expected (Reekers et al. 1975). The present study has been undertaken to investigate the relationships between complement dependent lymphocytotoxins (CdL) in the mothers and the bilirubin levels in the newborns during the first days of life.


beta2-glycoprotein I in rheumatoid arthritis.

Serum beta2-glycoprotein I of the patients with rheumatoid arthritis was studied by means of single radial immunodiffusion method. There was a significant lowering of beta2-glycoprotein I concentration in patients with rheumatoid arthritis. An inverse proportional correlation was seen between the concentrations of beta2-glycoprotein I and of alpha1-antitrypsin, and between the former and C-reactive protein (CRP) rates in individual specimens. Slightly positive relationship was observed between the concentrations of beta2-glycoprotein I and of alpha2-HS glycoprotein. The beta2-glycoprotein I concentrations in healthy adults were significantly higher than those of previous reports.


Subpopulations of B- and T-Lymphocytes in Peripheral Blood of Rheumatoid Patients.

Using the immunofluorescent staining for detection of surface membrane immunoglobulin and the spontaneous rosette formation with sheep erythrocytes, B- and T-lymphocytes were identified in lymphocyte populations obtained from the peripheral blood of 36 patients with classical or definite rheumatoid arthritis and 13 normal adults. In all of three immunoglobulin subclasses, the mean percentage of B-lymphocytes in the peripheral blood of the patients was significantly higher than that of the normal subjects. On the other hand, the mean percentage of blood T-lymphocytes in the patients was remarkably low as compared with that of the normal controls.


[Method of repeated determination of muscle heat resistance in individual frog specimens].

The heat resistance of m. interphalangialis of fingers of hind extremities of Rana temporaria L. has been determined. No significant differences were observed in the average values of the heat resistance in fingers 3 and 5 isolated simultaneously. In separate individuals there exists a high positive correlation between the heat resistance levels of these muscles. When the muscles are isolated successively rather than simultaneously, the correlation degree depends on the time lapse between their isolation from the organism. With 1-14 days lapse the correlation breaks down, to be restored after a longer interval. Taking this into account, a method of successive isolation of m. interphalangialis can be used when studying the dynamics of muscle resistance within the same organism.


Mycological and clinical observations on ringworm in cattle after treatment with natamycin.

A total of 41 calves which were naturally infected with Trichophyton verrucosum were treated with natamycin used as a total body spray. Ten other infected animals were not treated and considered as control animals. Clinical observation and mycological examination show partial improvement to complete recovery with simultaneous sterilisation of the infected skin areas. Five to six weeks after treatment, 88 per cent of the treated animals had recovered or showed a distinct improvement, 65 per cent had a negative culture. After 11 to 12 weeks these percentages were 95 and 91, respectively. All controls yielded a positive culture during the whole observation period. The method used for the detection of the presence of Trich verrucosum in skin scrapings and hairs permitted accurate diagnosis in as little as two to five days.


[Improvement of the indicators of cellular immunity under the effect of polypeptide epiphyseal extract (epithalamine)].

The data obtained previously at our laboratory have evidenced that pineal polypeptide factors enhance the sensitivity of the hypothalamo-hypophyseal complex to the inhibiting action of glucocorticoids and estrogens and show an antistressor effect and the capacity to decrease the level of insulin and triglycerides in the experiment, and also suppress the growth of transplantable mammary gland cancer. In view of this, the pineal polypeptide extract was employed in a patient with reduced indices of cellular immunity. A restoration of indices of blasttransformation reaction induced by phytohemagglutinin, an increased number of rosette-forming cells and an improved response to dinitrochlorobenzene skin test were noted.


[T- and B-lymphocytes in lymphogranulomatosis].

The authors report the results of the complex investigation of T-and B-lymphocytes in peripheral blood and functional features of T-cells in the reaction of blasttransformation with PHA in 27 patients with lymphogranulomatosis and in 30 healthy individuals. Generalized forms of lymphogranulomatosis of stage III-IV (in 21 of 27 patients) were predominating. All patients showed an active phase of the lesion. T-system immunity was found to be suppressed, that was manifested in reduced T-cells number, a decreased lymphocytes RBT to PHA per one or two dilutions. It is supposed that the observed T-lymphocytes disorders is one of the causes of the impairment of cell immunity reactions, found in vivo in patients with lymphogranulomatosis.


[Functional activity of mitochondria and intensity of nucleic acid and protein synthesis in rat liver and small intestine mucosa with different supplies of vitamin D].

Decrease in total content of mitochondrial protein in mucosa of small intestine, an alteration of distribution of the protein between the fractions of mitochondria, distinct decrease in the respiratory activity of mitochondria and in the activity of succinate- and NADH-dehydrogenases were observed in rats deficient in vitamin D. Deficiency in vitamin D was accompanied by decreased incorporation of labelled precursors into total, nuclear and mitochondrial DNA and RNA by 20-50% and into mitochondrial proteins--by 50% in mucosa of small intestine; these patterns were unaltered in liver tissue. Administration of ergocalciferol (at a dose 1000 IU) into rats normalized the impairments studied, whose alteration correlated with the increase of calcium concentration in blood serum.


Studies on production of biologically active substance which inhibits the intracellular multiplication of Toxoplasma within mouse macrophages.

In vitro assessments were carried out to study some biological aspects of immune lymphocytes producing a new lymphokine, called by the authors Toxoplasma growth inhibitory factor (Toxo-GIF), which inhibits the intracellular multiplication of Toxoplasma gondii within nonimmune mouse macrophages. Concanavalin A and phytohemagglutinin-P were found to induce vigorous production of Toxo-GIF, whereas bacterial lipopolysaccharide did not. In vitro treatment of splenic lymphocytes with rabbit anti-mouse thymocyte serum plus complement abolished almost completely their ability to produce Toxo-GIF. Treatment of splenic lymphocytes with inhibitors of protein synthesis, cycloheximide or puromycin resulted in a remarkable reduction of the ability of sensitized lymphocytes to produce this lymphokine. Thus the production of Toxo-GIF seems to be dependent on the cellular metabolic events of sensitized T-lymphocytes. The significant activity of Toxo-GIF was demonstrable even in the supernate of lymphocyte cultures incubated in serum-free medium and was also evident after immune lymphocytes and homologous antigen were incubated for the relatively short period of 10 h.


[Effect of schizophrenic patients' serum on the physiological state of lymphocytes under in vitro conditions].

The report is concerned with the action of the serum of schizophrenic patients on the physiological state of lymphocytes in normal donors. It was established that during the early stages of incubation the action of the serum in schizophrenic patients evokes the activation of lymphocytes in normal donors, that is seen in changes of the ultrastructure and adhesive properties of these cells. On the late stages of cultivation the serum of patients destroys 13.4 +/- 5.9% of lymphocytes of normal donors. In remaining population 21% of lymphocytes lose their capability to react to PHA stimulation by an increase of DNA content.


[Spontaneous and experimental vestibular activity following total removal of neurinomas of the auditory nerve].

Spontaneous and experimental vestibular activity in 84 patients after total resection of neurinomas of the acoustic nerve is analysed. In the immediate postoperative period the frequency of marked manifestations of spontaneous vestibular activity reduced sharply, but spontaneous nystagmus persisted in 97.5% of patients. In some patients spontaneous nystagmus to the side from which the tumor had been removed become more conspicuous. In the remote postoperative period spontaneous nystagmus was unilateral in 45.5% of patients, bilateral in 40.3%, and not recorded at all in 14.2% of patients. In the early postoperative period vestibular hyperreflexia was recorded in 93.7% of cases, in the remote period it was found in 76.6% of cases. Data obtained by comparing the results of caloric tests with cold and hot water in these patients are also analysed.


[Biliary hemorrhage due to a false aneurysm of the hepatic and gastroduodenal arteries (author's transl)].

Two cases of biliary hemorrhage due to false aneurysms are presented, one on an abnormal hepatic artery, the other on the gastroduodenal artery. Half of the cases of biliary hemorrhage have an intrahepatic etiology. Extrahepatic cases are equally divided between the main biliary duct and the gallbladder. Among the diagnostic investigations most authors agree on the choice of selective arteriography of the coeliac trunk. Controle of intrahepatic biliary bleeding can be obtained by partial hepatectomy or by ligation of the hepatic artery which is well tolerated. Treatment of extrahepatic bleeding is more diverse and takes into account both anatomical and surgical possibilities.


[Electric stimulation of the spinal cord].

After positive results of an experimental study of the possibility of spinal cord electric stimulation, the method was used in the clinic. The work presents the clinical results in the first 6 patients who underwent operation for the implantation of a radio-frequency stimulating device for the spinal cord. A 3-year follow-up period showed that radio-frequency electric stimulation of the spinal cord is most effective in the acute period of traumatic disease of the spinal cord and promotes the activization of the reflex and conduction functions of the intact spinal structures. The mechanisms of the effect caused by electric stimulation on the functional state of the injured spinal sructures require a further study.


[Increasing importance of Haemophilus influenzae in nose, ear and throat infections].

After the review of the morphology, the identification and the pathogenic properties of H. influenzae, its occurrence in the different ENT infections is discussed. H. influenzae is found in chronic tonsillitis in 64% of the cases, in the deeper tissue of the tonsils, while its occurrence in the throat swabs is rare. In acute otitis media H. Influenzae is present in 10 to 150% of the cases, while in rhinitis and sinusitis its increasing occurrence until 1974 is noted (28% of all sinusitis cases showed H. Influenzae in that year); since 1974 its occurrence is somewhat decreasing: 18% in 1976. Susceptibility testing for antibiotics with the disc-method is unreliable; we have to use the tube or plate-dilution methods. The increasing occurrence of ampicilline resistant strains of H. influenzae is discussed.


Action of alcohol on vestibular compensation and habituation in the cat.

Several effects of alcohol on vestibular nystagmus are well known, including positional alcoholic nystagmus, a depressive effect on post-rotatory nystagmus, and an inhibition of visual fixation. This study concerns the influence of alcohol on central vestibular compensatory phenomena. In one experiment, hemilabyrinthectomized cats were allowed to compensate for the postoperative spontaneous nystagmus and directional preponderance of post-rotatory nystagmus. Following alcohol injection, spontaneous nystagmus reappeared toward the intact side, positional nystagmus was unidirectional, and post-rotatory nystagmus was profoundly more depressed than for normals. Normal cats subjected to repeated accelerations showed less habituation of post-rotatory nystagmus with alcohol than without.


Indication of primary immune deficiency in Fanconi's anemia.

A girl with various congenital malformations developed pancytopenia and hypoplastic bone marrow at the age of 6 year. A chromosome study of lymphocytes showed numerous breaks, gaps and rearrangements, allowing the diagnosis of Fanconi's anemia. Treatment with corticosteroids and splenectomy did not result in hematologic remission. Repeated immunologic studies showed increasingly deficient T cell function as judged by lymphocyte transformation studies and skin test reactivity, whereas T cell number, T/B cell ratio, immunoglobulins, complement factors and neutrophil function were normal. A sever Pneumocystis carinii pneumonitis developed, but was successfully treated with pentamidine, sulfametoxazole with trimetoprim and transfer factor. Improvement of T cell function followed transfer factor therapy. Combined therapy with corticosteroids and androgens caused partial remission of the hematologic abnormalities. The probability of a primary immune deficiency in the patient is discussed.


Alpha-antitrypsin deficiency. Experience from an autopsy material.

Alpha-1-antitrypsin deficiency of genotype PiZ was found in 15 persons (6.3 per cent) out of an autopsy series of 238. The hepatic tissue was screened after diastase digestion and PAS staining. The globules demonstrated thereby showed by the immunoperoxidese reaction an antigenic identity with alpha-1-antitrypsin. It is estimated that one of the persons was homozygous, the others heterozygous. Among the latter, pulmonary emphysema was rather more common than found previously, whereas the hepatic changes were not quite so pronounced.


The importance of potassium in the function of frog semicircular canals.

The slow potentials and afferent discharge of impulses in frog semicircular canals have been studied at different endolymphatic and perilymphatic K+ concentrations. Results indicate that the presence of K ions in the bathing fluids is essential for maintaining the receptor function in crista ampullaris, although very low concentrations of this ion in the perilymph are sufficient to preserve the receptor responsiveness to mechanical stimuli. The hypothesis is put forward that K+ may be pumped from the exterior of the canal towards the intracupular structures, where it accumulates. A K-rich endolymphatic environment does, however, appear to be necessary to ensure the resting activity of ampullar receptors and their ability to be "disfacilitated" during inhibitory cupula deflections.


Responses of squirrel monkey vestibular neurons to audio-frequency sound and head vibration.

A study was made of the response of peripheral vestibular neurons in the squirrel monkey to head vibration and air-borne sound in the frequency range from 50-4 00 Hz. Responses were measured in terms of the phase locking of discharge and changes in firing rate. The lowest phase-locking thresholds for vibration were -70 to -80 dB re 1 g, and median values in the most sensitive frequency range (200-400 Hz) were -20 to -40 dB re 1 g; the minimum and median thresholds for sound were 76 and 120-130 dB SPL, respectively. Rate-change thresholds were 10-30 dB above phase-locking thresholds. The squirrel monkey sacculus has no special sensitivity to vibration in comparison with the other vestibular end-organs; the median phase-locking threshold to sound of saccular neurons exceeded 100 dB SPL. Irregularly discharging neurons are more sensitive than regularly discharging units. Evidence is presented that the response to intense sound involves a hair-cell mechanism.


Cause of the disproportion between the vast increase in plasma renin and the only small (if any) increase in blood pressure after manipulation of the submaxillary gland.

The cause of the disproportion between the vast increase in plasma renin concentration and the small, if any increase in blood pressure after manipulation of the submaxillary glands in mice is complex. The increase in plasma renin was found to cause a marked depletion of renin substrate, which however, was relatively so much less than the increase in renin that the (calculated) renin activity was markedly increased. The sensitivity of the vessels to angiotensin had only decreased in about half the animals studied, and even here the tachyphylaxis could not cope with the pronounced increase in plasma renin activity, as shown by a marked decrease in the blood pressure after blockade of the renin system. The finding that blockade of the renin system lowered the blood pressure below the pre-manipulation level made it probable that the vast release of submaxillary renin is followed by release of a depressor substance. The glands are known to contain kallikrein, but with the methods used it was neither proved nor disproved that the manipulation causes a release of kallikrein. Besides the factors studied, compensatory cardiovascular reflexes can play a role for the disproportion between plasma renin and blood pressure.


Electronystagmographic and gaschromatographic studies in rabbits.

Complaints of vertigo from people who are exposed to industrial solvents have focused interest on their toxic effect on the nervous system. In order to evaluate the influence of an organic solvent, xylene, on the mammalian vestibular system, a series of rabbit experiments were performed. To achieve a constant concentration, the xylene was infused as a lipid emulsion. Blood concentrations were estimated by gas chromatography. Electronystagmography in darkness revealed that at blood xylene concentrations of 30 ppm all rabbits had a positional nystagmus. The beat direction was the opposite of positional alcohol nystagmus. Another difference between the alcohol and the xylene reaction was that rotatory nystagmus responses were exaggerated. The relations between the present findings and the reactions and blood concentrations in people exposed to industrial solvents are discussed.


In vitro establishment and some properties of AKR thymoma cell lines.

Lymphoid cell lines could easily be directly established in vitro from spontaneous thymomas of aged AKR mice. The established lines all carried the Thy-1.1 antigenic marker of T lymphocytes. They differed markedly, however, from one another in several respects. Thus, they showed high or low quantity of Thy-1.1 antigens per cell, high or low sensitivity to cortisone and thymidine, as well as differing morphology and growth rate. The observed heterogeneity suggests that such AKR thymoma cell lines may provide a valuable tool to study T lymphocyte properties and the biology of the AKR thymoma, in particular non-immune and immune mechanisms influencing thymoma cell growth.


Alkaline phosphate in the differentiation of guinea pig T lymphocytes.

The majority of the guinea pig thymocytes have an intensive alkaline phosphatase (AP) activity, whereas less than one per cent of the peripheral lymphocytes are AP positive. The number of peripheral AP positive lymphocytes decreased after thymectomy and after antithymocyte serum treatment, and some of them formed. E-rosettes with rabbit red blood cells. The observations support the idea that some of these AP positive peripheral lymphocytes are T cells. It seems evident that the AP positive cortical (immature) thymocytes contain two separate cell lines; during the maturation one differentiates into AP negative and the other remains AP positive. This differentiation seems to occur within the thymus.


B- and T-cells and Ig-containing blast cells in healthy children.

Studies on rosette-forming cells and IgG, IgA, IgM and IgE-bearing lymphocytes were carried out in 70 healthy children aged 5 to 15 years. Furthermore, in 20 of these children, the percentages of IgG, IgA, IgM and IgE-containing blast cells after pokeweed mitogen stimulation of peripheral lymphocytes were evaluated. No differences in the percentages of rosette-forming cells, or in Ig-bearing and Ig-containing cells were found when three different age-groups were compared.


Freezing of rat lymphocytes. IV. In vitro and in vivo responses of T-cells.

Rat lymph node lymphocytes have been frozen-thawed with 10% dimethyl sulphoxide as cryoprotectant. The present study shows that these cells respond well in T-cell functional assays, such as stimulation with phytohaemagglutinin, as responder cells in the mixed lymphocyte reaction and in the local graft-versus-host assay. The magnitude of the responses obtained with frozen-thawed cells was some 70-80% of corresponding fresh cells.


Fever and behavioural temperature regulation in the frog Rana esculenta.

The skin and colonic temperatures were recorded in frogs (Rana esculenta) which had selected a suitable microenvironment in a box filled with 2-3 cm water. The water temperatures ranged from 0 degrees C to + 40 degrees C. Such measurements were performed before and after intraperitoneal injections of killed pathogenic bacteria (M. xenopi and M. range), killed non-pathogenic bacteria (M. aquae II) and 0.9% sterile saline, intraperitoneal injections of blood plasma from frogs pre-injected with killed M. ranae, injections of PGE1 into the brain. The injections of pathogenic bacterial endotoxin caused, after latencies of 5-120 min, higher preferred water temperatures, which produced an average maximum colonic temperature increase of 6.5 degrees C +/- 1.0 degrees C (S.E.) (p less than 0.001). The non-pathogenic bacteria and sterile saline caused no temperature change. Monophasic hyperthermia of shorter latency was caused by injections of blood plasma from frog preinjected with M. ranae. Monophasic hyperthermia of the shortest latency was observed after diencephalic injections of PGE1. Based on their similarity we suggest that ectothermic and endothermic fever have a common phylogenetic origin.


Substituted amphetamine derivatives. II. Behavioural effects in mice related to monoaminergic neurones.

The effects of the amphetamine derivatives (+/-)-amphetamine (A), 2-, 3- and 4-chloroamphetamine (CA), 4-methylamphetamine (MA) and chlorphentermine (CP) in producing central stimulation (increase in motor activity), antagonism of the reserpine syndrome, potentiation of 1-dopa and 5-hydroxytryptophan (5HTP) responses in mice were investigated. The inhibitors of the membrane amine uptake despramine (DMI) and chlorimipramine (CI)  were also included in the study. It was found that the order in central stimulating potency  was A greater than 3-CA = 4-CA greater than MA greater than CP. 2-CA, DMI and CI decreased the motor activity. All the compounds potentiated the 1-dopa response with the order of activity: 4-MA greater than A greater than 2-CA = 3-CA = 4-CA = CI greater than or equal to DMI greater than CP. The decrease in motor activity (sedation) produced by reserpine was only reversed by A greater than or equal to 3-CA greater than 2-CA. alpha-Methyltyrosine but not parachlorophenylalanine, antagonized the reversal effect. Three of the compounds (3-CA, 4-CA and MA) produced head-twitches in the reserpinized mice. The 5-HTP syndrome was potentiated in order of potency by MA = 4-CA greater than CI greater than CP greater than 3-CA whereas A, 2-CA and DMI had no effect.


Rosette formation in chicks: with special reference to QRBC-rosettes.

There are two types of RFC in lymphoid cells of normal unimmunized chicks, which form rosettes with QRBC. They might be separable subpopulations of lymphoid cells in reference to the thymus dependency. Ontogenetic developments of both of the RFCs suggest the presence of their interrelations in the maturation process of the lymphoid system in chicks. The nature of the receptor site for QRBC and the source or origin of RFCs are discussed.


Ontogeny of myelopoietic precursor cells in the chicken embryo.

The agar culture technique which enables enumeration of myeloid precursor cells was used to establish the time of appearance and further development of these cells in chick embryos. Yolk mesenchyme is the largest producer of precursor cells from day 6 to day 17 of incubation. In circulating blood precursor cells probably from the yolk appear at day 9 and stay at fairly high levels till day 17. Spleen and bone marrow have high percentage of precursor cells from day 10 till hatching, but afterwards rapid fall takes place to normal young adult levels. Thymus contains very few precursor cells during whole period of incubation. Bursa of Fabricius shows a very sharp peak of precursor activity on day 14 and 15 of incubation.


Genetic and cellular control of spontaneous autoimmune thyroiditis in OS chickens.

B-locus genotypes have been defined in Obese strain (OS) chickens that spontaneously develop autoimmune thyroiditis (SAT), and in White Leghorn Cornell C strain (CS) chickens from which the OS was selected. The B-locus influences SAT, and some possible mechanisms are discussed. Thymic abnormalities in OS, as contrasted with CB birds, are also discussed and may play a role in SAT, as may an intrinsic defect in the thyroid gland itself.


The production of a lymphocyte inhibitory factor (LyIF) by bursal and thymic lymphocytes.

In this study the migration and migration inhibition of different lymphoid cell populations from immunized and control birds were evaluated. Bursal, thymic, and splenic cells migrated in a capillary tube with thymic cells forming the characteristic cone of cells within 4 hours of culture. Both thymic and bursal cell populations from birds sensitized by Mycobacterium tuberculosis produced a lymphocyte inhibitory factor (LyIF) when stimulated by specific antigen in vitro. The ability of bursal cells to release LyIF declined subsequent to 10 weeks of age while LyIF was not apparent in thymic lymphocytes until 9 weeks of age and remained high until 27 weeks of age. The active material generated in specifically stimulated cultures from sensitized bursal cells appeared to be antigen dependent whereas thymic cell mediator is antigen independent. The production of LyIF in chickens, while correlating with delayed type hypersensitivity, does not solely reflect T-cell function but B-cell response as well.


Lymphocyte surface markers in acute lymphoblastic leukemia of adults.

Leukemic cells from eight adult patients with acute lymphoblastic leukemia (ALL) were examined for the T-lymphocyte (T-cell) marker of sheep erythrocyte (E) receptors and for B-lymphocyte (B-cell) markers of surface immunoglobulins (SIg), complement receptors and FC receptors. Six of these patients' leukemic cells were devoid of both T- and B-cell markers, and therefore were "null" cells. The leukemic lymphoblasts of a 79-year-old patient had all B-cell markers, including monoclonal IgG K and receptors for complement and Fc. In cells from another patient (21 years old), only complement receptors were found. A review of the literature revealed that, similar to childhood ALL, adult cases of ALL were mostly of "null" cell type. All of the T-cell type was found in approximately 20% of patients. ALL of the B-cell type occurred only rarely. The latter cell type appeared to occur mainly in the middle-aged and the elderly.


Ventricular dilation preceding rapid head growth following neonatal intracranial hemorrhage.

We describe two patients in whom ventricular dilation began within a week of neonatal intraventricular hemorrhage and preceded rapid head growth and clinical signs of increased intracranial pressure by days to weeks. The posthemorrhagic ventricular dilation is readily demonstrated in the neonatal period by computerized tomography of the cranium. These data indicate the importance of careful follow-up of survivors of intraventricular hemorrhage, early demonstration of ventricular dilation and prompt therapeutic intervention to prevent brain injury.


Inherited defect in hereditary pancreatitis.

Definite inherited defect in hereditary pancreatitis (HP) is not known. A new kindred with 3 definite and 6 suspected cases of HP was investigated for possible inherited abnormalities. No aminoaciduria (except for a slight rise in urinary histidine in one patient) and no hyperparathyroidism, hyperlipidemia, or chromosomal abnormality was present. An increase in serum IgM level of a polyclonal type was noted in 3 definitely affected sisters and also in 2 nonaffected members. Serum alpha-1-antitrypsin and serum trypsin inhibition were normal. However, very marked dilatation and ectasia of the pancreatic duct were found in the propositus. Reviewing the data from this family and previously described kindreds, it is postulated that the genetic abnormality in HP encompasses a wide variety of structural and anatomical defects in the sphincter of Oddi or the pancreatic ductal system. These predispose to intermittent obstruction of the duct with concomitant activation of enzymes and ductal metaplasia. In suspected cases an early effort should be made to outline the pancreatic duct as the defect may be amenable to surgery.


Serum factors influencing spontaneous rosette formation by lymphocytes of pregnant women.

The effect of sera from pregnant women on the percentage of spontaneous rosette-forming peripheral lymphocytes was investigated. Pregnancy lymphocytes displayed a significantly lower capacity to bind SRBC than control male lymphocytes. However, after an exhaustive washing, it was possible to demonstrate a significant increase of spontaneous rosettes formed by pregnancy lymphocytes. It was found that the incubation of pregnancy-washed lymphocytes with pregnancy but not homologous male serum restored to depressed levels the values of rosette-forming peripheral lymphocytes. This blocking activity was significantly higher with autologous serum than homologous pregnancy serum. Control lymphocytes were unaffected both by washing and by incubation with pregnancy sera. The blocking activity was found in the same ion-exchange chromatography fraction of pregnancy serum where paternal HLA antigens could be demonstrated, and was reproduced by a soluble HLA preparation from the husband's lymphocytes.


Perinatal addiction: outcome and management.

The care of the pregnant drug-dependent woman and her newborn infant has become a major and controversial health problem requiring specific approaches to this high-risk mother and neonate. A comprehensive approach to the care of 278 pregnant drug-dependent women and their infants at the Philadelphia General Hospital has significantly reduced maternal and infant morbidity heretofore associated with pregnancies complicated by opiate addiction. Most significantly, the incidence of low birth weight has been reduced to below 20 per cent, and a decrease in severe withdrawal in infants born to mothers in the comprehensive care program has occurred. We propose that application of this approach to women whose pregnancies are complicated by drug dependency is a significant factor in successful management.


Kinetic analysis of potassium transport in bullfrog kidney.

Techniques have been developed for studying the distribution and the rates of exchange of K among urine, the tubular cells, and the circulation in the isolated, pump-perfused, bullfrog kidney. Tubular cells were loaded with 42K via the portal circulation, and the subsequent washout of the tracer into the vena cava and into urine was measured. Analysis of the data indicated the existence of at least three cellular pools of K. Pools a and b have half times of exchange of 1.1 and 4.1 min and contain about 25 and 40% of tissue K, respectively. The remainder of cellular K is contained in one or more very slowly exchanging pools. The rate of exchange of K at the basolateral surface of tubular cells is 50-fold greater than at the luminal surface. A pulse-washout method was also devised to permit control and experimental measurements to be made in the same kidney. With this technique, we found that portal perfusion with 10 mM K increased the rate of uptake into pools a and b from the circulation and the rate constants for efflux into the urine from both pools, Acetazolamide increased uptake into pool a and the rate constants for efflux into the urine from both pools.


Gastroduodenal perforation after open heart surgery.

During a thirty month period, 319 patients underwent open heart operations, and of these, three experienced a life-threatening explosive abdominal catastrophe. Aggressive radiographic maneuvers established the diagnosis of gastroduodenal perforation. Appropriate abdominal surgery with plication of the perforation and, whenever possible, the establishment of tube gastrostomy for decompression and a tube jejunostomy for feeding is desirable. All three patients required mechanical ventilatory support and tracheostomy prior to the abdominal catastrophe. Prophylactic antacids and sedation seem appropriate, particularly for selected patients (those with a prior peptic history and those with pulmonary dysfunction). Pulmonary toilet for those identified by preoperative pulmonary screening may circumvent the need for postoperative ventilatory support, which increases the risk of stress ulceration. Of the three patients described, all survived the gastrointestinal surgery but only one left the hospital. One died twenty days and another forty-eight days after the intestinal surgery, both of pneumonitis and septicemia.


Ultrastructure of the blood-aqueous barrier in normal condition and after paracentesis A freeze-fracture study in the rabbit.

There is in the ciliary epithelium a barrier which prevents the passage of plasma proteins into the posterior chamber of the eye. The anatomical site of this blood-aqueous barrier is at the zonulae occludentes (tight junctions) located between the lateral plasma-membranes of the nonpigmented epithelial cells. Using the freeze-fracture technique we have studied these junctions in the pars plicata. As in many epithelia, they are formed by an anastomosing network of ridges on the fracture PF face and by a complementary set of furrows on the fracture EF face of plasma membranes. Features of these junctions are the presence of frequent parallel and closely associated double or triple ridges, and a few small gap junctions, associated with tight junctional elements of the zonulae occludentes. We also show that the number of junctional strands (ridges and furrows from apex to base) varies from a few strands to about 15, according to their position around the nonpigmented epithelial cells. These observations suggest that the rabbit's ciliary epithelium is to be classified among the 'tight' or 'very tight' epithelia (Claude and Goodenough, 1973). After paracentesis, we observed no breakdown of the zonulae occludentes. This supports the hypothesis that the site of leakage of the plasma proteins is elsewhere than ciliary epithelium.


Exfoliation material in different sections of the eye.

Nine trabeculectomy samples, five iridectomy samples and one lens of an exfoliation syndrom were examined. Next to typical exfoliation syndrome fibrils, the alteration of endothelial membranes and similar structures has been pointed out. Concerning the glaucoma genesis, it is being discussed whether a participation of the trabecular network in the disease course might be a preliminary condition for the development of glaucoma and, thus, mere infiltration of exfoliation material into the trabecular network alone could be responsible for developing a glaucoma.


Schlemm's canal after trabeculo-electropuncture (TEP).

The Schlemm's canals of two patients were examined histologically and electron-microscopically. The first patient had a tumor of the choroid. An electroprobe was inserted into the Schlemm's canal and then removed. In this eye, nearly all septa and almost the entire endothelial layer of the lumen were destroyed in the area of the inserted probe. The second tissue sample came from a patient who had had TEP surgery 2 years earlier and whose intraocular pressure had increased again. The preoperative gonioscopic examination showed an opening in the trabecular network, with blood evading from Schlemm's canal. Histologically, an opening approximately 50 micron wide, lined with endothelium, was found in the trabecular network. The lumen of the canal existed only in a section approximately 500 micron long. Elsewhere the inner and outer walls of the Schlemm's canal adhered to each other. In the area of this 500 micron long section of the canal, only one collector channel could be found. Thus, the insufficient decrease in intraocular pressure after operation can be explained by the side-effects of the insertion of the electroprobe into the Schlemm's canal.


The action of sensitized lymphocytes on the corneal endothelium of rabbits.

A host versus graft reaction is induced by the injection of sensitized lymphocytes into the anterior chamber of rabbit eyes. The reaction of these lymphocytes against the corneal endothelium is studied with S.E.M. and T.E.M. On the first and second days the transformation of lymphocytes into active cells with uropods is observed. These immunologic cells destroy the endothelium, but the endothelial cells regenerate quickly. On the sixth day there appear macrophages coming from the host, indicating that the lesions are being cleaned. These experiments present a good model for the study of the interaction between immunologic cells and an organized cellular structure.


The perfused cat eye: a model in neurobiologic research.

The viability of an arterially perfused mammalian eye preparation is demonstrated in (1) electrophysiological recordings of multineuronal responses (electroretinogram, optic nerve action potential) as well as of signals from single cells (ganglion cells, horizontal cells, pigment epithelium), and (2) in a quantitative analysis of the fine structure of the retina. The possibilities of assessing the function of the retina at several levels of information processing and of controlling the biochemical input without systemic effects favor pharmacologic studies in vitro. Results from our research on cholinergic transmission in the cat retina are presented, revealing reversible effects of physostigmine, atropine, scopolamine and mecamylamine on the activity of ganglion cells.


Effects of colchicine on phagosome-lysosome interaction in retinal pigment epithelium. I. In vivo observations in albino rats.

The retinal pigment epithelium (RPE) from young albino rats was examined under light and electron microscope 2 1/2 to 16 h after intravenous injections of colchicine (0.5 mg per 100 gm body weight). One of the primary effects of colchicine treatment on the RPE is the appearance of extensive acPase-positive dense body aggregates in the Golgi area. The size of the aggregates and the disappearance of microtubules appear to be related to the length of time allowed for colchicine to react. Acid phosphatase (acPase) activity is localized on the dense body aggregates and is particularly evident at a light microscopic level, where it can be observed as darkly stained clumps. Dense bodies are only rarely seen in the immediate proximity of acPase-positive phagosomes in colchicine-treated animals. The results of these experiments suggest the existence of an intracellular transport mechanism for acPase-carrying dense bodies. This intracellular transport is inhibited by colchicine, being probably related to a block of microtubular assembly.


Diurnal variation of autophagy in rod visual cells in the rat.

In the process of autophagy, parts of the cell's own cytoplasm are enclosed by membranes and subsequently digested by enzymes. Autophagy is a well-known process found in various tissues under different conditions (See Refs.). Autophagy in visual cells was first documented by Remé and Young (1977) and Remé (1977), and was considered to be a general and important degradative pathway in visual cell metabolism. Recently, La Vail (1976) demonstrated that the shedding of disks from the tips of rod outer segments followed a circadian rhythm in rats. The peak period of disk shedding occurred shortly after the onset of the lighting period. In this study we have demonstrated, by quantitative analysis, that autophagy in rod inner segments follows a diurnal variation. The peak period of autophagic activity occurs about 3 h after the peak period of disk-shedding. Both peak periods take place in daytime, when the animals are less active. This finding further supports our assumption of autophagy being an important pathway in visual cell degradative mechanisms.


Retinal glycogen content during ischaemia.

In the normal rabbit retina glycogen particles were only observed in the Müller cell. The glycogen was evenly distribution throughout the cytoplasm. The inner retina contained large amounts of Müller cell cytoplasm and consequently possessed substantial quantities of glycogen. The outer retina contained little Müller cell cytoplasm and only small amounts of Glycogen. Following total acute ischaemia induced by high intraocular pressure, the amount of glycogen in the retina fell rapidly so that by 45-60 min of ischaemia it was absent from the Müller cell. In the rabbit, ischaemia preferentially damaged the outer retina and especially the visual cells. This pattern of damage was thought to be a reflection of the amount of glycogen present in the different regions of the retina.


Light damage to the retina.

The retinae of anaesthetised Dutch rabbits were exposed to light of various known intensities for a period of 1 h. After this period the animals were sacrificed and tissue taken for investigation by light and electron microscopy. Changes were apparent in the visual cells and retinal pigment epithelium only at the highest intensities employed. The retinal pigment epithelium and the outer nuclear layer exhibited mild oedematous changes. The major components to be affected were the visual cell outer segments. Marked disruption and vesiculation were features of the cone outer segments, which was in distinct contrast to the focal damage observed in the rod outer segments.


The ultrastructure of preretinal macular fibrosis.

A case of preretinal macular fibrosis, following long-standing central vein occlusion and hemorrhagic glaucoma, was examined macroscopically and electron-microscopically. Pretreatment with cyclodiathermy puncture was performed twice before enucleation. The following morphologic results were observed: 1. Epiretinal cell layers in the peripapillar and foveolar regions which caused no 'puckering' of the retinal surface. These cell layers were mainly composed of glial cells. Some Müller cell processes and macrophages were also present. The epiretinal glial cells stem from the surface of the papilla and of the retina. They leave the retina through breaks of the basal lamina (especially where the latter is only a thin layer). 2. Folding (puckering) of the retinal surface was exclusively observed under condensed masses of fibrous tissue. The epiretinal fibrous tissue is composed of immature collagen fibrils of various diameters, of acid glycosaminoglycans, and of granular deposits of long-spacing collagen. The fibrillar material is firmly attached to the basal lamina of the retina. Shrinkage of the epiretinal fibrous tissue similar to the shrinkage of scar tissue is assumed to be the reason for the development of traction to the retinal surface. The epiretinal glial cells are assumed to be the sites of synthesis of the preretinal fibrous masses and glycosaminoglycans.


[Findings on retinal surface by scanning electron microscopy. II. Vitreous detachment (author's transl)].

The authors describe their findings by scanning electron microscopy of the surface of the retina following secondary and primary senile posterior vitreous detachment. These findings are correlated with those of transmission electron microscopy. Extended nets formed by vitreous fibrils can be found on the retinal surface. The fibrils form a continuous feltwork, which cannot be traced by biomicroscopy or dissection of enucleated globes. This feltwork desintegrates in places or over a wide area and the basal membrane of the Müller cells becomes exposed. Structural differences in consequence of the two examination techniques well as possible artifacts are shown.


[Findings on retinal surface by scanning electron microscopy. III. Epivascular glial clusters (author's transl)].

The findings by scanning and transmission electron microscopy of multiple glial excrescences from the retina into the cortical vitreous body are described. These formations are located in lines above superficial retinal vessels. The findings are compared with those from light microscopy of similar formations. The pathogenesis and the possible significance as retinovitreal attachments for rhegmatogenous defects of the retina and for posterior vitreous detachments are discussed.


[Binocular triplopia induced by weak prisms (author's transl)].

The prescription of weak prisms may induce monocular diplopia or binocular triplopia. The monocular double image is due to internal reflexion at the glass-air interface. The intensity of the secondary image is very weak (0.2% of the primary image). The prismatic deflection of the secondary image is six times the deflection of the primage image.


[Regression of corneal neovascularization by laser treatment? (author's transl)].

The corneal neovascularization produced by NaOH burns was examined in two groups of pigmented rabbits following laser treatment. The treatment was carried out with energy level 500 mW, spot diameter 200 micron, and exposure time 1 s throughout. In the first group, a single newly formed vessel was coagulated in each case. Subsequent fluorescein angiography invariably showed an incomplete occlusion of the vessel. In the second group, we coagulated a section of the neovascularization network at its origin in the corneal limbus. After 48 h, fluorescein perfusion was once again observed, but the vessels were predominantly finer than before. Fluorescence microscopy revealed a rich neovascularization of the more superficial layers of the corneal stroma. To be successful, laser treatment must involve both supplying and draining vessels.


[Contribution to the changes in the epithelium in macular corneal dystrophy (Groenouw's type II) (author's transl)].

In macular corneal dystrophy the epithelial cells display increased activity: they produce proteins and glucosaminoglucans. This may lead to the synthesis of collagen and of pathologic proteoglugans.


Investigations on trace elements in normal and senile cataractous lenses. Activation analysis of copper, zinc, manganese, cobalt, rubidium, scandium, and nickel.

A total of 125 human lenses (97 senile cataractous and 28 clear) were analyzed by means of neutron activation analysis for trace element concentrations of copper, zinc, manganese, cobalt, rubidium, scandium, and nickel. Tt was found that the rubidium concentration remarkably decreased and the copper concentration moderately increased with the progression of cataract. The concentrations of manganese, zinc, and cobalt showed some fluctuations without a definite increase or decrease, and the scandium and nickel content was found to be very low.


The effect of area on the critical flicker threshold.

The relation between the luminance required to discriminate flicker of constant rate (critical flicker threshold) and the size of theretinal area stimulated was determined under photopic conditions. At small stimulus fields (diameter less than 44 min of arc) the slope of the critical flicker threshold vs. area approximated to Riccò's law [log (I-A) = constant]; with larger fields (diameter up to 116 min of arc) the slope approximated to Piper's law [log (I-square root A) - constant].


Chronic pulmonary complications of early influenza virus infection in children.

In 3 male patients, chronic pulmonary sequelae followed influenza virus infection at 5, 24, and 42 months of age. Varying degrees of interstitial fibrosis, bronchial and bronchiolar erosions and metaplasia, obliterative bronchiolitis, and interstitial chronic inflammatory infiltrates were found on lung biopsy. Influenza A/Hong Kong/68 (H3N2) virus was isolated from the lung tissue of one patient 8 weeks after the onset of illness. This is the longest persistence of infectious virus in lung tissue yet reported. Persistent radiographic abnormalities included peribronchial thickening, interstitial densities, bronchiectasis, obliterative bronchiolitis, and segmental atelectasis. Pulmonary function tests showed an obstructive restrictive pattern, with mild improvement after bronchodilation and with deterioration after exercise. These observations suggest that influenza virus infection may be more serious in infants and young children than has been previously recognized and may contribute to the pathogenesis of unexplained interstitial pneumonitis, pulmonary fibrosis, obliterative bronchiolitis, and bronchiectasis.


Bleeding intestinal varices associated with portal hypertension and previous abdominal surgery.

Patients with portal hypertension may develop portasystemic communication in adhesions formed after earlier surgery. This condition causes localized mesenteric and intestinal varices which may lead to significant gastrointestinal hemorrhage. Two patients with this disease spectrum are discussed. The recommended treatment was resection of the involved intestine and formation of a portacaval shunt to eliminate recurrence of the varices and subsequent hemorrhage.


[Multiple sclerosis in Tunisia: cochleo-vestibular study (author's transl)].

The authors undertook in Tunisia a cochleo-vestibular study of multiple sclerosis. 94 cases were included, with the following results:--67 patients had spontaneous nystagmus in the dark.--With provocation studies: - 52 cases showed signs of an irritative-type central vestibular syndrome, - 25 cases had a deficiency-type central vestibular syndrome. All of the patients underwent audition studies but the results showed that only 5 patients had a bilateral and symetrical retro-labyrinthine type perception deafness.


[Detection of circulating immune complexes in lupus erythematosus by precipitation test with polyethylene glycol and complement consumption test (author's transl)].

Immune complexe-like materials have been detected by a precipitation test with polyethylene glycol (PEG test) in the sera of 14 (93.3 p. 100) of 15 patients with active SLE, in 11 (44.0 p. 100) of 25 patients with inactive SLE, in 5 (83.3 p. 100) of 6 patients with widespread DLE and 3 (42.9 p. 100) of 7 patients with localized DLE. A good correlation was demonstrated between the value of PEG test and the complement consumption activity measured by an anticomplementary method in the cases of SLE, but it was not clear in the cases of DLE. The anticomplementary activity has been observed in the macromolecular fractions obtained by gel filtration on Sephadex G-200 of serum samples from one patient with active SLE and one patient with widespread DLE. As the value of PEG test had shown a tendency to increase with the antinuclear antibody titer if the titer was higher than 1 : 128, it is probable that the antinuclear factors were the important elements of the composition of circulating immune complexes in the cases of SLE. Contrarily, in several DLE patients, PEG test was positive despite lacking antinuclear antibody. In most cases, no significant decrease of PEG titers after DNase action was recorded, suggesting the participation of complexes containing antigens different from DNA.


Beta-lactamase effect on ampicillin treatment of Haemophilus influenzae B bacteremia and meningitis in infant rats.

Intraperitoneal injections of 250 mg of ampicillin per kg every 6 h for 30 h sterilized the blood and cerebrospinal fluid of infant rats infected with either a beta-lactamase-containing strain of Haemophilus influenzae type b or a strain lacking the enzyme. However, a single injection of 100 mg/kg sterilized the blood and cerebrospinal fluid of significantly fewer of those rats infected with the beta-lactamase-producing strain. The results suggest that resistance of beta-lactamase-containing strains of H. influenzae in vivo may be inoculum dependent, as demonstrated previously in vitro. The infant rat model appears suited for the quantitative delineation of the effect of beta-lactamase on the treatment of H. influenzae bacteremia and meningitis with beta-lactamase antibiotics.


Side effects of minocycline: different dosage regimens.

The incidence of side effects due to two dosage regimens of minocycline was examined over a 5-day period. A total of 60 normal women volunteers were randomly assigned in a double-blind manner to either a group who took 100 mg of minocycline twice a day or a group who took 75 mg of minocycline twice a day for 5 days. Both groups were comparable from the standpoints of age, size, race, and the use of oral contraception, nicotine, and ethanol. They were seen on a daily basis, and symptoms were evaluated by both volunteers (from diaries) and physicians. Minocycline serum concentrations were determined on blood samples taken 2 h after the a.m. dose. Volunteers taking 150 mg of minocycline per day had significantly lower serum antibiotic concentrations than those taking 200 mg per day. However, both low- and high-dose groups exhibited similar incidence and prevalence of recorded symptoms, with the single exception of nausea, where the low-dose group had fewer symptoms than the high-dose group (P = 0.035). Symptomatic volunteers did not have higher serum concentrations of minocycline than their asymptomatic counterparts. When either weight or surface area was examined with antibiotic serum concentration there was a significant inverse correlation between the two on day 2 for both groups and also on day 4 for the low-dose group. It is concluded that, in women, a dose of 150 mg of minocycline per day is associated with the same degree of side effects as a dose of 200 mg per day.


[Familial dermo-chondro-corneal dystrophy (François' syndrome)].

The François' syndrome associates disseminated firm nodular subcutaneous lesions, a deforming arthropathy and a corneal dystrophy. Inheritance seems to be recessive. Six cases of this rare syndrome have been previously published. The syndrome is reported here in two Mexican brothers. In the authors' opinion the François' syndrome is not related to the xanthomatoses. It should be considered as a genetically recessive arthropathic nodular fibromatosis.


Choice of antibiotics in management of acute osteomyelitis and acute septic arthritis in children.

A survey of 158 children with acute haematogenous osteomyelitis, and of 94 children with acute septic arthritis over an 8-year period was made to determine which bacteria cause these infections. In the osteomyelitis group the organism most frequently detected was Staphylococcus aureus (74% of cases). In 16% of cases streptococci were found. Staph. aureus was also the most frequently grown organism in cases of acute septic arthritis (55% of cases), but Haemophilus influenzae accounted for 24% of positive cultures. On the basis of the survey it is the current practice of the author to use a combination of methicillin or cloxacillin and penicillin for acute haematogenous osteomyelitis, and methicilline or cloxacillin and ampicillin for acute septic arthritis. The choice of antibiotics is vitally important as treatment must start before the results of culture are known. Repeated evaluation of trends in the pattern of causative organisms is strongly recommended, in order to be aware of changing sensitivity of organisms to antibiotics.


Lymphocyte abnormalities in ankylosing spondylitis.

Peripheral blood T (SRBC rosette) and B (AgG- and C-receptor) lymphocyte subpopulations and responsiveness to phytohaemagglutinin (PHA) were assayed in 40 patients with ankylosing spondylitis and in 55 normal subjects. There was no significant difference in the lymphocyte concentrations or responsiveness to PHA between the two groups. However, the percentages of T lymphocytes were significantly lower in the patients irrespective of their HLA typing. This was probably due to an increase in the 'null' population since the percentages of both the AgG- and C-receptor cells were normal.


Anti-DNA antibodies in discoid lupus erythematosus. Follow-up study.

Anti-DNA antibodies have been detected previously in patients with chronic discoid lupus erythematosus (DLE) despite the absence of overt systemic manifestations. 27 patients with DLE were followed up 3 years after the detection of anti-DNA antibodies in 7. None had developed other features of systemic lupus erythematosus. We conclude that the occasional finding of anti-DNA antibodies in patients with DLE does not predict those likely to develop systemic disease.


Extraanatomical bypass of the aortic root: an experimental technique.

Endocarditis involving a prosthetic aortic valve is associated with persistently positive blood cultures and aortic regurgitation. With rare exception, it is a fatal disease. An experimental technique was developed that would allow for removal of the infected aortic prosthesis with debridement and permanent closure of the aortic root. An extraanatomical outflow for the left ventricle was created using a valve-containing conduit between the apex of the left ventricle and the descending thoracic aorta (apicoaortic anastomosis). The procedure was performed on 5 mongrel dogs through a left thoracotomy without use of cardiopulmonary bypass. Four survived the procedure and required no cardiotonic support. One died as a result of a technical problem. Intraoperative pressure determination revealed a 0 to 15 mm Hg gradient across the apioaortic prosthesis and a left ventricular end-diastolic pressure of 0 to 4 mm Hg. Both postoperative angiocardiogram and postmortem examination confirmed patency of the aortocoronary bypass grafts and good function of the prosthesis.


Hyperthermic effects of D-lysergic acid diethylamide (LSD) and its derivatives in rabbits and rats.

Several D-lysergic acid diethylamide (LSD) derivatives including metabolites of LSD in animals liver and Streptomyces such as D-lysergic acid ethyl, 2-hydroxyethylamide (LEO), D-lysergic acid ethylamide (LAE), D-norlysergic acid diethylamide (norLSD) and synthetic N6-allyl-D-norlysergic acid diethylamide (allyl-nor LSD) were studied with rabbits and rats. In rabbits, the order of the hyperthermic activities was allyl-norLSD greater than LSD greater than LEO, LAE, nor-LSD, and this order was parallel to that of 5-hydroxytryptamine-like activities of these compounds which was previously studied. However, the order was LAE greater than LSD greater than norLSD IN RATS. The hyperthermic effect of LSD in rabbits was attenuated by methysergide, but not by atropine when these drugs were intraventricularly administered. These results suggest the possibility that the metabolites of LSD contribute to the hyperthermic effect  of LSD in rats but not in rabbits, and support the idea that 5-HT receptors are involved in the hyperthermia induced by LSD in rabbits.