Characterization of various nervous tissues of the chick embryos through responses to chronic application and immunocytochemistry of beta-bungarotoxin.

beta-Bungarotoxin (beta-BT) was applied to chick embryos at 3-day intervals beginning on the fourth day of incubation to investigate ultrastructurally the effects of chronically and massively applied beta-BT on various nervous tissues and muscles. On the twenty-first day of incubation, spinal cords of beta-BT treated embryos were conspicuously decreased in size. Ventral root fibers dorsal root fibers, white matter, and motor neurons disappeared. Although spinal ganglia and sympathetic trunk ganglia were completely absent, Auerbach's and Meissner's ganglia nerve cells in the small intestine and adrenal medullary cells were not affected. In retinas of beta-BT treated animals ganglion cells and optic nerve fibers disappeared, but photoreceptor cells, bipolar cells and horizontal cells remained intact. Furthermore, olfactory nerve cells and their unmyelinated nerve fibers ensheathed by Schwann cells were quite undamaged. Skeletal muscles degenerated, whereas cardiac muscles were unaffected. In the present study various nervous tissues of the twenty-first day normal chick embryos were incubated with beta-BT and target cells of beta-BT were detected directly by the reaction with horseradish peroxidase labelled anti beta-BT guinea pig IgG. Motor nerve cells in the spinal cords, spinal and sympathetic ganglia nerve cells, ganglion cells and some nerve cells at the inner part of the inner nuclear layer in the retinas were positively stained, whereas Auerbach's and Meissner's ganglia nerve cells in the small intestine, adrenal medullary cells, photoreceptor cells, bipolar cells and horizontal cells in the retina and olfactory nerve cells were negative. Thus the present study shows the beta-BT has extensive destructive effects on various nerve cells which were revealed to be target neurons of beta-BT by immunocytochemistry. Those nerve cells, affected by beta-BT and positively stained with immunocytochemical reaction were supposed to have different characteristics from unaffected cells. One of the differences between these affected cells and unaffected cells may be whether there exist binding sites for beta-BT on the plasma membrane or not. The possibility of the use of beta-BT to characterize various nervous tissues is presented in the present study.


Relation of hormonal variations to nutritional studies and metabolism of ruminants.

Variations in concentrations of growth hormone, insulin, glucagon, prolactin, adrenal corticoids, and thyroid hormones in blood plasma of ruminants as related to circadian rhythms, environmental factors and nutrition are reviewed. Rhythms in prolactin concentrations are related to light and temperature. Concentrations of prolactin in plasma are higher in warm environments and during longer photoperiods. There is episodic secretion of growth hormone in cattle with frequent peaks in plasma concentrations during 24 h. Marked increases in environmental temperature result in greater secretion of growth hormone for short times followed by a decline in plasma concentration with prolonged exposure. Extreme cold temperature also increases growth hormone concentrations in plasma. Secretion of thyroid hormones increases in cold and decreases in warm environments. Circadian rhythms are definite for plasma concentrations of adrenal corticoids in ruminants adjusted to their surroundings. Peaks occur late in dark periods, and lows occur during the end of light periods. Circadian patterns have not been consistent for secretion of insulin. Prolonged subjection to stresses such as noise, handling, and restraint can modify concentrations of prolactin, growth hormone, and adrenal corticoids. Changes in concentrations of insulin may occur if blood glucose is increased. After feeding, concentrations of growth hormone in plasma decrease and concentrations of insulin and glucagon increase. Relationships of these changes with metabolism are discussed.


Cowden's disease: a case report and review of the literature.

Cowden's disease is one of the rare genodermatoses. The most characteristic findings in this disease are cutaneous and oral lesions that are widespread papillomas and verrucous papules. On the palms the lesions are keratoses. Aside from these findings, this syndrome complex is sooner or later associated with various internal abnormalities involving the mammary, thyroid, gastrointestinal, reproductive and skeletal systems. In the 28 reported cases, 13 cancers have been found, most of the breasts. Because of the characteristic cutaneous and oral lesions, it is possible to recognize this disease early and then to follow afflicted patients closely for the possibility of development of cancers or other abnormalities of other organs.


Airborne Aspergillus fumigatus levels outside and within a large clinical center.

Most considerations of Aspergillus fumigatus prevalence have implied that patterns of occurrence observed within London hospitals are generally applicable. Since prevalence data are almost nonexistent elsewhere, this assumption remains untested. To provide a comparison relevant to North America, we have monitored thermotolerant fungi outside as well as at two sites within the University Hospital, Ann Arbor, Michigan, during one year. Collections were made with paired Andersen samplers and malt agar for 30- to 40-min periods in a hallway adjacent to 6W, a general medical ward (47 days), and 2W, a lower level service and supply area (40 days); in addition, 10-min outdoor samples (44 days) were taken on an unobstructed hospital rooftop (out). Recoveries were analyzed after 3 and 7 days of 37 degrees C aerobic incubation. Virtually complete suppression of Cladosporium form species at 37 degrees left a mycoflora with A. fumigatus, A. niger, Paecilomyces spp., Mucor spp., and yeast/bacteria predominating. Although the proportions of samples yielding A. fumigatus were 76% for 6W, 57% for 2W, and 56% (out), levels exceeded 40 isolates/m3 only twice and were over 10 isolates/m3 on only 10 of 131 total samples. For 6W, 2W and out, respectively, means were 4.78, 1.97, and 6.25 isolates/m3; medians were 1.20, 1.05 and 1.75/m3 without annual trends indoors and with only a limited outdoor summer increase. Our data fail entirely to show the fall-winter abundance observed in the London report and suggest substantially lower indoor exposure levels of A. fumigatus than those noted in London.


A comparison of the prevalence of sensitization to Aspergillus antigens among asthmatics in Cleveland and London.

A survey of the frequency of sensitization to Aspergillus antigens was conducted in a group of asthmatics in Cleveland and compared with a group of asthmatics in London, using common antigens for testing purposes. The two groups were comparable except for earlier onset, longer duration of asthma, and a larger number of males in the London group. Twenty-eight per cent of the asthmatics from Cleveland and 23% from London had immediate skin reactivity to Aspergillus. Seven and one-half percent from the Cleveland group and 10.5% of the London group had Aspergillus precipitins in the serum. Aspergillus skin test reactivity was related to the severity of airways obstruction (p less than 0.01) but was not influenced by other factors. We conclude that sensitization to Aspergillus antigens occur with equal frequency in both the United States and the United Kingdom.


Depression in the elderly. I. Relationship between depression, psychologic defense mechanisms and physical illness.

Diagnosis of depression in the elderly is sometimes difficult owing to the presence of ego defensive mechanisms or somatic symptoms that can disguise the affect. Depression also may precede, or be associated with a variety of medical illnesses which are common among older persons. Specific ego defenses and representative medical illnesses are discussed. The concepts of a depressive equivalent and pseudodementia, which particularly act to disguise the depression, are reviewed in detail.


Ivan Basilevich: a gerontologist in transit.

Chance often determines the names that are recorded in history. Among an earlier generation's gerontologists, Ivan Basilevich was distinguished by the promise of his career and recognition in the USSR by his peers. The military invasion of his nation changed the pattern of his life. From a professional level in his native land, at the age of 50, he became a resident in psychiatry in Rhode Island where he continued his work on aging. He became a citizen in 1954 and by 1962 was the senior psychiatrist of his hospital's staff. His contributions to gerontology included his participation in the Kiev Congress of Aging in 1938 and a monograph in English (unpublished) on the medical aspects of natural old age. He wrote some 70 articles. In his papers on the subject of aging he heralded the transition of gerontology to its modern stage.


Tocopherol in Osteoarthritis: a controlled pilot study.

Thirty-two patients entered a simple-blind, cross-over study on the action of tocopherol in osteoarthritis; only 3 did not complete the course. Each patient was randomly assigned either to the tocopherol group (600 mg/day for 10 days) or to the placebo group. After 10 days the groups were transposed. The analgesic and other possible effects of tocopherol vs. placebo were assessed by the patients' daily records, by the physician's personal examination and interview, and by observations on the use of an additionally permitted analgesic (pro re nata). In 52 percent of the 29 patients who completed the study of good tocopherol analgesic effect was noted, but only 4 percent of those receiving placebo reported a similar effect. The difference was statistically significant. Further large-scale assessement of the influence of tocopherol in osteoarthritis would seem to be justified.


A further footnote to Freud's "fragment of an analysis of a case of hysteria".

While ther is no evidence that Freud ever had in analysis a leading political figure, he did analyze the sister of one, and made her the basis of an important case study. Dora's brother, Otto Bauer, was an influential Marxist theoretician and leader of the Austrian Socialist Party from 1918 to 1934. Freud's Dora case illuminates the psychodynamics of Otto Bauer's life and career, and a re-examination of the case together with recent research also provides us with new information about Freud's analysis of Dora and the milieu in which they both lived.


[New surgical technics in functional esotropias (the thread operation and classical technics)].

The surgical management of functional esotropias is now very different from some years ago with Fadenoperation settled by Cüppers. Indeed this procedure is the only one which can act in a fitted manner on muscular spasms responsible of more than 60% of convergent squints. The simultaneous using of classical technics remains necessary, but in very different way from the custom formely. In the first part of this work, the authors begin to analyze the mechenism of medical rectus recession, and they show that operation doesn't act by a modification in arc of contact as it was always said, but only by a muscular slacking. On the contrary the change in arc of contact is the main factor which intervenes in Fadenoperation, but the muscle exclusion has also an important part. Whereas the effects of Fadenoperation on adduction incomitance are perfectly clear, those on the deviation in primary position still remain very abstruse. A statistical report on 143 cases of operated blocking esotropias shows that often Fadenoperation alone does not bring a complete cure of motor troubles. The authors explain the reasons of these failures and point out the other accurate muscular actions which must be associated to obtain a good result.


Neurovascular free flaps from the foot for innervation of the hand.

Microneurovascular flaps from the first web space of the foot offer a solution to upgrade sensibility of the denervated hand. Based on the dorsalis pedis artery, it allows simple dissection and a large vessel for easy and safe anastomosis. Seven cases are presented in which combinations of the first web anatomy for a variety of denervation injuries were used. The technique is ideally suited in those cases where no areas of island flap tissue are available for transfer.


Chondrosarcoma of the trapezium: a case report.

Roentgenograms of a 46-year-old Caucasian man with progressive swelling and pain at the base of the thumb who had been treated for arthritis showed an enlargement of the trapezium. The entire bone and surrounding ligaments were removed and an iliac bone graft was used to fuse the trapezoid to the first metacarpal. Sections of the tumor were diagnosed as chondrosarcoma. No recurrence is apparent 3 years after excision.


Osteoid osteoma of the carpal bones.

Three cases of osteoid osteoma of the carpal bones are described, with a review of the literature. The scaphoid is the carpal bone involved most frequently. Typically the lesions are painful and respond to aspirin. Roentgenologic finding of the central area of lucency surrounded by sclerotic bone often is diagnostic. Block excision with bone grafting is an acceptable method of treatment.


Studies on the mechanism of long term survival of Taenia taeniaeformis in rats.

An attempt was made to determine if blocking antibody is involved in protecting cysticerci of Taenia taeniaeformis against a host immune response. Immunoflourescence microscopy confirmed that host antibody is presnet on the parasite surface within the capsule. To test if the larvae can still survive after such a coat of blocking antibody is removed, the larvae were trysinised and then implanted into recipients. The results indicate that blocking antibody could be involved in the survival of 1 year old established larvae. Untrypsinised larvae were normal 14 days after implantation into control or immunised rats. Trypsinised larvae implanted in control rats were alive but showed on intense cell adherence on their surface. On the other hand, trypsinised larvae implanted into immunised rats were dead and completely encapsulated. However, experiments with 1 month old larvae were inconclusive.


Histochemical differentiation of complex carbohydrates with variants of the concanavalin A-horseradish peroxidase method.

Various treatments carried out prior to the concanavalin A-horseradish perioxidase (HRP) method have been found to affect the staining and have permitted differentiation of three main classes of complex carbohydrates in the rat alimentary tract. Class I mucosubstances lose and class II and III paradoxically gain concanavalin A-horseradish peroxidase reactivity after periodate oxidation. Class II mucosubstances lose whereas class III retain or increase their reactivity with a reduction step interposed between oxidation and concanavalin A-horseradish peroxidase staining. Mucous neck cells, pyloric glands, Brunner's glands and mast cells exhibit strong class III staining, whereas other sites such as intestinal goblet and salivary gland acini differ widely in their type of staining. Liver glycogen stains like mucosubstances in an unstable subgroup of class III. The paradoxical increase in concanavalin A binding during oxidation correlates with the appearance of Schiff reactivity implicating oxidation of vicinal hydroxyls as the basis for the effect. The periodate-induced staining is therefore, thought to result from an oxidative disruption of linkages between vicinal hydroxyls of neighboring sugars and hydroxyls of mannose required for concanavalin A binding. Staining with the described concanavalin A-horseradish peroxidase variants appears to afford information concerning cytochemical distribution of mannose-rich glycoproteins as well as differences among these substances in the relation of mannose to neighboring sugars.


Localization of kallikrein in the coagulating and submandibular glands of the guinea pig.

Antibody to pure kallikrein from the coagulating gland of the guinea pig was used to localize kallikrein in the gland by immunofluorescence techniques. This antibody also reacted with the guinea pig's submandibular gland kallikrein. The specific fluorescence in the coagulating gland was present diffusely in all secretory cells lining the crypts. In contrast to its diffuse location in the coagulating gland, kallikrein in the submandibular gland was specifically located in the luminal border of striated and some larger duct cells, whereas the acinar cells and interstitial tissue showed no significant fluorescence.


Pederasty, heroism, and the family in classical Greece.

Male homosexuality in Classical Greece found its expression in relationships that conformed to a pederastic model. This socially endorsed hierarchical relationship between older lover and younger beloved can be understood as an integral part of the culture by examining the concept of heroism and of the ideal warrior/hero presented in the poems of Homer and discussed in classical literature. Pederasty functioned to support the family and the continued primacy of masculine values and ethics. There is evidence that by the Classical period, traditional views, formed on the model of the warrior/hero, were undergoing a weakening and confusion. Social critics of the time rediculed these weaknesses and urged a return to values that stressed the dominance and strength of the hero.


Decreased VO2 consumption during exercise with elicitation of the relaxation response.

Oxygen consumption is usually considered to be predictable and unalterable at a fixed work intensity. The relaxation response is hypothesized to be an integrated hypothalamic response which results in generalized decreased sympathetic nervous system activity. One physiologic manifestation of the relaxation response is decreased oxygen consumption. The possibility that the elicitation of the relaxation response could decrease oxygen consumption at a fixed work intensity was investigated. Oxygen consumption was decreased 4 percent (p less than 0.05) in eight subjects working at a fixed intensity when the relaxation response was simultaneously elicited.


Biochemical and functional characteristics of the plasma membrane of macrophages from BCG-infected mice.

A set of quantitative signs of activation, previously developed in studies of inflammatory peritoneal macrophages, has been applied to the study of immunologically stimulated peritoneal cells. Mice that are infected systemically with Bacillus Calmette Guérin (BCG) and then challenged locally with soluble mycobacterial antigens generate populations of cells that spread rapidly in culture, display an elevated pinocytic rate, ingest IgMC-coated sheep erythrocytes, and have diminished levels of 5'-nucleotidase activity. These effects depend on sensitization with live organisms, require secondary antigenic challenge, and develop on the same schedule as does effective cell-mediated immunity. The challenge is antigen specific and cannot be replaced by a nonspecific inflammatory stimulus. Thus, the characteristics of inflammatory macrophages that were previously defined are applicable to the study of immunologically mediated macrophage activation. Cells sharing this pattern of characteristics, whatever their mode of generation, are proposed to represent a distinct class of differentiated macrophages, as compared with the resident macrophage population.


Functional properties of EL-4 tumor cells with lipid-altered membranes.

The effect of fatty acid substitution of membrane phosphatides on a number of surface-mediated phenomena in EL-4 cells was examined. Tumor cells were grown in the presence of fatty acids that could be expected, on the basis of their physical properties, either to stiffen or fluidize the plasma membrane. Substitution of EL-4 cell membrane phosphatides with as much as 74% nonadecanoic acid (19:0) had no effect on either conjugation with effector cells or subsequent cytolysis by the effector cells. Substitution with linolenic acid (18:3) or elaidic acid (18:1trans) likewise affected neither conjugation nor cytolysis. Substitution with these fatty acids also had no effect on the susceptibility of EL-4 cells to cytolysis by antibody plus complement. On the other hand, the rate of patching of H-2 surface antigens was very sensitive to substitution by both 19:0 and 18:3. Although not conclusive, these results suggest that alterations of the fluid state of the membrane that affect lateral movements of surface proteins may not affect cytolytic processes.


Altered immune responsiveness associated with experimental syphilis in the rabbit: elevated IgM and depressed IgG responses to sheep erythrocytes.

Generalized suppression of immunoglobulin G (IgG) synthesis detectable by depressed responses to heterologous antigens may be a mechanism by which certain parasites evade host defenses and establish chronic infections. To determine if such a mechanism occurs in syphilis, rabbits were infected with Treponema pallidum, and at weekly intervals thereafter these rabbits and uninfected controls were sensitized with SRBC. Seven days later the number of antibody-forming cells present in the spleen was determined by the Jerne plaque technique. After a transient suppression in the 1st week, IgM-PFC were elevated from up to 7 weeks after infection. The IgG response to SRBC was depressed early in infection and continued to decline to less than one-tenth of control levels over the next few weeks persisting throughout overt infection and returning to normal by the end of 2 months. IgG-PFC, and 2-ME-resistant hemagglutinins and hemolysins were also significantly depressed in infected rabbits after two immunizing doses of SRBC. These results suggest that the depressed IgG response caused by syphilitic infection may enable treponemes to evade host immunity by interfering with immunoregulatory mechanisms.


The evolution of immunosuppressive cell populations in experimental mycobacterial infection.

Immunosuppressor activity of considerable potency and complexity was generated during the course of chronic, progressive infection of C3H/Anf mice by Mycobacterium lepraemurium. From the 5th through 10th week after inoculation, spleen cells from infected mice mildly but reproducibly suppressed the direct plaque-forming cell response of normal spleen cell cultures to sheep erythrocytes. Suppression at this stage of infection was mediated by cells with macrophage-like characteristics. A marked increase in splenic suppressor activity at 10 to 11 weeks was associated with the appearance of a second suppressor cell subpopulation composed of T lymphocytes. The appearance of these cells was closely related in time to the onset of rapid splenic enlargement and a loss of cutaneous delayed type hypersensitivity to antigens of M. lepraemurium in mice at 10 to 11 weeks of infection. Suppressor cells were not present in peripheral lymph nodes until terminal infection at 22 to 25 weeks. Suppressor spleen cells depressed the T-dependent antibody response most severely, but there was also a direct effect upon B cells as shown by moderate suppression of responses to TNP-LPS and DNP-Ficoll. Spleen cells from 14-week-infected mice generated a soluble suppressor factor(s) that induces depression of moderate severity, however, the immunosuppression by intact cells was far greater.


Immunochemistry of Salmonella O-antigens: preparation of an octasaccharide-bovine serum albumin immunogen representative of Salmonella serogroup B O-antigen and characterization of the antibody response.

The O-antigenic polysaccharide of phenol-water extracted Salmonella typhimurium (O antigens 4, 12) lipopolysaccharide was enzymatically cleaved by phage P22 endorhamnosidase. An octasaccharide with the (formula: see text) structure Gal-Man-Rha-Gal-Man-Rha was isolated and shown to retain the O-antigen 4 specificity of the native polysaccharide. After oxidation of the terminal reducing rhamnose residue to the corresponding aldonic acid, the octasaccharide was covalently linked to bovine serum albumin (OLS-BSA) by use of a water-soluble carbodimide. The resulting conjugate showed O-antigen 4 specificity in enzyme-linked immunosorbent assay (ELISA) ans passive hemagglutination inhibition tests. Immunization of rabbits with the OLS-BSA conjugate gave rise to antibodies directed toward both the octasaccharide and the carrier protein. ELISA titration with synthetic disaccharide-protein conjugates as antigens revealed that the antibody titer against the mannose-rhamnose structure was higher than against the abequose-mannose structure. In rabbits immunized with heat-killed whole bacteria the titers against the two disaccharides were equal. The reason for this difference is not obvious. It is evident, however, that the OLS-BSA conjugate elicited in rabbits O-antibodies with the same specificity as whole bacteria.


Lipopolysaccharide induction of IgM antibodies to polyadenylic acid in normal mice.

Lipopolysaccharide (LPS) is able to induce autoantibodies reversibly in normal mice. Single or multiple doses of LPS induced a rapid and dose-dependent rise in antibodies to Poly A from 113 ng to 590 ng/ml serum as determined by Millipore filter radioimmunoassay. The response peaked at day 3 and was over by day 21. No response was seen if the LPS was chemically inactivated or injected into genetically nonresponsive mice. Antibodies were specific for Poly A and were not induced by T cell mitogens. Sucrose gradient ultracentrifugation demonstrated only IgM antibody. Neonatal thymectomy altered neither the immunoglobulin class nor quantity of antibody. Neonatal splenectomy did not affect antibody class but reduced the amount produced. No free Poly A could be detected in circulation after LPS stimulation. These findings suggest that normal mice have B lymphocytes capable of limited and reversible autoantibody production.


Sequential expression of immunoglobulin on developing mouse B lymphocytes: a systematic survey that suggests a model for the generation of immunoglobulin isotype diversity.

Paired immunofluorescent staining with antibodies specific for the major isotypes of mouse immunoglobulin was used to study the ontogenetic expression of diversity of cell surface immunoglobulin. The first B lymphocytes to emerge, derived from cytoplasmic IgM+ precursors, express sIgM exclusively. Between birth and 3 days of age separate populations of sIgM+ B lymphocyte acquire a second isotype: sIgD, one of the subclasses of sIgG, or sIgA. At 3 days, all splenic B lymphocytes that bear sIg or sIgA also express sIgM, but virtually none stain for sIgD. By 7 days, a substantial porportion of sIgG+ or sIgA+ lymphocytes in spleen and most of those in lymph node express both sIgM ans sIgD. Anti-mu antibody treatment from birth prevented development of B lymphocytes expressing any isotype. These observations suggest that the immature sIgM+ B lymphocyte is the pivotal cell in the generation of the different sublines of B cells and that sIgD ig or IgA. The frequency of lymphocytes bearing only sIgG or sIgA is higher in old than in young mice, suggesting that sIgD and sIgM may be lost after stimulation by antigens. The occurrence of a nearly identical distribution of sIg isotypes on B lymphocytes from athymic, pathogen-free mice suggests that primary expression of isotype diversity does not require T cells.


Improved immunoadsorption procedure with anion-exchange bacterial cell columns.

Bacterial cell columns for immunoadsorption were prepared with Streptococcus cells and triethylaminoethyl cellulose (Cellex-T) matrix material as a model system. Good column flow properties and satisfactory retention of the cells were obtained with ratios as high as 2 ml of packed cells/3 g dry weight of cellulose. Anion-exchange fractionation of whole serum by the Cellex-T was prevented by using 0.25 M NaCl in the developing buffer. Antibodies were adsorbed directly from whole serum and recovered in high yield by desorption at pH 2.3. Pre-exposing bacterial cells to formalin and washing them with acetone was necessary to ensure that they remained on the columns. One strain of Streptococcus salivarius (SS 908) was satisfactorily retained on a column only after cells were labeled with fluorescein isothiocyanate and washed with acetone. The means by which Cellex-T retains bacterial cells appears to be a combination of electronic attraction and physical entrapment.


Epidemiology of group B Streptococcus: longitudinal observations during pregnancy.

A longitudinal, three-year study of the epidemiology of group B Streptococcus was conducted with repeated (four to 11) observations of 382 patients followed through pregnancy, delivery, and the postpartum period. Group B streptococci (2.3% of which were nonhemolytic) were isolated from the birth canal at first visit from 15% of the patients and from 28% with repeated cultures. Overall, group B streptococci were isolated at 12% of culture visits. Streptococcal carriage was significantly less common among patients who were Mexican-American, 20 years old or older, or in a fourth or later pregnancy. Multivariate analysis indicated that each of these three factors had a significant, independent bearing upon carriage of group B streptococci. Of 108 patients harboring these organisms in the birth canal, 36% could be classified as chronic, 20% as transient, and 15% as intermittent carriers. The relationship of infant colonization to the presence of streptococci in the birth canal at delivery and not to previous or subsequent carriage by the mother was consistent with the observation that maternal colonization was often inconstant.


Microflora of the cervix during normal labor and the puerperium.

The normal flora of the cervix was studied in 50 healthy women in labor and on the third day postpartum. Aerobic bacteria were the exclusvie isolates in 25% of these women, and 75% had anaerobic bacteria in addition to aerobes. Anaerobes were always found in association with aerobes. The most frequent isolate of Bacteroides was Bacteroides melaninogenicus, found in 20% of the women during labor and 14% during the puerperium. Bacteroides fragilis was distinctly absent during labor but was found in 6.8% of the women during the puerperium. Clostridia were found in 1% but histotoxic clostridia were not found. None had gram-negative diplococci (Neisseria or Veillonella). Gram-negative diplococci and spore-bearing bacilli visible by gram strain and B. fragilis demonstrated by culture, if present in the cervical specimens obtaineduring labor, should be considered abnormal.


Enzyme immunoassay of antibody to Rochalimaea quintana: diagnosis of trench fever and serologic cross-reactions among other rickettsiae.

Enzyme immunoassay (EIA) tests were used to diagnose trench fever and to determine cross-reactions of Rochalimaea quintana with other rickettsiae. The results were compared with those obtained by counterimmunoelectrophoresis (CIE). All sera from cases of primary or relapsed forms of trench fever were positive both in EIA, with serum antibody titers of 1:20-1:640, and in CIE, giving one to three precipitin lines. Sera from patients with other rickettsial infections were also tested for reactivity with R. quintana antigen: typhus group (Rickettsia prowazekii, Ricketsia mooseri), 15 sera; spotted fever group (Ricketsia ricketsii, Rickettsia akari), eight sera; and scrub typhus (Rickettsia tsutsugamushi), six sera. Strong reactions occurred with four sera from patients with scrub typhus, giving one or two lines in CIE and EIA titers of 1:40-1:160; these results were extended to guinea pig antisera to R. tsutsugamushi. About 50% of typhus group sera reacted with a single line in CIE and had antibody titers of 1:20-1:80 by EIA. The results show that EIA is accurate for the diagnosis of trench fever and, with the results obtained by CIE, suggest that R. quintana is antigenically related to R. tsutsugamushi and possibly to rickettsiae in the typhus group as well.


A double-blind, controlled trial of levamisole in the treatment of recurrent herpes labialis.

A double-blind, controlled trial of levamisole in the prevention and treatment of recurrent cold sores was performed. Forty-eight subjects received levamisole in a dosage of 2.5 mg/kg on two consecutive days each week for six months. The 51 control subjects were given a placebo identical to the drug in appearance. Both groups were given the same instructions. Nineteen subjects receiving levamisole and eight receiving placebo withdrew during the six months of the study. There were no significant differences between the levamisole-treated and control groups in the duration or severity of the lesions during the trial period or in the subjective assessment of drug efficacy by the participants at the end of the trial. Before treatment the frequency of lesions in the levamisole group was higher than in the control group. Only when this factor was taken into account by analysis of covariance did the decreased frequency of lesions during therapy appear significantly lower in the group receiving levamisole than in the placebo group. The difference remained clinically unimpressive. This study does not support earlier suggestions that levamisole, in these doses, is useful in the treatment of recrudescent circumoral herpesvirus infections.


Epidemiology of Escherichia coli in the United States.

Current evidence suggests that diarrheagenic E. coli are not important causes of disease in the sanitized urban centers of the United States at this time. However, enterotoxigenic E. coli are a leading cause of diarrhea among travelers who visit developing countries. The failure of diarrheagenic E. coli pathogens to gain a foothold in this country, despite problems with enteropathogenic E. coli in nurseries during the 1940s and 1950s and the more recent multiple introductions of enterotoxigenic E. coli by travelers returning from developing areas of the world, demonstrates the epidemiologic impotence of diarrheagenic E. coli in the relatively sanitized environment of the United States. Nondiarrheagenic E. coli seem to be major pathogens in community-acquired and nosocomial infections in extraintestinal sites.


Invasive Escherichia coli.

The present evidence indicates that Shigella-like pathogenicity is determined by a multiplacity of genes. Although deliberate attempts have been made to confer invasive virulence on E. coli strain K12 by employing classical procedures of recombination with virulent S. flexneri donor strains, they have not yet been successful. While we should, theoretically, be able to achieve this, the practical problem of testing for pathogenicity precludes screening larger numbers of hybrid clones for the acquisition of virulence. This increases the difficulty of successfully realizing that end. Nevertheless, since invasive-type pathogenicity is determined by multiple genetic loci, we consider it unlikely that random insertion of foreign DNA into the E. coli K12 genome could supply all of the genetic information necessary to convert this organism into an invasive enteric pathogen.


Factors affecting virulence in Escherichia coli urinary tract infections.

The prevalence of E. coli relative to other bacteria in the urinary tract is assumed to be the result of its proximity to and its close relationship with the gastrointestinal tract. Strains on E. coli may establish themselves more readily in the urinary tract, and/or invade the upper urinary tract, if they have a number of different virulence factors. The relative importance of these factors in the development of urinary tract infection, with or without renal involvement, is not clear. In addition, the means by which these factors may increase the virulence of E. coli are not understood, although there seems to be some evidence that the K antigens alter resistance to phagocytosis and serum bactericidal activity %9,10]. The main reason that certain E. coli serotypes are cultured from the urinary tract, however, still seems to be their dominance in the stool. The broader question of why certain O serotypes of E. coli dominate the bowel flora has not been examined adequately. The studies suggesting that the K antigen is a significant virulence factor seem to be in conflict with other studies indicating the dominance of certain serotypes of E. coli in the stool and in urinary tract infections. A resolution of this dilemma may possibly be found in the recent observations of Dr. Frits Orskov [20] and others discussed elsewhere at this meeting that the K and O serotypes appear to be interrelated.


Some characteristics of Escherichia coli strains isolated from extraintestinal infections of humans.

Escherichia coli strains isolated from extraintestinal infections of humans possess a constellation of phenotypes not usually found in random fecal isolates, enteropathogenic strains, or the laboratory strain E. coli K12. The phenotypes found more commonly in extraintestinal strains include hemolysin production, the biosynthesis of colicin V, and the hemagglutination of human erythrocytes in the presence of D-mannose (HAh). Hemolysin is assumed to be a cytotoxic factor, colicin V is assumed to interfere with host defense mechanisms, and HAh is assumed to play a role in specific tissue adherence. In addition, greater than or equal to 50% of E. coli strains from extraintestinal infections kill allantoically inoculated 13-day-old chick embryos. Some (20%) of the fecal E. coli also kill embryos, but E. coli K12 is innocuous in this virulence model. The plasmids for hemolysin and colicin V production have been transmitted to E. coli K12 derivatives but are not sufficient to convert laboratory strains to a form virulent for the chick embryo.


Mobilization of the Escherichia coli plasmid ColE1 (colicin E1) and ColE1 vectors used in recombinant DNA experiments.

The Escherichia coli Co1E1 plasmid, which codes for production of colicin E1, is inherently nontransferable (nonconjugative) by bacterial mating. Co1E1 can be transmitted at mating by a process called mobilization if Co1E1 is coresident with a transfer plasmid. Mobilization is governed in part by a Co1E1 gene called mob. Co1E1 is mob+. Several Co1E1 derivatives employed in recombinant DNA experiments, notably pBR313 and pBR322, are mob-. These cloning vehicles are mobilized at markedly reduced frequency relative to Co1E1. E. coli K12 carrying either pBR313 or pBR322 represents a useful host vector system for recombinant DNA experiments and affords a significant degree of biological containment.


Pathogenesis of bacteremia due to Pseudomonas aeruginosa in cyclophosphamide-treated mice and potentiation of virulence of endogenous streptococci.

Mice treated with cyclophosphamide on day 0 were killed at sequential intervals during subsequent administration of Pseudomonas aeruginosa in drinking water and were examined for sites of bacterial colonization and multiplication with use of peroxidase-labeled antibody and culture techniques. These studies were coordinated with those of clinical and histopathologic changes. Bacterial antigen was first detected on day 4 on the surface of nasal squamocolumnar junctions and the stratum corneum of gingival sulci and crests. Invasion of tissue by P. aeruginosa proceeded rapidly from these sites and led to bacteremia. There was no invasion of the lower alimentary canal. Endogenous group B beta-hemolytic streptococci colonized and penetrated ulcers created by previous pseudomonas invasion. These results suggest that epithelial colonization is the critical event in the pathogenesis of bacteremia due to P. aeruginosa in the immunosuppressed host. The resulting infection may provide a conduit for invasion and enhancement of the virulence of endogenous streptococci.


Probenecid and the antibacterial activity of cephradine in vivo.

The influence of probenecid on the concentrations in blood and antibacterial efficacy of cephradine was studied in experimentally infected mice. An infection was induced by injection of 5 X 10(6) Escherichia coli into the thighs of irradiated, granulocytopenic mice. Probenecid was given 1 hr later, just before the administration of cephradine. The control animals received only the vehicle. Concentrations of cephradine in blood were determined for 2 hr; the antibacterial activity was estimated from bacterial counts made in the homogenized individual thighs. The blood concentrations of cephradine were 1.77 times higher in the probenecid-treated animals than in the controls. The potency ratio for doses was 2.41, the potency ratio for the areas under the drug concentration in blood vs. time curves was 1.34, and that for the peak blood concentrations was 1.43.


The fourth auditory ossicle: fact or fantasy?

The fourth auditory ossicle (the Os Orbiculare or Lenticulare, or the Osselet of Sylvius) was described and depicted in all books on anatomy or otology up to the turn of the century. Its presence is no longer observed nowadays, despite the thousands of micro-surgical operations performed on the middle ear and its ossicular chain.


Experimental scleroma. A histopathological study.

Klebsilla rhinoscleromatis suspension was experimentally inoculated into the nose and maxillary sinus of eight adult healthy rabbits. Two normal litter-mates served as controls. The animals were killed at varying intervals up to five months following the inoculation. Histopathological examination of the upper and lower respiratory tracts revealed a consistent pulmonary peribronchial and perivascular granulomatous reaction with a Mikulic cell-like appearance. The reaction was present in all the inoculated rabbits and increased in severity as the survival period was prolonged. The significance of these findings in the aetiopathogenesis of scleroma and to scleroma in humans is discussed.


Plasma testosterone profiles in male macropodid marsupials.

Serial blood samples were collected over a 3.5-8 h period from ten adult male macropodid marsupials belonging to five different species to study the pattern of testosterone secretion. The concentration of testosterone in the plasma ranged from 0.5 to 9.5 ng/ml, and in each animal the levels declined progressively during the study; this effect was attributed to the stress effects of handling. Injection of 5 microgram synthetic luteinizing hormone releasing hormone induced a rapid and substantial increase in the level of testosterone.


Steroid priming of the luteinizing hormone response to luteinizing hormone releasing hormone.

Perifusion experiments were performed to study the stimulatory effects of luteinizing hormone releasing hormone (LH-RH) on the release of LH from anterior pituitary tissue. Exposure of pituitary tissue from normal male rats to LH-RH (5 ng/ml for 5 min) induced a small release of LH; in tissue from ovariectomized rats receiving no pretreatment, the release was more than three times greater and in tissue from gonadectomized male or female rats pretreated with oestradiol benzoate and progesterone, the release was six times greater than that observed in normal rats. Further exposure of pituitary tissue from gonadectomized steroid-pretreated male and female rats to LH-RH (5 ng/ml) induced an increase in the level of LH even greater than that seen after the initial exposure (priming action of LH-RH); in tissue from ovariectomized rats receiving no pretreatment, less LH was released than after the first exposure to LH-RH and in tissue from normal male rats the response was unchanged.


Effects of dexamethasone on the responses of luteinizing hormone and testosterone to two injections of luteinizing hormone releasing hormone in young postpubertal bulls.

Six young postpubertal bulls were studied in two experiments, 3 months apart. In experiment 1, three bulls received i.m. injections of dexamethasone (20 mg) and 5 h later these animals plus three control bulls received i.m. injections of luteinizing hormone releasing hormone (LH-RH, 250 microgram). In experiment 2, the controls from experiment 1 received dexamethasone and the treated animals from experiment 1 acted as controls for experiment 2. All bulls also received an i.m. injection of 250 microgram LH-RH on day 2 of each experiment. The concentrations of LH and testosterone in samples of jugular blood were determined by radioimmunoassay. There were no significant differences in the patterns of testosterone and LH release between the two experiments. On day 1, the response of LH to LH-RH was significantly (P less than 0.05) reduced by dexamethasone, but on day 2 values in the control and treated groups were similar although significantly (P less than 0.05) lower than values on day 1. The response of testosterone to LH-RH was not affected by dexamethasone. These results are discussed in terms of the site of action at which dexamethasone may act to depress the release of LH.


Effects of gonadal steroids and cycloheximide on the release of gonadotrophins by rat pituitary cells in culture.

The effects of oestradiol-17beta, testosterone and progesterone alone and together with cycloheximide on the basal and gonadotrophin releasing hormone (Gn-RH)-induced release of gonadotrophins were studied in cultured dispersed rat pituitary cells. In the control group (no steroid treatment), GnRH significantly stimulated the release of LH and FSH; cycloheximide partially inhibited this response, although it had no effect on the basal secretion of gonadotrophins. A dose of 5 ng oestradiol/ml had no significant effect on the response to GnRH; at a dose of 100 ng/ml the GnRH-induced release of LH was significantly augmented whereas the release of FSH was inhibited. Cycloheximide blocked the augmenting effect of oestradiol. The basal release of LH was slightly but significantly inhibited in response to 10 ng testosterone/ml and increased in response to progesterone (200 ng/ml). Testosterone at both dose levels and progesterone significantly inhibited the GnRH-induced release of LH and FSH and in testosterone and progesterone-treated groups, the response to GnRH was inhibited by cycloheximide, but not beyond the levels observed in the control group. It is concluded that steroids can act directly on the pituitary cells, that oestradiol stimulates the GnRH-induced release of LH and that cycloheximide blocks this stimulatory effect. Testosterone and progesterone, on the other hand, partially inhibit the response to GnRH.


The care of facial lacerations.

The final cosmetic and functional result of closure of a facial wound is many times determined by the promptness and appropriateness of initial care. This includes keeping the wound clean and not adding to the injury. A decision must then be made at the level of primary care to carry out the closure or refer the patient to someone with more expertise. This decision depends on many things including the condition of the wound, the type of wound, and the experience of the primary physician. It is important in the care of the wound that it be properly cleaned and debrided. Fine suture and accurate approximation of the wound edges are also extremely important. Careful follow-up of the wound for potential infection, suture reaction, etc, with removal of sutures as soon as possible, greatly enhances the healing of the wound. These points are discussed in detail with guidelines for making the decisions and providing good wound closure.


Transfection of Escherichia coli spheroplasts: infectious lambda prophage DNA.

High mol. wt. DNA was extracted from Escherichia coli lambda lysogens and was shown to be infectious. Its infectivity was due to prophage DNA integrated into the host chromosome rather than to DNA released from mature phage particles, as established by the following criteria: the titre of infectious DNA exceeded by 100-fold the titre of infectious units present before DNA extraction; mild shear selectively reduced prophage DNA infectivity to 2% of the unsheared DNA while lambda phage DNA infectivity retained 50% of its infectivity; DNA extracted from an E. coli (lambda c857 tsxisam6) lysogen yielded 200 times as many plaques on sup+ than on sup- spheroplasts. Thus lambda prophage DNA infectivity depends on expression of the excision gene while the infectivity of non-integrated forms of lambda does not. About 10(4) genome equivalents of E. coli DNA yielded one infectious centre unit in this assay system; this high infectivity should make prophage DNA a useful marker in genetic transformation experiments.


Evidence for three populations by size in L5 spinal ganglion in man.

In recent morphometric studies of the cytons of lumbar motoneuron columns, it was possible to discriminate various populations by the criterion of size. It was felt that the use of celloidin embedding, optimal enlargement to increase the number of counting windows, and the use of improved morphometric analysis had been important to this discrimination. Employing the improved methods of histologic preparation and morphometry to a study of the L5 spinal ganglia of man, it has been possible to show tentatively that there are at least three populations of cytons by diameter. The average number of large, intermediate and small cytons were 11,429, 31,675, and 25,389 respectively. It should now be possible to test whether selective congenital absence or degeneration of any of these three populations of cell bodies is found in disorders affecting primary afferent neurons.


Ultracryotomy of nerve-electroplaque synapses for immunocytochemistry.

In order to carry out ultrastructural immunocytochemical localization of acetylcholinesterase at cholinergic synapses, ultrathin frozen sections of aldehyde-fixed electric organs of Electrophorus and Torpedo were obtained by a modified ultracryotome technique. Dry frozen sections, picked up with rabbit serum and negatively stained, revealed, in the postsynaptic regions of the neuro-electroplaque junction, the presence of numerous rod-like or pin-headed protrusions (30 X 40 A) attached perpendicularly at 60 A intervals to the hydrophobic lamina of the plasma membrane, forming a comb-like structure oriented toward the synaptic cleft. A possible correlation is suggested between this comb-like structure and the 'acetylcholine receptors' observed by other authors with high resolution electron microscopy either after classical preparative techniques or after freeze-etching, of the postsynaptic membrane of vertebrae cholinergic synapses.


Continuous suturing for microvascular anastomosis. Technical note.

A continuous suture technique for the microsurgical end-to-side anastomosis of extracranial to intracranial arteries is described. This method combines the speed and even tension of a continuous suture line with improved visualization of the arteries to be anastomosed.


Immune surveillance and tumors of the nervous system.

The theory of immune surveillance postulates that one function of the immune system is to eliminate small numbers of malignant cells that arise spontaneously within the organism. Although there has been a great deal of both clinical and experimental evidence in favor of thistheory as it applies to general oncology, the question of whether or not such a surveillance system would be effective for tumors arising within the nervous system has never been studied. The young of pregnant rats which had been exposed to the neurocarcinogen ethylnitrosourea (ENU) were divided into control, immunosuppressed, and immunoenhanced groups. These lifetime alterations of the immune system had no effect on the course of nervous system tumor fromation. We believe that the most likely explanation for our results is that the "immunological privilege" of the brain prevents the usual interaction of the neoplasm and the immune system from occurring.


Radiometric estimation of the replication time of bacteria in culture: an objective and precise approach to quantitative microbiology.

In a recently developed, two-compartment liquid scintillation vial, the evolution of 14CO2 resulting from bacterial metabolism of uniformly labeled d-glucose was measured sensitively, cumulatively, and automatically in a liquid-scintillation counter. In each of eight species tested, a period of log-linear expansion of cumulative counting rate with time was observed. The exponential increase in cumulative counting rate was related to cell replication time by the integral of a first-order differential equation. Within a given species, the replication time measured by radioassay was found to be remarkably constant, unaffected by a fourfold variation in the activity of added labeled d-glucose, insensitive to the presence of carrier dextrose, and independent of the number of bacteria in the initial inoculum over a range of five orders of magnitude. These experiments demonstrate that the replication rate of an organism in culture is a highly reproducible characteristic that is susceptible to precise radiometric measurement in fundamental units of time under a variety of experimental conditions.


Plasmodium berghei infection in pregnant rats: effects on antibody response and course of infection in offspring.

The effects of primary, patent Plasmodium berghei infection in Sprague-Dawley rats during pregnancy upon the course of infection and the humoral antibody response to malaria in their offspring were examined. Malaria specific antibody determined by an indirect fluorescent antibody test correlated well with the parasitologic profiles of each experimental group. Utilization of foster mother groups indicated passive transfer of protective antibody through milk. Evidence for in utero sensitization by soluble malaria antigens was shown by an anamnestic-like antibody response during subsequent infection of offspring from infected mothers.


Bender Gestalt signs as indicants of conceptual impulsivity.

Sixty children were individually administered the Matching Familiar Figures Test and the Bender Gestalt Test. The mean age of the subjects was 10 years, 11 months. A significant relationship was found between errors on the Bender Gestalt test and impulsivity. More specifically, increased or decreased loops (figure four or six), change in angulation, loops for circles and circles for dots or dots for circles were all significantly related to children's impulsivity.


Black-white personality differences: another look.

Investigated the meaning of Black-White differences typically discovered on personality instruments by administering a pool of items derived from both the MMPI and California Psychological Inventory, as well as a group form of the Embedded Figures Test, to a sample of 226 black and white junior college students. A cluster analysis of the unexpectedly large number of inventory items significantly differentiating the two races produced reliable and meaningful configurations. Interpretations of race differences on these clusters and the EFT provide a new perspective on the meaning of Black-White personality differences.


The effects of mood upon imaginal thought.t.

The effects of mood upon imaginal thought were explored with a highly trained undergraduate female hypnotic subject. She was hypnotically programmed to experience free-floating anxiety or pleasure in varying degrees just before the exposure of combinations of three Blacky Pictures, and to produce dreamlike imagery in response to the Blacky stimuli while under sway of the mood. Data from 98 dream trials, separated by amnesia, indicated that the affective states clearly influenced imaginal processes. Blind ratings by a psychoanalyst showed anxiety moods to be more closely associated with primary-process features characteristic of nocturnal dreams, whereas pleasure had a relatively higher incidence of daydreamlike ratings. Empirical analysis of themes yielded significant relationships of anxiety to physical injury to the self and verbal aggression toward others; pleasure was associated with circular movements and overt sex themes.


Social cues, cognitive style, error magnitude, and male performance on the Felt Figure Replacement Technique.

A series of studies was undertaken to determine possible factors contributing to low predictive utility for Felt Figure Replacement Technique (FFRT) scores from normal, adult males. It was first postulated that normal adult males, compared to normal adult females, are less sensitive to social cues present in the FFRT task. Twenty-six undergraduate males and the same number of undergraduate females were asked to replace both a) department store manikins, thought to be less abstract, and then b) felt figures. While task differences were obtained, these were not dependent on gender, nor did any overall gender differences occur for three types of replacement error. The second study involved 31 college males and 33 college females replacing both felt figures and a male and female confederate. It was assumed that differential attention to social cues would be more visible in this comparison. The general results were identical to the first study.


A theoretical explanation of the dissociative reaction and a confirmatory case presentation.

A theoretical explanation for the classical distinction between the conversion and dissociative hysterias was advanced based on previous research with cases of conversion hysteria and multiple personality. The principles were illustrated and extended using Rorschach and Hand Test data from a fugue state.


Sporozoites of rodent and simian malaria, purified by anion exchangers, retain their immunogenicity and infectivity.

Sporozoites of rodent malaria, Plasmodium berghei, and simian malaria, Plasmodium knowlesi and Plasmodium cynomolgi, were partially separated from mosquito debris and microbial contaminants by passage of Anopheles material through a DEAE-cellulose column. In addition to eliminating most of the contaminants (80-90%), this simple technic has made it possible to recover rapidly large numbers of viable sporozoites (55-75% yield), which have retained their infectivity, immunogenicity, and capacity to react with known antisera. Mice injected with varying doses of column-purified sporozoites (CS) of P. berghei produced infections which paralleled those seen in the controls. Total protection against challenge with a potentially lethal dose of viable sporozoites was acquired by mice inoculated twice with irradiated CS of P. berghei CS of P. berghei and P. cynomolgi gave positive circumsporozoite precipitation (CSP) reactions, upon inoculation with the respective immune sera. The preservation of the surface antigens of CS was documented by immunofluorescence. It was shown that differences in elution behavior exist among sporozoites of certain species of Plasmodium as well as among sporozoiters of the same species derived from different organs of the mosquito. These results may be attributed to differences in the surface charge of the sporozoites or conditions in sample media. Purified sporozoites obtained by the method described in this report provide an adequate source of parasites for a variety of in vitro studies.


Checklist, host index, and annotated bibliography of Plasmodium from reptiles.

World literature on Plasmodium of squamate reptiles (1909-1975) includes 156 published accounts on 54 valid species and subspecies. AFRICA: 30 reports on 9 species; AUSTRALIA, ASIA & OCEANIA: 12 reports on 6 species and 2 subspecies; AMERICAS: 116 reports on 37 species. More than half of these reports and new species descriptions appeared during the last 10 years. Most concern plasmodia in lizards of the Neotropics, Georgia (Plasmodium floridense, a Neotropical-Caribbean parasite) and California (Plasmodium mexicanum). African host species are all lizards: 4 agamids, 3 skinks, 2 chamaeleonids, one chordyline, and one gerrhosaurine. Australasian host species are also all lizards: 6 agamids, 9 skinks, 2 lacertids, one (or two?) gekkonids, and one varanid. Known American host species include 12 snakes and 87 lizards: 34 anoline species, 12 sceloporines (plus 11 others experimentally infected), 4 basiliscines, 5 tropidurines, 2 iguanines, 2 skinks (one questionable), 2 anguids (a total of 4 animals), 4 sphaerodactylines, 2 gekkonines and 11 teiid species.


Biomedicine's failure to achieve Flexnerian standards of education.

The central principle of medical education advocated by Flexner was mastery of the scientific method and its application to all dimensions of medicine, whether the bench laboratory, the bedside, or the social arena. Not Flexner but the biomedical model has been responsible for curricular designs that have under stressed the application of the scientific method to clinical data and the more person-oriented, psychosocial dimensions of illness and patient care. Flexnerian standards of medical education have yet to be achieved.


Adhesion of fimbriate Escherichia coli to bovine mammary-gland epithelial cells in vitro.

The adhesion of bovine and a human isolate of Escherichia coli to epithelial cells from the teat and lactiferous sinuses of the udder was examined. Adhesion was detected with bacterial suspensions that produced mannose-sensitive agglutination of guinea-pig red cells. Adhesion to epithelial cells could be inhibited by mannose and the degree of adhesion occurring with a suspension correlated with its haemagglutinating activity. This demonstrated that fimbriae were responsible for the adhesion. The observation that whole milk inhibited attachment of E. coli to cells in vitro indicates that such attachment may not occur in vivo in the lactating cow.


The identification of pseudomonads and related bacteria in a clinical laboratory.

Non-fermenting, catalase-positive Gram-negative bacilli that grow on nutrient agar are often isolated in clinical laboratories. We have applied biochemical techniques appropriate to a typical clinical microbiology laboratory, and for the most part described in Cowan and Steel's Manual for the identification of medical bacteria (Cowan, 1974), to 428 clinical isolates and have evolved a scheme for their identification. Organisms were subdivided into groups on the basis of three tests, namely the glucose oxidation-fermentation test and tests for oxidase activity and motility. A choice was then made among other tests to produce indentification tables, containing only the most useful tests, for the various groups. The most complicated table has only 16 tests. This simple system identified 96.5% of the 428 organisms, as well as many subsequent isolates of the more common organisms.


Effects of choleragenoid and glucose on the response of dog intestine to escherichia coli enterotoxins.

Culture superantes of Escherichia coli from diarrhoea patients were tested in dog jejunal loops for thermostable (ST) and thermolabile (LT) enterotoxins. Pre-treatment with choleragenoid blocked LT but not ST. Glucose was found to reduce fluid accumulation induced by both types of enterotoxin. The findings confirm and extend previous evidence of similarities between cholera toxin and E. coli LT and differences between it and E. coli ST.


Interaction between erythromycin and lincomycin in Streptococcus pyogenes.

Ten strains of Streptococcus pyogenes isolated were moderately resistant to erythromycin and highly but paradoxically resistant to lincomycin, and they showed antagonism between the two antibiotics. Another strain was moderately resistant to erythromycin and sensitive to lincomycin, and it showed synergism between the two antibodies.


Hydrogen sulphide-positive strains of Escherichia coli from swine.

Thirty-two H2S-positive strains of Escherichia coli, isolated from the caecal contents or mesenteric lymph nodes or both of 60 apparently healthy pigs, were characterized. Eighteen different serotypes and 18 different fermentative types were found. During conjugation with E. coli K12, four strains transferred their Hys plasmids linked to Raf, and another transferred Hys associated with the Tc determinant. All Hys-Raf plasmids belong to incompatibility group FI, whilst Tc-Hys is an Fi- plasmid.


Carriage of Cryptococcus neoformans in the crops of pigeons.

Cryptococcus neoformans was found in the crops of four (1.3%) of 319 pigeons in the Charity Bird Hospital and the University Campus, Delhi. It was demonstrated repeatedly at the Bird Hospital in old pigeon excreta as well as in the air. The findings substantiate the current view that the pigeon itself is not a reservoir of C. neoformans although it may serve as a carrier of the fungus.


Relationship between gene function and gene location in Escherichia coli.

Genes of Escherichia coli were grouped according to the "biochemical relatedness" of the enzymes they specifiy, using two schemes to determine relatedness: similarity of reaction or similarity of reactants. The tendency of biochemically related genes as so defined to lie approximately 90 degrees or 180 degrees from one another on the circular genetic map was analyzed statistically. Of the classes analyzed, only the genes for the enzymes of glucose catabolism showed a significant departure from random distribution in this respect. The glucose catabolism genes showed a pronounced tendency to lie either 90 degrees of 180 degrees from one another (P = ca. 10(-9)), and, furthermore, most of these genes were found to lie in only four gene clusters on the E. coli genome. The significance of this observation is discussed in relation to evolutionary mechanisms and to mechanisms of gene expression.


Molecular conformation and protein binding affinity of progestins.

Analysis of X-ray data concerning 277 estranes, androstanes, and pregnanes and comparison with progesterone receptor binding data have prompted the following observations. In general: 1. The flexibility of natural steroid hormones permits them to take up conformations optimal for binding to sites on proteins that vary in individual structural requirements. 2. When substituents strain the fused ring system, the strain will be delocalized and often transmitted to the most flexible point of the molecule, thus giving rise to conformational transmission effects. Consequently, substituents will generally stabilize a specific conformation, limiting protein interaction and enhancing a specific hormone response. 3. Hydrogen bond patterns in crystals can be used to predict points of active site attachment. 4. Distortions resulting from crystal packing forms are insignificant. Progestin receptor binding affinity: 5. Complementarity of fit is not specific on the alpha and beta faces of the B, C, and D rings. 6. The delta4-3-one composition is the only consistently required element. 7. Five of the eight highest-affinity binders have inverted A rings. Others may be easily converted to it. 8. The inverted A ring is proposed as the optimal conformation and primary factor controlling binding. 9. An A ring binding pattern is apparent in other steroidal hormones. 10. The D-ring region is open to contribute to conformational change in the receptor or genome interaction.


Enzymatic modulation of hormonal action at the target tissue.

The relevance of metabolism of steroids in target tissues to hormonal action is discussed. Two mechanisms of metabolic regulation at the cellular level are considered: formation of active steroids from steroidal prehormones, and controlled conversion of the active compound to inactive metabolites. Factors regulating the direction in which interconversions between active hormones and inactive metabolites preferentially proceed are mentioned; methods of estimating the preferred direction in vitro and in vivo are described and examples are given. The estradiol-estrone system in human endometrium is used to describe a case in which a hormone (progesterone) induces an enzymatic activity (17 beta-hydroxysteroid dehydrogenase) and lowers the intracellular/extracellular ratio of concentrations of the active hormone (estradiol) by increasing its conversion to an inactive, or less active, metabolite (estrone). That hormone metabolism can effectively determine the level of unbound hormone available for association to receptors is shown with published data on estradiol in human endometrium, using a kinetic analysis in which binding and Michaelis-Menten equations are combined.


Role of sulfate conjugation in estrogen metabolism and activity.

There has been an increasing interest in the sulfate conjugates of estrogens as important metabolites in steroid hormone homeostasis and activity. In women estrogen sulfates have been known as major components of plasma originating from ovarian secretion and hepatic metabolism. However, only recently has the capacity to sulfurylate estrogens been demonstrated in estrogen target tissues. Porcine uterus estrogen sulfotransferase appears only after the first complete estrous cycle. Following puberty, gilt uterine sulfurylation of estrogens is extremely active during diestrus, whereas estrogen sulfotransferase is not present during estrus. This cycling of estrogen sulfurylation in porcine and human uteri can be related directly to plasma progesterone levels. Rodent and human mammary tumors are also highly active in both steroid alcohol and estrogen sulfotransferases. Unlike uterine sulfotransferases, these enzymes are apparently stimulated by factors that appear following ovariectomy. The function of estrogen sulfurylation by target tissues remains obscure. However, recent investigations have indicated that the cyclic variation in endometrial estrogen sulfurylation may control the availability of 17 beta-estradiol to the cytoplasmic receptor. This premise is supported by the continued high estrogen sulfurylation activity and low nuclear receptor levels during implantation in fertilized gilts and sows. Utilizing purified bovine adrenal sulfotransferase, the substrate and inhibitor requirements were determined for this enzymes. It was also possible to design a specific inhibitor that will block estrogen sulfurylation without interfering with the receptor binding and nuclear migration of physiological levels of 17 beta-estradiol. This inhibitor, 3-methoxy-4-nitroestrone, will help in establishing the role of uterine and mammary estrogen sulfurylation.


Hemodynamic and respiratory response to varying gradients between end-expiratory pressure and end-inspiratory pressure in patients breathing on continuous positive airway pressure.

Nine patients on intermittent mandatory ventilation (IMV) and continuous positive airway pressure (CPAP) were allowed to breathe spontaneously at varying end expiratory pressure-end inspiratory pressure (EEP-EIP) gradients up to 10 cm H2O. There was no change in the mean cardiac output and oxygen delivery despite a lowered mean airway pressure (MAWP) when the gradient was increased. Three patients were uncomfortable at the higher gradients and another manifested evidence of fatigue of the muscles of respiration by raising her arterial PCO2 (PaCO2) and intrapulmonary shunt (Qs/Qt). In view of the difficulty experienced by some patients and lack of improvement in cardiac outputs (CO) during spontaneous inspiration when the EEP-EIP gradient is raised from zero to 5 and 10 cm H2O, it is recommended that the variation in airway pressure during spontaneous breaths while a patient is on CPAP be minimized.


Intracranial pressure responses to PEEP in head-injured patients.

PEEP (positive end-expiratory pressure) was required in 12 head-injured patients in whom intracranial pressure (ICP) monitoring had been previously established. In six, ICP increased by 10 mm Hg or more as 4-8 cm H2O of PEEP were administered. In 10 patients the mean arterial pressure decreased during PEEP. Before PEEP, the mean cerebral perfusion pressure (CPP = BP-ICP) was above 50 mm Hg in all patients. The CPP was less than 50 mm Hg in six patients given PEEP. Neurological deterioration occurred in two patients during PEEP therapy. In head-injured patients, optimal titration of PEEP therapy should include ICP measurement and/or continuous evaluation of neurologic status.


Forage plant estrogens.

Forage plant estrogens occur at high levels in certain forage species. Such levels are responsible for reproductive and other effects in animals. Current progress regarding the chemical, metabolic, and biological effects, as well as occurrence of the several naturally occurring forage estrogens, is described. Forage estrogens occur as natural plant responses to foliar and other plant diseases. Their potency in animals is approximately 1/1000 to 1/10,000 that of the principal animal hormones such as estradiol. Coumestans and isoflavones comprise the two principal classes of forage estrogens, with coumestrol and genistein being the most potent and predominant of each class. Only very low levels of the coumestans occurred in alfalfa leaf protein concentrates prepared at alkaline pH.


Estrogenic activities of chlorinated hydrocarbons.

Some DDT analogs are estrogenic, particularly o,p'-DDT, which comprises approximately 15-20% of the commercial DDT mixture. Whether this compound or its metabolites are active has not been established. In fact, the data obtained thus far are more confusing than enlightening. For example, CCl4 pretreatment of immature female rats has been reported to inhibit or enhance estrogenic activity of o,p'-DDT, and SKF-525A pretreatment has been reported to enhance or not alter the estrogenic effect. Although o,p'-DDT inhibits binding of estradiol to the estrogen receptor from rat or human at low levels (approximately 1-10 micrometer) in vitro, higher levels are required to inhibit nuclear binding of [3H] estradiol in incubated whole uteri. Futhermore, o,p'-DDT appears to be neither estrogenic nor antiestrogenic in an in vitro estrogen assay. Methoxychlor appears to be "activated" by metabolism, and it is probable that phenolic metabolites are responsible for its estrogenic activity. Since chlorinated hydrocarbons often enhance the metabolism of steroids and may reduce circulating levels of steroids, interactions of the exogenous hormonally active agents with steroid receptors may be self-potentiating in vivo.


A new donor site for fingertip avulsion injuries.

A new donor site for split-thickness skin graft in fingertip avulsion injuries is described, which is simple and protects the remaining pulp padding. The benefits and methods of obtaining a graft from the same finger are discussed.


Pathological growth of androgensensitive tissues resulting from latent actions of steroid hormones.

Hormonal responsiveness should be considered in terms of at least three homeostatic constraint mechanisms. Observations on the induction of specific responses in rat prostate reveal that certain of these are controlled differentially, and also that immature cells can be modified by low levels of androgen. The conditioning effect of low levels of steroid is further demonstrated by the benefits of fractional hormone-replacement therapy in controlling and delaying tumor progression. A revised approach to endocrine therapy of cancer should be seriously considered. This would entail the fractional replacement of hormone after ablative surgery.


Effects and receptors of glucocorticoids in rat thymus cells and human peripheral lymphocytes.

Glucocorticoids are widely used for therapeutic purposes and have many toxic side effects. It seems likely that their physiological, therapeutic, and toxic effects are exerted through similar receptors and may be inherently inseparable. Lymphoid cells are targets for all these effects. With rat thymus cells in vitro, glucocorticoids immediately bind to cytoplasmic receptors, which are translocated to the nucleus, where they apparently induce messenger RNA for specific proteins that rapidly inhibit glucose transport. Protein and RNA metabolism are inhibited more slowly and eventually the cells die. The rate of formation of nuclear complexes and the timing of the hypothetical RNA-synthetic step are such as to suggest that the hormone-receptor complexes stimulate RNA synthesis in proportion to the rate at which they bind to nuclear sites rather than in proportion to the number of nuclear sites occupied. With normal peripheral human lymphocytes the rates of formation of hormone-receptor complexes are similar to those in rat thymocytes. The rate of onset of inhibition of glucose transport is lower, however, as is the rate of cytolysis. In human peripheral lymphocytes stimulated to undergo blast transformation with concanavalin A there is a dramatic increase in the number of glucocorticoid receptor sites per cell. This increase may be associated with a stage of the normal cell cycle, the mitogen stimulus inducing partial synchronization of the cell population. It has not been found, contrary to widespread belief, that mitogen stimulation renders cells insensitive to glucocorticoids.


Bitemporal flap reconstruction of forehead.

The bitemporal flap meets the increasing demand for esthetic reconstruction of forehead defects. The surgical technique, applied anatomy, and plastic surgery principles are reviewed. Illustrative case histories review the application of the bitemporal flap reconstruction technique.


Serial flap advancement in an avulsion defect of the forehead.

Staged revision of a forehead defect consisting of a wide fibrotic skin grafted mass in a young man is reported. Serial temporal flap advancement resulted in considerable cosmetic improvement. Closing of such wounds with some tension on the advancing edges is recommended.


Some alternatives to urinary diversion in children.

Many children with severe urologic problems have been treated by urinary diversions, often after unsuccessful operations to correct the original pathology. Urinary diversion should be avoided when possible, since often it is accompanied by chronic infection and quality of life is less good than it could be. Most diversions can be prevented by use of other alternatives including 1) reimplanting 1 ureter and transureteroureterostomy of the other, 2) psoas hitch, 3) wide mobilization and downward displacement of the kidney and ureter, 4) use of bowel as ureter, 5) cecal cystoplasty and 6) early repair of complex pathology. Autotransplantation is probably seldom indicated in childhood.


Effects of hypoglycemic agents on vascular complications in patients with adult-onset diabetes. VII. Mortality and selected nonfatal events with insulin treatment.

The University Group Diabetes Program is a long-term prospective clinical trial designed to evaluate the effects of various hypoglycemic agents on vascular complications in patients with asymptomatic adult-onset diabetes. Mortality and blood glucose levels were determined as well as certain nonfatal events for patients assigned to diet alone or to either of two insulin treatment regimens. Lower levels of blood glucose with mean values close to normoglycemia were achieved in the treatment group in which the insulin dosage was adjusted to achieve normoglycemia compared with the levels achieved in patients treated with diet alone or with a fixed dose of insulin. In spite of differences in blood glucose levels among the treatment groups, there were only minor differences in the occurrence of fatal or nonfatal events.


Legionnaires' disease in Vermont, May to October 1977.

Thirty-two confirmed and 24 highly probable cases of Legionnaires' disease occurred in Vermont between May 1 and Oct 15, 1977. Confirmed cases had positive results for direct fluorescent antibody testing of lung tissue or fourfold rise in antibody titer. Highly probable cases had one elevated titer (greater than or equal to 1:256) and a compatible illness. Forty-eight (86%) had underlying chronic disease, and 22 (39%) were immunocompromised. Prominent early symptoms were fever, cough, chills, and malaise. All but one patient had verified pneumonia. Courses ranged from a pneumonia not requiring hospitalization to respiratory failure necessitating support with mechanical ventilation. Seventeen patients died. Although the clinical presentation was variable, rapid development of high fever and leukocytosis together  with negative cultures of lower respiratory tract secretions strongly suggested the diagnosis in an epidemic setting.


Characterization of mummy bone ochronotic pigment.

Radiologic examination of an Egyptian mummy showed characteristic radiologic changes seen in ochronosis. Desiring to confirm the diagnosis of ochronosis, punch biopsy samples of ochronotic mummy bone were removed for biochemical analysis. An organic solvent extraction procedure was developed to selectively isolate mummy ochronotic pigment, and spectroscopic methods were used to characterize the pigment as a homogentisic-acid--derived polymer.


Reference values based on hospital admission laboratory data.

Laboratory values taken from more than 13,000 newly admitted patients to the University of Alabama Hospital were analyzed using a percentile ranking system, and histograms for 24 laboratory tests were prepared. The percentile system is a better way to express test results than the classic normal range. The ability to correlate a test result with a clinical problem rises proportional to the degree of deviation from the midrange. Minor deviations frequently are without explanation, even after intensive clinical investigation. Invariably, great deviations are explainable. If one limits the interpretation of results to three ranges--abnormally low, abnormally high, and normal--much of the value of laboratory test interpretation is lost.


Nitrate therapy for congestive heart failure.

A randomized double-blind crossover trial included 16 patients with severe congestive heart failure who received isosorbide dinitrate or placebo for eight weeks, and then the opposite treatment for eight more weeks. All patients received their usual maintenance therapy with digitalis and diuretics. Seven morbid events occurred during 85 patient-weeks of isosorbide dinitrate therapy compared with 17 during 76 patient-weeks of placebo. Severity of congestive heart failure improved in all eight patients who received isosorbide dinitrate compared with two patients who showed improvement and five whose symptoms became worse with placebo. No significant differences in physical findings, cardiac dimensions, or resting hemodynamics were observed. Maximal exercise duration increased significantly by 2.54 minutes with isosorbide dinitrate therapy, and rose insignificantly by 1.24 minutes with placebo. This preliminary trial suggests that long-term vasodilator therapy may be clinically beneficial in congestive heart failure.


Experimental botulism in chickens: the cecum as the site of production and absorption of botulinum toxin.

Highly purified preparations of Clostridium botulinum toxins were administered to chickens by various routes. Chickens were highly susceptible to type A toxin, but relatively resistant to toxins of other types. Type C toxin (12S) at a dose of 1 X 10(7) mouse ip LD50 failed to kill the chicken by the oral route. Oral administration of 10 or more of type A, C, or D spores killed normal chickens, whereas cecoligated chickens were insusceptible to oral administration of 10(6) spores. These results show that the site of production and absorption of botulinum toxin in chickens is the cecum. Peroral administration of spores of a type C strain cured of its prophages and producing the C2 factor only also killed normal chickens. Chickens appeared to the more susceptible to the C2 factor than to the C1 toxin. The C2 factor, therefore, may play more important role in chicken deaths from toxico-infection with type C organisms. The optimum temperature for growth of C. botulinum types C and D was found to be 40-42 C. Type C and D toxins were significantly more stable than type A toxin in the cecum contents with pH above 7. These characteristics and the high density of distribution of type C spores in the environment may explain prevailing cases of type C botulism among broiler chickens.


Enzyme-linked immunosorbent assay for detection of Clostridium botulinum toxin type A.

The enzyme linked immunosorbent assay using the so-called "double-sandwich technique" has been applied to determine botulinum toxin type A. By this assay, 50-100 mouse ip LD50 of toxin type A can be detected. No cross-reaction occurs with botulinum toxins of other types tested. In all probability this is due to the high specificity of the antiserum prepared against the toxic component of type A toxin.


Inhibitors and promoters of stone formation.

The understanding of the formation of urinary stones centers around three main mechanisms: the urinary concentration of stone-forming ions, the role of promoters, and the role of inhibitors of crystal formation and crystal aggregation. With respect to the promoting activity, lately emphasis has shifted from the role of the organic matrix to that of one salt inducing by epitaxy the precipitation of another salt. Among the inhibitors, it has become necessary to distinguish between those affecting crystal formation and those affecting crystal aggregation. For measuring the inhibitory activity, the various techniques and their relevance have been reviewed. It has been found that the main inhibitors for calcium phosphate and calcium oxalate precipitation are citrate, pyrophosphate, and perhaps magnesium. Those for calcium phosphate and calcium oxalate aggregation are glycosaminoglycans, pyrophosphate, and citrate. Among the synthetic inhibitors, the diphosphonates are the most powerful for both processes. The role and the therapeutic implications of these various concepts have been discussed.


Prevention of calcium stones with thiazides.

On the basis of almost 15 years of experience with thiazide treatment in 346 patients with calcium stones, we believe that the following conclusions are justified: 1) Stone progression ceases in at least 90% of patients who take hydrochlorothiazide (50 mg, twice daily) on a regular basis. 2) A reduced dose of hydrochlorothiazide, i.e., 25 mg twice daily, appears to be effective in a significant proportion of patients. 3) Thiazides are effective in normocalciuric as well as hypercalciuric patients and in most patients with tubular ectasia (medullary sponge kidney). 4. Side effects necessitate discontinuation of thiazide treatment in approximately 7% of patients. The incidence and severity of side effects is reduced by initiating treatment with a small dose and by increasing the dose progressively until the full maintenance dose is achieved. A trial with a reduced dose is warranted in patients who are unable to tolerate the regular maintenance dose. 5) The therapeutic efficacy of thiazides in stone prevention cannot be accurately predicted by the degree of hypocalciuric response. Stone prevention may cease despite a minimal hypocalciuric response, whereas stone progression may occur when an adequate hypocalciuric response has taken place. 6) In addition to the hypocalciuric action, thiazides reduce urine oxalate excretion and increase urine zinc and (probably) magnesium; these effects probably contribute to the efficacy of this agent in stone prevention.


[Nursing and drugs (author's transl)].

Depending on their physiochemical properties, foreign substances appear to a more or less substantial degree in mother's milk. The decision as to whether a drug may be administered during nursing is particularly difficult in the case of antibiotics. Due to the development of resistance and sensitization only a few of these drugs are allowed. A nursing stop should only be ordered when a dangerous drug is used with genuine indication and without a possible alternative. As a rule, those drugs which are believed to involve a certain danger for newborn, can be replaced by other nonhazardous drugs.


[Vitamin E in pediatrics (author's transl)].

The biochemical mechanism of vitamin E cannot be explained up to the moment. Empirically, there are several possibilities for the clinical use of vitamin E, especially in pediatrics. This review is focusing on the hemolytic anemia of the preterm infant, hereditary bullous epidermolysis, retrolental fibroplasia and bronchopulmonary dysplasia. Excess vitamin E must be considered as potentially toxic.


Replacement of ruptured chordae tendineae of the mitral valve with autologous pericardial chordae.

Severe mitral regurgitation owing to rupture of chordae tendineae has been repaired in 10 patients by construction of new chordae from autologous pericardium. The site of rupture was the posterior leaflet in eight patients, the anterior leaflet in one patient, and both leaflets in one patient. Cardiac catheterization demonstrated severe mitral regurgitation (average 49%) and a left atrial V wave of 45 mm. Hg. The reconstruction was carried out with pericardium rolled into a chorda with one end attached to the appropriate papillary muscle and the other attached to the flail edge of the mitral valve leaflet being repaired. One patient died on the seventh postoperative day from pneumonia. The remaining nine patients are alive and well (Functional Class I) from 6 months to 9 1/2 years (average 3 years) following the operation. None requires anticoagulants.


Pattern of arrangement of smooth muscle cells in neointimae of synthetic vascular prostheses.

Neointimae of fabric vascular prostheses of three types (crimped and knitted [A], stretchable [B], and expansile [C]) were examined under both light and electron microscopes from 1 to 1,240 days after implantation in the thoracic aorta of 161 dogs. With all types of prostheses, a very uniform arrangement of smooth muscle cells was observed beneath the endothelial cells. In the crimped and knitted prostheses (A), the smooth muscle cells in the neointima showed a regular arrangement perpendicular to the direction of the bloodstream at each inner ridge of the crimp. In the stretchable prostheses (B), which can stretch only longitudinally, the long axes of the smooth muscle cells oriented in rows parallel to the bloodstream. In the expensive prostheses (C), which can expand only circumferentially, the smooth muscle cells were perpendicular to the bloodstream. These observations suggest that the arrangement of the smooth muscle cells in neointima is largely governed by the tension to which they are subjected.


Extracorporeal membrane oxygenator support for human lung transplantation.

Extracorporeal membrane oxygenator (ECMO) support was provided for a 19-year-old boy undergoing right lung transplantation. Perfusion was begun several hours prior to transplant, to correct profound hypercapnia. After the operation, ECMO was required because of inadequate gas exchange by the transplanted lung. Perfusion was continued for a total of 96 hours. During this time, the temporary malfunction of the transplanted lung owing to the reimplantation response reversed, and the patient was successfully removed from the oxygenator and subsequently weaned from the ventilator. He died on the eighteenth postoperative day of bronchial dehiscence. ECMO support appears to be a feasible means of supporting patients during lung transplantation and during the period of reversible lung malfunction that may occur in the early postoperative period.


Mechanisms of reaginic hypersensitivity and immunotherapy.

Reaginic antibodies in hay fever patients belong to IgE. The immunoglobulin sensitizes basophilic granulocytes and mast cells from homologous species and mediates the release of chemical mediators which cause allergic symptoms. The sensitization is due to the binding of IgE to receptors on the target cells through the Fc portion of the molecules. High affinity of the molecules for the receptor is responsible for the biologic activity of IgE antibodies and for the persistence of sensitization with the antibodies. The initial step of the reaginic hypersensitivity reactions is bridging of cell-bound IgE antibody molecules by a multivalent antigen. Since IgE is firmly bound with receptors, cross-linkage of IgE molecules will cause a disturbance of membrane structure and/or interaction between receptor molecules at the cell membrane, which will activate membrane-associated enzymes. It appears that the activation of sequences of enzymes will lead to the release of chemical mediators from the cells. In view of the role of IgE antibodies in allergic diseases such as hay fever, attempts were made to depress the IgE antibody response to allergen. A experimental model in the mouse indicated that the generation of antigen-specific suppressor T cells is involved in the depression of IgE antibody formation by immunotherapy.


Mechanisms of headache.

It is thus evident that the mechanisms of headache differ widely from one syndrome or symptom complex to another. Both intracranial and extracranial structures may be involved. Knowledge of headache mechanisms is indispensable to the clinician charged with the management of his patient's complaints. Such knowledge should guide the investigations which may be required, and the treatment program to be instituted. As knowledge of headache mechanisms is broadened and our current concepts are altered, we can expect to learn more, not only about the complicated nature of the subject, but also about patients. Future research on headache will almost certainly concentrate on headache mechanisms and will be concerned with molecular mechanisms, immunity and the biochemistry of vascular mediators. That is as it should be, as the pursuits become increasingly focused and scientific. Yet it must also be emphasized that headaches occur, so far as we know, only in man, that they are unique to the human situation, and they cannot be understood without considering the personality, environment, and hopes and aspirations of the individual. In the end, many headaches will be seen to be a problem of inappropriate life adjustment, of poor tempo, a type of conditioned response evoked by the individual's attempts to deal with the vicissitudes of life. This "headache mechanism," so frequently a part of the human condition, will be understood by the perceptive physician as a symptom of his patient's dysfunction, and treated accordingly.


Chemical compostition of the preen gland secretions from some ciconiiform birds.

The preen waxes from four Ciconiiformes species are shown to be ester waxes of very different composition. Three species possess monoester waxes with branched wax acids and alcohols. In one of these waxes, homologous series of ethyl-substituted constituents are observed. In contrast to this, the uropygial gland secretion of the marabou is a triglyceride mixture.


Effect of renal transplantation on pituitary gonadal function.

Twelve adult male patients who had undergone successful renal transplantation were investigated. The gonadotropin responses to 100 microgram luteinizing hormone-releasing hormone (LRH) were studied, and basal serum testosterone and prolactin assayed. Significantly elevated mean basal levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were found, associated with a correspondingly excessive LH and FSH response to LRH. Mean basal serum testosterone levels in the posttransplant patients were significantly lower than in normal controls, while the mean basal prolactin levels were similar in the two groups. The results were not influenced by the varying degrees of renal function found in the posttransplant patients.


[Heliomycin decrease in the pool of purine- and pyrimidine-containing compounds in bacterial cells].

Heliomycin inhibited formation of the pool or purine and pyrimidine containing compounds in the cells of the growing cultures of Staphylococcus aureus and Escherichia coli both in the lag phase at the maximum rate of formation of the pool of compounds absorbing at 260 nm and in the exponential phase. A decrease in the concentration of purine and pyrimidine containing compounds in the acid-soluble fraction of the cells by the antibiotic was not caused by the disturbed permeability of the membranes. Apparently, heliomycin interfered with the regulation of RNA synthesis, either directly or through its action on the energy metabolism of the cells.


[Nucleotide makeup of the DNA of fast-growing mycobacteria and related microorganisms].

The melting points of DNA were used to determine the nucleotide composition of DNA from the following microorganisms with a high growth rate: Mycobacterium phlei, M. smegmatis, M. fortuitum, Nocardia asteroides, the organism of the "rhodochrous"--N. opaca group, and organisms related to strain "Mycobacterium" rhodochrous ATCC 13808. M. fortuitum had a higher mol% G+C (67.5--69.5) than M. phlei (66.9--67.5) and M. smegnatis (64.4--68.1); the strains of M. smegmatis were characterized by the most heterogeneous nucleotide composition of DNA. The organisms of the "rhodochrous" complex (mol% G+C=69.5--72.2) were closer to N. asteroides (mol% G+C=72.5--73.5) than to the mycobacteria with a high growth rate.


[Fluctuations in the numbers of Bdellovibrio bacteriovorus and host bacteria in a 2-component system].

The number of interacting organisms in a two-membered bacterial "Bdellovibrio bacteriovorus--bacterium-host" system varied within a long period of time. The variations occurred in the counterphase and had a complicated irregular character with an altering period. The Volterra principle of collisions can be applied to this type of interaction between microorganisms.


Physical, emotional and social adjustments to home dialysis.

Forty home dialysis patients and their families were interviewed by means of a standard questionnaire to determine their physical, emotional, and social adjustment to treatment. The results indicated a reasonable level of health, particularly in patients under the age of 50 years. However, home dialysis produced considerable strain in the family, particularly in the dialysis partners. Home training programmes should provide appropriate learning and technical experience for the dialysis partners and continued support, including integrated medical and paramedical services, domiciliary visiting, and regular holidays. Limited-care dialysis facilities should be provided where home dialysis is impractical or becomes intolerable.


[Cryofractographic study of the structure of yeast cells found in an anabiotic state].

Cryofractographic studies of normally growing yeast cells have shown that the length, number and arrangement of slit-like invaginations, as well as the number, frequency of arrangement and dimensions of pores on the nucleolemma, differ among various yeast species. The data on the structure of various organoids published earlier have been confirmed. The volume of all cellular organoids, with an exception of mitochondria, decreases upon dehydration. The invaginations of the plasmalemma coalesce to form a common network. This is important in the course of changes in the volume and density of the cytoplasm of cells in the anabiotic state, maintaining the structural connection of the plasmalemma with the cellular contents, which is necessary for the survival of an organism under extreme conditions.