Correlation between the location of hematoma and its clinical symptoms in the lateral type of hypertensive intracerebral hemorrhage. Observations on Pantopaque radiography of the hematoma cavity in cases of early surgical treatment.

The authors studied the Pantopaque radiograms of a hematoma cavity in 46 patients following early surgical treatment for the lateral type of hypertensive intracerebral hematoma. All patients were operated on within 7 hours after the apoplectic attack and most of them had a localized hematoma. It was concluded that they could be classified in three subtypes from the location of hematoma in the antero-posterior direction. Each subtype had particular clinical symptoms and prognosis.


Renal transplantation in children.

23 children aged 1--16 years of age have received renal transplantation during the years 1972-1975 at the Downstate Medical Center. Of 9 children transplanted from related donors, I died and 3 lost their kidney-2 were retransplanted; 1 lost the second graft. Of 14 children transplanted from cadaver donors, 2 died, and 3 lost their kidney. 3 were retransplanted; 2 of them lost the second and 1 the third kidney as wll. Hypertension is the most frequent early and late posttransplant complication. 65% of the original 25 patients now have functioning grafts and they are rehabilitated. The success of renal transplantation in children is similar to that in adults.


[Evaluation of the results of the surgical treatment of nerve injuries].

From the experience with 2341 operations for nerve injuries and from the evaluation of the results obtained in 750 cases some recommendations of rational estimation of the nerve suture have been set forth. Reliable conclusions may be drawn on the basis of an objective examination of the conductability of the injured nerve only. The duration of nerve regeneration ranges widely in conformity with the type and severity degree of the injury and depending on the results of the operation. Unsuccessful surgical interventions on the nerves are usually concerned with a severe type of an injury. Repeated operations on the nerves carried out to correct an earlier failure are not infrequently difficult to perform and have poorer results than the primary ones, even when the latters are delayed for several months. The greater number of errors happen when primary nerve suture is performed in a non-specialized medical establishment.


Bacterial adherence in mastitis caused by Escherichia coli.

The possible role of bacterial adherence in the pathogenesis of experimental mastitis in the mouse was examined with four strains of Escherichia coli. Two of these strains had a known adhesion antigen (K88) and two did not. The K88 antigen did not play a significant role in the virulence or infectivity of E. coli either in the murine or bovine mammary gland. Two E. coli strains, W1 (K88+) and J2 (K88-) were virulent in the mouse but did not adhere to epithelial cells. Both these strains produced clinical mastitis in the cow. A third strain, D282 (K88-), produced mild disease in the mouse but was avirulent in the cow. The fourth strain, 233/ID (K88+), was avirulent in both the mouse and the cow. Strains D282 and 233/1D were killed rapidly by bovine serum whilst J2 and W1 were more resistant. All strains were more sensitive than the control resistant strain E. coli P4, which is known to be highly virulent for the lactating udder.


[Lysogeny in Escherichia coli isolated from birds and the spectrum of the lytic action of isolated phage].

Studies was the lysogenicity in a total of 70 strains of Escherichia coli isolated from birds. As many as 19 lysogeneic strains were isolated, yielding 19 phages that had the signature of lysogenic strains. Two serologic groups of phages were established by means of the neutralization reaction. It was found that phages 30 and 229, representing the two serologic groups of bacteriophages could lyse up to 44 per cent of the E. coli strains isolated from birds, 7 per cent of those isolated from calves, and 4 per cent of those from pigs. Out of 74 Salmonella strains, belonging to ten species, the same phages lysed two strains of Salmonella newport and 1 strain of Salmonella anatum. It is believed that phage lysis could be used to establish the source of infection and to evaluate the effectiveness of the prophylactic measures applied, incl. disinfection.


[Experimental transmission of antibiotic resistance in chicks].

Multi-drug resistance of Salmonella heidelberg was transmitted to normal intestinal flora (E. coli organisms were resistant to ampicillin, streptomycin, tetracycline, erythromycin, and oleandomycin. The donor strains of Salmonella heidelberg used in the experiment was a carrier of the following nine markers of resistance: ampicillin, streptomycin, chloramphenicol, kanamycin, neomycin, novobiocin, tetracycline, erythromycin, and oleandomycin. The donor strains of Salmonella heidelberg used in the experiment was a carrier of the following nine markers of resistance: ampicillin, streptomycin, chloramphenicol, kanamycin, neomycin, novobiocin, tetracycline, erythromycin, and oeandomycin, novobiocin, tetracycline, erythromycin, and oleandomycin. The resistance to drugs was transmitted with the oral administration of the donor strain at the preliminary neutralization of the action of hydrochloric acid in the stomah secretion through sodium bicarbonate (1 cm3 of a 10 per cent sol.) an hour prior to feeding the birds with Salmonella heidelberg (1 cm3 of 10(10). In other experiments carboneum tetrachloratum was injected at rates of 0.08 to 0.15 cm3 (acocrting with the body weight of birds) one day prior to infection, followed by the administration of 0.20 to 0.40 cm3 of a 2 per cent solution of omnopon. Escherichia coli organisms acquired new markers of resistance--to chloramphenicol, kanamycin, neomycin and novobiocin. The level of resistance proved equal with that to the donor strain. A total of 1.8 to 5.4 per cent of the intestinal E. coli investigated proved to be carriers of the indicated markers of resitance. Highest level in acquiring markers of multi-drug resistance (13 per cent) showed E. coli organisms isolated from the liver of birds injected additionally with C. tetrachloratum omnopon.


[Epizootologic study of aspergillosis abortions in cows].

Studied were mycologically a total of 463 aborted fetuses from 32 farms in the district of Roussé in 1972-1974. The pathogenic Aspergillus fumigatus fungus was established in 16.19 per cent of the cases. Abortions occurred the year round, becoming more frequent on the hot and wet days in summer and autumn as well as at in-door rearing and inappropriate hygiene conditions in winter. Most frequently abortions set in between the third and seventh month of pregnancy, which should be taken into consideration in diagnosing the disease.


[Stomach ulcers in newborn swine].

Stomach ulcers were established in sucking pigs, aged 1-3 days, on a pig-breeding farm. Thirty-two out of 40 pigs (spontaneously affected) of 5 primiparous sows died for 24 hours. Necropsy revealed ulcers on the mucous membrane of the stomach, varying in size and development of morphologic lesions. Histologic investigations were also carried out. Hemolytic Escherichia coli organisms were isolated form the same pigs, and were studied for pathogenicity and toxigenicity. An analysis was made of the etiologic factors contributive of stomach ulcers in newborn pigs.


[Dynamics of agglutinins following vaccination against coli-bacteriosis in calves].

A bivalent vaccine, produced with strains Escherichia coli 078 and 0117 to control colibacteriosis in calves, was used to vaccinate experimentally 20 cows following up the agglutinin dynamics in the serum of calves born later on. It was found that the agglutinin titers of the 0 antibodies were lower than those of OK, and varied within the range of from 1:10 to 1:320, the titers of 1:20-1:40 values being prevalent. Highest level of titers was observed by the third day following birth. OK antibodies had titers that were 1-2 degrees higher, reaching their peak level as early as the 12-15 hour after birth. They persisted for a longer period in the blood serum of calves. The antibodies produced after vaccination were shown to be sensitive to 2-mercaptoethanol.


[Arenavirus antigen persistence in continuous cell lines. Attempts at isolating the infectious virus].

An attempt was made to isolate an infectious virus from FL cells in which arenavirus antigen revealed by immunofluorescence tests persisted. Inhibitors of macromolecular synthesis, ultraviolet irradiation, fusion with BHK 21/13S cells, and transfection of BHK-21/13S cells with DNA from FL cells were tested in order to activate the virus. Negative results were obtained in each of these experiments. Prolonged cultivation of FL cells at 31 degres or 41 degrees C resulted in a two-fold increase in proportion of the antigen-containing cells or its complete elimination, respectively. The likelihood of integration of transcribed proviral fragment into the cell genome is discussed.


[Chronic cell culture infection with the rabies virus].

Three cell cultures chronically infected with fixed rabies virus, strain MNIIVP-74, have been obtained: HEp-2/2, BHK/13S, and RK-13. In the former two cultures, the infectious virus titers were 2.0 to 5.25 Ig LD50/ml. In RK-13 cells, traces of the infectious virus were found. In the chronically infected HEp-2/2 culture the maximum amount of the antigen-containing cells determined by the fluorescent antibody procedure was 60% and in BHK/13S 80%. Chronically infected cultures had a reduced growth rate and were as sensitive as the controls of superinfection with vesicular stomatitis virus. The virus recovered from chronically infected culture produced a disease in mice at later intervals than the original virus used in the same doses.


[Use of the indirect hemagglutination reaction for the express diagnosis of influenza outbreaks].

A new method for express diagnosis of influenza is described. The method is based on agglutination of antibody-sensitized erythrocytes in the presence of virus contained in nasal washings. Fourteen outbreaks in institutions and 113 patients in appartment foci were examined. The sensitivity and specificity of the proposed test was found to be equal to those of the serological and immunofluorescent methods but to be more advantageous than the latter in the simplicity of its performance and demonstrative results.


[Is congenital hour-glass bladder always a malformation? (author's transl)].

Hour-glass bladder was detected by X-ray investigation in a newborn female infant with delayed postpartum micturition. No signs of difficulty in micturition or urinary tract infection were subsequently detected. Control X-ray investigation at the age of 5 1/2 months showed a completely normal-shaped urinary bladder. This finding contrasts with the general opinion that hour-glass bladder is caused by a congenital malformation.


[Structure of shigella antigens. Heterogeneity of specific polysaccharides of 2 Shigella flexneri strains and 2 Sh. flexneri/Escherichia coli hybrids].

The S-specific polysaccharide from 2 Sh. flexneri wild strains (with serological var. X- and var. Y-specificity, respectively) and 2 Sh. flexneri E. coli hybrids (with the same specificities) can be separated by means of gel chromatography on Sephadex G-200 and G-50 into altogether 6 fractions per strain. Fraction G-200/1 (molecular weight greater than 10(6)D) represents a polymer consisting nearly exclusively of glucose and is present mainly in the two Y-type strains, much less in the two X-type strains. Fractions G-200/2 and G-200/3 (molecular weight approximately 10(5)D and approximately 2 - 10(4)D, respectively) seem to consist mainly of the S-specific side chains while fraction G-50/2 (molecular weight approximately 2000 D) presumably contains an SR-polysaccharide (core with one repeating unit.) Fraction G-50/3 (molecular weight approximately 100 D) contains the core polysaccharide and fraction G-50/4 splitting products (mainly KDO). No significant differences in chromatographical behaviour and quantitative composition could be found between the polysaccharides of the wild strains and the hybrid strains. Because of the well-known stability of the glucosaminyl linkages the sugar analysis was not only performed after acidic hydrolysis. In some cases the acid hydrolysate was reacted with HNO2 to cleave the glucosaminyl linkages. In most cases the values obtaines now were higher than those obtained directly.


[Isolation and characterization of Proteus mirabilis mutants deficient in DNA degradation: function of endonuclease I in postmortem DNA degradation].

DNase deficient mutants of Proteus mirabilis selected for reduced toluene induced DNA degradation were isolated. Their defect in DNA degradation was shown not only after treatment by toluene but also in crude extracts after cell disintegration by ultrasonic and in untreated starved cultures. The degradation mutants behave just as the wild type with respect ot their in vivo functions proffed. The results inidcate that the affected DNase does not have an essential function in vivo but acts in postmortem DNA degradation. Probably the DNase in question concerns the endonuclease I of P. mirabilis described by Goebel and Helinski (1971 a, b).


[Effect of violamycin BI on the process of excision repair in Escherichia coli K 12 following UV irradiation].

The influence of violamycin B I on the process of excision repair of DNA-damages after UV-irradiation has been studied by observing the capacity to rejoin single-strand breaks introduced in the DNA at the beginning of the repair process. The number of single-strand breaks remaining unrepaired in the DNA was higher in presence of violamycin B I. Sedimentation analysis of the DNA of unirradiated cells showed in presence of violamycin B I only a small change in the molecular weight. As a possible reason for the lower capacity of the cells to accomplish repair steps following incision in presence of violamycin B I an inhibition of the function of repair enzymes by interaction of the antibiotic with the DNA-template is discussed.


Enzymes of the yeast lytic system produced by Arthrobacter GJM-1 bacterium and their role in the lysis of yeast cell walls.

Yeast lytic system produced by Arthrobacter GJM-1 bacterium during growth on baker's yeast cell walls contains a complete set of enzymes which can hydrolyze all structural components of cell walls of Saccharomyces cerevisiae. Chromatographic fractionation of the lytic system showed the presence of two types of endo-beta-1,3-glucanase. Rapid lysis of isolated cell walls of yeast was induced only by endo-beta-1,3-glucanase exhibiting high affinity to insoluble beta-1,3-glucans and releasing laminaripentaose as the main product of hydrolysis of beta-1,3-glucans. This enzyme was able to lyse intact cells of S. cerevisiae only in the presence of an additional factor present in the Arthrobacter GJM-1 lytic system, which was identified as an alkaline protease. This enzyme possesses the lowest molecular weight among other identified enzyme components present in the lytic system. Its role in the solubilization of yeast cell walls from the outer surface by endo-beta-1,3-glucanase could be substituted by preincubation of cells with Pronase or by allowing the glucanase to act on cells in the presence of thiol reagents. The mechanism of lysis of intact cells and isolated cell walls by the enzymes of Arthrobacter GJM-1 is discussed in the light of the present conception of yeast cell wall structure.


[Successes in novocain therapy in the control of premature ageing (author's transl)].

A group of 173 patients with the diagnosis of systemic arteriosclerosis received a treatment with Novocain, according to the following schedule: three times a week intramusculary injections of 2% procain 5ml, that means 12 injections a month in 3--5 series. The results were very encouraging in 46% of the treated patients, in 28% a slight improvement was obtained while in 26% the state was unchanged but not worse. The treatment with Gerovital H3 according to A. Aslans method gave very good results in the treatment of diseases like: heart ischemia, systemic arteriosclerosis, predominant cerebral arteriosclerosis, arteriosclerotic Parkinsons disease; obvious results were also obtained in the treatment of psychical disturbances related to arteriosclerosis. The comparison with the control group (patients with placebo) emphasized the good results of the treatment of Aslan: Gerovital H3.


[Experimental lung transplantation at the Research Institute for Lung Diseases and Tuberculosis Berlin-Buch. Technical standard and quality].

Report on the technical standard of unilateral orthotopic allogenic lung transplantation (allo- or homotransplantation) which has been developed and tried on animals since years at The Institute for Research on Pulmonary Diseases and Tuberculosis in Berlin-Buch. Technical insufficiencies which are crucial for essential alterations of the graft in autogenous lung transplantation (replantation) can not be excluded in allogenic transplantations also. By means of certain direct and indirect criteria the authors examined the development of quality of the technical standard between the years 1973 and 1976. Only based on optimal technique the results from examinations of recipient and graft can be correctly valued. On the other hand, optimal technique is an indispensable presupposition for optimal efficiency of several immunosuppressive methods. Duration of anesthesis, operation, ischemia of the transplantate, and of atrial, arterial, and bronchial anastomosis are considered for the assessment of the quality of technical standard. Thrombosis of pulmonary vein and of atrium was the most frequent complication in 71 allogenic pulmonary graftings. Their frequency decreased with improved technical skill, but some circumstances suggest that their formation is favored also by other factors. The duration of survival after unilateral allogenic lung transplantation is reported, although this is no direct scale for the technical performance.


[Surfactant in lung preservation with delayed experimental autotransplantation].

The authors examined the surfactant in canine lungs at autotransplantation by assessing the alveolar stability values after preparation according to the method of Pattle. Moreover, microscopic and ultrastructural examinations were performed. The stability value of the normal lung was found to be 0.84 +/- 0.031. No essential change occurred after immediate lung transplantation and at delayed autotransplantation with preservation up to 24 hours. Alveolar stability values were not lowered after lung preservation up to 2, resp. 24, hours at +4 degrees C. The acute dystelectasis by preservation for 2 or 24 hours had no effect on the surfactant. At longer preservation (48, 72, or 96 hours) the stability values of the alveoles decreased, suggesting a decrease of surfactant. Electron microscopy revealed decreased density of osmiophilic bodies 24 hours after lung preservation.


[Specific humoral immunity in the circulation of dogs with allotransplanted lungs].

A method appropriate for identification and quantification of circulating antibodies reacting with donorlungantigens is presented in allogenous lungtransplantation. Following incubation of native tissue-slides taken from the second removed but not grafted donor lung with the recipient's serum, the specific humoral antibodies are detected by indirect immunfluorescence. Quantifying evaluation is performed by serum-dilutions. The preexisting specific antibody-titer found in DLA-sensitized animals shows a significant correlation with the duration of graft function when compared with lymphocytotoxic antibody-titer. In unsensitized dogs a regular appearance of circulating specific antibodies can be seen beginning from the fourth or fifth postoperative day. The increasing antibody-titer during further course is a feature of a humoral graft rejection represented in the periphereal blood-circulation.


[Induction of lymphocytotoxic antibodies through transplantation of preserved allogeneic skin in mice].

The authors report investigations on inducing lymphocytotoxic antibodies by transplanting allogenic skin grafts in mice after different kinds of preservation. Immunogenic effect was found at the following test conditions: storage of the graft for 4 weeks at -196 degrees C without cryoprotection, storage for 1 day at -38 degrees C, and storage at room temperature after lyophilization immediately after removal. No immunogenity was found after storage for 3 weeks at -38 degrees C, and uncertain immunogenity after storage for 4 weeks in 4 per cent formaldehyde solution. Sometimes the average strength of the microcyte toxin test was lowered around the 7th to 9th day after transplantation. That is interpreted as sign of adsorption of circulating antibodies to the graft. The authors point at the coincidence of these findings and the rejection of primary grafts, and at the potential causal relations between both phenomena.


[Skin amyloidoses. A contribution to the current amyloid problem].

A concise review about the pathogenesis of amyloid is given. The amyloidoses of the skin are classified according to the classification of Missmahl in perireticular and pericollagenous forms. The different forms of amyloidosis of the skin are discussed.


[Foreign body reaction and pseudolymphoma of the skin. Possibilities of differential diagnosis of lymphomas].

A description of three patients with cutaneous pseudolymphoma is followed by a discussion of the possibilities for differential diagnosis of lymphomas. It is suggested that the presence of multinucleated foreign-body giant cells in the dermal infiltrate is a histological sign of a benign clinical course.


[Grafting of preserved homogenous cancellous bone. Results of 90 operations (author's transl)].

Description of a simple technique for the removal of homogeneous cancellous bone from heads of femur removed during replacement of the hip-joint. The material has been preserved for one year at -20 degrees C and can be used after simple washing. Results in 89 grafts are analysed: They all took perfectly at the site of grafting. There was no rejection, no local or general allergy. Risk of infection was not increased. The technique is simple and useful where much cancellous bone is needed.


[Experimental study on regeneration of bone in standardized defects of rabbits tibia after application of collagen grafts in comparison to transplantation of cancellous bone (author's transl)].

This study demonstrates, that regeneration of bone in cortical layer defect is about as intensive after application of collagen grafts as after transplantation of autologous of homologous cancellous bone.


[Effect of the fixation of biopsy specimens from rat testicles on the results of morphometric studies].

The kind of the fixation method of bioptic preparations of the testicles has a decisive influence on the morphometrically determinable average diameter of the seminiferous tubules. Under the same conditions experiments 207 preparations of the parenchyma of the testicles of rats were fixed in Bouin's and Carnoy's solution as well as in 10% formalin solution. The measuring values of the diameter of the tubules of the preparations fixed in Bouin's solution were largest. Therefore the authors recommend to perform the fixation of the bioptic preparations of the testicles in Bouin's solution. Thus standardized experimental conditions and possibilities of the comparison of morphometric findings may be got.


[Immobilization of leukocytes by Escherichia coli. A study with enterotoxigenic bacteria (author's transl)].

Rabbit peritoneal leukocytes showed reduced random motility and chemotactic responsiveness after incubation in the high molecular weight-fraction of Escherichia coli culture filtrates. Two leukocyte-immobilizing factors appeared in the incubation media. One of these factors was thought to be identical with the migration inhibiting substance described by Udaka. The other immobilizing factor was dialyzable and gave a molecular weight of about 300 by column chromatography. Minimal formation of the factors occurred in the presence of E. coli heat-labile Enterotoxin.


Findings of yersinia in rats and sewer rats.

Survey of first methodical experiences in the microbiological examination of sewer rats Rattus norvegicus and rats Rattus rattus for yersiniae. From total of 178 cadavers 30 yersinia cultures were isolated, including 4 Yersinia pseudotuberculosis serotype III strains. Yersinia enterocolitica serotype O3 was isolated only from rats Rattus rattus in pig houses. Importance of suitable treatment of cadavers (at best in frozen state) and their quick delivery to the laboratory is being discussed.


Localization of a phosphoglycolipid in Mycoplasma membranes using specific anti-lipid-antibodies.

A phosphoglycolipid, presumably identical to glyceryl-phosphoryldiglycosyl diglyceride, is the main component of the membrane glycolipids of Mycoplasma mycoides subsp. capri. It is immunologically active. Anti-phosphoglycolipid antibodies were induced in rabbits by intravenous injection of the flocculated complexes of methylated bovine serum albumin with a mixture of the phosphoglycolipid and the auxiliary lipids, phosphatidyl-choline and cholesterol. The specificities of the antibodies directed against the phosphoglycolipid, are due to both the phosphate and carbohydrate moieties of the lipid molecule. Anti-phosphoglycolipid antibodies were detected in the sera of rabbits intravenously immunized with intact M. mycoides subsp. capri. The intravenous method of immunization was chosen in order to select for a response to surface antigenic determinants. Anti-phosphoglycolipid antibodies specifically reacted with intact organisms and isolated membranes of M. mycoides subsp. capri, as shown by complement fixation and agglutination tests. The antigenic determinants of the phosphoglycolipid are mainly located on the outer membrane surface. It is concluded that the antigenic determinants of the phosphoglycolipid in intact M. mycoides subsp. capri significantly contribute to the surface architecture of mycoplasma membranes.


Clinical applications of echocardiographic studies of the mitral valve. A review.

We have reviewed the clinical usefulness of echocardiographic studies of the mitral valve in mitral stenosis, atrial myxoma, mitral valve prolapse, rupture of chordae tendinae and idiopathic hypertrophic subaortic stenosis. Emphasis has been placed on the recognition of different patterns of mitral valve motion and where necessary, to avoid misinterpretations, appropriates recording techniques.


Hepatitis syphilitica. A clinico-pathological study of 25 cases.

Specific histological alterations have been observed in 23 of the 25 patients with early syphilis with laboratory findings suggesting liver damage. Treponema has been detected in the areas of liver lesion in 70 per cent of the patients. Control examination carried out after penicillin therapy showed regression of the alterations. On the basis of the findings authors assert that treponema might induce hepatitis in early syphilis differing from liver damage of other origin.


Epidural anesthesia for surgery: a comparative double-blind study of etidocaine and bupivacaine.

The author reports the comparative effects of 2 local anesthetic agents injected into the epidural space: 1% etidocaine and 0.5% bupivacaine, both containing epinephrine (5 microgram/ml). Twenty ml of one of these solutions were administered under double-blind conditions to 40 patients undergoing orthopedic, urological, gynecological or general surgery. The onset of analgesia, as determined by the "pin-prick test" was more rapid after 1% etidocaine than after 0.5% bupivacaine. The duration of analgesia, the return of sensation and the extent and intensity of the sensory blockade were identical for both drugs. After etidocaine, motor block occurred more often, was more complete and developed more rapidly than after bupivacaine. The incidence of peroperative and postoperative complications was comparable in both groups.


The effect of doxapram on buprenorphine induced respiratory depression.

Doxapram administered as a single injection or infusion satisfactorily counteracted the respiratory depression produced by buprenorphrine when administered one hour after the analgesic in healthy subjects. The respiratory stimulant effect was relatively short lived, however, a more prolonged effect was found by study of the displacement of the carbon dioxide response curve.


Antibody in SSPE serum and brain igG against measles virus smooth nucleocapsids detected by immunoelectron microscopy.

SSPE patients characteristically have high complement-fixing (CF) and neutralizing (N) antibody titers against measles virus in their sera, CSF, and brain. However, using SSPE patients' sera, the immunoperoxidase (IP) labeling of smooth nucleocapsids in SSPE or measles virus infected Vero cells or measles virions has not been achieved using conventional EM fixatives. Using the periodate-lysine-paraformaldehyde (PLP) fixative developed by McLean and Nakane (1974), and the indirect IP technique, antibodies against smooth nucleocapsids in SSPE and measles virus infected Vero cell cultures have been detected in serum from SSPE patients and normal individuals with high measles antibody titers.


Sipple's syndrome with peculiar changes in pancreatic islets--an autopsy case.

A diagnosis of the heritable disorder Sipple's syndrome was made in a Japanese male aged 28 years. The coexistence of bilateral phenochromocytomas, bilateral medullary thyroid carcinomas and secondary hyperplasia of parathyroid was confirmed at the time of autopsy. Pancreatic islets were hyperplastic with marked proliferation of A and D cells. Transition of the ductal cell to the islet, i.e. "nesidioblatosis" was observed. There was no proliferation of B cells, but a retention of B cell granules, a manifestation of suppressed secretion of insulin attributed to the overproduction of catecholamines was evident. In the stomach, numerous petechial hemorrhages and proliferation of gastrin cells were found. The pathogenesis of changes in the pancreatic islets and stomach is discussed from the viewpoint of hormonal disorders induced by pheochromocytoma and medullary thyroid carcinoma such as are found in Sipple's syndrome.


Arthrography of the knee joint with amipaque.

In a double-blind investigation, 30 knee arthrographies were performed by injection of either Amipaque 290 mg I/ml or Urografin 60% (292 mg I/ml). Both contrast media are well tolerated, and give excellent initial contrast quality, which deteriorates rapidly. This occurs more slowly with Amipaque, which has lower osmolality and causes less joint effusion.


Early venous filling in transplanted kidneys.

Early venous filling in patients with renal transplants was found in the presence of ischaemic injury, acute rejection, and chronic rejection; thus it cannot be used in differential diagnosis. Early venous filling was present only when the cortical circulation was scored as adequate although when observed in acute or chronic rejection the prognosis for the graft was poor.


Cross-neutralization reactions of Escherichia coli and Vibrio cholerae enterotoxins as studied by rabbit skin inoculation test.

Neutralization of enterotoxins of Vibrio cholerae 569 B and Escherichia coli 10407 by antitoxins to V. cholerae 569 B, E. coli 334, 408-3 and 10407 was studies by intradermal inoculation test in the rabbit. Neutralization of V. cholerae enterotoxin by homologous as well as heterologous antisera of E. coli was observed, except that there was no neutralization of the enterotoxin by antiserum to E. coli 408-3 enterotoxin. Neutralization of E. coli enterotoxin to a varied extent by homologous as well as all heterologous antisera, including that of V. cholerae 569 B antitoxin, was also observed.


A stereotaxic atlas of the prefrontal cortex of the cat.

A survey of existing atlases of the cat's brain has revealed a lack of coronal sections on the levels of the prefrontal cortex. On the other hand, neurophysiological and behavioral studies of this region have increased greatly in recent years. As the extent of coronal sections through the prefrontal cortex was seen to differ markedly even at separations of 1 mm, a stereotaxic atlas was made on the basis of brain sections of 16 mongrel cats. Brains were cut with the use of the paraffin or freezing method, and stained with cresyl violet, Luxol fast blue, or Kluver-Barrera's combination. Statistical methods were used to yield representative coronal outlines of sections from +20 to +30 mm anterior in 1 mm steps. A comparison with Reinoso-Suarez five coronal sections within this range showed a marked congruence between the two atlases.


A multicentre study on the efficacy and safety of individualized dosage of haloperidol (Haldol) in refractory chronic psychotics.

This study was carried out on 38 chronic refractory psychotic patients who received partial multimodal treatment with individually adapted doses of Haldol. The study was based on: --Howard's experiences: more than half of his chronic psychotic patients were able to leave the State Hospital because of the multimodal treatment with high individualized doses of Haldol; -Paquay and Tanghe's experiences: one-fourth to more than one-half of their chronic refractory patients showed remarkable improvement with a partial multimodal treatment. This study shows that improvement is obtained in more than 2 out of 3 cases, thus proving that the best results are obtained when an adequate selection of the patients is made. As side-effects, above all, the extrapyramidal symptoms are possible. However, their frequency and intensity are not higher than those provoked by other incisive neuroleptics or conventional doses of Haldol. Special attention should be given to any pseudodepression or neurovegetative reactions. The individualization of the doses should be carefully done.


[Preliminary note on the antiautistic, antidelusional and hallucinolytic effect of teflutixol (author's transl)].

The first thioxanthene derivative without the double bind up to now considered mandatory for the antipsychotic effect, teflutixol, was administered in a phase II pilot efficacy trial to acute or subacute psychotic inpatients (mean age 36,1) during at least 5 weeks at a dosage of 3 to 20 mg p.d. once a day. The patients were abruptly switched from a haloperidol baseline therapy, which was administered on an average for 3 weeks at 15 mg p.d. Preliminary results are reported for the first 11 patients on a purely clinical basis. Despite the limitations of a small sample and of a qualitative analysis of data, it is hypothesized that teflutixol is a potent and original neuroleptic drug combining at 6 mg p.d. or less potent antidelusional, hallucinolytic and antiautistic effects. Latency and duration of action approximate 2 days. At 6 mg and above appear side-effects of the desinhibiting type (anxious and/or aggressive mood, withdrawal, flaring up of delusions, insomnia, agitation) and extrapyramidal side-effects of the akathisia type. No adrenolytic, anticholinergic or toxic effects were prominent. The patient followed up for the longest period (6 months on 3 mg p.d.) has not relapsed and has normal liver functions.


Evaluation of an experimental anticholinergic drug, elantrine, in treating the tremor of parkinsonism.

An experimental anticholinergic drug, elantrine, had shown significant improvement in tremor of parkinsonism in 89 patients not taking L-dopa. A double-blind study of 22 parkinsonian patients stabilized on L-dopa showed marked improvement in tremor and moderate improvement in rigidity and bradykinesia when elantrine was added to their treatment program. Nine of 15 patients taking L-dopa (or Sinemet) and elantrine had cessation of all tremor and have continued free of tremor to date, over two years.


Monitoring the critically ill surgical patient.

This review has focused on several aspects of monitoring the critically ill patient. A few of the more commonly used monitoring devices have been discussed to emphasize that their use carries some risk. Because of this, proper indications, based on the benefits to be achieved, must be available before they are used. Guidelines for the safe use of these devices have been outlines. We have dealth with hemodynamic assessment, renal insufficiency, pulmonary monitoring and stress ulceration. Guidelines and specific examples have been presented to illustrate the prevention, early diagnosis and management of problems.


Willem Einthoven's fortuitous invention.

It is usually assumed that Willem Einthoven started out as a young investigator to invent the electrocardiograph and that he succeeded. On the contrary, his career had several false starts. True, fortune smiled on him. But his diligence and clinical interest plus the scientific freedom of his age led to his remarkable discovery.


Sarcotubules and subsarcolemmal caveolae and their continuity with the sarcolemma in frog striated muscle.

After using tannic acid mordanting, T-tubules and subsarcolemmal caveolae show a dense staining with lead citrate, with some increase in contrast also of the sarcolemma, in frog muscle. While  a few T-tubules show direct continuity with the extracellular space, the majority open indirectly via caveolae. Caveolae lie immediately beneath the sarcolemma, mainly in a single row, and are more numerous in relation to I-bands.


Electron microscopic immunohistochemical localization of alpha-msh in the rat brain.

Using an immunohistochemical technique at the electron microscopic level, it has been shown that alpha-MSH is localized within the small vesicles of a few cell bodies found in the arcuate nucleus and numerous nerve fibers widely distributed throughout the brain. These findings suggest that alpha-MSH could possibly be considered as a neurotransmitter.


Urea biosynthesis I. The urea cycle and relationships to the citric acid cycle.

The urea cycle consist of five enzymatically controlled steps that are catalyzed by carbamyl phosphate synthetase, ornithine transcarbamylase, argininosuccinate synthetase, argininosuccinase, and arginase, respectively. The complete cycle is present in physiological meaningful levels in the liver of terrestrial vertebrates, and in man represents the sole mechanism for ammonia disposal. The formation of carbamyl phosphate and the synthesis of argininosuccinate are potential limiting steps in urea biosynthesis but substrate and not enzymes levels are rate-limiting under physiological conditions. In the adult, urea cycle enzymes change as a unit, and are largely influenced by dietary protein content. The urea cycle is closely linked to the citric acid cycle deriving one of its nitrogens through transamination of oxalacetate to form asparate and returns fumarate to that cycle. The biosynthesis of urea demands the expenditure of energy but less than 20% of the energy derived from metabolism of gluconeogenic amino acids is required for ureogenesis. Embryological development of the urea cycle in the tadpole and in mammalian fetal liver therefore permits use of amino acids as new sources of energy to meet oxidative demands for continuing growth.


Focal glomerulosclerosis in renal allografts: association with the nephrotic syndrome and chronic rejection.

Focal segmental and/or global sclerotic glomerular lesions with hyalinosis were noted in three allografts in association with the nephrotic syndrome (NS) and chronic rejection (CR). Similar lesions were absent in eight allografts with CR without NS. Previous reports have stressed the presence of this lesion in allografts with recurrence of the disease entity "idiopathic nephrotic syndrome with focal glomerulosclerosis". Both clinical and pathologic evidence suggest that recurrence was not a factor in the pathogenesis of the lesion in the three allografts with CR and NS. The presence of these lesions in failing allografts may represent the result of CR with associated NS rather than recurrence of the disease entity.


Group a beta-hemolytic streptococcal pneumonia: clinical course and complications of management.

Three childhood cases of beta-hemolytic streptococcal pneumonia are presented with a review of the literature. The disease, though uncommon in childhood, results in severe local and systemic effects. Hematologic fluid and electrolyte problems are frequent. Pericardial disease and secondary bacterial invasion are added dangers encountered in management. Early and vigorous drainage of the pleural cavity is essential to successful outcome. It appears that predisposing viral disease, including influenza, is essential for acquisition of this form of bacterial pneumonia.


Life cycle events in 15th century Florence: records of the Monte delle doti.

Records of a dowry investment fund operated by the city of Florence, Italy from 1425-1545 contain information on life cycle events of about 32,000 girls. This information includes date of birth, date and amount of investment, and date of dowry payment or death. In the present study, the first of 19 volumes of these records were used to compute death rates and payment rates (an approximation of marriage rates) and to analyze these rates according to age, time, and socioeconomic status. Usable records were obtained for 1631 girls. There were 315 deaths; death rates per 1000 person-years were 38, 17, 11, 16, and 19 for ages less than 5, 5-9, 10-14, 15-19, and 20+, respectively. Compared to previous and succeeding years, death rates increased 5-10 times in 1437-1438 and 1449-1450, years in which epidemics have been recorded. During these periods of epidemics, death rates were relatively low in the winter months. Death rate were made for 1274 girls. About three-fourths of these payments were made by age 20. Rate of payment increased with amount of investment. Proportionally, births were least frequent during December and January, indicating a deficit of conceptions around the time of Lent.


Immune complex deposits in Graves' disease and Hashimoto's thyroiditis.

The thyroid glands of four patients with Graves' disease and five patients with Hashimoto's thyroiditis were investigated to demonstrate in vivo immune complex deposition. By electron microscopy, electron-dense deposits were observed in the follicular basal lamina--basement membrane--(FBL) often associated with lymphocytic and plasma cell infiltration. A positive correlation was obtained with all cases by immunofluorescent studies using anti-IgG, IgA, IgM, C3 and antithyroglobulin conjugated serums. The staining was of a granular pattern and coincided to the FBL region. No discrepancies were noted in electron microscopic and immunofluorescent observations between patients with Graves' disease and Hashimoto's thyroiditis, and the occasional observation of immune complexes in areas devoid of infiltrate in some patients with Graves' disease. Morphologically, the deposits were found to be similar to those described in the Obese Strain chickens with spontaneous autoimmune thyroiditis.


Bacteriuria in a pediatric population.

A three-month survey was conducted to determine the distribution of organisms associated with urinary tract infection in both a hospitalized and an out-patient pediatric population. Of 2,671 consecutive urine specimens, 1,365 were from hospitalized patients and 1,306 from out-patients. Six hundred twenty-one cultures (23.2%) had 10,000 organisms/ml or greater; this represents 298 or 21.8% of the in-patient cultures and 323 or 24.7% of the out-patient cultures. Forty-seven of the significant growth urines were polymicrobic; 2% of the in-patients' urines showed mixed growth as opposed to 1.5% of the out-patients. E. coli was the most frequently isolated organism. Differences in the distribution of species of organisms are discussed.


Diseases of the retina: 1975-76 review.

Articles on the retina which appeared in the American Journal of Ophthalmology, Archives of Ophthalmology, and British Journal of Ophthalmology from July 1975 to June 1976 are summarized. Topics include a specific receptor for retinol-binding protein, retinal pigment epithelium, retinitis pigmentosa, diabetic retinopathy, infections, degenerations, maculopathy, sickle hemoglobinopathy, retinoblastoma and retrolent fibroplasia, and macular hole and retinal detachment.


Some notes on the Vértesszöllös occipital.

An examination of the Vértesszöllös occipital bone indicates the need for takings its condition and preservation as well as certain aspects of its morphology into account prior to a metric assessment of its features. This analysis confirms the presence of extrasutural bones on the lambdoidal suture as well as some distortion in the sagittal curvature of this region. The advisability of using the endocranial sutures as well as other data for defining lambda in cases such as this is discussed, and a procedure for determining the position of opisthion is indicated. A metric and morphological analysis is used to support the claim that the specimen can be considered a large late representative of Homo erectus in Europe.


The grieving spouse.

Loss of a spouse presents serious risks to the psychological and physical health and well-being of the survivor. This is particularly true for women. Physical disease, hospitalization, and mortality in widows all exceed expected rates. The author reviews the phases of mourning, the factors related to pathological grief, and the ways in which grief is resolved. He describes widow-to-widow care systems, which seem to have substantial merit. Pastoral counseling and in some cases psychiatric care and medication can be helpful, but time is the greatest healer of all.


Man or machine in psychiatric diagnosis.

The authors describe the previous studies of the stability of psychiatric diagnoses over time that have found such diagnoses to be unreliable, stating that the assumptions underlying these studies have been tested and disproved. On the other hand, the use of standardized interview techniques and categorization by computer yield reliable symptom ratings and precise diagnoses. The authors discuss the importance of these findings to the selection of the most appropriate treatment modality for individual patients.


[Quantitative morphological investigation of the effect of thiobutabarbitone sodium anaesthesia on the endocrine and exocrine pancreas of the albino rat (author's transl)].

In respect of controls the beta-cells of the Islets of Langerhans in fed rats showed a significant decrease in nuclear volume after 40 min of anaesthesia with Thiobutabarbitone Sodium in a double-maximum-load dose. The alpha-cells and the cells of the exocrine pancreas do not show such alteration. The reduction in beta-cell acitivity is referred to a time and dose dependent effect of narcosis on the metabolism of the beta-cells and possible membrane phenomena. According to the morphological picture the otherwise missing signs of impaired function of the cells indicate a peripheral disturbance of glucose utilization during nacrosis. The blood-sugar levels support the proposed explanation.


Relationship of the serum concentration of pancuronium to its neuromuscular activity in man.

The relationship between the time course of the decay of serum concentrations of pancuronium and its neuromuscular blocking effect has been investigated after the intravenous administration of 50, 80 and 100 microgram/kg doses to anesthetized patients. Following administration of these doses, maximal neuromuscular block in the adductor pollicis muscle developed in about 7, 2.5, and 2 minutes and lasted about 20, 40, and 60 minutes, respectively. The times from start of recovery to return of twitch tension to 25, 50, and 75 per cent of control were similar in the different dosage groups, but occurred progressively later with increasing doses. At times of 25, 50, and 75 per cent recovery mean serum concentrations (pooled values) were 0.13 +/- 0.01,0.11 +/- 0.01, and 0.10 +/- 0.01 microgram/ml (+/- SEM), respectively. Neuromuscular transmission to the adductor pollicis muscle started to recover at a mean serum pancuronium concentration of 0.21 +/- 0.03 microgram/ml. The data obtained in this study are in agreement with the experimental and clinical findings of similar studies with d-tubocurarine, and indicate that there is a correlation between the serum concentrations of muscle relaxants and the intensity of their neuromuscular activities.


Morphine and promethazine as intravenous premedicants.

Two hundred seventy patients received morphine 5 mg or 10 mg alone or with promethazine 6.25 mg, 12.5 mg, or 25 mg. Promethazine 25 mg alone also was studied. All drugs were given intravenously. Anxiety relief, sedation, patient acceptance, lack of recall, and side effects were the variables examined. Promethazine improved relief of anxiety, sedation, and patient acceptance when added to morphine. Doses of promethazine larger than 12.5 mg intravenously failed to improve these effects. Memory remained unaffected by any of the drugs.


Methods in the evaluation of antiparasitic drugs in the horse.

The critical test is the primary method used for the efficacy evaluation of drugs against the major internal parasites (bots, ascarids, large strongyles, small strongyles, and pinworms) of the horse. The critical test determines: (1) spectrum of activity, (2) effectiveness of removal, (3) pattern of discharge, and (4) physical condition of each species of these parasites. General characteristics of the major parasitisms of the horse are discussed briefly. Criteria of the critical test also are considered including: (1) number of tests, (2) strain variation and drug resistance, (3) selection of test horses, (4) diagnosis of parasitic species, (5) numbers of parasites, (6) minimal efficacy requirements, and (7) other parasitic species. The controlled test principally is used on a selected basis for the small nematodes in the proximal portion of the digestive tract which cannot be properly evaluated by the critical test, or for other limited objectives. Clinical trials are discussed briefly but are invaluable supplements to the critical and controlled tests in the total assessment of a drug as a new product or for continued effectiveness in clinical use. Experimental procedures used in the conduct of drug evaluations should not be rigidly prescribed but should reflect input by the individual investigatior.


Complement "specificity" and interchangeability: measurement of hemolytic complement levels and use of the complement-fixation test with sera from common domesticated animals.

The results from studies to measure lytic complement (C') in sera of different animal species were reviewed. The traditional system, using sheep red blood cells (RBC) and rabbit antibody, was confirmed as the most sensitive to measure C' levels in man, monkey, dog, guinea pig, and rat serums. Sera C' from horse, cow, and sheep were found to be best assayed using rabbit RBC, whereas C' from goat, cat, and rabbit were best assayed with human RBC. Antibodies and C' from the same species usually mediated lysis of foreign RBC, but this lysis occurred more readily with some RBC targets than with others and may be associated with the presence of natural antibodies in the test sera. The effects of the species origin of a C' source in immunologic reactions in vitro and in vivo are discussed.


Experimental hamster enteritis: an electron microscopic study.

Hamster enteritis (HE) was experimentally produced in weanling hamsters by orally inoculating healthy hamsters with suspensions of ilea obtained from hamsters with HE. Control groups of hamsters were inoculated orally with suspensions of ilea from healthy hamsters. Electron microscopy was done on ilea from 6 control hamsters, 31 hamsters with experimentally produced HE, and 4 hamsters with naturally occurring HE. Ultrastructural changes were not observed in the absorptive epithelium of control animals. Two different intracytoplasmic bacterial organisms were observed in epithelial cells of hamsters with experimentally produced HE. Organisms that were observed early in the disease process were identified as Escherichia coli. Organisms ultrastructurally similar to Campylobacter spp were observed later in the disease and were only within hyperplastic epithelial cells. The hyperplastic ileal epithelium of hamsters with naturally occurring HE contained campylobacter-like organisms.


Bovine respiratory syncytial virus infection of bovine embryonic lung cultures: a kinetic study by the fluorescent antibody technique.

Development of fluorescence in bovine embryonic lung cells infected with bovine respiratory syncytial virus (BRSV) was studied by the fluorescent antibody (FA) test. Similar patterns of fluorescence were seen with the direct FA test, in which the immunoglobulin G fraction of antiserum to BRSV was conjugated with fluorescein isothiocyanate and used; and the indirect test, in which antiserum to the Long strain of respiratory syncytial virus and fluorescein isothiocyanate-conjugated anti-rabbit immunoglobulin G were used. In different trials, fluorescence was first detected between 16 and 18 hours after inoculation with BRSV. Fluorescence always was confined to the cytoplasm. Before 24 hours, fluorescence consisted of fine fibrils, usually parallel to the long axis of the cell, and cytoplasmic granules. After 24 hours, coincident with rounding of the cells, fluorescence slowly moved to the periphery of the cytoplasm. Under the growth conditions used, syncytia did not develop. By the FA test and as determined by the release of BRSV into the supernatant fluid, the minimal time for a single cycle of infection was between 24 and 26 hours.


An assessment of the possible association of isoniazid with human cancer deaths.

The data from 2 U. S. Public Health Service trials of isoniazid preventive therapy were reviewed in an effort to evaluate the risk of death from cancer among persons who received such therapy. Each of these prospective trials used random assignment to either isoniazid or placebo. More than 25,000 persons participated in each of the trials. The length of follow-up ranged from 10 to 14 years in one trial and from 9 to 11 years in the other. No significant difference in the incidence of death from cancer was noted between groups treated with placebo or with isoniazid in either of the studies. This was true even when deaths due to specific types of cancer and age-specific cancer death rates were compared. These data do not support a carcinogenic effect of isoniazid in humans.


A method for the collection of alveolar macrophages for microscopy.

A method is described for the collection and fixation for microscopy of samples of alveolar macrophages harvested by bronchopulmonary lavage. The cell pellicles thus obtained were analyzed by light microscopy by measurement of cell profile diameters. Statistical comparison indicated that no gradient in profile size was present across individual pellicles; they were therefore suitable for random sampling. Mean profile diameters and size distributions were compared for the individual populations of alveolar macrophages.


Insulin secretion in obesity and diabetes: an illustrative case.

A patient with obesity and diabetes mellitus had insulin secretion studies done during a 3-year cycle of weight loss and regain in the course of which she progressed from frank diabetes to a normal state of carbohydrate tolerance and then back to her original diabetic state. The results suggest that therapeutic weight reduction not only reverses insulin resistance but also restores beta cell sensitivity and enhances beta cell capacity. The eventual re-establishment of a degree of obesity, hyperinsulinemia, and carbohydrate intolerance virtually identical to that originally seen is compatible with a primary disorder involving hypothalamic control of adipose stores and insulin secretion.


Ambulatory electrocardiography. A clinical perspective.

Advances in modern technology have made it possible to record and analyze the electrocardiographic data of ambulatory persons for as many as 24 h or more. This capability and an increasing awareness of cardiac dysrhythmias and myocardial ischemia as a cause of morbidity and mortality have led to the more widespread use of ambulatory electrocardiography in the examination of patients for various clinical conditions. From a clinical viewpoint, we review and summarize the present state-of-the-art of ambulatory electrocardiography and discuss when such studies are indicated, frequently warranted, or may be useful.


Classification of acute leukemia.

The classification of acute leukemia has almost invariably been based on the morphologic diagnosis into two broad categories: acute lymphocytic and acute myeloid leukemia. Despite the wide range of morphologic variation in both groups, strict criteria to define the subgroups have only recently been proposed. The conventional markers for B and T cells are now being applied to leukemic cells as are cytochemistry and electron microscopy, terminal deoxynucleotidyl transferase, serum lysozyme, and surface markers, E-rosettes, membrane immunoglobulin, antinull acute lymphocytic leukemia antiserum, and Fc and C3 receptors. The myelodysplastic syndromes may mimic acute leukemia and it is important that they be identified and treated appropriately. The high incidence with which chronic myelomonocytic leukemia terminates in acute leukemia suggests that it is a preleukemic condition, whereas refractory anemia with excess blasts and acquired idiopathic sideroblastic anemia may have long, drawn-out courses. Only a small population of patients with the latter conditions develop acute leukemia.


Free fatty acid turnover and the availability of substrates as a limiting factor in prolonged exercise.

A continual hydrolysis and release of FFA from the triglycerides stores of adipose tissue occurs during prolonged moderately severe exercise. The uptake and oxidation of plasma FFA by the working skeletal muscles represents a major source of energy during such exercise. During light and moderately intense prolonged exercise, lipolysis and the release of FFA from the adipose tissue exceeds uptake by peripheral tissue and the net result is an increase in plasma FFA levels. FFA uptake appears to be related to plasma concentrations and uses no membrane transport system. As work intensity increases the release of FFA from adipose tissue declines and the relative contribution of the plasma FFA to the work metabolism declines until at high work rates there is an almost complete reliance on the intramuscular glycogen reserves. At work loads above about 65% of the individual's aerobic capacity the limiting factor for prolonged exercise appears to be the glycogen stores of the working muscle. When these stores are depleted the work either must stop or its intensity be reduced. Trained individuals have a greater capacity to oxidize fats at high work loads than do untrained subjects. This, however, is not matched by an increased capacity for lipolysis. Why intramuscular glycogen stores are required for prolonged relatively severe exercise when the amount of FFA and glucose that perfuses the skeletal muscles under such conditions is theoretically capable of supporting the exercise metabolism is unknown.


[Water and antibioresistant bacteria: an ecological study (author's transl)].

The goal of this work is to describe the evolution of bacteria resistant to antibiotics in an aquatic environment and to compare their importance at different stages: human flora, sewage, surface water. Coliforms, fecal coliforms and Aeromonas are selected at test bacteria. The incidence of this difussion and influencing factors are discussed.


Intraocular pressures in children with glaucoma during halothane anesthesia.

Thirty measurements of intraocular pressure (IOP) were performed on 10 children either with congenital or secondary glaucoma, before and after halothane anesthesia. In 7 normal eyes, IOP decreased a mean of 3 mm Hg, while in 23 glaucomatous eyes, mean IOP decreased from 43 to 34 mm Hg. In 5 of the 23 glaucomatous eyes, IOP decreased below 25 mm Hg and in only one patient below 21 mm Hg. Our findings indicate that an abnormally elevated IOP during halothane anesthesia suggests a glaucomatous process. A normal IOP during halothane does not absolutely preclude the absence of glaucoma. Intraocular pressure greater than 21 mm Hg during halothane anesthesia should be viewed with suspicion when coupled with other clinical observations of pathologic significance. Awake, sedated IOP measurements appeared to provide a reliable index of glaucoma in the population studied.


A review of malingering and hysteria in clinical practice.

Hysteria and malingering, both commonly seen, especially in orthopaedic clinics, are reveiwed. Advances in psychology and psychiatry are often unknown or ignored by surgeons, who may thus mistreat or misdiagnose a multitude of conditions.


Factors governing the emergence of resistance to nalidixic acid in treatment of urinary tract infection.

Cultures of Escherichia coli were exposed to nalidixic acid in an in vitro model in which the conditions of drug-organism interaction resembled those of bacterial cystitis treatment. Results obtained in this way suggested that emergence of bacterial resistance should not be a major problem in treatment of uncomplicated urinary infection; such cases might indeed respond to a less intensive course of treatment than is usual. More prolonged, high-dosage therapy with nalidixic acid may be required for patients with more complicated infections if the risk of failure from the emergence of bacterial resistance is to be minimized.


Comparative effects of amoxycillin and ampicillin on the morphology of Escherichia coli in vivo and correlation with activity.

An experimental mouse intraperitoneal infection due to Escherichia coli was treated with subcutaneous amoxycillin or ampicillin. Specimens of blood and peritoneal washings from the infected animals were assayed for antibiotic concentrations and examined microscopically for observation of the effects produced by the two penicillins on the morphology of bacteria growing in vivo. Amoxycillin was significantly more effective than ampicillin in protecting the animals from the lethal effects of the infection, although the antibiotic concentrations in the body fluids were very similar for both compounds. However, microscopic examination showed marked differences in the morphological effects produced at equivalent dose levels by the two compounds against the bacteria present in blood and peritoneal fluid. Treatment with amoxycillin at dose levels that produced peak antibiotic concentrations in the body fluids ranging from one-quarter to three times the minimum inhibitory concentration resulted in the formation of spheroplast forms, which lysed rapidly. In contrast, at the same concentrations, ampicillin produced relatively stable filaments or long cell forms, which lysed much more slowly, although at higher dose levels the effects produced were generally similar to those seen with amoxycillin. It is concluded that the superior therapeutic activity of amoxycillin compared with ampicillin is due to its greater bacteriolytic activity in vivo.


Penicillins activate autolysins extracted from both Escherichia coli and Klebsiella pneumoniae envelopes.

Ampicillin at a 50-mug/ml concentration effects a doubling of the autolysis rate of cell envelopes isolated from Klebsiella pneumoniae Mir A12. This antibiotic increases also by two- to threefold the depolymerizing activity of both K. pneumoniae and Escherichia coli crude extracts on a labeled peptidoglycan-lipoprotein complex. Several other penicillins also activate autolysins.


Review: the role of coenzymes in clinical enzymology.

Coenzymes participate in many of the enzyme analyses performed in the clinical laboratory. Supplementation of assay systems with optimal levels of coenzymes has recently been recommended as part of efforts to achieve interlaboratory standardization of enzyme measurements. Aspartate aminotransferase and alanine aminotransferase require pyridoxal phosphate for expression of enzyme activity. The role of this coenzyme in enzymatic transamination and the effects of its supplementation on the clinical estimation of these two enzymes is reviewed. Other coenzymes discussed are flavins, coenzymes for glutathione reductase, glucose oxidase, cholesterol oxidase and diaphorase, as well as thiamine pyrophosphate, coenzyme for transketolase. Catalase and peroxidase are used as examples of hemoproteins utilized in clinical measurements. Two peptide coenzymes, colipase and glutathione, are also considered. Measurement of apoenzyme stimulation upon supplementation with specific coenzymes is discussed as a valuable technique for quantitative coenzyme measurements or assessment of vitamin nutritional status.


L-Histidine production by histidase-less regulatory mutants of Serratia marcescens constructed by transduction.

2-Methylhistidine (2MH) and 1,2,4-triazole-3-alanine (TRA) inhibited the growth of Serratia marcescens. These inhibitory effects were counteracted by L-histidine. Enzymatic studies showed that 2MH acts as a false feedback inhibitor and TRA acts as both a false feedback inhibitor and a repressor. Mutants resistant to each analog were isolated from a histidase-less mutant, because the wild-type strain possesses a potent histidase activity. 2MH-resistant mutants had a feedback-insensitive phosphoribosyltransferase, but they produced only small amounts of L-histidine. TRA-resistant mutants were divided into two types according to their histidine productivity. A mutant of one type produced about 8 mg of L-histidine per ml and had about a 10-fold increase in the enzyme levels of histidine biosynthesis. Moreover, this mutant had a partially feedback-insensitive phosphoribosyltransferase. A mutant of the second type produced only a small amount of L-histidine and had only derepressed enzyme levels. Accordingly, strains possessing the genetic alterations in both 2MH- and TRA-resistant mutants were constructed by PS20-mediated transduction. They had both feedback-insensitive phosphoribosyltransferase and derepressed enzyme levels. The representative strain HT-2604 produced about 17 mg of L-histidine per ml.


Measurement of phosphatases in biological fluids.

Electrophoretic and immunological studies are beginning to allow a detailed picture to emerge for the isoenzymes of both acid and alkaline phosphatase. Such findings are occasionally in conflict with the time-honored biochemical methods considered to revealthe organ of origin of a given isoenzyme. In this review, recent reports describing electrophoretic and biochemical studies are correlated, and an attempt is made to clarify the useful clinical significance of enzyme levels determined by the various chemical and electrophoretic methods.


Rapid identification and quantitation of small numbers of microorganisms by a chemiluminescent immunoreaction.

A method (patent pending) for rapidly identifying and quantitating small numbers of microorganisms was developed based on the specific immunoreaction of microorganisms with homologous antibodies linked by conjugation to peroxidase. The high sensitivity of the method is due to the use of a chemiluminescent reaction for the determination of the enzyme. The reaction was performed on Alcar supports with low nonspecific adsorption. The very low noise achieved permitted the detection of as few as 30 to 300 bacterial cells.


High-viability lyophilized Bacille Calmette-Guérin vaccine produced by deep-culture technique.

Evidence suggests that Bacille Calmette-Guérin (BCG) vaccine for use in cancer immunotherapy should have the following characteristics: high viability which is maintained on storage; high ratio of live to dead cells; high proportion of single cells; and low content of soluble antigen. The production of a vaccine with these characteristics was accomplished by use of a deep-culture technique. The medium was modified Proskauer and Beck medium containing Tween 80 and glucose. The mass culture was grown in a Wheaton double-side-arm bottle (6 liters of medium in an 8-liter container), aerated by means of an aquarium aerator and mixed by a magnetic stirrer. The culture was incubated 7 to 9 days at 37 degrees C, concentrated 11 to 15 times by ultrafiltration, diluted with equal parts of 25% lactose, and then lyophilized. The lyophilized ampoules, stored at -70 degrees C, were cultured at intervals ranging from 3 days to 450 days, and no loss in viability was observed. The mean number of viable BCG per ml of reconstituted vaccine was 8.75 log10. The viable count was 90% of the total bacterial count. Moreover, 85% of the cells were present as single bacilli.


Bdellovibrio and the intestinal flora of vertebrates.

Bdellovibrio strain MS7 force-fed to fish and frogs via an intragastric tube did not become an integral component of the intestinal microflora. Strain MS7 fed to mice in drinking water was not recovered from the intestinal tract of mice. However, in vitro, the organism multiplied in intestinal contents of frogs and mice. Bdellovibrio inoculated into rabbit ileal loops was greatly reduced in number within 24 h. It was concluded that strains MS7 could be considered nonpathogenic to animals, at least when introduced into the digestive tract, and that it is not feasible at the present time to lyse pathogenic, gram-negative bacteria in the alimentary tract with Bdellovibrio.


Determination of pools of tricarboxylic acid cycle and related acids in bacteria.

Methods for sampling, extracting, and quantitating the metabolic pools of organic acids from bacteria have been developed. The concentration of these metabolites was determined by a new gas chromatographic method that can quantitatively determine the levels of lactate, pyruvate, fumarate, succinate, malate, alpha-ketoglutarate, and citrate. Values obtained were confirmed by fluorimetric analyses of five of the individual acids. In Escherichia coli, pools range from about 1 to 5 mumol/g of dry weight, with a variation in replicate samples of 5 to 15%. Under similar conditions, these pools in Bacillus licheniformis are in the same range, although the pyruvic acid pool is significantly larger.


Double-antibody solid-phase enzyme immunoassay for the detection of staphylococcal enterotoxin A.

A simple double-antibody enzyme immunoassay that uses a microtechnique was developed for detecting staphylococcal enterotoxin A in food products. Sample preparation can be completed in less than 15 min. Assay sensitivity ranges from 0.4 ng (20-h test time) to 3.2 ng (1- to 3-h test time) of toxin per ml of prepared sample. Separation and detection of enterotoxin from spiked food products ranged between 72 and 98% of the amount added.


Effect of an activated carbon filter on the microbial quality of water.

Recently, there has been growing concern that microbial health hazards can be increased by the use of activated carbon filters in domestic water systems. The present study was undertaken to investigate the effect of carbon filters on the microbial content of water. Results indicated that the microbial content of filtered and unfiltered water increased to about the same level on overnight standing and, in both cases, was reduced by flushing the next day. In addition, the use of activated carbon for the filtration of contaminated well water over a period of 11 weeks had no effect on the total or coliform count. Under use conditions, activated carbon filters were found to have no significant effect on the number of bacteria present in the water.


Colonization of the botanical environment by Klebsiella isolates of pathogenic origin.

Growth, survival, and pathogenicity of Klebsiella growing in and on environmental foci were examined. Total coliforms present in raw wastes from pulp mills were in excess of 10(5)/ml, and 60 to 80% were Klebsiella. Fecal coliform counts ranged from 10(1) to 10(5)/ml. Klebsiella isolates from industrial effluents and a variety of human and bovine mastitis origins multiplied in pulp waste and commonly exceeded 10(6) cells per ml. Pathogenic isolates also multiplied in dilute aqueous extracts of sawdust to comparable levels. Klebsiella strains from vegetable surfaces and human infections grew rapidly on the surfaces of potatoes and lettuce and exceeded 10(3) organisms per g of surface peel and leaf after a 24h incubation at room temperature. After 7 weeks on potatoes stored at 5 degrees C, some 10 to 30% of the day 1 Klebsiella counts were recoverable. Three Klebsiella isolates of pathogenic origin were passed 45 times through sterile pulp effluent (270 generations), and mean lethal dose levels in mice were periodically monitored. In two instances, a significant decrease in virulence was noted after 15 to 26 passes (90 to 156 generations). The third culture, of bovine mastitis origin, retained its original mean lethal dose value. Botanical milieu provided suitable habitats for the multiplication and colonization of Klebsiella isolates of disease origins in the same manner as indigenous isolates. Aquatic environments polluted with botanical material served as potential reservoirs for perpetuating the growth and spread of opportunistic Klebsiella pathogens that may ultimately colonize animals, humans, and aquatic organisms.


Comparative dose-survival curves of representative Clostridium botulinum type F spores with type A and B spores.

Radiation survival data of proteolytic (Walls 8G-F) and non-proteolytic (Eklund 83F) type F spores of Clostridium botulinum were compared with dose-response data of radiation-resistant type A (33A) and B (40B) spores. Strain Eklund 83F was as resistant as strain 33A, whereas strain Walls 8G-F was the most sensitive of the four strains tested. The methods suggested for computing both an initial shoulder and a D value for the dose-survival curves yielded results comparable to the graphic techniques used to obtain these two parameters.


Oral pemphigus vulgaris. A report of ten cases.

The conditions of ten patients were diagnosed as pemphigus vulgaris limited to the oral cavity. In eight patients the histopathologic findings were consistent with oral pemphigus. Direct immunofluorescence demonstrated intercellular substance (ICS) deposition of C3 either alone or in combination with IgG, IgA, IgM, C4, C1q, properdin, and factor B in all nine patients tested. Circulating ICS antibodies were detected initially in eight of the ten patients, nine of whom had positive titers at a later date, without subsequent development of cutaneous lesions. Physicians should be alerted to a diagnosis of pemphigus in patients who have chronic erosive disease confined to the oral cavity. Prompt diagnosis by means of routine histopathologic and immunofluorescence studies followed by early initiation of treatment are warranted.


Photochemotherapy of psoriasis using methoxsalen and sunlight. A controlled study.

Fifty-one patients with psoriasis were treated with oral methoxsalen and sunlight exposure. Twelve of these patients received either methoxsalen or placebo prior to whole-body exposure. The remainder were treated with methoxsalen and sunlight to one side of the body and sunlight alone to the other. The conventional dose of methoxsalen (0.6 mg/kg) was compared with a low dose (0.3 mg/kg). Oral methoxsalen when used in the higher dose followed by sun exposure is an effective treatment for psoriasis. Accurate ultraviolet dosimetry is essential to avoid phototoxic burns. The advantages and disadvantages of solar photochemotherapy are discussed.


Intramuscular iron-dextran and susceptibility of neonates to bacterial infections. In vitro studies.

An increased incidence of E. coli sepsis has been observed in neonates given intramuscular iron-dextran for prevention of iron deficiency. Mechanisms for this apparent effect on susceptibility to infection were investigated by comparing phagocytic and antibacterial functions in paired samples of venous blood from 7 infants, median age 5 days, before and after iron-dextran. Post-treatment sera had increased inhibitory effects on leucocyte chemotaxis and markedly reduced bacteriostatic effects agaainst E. coli. The clinical relevance of the effects on chemotaxis is uncertain. The reduction in serum bacteriostasis is similar to that observed in other forms of hyperferraemia not associated with saturation of transferrin, and is a likely cause of the increased susceptibility to infection in vivo. We consider that prophylactic treatment with parenteral iron-dextran is contraindicated in early infancy.


Capability of complement fixation of pemphigus antibodies in vitro.

The capability of complement fixation of pemphigus antibodies was tested using combined in vitro complement immunofluorescent (IF) staining methods. Three sera out of 25 serum samples from 22 pemphigus patients revealed positive reactions, while all other sera gave negative results. Specificity control tests confirmed the positive reactions to be specific for complement staining. Complement fixing pemphigus antibodies were titrated lower than corresponding IgG antibodies and were demonstrable only in the extensive stage of the disease. Thus, the present work supplied evidence that pemphigus antibodies fix complement in vitro. However, the discrepancy still remains between the in vivo deposition of complement in most cases of pemphigus and in vitro capability of complement fixation in only few cases. More investigations should be needed to explain the exact role of complement in pemphigus acantholysis.


Neural mechanism for production of spasmodic expiratory response like cough induced by amygdala stimulation in the cat. I. Pathways from the amygdala to the lower brain stem.

The pathways descending from the amygdala to neural structures in the lower brain stem responsible for production of spasmodic expiratory response like cough (SER), which occurred upon electrical stimulation of the cortical nucleus of amygdala (Aco), were investigated using microinjection and ablation techniques in the cat. 1) Following transection of the bilateral stria terminalis (STT), the threshold for SER production was remarkably elevated. 2) SER was suppressed by administration of procaine (20 microgram) or diazepam (5 microgram) into either side of the hypothalamic ventromedial nucleus (Hvm); furthermore, SER completely disappeared after lesion of bilateral Hvm. After lesion of the ipsilateral Hvm to the side of stimulation, the threshold for SER was obviously elevated, but SER was not affected by lesion of the contralateral Hvm. 3) After section of the substantia grisea centralis at the midcollicular level, SER disappeared. 4) Both SER and peripherally-induced coughs were depressed by codeine (10 microgram), dextromethorphan (10 microgram) or procaine (20 microgram) administered into the solitary tract nucleus (STN) or the nucleus reticularis parvocellularis. 5) SER and coughs disappeared after lesion of the bilateral STN or nucleus ambiguus (AM). These results demonstrate that most of the efferent fibers from Aco get to Hvm via STT, and further to STN and AM in the medulla.


Neurophysiological assessment of site specific effects of chronic morphine administration in freely behaving rats.

Sensory evoked responses were recorded simultaneously from five structures (caudate nucleus, septum, periaqueductal gray, parafascicular nucleus and reticular formation) reported to play roles in morphine's acute actions (analgesia, dyskinesia) and in the development of tolerance. Daily recordings were made from unanesthetized male Holtzman rats before and after a challenge dose of 10 mg/kg of morphine sulfate over a four day period while tolerance was induced by multiple daily injections of morphine. Three patterns of changes were observed in the individual components of the evoked responses. 1) The challenge dose caused an initial increase in the amplitudes of the P2 and N2 components of the response in the naive rats. This effect was attenuated with each day of drug administration until day four, when the challenge dose was observed to exert no effect. This pattern occurred in the parafascicular nucleus and the septum. 2) Initial increase in P2 and N2 components by morphine was augmented for 2-3 days, after which there was a sharp drop to control values by day four. This pattern was observed in the caudate nucleus and the periaqueductal gray region. 3) Morphine caused a mixture of increases and null effects in the components over the four days. This effect was observed in the reticular formation.


Combination chemotherapy in advanced breast cancer.: a randomized trial comparing a three-vs a five-drug program.

A prospective randomized trial was undertaken to compare the efficacy of a three-drug regimen using cyclophosphamide, methotrexate, and fluorouracil to a five-drug regimen using vincristine sulfate and prednisone in addition to cyclophosphamide, methotrexate, and fluorouracil in advanced breast carcinoma. Seventy-two patients who had received no prior chemotherapy were randomized. Thirty-eight patients received three drugs, and 34 received five-drug therapy. The objective response rates, 34% and 50% respectively, did not differ signficantly (P = .13). As expected, myelosuppression occurred in most patients, and neurotoxicity was much more common in patients receiving vincristine. Three of 12 patients treated with the five-drug regimen after progession of disease while receiving the three-drug regiment showed an objective response to the five-drug regimen.


[The renin angiotensin system in the pathology of arterial hypertension of aortic coarctation].

Nine patients with aortic coarctation were studied. On the fourth day of a low diet, blood samples were obtained for plasma renin activity (PRA) at 8:00 A.M., 11:00 A.M. and 5:00 P.M. On the same day a 24 hour urinary collection was obtained for the determination of aldosterone excretion. The following day 60 mg. of furosemide were given orally at 8:00 A.M. and another blood sample was drawn at noon. This study protocol was done before and after surgical correction of the aortic lesion. Mean systolic and diastolic blood pressure decreased significantly (P less than 0.005), while mean PRA and urinary aldosterone values showed no significant modifications after surgery. With these results, it is concluded that the renin-angiotensin-aldosterone system, does not seem to play a role in the chronic hypertension of the coarctation of the aorta. However, tests with angiotensin II specific blockers have to be performed before a definite conclusion can be drawn on this point.


Endocarditis with myocardial abscesses and pericarditis in an adult: group B Streptococcus as a cause.

Group B beta-hemolytic Streptococcus, S agalactiae, is an uncommon cause of endocarditis in adults. We present the clinical, laboratory, and postmortem findings of an adult patient with group B streptococcal endocarditis and major arterial emboli. What to our knowledge are previously unreported features are purulent pericarditis and myocardial abscesses. Twenty-five cases of endocarditis caused by group B Streptococcus that are reported in the literature are reviewed.


Location of mannan and chitin on thin sections of budding yeasts with gold markers.

Mannan was located on thin sections of Saccharomyces cerevisiae and Candida utilis with the homologous anti-mannan antibodies or with Concanavalin A, both labelled with gold granules. Fully synthesized mannan was found in the cell walls, on the plasmalemma and within the cytoplasm sometimes associated with vesicles and vacuoles. Chitin or its oligomers were located with wheat germ agglutinin in the bud scars but also in the cell wall and the cytoplasm near the plasmalemma. Both mannan and chitin or its oligomers were found in the forming septum and are synthesized within the cytoplasm. The gold method was also suitable for marking mannan and chitin simultaneously.


Effect of chemical modification of cell surface components of a brewer's yeast on the floc-forming ability.

Effects of treatments with proteolytic enzymes and protein-modifying reagents on flocculation of brewer's yeast IFO 2018 were investigated. The floc-forming ability of the yeast cells was irreversibly eliminated by treatment with papain, trypsin, chymotrypsin or pepsin, indicating that certain proteins on the cell surface participate in the yeast flocculation. Chemical modification with reagents, known to act on disulfide bridges, carboxyl and/or phosphate groups, phenolic groups, amino groups, and imidazole groups, also destroyed the ability to flocculate, although in some cases a high concentration (8 M) of urea was necessary in addition to protein-modifying reagents. Thus, it is suggested strongly that these functional groups of amino acid residues of the proteins are essential for the floc-forming ability of brewer's yeast cells.


Properties of the cell envelope and a cell-envelope protein of Pseudomonas facilis.

The molecular weight of the protein moiety of a phospholipoprotein complex isolated from Pseudomonas facilis has been examined with a variety of sodium dodecylsulfate-polyacrylamide gel electrophoretic systems. A molecular weight of 35 000 was determined for the protein in all analyses. A 35 000-dalton protein was present in the EDTA extract of P. facilis and in the cytoplasmic and outer membrane fractions, but not in the lipopolysaccharide and peptidoglycan. Prior inoculation of mice with the phospholipoprotein complex led to a 7.5- to 15-fold increase in the LD50 when mice were subsequently inoculated with Salmonella typhimurium; this pathogen has a cell-surface protein which cross-reacts immunologically with antibody to the P. facilis phospholipoprotein complex.


In vivo and in vitro studies on the glucose dependent inactivation of yeast cytoplasmic malate dehydrogenase.

The cytoplasmic malate dehydrogenase in the yeast Saccharomyces cerevisiae is known to be inactivated by a glucose dependent process. In this paper it is shown that in vivo effectors of the glucose metabolism (arsenate, iodoacetate, acetaldhyde) inhibit the inactivation or change the inactivation kinetics. In vitro it was possible to inactivate the malate dehydrogenase by addition of the glucose metabolite glyceraldehyde 3-phosphate. The physiological relevance of this modification and the effect of malate dehydrogenase inactivation on the glyoxylate cycle in yeast is discussed.


[Aglossia-adactylia with jejunal atresia].

Case report of a newborn with the aglossy-adactyly syndrome associated with complete jejunal atresia. Review of the literature does not allow any conclusion concerning the etiology of the observed malformations. The jejunal atresia, present in this case is probably coincidental. Attention is drawn on the possibility of prenatal diagnosis of obstruction of the digestive tract by ultrasound whenever pregnancy is complicated by hydramnios.


[Generalized BCG infection in mixed and severe immunologic deficiency. Unfavorable outcome in spite of an attempted bone marrow transplant].

Generalized BCG infection can occur after vaccination in patients with a severe combined or T-cell immunodeficiency. In the reported case, generalized BCG infection developed in an infant with a severe combined immunodeficiency disease and presented mainly with hematological manifestations. This infection led to death of the patient in spite of an histocompatible bone marrow transplantation performed late in the course of the disease and followed by a minimal graft-versus-host reaction. Based on this case report and others from the literature, it is suggested that neonatal BCG vaccination should be performed after knowing at least the complete family history. Although the presented patient died, it should seem reasonable to treat such patients with an early immunological reconstitution and with anti-TB antibiotics.


[Personality development in children after renal transplantation].

Twelve children cared for renal failure at the Hôpital-des-Enfants-Malades, dialysed and who have been transplanted for more than one year, were studied from a psychological view point. We have been using the Rorschach's test, projective technique selected for a collaborative study by the European dialysis centers. During the stage of renal failure, there appears considerable worry about body image and functioning, and psychic upheaval. During the period of haemodialysis, conflicts become latent and regression comes to the foreground. Some time after the transplantation took place, the psychological conflicts are again mobilized. There is a danger that they lead to dead-ends if guilt feelings impair too heavily this dynamic process.


[Use of cardiotonic heterosides in pediatrics].

The indications for the administration of cardiotonic heterosides are quite similar in adults and children. However, their use in children raises several practical problems, generally related to differences in kinetics and/or tissular sensitivity. The pharmacodynamic properties and the kinetics of cardiotonic glycosides of digitalis are reviewed and therapeutic and toxicologic effects are discussed.


The role of easily released substances (ERS) from bacteria in physiologic solution in natural immunity. VI. Induction of opsonins for different genera of bacteria by ERS from Staph. aureus oxford.

ERS obtained from Staph. aureus by mild extraction with physiologic saline solution possess activity of inducing nonspecific opsonins which react with homologous bacteria and with related Gram-negative bacteria. ERS from Staph. aureus weakly stimulated precipitins and antibodies active in passive hemagglutination and induced a marked rise in agglutinin titers especially for the homologous strain and Gram-negative S. typhimurium bacilli. N-acetyl-D-glucosamine absorbed the opsonizing factor for various bacteria with heterologous activity.


Pathogenic effects of asbestos.

The enormous increase in the use of asbestos during this century has necessitated the intensive study of its pathogenic effects. The occurrence of pulmonary parenchymal and pleural fibrosis and an increased prevalence of pulmonary and gastrointestinal carcinoma and of pleural and peritoneal mesothelioma have been established. A relationship, also, to laryngeal carcinoma is probable. Mesothelioma has been associated with indirect occupational, domestic, and neighborhood exposure, and the possibility of a similar correlation of pulmonary carcinoma with low exposure has been suggested. Pulmonary fibrosis and pleural plaques have been demonstrated under these circumstances. The physical characteristics of the asbestos fiber appear to be the principal factors in its carcinogenic action. The ability of fine, short fibers, especially fragmented chrysotile, to reach the pleura would appear to account for many of the pathogenetic and anatomical features of asbestos-related disease.


[Characteristics of the ultrastructural changes of the large intestine mucosa after acute dysentery].

Electron microscopic examinations of biopsy specimens of the large intestine from 8 patients one month after termination of the acute phase of dysentery revealed dystrophic and destructive changes in surface epithelium cells consisting in the lack of glycocalyx, fragmentation of microvilli, vacuolation and subsequent homogenization of the cytoplasm. Swelling and destruction of mitochondria, pyknosis and rhexisof the nucleus, exposure and loss of the intactness of the apical membrane of the cells were observed. The altered colonocytes frequently became detached off the basal membrane, exposing the stroma. The results of the study attest to long-term persistence of both the pathological and infectious processes in protracted forms of Shigella infection in man.


[Study of an articular cartilage in rheumatoid arthritis by the immunofluorescence method].

The immunomorphological examinations of 20 biopsy specimens of articular cartilage in rheumatoid arthritis at various stages of the pathological process showed immunoglobulins of different classes and complement (C'3) to penetrate into the articular cartilage. In early stages mostly IgG was detected, and with increasing destructive processes in the matrix IgM was found. A certain tropism in the distribution of immunoglobulins in the cartilage matrix to the zones of chondrocytic capsules was observed which could be associated with the direction of immune reactions towards chondrocytes. The articular cartilage tissue may be the basis for the development of the autoimmune process and maintain permanent inflammatory process in the synovial membrane of the joint with local antibody synthesis. The process of phagocytosis of the antigenic substances of the articular cartilage or immune complexes deposed in it underlies the distribution of pannus.


[Zinc blocking as a possible cause of cell alteration].

Injection of the complex formers to animals leads to the development of an intravital histochemical reaction with zinc and to the consequent cell alteration. A correlation between the intensity of the reaction and the stability and degree of the cell destruction has been established. Zinc blocking may be one of the causes of cell alteration.


[Principles of the morphometry and its use in light and electron microscopy].

The paper presents a review of the literature on fundamentals of morphometry, describing morphometric parameters and their designations, as well as the use of morphometry in medical and biological investigations conducted by light and electron microscopy.


Therapeutic trials in muscular dystrophy. III. Studies of microbial proteinase inhibitors in murine dystrophy.

The microbial antiproteinases--antipain, leupeptin, and pepstatin--have been reported to inhibit the degeneration of chicken dystrophic muscle in tissue culture. Trials of antipain and pepstatin, and of leupeptin and pepstatin administered subcutaneously in murine muscular dystrophy, failed to produce evidence of benefit. It is suggested that these antiproteinases cannot pass through an intact sarcolemma into muscle fibers. Further studies with liposomes may allow these agents to enter muscle fibers.


Ocular tolerance of bacillus Calmette-Guerin organisms.

The results of this investigation indicate that 5 X 10(6) and 5 X 10(8) viable bacillus Calmette-Guerin (BCG) organisms (Mycobacterium bovis strain) can be safely administered in the subconjunctival region of the eye of New Zealand albino rabbits without producing toxic effects locally or within the eye. This study provides a format for testing the applicability of BCG immunotherapy for experimental melanomas.


Corneal rings with gram-negative bacteria.

Corneal rings have been described with corneal ulcerations caused by Gram-negative bacteria. Corneal rings were produced by intracorneal injections of viable Pseudomonas aeruginosa as well as heat-inactivated suspensions of Gram-negative bacteria (P aeruginosa and Escherichia coli) but not Gram-positive bacteria (Staphylococcus aureus) or Freund's adjuvant. It is suggested that endotoxin is the factor responsible for their production since purified endotoxin produced corneal rings after intracorneal injection. Histopathological examination of the areas corresponding to the corneal rings disclosed that the rings represented accumulations of polymorphonuclear leukocytes. Direct immunofluorescent studies of the corneal rings revealed staining for properdin and C3 complement but not for immunoglobulins. The present report suggests that endotoxin has the ability to stimulate the alternate pathway of complement through properdin activation with the production of chemotactic fragments that attract polymorphonuclear leukocytes into the cornea.


Transitory IgA-deficiency, persistent IgE deficiency and recurrent respiratory tract infectious disease after splenectomy.

In a 14 year old boy, a ruptured spleen was removed. Two months after the splenectomy he developed recurrent infections of the respiratory tract. A deficiency of IgA and IgE in his blood serum was found. His impaired resistance to respiratory tract infections responded well to substitution therapy with IgA. Spontaneous clinical recovery occurred during 3 years after the splenectomy, and was parallelled by a slow return of IgA to normal levels, whereas the absence of IgE persisted. The identical twin brother of the patient, who had his spleen intact, had normal levels of serum IgA and did not suffer from frequent respiratory tract inflammations.


Photoelastic analysis of post core restorations.

Photoelastic models were used to analyse the effects of stress distribution around post-core systems. Parallel post designs were found to distribute stress more evenly to the tooth root, as compared to tapered posts. Screwed posts were found to be more undersirable.


The clinical development of the glass-ionomer cement. III. The erosion lesion.

A clinical trial of the glass-ionomer cement, ASPA IV, as a restorative material for erosion lesions is reported. The failure rate, in a three-year trial, was nine per cent; most failures occurring within the first few months after placement.


Porosity in base metal partial denture casting alloys, related industrial alloys, and pure metals.

Two types of specimens were cast from a variety of pure metals and alloys. A unidirectional solidification system was used for the production of the first, whilst a deliberate feeding problem was incorporated in the production of the second. The specimens were subjected to radiographic and metallographic evaluation in conjunction with porosity determinations, in order to ascertain how the amount and pattern of porosity varied with alloy complexity and alloy composition.


Acute nephritis in fifty children: clinical and immunological studies.

The main clinical and laboratory findings in a group of 50 children with acute nephritis are described and discussed. All the group had evidence of a streptococcal aetiology. The wide spectrum of presenting complaints, the age distribution and the high incidence among Maori children are noted. The severity of the disease, as indicated by features such as hypertensive crisis, was greater than expected. Fifty per cent of our patients experienced one or more of our defined complications. Encephalopathy was seen in 12% of all patients and severe hypertension in 34%. The striking feature of the laboratory findings was the wide variation in complement changes. No constant patterns emerged which would have implicated either the "classical" or "alternate" pathway for the activation of complement in these patients. An unexpected finding was the relatively high incidence of a transient C3 nephritic factor in post-streptococcal cases. We found also that fibrin degradation products were present in high concentrations in the urine of patients with post-streptococcal nephritis, again an unexpected finding.