Harry Stack Sullivan colloquium: Sullivan's Clinical contribution during the Sheppard Pratt era--1923--1930.

HARRY STACK SULLIVAN came to The Sheppard and Enoch Pratt Hospital in Towson, Maryland, upon the initiative of Ross McClure Chapman, who had been appointed superintendent of the hospital in 1920. Sullivan had been at St. Elizabeths Hospital in Washington, D.C., where he had been associated with the foremost clinicians during there heyday of St. Elizabeths--William Alanson White, Edward J, Kempf, Ernest Hadley, and Lucile Dooley. Under Chapman's sponsorship Sullivan enjoyed complete autonomy in being able to set up a special unit at Sheppard, with free rein to hire his own nursing personnel. Although the date usually given for the initiation of his work at Sheppard is 1923, there is some indication from the correspondence with Chapman that he might have started as early as the latter part of 1922, either Novemeber or December. At the time, he was a quite young 30 or 31. Of special interest to us today is the fact that Sullivan arranged to have a stenographer take down a number of his interviews with patients during the years 1926 and 1927. These interviews, plus the routine records of staff conferences, including verbatim records of the case presentation, questioning of the patient, and various staff members' comments, constitute the bulk of the data for my presentation. This material enables us to develop some idea of Sullivan's clinical approach to a variety of psychiatric syndromes, as represented either by direct interview or by case conference comments 50 years ago. In this presentation I will outline Sullivan's approach to various clinical topics, and will include sample interviews which illustrate his clinical interviewing technique at that time.


Harry Stack Sullivan Colloquium: The significance of ego interpretive states in insight-directed psychotherapy.

I AM pleased and grateful to have the chance to speak with you on this special occasion when we can recall and evalute the contributions--conceptual, educational, and personal--which Harry Stack Sullivan made and still makes to our field and to the understanding of human living. Sullivan belonged to that group of scholars who analyzed human experience in terms of a psychology of action grounded in the philosophical basis derived from Brentano, Mead, and Dewey--and represented by Meyer. Freud and the psychoanalysts, Titchener, and most anthropologists and modern sociologists. A psychology of action includes purpose and intent in its basic terms, it recognizes the ubiquity of symbolic interpretation as characteristic of humans, and it emphasizes the importance of understanding in the sence of grasping human communication, rather than in the sense of understanding objective mechanisms. It stands in contrast to an effort at objectivity in a behaviorist sence on the one hand, and to a strictly phenomenological psychology on the other. Phenomenological and existentialist analysis consider dialogue, communion, and the sharing of experience as the source of creative novelty and discovery, and exclude classification which might, for instance, consider some persons sick and capable of recovery. The act psychologist tends to ask what the person is trying to do, whereas others would speak of a trait, a symptom, or a defect.


Harry Stack Sullivan Colloquium: George Herbert Mead and Harry Stack Sullivan: an unfinished synthesis.

HOW DO YOU create a new self? However he may phrase this question, it is a central theoretical and practical concern of the therapist every time he confronts a client who comes to him for help. What are the processes out of which the human self emerges? However he may phrase the question, it is a central concern of the social psychologist. The obvious convergence of interests indicated by these two questions should occasion no surprise among students of Sullivan and Mead. What perhaps should be surprising is that an effective synthesis of their theories has progressed no further than it has to date. My remarks today are based on the conviction that a more adequate psychiatric theory and practice and a more complete social psychological theory and research program depend on such a synthesis. Behavioral scientists concerned with the development of a truly interactionist social psychology are, I believe, generally agreed that George Herbert Mead (1863-1931), philosopher and social psychologist, and Harry Stack Sullivan (1892-1949), psychiatrist and social psychologist, have laid conceptual foundations upon which such a discipline can be erected. Now a vast assortment of activities is tagged as social psychology and its boundaries are, indeed, difficult to draw. However, for our present purposes we can define its focus as the study of the processes and products of inter- and intrapersonal and inter- and intragoup interaction, let the boundaries fall where they will.


Discussion of Sigmund Freud.

Between the years 1928 and 1932, Sigmund Freud occasionally assembled a small group of members of the Vienna Psychoanalytic Society for scientific discussions. These informal meetings took place on Wednesday evenings at Freud's home. The author reports what he was able to preserve of Freud's remarks on some of these occasions.


The unconscious in France before Freud: premises of a discovery.

The influence of German culture on Freud has long been acknowledged, while his indebtedness to French psychological and medical tradtion has often been overlooked. The author presents a study of the emergence and evolution of the concept of the unconscious in nineteenth century French scientific discourse and its influence on Freud.


Religious stigmatization: an historical and psychophysiological enquiry.

The historical accounts of religious stigmatization occurring during the past 750 years have been surveyed, with more detailed attention being given to late nineteenth- and twentieth-century medical investigations of some well-known cases. A case showing some features of religious stigmatization is described. The possible relationship of the phenomena of religious stigmatization to disease and psychophysiological processes in the subject is examined.


Synthesis of inducible enzymes in irradiated yeast: UV effects on regulation and activity per cell.

The synthesis of two inducible enzymes in UV irradiated cells was determined during an 8 h postirradiation incubatin. In contrast to the reduction of synthesis shortly after irradiation the effect after a longer period of incubation depends on the radiation sensitivity of the strain. Since exposure inhibits division leading to different cell number in controls and irradiated samples the data are also analysed on a per cell basis. ta considerable increase of the activity per cell was observed. A maximum is reached at the end of the division delay.


[Ten years of research and teaching at the special education department of the teachers' training college in cologne (author's transl)].

On the occasion of the 10th anniversary of the special education department the teachers' training college an "academic week" was held in Cologne from June 20-24, 1976. Many German and foreign educational scientists and social paedagogues reported on the problems and research findings in the different fields of education and rehabilitation of the disabled. Since 1966 this department has experienced an unexpectedly rapid development. The majority of today's approximately 2600 students are pursuing studies to become teachers at schools for maladjusted children, the deaf, mentally disabled, physically handicapped, for children with learning disorders, with speech disorders and the hard of hearing. Approximately 250 students are trying to obtain a degree in education. Since the beginning of this decade, research work has been considerably intensified and is not mainly concentrating on the following five aspects: Studies of the theoretical, terminological and methodological approaches of special education--research projects concentrating on the social-scientific aspects of the problem of disability and the disabled--psychological studies of the learning and performance behaviour and the work load capacity of children at special schools--projects to ameliorate the communication and language capacity of the disabled--studies in connection with the planning and organisation of learning and instructional processes such as didactive and communication aids at special schools.


The role of oral immunisation in stimulating Escherichia coli antibody of the IgM class in porcine colostrum.

Oral immunisation with Escherichia coli polysaccharide antigens provided a primary antigenic stimulus which facilitated the production of humoral IgM antibody following a single parenteral antigen dose. The peak antibody response of preparturient sows was manipulated to coincide with the period of colostrum formation so that high levels of IgM antibody were made available for neonatal defence. The characteristics of the immune response remained unchanged on reintroduction of the immunisation schedule for a second gestation period.


[Sensitivity of Serratia marcescens to chemotherapy].

The sensitivity of 112 S. marcescens strains, isolated under various clinico-epidemiologic conditions, was tested by the dilution in agar method against 10 different antibiotics and sulfonamides active against Gram-negative bacteria. With the maximum concentrations used only Gentamycin and nalidixic acid were active against a high proportion of the strains tested, i.e. 96.4% and 91.1%. Kanamycin, Neomycin, Chloramphenicol, Streptomycin and Tetracyclin had an inhibitory effect against less than 25% of tested strains. One strain was resistant to all the antibiotics, 49.1% were only sensitive to 2 antibiotics and 33.9% to 3 antibiotics. Among tested strains 22 different antibiotypes were established. Evidence of 2 or more types of resistance within the same epidemic outbreaux, reduces the value of the "antibiotype" as epidemiologic indicator within this species. The readily acquired transfer factors of resistance might be responsible for the marked "mobility" of the antibiotypes, as well as for the spread of S. marcescens in hospital pathology.


[Use of delto-pectoral flaps in extensive loss of cervico-facial tissue in oncology practice].

Five years of use of more than 200 delto-pectoral flaps have shown its great qualities in repairing vast losses of substance from the cervico-facial area. The techniques of application are very varied and depend upon the cases to be treated.


Reduction of the formation of dental plaque and gingivitis in humans by crude mutanase.

The effect of a Trichoderma harzianum enzyme preparation containing mutanase (alpha-1,3 glucan glucanohydrolase) on plaque accumulation and composition and on occurrence of gingivitis was assessed in 20 persons in a double-blind cross-over investigation. The enzyme preparation was administered in chewing gum. Two test periods of 1 week were preceded by scaling and cleansing of the teeth, oral hygiene instruction, and controlled hygiene for at least 3 weeks. Oral hygiene measures were discontinued during the test periods, while the persons chewed six pieces of chewing gum per day, one half using enzyme-containing gum, and the other half using placebo gum. The test periods were identical, only enzyme gum was used instead of placebo, or vice versa. Evaluations of plaque and gingivitis showed that less plaque had accumulated and less gingivitis developed during the enzyme than during the placebo period, but bacteriologic studies of interproximal plaque did not reveal differences that could explain the clinical findings. Treatment with the enzyme preparation caused some local side effects, but no primary skin irritation, delayed hypersensitivity, nor anti-enzyme IgE was detected in any of the persons.


Receptors for IgM on human B lymphocytes.

Using a rosette technique with IgM coated bovine red blood cells (EA-IgM) receptors for IgM can be demonstrated on human B-lymphocytes. While in the peripheral blood B cells with IgM receptors are found only occasionally, between 7 and 33%, mean 16%, of tonsil B-lymphocytes exhibit receptors for IgM. This was shown in double marker studies using EA-IgM for the demonstration of IgM receptors and fluorochrome labelled conjugates for the demonstration of S-IgD, S-IgM and B cell antigens. These receptors are specific for IgM, they can be completely blocked by IgM-anti OVA complexes and partially by free IgM, but not at all by aggregated human IgG. They are sensitive to trypsin and pronase but reconstitute after further incubation at 37 degrees C. These data show that not only T and CLL cells but also some normal B-lymphocytes have receptors for IgM. We favour the view that CLL lymphocytes may derive from these B-lymphocytes, which may represent a certain maturation step in B cell development.


Certain rheumatoid factors react with both IgG and an antigen associated with cell nuclei.

Rheumatoid factors (RF) were isolated by their affinity for human IgG. RF from three out of twenty-four sera (12%) with a RF-latex titre greater than or equal to 20 and an anti-nuclear antibody (ANA) titre greater than or equal to 250 cross-reacted with nuclei from mouse cells. This antibody which represents an unknown proportion of RF, is designated RF/ANA. Only one of the three sera (Nil) contained large amounts of RF/ANA. A fourth serum (Jos) had 6.6 mg of RF per ml and an ANA-titre of 4096; all the ANA-activity of this serum was absorbed by an IgG-agarose conjugate. Part of the RF-activity of serum Jos was carried by antigenically deficient IgM. The ANA-activity of purified RF/ANA from four sera was inhibited by low concentrations of aggregated human IgG and by higher concentrations of human Fcgamma fragments and non-aggreated mouse anti-DNP antibodies. The data provide strong support for the conclusion that certain antibody molecules can combine with both IgG and an antigen in cell nuclei.


A solid phase enzyme-linked immunosurbent assay (ELISA) for the demonstration of antibodies against denatured, single-stranded DNA in patient sera.

A solid phase enzyme-linked-immunosorbent assay (ELISA) for the determination of antibodies against denatured, single-stranded (ss-) DNA is described. Polystyrene cuvettes coated with ss-DNA were incubated with serum samples and the anti-ss-DNA antibodies bound were detected by means of an anti-IgG-alkaline phosphatase conjugate. The binding of anti-ss-DNA antibodies in individual sera was expressed as units calculated as % of the absorbance in relation to the absorbance value obtained with a reference pool. Absorption experiments showed that the assay is specific for antibodies against denatured DNA. By using immunologically purified anti-ss-DNA antibodies the assay was shown to detect specific antibodies in concentrations down to 1 ng/ml. Antibodies against DNA could be detected in 94% of sera with antinuclear antibodies.


Receptors for Helix pomatia A haemagglutinin (HP) on a subpopulation of human B cells.

Receptors for Helix pomatia A haemagglutinin (HP) have earlier been found on neuramidinase treated T-lymphocytes in human peripheral blood. In contrast, the majority of the B-lymphocytes, characterized by surface bound IgM and/or IgD(SIg)lack these receptors. Double marker experiments with fluorochrome labelled reagents have now shown that a minor fraction (3--24%) of the IgM/d bearing lymphocytes in normal human blood also have HP-receptors. These HP+ B-cells constitute approximately 1% of the HP+ lymphocytes in adult blood. Fractionation on HP-Sepharose columns showed that the HP+ B-cells are readily eluted with buffer containing 0.1 mg N-acetyl-D-galactosamine. In contrast, the majority of the HP+-SIg--cells require higher concentrations of the competing hapten for elution (1 mg D-Ga1NAc/ml buffer). This indicates that the HP-receptors on these B-cells differ qualitatively or quantitatively from those on the majority of the T-cells. Previous findings of HP-receptors on the SIg+ leukaemic cells in the blood of patients with chronic lymphocytic leukemia suggested that these structures are expressed on an immature variety of B-cells. This assumption is favoured by the present finding that approximately 80% of the lymphocytes with surface bound IgM/D in cord blood also have HP-receptors. Therefore, the HP-receptors seems to fall in the category of differentiation markers and constitutes a useful tool for characterization and separation of human lymphocytes within both the T- and the B-compartments.


Activation of primed rabbit blood lymphocytes by antigen: early phase of triggering and the specificity of the response.

The early phase of antigen-dependent triggering of rabbit blood lymphocytes (PBL) is described. Specific activation of PBL by streptococcal vaccines requires primed lymphocytes from high responder rabbits. B-cell memory is conferred by Ig receptors by both mu and gamma chains. Antigen-induced incorporation of leucine and thymidine reach peak values at day 5, with stimulation indices of 10 to greater than 100, closely followed by increases in the number of living cells. A second and less intensive phase of cell proliferation is seen on days 8--11. A large fraction of cells (between 3 and 33%) participates in proliferation. A rough calculation of the average doubling time of cells during the exponential growth phase gives values of 8--16 h.


Antibodies against microfibrils of developing connective tissue in patients with inflammatory conditions.

Sera from patients with chronic inflammatory disease were tested for the presence of connective tissue antibodies. Fetal human skin was used as a substrate in an indirect immunofluorescence assay. Histological staining for connective tissue fibres, antibodies to connective tissue components and immunoelectron microscopy were used to identify the antigenic structures. Some antigenic fibrils were associated with elastin. By immunoelectron microscopy antigenic extracellular microfibrillar structures were identified. Antibodies against these microfibrils were detected in higher titres only in chronic inflammation (14%). Our results suggest that antibodies against connective tissues microfibrils may occur in human sera.


[Basis for the interpretation of toxoplasmosis immunofluorescence serology].

Exact knowledge of the sensitivity and reproducibility of immunofluorescence serology is essential in interpreting antibody titers. Comparison of titers from laboratory to laboratory is difficult, and the expression of titers in international units is worth attempting. 66% of Bernese people over 20 years of age have fluorescent-reacting antibodies against Toxoplasma gondii.


[Recurrence of intramembraneous glomerulonephritis in 2 consecutive kidney transplantations].

A case of dense intramembranous deposit disease, partial lipodystrophy, hypocomplementemia, and nephritic factor-like activity in the serum is presented. Recurrence of underlying renal disease was noted in two consecutive renal allografts. The first transplant was lost 7 months after implantation, chronic renal rejection being an additional cause of graft failure. A favourable clinical course, however, was observed after the second renal transplantation. 22 months after surgery, the patient was fully rehabilitated and transplant function only slightly reduced despite electron microscopic evidence of typical dense intramembranous deposit lesions. Low C3-serum complement and normal C4-serum complement levels were constant findings throughout observation time. The case supports the assumption that patients with dense intramembranous deposit disease should not be excluded from renal transplantation As shown in the literature, maintenance of satisfactory graft function is usually obtained for a long period of time despite recurrence of original disease.


[The abrasion of amalgam and composites in the area of the lateral teeth].

Four materials: amalgam, Epoxydent, Adaptic and concise Cap were filled after certain criteria into class II mandibular cavities and examined after one year. The very accurate models were submitted to measuring with a three-dimensional measuring device. The results were the following: amalgam 18 +/- 58 micron Epoxydent 38 +/- 50 micron Adaptic 92 +/- 97 micron Concise Cap 146 +/- 75 micron Only the first difference between amalgam and Epoxydent is statistically insignificant, the others are all relevant. Furthermore, a mean abrasion of functional cusps of 70 micron and a maximum abrasion of 300 micron could be observed. Clinically, relative to marginal adaptation and discoloration, Adaptic was clearly superior to the other two composites. Class II cavities must routinely be restored with amalgam, and composite "streets" must be strictly avoided.


[Quantitative study of the mineral substance of the human dental cementum].

A study of the mineral substance of human dental cementum was made by various biophysical methods. In healthy teeth, average degree of mineralization of the cementum as well as crystallinity and fluoride content of its mineral substance, were found to increase as a function of age. This evolution, typical of the physiological ageing process of calcified tissues, is especially pronounced for the cementum, because of the absence of remodeling activity such as that occuring in bone tissue. Cementum of impacted or semi-impacted teeth was found to have a significantly lower degree of mineralization than that of sound teeth in occlusion. In periodontally diseased teeth, the increase in crystallinity and degree of mineralization of the cementum as a function of age is considerably greater than that observed in healthy teeth. These changes were found to affect the cervical cement first of all, and progressively, the entire tissue. No difference was observed, however, in the fluoride content of the cement of periodontally diseased teeth and healthy teeth of the same age.


[Periodontal conditions in patients with crowns and bridgework].

A study evaluating supragingival and subgingival placement of restoration margins in 24 patients following periodontal and reconstruction therapy is presented. After 1 year no significant differences in supragingival plaque retention, tooth mobility, and width of attached gingiva were observed between the two types of restorations. The gingiva of those restorations with supragingival termination of margins showed, however, significantly (p less than 0.001) less inflammation. The pocket depth of restored teeth was significantly greater (p less than 0.001) than that of non-restored. It is concluded that whenever feasable, restorations should terminate above the free margin of the gingiva. Every restoration terminating in the immediate vicinity of or in actual contact with surrounding soft tissue is a potential irritant to that tissue and increases the chance of precipitating periodontal disease. It is mandatory that the patients with such restorations participate in a regular dental hygiene recall program where oral hygiene can be evaluated, physiotherapy procedures reviewed and motivation reenforced.


[Clinical study on the effectiveness of Insadol].

The effectiveness of Insadol (Laroche-Navarron, Paris) was submitted to a clinical test. The following indexes and measurements were considered: Sulcus fluid, P-Index, Plaque-Index, Pocket Depth, Tooth Mobility, Bone Loss. The measurement of the Sulcus Fluid revealed a small, but significant decrease in the medicament group. The other considered parameters showed no change in the medicament group, which makes any therapeutical effect appear doubtful.


Viremia in experimental Creutzfeldt-Jakob disease.

Inoculation of the buffy coat of blood from guinea pigs infected with Creutzfeldt-Jakob disease resulted in passage of this disease to recipient animals. This demonstrates that there is a viremia in experimental Creutzfeldt-Jakob disease. These findings suggest that the hematogenous route may be implicated in the human infection and that the disease may possibly be transmitted by blood transfusions.


Microtubules in prokaryotes.

Longitudinally aligned microtubules, about 220 A in diameter, have been seen in the protoplasmic cylinders of the following spirochetes (symbiotic in the hindguts of dry-wood and subterranean termites): Pillotina sp., Diplocalyx sp., Hollandina sp. They are also present in a gliding bacterium from Pterotermes occidentis. These microtubules are probably composed of tubulin, as determined by staining with fluorescent antibodies to tubulin and comigration with authentic tubulin on acrylamide gels. Treponema reiteri lack tubulin by these same criteria. These observations support the hypothesis of the symbiotic origin of cilia and flagella from certain spirochetes.


Mummy of the "Elder Lady" in the tomb of Amenhotep II: Egyptian museum catalog number 61070.

An unidentified female mummy found in a cache of great kings and queens in 1898 in the Valley of the Kings was examined from the viewpoint of Egyptology, x-ray cephalometry, biostatistics, and biochemistry. The result was the identification of Queen Tiye, of the Eighteenth Dynasty, wife of Amenhotep III and mother of Akhenaton.


A mutant of yeast defective in cellular morphogenesis.

In the budding yeast Saccharomyces cerevisiae, each bud appears within a ring of chitin formed in the cell wall of the mother cell. Temperature-sensitive mutants defective in gene cdc24 synthesize chitin at restrictive temperatures, but do not organize it into the discrete rings found in normal cells, nor do they form buds. The chitin ring or an annular precursor structure may play an essential role in reinforcing the region of the cell wall involved in budding.


Septicaemia in kwashiorkor.

In blood and stool cultures from 90 Black children with kwashiorkor, the commonest organisms isolated were Gram-negative aerobic rods. The mortality rate was highest in the group who developed septicaemia. In patients with negative blood cultures, the outcome was much more favourable, although the majority of them showed evidence of respiratory and/or bowel infections. It is felt that routine antibiotic therapy is advisable in the management of kwashiorkor.


Femoral neuropathy after renal transplantation.

Two cases of postoperative femoral neuropathy have been encountered in 135 renal transplant patients operated upon at Groote Schuur Hospital since 1967. It is thought that the lesions were due to anoxia secondary to compression of the nerve by a self-retaining retractor blade. Electromyographic studies were useful in assessing the severity and prognosis of the lesion. A prolonged convalescence may occur with a varying degree of residual neurological deficit.


Escherichia coli gastro-enteritis in adults.

Two cases of gastro-enteritis in South African adults are reported. Stool cultures performed on both patients yielded pure growths Escherichia coli. One isolate was shown to have invasive ability, and the other to produce heatstable enterotoxin. Neither strain belonged to a 'classic' enteropathogenic serotype associated with infantile gastro-enteritis.


Multifactorial megaloblastic anaemia.

Ninety-five patients who had megaloblastic anaemia, and who lived in a subtropical climate, were studied to elucidate the importance of puerperium, malabsorption, gastric dystrophy, diet and infection in the aetiology of the disease. All 5 factors were found to be common, and to occur in a variety of combinations, producing a wide spectrum of illness variously resembling nutritional megaloblastic anaemia, sprue, pernicious anaemia and many stages in between. It is concluded that megaloblastic anaemia in this population is a multifactorial disease, and a tentative scheme, relating the aetiological factors, is drawn up. Neither serum vitamin B(12) levels, nor folate estimation in serum or red cells emerged as very reliable guides to the underlying biochemical deficiency.


Urologic complications in renal transplantation.

The current overall reported incidence of major urologic complications following renal transplantation is 5 per cent. The presence of such a complication increases the likelihood of patient mortality by a factor of three. Standard utilization of postoperative radionuclide scanning is very useful in early diagnosis. Vesical fistulas generally result from improper bladder closure. The incidence of bladder complications increases with secondary and tertiary grafts. Ureteral complications result when the blood supply of the ureter is impaired. These include fistula formation, necrosis, and obstruction. Immediate surgical correction is indicated in almost all serious urologic complications following transplantation; otherwise there is marked increase in morbidity and mortality. Complications appearing early in the postoperative period carry a poor prognosis for both graft and recipient survival. The presence of urinary tract infection early in the postoperative period also correlates negatively with graft survival. The presence of multiple renal arteries in the donor has been associated with an increased rate of urologic complications. Ureteral fistulas can be avoided by meticulous dissection of the donor at the time or organ harvesting. Great care must be taken to preserve the arterial and venous blood supply to the ureter by avoiding any dissection into the renal hilum. Aberrant renal arteries must be preserved or repaired if damaged. Ureteroneocystostomy is the preferred method for re-establishing urinary tract continuity following transplantation. The immediate surgical correction of urologic complications is mandatory, and the techniques involved are highly specialized and must be individualized with each patient.


Pancreatic whole organ transplantation.

Transplantation of the whole pancreas can produce normal glucose homeostasis and there is evidence that a functioning allograft is capable of arresting or even perhaps reversing the vascular changes of diabetes. The technical complications of necrosis, bleeding, and perforation of the transplanted duodenum and disruption of the duodenalenteric anastomosis can all be managed by immediate removal of the allograft at the first sign of rejection. While there is increasing evidence that islet cells are more violently rejectedly in the human than are some other transplanted tissues, it is not clear whether this is true with the organ pancreas transplant. The four relatively long-term successes of organ pancreas transplants in the human would suggest that the organ transplant may act more like a kidney transplant than do islet cells. In the author's opinion, many of the problems may be technical, and carefully controlled, staged whole or partial pancreas allografts in the human still hold promise for ultimate better long-term success.


Studies on the role of serotonin in gastric pepsin secretion.

The effect of serotonin depletion and replacement on histamine stimulated pepsin secretion was evaluated from Heidenhain pouches of dogs. Serotonin depletion by reserpine or antagonism by l-methyl-d-lysergic acid butanolamide significantly reduced histamine stimulated pepsin secretion. Serotonin replacement by 5-hydroxytryptophan elevated pepsin secretion, despite the prior depletion by reserpine. The data suggest that serotonin is a stimulator of histamine stimulated pepsin secretion in denervated gastric pouches in dogs.


Clinical and experimental transplantation in enzymatic deficiency disease.

Allotransplantation provides another strategy for the treatment of metabolic diseases. In disorders which primarily affect a specific tissue or organ, appropriate allografts have already proved therapeutically effective. Most of these diseases presumably result from dominantly inherited structural genetic defects. Metabolic transplantation, the grafting of tissues for the continuous production of the normal gene products, can provide effective treatment in appropriate, inherited, metabolic diseases. However, it must be emphasized that this approach is exploratory, and further studies in experimental model systems must be continued. Future advances in immunology and transplantation biology may increase the potential effectiveness of allotransplantation for the treatment of metabolic diseases.


Neovascularization of the iris (rubeosis iridis).

This is a review of neovascularization of the iris and the neovascular glaucoma that often follows. With the aging of our population, this has become a more frequent cause of blindness and enucleation of eyes. Iris neovascularization is never primary, but is always secondary to other ocular disorders. The pathology is described based on the study of 110 globes. Diagnosis, pathogenesis and treatment are discussed.


Ophthalmology at St. Thomas' Hospital, London: the 12th to the 19th centuries.

The author recounts the history of St. Thomas' Hospital from its medieval beginnings to its establishment by the end of the 19th century as one of London's twelve teaching hospitals. Among the members of its staff have been some of the first and most illustrious ophthalmologists--those whose discoveries, teachings and writings have contributed to the foundation and development of ophthalmology.


Elements of timbre perception.

An evaluative review of the timbre perception literature is made. Attention is given to physical, psychological, and physiological factors involved in the perception of controlled musical and speech stimuli. Timbre perception is considered to be a complex process involving the synthesis of three main elements: the overtone structure of the stimulus, a temporal integration of acoustical events, and the context of the stimulation.


[Bridge abutments and bridge anchors--functional, technological and methodological aspects].

The fixed partial prostheses form a functional unity together with the abutment teeth and the periodontium. They must be kind to these tissues and protect them effectually. With regard to these goals, the author outlines the choice of abutment teeth and the shaping of the anchors as well as the use of materials and techniques in the light of anatomical, physiological and material-specific findings.


[The periodontal-prophylactic effect of the toothpaste "Silka". 2. Effects of circulation-stimulations additives on the periodontium in relation to age and sex and in smokers based on Kötzschke's periodontal index].

On subdiving the patients into age-groups, it was found that the relative improvement in the 46--55 year-old patients amounted only to 18% as compared to nearly 27% in patients of age-groups in which hormonal influences are likely to occur. The sex-linked differences in the periodontal condition became evident by higher initial values for the inflammatory component and a low relative improvement (25.53%) in women than in men (28.25%). The relative improvement in smokers (43.49%) as compared to that in non-smokers (23.01%) demonstrated the beneficial effect of benzylnicotinate on the nicotine-induced vasoconstriction.


[The collection and evaluation of sulcus fluid in the juvenile periodontium].

On the collection and the evaluation of the crevicular fluid from the child's periodontium. In a methodological study on the collection of crevicular fluid, we used in 50 children with clinically healthy gingivae a method for the collection of crevicular fluid that we had modified. Small amounts of fluid could be collected in all instances, also during different periods of eruption, in the regions of deciduous and permanent anterior teeth, and in the molar region. It is planned to employ this method (after further improvements) in investigating the possible effects of changes in the crevicular fluid composition on the developmental and regenerative processes in the juvenile periodontium.


[Prosthetic measures in the mixed dentition].

Prosthetic measures in the mixed dentition must allow for the actualities of this developmental phase. Traumatic or developmental injuries to enamel and dentine, accidental tooth loss and hypodontia or oligodontia are indications for prosthetic treatment in school children, at which orthodontic aspects should always be considered. The prosthetic approach is  characterized by the respect to preventive aspects related to the further biomorphosis of the dentition. With reference to the different phases of mixed dentition, methodical suggestions are given in the form of tables.


[Effect of the shape of the edentulous alveolar process on stability and motility of the total lower prosthesis].

The stability and the mobility of full lower dentures (as determined in 185 edentulous subjects by mea-s of the tests according to Herbst) were brought in relation to the form of the endentulous alveolar process. There was a statistically significant relationship which may be used for prognostic purposes.


[A new clamp for the anchoring of partial removable prostheses].

The proposed clasp corresponds to two Ney type I clasps acting on one tooth. The two vestibular lower arms are overlapping. The clasp is applied to a cylindrical crown (like a inner telescope) or to the natural crown; it has proved a clinical succes especially in subtotal lower prostheses.


Suicide related to the assassination of President John F. Kennedy.

In complicated ways depression is related to suicide. If the national climate could be made depressive by mass media coverage of a depressing event (for example, the assassination of President John F. Kennedy), the suicide rate theoretically ought to increase, unless depression were not related to suicide during time of great national focus. This hypothesis was investigated by using a questionnaire survey requesting information concerning suicide rate for the period November 22--30 for the 17 years 1956--1972. Sixty-one cities were randomly selected and contacted; 29 responded. A total of 74 suicides--48 males and 26 females--were reported during the 17 years studied. The hypothesis that more suicides should have occurred during 1963 was not supported. No suicides occurred during November 22--30 in 1963, the year of the Kennedy assassination. The results were significant at the .01 level. The finding that during a time of focused national crisis fewer suicides occur coincides with the findings of Durkheim (1897/1951).


Suicide in the literary work of Cesare Pavese.

On the basis of an existential analysis (Daseinanalyse), the authors consider the suicide, at age 42, of Cesare Pavese, one of the most important Italian poets and writers of the post-World War II period. It is found that in his poems, his novels, and particularly his letters and diary the idea of suicide was present in his consciousness since adolescence; year by year it is possible to follow the development of his ideas and fantasies about suicide. Incapable of establishing authentic communication with others, Pavese narrowed his existential horizon to the point of being less and less capable of living in the world and projecting himself into the future. From these considerations it is concluded that Pavese's acute feeling of incapacity caused him to have lasting experiences of failure that brought him to view suicide as the only way to free himself from his own torment.


Effect of azathioprine and prednisolone on passive enhancement of rat renal allografts.

Passive enhancement provides only partial suppression of rejection in the (DA X Lewis)F1 to Lewis renal allograft model. Suboptimal (8 mg/kg/day) and supraoptimal (30 mg/kg/day) doses of azathioprine administered with enhancing serum failed to suppress the rejection reaction in enhanced animals. Similarly, suboptimal (4 mg/kg/day) and optimal (16 mg/kg/day) doses of methylprednisolone were ineffective. However, the onset of rejection in enhanced animals was delayed by the use of both azathioprine (30 mg/kg/day) and methylprednisolone (16 mg/kg/day). The survival times of enhanced animals treated with azathioprine were significantly shorter than those of animals treated with enhancing serum alone, suggesting that this agent may prevent the development of autoenhancement. Although suboptimal doses of antilymphocyte serum suppress rejection in this enhancement model, the dose requirements of conventional immunosuppressive agents appear to be maximal rather than minimal.


Perfusion pressure and human kidney preservation.

From July 1972 to September 1976, 708 kidneys received through the Interhospital Organ Bank, New England were divided into two groups. Both groups were preserved by continuous pulsatile perfusion. Group 1 (308 kidneys) was maintained at a systolic pressure of 60 mm Hg throughout the preservation period. Group 2 (399 kidneys) was perfused at an initial pressure of 60 mm Hg. The pressure was adjusted to 55 mm Hg at 1 hr, then no further adjustments were made. Comparison reveals that group 2 donors were younger and that the kidneys in group 2 were preserved for longer periods that those in group 1. Both groups had an equivalent number of kidneys that were discarded and kidneys that did not function. The incidence of immediate function was higher in group 2 but this difference is not statistically significant. Compared with conventional preservation, kidneys can be preserved at lower systolic and mean pressures without loss of quality, and in fact, may suffer less damage from perfusion.


Non-major histocompatibility system immunogenetic influences in rat renal allograft survival.

H-1-incompatible rat renal allograft survival rates are strongly influenced by the non-major histocompatibility system (MHS) genes. The same H-1 (MHS) incompatibility tested on four different non-MHS backgrounds gave widely differing results ranging from 11 to 60% fractional survival between the best and the poorest (P less than 0.01) at 105 days. These results can best be explained if non-H-1 and intra-MHS amplifiers and/or suppressors are invoked.


Anti-B cell lymphocytotoxic antibodies in kidney transplant recipients.

Serial serum samples from 47 renal allotransplant recipients were screened for antiperipheral blood lymphocyte, anti-B cell, and anti-Daudi cell line antibodies. Various associations of these antibodies were observed in 28 patients. Anti-Daudi did not correlate with graft survival, whereas anti-B, although they were often associated with anti-peripheral blood lymphocyte antibodies, showed the strongest correlation with chronic rejection (P = 0.00002). However anti-B cytotoxicity preceded or was concurrent with the onset of chronic rejection in only 53% of the cases. Antibodies were absent in six of nine patients with irreversible acute rejection, but they usually appeared after transplant nephrectomy. These findings suggest that anti-B cell antibodies may play a role in the rejection process. In 15 of 17 recipients (88%), anti-B cell antibodies occurred during the first trimester after transplantation. These patients showed 20% 1-year graft survival compared with 68% in those without antibodies at that time (P less than 0.005).


Prolongation of rat cardiac allograft survival by donor pretreatment. Screening of antineoplastic drugs.

We have made preliminary investigations into the effect of 33 different drugs on the survival of rat cardiac allografts, the drugs being administered to the allograft donor. All drugs were administered at LD50 i.v. to the graft donor 6 hr prior to removal of the organ. Especially effective were alkylating agents and antimetabolites. Pretreatment with cyclophosphamide, busulfan, methotrexate, azauridine, or bromodeoxyuridine prolonged the survival from 7 to more than 20 days. Pretreatment with chlorambusil, mannomustine, mannosulfan, 1-(2-chlorethyl)-3-cyclohexyl-1-nitrosourea, DTC, fluoruracil, or hudroxyurea prolonged the survival to more than 14 days. Several other alkylating agents and antimetabolites prolonged the survival moderately, i.e., to approximately 10 days or more. Purine antagonists, mercaptopurine and azathioprine, were totally ineffective as were also anticancer antibiotics and vinca alkaloids. Pretreatment with procarbazine or methylprednisolone alone increased the survival only moderately, whereas pretreatment with both of these drugs together increased the survival up to 27 days.


Renal transplantation and HLA-A,B matching. Theoretical considerations concerning pool size.

The rate of improvement in HLA matching quality with increasing pool size is predicted. The expected frequency of HLA-A,B-compatible matches increases rapidly up to approximately 47% for pool size 1,000 and from then on the increase is moderate, whereas for HLA-A,B-identical matches the increase in frequency is more constant, the expected frequencies being approximately 34 and 52% for pool sizes 1,000 and 2,500, respectively. The expected frequency of HLA-A,B fullhouse-identical matches is 33% at a pool size of 2,500. The waiting time for the first available HLA-identical kidney is estimated. For a random recipient there is a 25% chance of obtaining an HLA-identical match among the first 500 kidney donors. For two cooperating pools, it is calculated at which relative transplantation activity the kidney import to export is balanced and also the decrease in waiting time for an identical match when cooperating is estimated. The results of a kidney exchange simulation are presented and they agree well with the theoretical considerations.


[Ultrastructure and secretory cycle of the islands of Langerhans cells in pancreatic cancer].

By electron microscopy, the islets of Langerhans of 5 patients with cancer of the pancreas were studied. The most obvious ultrastructural changes were found in the insulin-producing B-cells. Their cytoplasm contained a reduced number of secretory granules. Many B-cells were seen at different stages of the secretory cycle, part of them being destructed. On studying secretory process, the formation and maturation of B-granules was demonstrated in the cistern of ergastoplasm without the Golgi complex being involved. The data obtained suggest the functional tensity of the insular tissue at the neoplastic process in the exocrine part of the pancreas.


[Preparation and properties of stretched polytene chromosomes. 2. Mechanism of stretching].

Isolated polytene chromosomes were stretched in a 0.125 M NaCl solution with constant speed, by constant force and by cyclically changing force. For each regime, the dependence of chromosome length on the time and force magnitude were recorded. From this it may be concluded that three processes are involved in chromosome stretching: viscoelastic deformation, viscous flow of DNP segments, and cristallization, i.e. intermolecular cross-linking of neighbour segments. At a high rate stretching (V greater than Vo) chromosome may be torn like at small deformation; when rate is V greater than Vo chromosome deformation is mostly viscoelastic; at rates V approximately Vo viscous flow of DNP segments if predominant. We estimate Vo approximately less than 3--6 mum/s. Electron microscopy shows that during chromosome stretching its DNP fibers are oriented along chromosome axis without detectable breaks.


Histologic and cytologic liver changes in 120 patients with malignant lymphomas.

The purpose of this study was to determine the frequency of liver involvement in malignant lymphomas. Non-specific liver changes were also registered. Percutaneous liver biopsy was performed on 120 patients with untreated malignant lymphomas. There were 38 patients with Hodgkin's disease, 42 with histiocytic and 40 with lymphocytic lymphomas. All the biopsy specimens were histologically and cytologically analyzed. Positive liver findings (lymphomatous infiltration) were observed in 27.5% of patients with lymphocytic, 23.8% with histiocytic lymphomas, and 7.8% with Hodgkin's disease. Liver involvement in non-Hodgkin's lymphomas was significantly higher (P less than 0.025) than in Hodgkin's disease. In the whole group of patients, there were non-specific liver changes: 23 chronic persistent hepatitis, 5 aggressive hepatitis, 9 liver steatosis and 4 liver hemosiderosis. Based on these results, it can be concluded that liver involvement with lymphomatous tissue is more common in non-Hodgkin's lymphomas. Knowledge of this is relevant for clinical staging and the treatment program. These findings also confirm that percutaneous liver biopsy is a valuable diagnostic procedure in the staging of malignant lymphomas.


[Ileal ureteral substitute and ileal urinary diversion in conjunction with renal transplantation (author's transl)].

A patient with transplanted kidney and immunosuppression treatment has been treated because of a total necrosis of ureter by a replacement of a ureter with a pyeloileocystoplasty. A second patient with transplanted kidney and immunosuppression therapy has been given care to with total cystectomy and supravesical derivation of the urine by a ileal conduit of a solid cancer or urinary bladder. The good clinical results, five, respectively two years after the operation confirm that neither kidney transplantation nor immunosuppression therapy are counter indications to the use of small intestine plastics of the bladder of the ureter.


[Autologous human skin flaps in partial replacement of bladder wall (author's transl)].

Untreated autologous compound skin (Rehn's skin flap) was used in three patients for partial replacement of the urinary bladder wall. The early postoperative results regarding the general tendency of the healing process, primary density, capacity, and functional voiding of the bladder correspond with an ideal replacement of the bladder wall. Observations of long-term controls will be reported later.


Chorioretinopathy in a case of systemic lupus erythematosus.

A 19-year-old woman with systemic lupus erythematosus had choroidal fluorescein leakage into discreet areas of subretinal fluid. The findings were abolished with corticosteroids. A choroidal vasculitis was suggested by mononuclear infiltration and immunofluorescent demonstration of immunoglobulin.


[Autologous blood transfusion in surgical treatment of deep burns and their sequelae].

The experience of the treatment of 74 burned cases by means of autotransfusion is presented. The application of autotransfusion made it possible to rule out donor blood transfusions in surgical treatment of a considerable group of the burned. There are grounds to believe that different variants of this method will be widely practised in specialized medical installations dealing with the treatment of the burned and with reconstructive surgery.


[Treatment of donor wounds after cutting of full-thickness skin transplants with a dermatome].

An analysis of the results of the treatment of 180 donor wounds following cutting off thick or full-thickness grafts by means of a dermatome in 123 patients with post-burn deformities and contractures is presented. The healing period variants, depending on the thickness of the grafts and on the treatment method, have been found. The authors recommend to cover the donor wounds with thin grafts or with sieve grafts.


[Osteoplasty in surgical treatment of hematogenic osteomyelitis of the spine].

A system of the radical reconstructive surgery for hematogenic osteomyelitis of the spine is described. 47 patients were operated upon; among them there were 16 children. A partial rejection of the bone graft was found in one patient. Repeated necrectomies for the progress of the local process were carried out upon 2 patients. One patient died in the late postoperative period. The radical reconstructive operations cure the disease and favour the recovery of the patients' working capacity.


[Change in the oxygen regimen in the skin of the extremities after the subcutaneous administration of nitrous oxide].

The work deals with the study of the skin oxygen rate in obliterating diseases of the lower extremities. In 40 patients the skin oxygen tension was studied in the first web space of the foot. 19 of these patients were the control group. In the main group (21 patients) nitrous oxide was injected in the subcutaneous fat of the lower extremities within the complex of the conservative treatment. In obliterating arterial diseases of the lower extremities the disorders of the tissue oxygen rate, particularly pronounced in the late stages of the pathological process, were found. The subcutaneous injections of nitrous oxide improved the regional blood flow in the low extremities.


[Results of the surgical treatment of direct and recurrent inguinal hernias using an autodermal implant].

The authors have developed the own method of inguinal herniotomy using an autodermal graft for the plasty of the posterior wall of the inguinal canal in direct and recurrent inguinal hernias. The technic of operation is described. The results of this modified method of herniotomy are analyzed.


[Relationship of postoperative complications to the surgical approach in treating cancer of the proximal portion of the stomach].

The authors have analyzed the interrelationship between postoperative complications and surgical approach in the treatment of carcinoma of the proximal portion of the stomach. The radical operations were carried out upon 140 patients; in 93 of them the transperitoneal approach was applied and in 47-the transpleural one. It has been found that in the transpleural approach the insufficiency of anastomosis sutures and postoperative pancreatitis occur much more seldom, and bronchopulmonary complications rate the first. Such complications are not infrequent after the transperitoneal approach either. The disorders of bronchial permeability constitute the main cause in the occurrence of these complications.


[Nitrogen balance in patients after a radical operation on the rectum].

The nitrogen balance was studied in cancer of the rectum cases before operation and in various periods after it. For a comparative analysis the nitrogen balance studies were carried out in duodenal and gastric ulcer cases and in 25 practically healthy individuals, who constituted a control group. A persistent negative nitrogen balance was found in cancer of the rectum. The authors developed an effective pathogenic therapy with due regard for revealed changes.


Oral administration of neomycin to chickens experimentally infected with Salmonella typhimurium.

Groups of healthy chickens with a light experimental Salmonella typhimurium infection were fed on a diet containing 225 g per ton (1016 kg) of neomycin for two days. This brought about only a slight reduction in the incidence of chickens that were excreting S typhimurium in their faeces. Examination of caecal contents two days after the cessation of treatment revealed the neomycin had not had any effect in eliminating infection. In one experiment, the neomycin administration resulted in the emergence of enormous populations of Escherichia coli in the alimentary tract of treated chickens that possessed multiple antibiotic resistance of the transmissible type. For these reasons the practice of feeding broiler chickens on diets containing neomycin immediately before slaughter should be actively discouraged.


[Cesostoma in tumors of the large intestine and a method for its closure].

Cecostomy is found to prevent effectively suture incompetency of entero-entero-anastomosis in intraabdominal resections in the large intestine in obese patients suffering diabetes and also in aged patients. The method of closing the cecostoma described may be also recommended for elimination of parietal fistulas constructed in other portions of the large intestine. Taking into account a simple technic of closure, using mechanic suture, the availability of suturing apparatuses in many hospitals, it may be recommended for a wide practical use.


[Therapeutic effect of Trental in diabetic angiopathy].

The effect of pentoxiphyline substance--Trental, production of Höchst, was studied in 37 diabetics (12 females and 25 males) aged from 36 to 78. Besides according to clinical manifestations, the therapeutic effect was objectivized in dynamics through the oscillography "Gesenius-Keller", double-rheography "Schufrid", skin thermometer--Tastotherm P 60 "Braun" and 6-canal ECG apparatus "Hellige". Favourable results, evaluated according to all mentioned methods were found in 89.2 per cent of the treated 37 patients; excellent effect in 15 of them 40.5%); very good--in 8 (21.6%); good--in 10 (27.1%) 1 and without effect--only 4 patients (10.8%). Trental is concluded to deserve a wide application in the clinical practice for the peripheral diabetic angiopathy treatment in patients with diabetes mellitus.


[Hazard criteria and the evaluation of the overall toxic and specific effects of chemical compound exposure].

A differentiated establishment of a chronic action threshold for a population and especially of a subthreshold is a basic hygienic parameter necessary for substantiating safe concentrations of chemical substances. Investigations aimed at detecting the penetration of substances into the cells, their intracellular distribution and ascertaining the extent of deranged biochemical processes localized in subcellular formations are of crucial importance in toxicological experiment.


Airway management in croup and epiglottitis.

Treatment techniques for airway obstruction in croup and epiglottitis are reviewed in the medical literature. Series totaling 295 nasotracheal intubations, and 591 tracheostomies were reviewed. There were two deaths attributable to airway complications in 126 patients in whom nasotracheal intubation was carried out. In three patients subglottic granulation tissue and subglottic stenoses developed from short-term nasotracheal intubation. There were no subglottic stenoses or tracheal stenoses reported in the 591 tracheostomies. From this review, it would seem feasible to use nasotracheal intubation for short-term airway treatment in croup and epiglottitis. The increasing occurrence of laryngeal and tracheal complications with long-term intubation suggests that tracheostomy be considered in such cases.


[Histological findings after application of Kveim antigen in animals (author's transl)].

The frequence of local granulomatous changes after injection of kveim antigen and previous sensibilisation (Freund's adjuvant, BCG-vaccine, atypical mycobacteria, implantation of sarcoidotic lymph nodes, human-gamma-globulin of sarcoidotic patients) was investigated in 69 mice and 38 guinea pigs. Granulomata with epitheloid and giant cells, resembling a "positive Kveim reaction" were found in 26% of the mice and 18% of the guinea pigs. Doubtful positive results were observed in 7% of the mice and 5% of the guinea pigs. A high percentage of non-specific foreign body reactions was observed in guinea pigs (82%), relatively scarcely in mice (16%). The most effective method for sensibilisation of the animals is the administration of Mycobacterium avium to guinea pigs or of Kveim antigen with complete Freund's adjuvant and the intraabdominal implantation of sarcoidotic lymph node material to mice.


[Metabolic studies under administration of oral contraceptives. A review].

The use of oral contraceptives can produce changes in the metabolism of carbohydrates, lipids, proteins, vitamins, and minerals. Responsible for the alterations seems to be the used oestrogen- and gestagen derivative and not so much the type of the contraceptive. The most frequent findings are raised serum-glucose-, insulin-, and triglyceride levels; disturbances in protein-metabolism increase the risk of developing thrombosis and hypertonia. Little is known about the significance of oral contraceptives on the vitamin- and mineral metabolism--yet extreme deficiencies have not been observed so far. Oral contraceptives can become an extra risk factor when given to women with metabolic disturbances.


[Colonic anastomoses. Mechanical and morphological findings].

In healthy mongrel dogs 45 colonic anastomoses were performed in one--and two layered inverting and single layered end-on technique. They were compared 4, 8, and 18 days after surgery macroscopically, histologically and by tension testing. All criteria showed the single layered end-on technique to be superior. The principle of Lembert, aiming for contact of large areas of serosa, should be replaced by a technique resulting in exact reconstruction of intestinal wall without mucosal damage.


[Psychosomatics in gastroenterology].

With regard to the superimposed concept "psycho-somatic correlation" we describe the psychopathological mark "Alexithymia" and the related psychodynamic processes (object loss which cannot be mastered, together with following narcissistic insult and aggression defense). In the frame of the psychosomatic pathology are outlined the psychodynamic processes in patients suffering from functional gastrointestinal disorders, duodenal ulcer and ulcerative colitis. With regard to the superimposed concept "soma-to-psychic correlation" we describe the secondary-psychic reactions following the patient's perception of a failure of his bodily functions, namely: reactive anxieties and depression as well as dependency wishes and denial-work. The psychotherapeutic possibilities in psychosomatic patients concern the modifications of the classical psychoanalytic techniques, namely: psychoanalytically orientated group therapy, psychotherapeutic consultation, supportive psychotherapy on the one hand and the behavior therapy on the other hand. In contrast to it, in patients suffering from secondary-psychic reactions particularly the principle of the doctor's and nurses' emotional presence is indicated. However, the ability to realize the emotional presence function presupposes a special advanced training.


Diagnosis of autoimmune chronic active hepatitis a simplified method for the detection of liver membrane autoantibodies (LMA).

A simplified method for the detection of liver membrane autoantibodies (LMA) in patient's serum is presented. Hepatocytes are isolated from the liver of young rabbits. A calcium-free solution without enzymes is injected into the portal vein with a normal syringe. The liver is then cut into small pieces in a solution with calcium, shaken in a water bath, filtered and washed in Eagle's medium. The isolated hepatocytes are incubated first in patient's serum and secondly in FITC labeled antihuman IgG. The test requires three hours and allow the detection of LMA, antinuclear and antimitochondrial antibodies simultaneously. The detection of LMA is valuable in the diagnosis of autoimmune chronic active hepatitis.


The radioimmunoassay and physiology of somatostatin in the pancreas and gastrointestinal tract.

Radioimmunoassays for somatostain have demonstrated that high concentrations of the polypeptide are present in the pancreas and gastrointestinal tract of a number of species. Although measurement in tissue extracts is relatively unproblematic, detection and characterization of somatostatin-like material in plasma has proved technically difficult. Studies of pancreatic somatostatin release in vitro suggest a possible function in the regulation of islet hormone secretion, but the mode of action remains to be elucidated. Although, at present, no clinical relevance can be attributed to the somatostain radioimmunoassay reports of somatostatin secreting tumors and changes in stomach tissue content in patients with ulcer disease indicate a contributory role in the pathophysiology of certain disease states.


[Sudden death in traffic due to natural causes (author's transl)].

Together with the increase in motorisation sudden death at the wheel by natural causes has also gained more importance although this is not a very frequent occurrence. Scattered reports on such cases in the literature are summarized and discussed with regard to recognition, frequency, age and sex distribution, pathological changes and marginal problems, e. g. diagnostic difficulties, risk and prevention. At the top of the list of the causes of sudden natural death at the wheel are disturbances of the cardiovascular circulation and under this heading the ischemical heart diseases with 83%. The frequency peak lies in the sixties age group and in the case of the ischemical diseases generally in the seventies age group which is an indication that driving is particularly a burden for the circulation. The percentage of women (2.6%) is approx. 10 times less than it is in sudden deaths generally, this obviously being due to the fact that women in advanced years do not drive as often as men. In approx. 50% of cases the sudden natural death takes place when the vehicle is stationary. Serious accidents are seldom. Diagnostic difficulties occur when alcohol has been consumed or when in an accident caused by the sickness the victim is fatally injured or when the question of guilt is not clear. Restrictive measures will not completely prevent sudden death when driving; it is most important that a patient with a history of myocardial infarction or of advanced age should be advised of the dangers of driving by the physician treating him.


[The change of the weight of the pineal gland by formalin-fixation (author's transl)].

The weights of 94 human pineal glands were submitted a 3-day-fixation in 10 per cent neutralized formalin, resulting in a loss in weight in one half of the pineal glands and in an increase in weight in the other. After fixation of 4 weeks the difference between actual and initial weight had diminished, only 10.6 per cent of the pineal glands showed a difference larger than +/- 10 per cent. Therefore, the weights of formalin-fixated pineal glands may be used in statistical comparisons. The question why the weights change differently cannot be answered by us.


[Proteinase inhibiting agents and glucagon in acute pancreatitis (author's transl)].

In two prospective studies the effect of proteinase inhibiting agents and glucagon in acute pancreatitis have been studied by a randomised series. Moreover the effect of the basic therapy was examined in additional 103 patients. Symptoms, clinical and laboratory chemical findings correspond to each other in all collectives. The results seem to be the best ones in those patients having been treated by basic therapy only.


[Liver transplantation in a case of angiosarcoma and thorotrast fibrosis (author's transl)].

After a short survey of the development of liver transplantation on the basis of three liver transplants performed in this department, a case of angiosarcoma due to thorotrast fibrosis is reported. The problems cocerning surgical technique have been overcome at this time. However the questions concerning immunology, procurement of organs and organ preservation are predominant. Critically observed, liver transplantation has not yet emerged from the stage of clinical experimentation today.


[Characteristics of the ovarianc cycle in the baboon (Papio hamadryas)].

The dynamics of estradiol, estrone, 17 alpha-hydroxyprogesterone, progesterone and 20 alpha-dihydroprogesterone were investigated in the blood plasma of the pavian (papio, hamadryas) with regard to the menstrual cycle and in comparison with the human. Furthermore results were presented about the basal temperature, the fern phenomenon and the development of the sex-skin in the pavian.


[1st experiences with a cytological data collection system based of EDP].

On the basis of the experience which was gained with the use of EDP in the documentation of patient data a compatible system for request, processing and documentation for cytological examinations was developed. It was introduced into routine work in July 1976. Since then there as been an increase in the efficiency of the cytological examinations by abolishing manual recording. Further on, this has lead to better possibilities for scientific evaluation. The system is user-oriented as far as the request for examinations and the establishment of diagnoses are concerned by automatically produced reports. The application of this project by others is possible.


[Hysterographic examination of unilayer lointed wound margins following cesarean section].

The authors give an account of their examinations with hysterography after caesarean sections and present the various arrangements of the subject in the literature. They state that the employment of a single-layered suture for the fusion of the lips of wound of the uterus gives a better result than the use of a double-layered suture. They emphasize the importance of the examination and mention the possibilities of therapy, too.


[Histological examination of uterus healing following cesarean section].

Scar tissues obtained in the course of a number of caesarean sections were histologically examined. The quality of the tissues were classified according to vascularization and muscularization. It has been found that the employment of a single-layered suture always gives a better result than that of a double-layered suture.


[Our experience in the surgical management of stress incontinence].

When performing correction of the cystocele in the procedure of the colporrhaphy, Kennedy stitches should be applied. By the formation of the muscular plaque where the urethra is sliding stress incontinence is corrected and recurrence of cystocele is prevented. --In cases of isolated occurrence of stress incontinence our result, in our opinion, are not satisfied. The recurrence is going from 13,04% to 24% in relation of the sort of operation and the degree of stress incontinence.


Enterotoxigenicity among salmonellae--a prospective analysis for a surveillance programme.

Gastroenteritis and food poisoning caused by several Salmonella serotypes are frequently observed in many countries. In particular, S. typhimurium has been found ranking first that put forward the question whether S. typhimurium can be characterized by distinct biological properties. In this paper attempts to characterized 378 Salmonella strains according to their enterotoxigenicity by means of the vascular permeability factor (PF) have been summarized. PF-positive strains are common among all Enteritis-Salmonellae, in particular among S. typhimurium. This serotype is also found with quantitative strongest PF activity. PF-positive strains are found to be active producers of exo-enterotoxins, which have been characterized as LT-enterotoxins by other assays, too. Since the capacity of Enteritis-Salmonellae to produce enterotoxins is in accordance with their clinical and epidemiological importance, the determination of the PF-factor as a rapid screening assay for enterotoxigenicity is proposed in this paper in order to survey epidemiological and clinical significant Salmonellae.


Shigella sonnei colicine and phage types in East Bohemia region.

From November 1972 to the end of 1975, Shigella sonnei types implicated in dysentery morbidity in a number of districts of East Bohemia region were studied. 301 strains subjected to phage typing and colicine typing were classified into 45 "combined" types. During the study five types prevailed in succession, each for a protracted period of time. Four of these types retained, in the great majority of cases, their original high drug sensitivity throughout the period of their prevalence. Other types were only encountered transiently and sporadically. As a result of a phagerestrictive effect of newly acquired plasmids there occurred, in rare instances in some strains, a change in phage type; or the colicine type changed while the phage type was retained as a result of another col factor having been acquired by the strain. The changes occurred in the course of epidemics.


[Construction and operation of an anaerobic glove box (author's transl)].

Construction and operation of an anaerobic glove box is described mainly built of commercially available material. The box is made of refined steel and has the dimensions of 150 cm in length, 62 cm in height and 68 cm in depth. It is equipped with one round vacuum tight steel airlock for transfer of material. Three Neopren gloves and an oblique glass window are installed into the frontside. The anaerobic box is continuously perfused by 35 l/h of O2-free gas. In the box the atmosphere is whirled round by a fan and hereby led over a layer of catalyst. The O2-content of the anaerobic atmosphere is less than 1 ppm-3 ppm to 4 ppm on a yearly average - measured by an oxygen trace analysor. All bacteriological work as cultivation and isolation of strictly anaerobic bacteria can be done within a continuous O2-free atmosphere by conventional technics. The anaerobic glove box described was used for three years without any failure. In glove boxes built in the same manner as above mentioned similar O2-values will be achievable.


Identification and reduction of carcinogens in the respiratory environment.

Epidemiological studies have implicated three factors in the overall increase of lung cancer--tobacco, especially cigarette smoking, urban pollution and, to a lesser extent, certain industrial respiratory environments. Some data were discussed on carcinogenic industrial inhalants, and on the possible effect of urban pollution. The reduction of pollution and that of specific environmental agents is stressed. Laboratory studies on the identification of carcinogens in cigarette smoke and their reduction toward the "less harmful cigarette" represent a part of this aspect.


[Problems in ecology and hygiene of coastal waters (as exemplified by the baltic sea) (author's transl)].

A summary is given on ecological and hygienic problems of coastal waters, beginning with an outline of the different standpoints in ecology and hygiene. Because of close interrelationships between these fields, the hygienist is introduced to the ecological problems of the Baltic Sea. Hygienic questions have drawn attention because of the so-called Baltic Sea disease (Red tides?--Indication of virus contamination by bacterial indicators of faeces?). On the basis of the results of a two-year authoritative study of the German Baltic Sea coast, a discussion is presented on 1) the relationship between the coli titer and the frequency of salmonella detection, 2) the necessity of routine tests for salmonella, 3) aims of bacteriological cleanliness, 4) the importance of chemical parameters for evaluation, 5) necessary measures for prevention of pollution of the water and beaches of the Baltic Sea. Emphasis is placed on the fact that for ecological reasons the third stage of sewage purification has attained increased significance. The paper refers repeatedly to international agreements (Baltic Sea Convention of 1974, the 1975 WHO report on the recreational quality of beaches and coastal waters, European Community guidelines of 1975) and their relations to the presented findings and considerations.


[Coprosterol as chemical indicator in coastal seawater (author's transl)].

As bacteriological examination of water often needs a longer time, it was tried to use chemical indicators for detecting sewage pollution of water. Such a chemical indicator is coprosterol, a sterin derivative, which is discharged from human and animal enteric systems. For epidemic evaluations, E. coli, normally not present in pure water, is a good fecal bacterial indicator. Wether there does exist a certain parallelity of the amount of coprosterol and the presence of E. coli, water from bankfiltration systems and coastal seawater were examined. The presence of E. coli was not in every case accompanied by a positive coprosterol test, so that epidemic evidence is not shown by the latter. Nevertheless, the test may be good to evaluate mixing procedures between two different kinds of sewage polluted water or between groundwater and surface water.


[Disinfection of effluents from municipal sewage  treatment plants with hydrogen peroxide (author's transl)].

Effluents from different sewage treatment plants were disinfected, using hydrogen peroxide in concentrations varying between 500 and 50,000 ppm. With a concentration of 5,500 ppm H2O2 and a contact time of 2 h more than 99% of bacteria were killed, including enterobacteria, total and fecal coliforms (Fig. 1 A, B, C and D) and fecal streptococci (Fig. 2 B). Staphylococci and micrococci were less sensitive and contact times of 2 h were not sufficient to kill 99% of this group (Fig. 2 A). Highly resistant were bacterial endospores (Fig. 2 C). With a concentration of 5% H2O2 50% of the spores still survived after a contact time of 2 h (Fig. 2 D). The effect of 5,500 ppm H2O2 by an exposure time of 2 h was then studied with other effluents. The results show that total counts were also reduced for 90% and some groups for more than 99% (table 1). There was no difference in reduction between catalase positive and catalase negative micro-organisms, indicating that the catalase activity of the bacteria offered no special resistance towards hydrogen peroxide in the concentrations used (table 2). Although the observations of some investigators have shown that metal ions act to increase the bactericidal effect of H2O2 as a result of formation of hydroxyl radicals, the additions of ferrous ions (5,25 and 50 ppm) did not improve the killing activity of H2O2 (table 3).


Dimensionality reducing displays in cell image analysis.

The paper discusses the problem of representation of multivariate cell data sets in two dimensions such that the essence of the situation as represented by the multivariate feature space is preserved. A corresponding projectional technique has been developed and illustrated on a set of five different cell types of ectocervical cells, including normal and carcinoma cells.


Computer recognition of ectocervical cells. Classification accuracy and spatial resolution.

The effect of a relaxation of the spatial resolution of images of ectocervical cells on classification accuracy by computer has been studied. The discriminatory capabilities of optical density, texture and shape features have been evaluated. Comparable computer classifications have been derived. The differences in the discriminating power of .5 and 1 mu resolution are found to be smaller than the differences corresponding to 1 and 2 mu resolution. While 2 mu resolution may be marginally acceptable in certain situations, the 4 mu resolution did not render acceptably good classification rates.


An analysis technique for biological shape-III.

The motivation for a syntactic theory of shape was a belief that computer shape analysis could mimic human recognition procedures. The results described here suggest that heuristic techniques can be used to decompose and analyze complex objects. The derived decomposition algorithm gives quite good results when compared with human lobe determinations. In addition, it seems to follow closely the actual procedures used by observers in classifying shapes. The list structure output of the program clearly describes each shape element and greatly facilitates further analysis. Extensions of this work should be directed toward the development of more specific "rules" for shape decomposition, and more complete orientation information in the output list structure.


Acid secretion and cyclic nucleotide content of the guinea pig isolated stomach in the presence of the ionophore A23187.

The involvement of calcium ions in stimulus-secretion coupling in the gastric mucosa is uncertain. Acid secretion and mucosal cyclic nucleotide content of an isolated stomach preparation from the guinea-pig have been measured in the presence of the ionophore A2318 (Lilly) over the concentration range 10(-6) M both in the presence and absence of a phosphodiesterase inhibitor (ICI 631978 1 X 10(-4) M). The rate of acid secretion and cyclic nucleotide content were increased by ICI 63197 as expected but were unaltered by the ionophore. These results suggest that a change in intracellular calcium ion concentration does not alter acid secretion in this preparation.


A system for scanning biological cells in three colors.

A system for scanning biological cells under high magnification has been developed which utilizes a three-color photometer. The spectral information has proved useful in improving computer recognition of certain cell types.


Computer recognition of binucleation with overlapping in epithelial cells.

A technique for computer recognition of binucleation with overlapping in epithelial cells was derived. The computer program uses analytic features related to nuclear contour only. The feature set includes moments, Fourier transform features and linguistic features. The algorithm works satisfactorily in instances where the human eye would detect the presence of two nuclei at first glance.


Solitary reticulum cell sarcoma of the uterine cervix with initial cytodiagnosis.

A minimally symptomatic elderly woman was discovered to have reticulum cell sarcoma involving the uterine cervix on the basis of cervico-vaginal smears taken in the absence of a visible mass lesion. The diagnosis was confirmed by biopsy, and subsequent clinical and operative staging revealed the tumor to be arising in and confined to the uterine cervix. The cytologic features of reticulum cell neoplasia are repetitive and highly characteristic irrespective of its site of origin.


Computer recognition of abnormal ectocervical cells. Comparison of the efficacy of contour and textural features.

The efficacy of contour and texture features for the computer recognition of abnormal ectocervical cells is compared. For this comparison, three cell groups were formed: benign, suspicious and malignant. Nine decision rules were derived. The discrimination attained by features derived from the contours of nucleus and cytoplasm is comparable to that achieved by textural features. A combination of both kinds of features gives best results.


I.C.I. 35868 - The effect of a change of formulation on the incidence of pain after intravenous injection.

I.C.I. 35868 is a promising new intravenous induction agent, but intravenous injection of the initial 2% formulation frequently caused pain. The solvent vehicle of the 2% formulation, which contained Cremophor E.L. and ethanol, was therefore investigated to see if this could be the cause of the pain. Twenty volunteers received both 5 ml isotonic saline and 5 ml solvent vehicle intravenously. The injection of saline never caused pain, but the solvent caused mild or moderate pain in 9 patients. I.C.I. 35868 was therefore reformulated in a 1% solution, excluding ethanol from the solvent. When intravenous injection of I.C.I. 35868 1% was compared to methohexitone 1% in 24 patients, both agents caused pain. Four out of 12 patients reveiving I.C.I. 35868 1% felt pain, with a total pain "score" of 6, but 6 out of 12 patients who received methohexitone 1%, felt pain, with a total pain "score" of 12. In no instance was intravenous injection followed by persistant pain, or evidence of thrombosis or phlebitis.


Cytomorphology of gynecologic specimens analyzed and sorted by two-parameter flow cytometry.

The purpose of this study was to define the fluorescence and light scatter properties of the different cell types encountered in gynecologic specimens. Samples stained with Chromomycins A3 were analyzed on a laser-activated electronic cell sorter, and two-parameter histograms of the cell populations were generated from measurements of nuclear fluorescence and small angle light scatter. Cell populations with defined scatter and fluorescence ranges were sorted, stained by a modified Papanicolaou technique, and evaluated using conventional cytomorphologic criteria. We focused on determining which regions of the histogram corresponded with abnormal cells and cells defining specimen adequacy (columnar and metaplastic cells). Sorted cells corresponding with the main fluorescence region are single, benign, mononuclear cells. Relative proportions of the different types of cells in this region vary with light scatter. Leukocytes predominate at low scatter, mature squamous cells predominate at high scatter, and metaplastic and endocervical cells occur throughout this range. Cells sorted with higher values of nuclear fluorescence include dysplastic and malignant cells as well as benign cells occurring as groups, multinucleates, or with adherent leukocytes or bacteria. This study demonstrates that cytomorphology is a useful method for monitoring and interpreting flow cytometry data.


Postnatal development of the pancreas in the opossum. Light microscopy.

The pancreas of the newborn opossum consists of a central region of forming islets surrounded by primitive tubules that end in proacinar cells. Paratubular buds, which are outgrowths from the tubular epithelium, characterize the newborn pancreas and eventually give rise to both exocrine and endocrine units. 4 days after birth, definite intralobular ducts, acini and centroacinar cells are observed. In addition to the central expanding islets (primary islets), endocrine cells are observed singly or in small groups in the ductal epithelium. The endocrine cells are believed to originate from the terminal cells of the ductal epithelium and, throughout the entire postnatal period, retain a close association with the exocrine epithelium. With the simultaneous proliferation of both endocrine and exocrine components from the ductal system, the majority of the islets observed at 24 days (5.0 cm) appear to be surrounded by a single layer of acinar cells. As acini develop and the ducts expand toward the periphery, this layer of acinar cells separates from the developing islets, the majority of which have become localized within the centers of lobules to form the secondary islets by the 10.0-cm stage (59 days). A marked development of lobules is observed by the 13.0-cm stage and the majority of acinar cells now are filled with zymogen granules. Acinar cells continue to proliferate late into the postnatal period and the majority of acini exhibit a tubular form in the juvenile and adult opossum.


Inhibitory action of rat insulin and synthetic rat C-peptide on insulin secretion in the perfused rat pancreas.

In order to determine whether both insulin and C-peptide have an inhibitory action on insulin secretion, the isolated rat pancreas was perfused with exogenous rat insulin or synthetic rat C-peptide in the presence of high or low concentration of glucose. In the presence of 2.8 mM glucose, exogenous rat insulin (4 or 10 ng/ml) and C-peptide 1 and 2 (100 ng/ml) show no effect on the insulin levels in the outflow from the perfused pancreas. However, the insulin response to 16.7 mM glucose decreased in the presence of exogenous rat insulin or synthetic rat C-peptide, showing a biphasic pattern of glucose-induced insulin release. When rat insulin or C-peptide were added at 20 min and removed at 40 min while the isolated pancreas was exposed to a 60-min glucose infusion (16.7 mM), glucose-induced insulin secretion decreased during the infusion of rat insulin or C-peptide. The present study clearly showed that exogenous rat insulin and synthetic rat C-peptide 1 and 2 inhibited glucose-induced insulin secretion. Although the suppressive mechanisms of the exogenous insulin and the C-peptide on insulin release are not yet proved, the inhibitory process is considered to be related to cyclic AMP in the pancreatic B-cell.


Morphological properties of experimentally produced target fibres in tenotomized rat gastrocnemius muscle.

The gastrocnemius muscles of 3 groups of 10 rats, sacrified 5, 7, and 12 days respectively, following tenotomy, were submitted to different types of fixation, fixative and embedding. The occurrence of target fibres is shown not to be an artefact due to the histological procedures. Further examination demonstrates that the target phenomenon occurs in the shortest fibres on the medial side of both heads of the gastrocnemius muscle and that it consists mainly of a disarrangement of the contractile elements of the muscle fibres. This study argues that this phenomenon represents some kind of myotonic state of a pathological muscle.


Microcirculation in grafted bone. A chamber technique for vital microscopy of rabbit bone transplants.

A method enabling in vivo observations of the microcirculation in orthotopically transplated bone in the rabbit is presented. The technique permits repeated study of a well-defined bone tissue compartment both before and after grafting to an autogenous or allogenous recipient site, respectively. It yields information about the reorganization of the microvascular system and the resorptive and formative processes of bone remodelling during incorporation of grafted bone. In the autologous experimental series, new capillaries were seen in the bone grafts 4 to 5 days after transplantation. No re-utilization of pre-existing graft vessels was observed.


Cotrel traction, exercises, casting in the treatment of idiopathic scoliosis. A pilot study and prospective randomized controlled clinical trial.

A pilot study of ten individuals with adolescent-onset idiopathic scoliosis demonstrated that a week of Cotrel traction and exercises did not improve curve correction obtained by the application of an elongation, derotation, flexion (EDF) cast. There was, however, a significant improvement on lateral bending correction during this period. A prospective, randomized, controlled clinical trial showed that the exercise programme and not the traction was responsible for rendering the spine less rigid.


Intraosseous lipoma. A report of two cases.

Intraosseous lipoma seems to be a rare condition as only some 20 cases have been reported so far. A further two cases are described the lesions being in the calcaneus and in the tibia. Radiographically the lesions appeared osteolytic and well delineated, containing calcified areas. The microscopic features were those of mature adipose tissue. Curettage and packing with autogenous bone grafts is recommended, if the lesion causes pain or a correct diagnosis cannot otherwise be obtained.


Comparison of nitrite and dipslide methods for bacteriuria screening.

The results of screening for bacteriuria by the nitrite reaction and the dipslide method were compared. The nitrite reaction was specific in 99.8%, its sensitivity was 93.1% and its reproducibility, 100%. Specificity of the dipslide method was 94.5%. The nitrite reactions is considered most suited for screening, owing to its specificity, satisfactory sensitivity, short time requirement and low cost. The dipslide method is not suited for screening, as apart from being expensive it yielded 5.5% false positive reactions, but proved excellent for estimating the bacterial count in nitrite positive samples.


MVPP chemotherapy combined with radiotherapy in the treatment of Hodgkin's disease in children.

Thirty-four children with Hodgkin's disease were treated during the years 1969--75. After radiotherapy, 7--15 cycles of MVPP were given within 24--53 months. In order to avoid chronic leukopenia, leukocyte counts were made frequently during chemotherapy, and the drug doses adjusted accordingly. A complete remission was obtained in 32 of the 34 children. Two patients died because of progressive disease. Twelve of the 32 survivors have been followed for at least 5 years, and a further 12 for at least 3 years. Three children are still on chemotherapy, whereas the remaining 29 being followed are in continued complete remission.


Successful treatment with CPAP of two infants with bronchomalacia.

Two children with severe bronchial collapse secondary to bronchomalacia improved dramatically after institution of continuous positive airway pressure (CPAP). Treatment was discontinued after 14 weeks without reappearance of symptoms. Repeated bronchoscopy revealed a diminution in the bronchial collapsibility. It is suggested that CPAP should be given if generalised bronchomalacia is present to tide the children over a bad period while the bronchus is becoming more stable.


On the disulfiram-like effect of coprine, the pharmacologically active principle of Coprinus atramentarius.

Coprine or disulfiram was given to rats in various doses at various time intervals before the administration of 2 g/kg ethanol. The ratio acetaldehyde/ethanol in the alveolar air was measured by gas chromatography and was taken as an index of the aldehyde dehydrogenase (ALDH) activity. The activity of dopamine beta-hydroxylase (DBH) was estimated in the same animals by measuring the amount of 14C-octopamine formed from 14C-tyramine in the heart. Coprine and disulfiram both caused an increase in the acetylaldehyde/ethanol ratio, coprine being more potent than disulfiram. Disulfiram, but not coprine, reduced the net yield of 14C-octopamine. In rats pretreated with either coprine or disulfiram, blood-pressure and heart-rate were recorded before and after intraperitoneal injections of 0.4 g/kg ethanol. In both cases ethanol caused a marked and rapid fall in blood-pressure. However, this effect was accompanied by tachycardia only in animals treated with coprine. It is concluded that coprine like disulfiram inhibits ALDH, but only disulfiram causes an additional inhibition of DBH. This difference may account for differences in the cardiovascular response to ethanol.


Activity of noradrenergic neurons of medial-basal hypothalamus of female rabbits in some stages of reproduction. Acta Physiol. Pol., 1978, 29 (2): 111--115. The differences were found in the activity of noradrenergic neurons of medial-basal hypothalmus (MBH) estimated by the analysis of metabolism of intraventricularly infused 3H-noradrenaline (3H-NA) in various stages of reproduction in female rabbits. The gonadal hormones and especially 17beta-estradiol seem to be involved in this activity. The rapid disappearance of 3H-NA from MBH, found immediately after mating, implicates an involvement of noradrenaline in the process of Gn-RHs release form the rabbit hypothalamus.


Large scale studies with vitamin C.

The combination of a regular daily supplement of vitamin C with extra dosage at the time of illness has been shown to reduce the disability due to common colds and other winter illness, but we have seen little effect on frequency of infections, sense of (well-being), or levels of serum cholesterol. The variable results that have been obtained from some other trials of vitamin C may be due in part to variation in the initial nutritional state of the subjects, with the greatest effects to be expected where there is most room for improvement. Because of the great variation in individual susceptibility to infection large numbers of subjects are required in these trials and they must be strictly double-blind. Although we have seen no clear evidence of harmful side-effects, occasional sensitivity to large doses of vitamin C cannot be ruled out, and the withdrawal depression of blood levels could conceivably interfere with a patient's ability to handle stress.


The nature of myospherulosis of the upper respiratory tract.

A case of myospherulosis of paranasal sinuses similar in appearance to those recently seen in St. Louis, Missouri, was examined to ascertain the nature of the sac-like structures seen in this disease. The morphologic features of these formations and their positivity with stains for hemoglobin, peroxidase, and lipofuscin strongly suggest that they represent collections of erythrocytes altered by a foreign substance. This interpretation was confirmed by experimental production of these structures by the action of tetracycline ointment on a pure preparation of human erythrocytes.


The leukemic phase of histiocytic lymphoma. Histologic, cytologic, cytochemical, ultrastructural, immunologic and cytogenetic observations in a case.

A case of histiocytic lymphoma that progressed to a leukemic phase was studied by various methods. Although the cells were found to bear a superficial morphologic resemblance to histiocytes, they more closely resembled transformed lymphocytes. Immunologic markers strongly supported a B-lymphoid origin in this case, while cytogenetic analysis indicated a large number of consistent chromosomal rearrangements, including a translocation involving chromosomes Nos. 8 and 14 which has been previously reported to occur primarily in Burkitt's lymphoma.


Visceral larva migrans. A review and reassessment indicating two forms of clinical expression: visceral and ocular.

Visceral larva migrans is a disease in which the larvae of animal parasites invade human tissues but do not complete their life cycles. The most frequent cause of this illness in children is the dog roundworm, Toxocara canis. A review of the literature, as well as our clinical experience, indicates that there are two forms of clinical expression: one, visceral, and the other, ocular. In general the clinical and laboratory abnormalities (hepatomegaly, recurrent pneumonia, eosinophilia, and hyperglobulinemia) usually associated with visceral disease are absent in children with ocular abnormalities. Conversely, there is a general lack of eye complications in patients with systemic disease. Reasons for these variations in clinical expression are unknown, but immune responses of the host and the antigenic composition of the parasite may be contributing factors.


Biochemical, immunological, and cell genetic studies in glycogenosis type II.

Fibroblasts from patients with the adult, juvenile, and infantile form of glycogenosis type II (Pompe disease) were cultured under standardized conditions, and the activity of acid alpha-glucosidase (E.C.3.2.1.20) towards glycogen, maltose, and 4-methylumbelliferyl-alpha-D-glucopyranoside was measured. Glycogen levels in muscle biopsies and in cultured fibroblasts from patients were determined. Residual enzyme activities varying from 7%-22% were detected in fibroblasts from patients with the adult form but not from patients with the infantile form of glycogenosis II. An inverse correlation was found between the severity of the clinical manifestation and the degree of residual enzyme activity in the fibroblasts. The kinetic and electrophoretic properties of acid alpha-glucosidase in fibroblasts from the adult patients and from control individuals were similar. Immunological studies suggested that the decrease of acid alpha-glucosidase activity is caused by a mutation that affects the production or degradation of the enzyme rather than its catalytic activity. Complementation studies were carried out by fusing fibroblasts from patients with the adult, juvenile, and infantile form of glycogenosis II, but neither conventional assays on multikaryons nor enzyme assays on single binuclear heterokaryons gave any evidence for genetic heterogeneity among these forms.