[Double blind study of the action of two topic drugs on the thrombosis of the carotid artery of rats after microsuture (author's transl)].

The action of 2 topic agents on the thrombosis of the carotid artery after microsuture was studied in rats. These drugs were magnesium sulfate whose antithrombotic effect has been demonstrated in vitro, and Ringer lactate considered inactive on coagulation. Twenty-two randomized rats underwent an end-to-end microsuture of the primitive carotid artery, the solutions being used to wash the lumen of the vessel and to irrigate the operative field. Arterial patency was controlled after one hour and after 10 days. No statistically significant difference was found between the two series.


Diagnostic problems on nosographic classification of polycystic disease of the ovary.

Nineteen patients with polycystic disease of the ovary have been studied. From the humoral point of view the group was found to consist of two populations distinguishable from one another by their basal LH levels. In type I cases LH was definitely increased (M = 53.46 +/- 12.79 mIU/ml) whereas FSH (M = 8.10 +/- 0.74 mIU/ml), prolactin (M = 10.48 +/- 2.12 ng/ml), 17beta-estradiol (M = 124.76 +/- 11.21 pg/ml), progesterone (M = 0.321 +/- 0.078 ng/ml) were all within the normal range for the follicular phase of the menstrual cycle. Testosterone levels were raised (M = 121.15 +/- 24.55 ng/100 ml) but not to an extent significantly different from that of patients with type II disease (M = 119,5 +/- 33.53 ng/100 ml). All the other hormonal parameters were within the normal range also in type II disease; for LH the difference between the means of the two groups was statistically significant (p less than 0.01). Urinary 17-ketosteroids were not significantly different in the two groups of patients and the values found always fell within the normal range for our laboratory. LH-RH stimulation (50 microgram i.v.) elicited an exaggerated response in type I and a normal one in type II. The FSH response was always deficient and delayed in both groups. Since there was no correlation of the humoral data to the macroscopic aspect of the ovary as visualized by celioscopy, the practical importanze of endocrine exploration of these cases is stressed, especially as regards LH levels and androgen secretion, at least for the identification of cases in which polycystic disease of the ovary is suspected.


Fresh autotransfusion in major surgery.

The purpose of this study was to investigate whether 600-800 ml of fresh autologous blood, withdrawn just before anesthesia and retransfused at the end of the operation, would reduce early postoperative anemia. Thirty-nine patients undergoing abdominal hysterectomy were autotransfused, while 44, submitted to the same operation, served as controls. Appropriate amounts of lactated Ringer solution were infused during phlebotomy and operation. The cardiovascular system remained stable and diuresis high. Postoperative complications were few and did not prolong hospitalization. The mean peroperative blood loss per patient was 680 ml. Fresh autotransfusion did not improve early postoperative anemia.


Morphological differentiation of the fossil dinosaur bone cells. Light, transmission electron-, and scanning electron-microscopic studies.

The investigation was carried out on the fossil dinosaur bone from before 80 million years. Samples for examination were prepared with specially elaborated methods. Thus the isolated osteocytes of the dinosaur bone, which had previously undergone natural fossilizing processes, were obtained. This permitted their morphological assessment. On the basis of the images obtained in the light, transmission electron, and scanning electron microscopes, two types of osteocytes were distinguished. Type I was characterized by an elongated shape, its length exceeding the width several times; the mean dimensions of this osteocyte amounted to 28.8/7.03 micron. Type II was shorter, its mean dimensions being equal to 20.28/6.88 micron. Moreover, two types of osteocytes processes were differentiated: the first was represented by thick processes, so-called 'axial processes', whose diameter ranged from 0.5 to 1.5 micron, and which, as a rule, departed from the pole of the cell. They ran farther from the mother cell body to more distant osteocytes. The other type consisted of thin processes departing from various points of the cell body in no particular arrangement but always extrapolarly. They branched off in a close vicinity of the mother osteocyte. Their diameter ranged between 0.076 and 0.35 micron.


Observations on living rat spermatogenic cells in different developmental stages.

In the seminiferous tubules of the rat, as in most mammalian species, the developing germ cells form associations with constant cell composition. These cellular associations or stages follow each other in a regular manner along the seminiferous tubules giving rise to seminiferous epithelial wave. When a freshly isolated unstained seminiferous tubulus of the rat is subjected to transillumination under a stereomicroscope, the different segments of the seminiferous epithelial wave absorb light in a characteristic manner permitting their recognition. Using this technique, small segments with accurately known cell composition can be isolated and studied in living state with phase-contrast microscopy. In several cases, the phase-contrast microscopy gives more information about the cell morphology than conventional histological methods. In this study all major developmental steps from early spermatogonia to mature spermatids have been described. The findings of the present study can be used as reference material in the evaluation and identification of the various cell types of the seminiferous tubules obtained, e.g. by the Staput fractionation method. In addition, the findings may be helpful in the evaluation of spermatogenic and Sertoli cells in culture conditions.


Marginal leakage and consistency of the composite resin material in etched cavities.

The purpose of the study was to evaluate the degree of adaptation of undiluted and diluted composite resin to etched enamel walls with and without an intermediary resin. Cavities (O = 2 mm) were drilled in extracted teeth and the walls were etched with phosphoric acid. Fillings were made of Concise composite resin, without applying an intermediary resin (1), after applying the resin layer (2), after diluting the mix with one (3) or two (4) drops of catalyst resin but without an intermediary resin, and after diluting the mix and applying the resin layer (5). The fillings were ground flush with the tooth surface and the teeth were cycled thermally between two dye solutions baths. The marginal penetration of the dye was evaluated by measuring the discoloured portion of the margin at different depths using a stereomicroscope. The restorations with an intermediary resin (2 and 5) exhibited significantly less leakage than fillings without the intermediary layer (1, 3 and 4). When no resin layer was applied the dilution of the mix seemed to reduce the leakage compared with undiluted material but the differences were not statistically significant. The results indicate the advantage of using an intermediary resin with etching even when the composite is diluted.


Glia-specific antigen in the intracranial tumors. Immunofluorescence study.

26 gliomas and 14 non-glial tumors were examined for the presence of nervous system specific antigen (CGSA) to assess the antigenic properties of neoplastic tissue in relation to histogenesis and degree of differentiation of tumors. Double layer immunofluorescence (IMF) technique was used for the cellular localization of the antigen. CGSA was found in the cytoplasm of normal, reactive and neoplastic neuroglial cells. Well differentiated astrocytomas showed the strongest IMF reactions and largest number of IMF-positive cells. Tumors with histological signs of anaplasia displayed foci of IMF-negative cells irregularly distributed in the sections. There were no completely negative astrocytomas owing to a marked affinity of the specific astisera to the astrocytic cell line. In the oligodendrogliomas a smaller amount of the antigen was found than in the astrocytomas. Histological evidence of malignancy in these tumors was accompanied by strikingly small number of positive cells and weaker IMF reactions as compared to the well differentiated oligodendrogliomas. Anaplastic gliomas showed only traces of CGSA and non-glial tumors were entirely negative. The results suggest a deficiency of normal antigenic material in the neoplastic glia, particularly of oligodendrogliomas and anaplastic gliomas.


The stability of water in the pores of acid etched human enamel.

A mechanism is proposed, explaining the fact that drying by compressed air for 5-10 sec. will remove acid and dissolved enamel from the relatively long and narrow pores of etched enamel surfaces. It is a consequence of the proposed mechanism that water in the liquid state is not stable in the pores, and accordingly, that condensation of water vapour on the etched and dried surfaces is not likely to occur. This was confirmed by studying tag formation in etched enamel surfaces under conditions where water vapour will condense on unetched tooth surfaces.


Intrauterine death due to infection with group B Streptococci.

During the 6-year period 1970-1975 5 cases of late intrauterine death caused by group B streptococcal infection were seen in two obstetrical departments in the Stockholm area. During the same period 17 638 infants were born in the two departments, and in 117 cases intrauterine death occurred. Hematogenous spread of the infection from the mother was the most likely cause in the 5 cases. This figure should be compared with a carrier rate of 15-20% in pregnant women in the Stockholm area.


Doxycycline (Vibramycin) in pelvic inflammatory disease.

Using standardized laparoscopy technique, fluid was aspirated from the pouch of Douglas, from the Fallopian tubes and from ovarian cysts in 85 cases with clinical diagnosis of pelvic inflammatory disease (PID). The concentration of doxycycline in the aspirates was measured after oral ingestion of 200 mg of doxycycline (Vibramycin). A therapeutic level was achieved in the tubes and in ovarian cysts within a few hours, and on continuation of the treatment these values followed the plasma concentration closely, still being within the therapeutic range 24 hours after the final dose. The clinical effect was excellent, 94% (60/64) of the cases with verified PID being cured by doxycycline.


[Therapeutic effect of piracetam in a case of posthypoxic action myoclonus (author's transl)].

Since the advent of intensive care units the number of cases of posthypoxic action or intention myoclonus has greatly increased. This has given rise to renewed research into the physiopathology and therapy of the disease. The latent effective treatment is based on derivatives of benzodiazepine, and especially L-5-hydroxytryptophan, administered with or without an inhibitor of peripheral decarboxylase. The disadvantages of these compounds, associated with their secondary effects, make our fortuitous discovery of the effectively curative action of piracetam doubly valuable.


Decreased fetal movements and polyhydramnios.

It was previously demonstrated that in high-risk pregnancies, pronounced reduction of fetal movements until cessation, with audible fetal heart sounds, indicates severe fetal distress and impending death. Immediate delivery is indicated provided the fetus is viable. Three instances of cessation of fetal movements associated with polyhydramnios are reported; the fetuses proved to have malformations lethal for the newborn infant. These cases of polyhydramnios with diminished fetal movements stress the importance of investigating fetal morphology in this condition. Antenatal diagnosis of congenital anomalies may influence decisions about intervening in cases of decreased fetal movements.


A double-blind study of the influence of tranexamic acid on the central corneal thickness after cataract extraction.

A double-blind study of the influence of systemic tranexamic acid on the central corneal thickness after cataract extraction was performed in 17 pairs of patients. Apart from the cataract, no were present. A sequential statistics was used to show that the increase in central corneal thickness after operation was significantly less in the tranexamic acid treated group than in the placebo group. There was no significant difference in intraocular pressure between the tranexamic acid and the placebo treated group. The possible influence of tranexamic acid on the thickness controlling mechanism of the cornea is discussed, and studies concerning the fibrinolytic system, the complement system and the aqueous humour amino acid treated patients are mentioned.


Progress in cataract surgery using microsurgical technique.

A microsurgical technique for cataract extraction is presented. The operations were performed with a corneal incision and a continuous nylon 10-0 suture. This technique is evaluated by the study of 1289 cases, consecutively operated on. The complication rate was very low. Haemorrhage in the anterior chamber was found in 1%. Delayed reformation of the anterior chamber occurred in only two cases. No cases of iris prolapse occurred. The intraocular pressure was not interferred with by the operation. Wound rupture following removal of the suture three months post-operatively occurred in 1%. The advantages of the corneal incision and continuous nylon suture are discussed (less irritation, good and secure wound closure).


The effect of 1.5% timolol maleate on intraocular pressure.

A controlled trial was instituted to compare the effect on intraocular pressure of topical administration of timolol maleate with epinephrine hydrochloride. A bottling error by the manufacturer resulted in the placebo bottles containing 1.5% timolol maleate. This drug given twice a day for two weeks significantly reduced intraocular pressure and produced no side effects.


Vascular histology of the guinea pig cochlea.

Detailed histological findings on all the regularly occurring cochlear vessels in the normal guinea pig are presented. Vessels were examined using a surface prepration technique and phase-contrast microscopy. Particular attention was paid to the density of red blood corpuscles, the thickness of the vascular wall, the occurrence of endothelial cells and pericytes, together with their possible influence on the vessel lumen and the existence of perivascular spaces and vessels lacking blood corpuscles. The data are compared with some previous findings of "vascular pathology" following noise stimulation. The possible functional significance of some of the morphological findings is also discussed.


An ultrastructural study with enzyme-labeled antibody technique on immunoglobulin-containing cells in human tonsils, especially in germinal centers.

Localization of IgG, IgA and IgM in human palatine tonsils, especially in germinal centers, was studied with the electron microscopical enzyme-labeled antibody method. The large germinal center cells differentiate into two kinds of cells within the germinal center; one was the medium-sized germinal center cells not engaging in intracytoplasmic production of immunoglobulins and another was the immature cells producing at least one of the three classes of immunoglobulins, especially IgM. The latter continued to maturate and developed into the intermediate-matured cells and probably into the plasmocytes. The three classes of immunoglobulins were also deposited in the form of admixtures in the intercellular spaces among the constituent cells of the germinal centers, mainly attaching on the cell membrane of desmodendric cells. In addition, some of the deposits were found freely in the intercellular spaces. Some differences between the immunoglobulin-containing cells outside and within the germinal centers were pointed out.


Communication in the family of the asthmatic child. An experimental approach.

The literature is reviewed in order to see what support, direct or indirect, was to be found for adopting a communication perspective in gaining insight into childhood asthma. A study is presented on the communication (pattern and efficiency) of parents having an asthmatic child in a standardized communication situation in which a communication conflict is induced. Parents of children with severe chronic heart disease were used as control couples. As expected, the parents having asthmatic children proved to be a heterogeneous group with respect to communication efficiency. Two-thirds of the couples showed a communication as efficient as that of the control couples, whereas one third demonstrated an extremely inefficient communication in that they failed totally to cope with the experimentally induced communication conflict.


Gradual reduction of neuroleptic drugs among chronic schizophrenics. A double-blind controlled study.

Neuroleptic drugs were gradually reduced from 25 hospitalized chronic schizophrenics while 23 such patients were maintained on matched dosages of neuroleptics. At the end of 15 weeks, 74% of the drug-reduced subjects and 80% of the drug-maintained subjects were rated to have decompensated. Drug-reduced patients decompensated while receiving a mean of 75 mg equivalent of chlorpromazine. Clinical stability was obtained at 150 mg equivalent of chlorpromazine. Twenty-six percent of the drug-reduced patients showed no signs of clinical relapse at the end of the 15-week trial and were receiving a mean of 8 mg equivalent of chlorpromazine. The results suggest that gradual and successive reductions in maintenance antipsychotic drugs can be implemented with minimal risk to the clinical status of the chronic mental patient.


The excretional patterns of lactate, pyruvate and alpha-ketoglutarate in renal transplants.

The excretional patterns of lactate, pyruvate and alpha-ketoglutarate were investigated after renal transplantation in 36 patients. Fourteen patients had received a living-donor kidney with short ischemia time and good initial graft function, 22 had a cadaver transplant with an initial 125iothalamate clearance of more than 6 ml/min. The excretion of lactate and pyruvate did not vary significantly from that seen in normal controls or patients with uremia. In six patients with cadaver transplants, clearance values of alpha-ketoglutarate exceeded that of the glomerular filtration rate, indicating a net tubular secretion of this substance. During acute rejection episodes in 5 patients, no changes were seen in the excretional patterns of lactate, pyruvate and alpha-ketoglutarate.


The glutathione S-transferases: a group of multifunctional detoxification proteins.

The physiological roles of the glutathione S-transferases, by whatever name, seem to result in detoxification. As is true of albumin, members of this group of proteins bind an enormous number of compounds that appear to have in common only hydrophobic topography; the binding of bilirubin is an example of a major function common to all higher species. If the ligand bears a sufficiently electrophilic center, it will be attacked by the nucleophile GSH; such compounds would be the substrates of the enzyme. And should such a ligand be extraordinarily reactive--as, for example, some of the epoxide carcinogens generated by the cytochrome P450-linked, mixed-function oxidases, or even 1-chloro-2,4-dinitrobenzene--then reaction may occur either with GSH or irreversibly with the transferase itself. By reason of the wide distribution and high intracellular concentration of these proteins, there appears to be sufficient enzyme for all three roles in detoxification.


The possible role of neutrophil proteinases in damage to articular cartilage.

The proteolytic degradation of articular cartilage that is seen in the arthritides affects both of the major structural components of the tissue, proteoglycan and collagen. Neutrophil leucocytes are abundant in the synovial fluid of the inflamed joints, and we have considered whether the large quantities of neutral proteinases carried by these cells could contribute to the cartilage degradation. The two neutrophil serine proteinases have been isolated, and shown to break down both proteoglycan and collagen in articular cartilage. The enzymes attacked the non-helical terminal peptides of the collagen, eliminating the cross-links, thus destabilizing and solubilizing, the fibres. The soluble collagen then denatured spontaneously, and was further degraded. Although large quantities of the neutrophil proteinases are probably released in the synovial fluid each day, the inhibitory capacity of the fluid is seldom, if ever, saturated. Nevertheless, immunologically mediated release of the neutrophil enzymes in 'frustrated endocytosis' at the cartilage surface could give rise to the generalized damage that has been reported by others.


Macrophage proteases and rheumatic diseases: regulation of plasminogen activator by thymus-derived lymphocytes.

Macrophages in culture secrete a variety of products including neutral protease activities such as plasminogen activator(s) (P.A.), collagenase and elastase. These products are not made by unstimulated macrophages, but only after induction by inflammatory stimuli, phagocytosis and lymphokines. Phagocytosis induces the prompt release of high levels of P.A. by endotoxin-primed macrophages and prolonged secretion follows uptake of non-degradable particles. Stimulation of lymphocytes results in the release of a supernatant product which enhances P.A. secretion by unstimulated mouse macrophages up to 5-fold. The production of the P.A. inducer (P.A.I.) is immunologically specific and is found in allogeneic mixed leukocyte culture (MLC) reactions, but not in syngeneic controls. The P.A. is also induced in activated macrophages from animals infected with BCG of T. cruzi and challenged with specific antigen. Production of the P.A.I. in MLC reactions depends on the presence of thymus-derived (T) lymphocytes and is closely correlated with the appearance of macrophage migration inhibition factor (MIF). The induction of macrophage P.A. and other proteases provides an important pathway for activating macrophages in delayed hypersensitivity reactions and could contribute significantly to tissue destruction in chronic inflammatory diseases in joints.


The role of macrophage activation in chronic inflammation.

The macrophage is the characteristic cell type in chronic inflammatory reactions, in the rheumatoid synovium, as in other sites. When macrophages are activated, considerable synthesis of enzymes and other proteins occurs. Macrophages can be activated by (i) products of activated lymphocytes, (ii) immune complexes and (iii) the complement cleavage product C3b. Among the many consequences of macrophage activation are (i) secretion of hydrolytic enzymes, (ii) cleavage of C3 into C3a, which is cytolytic, and C3b, (iii) production of tissue thromboplastin, a powerful procoagulant, and (iv) formation of polyamine oxidase, which in the presence of appropriate substrates generates factors that lyse or limit the proliferation of tumour cells, lymphocytes and micro-organisms. The relevance of these observations to the pathogenesis of chronic inflammatory reactions is discussed.


The polymorphonuclear leukocyte.

Polymorphonuclear leukocytes (PMNs) are one of the main sources of enzymes responsible for tissue damage in inflammatory processes. These enzymes are stored in two types of cytoplasmic granules. Azurophil granules contain lysosomal hydrolases, neutral serine proteinases, and bactericidal elements (myeloperoxidase and lysozyme). Specific granules contain collagenase, lysozyme and lactoferrin but lack lysosomal hydrolases. PMNs store all four classes of tissue proteinases, carboxyl, thiol and serine proteinases in the azurophil granules, and metallo proteinases in the specific granules. Three serine proteinases have been identified, elastase, cathepsin G and a third enzyme, which together account for a large proportion of the protein of the azurophil granules. In the course of phagocytic events, all these enzymes are released extracellularly. The neutral proteinases degrade proteoglycans and collagen. In vitro, they stimulate B-lymphocytes, which suggests that they may have immuno-potentiating activity when they are released at sites of chronic inflammation.


The influence of atrial activity on ventricular capture by failing artificial pacemakers. I. Report of two new cases and review of the literature.

Atrial activity can influence the ability of a failing artificial pacemaker to excite the heart. An appropriately timed atrial beat may cause failure in excitation by pacemaker stimuli which are usually successful in ventricular capture. Conversely, stimuli which usually fail in excitation may be made to succeed by an appropriately timed atrial beat. Two case reports and a review of the literature are presented. Alternative mechanisms for this influence of atrial activity are electrotonic effects (Wedensky facilitation or inhibition) and mechanical effects (motion of the pacing catheter or ventricular myocardium). The authors consider the latter mechanism preferable.


"Aspergillus fumigatus"--a pathogen and allergen.

Aspergillus fumigatus is being increasingly recognised as causing various pathological conditions in man, animals and birds. In man the use of antibiotics has increased the importance of fungi in various clinical situations as opportunistic infective agents. In man, cavities in the lung are often (20 per cent) colonised by Aspergillus species, nearly always A. fumigatus. The mycetoma so formed can be specifically diagnosed by finding precipitating antibodies to A. fumigatus in the serum. In an asthma clinic, the findings of an immediate positive prick skin test to A. fumigatus, with or without precipitating antibodies to the fungus, confirms the diagnosis of pulmonary aspergillosis. These asthmatic patients develop transient lung infiltrations and proximal bronchiectasis, so that they eventually develop some degree of irreversible airways obstruction. Except for a small number of old patients, there are usually multiple positive type I skin responses to other inhalant allergens which will include other aspergilli species. Basically the complaint is a complication of allergic asthma. When first seen the patients often have treated with repeated courses of antibiotics for presumed infective asthma. Some of the findings in 86 asthmatic patients suffering from pulmonary aspergillosis will be presented.


Iron deficiency, infections, and immune function: a reassessment.

Many physicians believe that patients with iron deficiency have an increased susceptibility to infections. Data in the literature, however, are contradictory, and in many instances the reports are vulnerable to critical review. Literature available through 1976 was analyzed in an attempt to define possible relationships between infections, immune function, and states of iron imbalance, both iron deficiency and overload. Critical points that must be considered for an accurate interpretation were emphasized. It seems clear that the inflammatory response, when assessed by skin reactivity, is diminished in iron deficiency. The precise molecular defect remains undefined, but the abnormality is detected by several assays measuring cell-mediated immunity. Normal function is usually restored following iron repletion.


The pathos of pathology and a possible cure: H.P. Smith Memorial Lecture.

This H.P. Smith Memorial Lecture attempts to define and prescribe treatments for a malady afflicting clinical pathology today--its difficulty in communicating the vital role of the pathologist in patient care to the public, politicians--and, in many instances, our own colleagues in other medical specialties. In paying tribute to a pioneering clinical pathologist, Dr. H. P. Smith, attention is drawn to his diagnosis of these problems--a diagnosis he perceived decades ago. The ancient meaning of pathos, the Greek stem for which the word pathology comes, is used to pinpoint the problems that have led to clinical pathology's own pathos--the lack of recognition afforded those physicians who practice it. A review of the conditions that led to this state is presented, and these conditions are compared with others present in our specialty, e.g., the "behind the scenes" situation of surgical pathology and the decline of the utilization of the autopsy. Factors that tend to frustrate the normal relationship between the clinical pathologist and the patient, as well as his or her role as a consultant to the attending physicians, are summarized. Suggestions are put forward for changing the image of the clinical pathologist from one of near invisibility to one of dynamic interaction with patients and with other physicians of the medical care group, for the good of all concerned.


Cytochemical findings in human nonneoplastic blood and tonsillar B and T lymphocytes.

The cytochemical profiles of B and T lymphocytes from the bloods of eight normal donors and the tonsils of three normal individuals were studied. An intense and localized alpha-naphthyl acetate esterase (alpha-NAE) activity was found in the majority of blood and tonsillar T lymphcytes, in contrast to the very low alpha-NAE activity observed in the blood and tonsillar B lymphocytes. A very low percentage of tonsillar B lymphocytes had beta-glucuronidase (betaG) activity, while relatively normal betaG activity was observed in the tonsillar T lymphocytes and the blood B and T lymphocytes. Acid phosphatase (AcP) activities were found to be similar in both B and T lymphocytes from blood and tonsils. These findings suggest that the alpha-NAE reaction may be useful as a cytochemical marker for distinguished B from T lymphocytic proliferations. They also revealed that there is no appreciable difference in AcP and betaG activity between B and T lymphocytes obtained from the blood of normal donors.


A rapid slide test for penicillinase.

The authors developed a rapid slide test modification of the iodometric method for detection of penicillinase produced by organisms growing on routine plating media. A loopful of colonies is scraped from the agar surface and emulsified in one drop of an iodine-penicillin solution on a glass slide. Addition of a drop of 0.4% starch solution results in a purple color when penicillinase is not present; a colorless reaction denotes a positive test. The slide test yielded positive results identical to those of a starch agar-plate method with 26 Staphylococcus aureus isolates; a further seven showed comparable negative tests. Penicillinase production was associated with a S. aureus penicillin MIC of greater than or equal to 0.5 micron/ml. All 15 Staphylococcus epidermidis isolates gave negative test results, as did 22 Bacteroides fragilis (MIC greater than or equal to 3.1). Twenty ampicillin-susceptible Haemophilus influenzae were negative by both the slide test and a Levinthal broth method; an additional five resistant (MIC greater than or equal to 10) isolates were positive by both methods. Twenty-eight (penicillin MIC greater than or equal to 0.8) of 50 Bacteroides melaninogenicus were slide test-positive for penicillinase. Two penicillinase-producing strains of Neisseria gonorrhoeae gave positive slide tests, while eight other non-penicillinase-producers were negative.


Jejunoileal bypass for morbid obesity. A critical appraisal.

One hundred one carefully screened morbidity obese patients underwent jejunoileal bypass and were followed closely over a mean follow-up period of 32 months. Although there were no operative deaths, three per cent of patients died postoperatively of liver failure or its complications. A fourth patient died of a pulmonary embolus after reoperation, and the fifth patient died cachectic with severe diarrhea after excessive weight loss. Nineteen per cent of the patients required restoration of intestinal continuity (reversal), most for either liver failure or late fluid and electrolyte derangements. All but two survived reversal and are doing well despite massive weight gain. Fifty-eight per cent of the patients had major complications which either required major reoperation (reversal, cholecystectomy or incisional hernia repair) or were potentially life-threatening (liver failure, hepatic fibrosis or urinary tract stones). As described in other series, abnormalities in serum electrolytes and vitamins were seen. In addition, hypovitaminosis D occurred in a number of patients and as with other serum parameters measured, was time-dependent in that improvement was seen in most patients over the postoperative interval studied. Because of the high rate of complications and reversals, we believe that jejunoileal bypass should be reserved for patients with morbid obesity whose lives are imminently threatened by obesity or its sequellae.


Fatal viscerotropic Rocky Mountain spotted fever. Report of a case diagnosed by immunofluorescence.

A case of fatal viscerotropic Rocky Mountain spotted fever with virtual absence of cutaneous lesions was diagnosed at autopsy by specific immunofluorescent demonstration of Rickettsia rickettsii in spleen, kidney, epididymis and skin. The clinical presentation was that of insidious onset of fever, renal failure, hypotension, hyponatremia and obtundation over a 10 day period. The patient had respiratory insufficiency, hypocalcemia, increases in creatinine phosphokinase (CPK), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), alkaline phosphatase, billirubin and serum phosphate, grand mal seizure, myalgia and unremitting shock with death occurring on day 12 of illness. Postmortem examination revealed severe vasculitis with interstitial nephritis and multifocal tubular necrosis, pericholangitis with bile stasis, glial nodules in the brain, multifocal rhabdomyonecrosis, interstitial pneumonitis and mild interstitial myocarditis. Risk factors which this patient shared with other patients with fatal Rocky Mountain spotted fever were failure to recognize a rash, failure to obtain a tick bite history, male sex, black race and age greater than 30 years.


Acid maltase deficiency in adults presenting as respiratory failure.

During the past nine years 10 patients with the adult form of acid maltase deficiency have been observed at the Mayo Clinic. Three of the adults presented with respiratory failure. In all three the respiratory manifestations dominated the clinical picture and the cause of the respiratory failure (muscle weakness) and the underlying myopathy (glycogen storage disease) were initially unsuspected. Careful evaluation of the respiratory function tests, including the maximal static respiratory pressures, electromyographic examination and histochemical and biochemical studies of muscle biopsy specimens eventually led to the correct diagnosis.


Replacement therapy for inherited enzyme deficiency: liver orthotopic transplantation in Niemann-Pick disease type A.

Liver homotransplantation was attempted as replacement therapy in a 2-year-old patient with near total absence of sphingomyelinase activity of Niemann-Pick disease type A. Satisfactory function of the graft was observed until the death of the recipient from respiratory complication 2 years after transplantation. The clinical stigmata of the disease became less severe during the first 6 months after transplantation, with no further improvement thereafter. Sphingomyelinase activity was restored to near normal levels in serum, was present in cerebrospinal fluid and was maintained in the graft at normal or supranormal levels. No accumulation of sphingomyelin was observed in the transplanted organ as evaluated by histopathological and chromatographic studies. These findings support the interest of organ transplantation for long-term enzyme replacement in Niemann-Pick disease type A and similar lysosomal deficiencies.


Pituitary response to bolus and continuous intravenous infusion of luteinizing hormone-releasing factor in normal women and women with polycystic ovarian syndrome.

Plasma luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were measured in response to luteinizing hormone-releasing factor (LRF), given as a 100 microgram intravenous bolus and/or as a 4 hour infusion of 0.2 microgram per minute to 27 normal menstruating women and 15 women with the polycystic ovarian syndrome (PCOS). In PCOS, LH response to bolus LRF was significantly greater than those of normal women at days 1 to 4 and 8 to 10 of the cycle, whereas FSH responses were similar in all women studied. Continuous LRF infusion resulted in a biphasic LH release pattern. In normal women, the early phase was low until days 12 to 14 of the normal cycle, whereas the second phase rose progressively from the early follicular to the periovulatory period. In PCOS, the early phase was relatively large and qualitatively resembled the normal periovulatory pattern. The increased pituitary LH response to LRF in PCOS is associated with a relatively large early releasable LH pool and a low FSH response.


Real-time B-scan-directed amniocentesis.

Utilizing real-time B scan, 150 amniocenteses, 14 in the second trimester and 136 in the third trimester, were carried out in 143 patients. In 146 procedures, amniotic fluid was obtained with a single attempt. In four other procedures, two attempts were required, and oligohydramnios was present in two. In one, both taps were dry, while in the other a second tap yielded a slight amount of meconium fluid. One patient was tapped in a site other than that suggested by real-time scanning, and a bloody tap (Apt negative) was obtained. Clear fluid was obtained when the real-time-indicated site was used. The remaining patient had premature rupture of membranes, and two attempts yielded bloody fluid (Apt negative) and the procedure was abandoned. Amniocenteses in eight patients had failed previously (one to three attempts). With the subsequent aid of real-time B scan, fluid was obtained in a single attempt. These data suggest that real-time B scanning prior to and/or during amniocentesis is as reliable as the static B scan method and, in some cases, may have a clear advantage.


Monocyte function in familial Mediterranean fever.

Monocytes derived from the peripheral blood of patients with familial Mediterranean fever (FMF) demonstrated a consistently lower phagocytic capacity (38-44%) for 125I-labelled Shigella flexneri when compared to monocytes from healthy subjects. Phagocytosis of both viable and killed Staphylococcus albus was similar in patients and controls. However, FMF monocytes had a two- to eight-fold depressed bactericidal capacity against S. albus in comparison to normal monocytes. Acid phosphatase and beta-glucuronidase monocyte activities were similar in patients and controls. It is suggested that the defects in monocyte function may be of importance in the pathogenesis of FMF. Colchicine had no effect on any of the indices studied.


The lecithin/sphingomyelin ratio in 132 insulin-dependent diabetic pregnancies.

A total of 228 determinations of L/S ratios were performed in 132 insulin-dependent diabetic pregnancies. A declining L/S ratio was observed in 6 per cent of the cases without adverse effects on the fetus. No significant difference in the percentage of mature L/S ratios by weeks of pregnancy was found in the different classes of diabetes. An immature L/S ratio was associated with a significant increase of low Apgar scores. At each stage of pregnancy, there was no significant difference in the percentage of mature L/S ratios according to the sex of the baby nor according to the presence or absence of polyhydramnios. Among the five infants with HMD two had a mature L/S ratio within 2 days of birth. This represents 3 per cent incidence of false-positive results. Despite this finding, we feel that the determination of L/S ratio is a useful advance in the management of diabetic pregnancies.


Factors affecting pituitary gonadotropin function in users of oral contraceptive steroids.

In order to determine whether certain factors influence the direct pituitary suppressive effect of contraceptive steroid, 50 subjects who had used various formulations of oral contraceptive steroids for periods of time ranging from one to nine years were stimulated with 50 microgram of gonadotropin-releasing hormone (GnRH) during the last week of oral contraceptive ingestion. The response of lutinizing hormone (LH) and follicle-stimulating hormone (FSH) was compared to the results obtained in nine control subjects with regard to: (1) age of subject. (2) type of contraceptive formulation used, and (3) length of use. Prestimulation levels of LH and FSH, respectively, were significantly decreased in 37 (74 per cent) and 42 (84 per cent) of the subjects. Following GnRH stimulation, peak responses of serum LH and FSH, respectively, were also significantly lower than those in the control subjects in 40 (80 per cent) and 45 (90 per cent of the subjects. The degree of suppression of pituitary gonadotropins, both before and after GnRH administration was significantly correlated with the type of steroid formulation used, being greatest with a combination of d-norgestrel and ethinyl estradiol. No correlation was found with length of use of oral contraceptives or age of the subjects.


Chromosomes and the gynecologist.

Recent advances in cytogenetic techniques made a valuable contribution toward the modern practice of obstetrics and gynecology. The state of the art regarding the application of these techniques is reviewed in the following areas: the clinical features related to the various sex and autosomal chromosomal anomalies, the cytogenetics of gynecologic malignancies, the chromosomal analysis of spontaneous abortion and of parents with habitual abortions. Chromosome studies in male infertility revealed abnormalities in 11.5 per cent of 69 patients with azoospermia and 9.1 per cent of 165 patients with oligospermia. Among 77 patients with primary amenorrhea, 27.3 per cent revealed chromosomal abnormalities compared to 3.8 per cent in 103 patients with secondary amenorrhea. The term "ovotesticular dysgenesis" is used for the first time in the literature to describe a specific histologic type of streak gonad which contains ovarian stroma and dysgenetic testicular tubules.


Cholelithiasis and cholecystitis in pre-Columbian Chileans.

Two cases of gallbladder disease found in Chilean mummies are presented. The cholesterol gallstones in these cases produced in one individual a localized peritonitis and in the other a probable duct obstruction. No cases of this disease have been seen in Peruvian mummies while in Chile it seems quite common, suggesting some environmental factor in the etiology.


The unmotivated patient syndrome: survey of therapeutic interventions.

The authors describe five groups of patients who have been found to respond poorly to psychiatric treatment--people from lower socioeconomic groups, juvenile delinquents, drug-addicted individuals, alcoholics and military psychiatric patients. Although these groups of patients represent different etiologies and symptom-specific pathologies, many of their members have in common a lack of motivation for change. The authors discuss the reasons for this lack of motivation, suggesting that focusing on this factor would promote a better understanding of the unmotivated patient syndrome and lead to the development of more effective psychotherapeutic efforts.


Acetylation phenotype, platelet monoamine oxidase inhibition, and the effectiveness of phenelzine in depression.

The authors treated 16 depressed patients with up to 90 mg/day of phenelzine. After acetylation phenotype was determined and platelet monoamine oxidase (MAO) activity measured, no significant relationship was observed between clinical improvement and acetylation phenotype or between MAO inhibition and acetylation. Discrepant findings regarding acetylation phenotype and the effects of phenelzine are discussed. The authors do not recommend a sulfamethazine phenotype test as a predictor of outcome for phenelzine.


Inhibition of platelet monoamine oxidase in depressed subjects treated with phenelzine.

The authors treated 19 depressive inpatients double-blind with a mean dose of 78 mg/day of phenelzine for 3 weeks to determine the possible relationship between monoamine oxidase (MAO) inhibition and the effectiveness of phenelzine. Clinical ratings made on the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the SCL-90 indicated a minimum of 60% MAO inhibition had to be achieved for the drug to be consistently beneficial.


The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study.

The authors used data from an earlier nonblind study to identify 16 autistic-type child outpatients who had apparently improved when given vitamin B6 (pyridoxine). In a double-blind study each child's B6 supplement was replaced during two separate experimental trial periods with either a B6 supplement or a matched placebo. Behavior was rated as deteriorating significantly during the B6 withdrawal.


The ultrastructural diagnosis of diffuse large-cell ("histiocytic") lymphoma. Fine structural study of 30 cases.

Thirty cases of diffuse large-cell ("histiocytic") lymphoma were studied with the electron microscope. The purpose was to define the criteria requisite for the ultrastructural diagnosis of large-cell lymphoma. The fine structural features of the lymphoma cells were compared to those of similar appearing reticuloendothelial neoplasms and other tumors that may simulate large-cell lymphoma by light microscopy. Two variants of large-cell lymphoma were recognized, each composed of neoplastic lymphoid cells with the morphologic features of transformed lymphocytes. The larger group represents large noncleaved cell lymphoma of Lukes and Collins' functional classification, while the second type corresponds to lymphoma of large cleaved cells. The ultrastructural features of large-cell lymphoma are uniform and usually easily identified. By utilizing diagnostic electron microscopy, large-cell lymphoma can often be distinguished from similar appearing tumors presenting as diagnostic problems at the light microscopic level.


The relationship of alcohol to aging and the elderly.

Alcohol may be related to diminution of function in tissues and organ systems as well as individuals. Aging cells, systems, and people may respond differently to alcohol. These concepts are explored.


Diagnosis and treatment of the elderly alcoholic.

Treatment interventions will be much more effective when delivered through facilities serving the aged, such as senior citizen programs, outpatient, geriatric, medical or psychiatric programs, nursing homes, or home-care programs. It is unlikely that significant numbers of elderly will be willing to go to alcoholism programs to deal with their problem drinking.


The elderly as a unique population: alcoholism.

The clinician who is faced with the task of diagnosing alcoholism in the elderly should be aware of the limitations of the diagnostic criteria for this population and should regard these criteria merely as areas from which to begin a much more detailed inquiry into the role of alcohol in any problems the patient may report.


Drug therapy in the elderly: the clinical pharmacology of aging.

It is becoming increasingly apparent that age and the changes of aging are factors to be taken into account in drug therapy and in the study of drug actions. Older people have more adverse reactions to drugs than do younger people. Several studies in hospitalized patients have confirmed the fact that the incidence of untoward reactions to drugs increases with advancing age.


Alcoholism and aviation medical certification.

A "history" of alcoholism may be 2 mo old or 20 yr ago. No two individuals are completely alike, and it would be nearly impossible to write a satisfactory regulation that could define when an individual is medically safe to return to flying. Individual consideration would seem to be the fairest way to deal with this issue.


Characteristics of alcoholics who drink socially after treatment.

This study is concerned with the differences among groups of alcoholics who became social drinkers, abstinent, or remained nonsocial drinkers after treatment. A total of 1091 alcoholics were studied. It appears as if those who become social drinkers are those who are less serious alcoholics with more social and other supports.


An assessment of hospital care for the alcoholic patient.

Current medical practice, vis-à-vis chemical dependency, was assessed in a university hospital setting. Findings indicate that the majority of physicians and nurses at this facility (1) did not take adequate alcohol and drug use histories, (2) did not identify chemical dependency as a medical problem even when they knew dependency was present, and (3) did not involve themselves in treatment or treatment recommendations even when the problem was identified.


Alcohol metabolism and sensitivity reactions among the Reddis of South India.

Alcohol was given orally to 41 healthy young male volunteers from small Hindu (Reddis) farming villages in south and central Andhra Pradesh, India. A complete description of the Reddis study, plus transcultural group differences, is given, and the alcohol metabolism and sensitivity literature is critically reviewed.


Racial differences in circadian variation of ethanol metabolism.

In two experiments, independent groups of male social drinkers were administered equal doses of ethanol per unit of body weight (0.66 ml/kg) at different times during the day. Peak blood alcohol concentration (BAC) was achieved, and the time taken to return to a BAC of 20 mg/100 ml and the rate of ethanol metabolism per hour were determined.


Ethanol metabolism in male American Indians and whites.

Ethanol metabolism rates were investigated in a group of 17 male American Indians and a group of 17 male whites of similar age, education, weight, and drinking history. A moderate dose of alcohol (0.52 g/kg) was administered orally to each subject, and blood alcohol levels were determined by breath analysis. The American Indian group demonstrated a significantly faster rate of alcohol metabolism than the white group. The peak blood alcohol level was significantly higher for the American Indians than for the whites, and the American Indian group demonstrated a significantly faster absorption rate than the white group.


Racial comparisons of alcohol metabolism: background, problems, and results.

The background of and problems in making comparisons among different racial groups in their rates of alcohol metabolism are reviewed. The results of five studies are discussed. It is concluded that the variation among races in rate of alcohol metabolism is not different in kind than variation among individuals within a given race. There are good reasons to expect the former variation to be smaller than the latter.


Metabolic responses of Chinese, Japanese and Europeans to alcohol.

Thirty-nine Chinese, 47 Japanese, and 68 Europeans were tested for rate of alcohol metabolism under standardized conditions. The Japanese and Chinese metabolized at a significantly higher rate. Possible sources of such differences are considered.


Impaired visual search in alcoholics.

Visual search performance was studied in detoxified long-term alcoholics, short-term alcoholics, and nonalcoholic controls. Measures of search time and errors indicated that alcoholics had significantly longer search times than controls and that long-term alcoholics had comparatively longer search times and more shape errors in the left visual hemispace than the other groups. The results are consistent with the hypothesis that alcoholism results in subtle frontal lobe and right hemisphere dysfunctions.


Can dopamine beta-hydroxylase levels predict adverse reactions to disulfiram?

Disulfiram had more pronounced sedative effects on healthy normal subjects with low levels of plasma dopamine-beta-hydroxylase (DBH) than it did on subjects with higher levels. It is suggested that DBH levels might provide a means of predicting increased susceptibility to disulfiram side effects.


[General anaesthesia in microlaryngeal surgery by injection-technique with a modified Carden tube (author's transl)].

A method of general anaesthesia and pulmonary ventilation with automatic intermittent positive pressure for endoscopic laryngeal surgery is described. We have used a technique with a modified Carden tube which gives more freedom to the otolaryngologist. Arterial blood gas studies performed on 10 patients indicated adequacy of ventilation throughout and following the procedure. The special features of this technique are mentioned.


[The early history of the anatomical journals and the significance of the anatomischer anzeiger (author's transl)].

It is reported the history of the eldest anatomical journals and their precursors, the periodicals of scientific societies and academies (part 1). The first anatomical periodical striktly speaking is the Archiv für die Physiologie founded in 1795 by the famous neuronanatomist REIL in Halle/Saale. Subsequently the genealogy of several journals founded in the 19th century is represented and continued up to our days. In the same way it is proved the history of the refering and abstracting publications. The eldest refering magazine is the Bericht über die Fortschritte der Anatomie und Physiologie published by HENLE and MEISSNER in 1856--71. The Publisher GUSTAV FISCHER in Jena takes a leading part in publication of anatomical periodicals, esp. Anatomischer Anzeiger and his supplements Verhandlungen der Anatomischen Gesellschaft, and of annual reports in anatomy. In the centre of this paper it is standing the importance of the Anatomischer Anzeiger founded by KARL VON BARDELEBEN in 1886 and published by the Gustav Fischer Verlag Jena. Reporting the fateful history of Anatomical Recorder and of the Proceedings of the Anatomical Society until 1945 (part 2) and since the last world war (part 4) it is told about the editors follows one upon another. The Anatomischer Anzeiger represented a central paper of the entire scientific anatomy and in a body one of the most spreaded and versatilest anatomical journals in the world. Important stages in the history of anatomy are formed by the Anzeiger till our days.


[VEB Gustav Fischer Verlag Jena and its journal Anatomischer Anzeiger (author's transl)].

On the occasion of the 100th anniversary of the VEB Gustav Fischer Verlag Jena it is perhaps appropriate to pay tribute to the extraordinary merit due to this firm for the publication of the Anatomischer Anzeiger established by Karl von Bardeleben in 1886. This contribution shows that the viability and great international regard enjoyed by the journal are due not only to the advanced ideas upon which it was based but also to the publishing spirit exhibited by the original publisher, Gustav Fischer. The Anatomischer Anzeiger will retain its international character in future and will remain a versatile anatomical journal publishing profound and scientifically stimulating papers in all fields of anatomy.


[On the development of anatomical investigation of the pancreas from Vesal till Bichat (author's transl)].

This investigation contains the knowledge of the pancreas from the 17th to the 19th century. A boundray-stone are the investigations of BRUNNER (1689). He has in pancreatectomized dogs the symptoms of diabetes mellitus described but not the diagnosis. An other culminating point is the system of tissues, described by Bichat (1800). In the other hand the knowledge of histology of pancreas is in this period very small.


Functional anatomy of the portal vein and its main and segmental branches in the adult man.

The AA. study the special disposition of collagen, elastic and muscular fibers in the supraduodenal portion of the portal vein and its main and segmental branches. Forty specimens were removed at necropsy from adult individuals and prepared by various methods: a) pellicle preparations stained by resorcin-fuchsin (Weigert), Azan, azo-carmine B, alum-carmine, or else examined by polarized light without staining, b) dissection under stereomicroscope of specimens treated by the method of Semper or van Gieson, c) histological sections stained by Masson's trichrome, Azan, Weigert's resorcin-fuchsin and Verhöff methods. The results corresponding to the different layers and levels of the vascular system studied are schematically reported in Figures 1A, 1C, 2A, 2E and 4B and are commented upon under a morphofunctional criterion.


Heterogeneity of the MtTW15 mammosomatotropic tumor. I. Light microscopic evaluation of cell types by means of immunocytochemistry, morphometric quantitation, fluorescence cytophotometry and radioimmunoassay.

Large MtTW15 pituitary tumors produced 200- to 800-fold elevations in serum growth hormone (GH) and prolactin (PRL) levels. Female tumor hosts showed doubling in body weight, milk secretion, and a 2-fold hepatosplenomegaly. Pituitaries of host animals were reduced by about 50% in both weight and concentrations of GH and PRL. Large tumors were well-encapsulated, multinodular and showed variable amounts of necrosis and hemorrhage. Cytofluorometric analysis revealed a range of 100-fold in nuclear DNA content of tumor parenchymal cells which were chromophobic, pleomorphic and frequently mitotic. Concentrations of hormones in tumors were less than in normal pituitaries and highly variable with the ratio of GH/PRL ranging up to 30-fold within the same tumor. Immunostaining and linear scanning quantitation showed that about 50% of the tumor cells contained immunodetectable hormones. Comparison of immunostained adjacent sections showed that hormone-containing tumor cells were pleomorphic, unequally distributed within nodules, lacking in distinctive identifying morphological characteristics and that they contained GH or PRL but not both hormones simultaneously. Collectively our results show that large MtTW15 tumors are comprised of a markedly heterogeneous population of tumor cells and they suggest that the hormone-containing cells are monohormonal secreting tumor cells which can produce GH or PRL but not both hormones.


Actin- and myosin-like filaments in rat brain pericytes.

Heavy meromyosin (HMM) labeling was used to identify the nature of the filaments which form bundles in the cytoplasm of the pericytes in brain tissue. Rat brain tissue pieces were incubated in glycerol solutions at 4 degrees and then transferred into buffer (pH 7.0), (1) without HMM, (2) with HMM, (3) with HMM + 5 mM ATP, and (4) with HMM + 2.5 mM Na+ pyrophosphate. In pericytes from untreated tissue, smooth-surfaced microfilaments, averaging 6 nm in diameter, appear to branch and anastomose and to anchor on the plasma membrane. After exposure to HMM, the number and the density of the microfilaments are strikingly increased. These tightly-packed microfilaments are now heavily coated with exogeneous HMM thus increasing in width to 18-20 mm. They intertwine in closely-woven networks. After incubation in HMM solutions containing ATP or Na+ phosphate, they are no longer coated with thick sidearms. It can thus be concluded that these microfilaments are of actin-like nature. In addition, after incubation in ATP, they are intermingled with, and converge onto the surfaces of, thick, tapered filaments, which we have tentatively identified as of myosin-like nature. Thus, it appears that certain of the major elements necessary for contraction are present in brain pericytes.


Ultrastructure of the corneal nerves after fixation with potassium permanganate.

The innervation of the rat cornea was investigated electron microscopically after KMnO4 fixation. Myelinated nerve fibres were observed only in the limbal margin of the cornea, whereas the axons located in the stroma of the avascular cornea were surrounded by the Schwann cell cytoplasm. Axon profiles with small (300-500 A) granular vesicles and another type with agranular vesicles were seen among the non-vesiculated fibres in all parts of the cornea. After superior cervical ganglionectomy it was not possible to find any axons with small granular vesicles. On the other hand, sone degenerating axon profiles were observed in the stromal nerve trunks after ganglionectomy. In the epithelium-naked axons with an occasional mitochondrion and a few agranular vesicles penetrated between the epithelial cells. Moreover, axons filled with several mitochondria were rarely observed in the epithelium, but these were difficult to differentiate from the surrounding epithelial cells. The role of the different nerve types observed in the cornea is discussed. The results suggest that the rat cornea  has a dual vegetative innervation.


A comparative evaluation of fenoterol and terbutaline in the treatment of asthma.

In a double-blind trial of six weeks' duration 30 chronic asthmatic outpatients were treated with 5 mg tablets of either fenoterol or terbutaline two to four times daily. In pulmonary function tests on days 1, 21 and 42 there were no statistically significant differences between the two drugs in terms of mean increases in FEV1 or in duration of effect. No decline in efficacy musculoskeletal side effects declined as the study progressed.


The usefulness of transfer factor in asthma associated with frequent infections.

Fifteen patients underwent controlled trial with transfer factor for repeated infections and severe asthma. Marked decrease in respiratory infections and striking improvement in asthma resulted. The authors suggest that transfer factor may reconstitute immune function, thus representing a unique approach to severe asthma associated with frequent infections.


The cardiorespiratory effects of oral terbutaline and an ephedrine-theophylline-phenobarbital combination: comparison in patients with chronic obstructive ventilatory disorders.

Initial responses and changes in baseline after two-week treatments with a sustained release ephedrine-theophylline-phenobarbital (ETP) tablet and terbutaline tablets were studied in a double-blind crossover trial for 20 patients with chronic obstructive lung diseases. At the 12th hour after the second dose of terbutaline both drugs were active with mean changes at four and eight hours favoring ETP. After two weeks of treatment improvement in baseline functions also favored the combination. Although terbutaline was effective, ETP was the superior bronchodilator with a later peak response, greater magnitude of improvement and longer duration of action. The differences suggest the advantage of reinforcing ephedrine with a methylxanthine derivative.


Environmentally triggered cardiac disease.

Twelve highly selected patients with non-arteriosclerotic cardiac arrhythmias and/or chest pain refractory to medication and having symptoms related to smooth muscle sensitization were studied in a rigidly controlled, relatively fume- and particle-free environment. The majority of signs and symptoms cleared in 10 patients without medication while under environmental control, and in 10 of the 12 patients all arrhythmias were reproduced with controlled, repeated individual-blind and double-blind incitant challenges. Blood abnormalities occurred in the complement and T-lymphocyte systems.


A sustained release theophylline preparation: efficacy in childhood asthma with low serum theophylline levels.

In a double-blind, crossover study a sustained release theophylline preparation was found to be effective and safe while controlling the symptoms and improving the measured pulmonary function of 16 chronic childhood asthmatics. Serum theophylline levels between 2.5 and 8.1 microgram/ml were adequate for control of clinical disease.


Collection and cultivation of and phagocytosis by pulmonary macrophages obtained from hysterectomy-derived pigs.

Methods were developed for procuring phagocytically active macrophages from porcine lung with minimal damage to respiratory tissues. Procedures included anesthetizing, surgically introducing a T-shaped tracheal catheter, and repeatedly flushing the respiratory tract. Macrophages collected in this manner were characterized as to numbers, types, and phagocytic activity, nonselective lavage of the pulmonary airways of unstimulated and stimulated (evoking agent: thioglycolate medium) animals yielded 5 X 10(7) and 11 X 10(7) respiratory cells per pig, respectively. Because sufficient quantities (300 to 600 cells/test) of unstimulated cells were collected, stimulated cells contaminated with thioglycolate were not further tested. Morphologically, unstimulated macrophages were mainly spherical and mononucleated by variable in size, ranging from 9 to 30 micrometer. Culturally, macrophages adhered to plastic or glass surfaces and readily phagocytized fungal spores, staphylococci, and latex particles in an enrichment medium containing greater than or equal to 20% bovine fetal serum. Macrophages failed to replicate during a 3-week maintenance period. The data suggest that porcine phagocytes of the pulmonary system comprise a free-cell population that is a major surface-constitutive part of the luminal surface of the airways.


African swine fever: microplaque assay by an immunoperoxidase method.

A microplaque assay for Vero cell-adapted Lisborn '60 strain of African swine fever virus (L'60-uncloned) and a large plaque-forming strain cloned from the L'60-uncloned strain was developed by an immunoperoxidase method. The immunoperoxidase method can be used to stain microplaques of 3 days after inoculation, whereas the conventional plaque assay requires 5 to 7 days to develop visible plaques. A linear relationship between viral concentration in the inoculum and plaque numbers was observed. Viral titers obtained by both microplaque assay and conventional plaque assay were comparable, and both methods were reproducible and reliable. The viral titer obtained by either one of the plaque assay methods was approximately 0.9 log10 lower than that obtained by the hemadsorption test.


Bovine antibody against Streptococcus agalactiae, type Ia, produced by preparturient intramammary and systemic vaccination.

Four pregnant heifers were immunized by the intramammary route with killed or live Streptococcus agalactiae vaccine, and a 5th heifer was vaccinated by the intramuscular route with killed vaccine. Antibody in the colostrum from vaccinated and non-vaccinated glands was compared. Antibacterial glands was compared. Antibacterial antibody titers of the 4 immunoglobulin classes were determined by indirect fluorescent antibody assay. Although the content of immunoglobulin G1 (IgG1), IgG2, and IgM in the colostrum from the vaccinated glands was not substantially different from the nonvaccinated glands, IgA content was considerably greater in the former. Antibody specific to S agalactiae was isolated from all colostrum samples. The mouse passive protection test and Ouchterlony analysis were used to demonstrate the presence of type-specific antibody to Ia strain used for vaccination. The passive mouse protection test also was useful to compare the protective capacity of specific S agalactiae, type Ia, antibodies of immunoglobulin classes IgG, IgM, and IgA. Increased protective capacity of IgM and IgA over IgG1, on a weight basis, was demonstrated. The present study indicates that S agalactiae preparations, when introduced into the mammary gland, can give rise to local antibody synthesis in the vaccinated glands.


Comparison of three methods of differentiating bovine mycoplasma.

Growth inhibition (GI) by specific antisera, direct fluorescent antibody technique (FAT), and fatty-acid profile analysis by gas-liquid chromatography (GLC) were compared as methods for identifying 13 strains of bovine mycoplasma. By the FAT, there were 8 bilateral and 13 unilateral cross reactions. In the GI study, there were 4 bilateral and 7 unilateral cross reactions. In both FAT and GI studies, there were fluorescence and inhibition, respectively, with 13 homologous antisera. Analysis by GLC revealed the 13 mycoplasmas could be placed into 4 distinct chromatographic groupings. The GLC profiles of 2 organisms were sufficiently unique that they could be used for specific identification.


Massive colonic diverticular hemorrhage in a transplant patient.

An infrequent colonic complication, massive diverticular hemorrhage, occurred in a high-risk renal transplant recipient. Arteriographic location of the bleeding site, colotomy and arterial ligation were used to successfully control the hemorrhage and gave a satisfactory longterm result.


Salmonella typhimurium pancreatic abscess: report of a case.

A case of pancreatic abscess from Salmonella typhimurium is reported. After surgical drainage of the abscess, positive stool cultures persisted. Finally, after intensive antimicrobial therapy with tetracycline and chloramphenicol, and cholecystectomy, stool cultures became negative. This is, to our knowledge, the first published case of S. typhimurium pancreative abscess.


Abnormal function of endocrine pancreas and anterior pituitary in Friedreich's ataxia. Studies in a family.

A family had three siblings affected with classic Friedreich's ataxia. One sibling died at age 20 with fulminant diabetic ketoacidosis. The other two affected siblings are identical twin sisters without clinical diabetes but with an abnormality in the metabolism of exogenously administered glucose. These twins also have abnormal hypothalamic-pituitary control of prolactin and possibly of growth-hormone secretion. This study extends the previous reports of endocrine deficienceis associated with Friedreich's ataxia. The mechanisms underlying this association are undetermined but could represent pleiotropic effects of the Friedreich's ataxia gene or secondary manifestations of the primary central nervous system degeneration, or both.


Asthma improved by nonsteroidal anti-inflammatory drugs.

A patient who claimed benefit from aspirin for her reversible bronchospasm was challenged orally in a placebo-controlled study with aspirin and other aspirin-like drugs. Specific airways conductance and spirometry were monitored for up to 150 minutes after oral challenge. Aspirin, mefenamic acid, and ibuprofen administration resulted in marked (45% to 80%) improvement in forced expiratory volume in 1 second (FEV1) compared to lactose placebo. Indomethacin, sodium salicylate, and tartrazine resulted in modest (15% to 25%) FEV1 improvement, while phenylbutazone produced a 25% decrease. These results are discussed here in terms of the ability of these drugs to inhibit the prostaglandin synthetase enzyme system. This case suggests that aspirin and other nonsteroidal anti-inflammatory drugs may be beneficial rather than harmful in some asthmatic patients.


Management of household contacts of leprosy patients.

We describe an approach to the management of household contacts of leprosy patients and the rationale on which it is based. Initially, all household contacts should be interviewed and examined for symptoms and signs consistent with leprosy and appropriate diagnostic measures taken. Contacts of untreated lepromatous and dimorphous (borderline) leprosy patients are at relatively high risk of disease and should be examined annually for at least 5 years. Dapsone prophylaxis has been shown to prevent secondary cases in contacts up to 25 years old and should be used in these and possibly in older persons. Insufficient data exist to support a recommendation for the use of BCG at present.


Corticosteroid-induced lymphopenia, immunosuppression, and body defense.

The apparent paradox of heightened adrenal corticosteroid levels associated with reduction in the competence of the body's defensive apparatus to cope with exposure to new microbial antigens is considered. The question is asked how this lowered defensive capability, which occurs in the face of a threat to body integrity, is consistent with Cannon's principals of the "wisdom of the body." The suggestion is offered that the immunologic response to self-antigens exposed by disease or trauma may be suppressed by corticosteroid to offset the likelihood of autoimmune attack.


[Manic-depressive psychoses. Chronic treatment with tricyclic antidepressive agents].

Long-course Tricyclic anti-depressing treatment affonds clinical healing--i.e. abolition of the recurrences--in melancolic unipolary periodic depressions. This treatment--T.A.T.C.--allows a good prevention of melancolic recurrences in bipolar periodic patterns of psychosis. For the authors Lithium and/or Dipropylacétamide are not sufficient protection for melancolic or maniac recurrences in this patterns. It seems to be three patterns in fact: pure melancolic, pure maniac, and maniaco-depressive. Therapeutic and psychopathologic considerations.


Comparative intraocular pressure effects of adsorbocarpine and isoptocarpine.

Nine symmetrical ocular hypertensives used Adsorbocarpine in one eye and Isoptocarpine in the other. Each medication was given twice daily for one week, then Isoptocarpine was used 4 time daily. The 2 drugs were equally effective as twice daily medications while Isoptocarpine 4 times daily was significantly more effective than either given twice daily. The pH of the Adsorbocarpine may not have been optimal although commercially available solutions were used. The results indicated that pilocarpine in either vehicle can lower intraocular pressure when given less than 4 times daily; however, conclusive studies are needed before this can be recommended as a widespread clinical practice.


Senile entropion: modified Schimek operation.

Senile entropion is a common cause of ocular discomfort. Medical treatment is ineffective for it and a definitive operation generally is required. Many surgical procedures are available, but most of them are not effective. The operation described in this paper was devised by one of us (H.G.S.) 9 years ago, employing a modification of the Schimek procedure. It has the advantage, however, of fixation of the sutures to the periosteum of the lateral orbital rim and thus provides firm support for the lid septum. The operation is simple, safe, and takes little more. Even if entropion recurs, the operation can be repeated with no damage to the lid.


[Investigation on the incompatibility groups of some colicinogenic factors Ia (author's transl)].

Compatibility studies of six ColIa factors showed that these plasmids do not always constitute an homogeneous group: four factors belong to the usual Ialpha group, one factor to the O group and the last one is simultaneously incompatible with Ialpha and O plasmids.


Wound closure with Dexon (polyglycolic acid) mass suture.

A series of 814 consectuvie laparotomy incisions at three hospitals were closed with No 2 Dexon (polyglycolic acid) sutures using the 'near and far' technique. The incidence of wound dehiscence was 0.5%, of sinus formation 1%, and of incisional hernia 2.2% at 6 months and 6% at 3 years.


The burning of John Hunter's papers: a new explanation.

It is commonly accepted that Sir Everard Home destroyed the Hunterian Manuscripts to hide the extent to which he had used them for his own publications. We suggest that his real reason for burning the papers was to hide the identity of the person who had been the subject of John Hunter's famous inoculation experiment.


Total body suspension in the treatment of burns. Report of two cases.

Total body suspension by skeletal traction was used in the treatment of two children with severe circular truncal burns. The authors do not know of any previous reports on complete body suspension, and the demonstration of the possible treatment of burn injuries in this way is considered important. The favourable aspects of the treatment, i.e. prevention of infection and pressure sores, easier nursing, physiotherapy and handling during operations, are emphasized.


[Tasks and methods of industrial anthropology. A review].

In the course of the industrialization of our work-environment, and in conjunction with the mass production of consumer goods, it has proven necessary to determine systematically the body-measurements important to this area, and to develop a constellation of technical aspects for their application. This has required the development of new measuring methods which go beyond those of classical anthropology; the acquisition of data concerning the distribution of body size and proportion in the various regional and social sub-populations; and finally, determination of the parameters of work-environment which are dictated by human form and function. Industrial anthropology has developed more and more in the past few years as a field of study whose object is the interaction between people and their technical environment.


The measurement of total serum proteins by the Biuret method.

The biuret reaction for proteins provides a simple and precise method for measuring serum proteins; Beer's law is obeyed to at least 10 g per dl. Several stable biuret reagents are available. Hemoglobin is the only important cause of interference which cannot be minimized by use of a sample blank. The mechanism of the biuret reaction is described and attention is drawn to the heterogeneity of the serum proteins and to the use of a certified albumin standard.


Osmotic pressure of the serum proteins.

The osmotic pressure of the serum proteins (colloid osmotic pressure [COP] or "oncotic" pressure) is only one of the four Starling forces (plus the capillary permeability coefficient) which affect the net filtration of fluid from the capillaries. The COP will vary with the concentration of total serum proteins, but more so with the specific pattern or composition of the protein components, especially albumin. The use of formulas utilizing total protein (or albumin/globulin) to calculate COP is not warranted. COP should be determined; this is easy at the present time with the advent of a compact commercial instrument. Generalized or localized edema (e.g., pulmonary edema or ascites) has been associated with low serum albumin and low COP values. This is not always so since cases of analbuminemia do not necessarily exhibit edema. The study of COP is warranted but precautions are necessary in proper interpretation of the causes of "edema,"--the Starling forces and hemodynamic factors, capillary permeability, lymphatic return, etc., are all involved in the phenomenon.


General considerations of coagulation proteins.

The coagulation system is part of the continuum of host response to injury and is thus intimately involved with the kinin, complement and fibrinolytic systems. In fact, as these multiple interrelationships have unfolded, it has become difficult to define components as belonging to just one system. With this limitation in mind, an attempt has been made to present the biochemistry and physiology of those factors which appear to have a dominant role in the coagulation system. Coagulation proteins in general are single chain glycoprotein molecules. The reactions which lead to their activation are usually dependent on the presence of an appropriate surface, which often is a phospholipid micelle. Large molecular weight cofactors are bound to the surface, frequently by calcium, and act to induce a favorable conformational change in the reacting molecules. These molecules are typically serine proteases which remove small peptides from the clotting factors, converting the single chain species to two chain molecules with active site exposed. The sequence of activation is defined by the enzymes and substrates involved and eventuates in fibrin formation. Multiple alternative pathways and control mechanisms exist throughout the normal sequence to limit coagulation to the area of injury and to prevent interference with the systemic circulation.


[Determination of the microbial contamination of tablets of tetracycline series antibiotics].

The experiments showed that the method of direct plating of tetracycline tablet suspensions on solid nutrient media containing magnesium sulfate may be used for determination of microbial contamination. The method provided determination of both the antibiotic resistant and the antibiotic sensitive organisms which may be present in the drug. Dilution of the basic suspensions increased the probability of the microbe detection in the tablets.


[Phosphate group donors for neomycin inactivation by resistant microorganism strains].

The substrate specificity of aminoglycoside phosphotransferases isolated from 3 strain of E. coli and purified was studied. All pure enzymes phosphorilated neomycin, paromomycin, lividomycin, neamine, ribostamycin, kanamycins A and B. Only ATP was the donor of the phosphate groups in these reactions, while in the non-purified extracts GTP but not UTP or CTP served as the donor of the phosphate group for inactivation of neomycin. The substrate specificity indicated that the above enzymes were aminoglycoside-3(1)-phosphotransferases. Inactivation of neomycin with the use of the phosphate group of phosphoenolpiruvate as the donor in the non-purified enzymatic preparations of the neomycin-resistant strains of E. coli and Pseudomonas was not observed.


[Comparative study of the effect of different rifamycins on bacterial cell metabolism and on the RNA-polymerase reaction in a cell-free system].

The results of the study on the inhibitory effect of a number of rifamycin derivatives, such as rifamycin B, rifamycin O, rifamycin, rifamycin A, 25-desacetylrifampicin and rifampicin are presented. It was shown that rifampicin had the highest inhibitory effect on the synthesis of RNA in the cells of E. coli and Staph. aureus. It inhibited the above process by 93.0 and 98.8 per cent respectively. The data on the cells of Staph. aureus, as well as the data on comparison of the inhibitory effect of rifampicin derivatives with respect to the RNA-polymerase reaction in acellular systems are presented.


[Heliomycin suppression of RNA synthesis in a cell-free system].

Heliomycin inhibited in vitro the RNA-polymerase reaction catalyzed by the preparation of DNA-dependent RNA-polymerase from E. coli. The blocking effect increased with a rise in the antibiotic concentration. The inhibitory effect of heliomycin decreased, when the amount of RNA-polymerase in the system increased. Yet, it did not depend on the content of DNA and the nature of the DNA preparation. Preincubation of RNA-polymerase with DNA resulting in formation of the enzyme-matrix complex did not prevent blocking RNA synthesis by heliomycin. Suppression of the RNA-polymerase reaction did not depend on the time of the antibiotic addition to the polymerizing system. Heliomycin had a significant activity not only with respect to the bacterial RNA-polymerase, but also in the system containing the enzyme isolated from the cells of Crithidia oncopelti.


[Effect of gentamycin, decamethoxin and prodigiozan on the course and outcome of experimental pyocyanic infection in white mice].

The therapeutic and prophylactic effectiveness of gentamicin, decamethoxin and prodigiozan was determined on albino mice infected with two-fold lethal doses of the antibiotic-resistant strain of Ps. aeruginosa. Correlation between the effectiveness of the drug and the dose and time of its administration was found. Pronounced prophylactic and therapeutic effect of gentamicin in combination with decamethoxin was noted. Prodigiozan, a bacterial polysaccharide had no significant effect on the experimental pyocyanic infection of albino mice.


[Stimulating effect of prodigiozan on nonspecific reactivity in typhoid fever, dysentery and staphylococcal infection].

A number of factors of nonspecific reactivity, i.e. complement, lysozyme, properdin, blood serum bactericidal activity, leucocyte phagocytal activity, phagocytal index and completed phagocytosis were studied on 160 guinea pigs with experimental typhoid fever, dysentery and staphylococcal infections. The data of the study showed that with the use of prodigiozan the non-specific reactivity of the host increased even within a short period of time. At the same time the pathological changes in the internal organs in their histochemical investigation decreased.


[Results of 10 years of use of lincomycin (1966-1976) in the clinics of the N. N. Priorov Central Research Institute of Traumatology and Orthopedics].

During 10 years 1063 patients were treated with lincomycin used parentally or orally at the N. N. Priorov Central Research Institute of Traumatology and Orthopedy. The doses and the rate of its use depended on the state of the patient, its age and weight. Lincomycin was used for the treatment of patients with osteomyelitis or purulent wound infection, as well as for prophylaxis of suppuration. The drug was used for a long period of time under conditions of the same hospital, and it was shown that it remained up to the present days highly effective in therapy of infections and especially bone infections caused by staphylococci sensitive to it. The 10-year study of staphylococcal sensitivity to lincomycin revealed an insignificant increase in the development of resistance to it. The paper presents data on the importance of adequate surgical interventions in addition to the antibiotic therapy in cases with bone infections. A possibility of lincomycin combined use with other antibiotics and gentamicin or kanamycin in particular was shown. Complications, such as diarrhea and urticaria were registered in 11 patients.


Selective enrichment of aromatic amino acid auxotrophs in Hansenula polymorpha.

Aromatic amino acid auxotrophs of the methanol-utilizing yeast Hansenula polymorpha were effectively selected by the use of nystatin and a medium that inhibits the growth of tyrosine auxotrophs. The procedure resulted in a frequency of aromatic auxotrophs of 2% of survivors and an enrichment of 20-fold. The new procedure also takes less time than traditional procedures. Of the auxotrophic mutants isolated, two-thirds required tyrosine and the remainder were tyrosine-phenylalanine double auxotrophs.


Construction of a urocanic acid-producing strain of Serratia marcescens by transduction.

In Serratia marcescens, the mutation responsible for triazolealanine (TRA) resistance was transferred from a TRA-resistant mutant to a urocanase-less mutant by PS20-mediated transduction. The two crosses were performed using as donors two TRA-resistant mutants, whose phenotypes included increased levels of histidine-biosynthetic enzymes and feedback-insensitive phosphoribosyltransferase. In one cross, TRA-resistant transductants were urocanase-less mutants having only increased levels of the enzymes and barely detectable levels of urocanic acid. In the other cross, the transductants were urocanase-less mutants having both phenotypes of the donor, and most produced high concentrations (10.5 mg/ml) of urocanic acid.


Membrane filter procedure for enumeration of Candida albicans in natural waters.

A membrane filter procedure is described for the enumeration of Candida albicans in natural waters. Several hundred milliliters of sample can be examined by filtration through 1.2-micrometer membranes. Selectivity is achieved by the use of a defined (yeast-nitrogen base plus maltos-) agar medium inclusion of the antimicrobial agents chloramphenicol and cycloheximide, and incubation at 37 degrees C. C. albicans colonies are differentiated primarily through color by use of a bismuth salt indicator system. Average recovery of various strains of C. albicans stressed in seawater at 4 degrees C was 82%, compared with those of spread plate controls on a noninhibitory medium. With river water and raw sewage, 90% of typical C. albicans colonies were confirmed as such in a simplified germ tube test. Atypical colonies verified as C. albicans were infrequent (3%). C. tropicalis and Torulopsis candida were the most common false-positive colonies.


Airborne enteric bacteria and viruses from spray irrigation with wastewater.

The relationship between bacterial concentrations in wastewater used for spray irrigation and in the air was examined. Aerosolized coliforms were detected when their concentration was 10(3)/ml or more in the wastewater. Relative humidity and solar irradiation appeared to affect viable bacteria in the air; a positive correlation was found between relative humidity and the number of aerosolized bacteria. The correlation between solar irradiation and bacterial level, on the other hand, was negative. During night irrigation, up to 10 times more aerosolized bacteria were detected than with day irrigation. Wind velocity did not play an important role in the survival of aerosolized bacteria. Echovirus 7 was isolated in 4 out of 12 air samples collected 40 m downwind from the sprinkler.


Restriction endonuclease analysis for the identification of baculovirus pesticides.

Gel electrophoresis of deoxyribonucleic acid (DNA) fragments generated by digesting the DNA genomes of nuclear polyhedrosis viruses (NPV) with restriction endonucleases provides DNA fragment patterns that may be used to identify different viruses of this group. Characteristic fragment patterns were obtained for three NPVs, which are important as biological pesticides (Autographa californica NPV, Orgyia pseudotsugata NPV, and Heliothis zea NPV). The DNA fragment patterns of the A. californica NPV genoms did not change with passage through the alternate insect host, Trichoplusia ni. Heterogeneity in one preparation of O. pseudotsugata NPV was observed. The identification procedure is direct and precise. Applications of this procedure include quality control of commercial preparations of viral pesticides and screening for genetic alterations in the viruses.


Recovery of sublethally heat-injured Salmonella typhimurium on supplemented plating media.

The efficacy of 32 additives to Levine eosin-methylene blue-salts agar medium (EMBS) for the recovery of sublethally heat-injured Salmonella typhimurium was evaluated. In order of decreasing effectiveness, lactate, mannitol, and alpha-glycerophosphate mediated 90% or more recovery of injured cells; similar levels of recovery were obtained on EMBS supplemented with 1% (wt/vol) tryptic soy broth, protease peptone, or plate count agar. Other additives showed little or no capacity for repair or strongly inhibited heated and nonheated cell suspensions. Conditions of growth and storage before heat treatment were also found to markedly affect susceptibility to heat injury.


Computer-assisted identification of anaerobic bacteria.

A computer program was developed to identify anaerobic bacteria by using simultaneous pattern recognition via a Bayesian probabilistic model. The system is intended for use as a rapid, precise, and reproducible aid in the identification of unknown isolates. The program operates on a data base of 28 genera comprising 238 species of anaerobic bacteria that can be separated by the program. Input to the program consists of biochemical and gas chromatographic test results in binary format. The system is flexible and yields outputs of: (i) most probable species, (ii) significant test results conflicting with established data, and (iii) differential tests of significance for missing test results.


Relation between radiation resistance and salt sensitivity of spores of five strains of Clostridium botulinum types A, B, and E.

The NaCl tolerance of different strains of Clostridium botulinum varies over a wide range, and the patterns of NaCl inhibition differ distinctly and characteristically from strain to strain. The more radiation-resistant strains, such as 33A, 62A, and 7272A, are more resistant to NaCl, whereas the more radiation-sensitive strains, such as 51B and 1304E, are more sensitive to NaCl. This rule appears to hold irrespective of whether the spores were unirradiated controls or whether they were radiation damaged prior to exposure to NaCl in the recovery media. The data seem to indicate that radiation doses in the shoulder portion of the radiation survival curves did not noticeably sensitive the spores to NaCl, whereas radiation doses in the exponential-decline portion of the survival curve invariably produced a distinct sensitization. Thus, strains 33A and 62A were not sensitized to NaCl by 0.3 to 0.4 Mrad, i.e., in the shoulder portion of the survival curve. Radiation-sensitive strain 51B, which shows no distinct shoulder in its survival curve, was sensitized to NaCl by 0.1 Mrad, the lowest radiation dose employed in this study. These observations seem to suggest a possible relationship between deoxyribonucleic acid repair capacity and salt tolerance.


Characteristics of the constituent substrains of Bacillus popilliae growing in batch and continuous cultures.

Continuous culture of Bacillus popilliae was achieved for the first time in a small chemostat. Initially, variable cell yields during steady-state chemostat growth led to a re-examination of growth rates in batch cultures. B. popilliae NRRL B-2309 and a wild strain were both found to be natural mixtures of three substrains characterized by different growth rates and colony morphologies and varying stability. Selected subcultures grown continuously provided data for three different cell production curves. Cell yields were two to three times greater per unit of medium in continuous than in batch culture, and about 1% of slow-growing chemostat cells formed typical spores.


Isolation and cultivation of spirochetes and other spiral-shaped bacteria associated with the cecal mucosa of rats and mice.

A method for the culture of spiral-shaped bacteria associated with the intestinal mucosa of rodents is described. The appearance in culture of a spiral organism from rat ceca and a spirochete from mouse ceca is illustrated; these organisms are morphologically similar to the major inhabitants of the cecal mucosa in each animal species.


[Erythema elevatum diutinum. II. Immunoelectronmicroscopical study of leukocytoclastic vasculitis within the intracutaneous test reaction induced by streptococcal antigen (author's transl)].

A leukocytoclastic vasculitis was induced by intracutaneous injection of streptococcal antigen in a patient with erythema elevatum diutinum (E.e.d.). The immunoelectronmicroscopical demonstration of C3 was performed by use of the peroxidase-antiperoxidase multistep technique 24 h after the injection of the antigen. Deposits of C3 were found between endothelial cells, on the outer surface of endothelial cells, pericytes, and smooth muscle cells, as well as within the multilayered basal lamina of small vessels. Intact and disintegrating neutrophils accumulate within the vessel walls and in their surroundings. Necrosis and fibrin deposition are present in advanced stages. The findings demonstrate the sequence of events in leukocytoclastic vasculitis at the ultrastructural level. They also support the hypothesis that in E.e.d. an Arthus type reaction induced by bacterial antigens may be of pathogenetic significance.


Acute neurological complications after liver transplantation with particular reference to intraoperative cerebral air embolus.

Nine of 48 adult patients who underwent orthotopic liver transplantation developed significant clinical neurological abnormalities recognized shortly after operation. Decrease in consciousness occurred with resultant coma, focal and generalized seizures and the occasional appearance of a state of akinetic mutism. Neuropathological abnormalities consisted of multifocal areas of infarction in cerebral cortex and basal ganglia in five patients, central pontine myelinolysis in five (often more extensive than usually reported), Wernicke's encephalopathy in three, glial nodules in two, and fungal abscesses in one. Alzheimer II astrocytosis was found in all brains available for retrospective study. There was direct evidence in two  of the patients that air embolization from the homografts had occurred. Correlation of this with the brain infarcts in these and other cases seems reasonable. The ease with which air passed to the systemic circulation is explicable by the right to left venous--arterial shunts that are common in chronic liver disease. With the delination of this cause for the neurologic complications, measures to prevent it in future cases have been described.


A comparative study of IPPB, the incentive spirometer, and blow bottles: the prevention of atelectasis following cardiac surgery.

Following cardiac operations, 145 patients were treated with either intermittent positive-pressure breathing (IPPB), blod bottles, or an incentive spirometer in an attempt to alter the incidence of atelectasis. Pulmonary complications occurred in 30% of the patients receiving IPPB, 15% of those using an incentive spirometer, and 8% of those using blow bottles. Gastrointestinal side-effects occurred in 20% of the IPPB group and were rare in other groups. The cost of IPPB is also considerably greater than either incentive spirometry or blow bottles. IPPB is not essential to prevention of atelectasis in postoperative cardiac surgical patients and may be inferior to other methods.


Platelet dysfunction associated with cardiopulmonary bypass.

The clinical significance and pathogenesis of the platelet dysfunction following cardiopulmonary bypass were studied in conjunction with the degree of functional impairment associated with the use of membrane and bubble oxygenators. Forty consecutive patients had the following tests preoperatively and postoperatively: complete blood count (CBC), platelet count, prothrombin consumption time, bleeding time, prothrombin time, partial thromboplastin time, fibrinogen, euglobulin clot lysis, fibrin degradation products, and platelet aggregation tests. Six patients were given 14C-serotonin tests before and after operation, and preoperative and postoperative electron micrographs were made of the platelets of 3 patients. The amount of blood lost, the blood transfused, and plasma hemoglobin levels were also measured. Abnormal aggregation of platelets was found, with no difference between the membrane and bubble oxygenators. In vitro aggregation tests with protamine sulfate and hemoglobin solutions, as well as the 14C-serotonin studies and electron micrographs, suggest that platelets acquire storage pool deficiency and an abnormal membrane during cardiopulmonary bypass.