[GAST after 3 years' use].

Increasing of systematic syphilis screening has led many scientists to think to automatisation of classical cardiolipid reactions. The Debains-Kolmer reactions have been adapted to continuous flow but they appear actually inefficient. The use of ART (automated reagin test) gives very satisfying results and this reagent has obtained its homologation in the United States. The apparition of Groupamatic has incitated M. GARRETTA to adapt on this material the K. Antigen reagent manufactured by the Blood Transfusion Center in Lille and has led to the definition of GAST reagent (Groupamatic automated syphilis test). The authors describe the method of preparation of this reagent and its utilization on Groupamatic. It appears that the bovin cardiolipidic extract, non specific by definition, lays down to antagonist problems: to be sensitive enough when specific enough. It's the final reagent settlement which is the more delicate and which needs the maximum in manipulation. Yet, the composition of GAST is now well established and this reagent, ready for use, may be kept during three months at 4 degrees C. Then the authors describe the results of their own use of GAST, in routine on Groupamatic 360: out of 6 079 plasmas of blood donnors examined, 3 per cent of reactions are positive or doubtfull (which stays compatible with the screenings in large number). After confirmation with complementary tests made with manually GAST, RPR with microscopic reading, haemagglutination, and lastly fluorescent method, it appears that the rate of positive reactions is 1,7%. This result is conformable to habitual statistics. In conclusion, the GAST is a well-adapted reagent for Groupamatic technology, and represents a progress compared with classical manually methods. The adaptation of syphilis screening on Groupamatic is a factor of rentability of this equipment, allowing to realize 360 tests in one hour. At last, considering that cardiolipidic reactions are not of an absolute diagnostic value, treponemic complementary tests are necessary in order to confirm positive results picked up on Groupamatic.


[The passive hemagglutination test in the diagnosis of syphilis].

Studies were carried out on the comparative value of passive haemaglutination, cardiolipin and treponema tests in a total number of 4327 sera syphilitic patients in various stages of the disease and apparently normal subjects or free of syphilis. The results demonstrated the specificity and sensitivity of passive haemagglutination in all the stages of syphilis. In view of the qualities and simplicity of the test, the author recommends it as a screening test combined with a micromethod using the cardiolipin antigen (flocculation test).


[Cellular mediated immunity in virus infections].

The intervention of cellular immunity in the course of specific antiviral defence is suggested or confirmed by a series of clinical and experimental findings, i.e. the evolution of certain viral diseases following a second contact with viral antigens; discrepancy between the level of antiviral serum antibodies and the clinical course of some viral diseases; pathohistological alterations in some viral diseases, suggesting the intervention of cellular immunity; the clinical aspects of natural or experimental viral diseases in primary and secondary immunodeficiency. Investigations were likewise carried out on certain indices of cellular immunity in human or experimental viral diseases, such as delayed hypersensitivity skin tests; the transfer of immune lymphocytes; lymphocytic blastic transformation; inhibition of macrophage migration; specific cytotoxicity test. The problems concerning the role of cellular immunity in the specific defence against viruses may be grouped as follows: mechanisms of induction of the immune cellular response in viral infections; relationship between cellular and humoral immunity in antiviral resistance; relative independance of systemic and local cellular immunity in the course of viral diseases; the cellular basis of cellular mediated immunity in viral diseases.


[Extraction of the soluble protein fraction from Treponema Reiter for use as antigen in syphilis serodiagnosis].

The present paper reports on two methods for extraction of the protein antigen from Treponema Reiter and shows the chemical and immunochemical characteristics of the extracts. Serologic testing of 1810 sera from syphilitic patients in various stages of the disease, from healthy subjects and from subjects with a false positive reaction to lipoid antigens, showed the value of the Reiter antigen to be equal to the cardiolipin antigens and those prepared from pathogenic Treponema. It is recommended to associate this antigen, in view of its qualities, to the cardiolipin tests used in the serodiagnosis of syphilis, especially in the laboratories that do not currently apply other treponema tests.


The morphological basis of the glomerular permeability to proteins.

The morphological basis of the glomerular permeability to proteins is reviewed and a survey is given of the studies done with ultrastructural tracer substances. In the normal GCW two structures have been considered important as a possible barrier to macromolecules: the GBM and the epithelial slit pore and slit diaphragm. The currently available evidence indicates that under normal conditions most plasma proteins do not penetrate beyond the subendothelial layer of the GCW. However, it is probable that the epithelial slit diaphragm acts as a secomdary barrier to macromolecules. In glomerular proteinurai the transport of anionic macromolecules through the GCW is increased, but the passage of uncharged macromolecules (PVP, dextran) is less than in the normal glomerulus. The number of anionic sites in the GCW is much smaller than in the normal glomerulus and there is a change in the normal arrangement of the foot processes and a decrease in the number of slit pores. At present, it is still incompletely understood in which way these changes are related to each other. Assuming the presence of focal leaks in the GCW, a possible sequence of events leading to glomerular proteinuria is discussed.


Circulating immune complexes in nephritis.

Serum samples from 115 patients with various kidney disease were studied by means of precipitation in 3.5% polyethylene-glycol (the PEG test) and by inhibition of agglutination of IgG-coated polystyrene particles induced by C1q, two tests developed for the detection of circulating immune complexes. Positive results were found in acute glomerulonephritis, particularly in its early stages, and also in chronic forms of glomerulonephritis: membranous, focal sclerosing, mesangiocapillary and focal glomerulonephritis. High levels of circulating immune complexes were found in lupus nephritis. In most cases the test results showed a good correlation with the clinical course of the diseases.


Bond strength of composites applied to acid-etched enamel.

The adhesion to acid-etched enamel of a four-component composite, Concise Enamel Bond System, was studied. The composite was applied undiluted over an intermediate resin layer and diluted with different amounts of resin. Corresponding surfaces of contralateral premolars were used to ensure that the composite samples were tested on areas with similar enamel etch patterns. Eighty specimens were tested. The results of this study indicated that the adherence of undiluted composite to etched enamel surfaces was not improved by using an intermediate layer of low-viscous resin. Composite diluted with liquid resin had poorer adherence than undiluted composite. There was no difference in the results from two degrees of dilution.


Trimipramine in the treatment of gastric ulcer.

Forty patients with endoscopically confirmed gastric ulcers, completed a double-blind study comparing trimipramine with placebo during 4 weeks' treatment. The daily dose of trimipramine was 50 mg given before bedtime. No serious side-effects occurred. After four weeks' treatment 12 of the 20 patients receiving trimipramine had endoscopically completely healed ulcers, while in the placebo group only 4 of the 20 ulcers were healed (P = 0.025). With regard to the patients' complaints, a distinct and statistically significant improvement was also observed in the patients receiving trimipramine (P = 0.025). It is assumed that the previously shown antisecretory effect of the drug, together with the sedative and anti-depressive effect, make trimipramine a valuable drug in the treatment of peptic ulcer disease.


Anti LH and FSH activity of the human urinary antisteroid substance.

The antisteroid urinary substance was checked out for its effect on LH and FSH under endogenous (castrated animal) and exogenous (administration of releasing hormone-GnRH) stimulation of the rat hypophysis. Administration of this substance partly blocked the castration induced LH and FSH serum increase by 65% and 37% respectively (p less than 0.01) and inhibited the GnRH stimulating effect depressing serum LH by 50% and FSH by 33% (p less than 0.05). In both experiments the LH and FSH content of the hypophysis was not influenced.


Group B streptococcal meningitis in previously healthy adult males.

Two previously healthy men, aged 38 and 39 years, with meningitis due to group B streptococci are described. These patients are unique as only one or two adults with group B streptococcal meningitis without predisposing diseases have been reported previously.


Experience of a platelet factor 3 immunoinjury technique in the detection of antiplatelet antibody in systemic lupus erythematosus and other clinical disorders.

Using a recently described platelet factor 3 (PF3) immunoinjury technique designed for the detection of antiplatelet antibody, sera from 62 patients were analysed. 30 of the subjects had systemic lupus erythematosus and the remaining 32 had other clinical disorders. Platelet survival studies were also carried out in every subject. The PF3 test proved positive in 10 of our patients. However, only 1 of these 10 subjects had shortened platelet survival. It is concluded that the PF3 test does not appear to be of use in the detection of circulating antiplatelet antibody.


[Therapy of duodenal ulcer using cimetidine].

55 patients with endoscopically confirmed duodenal ulcers received either cimetidine (26 patients) or placebo (29 patients) in a double-blind trial. At four weeks, 85% of the patients treated with cimetidine and 62% of those receiving placebo had endoscopically healed ulcers. This difference is not statistically significant. However, patients on cimetidine showed a more rapid and statistically significant reduction in the size of their ulcers.


[Colonization of the pregnant woman and the newborn by group B streptococcus: therapeutic and preventive implications].

In a search for group B streptococci, vagina and urethra of 196 pregnant women entering the delivery room were cultured using a selective medium. Sixteen (8.2%) were positive. Fifteen (15%) of 101 nonpregnant women cultured similarly during a clinical consultation were positive. Esogastric aspiration fluid of 199 neonates from the former group of women was also cultured: 8 (4.0%) were positive. Thus, maternal genital colonization was accompanied by neonatal contamination in 7 of 16 cases (43%). Typing of the streptococci revealed identity between all maternal and neonatal isolates tested. These values are comparable with those obtained in other countries. Their epidemiological implications and the prophylaxis and therapy of the neonatal disease are discussed.


[Psychological and psychosomatic aspects in dentistry].

Overemphasis on technical knowledge and ability is often the cause for neglecting patients psychosomatically. In the center of patient-dentist relationship stands fear in its various forms. Also, an increasing number of patients come with mental disturbances and expect understanding from the medical person in the first place, and technical knowledge in second only. It is important that the student already be familiarized with these problems. The method of Balint, successfully used in general medecine, seems to be very useful to this end, because it teaches the student to know his own mental reactions aslong with those of his patients.


[Long-term experience in endosseous endodontic implantation].

The results of 9 years experience with transfixed abutment-teeth for bar-joint dentures in the lower jaw were collected. The method has been slightly altered since the beginning, and these changes are described in order to complete earlier publications: there are special chapters dealing with the implant-material Syntacoben, which is used in human and veterinary medecine mainly, and with the transfixation technique. By measuring the tooth mobility over a period of 20 months in a group of subjects, one has shown that the stabilisation (4.5 +/- 1.0.10(-2) mm) of loosened lower anterior abutment teeth combined with a bar-joint denture is lasting, even under masticatory pressure. The long-term results (mean wearing-time is 5.5 years) are gathered in a summarized survey. In 62 patients with 100 transfixed abutment-teeth (making a total of 159 abutment-teeth) there was a success of 62%, 15% partial success, and 23% failure. 5 success-cases are also radiologically shown. Within strict indications, transfixation can be recommended today to the practitioner.


[Free gingival grafts in muco-gingival surgery: presentation of clinical cases].

Several indications of the free gingival graft have been reviewed. When utilized alone, this procedure allows to increase the height of the attached gingiva, to stabilize a recession or to prepare a sufficient zone of attached gingiva before placing a prosthesis. To cover one or several recessions, the gingival graft has to be placed in a first step and then a flap is repositioned coronally.


[Tricalcium phosphate and its biodegradable ceramics in periodontal bone surgery. A review of the literature].

The chemistry, structure, biocompatibility and effect of biodegradable tricalcium phosphate and tricalcium phosphate ceramic are evaluated with the pertinent literature. With proper indication and use the biodegradable tricalcium phosphate implants for the formation of new bone and reattachment in periodontal pockets may be successful. The biodegradable material has to be sufficiently tried out and examined in further animal and clinical studies before recommending it for general use.


The role of LH-RH in induction of spawning in grass carp (Ctenopharyngodon idellus). I. Cytological and histochemical studies of the pituitary and of the ovary.

Histochemical studies indicate that in teleost, just like the case in mammalian species, the functional changes of the pituitary and the ovary are directly and indirectly under the control of the hypothalamic releasing hormone. The medium lobe of the grass carp's pituitary has only one type of gonadotroph which contains two kinds of granules differing in size and staining reaction. The gonadotrophs show extensive activity of hormone synthesis and release following the LH-RH treatment. This is evidenced by the progressing decrease in number of the small granules, increase in number and size of the huge heterogenous  granules and the appearance of cytoplasmic vacuolation. The small granules are likely to be the LH secreting granules and the huge granules, the FSH secreting granules. Owing to the rapid elevation of pituitary LH, the ovary is activated. This is demonstrated by the increased activities of G-6-Pase, AKP, 3 beta-0H-SDH, and ACP in the follicular cells of the ovary after hormonal treatment. The result suggest that the steroid hormone plays an important role in the regulation of the gonadotropin action.


Obstruction due to malignant tumors.

An overview of the causes, the clinical pictures and the management of obstruction in three major organ systems due to primary and secondary malignant neoplasms has been presented. Such obstruction often produces dramatic clinical pictures that require careful, appropriate, and often aggressive therapy if patients are to receive the quality of palliation they deserve or the attendant improvement in survival that may result.


A long-term study of diclophenac sodium in the treatment of rheumatoid arthritis and osteo-arthrosis.

One hundred and two patients with either rheumatoid arthritis or osteo-arthrosis were treated for prolonged periods with diclophenac sodium (Voltaren; Geigy) to evaluate the efficacy and tolerability of the drug. Fifty-seven patients completed a trial of 12 months. A total of 70% showed an improvement in functional class, and 40% of the total had complete functional capacity by the end of the trial. The drug was well tolerated. The side-effects (heartburn, abdominal cramps, headache and dizziness) were mild and in most cases did not require cessation of treatment. In 9 patients the Coombs test became positive during the trial, but this did not require cessation of therapy.


Hormonal and metabolic responses to an oral glucose load in obese Black diabetics.

Plasma insulin responses to a 4-hour glucose tolerance (100 g) were studied in urbanized Black people. Persons of normal weight without diabetes (12) and obese persons without diabetes (18) were compared with obese diabetics (19). Fasting serum ketone levels were measured, and the plasma potassium, triglyceride and growth hormone responses during the glucose tolerance test were determined. Obese subjects without diabetes had a twofold greater total plasma insulin response (area under curve) than their counterparts of normal weight, but there was a progressive fall in total plasma insulin response from subjects with mild diabetes (with fasting normoglycaemia) to those with severe diabetes (with fasting hyperglycaemia). The early plasma insulin responses of the group with mild diabetes were significantly impaired, and the peak response was only reached at 120 minutes. The subjects with severe diabetes had a flat insulin response curve. Fasting serum ketone levels were highest in the group with severe diabetes. The growth hormone responses were similar in all the groups. Plasma potassium and tryglyceride levels fell less during the glucose tolerance test in the group with severe diabetes than in the other three groups. These data indicate that insulin secretion is reduced in obese Blacks with chemical evidence of diabetes and this reduction becomes severe in the symptomatic diabetic.


Rupture of an amoebic liver abscess in pregnancy. A case report.

The association between hepatic amoebiasis and pregnancy is rare. Between 1966 and 1976 only 5 cases have been described in the world literature. A sixth case is described, and the literature to date is reviewed. Guidelines for management are presented.


The genetics of diabetes mellitus.

Diabetes mellitus is a geneticist's nightmare. We examine herein what causes the nightmare, how bad it is and how it is being alleviated by modern advances. Diabetes is more than one disease, it is indefinable, probably genetically multifactorial, and presents several facets with varying degrees of heredity and environment in their constitution.


Long-term effect of perhexiline maleate on ventricular ectopic activity.

The effectiveness of perhexiline maleate in the suppression of ventricular ectopic activity has been studied in 10 patients after myocardial infarction. Before treatment all patients exhibited frequent ectopic beats, i.e. more than 8 per hour. Numerous Holter magnetic tape recordings were made over a 9 - 10-month period of treatment. During the entire period of monitoring significant suppression of ectopic activity was observed in 5 patients and transient suppression in 4, of whom 3 subsequently showed a transient increase. The drug was discontinued in 1 patient because of nausea, anorexia and weight loss. No other adverse effects were encountered.


Maintenance dialysis and renal transplantation facilities in South Africa--1977.

A survey undertaken in July 1977 revealed that 27 hospital centres were treating 307 patients with chronic renal failure by maintenance haemodialysis and 22 patients by chronic peritoneal dialysis. An additional 28 patients were receiving home dialysis. Seven of the centres had transplantation programmes and were treating 271 survivors with functioning renal homografts.


[William Harvey (2 April 1578)--400 years of physiology].

William Harvey, born on 2 April 1578, was the founder of modern scientific physiology. The importance of his work was that he was the first prominent exponent of the tremendous value of experimental physiology. By postulating the machine model of the circulatory system he also reinforced the idea of Descartes that man is a machine. During the past 400 years this model led to sensational discoveries on the one hand, as well as scientific limitations and cultural and spiritual crises on the other. Serious rethinking about prescientific and prephilosophic premises is urgently needed for the future.


Another look at erythromycin.

The erythromycins are broadly reviewed from a clinical viewpoint. The antimicrobial spectrum, clinical indications, pharmacokinetics and toxicity are dealt with. The usefulness of erythromycin for respiratory tract infections is stressed. New evidence to support bactericidal activity of this antibiotic is noted. There seems little reason to use the potentially hepatotoxic estolate form of erythromycin. The safety of the other forms of this antibiotic available in this country is emphasized.


Open lateral wedge osteotomy of the calcaneum for severe postural pes valgus in children.

Conservative treatment for postural pes valgus in children is, on occasions, unsuccessful in the more severe cases. Where adequate conservative treatment had failed, it was decided to correct the deformity by performing an open lateral wedge osteotomy of the calcaneum, as advocated by Dwyer. When the Achilles tendon was short, an open elongation of the tendon was added to the procedure. In this series, 10 patients from 5 to 14 years of age with marked postural pes valgus were treated. Satisfactory results are reported after an average follow-up period of 9 years. A possible explanation for the success of the operation is discussed.


Levamisole and the treatment of Herpesvirus hominis infections. A case report.

The successful treatment with levamisole of 3 categories of Herpesvirus hominis infection is described. A fourth category of patients infected with vulval condylomata acuminata were unsuccessfully treated with levamisole. The dosage regimen is discussed. The most dramatic feature was the relief of the severe pain encountered in the acute cases. Levamisole has also prevented further attacks to date. There is no doubt that levamisole has a definite place in the treatment of H. hominis infections.


Migration of a kirschner wire in the body. A case report.

Foreign bodies may enter the body by various ways, yet migration in the body seldom occurs. A case is described where a Kirschner wire, which had been inserted in the shoulder joint, migrated through the pleural cavity and the diaphragm, apparently by force of gravity. It was subsequently easily removed by laparotomy.


Comparison of carbuterol and hexoprenaline aerosol in bronchial asthma.

A new beta 2-adrenergic bronchodilator, carbuterol, was compared with hexoprenaline and placebo, by double-blind crossover technique in 10 adult asthmatic patients. Carbuterol 200 microgram was compared with hexoprenaline 200 microgram, corresponding to 2 inhalations from a standard aerosol in each case. The carbuterol effect, in terms of vital capacity and forced expiratory volume in 1 second (FEV1) was significantly longer than that of hexoprenaline. Its effect on airways resistance also appeared to be longer, although this difference was not statistically significant. The difference in duration of action may be due to greater potency of carbuterol, or to a longer elimination half-life of carbuterol. No significant effects on heart rate or blood pressure were noted with either drug.


Treatment of hypertension with single daily doses of acebutolol.

The efficacy of single daily doses of acebutolol, alone or combined with chlorexolone, was investigated in a group of 20 ambulant patients with uncomplicated hypertension of mild-to-moderate severity. severity. Patients were seen at fort-nightly intervals when doses were adjusted. Blood pressure was measured in all instances at 2 and 8 hours after medication, and after it had stabilized, at 26 hours after the last dose. The results indicate that a single dose of acebutolol alone produces significant lowering of supine and erect blood pressures for 24 hours (P less than 0,005). Combining chlorexolone with acebutolol does not improve the hypotensive effect of the beta-blocker significantly, but makes a smaller dose effective.


Current concepts in congenital vesico-ureteral reflux.

Primary vesico-ureteric reflux must be graded according to severity. Significant reflux up a dilated ureter appears to be an important factor in causing renal damage. There is evidence in favour of the theory that the renal deterioration seen in some cases of reflux can be explained on a congenital basis of site or origin of the ureteral bud and resultant dysplasia of the developing kidney. Surgery should be reserved for selected patients with significant reflux.


Diet and coronary heart disease.

Coronary heart disease (CHD) is rare in South African Blacks, even in urban dwellers, but very common in Whites. The disease is multifactorial in causation. Habitual pattern of diet undoubtedly is strongly involved. Epidemiological and other evidence suggests that for the primary and secondary dietary prevention of CHD, intake of fat (also cholesterol) should be reduced, with an increase in the polyunsaturated moiety, and obesity should be controlled. Less specific general recommendations are increased consumptions of unrefined or partially refined grain products, and fruit and vegetables. Controversies over interpretations of evidence, over dietary recommendations, and also over the changes of their adoption, are discussed.


Left innominate vein (brachiocephalic) monitoring of central venous pressure after cardiac operations.

Pre-operative insertion of a central venous pressure monitoring line may be difficult when superficial veins are lacking. Groin cannulations predispose to bacterial endocarditis, and are difficult to keep from becoming obstructed by hip flexion. Internal jugular lines are precarious and tend to be unreliable. Innominate vein cannulation before cardiac surgery is safe, easy to perform, reliable and comfortable for the patient. Complications have not been encountered.


Successful use of a soya-maize mixture in the treatment of kwashiorkor.

Forty-eight children aged 5 years or less admitted consecutively with a clinical diagnosis of kwashiorkor were randomly allocated to two groups. One group was treated with milk while the other group was fed soya-maize porridge; both groups received the same supportive treatment. The recovery rate in both groups was comparable. Protein intake and the rate of rise in serum albumin and transferrin concentrations were greater in the milk-fed group. The incidence of diarrhoea was significantly less in the children fed soya-maize. Soya-maize porridge is recommended as an effective and inexpensive treatment for kwashiorkor.


Oxamniquine in the treatment of various schistosome infections in South Africa.

Trials of a new schistosomicide oxamniquine (Vansil) were carried out in the lowveld of the Eastern Transvaal. After initial dose-finding trials, the safety and efficacy of oxamniquine against Schistosoma mansoni at an oral dose of 15 mg/kg twice a day for 2 days (total dose 60 mg/kg), were confirmed. No detectable effect was noted against S. haematobium or S. mattheei.


Chemotherapy and chemoimmunotherapy of colorectal cancer. Role of the carcinoembryonic antigen.

The current status of treatment for patients with colorectal cancer is suboptimal. Although approximately 80% of patients are amenable to surgery, cure is only possible for 40%. Survival of patients is closely related to disease staging at the time of surgery, being poorer for patients presenting with locally advanced disease or with distant metastases. Patients who undergo curative resections and are categorized as having a high risk of developing recurrence, such as those with regionally involved lymph nodes, should be subjected to studies of adjuvant therapy. Although the definite role of such studies is still under evaluation, there already exist studies of chemotherapy with 5FU, chemoimmunotherapy with 5FU-BCG, and radiation therapy, suggesting the beneficial effect of these treatment modalities based on prolongation of the disease-free interval and survival of patients. The status of available treatments for patients with advanced disease is poor. There exists no single or multidrug regimen capable of producing significant tumor regression to improve the patient's quality of life and survival. Accordingly, the active clinical investigation of newer and potentially effective chemotherapeutic agents should continue. The role of present immunotherapy is not fully determined, although several studies suggest its potential usefulness in the adjuvant and the advanced situations. Serial determinations of CEA are extremely helpful in the postsurgical monitoring of patients receiving adjuvant treatments and also in the follow-up of patients undergoing therapy for overt metastatic disease.


Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control.

One hundred stereotactic thalamotomies performed for upper extremity tremor were reviewed and the spatial positions of the anterior limit of ventralis posterior (VP), the thalamic-internal capsular boundary and somatotopic areas within VP plotted with respect to the midline and the place of the anterior comissure. Considerable variability was noted as to the location of these points. The surgical results following 97 of the 100 thalamotomies were evaluated at least three months after the procedure. Fifty-six of 70 patients with Parkinsonian tremor had complete abolition of their upper extremity tremor, as did 20 out of 27 patients with intention tremon. Plotting the spatial positions of the lesions in those cases in which the tremor was abolished and those cases in which tremor continued revealed little difference. However, in all of the cases in which upper extremity tremor was totally abolished, the lesion site was situated in ventralis lateralis anterior to the VP representation of the buccal commissure, thumb, or index finger. This study not only demonstrates the wide range of individual spatial variability in thalamic structures, and the necessity for neurophysiologic corroboration of radiologic information during stereotactic surgery if optimal results are to be obtained, but also suggests a somatotopic organization within ventralis lateralis.


Retinal branch vein occlusion.

Obstruction of a major temporal branch vein, or one of its macular tributaries, presents a significant threat to vision. Visual acuity may be reduced by macular edema or the consequences of retinal neovascularization, and these afflictions frequently become irreversible. Since the complicating macular edema and retinal neovascularization respond, at least in part, to argon laser therapy in some other conditions, some investigators have begun to treat branch vein occlusions with this modality. However, since the pathogenesis and natural history of the disorder have not yet been elucidated by prospective studies, it is not clear whether such treatment is indicated. Clinical and experimental studies are reviewed, and treatment rationale and techniques are discussed. The authors emphasize the need for well-controlled randomized studies to evaluate the natural history of branch vein occlusion and the efficacy of photocoagulation in its treatment.


The incidence of significant bacteriuria in the dog.

Counts of the number of bacteria in canine urine samples have a bimodal distribution similar to that found in man. Therefore it is reasonable to accept the same criterion of significant bacteriuria in the dog as in man, namely a count of 10(5) or more organisms/ml. of urine. The incidence of significant bacteriuria in the total canine population was 1.4%. It was higher in bitches compared with male dogs, and higher in older animals. The larger proportion of Boxers affected was attributed to their greater age compared with the mean of the sample population. The most frequently observed clinical signs in case of significant bacteriuria were haematuria, incontinence and frequent urination, and only 4.1% of such cases were asymptomatic.


[Orthodontic prophylaxis].

The problems related to the prevention of dental anomalies are very complex. They include the health care for the expectant mother and become evident above all if one considers the long period of development during which the dentition must be protected against adverse causative effects. The developmental phases of the orofacial system from birth to the time at which the permanent anteriors begin to erupt are set forth and measures are deduced that may contribute to the reduction of malformations. It is emphasized that orthodontic prophylaxis will be efficient only if the causative relationships, the conditions of development and the efficiency of the measures taken are realized correctly and evaluated according to high standards.


[The Berlin crown--a study from the prosthetic and periodontologic point of view].

The present study deals with the assessment of 112 Berlin crowns from the viewpoints of prosthodontics and periodontics. In the anterior region, porcelain-plastic jacket crowns offer the advantage of optimal esthetic achievement. In the cervical and palatine regions, the Berlin crown has no advantage over the plastic jacket crown. The confection of the Berlin crown requires exact preparation of the plastic portion and anatomical reproduction of the crowned tooth. Reactions of the periodontium to crowning were observed only in case of faulty technique.


[Review of the literature on the use of substance P in dental practice].

The authors reviewed the relevant literature to find out whether vexed questions of stomatological research or dental practice (such as conduction in the dentine, prevention of pain produced by cavity preparation, conservative treatment of pulpitis) could be settled by means of the substance P. It seems that this is not the case at present.


[Prosthetic therapy for shortened dentitions].

The cast removable partial prosthesis is the choice for the management of unilaterally and bilaterally reduced tooth rows in practice. General constructional aspects concerning the shaping of the saddles and the utilization of the remaining teeth as abutments are treated together with problems of prevention.


Controlled trial of aspirin in cerebral ischemia. Part II: surgical group.

Patients (125) who had carotid transient ischemic attacks (TIAs) and one or more accessible carotid lesions visualized angiographically had reconstructive operations of the carotid artery and were then randomly assigned to aspirin or placebo treatment. The were followed to determine the incidence of subsecquent TIAs, death, cerebral infarction, or retinal infarction. Life table analysis (for 24 months follow up) that eliminated deaths which were not stroke-related revealed a significant difference in favor of aspirin. Because of the small number of patients and the short period of follow up, these results should be interpreted only as consistent with those reported in the initial publication but not conclusive of an aspirin effect in preventing cerebral infarction.


Further reflections on the suicide of Kawabata Yasunari.

The suicide of Kawabata Yasunari has been studied in terms of loneliness, aestheticism, postwar Japan's mass democracy, and ill health and old age. This paper places focus on the Oedipus complex in relation to Kawabata's concepts of beauty, life, and death. This analysis was supported by the psychosocial data which were provided by Jiko no Tenmatsu (An Account of the Incident) by Usui Yoshimi. The book is based on the story told by a maid of Kawabata, who is believed to have played an important role in his suicide. Although it is a novel, Usui claims that he followed events as told by the reporter as closely as possible.


Xenon-133 inhalation method for regional cerebral blood flow measurements: normal values and test-retest results.

The purpose of this investigation is to determine the normal values for regional cerebral blood flow (rCBF) as determined by the xenon inhalation method of Obrist. Normal values for all rCBF parameters were measured in 15 healthy individuals. Our data are compared with the normal data obtained by other investigators. In addition, test-retest rCBF measurements were performed to determine the reproducibility of the method. Our results show that the method is highly reproducible when carried out in serial studies over a short period of time.


Immunodiagnosis of parasitic zoonoses: comparative efficacy of three immunofluorescence tests using antigens purified by affinity chromatography.

Three immunofluorescent antibody assays were developed during this study: the direct (DFAT) and indirect (IFAT) fluorescent antibody tests using frozen worm sections, and the cyanogen bromide indirect fluorescent antibody test (CNBr-IFAT) using helminth antigens purified by affinity chromatography bound on to commercially prepared CNBr-Sepharose 4B beads. Purified antigens used in the CNBr-IFAT gave greater specificity and sensitivity than either the DFAT or IFAT. Dirofilaria immitis, Toxocara canis, Angiostrongylus cantonensis and Ascaris lumbricoides infections were studied in natural and zoonotic hosts and in rabbits immunized with antigens prepared from these parasites. In addition, a serological survey of Aboriginal Australians from Queensland was made.


Are tumor-associated transplantation antigens of chemically induced sarcomas related to alien histocompatibility antigens?

The hypothesis tested was that tumor-specific transplantation antigens of chemically induced tumors cross-react with allogeneic histocompatibility antigens. This hypothesis makes several predictions that can be tested experimentally. First, tumors should grow better and be less immunogenic in certain F1 hybrids than in their syngeneic parents, owing to the hypothecated cross-reactivity of the tumor-specific transplantation antigens with F1 antigens. This is in contrast to the more common observation that parental strain tumors grow worse in the F1 hybrids than they do in the parent. Also certain allogeneic skin grafts might immunize the parental strain mice against their syngeneic tumors, and, finally, immunizing parental mice with syngeneic tumor might cause accelerated rejection of certain skin allografts. The results show that certain tumors grew better in the F1 mice than they did in the parents but that the tumors were not less immunogenic in the F1 hybrids. Mice immunized against alloantigens showed a dose-dependent enhancement of syngeneic tumor growth. Finally, mice immunized with syngeneic tumors demonstrated an apparent prolongation of certain skin allografts. The discussion considers possible alternatives explaining these results.


The course of pancreas allografts in rats conditioned by spleen allografts.

A new technique for transplanting duct-ligated rat pancreas grafts, rather similar to the technique for spleen grafting in rats, is presented. Inbred AGUS and WAG rats with a strong Ag-B incompatibility were used. Duct-ligated pancreas AGUS to AGUS isografts survived indefinitely in streptozotocin-induced diabetic hosts while WAG to AGUS allografts were quickly rejected. However, when WAG spleen and pancreas were transplanted en bloc to AGUS rats, endocrine pancreas graft function persisted for up to 6 weeks. This finding of a transient protection of pancreas allografts by donor-strain spleen allografts led to further experiments. AGUS recipients first received WAG spleen allografts which then were removed after 3 to 5 months, at which time WAG pancreas allografts were inserted. Sixty-eight per cent of these grafts survived and cured their hosts of streptozotocin-induced diabetes.


Mitotic behaviour and proliferative metabolism in allogenic rat kidney transplants in the first 6 days after recirculation.

Comparative experiments were performed on 41 allogenic rat kidney transplants to determine the mitotic behaviour and proliferative metabolism (application of 3H-thymidine) in the first 6 days after recirculation. Three days after transplantation, DNA synthesis in the tubular epithelial cells of the cortex and the medulla reached its peak. After this time the 3H-thymidine labelling index for these cell nuclei dropped. On the 6th day, the value was equal to that of the first day. The following points are signs of rapid transplant rejection. It was predicted that the DNA synthesis in the epithelial cell nuclei would decline, and also that the lymphocytes would proliferate in the interstitial tissue of the transplant's cortex and medulla. From the 4th day on, these changes were observed. The changes in the proliferative metabolism of the tubular epithelial cell nuclei preceded the mitotic changes by a few hr. The transplant changes caused by ischemia followed by tissue rejection can be made comprehensible by the determination of the average cell density of 3H-thymidine-labelled cortical, medullar, and tubular epithelial cells.


Lymphocytotoxic antibodies and antiglobulins in renal allograft recipients. Correlative study with acute rejection.

In 45 patients who received kidney transplants, both homologous and heterologous human antiglobulins (anti-Ig) and HLA cytotoxic antibodies have been studied before and after transplantation and in some cases after nephrectomy. A similar study has been performed in a control group of 1,019 healthy blood donors and in 130 patients with acute or chronic glomerulonephritis. After transplantation, homologous anti-IgG were found in 60% of the patients, as compared with 3.5% in the healthy blood donors and 21% in patients with various forms of glomerulonephritis. This difference is particularly striking in sera obtained prior to nephrectomy; the presence of anti-IgG and cytotoxic antibodies in the same patient being significantly associated with early transplant failure. Anti-IgA were found in 75% of the patients with transplants and in 37% of the patients with glomerulonephritis. There was no relationship between the anti-IgA and the outcome of the graft. On the other hand, heterologous anti-Ig were unchanged in the three groups investigated. The mechanism of formation of the anti-IgG is not clear. They are probably antibodies against antigenic structures of the patient's own antibodies, previously combined with a soluble antigen or an antigen on the transplant that has undergone molecular transformation in the course of this reaction. Their pathogenic role, although not demonstrated, can be strongly suspected, and, in a practical way, screening for the anti-Ig in kidney transplant recipients could be of value as a prognostic test.


Mechanisms of immunoregulation. Immunoregulation by antibody and antigen-antibody complexes.

Biologically important regulatory mechanisms exist in many immune responses. The anatomic characteristics of lymphoid tissues and the cell-collaborative events exhibited in immune responses may be explicable in terms of potent regulatory phenomena rather than or as well as requirements for the initial activation of an immune response by antigen. Mechanistically, the regulatory web54 may be a series of Fc portion attachments to Fc receptors directed by the variable region specificities of the antibodies involved.


Renal transplantation in the presence of a positive crossmatch.

Eighteen renal transplants have been performed prospectively in the presence of a positive serologic crossmatch against donor B lymphocytes. Four transplants have failed, three from rejection and one from renal artery thrombosis. Fourteen are functioning at 3-17 months after transplant. Thus, a renal transplant may be performed in the presence of a positive B-cell crossmatch in most instances without immediate graft rejection.


A role of anti-"LD" antibody in induction of active enhancement in rat heart allografts.

Heart allografts from S-D to Wistar rats pretreated with 5 x 10(7) spleen cells taken from donor strain 1 or 2 weeks before, survived indefinitely. Sera taken from the pretreated rats showed high lymphocytotoxic titers and obvious blocking activity against LMC of immunized Wistar spleen cells. Even though the sera were exhaustively absorbed with RBC, this blocking activity was not impaired, although CDC was reduced. The active prolongation of graft survival, therefore, correlates with the presence of anti-LD antibody.


Antibody responses in patients with cutaneous leishmaniasis of the Old World.

74 persons of Northern European origin with recent primary exposure to Leishmania tropica in Saudi Arabia were examined for their antibody responses to leishmaniae with the fluorescent antibody test (FAT), the complement fixation reaction. (CFR), and the indirect hemagglutination test (IHA). The FAT detected antibodies to L. donovani in 19 of the 41 individuals with acute lesions or scars characteristic of cutaneous leishmaniasis but in none of the 33 individuals without lesions. Our data suggest that the high proportion of persons with antibodies, as compared to other studies of cutaneous leishmaniasis of the Old World, may be the result of the relatively severe course of the disease in the majority of our patients. The CFR and the IHA did not prove to be useful for the diagnosis of this disease.


Lymphocyte mitogenic factor in sera from patients with falciparum malaria.

To test for the presence of a lymphocyte mitogenic factor in malaria, sera were obtained from 10 patients with malaria (9 with falciparum and one with vivax), and 10 noninfected controls. The sera from the malarial patients caused an increased blastogenesis in mouse splenic lymphocyte cultures and inhibited hemagglutination between lipid-A-coated erythrocytes and lipid-A antibodies. None of the sera were positive using the limulus amebocyte lysate test. These results could be interpreted to demonstrate that patients with falciparum malaria have a circulating mitogen which cross-reacts with endotoxin. However, alternate explanations must be considered, including an hypothesis that antiglobulins and/or immune complexes in the sera of malarious patients both caused the blastogenesis of mouse spleen cells and inhibited hemagglutination to lipid-A antibodies.


Survival of parasites in mice immunized against Plasmodium berghei.

The rodent malaria parasite Plasmodium berghei may survive im immunized Swiss and C3H/StZ mice for a considerable period of time. Despite considerable differences in the observed survival time in animals of a given strain, a general, strain specific pattern is observed. Parasites generally survive longer in Swiss than in C3H/StZ mice. In some of the Swiss mice parasites survived throughout the experimental period, whereas in the others restricted survival was observed, possibly reflecting genetic disparity. Since booster infections did not affect the survival pattern, the effectiveness of elimination is not determined by "antigen" dependent, gradual differences in quality of the hosts' immune response. Repeated biotechnical manipulation of the animals may influence experimental results.


High dose medroxyprogesterone acetate (MPA) treatment in metastatic carcinoma of the breast: a dose-response evaluation.

The results of controlled clinical trial that used high doses of medroxyprogesterone acetate (MPA) in the treatment of metastatic breast cancer are reported. Two treatment reigmens were used: regimen A, 500 mg daily with a total dose of 30 g; regimen B, 1,000 mg daily with a total dose of 60 g. The overall response rates were similar, with no statistically significant difference between the two treated groups. Regimen A (lower dosage group) reached a remission rate of 44%, whereas regimen B (higher dosage group) had a remission rate of 41%. The mean duration of response was 8 months with regimen A and 9 months with regimen B. The advantages of the lower dosage regimen as opposed to the higher dosage regimen of MPA in the treatment of advanced breast cancer are discussed.


Estrogen receptors and post-receptor markers in human breast cancer: a reappraisal.

Several major defects in the estrogen receptor pathway have been evidenced in most human breast cancers by an immunofluorescence tracing of estradiol receptor complexes at the single cell level. Endogenous peroxidase seems a reliable postreceptor marker for estrogen-sensitive breast cancer cells. Since almost all human breast cancers appear to include both hormone-sensitive and autonomous cell populations, a combined use of endocrine and cytotoxic regimens is urged. The hormonal regulation of tumor growth parameters could be exploited in order to achieve a maximum recruitment of synchronized tumor cells at risk to chemotherapy.


Xanthogranulomatous pyelonephritis masquerading as occult malignancy.

Xanthogranulomatous pyelonephritis (XGP) can present with weight loss, anemia, leukemoid reaction, and generalized debility; there may be no signs or symptoms referable to the urinary tract. Confusion between XGP and renal adenocarcinoma is well recognized, but other malignancies can also be simulated. Case histories of patients with proved XGP whose clinical presentations suggested occult malignancies are recorded. Proteus urinary tract infection, calculi, and a nonvisualizing kidney on intravenous pyelogram should suggest the correct diagnosis. The pathology, bacteriology, diagnosis, and treatment are reviewed.


Antibody-coated bacteria in urine of patients with ileal conduit urinary diversion.

The antibody-coated bacteria (ACB) test is a helpful adjunct for differentiating pyelonephritis from cystitis in the intact urinary tract, particularly in female patients. This test was used in patients with ileal conduits and infected urine in an attempt to determine whether bacilluria was of renal or conduit origin. Every patient with infected conduit urine had a positive ACB test even though no patient had clinical stigmas of acute pyelonephritis. In patients with ileal conduits, the ACB test cannot be used alone as an indicator that bacilluria is a cause of symptoms or renal damage.


Uropharmacology: VIII. Sympathomimetic agents.

Sympathomimetic drugs stimulate the receptors of the sympathetic nervous system. Although the bladder possesses sympathetic receptors, sympathomimetic drugs, in general, have little effect on bladder function. Their most useful clinical applications on the urinary tract are to increase or decrease bladder resistance.


[Conservative treatment of hepaticocholedochus stones via external biliary fistulae].

The experience with non-surgical treatment of retained stones in 13 patients is described. The treatment was successful in 8 cases. The method of dissolution of the stones and their mechanical removal with the help of a lithotrap of own design was used. The conclusion is drawn, that the treatment of the patients with gallstones in presence of external biliary fistulas should start from conservative methods.


[Immunochemical, electrophoretic and enzymatic analysis of the pepsinogen-pepsin isoforms of human gastric mucosa and gastric tumors].

The obtained specific antiserum against the 1st isoform of pepsinogen of human gastric mucosa responds in immunodiffusion only to the 1st pepsinogen isoform but not to the IId and IIIth one. Human pepsinogen has no common antigenic determinant with pig pepsinogen. The methods of electrophoresis and immunodiffusion reveal the Ist, IId and IIIth isoforms of pepsinogen in human gastric tumors and their metastases, however, they do fail to show any enzymic activity.


[Survival of 5-fluorouracil-treated stomach cancer patients in the far-advanced stages].

Umder study was the survival rate in 73 patients treated routinely with 5-fluoruracil for recurrences and metastases of gastric cancer. The survival of 33 patients, treated with the clinical effect proved to be reliably higher than that in 40 patients in whom no effect was gained (the time of 50% survival was 7.1 and 2.4 months accordingly). The compared groups of patients did not differ reliably in such prognostic factors as the tumor spread to the onset of chemotherapy and duration of the interval since the primary operation till tumor progression. It is concluded that the longer survival in patients treated with the effect is due to 5-fluoruracil administration.


[Formation of an esophageal-intestinal anastomosis in stomach cancer].

It is suggested to contruct entero-entero, and entero-esophageal anastomoses by means of the SPTU-suturing apparatus with detachable heads through the lumen of the anastomosed jejunum. The technic in use prevents the development of reflux-esophagitis, thus greatly accelerating the accomplishment of the most painstaking stage of the operation--constructing of the anastomoses, and reduced the incidence of suture incompetency of entero-esophageal anastomosis.


An immunohematologic complication of isoniazid.

The characteristics of an immunohematologic reaction to isoniazid are described with emphasis on the mechanism of development of the positive antiglobulin test. In contrast to previous findings, the antibody is a firmly bound IgG complement-binding antibody, reacting best at 37 degrees C by antiglobulin techniques and only with isoniazid presensitized cells. A method for preparing isoniazid-sensitized cells is described.


[Use of an immunofluorescence method and a flocculation test with DNA-sensitized bentonite particles in the serodiagnosis of disseminated lupus erythematosus (SLE)].

The determination of antibodies against native DNA is of great importance in the solution of the diagnostic and therapeutic problems of dissiminated lupus erythematodes. The practical results are in a direct dependence on the laboratory methods for their determination. The diagnostic significance of two methods was studied with the present investigation: indirect immunofluorescent test and flocculation test with DNA-sensibilized bentonite particles. Under the conditions of the investigation, with the aid of the first method, antibodies against native DNA were found in 86.1 per cent of the sera of lupus nephropathy patients as well as in 13.3 per cent of the sera of patients with renal diseases not associated with LED. High serum titres including up to 1/128, were observed only in LED cases. The continuous persistence of antibodies against LED is also characteristic for the latter. The flocculation test was positive in 60.7 per cent of the sera investigated only with LED cases. The conclusion is that both methods could more wisely be used in LED immunodiagnostic because they combine high sensitivity with specificity of reaction, are easy to perform and no expensive material and apparatuses are required.


[Pathogenesis of diabetes in adulthood. I. Insulin secretion at different evolutionary phases of diabetes].

Intravenous loading with glucose and glucose+tolbutamid was conduced in five groups of subjects, selected in a way that the intensity of insulin secretion gradually decreases from one group to the other (control group, relatives of patients with diabetes, diabetics sensitive to SUP and diabetics resistant to SUP). With insulin deficiency (in the last three groups) the early insulin secretion (absence of summit in IRI curve at the tenth minute), was established to grow weak, whereas in latent diabetes and in SUP sensitive diabetics it was preserved and insulinemia was protracted during the second half of the test. Early insulin secretion, in the control group and in the relatives of the diabetics, with loading with glucose-tolbutamid was twice as high as compared with that, obtained with loading solely with glucose. Diabetes at a mature age is concluded to be with a changed sensitivity of B-cells, at the beginning, versus glucose as a stimulator with signaling character, but the ability for synthesis and secretion of insulin, in general, is preserved. With the evolution of diabetes defect, the falling-off of insulin-synthesis ability is included in the pathogenetic mechanisms. A state of complete insulin deficiency develops--hence non-sensitivity to SUP.


[Microcarcinoma of the cervix uteri (author's transl)].

Microcarcinoma in the true sense of the word must be distinguished from so-called early stromal invasion. A clear diagnosis must be based on the histological investigation of an adequate biopsy specimen which encompasses the entire changes and enalbes tumour measurement in all three dimensions. With increasing experience it was recognized that the mortality due to microcarcinoma was very low even when limited surgery was performed. When only clearly defined cases were considered, the mortality was nill in early invasion and merely 1.2% in microcarcinomas with a fictitious volume of up to 500 cmm. Both morphological signs of regression of invasive buds and recent knowledge of tumour immunology point to the effectiveness of immunological defence reactions, which are directly related to the tumour mass. A correctly diagnosed microcarcinoma represents a still-localized disease process unless other speical criteria such as lymphatic invasion point to the possibility of discontinuous spread. The method of treatment must be chosen between the extremes: When the danger of metastasis may be neglected local excision of the total diseased area will suffice; in the opposite case, radical operation with lymphadenectomy is indicated. Limited treatment of a microcarcinoma is only justified following clear definition of the lesion based on adequately removed and histologically accurately analyzed biopsy material.


[Spontaneous rupture of renal allografts (author's transl)].

Spontaneous rupture of an allografted kidney is not such a rare complication of kidney transplantation. In our series 5.2% of the transplanted kidneys ruptured spontaneously. The condition is an acute emergency characterized by the triad, acute abdomen, swelling in the region of the transplant and haemorrhagic shock. The aetiology of transplant rupture seems to be multifactorial, but the superimposition of an acute rejection episode on ischaemic tubular damage with acute renal failure was found to be the most important combination of events leading to transplant rupture in our patients. Exceptionally precise immunological monitoring in the early phases following transplantation and early aggressive therapy of an acute rejection crisis associated with acute renal failure should prevent allograft rupture.


[The Second Gynaecological Department of Vienna University (author's transl)].

70 years ago, on October 21st, 1908, the new building of the Second Gynaecological Department of Vienna University--a fine example of Jugendstil--was opened. This jubilee takes place at the time when the whole structure of the university clinics is undergoing fundamental change, the new "Allgemeines Krankenhaus" is under construction and while the Jugendstil is enjoying new popularity. An attempt is made to outline the lives and work of the outstanding representatives of the Second Gynaecological Department of Vienna University and the history of the building.


[The development of Obstetrics at the 2nd Department of Obstetrics and Gynecology, University of Vienna, Medical School, during the last 20 years (author's transl)].

Including the deliveries in 1956, 1961, 1967, 1970, 1971, 1975, 1976 the development of obstetrics at the 2nd Department of Obstetrics and Gynecology, University of Vienna, Medical School, is shown. The frequency of vaginal operative deliveries was reduced, the indicence of ceasarean sections increased from 1.6 to 6.9%. In premature newborns it was possible to gain a higher birthweight, perinatal and postpartum mortality fell from 4.4 to 2.8% and from 3.3 to 1.5% respectively. The connections between these positive results and the new methods and possibilities introduced at the department are discussed.


Kinetics of petite mutation and thermal death in Saccharomyces cerevisiae growing at superoptimal temperatures.

Mass formation of petite mutants took place in a strain of Saccharomyces cerevisiae when grown at superoptimal temperatures. After an initial period of exponential growth, a second period followed during which exponential death and net exponential petite mutation concurred with exponential growth. The specific rates of the three exponential processes were of the same order of magnitude and varied with the temperature. Net exponential petite mutation did not occur during the deathless first period of growth at superoptimal temperatures nor at any time during growth at suboptimal temperatures. Mitochondria are discussed as possible targets of thermal death in mesophilic yeasts.


Pills for the poor: John Wesley's Primitive Physick.

While John Wesley's Primitive Physick (1747) cannot be termed a classic of British medical literature, it must certainly be identified as one of the most popular volumes published in England during the eighteenth century. Although the work came under attack from contemporary surgeons, physicians, and apothecaries, who maintained that its remedies were founded upon ignorance, Wesley probably knew as much as most members of the medical profession; in fact, on no less than twenty instances throughout the volume, he paraphrases or cites directly from prominent physicians and theorists-such figures as Sydenham, Boerhaave, Cheyne, Mead, and Huxham. However, despite its obvious emphasis upon practical remedies, the underlying focus of Primitive Physick is upon the soul of man. Wesley had consulted some sources, common sense, and his own experience, tempering those with the general principle of "doing good to all men," particularly "those who desire to live according to the gospel...." Thus, the Methodist patriarch's own formula for life had as much to do with the spread of Primitive Physick throughout eighteenth-century Britain and America as did all of the remedies and suggestions imprinted upon its pages.


[Polyphenols in brewing (author's transl)].

Analytical methods for the determination of polyphenols of malt, barley, hop, wort, and beer are described. Malt or barley tannins has hitherto not received as much study as hop tannin. Polyphenols or tannins are classified. Studies on non-biological hazes are discussed in relation to the haze problem in brewing. The leucoanthocyanins of malt differ from those of hops in ability to form hazes. Subfractionation of polyphenol concentrates on sephadex columns allows isolation of individual tannins.


[Surgery for hypospadias using a penile and scrotal skin flap].

It is reported on a penoscrotal operation method, where the penile urethra is formed by a skin stripe of penis and scrotum. 35 cases operated by means of this method, the operation technique of which is described in detail, operated cases had altogether good functional and cosmetic results with a completely complicationless postoperative course.


[Postoperative urodynamic examination in hypospadias (author's transl)].

54 boys underwent modified Denis-Browne operations for hypospadias and were followed up by urodynamic examination. Measurement of the urethral pressure profile may be useful for localising micturition disorders.


[50 years ago--1927--the 1st demonstration of chorionic gonadotropin in the urine of pregnant women by Aschheim and Zondek].

In memory of Aschheim and Zondek 50 years ago it is described the first detection of human chorionic gonadotropin (HCG) and so the first biologic pregnancy test. In the following our essential present knowledge about HCG is reviewed.


[Action of Na-RNA on infection in mice infected with Shigella flexneri].

Experiments were conducted on albino mice. Experimentally induced dysentery infection proved to become aggravated under the effect of yeast Na-RNA expressed in the increase of the number of animals which fell ill and perished. This phenomenon proved to be based on the acceleration of reproduction of the causative agent, with a simultaneous selection of its virulent clones seen both in vitro and in vivo.


[Immunohistochemical study of the accumulation of antibody-forming cells in the lungs following intrapulmonary and subcutaneous administration of apneumotropic antigen].

Accumulation of the antibody-synthesizing cells in the lungs of guinea pigs in intratracheal and subcutaneous immunization was studied on a model of a complete typhoid bacilli antigen by means of Coons' method. Antibody-forming cells located in the interalveolar septi and in the peribronchial and perivascular connective tissue appeared with both method of the apneumotropic antigen administration. More of these cells accumulated in intrapulmonary application of the antigen. Repeated immunization by any method also led to the increase of their amount. The problem on the role played by the lungs in the immunogenesis is discussed.


[Possibilities of viral hepatitis diagnosis by immunofluorescent examination of patient blood smears].

The authors demonstrate possibilities of viral hepatitis diagnosis by means of fluorescent antisera labeled phiiTts. The antisera were obtained from the blood of convalescents after infectious hepatitis (with an uncomplicated course) on the 25th--30th day of the disease, and also from the placental gamma-globulin of persons who had had viral hepatitis (in the anamnesis). Both diagnostic preparations proved to be highly specific, although the first of them was somewhat more sensitive. Blood smears were stained with fluorescent antisera. The fluoresence was revealed in the cytoplasm of the white blood formed elements--lymphocytes and neutrophils; the nucleus was dark. Materials of this investigation permit experimental substantiation of a possibility of prolonged antigenemia in the blood leukocytes of patients suffering from viral hepatitis.


[Study of the properties of E. coli of serological group 03 isolated in acute intestinal diseases].

The authors studied the properties of 115 strains of E. coli of serological group 03 isolated from 49 children and adults with acute intestinal disturbances. The majority of the children (82.9%) were aged under one year. Results of the study of the antigenic structure and biochemical properties permitted to differentiate the strains isolated into 3 serological types, with the prevalence of strains of type O3 : K2 (L) : H2 (78.3%), and 8 biochemical variants. The majority of the strains possessed hemolytic properties. Strains of serological group O3 were  isolated repeatedly from the patients during the sickness, whereas none were revealed in examination of 132 healthy children and adults. The data obtained permitted to consider these microbes to be possible causative agents of intestinal coliinfection, and to refer them to the enteropathogenic category.


[Comparative assessment of the efficacy in humoral response of T-cells of various organ origin and their substitutes].

A linear dependence of the response to the thymus-dependent antigen (log of the plaque-forming cell count) on the T cell dose at the initial curve section was observed in syngeneic transfer of T and B cells mixture. The exponential slope differed for T cells of different origin and could serve as the measure of helper activity. In case of an excess of T-lymphocytes the response reaches the maximum, whose level is independent of the organic origin of T cells. By the helper activity T cells are distributed in the following order: T cells of the spleen and cortisone-resistant thymocytes greater than T cells of the lymph nodes greater than cortisone-sensitive thymocytes. There was established a quantitative equivalence by the capacity to activate B cells between the T-lymphocytes and E. coli lipopolysaccharide.


[Transmission of plasmid Rldrd19 from E. coli to Hafnia].

Investigations carried out demonstrated a possibility of transmission of plasmid Rldrd19 from E. coli to Hafnia. The incidence of the plasmid transmission varied from 10(-7) to 10(-9) and depended on the properfies of Hafnia strains. Tra-operon of plasmid Rldrd19 in the Hafnia 614 strain functioned with the same efficacy as in E. coli. Plasmid Rldrd19 in Hafnia was unstable and was eliminated from the cells in case of storage at low temperatures. As shown, plasmid Rldrd19 was under strict replication control in Hafnia as in E. coli. Formation of the CCC-form of the plasmid Rldrd19 was suppressed in Hafnia at 29--30 degrees C and was not suppressed in E. coli.


[Biochemical and serological characteristics of Escherichia belonging to the serological group 01].

A circulation at the territory of the country of various biochemical and serological variants of escherichia belonging to serological group O1, isolated in acute intestinal diseases of children and adults, was revealed. Nonhomogeneousness of the partial composition of the O-antigen was demonstrated; K-antigens were determined; new H-antigens were described. Of the 10 serological types of escherichia there proved to prevail O1 : K? : Hp and O1 : K1 : Hp; in group and sporadic acute intestinal diseases there were for the first time isolated O1 : K1 : H34, O1 : K1 : H20, O1 : K1 : Hp, O1 : K51 : H7, and O1 : K? : H20.


[Immunoglobulin and antibody content in the blood serum, coprofiltrate and saliva of patients with Sonne dysentery].

The authors studied the immunoglobulin and specific antibodies content of various classes in the serum, coprofiltrates and the saliva of 68 patients suffering from Sonne dysentery and in 48 healthy adult persons. Mancini's test demonstrated a significant elevation of IgG and IgM content in the blood of dysentery patients in comparison with that in healthy persons, and the absence of any changes in the IgA content. The titres of specific IgG-, IgA- and IgM-antibodies in determination in the modified Coombs' test increased consideerably during dysentery infection and were found in high titres during the first week of the disease; they reached the maximum during the second week and persisted at this level for 3 weeks. The greatest antibody elevation was in the IgA-class. Antibodies revealed in the coprofiltrates and the saliva of dysentery patients belonged to IgA- and IgG-class. There proved to be a correlation of the antibody changes in these two secretions.


Effect of the isolated removal of the median eminence (ME) and pituitary stalk (PS) on the immunohistology and hormone release of the anterior pituitary gland grafted into the hypophysiotrophic area (HTA) and/or of the in situ pituitary gland.

Isolated removal of the median eminence (ME) and pituitary stalk (PS) of female rats was performed under visual control, using a new instrument to open up the 3rd ventricle. Atrophy of the uterus, the follicles and the intersitial tissue in the ovaries was accompanied by persistent corpora lutea and persistent diestrous vaginal smears in rats which had undergone a successful removal of ME and PS. No change was, however, detected in the weight of the thyroid and adrenal glands at the end of the six weeks experimental period. An adenohypophysis implanted in the place of the ME at the time of the surgery, could not prevent these changes. In animals, in which the removal of the ME was not complete, the changes of the gonadal system were less pronounced. Immunocytology of the pituitary LH-, FSH, TSH- and prolactin-cells in animals with completely removed ME and PS showed inactive LH- and FSH-cells both in the grafted and in situ pituitaries, while the TSH- and prolactin-cells appeared to be in a stimulated state. In animals with ME remnant, LH-RH axon terminals were localized only on the blood vessels of the remnant. The part of the pituitary graft in contact with these blood vessels, as well as some areas of the in situ pituitary gland, contained active LH cells as judged from their size and immunohistological appearance. Since in the absence of the ME, the hypophysiotrophic area is not able to exert its regulatory effect on the gonadotrophs of the pituitary implant in this area, the authors suggest that this effect is mediated by the blood circulation of the ME which is rich in releasing hormones and is drained toward both the anterior pituitary and the medial basal hypothalamus.


Effects of cimetidine on prolactin, LH, and sex steroid secretion in male and female volunteers.

The histamine H2-receptor antagonist cimetidine, which has recently been introduced for the treatment of gastric and duodenal ulcers and haemorrhage, respectively, stimulates prolactin (PRL) secretion. The release of PRL after a bolus injection of the compound is significantly higher in female than in male volunteers, and is more pronounced during the luteal than during the follicular phase of the menstrual cycle. Oral administration of the drug stimulates PRL to a similar extent as parenteral administration. Treatment of male and female volunteers with cimetidine for 20 days (1 g/day orally) resulted in elevated serum PRL concentrations in both sexes. Basal LH levels as well as the response to 25 microgram LH-RH were not significantly changed after treatment. Testosterone levels in males and oestradiol levels in females were not altered. Luteal progesterone, however, was significantly diminished in the menstrual cycles when cimetidine was given. The mechanism underlying the stimulatory effect of cimetidine on PRL secretion is not clear, but it does not seem that this ability is exerted via an inhibition of pituitary dopamine receptors. The dopaminergic effect of lisuride, an ergot alkaloid, could not be reversed by cimetidine.


[Use of the tetrapolar rheocardiographic method for determination of minute blood volume in neurosurgical clinical practice].

The stroke blood volume and the MBV were determined by tetrapolar rheocardiography at rest and under the effect of muscular exertion in neurosurgical patients (35), in surgical patients (20) and in a control group of healthy subjects (10). A Soviet device, the Ppigamma2-02 tetrapolar rheocardiograph was employed. The method of tetrapolar rheocardiography is simple, atraumatic and provides for prolonged continuous recording. It is sufficiently precise as a method of indirect determination of the minute volume: comparison with data of the radioisotope method shows the precision of tetrapolar rheocardiography to be +/- 5.5%. Its main disadvantage consists in the difficult calculation of MBV in deep, frequent and irregular respiration when the rheocardiogram waves are sharply distorted.


Factors affecting the beta-cell sensitivity to alloxan in vivo. Influence of pre- and post-treatment with protective substances.

Blood glucose and pancreatic islet morphology were studied in mice subjected to different kinds of treatment both before and after alloxan administration. d-Glucose, d-mannose, d-fructose, NaHCO3 and sodium lactate protected against alloxan when given before, but not when given after alloxan, whereas l-leucine protected when administered before, and also when injected 1 or 3 min after alloxan. No protection was seen in animals receiving l-leucine 10 min following alloxan. The findings may indicate that the mechanism for alloxan protection by l-leucine differs from that of the other compounds tested.


Demodex folliculorum in a nipple imprint.

Demodex mites were found in a nipple imprint. Their morphologic features in this cytologic preparation have been described and illustrated. These mites are common parasites of human skin and are apparently of little or no pathologic significance.


Chronic treatment with LH-RH in golden hamsters.

Male golden hamsters were treated with low doses (50 or 100 ng) or high doses (500-1000 ng) of LH-RH for periods of 10 to 21 days. Gonadal atrophy was induced by blinding. Treatment of intact hamsters with high doses of LH-RH reduced pituitary sensitivity to a test dose of LH-RH given at the end of the experiment. Concomitantly, testis and seminal vesicles were reduced in weight. In blind hamsters with gonadal atrophy, low dose treatment with LH-RH for 21 days reversed testicular atrophy and restored spermatogenesis, while the high dose treatment partly reversed testicular atrophy (viz. increased tubular diameter) but inhibited spermatogenesis. Low dose treatment also increased testicular and seminal vesicles weight in blinded hamsters, whereas high dose treatment did not change these parameters. It is concluded, that a positive effect on testicular functiion may only be obtained by low dose treatment with LH-RH, whereas high dose treatment induces a negative feedback blocking the effect of LH-RH on pituitary gonadotrophin secretion.


Dihydroergotamine: pharmacokinetics and usefulness in spinal anaesthesia.

In a double-blind study, 0.5 mg of dihydroergotamine or the same volume of placebo was used to prevent hypotension caused by spinal anaesthesia. The plasma concentrations of dihydroergotamine were determined by a new radioimmunoassay developed for ergot alkaloids, and pharmacokinetic calculations were based on the equation of a two-compartment open model. No significant changes were observed in the heart rates of the two patient groups. In Group I, which received dihydroergotamine, significant increased in both systolic and diastolic blood pressures were measured after drug administration, and, compared to the base-line measurements before spinal anaesthesia, no significant decreases in systolic or diastolic blood pressures were recorded. In contrast to Group I, there was a significant decrease in both systolic and diastolic blood pressures in the placebo Group II during spinal anaesthesia. There were no significant differences, however, in the temperature of the great toe between Groups I and II. Dihydroergotamine disappeared quickly from plasma, with a mean alpha-phase half-life of 1.35 min, which explained its rapid effect on blood pressure. Beta-phase half-life (mean 23.20 min), the volume of distribution at beta-phase (mean 0.25 I/kg), and the total plasma clearance (mean 1562.8 ml/min) indicate rapid elimination of the drug from the body.


Arterial segmentation in the goat (Capra hircus) spleen. A study by corrosion cast.

50 corrosion casts of the splenic artery and its tree were studied to observe the arterial segmentation in the goat spleen on the basis of the intrasplenic distribution. The following observations were made: (i) 74% showed the presence of two arterial segments, a right and a left one; (ii) 10% revealed three arterial segments, a hilar, a right and a left one, and (iii) 16% showed the absence of arterial segmentation in the goat spleen.


Leptomeres in cultured human muscle.

Leptomeres, the laminated structures consisting of bundles of very fine filaments separated into bands about 260 nm wide by periodic transverse dense lines 20--80 nm wide, were observed frequently in cultured muscle fibers of 8 patients with acid maltase deficiency, 4 with sporadic, adult-onset idiopathic "autophagic" vacuolar myopathy (that is not acid-maltase deficient) and one with abnormal mitochondria, but in only one of greater than 50 other cultures of normal and denervated human muscle. They were also induced abundantly in cultured normal human muscle by exposure to 0.5 mM DNP.


Cathepsin D. Purification from rat liver and immunohistochemical demonstration in rat incisor.

Rat liver cathepsin D (EC 3.4.23.5) was purified using precipitation technique, ion exchange chromatography, molecular sieve chromatography and isoelectric focusing. Rabbit anti-rat cathepsin D IgG was prepared and rat incisor teeth were cross-sectioned in a cryostat. These sections were incubated with FITC-conjugated anti-rat cathepsin D IgG. Marked fluorescence, indicating the localization of cathepsin D, could be seen over the odontoblast and predentin area. No specific fluorescence could be dmonstrated in the pulp connective tissue proper nor in the dentin.


Effect of cleansing procedures on the retentive ability of two luting cements to ground dentin in vitro.

A method has been described to measure the retention of luting cements to ground dentin in vitro. Using a specially designed apparatus, a circular disc of cement was produced on a ground dentin surface of equal diameter. In a universal testing machine a tensile stress was applied to the cement disc pulling it parallel with the dentin surface at right angles to the diamond grooves until separation. The effect of two different cleansing procedures on the retentive ability of two dental cements was investigated. The cleansing procedures were: rubbing ground dentin with Tubulicid or polishing with wet pumice. The cements studied were a polycarboxylate cement (Durelon) and a zinc phosphate cement (De Trey's Zink Zement Improved). The retentive ability of the polycarboxylate cement showed values from six to seventeen times those of the zinc phosphate cement. The retentive ability of zinc phosphate cement was only slightly affected by the two cleansing procedures, while for polycarboxylate cement it was somewhat reduced following rubbing with Tubulicid and greatly improved after polishing with pumice and water.


Adaption of luting cement to enamel, dentin and restorative material.

Thirty-two teeth with artificial crowns cemented with four different cements were sectioned and the cementing interfaces were studied by means of a replica technique. Scanning electronic microscopic examination of the replicas demonstrated that slits occurred in all specimens either at the cement/tooth interface, the cement/alloy interface or both. Differences between the various cements in width and length of the slits could not be assessed by this method, but marked variations in the localization of the slits were noted. A composite resin cement showed slits only at the cement/tooth interface. A zinc phosphate and an EBA cement showed slits at both interfaces whereas a polycarboxylate cement was the only cement which exhibited good adaption to enamel and dentin, leaving gaps at the cement/alloy interface.


Metastatic osteomyelitis following BCG vaccination.

An 8-year-old girl, who had been vaccinated with BCG without subsequent regional reactions, developed osteomyelitis in the left calcaneus 7 months later. The process healed after surgical treatment and chemotherapy for 1 year. Culture from the bone abscess gave growth of mycobacteria which could not be distinguished from BCG.


Bone mineral content in women with Colles' fracture: effect of calcium supplementation.

The effect of dietary calcium supplementation on bone mineral content was studied in 40 postmenopausal women with Colles' fracture. The participants were divided into two groups which were given either placebo or 1 g of calcium per day. The bone mineral content of the femur was determined before and after 1 year of medication. Women with Colles' fracture were found to have the same mineral content in the femur as age-matched controls without fractures. Calcium supplementation had no significant effect on the bone mineral content.


The early detection of the acoustic neurinomas. Otoneurological indications of the radiological investigation.

The diagnostic possibilities concerning the early diagnosis of an acoustic neurinoma are discussed. As it is very important to detect these tumors in the otological stage, we scrutinize the different symptoms and signs which can arise this suspicion and try to delineate the criteria for further investigation, which signifies the indications for the radiological investigation: tomography and cisternography. The survey of the results obtained during 1976 confirms the value of the rules we adopted. Every patient complaining of hearing loss or tinnitus has to be examined by audiometry. Every unilateral or asymmetrical perceptive deafness calls for an examination of the functional state of the vestibular system. A perceptive hearing loss with unilateral vestibular functional loss, is an indication for a radiological investigation of the MAI and here a tomography has to be preferred. If the tomography indicates an asymmetry corresponding with the functional loss, a cisternography is to be done. In the cases in which the functional loss goes together with normal radiography, we advise a close follow-up, repeating the functional evaluations at fixed intervals. In case of further deterioration, a control tomography and a cisternography is to be taken into consideration. The case with borderline data, or in which some opposition in the findings is recorded, the cases with negative cisternography and certainly the cases with a dubious cisternography are to be followed too. As on the one side a negative tomography can hide a tumor, and on the other hand a cisternography is a heavy decision for a dubious anomaly, we are inclined to insist more and more on a close functional follow-up rather than extend the indications for cisternography.


Gonadal dysfunction in patients with ataxia telangiectasia.

Two males and three females with ataxia telangiectasia aged from 4 6/12 to 23 years were subjected to an i.v. LH-RH test. All were found to have elevated basal levels of FSH and three had elevated levels of LH. In all the response of FSH to LH-RH was supranormal. In the pubertal and adult females the basal levels of estradiol were low. The laboratory and clinical findings in these patients as well as data reported by others indicated that the primary gonadal failure is an integral part of AT.


Fatal BCG infection in an immunocompetent girl.

A 6-year-old girl developed progressive symptoms of increased intracranial pressure starting 5 months after BCG vaccination. Thirteen months later craniotomy revealed an epithelioid cell granuloma of the arachnoid occluding the foramen of Magendie. No tubercle bacilli were found on histological examination. Insertion of a Pudenz shunt relieved the symptoms. Six months later generalized BCG infection developed, and in spite of treatment with ethambutol, rifampicin and isoniazid for 10 weeks, death occurred during an episode of increased intracranial pressure. Mycobacterium BCG could be cultured from several organs. The patient showed no obvious evidence of immuno-deficiency as judged on the basis of previous disease history, particle concentration of granulocytes, B and T lymphocytes in peripheral blood, concentration of immunoglobulins in serum, response of lymphocytes to transformation with mitogens and antigens, and histological findings in the thymus and BCG granulomas.


Studies on rickettsia-like body in Kawasaki disease. Attempts of the isolation and characterization.

Rickettsia-like bodies were reportedly found in biopsies of the skin and lymph nodes from half the number of patients with Kawasaki's disease. In our present work, these microbodies were isolated from the peripheral whole blood of a patient with Kawasaki's disease (MLNS) through passage of guinea pigs and yolk sac culture. However, the isolated strains disappeared spontaneously during their stores at -80 degrees C for two weeks.


Rabbit lung plasma and erythrocyte volumes. Lung hematocrit in relation to total body hematocrit.

The total body hematocrit has been reported to be 85--90% of packed cell volume (PCV) in several species. We have found similar values in rabbits. An "extra" plasma volume must exist somewhere in the vascular bed to explain this observation. We have looked for such an extra plasma volume in the pulmonary vasculature. The dynamic hematocrit was estimated in isolated, perfused rabbit lungs from distribution volumes for plasma and erythrocyte tracers. Estimation was also obtained from indicator-dilution curves using bolus-injections of such tracers avoiding their recirculation. It was thus possible to calculate mean transit times for the tracers from their dilution curves directly or applying monoexponential extrapolation from the first part of the downslope of the curves. The dynamic hematocrit of the lung vessels was about 94% of perfusate PCV and there was no difference between the results obtained by the different methods. We concluded that in the rabbit only a very small part of the extra plasma volume is located in the lung vessels. The lung plasma volume is not underestimated by the indicator-dilution technique.


High doses of fluphenazine enanthate in schizophrenia. A controlled study.

The results from this controlled study of 12 schizophrenics refractory to ordinary doses of neuroleptics indicate that treatment with fluphenazine enanthate in higher doses than normal (10--20 times higher) might give reduction in psychopathology beyond what can be obtained with normal doses. In four patients the symptom reduction on high doses was pronounced. Moreover, we found that the high fluphenazine plasma levels demonstrated did not increase extrapyramidal and general side effects. The results presented also speak in favour of certain "non-responding" patients needing a higher plasma level of a neuroleptic drug than the average patient.


A double-blind clinical evaluation of different dose intervals with fluspirilene (IMAP).

The possibility of a biweekly dose of fluspirilene, without deterioration of the clinical picture, was investigated in a group of 34 chronic schizophrenic patients. There were no significant clinical difference between the patients receiving fluspirilene every week and the patients receiving it every two weeks. Therefore it is possible to give fluspirilene in individually adjusted doses with a dose interval of 14 days in stabilized patients.


A clinical trial comparing sustained release amitryptyline (Saroten Retard) and conventional amitriptyline tablets (Saroten) in endogenously depressed patients with simultaneous determination of serum levels of amitryptyline and nortriptyline.

The clinical effect of a sustained release preparation of amitriptyline has been compared with that of conventional amitriptyline tablets in a double-blind cross-over study with 24 patients suffering from endogenous depression. The sustained release preparation was given in a single evening dose (9 p.m.) of two thirds the total daily dose of conventional tablets, which was given in a three times-a-day regimen (8 a.m., 12 a.m. and 9 p.m.). Serum concentrations of amitriptyline and its active metabolite, nortriptyline, were determined. No difference was found between the two preparations as regards either clinical effect or side effects. No correlation could be shown between the clinical effects and the serum concentrations of amitriptyline and nortriptyline.


A six-month follow-up of refractory chronic psychotics treated with Haldol-AID.

Nine refractory chronic psychotics were switched to a lower dosage of, mostly, a long-acting diphenylbutylpiperidine after having been treated with high initial and maintenance doses of Haldol. This switch-over was rated as very good in three patients (allocation to nursing family) and good in two patients on fluspirilene (Imap); it was also rated as good in one patient on fluphenazine decanoate and one on pipamperone. One patient could discontinue neuroleptic treatment. One was rated as a failure. A switch-over is not always easy as it is a time of trial and error. A switch-over to a parenteral diphenylbutylpiperidine offers good prospectives. As a rule, further improvement is feasible after a period of Haldol medication. It seems that the advantages of a maintenance therapy with Imap are its lack of inconveniences for the patient (not sedative, only slightly hypokinetic) and its good antipsychotic and adequately prolonged activity 2 weeks).


Double-blind therapeutic evaluation of fluspirilene compared with fluphenazine decanoate in chronic schizophrenics.

Fifty chronic schizophrenics were randomly assigned to a 16-week treatment either with fluspirilene or with fluphenazine decanoate. The aim of the study was to compare the antipsychotic action and the side effects of the two neuroleptics. Fluphenazine decanoate caused more side effects and the difference between the two groups was statistically significant in the items tremor, severe extrapyramidal effects and parkinsonism. More patients in the fluspirilene group (nine patients) compared with only three in the fluphenazine decanoate group remained free of side effects during the whole trial. Judged from the BPRS fluspirilene proved an equally potent neuroleptic with fluphenazine decanoate although statistically significant improvement has been obtained in more items of the scale in the fluspirilene group. The improvement in the NOSIE-30 was much more clear in the fluspirilene group. Although Clinical Global Impressions of the investigators and the nursing personnel favored fluspirilene, the differences between the two groups were not statistically significant.


A retrospective evaluation of pipamperone (Dipiperon) in the treatment of behavioural deviations in severely mentally handicapped.

Nineteen severely mentally handicapped female patients (15-24 years), whose IQ was between less than 30 to 36, were treated with pipamperone (Dipiperon) because of behavioral disturbances. The dose varied from 40 to 180 mg/day spread over one to three intakes. The duration of treatment ranged between two and ten months. The therapeutic effect was evaluated by means of a 12-item rating-scale. A statistically significant improvement was obtained for nine of the 12 items. Overall improvement was very good in two, good in ten, moderate in five, and insufficient in two patients. Serious side-effects were not observed.


Angiography and scintigraphy of human pancreatic allografts.

Serial graft angiographies and scintigraphies were obtained in 4 human pancreatic allograft recipients. Important information was obtained both of graft morphology and function. Graft rejection was accompanied by characteristic abnormalities, including arterial irregularities and prolonged contrast medium passage time. On scintigraphy, rejection was associated with reduced isotope uptake.


A syndrome from a possible GABA deficiency. Clinical-therapeutic report on 15 cases.

A detailed presentation of 15 case-histories of subjects of both sexes, drawn from all decennies of life from the first to the eight, suggesting a syndrome originated from a possible GABA deficiency, is carefully made. Such syndrome is believed to be characterized by basic depressive state, loss of the habit of stretching oneself, sleep disorders, mostly with early morning awakening, constipation and nuchal headache. The above symptoms have been associated to a deficiency of GABA after noting the very speed recovery after administration of N-dipropylacetic acid, an inhibitor of GABA transaminase.


Ascending projections to the hypothalamus and limbic nuclei from the dorsolateral pontine tegmentum: a biochemical and electron microscopic study.

Axons arising from the dorsolateral pontine tegmentum of the rat were traced in various hypothalamic and limbic nuclei by the electron microscopic degeneration method (0.5-8 day survival times) and by measuring regional norepinephrine (NE) concentrations after 12 days of survival using a radioenzymatic method. Significant reductions (41-85%) in NE contents were observed in the supraoptic, arcuate, basal and lateral amygdaloid nuclei and in the hippocampus 12 days after the bilateral electrolytic lesions of the locus coeruleus. No changes in NE concentrations were observed in the ventromedial, septal, central amygdaloid nuclei, in the median eminence and olfactory tubercle. Parabrachial lesions resulted in a decrease of NE content only in the olfactory tubercle. By means of electron microscopy terminal degeneration was found in the hypothalamic paraventricular, dorsomedial nuclei, in the median eminence, in the bed nucleus of the stria terminalis, in the central, lateral and basal amygdaloid nuclei, in the hippocampus and in the anterior ventral thalamic nucleus.


Dangers of positive pressure respiration breathing with special reference to the so-called "surfactant factor".

Atelectasis and emhysema have been induced in rabbits after anaesthesia and IPPB for one hour at 30 cm water pressure. The pulmonary surfactant became coarsely granular and appeared in the form of large drops. A correlation is suggested to exist between this phenomenon and the atelectasis and emphysema which developed during IPPB.


Stereotactic biopsies and computer tomography in gliomas.

This study was carried out in order to obtain data on the relation between tumour structures seen in computer tomograms and the corresponding histopathology and cytology. Nine consecutive patients were studied, and stereotactic biopsies were obtained from sites determined on contrast enhanced computer tomograms. Biopsies were obtained from tumour areas with high and low contrast uptake and from the low attenuating areas surrounding the tumours. The results indicated a close correlation between the microscopical morphology of gliomas and the pattern of the computer tomogram. Biopsy samples from low-uptake central areas contained tumour tissues, necrotic tissue, and in one case a cyst. Biopsies from high-uptake areas typically contained tumour tissue, whereas biopsies from low-uptake surrounding areas contained oedematous non-tumour tissue. For tumour diagnosis biopsies should be obtained from both low and high attenuating tumour areas.


Magnetic circular dichroism approach to hemoprotein analyses.

Accumulative magnetic circular dichroism (MCD) spectra have shown that MCD is indispensable in exploring the structures and electronic states of hemoproteins. Theoretical and instrumental introductions of MCD spectroscopy were followed by a specific theoretical treatment for applying MCD to various oxidation, ligand, and spin states of hemoproteins. By including explicit electronic states of the heme iron, the theory can systematically interpret the MCD results of various states of hemoproteins. The MCD spectra of myoglobin derivatives offered a typical example for various states of hemoproteins. As an MCD application to heme enzymes, MCD studies on cytochrome P-450 were described in detail, and other extensive applications of MCD to various hemoproteins were cited.