[Acid application on dental tartar as preliminary treatment before mechanical scaling].

The action of the preparation studied, containing 20% hydrochloric acid in an alcohol-chloroform medium: 1) affected both white tartar as well as the submucosal tartar, progressively replacing the phosphorus radicles of tricalcium phosphate by CL ions, transforming the insoluble tricalcium phosphate into soluble calcium chloride; 2) was practically complete in 2 minutes; 3) was more rapid on tartar than on enamel or even cement; 4) did not appear to alter the superficial structure of the tooth in 4 minutes whilst, for the same period of time, the superficial structure of the cement was deeply attacked with 50% preparations of citric acid or phosphoric acid; 5) in our trials, carried out after 4 minutes treatment, caused the tartar to undergo a relatively superficial but adequate chemical action to facilitate its removel, whilst leaving the underlying hard tissue, enamel or cement, unharmed. It would thus appear that such a substance may be used for the preparation and speeding of mechanical descaling.


Characterization of the normoblast population in beta-thalassaemic blood by rapid-flow cytofluorometry.

Samples of peripheral blood from patients with beta-thalassaemia major which contained significant numbers of nucleated normoblasts were stained with acridine orange and analyzed with rapid-flow cytofluorometry. The pyknotic normoblast-nuclei gave less green 'DNA' fluorescence than the (diploid) leucocytes and constituted a separate, distinct subpopulation. Mean values of the fluorescence intensities and standard deviations as displayed by multichannel analyses gave a numerical value for normoblasts with regard to their maturation stages. These mean values correlated with the differential counts of 'early and late' normoblasts in the light microscope under rigidly standardized conditions. Rapid-flow cytofluorometry thus provides an objective and quantitative way to monitor and define peripheral blood normoblast populations as a measure of the severity of 'erythropoietic stress'.


Surface membrane characteristics of cells from human acute monocytic leukaemia.

The clinical and laboratory features of 4 patients with acute monocytic leukaemia are described. Surface membrane receptor studies of these patients have shown increasing strength of receptor expression occurs with increasing morphological maturity of the monocyte. In addition, the study shows that expression of membrane receptors can vary from patient to patient and also with time and treatment in an individual patient. A further finding has been the loss of positivity with specific anti-monocyte serum when the disease becomes refractory to therapy.


The binding of murine IgM to Staphylococcal A protein.

The binding of Staph A protein to murine immunoglobulins has previously been thought to be restricted to the IgG2 and IgG3 classes. In this study five IgM proteins were assessed for binding, and of these one showed marked Staph A binding. Pepsin digestion of this IgM molecule produced several different sized fragments, and the binding studies with these fragments indicated that the binding site is in the CH2 domain.


[EEG and biochemical considerations on 40 cirrhotic patients surgically treated by portacaval anastomosis or mesenterico-caval bypass].

Starting from biochemical hypotheses on hepatic encephalopathy, which presuppose at the basis of this disease first of all some modifications of the plasmatic values of octopamine, ammonia, serotonin and of particular aromatic aminoacids, the Authors compared the levels of ammoniemia and of octopaminemia with eegraphic data, in two groups of cirrhotic patients, operated of porto-cava anastomosis (16 patients) ad of mesenterico-cava by-pass (24 patients). All this in order to value if there are significant correlations between these values and the cerebral damage and also if there are differences between the two types of operation. Attained data show a good correlation between neuropsychiatric symptomatology and importance of the cerebral damage noticeable at the E.E.G. As to the possible correlations existing between biochemical data and E.E.G., while as to plasmatic octopamine no significant modifications were found, as to ammoniemia, highest values correspond to findings of greater cerebral compromission. Moreover, it seems that between the two types of operations, the mesenterico-cava by-pass is the one that allows a better clinical and eegraphic evolution.


IgG autoantibody to human serum albumin studied by the ELISA-technique.

ELISA was applied for analysis of the HSA-human IgG autoantibody system responsible for the immunoelectrophoretic 'Tailing Albumin' (TA) phenomenon induced in most of the TA patients by prolonged nitrofurantoin therapy. Both hyperimmune porcine anti-HSA and autoimmune human anti-HSA antibodies of the IgG class were detectable by ELISA. The presence of autologous or added HSA had some inhibitory effect upon the detectability of the anti-HSA antibodies. Partial elimination of the autologous HSA by sucrose gradient ultracentrifugation or salt precipitation increased or unmasked the anti-HSA activity of some TA sera. The sensitivity of the ELISA as detector of the anti-HSA autoantibodies of whole human sera was roughly equal to that of the immunoelectrophoretic TA phenomenon. The analogy of the anti-HSA autoantibodies and the rheumatoid factors and the theoretical interest of both of them is stressed.


Presence of alloantigen-reactive cells in neonatally tolerized mice.

Neonatally induced fully tolerant mice possess cytotoxic effector cells, specific for the tolerizing antigens, which can be induced by polyclonal T cell activators in vivo (Con A) on in vitro (poly A:U). Therefore, clonal deletion of specific effector cells is eliminated as the mechanism by which skin grafts are retained in tolerized mice.


[Quantitative and qualitative bacteriological studies on urine specimens obtained by suprapubic needle aspiration and on midstream-voided samples].

In 398 patients with suspected urinary tract infection, quantitative and qualitative bacteriological studies were conducted in urine samples obtained by suprapubic needle aspiration of the bladder (BPU) and in midstream-voided specimens (MSU) collected immediately following the aspirations. In MSU, bacteria were found in 96.5% of all cases and in BPU in only 38.2%. Of the infected MSU, 63.3% showed mixed infections, while mixed cultures were found in only 11.2% of infected BPU. In 80% of the investigated patients, the MSU contained at least one more type of bacteria than the BPU, thus indicating urethral contamination. Of the patients with bladder bacteriuria, only 74% had bacterial counts of 10(5)/ml or more in the midstream-voided urine. Accordingly, 26% of the urinary tract infections diagnosed by bladder aspiration would not have been recognized on the basis of a single bacterial count in the midstream-voided urine. On the other hand, about 4% of patients with bacterial counts of 10(5)/ml or more in the MSU had a sterile bladder aspirate. In 72.4% of the infected BPU, E. coli was found, followed in frequency by Enterococcus (14.5%). In the infected MSU, however, Enterococcus was more frequent than C. coli (65.6% and 61.7% respectively). Thus, E. coli appears to be the most important etiological species in infections of the bladder and the kidneys, while Enterococcus seems to be the most frequent contaminant during urethral passage. The most frequent bacterial combination in mixed cultures in both BPU and MSU was that of E. coli and Enterococcus.


[Reconstruction of the breast after mastectomy].

A wider use of reconstructive surgery of the breast has become possible since Patey-modified mastectomy has been preferred to Halsted classic radical mastectomy for operable breast cancer and routine use of postoperative radiotherapy discontinued in patients eligible for adjuvant chemotherapy. Reconstructive techniques are reviewed and pitfalls subjected to careful scrutiny. It is thought that women might be encouraged to seek earlier medical advice after noticing a lump in the breast if they are alive to the prospect of possibile restoration of the contours of the breast after ablative surgery.


[Tumors of the efferent parts of the urinary tract and abuse of analgesics].

Since 1965, when Swedish authors first suggested that analgesic abuse could cause uroepithelial tumors associated with or without analgesic nephropathy, an increasing number of cases have been reported from many parts of the world. In a retrospective analysis of all patients admitted to the medical department of the University Hospital in Basel from 1966 to 1976, records of 20 patients with analgesic nephropathy and tumors of the urinary tract (excluding hypernephroma) were found (17 uroepithelial tumors, 2 sarcomas, 1 chorionepithelioma). Typical symptoms, outcome and actuarial survival of the patients with uroepithelial tumors are summarized. Phenacetin as the common ingredient in analgesic mixtures has been regarded as carcinogenic, since some of its metabolites are similar in chemical structure to well-known industrial carcinogens. In animal experiments malignant tumors have in fact been induced with 2-hydroxylated metabolites and areneoxydes of phenacetin and paracetamol, and there is even more convincing evidence of the carcinogenic properties of N-oxydized metabolites such as N-hydroxy-phenetidine and N-hydroxy-phenacetin. Dimethylnitrosamine formed from aminophenazone appears to be improbable as a cause of uroepithelial tumors associated with analgesic abuse, since aminophenazone has not been a common ingredient of analgesic mixtures in Australia, where the incidence of uroepithelial tumors appears to be as high as in Sweden, where abuse of aminophenazone-containing analgesics has been massive.


Chloroquine resistance produced in vitro in an African strain of human malaria.

After condinous cultivation in the presence of chloroquine, an African strain of the malaria parasite, Plasmodium falciparu, acquired resistance to the drug. The resistance was stable and comparable in vitro to that occurring naturally in a strain from Southeast Asia. This suggests that chloroquine resistance, absent until now in Africa, might arise in the future.


Neural organization and evolution of thermal regulation in mammals.

This article proposes a modification of the currently accepted view of the central neural integration of body temperature. In place of a single integrator with multiple inputs and outputs, the new model includes as many integrators as there are thermoregulatory responses. Futhermore, these integrators are postulated to be represented at many levels of the nervous system, with each level facilitated or inhibited by levels above and below. The purpose of such a complicated arrangement is to achieve finer and finer control over body temperature. A consideration of how endothermy might have evolved, with originally nonthermally related responses gradually coming under thermal control, makes such a brain organization highly reasonable.


Attraction by repellents: an error in sensory information processing by bacterial mutants.

Normal Escherichia coli bacteria are repelled by acetate, benzoate, and indole and attracted by alpha-aminoisobutyrate. We have isolated mutants that are attracted to acetate, benzoate, and indole and may be repelled by alpha-aminoisobutyrate. These reversed-taxis mutants are defective in a central processing component: a set of methylated proteins known as MCP 1. The mechanism of reversal of taxis is discussed.


Effects of naloxone on schizophrenia: reduction in hallucinations in a subpopulation of subjects.

Endogenous opiate-like peptides (endorphins) are putative neuroregulators located throughout the mammalian brainstem. There is some evidence for their role in pain, stress, and affect. We report that the opiate antagonist, naloxone, alters some schizophrenic symptoms. In a double-blind, cross-over study, naloxone produced decreases in auditory hallucinations in some schizophrenic patients. This finding supports the hypothesis that the endorphins may play a roll in modulating hallucinations in a highly selected subgroup of chronically hallucinating schizophrenic patients.


Irreversible gene repression model for control of development.

As the pluripotent cells of early embryos differentiate, each progressively loses the potency to develop into several phenotypes. Ultimately, each cell becomes irreversibly restricted to the expression of a single phenotype. Although in many instances details regarding those restriction events are well known, there is little information concerning the nature of the gene transcription changes involved. A model that accounts for the diminution of developmental potential as resulting from progressive, irreversible repression of previously active genes is presented. A scheme of progressive gene repression, rather than selective gene activation, is most consistent with observations from experimental embryology as well as from more recent biochemical experimentation.


A fertility reaction to a historical event: southern white birthrates and the 1954 desegregation ruling.

On 17 May 1954 the Supreme Court, in its decision in Brown v. Board of Education, declared de jure segregation of the public schools to be unconstitutional. It is argued here that a consequence of that decision was a decline in childbearing among white Southerners. In the nation as a whole, period fertility rates increased between 1954 and 1955, but in 9 of the 11 former Confederate states they decreased. Further analysis shows that these Southern fertility decreases began about 12 months after the Supreme Court decision. This variation in behavior in reaction to a historical event has important implications for the explanation and prediction of fertility.


Physostigmine: improvement of long-term memory processes in normal humans.

Nineteen normal male subjects received 1.0 milligram of physostigmine or 1.0 milligram of saline by a slow intravenous infusion on two nonconsecutive days. Physostigmine significantly enhanced storage of information into long-term memory. Retrieval of information from long-term memory was also improved. Short-term memory processes were not significantly altered by physostigmine.


Human serial learning: enhancement with arecholine and choline impairment with scopolamine.

Arecholine (4 milligrams), a cholinergic agonist, and choline (10 grams), a precursor of acetylcholine, significantly enhanced serial learning in normal human subjects. The subjects received methscopolamine prior to both arecholine and placebo injections. Conversely, scopolamine (0.5 milligram), a cholinergic antagonist, impaired learning and this impairment was reversed by arecholine and choline and the impairment after scopolamine were inversely proportional to the subject's performance on placebo; that is, "poor" performers were more vulnerable to both the enhancing effect of cholinergic agonist and precursor and the impairment after cholinergic antagonist than "good" performers.


Adherence of group A streptococci to pharyngeal cells: a role in the pathogenesis of rheumatic fever.

We used an assay in vitro to investigate the possible role of streptococcal adherence to human pharyngeal cells in the pathogenesis of acute rheumatic fever. There was no difference in adherence of rheumatic fever-associated and non-associated strains of group A streptococci to pooled pharyngeal cells of normal people. Likewise, streptococci not associated with rheumatic fever adhered equally well to cells taken from normal people and from patients with rheumatic heart disease. However, the pharyngeal cells of all nine rheumatic heart disease patients tested had increased avidity for adherence for a rheumatic fever-associated strain of streptococcus compared to the pharyngeal cells obtained from age- and sex-matched controls. Increased streptococcal adherence to pharyngeal cells of rheumatic fever-prone patients may play a role in the pathogenesis of rheumatic fever.


Enkephalin-containing neurons visualized in spinal cord cell cultures.

Neuronal cells, axons, and terminals containing immunoreactive enkephalin have been visualized in cultures of dissociated fetal spinal cord. These cultures may provide a valuable system in which to explore the effects of chronic drug treatment on the physiology of enkephalin-containing cells and their interactions with other cells.


Double-blind comparison of lidocaine and etidocaine during continuous epidural anesthesia for vaginal delivery.

Etidocaine 0.5% plain, etidocaine 0.5% with epinephrine 1:200,000 and lidocaine 1% with epinephrine 1:200,000 were compared in a series of patients receiving epidural anesthesia for vaginal delivery. Results, based on data from 48 patients, showed a significant increase in the duration of action (P is less than .01%), the degree of sensory analgesia (P is less than .02%) and the degree of motor blockade (P is less than .01%) in the group that received etidocaine with epinephrine compared to the remaining groups. There were no significant differences in the duration of labor or the number of complications. It was concluded that etidocaine and lidocaine in the concentrations used were unsatisfactory for labor and delivery.


Saturday Conference: a clinician looks at the aminoglycoside antibiotics.

Aminoglycoside antibiotics provide physicians with valuable drugs for coping with serious, often hospital-acquired gram-negative rod infections which are occurring with increasing frequency. Use of these agents may be advantageous and even lifesaving. There are potential hazards associated with their administration. Narrow therapeutic indices coupled with susceptibility to degradation by resistant bacteria should temper our enthusiasm for aminoglycosides.


A bacteriological study of some frozen and nonfrozen foods.

Over a period of 19 months, a total of 331 food samples were submitted to the Food Section of the Bacteriology Division for bacteriological examination. These included 184 samples of frozen seafoods from exporters and 147 samples of fresh, nonfrozen foods from food caterers. The total bacterial count for frozen seafoods ranged from 1 x 10(2) to 2.98 x 10(6) per gm with a mean of 2.14 x 10(5) per gm. Coliforms, Escherichia coli and Staphylococcus aureus were present in 48.9%, 3.3% and 8.2% of the samples examined respectively. Two of the cooked prawn samples showed the presence of Vibrio parahaemolyticus. For the fresh, nonfrozen foods, the total bacterial count ranged from 1 x 10(2) to 3.87 x 10(6) per gm with a mean of 2.58 x 10(5) per gm. The examination also showed that 74.8% were coliform positive, 14.9% were E. coli positive, and 4.8% were S. aureus positive. V. parahaemolyticus was not isolated in any of the samples tested. Other pathogens, namely, Vibrio cholerae, Salmonella and Shigella were not isolated from any of the foods examined. The bacterial levels in these foods were determined and their sanitary and public health significance is discussed.


Diarrhoeal disorders of bacterial origin in Jakarta.

During a 21-month period from April 1974 to February 1976, 948 children with gastroenteritis were studied. Aetiologic agents were identified in 43% of these patients. Isolates were identified as follows: V. cholera El Tor, 273 (67%); Salmonella enteritidis, 64 (16%); enteropathogenic E. coli, 28 (7%); Shigella, 28 (7%); Vibrio (NAG), 9 (2%): and V. parahaemolyticus, 7,2%). Gastroenteritis with dehydration is a serious continuing pediatric problem in Jakarta, constituting 30% of admissions to Sumber Waras hospital. The incidence of both cholera and salmonellosis increased during the past 2 years, as judged by the distribution of enteric bacteria isolated from the rectal swabs of gastroenteritis patients in Sumber Waras hospital.


Heat-labile enterotoxigenic Escherichia coli and intestinal protozoa in asymptomatic travellers.

Thirty-two asymptomatic travellers who had recently journeyed in the Near, Middle, and Far East and had experienced a high incidence of diarrhoeal disease were screened for heat-labile enterotoxigenic Escherichia coli (ent+ E. coli) and other bacterial and parasitic pathogens. Six percent were colonized with ent+ E. coli and while other bacterial pathogens were not found, the intestinal protozoa Giardia lamblia (13%), Entamoeba histolytica (6%), Entamoeba coli (6%), Endolimax nana (6%), and Entamoeba hartmanni (3%) were detected in the stools. Ent+ E. coli, G. lamblia and E. histolytica should be considered in the differential diagnosis of gastrointestinal disease in travellers returning from the Orient. Furthermore, these travellers may be a potential source for the introduction of ent+ E. coli into communities where such organisms are relatively rare.


Fracture dislocation of the cervical spine. Value of anterior approach with bovine bone interbody fusion.

Twenty surgically treated cases of fracture dislocation of the cervical spine are presented. All patients had hyperflexion injuries with associated rupture of the intervertebral disc. All patients were operated on through an anterior surgical approach. Ten consecutive patients had interbody fusion with autogenous bone and ten consecutive patients were fused anteriorly with bovine (Kiel) bone. All patients' injuries fused satisfactorily. There was no significant difference between the use of autogenous bone and bovine bone.


Cadaveric renal preservation with hyperosmolar, intracellular hypothermic washout solution and cold storage.

All 54 kidneys obtained from heart-beating cadavers functioned when preserved by a brief washout using a hypothermic, hyperosmolar, hyperkalemic perfusate, followed by cold storage. The duration of preservation ranged from two hours and 57 minutes to 39 hours and 47 minutes. Two other kidneys retrieved from a nonheart-beating cadaver and preserved by the same technique failed to function because of irreversible acute tubular necrosis. Fifty-six consecutive transplant patients were divided into four groups according to the period of preservation. There was no correlation between graft rejection, frequency of post-transplant dialysis, long term graft function and survival time, when the duration of preservation was less than 24 hours. The advantages of this technique included technical simplicity, low cost, minimal risk of graft infection and easy transportation. The two primary disadvantages were an apparent 24 to 30 hour limit of organ preservation with prompt function and the inability to determine intrarenal perfusion pressure during preservation, thereby missing an important parameter of graft viability.


Understanding postoperative fatigue.

Performance characteristics of the central nervous, cardiovascular, respiratory and muscular systems in man postoperatively have received little investigative attention, despite the well known syndrome of postoperative fatigue. The impairmen in perception and psychomotor skills that has been shown to result from caloric restriction, bedrest, sedation and sleep deprivation suggests that a similar deficit may occur after surgical procedures. After a simple elective surgical procedure, maximal oxygen uptake decreases and the adaptability of heart rate to submaximal workloads is impaired. Similar deleterious effects on cardiorespiratory performance have been documented with starvation and bedrest; an understanding of cardiorespiratory performance postoperatively awaits further investigation. Maximal muscular force of contraction is also impaired by caloric restriction and bedrest, suggesting that similar effects may be seen in the postoperative state, although this has not been studied. A better understanding of the syndrome of postoperative fatigue could be achieved by a descriptive analysis of physiologic performance postoperatively. Such descriptive data could form the basis for objective evaluation of therapeutic measures intended to improve performance, such as nutritional supplementation and pharmacologic intervention. The observation that exercise with the patient in the supine position may decrease the impairment in maximal aerobic power otherwise expected in immobilized patients suggests that controlled exercise therapy may be of value in reducing physiologic impairment postoperatively.


A comparison of oral and inhaled steroids in patients with chronic airways obstruction: features determining response.

Two trials comparing aerosol and oral steroid treatment were carried out in patients with chronic airways obstruction. All patients had a history of chronic productive cough and an FEV1 less than 70% predicted but did not have episodic or seasonal breathlessness with wheezing. One trial involved 18 outpatients, the other 18 inpatients. Both studies involved three consecutive treatment periods, the first with placebo aerosol, the second with active aerosol (betamethasone valerate, 800 microgram/day), and the third with oral prednisone or prednisolone (30 mg/day). Six patients showed a significant improvement in ventilatory capacity on steroids. Initial assessment included a comprehensive history using a questionnaire, skin tests, blood and sputum eosinophil counts, and chest radiography. In addition, for the inpatients, response to isoprenaline, daily sputum volume, and PaCO2 were measured. Only blood eosinophilia and variability in ventilatory capacity during the placebo period seemed indicative of a likely response to steroids. However, there was a large overlap between various features on assessment in the responders and non-responders, and the management of every patient with chronic airways obstruction should include a controlled trial of steroids. The steroid aerosol produced a good improvement in ventilatory capacity in the responsive patients who were hospitalised and this was thought to be helped by supervision of aerosol technique. Such an aerosol could therefore be used for a steroid trial although oral steroids were found to give a more definitive response.


Comparison of reports on lung function tests made by chest physicians with those made by a simple computer program.

The numerical results of 60 sets of pulmonary function tests were submitted to five consultant chest physicians for independent reporting. The chest physicians' reports were compared with the reports generated by the on-line computer reporting system in routine use in the pulmonary function laboratory at Westminster Hospital. There was good agreement between the reports of the chest physicians among themselves and with the computer. The individual reports were compared with the consensus opinions of the physicians and the computer. The computer's decisions differed from the consensus opinion in 4.6% of instances. The comparable figures for the five physicians were respectively 2.9%, 2.9%, 2.9%, 4.0%, and 4.6%. Decisions differing from the consensus were due to mistakes or actual sustained disagreements of opinion. The physicians made more mistakes than the computer even though they were performing under test conditions. They made up for this, however, by producing fewer genuine disagreements from the consensus opinions. It is concluded that in routine day-to-day practice the computer report will be as consistently useful as the chest physicians' reports and more immediately available.


Diethylhexyl phthalate as a factor in blood transfusion and haemodialysis.

Di-2-ethylhexyl phthalate (DEHP), the most frequently occurring plasticiser in medical equipment manufactured from polymers of vinyl chloride, forms about 40% w/w of tubes and containers used for storing blood and for haemodialysis. The plasticiser leaches out into liquids with lipid contents, although it is very sparingly soluble in purely aqueous solutions. On infusion of 2-3 1 of stored blood, up to 200 mg DEHP may be transferred to the patient, while much higher quantities may be given during dialysis, which is moreover often repeated frequently over long periods. The acute toxicity of DEHP is very low (greater than 20 g/kg as LD50 in rats), and the ester is rapidly metabolised to products which are excreted in the urine and bile; chronic toxicity from the levels of dosage obtaining is thus very improbable. Carcenogenicity has never been demonstrable in animals, while teratological effects are of a very low order. Serious acute results observed after transfusion of neonates have not been proved to be caused by DEHP, and might be ascribable to accompanying foreign substances. Atheroma in chronic dialysis subjects is still unexplained, but hepatitis probably caused by diethylphthalate from plastic was resolved when apparatus plasticised by DEHP alone was substituted. The benefits of DEHP appear vastly to outweigh any risks. The status of DEHP as environmental contaminant is noted.


A randomized prospective study of cadaver donor pretreatment in renal transplantation.

In a randomized study ww have been unable to demonstrate any beneficial effect of cadaver donor pretreatment with 5 g of methylprednisolone and 7 g of cyclophosphamide on graft function or survival in 22 recipients of pretreated kidneys compared with 30 recipients of nonpretreated kidneys.


Chimaerism in lymph nodes of F1 into irradiated parental recipient chimaeras rejecting skin allografts from the other parent.

Mice of the C57BL strain were irradiated with 800 R over the whole body. The next day they received i.v. a mixture of 50 x 10(6) spleen and bone marrow cells from (C57BL x CBA-T6T6)F1 hybrid mice, and were challenged with CBA-T6T6 skin grafts later on. About 20% of the recipients rejected the CBA-T6T6 skin, whereas the others were completely tolerant for more than 200 days. By using the cytotoxic test, we found that both tolerant and nontolerant recipients were complete chimaeras, i.e., had only (C57BL x CBA-T6T6)F1 cells in their lymph nodes. However, analysis of the same mice by the chromosome marker technique disclosed a proportion of host (C57BL) cells in lymph nodes of both tolerant and nontolerant chimaeras. The percentage of host metaphases in nontolerant chimeras was significantly higher than that in tolerant chimaeras (P less than 0.01). It is possible therefore that the CBA-T6T6 skin grafts were rejected by residual host (C57BL) cells rather than (C57BL x CBA-T6T6)F1 cells reacting against skin-specific transplantation antigen(s) of the parental graft.


Direct identification of the murine pluripotential stem cell using rabbit anti-mouse brain serum.

Previous studies have shown that antisera prepared in rabbits against mouse brain tissue (RAMBS) contain activity against the murine bone marrow colony-forming unit (CFU-s) or pluripotential hemotopoietic stem cell. In the present study, the F(ab')2 portion of RAMBS was examined for its potential efficacy in the identification of the mouse CFU-s when used in an indirect immunofluorescence-labeling technique. After separation of mouse bone marrow cells by a discontinuous bovine serum albumin density gradient, fluorescent cells were observed only in those bands which, by the splenic colony-forming assay, demonstrated CFU-s. Furthermore, the quantity of CFU-s demonstrated by the spleen colony-forming assay approximated the number of fluorescent cells observed in the corresponding band. It appears that the F(ab')2 portion of RAMBS used in an immunofluorescent assay may provide a method for the direct quantitation and identification of the CFU-s content of murine bone marrow.


Anti-M in children with acute bacterial infections.

Four children, 7 to 24 months old, were found to have anti-M at the time of admission to the hospital for severe acute bacterial infections. All were M-N+. Two patients had meningitis, one had septic arthritis, and the fourth had a third-degree burn of the left hand. In follow-up studies the anti-M of patients No3 and No4 were no longer detectable after 12 and 11 months respectively. In all patients no demonstrable antibody was in either maternal or cord sera at time of birth. The clinical data and bacterial isolations lead us to postulate that bacterial infections account for the formation of naturally occurring anti-M in M-negative persons.


Factors affecting trophoblast growth in extrauterine sites.

The effect of genetical dissimilarity between the trophoblast and host on trophoblast growth was studied in extrauterine sites, where people can observe trophoblast growth without the complicating factors of the uterine environment. Trophoblast growth was estimated in this study by measuring the extent of trophoblast proliferation in the kidney and testis per body weight in the testis. The results showed that the trophoblast growth was not enhanced by genetical dissimilarity, but was probably determined by the capacity of the host to support trophoblast growth and the capacity of the trophoblast itself to grow. No hormonal influence on trophoblast growth was observed. When hosts were immunized with double skin grafts from donors, however, the success rate of attempted transplantation of the blastocyst was remarkably lowered and trophoblast growth was also suppressed in terms of the number of trophoblast cells and the extent of trophoblast proliferation. In such cases, intensive lymphocytic infiltration was seen between the trophoblast and host tissues. This suggests that some antigenicity on the trophoblast may be expressed in vivo under some conditions, e.g., in the strongly immunized host by the donor's antigen and the immunity to this antigen suppresses trophobalst growth.


Demonstration of Diego (Dib) and Scianna (Scl) antigens on phagocytic leukocytes of the blood.

The high-incidence erythrocyte antigens Dib and Scl have been demonstrated on leukocytes, using an antibody absorption technique. Tests with separated platelets, lymphocytes and neutrophils indicate that these antigens are restricted to the phagocytic leukocytes. Studies using the same methodology do not show Lan or Coa antigens on leukocytes.


Correlation of the in vivo and in vitro activities of antithymocyte sera (ATS) with the immunizing antigen dose.

Rabbits were immunized with 1, 3, 10, 30, 100, 300, or 1,000 x 10(6) murine thymocytes per kg according to the method of Levy and Medawar. Thus, 33 individual and 6 pooled antimouse antihymocyte serum (ATS) preparations were obtained and tested for in vivo immunosuppressive (graft-protective) as well as for in vitro thymocytotoxic activity. It was found that: (1) at least 3 x 10(6) thymocytes/kg were necessary for inducing ATS of appreciable immunosuppressive activity; (2) rabbits immunized with 30 x 10(6) thymocytes/kg supplied sera of the most potent immunosuppressive activity; (3) the increase of the immunizing antigen dose over 30 x 10(6) thymocytes/kg resulted in ATS preparations of decreased immunosuppressive activity; (4) the graft-protective activity of an ATS pool corresponded to the average of the activities of the individual ATS preparations from which the pool had been mixed, i.e., the process of pooling itself did not modify the immunosuppressive activity; and (5) there was a good correlation (r = 0.72, P less than 0.001) between the in vivo immunosuppressive (graft-protective) activity and the in vitro thymocytotoxic titre of ATS preparations. The theoretical and practical significance of these results if discussed.


Demonstration of cell surface antigens and their antibodies by the peroxidase-antiperoxidase method.

The unlabeled antibody enzyme method, using the peroxidase-antiperoxidase immunocomplex for labeling, was applied to freshly prepared viable lymphocytes to detect antibodies in individuals preimmunized by pregnancies or blood transfusions. The "sandwich" incubations and washing steps were carried out with cells attached to poly(L-lysine) glass slides, in order to facilitate the handling of the samples and to save antisera and time. In comparison to the lymphocytotoxicity test, the described method is more sensitive and able to detect additional antibodies. Our findings indicate that further investigation of the use of this test for the demonstration of cell surface antigens and their antibodies appears to be worthwhile.


The effect of metoclopramide (Primperan) on the pyloric sphincter during gastroscopic examination. A double blind investigation versus placebo.

The effect of metoclopramide and placebo on relaxation of a spasmodic pylorus during gastroscopy have been compared using a double blind technique. Metoclopramide showed a better result and the difference between its effect and the effect of placebo is statistically significant (p less than 0.01). Metoclopramide is a useful agent during gastroscopic examination in cases of spasmodic pylorus. It facilitates the passage of the gestroscope through the spasmodic pyloric sphincter. The reported relaxation and dilatation of the pyloric sphincter clarifies the amelioration of symptoms in different gastrointestinal troubles.


[Effect of group B vitamins on 35S-lipoic acid intake by mouse tissues].

Lipoic acid intake following parenteral administration with functionally linked vitamins depends on molar relations between them. It is shown that a combined administration of 35S-lipoate with these vitamins decreases radioactivity 30-120 min after the injection in most of tissues as compared to the control, except for the liver where it does not change or increases (60 min after administration in combination with thiamin or pantothenate). Following 18h thiamin and mixture of vitamins induce an intensified intake of labelled lipoic acid by the brain tissue, a 4-fold increase in case of thiamin and a 2.6-fold increase in case of the vitamins mixture.


[On the regulatory role of amino acids in biosynthesis and formation of protein structure].

There exist definite relations between certain amino acids in the process of protein biosynthesis. Interactivation in their incorporation into synthesizing proteins is observed between ones and interinhibition between others. The mentioned phenomena are observed in studies both at the model experiments on the enzymic systems in vitro and on the intact animals in vivo. This testifies to the fact that the established interrelations between certain amino acids are not artefacts but reflect the regulatory role of amino acids in protein biosynthesis. Amino acids, inhibiting incorporation into protein, inhibit its biosynthesis and, vice versa, activating incorporation of other amino acids they activate protein biosynthesis as well. Excess of any amino acid in the animal ration, especially against a background of the protein-free diet, causes in aminals the biosynthesis of proteins with another primary structure differing from that of proteins synthesizing with normal nutrition. So, the regulatory role of amino acids concerns not only the quantitative but also the qualitative side of the protein biosynthesis. Proteins with another primary structure differing from the normal one are synthesized as well in such extremal states of the animal organism as a long complete fasting, protein-free nutrition, cancer diseases at the last stage, thyrotoxicosis, developed atherosclerosis, and others. Here side by side with changes in the primary structure the physicochemical and immunobiological properties as well as the enzymic activity of proteins-enzymes change. Possible mechanisms are discussed of changes in the primary structure of the proteins synthesizing in the organism in the above-mentioned extremal states, including the effect of certain amino acids excess against a background of deficient protein nutrition.


The effect of two different renal preservation methods on canine renal allograft survival.

Preservation of human cadaver kidneys for transplantation has been achieved primarily by two methods, hypothermic pulsatile perfusion with cryoprecipitated plasma and cold storage with an electrolyte solution. It has been suggested that pulsatile perfusion results in an increased antigenicity of the transplanted kidney. To investigate the possibility that pulsatile perfusion causes changes which may accelerate allograft rejection, machine preservation was compared with simple cold storage. The kidneys were preserved by either one of the two methods for 6 or 24 hours followed by allotransplantation in nephrectomised dogs. No immunosuppressive drugs were given. Kidneys which were allografted without undergoing any preservation (0 hrs) had a mean survival time of 10.4 +/- 1.7 days (n =5). Kidneys preserved by machine perfusion for 6 and 24 hours survival for 9.6 +/- 1.4 (n = 5) and 10.9 +/- 1.3 (n =9) days respectively. The mean survival time for simple cold storage for 6 and 24 hours was 9.3 +/- 1.3 (n =7) and 12.0 +/- 1.9 (n =6) days. Our findings suggest that in kidneys exposed to minimal warm ischaemia there is no significant difference between the two methods of preservation on renal allograft survival for the time intervals tested.


Methylene blue as an inhibitor of stone formation.

Kinetics of growth and dissolution of calcium oxalate monohydrate were examined in the presence of small concentrations of methylene blue. The data presented show moderate retardation in growth and dissolution rates. It was also found that methylene blue decreased the decalcification rate of calcium oxalate renal calculi. The implications of these findings in the treatment of urolithiasis are discussed.


Lesions of Cowper's ducts and glands in infants and children.

Lesions of Cowper's duct and gland are more common than previously reported. They may be asymptomatic or may cause micturition difficulties or urinary retention. They may be congenital or acquired (usually inflammatory). Radiographic findings are either a rounded filling defect arising from the floor of the bulbous urethra or reflux into a dilated duct which parallels the bulbomembranous urethra. Panendoscopic fulguration is a simple and effective method of treatment for symptomatic patients with retention cysts. Asymptomatic patients do not need any therapy. A dilated duct should not be confused with partial urethral duplication, a urethral diverticulum, or an ectopic ureter since such an error may lead to an unnecessary operation.


Spermatic cord: cause of ureteral obstruction in renal allotransplant recipients.

Two cases of renal allotransplants are presented with urologic complications caused by the spermatic cord. Management of these patients is discussed, and a question is raised about the insistence of placing the ureter under the spermatic cord in all cases.


Recurrent dense deposit disease in renal allograft.

This report documents the recurrence of dense deposit disease in a renal allograft thirty-three days post-transplantation and stresses the usefulness of immunofluorescence in early detection.


[Drainage of the thoracic lymphatic duct and lymphovenous anastomosis in treating portal hypertension].

To correct the portal blood flow 52 operations on the thoracic lympheduct (TLD) were performed on 43 patients with decompensated portal hypertension syndrome. The external drainage of the TLD (lymphaticostomy) was carried out upon 22 patient and the internal drainage of TLD (lympho-venous anastomosis-LVA) upon 26 patients. 4 patients underwent other operations. The authors conclude that the selection of a LVA variant should be individual, depending on peculiarities of topographo-anatomical correlations between TLD and the anastomosed vein.


[Results of skin integument restoration using mesh autografts].

The experience with transplantations of 705 mesh grafts in 397 cases of vast deep burns mainly, together with the clinico-morphological investigation of the skin restoration processes have shown a high effectiveness of the method especially in case of the shortage of the intact skin. Good results have been obtained in 94.8% of cases.


Escherichia coli and diarrhoea in the rabbit.

An outbreak of severe diarrhoea and death in young rabbits was associated with many nonenterotoxigenic Escherichia coli in the caecum. The severe clinical, pathological and bacteriological features of the diesase, acute diarrhoea associated with typhlitis and many E. coli in the caecum, could be reproduced either by the intraintestinal inoculation of many bacteria recovered aerobically or anaerobically from the caecum of these rabbits or by the intestinal inoculation of large numbers of a serogroup of E. coli, 0153, recovered from the caecum. Further experiments showed that this serogroup of E. coli, as well as a nonenteropathogenic serotype recovered from human faeces, would cause typhlitis and diarrhoea if inoculated in large numbers into the jejunum; pathological changes also were seen in the liver and kidney. Similar changes also could be induced by intravenous inoculation of a freeze-thaw (endotoxic) extract prepared from these strains. Any factor that allows rapid multiplication of E. coli in the rabbit caecum may be followed by absorption of endotoxin and subsequent typhlitis and so metimes by severe diarrhoea; this effect is seen in some field cases of diarrhoea in the rabbit.


[Protein composition and synthesis in islands of Langerhans isolated from normal rats and rats with alloxan diabetes].

Protein fractions with dissimilar electrophoretic mobility were identified in Langerhans, islands. In solitory islands, isolated from pancreas of rats with alloxan diabetes as compared with normal rats the protein composition varied distinctly: fractions of "constant" proteins and, specifically, the insulin fraction disappeared completely, total amount of identified fractions was decreased with relative alteration in their mobility. The total protein-synthesizing activity of Langerhans' islands from diabetic animals was 3-4-fold decreased as compared with that of control animals. An effect of "glucose repression" of protein synthesis was observed in isolated Langerhans' islands.


[Effect of S-nucleosyl-L-homocysteines on the activity of DNA methylases].

It was studied effect of S-adenosyl, -uridyl, -citidyl and -inosyl homocysteines on activity of bacterial adenine and cytosine methylases from E. coli CK as well as on guanine methylase specific for DDVI phage. S-adenosyl homocysteine was shown to be the strong inhibitor of methylation; 10 micrometer of the substance inhibited all the enzymes studied by 98--99%. Use of total enzymatic preparations did not enable to find a difference in affinity of S-uridyl, -citidyl, and -inosyl homocysteines to various DNA methylases studied. All these preparations inhibited DNA methylases by 55--65%. Increase in concentration of inhibitor up to 20 micrometer did not elevate the inhibitory effect. Action of S-nucleosyl homocysteines did not depend on the type of acceptory DNA.


[Leukocyte adhesion suppression reaction for determining the immunological reactivity of oncological patients].

By means of the reaction of inhibition of leucocytes adhesiveness, suggested by Halliday and his coworkers, the authors examined the immune reactivity of 52 oncological patients and 25 healthy donors. The specific cell activity was observed only in oncological patients, and mainly against the antigen from autologous or histologically identical tumor. In a third of patients under examination blood serum would block the specific cell activity. The intensity of the reaction was enhanced in immunotherapy with FHA activated lymphocytes. The sensitivity of the reaction involved proved to be higher than that of the reaction of lymphocytes migration inhibition by the same antigens.


[Induced blood serum chemiluminescence in lymphogranulomatosis patients].

The authors report the results of studying the parameters of the kinetics of induced chemiluminescence of blood serum in patients with lymphogranulomatosis prior to and after the therapy. The luminescence characteristics in patients were found to differ from those in donors. Following the treatment the kinetic parameters approach the initial values. The data obtained have demonstrated the possible aspects of using the method concerned in the complex diagnostics, and to control the efficacy of the therapy for the given pathology.


Influence of various physicochemical factors on hemagglutination.

A study is made of the influence on hemagglutination of various physicochemical parameters, such as: cell shape, cell distance, extracellular colloid-osmotic pressure, degree of hydration of the cell surface, and cell zeta-potential. To a varying extent these are changed by: the addition of divers soluble polymers, the action of enzymes, the presence of various salt ions, centrifugation, agglomeration at low ionic strength, complex coacervation with cationic polymers, and the interaction with different kinds of antibodies. Among the more important parameters are cell distance and cell shape (particularly when the latter tends to spiculation), while the influence of zeta-potential appears to be of fairly minor consequence. The action of dissolved polymers is mediated through polymer bridging, increase in extracellular colloid-osmotic pressure, decrease of cell surface hydration, and change in cell shape. A peculiarity of dextran is that in addition to all of the above, it causes pronounced erythrocytic spiculation.


[Microfloral makeup of the feces of infants on various types of feeding].

Dissimilarity in the fecal microflora of infants fed with breast milk and the ones receiving in the neonatal period the mixture "Malyutka" and experimental samples of the dry acidopilic mixture "Malyutka" because of their mothers' state of hypolactation. Features specific for intestinal biocenosis in the breast-nursed infants is the prevalence of bifidobacteria, low abundance of microorganisms accomplishing proteolysis and also a high percentage of colicinogenic cultures of colibacillus. In further preparations of adapted milk mixtures it appears expedient to go on with investigations oriented toward incorporation in their composition of factors contributing to bringing the intestinal microflora composition closer to that in natural feeding.


The properdin system: composition and function.

This article summarized the physicohemical data on the factors which compose the properdin system in guinea pig and man. The following other topics are discussed: (1) Activation of the properdin system; (2) Formation of the initiating and amplification C3 convertases; (3) Formation of the C5 convertase, and (4) Regulatory control mechanisms of the properdin system.


Results of a multicentre clinical trial of the solid-phase enzyme immunoassay for hepatitis B surface antigen.

The results obtained in a multicentre clinical trial of an enzyme immunoassay (EIA) method for hepatitis B surface antigen (HBsAg) (65,451 sera tested) have demonstrated that this new test has a significantly higher sensitivity than a reversed haemagglutination test (rHA). In a part of the trial, EIA was also compared with radioimmunoassay (RIA). Only a small number of discrepant results was obtained with these two tests, indicating similar sensitivities. No definite conclusion about a difference in sensitivities could be drawn from these results. Although the specificity of the EIA screening test is lower than that of rHA and RIA, the mean percentage of false positives was 2.2% of the total number of donor samples screened. Presumptive positives in EIA were subjected to a confirmatory test based on neutralization with human antibodies to HBsAg. After elimination of false positives in EIA screening, there was excellent agreement between EIA and RIA results.


[Comparative study of B-lymphocyte activity in the spleen of mice infected with viruses of the tick-borne encephalitis complex].

Most arbovirus infections are characterized by multiplication of the causative agent in tissues of the reticuloendothelial system. In this study, the effect of some viruses of the tick-borne encephalitis complex on the reaction of B-cells of mouse spleens was investigated by the hemolysin-producing activity (number of plaque-forming cells). To equal small doses of a highly virulent (Pan), naturally attenuated (Tp-21) and experimentally attenuated (Tp-21-237) strains the immunocompetent cells of mouse spleens responded by active reactions. The immunocompetence of these cells after primary introduction of the antigens persists and revaccination response occurs after a secondary infection with the same viruses. Under these experimental conditions the active response of spleen cells to the antigenic stimulation correlates with formation of the specific resistance and does not correlate with the level of antihemagglutinins in the blood.


The laboratory diagnosis of megaloblastic anemias.

The diagnostic approach to megaloblastic anemia involves four usually sequential steps. The first step, recognition of megaloblastosis, requires attention to altered blood cell size and morphology. These changes may sometimes be subtle or masked. The cornerstone of the second step, identification of the specific vitamin deficiency, is assay of serum vitamin B(12) and folic acid levels, although they may occasionally be misleading. The third step, identification of the specific disease entity responsible for the vitamin deficiency, generally revolves around tests of absorption and gastric function. The fourth step, reevaluation after replacement therapy, is often not thought of as a diagnostic step but carries important diagnostic implications and is sometimes the only way in which coexisting abnormalities can be unmasked and identified.


[Neurophysiology of epileptic seizures (author's transl)].

The paper is a review of the progress made over the past years in the understanding of electrical processes occurring during epileptic seizures as elicited by the local application of penicillin. The events at the cellular level of the neocortex are discussed, as well as cortico-subcortical relationships and microtopography of the seizure patterns. The increased excitability under penicillin induces a great number of feedback processes, the electrical effects of which become visible in the seizure EEG with its high degree of organization. Neocortical architectonics is of great importance for the shape of the potentials and their distribution. Seizure patterns of different shape are found in the different layers of the cortex.


[The operative treatment of scoliosis and kyphosis (author's transl)].

The first part of this paper consists of a discussion of the prognosis of the main forms of scoliosis and the operative treatment of this condition. The various modes of pre-operative curvature correction are detailed, as well as the main operative techniques from the dorsal (mainly the Harrington procedure) and ventral spinal approach (dwyer procedure, wedge resection). The second part describes the operative treatment of kyphosis. The most important complications are described.


[Partial gluing in extra-intracranial microvascular anastomoses (author's transl)].

In an extensive series of experimental studies conducted on the common carotid artery in rats, a combined technique involving suture and gluing with human fibrin glue has been developed. In view of the good results achieved, this technique was then applied in 12 patients in whom anastomosis between the superficial temporal artery and a cortical branch of the middle cerebral artery was carried out. This modified surgical technique shortened the duration of operation and also reduced the incidence of complications. Late results, too, seem to be more satisfactory, as far as can be ascertained within the given observation period. 10 patients showed a marked improvement in the clinical neurological findings. Working capacity was completely restored in 5 out of these patients. In one patient, clinical symptoms deteriorated on account of an intra-operative contralateral cerebral haemorrhage. The condition of one patient remained unchanged.


[Management of tracheo-innominate artery erosions following tracheal resection (author's transl)].

The most important points in preventing innominate artery erosions following tracheostomy are proper placement of the stoma and selection of flexible tubes with appropriate low pressure cuffs. In tracheal resections the risk of a tracheo-innominate artery fistula can be reduced by avoiding damage to the adventitia of the artery fibrosed to the stenotic tracheal segment and by interposing tissue between artery and anastomosis. If haemorrhage occurs this can be controlled by hyperinflation of a cuffed endotracheal tube in most cases. Permanent control of this complication can be achieved by resection of the artery without interposing a vascular graft. No cerebral damage will result. A great number of patients can be saved by the timely institution of proper measures.


[The diagnostic scope of ultrasonography in renal pathology (author's transl)].

The accuracy of ultrasonography in the diagnosis of different pathological renal conditions is evaluated. Correlations were established to the findings on intravenous urography and selective angiography. Ultrasonography is suitable for the determination of the exact size and site of the kidney and, therefore, should be used routinely in the follow-up of renal transplant recipients. The ability to differentiate between solid and cystic lesions is of partcular value. Moreover, perirenal changes are easily recognizable. The limits of B-mode sonography lie in the interpretation of central expanding lesions with a diameter of under 3 cm. This non-invasive method should be used selectively in the diagnosis of renal disease, whereas angiography should be limited to the classification of equivocal ultrasound findings and in the case of solid tumours.


[Frequency of cardiovascular risk factors in renal transplant patients (author's transl)].

The incidence of cardiovascular risk factors was studied in 83 renal transplant recipients: 84.3% showed at least one cardiovascular risk factor, hyperuricaemia was found in 42.2%, hypertension in 39.7%, hypercholesterolaemia in 31.3%, hypertriglyceridaemia in 27.7%, diabetes mellitus in 19.3%, obesity in 14% and nicotine abuse in 13.2% of the patients. Patients aged from 30 to 39 and 40 to 49 showed a mean incidence of 2.7 and 2.9, respectively out of the 7 investigated cardiovascular risk factors. The results demonstrate that renal transplant patients are a high-risk group for the development of degenerative cardiovascular diseases.


[Effect of 1,3,5-triazines on various bacteriophages and their hosts].

In the agar diffusion test 24 triazines were investigated with regard to their action on the mulplication of DNA phages (lambda and LPP-1) and RNA phages (M12 and Qbeta). In several cases the amount of plaques was diminished or increased depending on the kind of triazine and virus. The investigations demonstrate the triazines to be able to interfere with the formation of plaques by virulent and temperate viruses of procaryotes.


[Severe Klebsiella serogenes infections].

It is reported on 2 cases of Klebsiella-septikaemia with difficult course. Germs of the group Klebsiella aerogenes could be proved microbiologically. On the basis of the peculiarities of the clinical course the author adopts a definite attitude to the development of the infection, the pathogenesis, to the microbiological proof and to the aimed antimicrobial chemotherapy. The antibiotic treatment was successful in the first case with karbenicillin and gentamycin and in the second case with cephalotin and gentamycin during 4 weeks when a penicillin allergy was present and following this with chloramphenicol and streptomycin during 3 weeks.


Ultrastructural neurohistochemical evidence for a neuro-endocrine link in the regulation of the extra-hepatic biliary dynamics.

Electron microscopical neurohistochemical studies of the choledocho-duodenal junction of the cat revealed acetylcholinesterase-positve nerve terminals closely abutting on ("ectopic"), mono-amine(s)-containing alpha-cells (of the islets of Langerhans) scattered in small clusters between bundles of the sphincteric smooth muscle (of Oddi). The cell membrane of the alpha-cells at and near the site of the neuro-effector contacts was reactive, too. This finding may be considered as some evidence for cholinergic innervation of cholinoceptive neuro-endocrine cells, and obviously represents one of the neuro-endocrine links involved in the regulation of the extra-hepatic biliary dynamics, demonstrated earlier in physiological and pharmacological studies.


[Problems concerning head and brain injuries (author's transl)].

Treatment of patients with head and brain injuries is highly dependent on qualified initial care, diagnostic and therapeutic activities inside the clinic, the after treatment outside the hospital and rehabilitation. Every patient of this kind has to be observed for at least two days in a hospital. Before discharge the diagnosis has to be defined. The author proposes a new classification: slight, middle, severe and highly-severe brain injury.


[History of the obstetric and gynecologic publishing industry. 100th anniversary of the "Zentralblatt für Gynäkologie"].

A short survey on history of medical-scientific periodicals under special obstetrical and gynaecological aspects. To the end of the XIX century 1422 medical periodicals were edited in German language. 66 of them had a single or combined obstetrical-gynaecological title-theme. The development of of "Zentralblatt für Gynäkologie" were sketched with an especial appreciation of its founders H. Fritsch and H. Fehling.


The use of lysozyme-peroxidase-conjugates for the electron microscopic detection of peptidoglycan in the cell wall of streptococci.

Conjugation of lysozyme with horse radish peroxidase by means of glutaraldehyde results in a complex which retains the activities of both enzymes. The incubation of peptidoglycan with lysozyme-peroxidase followed by the reaction with 3,3'-diaminobenzidine and H2O2 results in a strong labelling of both sides. In contrast, after treatment with peroxidase alone no reaction was observed. Thus, the specific binding of lysozyme-peroxidase can be used for the electron microscopic localization of this component in the bacterial cell wall. Isolated peptidoglycane as well as trypsinized cell walls of group A and C streptococci were labelled both on the inner and the outer surface. The surface of intact cells of group A- and C-streptococci was labelled only sparsely. In contrast, by means of the indirect immunoferritin technique strong labelling of intact cells was effected with specific anti-peptidoglycan antibodies. The specificity of these antibodies are mainly directed to the peptide side chains. From this we suggest that in the cell wall of group A and C streptococci the lysozyme-sensitive part of the peptidoglycan is not so superficially localized as the peptides.


[Comparison of three serological methods for determination of antistreptokinase following fibrinolytic therapy (author's transl)].

By means of three different reactions, precipitation, passive haemagglutination and the determination of antifibrinolytic antibodies the formation of streptokinase antibody after streptokinase treatment was investigated. The earliest antistreptokinase we found with the passive haemagglutination reaction at day 4 on the beginning of streptokinase therapy. Precipitating and antifibrinolytic antibodies were found at day 7. One patient did not develope  precipitating, an other formed no haemagglutinating streptokinase antibodies, the reason is discussed.


Serogropus of escherichia coli in symptomatic and asymptomatic urinary tract infections in Christchurch.

525 isolates of E. coli were obtained from the urine of patients during episodes of urinary tract infection (UTI). Of these, 250 cultures were from asymptomatic patients, detected during screening of adolescent or pregnant women. The remaining 275 cultures were from patients who attended general practitioners with symptoms of UTI. When isolates were typed using commercial urinary E. coli O antisera, 39.2% from asymptomatic UTI and 32.4% from symptomatic UTI were non-typable. There were 29.2% autoagglutinating isolates from asymptomatic and 14.5% from symptomatic UTI. The most frequently isolated O serogroups were O6, O75 and O18. Numbers of O6 and O75 were higher in symptomatic UTI than asymptomatic: 20% and 15.3% compared with 8.8% and 7.2%. Distribution of other serogroups was similar for both series. Therefore the most striking differences were the greater number of autoagglutinating organisms in asymptomatic UTI and of O6 and O75 serogroups in symptomatic UTI.


Transferable antibiotic resistance in enterobacteriaceae isolated from urinary tract infections in general practice.

138 different coliform isolates from patients with UTI in 2 General Practices in Stockport, England, showed an incidence of drug resistance of 36%: 47% of these strains transferred resistance to E. coli K12. Multiple resistance, i.e. resistance to more than 2 drugs occurred in more than a quarter of resistant isolates and sulphonamide resistance was most common. More than twice as many strains in this series (1973--74) were sulphonamide resistant compared with a previous survey (1968--70). MIC values of R+ resistant isolates were much higher with sulphonamide resistant strains than the probable urine levels during therapy, but the situation with ampicillin and tetracycline levels was variable.


[Antibody pattern in patients with different forms of leishmaniasis (author's transl)].

Using the indirect fluorescent antibody test, leishmanial antibodies could be demonstrated in patients with Leishmaniasis. In 18 of 22 cases of kala-azar the titers ranged between 1:160 and 1:1280. In the complement fixation test the titers in patients with kala-azar varied between greater than 1:4 in one case and less than or equal to 1:512 in twelve of the 22 patients. Complement fixing antibodies could not be detected in five of the nine patients with cutaneous or mucocutaneous leishmaniasis. The indirect haemagglutination test proved to be not suitable for diagnostic purposes because it did not detect antibodies in nine out of 22 cases with kala-azar. The IgG fraction of the serum immunoglobulins was increased in most patients with kala-azar. Sensitivity and specificity of the three immunological methods are discussed with reference to the results in 832 undefined sera submitted for routine diagnosis.


[Immunodiagnostic results of amoebiasis. The value of counter immunoelectrophoresis in comparison to three other immunotests (author's transl)].

63 cases of extraintestinal amoebiasis, 17 cases of intestinal amoebiasis, and 25 selected control persons were examined for serum antibodies to antigen from E. histolytica using the counter-immunoelectrophoresis, the complement fixation test, the indirect haemagglutination test and the latex agglutination test. In addition counter-immunoelectrophoresis was applied to 41 sera from patients with extraintestinal amoebiasis whose other serological results were included in a previous study. Even with the employment of our immunological methods, the test results can be used for diagnostic purposes only when they are in accordance with the clinical picture and the exposure. Complete failures of the immuno-diagnostic tests did not occur in our study. On the other hand, there are persons with no symptoms of amoebiasis who have antibodies in two tests, among them sometimes the counter-immunoelectrophoresis, with levels corresponding to those of intestinal or extra-intestinal amoebiasis.


Photogrammetric target point determination in stereotaxy.

The photogrammetric determination of the target point in stereotactic operations enables a simplification of the photographic equipment and an avoiding of calculating errors during the operation. This is possible on the one hand by excluding the X-ray distortion also without distance taking and, on the other, by the use of a computer which is connected up to the stereocomperator. In addition to the continuous mathematical controls, a visual control of the spatial picture on the stereocomperator is possible.


[Conditions and factors determining the etiological structure of dysentery and its changes. Report 1. Epidemiological theory of etiological selectivity of the main (primary) pathways of infection and their differences in various nosological forms of dysentery].

The authors present the elaborated and formed epidemiological theory ("conformity theory") according to which the etiological structure of dysentery is determined by the etiological selectivity of the main (primary) waves of transmission of the infection differing in various nosological forms of dysentery. In Grigoriev-Shiga dysentery the domestic way of the spread of infection plays the main role, in Flexner and Newcastle dysentery--the water way, and in Sonne dysentery--the food way (particularly through the milk). Evolution of the etiological structure of dysentery serves as the reflection of evolution of the principal ways of transmission. The complex of prophylactic and antiepidemic measures in individual noslogical forms of dysentery should be differentiated and be directed in epidemiological sense to the neutralization of the corresponding main (primary) way of transmission of the infection.


[Specific experimental therapy in sensitization to group A streptococci].

A model of delayed hypersensitivity to Streptococcus hemolyticus, group A, were obtained in guinea pigs and rabbits. Studies of spontaneous changes of the immuno-allergic reactivity revealed that after a month of sensitization there developed delayed hypersensitivity only; according to the results of late skin tests it lasted not less than 6 months (the duration of investigation). The delayed hypersensitivity component began to manifest itself in 2 1/2 to 3 months and increased later on. Specific hyposensitization was performed with streptococcus allergens differing by physico-chemical conditions, i.e. the corpuscula allergen, the one that was lysed by ultrasonic waves, and Ando-Verzhikovsky's allergen. The latter had the most intensive hyposensitizing features. Specific hyposensitization was more demonstrative after the intracutaneous long-term course injections of threshold doses. Administration of subthreshold doses, as well as subcutaneous or intravenous injections of the allergen, was ineffective.


[Nature of inhibition of the activity of macromolecular antibodies].

The presence in the organism of an inhibitory factor expressing its activity under conditions of increased macromolecular globulins production (of M-immunoglobulins in particular) was established experimentally. The inhibitory factor depressed the avidity of the macromolecular antibodies; its appearance preceded reduction of the macromolecular protein level in the blood serum. The inhibitory effect of the blood serum in blood letting and vaccination with bacterial antigen is connected with the blood serum albumins, and with increased cystein and sulfhydryl groups concentration.


[Study of anaphylectic hypersensitivity manifestations to blood protein in guinea pigs with using the neutrophil damage test in vitro].

The paper is devoted to the study of hypersensitivity of anaphylactic type to horse serum in guinea pigs by means of neutrophil injury index in vitro. Simultaneously, for control, the same method was applied to the study of delayed hypersensitivity manifestations; for this purpose allergy to hemolytic staphylococcus was reproduced in these animals. The state of hypersensitivity of "anaphylactic type" against the foreign serum in guinea pigs was not accompanied by any enhanced blood neutrophil reactions, whereas high values of the test under study were characteristic of the process of guinea pigs sensitization with staphylococcus culture.


[Study of the immunological activity of blood in various rickettsial and viral infections].

The content of various types of antibodies were studied in the blood serum of laboratory animals in experimental tick-borne rickettsiosis of Northern Asia. This was done by a simultaneous staging of indirect hemagglutination, indirect hemolysis, compliment fixation under cold conditions, and agglutination with Proteus antigen OX19 tests. Immune horse sera to the influenza virus were also studied with the aid of several serological tests. The data obtained pointed to the significant differences in the properties of individual types of antibodies. Immunological activity of the sera under study depended on the correlation in them of various types of antibodies at various periods of the infectious process in combination with the influence upon the immunogenesis of the individual and species immunological reactivity.


[Ultrastructure of Clostridium tetani. I. Structural features of the surface structures of vegetative cells].

Crest-like structures formed by internal layer of cell wall and cytoplasmic membrane were revealed in G1.tetani 471 by electron microscopy with the use of negative contrasting, ultrathin sections and freezing-etching. The transverse section of these crest-like structures was 56.3 nm and they were localized 4 to 6 in one row girdling the protoplast in different directions. Ring-like subunits located in rows with the periodicity of 5.9 nm, perpendicularly to the long axis of the cell, were revealed on the surface of the cell wall.


[Resistance of Serratia marcescens to an etbylene oxide-methyl bromide mixture and the possibility of using it to control the effectiveness of disinfectant measures].

The authors studied the Serratia marcescens (strain No. 851) resistance to the okćbm mixture by the method of test objects in comparison with the vaccine virus (strain B-51) at a temperature of 20, 30, and 40 degrees C. Resistance of the mentioned bacteria to the okćbm mixture proved to be somewhat greater than that of the vaccine virus at 20 and 30 degrees C, whereas at 40 degrees C their resistance was found to be practically identical. This permits to use Serratia marcescens to control the efficacy of gaseous sterilization of materials.


[Effect of exogenous interferon on the transplantation reactions of mice].

The authors studied the influence of the serum obtained at various periods after the administration of interferon inductors (New castle disease virus, amino ethylisothiouronium, E. coli endotoxin) on the rate of rejection of the skin or cell transplant of mice C3H and CBA, and also CC57Br. The allogenous skin transplant perished more rapidly; there was also an acceleration of elimination of allogenous lymphoid cells, suppression of colony formation by the cells of allogenous bone marrow in the spleen of the irradiated recipient in administration of the serum obtained at the period of maximal content of interferon induced by the Newcastle disease virus and by amino ethylisothiouronium. The cytotoxic activity of lymphocytes of mice CC57Br against the allogenous target cells rose in the presence of these sera. The serum containing interferon induced with E. coli endotoxin failed to influence the rate of the allotransplant rejection and did not increase the cytotoxic activity of lymphocytes.


[Ribosomal dysentery vaccine. I. Method of production, physical and chemical properties].

Studies of A. and G. Youmans on the experimental tuberculosis led to discovery of a fundamentally new type of vaccines (ribosomal vaccines) which proved to be highly effective in the prophylaxis of many experimental infections. Therefore it seems reasonable to prepare analogous vaccine from Shigellae for the study of its efficiency in experimental shigellosis. Ribosomal preparations from Shigella sonnei were prepared by sonic disruption of microbial cells followed by differential ultracentrifugation according to A. and G. Youmans' method with slight modifications. The yeild of ribosomal fraction was about 2 per cent by weight; all the series had an UV adsorption maximum at 260 nm, the ratio OD260:OD280 being approximately 2. They contained about 55% of RNA, 35% of protein and no more than 8% of saccharides. As shown by centrifugation in sucrose gradient and by analytical ultracentrifugation the preparations were homogeneous. The presence of undissociated ribosomes was confirmed by electron microscopy. Thus, the ribosomal preparations obtained proved to be sufficiently purified for carrying out experimental investigations of their biological activity.


[Method of electrophoretic mobility of macrophages and its use in clinical immunology].

A test of measurement of the electrophoretic mobility of macrophages (EMM) is used for detection of the product secreted by the sensitized lymphocytes after the contact with the antigen. Thus, by reduction of the macrophage mobility it is possible to assess the sensitization level of the lymphocyte population under study. This offers a possibility of using this test for the diagnosis of some infectious diseases, for provisional diagnosis of malignant growth, and also of destructive affections of the nervous system. The EMM test finds wide application in the determination of compatibility of donor's and the recipient's tissues before the transplantation, and also to assess the efficacy of immunodepressive therapy.


[Differential characteristics of the I and II phases and R-form of Sh. sonnei].

Characteristics of various phases of Sh. sonnei were determined on the standard strains of Sh. sonnei of phases I and II and R-form used for the industrial production of agglutinating monoreceptor sera. Bacteria of phase I displayed a distinct morphological, cultural and serological differences. For the differentiation of Sh. sonnei of the II phase and R-form, representing the greatest difficulty in this respect, it is recommended to use phages RFfm and 6-SR, and also indirect immunofluorescence method with the application of agglutinating monophasic serum against the II phase of Sh. sonnei. In addition, a study was made of over 20 various Sh. sonnei strains at different dissociative process phases. Verification data completely confirmed the specificity of phages RFfm and 6-SR for Sh. sonnei in the II phase. The efficacy of the immunofluorescence method was confirmed on 6 strains.


[Experience with the diagnosis of dysentery in adults by determining antibodies to Shigella in the saliva].

Concentration of immunoglobulins and titres of antibodies to Sh. sonnei, Sh. flexneri and enteropathogenic E. coli 0111 was determined in mixed saliva and the blood serum of patients suffering from Sonne dysentery, acute intestinal diseases of unknown etiology, and healthy individuals. The sum total immunoglobulin concentration in mixed saliva proved to be 53--81 times less than in the blood serum, but in the first substrate there was 53--75, and in the second--15% of immunoglobulin A. There proved to be distinct changes in the specific IgA-antibodies in the saliva of patients with Sonne dysentery. A preponderant accumulation of IgG-antibodies was noted in the blood serum. Elevation of both types of antibodies was maximal during the second week of the disease. Sonne dysentery was diagnosed in 80% of the patients by recording the intensity of shifts in the specific antibodies in the saliva, and in 63%--in the blood. The expediency of immunological testing of saliva for the diagnosis of dysentery is substantiated.


[Effect of the transmission of a different type of mutation in the strA locus on the virulence of Sh. flexneri].

The authors noted a different influence upon the virulence of Sh. flexneri (determined by keratoconjunctival test) of transmission of different alleles of the strA-gene (A1, A2, A40, A60). There was revealed no correlation between the extent of the changes in virulence and the extent of capacity ot the limiting of suppression in donor strains.


[Serological method of detecting the antigens of the causative agent of Sonne dysentery in lysates of the fecal inoculates from patients].

Serological method of detection of Sh. sonnei antigens in the lysates of the patients, fecal cultures is suggested and approved. In the majority of cases of the results of bacteriological and serological methods of study of the feces coincided. Data confirming the specificity of the antibody neutralization test (ANT) in Sonne dysentery are presented. In connection with detection of the screening action of the Vi-antigen of typhoid bacilli there were elaborated additional methods for verifying the specificity of the ANT results. It is recommended to keep agar plates after selection of suspicious colonies during the bacteriological test; the lysate of the microbial crop should be additionally subjected to the ANT, this considerably increasing the percentage of laboratory confirmations of dysentery caused by Sh. sonnei.


[Comparative study of the virulence of the Shigella isolated from bacterial carriers and from acute dysentery patients].

The authors present the results of study of the virulence of shigellae isolated from carriers and patients suffering from acute dysentery, on a continuous culture of E1 and Hep-2 cells. The virulence of shigellae isolated from carriers displayed no significant difference from the virulence of shigellae isolated from patients with a mild and moderately severe forms of dysentery. In the patient's organism shigellae were capable of retaining the initial virulence for a long time, despite the treatment and the influence of the macroorganism's protective factors. The authors believe that this was connected with the capacity of Shigellae to parasitic life in the cells of human intestinal epithelium, and, apparently, played a definite role in the formation of carrier state.


[Morphological characteristics and biological properties of morphological mutants of Escherichia coli K12].

E. coli mutants K12, PA6021, and AB312 characterised by changed morphology were obtained. Various morphological elements encountered in the mutant populations, and the capacity to phenotypical reversion are described. Some other properties (cultural, tinctorial, mobility, osmotic stability) changed in the mutants under study in addition to morphology.


[Properties of E. coli of serological group 06:K13(L) isolated in acute intestinal diseases].

A study of 88 E. coli strains belonging to serological group 06: K13 (L) isolated from 50 children and 5 adults suffering from acute intestinal disturbances permitted to refer them to the serological types 06: K13 (L):H1 (82 strains) and 06: K13 (L): H--(6 strains), and to 5 biochemical types. Repeated isolation of E. coli belonging to serlogical group 06: K13 (L) in patients with acute intestinal diseases, and their absence in healthy children and adults indicated these microbes to be a possible etiological factor of the disease and to refer to the group group of enteropathogenic ones. Wide introduction of agglutinating sera 06: K13(L) into the work of practical laboratories is of expedience in connection with this.


[Quantitative assessment of antithymocyte antibodies in schizophrenia].

The use of the method of fluorescent antibodies and cytotoxic tests showed that the blood serum of schizophrenic patients and normals possess an antithymocytic activity. However, the level of this activity in patients exceeds the corresponding indices in normals (p less than 0.02). The use of indirect immunofluorescent methods permitted to demonstrate that the antithymic antibody titres in schizophrenic patients is much higher than in normals. The amount of the cytotoxic index is in direct correlation with the level of antithymic antibodies determined by the fluorescent antibody method.


The host cell fraction that increases the infectivity of bacteriophage f2.

A fraction that increases infectivity of bacteriophage f2 was isolated from uninfected E. coli cells. The greatest effect was obtained when the fraction was added to the phage reconstituted in vitro. The fraction isolated from the ribosome-free supernatant consisted of proteins, lipids, carbohydrates, and unidentified material. Cleavage of protein by the treatment with trypsin did not significantly affect the infectivity-restoring activity. It is suggest that lipids may play an essential role in the activity of the fraction isolated from the host cell.


Excessive foreign-body reaction following abdominal surgery. A case report.

A case with starch peritonitis following abdominal surgery is presented. The operative findings differ somewhat from those generally reported in the literature, since the severe pathological changes were localized, and furthermore demanded bowel resection.


Quantitation of somatostatin inhibition of insulin-stimulated gastric acid and pepsin secretion in the cat.

Somatostatin inhibition of gastric acid and pepsin secretion stimulated by insulin-hypoglycaemia was quantified in six conscious cats prepared with cannulated gastric fistulae. Somatostatin 0.5-5 microgram kg-1h-1 produced a dose dependent reduction of both acid and pepsin secretions stimulated by insulin 0.2 u kg-1h-1. The doses of somatostatin which produced 50% inhibition of pepsin and acid secretions (ID50) were not significantly different (0.70 +/- 0.16 and 0.93 +/- 0.11 microgram kg-1h-1 respectively). The slope of the calculated correlation line relating % inhibition of pepsin and % inhibition of acid is within experimental error of unity indicating equality of action of somatostatin on insulin-stimulated acid and pepsin secretion. The results indicate that somatostatin is a more potent inhibitor of insulin 0.2 u kg-1h-1 stimulated acid secretion than pentagastrin 8 microgram kg-1h-1 stimulated acid secretion, but is a more potent inhibitor of pentagastrin--than insulin--stimulated pepsin secretion. As insulin stimulates less acid and more pepsin secretion than pentagastrin, the differences in sensitivities to somatostatin of these secretions produced by the two stimulants is thought to be a result of the different absolute amounts of secretion produced by the stimulants.


Baclofen trial in six myotonic dystrophy patients.

Six young adult patients with grade I myotonic dystrophy and a complaint of daytime somnolence underwent 36-hour polygraphic monitoring, dynamometric and electromyographic studies before and under baclofen (60 mg/daily). Patients with the most severe daytime sleepiness had pathologic Sleep Apnea Indexes. After 6 weeks' ingestion of baclofen, no subjective or objective effect on patient symptomatology was found.


Levamisole in multiple sclerosis; with special reference to immunological parameters. A pilot study.

Nineteen patients with multiple sclerosis (MS) have been given one course of levamisole therapy, and 16 patients two courses of levamisole treatment in daily dosages of 100--150 mg over two periods lasting from 1 month to 22 weeks each. Clinical effect was evaluated using Kurtzke's disability status scale. Immediate clinical evaluation showed that 15 patints remained unchanged, two improved and two became worse. Follow-up revealed after 4--14 months that another four patients deteriorated and none improved. Altogether 10 patients developed 13 relapses. During this brief therapy, no convincing conclusions may be drawn regarding an influence upon the course of the disease, although there is the suggestion that levamisole was not beneficial in MS patients. There was no statistically significant effect of levamisole on peripheral blood lymphocyte count, lymphocyte stimulation tests, leucocyte migration inhibition tests, short and long incubation E-rosette forming cells and serum IgA, IgG or IgM levels. A group of MS patients showed after 1 month of levamisole treatment either short-lasting restored or potentiated skin hypersensitivity to bacterial and fungal antigens (P less than 0.05).


A double-blind clinical trial of a guanethidine/adrenaline combination, compared with the two separate components, in glaucoma.

In a double-blind cross-over study, the intraocular pressure-lowering action and side effects of a 5% guanethidine/1% adrenaline combination were studied and compared with those of two components alone. The subjects were 63 glaucoma patients divided into three random groups given the three preparations in a different order. The pressure-lowering effect of the combination is significantly better (P less than 1%) than that of either component alone but the side effects were more severe.


[Clinical study of sodium dantroline (Dantrium) in multiple sclerosis (author's transl)].

The authors have studied the antispastic action of Dantrium in 50 patients with multiple sclerosis; in all cases, hypertonia, spasms or clonus constituted a severe obstacle to remedial therapy or nursing. After one year, the authors have found that Dantrium is effective in reducing hypertonia in 40% of the patients, in improving spasms in 65% and in reducing clonus in 50% of the cases. Secondary effects are fairly frequent (60%), characterized in most cases by diminished muscular strength and greater fatigability.


Diclofenamide in the treatment of therapy-resistant epilepsy.

An average daily dose of 33 mg of diclofenamide, a carbonic-anhydrase inhibitor, was added to the anti-epileptic medication already employed in 105 cases of severe epilepsy which had shown insufficient clinical improvement. A favourable action on seizures, often accompanied by an improvement in the EEG tracing, was observed in 83 cases. The effect was of long duration in 47 cases in that it lasted for more than a year. It persisted for one to twelve months in a further 17 cases, while in 19 patients, who had reacted favourably to the treatment, medication had to be suspended because of intolerance.


Binding of aggregated IgG in the presence of fresh serum by group A streptococci producing pharyngeal infection: possible connection with types frequently involved in acute nephritis.

109 streptococcal strains, belonging to diverse serological groups and types, were investigated as regards their capacity to bind IgG aggregates in the presence of fresh serum. Strains capable of such binding were not found in groups B,C,D,E,G,L,M or N. Such binding was restricted to a few types of group A streptococci: the potentially nephritogenic types 2, 6 and 12, and four strains belonging to type M 39, M 46 and M 22 or M 62, the nephritogenic capacity of which is unknown. Two of five strains isolated from patients with acute post-stretococcal glomerulonephritis (AGN) and 19/28 type T 12, SOR-strains, isolated during an epidemic in a kindergarten with associated cases of AGN, were found to bind aggregates. The findings suggest a possible association between capacity to bind aggregates in the presence of serum and the serological types of group A streptococci involved in acute nephritis following pharyngeal infection.


Maintenance treatment of chronic schizophrenic patients. A study with the long-acting thioxanthene derivative, cis(Z)-clopenthixol decanoate-sordinol depot.

The clinical effect of clopenthixol decanoate has been assessed in a 5-month controlled including 21 hospitalized chronic schizophrenic patients. The ratings were done with BPRS, NOSIE 30, the two psychological tests of WAIS and Grübaum, and the rating scale of Simpson & Angus to assess extrapyramidal side effects. Clopenthixol decanoate was found an effective and long-acting antipsychotic compound with few autonomic and neurological side effects. Compared with previous maintenance treatment it also showed a positive influence on depression and facilitation of the social adaptation of the patients.


[Immunofluorescence in the serodiagnosis of human hydatidosis].

Of the serological methods for the diagnosis of hydatid cyst immuno-fluorescent technique using frozen section of the scolex as antigen has given encouraging results. In the present study examination of 85 sera corresponding to hydatidose patients by this méthod, has shown that 94% of the cases can be detected with this high sensitivity technique. And this method can be considered as one of the best serological methods for the diagnostic of Echinococcosis.


Cytostatic treatment of glomerular diseases. IV. The effect of combined immunosuppressive treatment on serum creatinine and proteinuria evaluated by sequential statistical analysis. Report from a Copenhagen study group of renal diseases.

Sequential statistical testing of the development of the disease in the single patient was used in the assessment of immunosuppressive treatment of renal glomerular diseases. After an initial period of prednisone (P) treatment, this was supplemented first by azathioprine (A) and later in addition by cyclophosphamide (C). The time of transition from one treatment to another was determined by the result of the current statisical testing of the correlation between serum creatinine concentration and proteinuria on the one hand and the time and the varying doses of the drugs on the other. Twenty-nine patients entered the study. Thirteen were withdrawn, eight for technical reasons, three due to side-effects and two on account of renal deterioration and transfer to dialysis treatment. Eight patients were cured, one during P treatment, five during P + A, and two during the combination of P, A and C. Eight patients completed treatment without being cured. In the overall material no statistically significant change in serum creatinine was noted, whereas the proteinuria decreased during P + A and P + A + C. No dose-dependent therapeutic effect of the drugs was demonstrated. In conclusion, this combined treatment with P, A and C did not seem to yield any major therapeutic progress. The technic of sequential statistical testing may be a useful tool in clinical research.


Glomerulonephritis in dermatitis herpetiformis. A case study.

A patient with dermatitis herpetiformis, proteinuria and reduced renal function is described. A renal biopsy studied by light and immunofluorescence microscopy revealed a glomerulonephritis with deposits of predominantly IgA and complement C3. Deposits of IgA and C3 were also demonstrated in a biopsy from normal skin, and a common pathway for the skin and renal lesions is suggested.


A prospective study of streptokinase and heparin in the treatment of deep vein thrombosis.

In a prospective trial, 42 medical patients with a history of deep vein thrombosis of less than five days were allocated at random to treatment with streptokinase or heparin. Only patients with extensive thromboses were included. Streptokinase was given in a loading dose of 250 000 IU and a maintenance dose of 100 000 IU/hour for 4 days as a mean. Heparin was given in a loading dose of 15 000 IU and a maintenance dose of 20 000-50 000 IU/day. The therapeutic results were evaluated by phlebography. Significant thrombolysis occurred in 71.4% of 21 patients treated with streptokinase and in 23.8% of the 21 heparin-treated patients. Using the chi2-test for overall association, this difference was statistically highly significant (p = 0.002). Three patients in each treatment group experienced major bleeding, two in each group requiring blood transfusions. Minor bleeding and slight rise in temperature were encountered more often in the streptokinase than in the heparin group. It is concluded that patients with acute deep vein thrombosis with proximal extension of the thrombus beyond the calf veins should be offered a therapeutic trial with streptokinase.


A controlled clinical trial of streptokinase and heparin in the treatment of major pulmonary embolism.

Treatment with streptokinase or heparin was allocated randomly to 20 patients with major pulmonary embolism verified by angiography. In addition, 4 patients treated with streptokinase and 1 patient treated with heparin were included in the trial prior to the start of treatment. Streptokinase of heparin was given for 72 hours and pulmonary angiography was repeated. The angiographic evidence of thrombolysis was significantly greater (p less than 0.01) in the 14 patients treated with streptokinase than in the 11 treated with heparin. In the heparin group, 1 patient died from massive embolism 15 hours after the start of treatment. In another patient who died 4 weeks later from cerebral glibolastoma, persistent massive embolism contributed to the fatal outcome. In the streptokinase group, 1 patient with a metastatic pulmonary carcinoma died 3 weeks after the start of treatment from gangrene of both legs following thrombotic occlusion of the inferior vena cava. Bleeding was more common after treatment with streptokinase than with heparin, but was not a serious problem in any patient. It is concluded that patients with life-threatening pulmonary embolism should be offered the benefits of streptokinase.


The concept of identity: research and theory.

The concept of identity is one of the few themes of psychosocial theory that has been researched directly. The dichotomy between identity achievement and role diffusion can be more accurately understood as two potential statuses among a number of resolutions to the identity crisis. Identity status appears to be related to significant childrearing experiences, particularly to dimensions of warmth, limit setting, values of autonomy, and achievement orientation. The pattern of identity achievement is different for males and females. Successful achievement of identity reflects different parental child-rearing practices for males and females.


Restorative chemotherapy in degenerative hip disease.

Twenty patients with degenerative joint disease (DJD) of the hip were treated for prolonged periods with an extract of cartilage and bone marrow. Although clinical improvement, lessened joint pain and increased function, occurred in a majority of the patients, the most significant changes were in four who had concomitant x-ray improvement. These patients had roentgenographic evidence of recovery of joint space and regeneration of the femoral head. Discussion is presented of possible mechanisms by which this tissue extract induces changes in chondrocyte metabolism. A theory is proposed to explain DJD as a multifactorial disorder in which liver impairment in processing growth hormone is the key malfunction. Treatment of DJD of the hip by injections of the tissue extract of cartilage and bone marrow is a rational and effective therapy without significant toxicity.


The Schultz-Dale reaction: a review.

Vascular (pulmonary and hepatic blood vessels) and nonvascular (gastro-intestinal, reproductive and respiratory systems) smooth muscle preparations obtained from specifically sensitized animals of numerous species including man contract to specific antigen in vitro (Schultz-Dale phenomenon). This immunopharmacological technique is a useful tool to demonstrate immediate-type hypersensitivity in actively or passively sensitized tissues and may be used to investigate the nature of the principal pharmacological mediators involved in a particular tissue as well as to screen anti-anaphylactic (anti-allergic) drugs. However, much remains to be investigated on the complex mechanisms of action of antigen, desensitization and resensitization (recovery) of anaphylactic responsiveness.