[Innervation of the autotransplanted lung. Experimental study].

The authors investigated the changes of the nerve-structures after autotransplantation of a lung or the lobe of a lung as well as the moment and the kind of recovery of the innervation after the operation. 186 autotransplantations of the left lung or of one lobe of a lung was done by experiments on healthy mixed breed dogs. The longest time of observation was 9 years. The authors found out that there developed changes in the nervetracts in the wall of the main bronchus and the lung artery after autotransplantation. The majority of the nerve-cells in the ganglions of the bronchuswall in the autotransplanted lung succumbs an abundant destruction at several times after the operation. However the structure of a part of the nerve fibres, distal of the bronchus- and the lung artery anastomoses, will remain simultaneously. The regeneration of the nerve structures in the wall of the bronchus and of the lung artery, distal of the anastomoses, already begins in the first weeks after the autotransplantation and continues for 4 to 6 months. The authors could not find any convincing morphologic findings for the utter regeneration of the peripheric nerve-structures in the lung parenchyma. This circumstance can be the cause for the absence of the Hering-Breuer reflex for a long time after the autotransplantation.


[The microbiological cancer test--further studies with experimental mouse tumor tetanus and wound tetanus].

A re-evaluation of the specificity of the tumour-tetanus assay of the mouse was performed by analysing the wound-tetanus assay under comparable test conditions. This was achieved by injecting 1 X 10(6) viable Ehrlich carcinoma cells admixed with 1 X 10(2) tetanus spores subcutaneously, in a 0.1 ml dose volume or, 1 X 10(2) tetanus spores suspended in 5% CaCl2 solution, respectively. By comparison, these two groups of mice developed about the same tetanus mortality rates, however, following tetanus antitoxin therapy with 3 doses of 100 IU each day on days 0, 4 and 7 after infection, clinical signs of late tetanus exclusively belonged to tumour bearing animals. This typical tetanus behaviour may be explained by a spatial-temporal association between growing tetanus rods and proliferating cells of warm-blooded animals. In this manner tumour tissue can be differed from wound granulomatous tissue by way of permanently cloning stem cells.


[Review of the development of air humidifiers working on the principle of evaporation with reference to their experimentally assured efficacy].

Basing on own measurements of the efficiency of customary water-bath humidifiers (humidifier of the ventilator RO-5 R, humidifier of the ventilator Engström ER 200, Bennett Cascade Humidifier, Hydrotrop 200 and Nicholas Humidifier) a critical review is given. As the results show only 3 of the humidifiers (Bennett Cascade Humidifier, Hydrotrop 200 and Nicholas Humidifer) make sure a really breathing air "conditioning" (moistening and rewarming). The humidifers of the ventilators RO-5 R and Engström ER 200 have only a very low efficiency, therefore they are not suitable for long term ventilation. Finally, the safety for the patient (the dangers of watercondensation, watertransport into the lungs, overheating, hypothermia and superhumidication) and the different expenditure of the clinical use of the humidifiers should be mentioned.


[Secretion of acid, proteolytic activity and gastric juice at normal subjects and duodenal ulcer patients (author's transl)].

The basic and with pentagastrin stimulated (dose response) secretion of acid and proteolytic activity of the stomach were estimated at five healthy volunteers before and after a six-week-antacid-therapy as well as at ten patients with duodenal ulcer disease. After a six-week-antacid-therapy the BAO and the basic proteolytic activity were reduced for 50% as compared to the healthy volunteers without it while the maximal stimulated secretion of acid and proteolytic enzymes was not altered. After a three-day-antacid-therapy these changes did not occur. The basic acid output (BAO) was increased for 60% and the basic secretion of proteolytic enzymes was increased for 50% at duodenal ulcer patients. The changes of the gastric juice volumes at the different steps of stimulation and within the three groups of patients do not seem to be correlated constantly to the changes of secretion of acid and proteolytic activity. After a three-day-antacid-therapy, however, the volume of the basic and stimulated gastric juice turned out to be identically reduced as after a longtime antacid therapy. These results suggest that the secretion of acid, proteolytic activity and gastric juice occur independently.


The ultrastructural characterization of the tegument of Clonorchis sinensis (Cobbold, 1875) cercaria.

The tegumental ultrastructure of the cercaria of the liver fluke, Clonorchis sinensis (Cobbold, 1875), was studied by scanning and transmission electron microscopy. The body surface is almost encircled by many rows of regularly arranged spines. The tegumental syncytium of the body contains many rod-shaped dense granules and central electron-lucent bodies, neither of which are present in the tail tegument. There are four rows of hooked teeth and modified spines on the oral cone. These teeth are differentiated morphologically and probably functionally from the other body spines. Disc-shaped papillae with long or short cilia are distributed on the body in a bilaterally symmetrical pattern dorsally and ventrally. There are 30 to 37 papillae with much longer cilia laterally. Four pairs of papillae were found on the tail. From their structure and location these papillae appear to have a mainly tango- or rheoreceptive function. Another type of sheathed papillae is situated around the oral sucker. The cuticular tegument is expanded laterally at the base of the tail, forming a characteristic sac-like structure.


Vaccination against virus diseases.

One of the most important and most lasting benefits of medicine to human health and health expenditure is the controlled immunological interruption of the vicious cycle of infectious disease such as smallpox, poliomyelitis, yellow fever, measles. Smallpox, with globally more than 2.5 million cases ten years ago, is gone. The incidence of infectious diseases with available immunoprophylaxis has been reduced by 90 % over the past two decades, while the incidence of diseases without vaccine has nearly tripled. By contrast, influenza, a disease against which there have been vaccines in existence for many years, demands more deaths than any other infectious disease. Reasons for this failure of influenza immunoprophylaxis are discussed and suggested to include: indiscriminate use of available vaccines of which some types are much less antigenic than others, the disappointment that influenza virus vaccines will not protect against influenza-like illnesses caused by noninfluenza virus pathogens and the concomitant indiscriminate rejection of all influenza vaccines as being of doubtful value; superficial vaccination policies which aim at narrow populations, leaving those most likely to spread the virus the full potential to do so; the unjustified fear of side reactions following vaccination which are considerably less severe than the disease this vaccination is attempting to prevent.


[Quantitative angiographic studies for the differential diagnosis of early acute kidney failure of ischemic and rejection-damaged grafts].

On 22 auto- or homotransplanted kidneys of dogs a quantitative angiographic evaluation of the corticalis perfusion was carried out. For this purpose four special parameters were evaluated. With the help of the linear discriminance analysis we succeed in a sufficient secure separation between autografts impaired by ischaemia or shock on the one hand and homografts impaired by rejection on the other. It is referred to the prognostic significance of angiography in human graft kidneys with disturbed function.


[Myorenal (crush) syndrome from the nephrologic and urologic viewpoint].

The following measures contribute to the decrease of lethality in the crush-syndrome: 1. possibly rapid rescue measures with simultaneous infusion therapy, if technical difficulties delay them, 2. beginning of the infusions on the spot, particularly solutions of sodium bicarbonate, concentrated glucose solutions, remedies of blood substitute, but no blood transfusions, 3. transport into a hospital with possibilities of dialysis, 4. early fasciotomy or amputation, 5. early haemodialysis, 6. adequate antibiotics, 7. sufficient supply of calories and protein, perhaps infusions of amino acids.


[Physiologic views of A. N. Radishchev].

The analysis of A. N. Radischev's treatise "On man, his mortality and immortality" reveals a number of ideas which show that the author had a materialist approach to the problems, which in modern terms are the problems of the higher nervous activity. A great Russian materialist thinker, he naturally had a considerable influence on the formation of the materialist school in the national science, in particular in physiology. Hence considerable attention in the history of this field of knowledge should be given to Radischev and his works.


[Clinical experience obtained from attention to and delivery of pregnant women with diabetes mellitus with insulin treatment required (author's transl)].

Perinatal mortality recorded from 87 patients with diabetes mellitus requiring administration of insulin was 6.66 per cent between 1975 and 1977. The authors' results are compared with those obtained at different obstetric centres and discussed. Optimum regulation of metabolism and full utilisation of all diagnostic facilities available during pregnancy were found to be essential to individual delivery in the closest possible vicinity of the calculated term.


Nasal system for application of CPAP in treatment of newborn infants with moderate respiratory insufficiency.

The authors describe their own modified apparatus for nasal application of CPAP to newborns. Plastic cannulas are used. Their lengths and diameters depending on the sizes of nasal passages of the infants concerned. The whole system is based on a distributor-holder to direct gas flows, as required. - The system so far has been used on 30 newborns of all gestation ages with moderate respiratory insufficiency.


[Blastomyces infestation of vagina, oral cavity, and rectum of young women, with particular reference to promiscuity (author's transl)].

Venereological patients (Group I, n = 210), intact women without any gynaecological disease (Group II, n = 125), pregnant women close to full term (Group III, n = 200), and women with vaginal fluor (Group IV, n = 380) were examined and compared for the occurrence of blastomyces, particularly Candida albicans (C. albicans), in the vagina, oral cavity, and rectum. The presence of C. albicans in vaginal secretion was established from 15.7 per cent of all probands in Group I, 12.0 per cent in Group II, 24.0 per cent in Group III, and 31.6 per cent in Group IV. The difference between Groups I and II was not significant. Promiscuity, consequently, did not seem to have major impact upon vaginal blastomyces infestation of young women. Probands with rectal infestation of C. albicans accounted for figures between 20.0 and 27.5 per cent in all four groups. Group I took first position in oral infestation of C. albicans, the figure being 64.8 per cent which was significantly above those recorded from all other groups, between 33.9 and 37.5 per cent. The correlations between rectal and vaginal occurrence of C. albicans are discussed.


[To the historical development of the abdominal radical operation (author's transl)].

The most important stages in the development of the abdominal radical operation of the carcinoma of the cervix are discussed. These different stages are associated with the following names: Freund and collaboratores; Ries, Rumpf, Clark, Latzko; Wertheim; Bumm; Latzko and Schiffmann; Okabayashi and Meigs. After having reached the limits of the radicality with respect the extirpation of parametrial tissue samples the main emphasis should be the complete lymphonodectomy in the future.


[Use of phase-contrast and interference-contrast microscopy for immediate cytological tests in gynaecological practice (author's transl)].

Vital cytological tests of cervical smears obtained from 1,083 patients in a gynaecological practice are reported. The smears had been taken in search for malignant changes, in addition to the need for appraisals of ovarian function and vaginal flora. Smears which produced suspicious colposcopic and vital cytological findings were restained by means of Papanicolaou stain. The diagnoses based on both methods were compared. The results have confirmed the vital cytological technique to be extremely suitable for functional and flora diagnosis, while the Papanicolaou method was found to be superior to vital cytology in cancer screening.


[Immunology of pregnancy -- more recent aspects of immunological mother-child relations (author's transl)].

An account is given of some topical aspects relating to immunology of pregnancy, with reference being made to more recent literature. Included are hypothetical considerations on undisturbed embryonic development, the barrier function of the placenta, the ontogenesis of the immune system, immunosuppressive factors of pregnancy serum, the macrophage function of placental cells, pregnancy proteins, and immunological peculiarities of EPH gestosis.


[Complications of immunosuppressive therapy after kidney transplantation].

The complications of immunosuppresive therapy that occurred in a series of renal transplant patients presented were many. Of the total 28 renal transplants performed in Sarajevo, 25 were observed. These complications were diagnosed in 19 cases (6 of which exited), Death in each case was due to virual and not bacterial infection which occurred most often in the lungs. No urinary infections occured in any of these cases. The actual cause of death in most of the patients was most frequently due to pneumocystis and alveo-capillary block of the lungs which is very difficult to diagnose. When this complication presented itself the method of choice was rapid manipulation of the immunosuppressive therapy together with the administration of concentrated granulocytes which did not significantly impair the function of the grafted kidney in any of the cases save those with cortizone diabetes. High body temperature was also of diagnostic importance. The authors feel that quick action and accumulated clinical experience prevent the fatal outcome of many renal transplant patients with complications from immunosuppressive therapy.


Immunological studies on synovial joint membranes in psoriatic arthritis.

Psoriatic arthritis (PA) is included in the seronegative arthritis group, though it is now generally considered to represent a clinical entity. In PA, in contrast to psoriasis vulgaris and to other types of rheumatoid arthritis, only a few immunological studies have been reported. In the present report synovial joint membranes from patients with PA and control groups have been studied for the presence of (a) vascular changes, (b) fibrin, (c) immunoglobulins and complement factor C3.


Immunohistochemical study of dermal cell popoulation in psoriatic skin.

As demonstrated by means of an immunoperoxidase technique, the great majority of the infiltrating mononuclear cells located in the superficial and middle dermis of psoriatic skin consisted of T-lymphocytes. On the contrary, immunoglobulin bearing cells, investigated by means of both immunoperoxidase and immunofluorescence methods, were scarce; IgA and IgG cells were predominant, whilst IgM cells were scarcely represented. Macrophages and monocytic cells were observed in the superficial dermis by means of the alpha-naphtyl-acetate-esterase method, in frozen sections. The role of the above mentioned cells and the significance of their reciprocal relationships still remains in discussion.


Insulin receptors in psoriasis.

We have demonstrated how in psoriasis, irrespective of any diabetic family history, there exists a state of hyperinsulinism with a decreased resistance to insulin, which is aggravated by obesity. Since reviewing the latest studies concerning diabetes at the receptor level, we have carried out a comparative study dealing with insulin receptors in lymphocytes in homogeneous groups of normal, obese, and psoriatics of normal weight and overweight. We have also made a comparison regarding the behaviour of the receptors in these various metabolic states.


Insulinogenic indexes in psoriasis.

We have earlier demonstrated that in psoriasis there exists a reduced tolerance to carbohydrates in association with hyperinsulinism. To pursue this problem further, we felt it worthwhile to deal with the results of the oral glucose tolerance test performed on 78 subjects (divided into homogenous groups of normal, obese and psoriatic groups, both with and without diabetic genetic history and obesity) with determinations of both blood glucose and blood insulin levels. We have calculated the insulinogenic indexes by using the techniques elaborated by various authors (I/G, delta I/delta G, AI/AG) and we have then carried out a statistical evaluation both of these indexes and of the ratio between the various indexes employing not only the usual techniques but also that of correlation and simple and multiple regression. We have done this in order to evaluate which of these indexes is better suited to demonstrate the physiopathological mechanism concerning the relationship between insulin hypersecretion and reduced carbohydrate tolerance in the various pathological conditions which we have dealt with.


Cellular and humoral immunity in psoriatic patients.

The degree of cellular immunity was found to be reduced in about 23% of 56 psoriatics, especially so in those with flexural and arthropathic lesions. Humoral immunity was only slightly reduced. Lysozyme activity levels in serum were normal, while those of healthy skin were depressed in 6 patients.


Influence of the purity of the iodinated tracer on the specificity of the radioimmunoassay of human follicle-stimulating hormone.

The objective of this study was to establish whether [125I]hFSH subunits are formed during iodination of hFsh by a mild (lactoperoxidase) technique, and if so which fractionation procedure provides the best separation of [125I]hFSH from its subunits. In addition, the effect of the 125I subunits on the specificity of the hFSH radioimmunoassay technique was examined. The products of iodination of hFSH were fractionated by a number of techniques consisting of low and high resolution gel filtration procedures and adsorption on either cellulose of Concanavalin A coupled to Sepharose. The efficacy of the adsorption methods was assessed by a subsequent high resolution gel filtration procedure (Ultrogel AcA 54). Radioreceptor and radioimmunoassay methods were used to monitor the profiles of hFSH, hFSH alpha and hFSH beta subunits and to assess the recoveries of radioreceptor-active hFSH obtained by the different procedures. Iodination of a highly purified hFSH preparation invariably resulted in the formation of both [125I]hFSH subunits. The proportion of radioactivity associated with the 125I subunit peak to that of the [125I]hFSH peak was 10% when the iodination products after low resolution gel filtration were fractionated by a high resolution gel filtration procedure. The corresponding amount of subunits obtained by adsorption on cellulose and Concanavalin A was 71% and 6%, respectively. Thus in comparison with low resolution gel filtration there was a partial separation of [125I]hFSH from [125I]hFSH subunits on Concanavalin A while no separation was effected on cellulose. In fact, the results suggest that 125I subunits were formed during fractionation on cellulose. The recoveries of hFSH activity following fractionation on cellulose and Concanavalin A were significantly lower (27% and 65%) than those obtained by either low or high resolution gel filtration techniques. A marked reduction ;n the specificity of the RIA of hFSH was found when [125I]hFSH subunits rather than [125I]hFSH were used as tracer in the assay. It is concluded that the presence of 125I subunits in [125I]hFSH preparations used as tracer in the RIA of hFSH can diminish the specificity of the assay. The routine employment of a high resolution gel filtration procedure which provides a complete separation of 125I subunits from the intact hormone, is suitable for the elimination of this source of assay invalidity while the other fractionation procedures tested (cellulose adsorption or Concanavalin A) are not.


Heat, cold and inflammation.

Although therapeutic heat and cold measures are widely used in rheumatic diseases, their application in joint inflammations is still broadly empirical. Animal experiments concerning the effects of systemic hyperthermia and of local heat and cold applications upon experimentally induced inflammations (dextran edema, formol edema, kaolin edema, carrageenan edema, adjuvant arthritis) show that some inflammations are significantly depressed, i.e. they are effected by a useful therapeutic influence, but that cold and heat can also act as enhancing inflammatory stimulus. Under certain conditions, whole-body hyperthermia has immuno-suppressive effects. Although the exact points of intervention of heat and cold investigations, acute exsudative inflammations seem to be better influenced by cold; on the contrary, chronic torpid and proliferous inflammations are better influenced by heat. Prostaglandin mediated inflammations can be aggravated by cold, because it stimulates the prostaglandin synthesis; acute exsudative inflammatory processes are most often aggravated by heat. These results show that both therapeutic agents should be applied within a well-defined range and with care.


Prolactin-secreting pituitary adenoma in a man with gigantism: a case report.

A prolactin-secreting pituitary adenoma was removed trans-sphenoidally from a 37 years old man with gigantism (218 cm). Serum levels of prolactin (PRL) were elevated pre-operatively and decreased after administration of L-Dopa with no increase after TRH as is usually observed in PRL-secreting adenomas. Growth hormone (GH) and somatomedin serum levels were normal with no modification of GH after insulin hypoglycemia, oral glucose loading or L-Dopa. Morphological examination of the tumour demonstrated the presence of lactotrophs by light and electron microscopy and by immunofluorescense staining. No somatotrophs were found. In this unique case, the relationship between a PRL-secreting adenoma and gigantism is discussed.


Studies on a protein synthesis dependent step in LH release by LH-RH.

The hypothesis that LH-RH induces LH release partly through a protein synthesis dependent step (protein factor) was further investigated using two different experimental designs. First, during incubation of pituitary glands of intact dioestrous female rats with a maximally active concentration of LH-RH, the inhibitor of protein synthesis cycloheximide was added at various times after the beginning of the incubation. The results show that it takes a relatively long time, i.e. more than 1 h of exposure to LH-RH before the amount of the protein factor has increased sufficiently to allow a maximal LH secretion. Secondly, LH-RH was injected iv after which the protein factor was assayed by incubating the pituitary glands with a maximally active concentration of LH-RH in the presence of cycloheximide and measuring LH release in vitro. It was found that 1 h after the injection sufficient protein factor was present to permit an elevated response to LH-RH. This response could be suppressed by injecting cycloheximide prior to LH-RH. When the interval between injection of LH-RH and beginning of the incubation was increased to 2 h, LH release in vitro decreased again. However, ovariectomy immediately before LH-RH injection resulted in maintenance of the elevated response toLH-RH in vitro, indicating a role of the ovaries in this phenomenon.


The use of 2-molar urea as a hemolyzing solution for cytologic smears.

A technique for using 2-M urea as a hemolyzing agent not only for fresh smears but also for previously stained smears is described. It is simple, inexpensive, rapid acting and easily prepared.


Clinical significance of specific gravity of spinal anaesthetic agents. Two double-blind studies with hyperbaric 5% lidocaine.

In two double-blind studies two hyperbaric 5% lidocaine solutions containing glucose in concentrations of 75 mg/ml and 50 mg/ml, respectively, were compared. The onset and total onset time, spread, intensity, duration of analgesia and motor block were studied. The spinal anaesthesia was given with the patient either sitting or in the lateral recumbent position. A tendency to a longer duration of anaesthesia near dermatomes Th X-L II and L IV-L V was noted in the group of patients in the sitting position and receiving lidocaine with a lower glucose concentration. Otherwise there were no differences between the two lidocaine solutions. The result shows that the glucose concentration can be reduced from 75 to 50 mg/ml in "heavy" lidocaine without any clinical disadvantage. This means a more isotonic solution in relation to the cerebrospinal fluid, resulting in milder osmotic effects on interspinal structures.


Enflurane in renal transplantation: report of 375 cases.

Our experience to date covers 675 kidney grafts performed in the Transplantation Department of the University of Louvain. The evolution of our anaesthesia methods has led us since the end of 1973 to conduct 375 transplantations with enflurane. The patients, aged between 18 months and 50 years, receive a conventional premedication, do not receive corticoids preoperatively nor undergo dialysis immediately prior to operation, but systematically receive a 5-unit transfusion beforehand. Having successively abandoned gallamine, succinylcholine, thiopentone and finally halothane, our present anaesthetic protocol is as follows: induction under benzodiazepines, fentanyl and enflurane, intubation under laryngeal anaesthesia. Maintenance: enflurane (2--3 MAC hours) in open circuit, pancuronium (0.02 mg/kg/h) and occasionally fentanyl. Details and comparative advantages are discussed. This anaesthesia technique combined with the systematic administration of antilymphocytic and antithymocytic serum in the postoperative period, and particularly the preliminary transfusion (producing blocking antibodies), has provided us, using cadaver kidney, with a survival rate of 96% at 6 months, 86% at 1 year and 80% at 2 years, the longest presently being 15 years.


A simple method of preparation and identification of cells for scanning electron microscopy.

A simple and inexpensive method of cell preparation for scanning electron microscopy (SEM) is described. This method allows for rapid identification of the same cells under the light microscope and by SEM. The method does not perceptibly alter the ultrastructural surface features of target cells. It is applicable to all cells in suspension, and its performance has been tested on human urinary sediment and effusions.


[Myoclonus in Alzheimer's disease. 2 anatomoclinical cases].

A few autopsy proved cases of Alzheimer's disease with myoclonus have been hitherto reported. We think that myoclonus is a frequent clinical feature in advanced cases of Alzheimer's disease. Our second case is such an example with a chronic evolution. In cases like our first one, with a short history, myoclonus, and atypical, diphasic, periodic complexes in the EEG, clinical differential diagnosis with Creutzfeldt-Jakob disease can be very difficult. Alzheimer disease has been considered an unitary clinico-pathological entity.  However, transmission to the non human primates has been successfully achieved only in familiar cases but no in the sporadic ones. On the other hand some of his neuropathological features have been found in two cases of Creutzfeldt-Jakob disease, one of them successfully transmitted to the chimpanzee. All these points could eventually modify our present unitary concept on Alzheimer's disease.


Puerperal lactation suppression and prolactin.

Five methods for puerperal lactation inhibition were assessed in a randomized fashion. The 90 women were divided into five groups. Four of these received a pharmacologic treatment: oral stilbestrol (15 mg dd for 5 days), a diuretic compound (bendroflumethazide 15 mg dd for 5 days) by mouth, oral bromocriptine (5 mg dd for 14 days), or an intramuscular injection containing estradiol (10 mg and testosterone (200 mg) esters administered immediately after delivery. To the women in the remaining group only physical methods were applied (breast support and local infra-red waves) and they served as controls. Prolactin plasma concentrations were determined daily for five consecutive days and showed a correlation with the clinical effectiveness of the various treatment schedules. While bromocriptine reduced and stilbestrol augmented prolactin levels, both types of treatment were equally effective in preventing lactation during the observation period. Treatment with a diuretic compound or with an injection of steroids, though less effective than the first two regimens, was nevertheless significantly more efficacious than physical treatment.


Methodological aspects of some inner ear vascular techniques.

Modifications of preparation technique assessing cochlear vasculature together with suggestions regarding their applicability to various types of research projects are presented. Detailed information is given regarding the 'soft-surface' dissection and preparation technique along with selected parameters for evaluating the cochlear vasculature. Some basic requirements for any histological technique studying the inner ear blood supply are suggested.


Combination chemotherapy in advanced postmenopausal mammary carcinoma. A comparison between VAC and VACM therapy.

A randomized trial comparing Vincristine, Adriamycin, Cyclophosphamide (VAC) with or without Methotrexate with citrovorum factor rescue (VACM) was performed in 64 patients with metastatic postmenopausal mammary carcinoma. Previous treatment of metastases, dominant site of metastases and performance condition were similar in the patients. No significant difference was found in the response rates (complete remission + partial remission; VAC 21/31, VACM 25/33), in the duration of the remissions or in the survivals. The duration of remission in CR was significantly longer than in PR. No serious side effects were observed. The VAC regimen is preferable, particularly with respect to the costs and the simple procedure of administration.


Effect of 24-hour somatostatin infusion on glucose homeostasis and on the levels of somatomedin A and pancreatic and thyroid hormones in man.

In order to investigate whether somatostatin plays a role in the regulation of thyroid hormone secretion we have compared the effects of a prolonged somatostatin infusion on insulin and glucagon levels, on the one hand, with its effect on T4, T3, rT3 and TSH, on the other. Furthermore, the serum levels of somatomedin A were determined. Saline was infused in control experiments. Cyclic somatostatin was given as an i.v. bolus of 200 micrograms followed by a constant rate infusion of 50 micrograms/h during 24 hours. Somatostatin suppressed basal insulin and glucagon levels as well as insulin responses to meals but did not influence somatomedin A levels. T4 and T3 decreased during the first hour, whether somatostatin was given or not. Thereafter, T4 and T3 remained stable in the control experiments, while they continued to decrease slowly when somatostatin was added. The suppressive effect of somatostatin was significant 11 hours (p less than 0.05) and 24 hours (p less than 0.005) after the onset of the infusion. In contrast, rT3 and TSH were not suppressed by somatostatin. The fact that basal TSH did not decrease, favors the idea that the suppression of T4 and T3 was mainly due to a direct inhibitory effect of somatostatin on the thyroid gland. Our observation that a low dose of somatostatin decreases peripheral T4 and T3 levels supports the idea that somatostatin plays a role in the regulation of thyroid hormone secretion.


Incidence and significance of heartmuscle antibodies in patients with acute myocardial infarction and unstable angina.

The incidence of heartmuscle antibodies was studied prospectively in 136 patients consecutively admitted for acute myocardial infarction (AMI) and in 95 patients with unstable angina. Heartmuscle antibodies were determined with the indirect immunofluorescence technique on days 1, 10, 20 and 30 in patients with AMI and on days 1 and 10 in patients with unstable angina. Heartmuscle antibodies were found in 16/136 AMI patients (12%) and in 3/95 (3%) with unstable angina. None of the AMI patients developed post-myocardial-infarction syndrome in the 2--4 weeks after infarction or during the one-year follow-up. The AMI patients with and without heartmuscle antibodies were comparable with respect to age, sex, site and size of infarction, incidence of early pericarditis and previous infarction.


Histochemical differentiation of endocrine gastrointestinal cells in test animals, with special reference to chicken embryos.

Based upon the characteristics of argent-affinity and argyrophilia and the application of specific immune histochemical methods, endocrine cells can be differentiated in the most prominent species of test animals. These methods are demonstrated in chicken embryos, because embryological studies made in order to reveal the still unknown endodermal or neuroectodermal origin of these cells are highly important.


Non-invasive methods of the evaluation of obliterative disease of the subclavian or innominate artery.

The preoperative investigation of 25 patients referred for evaluation of subclavian artery obliteration is reported. Non-invasive methods were used prior to angiography to assess arm circulation and the direction of blood flow in the vertebral artery. A retrograde flow in one vertebral artery was found in 18 patients, but only 7 had symptoms judged to be caused by the reversal of flow. In only one patient was the arm circulation so impaired as to justify the diagnosis of arm claudication. A high frequency of carotid lesions was found on the angiograms. The report demonstrates that in cases of suspected subclavian steal and/or arm claudication due to a subclavian artery obliteration, non-invasive methods should be used to screen the patients before angiography. In many cases it will be found that symptoms cannot be attributed to steal or impairment of the arm circulation and therefore angiography is not indicated. However, in some cases signs of a coexistent carotid lesion may still necessitate angiography.


Prevention of subarachnoid fibrosis after subarachnoid haemorrhage with urokinase. Scanning electron microscopic study in the dog.

The author used the scanning electron microscope (SEM) to study the influence of urokinase on subarachnoid fibrosis after experimental subarachnoid haemorrhage (SAH). In the subchronic group of dogs, which were sacrificed three weeks after SAH, an average of 45--50 IU/kg of intrathecal urokinase diminished the fibrosis. In the chronic group, which was sacrificed three months after SAH, an average of 250 IU/kg of intrathecal urokinase also had considerable reducing effect. The author supposes that fibrinolytic therapy, with lysis of blood clot, contributes to clearance of the blood. We contrast this mechanism with the mechanism and effect of antifibrinolytic therapy. This experiment is the first successful attempt to influence subarachnoid fibrosis, and also the first experiment in which subarachnoid fibrosis could to some extent be prevented.


[The 32P test in ophthalmology].

Rapidly proliferating tissue incorporates more phosphorus than normal. Thus, following administration of radioactive phosphorus (32P), tumors emit increased amounts of radiation which can be detected. With the proper test technique, a correct diagnosis rate of 96-100% is quoted in the literature. By comparison, between 4 and 20% of all eyes enucleated for suspected malignant melanoma without prior 32P testing contained no neoplasm histologically. The radiation exposure is minimal due to the short half-life of 32P and the low penetration of beta-particles. However, the test usually involves a small operation (conjunctiva and Tenon incision). Testing with gamma rays, however, is not yet wholly satisfactory due to the lack of a suitable gamma-ray detector.


Costenbader Memorial Lecture: Genesis and genetics of retinoblastoma.

(1) The incidence of retinoblastoma is 1/20,000. (2) About 94% of all retinoblastoma cases are sporadic, while 6% are familial. (3) The hereditary retinoblastomas, whether sporadic or familial, represent 40% of all cases. (4) A new dominant germinal mutation is responsible for 100% of the bilateral sporadic cases and for 10-15% of the unilateral sporadic cases. (5) Knudson's multistage mutation is the best explanation of retinoblastoma's behaviour. (6) A deletion of the long arm of a D-chromosome (13q14) may be the cause of some, if not of all retinoblastomas. (7) The main difficulty in genetic counseling is the lack of means for identifying which sporadic unilateral retinoblastomas are due to a new germinal mutation.


[Home remedies and prescriptions for children and juveniles, based on individual data from the 17th through the 19th century].

In personal recollections, letters a.s.o. written by 23 authors in the sixteenth to the nineteenth century are to be found 52 remarks on home remedies or prescriptions for children or juveniles. It seems that they belong more to dietetics than to pharmacotherapy.


[The brain and the visual recognition of human faces (author's transl)].

The first part presents some studies in normal subjects. We observe that faces recognition is a very primitive behavior in human child, that the symmetry and some parts of a face may play a specific role, and that the right cerebral cortex is dominant for this function. Problems of specificity are also examined. Studies in pathological subjects are then presented. We examine some publications concerning child's psychiatry and neurology. Prosopagnosia, his associated symptoms, and the anatomical questions are then considered. Finally we examine researches concerning the relationships between brain lesions and the recognition of human faces, with a special attention to the mnesic processes and to the questions of specificity.


Diet and status at Chalcatzingo: some empirical and technical aspects of strontium analysis.

Determination of the levels of particular trace elements preserved in bone provides a potential pathway for reconstructing the diet of extinct primate species and archaic human groups. Strontium is one of the most useful trace elements for dietary reconstruction but several empirical properties of strontium must be considered during the interpretation of results. (1) Strontium is distributed unevenly throughout the physical environment. (2) Plants, in general, do not discriminate against strontium. (3) During ionic transfer across biological membranes, strontium is discriminated against by terrestrial vertebrates. (4) It is unlikely that strontium would be selectively removed from bone mineral during diagenesis. A particular difficulty in trace element analysis is caused by interaction between analytical technique and sample matrix. To assess this problem the skeletal population from Chalcatzingo was analyzed by two techniques: atomic absorption spectrometry and neutron activation analysis. The results from the two techniques compared favorably indicating that the pattern of bone strontium levels could be accepted as an accurate reflection of the distribution of bone strontium within the population. After demonstrating the internal accuracy of the results, the bone strontium level and position of social rank within Chalcatzingo were compared. Ethnographic and archaeological evidence on chiefdoms and states indicate that dietary differences in the amount of meat consumed occur between social ranks. The relative social ranks were reconstructed by using a "pattern analysis" of the burial goods accompanying each individual. The individuals accompanied by jade had the lowest mean bone strontium level (X = 532). Those individuals buried with a shallow dish had a slightly higher level (X = 635). A third group, which had no grave goods, had the highest mean bone strontium level (X = 700) which suggests that their diet contained less meat than was available to the rest of the community.


The assessment and meaning of intraobserver error in population studies based on discontinuous cranial traits.

Intraobserver scoring precision of 50 discontinuous (discrete) cranial traits was assessed on a sample of 125 intact Iroquois crania using the square of the phi coefficient. Scoring consistency was high for most traits although several were subject to low precision (phi 2 less than 0.7). Most errors were random rather than systematic. Taken collectively the problematic traits exceeded their expected contribution to MMD coefficients among four Woodland samples from southern Ontario. A traitlist with the problematic variants excluded produced more meaningful biological relationships among the samples. Further, the % contribution of the problematic traits increased with the time interval between the scoring of the individual samples. It was suggested that intraobserver error could effectively distort the interpretation of biological relationships and that it must in part be responsible for the poor performance reported for discontinuous traits in some studies. Therefore, it was argued that the results support rather than compromise the use of discontinuous skeletal traits in population studies and that the assessment of intraobserver error should be a standard procedure of the research design.


Rhabdomyosarcoma of infancy and childhood. Problems of morphologic classification.

The classification of the histologic types of rhabdomyosarcoma is based on poorly defined criteria. This has resulted in marked disparities in studies reported from different institutions, as well as difficulties in assessment of the clinical behavior of the different histologic types. A retrospective morphologic analysis of 36 consecutive cases of rhabdomyosarcoma of childhood was undertaken according to predefined and strict guidelines for diagnosis. Undeflecting adherence to such criteria identified the embryonal type as the most common form, and the alveolar variant as a distinct clinicopathologic entity with a much more aggressive course; it also resulted in a large proportion (approximately one-fourth) of sarcomas of undertermined histogenesis. In spite of either prolonged follow-up observation with repeated biopsies, autopsy study, or electron-microscopic study of tumor tissue, no evidence could be obtained to substantiate the rhabdomyogenic derivation of the latter group of neoplasms. Precise systematization of the morphology of these cases may be contingent upon careful inventory of their fine structural features; current classifications appear to have disregarded the morphologic heterogeneity of this group of tumors.


Lymphadenopathy as the initial manifestation of histiocytosis X.

Seventeen cases of histiocytosis X presenting as lymphadenopathy, in which the initial diagnosis was based on lymph node biopsy, are reviewed, the characteristic histopathologic findings described, and the differential diagnosis discussed. Clinical evaluation reveals a broad spectrum of associated manifestations varying from solitary eosinophilic granuloma of lymph node to a disseminated Letterer-Siwe-like syndrome. Follow-up confirms the essentially benign nature of this disorder when defined by strict histologic criteria. The implications of these findings on the continuing controversy surrounding histiocytosis X are discussed.


Sedation for outpatient conservative dentistry. A trial of pentazocine supplementation to diazepam and local analgesia techniques.

Pentazocine 30 mg. or 15 mg or a placebo, was administered randomly to forty-nine patients undergoing conservative dental treatment in combination with a local analgesic block and intravenous diazepam. Simple cardiorespiratory measurements were made throughout the treatment period. Patients in the 30 mg pentazocine group required some 6 mg diazepam less than the placebo (control) group (P less than 0.05). Patients receiving 15 mg pentazocine also required less diazepam compared to the control group, but this difference was not statistically significant. There were no significant differences between the three groups either in recovery times or the cardiorespiratory measurements.


[Release of LH and FSH following administration of an LHRH analog in patients with with congenital adrenal hyperplasia].

D-Ser(TBU)6-EA10-LH-RH, an analogue of LH-RH with prolonged and increased effect upon the release of LH and FSH, induces in normal male subjects a secretory response of LH and FSH, which is qualitatively different from that seen in normal females. Female patients with increased plasma-concentration of testosterone due to congenital adrenal hyperplasia or adrenal neoplasm present upon the LH-RH-analogue with a secretory response of LH and FSH which is similar to that observed in normal female subjects. It is concluded that elevated plasma-adrogens fail to induce a masculine pattern of gonadotropin-secretion in patients with a genetically female determination of the hypothalamo-pituitary-gonadal system.


The use of bactericidal concentrations of antibiotics in hypothermic pulsatile perfusion and the effects on canine renal autograft function.

Although cadaver allograft contamination occurs frequently, the potential danger to the transplant recipient varies. Usually the results of culture from the donor and kidney perfusates are not available at the time of transplantation. A positive culture result often necessitates the use of prophylactic antibiotics. The antibiotic may be potentially nephrotoxic, and in the setting of minimal or changing renal function this effect may be potentiated. If significant contamination with virulent organisms is found prior to transplantation, clinical judgment often dictates that the graft be discarded. Perfusion and storage with solutions containing broad-spectrum antibiotics would substantially reduce the incidence of contamination in perfused kidneys. This would in turn reduce the requirement for potentially nephrotoxic antimicrobial therapy in the transplant recipient. Since the antibiotics tested are effective against a wide range of contaminants and apparently cause no detrimental effects, it would seem reasonable to add them routinely to the perfusate solution.


Fourier analysis of airflow and transpulmonary pressure signals filtered on-line.

Airflow and transpulmonary pressure curves obtained from a normal man and a dog, during hyperventilation or when breathing spontaneously, were analysed on a digital computer by means of the fast Fourier transform. The same curves were also analysed after passing through an on-line RC filtering algorithm having cutoff frequencies extending from 10 down to 0.1562 Hz. Results show that respiratory parameters can contain a large amount of biological background noise mainly related to cardiovascular motion. The only instance in which the magnitude of fundamental harmonic was not the largest was for the airflow of the dog measured during spontaneous breathing. It was concluded that the cutoff frequency should be adjusted to a value 3-4 times that of the fundamental frequency. More pronounced filtering would cause important distortions of the physiologic signals.


Restoration of DNA synthesis at non-permissive temperature and of UV resistance induced by bacteriophage Mu in Escherichia coli lig ts7 strain.

Infected by Mu, a mutant of E. coli, carrying the mutation lig ts7 shows a UV sensitivity intermediate between that of the uninfected lig-strain and that of the parental lig+ strain. At non-permissive temperature bacterial DNA replication is restored upon infection. These results suggest that DNA-ligase activity is coded for by the phage Mu genome.


["Beta-lactamase enzymogram": an agar adaptation of the iodometric method (author's transl)].

This paper deals with an agar-gel adaptation of the Perret-Novick iodometric titration of degradation products from beta-lactam antibiotics when they are submitted to a beta-lactamase action. Petri dishes containing an agar-gel make up from the classical iodine-iodide-starch system, initially present a dark blue colour. When beta-lactam compounds are opened by beta-lactamases from crude extracts or whole bacteria, the gel is locally destained. Two experimental variants of this procedure are proposed. This semi-quantitative, inexpensive, accurate and simple method is very convenient for routine experiments. Thus with crude extracts or even whole cells, information can be obtained about beta-lactamase specific activities, substrate profils or activity of inhibitors such as cloxacillin or clavulanic acid.


Current status of thymosin research: evidence for the existence of a family of thymic factors that control T-cell maturation.

Thymosin fraction 5 contains several distinct hormonal-like factors which are effective in partially or fully inducing and maintaining immune function. Several of the peptide components of fraction 5 have been purified, sequenced and studied in assay systems designed to measure T-cell differentiation and function. These studied indicate that a number of the purified peptides act on different subpopulations of T-cells (see Figure 1). Thymosin beta 3 and beta 4 peptides act on terminal deoxynucleotidyl transferase (TdT) negative precursor T-cells to induce TdT positive cells. Thymosin alpha 1 induces the formation of functional helper cells and conversion of Lyt- cells to Lyt 1+, 2+, 3+ cells. Thymosin alpha 7 induces the formation of functional suppressor T-cells and also converts Lyt- cells to Lyt 1+, 2+, 3+ cells. These studies have provided further evidence that the thymus secretes a family of distinct peptides which act at various sites of the maturation sequence of T-cells to induce and maintain immune function. Phase I and Phase II clinical studied with thymosin in the treatment of primary immunodeficiency diseases, autoimmune diseases, and cancer point to a major role of the endocrine thymus in the maintenance of immune balance and in the treatment of diseases characterized by thymic malfunction. It is becoming increasingly clear that immunological maturation is a process involving a complex number of steps and that a single factor initiating a single cellular event might not be reflected in any meaningful immune reconstitution unless it is the only peptide lacking. Given the complexity of the maturation sequence of T-cells and the increasing numbers of T-cell subpopulations that are being identified, it would be surprising if a single thymic factor could control all of the steps and populations involved. Rather, it would appear that the control of T-cell maturation and function involves a complex number of thymic-specific factors and other molecules that rigidly control the intermediary steps in the differentiation process.


Regulation of lymphokine function.

Although we have focused on desensitization as an experimental model, the findings obtained suggest mechanisms by which physiological control of cell-mediated immunity is attained. Thus, such regulation may occur either at the stage of expression of lymphokine activity or at the level of lymphokine production itself. The former may involve unique suppressor molecules, but as indicated above may be due to the inflammatory lymphokines themselves. The latter appears to involve suppressor systems similar to those operative in antibody formation. Over and above any specific model for regulation, the findings presented here suggest that local fluctuations in lymphokine distribution can modulate immunologically induced inflammatory responses, either through alterations in chemotactic gradients, or by other mechanisms as yet unknown.


Macrophage-lymphocyte interactions mediated by soluble factors.

Adherent-cell-depleted primed rabbit splenocytes were capable of mounting an in vitro response to SRBC. The addition of alveolar macrophages (AM) to adherent-cell-depleted or unseparated lymphoid cell populations resulted in significant suppression of the PFC response. Suppressive activity was limited to AM and dependent on the presence of a ratio of 1 AM:20 lymphocytes. The cell-mediating suppression was found to be resistant to irradiation and antithymus globulin but sensitive to heat, freeze-thawing, and treatment with iodoacetamide. Suppression was mediated by a soluble factor (MW greater than 10,000 daltons) that required an AM-lymphocyte interaction for its production. Suppression appeared to be achieved through the inhibition of proliferation of antigen sensitive cells although the effect of AM could possibly be exerted on an early event in the immune response. AM were capable of enhancing the proliferative responses of rabbit lymphoid cells to PHA and Con A. Enhancing and suppressing activities of AM were abolished by inhibition of RNA synthesis but unaffected by inhibitors of DNA and protein synthesis.


Factors from lymphoid cell tumor affecting immune responses.

Friend leukemia virus induces erythroblastic leukemia in genetically susceptible BALB/c mice. FLV-containing leukemic cells markedly depressed the humoral immune response to SRBC in the appropriate mouse strain. Both immunosuppression and leukemogenesis were readily transmitted by cell-free virus-containing homogenates of the FLV leukemic splenocytes into normal BALB/c mice. In the present study it was found that both Friend leukemic splenocytes as well as virus containing extracts from the leukemic cells were neutralized by heating and by specific antisera. Suppressive activity passed through a 0.45 mu filter but not a 300,000 MW filter and could be pelleted at 100,000 x g. They were also highly resistant to inactivation by irradiation. Mice given leukemic splenocytes after irradiation with up to 32.000 rads still developed leukemia. Addition of either normal or irradiated FLV-leukemic cells to normal spleen cell cultures in vitro markedly suppressed antibody formation. At least 32,000 rads were required to significantly impair the immuno-suppressive activity of the FLV-leukemic cells. Thus, virus per se appears to be directly responsible for suppression of antibody formation to FLV.


Macrophage factors that enhance the antibody response.

The immunological mechanism of the primary in vitro antibody responses to sheep erythrocyte antigens involves soluble immunomodulatory factors. These studies have demonstrated that the stimulation of immunocytes with lipopolysaccharide (LPS) induced the release of a helper factor which appeared to be a monokine. This helper factor was released by stimulated adherent splenocyte cultures but not by nonadherent cell populations. The P388D-transformed macrophage cell line also produced the factor in response to LPS. LPS-induced helper factors were absorbed from solution by bone marrow cells but not by thymocytes, thereby indicating that the factor may selectively bind to B-cells or to undifferentiated stem cells. Mature T-cells did not appear to be involved in the immunostimulatory effects of this macrophage-derived factor as evidenced by the results of several studies. These included observations that splenocytes from athymic BALB/c nu nu mice both produced the factor and responded to it.


[Limited-time feeding ("meal-feeding") and avitaminosis A : respiratory exchange and metabolic adaptation in rats].

Weanling male rats were fed ad libitum for 6 weeks with a normal or vitamin-A-deficient diet and then meal-fed 1 1/2 hours per 24 hours a 65 p. 100 glucose diet for not less than 3 weeks. The stomach of meal-fed rats develop and food intake is sufficient to ensure a normal rate of growth until deficients reached a plateau of weight. After the single daily meal the respiratory quotients are remaining high (QR greater than 1) all throught the day and decreases during the night (0,8) with all the animals. Fasting glycemia, insulinemia and liver glycogen of meal-feds are higher than ad libitum rats ones, but lower in deficients than in controls. Activities of NADPH2-linked enzymes (G6PDH, 6PGDH and NADP malate DH) are increased in meal-feeding, but avitaminosis A reduces by half this increase.


[Compressive brachio-cephalic arterial trunk and gastro-oesophageal reflux following surgery for oesophageal atresia (author's transl)].

6 cases of cardiorespiratory complications occurring after surgical treatment of oesophageal atresia are reported by virtue of the association of tracheal compression by the brachio-cephalic arterial trunk and of gastro-oesophageal reflux. In all cases, medical (2 cases) or surgical (4 cases) treatment of gastro-oesophageal reflux led to the disappearance of all respiratory symptoms and signs. Emphasis is placed upon the need for a routine and thorough search, radiological and endoscopic, of such associated oesophageal pathology, before proceeding to surgery on the compressive brachio-cephalic arterial trunk.


[Familial facial paralysis. Generalised cortical hyperostosis (author's transl)].

Generalised cortical hyperostosis is a rare disease. In our own field it involves the lower jaw and the skull. Certain nerves, including the facial, may be compressed as a result. This condition behaves genetically in a recessive or dominant manner.


Pyogenic spondylitis. Analysis of three surgically treated cases.

During a period of 10 years (1964--1973) three patients developing pyogenic spondylitis were operated on. The patients suffered from severe localized back pain and showed sings of infection, as elevation of temperature and raised ESR. The earliest radiological changes were diagnosed on the average after 3 months. As treatment with antibiotics could not cure the infection, the patients were operated on by evacuation of a vertebral focus, and this measure was complemented with bone transplantation. All patients were cured from the fulminant spondylitis, and two of them returned to regular work. No recurrence was noted during an observation period averaging 8 years. Surgery seems to be indicated in some cases of nonspecific spondylitis, especially when a paravertebral spread of the infection is recorded and antibiotic treatment does not primarily show sufficient effect.


An absorbable purse-string suture around the prostatic capsule. A method to control the bleeding during transvesical prostatectomy.

8 patients with profuse bleeding from within the prostatic cavity during transvesical prostatectomy were treated with an absorbable purse-string suture around the prostatic capsule. The method, which is described, has been shown to be effective in control of operative and postoperative bleeding.


A biochemical and clinical comparison of two commercially available creatine kinase iso-enzyme MB assay kits suitable for use in the routine medical laboratory.

Two methods for the measurement of plasma creatine kinase MB (CK-MB) activity were compared for analytical performance, cost, practicality, and diagnostic correlation with clinical and electrocardiographic findings in patients admitted to the coronary care unit of a district general hospital. The methods were column chromatography and immunoinhibition. Both methods were found acceptable, and the method to be adopted would depend on the staff arrangements and resources available in the laboratory.


Accuracy of serum anticonvulsant measurements. A comparison of enzyme multiplied immunoassay technique and gas-liquid chromatography.

An enzyme multiplied immunoassay technique is compared with a gas-liquid chromatographic technique for the measurement in blood serum of the anticonvulsants phenytoin, carbamazepine, phenobarbitone, primidone, and ethosuximide. The correlation between results obtained by each method was excellent, and both systematic and random errors were well within acceptable limits.


Inhibition of bacterial growth by granulocytes measured by an automated technique.

Granulocytes, collected by several methods, were assayed for antibacterial activity utilizing a technique originally developed for automated antibiotic susceptibility testing. The granulocytes were incubated with either Escherichia coli or Staphylococcus for one hour at 37 degrees C and were then separated from the suspension by gentle centrifugation at 170 g. The bacteria remaining in the supernatant broth were incubated in culture medium (eugonic broth) and their growth density was compared with diluted controls (without granulocytes) by measurement in an Autobac I (an automated nephelometer). Measurements of the density of growth at 30 minute intervals showed a marked delay in the development of density suggesting only small numbers of organisms remained after incubation with granulocytes. Once density was measurable, the rate of growth appeared similar to controls. After 2.5 hours in the Atuobac I, the density of growth was used to determine the inhibitory effect of granulocytes. The density of growth was inversely related to the concentration of granulocytes present during the preincubation phase. Filtered granulocytes showed significantly lower inhibitory effect than centrifuged granulocytes. This rapid, inexpensive method of determining microbial growth appears to be adaptable as a measure of granulocyte function.


Effects of lysozyme on Trypanosoma lewisi.

Daily lysozyme (hen egg) injections, beginning on day 6 of Trypanosoma lewisi infections in rats, significantly reduced the number of circulating trypanosomes. The effect was dose dependent. Maximum reduction (50%) occurred 24 hours after one treatment of 80 mg was given intraperitoneally (I.P.). The same dose of lysozyme was more effective when divided equally into two injections per day. Controls consisting of appropriate buffers as well as human serum albumin had no effect on trypanosome populations. Animals receiving lysozyme exhibited a weight loss of 5% 24 hours following the first injection, but not other ill effects of the treatment were observed. In vitro experiments indicated that lysozyme did not cause lysis or immobilization alone or in combination with fibrinogen or rat antitrypanosomal serum. These results suggest that the cellular immune response of the host and lysozyme's cationic properties may be important in mediating the anti-trypanosomal response. Lysozyme may thus be an effective trypanocide against trypanosomes whose membranes resemble T. lewisi, such as T. cruzi, or as an adjunct to chemotherapy.


Failure of electroencephalography to diagnose brain death in comatose children.

Two isoelectric electroencephalograms obtained 24 hours apart support a clinical diagnosis of brain death in prolonged coma. Without documentation of electrocerebral silence, physicians are reluctant to discontinue vital support systems. A radionuclide bolus technique has been developed that documents the absence of cerebral blood flow in suspected brain death and supplements the flat EEG. In a recent review of this technique, all 27 adults who had EEG activity maintained the integrity of their cerebral blood flow. This contrasts to our studies of 5 children, all of whom demonstrated persistent EEG activity but had no evidence of cerebral blood flow by either the isotope bolus technique (5 patients) or cerebral angiography (4 patients). These children (mean age, 7 months) lacked cephalic reflexes and were maintained on assisted ventilation for an average of 15 days. Multiple electroencephalographic tracings persistently demonstrated low-voltage cortical activity over this time. Despite the lack of cerebral blood flow, all patients were continued on respiratory support. At autopsy, extensive brain liquefaction necrosis was noted. In comatose children, EEG monitoring may be of limited value while cerebral blood flow measurements can provide more practical and prognostic information.


Skin fibroblast microtubular network in Alzheimer disease.

A preliminary observation from another laboratory recently suggested that a systemic microtubular defect may exist in Alzheimer disease. To investigate this hypothesis, we obtained skin biopsies from 4 patients with Alzheimer disease and 2 age-matched controls. Fibroblast cultures were established and the tubulin networks examined using immunoadsorbent purified antitubulin antibody and the indirect immunoperoxidase technique as well as electron microscopy. The cells were also examined after treatment with vinblastine and at senescence. The microtubular network appeared as delicate fibers radiating from the perinuclear region toward the cytoplasmic margins. No differences were recognized between the controls and the fibroblast cultures from patients with Alzheimer disease. Microtubules were not visualized following incubation with vinblastine, but positively staining intracytoplasmic paracrystalline inclusions were noted. No abnormalities of microtubules were recognized in the electron microscopic examinations. These findings suggest that the neurofibrillary neuronal degeneration of Alzheimer disease is not a manifestation of a systemic disorder of the microtubular network.


Alzheimer neurofibrillary tangles: antiserum and immunohistological staining.

A 50,000-dalton polypeptide has been purified from fractions enriched with neurofibrillary tangles of paired helical filaments from human autopsy specimens of Alzheimer disease and senile dementia of the Alzheimer type. An antiserum to this polypeptide was raised in a rabbit. This antiserum formed an immunoprecipitation line with the purified antigen and with human neurotubules in ouchterlony double-diffusion plates. The reactivity of the anti-paired helical filament protein serum with neurofibrillary tangles was studied by immunofluorescence on cryostat sections of hippocampus from Alzheimer autopsy tissue and by the peroxidase-antiperoxidase technique on paraffin sections of an Alzheimer brain biopsy. The tangles were stained with the antiserum in both systems. Preimmune rabbit serum and unrelated hyperimmune sera, used as controls, did not stain the tangles. These results show that the 50,000-dalton polypeptide purified from the neurofibrillary tangle-enriched fractions is a constituent of Alzheimer neurofibrillary tangles and, perhaps, of the paired helical filaments of which the tangles are composed.


Enhancement of leukocyte activity against Escherichia coli after brief exposure to chloramphenicol.

The effect of brief exposure of Escherichia coli to chloramphenicol on the antibacterial activity of normal human leukocytes was studied by following changes in viability of the bacteria in the presence of leukocytes and serum. Growth was suppressed, and the extent of suppression was directly related to the period of exposure and the concentration of chloramphenicol. When exposed to clinically achievable levels of the drug for 10 min, E. coli failed to resume normal growth for 1 to 4 h in the presence of leukocytes and serum after removal of the drug. The post-antibiotic leukocyte enhancement effect required the presence of antibody and complement. This effect demonstrates the importance of early events in the encounter between antibiotic and microorganism in determining the subsequent activity of host defense components.


Incidence of antibiotic-resistant Escherichia coli associated with frozen chicken carcasses and characterization of conjugative R plasmids derived from such strains.

Escherichia coli were isolated at concentrations of about 10(2)/ml from the fluid obtained after thawing each of five frozen chicken carcasses. Between 13 and 89% of the E. coli were resistant to mercury(II) or to at least one of eight antibiotics tested. Multiple resistance was more common than single resistance, and resistances to tetracycline, streptomycin, sulfathiazole, or chloramphenicol were more frequently encountered than was resistance to ampicillin or mercury(II). Resistance to kanamycin, gentamicin, or trimethoprim occurred rarely. Upwards of 30% of the E. coli apparently carried conjugative plasmids and could transfer at least one of their resistance determinants to E. coli K-12. Twenty-five conjugative R plasmids obtained in this way were characterized within strain K-12 by a variety of phenotypic criteria. Twenty could be assigned to the incompatibility groups Inc X, Inc N, Inc FI, or Inc I alpha.


Quantitative assessment of antimalarial activity in vitro by a semiautomated microdilution technique.

A rapid, semiautomated microdilution method was developed for measuring the activity of potential antimalarial drugs against cultured intraerythrocytic asexual forms of the human malaria parasite Plasmodium falciparum. Microtitration plates were used to prepare serial dilutions of the compounds to be tested. Parasites, obtained from continuous stock cultures, were subcultured in these plates for 42 h. Inhibition of uptake of a radiolabeled nucleic acid precursor by the parasites served as the indicator of antimalarial activity. Results of repeated measurements of activity with chloroquine, quinine, and the investigational new drug mefloquine demonstrated that the method is sensitive and precise. Several additional antimalarial drugs and compounds of interest were tested in vitro, and the results were consistent with available in vivo data. The use of P. falciparum isolates with known susceptibility to antimalarial drugs also permitted evaluation of the cross-resistance potential of each compound tested. The applications and expectations of this new test system within a drug development program are discussed.


Compounds affecting membranes that inhibit protein synthesis in yeast.

The regulation of translation has been investigated in yeast cells by means of ionophores and other compounds affecting the ionic concentration inside the cell. Treatment of a variety of cells with these compounds produces a drastic inhibition in the protein-synthesizing activity of the cell. Protein synthesis in yeast is strongly inhibited by amphotericin B and nystatin. Mammalian cells are blocked in their translation capacity by gramicidin D, nigericin, monensin, nystatin, A23187, and bromolasalocid. The effects of these compounds on protein synthesis in Escherichia coli and Staphylococcus aureus were also investigated. Amphotericin B is a powerful inhibitor of both protein and ribonucleic acid syntheses in yeast cells at concentrations that do not affect the transport of the labeled amino acid or nucleoside precursor. The analysis of the polysomal profiles in yeast spheroplasts could indicate that initiation is the target of amphotericin B action on translation. Studies on the reversion of the protein synthesis blockade by amphotericin B by increasing the potassium concentration in the medium suggest that changes in the potassium concentration in cellular cytoplasm might be responsible, at least in part, for the inhibition of protein synthesis.


Increased production of beta-lactamase under anaerobic conditions in some strains of Escherichia coli.

A simple biological assay to detect beta-lactamase activity exhibited by selected cultures of Escherichia coli was used to test enzyme production in cells incubated aerobically and anerobically. Anaerobic incubation resulted in increased size of zones of drug inactivation by some beta-lactamase-producing strains. The beta-lactamase activity of cell lysates was determined iodometrically for aerobically and anaerobically grown cells. The specific beta-lactamase activity for anaerobically grown cells was three to five times greater than for aerobically grown cells. Beta-lactamase production was determined to be constitutive in all strains and to be plasmid mediated, as demonstrated by transfer to E. coli K-12 by conjugation.


Comparison of m-Endo LES, MacConkey, and Teepol media for membrane filtration counting of total coliform bacteria in water.

Total coliform counts obtained by means of standard membrane filtration techniques, using MacConkey agar, m-Endo LES agar, Teepol agar, and pads saturated with Teepol broth as growth media, were compared. Various combinations of these media were used in tests on 490 samples of river water and city wastewater after different stages of conventional purification and reclamation processes including lime treatment, and filtration, active carbon treatment, ozonation, and chlorination. Endo agar yielded the highest average counts for all these samples. Teepol agar generally had higher counts then Teepol broth, whereas MacConkey agar had the lowest average counts. Identification of 871 positive isolates showed that Aeromonas hydrophila was the species most commonly detected. Species of Escherichia, Citrobacter, Klebsiella, and Enterobacter represented 55% of isolates which conformed to the definition of total coliforms on Endo agar, 54% on Teepol agar, and 45% on MacConkey agar. Selection for species on the media differed considerably. Evaluation of these data and literature on alternative tests, including most probable number methods, indicated that the technique of choice for routine analysis of total coliform bacteria in drinking water is membrane filtration using m-Endo LES agar as growth medium without enrichment procedures or a cytochrome oxidase restriction.


Improved detection of coliforms and Escherichia coli in foods by a membrane filter method.

Analytical procedures based on filtration of homogenates through membrane filters, and particularly hydrophobic grid-membrane filters (HGMF), offer definite improvements in the enumeration of Escherichia coli and coliforms in foods. Whereas the counted specimen in pour plates may not usually be greater than 0.1 g, up to 1.0 g of ground beef, green beans, potato, cod, strawberries, or grapes could be filtered and counted on HGMF. Greatly improved limit of detection, reduced interference by noncoliforms, and complete removal of growth inhibitors such as polyphenols were demonstrated for HGMF, using violet red bile and mFC agars. In addition, counting on HGMF eliminated a false-positive reaction caused by sucrose in ice cream.


Menarcheal age in Oslo during the last 140 years.

Data from maternity clinics have been used to study the trend in menarcheal age among girls born in Oslo after 1840. The investigation was based on recordings from approximately 50 women from each year. The women were divided into social categories according to their own or their husband's occupation. The results show a trend toward earlier maturation within the working class, which is characterized by two periods of rapid fall in menarcheal age. The first period covers women born between 1860 and 1880, and shows a fall in menarcheal age from about 15.6 to about 14.6 years. During the second period of rapid fall, which covers women born between 1905 and 1940, the menarcheal age was further reduced from about 14.6 to 13.3 years. The age at menarche has been stable at about 13.3 years for women born after 1940. These results contrast with those of some earlier studies of the menarcheal age in Norway. However, it is shown that the discrepancies between these investigations and our own disappear when the same computational methods and the same interpretation of the age recordings are used.


Genetic susceptibility to cholera.

In the course of studies of immunity to experimental cholera in man, 10(5) or 10(6) Vibrio cholerae were given to 66 college students and other community volunteers under quarantine in an isolation ward. HLA antigen and blood group determinations were carried out to test the hypothesis that severity of clinical cholera is dependent in part upon genetically-determined host susceptibility. Fifty-five volunteers developed diarrhoea; 38 had mild illness and 17 had severe cholera (stool volume greater than or equal to 5.0 litres). HLA antigens were found in similar frequency in volunteers with severe, mild or no diarrhoea; antigen A1, A2, A3 and B7 were most common. Blood group O, however, was found in 64% of persons with severe cholera versus 36-38% of volunteers with mild or absent illness. Thus, while no correlation was found between HLA type and severity of cholera, these results do support the claims of other investigators that blood group O is found more frequently in patients with severe cholera than in the normal population.


Isolation of radiation-resistant bacteria without exposure to irradiation.

Resistance to desiccation was utilized in the selection of highly radiation-resistant asporogenous bacteria from non-irradiated sources. A bacterial suspension in phosphate buffer was dried in a thin film at 25 degrees C and 33% relative humidity. Storage under these conditions for 15 days or more reduced the number of radiation-sensitive bacteria. Further selection for radiation-resistant bacteria was obtained by irradiation of bacteria on velveteen in the replication process, thereby avoiding the toxic effect of irradiated media. The similarity of radiation resistance and identifying characteristics in irradiated and non-irradiated isolates should allay some concerns that highly radiation-resistant bacteria have been permanently altered by radiation selection.


Respiration and viability of thermally injured Saccharomyces cerevisiae.

Resting cells of Saccharomyces cerevisiae Y25 were heated at 56 degrees C for 0 to 2 min. Respiratory activity of the cells reflected the severity of the heat stress. The endogenous respiration was approximately 50 microliter of O2/mg per h for cells heated for 2 min at 56 degrees C as compared with 2 microliter of O2/mg per h for nonheated cells. There was a distinct decrease in respiration after 1 to 3 h, and after 20 h the respiration rate of heated cells was less than that of nonheated cells. Along with increased rates of endogenous respiration, respiratory quotients of cells were altered after heat stress. Addition of 2,4-dinitrophenol stimulated O2 (uptake) in nonheated cells but decreased O2 (uptake) of heated cells. Due to the high rate of endogenous respiration, addition of glucose resulted in no substantial change in the rate of respiration of heated cells. However, addition of glucose prolonged the presence of the high rates of respiration observed in heated cells.


Wipe-rinse technique for quantitating microbial contamination on large surfaces.

The evaluation of an improved wipe-rinse technique for the bioassay of large areas was undertaken due to inherent inadequacies in the cotton swab-rinse technique to which assay of spacecraft is currently restricted. Four types of contamination control cloths were initially tested. A polyester-bonded cloth (PBC) was selected for further evaluation because of its superior efficiency and handling characteristics. Results from comparative tests with PBC and cotton swabs on simulated spacecraft surfaces indicated a significantly higher recovery efficiency for the PBC than for the cotton (90.4 versus 75.2%). Of the sampling areas sites studied, PBC was found to be most effective on surface areas not exceeding 0.74 m2 (8.0 feet 2).


MICRID: a computer-assisted microbial identification system.

An extensive computer-assisted identification system for bacteria and yeasts (117 genera and 1,430 species) was developed, and applications proved very useful in teaching situations.


Effect of waterfowl (Anas platyrhynchos) on indicator bacteria populations in a recreational lake Madison, Wisconsin.

A public swimming beach in Madison, wis., experienced intermittent high fecal coliform counts during the late summer and early fall of 1978. Public health officials closed the beach on a number of occasions. A public health survey identified a combination of waterfowl wastes and meteorological events as the explanation for the high bacteria counts. Fecal coliform bacteria were deposited by mallard ducks and multiplied in the beach sands. The bacteria were subsequently transported into the lake and resulted in high fecal coliform counts in the swimming area.


Are Langhans giant cells precursors of foreign-body giant cells?

Granulomas were induced in rats by subcutaneous implantation of pieces of Melinex plastic into the dorsum. The pieces of Melinex were removed at intervals varying from 16 h to 14 days, and the adherent cells were studied morphologically and quantitatively. Giant cell formation started about 32 h after implantation. The first giant cells to appear were of the Langhans type. Two days after implantation, most of the giant cells are still Langhans-type cells. A few giant cells of the foreign-body type and transition forms between the Langhans and foreign-body types are also present. From the third day on, the foreign-body type gradually becomes predominant. Independent of the duration of implantation, giant cells with 3, 4, or 5 nuclei are virtually without exception of the Langhans type. The higher the number of nuclei between 6 and 30, the more cells are of the foreign-body type. Giant cells with 30 or more nuclei are all foreign-body type. The findings are discussed in the light of current knowledge concerning giant cell formation. It is concluded that under the present experimental conditions, Langhans-type giant cells are the precursors of foreign-body-type giant cells.


Effects of 8-methoxypsoralen plus 365 nm UVA light on Candida albicans cells. An electron microscopic study.

Candida (C.) albicans cells were exposed to 8-Methoxypsoralen (8-MOP) concentrations of 1.0 microgram/ml and 10.0 micrograms/ml medium and irradiated with 365 nm light. The amount of energy emitted was 4.8 J/cm2. Two divergent types of cell damage occured concerning yeast cell cytoplasm and cell wall. Two hours after exposure cytoplasmic changes involving mitochondria, which showed irregularities in shape, blurred appearance or loss of mitochondrial cristae and outer membrane were seen. The number of vacuoles was increased. The cytoplasm showed large electron transparent areas, the cytoplasmic membrane disappeared in some areas completely. Nucleus and nuclear envelope usually remained intact in early stages. 24 h after exposure conspicuous cell wall alterations were observed in addition to cytoplasmic changes. Newly produced cell wall material formed ball-like protrusions or was adherent sickle-shaped to the cell wall. The investigations strongly suggest that the results found after 8-MOP-UVA treatment of C. albicans cells can not be interpreted in the sense of a general cytotoxic effect. Apparently it takes the form of a combination of events involving regressive and progressive alterations.


In vitro studies on microphage functions in chronic pyoderma vegetans.

The function of microphages has been studied in two patients with chronic pyoderma vegetans by in vitro determination of phagocytosis as well as chemotaxis. The results showed a striking decrease in the chemotactic activity of the neutrophil granulocytes, a reduced phagocytosis of Candida albicans and Staphylococcus aureus, and a weakness of the intracellular killing of these microorganisms. However, the NADH-dependent oxidase activity appeared to be intact. No defect was found in the specific cellular or humoral immune system in either patient.


Size of rat spermatozoa during maturation along the epididymis.

An electrical sizing apparatus based on the Coulter Counter was used to measure rat spermatozoa from the proximal (caput) and distal (caudal) ends of the epididymis and from the ejaculate. The typical size distribution is unimodal with a positive skew, the crescent shape of the cells precluding absolute volume determination. During their passage through the epididymis, spermatozoa decrease in size as part of maturation. Saponin causes cell lysis and chymotrypsin cell shrinkage, both effects being more pronounced in the proximal region. It would seem that, during the maturation process within the epididymis, changes occur in the spermatozoon membrane that make the cells more stable.


[Nutritional optimization of thermal processing of canned food].

The model developed by Barreiro, Salas and Herrera (7) for the prediction of nutrient losses during the thermal processing of conduction heated foods was used in this work to optimize the thermal processing, maximizing nutrient retention in processes with equivalent sterilization values. The processes were stimulated in a digital computer (taking pea purée canned in cans 307 x 409 as the product analyzed). Aall of the processes had equivalent sterilization values with respect to Clostridium botulinum. The thiamine retention associated with each process was calculated by the model of Barreiro, Salas and Herrera (7). The maximum fraction of thiamine retained was of 0.688 for a process at 114.2 degrees C (237.5 degrees F) for 95 minutes. Also, the possibility of the existence of a can with optimum dimensions for maximum thiamine retention, with the same sterilization values, was studied. It was found that this optimum, with the same does not exist; on the contrary, the retention was at a minimum when the diameter approaches infinite and the height zero, and viceversa. For this reason, from the nutrient retention point of view, it is better to process the product in flat or slender cans for a given sterilization value.


[Studies of bovine mycoplasma mastitis. 1. Review of literature on the occurrence of bovine mastitis with Mycoplasma involvement].

The clinical pattern as well as the pathologico-anatomic or histological changes due to mycoplasma mastitis are neither specific nor pathognomic. Mastitis pathogens so far described included M. bovis, M. bovigenitalium, A. laidlawii, A. axanthum, M. alkalescens, M. canadense, M. dispar, M. bovirhinis, strains of Group 7 according to Leach, strain ST 6, and ureaplasma strains. In the GDR, enzootic mastitis has been confined to A. laidlawii and A. axanthum.


[Studies of bovine Mycoplasma mastitis. 2. Testing of various culture media and culture methods for the isolation of Mycoplasma from milk samples].

The recipes Medium-I broth, Medium-B broth, and Weissenseemycoplasma broth as well as Medium-I agar, Medium-B agar, and MRL agar were tested for their applicability to culturing mycoplasma from milk samples, using the direct and indirect techniques. No dependable information on the occurrence of mycoplasma was obtainable from tested material unless several nutritive media and techniques were combined. Medium I, for which almost no imported substances were needed, was in no way inferior to common international nutritive substrates. Its use in conjunction with the indirect culturing technique is recommended for routine diagnosis.


Lack of enhancement of chemical mutagenesis by saccharin in the Salmonella assay.

A purified batch of the artificial sweetener saccharin (S-1022) was assayed for mutagenicity and comutagenicity by the Ames Salmonella assay system. Saccharin was not mutagenic and failed to enhance the mutagenic activity induced by a wide variety of known mutagens. These results do not argue against the tumor-promotor-like activity of saccharin but only indicate that the Ames Salmonella assay is not capable of detecting saccharin as a promoter of mutagenesis.


The anterior cerebral artery. II. A computer model of its cortical branches estereotaxically obtained from anatomical specimens.

This article is a corrollary of a previously published anatomical study of the anterior cerebral artery. The authors propose a method to obtain a computer model of the anterior cerebral artery, based on a combined system of stereotaxic coordinates and a specially developed computer program. The graphic analysis, thus obtained, is projected on a model atlas brain and an ideal diagram of this anatomical structure is obtained. Forty anatomical specimens were used for this study.


[Immunoglobulins of the normal cerebrospinal fluid].

The most important methods and results found in literature on immunoglobulins of the normal cerebrospinal fluid (CSF) are reviewed. A study was made of immunoglobulins in the CSF of 50 individuals who suffered from chronic migraine but showed normal results for the physical and neurological examinations; electroencephalograph, CSF tests (sub-occipital puncture) and proteinogram of the serum also fell within the limits of normalcy in all of the 50 cases. The study of immunoglobulins was conducted through the radial immunodifusion method. Results obtained as to immunoglobulins of the CSF varied between 1,55 and 3,97 mg/100 ml, or 0,17 and 0,44 for IGG; values lay between 0 and 0,62 mg/100 ml, or 0,37 UI for IGA. Presence of IGM was not detected in any of the cases studied. Analysis of the results showed that, for the CSF of the cisterna magna in normal individuals, IGG is always found at an average concentration of 2,37 mg/100 ml and a standard deviation of 0,59. IGA is mostly found at an average concentration of 0,34 mg/100 ml and a standard deviation of 0,17. IGM is not demonstrable, under normal conditions, by the method chosen by the author.


[The personality of the alcohol. Socio-cultural, psychopathological and psychodynamic variables].

86 chronic alcoholics hospitalized in three psychiatric clinics, were studied through a questionnaire and the Szondi Projective Test. Dividing the sample into two groups, "social" and psychotic alcoholics brought several significant differences to light. The mean age of the psychotic patients was lower than of the "social" alcoholics, suggesting that the pathology of the former had begun sooner. Furthermore, the projective test revealed that the pathology of the psychotic patients was qualitatively different in that they use negation and selfblocking defense mechanisms at a self-destructive level. This hinders individualization and fixates the patient, without internal consistency, at a level of pre-genital regression which is manifested in their social marginality.


Prediction of solute transport during peritoneal dialysis.

Solute transport, predominantly diffusion, across the peritoneum correlates inversely with molecular weight. Provided that the solute is water soluble, not protein bound, not of unusual density, not ionized, does not have a large hydration shell, and is transported from plasma to dialysate, the peritoneal clearance is predictable over the molecular weight range from 60 to 11,000 daltons. Transport reates that deviate from the predicted can be explained by known physical properties of particular solutes.


Counterregulatory system in an artificial endocrine pancreas. Glucose infusion algorithm.

An artificial endocrine pancreas has been developed by adding a glucose infusion system to the artificial beta cell system. In this computer algorithm, glucose is infused on the basis of proportional and derivative actions to blood glucose concentration with the time delay constant between blood withdrawal and initiation of glucose infusion. When glucose was infused on the basis of proportional action with a 20-minute time delay, the prompt restoration to normoglycemia from the hypoglycemic state with a smaller amount of glucose was shown in depancreatized dogs. These results indicate that the artificial endocrine pancreas thus prepared is not only a useful device to safely control blood glucose, but also is an efficient research tool for the analysis of the blood glucose regulatory mechanism.


A protease-antiprotease system in antrochoanal polyp. I. Evidence for the existence of proactivator.

Tissue extract of antrochoanal polyps showed a faint lysis area on standard fibrin plates, but streptokinase (SK)-added tissue extract showed a large lysis area. No fibrinolytic activity was observed on plasminogen-free fibrin plates. It is concluded, therefore, that the fibrinolytic activity observed after SK addition is indicative of the existence of SK-responsive protein proactivator. The tissue extract did not contain plasminogen or antiprotease against trypsin or papain. It was stable at neutral pH at 37 degrees C and stable at acid pH at 70 degrees C. The role of proactivator is discussed in relation to the growth or enlargement of antrochoanal polyps.


The treatment of symptomatic urinary tract infection.

779 patients suffering from symptoms of urinary tract infection have been studied. Fifty-two per cent were found to have true bacterial infection of the urine. Several treatment regimes were assessed, and of these it appeared that sulphamethizole 1g three times a day was most effective, both in terms of a lower rate of relapse of infection and also a low incidence of side effects.


Local immune response in mice to Vibrio cholerae.

Cholera immunization schedules were investigated in mice, with emphasis placed on obtaining an immune response in the intestine. The most effective schedule for producing a good local response was found to be several orally-given priming doses of the organism followed after 14 days by an intravenous boosting dose. Major differences between the immune responses in the spleen and the intestine were noted.


Antibody responses to influenza vaccines containing A/USSR/90/77.

Studies were undertaken in adult groups aged 17-24 years, 25-64 years and 66-100 years to determine the haemagglutination-inhibiting antibody responses to sub-unit influenza containing A/USSR/90/77 (H1N1). Antibody responses to A/USSR/90/77 were low in all groups. The young adult group (17-24 years) produced a primary response to A/USSR/90/77 and showed a significant response to a second dose of vaccine, whereas their responses to the A/Texas/1/77 (H3N2) and B/Hong Kong/8/73 components were of the anamnestic type and showed no significant increase to a second dose. The adult (25-64 years) and aged (66-100 years) groups responded anamnestically to all three vaccine components. There was no impairment of the antibody response in the aged group in comparison with the response in the adult group. A comparative assay in microtitre trays and WHO plates showed two- to four-fold differences in antibody titre to A/USSR/90/77 in these systems.


HLA patterns in Australian patients with insulin dependent diabetes mellitus (IDDM).

HLA antigens were determined in 169 Australian patients with insulin dependent diabetes mellitus (IDDM). HLA-B8 (47.9% v. 23.8%) and B15 (18.9% v. 8.2%) were significantly more frequent in the IDDM patients than in 1460 controls. The relative risks for developing IDDM in people carrying these antigens were 2.94 and 2.59 respectively. Carriers of the B8/B15 genotype had a relative risk of 5.48. These HLA associations in Australian IDDM patients are similar to those reported in other predominantly Caucasian populations.


Exchange of cadaveric kidneys for transplantation in Australia and New Zealand.

In the period from March 1970 to April 1978, 176 kidneys from 137 cadaver donors were exchanged, on the basis of HLA matching, between transplant centres throughout Australia and New Zealand. The kidneys were preserved by simple ice storage or machine perfusion, and transported by air in chipped ice. Total ischaemia times ranged from 3.5 to 28.6 hours and immediate function occurred in 52% of cases. Graft survival was 62% at one year, 51% at three years and 47% at five years, the corresponding patient survival rates being 86%, 74% and 71%. An average of 1.4 antigens mismatched was achieved, and 59% of recipients received kidneys with zero or one antigen mismatched. These kidneys survived better than those with two or more antigens mismatched, the difference being 12% at one year, and rising to more than 20% at five years. The results confirm the practicability and potential value of the Organ Sharing Scheme, and indicate that effective sharing of kidneys on the basis of zero HLA mismatches could substantially improve the current success rate of clinical cadaveric renal transplantation.


Cytochemistry of normal and leukaemic lymphocytes: a review.

Findings with six cytochemical reactions demonstrable in normal and leukaemic lymphocytes were reviewed. The two methods which are presently of greater diagnostic value are the acid phosphatase (AP) and alpha-naphthyl acetate esterase (ANAE) reactions. AP has a definitive role in the diagnosis of acute and chronic T-cell leukaemias, where a strong positive reaction helps to distinguish them from most B-cell lymphoproliferative disorders. New findings concerning the ultrastructural localization of this enzyme are presented. ANAE is of value in distinguishing T-lymphocytes (positive localized reaction) from B lymphocytes (negative reaction) and the T micron from the T gamma subpopulation of T-lymphocytes, a positive reaction demonstrable only in the T micron cells. Other reactions reviewed were PAS, beta-glucoronidase, hexosaminidase and alkaline phosphatase.


Current management of cardiac transplant recipients.

Changes in the management of cardiac transplant recipients over the past 10 years have resulted in a substantial improvement in the outlook for survival. Imuran and prednisone remain the primary immunosuppressive agents, but rabbit antihuman thymocyte globulin is used initially and reinstituted during rejection. Endomyocardial biopsy has allowed more precise diagnosis and management of rejection, and more recently immunological monitoring has been introduced to provide more frequent assessment of the host immune response. Infection is the major cause of death, and its diagnosis and treatment is managed aggressively. Current survival figures justify the use of cardiac transplantation, by an experienced team, when other measures have been exhausted.