Effect of acupuncture on headache measured by reduction in number of attacks and use of drugs.

The experiment was performed in order to study the effect of acupuncture on headache by comparing the number of attacks during a 2-month period after acupuncture with the number of attacks during a similar period before treatment. Twenty-nine students (age: 19-24 years) all suffering from headache filled out questionnaires noting the days with attacks of headache and the amount and type of drugs used for 60 consecutive days. After acupuncture this observation procedure was repeated. One group of 10 students, however, received a placebo treatment instead of acupuncture but followed the identical questionnaire procedure. After 120 days acupuncture was given to this second group without revealing that the first treatment was a placebo. This treatment was again followed by a 60-day observation period. Comparison of the questionnaires before and after acupuncture showed a significant reduction in the number of days with headache. The placebo treatment resulted in a nonsignificant reduction in attacks of headache. A reduction in the amount of drugs used, especially the acetylsalicylate type, was noted following the acupuncture treatment. It is concluded that acupuncture is a relevant therapy for headache with a definite symptomatic effect.


Effect of orally administered 15(R)-15-methyl prostaglandin E2 and/or an anticholinergic drug on meal-induced gastric acid secretion and serum gastrin level in patients with duodenal ulcers.

The purpose of the present series of tests was to measure and compare the effects of ingestion of gelatin capsules containing 15(R)-15-methyl PGE2 (PG) and/or an anticholinergic drug (methscopolamine bromide, Pamine) on meal-induced gastric acid secretion and serum gastrin level. Eleven duodenal ulcer patients were stimulated by a 5% peptone meal. Acid secretion was determined by the intragastric titration technique, and serum gastrin was measured by radioimmunoassay. The tests were randomized and double-blind. PG alone given 30 min before a test meal at a dose of 50 micrograms or 100 micrograms produced no side effects and inhibited meal-stimulated acid secretion by about 43% and 55%, respectively. Gastric acid inhibition after a single dose of PG was most pronounced in the first hour of a test meal and was accompanied by almost complete suppression of the meal-induced serum gastrin level. Pamine alone in a dose of 2.5 mg reduced gastric acid response to a meal by about 29% but caused a further rise of postprandial serum gastrin level over control values. The combination of PG, 50 micrograms, and Pamine, 2.5 mg, did not result in significantly greater acid inhibition (about 48%) than when either compound was given alone. When the higher dose of PG (100 micrograms) was given together with Pamine (2.5 mg), the degree of inhibition produced by PG alone was not changed. It is concluded that PG given orally in capsules is a potent inhibitor of gastric acid and serum gastrin response to a meal and that this effect may be of potential value in the treatment of peptic ulcer disease.


Transit time in constipated geriatric patients during treatment with a bulk laxative and bran: a comparison.

Transit time, as estimated from the passage through the gut of an isotope (131I)-containing capsule, was studied in 10 constipated, geriatric in-patients on a bulk laxative regimen and during treatment with wheat bran. The patients received a conventional bulk laxative (Vi-Siblin, 6 g twice daily) during a period of 8 weeks. The bulk laxative was then replaced by bran (10 g twice daily) during the following 8-week period. Measurements of transit time were taken after 4 and 6 weeks on each regimen. The mean transit time was 126 h for the bulk laxative regimen and 89 h for the bran treatment, the difference being statistically significant. The decrease in transit time for the bran treatment was essentially due to a faster passage through the rectosigmoid part of the bowel. Less additional laxative therapy was needed during bran treatment than during the bulk laxative treatment. The favourable properties of bran may tentatively be explained by the effects remaining in the distal part of the colon. A slight but significant lowering of the serum calcium level and a significant increase of the total iron-binding capacity of the serum were found after 7 weeks of bran administration, whereas no change was observed after 42 weeks. No significant change was demonstrated in serum iron during bran treatment.


Maintenance treatment of duodenal ulcer patients with a single bedtime dose of cimetidine.

Fifty-eight patients with endoscopically verified duodenal ulcers were treated with cimetidine, 1 g/day, for 6--10 weeks. The ulcers healed in 52 out of the 54 patients completing the treatment (96.3%). Forty-seven of the patients with healed ulcer were randomly allocated to 1 year of maintenance treatment, 23 patients with cimetidine, 400 mg at night, and 24 patients with placebo tablets. In the cimetidine-treated group 2 out of the 20 patients (10%) completing the trial had recurrence of ulceration, whereas 16 out of the 23 patients (70%) completing the placebo treatment had ulcer recurrence (p less than 0.001). The drug was well tolerated and, except for a marked increase in serum transaminases in three patients, no serious side effects were seen.


Total plasma cholesterol in obesity after jejunoileal bypass with 3:1 or 1:3 jejunoileal ratio. A randomized trial.

Total plasma cholesterol (TPC) was measured repeatedly in 95 morbidly obese patients who had been randomized to non-operative management or jejunoileostomy with either a 3:1 or a 1:3 jejunoileal ratio. Initially, TPC was on average 6.4 mmol/l. and it remained stable in those not operated on. Within 1 month of surgery TPC decreased to a mean of 3.9 mmol/l, at which level it remained for the following 3 years. There was no difference in TPC between patients who had a 3:1 and those who had a 1:3 jejunoileal ratio of the functioning segment. Previous studies indicated that the increase in degradation of cholesterol to bile acids is much less in 1:3 than in 3:1 bypass. This study suggests that the changes in cholesterol metabolism after jejunoileostomy are dependent on the length of functioning jejunum and ileum in such a way that the effects of the two segments counterbalance each other.


Tranexamic acid in massive haemorrhage from the upper gastrointestinal tract: a double-blind study.

In a double-blind trial of tranexamic acid in massive upper gastrointestinal haemorrhage, 76 patients were treated with the active drug and 73 patients with placebo. The doses were 1 g intravenously six times daily for a maximum of 3 days, followed by 1.5 g orally four times daily for a maximum of 4 days. The treatment group and the placebo group were comparable with respect to mean age, diagnoses and laboratory tests but differed slightly with respect to sex and alcohol consumption. The transfusion requirement in the treatment group was less than in the placebo group during the first days after admission, the difference being significant on the second day after admission. Ten patients in the treatment group and 18 patients in the placebo group were operated on. Eleven patients in the treatment group and 12 patients in the placebo group died. In the tranexamic-acid-treated group fewer operations were performed and significantly less blood was needed. It therefore seems highly likely that tranexamic acid has a beneficial effect, although small.


Pharmacological and clinical aspects of some drugs used in peptic ulcer treatment.

A healing effect of carbenoxolone and colloidal bismuth on gastric and duodenal ulcer has been demonstrated in several studies. The use of carbenoxolone is limited by the high frequency of side effects. Information on the ability of these drugs to prevent ulcer recurrences is sparse. Further studies are needed to determine the ulcer-healing effect of deglycyrrhizinised liquorice. Sulpiride, a dopamine-blocking agent, seems to have interesting inhibitory effects on gastric secretion but its anti-ulcer activity is not yet clear.


Acid alpha-naphthyl acetate esterase (ANAE) activity and DNA synthesis of lymph nodes cells in Hodgkin's disease.

Lymph node and peripheral blood lymphocytes in a case of Hodgkin's disease (mixed cellularity) were studied using May-Grünwald-Giemsa (MGG), acid naphthyl acetate esterase (ANAE), immunoperoxidase staining and lymphocyte surface markers, autoradiographic, and lymphocyte stimulation techniques. According to MGG staining and autoradiographic studies of lymph, node cells, small lymphocytes, intermediate lymphoid cells, and large mononuclear cells resembling in-vitro stimulated immunoblasts, Hodgkin's cells and Reed-Sternberg (RS) cells formed a morphologically continuous DNA synthetizing series. A large majority of small lymphocytes from a lymph node were ANAE positive, thus being T-lymphocytes, and formed rosetts around large mononuclear cells and RS cells. Most RS and large mononuclear cells had ANAE positive spots in the cytoplasm, thus resembling T-lymphocytes more than diffusely staining monocytes. These cells did not contain cytoplasmic immunoglobulin and were muramidase negative. Both lymph node and peripheral blood lymphocytes responded strongly to PHA. The role of T-lymphocytes in Hodgkin's disease and the origin of RS cells are are discussed on the basis of the findings.


Growth of the Reh cell line in diffusion chambers. Evidence for differentiation along the T- and B-cell pathway.

Cells of the Reh line, originally derived from an ALL of the 'Non-T, Non-B' type were cultured in diffusion chambers implanted intraperitoneally into perirradiated CBA mice. At different intervals over a period of 20 d changes in surface characteristics were examined by labelling the cells with AcALLG, ATCG as well as with polyvalent AIg. The evaluation was performed by using direct immunofluorescence. In addition, the ability to form rosetts with SRBC, AET-treated sheep erythrocytes, mouse red blood cells and EoxAC was tested. On day 0 of the diffusion chamber culture the cells only carried cALLA, and no rosette formation was observed. In the course of the diffusion chamber culture the cells unequivocally developed T-cell antigen, and in 1 of 2 experiments they further acquired a receptor for forming AET- and E-rosettes. Conversely, in the other experiment a receptor for mouse red blood cells was detected in a considerable portion of the cells. Our data show that the rather undifferentiated Reh line cells in vitro are able to develop features of mature T-cells and attributes of early B-cells during the diffusion chamber culture. In vitro they apparently retain a bivalent potentiality of lymphatic maturation. The diffusion chamber system proves to be a suitable tool for promoting differentiation in these cells.


The effects of phthalylsulphathiazole on the bacteria of the colonic mucosa and intestinal contents as revealed by the examination of surgical samples.

The isolation of a bacterial flora specifically associated with the colonic mucosa of patients undergoing large-bowel surgery is described. This flora differed from that of faeces in both the numbers and the types of bacteria isolated. The most striking difference was the reduction in the number of anaerobic bacteria isolated from the colonic mucosa. The ratio of anaerobic to aerobic was approximately 1:1 for mucosa compared with 100:1 for faeces.


The role of hepatic control of glucose homeostasis in the etiology of neonatal hypo- and hyperglycemia.

Precise control of glucose homeostasis is well recognized in the adult. Going from a period of complete dependence on the maternal organism for delivery of substrate, the fetus is born not only with a need to furnish himself with glucose for energy and rapid growth but also with the need to maintain a balance between glucose deficiency and excess. This is especially difficult because of the intermittent nature of exogenous oral intake in the neonatal period. Development of glucose homeostasis requires a balance between substrate availability (both absolute and relative) and coordination of hormonal, neural and enzymatic systems. The large number of conditions producing or associated with both hypo- and hyperglycemia in the newborn, especially the low birth weight or sick neonate, emphasizes this vulnerability. Newer techniques including stable isotope methodology, now being employed with increasing frequency, will help define maturation of neonatal carbohydrate homeostasis and further clarify nutritional requirements in this transitional period.


Polyunsaturated fatty acids in the low-birth-weight infant.

The essentiality of certain PUFAs is related to their capability to be incorporated into lipids and to act as precursor in the formation of prostaglandins. Via phospholipids the EFA's influence the physico-chemical characteristics of biomembranes. EFAs are metabolized differently from nonessential PUFAs. While the nonessential fatty acids are metabolized rapidly, the organism tends to conserve the stores of EFAs. Inhibitions and competitions among the EFAs of the three series (oleic, linoleic, and alpha-linolenic) have been demonstrated. Apparently, for any given chain length the more unsaturated fatty acid has a greater affinity for the enzyme system responsible for further elongation and desaturation. EFAs are also necessary for the proper utilization of the saturated fatty acids. Vitamin E and pyridoxine seem to be involved in EFA metabolism. Normal growth of infants is dependent upon an adequate supply of EFA. The human fetus, like the adult, is unable to synthesize the EFAs, which must therefore be derived from the maternal circulation and pass through the placenta. In the fetus, increased concentration of the polyenoic fatty acids with advanced gestational age may result from increased activity of the fetomaternal unit by preferential transfer of these FAs. Enzymatic activity in the placenta or the fetus may also be responsible for desaturation and elongation of these EFAs. Several clinical manifestations have been ascribed in the human infant to prolonged EFA deficiency; however, none of these findings was noted in a group of sick newborn infants with very rapid onset of deficiency. Platelet dysfunction, decreased prostaglandin biosynthesis and turnover and altered pulmonary surfactant are among the effects of EFA deficiency on infants. Supplementation of the EFAs by the diet, parenterally or by the inunction of oil rich in linoleic acid, were reported to alleviate the symptoms of EFA deficiency. The minimal estimated requirement of linoleic acid is 1% of calories and 4% is an optimal intake. Most diets, including human breast milk, infant formulas and parenteral fat emulsions, far exceed the optimal intake of linoleic acid. Relatively little is known about the possible effects of high levels of linoleate in the diet; however, early studies suggest an adverse effect on platelet function, prostaglandin biosynthesis, pulmonary gas exchange and immune function.


Sodium homeostasis in the newborn and low-birth-weight infant.

Sodium homeostatic mechanisms and clinical disturbances in the VLBW infant have been reviewed. Attention has been given to the unique natriuresis experienced to the greatest degree by the smallest and most ill infants reflecting unique differences in renal and neuroendocrine mechanisms. The precise requirement for sodium in relation to protein feeding practices may not yet be fully elucidated and will require further clinical evaluation.


Nutritional anemias.

The role of the metals, iron and copper, and the vitamins E, folic acid, and B12 in the genesis of nutritional anemias in infancy have been reviewed. All are preventable. The precise requirements for each of these trace elements and vitamins in the small premature infant remain to be defined. The nonhematologic consequences of these nutritional deficiencies require further study. Anemia may prove to be the least important manifestation of the deficiency states.


Microfilaraemia survey in Vientiane, Laos.

During the period June 1977-January 1978 a microfilariaemia survey was conducted for the first time in 27 villages (population: 9,300) of Vientiane province of Laos. A total of 2,339 persons, 1,372 males, 967 females, mostly adults, were blood tested between 2000--2400 hours; one thick smear, approximately 20 c.mm, was collected from each one and stained with 10% Giemsa for 30 minutes; only one positive was detected with microfilaria of W. bancrofti in a 22-year-old male; unusually the sheath was well stained. Two cases of elephantiasis of the left leg in two middle-aged women were also diagnosed during the clinical survey. All the three cases were probably infected in the north-eastern province of Houa Phanh.


Studies on human filariasis in Malaysia: immunodiagnosis using indirect immunofluorescence.

The indirect immunofluorescence test using sonicated microfilariae of Brugia malayi has been evaluated on 173 sera from patients and persons exposed to Wuchereria bancrofti and B. malayi in endemic areas of Peninsular Malaysia. In the microfilaria-negative group, without signs and symptoms of filariasis 55/62 sera (89%) had titers of 1:16 and less. In the microfilaremic groups and in the amicrofilaremic cases with clinical filariasis, all the sera tested were positive, with the antibody titers ranging generally from 1:16 - 1:256. Cross-reaction tests were done on 16 samples of onchocerciasis sera from West Africa using sonicated antigen as well as antigen-coated CNB1-activated sepharose. Antibody titers were detected in all the sera. The usefulness of the sonicated microfilarial antigen in serodiagnosis of filariasis is discussed.


Sub-populations of peripheral lymphocytes from patients with shigella bacillary dysentery with associated leucocytosis.

In this study we ascertained the proportion and absolute number of T, B and nul cell peripheral lymphocytes from Shigella dysenteriae type I patients and compared these results with those from age matched controls. Single blood samples were collected from 13 Bangladeshi children who complained of symptoms for one or more weeks. Patients were divided into two categories, with and without a leukaemoid response. The leukaemoid response was primarily granulocytic in nature, but there was a substantial increase in the mean number of lymphocytes. Over one third of the lymphocytes were nul cells. These cells rose proportionally to the decrease of T-cells, as the proportion of B-cells remained within normal range. One leukaemoid patient died. The absolute number of lymphocytes was normal and the B-cells were normal in respect of both proportions and absolute numbers. T-cell percentage and numbers were well below normal values.


Juvenile diabetes mellitus in Ethiopians.

The clinical features seen in 27 Ethiopian juvenile diabetics, which were similar to those of juvenile diabetics elsewhere, are summarized in this first published report from an African country of childhood diabetes. Control was difficult and admission to hospital frequent because of poverty, uncontrolled diets and irregular supplies of insulin. This group of childhood diabetics represents 9.8% of patients attending a diabetic clinic in Addis Ababa. Survey of the published information on diabetes mellitus in African populations reveals that most series do contain several children and a significant number of teenagers. It is concluded that juvenile diabetes mellitus is not rare in African countries.


From research to policy: rural women in India.

The following article describes the new awareness of rural women's role in development in India that has resulted from studying rural women directly. It indicates the possibility of moving from research on rural women to the formation of policy and the design of programs that take into account the reality of rural women's lives.


Indirect immunoperoxidase tests in the diagnosis of schistosomiasis.

An enzymatic technique, immunoperoxidase histochemistry, was applied in the diagnosis of human schistosomiasis. Sera of patients with S. haematobium, S. mansoni and mixed infection, together with control sera, were studied. The test proved easily applicable and gave reliable results particularly with S. mansoni and double infection. The depth of the colour reaction, was then compared with ELISA readings, but there was no relation in the results of the individual cases.


Attempts to infect Meriones unguiculatus and Mastomys natalensis with Wuchereria bancrofti from West Africa.

44 male and female Meriones unguiculatus and 13 male Mastomys natalensis were inoculated with infective stage larvae of Wuchereria bancrofti from West Africa and dissected between 16 and 360 days after inoculation. Fourth stage larvae of W. bancrofti were recovered in Meriones until the 90th day p.i. and in Mastomys until the 175th day p.i. The longest larva obtained from Meriones measured 9.5 mm and from Mastomys 6.5 mm.


Data on the involvement of some viruses in the etiopathogeny of human tumors.

Literature data concerning the relationship between some viruses (adenoviruses, herpes viruses, C-type oncornaviruses, papova viruses) and human cancer are briefly reviewed. Mention is made of the contribution to this domain of the Romanian school of virology and some of the author's viewpoints on the role of viruses in carcinogenesis are presented.


[The value of postoperative irradiation in the curative management of breast cancer (author's transl)].

A report is presented of the value of post-operative irradiation in patients with operable breast cancer. A combination of conservative surgery followed by irradiation provides optimal loco-regional results. Improved 10-year survival rates have already been reported with adequate irradiation of the peripheral lymphatics. The location and size of the primary tumour, as well as exact quantitative statements about histologically positive axillary lymph nodes are parameters of utmost importance.


[Effect of alternating milieu changes on specific substrate consumption in microorganisms].

In technical microbiology microorganisms often undergo alternating milieu changes. For instance, this is the case in recirculation reactors. The organisms react on these changes with an increase of entropy production and in connection with this with increasing substrate consumption. This increasing substrate consumption contradicts the aim of an optimum yield from a given substrate. Thus, studies of the reaction of microbial growth to alternating milieu changes are of great importance. A simple model of the influence of alternating milieu changes on specific substrate consumption is given. In it the biological conversion of substances is built up by an irreversible consecutive reaction. After preliminary examinations on the analogue computer the reaction of the model to alternating perturbations is simulated on the digital computer. The results of the stimulations are compared with experimental data. The good agreement of experiment and model justifies the use of the simple formulation in the preparation of technical processes.


[The molecular biology of aging -- 15: Structure and function of the genetic apparatus in aging. II. Synthesis and metabolism of RNA].

With aging in different organs there are similar or tissue specific changes of the ribonucleic acids in respect of the quantity, the spectrum of different RNA species and the metabolism of RNA. Among these processes the template function of the chromatin and the behaviour of the RNA polymerases are important influencing factors. In aging the sensitivity of the RNA synthesis against hormonal stimulation is decreased in the most cases. A survey about the results of many in vivo and in vitro experiments of the literature is given. The opinion is advocated that the problems of the gene regulation and gene expression are a important field of work in the experimental gerontology.


Comparative study of the effects of chondroitin sulfate isomers on atherosclerotic subjects.

Effects of isomers of chondroitin sulfate on atherosclerosis were clinically compared, based on sulfate linkage and the amount of sulfate, by using chondroitin 4-sulfate, chondroitin 6-sulfate and chondroitin polysulfate. Fourty eight age-matched atherosclerotic subjects were selected from a home for the elderly in order to the treatment with the agents. The isomers of chondroitin sulfate were given a daily dose of 4.5 g perorally. During the experimental period for 64 months, mortality, serum cholesterol, thrombus-formation time and thrombus weight were examined. The result obtained was as follows: mortality in the groups treated with the isomers of chondroitin sulfate was less than the age-matched untreated control group. Serum cholesterol value in the group treated by the isomers of chondroitin sulfate, chondroitin polysulfate group in particular, fell lower than the pre-treatment value. Thrombus formation time prolonged 150% in the group treated with chondroitin polysulfate over the untreated control group and the resultant thrombus weight was reduced in the treated group. Thus, these data indicated that the isomers of chondroitin sulfate are clinically effective on the treatment of atherosclerosis in the order of chondroitin polysulfate, chondroitin 4-sulfate and/or chondroitin 6-sulfate.


[Differential diagnosis and therapy of nephrogenic hemorrhagic diathesis].

For the development of nephrogenic haemorrhagic diatheses in the first place a decreased function of the thrombocytes and a thrombocytopenia are responsible. An inhibition in the intrinsic system may be referred to a lesion of the thrombocytic factor 3. Up to now defects in the extrinsic system do not allow a systematic classification. The best causal therapy are an effective haemodialysis and a renal transplantation. The detection of defects in the coagulation system is of importance for the dosed heparinisation and the control of the treatment with cytostatics for the immune suppression. Among 33 patients undergoing dialysis only 3 patients the Quick-value was reduced to 50% in 9 patients the thrombocyte values were below 150,000 mm3 and in 2 patients below 100,000 mm3. Among 28 carriers with renal graft only in 1 case the Quick-value was reduced to about 50%. In 12 patients the thrombocyte values were decreased below 150,000 mm3 and in 4 patients below 100,000 mm3. A correlation between the two global tests was not to be proved.


[Detection of the ischemic reaction of the myocardium by means of the polar coordinates of the ST segment in the corrected orthogonal ECG].

In the case of coronary heart disease the behaviour of the ST segment proved to be of major diagnostic importance for the recognition of hypoxidotic processes in the myocardium. Isolated consideration of the T-wave does not provide any characteristic information. The so-called ischaemic reaction is characterized by a typical jump of polar vectors from the left to the right side, which are moved rearwards without usually leaving the right-hand quadrant at the front. The angles of elevation are in a horizontal position or directed slightly upwards. This change of the direction can but need not include an increased magnitude. It is possible to observe the development of ischaemia as exercise is increased, with the polar vectors increasing or unchanging in magnitude and being moved rightwards, rearwards, and upwards. This characteristic movement invariably starts at the J point, involving additional portions of the ST segment as ischaemia is developed during increasing exercise. The J point depression should be considered to be only a "normal" response to exercise, provided the variations relate to the J point or 20 ms away from the latter.


[Johann Reinhold Forster (1729-1798) and Johann Georg Forster (1754-1794) in Halle. On the 250th anniversary of Johann Reinhold Forster's birthday].

The 250th anniversary of the birthday of Johann Reinhold Forster as well as the 225th anniversary of Johann Georg Forster gave rise to the memory of the life-work of these two famous scientists, whose life-work is in various forms connected with the University of Halle. The most important stages of these connections which include also the medicine of their epoch are demonstrated with the help of preserved documents.


[Bone diseases due to long-term administration of anticonvulsants during the age of growth].

On the basis of literature and 2 own observations a survey is given concerning the modern knowledge of bone changes as concomitant effect by long-term treatment with anticonvulsive drugs (diphenyl hydantoin and primidon) at the age of growth (osteopathia antiepileptica). The discussion of arising actual questions is demonstrated on instructive cases with consequences important for practice.


[Cerebrospinal fluid pressure studies after the intravenous administration of the steroid narcotic, alphaxolone + alphadolone acetate (Althesin)].

The effect of alphaxalon + alphadolon-acetate on cerebrospinal fluid pressure (CSFP), mean arterial blood pressure (MPA), heart rate (BMP) and blood gases was investigated in 18 patients. Cerebral perfusion pressure (CPP) was calculated from the difference MAP minus CSFP. Alphaxalon + alphadolon-acetate lowered the normal CSFP and normalized ketamin induced increase of CSFP. Premedication with alphaxalon + alphadolon-acetate delayed the ketamin induced increase of CSFP, which returned to norm after a second dose of alphaxalon + alphadolon-acetate. This effect was seen despite elevation of pCO2 in all patients breathing spontaneously.


[Dietrich Geotg Kieser (1779-1862)--merely a romantic physician?].

As an adherent of Schelling Dietrich Georg Kieser (1779-1862) was an outstanding representative of the German medical romanticism. From 1812 to his death he was professor of medicine in Jena. Despite natural philosophical-speculative theories his general pathology contains dynamic views of the disease including psychosomatic opinions. The basis for this is the holism of man under the aspect of developmental history. Kieser did an eminent good work in the field of medical practice and organisation. He was the head of several clinics and from 1847 he was the first professor in Jena who only worked in the field of psychiatry. 1858 he was elected president of the Imperial Leopoldino-Carolinic German Academy of Scientists.


[New aspects of the pathophysiology of gestosis/pre-eclampsia (author's transl)].

An increased pressor responsiveness is consistently found in nulliparous patients with gestosis. The following mechanisms may be able to influence arterial reactivity: sodium balance, factors of the kallikrein-bradykinin and the renin-angiotensin systems, an imbalance between vasoconstrictive and vasodilatatory prostaglandins, the sympathetic nervous system, and possibly prolactin, too. A mechanism which is involved in the regulation of uteroplacental blood flow seems to be important in the etiology of gestosis. The immunological changes found in patients with gestosis are insufficient to support the concept of a primary immunopathogenesis. The usefulness of the supine pressor ("roll-over") test, of the angiotensin sensitivity test and serum uric acid determination in predicting hypertensive disorders of pregnancy is evaluated. The supine pressor test is recommended as an appropriate and practical method for routine screening in nulliparous pregnant women.


[Lichen ruber ulcerosus (dystrophicans)].

Report on two women suffering from chronic painful ulceration of the feet combined with interdigital synechia, loss of nails, alopecia and oral lesions of lichen planus. Hint at certain clinical parallels of dystrophic skin symptoms with epidermolysis bullosa hereditaria dystrophica yet demonstrating different mode of blister formation.


Biofeedback and the behavioral treatment of disorders of disregulation.

This paper reviews biofeedback research from the perspective of cybernetic/feedback theory and applies the theory to the behavioral treatment of psychosomatic disorders. The concept of disregulation is used to elucidate how environmental factors can modulate the central nervous system and effect homeostatic, self-regulatory control of peripheral organs. When feedback from peripheral organs is disrupted, it is hypothesized that disregulation occurs, leading to physiological instability and functional disease. Within this framework, biofeedback provides a new feedback loop that can help individuals regain physiological self-control. Basic research using biofeedback to enhance self-regulation of cardiovascular responses is reviewed. The use of biofeedback in the behavioral treatment of disorders such as tension and migraine headache, hypertension, and epilepsy are selectively reviewed and critically evaluated. The need to consider feedback mechanisms in behavioral and biomedical approaches to treatment is highlighted. Predictions regarding the potential inadvertent perpetuation of disregulation and disease through inappropriate biomedical intervention is also considered.


Amino acids and cell regulation.

Free amino play an important role in regulating cell volume in fishes. Four tissues/cells (skeletal muscle, RBC, brain, and myocardium) of the little skate, Raja erinacea, were selected for detailed study because of their special importance or unique advantage as experimental models. Three particular amino acids, beta-alanine, taurine, and sarcosine play a predominant role in all four tissues. As in higher vertebrates, amino acid uptake in skate brain, heart, and RBC is mediated via a Na+-dependent process. Amino acids leave the skate brain rapidly in response to a sudden decrease in plasma osmolality and/or to a simultaneous drop in extracellular Na+ concentration. However, although amino acids are important for volume regulation in normal brain cells, they do not appear to be likely candidates for the unidentified "idiogenic" osmolytes in mammalian brain cells. The high concentration of taurine in skate myocardium is of special interest because of the special role of this amino acid in myocardial contractility. Thus, unlike beta-alanine and sarcosine, taurine may play a dual role in regulating both cell volume and contractility of myocardial cells. The isolated skate atrium is well suited for in vitro studies of these two processes.


Evaluation of lung recovery assay for schistosomula in mice immunized with x-irradiated cercariae of Schistosoma mansoni.

The lung recovery assay for schistosomula has recently been used as a rapid method for measuring the state of immunity of a challenged animal. Its merit rests on the fact that the peak day of schistosomular recovery in the lungs of both normal and immune hosts falls on the same day and the degree of immunity can be measured by the percent of schistosomular recovery on this particular day. An evaluation of this method for mice immunized with highly X-irradiated cercariae of Schistosoma mansoni was made. The results indicate that in the immunized mice the peak day for the schistosomular recovery was delayed and the number of schistosomula recovered on the peak day was decreased. The delay of the peak day was increased by the degree of host immunity, so its identification for a host of an unknown immunologic status was not a simple matter. In addition, this method measured only the immune effect which took place in the skin and on prepeak days in the lungs. It was not as competent as the conventional liver perfusion method which measures the total result of the immune effect of the skin, lungs, and liver. Our conclusion is that for measuring the immunizing effect of irradiated cercariae, the lung recovery method is not suitable for the determination of the state of immunity induced.


Comparative physiology of renal tubular transport mechanisms.

This manuscript discusses current concepts of glomerular filtration and tubular transport of sodium, water, potassium, and urinary acidification by vertebrate kidneys in a comparative context. Work in mammalian and amphibian nephrons receives major emphasis due to our interest in application of new techniques for investigation of cellular mechanisms; when available, data from other vertebrate classes are discussed.


Humoral response to sheep red blood cells in C57L/J mice during early and chronic stages of infection with Echinococcus multilocularis cysts.

C57L/J male mice infected with Echinococcus multilocularis cysts were challenged intraperitoneally at 4, 8, and 12 weeks postinfection (p.i.) with 3 x 10(9) sheep erythrocytes. The direct plaque forming cells, 2-mercaptoethanol (2-ME) sensitive (4-day sera) and 2-ME-resistant (8-day sera) haemagglutinin responses were significantly elevated at eight and 12 weeks p.i. as compared to controls or the fourweeks postinfected mice. Possible mechanisms of immunopotentiation in the chronically infected mice is discussed in relation to the larval cyst mass, splenomegaly, and B cell hyperplasia in the lymphoid tissues during the course of infection.


[Adult day care in the USA].

This travel report describes the supply of the USA with adult day care centers and it wants to enable a comparison with the situation in other countries. The US situation is characterized by a great number of centers, most of which are not day hospitals but day care centers. The spectrum of services offered is rather big with a great diversification. Financing and organising of transport service is a great problem in many an institution. A great part of the American population has no health insurance. For patients of 65 and over, medicare, a federal program will take over the cost for treatment. Regulations of medicare are similar to the right of German health insurance: health insurance will pay for people in need of treatment, patients who are just in need of maintenance therapy or care will have to pay for themselves. Medicaid, a federal welfare program, will only pay for them, if they cannot afford the money. If medicare would pay for day treatment in general, a rise in the number of day care centers and day hospitals could be expected. There are only rudiments for cost-benefit-analysis in day care in existence. Four centers in different states were described in detail.


[Cimetidine--a new principle in treating peptic lesions (author's transl)].

A survey is given on the present state of experience with Cimetidine. Cimetidine significantly promotes healing of duodenal and gastric ulcers; this effect is especially significant in countries with low spontaneous ulcer healing. Prophylactically administered Cimetidine is the only drug capable of decisively lowering the recurrence rate of duodenal ulcers. In certain cases, Cimetidine long-term treatment therefore seems to compete with elective gastric operations. However apart from the operative risk surgery of the stomach (especially selective gastric vagotomy) still provides certain advantages. Controlled long-term trials are still required in order to come to a clear-cut delimitation between the indications for Cimetidine prophylaxis and elective operation. Furthermore prophylaxis with Cimetidine prevents gastric bleeding from erosions in stress-patients. Even in Zollinger-Ellison-syndrome Cimetidine enables ulcers to heal and patients to reach operability. In patients with operable gastrinomas the long-term treatment with Cimetidine seems to replace palliative total gastrectomy by curative resection of the tumour.


The insulin test after vagotomy and antral resection or drainage. Stability and reversal of test response in repeated tests.

Repeated insulin tests were carried out on 118 patients after vagotomy and antral resection or vagotomy and drainage. The main indication for operation was gastro-duodenal ulcer. The test was performed in both the early (average 13.7 days after the operation) and late (average 3.3 years) postoperative phase. After vagotomy and antral resection, the proportion of Hollander-positive responses decreased from 21.1% in the early phase to 11.1% in the late phase, but after vagotomy and drainage, it increased from 32.1% to 57.1% (p greater than 0.05 in both). Changes of the test response from negative to positive and vice versa were seen after both types of operations. After vagotomy and antral resection, in tests with a change of the response from positive to negative (14.4%) there was a significant decrease in insulin-stimulated acid secretion. After vagotomy and drainage, there were more changes from negative to positive (28.6%), but no significant differences were seen in acid secretion values. Some tests showed a change from early positive to late positive (Ross & Kay). The significance and possible explanations for the changes are discussed in the light of acid secretion values.


Surgical treatment of local recurrences of breast carcinoma in the skin and subcutaneous tissues.

Twenty-six cases of local recurrence of breast carcinoma in the skin and subcutaneous tissues after treatment with radical excision and large skin grafts or reconstruction are presented. Seventy-seven per cent of the patients were alive 2 years after the treatment. As a chest wall recurrence of breast cancer in the absence of distant metastases does not always indicate a generalization of the disease, radical reconstructive surgery is recommended as the therapy of choice.


[Pericecal abscess and infiltration as a complication in the early phase of acute non-differentiated cell leukemia].

Acute abdomen syndrome was the presenting sign of leukaemia in the reported case. The authors discuss indications to surgical treatment in patients with leukaemia.


[Radiologic diagnosis of the hemodynamic situation in the pulmonary circulation in chronic obstructive ventilatory disorders].

Hemodynamic consequences, especially in view of a developing pulmonary hypertension are essential factors regarding the course and prognosis of an obstructive airflow disturbance. The characteristic roentgen symptoms of pulmonary vascular changes in a group of patients are collected and statistically evaluated to find those symptoms correlating best with the results of cardiac catheterisation. The importance of using not a single symptom but characteristic groups of symptoms for the radiological diagnosis of pulmonary hypertension is stressed. Radiological signs of increased pulmonary pressure do not directly correlate to the degree of measurements, false positive radiological reports need not be expected. Positive radiological symptoms indicate irreversible anatomical changes in pulmonary circulation. For the individual patient the pulmonary arterial pressure by cardiac catheterisation alone is not sufficient for the diagnosis and prognosis of this case as in obstructive air-way disturbance two definitely different types of diseases, namely type A (emphysema) and type B (bronchitis) with divergent hemodynamic consequences must be distinguished. For this differentiation the radiological evaluation of the anatomical situation is essential.


[Case of heterozygotic SC hemoglobinopathy with high titre of indirect immunofluorescence reaction with Plasmodium falciparum antigen].

The authors report the first in the Polish literature case of combined heterozygotic SC haemoglobinopathy in a Nigerian aged 20 years. The diagnosis was based on the results of haemoglobin electrophoresis and clinical signs. The titre of IFP with Plasmodium falciparum was very high and malarial pigment was found in lymph nodes.


Tubo-ovarian abscess: a review of 46 cases.

Forty-six patients with tubo-ovarian ascess are analysed. The abscess developed mostly in young multiparous women soon after menstruation. Coliforms were the main causative organism. The abscess resolved with conservative management in 21 cases and surgical intervention was necessary in 25. The mortality (4.4%) due to conservative medical and surgical management was nearly half that of radical surgery.


Anesthetic management of conray toxicity.

Conray (meglumine iothalamate), the contrast media frequently used in shuntograms for diagnosing malfunctioning ventriculo-peritoneal shunts, will occasionally cause severe muscular spasms and seizures. In this article, the authors describe anesthetic and critical care management of a case with this complication.


Effects of estrogen on the lymphoid regeneration and immune response in irradiated and marrow-reconstituted mice.

Various doses of estriol (E3) were given to mice intraperitoneally, immediately after lethal irradiation and marrow reconstitution. The assessment of the plaque-forming cell (PFC) response to sheep erythrocytes in the spleen and the histological assessment of lymphoid tissues were carried out 30 days later. The effects appeared to be dose-dependent and resulted in a marked suppression of the PFC response. The depletion of lymphocytes was dramatic and dose-dependent in the thymus, and in the thymus-dependent and in the thymus independent areas of the peripheral lymphoid tissues. These results suggest that E3 acts on the differentiation of stem or precursor cells toweard both the populations of T and B lymphocytes. Although E3, given on day 7 after irradiation and marrow reconstitution, suppressed the lymphoid regeneration and PFC response markedly, E3 given on day 14 had no effect. On day 7 the majority of regenerating lymphoid tissues were large pyroninophilic cells and on day 14, small lymphocytes. These results suggest that the precursor or immature lymphocytes are sensitive to E3, while mature lymphocytes are resistant. Lymphoid regeneration and PFC response were retarded in mice irradiated and reconstituted with bone marrow cells from donors pretreated with E3. These results suggest that E3 acts on the stem or precursor cells capable to differentiate in the direction of lymphoid populations and reduce their number in the bone marrow.


Light- and scanning electron-microscopy of the nasal mucosa.

The article is a short review of some aspects of the surface structure of the human nose. It deals with the morphology of the surface epithelium in nasal allergy, viral and bacterial infection. Kartagener's triad and in rhinitis patients continuously treated with topically active steroids.


Ultrastructure of normal epithelial cells in Papanicolaou-stained cervical smears. An application of a modified open-face embedding technique for transmission electron microscopy.

The results of an open-face embedding technique applied to Papanicolaou-stained uterine cervical smears are presented. By this technique, cells are smeared on a plastic sheet, fixed in 1.5% buffered glutaraldehyde and stained by the Papanicolaou method; areas of special interest are then selected by light microscopy for electron microscopic observations. Thus,  a comparison is possible between the light  microscopic characteristics of cells in smear preparations and their ultrastructural counterparts. The good ultrastructural preservation allowed detailed study of nuclei and cytoplasm. The endocervical cells had intact nuclei with nuclear envelope, Golgi apparatus, well-preserved mitochondria and two types of secretory material. The superficial and intermediate squamous cells showed loss of desmosomes; dense, fine cytoplasmic fibrils; small, fatty droplets; and degenerated nuclei with loss of the nuclear envelope. Compared with ultrastructural studies on cervical tissues, the intermediate cells in cervical smears were more degenerated, presumably because predominantly degenerated intermediate cells exfoliate. This study indicates that the light microscopic impression of the nuclear appearance is misleading: in the routine smear the nuclei of superficial and intermediate cells may look "intact" and "well preserved" whereas ultrastructurally the nuclei are degenerated.


C-reactive protein (CRP) in early diagnosis of neonatal septicemia.

The usefulness of CRP in early detection of neonatal septicemia/meningitis and urinary tract infection was studied in a neonatal unit using a semiquantitative latex-agglutination as a rapid screening method, and electroimmuno assay as reference method for CRP determination. In 94% of non-infected infants CRP was less than or equal to 15 mg/l and 82% had CRP less than 10 mg/l up to 3 days of age. After 3 days of age 96% had CRP less than 10 mg/l. The initial CRP level was increased in 16 out of 18 patients (89%) with bacterial septicemia. Low CRP was seen in one patient with total agranulocytosis and septicemia from Streptococcus type B and in one patient with Staphylococcus albus sepsis. A rise in CRP was also seen in very pre-term infants with septicemia. Increased initial CRP was uncommon in neonatal urinary tract infection (2 of 9), but a rise was seen in 3 additional patients. A comparison between CRP, total neutrophil blood cell count and band neutrophil count as diagnostic parameters was in favour of CRP at this early stage of infection. CRP is of definite value as an aid in early diagnosis of neonatal septicemia and bacterial meningitis.


Group B streptococcal colonization of pregnant women and their neonates. Epidemiological study and controlled trial of prophylactic treatment of the newborn.

Colonization with group B streptococci of the genital tract was studied in 1 115 women during the last trimester of pregnancy. 76 or 6.82% were found to harbour this bacterium. The incidence of contamination was significantly higher among Belgian women than among parturients of Mediterranean origin (p less than 0.001). It was also more frequent in primigravidae (p less than 0.05) and in the poorer (0.10 less than p greater than 0.05). At the time of admission in the delivery room, it was noticed that rupture of the amniotic membranes for more than 24 hours was more often associated with group B streptococcal carriage by the mother (p less than 0.001). 29 out of 68 (42.6%) infants born to group B streptococci positive mothers were colonized at birth. 67 of them were submitted to a controlled trial of immediate versus delayed penicillin therapy. 44.8% and 42.1% of the neonates were contaminated at birth in each group of treatment respectively. No instance of group B streptococcal infection developed in either group. This suggests that immediate therapy with penicillin of infants of group B streptococci positive mothers has no definite advantage upon delayed treatment.


Surface properties of Staphylococcus saprophyticus and Staphylococcus epidermidis as studied by adherence tests and two-polymer, aqueous phase systems.

S. saprophyticus is an established pathogen in man, devoided of characteristics associated with pathogenicity in Staphylococcus aureus. The ability of this species to attach to cells from regions, viz. the urinary tract, where it acts as an invador and to cells from areas where it is known as a commensal, was compared to its behaviour in this respect with another staphylococcal species, viz. S. epidermidis. S. saprophyticus showed a preferenital adherence to human exfoliated urogenital cells, when compared with its ability to attach to skin and buccal cells from man and also when compared with procine cells from these regions. The profound ability to adhere to human exfoliated urogenital epithelial cells by far exceeded that of S. epidermidis, while no such species difference was found when testing porcine cells (S. saprophyticus is unknown as a urogenital tract pathogen in pigs). When studied in a two-polymer, aqueous phase system, S. saprophyticus and S. epidermidis were found to have a negative surface charge at pH 7.2, but the former carried a considerably higher surface charge density. Both staphylococcal species exhibited a poor hydrophobic interaction liability. These physico-chemical surface characteristics are briefly discussed with regard to the differential bacteria-cell interactions of these species.


Phagocytosis of 32P-labelled Escherichia coli by human polymorphonuclear cells (PMN). Effect of different sera and PMN with reference to the ABO blood group system.

A study on the interaction of different sera and polymorphonuclear cells (PMN) with reference to the ABO blood group system on the phagocytosis of a radiolabelled strain of E. coli is reported. Using untreated sera, O cells were found to be the least sensitive and AB cells the most sensitive to reduction in phagocytic activity. No reduced phagocytic capability relative to the different sera used was observed when heat-inactivated sera were applied. Aspects of these results are discussed.


Aggression-provoked renin release from extrarenal and extrasubmaxillary sources in mice.

In submaxillary sialoadenectomized and nephrectomized mice aggressive behaviour provoked 5 to 40-fold increases in plasma renin concentration. The changes in renin concentration with time were different in different groups of confronted mice with only partial correlation between the pattern and the observable degree of fight. The changes were similar in sialoadenectomized mice with untouched kidneys as in sialoadenectomized and nephrectomized, indicating that aggression causes no measurable, if any, renal renin release. Repeated aggression with 2 hourly intervals provoked repeated renin release from extrarenal and extrasubmaxillary sources. The renin concentrations of different organs showed the same mutual relationship as in other mammals, but were about 10-fold higher. Splenectomy was without effect on the aggression-provoked renin release. Antibodies against pure mouse renin neutralized the renin in plasma and organs, which contained only insignificant, if any, pepsin activatable inactive renin. Adrenaline, apomorphine, carbachol and dihydralazine were as isoprenaline and noradrenaline without effect on renin release in sialoadenectomized and nephrectomized mice.


Nonspecific factors and side effect complaints. Factors affecting the incidence of drowsiness in drug and placebo treated anxious and depressed outpatients.

Discriminant function analyses were applied to data obtained from anxious psychiatric outpatients treated with either chlordiazepoxide (n = 353) or placebo (n = 259) and depressed outpatients treated with either amitriptyline (n = 310) or placebo (n = 328), who had participated in controlled drug trials of 4 weeks' duration, in an attempt to identify factors associated with complaints of drowsiness made by these patients. Although the magnitude of the relationships between individual predictors and drowsiness was small, several factors emerged which had consistent impact across treatment groups. Predictors of complaints of drowsiness attributed to active drugs arose primarily from demographic attributes probably reflective of life style, and from illness and treatment history. In contrast, predictors of drowsiness attributed to placebo were almost exclusively confined to indices of the severity of several aspects of presenting symptomatology. In particular, more frequent complaints of drug-induced drowsiness were found among better educated individuals with an illness of long duration. Complaints of placebo-induced drowsiness were more common among patients with more severe emotional (phobic-obsessive) symptomatology and more frequent headaches and among those individuals in whom hypochondriasis was less severe.


Endotoxin tolerance in rats treated with antilymphocyte serum.

Rats were treated with rabbit anti-rat lymphocyte serum (ALS). The subsequent selective immunosuppressive effect on the immune response of thymus dependent antigen was shown by immunization with sheep red blood cells (SRBC). Endotoxin tolerance could be evoked in ALS treated animals. This suggests that the establishment of endotoxin tolerance is independent of thymus function and makes it possible to enhance the nonspecific resistance of immunosuppressed patients with a transplanted organ.


Psychobiology of mental disorders associated with childbearing. An overview.

The diagnostic issues, classification, incidence, genetic factors, and theories of etiology of psychiatric illness associated with childbirth are reviewed. Psychologic influences, psychosocial factors and the concept of biologic maladaptation associated with prospective motherhood are discussed. Postpartum mental distress is not a unitary phenomenon. The physiology of the puerperium is thus not a cause in itself of any of the symptoms, but rather must be regarded as a contributing or triggering factor acting upon an underlying predisposition. Clinical research of postpartum psychiatric syndromes (PPS) and animal behavior studies are inconclusive. It is suggested that major neuroendocrine research strategies currently used in studying affective disorders and schizophrenia should be applied in studying PPS.


[Three years of CPAP-breathing therapy in immature and mature newborns (author's transl)].

162 immature and mature asphyctic newborns were treated by CPAP breathing. The overall survival was 42%. Taking babies without primary asphyxia not into account, 55% per cent survived. On children born before the 34. week of gestation, the therapeutic effectivity decreased markedly.


The sphincter of Oddi, sphincterotomy and biliopancreatic disease.

The physiology and pathophysiology of the sphincter of Oddi are poorly understood. The relationships of functional disorders of the sphincter to biliary and pancreatic disease and of organic lesions of the papilla to pancreatic inflammatory disease are subjudice to say the least. The efficacy of sphincter section in the treatment of chronic pancreatitis is unproved. Section of the sphincter may be necessary to treat biliary tract pathology but its use should not be routine or indiscriminative since, there is morbidity as well as mortality. Finally, the price of sphincterotomy is: 1. hemorrhage; 2. duodenal perforation; 3. pancreatic duct damage--a. acute pancreatitis; b. chronic pancreatitis; 4. sphincter incompetence--a. common duct regurgitation--cholangitis; b. pancreatic duct regurgitation--pancreatitis; 5. sphincter stenosis--obstructive jaundice; 6. stasis cholecystitis; 7. diarrhea; 8. morbidity 10%; 9. mortality 1.9%.


Brief historical note: the concept of "gonadal dysgenesis".

The history of gonadal by dysgenesis cautions against overinterpretation of data: The streak gonads are neither the result of dysgenesis nor of embryonic origin but represent late fetal/neonatal degeneration; the X-chromatin-negative character of the buccal smear and the frequency of color vision defects did not indicate male sex in the Ullrich-Turner syndrome but rather an XO constitution; severity of dysgenesis did not correlate with risk of gonadal neoplasia but with genotype; the gonadal lesion in the Ullrich-Turner syndrome was not due to a pituitary defect but a primary ovarian lesion; patients with the Noonan syndrome do not have the Turner phenotype. The concept of gonadal dysgenesis, introduced to Kermauner in 1912, has outlived its usefulness. Improved methods of phenotype analysis, family studies, and endocrine and cytogenetic methods have showen it to be causally and pathogenetically heterogeneous and have contributed to a better identification and delineation of the several different genetic entities which it formerly comprised.


Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms. Report of nine cases, including three males.

This study pertains to an entity characterized by the presence of multiple intrapulmonary nodules, which consist of an admixture of bundles of well-differentiated smooth muscle cells and epithelial-lined spaces. These lesions have been frequently interpreted as a variant of hamartomas. However, in this review of the literature, and careful analysis of nine cases of this entity, we concluded that they should be considered metastases from smooth muscle tumors which incorporate some structures of mature lung parenchyma as they slowly expand. We affirm that the designation "fibroeliomyomatous hamartoma" should be discarded. Our cases occurred in six female and three male patients. In all but one female the primary source for lung metastases was uterus, while the male patients had primary lesions in the saphenous vein, diaphragm, and soft tissues. These lung lesions increase in size and number and are potentially fatal, though this may take many years. Even though the smooth muscle cells of the lung nodules appear bland on light microscopy, we were always able to demonstrate mitotic activity; electron microscopy indicated immaturity of the cells. For these reasons, we believe the tumors to represent metastatic leiomyosarcomas.


Lamellar keratoplasty in keratoconus.

The authors present the results of 11 keratoplasties in cases of keratoconus, comparing the visual acuity and the ocular refraction before and after the operation (ophtalmometry, objective and subjective refractometry). The statistical data indicate a meaningful flattening of the corneal curvature (12.84 dpt average) and a mean reduction of the myopia for 8.227 dpt. In fact, the basic regular astigmatism of the cornea had not been altered. The mean visual acuity was 0.68 (with an improvement of 0.495). No further damage of acuity had been observed. After 10 to 69 months a medical checkup revealed transparent grafts in five cases; four presented small maculae; one, thin folds of Descemet's membrane. Based on the authors' experience and on the literature, the paper recommends lamellar keratoplasty in cases of keratoconus, the surgeon must choose the appropriate moment in the course of the development of this disease.


Immunohistological localization of prostatic acid phosphatase.

Antisera demonstrated by precipitation and passive haemagglutination to posses antibodies specific for prostatic tissue-specific acid phosphatase have been employed to localize this isoenzyme in the prostate by indirect immunofluorescence. Antisera specific for prostatic acid phosphatase may permit the immunohistologic identification of this enzyme, thereby serving as a biological marker for metastatic prostatic cancer, where histological and/or clinical staging of the primary tumour remains questionable.


Results of therapy in systemic nocardiosis.

The effect of therapy on the clinical course of pleuropulmonary and systemic Nocardia asteroides disease in 78 reported cases was analyzed. All patients were treated with drugs. In 72 cases sulfonamides alone or in combination with other antibiotics was given; 45 patients underwent surgical procedures. The extent of disease had a bearing on survival as only 3 of 39 patients (7.6%) with isolated pleuropulmonary involvement died. These fatalities occurred among the 16 patients of this group who received immunosuppressive drugs. One of 12 patients (8.3%) with suppurative foci other than brain abscess and pleuropulmonary nocardiosis died, whereas the fatality rate of cases with nocardial brain abscess was 47.8%. Thirty-one patients relapsed or had progression of disease while receiving drugs for nocardiosis, 30 of them within the first three months. Prolonged post-treatment observation is essential in the management of nocardiosis as four patients relapsed after drug therapy was discountinued, three of them between six and eight months. Although there was no significant difference in the survival of patients treated with only drugs when compared to those who also had surgery, no fatalities occurred among those medically treated for six months or longer (p = .0091).


Nasal continuous positive airway pressure in the treatment of whooping cough.

A 3-week-old baby, suffering from whooping cough with severe attacks of apnoea and hypoxia, was treated by nasal CPAP with a positive airway pressure of about 5 cm H2O. The respiration improved rapidly and the transcutaneous oxygen tension increased to a normal level. The treatment was carried on for 7 days and discontinued gradually in the course of 3 days. The child was also treated with pertussis immunoglobulin and erythromycin. The CPAP system employed is easily and rapidly applied and allows normal nursing of the child during the treatment and manual lung physiotherapy in upright position. The treatment probably proved lifesaving.


Pulmonary lavage in a case of alveolar proteinosis. The value of continuous display oxygen--haemoglobin saturation using ear-oximetry.

A case of alveolar proteinosis is reported which was treated by lung lavage. The technique requires a Robertshaw double-lumen tube to isolate each lung. Initial ventilation with 100% oxygen removes lung nitrogen and the first 500 ml of saline occupies part of the functional reserve capacity and is not recovered. Lavage is then continued with 500-ml aliquots until the washings become clear. Monitoring the oxygen--haemoglobin saturation by ear-oximetry showed changes of between 15 and 20%, falling during suction and rising during infusion of lavage fluid. At the end of lavage, gas exchange is severely impaired by retained saline and a variable period of controlled ventilation may be required.


[Attempt to demonstrate beta-HCG in germinal testicular tumors of the adult by an indirect immunoperoxidase method].

In 25 cases of germinal testicular tumours of the adult, a technique of indirect immunoperoxydase was applied to histological sections with the aim of demonstrating a substance reacting with an anti-beta HCG antibody (sub-unit of chorionic gonadotrophin hormone). If the experimental conditions were appropriate, the substance should actually be beta HCG.


[Immunocytochemistry of pancreatic and pancreatico-duodenal apudomas].

Immunocytochemical techniques, applied to material fixed with Bouin's fluid and using immune sera specific to various hormonal polypeptide(s), give a classification of pancreatic and pancreatico-duodenal apudomas based upon cellular functional activity. With a rane containing a minimum of five antibodies (gastrin, insulin, glucagon, somatostatin and pancreatic polypeptide), 15 tumours could be identified amongst the 22 tested. They were either "monohormonal" tumours (10 cases) or "bi- or polyhormonal" tumours (5 cases). In the remaining 7 cases, only rare cells were immunoreactive. A large number of immunoreactivities thus revealed in histological sections are clinically silent or are present in a "forme fruste".


[IgA linear dermatosis (author's transl)].

Besides the typical forms of dermatitis herpetiformis (DH) and bullous pemphigoid (BP) of adults and children, there are cases combining clinical, histological and electronmicroscopic features of both. Linear continuous IgA deposits along basement membrane zone (BMZ) are a most characteristic finding. They differ from the granular IgA deposits in DH, even if these are also distributed along the BMZ (however, preserving as a rule their granular pattern). IgG circulating anti-BMZ antibodies are absent, whereas in some cases IgA anti-BMZ antibodies may be found. In contrast to DH, there is no gluten-sensitive enteropathy, and the gluten-free diet is ineffective. The recognition of this bullous disease as a distinct entity is of practical significance because these cases respond well to combined treatment with sulfones and corticosteroids, all in small doses. Because of diagnostic importance of linear IgA deposits at BMZ we have proposed the name IgA linear dermatosis. In children a counterpart of IgA linear dermatosis of adults is chronic bullous disease of childhood (CBDC), which we propose to call IgA linear dermatosis of childhood.


[Imported malaria in a tropical unit in Paris. About 100 cases (author's transl)].

From a hundred cases of imported malaria observed in Paris, the authors emphasize the following points: annual increase of cases, lack or inadequacy of prophylaxis, frequent reinfestations among black africans living in France, and comming back in endemic area for a brief journey, high risks for pregnant women.


Neonatal respiration, feeding and neurobehavioural state. Effects of intrapartum bupivacaine, pethidine and pethidine reversed by naloxone.

The effects on mature newborn have been compared at 0.5, 4, 8 12 24 and 48 hr after birth, of maternally administered epidural bupivacaine (11 babies) or pethidine (18 babies) or pethidine reversed by naloxone administered intramuscularly to the newborn (15 babies). Bupivacaine (mean dose 130 mg) had less effect that pethidine (mean dose 183.3 mg) on alveolar carbon dioxide tension (PACO2) at 0.5 hr after birth, but had a similar effect to pethidine on feeding, elicited reflexes and produced more depression of muscle tone up to 48 hr. Bupivacaine had more effect on PACO2 feeding measures, elicited reflexes and muscle tone at almost all examination periods than pethidine (mean dose 157.0 mg) reversed by naloxone (200 micrograms intramuscularly). Except at delivery, the effects of bupivacaine or pethidine on respiration and feeding up to 48 hr after birth were similar. There were more signs of depression with both drugs than when pethidine had been reversed by naloxone.


Our experience with pharyngoesophageal reconstruction.

Our experience with 11 cases of cervical esophageal reconstruction following excision of the hypopharynx and conservative neck dissection is reported. For the reconstructive procedure, we utilized a full-thickness skin graft from the penis according to Kaplan and Markowicz in 2 cases and a deltopectoral flap according to Bakamjian in 9. Critical evaluation of the clinical follow-up has led us to prefer the second method. It seems, in fact, to be the solution of choice in this kind of surgery, for the deltopectoral flap offers a generous source of viable skin due to its good blood supply.


The role of the plastic surgeon in a cancer hospital.

This paper discusses and illustrates the complicated problems faced by the plastic surgeon in a cancer hospital. His patients are often weakened, both physically and psychologically, not only by the cancer itself, but also by extensive ablative surgery. The goal of the plastic surgeon is rehabilitation of the patient after he is cured of cancer. Good planning with the cancer surgeon before the ablative operation is very important, as is immediate repair, whenever possible. The simplest procedure with the fewest stages that can accomplish satisfactory repair in the shortest time should be chosen, as we can never, even after the most extensive cancer operation, be sure that no recurrence will appear. Partial surgical repair and the use of a prosthesis should be considered for complicated defects in old and weak patients. Postoperative radiation therapy, if indicated, can be given after the flap has healed into the defect but before the pedicle is separated. The plastic surgeon should always be aware that his most important goal is speedy and satisfactory rehabilitation of the patient.


[Mycological comparative study of Candida stellatoidea and C. albicans (author's transl)].

The taxonomical value of the specific distinction of C. albicans and C. stellatoidea was in mind, in the mycological study of: one homogenous group of 292 isolates of C. albicans and an other of 11 C. stellatoidae, of collection in majority. The growth in a liquid medium, the production: of chlamydospores, mycelium, pseudomycelium, germ-tubes, the fermentation and assimilation of carbohydrates, the tetrazolium-test, the actidione resistance and the maximal temperature for growth were the morpho-physiological characteristics studied. Were also reported some variations observed on two C. stellatoidea from which the type-strain of that species, cultured in two different laboratories.


A pharmacological approach to the structure of sodium channels in myelinated axons.

Figure 6 summarizes the present state of our knowledge on the sodium channel in myelinated nerve fibers. Two sites have been discussed in detail: a metal cation binding site accessible by tetrodotoxin and saxitoxin from the outside surface only; and a second site accessible from the inside surface with which local anesthetics combine. Hydrogen ions gain access to this region of the sodium channel (and hence determine the relative local concentration of protonated drug) more readily from the extracellular fluid than from the axoplasm (Schwarz et al 1977). In addition, a variety of other sites have been mentioned, binding of drugs to which alters selectively the kinetics of opening and closing of the h and m gates. In myelinated nerve fibers these channels are packed tightly on the nodal membrane. The highest estimate for the sodium channel density in the mammalian node is 10,000 micron2. A re-evaluation of the effective nodal area, however, might reduce this value to 3000-5000/micron 2. This would still leave the nodal membrane rather crowded with sodium channels. Furthermore, the channel density would still be greater than the density of particles, sometimes believed to be sodium channels seen in freeze fracture studies (Rosenbluth 1976). One possibility for resolving this problem is that the units detected by X-ray inactivation (Levinson & Ellory 1973), and those seen in freeze-fracture studies (Rosenbluth 1976) represent not single sodium channels but groups of three. Catterall & Morrow (1978) in a comparison of the binding of saxitoxin and Leiurus sculpturatus scorpion toxin venom have concluded that there are three saxitoxin binding sites for each scorpion toxin binding site. On this basis, three saxitoxin molecules might act to block independently each of the three openings of the channels; while the the conformational change produced by the scorpion venom molecule would affect the inactivation process of all three channels.


Free vascularised bone graft using microvascular technique.

The authors investigated 212 dried human fibulae to find out the length, the circumference and the entry points of nutrient artery to the fibula. Angiography of six freshly amputated limbs was studied to show the relationship of the posterior tibial artery and peroneal artery. Seven clinical cases of free vascularised fibula graft are reported. The length of the fibula graft varies from 10 cm to 20 cm. A postoperative 113M-In EDTMP examination revealed the blood supply to the grafted fibula was adequate. The bony healing and functional restoration of the extremities proved to be satisfactory.


Evidence for more than one division of bacteria within airborne particles.

When the protocol that we had used to demonstrate a single division of bacterial cells in airborne particles was changed to one that increased the glycerol content of the atomizer fluid from 1 to 5% (vol/vol), thus producing larger particles, more than two (and nearly three) divisions of bacteria occurred within 6 h of aerosol time.


Phosphate uptake in Saccharomyces cerevisiae Hansen wild type and phenotypes exposed to space flight irradiation.

Rates of phosphate uptake were approximately twice as great for Saccharomyces cerevisiae single-cell phenotypic isolates exposed to space parameters as for the wild-type ground control. Quantitative determination of 32P was performed by liquid scintillation spectrometry utilizing Cerenkov radiation counting techniques.


Expansion of the host range of coliphage P1 and gene transfer from enteric bacteria to other gram-negative bacteria.

The bacterial host range of coliphage P1 was extented by using the heat-inducible phage P1clr100KM. A gene for kanamycin resistance was transferred from Escherichia coli to members of the family Enterobacteriaceae and some other genera of gram-negative bacteria. P1 phage was produced by thermal induction from the lysogens of all these kanamycin-resistant bacteria except some strains.


[Quantitative and qualitative analysis of cell lesions from the pancreas after 4 weeks of B1-avitaminosis (author's transl)].

Light- and electronmicroscopical observations are made on the pancreas of 18 rats after 4 weeks of B1-avitaminosis. The B1-avitaminotic animals show a definite decrease in bodyweight and in the weight of their pancreas. The mitochondria of the acinar cells are swollen and invaded by numerous vacuoles. Single cells die by eosinoplilic necrosis. The islets of Langerhans demonstrate a definite hyperplasia (polynesis) and hypertrophy (macronesis). The mitochondria are swollen and also transformed into vacuoles. There is a lysosomial granulolysis. Only occasional lesions are observed in the A1 and A2 cells of the islets.


[Teratogenic effect of hyperbaric oxygen in rat and mouse (author's transl)].

The teratogenic effect of hyperbaric oxygen is studied in Rat and in Mouse. Oxygen under high pressure causes some wastage in cardiogenesis and brain differentiation in Rat only. But fetal suffering is observed in both species.


[Arterial collateral ways of the limb arteries (author's transl)].

Arterial collateral ways are reviewed correlatively with five differents levels of obliteration : aortic, iliac, ilio-femoral, femoro-popliteal, dista. A double visceral and parietal supply system caracterize each obliterated level; the importance of this double system varies considerably with the site of obliteration.


[Ultrastructural study of the normal development of the oocytes and of the follicle cells in Locusta migratoria (L.) (Orthoptera) (author's transl)].

Vitellogenesis in Locusta migratoria is studied by electron microscopy, and may be divided into two major periods: a. the first stage of growth (oocyte length from 0,8 mm to 1,8 mm) is characterized by protein synthesis and storage in the rER, by transfer of material of nucleolar origin into the oocyte perinuclear cytoplasm as well as by pinocytotic activity giving rise to granulo-membranous structures. At this stage the apical part of the follicle cells differenciates as attested by mitochondrial accumulation and microvilli development; b. the second period of vitellogenesis (oocyte length from 1,8 to 6,8 mm) is characterized by accumulation of hemolymphatic material which partly separates the follicle cells and progressively detaches the follicular epithelium from the oocyte. The intense uptake of this material by oocyte leads to the formation of typical yolk globules. The material of nucleolus origin disappears from the cytoplasm at the beginning of this stage. The secretory activity of the follicular epithelium starts by the end of this second period (oocyte length 4 mm), leading vitelline membrane formation, and intensifies when the chorion is formed. The secretory material is excreted in soluble form. In the vicinity of the oocyte, this material is submitted to a series of complex modifications: it precipitates again in granular form, progressively unites and finally leads to the "scale-like" structures which are characteristic of the chorion.


[A study of the early stages of biliary extrahepatic ducts organogenesis in the rat (Rattus norvegicus albinos) (author's transl)].

In the early stages of morphogenesis, the hepatic diverticulum of the rat develops as in other mammals. Its anterior part gives rise to epithelial cell-cords bound by an epithelial primary plate to a single hepatic duct which joins the liver to the midgut. The interlobular bile-ducts develop from secondary epithelial plates which derivate from the primary one. The posterior part of diverticulum gives rise to a duct which may be assimilated by its position, structure and evolution, to the initial cystic duct of other mammals. This duct never participates to the formation of biliary extrahepatic ducts, but builds the ventral pancreas. Cellular necrosis is observed in relation with the development of the anterior part of diverticulum during the three first days of the hepatic morphogenesis.


[The reaction of the insect excretory tissue to a heavy metal: uranyl nitrate (author's transl)].

The present paper describes the modifications induced in Malpighian tubules of Locusta migratoria by uranyl nitrate. These modifications are observed only if doses injected are approximately a hundred times higher than those which affect the renal epithelium of Vertebrates. The elimination of the uranyl salts seem to occur by apical excretion of dense metallo-proteic granules. When strong doses are used, metallic particles are seen on the basal membrane and in the extracellular spaces. Such intracytoplasmic particles are rarely observed.


[Role of the condylar cartilage in mandibular growth (author's transl)].

Our purpose is to bring a contribution to a better understanding of the role played by the condylar cartilage in children's mandibular growth. In the newborn, microradiographical analysis of frontal (fig. 1, 2 and 3 A) or sagittal sections (fig. 4 A) has been used to locate trabecular bone of endochondrial origin. This trabecular bone contains islets of calcified cartilage easy to identify in the microradiograph (fig. 3 B) or in the section itself after methylen blue staining (fig. 4 B) and resulting from the activity of the condylar cartilage (fig. 4 C). At four month of age, the condylar cartilage is still in activity (fig. 5 A and 5 B). From both morphological and physiological points of vue, this work leads to suggest that the condylar cartilage must be compared to a growing epiphyseal nucleus or to a so-called infertile extremity of a small long bone rather than with a true growing cartilage.


Viruses and lymphocytes in rheumatoid arthritis. II. Examination of lymphocytes and sera from patients with rheumatoid arthritis for evidence of retrovirus infection.

The possible involvement of retroviruses in the aetiology of rheumatoid arthritis (RA) was investigated. Retrovirus antigens were not expressed on rheumatoid synovial and peripheral blood lymphocytes as judged by membrane immunofluorescence, radioimmunoassay, and complement-mediated cytotoxicity. The specific antiretroviral (anti-RD-144 and anti-SSAV) sera used in this study were produced in rabbits immunised with viral antigens grown in a homologous system (rabbit cells and medium supplemented with normal rabbit serum), avoiding non-specific immunofluorescence previously detected with donated antiretroviral sera. Immune complexes lodged in the rheumatoid synovial membranes did not contain, and other cells within the membranes did not express, retroviral antigens. Antibodies cross-reacting with primate retrovirus antigens were sought in sera from patients with 'autoimmune' diseases by means of solid phase radioimmunoassay. There were no retrovirus antibodies in the 3 groups of patients studied, that is, those with rheumatoid arthritis, systemic lupus erythematosus, and with non-RA conditions. Absorption of rheumatoid factor did not alter this conclusion. These results give little support to the hypothesis that activation of endogenous human retroviruses or an infection with horizontally transmitted retroviruses is associated with the rheumatoid process.


The Noguchi-Adler phenomenon: an ultrastructural study of the effects of homologous antiserum on the growth of promastigotes of Leishmania braziliensis braziliensis and Leishmania hertigi hertigi.

A light and electron microscope study was made of the agglutinated bodies formed on growing promastigotes of a Leishmania b braziliensis and a L. h. hertigi strain in their homologous antisera to determine the role of leishmanial excreted factor (EF) in the Noguchi-Adler phenomenon, since the L. b. braziliensis strain produced a demonstrable EF, whereas the L. h. hertigi strain did not. Promastigotes of L. b. braziliensis, when grown in high concentrations of homologous antiserum, formed Noguchi-Adler (N-A) bodies, in which the cells were embedded in an extensive amorphous matrix. The cells of L. b. braziliensis in the embedding matrix often appeared unhealthy or dead, with swollen flagellar pockets and distorted flagella, with which small visicles were associated. Even though promastigotes of L. h. hertigi do not produce an EF that precipitates with homologous antibody, N-A bodies containing agglutinated cells separated by a thin structured layer of precipitate were formed during growth in homologous antiserum. In high concentrations of antiserum, some of the agglutinated cells of L. h. hertigi were enlarged and showed syncytial characters that included up to five nuclei, two dividing nuclei and five basal bodies associated with a single kinetoplast. Small vesicles and membranous folds were also observed between cells. The complexity of the Noguchi-Adler phenomenon and significance of the morphological changes seen are discussed.


Energy requirement for maintenance of the transmembrane potassium gradient in Klebsiella aerogenes NCTC 418: a continuous culture study.

With a glucose-limited culture of Klebsiella aerogenes, growing at a fixed dilution rate (0.4 h-1), the specific respiration rate varied progressively as a function of the transmembrane K+ gradient. The latter was varied by changing the input K+ concentration and, under these conditions, the specific respiration rate was linearly related to the electrochemical potential of the K+ gradient. Increasing or decreasing the transmembrane K+ gradient in putatively potassium-limited cultures elicited marked changes in respiration rate consistent with the conclusion that the exceptionally high respiration rates expressed by fully glucose-sufficient potassium-limited cultures (i.e., values in excess of 25 mmol O2/g dry weight organisms . h, at D = 0.4 h-1) are necessary to scavenge traces of K+ from the environment and hence maintain an exceptionally high transmembrane K+ gradient.


Influence of the glucose input concentration on the kinetics of metabolic production by Klebsiella aerogenes NCTC 418: growing in chemostat culture in potassium- or ammonia-limited environments.

With chemostat cultures of Klebsiella aerogenes growing at a fixed dilution rate, initially under conditions of glucose-limitation, transition to either potassium-limitation or ammonia-limitation was found not to be a steep step function. A wide range of intermediate steady states could be established in which neither substrate was present in excess of the growth requirement. As the molar ratio of glucose: K+ in the feed medium was progressively increased, the additional glucose carbon was first converted solely to CO2. Thereafter, when the molar ratio exceeded 45, acetate, and then pyruvate and 2-ketogluconate were excreted at increasing rates. In contrast, transition to ammonia-limitation provoked an early excretion of 2-oxoglutarate and 2-ketogluconate, followed (at higher glucose input concentrations) by acetate and pyruvate. These patterns of product excretion are considered in relation to the specific nature of the growth-limitation, to probable changes in the energy charge and redox balance within the growing cells, and to the accompanying modulation of tricarboxylic acid-cycle activity.


[Duodenal stimulation of insulin secretion. Role of intestinal villi].

Insulin secretion is partially regulated by hormonal and nervous signals arising from the duodenum. To ascertain the role of absorption through the villi on insulin secretion, the blood levels of immunoreactive insulin (IRI) in 13 normal children (T) were compared with those in 13 with flat jejunal mucosae (MJP). The bowel was stimulated by the infusion of Nutramigen direct into the duodenum at 4 ml/mn m2. In the control group (T) IRI increased from the 10th minute of the perfusion to reach a plateau after the first hour (256 +/- 107 pmol/l). In the MJP group the rise of IRI was delayed and the plateau lower (169 +/- 25 pmol/1) but the difference in the two groups was not statistically significant. During the first 10 minutes when there is no significant change in blood glucose levels IRI levels increased in the T group (p less than 0.01) but there was no significant change in the MJP group. These results suggest that when villi are intact stimulation of the duodenum causes insulin secretion; but when there are no villi, there is a delay in the secretion.


LH-RH neuron system of the newt by immunohistochemical study.

The location of LH-RH producing neurons, the pathways and terminal distributions of their fibers in the newt, Cynops pyrrhogaster were studied immunohistochemically. The LH-RH positive perikarya are located in the nucleus of the diagonal band of Broca and the medial septal nucleus. No LH-RH immunoreactive neuronal perikarya could be detected in the diencephalon. The pathways of fibers originating from the LH-RH reactive neurons were classified into three groups: the first project to the median eminence, the second to the olfactory bulb and the third to the habenular nucleus. The latter two pathways are extrahypothalamic, similar to those in mammals. These observations are briefly discussed and compared with those in other amphibian and mammalian species.


Proposal of a a neurosecretory system in the pancreas. An electron microscope study in the dog.

The nerve fibers supplying the islets of the dog pancreas were examined by electron microscopy. Axons with swollen portions containing various types of synaptic vesicles, including a cholinergic type, two varieties of presumable aminergic type and a possible peptidergic type, rush to the pericapillary space to end there, whereas only a small part of them seem to terminate on the endocrine cells of the islet. Schwann cell cytoplasm invests the axons and often separates these from the endocrine cells. The terminal portions filled with vesicles usually become free of the Schwann sheath on the side facing the blood capillary. Here the neuronal secretions are believed to be released into the blood stream through the pored endothelium of the capillary. The neurosecretions, together with the islet hormones are distributed to the exocrine pancreas in high concentrations via the insulo-acinar portal system. It seems thus sufficient for the nerves to supply the islet in order to control the exocrine function of the pancreas.


Neuro-insular complex type I in the mouse. Re-evaluation of the pancreatic islet as a modified ganglion.

Autonomic ganglia in the pancreas may include islet cells; while islets sometimes contain a group of ganglion cells. Electron microscope observation in adult mice confirms occurrence of a structure called neuro-insular complex type I by Fujita (1959), in which islet cells are juxtaposed to nerve cells either directly or by intercalation of a thin glial cell cytoplasm. Islet cells are equivalent to neurons in their attitude towards neurons and towards glial elements in the neuro-insular complex. There seems to be every gradation between pure ganglia, mixed forms representing the neuro-insular complexes, and pure islets. Pancreatic islets may thus be regarded as modified ganglia.


[Renal diabetes. Apropos of 103 cases in children].

A longitudinal study of 103 cases of renal glycosuria (94 families) led to the following conclusions. 1. When the condition is genetically determined, it is probably inherited as an autosomal recessive. 2. There is no relationship with diabetes mellitus. 3. The renal glycosuria is persistent but does not get worse.


Clinical evaluation of a restorative resin with organic filler. Preliminary report and discussion.

Assessment of 192 Class III and V Isopast restorations was made up to 18 months after insertion. Within this time, there was no evidence to suggest early, marked marginal failure. Continued evaluation is required to assess marginal adaptation and discolouration over a longer period.


Classification schemes for dental school libraries.

The provision of an efficient and acceptable library system for the dental literature is examined. It is suggested that an index to the dental literature is best provided by a combination of Index Medicus and Medical Subject Headings. The Library of Congress scheme would be best for an autonomous dental school and, where a dental school library is provided by a large medical library, the National Library of Medicine Classification would be suitable for dental student use.


Evaluation of an indirect fluorescent antibody test to diagnose Babesia equi infection in horses.

An indirect fluorescent antibody (IFA) test for the diagnosis of Babesia equi infections was evaluated. Antigen prepared by conventional methods was of high quality in one instance and of lesser quality in a second when possible autofluorescence of the horse blood caused inconvenience in reading tests. Tests on 14 horses shown by parasitological means to be either infected (9) or uninfected (5) produced reactions at dilutions of 1/270 to 1/7290 for infected and at 1/10 to 1/90 for uninfected animals. The accuracy of the test was further demonstrated during investigations of 701 horses in 3 states of Australia. The 30 horses reacting at 1/270 to 1/2430 were from 33 imported to 3 different farms in Australia from a common source. Investigations of crossreactivity between B. equi and B. bovis of cattle suggested that B. bovis would not interfere with the test for B. equi, but that the reverse was possible.


Bacteriological aspects of the disposal of manure from beef cattle.

Manure, collected from cattle housed in yards, was spread on experimental plots at the rate of 120 tonnes per hectare per annum. The manure was applied to 2 plots at 6-monthly intervals while a further 2 plots received monthly applications. Samples of manure soil, run-off and ground waters were examined for their counts of total aerobic bacteria, coliforms, faecal coliforms and for the presence of salmonellae. Comparison of the bacterial counts from samples from the test plots to those of the control plots showed that no change occurred in the levels of coliforms or faecal coliforms over the 3 years of manure application. One hundred and fifty-seven isolations of salmonella were made from the soil and water samples, but only 51 could be attributed to the manure. No difference was observed in the effects of different application frequencies.


Mutational study of the alcohol dehydrogenase-1 FCm duplication in maize.

The alcohol dehydrogenase-1 FCm (Adh-FCm) duplication in maize was subjected to ethyl methanesulfonate (EMS) mutagenesis. Of the mutants recovered, eight produced ADH polypeptides with altered electrophoretic mobility. Four produced new mobilities of the progenitor F with no change of the Cm molecule; the remainder altered only the Cm enzyme. No cases were found in which the electrophoretic mobilities of the two types of subunits were simultaneously altered, and no complete nulls lacking both F and Cm were recovered. These observations confirm the duplicate nature of the FCm complex.


Equine peptidases: correspondence with human peptidases and polymorphism for erythrocyte peptidase A.

Equine erythrocyte peptidases were compared to the six human erythrocyte peptidases, A, B, C, D, E, and F, regarding substrate specificity, relative activity, and electrophoretic mobility. Five equine erythrocyte peptidases appeared homologous to human peptidases A, B, D, E, and F. In contrast to human, equine peptidase C was absent in red cells, although it was weakly active in white cells. On the other hand, an equine peptidase, probably homologous to human peptidase S, was weakly active in red cells as well as present in white cells. Polymorphism for equine erythrocyte peptidase A is reported.


Kinetic and spectroscopic evidence of cation-induced conformation changes in yeast K+ -activated aldehyde dehydrogenase.

The activity, stability and spectroscopic properties of yeast K+ -activated aldehyde dehydrogenase were measured at various times after removal from, and after returning to a solution containing K+. Enzyme activity is rapidly lost on removal of most of the K+ and rapidly regained if K+ is replaced immediately. These activity changes are slower than likely rates of K+ dissociation and association. These rapid changes in concentration result in altered enzyme stability with enzyme in K+ the more stable. U.v. difference spectra are produced whenever enzyme in an activating environment (K+ or Tl+) is compared with enzyme in a non-activating environment (Tris+ or Li+). These spectral changes occur within 10s. The saturation characteristics with K+ are hyperbolic for all three phenomena of activation, stabilization and spectral change, with estimated apparent dissociation constants (Ks) for K+ of 7.5 mM, 5.5 mM and 6 mM respectively. Continued incubation of enzyme in the absence of K+ results in the accumulation of an enzyme form that re-activates only slowly on replacing K+. Stability characteristics in various concentrations of K+ over equivalent time scales are consistent with the existence of additional conformations. Spectroscopic evidence also indicates such additional slow conformation changes. Results have been interpreted in terms of two separate conformation transitions induced or stabilized by K+.


Identification of a defence mechanism in vivo against the leakage of enterokinase into the blood.

1. The serum proteinase inhibitors alpha 1-antitrypsin, alpha 2-macroglobulin, inter-alpha-trypsin inhibitor and C1-esterase inhibitor were found not to affect the catalytic activity of human enterokinase, whereas bovine trypsin activity was modified essentially as expected. Enterokinase was also not inhibited by Trasylol (trypsin inhibitor from bovine lung) or bovine pancreatic trypsin inhibitor. No other component in human or mouse serum complexing with enterokinase was identified. 2. Human enterokinase administered intravenously into mice was rapidly cleared from the circulation with a half-life of 2.5 min. This removal was not the result of the difference in species, since partially purified mouse enterokinase was cleared at the same rate as the human enzyme. Clearance was mediated by recognition of the carbohydrate portion of enterokinase and not through specific recognition of its catalytic site. Immunofluorescent staining showed that the enzyme accumulated in the liver. Attempts to block the clearance by the simultaneous infusion of competing glycoproteins suggested that enterokinase was taken up by hepatocytes. Of the glycoproteins tested only two, human lactoferrin (terminal fucosyl alpha 1 leads to 3 N-acetylglucosamine) and bovine asialo-fetuin (terminal galactosyl beta 1 leads to 4 N-acetylglucosamine) were weakly competitive. Two inhibitors of endocytosis, Intralipid and Triton WR1339, failed to delay the removal of enterokinase. It is proposed that enterokinase is cleared from the circulation by an as yet uncharacterized hepatocyte receptor.


Inhibition of collagen-induced platelet aggregation by antibodies to distinct types of collagens.

Aggregation of platelets by fibrils formed from collagens type I, II and III could be inhibited by coating the fibrils with anti-collagen antibodies or Fab fragments. Similar results were obtained in a clot-retraction assay. Inhibition was achieved with stoichiometric amounts of antibodies and was specific for each type of collagen. Aggregation caused by a mixture of type-I and -III collagens could only be inhibited by a mixture of antibodies against both collagens. The data show that each interstitial collagen is capable of interacting with platelets and do not support the concept of an outstanding activity of type-III collagen.