Replication techniques with new dental impression materials in combination with different negative impression materials.

New materials and new techniques have enabled the fabrication of more reliable and more accurate replicas. Not only is the reproduction of detail of importance, but the expertise required from the operator and the time involved to produce a replica are considered key factors. For various reasons a reliable and reproducible replication technique for scanning electron microscopy offers many advantages. Recently a new dental precision impression material has been introduced, which in combination with low viscosity resins has produced superior results over other techniques. This combination processed by means of a centrifugal casting machine has produced replicas which could easily be compared to a standard test die at magnifications up to 3000 X. More in depth testing will have to be performed to establish whether these materials can be universally applied to a broad spectrum of replication problems. The combination Reprosil/Spurr low viscosity imbedding medium yielded replicas of high quality which can be made with simple equipment and without possessing special skills. Centrifugation of the positive replication material into the negative impression virtually eliminated the entrapment of airbubbles.


IgG molecules, Fab' fragments and IgG-peroxidase conjugates as markers in replicas of deep-etched, labeled cell surfaces.

Sheep red blood cell (SRBC) ghosts were incubated with preparations of anti-SRBC IgG, antigen-binding fragments (Fab') or IgG coupled to horseradish peroxidase (HRPO). Frozen samples of the labeled ghosts were deep-etched and replicated with platinum-carbon to visualize their surface features in the transmission electron microscope. An analysis of both size and density of surface "particles" observed on labeled ghosts was performed to evaluate which markers could be practically used to label these membranes. It was concluded that in this system a marker must exhibit a diameter of greater than 150 A (the apparent size of IgG-HRPO conjugates) to be consistently seen over extensive surface areas and to be distinguished from the background granularity of the SRBC ghost surface. This rules out the use of Fab' or IgG as markers in this system.


Inlayed teeth of ancient Mayans: a tribological study using the SEM.

A study has begun of inlayed teeth of Meso-American Indian skulls using scanning electron microscopy and modelling techniques. Round cavity preparations 2-3 mm in diameter and 1-2 mm deep had been cut through the enamel and just into the underlying dentin of the teeth. The vertical walls of the preparation met the floor in either a square, rounded or undercut form. Towards its center, the floor was occasionally elevated, sometimes depressed and commonly rounded. Closer examination showed abrasion anomalies as concentric, shallow grooves cut into the tooth tissue. A modification of the Semenovian principle was employed to determine the tool: 1) from the marks registered the the cavity and 2) the outline form of the preparation itself. Preparing cavities experimentally in teeth using wood and stone drills and sand as an abrasive produced certain characteristics consistent with those in the Meso-American teeth in which wooden drills created a variety of cutting patterns which included flat, elevated and depressed floors in the preparations. We have tentatively concluded that suggestions for the use of a tubular drill does not adequately explain the variety of forms encountered and that the cutting patterns were more consistent with the use of a wooden drill and sand.


Immunologic techniques for the identification of virion and cell surface antigens by correlative fluorescence, transmission electron and scanning electron microscopy.

The present resolution (75-100 A) of the conventional scanning electron microscope (SEM) and its ability to image the surfaces of large numbers of whole cells in situ permits the approach of problems such as viral and cell surface antigen localization by immunological labeling with visual markers. Identification of virus and cell surface antigens in situ has been accomplished in indirect reactions by conjugated and unconjugated markers. Hemocyanin (Hcy) from whelk, Busycon canniculatum, has been developed as an immunospecific marker for virion and cell surface labeling in the electron microscope. Its size (approximately 30 x 50 nm) and distinct cylindrical shape permit easy visualization in the SEM and TEM. The Hcy method involves the preparation of antisera to Hcy in appropriate hosts for use in an unlabeled antibody macromolecular procedure based exclusively on antigen-antibody affinity to couple the macromolecule to the antigen site. Further correlative data from fluorescence microscopy can be obtained from similarly labeled samples by binding fluorescein to the bridging antibodies used in the Hcy technique. The usefulness of the Hcy marker system was demonstrated using antisera to the major envelope and cell surface glycoprotein (gp70) of Rauscher murine leukemia virus (R-MuLV), a type C retrovirus. The antiserum was shown to bind to the virion and cell surfaces of virus-infected cells in the homologous virus-infected cell system. It also demonstrated the expression of R-MuLV gp70-related antigens on a murine cell line Mm5mt/c1 which produces mouse mammary tumor virus (MuMTV), A type B retrovirus. Furthermore, when used in the Hcy marker system this antiserum was able to distinguish type B from type C budding virus on the same cell. Examples of other marker systems (ferritin, peroxidase, colloidal gold, and latex) used to show anti-gp70 serum reactivity will be presented to demonstrate their applicability to cell surface labeling studies. Methods for the preparation of immunoreagents and labeling of cells are discussed.


Principles of X-ray microanalysis in biology.

Progress in biological X-ray microanalysis has been limited in recent years by specimen preparation procedures. Instrumentation and high levels of sensitivity for low concentrations are well developed for a large number of biological applications but reliable preparation of samples in the thick or thin form has yet to be establisehd. In addition the possible damage of specimens by the electron probe has been incompletely studied in the majority of applications. In this review the basic principles of X-ray production, design and operation of X-ray detectors, quantitative procedures for thick and thin samples, analytical operation of the microscope, and current specimen preparation techniques are briefly described with the aim of highlighting weaknesses and discussing recent developments in each field.


General considerations of X-ray microanalysis of frozen hydrated tissue sections.

X-ray microanalysis of frozen hydrated sections can be applied for analysis of diffusible or highly mobile elements which might be displaced or lost when conventional preparatory techniques are used. Once frozen the specimen must be handled in such a way that it becomes vacuum compatible for subsequent analysis. Analysis cannot be accomplished without compartment recognition. Initial freezing can be considered successful if ice crystal damage does not exceed the dimension of the compartment to be analyzed. As compartment size decreases ice crystal artifacts become a significant problem. The application of special freezing methods including use of non-penetrating cryoprotectants is an important advance in freezing methodology for X-ray analysis. Cryosectioning is a fracturing process at low temperatures which can affect morphology and may affect analysis. An understanding of this process can aid in optimizing cryosectioning for use in preparing frozen hydrated and frozen dried section for X-ray microanalysis. Special equipment is necessary for both freeze dried as well as frozen hydrated specimen; while special transfer devices are necessary for frozen hydrated specimen transfer. Because of the design of cold stages special consideration for reducing extraneous background radiation is an intrinsic part of their application to biological X-ray analysis.


Origin of artifactual quantitation of electrolytes in microprobe analysis of frozen sections of erythrocytes.

Frozen sections of erythrocytes have been used to validate microprobe X-ray analysis of diffusible elements in biological samples. At this meeting last year we reported that intracellular Na concentrations measured by microprobe were much higher than those measured by bulk chemical methods. It was suggested that this might be due to the movement of extracellular material over the cells by microtomy. We now present evidence that such results are better explained by electron scattering within the sample during analysis. This evidence includes observations that the excess measured Na varies directly with section thickness and inversely with accelerating voltage. At 80 kV accelerating voltage there is excellent agreement between microprobe and chemical analysis. It may be concluded that specimen preparation techniques such as used in our laboratory are satisfactory for reliably localizing diffusible elements in small volumes, but that instrumental factors can seriously affect their quantitation.


Scanning immunoelectron microscopy for the identification and mapping of two or more antigens on cell surfaces.

This study demonstrates the feasibility of using scanning electron microscopy for the identification and mapping of two or more antigens on cell surfaces. Three types of cells: human type B red cells, tumor cells and their associated virus, and guinea pig hepatocarcinoma cells were immunolabeled with ferritin or gold conjugated to IgG fractions of antigen-specific antisera. Gold particles, 300-500 A in diameter, were conjugated to an IgG fraction either directly or indirectly using Staphylococcal protein A. Gold particles of this size can be distinguished from ferritin label using a high resolution scanning microscope. Correlative light, transmission electron microscopy, and scanning electron microscopy studies, as well as x-ray diffraction analysis and the study of stereo micrographs, were performed to visualize the simultaneous immunolabeling by ferritin and gold of two antigens on the guinea pig hepatocarcinoma cell.


Non-freezing techniques of preparing biological specimens for electron microprobe X-ray microanalysis.

In this paper a review is presented of the many ways the fluids involved in conventional wet chemical E.M. preparative techniques (including precipitation procedures) disturb the in vivo chemical integrity of biological tissues. The artifacts discussed are: (i) bulk element loss, (ii) phase transformations in mineralized tissues, (iii) redistribution of endogenous tissue elements; (iv) introduction of extraneous elements. Finally, the range of biological applications to which wet chemical methods have been successfully applied by various authors is briefly discussed to provide a realistic working perspective. It is stressed that in most of these applications the authors restrict themselves to a comparison of the chemistry of cells or their constituent organelle systems and do not attempt to define the in vivo chemical composition of cells. The author concludes that since all preparative procedures available to the microprobe analyst suffer from some form of restrictive compromise, it may not be advisable to think of a general microprobe preparative technique but, alternatively to apply different preparative techniques according to the specific biological answers sought.


Scanning electron microscopy of macrophages: a bibliography.

In this bibliography an attempt has been made to gather together as much as possible of the widely spread literature on the scanning electron microscopic appearances of macrophages. The primary source for these references was a medline search, supplemented by any secondary references obtained. The listed references have all been examined in detail by the compilers. In the subject index, an attempt has been made to draw the reference together into broad categories of biologic interest, as well as indexing for specific anatomic sites, pathologic conditions, toxic agents and so on. We hope that this compilation may be of some help to those seeking information on the surface morphology of the mononuclear phagocytes.


Documentation of environmental particulate exposures in humans using SEM and EDXA.

There is increasing awareness of health hazards from environmental and occupational exposures to particulates. Scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDXA) can document these exposures by analysis of small portions of cells, tissues and environmental samples. Previous work is briefly reviewed and special attention is given to discussion, with examples, of the various types of particulates which may be found in tissues (exogenous, endogenous, inhaled, injected, ingested, inorganic, organic), the different tissues in which they may be found (lung, heart, liver, skin, brain, kidney, lymph nodes, etc.), methods of tissue sampling (e.g. pulmonary lavage, transbronchial biopsy, open biopsy, percutaneous biopsy, autopsy), specimen preparation (fixation, embedding, sectioning, choice of substrate), SEM and EDXA data collection (backscattered electron imaging, etc.) data interpretation (artefacts, limitations of SEM and EDXA) and other new techniques (ion microprobe, laser Raman microprobe).


An ultrastructural study of lymph nodes in antilymphocyte serum-treated mice.

The cytoarchitecture of regional axillary lymph nodes of C57BL/6 mice with DBA/1 skin allografts were examined by light microscopy (LM), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Lymph nodes from skin-grafted mice injected with rabbit anti-mouse lymphocyte serum (ALS) or normal rabbit serum (NRS) were examined ultrastructurally for the pattern of distribution, density and surface topography of their cellular constituents. The lymph node cortex consisted of smooth surface polyhedral-shaped cells tightly packed in the reticulum. A homogeneric population of lymphocytes more spherical in shape and more loosely distributed occupied the follicular region of the cortex. These cells exhibited surface microvilli and were similar in appearance to the free lymphocytes observed in the sinusoidal spaces. Post-capillary venules containing highly villous lymphocytes were observed in the deep cortex. Degradation of cellular organization and cell damage was observed in lymph nodes from ALS-treated mice. These alterations were believed to be a direct effect of ALS. This conclusion was based on the character of the cell damage observed in isolated lymphocytes, in suspension exposed to ALS with and without complement.


X-ray microanalysis of pyroantimonate-precipitable cations.

Modifications of the Komnick potassium (pyro)antimonate precipitation method have been widely used for the subcellular localization of a variety of cations. The identity of cations precipitated with this method has often been controversial, and it is therefore important to establish definitive criteria for identifying precipitated cations in situ. In the present study, we have precipitated antimonate salts in vitro and examined the salts both in crystalline powder form and after embedment in Epon, using energy-dispersive X-ray microanalysis, in an attempt to identify biologically important antimonate-precipitable cations. We have found that the cations sodium, magnesium, and calcium, if present in physiological concentrations, will precipitate antimonate under "standard" conditions (2.5% antimonate, pH 7.2 - 7.4, in the presence of 1% OsO4). Characteristic X-ray emissions were observed for sodium and magnesium, as well as for lead similarly precipitated, but Lalpha and Lbeta emission peaks from antimony interfered with calcium identification and necessitated complex computerized deconvolution or peak stripping to determine the presence of a calcium peak. Precipitates of sodium did not contain appreciable potassium, whereas variable amounts of potassium were present in precipitates of calcium and lead, depending upon the extent of washing prior to dehydration. Sizeable potassium peaks were consistently present in even well washed magnesium precipitates. X-ray spectra of standardized precipitates were found useful as an aid in interpreting the more complicated spectra obtained from tissue samples.


Cupula-receptor cell relationships with evidence provided by SEM microdissection.

Ampullae from the inner ear of the skate, Raja ocellata, were examined by SEM to further elucidate the relationships of the sensory hairs of the receptor cells to the overlying cupula. Specimens were prepared by a variety of methods and were fractured to visualize these relationships. Critical point drying resulted in good cellular and sensory hair preservation, but the cupulae were grossly shrunken. Freeze-dried cupulae, in contrast, more closely approximated the in vivo condition. Although tissues suffered freezing damage, sensory hair bundles were readily discerned. In both critical point dried and freeze-dried ampullae, the peripheral hair cell bundles and the kinocilia of most of the central hair cells, extended across the subcupular space and contacted the cupular material. Some of the specimens were further investigated by dissection in the SEM, the process being viewed in real time stereo. Microdissection confirmed that most kinocilia were attached to the cupula. When the cupula was displaced, sensory hair bundles remained attached to it and broke preferentially at their base from the receptor cells.


Preparative techniques for freezing and freeze-sectioning macrophages for energy dispersive x-ray microanalysis.

In order to study the subcellular distribution of normal intracellular electrolytes and of metal pollutants, rabbit alveolar macrophages and mouse peritoneal macrophages were maintained in standard tissue culture medium with or without various concentrations of cadmium chloride or ammonium vanadate. A variety of preparative techniques were employed to study both monolayers and cell pellets by light microscopy, transmission electron microscopy, scanning electron microscopy and energy-dispersive x-ray microanalysis. Pellets of macrophages centrifuged in narrow bore centrifuge tubes were successfully snap-frozen in liquid-nitrogen-cooled liquid propane and either sectioned on a cryoultramicrotome or freeze-substituted with 1% osmium tetroxide in acetone and embedded in Epon. Spot probes of freeze-dried, frozen thin sections for normal intracellular electrolytes such as potassium, phosphorus and sulfur showed good localization to the cells and differences between organelles. Monolayers were freeze-dried and directly embedded in Epon. When Epon thin sections of these cells and of the freeze-substituted, Epon embedded pellets were obtained with a dry knife, intracellular electrolytes such as potassium, phosphorus and cadmium could still be detected by energy-dispersive x-ray microanalysis. It is concluded that in studies using snap-freezing for element localization, maximum information is obtained with the simultaneous application of a combination of preparatory techniques.


Some aspects of structural organization in the cochlea of the bat, Pteronotus parnellii.

The scanning electron microscope was used to study some specific features of the organ of Corti in the bat, Pteronotus parnellii parnellii. The region of the outer tunnel and the external sulcus were analyzed in detail. Good visualization of the geometric arrangement of the external sulcus cells and the deep channels for their root processes was obtained by digestion of fixed material with 1% trypsin. Processes of the cellular elements forming the roof of the outer tunnel are very thin and appear to be weakly attached to the heads of the phalangeal processes of the third row of Deiters' cells. In much of the overstimulated and trypsin digested material the weak junction was broken and the outer tunnel elements exposed. Two distinct cellular elements occur along the outer wall of the tunnel. One type has a surface with numerous projections on tis outer tunnel surface. The other has a smooth surface and an expanded fanshaped extremity which forms at least part of the roof of the tunnel. With trypsin digestion some of the more deeply situated cells were exposed.


Suppressed development of experimental glomerulonephritis in lactating rats.

Five of six lactating rats did not develop proteinuria after an injection of nephrotoxic serum, whereas four out of five non-lactating, non-pregnant rats showed the usual proteinuric response (P = 0.06). The amount of heterologous IgG deposits was similar in both groups, but the lactating rats had significantly less autologous IgG (P = 0.004) in the glomerular basal membrane. It is suggested that hormonal factors influence the development of experimental glomerulonephritis in lactating rats.


Characterization of IgD. II. Molecular forms of IgD in human B cells.

Endogenous and surface labeling techniques were used on human lymphoid cells to characterize intracytoplasmic, membrane and secreted IgD, IgD synthesized by lymphocytes and inserted into the cell membrane displayed a single molecular form with the same mobility in sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) as the previously described slow migrating serum IgDl. Plasma cells produced and secreted IgDl and another IgD corresponding to the faster-moving serum IgD2. Conversion of one molecular form into the other was never observed, thus indicating that neither molecule is a precursor or a degradation product of the other.


In vitro enhancement of natural cytotoxicity by tumour necrosis serum.

Cells cytotoxic for syngeneic, allogeneic and xenogeneic cultured target cells are shown to be induced spontaneously in cultures of murine lymphoid cells. Serum containing bacillus Calmette-Guérin and endotoxin-induced tumour necrosis factor accelerates the appearance of observed natural cytotoxic cells.


Double blind comparison of short and medium term sulfonamides, sulfamethizole and sulfamethoxazole, in uncomplicated acute urinary tract infections.

Sulfamethizole and sulfamethoxazole were compared in a prospective, randomized, double blind study on uncomplicated, acute urinary tract infections. 59 patients were evaluable for therapeutic effect of sulfamethizole and 53 for sulfamethoxazole. The cure rates were 91.5 and 92.5% respectively for sulfamethizole and sulfamethoxazole. The rates of side effects were the same in the two groups, 5.4% and 4.2%. Also instances where the infecting bacteria were sulfonamide-resistant were cured.


Concentration of dicloxacillin and benzylpenicillin in fracture haematoma.

Prophylaxis with loading doses of dicloxacillin (3 patients) and benzylpenicillin (5 patients) has been used preoperatively for malleolar fractures treated in a standardized manner. Postoperatively, the same dose was given every 6 h for a total period of 48 h. The concentration of antibiotics was measured in serum before and after operation and 6 h after the first infusion. Samples from the haematoma were taken during operation and from the drainage collected during 24 h. Satisfactory concentrations were found in serum pre- and postoperatively and in the haematoma.


Estimations of the incidences of toxoplasma infections among pregnant women from different areas in Norway.

2342 male military recruits from different parts of Norway were selected for serological screening with the dye test or the IgG-indirect fluorescent antibody test. The highest frequency of toxoplasma antibodies was observed in the south-western areas (27%), whereas the prevalence was found to be as low as 2% in the northermost areas of the country. On the basis of the prevalence values obtained in the different counties, the incidence rates for acquired infections in the pregnant population have been calculated. The annual incidence in Norway was estimated to be 4 0/00 and the incidence of congenital toxoplasmosis would be maximally 2 0/00 (or about 110 cases/year).


The efficacy of intra-articularly administered MYC 2095, triamcinolone hexacetonide and placebo in gonarthritis. A combined double-blind clinical trial.

We report the results of a double-blind three-centre study, employing a cross-over design, set up to compare the efficacy of intra-articular injections of Myc 2095 (20 mg), triamcinolone hexacetonide (Lederspan) (20 mg) and placebo in 40 patients with synovitis of the knee joint. Each patient included in the study contributed data on 2 of the 3 treatment variables being compared. Seven clinical parameters were assessed every 6 weeks, while the doctor's and the patient's assessments were scored. Intra articular treatment both with Myc 2095 and triamcinolone hexacetonide proved to be effective. Placebo response was also very high. After the first Myc 2095 injection, improvement in "tenderness", "pain under load" and "swelling and hydrops" was significantly superior to that following placebo treatment. The evaluation of the second injections indicated a marked carry-over effect from the first course. This was also evident from the doctor's and patient's assessments. The importance of including a placebo in the evaluation of anti-phlogistic drugs in clinical trials, emerged from this study.


Gastrointestinal blood loss caused by controlled-release and conventional acetylsalicylic acid tablets.

Gastrointestinal blood loss has been studied following oral administration of the novel controlled-release acetylsalicylic acid tablet preparation Acetard and the instant-release acetylsalicylic acid tablet Magnecyl (Ph. Nord. 63). Acetard contains micro-encapsulated acetylsalicylic acid crystals having an in vitro release time of approximately 4 hours. The investigation was carried out as a two-part, randomized cross-over trial, and with a test dosage of either 1 g X 4 or 2 g X 2 per day, given to 10 and 14 male students, respectively, during two 5-day periods separated by a one week interval. The dosage of the plain formulation was maintained at 1 g X 4 daily in both parts of the investigation. Faeces were collected every 24 hours throughout the trial, covering a total of 4 weeks. Blood loss was measured using the 51Cr labelling technique. Acetard was found to cause statistically significantly less gastrointestinal blood loss as compared with the plain formulation, irrespective of whether Acetard was given twice or four times a day.


Systemic lupus erythematosus--a zoonosis?

The medical history was obtained and a physical examination carried out--in addition to an immunological investigation of the blood and skin--on 11 dogs in the ownership of patients with systemic lupus erythematosus (SLE). The results were compared with those obtained from a control group and it was found that they do not support the hypothesis that SLE is a zoonosis.


Immunofluorescence study of renal biopsies in chronic rheumatoid arthritis.

Renal biopsy specimens from 20 patients, 14 women and 6 men, with rheumatoid arthritis (RA) of at least 6 months' duration were studied by direct immunofluorescence microscopy for the presence of immune deposits. Pathological changes were most prominent in patients with longstanding or malignant disease and in patients previously on gold salt therapy. Staining for IgG and C3 was negative in 4 patients with an arthritis of 2 year's duration or less. Fifteen patients had glomerular deposits containing IgG or C3, or both. In 6 of these patients staining was also positive for IgM and in 3 for IgA. In 8 patients C3 was distributed in irregular deposits along the tubular basement membrane. These results suggest that in patients with RA, immunological processes have an untoward effect on the kidneys. The long-term effects of these processes might contribute, moreover, to the development of late renal complications. There is no evidence, however, that the renal immune deposits documented so frequently in this study derive from the rheumatoid disease itself.


Recruiting collapsed lung through collateral channels with positive end-expiratory pressure.

We studied reinflation of collapsed parts in excised normal human lungs through both the ordinary bronchial route and through collateral channels. A model of atelectasis was made either by simple collapse or by applying a positive pressure to the pleura and a negative to the airway. Five different ventilatory patterns were used for reinflation: simulated normal breathing with and without continuous positive airway pressure (CPAP), simulated deep breathing and mechanical ventilation with and without positive end-expiratory pressure (PEEP). All methods, except normal breathing without CPAP, reinflated the collapsed part with pressures well within the range used clinically. The most effective way of re-expanding collapsed lung was the application of CPAP during simulated normal breathing or PEEP during mechanical ventilation, which required smaller transpulmonary pressure swings than the other methods. A comparison between CPAP and PEEP showed CPAP to be preferable. Collateral reinflation occurred just as readily as normal reinflation and the results suggest that collateral reinflation is the primary choice. This route of reexpansion also has a potential secretion clearing effect in that pressure is built up distal to an obstruction.


[Classification of tubular testicular atrophies in the diagnosis of sterility. Significance of the so-called "bunte Atrophie"].

In the course of testicular biopsies from 2317 patients in the years 1969--1978 at the Institute of Pathology of Zurich University, 1165 cases with tubular atrophy were retrospectively examined and classified on the basis of distribution of atrophy on the one hand and degree of atrophy (progressive depopulation) on the other. In virtue of this histological classification, an attempt was made to provide an absolutely or relatively reliable statement respecting the fertility situation, which was possible in 25% of the cases. In the group of the so-called "bunte Atrophie" an alteration could be described which is of interest not only because it accounts for a quarter of all testicular atrophies but also because there is a difference between the slight histological alterations and the obviously serious clinical consequences. It was possible to prove that an increase in the atrophy grade characterized by loss of spermatids is already responsible for rapid shrinkage of tubulus diameter in this group.


[High hemoglobin concentration and high hematocrit values in patients with homologous kidney grafts].

9% of kidney allograft recipients were found to develop high hemoglobin concentrations and high hematocrit levels. This abnormality was found only in patients carrying their own diseased kidneys. The majority of graft recipients exhibit low normal erythrocyte counts, whereas the patient group described shows high normal values for red cells. It is suggested that erythropoietin secreted from ischemic regions of the patients' own kidneys may be responsible for the observed difference in erythrocyte counts. No adverse effects were noted clinically.


[Acute respiratory insufficiency in internal medicine].

The definition, causes and some pathophysiological aspects of acute respiratory failure are discussed and a systematic clinical workup for these patients is proposed. The clinical and functional parameters for intubation and artifical ventilation are described. Finally, some special problems of therapy in some diseases leading to acute respiratory failure are mentioned. The basic disease not only indicates the criteria for intubation but also determines modifications in ventilatory support.


[Possibilities of respiratory rehabilitation in the hospital].

Among the forms of respiratory insufficiency, those of acute decompensation have the best chance of cure and require all the facilities of clinical and emergency treatment. The therapeutic bases are antibiotics, IPPB, inhalation of broncholytic and secretolytic aerosols, physiotherapy and in some cases steroids. The home care program must be established and practised in the hospital, and its performance controlled and adapted in cooperation between family doctor and lung function laboratory in the clinic.


[Mechanical ventilation: modern technics and respirators].

The techniques of ventilatory support have been improved during the last few years by two series of modifications: first, the introduction of the trigger and the IMV allows and stimulates greater participation of the patient in the regulation and work of respiration; second, higher levels of PEEP and CPAP produce an improvement in pulmonary gas exchange. The development and perfecting of these techniques has not increased the cost of modern ventilators. This article considers some of the advantages and shortcomings of a number of recent models.


[Dental reconstruction with non-precious metal screws and posts].

A short review of the current methods for restoring destroyed dental crowns by mechanical retentive elements. The causes leading to failure in such restorations are mentioned in a short review of literature. Main causes are corrosive changes in posts and screws anchored in root canals. This is why a special chapter deals with the problem of corrosion. A systematic enumeration of various corrosions in posts and screws is illustrated by a choice of clinical and radiological illustrations. The author's own metallurgical analytic investigations of the posts and screws available commercially allow to divide them into 4 typical nonprecious metal groups: Inox steel, cromium nickel steel, cromium nickel molybdene steel and brass alloys. The reasons for resistance to corrosion lie in the different metallographic structures and processing methods. Further investigations are finished and will be published later in this journal.


[Removable partial denture. Excerpts from the literature 1977--1979].

In partial denture prosthesis research and advances were made principally on: -- the fundamental biomechanical properties of the demodont and the fibromucosa. In the light of these findings, the justification of stressbreaking as a principle is questioned -- the mechanical properties of chromium-cobalt alloys -- checking of castings by radiography -- simplification of the designs for removable partial denture frameworks -- impression materials and techniques (fluid-wax functional impression and altered cast-procedure) -- the combination of restauration and plaque control for successful dentistry.


The composition of human milk.

Mature human milk contains 3%--5% fat, 0.8%--0.9% protein, 6.9%--7.2% carbohydrate calculated as lactose, and 0.2% mineral constituents expressed as ash. Its energy content is 60--75 kcal/100 ml. Protein content is markedly higher and carbohydrate content lower in colostrum than in mature milk. Fat content does not vary consistently during lactation but exhibits large diurnal variations and increases during the course of each nursing. Race, age, parity, or diet do not greatly affect milk composition and there is no consistent compositional difference between milks from the two breasts unless one is infected. The principal proteins of human milk are a casein homologous to bovine beta-casein, alpha-lactalbumin, lactoferrin, immunoglobulin IgA, lysozyme, and serum albumin. Many enzymes and several "minor" proteins also occur. The essential amino acid pattern of human milk closely resembles that found to be optimal for human infants. Possible special functions of milk proteins and enzymes other than as a source of amino acids, are as yet largely speculative. The principal sugar of human milk is lactose but 30 or more oligosaccharides, all containing terminal Gal-(beta 1,4)-Glc and ranging from 3--14 saccharide units per molecule are also present. These may amount in the aggregate to as much as 1 g/100 ml in mature milk and 2.5 g/100 ml in colostrum. Some of them may function to control intestinal flora because of their ability to promote growth of certain strains of lactobacilli. Human milk fat is characterized by high contents of palmitic and oleic acids. the former heavily concentrated in the 2-position and the latter in the 1- and 3-positions of the triglycerides. Fatty acid composition of milk fat varies somewhat with the composition of diet, particularly the fatty acids which it supplies. Phospholipids, amounting in the aggregate to about 75 mg/100 ml, include phosphatidyl ethanolamine, phosphatidyl choline, phosphatidyl serine, phosphatidyl inositol, and sphingomyelin. The principal mineral constituents of human milk are Na, K, Ca, Mg, P, and Cl. Calcium concentrations reported in various studies vary from 25--35 mg/100 ml. Phosphorus at 13--16 mg/100 ml is much more constant but is lower in proportion to casein and calcium than in milks of most other species. Iron, copper, and zinc contents of human milk vary considerably. A long list of other trace elements has been reported. About 25% of the total nitrogen of human milk represents nonprotein compounds including urea, uric acid, creatine, creatinine, and a large number of amino acids. Of the latter, glutamic acid and taurine are prominent. All of the vitamins, except K, are found in human milk in nutritionally significant concentrations.


Nursing the newborn.

Factors affecting successful breast-feeding that have been discussed include good prenatal and postnatal patient education, supportive routines in the hospital, and prevention and/or treatment of common early problems. Suggestions have been made of ways in which the breast-feeding experience can be enhanced. As these measures become more widespread, along with knowledge of the benefits and advantages of human milk and breast-feeding, we should be able to continue to reverse the trend away from breastfeeding.


Immunologic aspects of breast feeding, antiinfectious activity of breast milk.

The most apparent immunologic role of the mammary gland is supply to antibodies to the neonate. In cattle the gland must be able to secrete large quantities of IgG antibodies over a short time period to supply the offspring with protection against systemic pathogens. This is accomplished by selective transfer of IgG from serum to the gland followed by eventual absorption by the neonate gut. In all mammals, the mammary glands provide IgA antibodies specific for pathogens or antigens which enter or invade the neonatal gut. An entero-mammary cell circulation provides the mechanism for conveying such specificity to the lacteal IgA antibodies. Some IgA antibodies may also be derived from the circulation so that the quantitative significance of serum derived versus locally produced IgA in different species requires clarifications. IgG and IgG lacteal antibodies ingested by the neonate, provide short-term systemic and long-term enteric humoral immunity to the neonate. In addition to providing passive immunity, at least swine IgG appears to have a regulatory role in the development of the systemic humoral immune system of the neonate. Such a phenomenon may be general for IgG antibodies transferred in colostrum or in utero. While passive antibodies and immunoglobulins may be most important for the neonate, the many other potentially anti-infectious elements transferred in colostrum and milk may also play important roles. 'Bifidus' factor particularly, but also lysozyme and lactoferrin are probably all important although more convincing experimental data will be needed to support this assumption. Studies of cells of the lymphoid and reticuloendothelial systems in milk are more recent and their role in the neonate remains to be convincingly demonstrated. In summary, the immunologic and anti-infectious roles of the mammary glands are (1) Supply of IgA antibodies against enteric antigens to the neonate on a 'long-term' basis throughout lactation; (2) Short-term supply of IgG (and IgA) in Group II and III mammals for eventual absorption into neonatal serum; (3) The supply of numerous nonspecific factors such as 'bifidus factor,' lactoferrin, and lysozyme throughout lactation; (4) Regulation of the development of humoral immunity by an apparent feedback mechanism involving maternal IgG; (5) Self-protection of the gland by sensitized T-lymphocytes acting directly or using lymphokines on macrophages; and (6) Self-protection of the gland by secreted antibodies that may act in complement-independent cytolysis, as opsoins for polymorphonuclear-leukocytes or directly as agents preventing colonization.


Pregnancy and lactation in relation to breast cancer risk.

In the past, numerous efforts have been made to define risk and protective factors of breast cancer. Among these, pregnancy and lactation have been extensively discussed in connection with breast cancer. Unfortunately, many of the reports on the protective effects of pregnancy and lactation are equivocal; caution needs to be exercised when interpreting the results of a single publication. Development of breast cancer is often preceded by the occurrence of preneoplastic mammary lesions, which may be the result of long-term exposure to estrogens and prolactin. Since endogenous estrogen levels regulate pituitary prolactin secretion to some extent, it has been postulated that a hormonal imbalance exists in early mammary carcinogenesis. Exogenous estrogens directly increase pituitary prolactin secretion. During gestation, greatly increased levels of endogenous sex steroids efficiently stimulate pituitary prolactin secretion; during lactation, the stimulus of suckling is responsible for hyperprolactinemia. However, most studies did not reveal a cause-effect relationship between prolactin levels and enhanced risk of breast cancer. At present, the role of pregnancy and lactation in the development and prognosis of breast cancer is not determined.


The role of the dentist in the comprehensive management of hemophilia.

Routine dental procedures do not generally involve bleeding; consequently, there is no contraindication to routine dental treatment for hemophiliacs. Preventive dentistry is vital to the younger hemophiliac patient world-wide; older hemophiliacs may require extensive treatment to restore mouths that have been neglected. Surgical dental procedures may be performed for hemophiliacs, but they must be judiciously coordinated by the dental and medical team. The facilities and treatment available will determine the feasibility of treating such patients in the hospital or on an outpatient basis.


The history of the A family of inbred mice and the biology of its congenital malformations.

The A family of inbred mice which originated in 1921, came during its early development to have incorporated into its genome the tendency to several congenital malformations, among them cleft lip and palate. These sporadic abnormalities are of interest because they closely resemble their human counterparts in morphology and development, and because they share with them a multifactorial basis. The origins and development of the A family are traced, and the abnormalities are described and the forces affecting them detailed.


Neural tube closure defects caused by papaverine in explanted early chick embryos.

Papaverine (50 micrograms/ml) preferentially inhibited uplifting of neural folds in explanted stage 8 chick embryos. Affected neuroepithelial cells often lost their wedge-shaped and elongated appearance. Also, luminal surfaces of most affected cells were smoother than usual as evidenced by the marked decrease in the number of cytoplasmic extensions, but the integrity of other structures (including cytoskeletal components) was not noticeably affected. The observed changes in cell surface topography were due, at least in part, to the imparied ability of apical microfilaments to contract and their eventual relaxation. The "relaxing" effect of papaverine on neural folds could be reversed by subsequent treatment with ionophore A23187. Since papaverine and ionophore A23187 are known to alter the normal distribution of intracellular Ca2+ and changes in cell surface topography are correlated with contractile activities of apical microfilaments, papaverine elicits neural tube closure defects by lowering intracellular free Ca2+ levels, thereby relaxing contracted apical microfilaments in neuroepithelial cells.


Lobectomy with sleeve resection of the bronchus for malignant disease of the lung and the influence of the suture material used for the bronchial repair.

A series of 100 consecutive cases of lobectomy combined with sleeve resection of the bronchus for malignant disease of the lung is presented. In 13 of these cases a sleeve resection of the appropriate pulmonary artery was also carried out. An operative mortality of 8% was encountered and a crude 5-year survival of 40% was achieved. A comparison of absorbable and non-absorbable suture materials for the bronchial anastomosis indicated that the absorbable suture, Polyglycolic Acid (Dexon), minimized the morbidity from complications at the bronchial anastomosis.


Time-dose-response studies on cellular immunity.

The time-dose responses to several murine histocompatibility antigens were studied using lymphocytes as an antigen source for immunization and the speed of rejection of skin grafts as an assay of the level of immune responsiveness. It was observed that the weaker the first set response to an antigen the higher the minimal immunizing dose and the lower the tolerizing dose; thus, there was a small "immunizing window." The speed of onset of immune responsiveness and the magnitude of change in it following first antigen contact depended on the "strength" of the antigen. When the antigen was "strong" the level of response increased rapidly following first antigen contact. When the antigen was "weak" a period of tolerance appeared following first antigen contact, which then gave way to a state of immunity; the "weaker" the antigen the longer the interval and the greater the magnitude of tolerance. Increasing the antigen dose tended to magnify and prolong the tolerance. The "weaker" the antigen the longer the interval between first antigen contact and the appearance of immunity. Once established, the level of immunity was not constant. Undulations in the levels of all responses were noted; the "weaker" the antigen the larger the undulations. Possible explanations for the undulations and implications of the time-dose-response curves in immunotherapy are discussed.


Immune adherence of platelets to sensitized leukocytes: a model of hyperacute rejection.

Specifically hypersensitized recipients of canine renal allotransplants demonstrate an accumulation of host platelets in the transplanted kidney within minutes following implantation. Transplant function is ra,idly lost. The present work describes an in vitro model of this hyperacute rejection mechanism. Renal donor leukocytes sensitized with host serum are incubated with donor platelets. Within a few minutes the platelets adhere to the sensitized leukocytes to form rosettes. Serum complement is required for platelet rosette formation. Platelets act as indicators in this reaction and they may be obtained from any dog. Donor platelets were used to avoid the transfer of specific antibody to the test mixture. The in vitro model supports the view that hyperacute rejection in the dog is a specific example of the immune adherence reaction in which platelets bind to antigen-antibody-complement complexes.


HMM-decorated filaments in leukocyte nucleus.

HMM-decorated filaments could be observed in the leukocyte nucleus under an electron microscope. The filaments were distributed in parallel or randomly among chromatin granules and showed "arrowhead" structures similar to those of cytoplasmic filaments. These observations suggest that the leukocyte nucleus may possess contractile filaments containing actins which probably function in the structural transformation of the nucleus.


Differential volumetry of A, B and D cells in the pancreatic islets of diabetic and nondiabetic subjects.

The percentile volumes vA, vB and vD of A, B and D cells in the islets of Langerhans were histometrically estimated in the pancreases from 59 autopsy cases including maturity- and growth-onset diabetics and nondiabetics. Volumetry was performed microscopically by point counting method using a square-lattice eyepiece, then the total A, B and D cell volumes VA, VB, and VD were calculated from the total islet volume Vi of the pancreas in VB between the three groups. Namely, it was only 0.156 and 0.388 cm3 in the growth- and maturity-onset diabetics, much smaller values than 0.636 cm3 in nondiabetics. The simultaneous investigation on clinical records revealed a negative correlation between VB and the maximum blood sugar of the individual. The smaller VB in diabetes was attributed to the diminution of Vi because vA, vB and vD were almost the same regardless of the presence or absence of diabetes. These results strongly suggested a failure of insulin production in diabetes due to quantitative deficiency of B cells.


Effects of eight amino acids on the exocrine and endocrine pancreatic function.

Eight amino acids were intravenously administered in a dose of 2 mmoles/kg/hr to dogs with chronic pancreatic fistula, and the effect of each amino acid on endocrine and exocrine pancreatic secretions was investigated. Asparagine, arginine, isoleucine and phenylalanine administered under the stimulation of secretin-pancreozymin significantly inhibited the secretion of pancreatic juice by 23%, 15%, 13% and 13%, and the output of amylase by 53%, 37%, 27% and 18%, respectively. Threonine, glycine or methionine brought about no significant changes in pancreatic secretion, but valine significantly increased pancreatic juice secretion by 13% and amylase output by 15%. Any of the eight amino acids caused no noticeable change in the concentration of bicarbonate.


A biological study on hot-water extract from delipidated Mycobacterium bovis strain BCG.

The biological activity of a hot-water extract from delipidated BCG, designated as HSA (Hot-water Soluble Adjuvant), was investigated. The HSA did not induce hyperreactivity to bacterial endotoxin. The hot-water extract from which nucleic acids had been removed by streptomycin (SM-HSA) was found to enhance the delayed-type hypersensitivity as evidenced by the results of footpad reaction of mice. The HSA and SM-HSA could be injected to mice by an intraperitoneal route for 20 consecutive days without undesirable side effects. A comparative study was made on the effects of HSA in relation to the duration and doses of treatment with HSA using the ddI mice inoculated with Sarcoma-180. The most remarkable effect was observed when 0.25 mg of HSA had been injected for 20 consecutive days. Also SM-HSA was found to exert antitumor activity when applied in the same manner as above. These results suggest that the presence of nucleic acids is not related to the biological and antitumor activities of the hot-water extract.


[Prosthetic abutment preparation related to tooth shape and pulp extension].

Using a radiographic measuring technique, the authors determined the pulp-hard tissue ratio in 759 extracted, cariesfree, maxillary and mandibular teeth of exactly indicated ages. On the basis of the results obtained, recommendations are given for the depth of preparation of the various surfaces of the teeth as related to their ages. The suitability of various types of preparation for prosthetic abutments is discussed. For the preparation of the vestibular surface, the authors describe a modification of the grooving technique as yet recommended.


[Studies on the proper processing of silver-palladium casting alloys].

The internal structure and the hardness of three silver-palladium alloys (Sipal 306, Spall WT 52, Bego Gold-EWL G) were investigated in the as-cast condition, after homogenization and after salt-bath hardening. From the results obtained it is concluded that the optimal processing conditions for Sipal 306 and Spall WT 52 are: homogenization at 850 degrees C for more than 2 hours, and hardening at 430--450 degrees C for 15 minutes. The hardness values thus obtained meet the requirements of the type IV indication of the FDI specification no. 7; however, the inhomogenous structure causes a lower resistance to tarnish.


[Reconstruction of continuity after resection of the mandible].

By way of introduction, the authors deal briefly with problems resulting from a continuity resection of the lower jaw with regard to the patient's physiological functions, psychological reactions and social position. They give a short historical survey of the development in this field and, utilizing the pertinent literature, they outline the present state. In the light of their own experience, the authors discuss the immediate reconstruction of the lower jaw by means of modern osteosynthesis techniques. The reconstruction is achieved by the use of autoplastic and xenoplastic material, among other things, also by boiling-out and replanting the resected bone. In addition, results from clinical, radiographical and histological re-examinations are presented.


Prostaglandin I2 and indomethacin prevent impairment of post-ischemic brain reperfusion in the dog.

Twenty-seven heparinized dogs were exposed to 35 min of cerebrospinal fluid compression ischemia followed by 30 min of recirculation. The degree and distribution of post-ischemic reperfusion was then assessed by means of a 14C-antipyrine autoradiographic blood flow study. The animals were assigned to 5 groups by the administration of drugs as follows: 1) no additional drugs; 2) indomethacin 1.5 or 4 mg/kg prior to ischemia; 3) indomethacin 4 mg/kg 5 min after ischemia; 4) prostaglandin I2 (PGI2) infusion 30--180 ng/kg/min beginning 5 min after ischemia; and 5) indomethacin 4 mg/kg 5 min after ischemia plus PGI2 infusion 30--130 ng/kg/min beginning 5 min after ischemia. Animals receiving no additional drugs had relatively low post-ischemic blood flows with focal zones of greatly impaired reperfusion. Animals receiving either indomethacin or PGI2 after ischemia did not differ significantly from the no additional drug group. A significant enhancement of post-ischemic reperfusion occurred in animals receiving indomethacin prior to ischemia and those receiving the combination of indomethacin and PGI2 after ischemia. These observations implicate an imbalance in prostaglandin pathways at the blood-endothelial interface in the genesis of post-ischemic reflow impairment and suggest novel drug therapy for enhancing nutrient flow after ischemia.


Gaseous oxygen perfusion of the renal vessels as an adjunct in kidney preservation.

Gaseous oxygen perfusion of the stored kidney provides life-supporting renal function in canine kidneys damaged by 30 min of warm ischaemia followed by cold storage for a total of 24 hr. Other simple methods of renal preservation, including simple flushing and cold storage and oxygenation of the flush solution and the fluid surrounding the kidney during storage, did not result in consistent life-supporting renal function under these experimental conditions. Low pressure venous oxygen perfusion of the kidney produced significantly better renal function than arterial oxygen perfusion as measured by post-transplant creatinine values. This preservation technique uses apparatus readily available in hospitals and once instituted does not require supervision. It may have clinical application in cadaveric renal transplantation, particularly if the donor kidney has been subjected to warm ischaemia.


Extended treatment with antithymocyte globulin (ATGAM) in renal allograft recipients.

Twenty renal allograft recipients were treated with antithymocyte globulin (ATGAM; ATG) for up to 16 weeks in addition to azathioprine and prednisone, while 20 controls received no ATG. The ATG group showed a lower incidence of first rejection episodes during the first month after transplantation, and also a better functional graft survival rate up to 2 years after transplantation. The results in this early ATG trial were better than those in subsequent trials which used 14-day treatment regimens. Longer treatment deserves another look.


Leucocyte migration inhibition test in cadaveric renal transplantation.

The leucocyte migration inhibition test has been studied in a series of 192 renal allograft recipients. Seventy-seven patients showed no evidence of inhibition in the early post-transplant course, but 31 of these demonstrated clinical evidence of rejection, a false-negative rate of 16%. The remaining 115 recipients all demonstrated inhibition, with 13 of these showing no clinical evidence of rejection, a false-positive rate of 6.7%. Early antirejection therapy on the basis of inhibition did not result in improved kidney survival when compared with those recipients who did not receive specific therapy until there was clinical evidence of rejection. The leucocyte migration inhibition test did not detect changes attributable to humoral factors, which probably accounts for the high false-negative rate, and has not proved to be sufficiently reliable to be of value clinically as a single test. A combination of tests designed to detect both humoral and cellular factors responsible for rejection deserves further study.


A rapid method for preimmunisation and grafting of mice with ear skin.

A schedule for a histocompatibility test among mice involving preimmunisation with ear skin is described and has been tested with the weak transplantation antigen H-Y in C57BL responder and C3H nonresponder strains. The transplantation technique was tested by autografting, and more than 99% of the operations were successful. The priming method reduces the survival of ear skin grafts in every combination tested.


Enhancement of heart allograft survival across H-2D differences.

The use of split heart allografts in the study of immunological enhancement was evaluated. The study revealed that, in contrast to the results with skin grafts, it is possible to obtain exceptional increases in the survival of heart grafts across differences at the H-2D end of the H-2 complex. The factors affecting graft survival were the age of the heart tissue used in grafting, the haplotype of the donor and host, the regimen of injections of antibody, and the immune reagent used. The data suggest that a difference exists in the mechanism by which anti-Ia and anti-H-2D antibodies mediate their enhancing effect.


Rejected human renal allografts: recovery and characteristics of infiltrating cells and antibody.

Viable infiltrating host leukocytes have been isolated from 10 rejected human renal allografts, removed 1 to 67 months after transplantation. The cell populations have been identified by surface characteristics and their cytotoxic capacities were assessed. A heterogenous population of cells of host origin accumulated in the grafts, including T and B lymphocytes, Fc+ cells, and macrophages. Using a 51Cr release assay, specific cytotoxicity against donor alloantigens was determined. Cytotoxicity of the infiltrating cells was almost invariably greater than cytotoxicity mounted by recipient peripheral blood lymphocytes. Deletion studies confirmed previous work and suggested that T cells were primarily responsible for cytolysis in early acute rejection; non-T cells more often in late chronic rejection. Antibodies eluted from the grafts demonstrated both specific antidonor and nonspecific activity as well as cross-reacting anti-HLA activity. Allograft morphology was examined and cellular and humoral host responses were assessed. These studies emphasize the complexities of immune responses produced by the host against transplanted tissues.


[Hepatocyte dynamic reserve: the mechanism for the assurance of specialized functions in the regenerating liver].

A short review is presented of the experimental data on the interrelation between specialized functions and proliferative activity of cells in regenerating mammalian liver. Using the results of the kinetic analysis of induced cell proliferation makes it possible to elicit an existence of the dynamic redistribution of hepatocytes between "the reserve" of quiscent cells (in respect to the mitotic cycle) and the population of actively proliferating cells. This fenomen referred to as "the dynamic reserving of cells" is considered in this work as a possible mechanism of maintenance of the specialized functions of the liver during its regeneration after a partial hepatectomy.


[New measurement standard for cytofluorimetry].

New phosphor crystals, on the basis of zeolit, activated by tin (Sn), appeared to be a very suitable permanent fluorescent test-object for setting up microscopes, intructing new users and for calibrating microfluorimeters. Their properties provide the control of conditions of various fluorescent experiments in both visible and ultraviolet regions. The crystal size may vary from 1 to 100 micron along the facet. Spectral, polarization and fading fluorescence characteristics of the new crystals are described.


[Method of cell cultivation in microdishes].

A method is proposed of cell cultivation on the microscopic glass. Glass rings with inner diameter of 6 mm are fixed on prepared glasses. A simple of 0.2 ml cell suspension is poured into so-formed microcups. The cultivation is carried out in hermetic Petri dishes under conditions of the 5% CO2 atmospheric saturation at 37 degrees C.


Comparative survival of 673 patients with chronic uremia treated with renal transplantation (RT) and maintenance hemodialysis (MD).

We performed a retrospective analysis of 673 patients with chronic uremia treated from 1973 through 1978. While MD had a high mortality during the first year, overall mortality was less than 50% in 5 yrs. Diabetics treated by MD have lower survival than do nondiabetics, though 14% may live for 4 yrs. Our local experience with RT has not been good with only 17% of 69 patients living through their third post-transplant year. Until the reasons(s) for our unsatisfactory transplant experience is discerned and remedies introduced, it can be expected that patient preference will be biased toward MD.


Clinical trial of maintenance sequential ultrafiltration and dialysis (UFD).

Because of its better tolerance, sequential ultrafiltration and dialysis may be useful for intermittent fluid removal in dialysis patients. It offers no major clinical benefits as a chronic form of therapy and may be deleterious for some parameters.


[Primary reconstructive operations in open injuries of the hand and fingers].

The experience with 1613 plastic operations is described. The use of skin plastic reconstruction resulted in the healing of the wound by first intention in 80,7% of cases.


[Treatment of animal bites].

Bite wounds made by animals make up 2% of all the injuries. The authors show advantages of the treatment by surgery and by putting primary and secondary sutures. The surgical treatment and putting the primary and secondary sutures added by the use of antibiotics contribute to healing the wounds by first intention in 84,6% of cases.


[Preparation of autodermal transplants for plastic surgery].

The bacteriological examination of skin grafts prepared by V. N. Yanov's method, has confirmed a sufficient efficiency of such treatment of transplants for burried plasty.


[Peace-time heart injuries].

Basing on the experience of treatment of 23 patients the authors emphasize the importance of rendering the correct urgent aid to patients with such injuries. Cases of injuries of "dangerous zones" of the heart are analyzed. Postoperative complications in such patients are described. The conclusion is made that the time is a decisive factor in decreasing the mortality rate of patients with heart injuries.


[Treatment of injuries of the heart and pericardium in a regional hospital].

Wounds of the heart and pericardium were observed in 19 patients. Four patients died. The main causes of death were acute blood loss, shock, tamponade of the heart. Urgent operations are indicated to all the patients with wounds in the cardiac area. The outcome of the surgery is dependent on the rapid and efficient operation and adequate blood supply.


[Kidney functional dynamics in eliminating vasorenal hypertension by a kidney autograft].

In acute and chronic experiments on 45 dogs the authors obtained vasorenal hypertension, the elimination of which was fulfilled by means of autotransplantation of the kidney without transection of the ureter. The dynamical study of renal function was carried out through an analysis of arterial blood pressure, erythropoietic activity, blood serum, reticulocytic count, creatinine, residual nitrogen, diuresis, radioisotopic investigation, chromocystoscopy at open bladder, excretory urography, aortograhy, phlebography and morphometric studies of the renal glomeruli.


[Ultracytological studies of the morphogenesis and structure of the nuclear polyhedrosis virus in the silkworm moth, Bombyx mori L].

An electron-microscopic investigation was made on hypodermal tissues of silkworms spontaneously infested by nuclear polyhedral disease, due to low temperature stress. It was established that the polyhedral virus is formed in the viroplasma produced after viral cell infection, is included in the intimate and developing membrane singly or in fascicles containing several (up to 9) and is finally incapsulated in polyhedral protein. Besides viral rods, various polymorphic forms were observed in the nucleus and around the polyhedras in the process of formation, which are considered as viral substructures (or nucleocapsidless viruses), membrane structures and surplus synthetized polyhedral protein. It can be presumed that virus replication in single cell nucleus is a continuous process which goes on until complete nuclear structure depletion.


[Changes in the drug resistance of coliform bacteria in the digestive tract of poultry under the influence of antibiotics at different dosages].

Changes in drug-sensitivity of hen intestinal flora following various chloramphenicol, kanamycin and gentamycin dose applications to the fodder rations were studied under experimental conditions. Selection of resistant strains was observed following chloramphenicol application of "nutrient", prophylaxis and medicative doses as well as selection of strains resistant to 6 antibiotics following chloramphenical, kanamycin and gentamycin application in medicative doses. It was proven that some of these strains are carriers of conjugative plasmides possessing markers of tetracycline-, chrloamphenical-, kanamycin-, spectinomycin-, ampicylin- and gentamycin-resistance.


Research on viral hepatitis performed in the "Stefan S. Nicolau" Institute of Virology.

The first phase of research on viral hepatitis (VH) performed in the Institute of Virology (1949--1967) consisted of etiopathogenic, clinico-epidemiological and histopathological investigations which outlined the concepts of VH plurietiology,  of infravirus, as well as the characteristic symptomatic triad, the "age group" phenomenon, the clinico-morphological characteristics of sclerogenous hepatitis. The 2nd research phase was mainly devoted to the study of the distribution, properties and clinico-epidemiological correlations of HBsAg. The application of a modern methodology confirmed many of the previously obtained results.


Study of arboviruses in Romania (1958--1978). Results obtained in the "Stefan S. Nicolau" Institute of Virology.

The results obtained in the Institute of Virology by the study of arboviruses in Romania are reviewed. Isolation of tick-borne encephalitis virus and detection of specific serum antibodies in humans, animals and migratory birds demonstrate its presence on the territory of Romania. Serum antibodies could also be detected to other three flaviviruses (West Nile, Ntaya, dengue types 1, 2, 3), though none of them could be isolated in our country. However, isolation of Kemerovo and Tahyna viruses and detection of antibodies to these viruses as well as to Calovo virus draw attention to the possibility of human infections with arboviruses belonging to Kemerovo, California and Bunyavirus groups.


Research on respiratory virus diseases performed in the "Stefan S. Nicolau" Institute of Virology.

The studies on respiratory virus diseases performed for 30 years in the "Stefan S. Nicolau" Institute of Virology approached various aspects of the ecology of inlfuenza and parainfluenza viruses, adenoviruses and other respiratory viruses, including numerous experimental, fundamental, clinical and morphopathological investigations. Special attention was paid to specific influenza prophylaxis and to the preparation of an inactivated influenza vaccine applicable by nasal and oral route.


Thirty years of research on animal virus diseases performed in the "Stefan S. Nicolau" Institute of Virology.

The results of a 30-year research activity in the field of animal virus diseases performed in the "Stefan S. Nicolau" Institute of Virology are briefly reviewed. Investigations referred to swine pest, fowl pest, Newcastle disease, fowl pox, sheep pox, Aujeszky's disease, Rubarth virus, foot-and-mouth disease, chlamydial infections, etc. Mention is made of the preparations obtained for the specific prophylaxis of most of these diseases.


Studies on the infectivity of viral nucleic acids performed in the "Stefan S. Nicolau" Institute of Virology.

The investigations on viral nucleic acids (NA) performed in the Institute of Virology since 1957 refer to the infectivity of NA (RNA or DNA) from large, complex viruses, from RNA viruses (ECHO, MM Coxsackie, etc.), from modified viruses, as well as to the biological activity (oncogenicity and infectivity) of NA from tumors and leukemic tissues of human, murine, bovine and avian origin. Studies are reviewed as regards the action of physical and chemical agents on the behaviour of viral and cellular NA and the implications of the use of such agents in viral vaccine preparation are discussed.


[Radionuclide cardangiography as non-invasive assessment in coronary heart disease (author's transl)].

The method of radionuclide cardangiography (RNCA) has become a well-established method amongst non-invasive assessments in coronary heart disease (CHD). By means of RNCA the most important parameters of left ventricular function, viz. ejection fraction (EF) and wall motion (WM), can be determined very exactly. The first bolus pass method (FBP), which allows satisfactory separation between right and left heart, enables the additional determination of EF distribution, stroke volume (SV) and SV distribution. This method requires the technical necessity of a multicrystal gamma camera. Special nuclear medicine characteristics have been worked out for different groups of CHD. EF and WM show typical signs of angina pectoris, caused by exercise correlating with reduced perfusion in the referring section of WM. While these changes may be reversible after nitrate administration, pathological myocardial function caused by acute myocardial infarction (AMI) or manifest heart failure is not reversed by nitroglycerine. Typical findings were seen in the course of AMI: initial decrease in global EF and diffuse (multilocated) asynergies in the left ventricular wall; in the second week possible start of recovery, including regression of dyskinesia to akinesia at the end of hospitalization. Especially in the early phase of AMI it was demonstrated that FBP--as a non-invasive technique--gives high information quality which is unequalled by other comparable methods. Therefore, the described method of FBP should be classified as very useful and effective in clinical cardiology.


[Localization of the degradation of injected maltose].

The major maltase activity was found in the kidneys, followed by liver, muscle and blood. Only low maltase activity has been found in adipose tissue, muscle, and brain. The pH-optimum of kidney maltase was at pH = 6.0, the Michaelis-Menten Constant was measured to be 15.6 X 10(-3) mol/l. Even with a dose of 200 mg maltose/100 g body weight saturation of the hydrolysing system could not be attained in living rats. In nephrectomized rats the maltose oxidation was reduced to 55%. Only 0.2% of the applied maltose is excreted into the bile. According to our results the following main pathway of metabolism of maltose is suggested: glomerular filtration of maltose, hydrolysis of maltose to glucose by maltases which are localized in the membrane of the kidney brush borders, absorption of glucose, oxidation of glucose to CO2. In addition an extrarenal maltase activity is considered in the liver. The metabolism of injected trehalose was only 10% when compared with the metabolism of maltose.


[Basic medical study in the early 18th century. On the 300th anniversary of the birthday of Georg Daniel Coschwitz (1679-1729)].

The 300th anniversary of Georg Daniel Coschwitz's birthday gives rise to remember his engagement in the service of the Medical Faculty of Halle University. Under his personal initiative with the construction of an anatomical theatre an important institutional gap of the educational programme in Halle is closed. The basic study of medicine of the early 18th century is described with the help of the example of Halle university. In this phase the educational practices are vastly determined by individual activities which form the basis for later regulations by the state.


Comparison of human and bovine protoporphyria.

Protoporphyria (PP) is an inherited disorder of porphyrin metabolism in man in which there is excessive accumulation and excretion of protoporphyrin. Recently, a similar disorder has been described in cattle. In this report, the clinical, biochemical, and genetic features of bovine and human PP are compared. Human and bovine PP are characterized by photosensitivity and elevation of erythrocyte and fecal protoporphyrin levels. In both disorders, a deficiency of heme synthase activity is present in all tissues which have been examined. The diseases differ clinically in that hepatobiliary disease has been found thus far only in human PP. They also have different inheritance patterns. Human PP is an autosomal dominant disease, while initial studies strongly suggest that there is an autosomal recessive pattern of inheritance in bovine PP.


[Clinical experiences with clotrimazole in treating vaginal candidiasis].

The results of a clinical trial using Clotrimazole (Canesten) vaginal pessaries in the treatment of mycologically confirmed cases of vaginal candidiasis are presented. Treatment schedule consisted in the application of vaginal pessaries each containing 100 mg Clotramizole at bedtime on 6 successive days. In 68 patients who adhered to the treatment schedule and completed the observation and follow-up periods an overall cure-rate of 78.4% was recorded. There were no adverse reactions. Treatment schedules would vary from case to case and in instances of reinfection a repeated course of treatment is recommended.


[Eosinophilic granulocytes in the inflammatory infiltrate in basaliomas and spinaliomas].

In this study the proportion of eosinophilic leukocytes was examined in fifty sections of basal cell and squamous cell carcinomas. With the aid of the specific technique of Schaefer and Fischer it was easy to identify eosinophilic leukocytes. The proportion of eosinophilic leukocytes was found to be smaller than the supposed number seen in H. E. sections. There is no significant difference of the number of eosinophilic leukocytes between the middle and the periphery of the tumor.


Risk-benefit stratification as a guide to lidocaine prophylaxis of primary ventricular fibrillation in acute myocardial infarction: an analytic review.

Early investigators suggested that ventricular fibrillation without heart failure in acute myocardial infarction was reliably preceded by warning arrhythmias, and that suppression of such arrhythmias with intravenous lidocaine could avoid the need for resuscitation. While the efficacy and safety of lidocaine have been substantiated, the reliability of warning arrhythmias as predictors for primary ventricular fibrillation has not. We present data showing that the risk of primary ventricular fibrillation is most dependent on the patient's age and the interval since the onset of his symptoms, rather than on the presence of warning arrhythmias. We have estimated that lidocaine prophylaxis would have to be given to about 12 patients in the highest risk group (patients under age 50 and within six hours of the onset of symptoms), compared to about 400 patients in the lowest risk group (patients above age 70 and more than 24 hours since the onset of symptoms), to prevent one episode of primary ventricular fibrillation in each group. We propose that these risk stratifications, as adapted to the conditions in specific hospitals, provide the most rational approach to lidocaine prophylaxis of primary ventricular fibrillation.


[Systemic treatment of oral lichen planus with an aromatic retinoid (Ro 10-9359)].

Experiences in the treatment of lichen planus mucosae (including the erosive type) are reported. Good therapeutical results could be obtained in all patients. Leukoplakic patches showed a partial involution and in some cases erosive alterations healed completely. After interruption of medication a relapse was observed in most cases. Concerning side effects, some patients complained in particular of minor dryness of both labial and nasal mucosa and of diffuse hair effluvium.


[Treatment of psoriasis vulgaris with external sulfur mustard gas with particular reference to its potential carcinogenic risk. III. Clinical and experimental studies on the extent of percutaneous and inhalational uptake of sulfur mustard gas].

Concerning the often discussed carcinogenic risk of psoriasis treatment with 0.005% S-mustard-vaseline (so-called Russian Ointment) -- especially by inhalation -- 19 patients were treated with a radioactive labeled S-mustard-ointment and examined. The patients' whole bodies were inuncted for 1--2 days with about 50 g of radioactive S-mustard vaseline (U14C, 3 muCi/g). Afterwards the radioactivity was determined in the patients' expired air, blood, urine, and in their surrounding air. In three patients punch biopsy material from normal and psoriatic skin was assayed for radioactivity after combustion. In the skin, radioactivity distinctly decreased from the epidermis (13.1 pCi/mg) to the subcutis (0.77 pCi/mg) without significant differences between normal skin and psoriatic lesions as confirmed by autoradiography. In all samples of air, body fluids and tissue, definitive amounts of radioactivity were found, which, however, were far below the US-American MAK-values. Between skin surface and shirt, the values varied from 1.5 to 13.7 nCi/20 l air, at a distance of 2 meters by 0.3 nCi/100 l air, in the breath by 0.5 nCi/20 l. The radioactivity decreased to 1/10 of the maximum values after 1--2 hours. In blood the activity was at the limit of detection and was parallelled by the activity of the urine. Generally, 1--7% of the radioactivity applied to the skin was eliminated with the urine within one week. Thus, the carcinogenic risk may be very low in the external S-mustard therapy of psoriasis and other skin diseases.


[Experience with deep-frozen fresh pig skin in the treatment of 100 burn injury patients].

Our report is based on the treatment of 100 extensive burns with the employment of fresh frozen porcine skin used as biological dressings. Our experience shows that fresh frozen porcine skin equals in most respects non-typed homografts. Its utilization is economical and it is also recommended in cases where the number of human donors is limited.


[New bone formation in an autologous spongy graft: an experimental morphological study].

Up to 5 days after an transplantation of autogenous cancellous bone in a defect of the ulna of dog which was stabilized by osteosynthesis no remarkable osteoblastic cell activity can be made out by light microscopy using the semithin sectioning technique. On the other hand, there is an obvious increase of osteogenic cells which normally only occur in small numbers in adult dog's cancellous bone of the iliac crest. Only after 7 days, numerous typical osteoblasts can be detected in association with transplanted cancellous chips, osteoblasts which seem to originate from the osteogenic cells by mitotic divisions. One week after the test's commencement, an extensive revascularisation of the transplant can be noticed as well. The osteoblastic cell activity and the forming of new bone are obviously dependent on a sufficient vascular supply in autogenous cancellous graft. The high osteogenic power of an autogenous cancellous graft is based on the ability of survival of the osteogenic cells, which proliferate and differentiate into osteoblasts in the course of one week, wherever its are close enough to functioning capillaries.


[Surgical treatment of decubitus ulcer in paraplegics].

In spite of prophylactic treatment pressure sores in para- and tetraplegics often occur. The pressure ulcers are mostly found in certain places. Surgical intervention will be eventually necessary in most cases. Surgery should include the radical excision of the ulcer, the removal of prominent bone areas and the closure of the defect. In order to avoid large scars the surgical procedure should not exceed a certain extent. We feel that the slide and swing method after Schrudde is the most efficacious because by means of this technique large scars and free transplants which are very sensitive postoperatively can be avoided. We report on a total of 128 patients with 169 pressure sores.


[Use of the dura in the surgical treatment of bladder cancer].

It is reported on 9 patients in whom a dura graft was performed on account of a carcinoma of the urinary bladder. Apart from one patient who before underwent radiotherapy the dura healed. As to complications three times formations of calculi and twice rejection of larger parts of the dura were found. Indications to dura graft as well as its advantages and disadvantages are discussed and it is referred to immunological problems which are still to be clarified.


[Cystoscopy and its importance in urology].

From the enumeration of modern endoscopic methods for diagnosis and treatment of urological disease, the characteristics of their value and their importance for modern urology becomes evident that by means of these methods, the basis of which was created 100 years ago with the introduction of the cystoscopy, examination and treatment became possible in all regions of the urinary tracts. Based on cystoscopy a subspeciality in urology developed, which might be called endoscopic surgery in urology. The endoscopic treatment methods are relatively atraumatic and loaded with a more insignificant complication rate than the open operative interventions. However, they demand an exact knowledge of the indications and contraindications. By the great possibilities which nowadays open the modern methods of endoscopic diagnostics and therapy we are indebted to their inventors still 100 years after the detection of the cystoscope, among the inventors German researchers and masters play an important role.


[Experimental study on erysipeloid arthritis in the rabbit after blockage of lymph drainage].

The lymph drainage was radically blocked in 29 rabbits. One to three days after the operation Erysipelothrix rhusiopathiae was inoculated subcutaneously into the animals. Some control animals were injected with agents of erysipelas and some only with the sterile solution without additional blockade of the lymph drainage. Light and electron microscopy as well as immuno-histological tests showed that the erysipelas arthritis developing in rabbits closely resembles human rheumatoid arthritis with exsudative-necrotising changes of the synovial membrane, proliferation of synovial cells and subsynovial, perivascular plasmacell, and lymphocyte infiltration. The changes were not intensified by the additional blockade of the lymph drainage, when comparing the side with lymph drainage blockade and the non-operated side. The results may be explained by a marked pathogenetic importance of the erysipelas infection in comparison to the relatively mild, lymphostate dependent alterations as well as by mobilisation of macrophages on the operated side.


[Surgical treatment of cancer in the middle 3d of the esophagus].

19 cases with carcinoma of the middle third of the oesophagus were treated by resection in one session by laparotomy and right thoracotomy: in two cases with instrumental perforation substitution of the oesophagus by stomach via the retrosternal route--in 15 cases resection and high intrathoracal oesophagogastrostomy--in 2 cases resection and colon interposition because of previous gastric resection. 2 patients died postoperatively. 2 patients survived more than 5 years. There is an indication for resection in all functionally and technically operable cases.


[Surgical therapy of peptic ulcer of the stomach (author's transl)].

Initially recent opinions about the etiology of the peptic ulceration of the stomach, diagnostical possibilities and the indication for surgical treatment are discussed. In view of the malignant degeneration and the increasing incidence of "early cancer", the 2/3 resection-method is prefered now again.


[Reactive changes in the hypothalamus after implantation of bipolar insulated electrodes and electrostimulation of the adenohypophyseotropic zone].

Histological changes were studied in the hypothalamus of cats in a stereotaxic implantation into the middle zone of bipolar electrodes both by electrostimulation and without it. A wider zone of pathology is localized near the active surface of electrodes, around which a layer capsule is formed and which is surrounded externally by a zone of reactive gliosis. In conditions of electrostimulation quite frequently figures of mitosis of hypertrophied astrocytes are encountered. There is a definite increase of the neuroglial index. Different signs of neuron pathology of the conductive and secretory types, neuron fibres and synapses were found. The described changes were more intense in experiments of 7--15 day electrostimulation. On the 60th day the reactive-destructive process drops, however, the morphological changes in the tissue elements of the hypothalamic area may be marked in all the parts. The extensive pathology in the midbrain develops not only due to a trauma of the hypothalamus during electrode implantation and electrostimulation, but most likely under the influence of the growing capsule as an "alien body". Owing to this factor the changes in the midbrain persist even during the late periods of experiments without electrostimulation.


[Clinical significance of "empty symbolism" in pictograms].

A study of the pictogramms in 500 normals, 150 schizophrenic, 50 neurotic and 70 patients with late sequelae of brain trauma allowed the following conclusion: "futile symbology" as some other disorders of thinking described in schizophrenia is not pathognomic for this disease. Not being symbology in the general sense of this word, "futile symbology" reflects a drop in motivation when accomplishing the tests, and a formal approach of the examinee to such testing.


[Analysis of hippocampal sensory EP-changes in dependence on activation level].

Photically evoked potentials were recorded from the visual cortex (VC) as well as CA 1/2- and CA 4/Fascia dentata-region of the dorsal hippocampus in alert resting rabbits. Analysing the whole time-course of the individual hippocampal EP attention was focused on components corresponding in time to the late negative complex of the cortical EP. Enhancement of such components was seen following habituation to repeated flashes. These changes occurred concerning components in the CA 4/FD-record with shorter latency. The duration and peak latency, however, was longer in CA 4/FD than in the other records. During stimulation of the medial septal nucleus a diminution of late EP-components was seen in the visual cortex and less pronounced in the hippocampus. The time-course of the changes was almost the same in VC and CA 4/FD, whereas in CA 1/2 later components were affected. RF-stimulation caused very similar changes, while those in hippocampal EP's were extended up to later components. Whereas the time range of changes in the hippocampal EP's to all influences under investigation was almost the same, in the VC by RF-stimulation in contrast to habituation components with shorter latencies were affected. In this way it is supposed that for the VC different processes are affected by the three influences, while this could not be established for the hippocampus.


[Evaluation of the results of neurorrhaphy using microsurgical and ordinary technics (experimental study)].

For comparative assessment of an ordinary epineural suture and neurorrhaphy with the use of neurosurgical techniques operations were conducted on rabbits with a subsequent histological examination. It was established that the granulation tissue containing fine collagen fibers formed more rapidly when microsurgical techniques were used than in the controls. Besides, the rate of growth of the nerve elements in the region of the anastomosis was higher and by the end of the study the newly formed myelin axons acquired a clear linear direction.


[Stereotaxic combined dentate-thalamotomy in the treatment of spastic-hyperkinetic forms of subcortical dyskinesias].

The work is based on the results of operations on the cerebellar dentate nuclei in 92 patients. In 42 of them, combined manipulations were carried out on the cerebellar dentate nuclei and the diencephalic structures (relay nuclei, median centre, pulvinar and subthalamus). Analysis of the results showed that stereotaxic destruction of the ventrooral parts of the cerebellar dentate nucleus is a very effective surgical manipulation in various forms of spastic dyskinesia. A natural decrease in the spastic component of the muscular hypertonia is the principal clinical effect of dentatotomy. Its effect on the rigid component of muscular hypertension is negligible. Combined manipulations on the cerebellar dentate nuclei and diencephalic structures are indicated in cases with combined spastic conditions and hyperkinesia which cannot be corrected by dentatotomy. The analysis of the results of combined interventions on the nuclear structures of the thalamus shows that pulvinarotomy is most effective, it reduces or corrects hyperkinesia in infantile cerebral paralysis and, in addition, causes diminution of the general hypertonia, of the upper extremities before all else. Proper rehabilitation treatment is the decisive factor in the final outcomes of stereotaxic intervention on the cerebellar motor systems and on those of the diencephalon in spastic forms of hyperkinesia.


Effect of preoperative administration of oxytetracycline and neomycin on the development of local tumour recurrences in cases of cancer coli-recti.

In the available literature some evidence has been shown, implying that antibiotic prophylaxis in connection with colorectal surgery might increase the frequency of local recurrences of the carcinoma. 134 patients undergoing elective curative surgery of the large bowel have been followed for 20-52 months. 66 patients had been pretreated with Enterobiotic; 68 patients were controls. In our study, we found no difference between the pretreated and non-pretreated group concerning the frequency of anastomotic suture line recurrences or other types of local recurrences in the operation field.


[Repeated perforations of the small intestine in muscular agenesis in a newborn infant. Apropos of a case. Review of literature].

A rare case of intestinal muscular layers agenesis is described. Ten other cases were founded in the literature and are briefly reported. Association of ischemia and congenital abnormality of the muscular layers is probably the cause of the perforation. Prognosis is very bad: all the children with clinical symptoms (occlusion or perforation) died.


Striae cutis atrophicae. Morphokinetic examinations in vitro.

The in vitro behaviour of fibroblasts and epidermis cells taken from recently developed striae distensae was studied in morphokinetic examinations in the cell culture and the results were discussed. The findings give rise to the assumption that the antianabolous effects of the adrenocorticotrophic hormones do not only indirectly cause the atrophia of the epidermis by decrease of the elasticity of the connective tissue, but it appears that primarily epidermis and corium are simultaneously involved in the pathomechanisms of these alterations by irreversible cellular damage.


Pagetoid reticulosis. A further case report with a review of the literature.

A further case of pagetoid reticulosis (PR) was studied, and the findings were compared with 18 previous case reports in the literature. There seem to be two variants: The generalized type (Ketron-Goodman) with disseminated lesions and a poor prognosis, and the localized type (Woringer-Kolopp), with a single lesion usually located on the extremities with a good prognosis (if the lesion can be totally cleared by excision or highdose-radiation). The basic criterion of diagnosis is a very strong cellular infiltrate within the epidermis, but usually weak in the upper dermis. The etiology of PR remains unclear: In some cases a T-cell lymphoma seems a likely interpretation. In others, epidermal infiltrating cells are not typically lymphoid, but remain morphologically unclassifiable.


Oral retinoid for psoriasis. A report of a double blind study.

Oral administration of an aromatic retinoid has a marked beneficial effect on psoriasis and does not produce significant changes in liver function or the blood count when given at a dose of 25 mgm three times a day for six weeks. This effect does not occur unless the drug has produced dermatological side-effects and this may inhibit its future acceptance but the present findings indicate that, at least in the less developed parts of the world where many Western treatments are unacceptable for various reasons, oral retinoids are a useful and relatively safe addition to the present range of medications available for psoriasis.


Percutaneous transperitoneal aspiration of pancreas guided by ultrasound: morphologic and cytochemical appearance of normal and malignant cells.

A pancreatic aspirate was obtained by fine needle biopsy guided by ultrasound in a patient clinically suspected of having a pancreatic malignancy. The cytomorphologic features of well-differentiated adenocarcinoma are described and illustrated. Comparison is made between the carcinoma and normal pancreatic cells. PAS-Trichrome stain is described as a useful cytochemical technique to properly identify normal acinar and islet cells.


Topical methoxsalen photochemotherapy in the treatment of palmoplantar pustulosis and psoriasis.

Topical methoxsalen photochemotherapy has been assessed in 22 patients suffering from recalcitrant palmoplantar pustulosis or psoriasis predominantly involving the hands and feet. Although 20 out of 22 patients improved and good results were obtained in exactly half of those treated, only 4 patients were classified as being "clear" or "minimally involved" at the end of 12 weeks. Two patients have shown no improvement at all. Minor local side effects were relatively common and included symptomatic erythema, blistering and local pigmentation. The histological findings in post PUVA treated skin are discussed and the pros and cons of topical photochemotherapy in this group of diseases is reviewed.


Pre-pin-point papules. Changes preceding pin-point lesions of psoriasis.

Skin areas of 10X10 cm were marked out and closely observed during 14 days in 22 patients with active and 18 cases with less active psoriasis. The first changes - minute papules, slightly erythematous, almost flush with the skin (pre-pin-point papules) appeared within this period and transformed after several days into pin-point lesions. Histological examinations performed in 25 pre-pin-point and 10 pin-point papules, as well as cytochemical studies have shown significant differences. In the pre-pin-point papules inflammatory infiltrates were in a great part polymorphonuclear, and the epidermis had no features characteristic of psoriasis. The performed studies have shown that the earliest changes preceding the appearance of spontaneous psoriatic papules are very much like those of provoked Koebner phenomenon.


[Mechanical suture during resection of the rectum through the abdomen (author's transl)].

A mechanical suture using the URSS PKZ 28 or SPTU stapler was used in 30 low colo-rectal anastomoses. There were two deaths related to anastomotic complications. It is safe to establish a colostomy when the colon is not well prepared. Fistulae are frequent after palliative operations: this is a poor indication. Local recurrences are no more frequent with stapling than with manual suture.


Lichen planus and bullous pemphigoid.

A patient is described who had clinical and histopathological features of lichen planus and bullous pemphigoid; deposits of in vivo bound C3 at the basement membrane zone, which, at the electron microscopy level, were deposited in the lamina lucida; and with circulating IgG antibasement membrane zone antibodies which exhibited a pronounced C3 binding capacity. The similarity of our case to others described in the literature suggests that bullous lichen planus in fact represents the coexistence of two distinct diseases, namely lichen planus and bullous pemphigoid.


Binding sites for endotoxic lipopolysaccharide on the plasma membrane of isolated rabbit hepatocytes.

The in vitro fixation of bacterial lipopolysaccharide (LPS) on the plasma membrane of mechanically or enzymatically isolated hepatocytes from rabbits was studied by immunofluorescence technique. Antisera against LPS from E. coli 026:B6 and 0111:B4 were induced in rabbits. Antibody titers up to 1:1024 were determined by the passive hemagglutination test. There was no immunologic cross reactivity between the two antisera. IgG and IgM were prepared from anti-LPS as well as from normal rabbit serum and conjugated with fluorescein-isothiocyanate. The antibody activity against LPS was localized in the IgM fraction. Hepatocytes were isolated by a perfusion technique without enzymes and with collagenase. LPS binding to the hepatocellular plasma membrane increased proportionally with the LPS concentration in a range between 0.01 and 1.0 mg per ml. The fluorescence pattern of the membrane fixed IgM anti-LPS-antibody at the surface of LPS coated hepatocytes was coarse granular. The in vitro reaction of LPS with hepatocytes was not influenced by the presence of complement. The demonstration of binding sites for LPS on the hepatocellular plasma membrane supports the hypothesis that not only Kupffer cells but also parenchymal liver cells are involved in the hepatic clearance activity for endotoxin.