[The radiological diagnosis of the hemodynamic situation in the pulmonary circulation in chronic obstrictive ventilation disorders].

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


SSPE: immunohistochemical demonstration of measles virus antigen(s) in paraffin sections.

We used the indirect immunoperoxidase method to study formalin-fixed, paraffin-embedded brain sections of four autopsied subacute sclerosing panencephalitis (SSPE) patients. Specific reactions with measles virus antigens was noted in all cases. Positive staining was observed in neurons and glia cells and both nucleus and cytoplasm were usually stained in these positive cells. Electron microscopy revealed intranuclear and intracytoplasmic nucleocapsids stained with electron-dense reaction products. Our findings suggest that for immunoperoxidase studies of SSPE formalin-fixed, paraffin-embedded material can be used.


A new anti-inflammatory derivative of imidazole which is less ulcerogenic than indomethacin in rats.

The mechanism of the anti-inflammatory activity and ulcerogenicity of (2-dimethylamino-1(2)-methyl) ethyl ester of the 1-(2-carboxyethyl)-2-(p-chlorophenyl)-4,5-bis-(p-methoxyphenyl)-imidazole (A-162-ester) was compared with that of indomethacin in rats and enzymatic preparations derived from other species. A-162-ester was found to be deesterified in plasma to A-162. A-162-ester was about 3 times less anti-inflammatory and about 17 times less ulcerogenic than indomethacin. A-162-ester, when given orally, decreased prostaglandin I2 (PGI2) biosynthesis by gastric mucosa. The IC50 was close to the ulcerogenic ED50. Indomethacin--in the same test--was 37 times more potent than A-162-ester and the PGI2 inhibition and ulcerogenic dose-response curves for indomethacin were parallel. In other in vitro systems of prostaglandin (PG) biosynthesis, the inhibitory activity of A-162 was comparable to that of indomethacin. It is concluded that the ulcerogenicity of indomethacin results from a high affinity of this drug to gastric mucosal wall PG-synthetase which leads to decreased PGI3 formation at this site. The relatively low ulcerogenicity of A-162-ester most probable results from a lower affinity of this drug to the same site.


Regional blood flow in canine myocardium as determined by local washout of a freely diffusable radioactive indicator.

The aim of this study has been to examine the utility of the washout of a freely diffusable radioactive indicator as a measure of regional myocardial blood flow in open-chest anesthetized dogs. The method employed was direct intramyocardial injection of Xenon-133 followed by measurement of its gamma-radiation. The experimental washout curves show, after a short acceleration period, monoexponential washout of the indicator over two decades. We found indications of insignificant veno-arterial shunting by diffusion of the blood flow level measured, insignificant arterial recirculation of the indicator, and minimal radioactive contribution to precordial residue versus time curves arising from right heart or non-myocardial tissue. We suggest that diffusion equilibrium between the tissue in the counting field and the blood leaving it is maintained during the linear down slope of two decades of the clearance curve, and that local blood flow can be calculated from washout rate constant obtained from this part of the curve. The method employing intramyocardial injection of Xenon-133 was found to give the same results as atraumatic epicardial labelling indicating negligible effect of the injection trauma and supporting the validity of the local injection method using small volumes (2-10 microliter).


Measurements of cardiac output and organ blood flow in rats using 99Tcm labelled microspheres.

The cardiac output and regional blood flow have been simultaneously determined in the anesthetized rat by using the reference organ method. 99Tcm labelled dextran 15 micron microspheres were injected in the left ventricle while simultaneously an arterial reference sample was drawn at constant known rate. The values calculated regarding cardiac output agree well with previously recorded series. Regional organ blood flow in the rat is presented as ml . min-1 . g-1 tissue and values do agree with those reported by others. The results indicate that the reference organ method can be used in the rat for the study of cardiac output and regional blood flow.


Formation and action of prostacyclin in the isolated human umbilical artery.

The transformation of [1-14C]arachidonic acid by homogenates of human umbilical arteries was studied. The major compound formed was the stable end product of PGI2, i.e. 6-keto-PGF1 alpha (lactol form) as analyzed by gas-liquid chromatography-mass spectrometry. PGI2 was generated by incubating PGH2 with a lyophilized pig aorta microsome preparation. PGI2 concentrations around 10 ng/ml relaxed the human umbilical artery preparation significantly. Formation of PGI2 by umbilical arteries during pregnancy might be a mechanism for regulation of blood flow to the fetus.


Effects of fluorostigmine, toxogonin and atropine on monoamine oxidase activity and the level of biogenic amines in mouse brain. Acta physiol. pol., 1979, 30 (4): 437--444. Fluorostigmine (DFP) given i.p. to mice in doses of 1.2 and 2.45 mg/kg reduced MAO activity in the brain. Given in doses of 0.6 and 1.2 mg/kg it reduced the level of noradrenaline and dopamine as well as 5-hydroxytryptamine in the brain. DFP in such doses had no effect on the brain level of 5-hydroxyindoloacetic acid. Toxogonin (5 mg/kg i.p.) or atropine (5 mg/kg i.p.) given together with DFP reduced or abolished completely the inhibitory effect of DFP.


Comparison of Vivalan (viloxazine hydrochloride) with imipramine in the treatment of depression. A double-blind study.

Twenty-eight hospitalized patients with depressive illness entered a double-blind trial to compare viloxazine hydrochloride (Vivalan) with imipramine. Both drugs produced a statistically significant improvement in the depressive symptoms as early as the 7th day, measured by the HRS. A side effects check-list showed no significant difference between Vivalan and imipramine. A lack of anticholinergic effects was noted in the Vivalan group although upper gastro-intestinal side effects were more frequent. Two patients in the Vivalan group withdrew due to gastric symptoms.


The comparative antidepressant value of lofepramine and amitriptyline. Results of a controlled trial with comments on the scales used.

A double-blind controlled trial comparing the antidepressant activity of amitriptyline with lofepramine is reported. Forty-six patients entered the 4-week trial. Analysis of the Hamilton Depression Rating Scale scores at the beginning and end of the trial showed no significant difference between the therapeutic efficacy of lofepramine and amitriptyline. However, patients with endogenous depression responded significantly more rapidly to lofepramine as measured by Visual Analogue Scales and showed a significantly greater degree of clinical improvement after 4 weeks' treatment, as measured by Global Assessment. Adverse effects were similar in the two treatment groups. The use of rating scales in trials of depressive illnesses is discussed. The Visual Analogue Scale for depression was found to be a simple, useful and valid measure.


Diabetes mellitus challenges for the future.

The future in diabetic research is both stimulating and exciting. Diagnostic subclassification as to specific etiology appears well underway and will provide a more scientific basis for therapeutic approaches. The importance of the histocompatibility complex and its many secrets are rapidly becoming apparent in the etiology of juvenile diabetes. Further studies in obesity and the neuroendocrines may solve adult-onset diabetes. Pancreatic transplantation and artificial devices may provide important therapeutic approaches. Further genetic explorations will, no doubt, provide clarity to the somewhat muddy picture of both etiology and complications. The challenges are here, let's hope that enough young scientists hear the call to provide the manpower to solve this major dilemma.


Scanning electron microscopy of the subarachnoid space in the dog: evidence for a non-hematogenous origin of subarachnoid macrophages.

Injection of viable BCG into the subarachnoid space of immunized and non-immunized dogs produced a 10-fold increase in the populations of pial free cells. In immunized animals injected three days previously with BCG, stereoscopic SEM revealed that many pial cells had rounded up and were protruding into the subarachnoid space. With continued rounding these cells took on amoeboid characteristics, with shapes that suggested a capacity for cell movement. Internally, these pial cells possessed an increased volume of perinuclear cytoplasm and organelles. Reactive pial cells could be distinguished from macrophages of presumed hematogenous origin on the basis of their surface morphology. These findings suggested that pial cells had the ability to alter their normal structural and behavioral characteristics and to become macrophage-like under these conditions of secondary challenge by BCG.


Retinoic acid--a review.

Retinoic acid (RA) is now considered anormal metabolite of vitamin A. It has been established that RA maintains health and supports growth in animals but differs from other forms of vitamin A in that RA does not function in visual or reproductive processes. RA and RA analogs also differ from other forms of vitamin A in: absorption, transport, metabolism, storage, turnover, biochemical functions, excretion, pharmacology, and toxicology.


Effects of differences in amount and kind of dietary carbohydrate on plasma glucose and insulin responses in man.

The effect of variations in kind and amount of dietary carbohydrate on plasma glucose and insulin responses was studied in normal subjects and in patients with chemical diabetes. Plasma glucose and insulin responses fell when the proportion of total calories given as carbohydrate were decreased by 15% (coincidental with a comparable increase in dietary fat). Associated with the lower plasma glucose and insulin concentrations was a fall in fasting and postprandial triglyceride levels. Plasma glucose and insulin responses were also lower when equivalent carbohydrate challenges were given as part of a mixed meal, as compared to a drink. Furthermore, carbohydrate given as starch also led to an attenuated glucose and insulin response when compared to an equivalent amount of glucose administered as either dextrose or sucrose. Finally, significant differences were also seen after the ingestion of different kinds of starch, with potato being the most like dextrose, and rice the least. These results indicate that differences in amount and kind of ingested carbohydrate can modify ensuing plasma glucose and insulin responses, and raise the possibility that such dietary manipulation may have some therapeutic utility in patients with abnormal carbohydrate and lipid metabolism.


Chordoma. A clinicopathologic study of metastasis.

Thirty cases of chordoma were reviewed with respect to the incidence of distant metastases. Follow-up information was obtained in 27 (90%), and the incidence of metastases was approximately 30%. The sites of the metastasizing primary tumors were predominantly sacral and vertebral. The sites of the metastases were predominantly skin and bone, although metastases were found in the lungs and lymph nodes. In two of the three patients with dermal metastases, the metastases were present prior to the diagnosis of the primary lesions. All three dermal metastases were initially diagnosed as mixed tumors of the skin, and all three patients had at least four such lesions of the skin. Accurate prediction of which chordomas will eventually metastasize is difficult. Clinically, local aggressiveness and radiotherapy were positively correlated with this ability; histologically, more anaplastic chordomas were more likely to metastasize.


Clinical usefulness of the Crithida luciliae test for antibodies to native DNA.

The Crithidia luciliae assay (CL-IF) for antibodies to native DNA was found to be significantly more sensitive and specific for systemic lupus erythematosus (SLE) than the Farr radioimmunoassay (RIA). High titers of antibodies to native DNA were seen exclusively in patients wtih SLE using the CL-IF test. The titers correlated with the activity of SLE and nephritis, in that the highest titers occurred in patients with active disease and severe nephritis, the lowest in patients with inactive lupus and normal renal function. Favorable responses to therapy were associated with decreases in CL-IF titers. The CL-IF assay can detect complement-fixing antibodies to native DNA. Their presence correlated with the disease activity and nephritis in SLE patients. The simple and inexpensive CL-IF test could either replace the RIA in clinical laboratories or be used in conjunction with the RIA as a confirmatory test for antibodies to native DNA.


The efficacies of common dyes in primary isolation media for recovery of pathogenic fungi.

Dyes incorporated into a basal medium of brain heart infusion, Sabhi, tryptic soy, or yeast extract--pepton--glucose (YxPG) agar for selective isolation of fungi were investigated. Dilutions of 1:500, 1:750, 1:1,000, 1:5,000, and 1:10,000 of 33 common dyes were tested against 11 gram-positive and 16 gram-negative bacteria. In addition, these dyes were tested against Cryptococcus neoformans, Candida albicans, and the dimorphic phases of Histoplasma capsulatum and Blastomyces dermatitidis. Twenty-one of the dyes did not inhibit any of the organisms tested. Brilliant green, gentian violet, and malachite green (at three dilutions) inhibited all the organisms tested. Methyl red was found to be the best dye in selecting for fungi. Several dyes were also found to inhibit selectively C. neoformans or C. albicans and the dimorphic fungi H. capsulatum or B. dermatitidis.


Antimicrobial selection for meningitis in young infants.

Organisms causing community-acquired meningitis in the first four months of life were reviewed. Species of Streptococcus and Enterobacteriaceae were preponderant in the neonatal period, whereas S pneumoniae and Haemophilus influenzae were preponderant after the first month of life. The Enterobacteriaceae, other than Salmonella, were not associated with meningitis after one month of age. Implications for antimicrobial selection were considered.


Sensitivity of group A streptococci to antibiotics. Prevalence of resistance to erythromycin in Japan.

More than 60% of all strains of group A streptococci isolated during the period from 1974 to 1975 from children with streptococcal infections in Hokkaido district, Japan, were highly resistant to erythromycin. These strains were found to be multiply resistant to lincomycin hydrochloride monohydrate, chloramphenicol, and tetracycline, and were exclusively type 12 by T-protein typing. The clinical symptoms produced by these organisms were rather mild, responded to penicillin well, and were rarely complicated with glomerulonephritis. The high prevalence of resistant group A streptococci was nationwide, which may have been related to recent excessive use of erythromycin and other macrolide antibiotics. Erythromycin can no longer be considered the drug of choice in the management of streptococcal infections in Japan. This suggests that a periodic surveillance of antibiotic sensitivity of streptococcal isolates may be necessary in other countries in which macrolide antibiotics are frequently prescribed.


Streptococcal pharyngitis therapy. A comparison of two erythromycin formulations.

The recommended dosage of erythromycin, without regard to the formulation prescribed, for children with streptococcal pharyngitis is 30 to 40 mg/kg/day. We previously reported an acceptable streptococcal eradication rate among patients with pharyngitis treated with erythromycin estolate, 20 mg/kg/day. In this study, an extension of the earlier one, the efficacy of this same dosage of erythromycin estolate was compared with a 40 mg/kg/day dosage of erythromycin ethylsuccinate. Streptococcal eradication rates were nearly identical in the two groups of patients. The efficacy of erythromycin estolate at a dosage lower than that recommended for children is most likely explained on pharmacologic grounds: better absorption and higher levels in serum and tissue than those achieved with other erythromycin formulations. It seems rational to calculate required dosages of erythromycin on the basis of the formulation being administered.


Hyaline membrane disease. Comparison of continuous negative pressure and nasal positive airway pressure in its treatment.

The effectiveness of continuous negative pressure (CNP) and nasal continuous positive airway pressure (CPAP) in the treatment of hyaline membrane disease and the incidence of complications were compared in 36 preterm infants randomly treated with CNP or nasal CPAP. Both methods of treatment were effective in increasing PaO2 and allowing a decrease in inspired O2 concentration. The time required with mechanical assistance and with an O2 concentration of more than 40% was equal in both groups. In the CNP group, four infants required mechanical ventilation because of clinical deterioration whereas in the nasal CPAP group, seven needed this type of therapy. Three infants in each group had extraalveolar air, and two patients in each group died. The results suggest that both methods of applying continuous distending airway pressure are effective. Nasal CPAP has the advantages of easier application and better access to the infant.


Frequency of use or abuse of amphetamine-related drugs.

A survey was done on over 10,000 urine samples from the Los Angeles County Probation Department and methadone maintenance programs to determine the frequency of use of eight sympathomimetic amine drugs including amphetamine, methamphetamine, ephedrine, mephentermine, phendimetrazine, beta-phenethylamine, phenmetrazine, and phentermine. As expected, the frequency of use of amphetamine was relatively high followed by phentermine, ephedrine, and methamphetamine. The extensive use of ephedrine and phentermine may warrant testing for these drugs on a more routine basis in drug monitoring programs.


State of the art. Primary biliary cirrhosis and the immune system.

The immunologic features of diseases associated with primary biliary cirrhosis (PBC) such as Sjörgren's syndrome, scleroderma, rheumatoid arthritis and others are reviewed. Immunologic abnormalities involving both humoral and cell mediated immunity have been found in PBC. The morphologic and immunologic data have been used to propose a pathogenetic mechanism for PBC. Recent studies of penicillamine indicate that the drug may influence liver copper content and the deposition of immune complexes.


Ovulation induction with luteinizing hormone--releasing hormone in amenorrheic, infertile women.

Thirteen women with infertility thought due to anovulation were treated with LRH. Etiologic diagnoses of amenorrhea included hypothalamic or "idiopathic" and PCOD. All patients had normal gonadotropins and otherwise normal endocrinologic and infertility evaluations; none had ovulated with clomiphene. Patients were studied for six 35 day cycles, single blind, and received LRH or placebo by subcutaneous injections for 28 days/cycle (LRH dosage 1.0 mg 2 or 3 times each day). Frequent assessments of physical status, cervical mucus, vaginal cytology, and serum LH, FSH, estrogen, and progesterone were performed. Ovulation was documented by basal temperature, serum progesterone and, on occasion, endometrial biopsy. Follow-up was continued for 6 months after therapy. Of the 13 patients treated, eight have ovulated and five have conceived. There were no complications of therapy.


Pneumatosis oculi and spontaneous hyphema in association with pneumatosis intestinalis.

A premature infant with acute necrotizing enterocolitis, Escherichia coli sepsis, and disseminated intravascular coagulation developed spontaneous bilateral hyphemas at 3 days of age. The necrotizing enterocolitis was associated with gas bubbles in the intestinal walls. The anterior chambers of both eyes also contained bubbles of gas, formed possibly by a mechanism similar to those in the intestine.


Radial buckling of posterior retinal tears.

We devised a method for safely placing mattress sutures for radial scleral buckling of posterior retinal holes. The ability to pass the needle in the anteroposterior direction, as well as the ability to tie the posterior ends of the mattress suture anteriorly where they are easily accessible, makes this method of placing the mattress suture safe and effective for posterior radial buckles.


Overlooked resources: the place of the library in visual science research.

Effective research should be based on familiarity with what has already been accomplished in the field. The best place to look for this information is a library, since even the most widely read professional may miss much that is relevant. Libraries not only provide access to their own holdings but assist the investigator by means of computerized literature searches and the use of indexes, abstracts, and other forms of printed reference material. Efficient use of library facilities can aid research and facilitate preparation of grant proposals.


Treatment of compromised teeth: a multidisciplinary approach.

Treatment for uprighted abutment teeth that may have infrabony pockets can be considered complete when the following criteria are met: 1. The uprighted tooth is in its proper vertical axis. 2. There is a significant decrease in soft-tissue pocket depth. 3. Crestal leveling is evident radiographically. 4. Adequate space has been created to accommodate a pontic (minimally 6.5mm). The advantages of employing this orthodontic-periodontal technique are as follows: 1. Leveling of the osseous crest fosters pocket elimination obviating the necessity for removal of a great deal of supporting bone. Concomitantly, a significant decrease in pocket depth usually eliminated the need for periodontal surgery. 2. The resulting occlusal forces are placed in favorable axial inclinations. 3. There is an improved crown-to-root ratio, since the uprighted and extruded tooth is reduced to the level of the occlusal plane. This reduction is sufficient to improve considerably the prognosis of a questionable abutment tooth. 4. A pontic space is created for an esthetic and properly contoured pontic. 5. Parallelism is attained, so that the marginal integrity is more easily accomplished. 6. The orthodontic procedures are relatively uncomplicated, efficient, and esthetic, provided there is little or no lower anterior crowding. 7. The restorative dentist has a proper abutment tooth with a good prognosis for prosthesis.


In vitro evaluation of radiation-induced augmentation of the immune response.

Small doses (5--25 rads) of radiation augment the in vitro response of murine spleen cells to sheep red blood cells (SRBCs). Such augmentation appears to result from radiation-induced disruption of a homeostatic component of the response that exerts maximum effect soon after the introduction of antigen. Evidence is presented to support the concept that augmentation is due to injury of an exquisitely radiosensitive subpopulation of T cells with suppressor activity.


Studies of the functional and morphologic status of islets maintained at 24 C for four weeks in vitro.

Isolated rat islets were maintained in vitro at 24 C for 1-4 weeks in tissue culture medium containing D-glucose (1.5 mg/ml). The rate of insulin release at 24 C remained stable for three weeks (2.2 muU/islet/hr) and decreased to 1.2 muU/islet/hr during the fourth week. Increasing the temperature from 24 C to 37 C at the end of 1, 2, 3, or 4 weeks produced a 5--7-fold increase in the rate of insulin release in the presence of glucose (1.5 mg/ml). This rate of secretion was comparable to control islets maintained at 37 C for 1--4 weeks. Light- and electron-microscopic studies revealed minimal central necrosis of large islets maintained at 24 C for 3 weeks. In contrast, extensive central necrosis was present in large islets maintained at 37 C for only 1 week. Degranulation of B cells occurred at 24 C with almost complete degranulation at 28 days. Regranulation occurred when the temperature was increased to 37 C. These findings indicate that isolated islets maintained at 24 C remain functionally and morphologically intact for 4 weeks. Initial studies have shown that maintenance of islets at 24 C for 1 week in conjunction with a single injection of antilymphocyte serum will produce marked prolongation of survival of islet allografts. The finding that isolated islets will survive for prolonged periods of time at 24 C should be of importance to future studies on islet transplatation, immune rejection, and investigations on hormonal release from islets maintained under these conditions.


Dynamic aspects of cancer cell populations in metastasis.

Consideration of the entire metastatic process reveals it to be very inefficient in terms of cancer cells. Of the millions of cells released from primary cancers, relatively few metastases result. This disparity implies that in some way the process is selective. Some evidence will be reviewed that indicates that cancer cells in metastases are in some way different from those in the primary cancer from which they arose. Primary cancers and their metastases, then, should possibly be regarded as distinct entities when one is considering therapy or seeking an understanding of the fundamental aspects of metastasis. In this presentation some nonexclusive mechanisms will be discussed that could be responsible for differences between primary and secondary cancers. These include: 1) Random (statistical) selection of metastasis-forming cells; 2) The existence of genotypic metastatic subpopulations; 3) The existence of transient metastatic "compartments" within primary cancer; 4) Site-induced changes (modulation) occurring in the metastasizing cells after they arrive in the target organ; 5) A combination of the above.


The psychiatric use of electrically induced seizures.

ECT is an effective but also controversial treatment modality in psychiatry. The decision of when to use ECT is predicated on a knowledgeable assessment of anticipated benefits and possible risks as they apply to each individual case. Refinements in ECT technique have minimized risks, but have also increased the methodological complexity. The author presents a clinical review of ECT use with particular emphasis on practical issues related to efficacy, risks, and technique.


The use of a technical questionnaire in laboratory proficiency testing.

As an adjunct to laboratory improvement, a technical questionnaire concerning specific steps of the more commonly employed laboratory procedures was incorporated into three proficiency testing evaluations: syphilis serology, mycobacteriology, and parasitology. This addition to proficiency testing revealed some basic and detrimental procedural deviations which could affect the validity of reported clinical values. These procedural deviations were communicated to the laboratories in an attempt to improve performance.


Parasitic disease control in a residential facility for the mentally retarded.

Asymptomatic infection with either Entameba histolytica or Giardia lamblia was found in 61 per cent of the residents of a dormitory in an institution for the mentally retarded; two other dormitories had rates of 20 per cent and 22 per cent. Drug therapy was successfully undertaken in all three dormitories, and environmental improvements were introduced in the heavily infected dormitory. A one-year follow-up showed a reduction in parasitic disease in two dormitories but, in the most heavily infected dormitory, infection had returned to pretreatment levels.


Possible chloroquine-resistant Plasmodium falciparum in Nigeria.

A 42-year-old hospital worker had a recrudescence of falciparum malaria after chloroquine therapy. Further adequate treatment with chloroquine given orally did not clear the infection. He was then given a combination of sulphadiazine and pyrimethamine, which produced a radical cure. This points to the possibility of chloroquine-resistant Plasmodium falciparum in Nigeria, an African country where this has been thought to be unlikely. Because of this and earlier reports, clinicians should be on the alert to the possibility of chloroquine-resistant P. falciparum in this area, and efforts should be made to establish or reject the presence of malarial parasites resistant to chloroquine in Africa.


Epidemiologic studies among Amerindian populations of Amazonia. II. Prepvalence of Mansonella ozzardi.

The prevalence of microfilaremia among Indians in 13 Amazon Indian villages was determined by examining Giemsa-stained peripheral blood smears and preparations from peripheral blood lymphocyte cultures. Mansonella ozzardi was the only species found in the 601 persons tested. Prevalence was highly village-specific, ranging from 0% in four villages to as high as 93% among persons aged 10 years and older in others. Comparisons of the two methods showed that the concentration effect of the peripheral blood lymphocyte culture preparations allowed the detection of a greater number of microfilaria-positive persons, especially women and children with lower levels of parasitemia.


Viability of frozen allografts.

The use of meshed skin grafts allows an evaluation of the biologic properties of stored tissues such as skin. Frozen allograft may serve as an excellent biologic membrane, but it is not a satisfactory product for longer term allografting (intermediate allografting). The method of thawing (microwave oven versus water bath) appeared to have little effect on the ultimate viability and outcome of the frozen allograft.


Microflora of the human small intestine.

The human small intestine is normally sterile in nearly one half of North American subjects. In this study the duodenum, jejunum, and ileum were sterile in 82, 69, and 55 per cent of the cases, respectively. Gram-positive cocci were the most frequent finding. E. coli, Enterobacter, and Klebsiella were present in the small bowel in nearly 7, 15, and 35 per cent of duodenal, jejunal, and ileal samples, respecatively. They were present in significant numbers (greater than 1 X 10(5)/ml) in the mid-jejunum in two patients and in the mid-ileum in seven patients (23 per cent). Even with modern anaerobic techniques, anaerobes are scarce in the small bowel; 4 to 6 per cent of persons may have aerotolerant anaerobes like clostridia, but strict anaerobes like bacteroides are rare. Our study provides baseline data for use in interpreting the intestinal bacterial overgrowth associated with certain postoperative disorders.


Increases in cuff volume and pressure in red rubber endotracheal tubes during anaesthesia.

Increases in endotracheal tube cell volume and pressure during anaesthesia have been reported to be due to the diffusion of nitrous oxide into the cuff. This study compared cuff volume and pressure changes in anaesthetized intubated patients who were ventilated with those allowed to breath spontaneously. The cuffs of Magill red rubber endotracheal tubes were inflated with either air or a nitrous oxide-oxygen mixture. Serial pressure and volume recordings confirmed that both parameters increased when the cuff was inflated with air. The increase in cuff pressure was however, greater during intermittent positive pressure ventilation than for spontaneous respiration. There were no significant changes when the cuff was inflated with the nitrous oxide-oxygen mixture.


Anatomical observations about the closure of the ductus venosus in the dog (Canis familiaris).

The observation of the anatomical closure of ductus venosus was carried out in 108 dogs (62 females and 46 males) with age varying between 3 hours and 21 days old. We have observed that within 2 days old, the ductus venosus was found pervious in 100% of the animals sacrified; 3 days old, in 81% of the animals; 4 days old, in 62% of pups; 5 days old, in 25% and over 6 days old, the ductus venosus was anatomical closed in 100% of the animals. We have also observed that the closure starts within 48 hours on the caudal vena cava caudal side.


[Area mesencephalica on the raphe and its importance. (Stereometric reconstruction in cat) (author's trnsl)].

The cat's mesencephalic raphe, caudally extended to the locus ceruleus and rostrally to the habenulo-interpedunculary area, was reconstructed with foamy-plastic plates in a stereotaxis ensemble of the brainstem. This reconstruction serves as an important reference to the topography and for interpreting the functional background of the stereotaxic lesions accumulated in the last 5 years. The alterations of the lung's alveolar interstitium after the nervous lesions, were classified in different groups of common evolution.


Surface area ratios. II. A stereological method for estimating changes in average cell volume and frequency.

The study describes a sterological method for detecting relative changes in cells--with respect to their average volumes and to their frequencies within one cm3 of exocrine cells. The method is based on surface area ratios (Bolender, '79) and can detect changes comparable to those obtained with the numerical density approaches (Loud, '68; Weibel et al., '69; Bolender, '74; Williams, '77). The new method requires only intersection counts--the same ones that are used for surface density estimates--and, as a result, avoids the difficult and often problematic procedures of the numerical densities. In analyzing the cellular changes in vitro, the choice of either a zero or timed control was found to exert a major influence on the results. Timed controls were required to "isolate" the experimentally induced changes from those produced by the incubation medium.


Induction of exocytosis from glomus cells by incubation of the carotid body of the rat with calcium and ionophore A23187.

Carotid bodies from adult rats were electron microscopically studied after incubation in glucose-containing salt solutions containing calcium and/or ionophore A23187 or neither. In the absence of the ionophore, adding or omitting calcium had no effect on the fine structure of the glomus cells. Incubation in the medium containing both 1 mM calcium and the ionophore caused the appearance of exocytotic membrane profiles in several glomus cells. Exocytosis was not seen when only A23187 and endogenous calcium was present. For exocytosis to occur, calcium appeared to be essential and the event seemed to be due to a rise in the intracellular calcium concentration caused by the ionophore.


[Review of in vitro feeding of bloodsucking anthropods].

A review on methods of in-vitro-feeding of bloodsucking arthropods is given. The most important sphere of application of these methods are the in-vitro-rearing, experiments of transmission of virulent and avirulent pathogens, investigations about the nutrition of haematophagous arthropods, and about the efficiency of phagostimulants, repellents et al. Composition, preparation and preservation of natural blood are briefly described. The kind and the handling of the blood and the suitability of methods depends on the bionomic and feeding behaviour of arthropods and on the specific task of work. The most important methods of the in-vitro-feeding are inoculation, capillary method, feeding from the absorptive substrats of from embryonated eggs, and especially feeding through membranes.


Indirect blood pressure measurements: a matter of interpretation.

The indirect measurement of arterial blood pressure is discussed from the standpoint of the intravascular phenomena that occur under the cuff during the production of Korotkoff sounds. The influence of the physical and elastic properties of the vessel wall and blood flow parameters on indirect blood pressure measurement were investigated by using the results of model studies carried out in a properly scaled, simulated mechanical system under controlled conditions. The results of those studies indicate that auscultatory readings may be subject to large errors, depending on the thickness and stiffness of the artery wall. These results are shown to be consistent with comparisons of direct and indirect blood pressures in human subjects in that errors of the order of 30 to 50 mm Hg are not uncommon in the elderly or in patients with advanced arteriosclerosis. The errors discussed here are inherent to the auscultatory technique and are not related to instrument calibration, auditory acuity, or office technique.


The usefulness of theophylline in nonasthmatic airway obstruction.

This study evaluated the effectivness of oral bronchodilator therapy using theophylline in patients with nonreversible chronic obstructive pulmonary disease. Twelve chronic obstructive pulmonary disease patients were entered into a doubleblind crossover study using either active drug theophylline in 200 mg capsules (Elixophyllin) or placebo for 3 months, followed by 3 months of the alternate capsule. At baseline and monthly visits, data were recorded, including history, physical examination, and pulmonary function testing. Clinically, 7 of 11 patients responded favorably to theophylline, 3 were unchanged, and 1 improved on placebo. Comparison of each sign and symptom individually revealed no statistically significant differences. Pulmonary function (FEV1 and FVC) showed slight deterioration with placebo, but not with active drug therapy. These findings suggest that nonasthmatic patients may improve clinically during theophylline therapy whereas their pulmonary function may deteriorate during placebo therapy.


The recementation of orthodontic bands using different cements.

A clinical study on band failure rate was carried out on 5949 bands cemented to the teeth of 293 patients drawn from three orthodontic practices. The failure rate ranged from a minimum of 7% in a sample from a practice where bands were cemented with Durelon cement (Group 2) to a maximum of 19% in a sample from a practice where bands were cemented with oxyphosphate cements (Group 3). Comparison between the results of the two controlled prospective studies from one practice (Groups 1 and 2) indicated that the use of a commercially available polycarboxylate cement (Durelon) resulted in a lower failure rate than that experienced with an experimental formulation of polycarboxylate cement. The teeth on which cemented bands failed most frequently were the maxillary central incisors. Comparison of the band failure rates between different practices (Groups 2, 3 and 4) showed that patients in Groups 3 and 4 experienced a higher band failure rate than patients in Group 2, due possibly to different types of bands, cements, and cementing procedures of the different operators.


The production and analysis of antilymphocyte sera following pregnancy and skin grafting of cattle.

This paper presents evidence to show that high titre antilymphocyte sera can be prepared more easily by skin grafting than from parous sera. It also shows that it is possible to analyse complex antilymphocyte sera by absorption with lymphocytes to produce working reagents. Following the 1 International BoLA Workshop the genotype of some of the animals used for skin grafting was ascertained and it was found that in each case where the resulting serum had been studied the main antiserum specificity that had been produced reacted with one of the BoLA specificities present in the skin donor.


Correlation of immediate skin test responses to antigens introduced by multi-test and intracutaneous routes.

The Multi-Test applicator is a disposable plastic device for the simultaneous prick-puncture administration of different antigens at eight sites, in a rapid, relatively painless and reproducible manner. To determine its utility in immediate or reaginic skin testing, it was compared with the intradermal technique in children and adults. Skin test responses to glycerinated inhalant antigens, 1:20 or 1:10 W/V, administered by Multi-Test were comparable to those obtained from the same antigens applied intradermally in aqueous dilutions of 1:1,000 or 1:1,500 W/V.


Inflammatory reactions and chemotactic factors.

Inflammatory reactions are mediated by a large number of chemical substances called chemical mediators, including chemotactic factors, which are released by immunologic as well as non-immunologic mechanisms. Chemotactic factors which act indirectly on target tissue can not only enhance inflammatory reactions (NCF-C) but may also eliminate the reactions (ECF-A).


Heat extraction of animal plasma in preparation for endotoxin testing with the limulus amebocyte lysate test.

A heat-extraction procedure for endotoxin extraction from animal plasma has been developed for use with the limulus amebocyte lysate test. The procedure is simple to use, is accurate, and has shown good sensitivity with blood from several animal species.


Equine Escherichia coli endotoxemia: comparison of intravenous and intraperitoneal endotoxin administration.

Certain physiologic and hematologic data were determined in ponies given Escherichia coli endotoxin by three routes: single IV dose, single intraperitoneal (IP) dose, and multiple IP boluses. In all ponies, the reaction was characterized by weakness, depression, peripheral circulatory abnormalities, and pyrexia. The pyrexia was more severe and was sustained in the ponies given multiple IP bolus endotoxin. Changes in packed cell volume, peripheral blood neutrophil, lymphocyte, and thrombocyte counts, and blood glucose were noticed in the three groups. Blood lactate and beta-glucuronidase values were determined and increases occurred only in the two IP endotoxin administration groups. A fibrinogen increase was observed in only the multiple IP bolus group. Attempts were made to correlate the lactate and beta-glucuronidase values with the severity and prognosis of the endotoxemia response. In general, the single IV bolus and, to a lesser extent, the single IP bolus endotoxin produced abrupt but transient responses. The multiple IP bolus endotoxin administration produced a more gradual and sustained response, which was more closely comparable with a clinical gastrointestinal disease problem than the other routes of administration produced.


Failure of positive end-expiratory pressure to decrease lung water content in alloxan-induced pulmonary edema.

The effect of 10 cm H2O of positive end-expiratory pressure (PEEP) on pulmonary extravascular water volume (PEWV) was measured in an animal model of noncardiogenic pulmonary edema. Three groups of animals were studied: (1) controls, (2) those given a saline infusion plus alloxan, and (3) those which received saline infusion plus alloxan and PEEP. All animals were ventilated with a constant volume ventilator. Mean PEWV (+/- SEM) in milliliters per gram of dry lung weight was 4.00 +/- 0.21 for group 1, 6.01 +/- 0.70 for group 2, and 5.77 +/- 0.83 for group 3. Mean PEWV increased significantly in both alloxan groups (groups 2 and 3) as compared to the control group (for both, p less than 0.05); however, PEWV did not differ significantly in the group that received PEEP, as compared to the group ventilated without PEEP. Arterial PO2 and airway pressure required to deliver a constant tidal volume did not change significantly in the experimental groups as compared to the control group. It was concluded that PEEP does not decrease lung water content in pulmonary edema caused by damage to fluid-exchanging vessels.


Ventilation-perfusion distributions in the adult respiratory distress syndrome.

The distribution of ventilation-perfusion ratios, as determined by the multiple inert gas elimination technique, was measured in 16 patients with the adult respiratory distress syndrome. In each case, the distribution of ventilation-perfusion ratios was bimodal. The upper mode consisted of units with normal ventilation-perfusion ratios that received a mean of 52% of the cardiac output. The lower mode, which received the remainder of the cardiac output, consisted of either pure shunt or shunt plus a small number of units with very low ventilation-perfusion ratios (less than 0.01). The measured arterial PO2 and that predicted from the distribution of ventilation-perfusion ratios were very closely correlated (r = 0.93), indicating that the hypoxemia was completely explained by the measured ventilation-perfusion inequality. In 12 patients, the effect of positive end-expiratory pressure on the distribution of ventilation-perfusion ratios was also determined. The addition of positive end-expiratory pressure uniformly resulted in a decrease in blood flow to the lower mode and an increase in the ventilation of unperfused alveoli. Increasing positive end-expiratory pressure also led to a uniform decrease in cardiac output. We conclude that the hypoxemia of the adult respiratory distress syndrome is caused by the presence of shunt or units of very low ratio of ventilation to perfusion and that positive end-expiratory pressure increases the arterial PO2 by decreasing the perfusion of unventilated lung. The mechanism of this decrease is yet to be defined.


Disulfiram for the treatment of alcoholism. An evaluation in 128 men.

One hundred twenty-eight alcoholic men were assigned randomly to receive either a regular dose of disulfiram (250 mg), a pharmacologically inactive dose (1 mg), or no disulfiram. There were no statistically significant differences among the three treatment groups in total abstinence, percentage of drinking days, days worked, family stability (living with same relative), or percent of scheduled appointments kept. However, 21% of those who received the regular dose of disulfiram and 25% who received the pharmacologically inactive dose remained abstinent, whereas only 12% of those who received no disulfiram did so. These results indicate that disulfiram may be of limited value in the treatment of alcoholism, fear of the disulfiram-ethanol reaction is important in preventing drinking, and patients willing to take disulfiram are more likely to be abstinent if given the drug. We also found that complete abstinence correlated significantly with compliance and obtaining employment.


Identification of tubercle bacilli.

Initial screening of tubercle bacilli with 2-thiophene carboxylic acid hydrazide (TCH) or 2-furoic acid hydrazide (FAH) separates them into two groups. Resistant strains are Mycobacterium tuberculosis. Sensitive strains include M. tuberculosis, M. bovis and BCG which are separated by nitratase and oxygen requirement tests. Pyrazinamide sensitivity tests allow M. bovis and M. africanum to be identified. The niacin test is not used. Most strains of M. tuberculosis from Europeans are resistant to TCH and FAH and are in phage groups A and B, while most strains from Asians are sensitive and are in phage group I.


[Inhibition of Escherichia coli haemagglutinations by antibiotics].

Escherichia coli has been associated with a colonization factor antigen responsible for the bacterial adherence to the intestinal mucosa. This colonization factor is also responsible for haemagglutination. Among 32 antibiotics tested, only tetracyclines, chloramphenicol and nafcillin inhibit haemagglutination. Tetracycline hydrochloride, tetracycline phosphate and doxycycline are the most effective, followed by oxytetracycline, minocycline, chloramphenicol and nafcillin. Doxycline at a concentration at 0.8 mg/ml in buffered saline, chloramphenicol at 12.8 mg and nafcillin at 31 mg inhibit haemagglutination in 2 h. The inhibition of haemagglutination occurs both with E. coli susceptible and resistant to doxycycline. Pretreatment of crythrocytes with doxycycline does not prevent inhibition of haemagglutination where as pretreatment of E. coli does, suggesting that doxycycline acted on the bacteria. Once haemagglutination had occurred, doxycycline can reverse the haemagglutination, "unhooking" the bacteria from the erythrocytes. These data raise the possibility that some antibiotics may prevent adherence of E. coli to the intestinal mucosa, regardless of the susceptibility or resistance of the bacteria by a direct effect on the colonization factor antigen. Furthermore, some antibiotics may be able to detach the bacteria once adherence to the mucosa has occurred.


[Release of "Saccharomyces cerevisiae" protoplasts: scanning electron microscope study (author's transl)].

In a previous study we described the minimal methodology used to obtain protoplasts from ascomycetous yeasts. Using a reducing agent associated with 1,3-beta-glucanase at 26 degrees C, protoplasts were invariably obtained. In the present study we localized the disruption spots of the cell wall using the two same reagents. The observations were made with the scanning electron microscope. The disruption site was always in the subterminal region, and this very simple structure (proteins with disulphide bridges and 1,3-beta-glucans) was opposite the birth-scar. The dissociation of the two reagents showed that a small part of the yeast population was able to release protoplasts with only glucanase. We believe these very sensitive yeasts (2 to 10% population) to be very young cells. These disruption sites seemed very different from budding-sites. They might be identical with elongation-sites, or with the opening in the ascus-wall during germinating ascospore release.


[Differentiation of "Pasteurella" and "Actinobacillus" from Enterobacteriaceae" by use of the O/129 vibriostatic agent (author's transl)].

Out of 134 Pasteurella and Actinobacillus strains studied, 132 are found to be susceptible to the O/129 vibriostatic agent with growth inhibition diameter ranging from 10 to 42 mm (86% in the range 25 to 32 mm); 46 reference strains of Enterobacteriaceae including Yersinia are resistant to the O/129 vibriostatic agent. This test can quickly differentiate between typical or atypical Enterobacteriaceae and the genus Pasteurella or Actinobacillus.


[Primary malignant teratoma of the thyroid. Report of one case and review of the literature (author's transl)].

Malignant teratomas of the thyroid in the adult are rare. A personal case is presented. It brings the total number of cases found in the literature to nine, and illustrates the terrible prognosis of these tumours regardless of the treatment used (extensive surgery, radiotherapy, chemotherapy). Teratomas in the adult thus differ from those in the newborn and child. The latter are much more common and recurrences virtually non-existent. The histogenesis of these tumour is discussed. It may dysgenetic heterotypism, but no definite conclusions may be offered.


Oligodendrocyte staining by multiple sclerosis serum is nonspecific.

The immunofluorescent staining properties of 65 serum samples from 54 patients with multiple sclerosis (MS), 63 samples from 55 patients with other neurological diseases (OND), and sera from 14 healthy normal individuals were examined on frozen sections of bovine and human brain. When tested on bovine brain sections, positive oligodendrocyte staining was present in 63% of MS sera, 43% of OND sera, and 29% of normal sera. The percentages were lower with human brain tissue. Astrocyte and myelin staining was common. F(ab')2 fragments purified from selected positive and negative MS and control sera gave no staining, though IgG fractions from the same sera prior to pepsin digestion gave positive staining. When tested against antihuman IgM and IgA conjugates, the same positive sera and their IgG-depleted globulin fractions gave minimal or no staining. These results indicate that oligodendrocyte staining is not specific for MS, is not due to specific antibody, and is probably the result of nonspecific binding to Fc receptors.


Controlled trial of EMG feedback in muscle contraction headache.

Twenty-eight patients suffering from severe, longstanding muscle contraction headache were randomly assigned to two groups, one receiving electromyographic (EMG) feedback therapy and the other, "most suitable alternative therapy." Headache intensity and severity as well as drug intake were reduced in the feedback group (p less than or equal to 0.01) as opposed to no improvement in the control group. The positive treatment effect in the feedback group persisted through a three-month follow-up period. EMG feedback therapy is effective in the treatment of muscle contraction headache even in its chronic, severe form, which is resistant to traditional treatment methods.


The CSF-FTA test and the significance of blood contamination.

Although the fluorescent treponemal antibody absorption (FTA-ABS) test has found wide application in the diagnosis of syphilis, the cerebrospinal fluid fluorescent treponemal antibody (CSF-FTA) test is still controversial in the diagnosis of neurosyphilis. We found the CSF-FTA test extremely sensitive to contamination with FTA-ABS-reactive blood at concentrations in CSF that could not be detected by visual inspection. Interpretation of a reactive test should be made with caution if red cells are present in CSF.


Botulism, type A, and treatment with guanidine.

In a double-blind crossover study in which patients received placebo or active drug for varying periods, we evaluated the ability of guanidine hydrochloride (20 to 35 mg/kg per day perorally) to improve the rate of recovery in patients with moderate or severe botulism, type A, intoxication. Among 14 patients who received conventional botulism therapy, there was no improvement in recovery rate in those who received guanidine compared with the nontreated group. Individual patients in the treated group showed neither an acceleration in their rate of improvement when they received guanidine nor a regression in their progress when the drug was stopped. Individual patients, likewise, noted no subjective improvement when they received the drug compared with the placebo. Treatment with guanidine does not enhance recovery from botulism.


[Doxycycline bioavailability in capsules].

Soviet doxycycline capsules in a dose of 0.1 g were studied in vitro (for disintegration and solubility) and in vivo (pharmacokinetics on 25 patients). It was found that Soviet doxycycline capsules provided comparatively rapid absorption of doxycycline. The antibiotic availability may be characterized by the solubility test. The results of the study on bioavailability of Soviet doxycycline capsules were compared with the results of analogous studies published by American authors for doxycycline capsules manufactured by various firms of the USA.


[Characteristics of a strain of C. albicans resistant to polyene antibiotics].

It was found that a resistant strain R2 of C. albicans obtained as a result of passages on media containing increasing concentrations of amphotericin B differed from the initial strain by its lower pathogenicity. Treatment of the infection caused by the resistant strain on modeling of candidiasis in mice was not successful. The decrease in the average life span of the mice infected with the resistant strain R2 and treated with amphotericin B was lower than that in the control animals and such indices of the disease as the levels of the kidney dissemination and the cell vegetation even increased under the effect of amphotericin B. The results of the study suggest that the resistant strain R2 of C. albicans depend on amphotericin B in the host. The data obtained emphasize the necessity of determinining the antibiotic sensitivity of C. albicans strains isolated from patients.


Experimental endocarditis: prophylaxis of Candida albicans infections by 5-fluorocytosine in rabbits.

The prevention of Candida endocarditis in the rabbit was easily accomplished with a single intramuscular injection of 75 mg of 5-FC (A predominantly fungistatic agent) per kg either 40 min before, or at the same time as, the intravenous challenge with Candida albicans. Renal infarcts were observed more often in rabbits with infected valvular vegetations than in control rabbits with sterile endocarditis. The prophylactic effect of 5-FC is greater in aortic vegetations than in the kidneys. This may be related to differences in the pathophysiology of infection and the pharmacokinetics of 5-FC in the two areas.


Australian evaluation of Autobac I with suggested interpretive and technical modifications.

Autobac I, a recently introduced semiautomated method for rapid antibiotic susceptibility testing, has been evaluated by comparison with the calibrated dichotomous sensitivity disk diffusion technique, which is routinely used in many Australian hospitals. Only the most common clinical isolates, Staphylococcus aureus, Escherichia coli, Klebsiella sp., and Proteus mirabilis, were included in this evaluation, and an overall interpretive agreement of 93% was obtained. However, an unusually high rate of discrepancy was noted in several organism-antibiotic combinations, in particular E. coli and P. mirabilis with ampicillin, S. aureus with penicillin, and methicillin-resistant S. aureus with methicillin, erythromycin, and clindamycin. The discrepancies associated with ampicillin have been reduced from 29 and 24% for E. coli and P. mirabilis, respectively, to less than 5% after the utilization of commercial 10-micrograms diffusion disks, in preference to the lower antibiotic content disks supplied by the Autobac manufacturer. Furthermore, modifications in the interpretive procedure have eliminated discrepancies associated with S. aureus and penicillin.


Netilmicin treatment of complicated urinary tract infection in patients with renal function impairment.

The efficacy and tolerance of netilmicin was studied in 28 elderly male patients with varying degrees of renal function impairment who suffered from complicated urinary tract infections. Doses of netilmicin, equivalent to 2 mg/kg divided by milligrams of creatinine per 100 ml, were administered every 12 h. A 62% cure rate, defined as negative urine culture at 1-week follow-up, was obtained. Treatment failure correlated with impaired renal function. Nephrotoxic reaction, defined as any significant increase in serum creatinine during treatment, was found in 6 of 28 patients (21%). The increase in serum creatinine was transient in all except one of these patients. Apart from the finding of a significant correlation between nephrotoxic reaction to netilmicin and postoperative urinary tract infection, no clinical or therapeutic features correlated with nephrotoxicity; trough concentrations correlated with serum creatinine.


Urticaria. An immunofluorescence and histopathology study.

Fourteen randomly chosen patients with "garden variety" urticaria were studied for the presence of vasculitis and immunoglobulins and complement. Results of direct immunofluorescence (DIF) of the involved skin were negative, although two patients had immunoglobulins and complement demonstrable in the cytoplasm of the epidermal cells. Results of DIF of uninvolved skin were also predominantly negative. Findings from serum samples tested by indirect immunofluorescence (IIF) were negative, except for one positive in low titer (1:10, the basement membrane zone). Serum C3 and C4 levels were normal in five patients, both levels were low in two, and the C4 level was low in one patient. No skin-reactive immunoglobulins were found in these three patients by DIF or IIF. The ESR was measured and found to be elevated in four patients. Results of immunofluorescence proved negative in these cases. Of the 12 patients studied by hematoxylineosin staining to determine histology, none exhibited vasculitis. We believe that vasculitis with antigen-antibody reactions is not the rule in "garden variety" urticaria.


The early history of tuberous sclerosis.

The early history of tuberous sclerosis can be traced from European wax models of the skin lesions in the 1830s to its recognition as a systemic disease by the early 1900s. There are various origins for the terms used for tuberous sclerosis, including Pringle's disease, Bourneville's disease, adenoma sebaceum, and epiloia. Since these terms are confusing and inaccurate, we urge that they no longer be used.


Antinuclear antibodies and oral methoxsalen photochemotherapy (PUVA) for psoriasis.

In view of theoretical concern that psoralen ultraviolet A radiation (PUVA) therapy might induce a systemic lupus erythematosus-like syndrome, we studied serum antinuclear antibodies (ANAs) in patients with psoriasis who received PUVA and are participating in a five-year prospective study. At 14 centers, 1,023 patients had two or more ANA determinations. When first and last tests were compared, the incidence of positive tests for ANAs was not significantly different (P greater than .2). In addition, there was no apparent relationship between the frequency of PUVA treatments and the probability of a positive test. Over a two-year period, there is no evidence to indicate that PUVA therapy for psoriasis has resulted in a significantly higher number of positive tests for ANAs within our population.


The spectrum of epidermolysis bullosa acquisita.

A patient has an acquired, scarring, bullous eruption. The severity of the cutaneous, ocular, esophageal, and laryngeal scarring was suggestive of cicatricial pemphigoid or the severely dystrophic forms of epidermolysis bullosa. Clinical features and histologic and immunofluorescence and electron microscopic study led to the diagnosis of epidermolysis bullosa acquisita. The spectrum of epidermolysis bullosa acquisita includes cases that closely approximate the severity of disease previously recognized only for the recessive form of epidermolysis bullosa dystrophica.


Virus infections in children with acute lymphoblastic leukaemia.

The pattern of virus isolation and illness was studied in 64 children with acute lymphoblastic leukaemia (ALL) during periods of apparent infection and when the children were well. The virus isolation rate of 2.2 viruses per child a year is similar to that previously found in normal children. In only 32% of children with symptoms were viruses found and 14.5% had viruses isolated when asymptomatic. The children with ALL appear to be more vulnerable to multiple virus infections and to excrete the virus for longer periods. This may be due to failure of production of both local and systemic antibodies. The failure in the past to recognise the true importance of virus infections in ALL may have been due to inadequate diagnostic techniques.


Bacteriological monitoring of unheated human milk.

To assess the bacteriological quality of unpooled expressed breast milk, a pilot bottle sample of each donation was examined before the milk was given to the neonate. Provided the milk did not contain greater than 2500 organisms/ml or potential pathogens it was used unheated. Milk containing between 2500 and 5000 organisms/ml and no potential pathogens was used after pasteurisation. Using these criteria, 67% of 460 donations were acceptable. However, because the bacteriological quality varied, 45% of domiciliary donations were discarded compared with only 29% of those from hospital.


Viruses and acute abdominal pain in childhood.

Children aged at least 4 years admitted to hospital with acute abdominal pain, excluding appendicitis, were investigated for the presence of viruses. Out of 181 children 29 were found with viruses of whom 18 had nonspecific abdominal pain. Eight others were found to have virus-like particles on electron microscopical examination of their faeces. Virus infections contribute to a small extent to nonspecific abdominal pain in childhood, but in many cases the cause remains unknown.


Status asthmaticus in children: a one-year study.

50 children were admitted on 72 occasions during one year in status asthmaticus, defined as wheezing not relieved by two doses of bronchodilator 4 hours apart. At least one-third of children were hypercapnoeic on admission. They were managed with either oral prednisolone and nebulised salbutamol. Those with peak expiratory flow rates of greater than 25% expected for height were satisfactorily managed on the oral regimen. One child needed assisted ventilation. 73% were fit for discharge within 4 days and more than half of them needed a change in maintanance treatment.


Neutrophil function in children with acute lymphoblastic leukaemia in the presence and absence of viral infections.

Neutrophil function was assessed regularly in 26 children with acute lymphoblastic leukaemia (ALL) in remission, both when they were well and during viral infections. Tests of candidacidal ability when these children were apparently free of infection showed a trend towards lower levels compared with controls. The most pronounced depression of candidacidal ability and chemotaxis was during viral infections, and these two functions of neutrophils were more likely to be abnormal then than when the children were free of infection. In children with ALL in remission, whose neutrophils may function abnormally even when they are well, the risk of acquiring bacterial or fungal infections may be made greater by virus infections.


Intrathecal serotherapy in neonatal tetanus: a controlled trial.

60 infants with neonatal tetanus were treated at random either by 40 000 units of equine tetanus antitoxin (TAT), intravenously and intramuscularly, or by 40 000 units TAT, IV and IM, plus 150 units of human tetanus immune globulin TIG) intrathecally. There were 30 infants in each treatment group. Babies were similar in age, sex, weight, incubation period, temperature, and signs and symptoms on arrival at the hospital. The mortality rate, days in hospital and days of sedation were not significantly different in the two groups.


Acute necrotising fasciitis due to streptococcal infection in a newborn infant.

A 3-day-old baby girl developed septicaemia, meningitis, and necrotising fasciitis due to group A beta-haemolytic streptococcus, type M52, which was also cultured from the mother's cervix. Necrotising fasciitis is a severe infection of the skin and subcutaneous tissues with infarction, necrosis, and sloughing of the affected areas. Early recognition of this condition is essential so that appropriate treatment can be given.


Acid hydrolases in experimental and spontaneous bullae.

The activities of eight acid hydrolases have been measured in blister fluid from various bullous disorders and from experimental suction blisters. The levels of all enzymes increased dramatically for at least 24 h after induction of the blister. No correlation was found between acid hydrolase activity and any individual disease. The levels of activity in spontaneous bullae were similar to those reached after 24 h in experimental suction blisters which had been raised on previously inflamed skin. We conclude that the release of acid hydrolases may be a consequence rather than the cause of blister formation. This conclusion is supported by the lack of inflammatory response to the i.c. injection of blister fluid into normal skin.


Plasma amino acids as predictors of the severity and outcome of sepsis.

Sepsis is a major catabolic insult resulting in a peripheral energy deficit which is made up in part by increased breakdown of lean body mass and oxidation of amino acids, principally the branched chain amino acids. The prognosis in any given case of sepsis is difficult to predict, but should theoretically be related to the degree of disturbance in peripheral energy deficit, which may in turn, be related to plasma amino acid pattern. In order to study whether this hypothesis was correct, plasma amino acids and some of their metabolic byproducts, the beta-hydroxyphenylethanolamines, were studied in 25 septic patients, and were used as discriminant variables in a series of computer performed discriminant analyses and multiple regressions. The two functions tested were the degree of metabolic septic encephalopathy as a determinant of the severity of sepsis and the final outcome in the septic patient. Plasma amino acid patterns exhibited elevated levels of the aromatic and sulfur containing amino acids, phenylalanine, tryosine, tryptophan, methionine, cysteine, and taurine, normal concentrations of alanine, and low normal concentrations of the branched chain amino acids, valine, leucine and isoleucine. Arginine levels, as previously noted, were very low. Patients not surviving the septic episode exhibited higher concentrations of aromatic and sulfur containing amino acids, while patients surviving sepsis had higher concentrations of the branched chain amino acids and arginine. When the degree of encephalopathy as a determinant of the severity of sepsis and step wise discriminant analysis with multiple crescent techniques were used, the best discriminant function between patients with and without encephalopathy was found to result from the interaction of cysteine, methionine, phenylalanine, isoleucine, leucine, and valine. These amino acids gave a correct classification in 82% of patients with no encephalopathy, and 80% of patients with septic encephalopathy. When the same amino acids were used for the discriminant analysis for patients dying of sepsis and patients surviving, the best discriminant function was achieved by using plasma concentrations of alanine, cysteine, methionine, isoleucine, arginine, tyrosine and phenylalanine resulting in 91% of the nonsurvivors, and 79% of the survivors correctly classified. The results suggest a close and significant relationship between the deranged energy metabolism and muscle protein breakdown in sepsis, and the outcome. This further suggests a central role for certain amino acids in perhaps predicting the severity of sepsis and its outcome.


Long-term fate of lung autografts charged with providing total pulmonary function. I. Light and electron microscopic studies.

Two groups of dogs underwent light and electron microscopic examination of both lungs up to five years after left lung autotransplantation. In one group of four dogs that had undergone ligation of the right pulmonary artery at the time of left lung autotransplantation, no generalized or consistent lesions were present in the transplant except for slight distension of net capillaries and slight capillary basement membrane thickening. Aside from theseminor changes which were probably of no functional significance, most areas of lung examined up to five years after transplantation were normal. In the second group of four dogs that did not have contralateral pulmonary artery ligation at the time of left lung autotransplantation, no consistent abnormality was present in either the transplanted left or nontransplanted right lung. In three animals in this group, widespread normal areas were present bilaterally up to five years after transplantation. One animal in this group had focal changes consistent with chronic pulmonary disease in both of its lungs. Thus, transplanted lungs do not necessarily develop significant late pathologic lesions.


Long-term fate of lung autografts charged with providing total pulmonary function. II. Hemodynamic, functional and angiographic studies.

Four dogs underwent autotransplantation of the left lung with immediate ligation of the right pulmonary artery and survived up to five years. Mean pulmonary artery pressures increased from 15 +/- 2 mmHg preoperatively to 23 +/- 4 mmHg immediately after operation and remained at the level (24 +/- 3 mmHg) up to five years operation. Arterial and venous blood gas values, determined while the animals were breathing ambient air spontaneously under light anesthesia, did not deteriorate with time and were within the normal range. The vascular resistance of the transplanted lungs up to five years after operation were not significantly different from those determined immediately after operation and remained lower than preoperative values, indicating that transplanted lungs retain indefinitely the ability to vasodilate with increased blood flow. Periodic angiography performed from 3-5 years after operation confirmed that the right lungs received no pulmonary blood flow and revealed normal vascular morphology except for moderate dilatation of the large arteries in the transplanted left lung. Thus, single transplanted lungs can provide total respiratory function while carrying the entire pulmonary blood flow at tolerable arterial pressures for at least five years without evidence of functional deterioration.


External ureteroneocystostomy and ureteroureterostomy in renal transplantation.

"External" ureteroneocystostomy is a method of reconstructing the urinary tract for renal transplantation. As performed by us, it is a modification of the technique of Witzel, Sampson, and Lich. It has the advantages of requiring a very short length of ureter, avoiding a separate and large cystotomy, and retaining the antireflux mechanism. This technique is described in detail. Ureteroureterostomy has been used as the preferred procedure when the bladder wall is very thin or when the vascular attachments are such that a ureteral length of greater than 6-7 cm would be required for bladder implantation. Since using these techniques we have reduced the early complication rate of ureteral implantation from 11.9% in a consecutive series of 126 transplants to 0% in the last 88 consecutive transplants. A review of the literature which led to the adoption of these techniques is also presented.


A mechanical device for sutureless aorta-saphenous vein anastomosis.

The aorta-saphenous vein anastomosis is a very common anastomosis with constant anatomy. A device for sutureless aortovenous anastomosis is presented which adapts the principle of venous eversion to the end-to-side anastomosis. The use of this device in 20 dogs demonstrated that reasonable early patency (85%) and subsequent long-term patency (100%) can be achieved. The device possesses the potential for rapid multiple anastomoses to the proximal aorta, but the eversion principle requires that the anastomosis be smaller than the vein utilized. Clinical application of this technique will require both modification to enlarge the anastomosis and demonstration of long-term patency competitive with suture techniques. The device is not yet ready for clinical use.


Effect of calcium and magnesium on transport processes by the turtle bladder.

The role of the changes in intracellular concentration of Ca and Mg in Na and H+ transport by the turtle bladder in vitro was studied with the use of the ionophore A23187. This ionophore increases the permeability of living and artificial membranes to divalent cations. In the presence of a minimal concentration of Ca (0.2 mM), which is necessary for the membranes to remain stable, the ionophore failed to alter the rate of Na transport or H+ secretion in the presence of 2.5 mM Mg. These data demonstrate that changes in intracellular Mg do not play an important role in Na or H+ transport by the turtle bladder. In the presence of 1.8 mM Ca the ionophore caused a significant decrease in Na transport as compared to control hemibladders treated with dimethylsulfoxide, the vehicle used to dissolve the ionophore. In the presence of  a minimal concentration of Ca (0.2 mM) the ionophore failed to alter the rate of Na transport. These observations demonstrate that the decrease in Na transport in the presence of Ca was the result of changes in intracellular Ca concentration rather than a non-specific effect of the ionophore. The data further demonostrate that calcium plays an important role in Na transport by the turtle bladder but that Mg does not seem to be important in the regulation of Na or H+ transport by this membrane.


Netilmicin in the treatment of infections in patients with cancer.

Ninety-two patients with cancer with 100 infectious episodes were treated with netilmicin sulfate, a new aminoglycoside. Netilmicin was administered intravenously, either intermittently or by continuous infusion. The overall cure rate was 60%. Gram-negative bacilli were the most common causative organisms and the response rate for these infections was 32/53 (60%). The most common pathogens were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Pneumonia, urinary tract infection, and septicemia were the most common types of infection treated and the response rates were 23/47 (49%), 19/21 (90%), and 9/17 (53%), respectively. Nephrotoxicity occurred in ten patients (6%) who had normal renal function initially. Netilmicin is an effective aminoglycoside with a spectrum of antibacterial activity similar to that of gentamicin sulfate and it appears to be less nephrotoxic.


[Effect of reduced gastrointestinal motility on the regulation of gastrointestinal flora and the pathogenesis of coli enterotoxinemia in market swine].

Opium tincture and Spasmentral were applied to piglets early after weaning and reduced their gastro-intestinal motility, which, however, caused only very minor changes in quantitative germ flora composition in those first days. Short-time suppression of gastro-intestinal motility obviously does not result in detrimental consequences to the organism as a whole, since there seem to be several factors which are involved in the control and regulation of the intestinal germ flora. Impairment of gastro-intestinal motility appeared to be of no importance to the pathogenesis of coli-enterotoxaemia, as it was not followed by higher incidence of the disease.


[Epizootiology of Salmonella typhimurium infection in chickens].

The incidence of S. typhimurium infections among fowl increased in thr region of Potsdam in general, and on various big farms in particular, 1976 and over the first half of 1977. The outbreaks included subclinical infections and clinically manifest diseases which caused remarkable loss of broilers from the affected stocks (up to 15.92 per cent). Parent stocks contaminated with S. typhimurium were to be the sources of infection in all cases. A total of 1,220 Salmonella strains were isolated from fowl and its environment, with 1,151 of them being S. typhimurium (2.98 per cent of all samples tested). The following amounts of S. typhimurium strains were isolated from different types of samples which had been collected from infected broiler stocks: 8.10 per cent from dead broilers, 5.86 per cent from dead broiler parents, 2.11 per cent from pulp linings of transport cages for day-old chicks, 1.23 per cent from litter, 1.0 per cent from hatching material (eggs or dead and jammed embryos, and 0.12 per cent from swabs used in hygiene supervision). No Salmonellae were isolated from feedstuff. The transmission of S. typhimurium, therefore, is though to have taken the route via the hatching egg and via congenitally infected chicks traded between breeders and propagation farms. The control and prophylaxis of S. typhimurium infections, therefore, should be based primarily on action in the centralised breeding stocks. Specific steps of such action are proposed. Fifty-three strains were biochemically and lysotypically analysed, with the following types being determined: ut/Ph 30 BT b, ut/Ph 30 BT c, n.c. 1/72/n.c. BT b, 2 n.c. BT a, and 1A/6 BT a. The first two types covered 84.9 per cent of all strains isolated from the fowl. All lysotype ut/Ph 30 strains isolated from fowl fell under the copenhagen variant which had rarely been isolated from man in the past. These results are likely to support the demand for a joint control programme for enteritis Salmonellae, with particular emphasis on S. typhimurium, for implementation in human and veterinary medicine.


Microproliferation of enterochromaffin cells and the origin of carcinoid tumors of the ileum: a light microscopic and immunocytochemical study.

Using light microscopy, we studied the enterochromaffin (EC) cells in the intertumoral normal-appearing ileal mucosa in four cases of multiple ileal carcinoid tumors to investigate the mode of development of these tumors. There were 54 (39 mucosal, 15 submucosal) grossly invisible neoplastic microproliferations of cells with the attributes of EC cells, including immunocytochemical characteristics. No direct connection between these microproliferations and the intramucosal EC cells were demonstrated, nor was hyperplasia of EC cells found. Thus, we did not find a direct link between the intramucosal EC cells and carcinoid tumor.


Nesidioblastosis and congenital neuroblastoma: a histologic and immunocytochemical study of a new complex neurocristopathy.

Congenital neuroblastoma and nesidioblastosis occurred simultaneously in a neonate with severe hypoglycemia. This combination may represent a rare type of complex neurocristopathy. Immunocytochemical staining revealed a diffuse proliferation of alpha, beta, and delta cells as clusters and individual cells. The total islet volume was less than control values and beta cell counts were not increased. This case tends to support the hypothesis that morphologic integrity of the normal islet architecture is important in the control of function and not merely excessive numbers of one cell type.


The 'dying back' process. A common denominator in many naturally occurring and toxic neuropathies.

The "dying back" process can be defined as a pathological changes affecting certain neurons in a number of systematized degenerative conditions. Examples exist to illustrate the nature of this process, which is unique to nervous tissue, and there is an association of this process with certain chronic vitamin-deficiency syndromes and some important neurotoxic chemicals. Albeit largely speculative, one can attempt to group the conditions showing the dying back process in terms of putative metabolic lesions. Although this attempt is admittedly only a first approximation, it enables us to look ahead to a future understanding of the metabolic problems of long neurons and how their selective degeneration comes about.


Spiroplasma-like inclusions in Creutzfeldt-Jakob disease.

Spiral membranous inclusions were discovered on electron microscopic study of brain biopsy tissues from a 46-year-old man with Creutzfeldt-Jakob disease (CJD). These replicate coiled membranous configurations measured 850 to 1,000 nm in length and 75 to 137.5 nm in width and were located within axoplasm, primarily in presynaptic terminals. These inclusions closely resemble Spiroplasma, a plant pathogen, and the finding of these structures in CJD suggests the concurrence of Spiroplasma infection with a human chronic degenerative brain disease.


Histomorphological investigations of coxa femoral ends following double-cup arthroplasty according to Freeman.

Of 20 shell prostheses inserted in cases of early coxarthrosis in our clinic during the period from mid-1976 to the end of 1978, three had to be removed. Morphological examinations, employing different techniques, were made of the coxa femoral ends which were removed. The foreign body reaction of the bone tissue beneath the cement within the prosthetic shell and the biomechanical response were investigated on the basis of macroscopic and microscopic structural analyses. Dependent upon the time elapsed, the exposed spongiosa surface was observed to have become remodeled to a thin cortical protective layer. Independent of time between insertion and removal of the prosthetic shell, a continuous wide layer, consisting of cellular and fibrous tissue, was formed between the bone and the cement (which remained intact) even after the formation of the above-mentioned cortical bone substrate.


Detection of measles virus antigen(s) in peripheral lymphocytes from patients with subacute sclerosing panencephalitis.

Peripheral blood lymphocytes from 5 patients with subacute sclerosing panencephalitis (SSPE) were stimulated with phytohemagglutinin (PHA) and analyzed for the presence of the measles virus antigen(s) by immunofluorescence (IF). For detection of viral antigen fluorescein-conjugated globulins from SSPE patients or from measles convalescents both with high anti-measles titer were used. Peripheral blood lymphocytes from 5 children with measles were used as a positive control. Measles virus antigen(s) were localized in PHA-transformed lymphocytes in all SSPE patients. The present results indicate that in SSPE measles-like virus infection may be found not only in the central nervous system, but also in the circulating lymphoid cells.


Application of single-radial-haemolysis test for the detection of antibodies to togaviruses.

The newly developed single-radial-haemolysis technique was employed in this study for screening of sera for detection of antibodies to three Nigerian togaviruses. This technique was compared with the standard haemagglutination-inhibition method. A close correlation between the two techniques was observed.


Interference with polyhedral inclusion body (PIB) production in Trichoplusia ni cells infected with a high passage strain of Autographa californica nuclear polyhedrosis virus (NPV). Brief report.

Trichoplusia ni cells infected with a low passage (LP) strain of Autographa californica nuclear polyhedrosis virus (NPV) produce large numbers of polyhedral inclusion bodies (PIBs). Interference with PIB production occurs when T. ni cells are first inoculated with a high passage (HP) strain and then challenged with the LP strain. PIB production is reduced 100 fold to the level seen with HP virus infection only.


[Biochemical aspects of lipid metabolism in multiple sclerosis].

The biochemical features of lipid metabolism in multiple sclerosis are discussed and the contribution made by work on the aetiopathogenesis of the disease is illustrated. Reference is made to diagnostic tests (E-UFA and MEM tests), whose premisses are based on lipid metabolism. A link between biochemical and immunological research in this field is put forward.


[Clinical and secretory evaluation of the use of cimetidine in peptic ulcer].

Cimetidine (an H2 receptor blocking agent) was used to treat 35 patients with gastroduodenal peptic ulcer. Endoscopic and secretory controls before and after the treatment showed that pain was reduced in all cases, that complete or partial re-epithelialisation occurred in 33/35, and that there was a significant reduction in basal and post-histamine acid secretion. Alkaline secretion was not significantly altered. Follow-up of the series is regarded as indispensable.


[Epidemiology of group A beta-hemolytic streptococcus in the school population of Pordenone Province].

During the winter months of 1976-1977, our group carried out an epidemiological study in the school population aged 7 years and 10 years respectively, living in the towns of Pasiano (pop. 6,389) and Zoppola (pop. 7,383) in the province of Pordenone. The aim of the study was to determine the incidence of individuals in the school-age group having group A beta haemolitic streptococcus in the pharynx. The results of the study showed a high incidence of children with a positive throat swad. Of the 284 scholars examined, 107 (45.7% of the entire population examined) were carriers, in the pharynx, of group A beta haemolytic streptococcus.


[Macrophage reaction in the bed of an allogeneic skin transplant].

The character of cell reactions, number of macrophages at the place of skin allograft was demonstrated to depend on the stage of posttransplantational period. Macrophagal reaction increases as the crisis of rejection is approaching; functional and metabolic activity of macrophages is increasing that is evident from an intensive vacuolization of cytoplasm, decreased contents of glycogene, enhanced acid phosphatase activity in them, increased amount of H3-thymidin labelled cells.


Immunosuppressive measles encephalitis in a patient with a renal transplant.

An inclusion body encephalitis developed in a patient with a renal transplant that was shown by immunofluorescence and electron microscopic studies to be due to measles virus. Measles encephalitis may be an opportunistic infection in children and adults with immunodeficiencies secondary to tumors or to the administration of immunosuppressive drugs.


Intraocular carbon dioxide laser photocautery. II. Preliminary report of clinical trials.

Carbon dioxide laser photocautery was used successfully intraocularly in human patients to seal fibrovascular fronds and retinal tears at the time of vitrectomy. Closure of rubeotic vessels in the iris was demonstrated histologically. The 10.6-microgram infrared radiation was delivered to the intraocular treatment site by means of 1.5-mm-diameter photocautery probe containing a 1.0-mm-diameter lumen closed at the end with an infrared transmitting window. Treatment was localized to the tissue adjacent to the window. Typical energy dosage was 0.4 W for 2 to 4 s duration. These early clinical trials were carried out under the guidelines established by the Food and Drug Administration; informed consent clearly outlined the experimental nature of these studies.


Transplantation of cultured bovine corneal endothelial cells to species with nonregenerative endothelium. The cat as an experimental model.

The in vivo transplantation of cultured bovine corneal endothelial cells has been attempted in the cat. Cat corneas denuded of their endothelium were coated with bovine corneal endothelial cells previously maintained in tissue culture. When grafted back into cat recipients, the corneal buttons remained clear with no edema. Alizarin red staining of the endothelial side of the corneal transplant demonstrated that the coated bovine corneal endothelial cells reorganized themselves into a highly organized cell monolayer within eight days in vivo. In contrast, corneas denuded of their endothelium became opaque and edematous within seven days and remained so thereafter. These results demonstrate that cultured corneal endothelial cells remain functional in vitro and can replace a damaged or nonfunctional endothelium i


Localization of IgE in adenoids and tonsils: an immunoperoxidase study.

An immunoperoxidase technique was applied to the localization of IgE in formaldehyde-solution-fixed, paraffin-embedded tissue. The content and distribution of IgE in tonsil and adenoid tissues from ten patients with histories of inhalant allergies and elevated serum levels of total and allergen-specific IgE were investigated. Compared with tissues from five nonatopic subjects, the tissues from atopic individuals were observed to harbor a much larger population of IgE-formating plasma cells. The profusion of IgE plasma cells in nasopharyngeal lymphoid tissue, observed in this study, furnishes strong anatomic evidence for a pathogenetic role of IgE in inhalant allergies. For cellular and tissue localization of IgE, the immunoperoxidase technique offers clear advantages over previously used immunoflorescence procedures.


The Siamese twins, Eng and Chang: their lives and their hearing losses.

Eng and Chang were conjoined twins who were born in Thailand and settled in the United States at the age of 18 years. Numerous surgeons in the United States and Europe examined them and almost all of them believed that an attempt at separation would be fatal. They married sisters and lived on a farm in North Carolina where they loved to hunt wild game. Both used shotguns placed on their right shoulders. At the age of 58 years, it was noted that Chang, who was located to the left of Eng, had a hearing loss in both ears and that Eng had a loss that was greater in the left ear. It is proposed that these hearing losses may have been caused by muzzle-blast injury from hunting and that only the right ear of Eng was privileged to experience the protective effect of head shadow.


Lymphomatoid granulomatosis in a renal transplant recipient.

Lymphomatoid granulomatosis is a multi-system disorder of high mortality and characterised by angiocentric and angiodestructive lymphoreticular proliferative and granulomatous change. A case is described of this disease occurring in a renal transplant patient. The patient underwent a rapid remission of the disease after a course of combined cytotoxic therapy and remains free of disease three years after treatment. This case is the second described renal transplant patient to develop the disease and the first to be successfully treated. It is likely that the disease originated as a consequence of immunosuppression similar to the development of lymphomas in allograft recipients.


Home blood pressure monitoring and changes in plasma catecholamines during once or twice daily treatment with atenolol in patients with mild hypertension.

1. The effects of atenolol on diurnal blood pressure control, heart rate and plasma catecholamines were studied in nine hypertensives, six of whom also received diuretics. The patients completed a double-blind trial in which the effects of once and twice daily administration of atenolol were compared with placebo. 2. Atenolol (100 mg) given once a day produced significant reduction in diurnal blood pressures recorded at home but the effect was slightly less than either 50 mg given twice a day or 200 mg once a day. 3. Effects on heart rate and blood pressure were seen within 36 hours of the first dose, and were near maximal at 72 hours. After cessation of the drug, mean resting heart rate increased gradually and reached pre-treatment levels five days later, suggesting strong tissue binding of atenolol. Blood pressure increased more slowly over 8--10 days. 4. Plasma noradrenaline levels were increased at rest with atenolol. This argues strongly against the antihypertensive effect of atenolol being due to a reduction of sympathetic nerve activity. 5. Once daily administration of atenolol in this group of patients with mild hypertension produced satisfactory diurnal blood pressure control and beta blockade without "rebound" hypertension on cessation of therapy.


Omental transposition and skin graft in the management of chest wall recurrence of carcinoma of the breast.

The greater omentum is readily available for the reconstruction of the defect produced after palliative excision of recurrent breast carcinoma. It covers a wide area and readily accepts a skin graft, and it has been observed that there is some local immunity to the reappearance of further recurrence at the site of the graft. The operation can be combined with endocrine ablation.


The treatment of deep burns of the hand.

Early debridement of deep dermal or full thickness burns to the dorsum of the hand is recommended as a means of promoting early healing and mobilization, and therefore less residual disability. The results of treatment of 27 patients with deep hand burns are reviewed and some illustrative examples are discussed. A plan of management for these injuries is presented.


Contraceptive use in Australia.

The purpose of this paper is to trace the pattern of contraceptive use in Australia during the past 50 years, discussing reasons and circumstances related to the changing preference for specific methods, against the background of demographic trends in childbearing and woman's changing role in society. The analysis is based on unique information regarding married couples and young adults in Australia obtained from large-scale demographic surveys carried out in Melbourne during 1971 and 1977 by the Department of Demography at the Australian National University.


Amyloidosis of the pancreas: histochemical differentiation between insular and extrainsular deposits.

The results of a study of eighty-two human pancreases affected by deposits of amyloid in the islets of Langerhans are presented. Two different types of amyloid deposits were observed, one affecting the exocrine tissue and the other affecting the islets. These deposits were found to be histochemically different and appeared to indicate two different aetiopathogenetic processes. The deposit found in the exocrine tissue is essentially perivascular and might be considered an extension to the pancreas of a systemic amyloidosis of the "senile type"; the islet deposits appear to be a completely different phenomenon that could become part of the biology and pathology peculiar to the so called APUD system. The coexistence of the two types of amyloid in the human pancreas would seem, therefore, to represent a casual event.


Biosynthesis and turnover of outer-membrane proteins in Escherichia coli ML308-225.

Isolated outer membranes and outer-membrane extracts from Escherichia coli ML308-225 in the early-exponential growth phase contain more protein than do corresponding preparations from late-exponential- or stationary-phase bacteria. Isotope-dilution experiments show that this is due to a loss of protein from the membrane during the exponential growth phase. Inhibition of bacterial growth and protein synthesis stabilizes the outer-membrane-protein concentration. Protein synthesis in the absence of bacterial growth results in higher concentrations of protein in the outer membrane.