Diagnostic value of pancreatic biopsy.

This review emphasizes that the value of pancreatic biopsy is unquestionable for the preoperative and peroperative diagnosis of pancreatic carcinoma. Improvement of biopsy methods will further increase the importance of the preoperative pancreatic biopsy. However, the considerable technical difficulties and the time expenditure associated with these methods do not allow the use of pancreatic biopsy or one of the other diagnostic procedures as a screening procedure for detecting pancreatic carcinoma before it has led to subjective symptoms such as biliary obstruction. We should concentrate on the development of an immunological test for identifying the asymptomatic patients. Some progress on this area has been initiated by an attempt to characterize a pancreas-specific oncofetal antigen (Hobbs, 1976). The early demonstration of such an antigen in serum and pancreatic fluid would substantially improve the otherwise unfavourable diagnosis of pancreatic carcinoma. Therefore, we hope that the pessimism regarding the diagnosis and prognosis of pancreatic cancer will be replaced by realistic optimism in the future.


Palmar fibromatosis-"Dupuytren's contracture". A comparison of light electron and immunofluorescence microscopic findings.

A comparison of light, immunofluorescence and electron microscopic findings in palmar fibromatosis (Dupuytren's disease) revealed that the three morphologic phase of Luck; I. proliferative, 2. involutional, and 3. residual, corresponded for the most part to I. fibroblastic, 2. myofibroblastic or 3. fibrocytic lesions, respectively. The spectrum between proliferative phase and residual phase appeared immunohistochemically as a decrease in collagen type III, and an increase of collagen type I. Myosin was found in substantial quantities only during the involutional phase, distinguished by myofibroblasts, presumably with contractile capabilities. Thus, the clinical presence of contractures with palmar fibromatosis might also be explained in the absence of distinct fiber formation.


Dose response for blood pressure and degree of cardiac beta-blockade with atenolol.

The hypotensive effect of 25 mg, 50 mg, 75 mg, 100 mg and 0 mg of atenolol daily were compared in a double-blind within-patient study. The fall in blood pressure with 25 mg daily was not significantly different than with 100 mg. The dose response curve lies between 0 and 25 mg daily. Cardiac beta-blockade (measured by suppression of exercise tachycardia) was not maximal with 25 mg of atenolol daily. The dose response curves for beta-blockade and the hypotensive effect are not parallel.


[Comparison of different methods for measuring nucleic acids and protein in the biomass, half-products and preparations of E. coli and yeast].

In the E. coli biomass, half-products and RNA preparations a comparative measurement of nucleic acids and protein was carried out using different methods. As a result, the following methods can be recommended: to assay RNA in the biomass--spectrophotometry, to determine RNA in half-products and preparations--the phosphate method, to assess DNA--the diphenyl amine method, and to measure protein--according to Lowry. The same methods can be recommended to estimate RNA from baker's yeast.


[Methylation of prokaryotic RNA by S-methyl methionine in in vivo experiments].

While cultivating the E. coli 113-3 strain on the mineral medium containing S-methyl-(methyl-3H)-methionine, the incorporation of methyl groups into 4S, 16S and 23S RNA proved to be over 5 times more effective as compared with the control, when L-(methyl-3H)-methionine acted as a donor of methyl groups. The ratio of methylated components has much in common and significant differences. All the types of RNA of E. coli grown in the mineral medium containing S-methyl methionine showed an increased ratio of m2G as compared with the corresponding types of RNA of E. coli after its cultivation in the methionine containing mineral medium.


[Application of lytic enzymes for disruption of microbial cell walls to isolate DNA].

The possibility of isolating DNA from yeast and actinomycete cells, previously exposed to enzymic disruption, was explored. The enzyme was produced from Actinomyces griseinus II. The highest yield of DNA from microbial cells was obtained as a result of detergent pretreatment of the yeast and actinomycetes and subsequent disruption of cell walls with the above enzyme.


Genetic influences on pharmacodynamic properties of psychotropic drugs.

Most of the well-known examples of pharmacogenetics are based on differences of biotransformation and elimination of drugs. Since a drug interacts with a genetically determined biological target, hereditary differences on the pharmacodynamic level are also probable. Especially psychotropics show interindividual variation in their pharmacological effects. The differential effects of psychotropic drugs on the EEG presumably reflect genetic differences of brain function. Lithium transport across the erythrocyte membrane exhibits large interindividual differences that have a genetic basis, and that possibly indicate a link between lithium transport and manic-depressive psychosis.


Procedures for EMG biofeedback training in involved upper extremities of hemiplegic patients.

This article presents practical information about using electromyographic biofeedback to train specific muscle groups in the involved upper extermity of hemiplegic patients. Our approach is first to reduce hyperactivity in spastic musculature and then to increase activity levels in weak muscles. Electrode placements and a sequence of training procedures for muscles whose functions are most commonly impaired following stroke are described.


A retracting wire knife for cutting fiber bundles and making sheet lesions of brain tissue.

A retracting knife which has two cutting wires for the transection of fiber bundles is described. The knife holds the fiber bundles of the stria terminalis between the two cutting wires and transects them by a shearing movement as the wires close. In addition, the feasability of such a knife producing a sheet lesion around the n. caudatus is also described.


Superiority of the deep circumflex iliac vessels as the supply for free groin flaps. Clinical work.

In this paper we present 16 cases of free transfer of compound flaps from the groin, 11 using the deep circumflex iliac vessels as a stem and 5 using the superficial circumflex iliac vessels as a stem. We found the deep vessels superior in many ways  to the superficial vessels for this purpose; they are larger, permitting greater ease in anastomoses and providing more reliable blood flow. We believe that larger osteocutaneous or myocutaneous flaps can be transferred on the deep vessels than on the superficial ones-and that the deep circumflex iliac flap may supplant the conventional free going flap in most situations. The method evolved in response to patient need, not for surgical éclat.


Successful replantation of lower leg and foot, with good sensibility and function.

The successful replantation of the lower part of a leg with the foot is reported in a 17-year-old boy. Adequate protective sensibility was obtained, and he walks well with a 3-inch lift on that shoe. He is also able to hike, climb, swim, dive, and engage in most normal activities. The pros and cons of leg replantation are considered.


The extended dorsalis pedis flap.

An extended dorsalis pedis island flap was used to cover the heel in two patients. The arterial predicles were extended by cutting and bridging with vein grafts to allow the flaps to reach the defects. By this method, excellent coverage is obtained and the protective sensation may be retained or restored by preservation or extension of the sensory nerves.


Repair of large defect of frontal bone with free graft of outer table of parietal bones.

We present a case with a full-thickness bony defect in the frontal area. It was corrected successfully by a free bone graft to the outer table from the parieto-occipital area, partly covered by a flap of periosteum from the same area.


On the medical history of the doctrine of imagination.

In the early modern era the notion of imagination was made responsible for phenomena which were later explained in terms of embryology, genetics, psychology, bacteriology or other scientific disciplines. Images, often seated in the upper abdomen (hypochondriac region) or the womb (hysteria), were regarded as powerful influences on material reality. In the course of the seventeenth and eighteenth centuries the hypochondriac forms of imagination became mere whims and spleens, but they kept much of their original potency in respect of the uterus, accounting for monstrosities and the shaping of human offspring. The hysterical conversion of imagination into somatic phenomena has never been questioned. Since the two World Wars the realm of imagination has again expanded beyond the uterus and the older disease-concepts. In the last 10-20 years images seem to have regained some of their original creative force.


Body image disturbance in anorexia nervosa during the acute and recuperative phase.

Perception of body size, subjective experience of body image distortions and differentiation of body concept in the human figure drawing were assessed in adolescent anorexia nervosa patients and controls shortly after hospital admission, and again 6 months later during the recuperative phase. Size estimation was not found to be a distinguishing variable, as both groups exhibited overestimation tendencies of comparable magnitude at both time periods. By contrast, experiences denoting estrangement from the body, insensitivity to body sensations, and weakness of body boundaries were more prevalent in anorexics, and persisted at high levels after frank symptoms of weight and eating disorder had subsided. Anorexics were also shown to depict the human figure with less differentiation relative to controls. Within the anorexic sample the presence of vomiting was linked to greater subjective experience of body image distortion, and such phenomena appear to be a more enduring feature in this subgroup. Overall, the results were viewed as lending support to the argument that defects in body image formation render the anorexic vulnerable to their manifest pathology, which is itself activated by maturational conflicts unique to adolescence.


The reproductive ecology of the house mouse.

This paper attempts to integrate the physiological and ecological perspectives of the reproductive biology of the house mouse (Mus musculus). The endeavor is made within a larger context to provide a prototype for mammalian reproductive ecology in general. Specifically, the environmental regulation of the reproduction of Mus musculus is examined in relation to its ecological opportunism and, in particular, in relation to its history of global colonization. House mice can live as commensals of man or under totally feral conditions. Stable, high density, commensal populations are characterized by an insular division of the living space into demeterritories, each dominated by a single male. Feral populations typically are characterized by temporal, spatial, and social instability. Territoriality is improbable under such conditions, particularly given the necessity for large home ranges in most feral habitats. In both feral and commensal populations, however, male aggressiveness promotes the large-scale dispersal of young, all of which are potential colonizers. Of the ten or so environmental factors known to influence reproduction in house mice, seven probably are of routine importance in natural populations: diurnal modulation by daily light:dark cycles; caloric intake; nutrition; extreme temperature; agaonistic stimuli; socio-tactile cues; and priming pheronomes. The last two factors named operate directly on the secretion of luteinizing hormone or prolactin; the others act at many points in the reproductive system. Reproduction in the house mouse seems divorced from photoperiodically induced seasonality; indeed, this species breeds well even in constant darkness. Seasonal breeding may or may not then occur, depending upon dietary considerations, with or without a secondary interaction with variation in ambient temperature. There is no evidence for a dependence upon secondary plant compounds. Some of the effects of priming pheromones that have been observed previously in laboratory mice probably play no meaningful role in wild populations. The remaining pheromonal phenomena can be conceptualized as a single cueing system that has three components: (a) urinary cues of socially dominant males can accelerate ovulation in females, adult or prepubertal; (b) female urinary cues may elevate pheromonal potency in adult males, thereby forming a feedback loop by which the females elicit their own ovulation; and (c) the male's action on prepubertal females can be blocked by urinary cues emanating from other females. When all of the above is viewed in toto, the reproductive biology of the house mouse seems uniquely suited to support ecological opportunism. The relatively few environmental inhibitors of reproduction in this species should enhance the ability of dispersing young to colonize an exceptionally wide variety of habitats and climates...


[Problems in the classification of psychopathological disorders following cardiac surgery with extracorporeal circulation].

Classifications of postoperative psychopathological disorders after heart surgery according to the literature are very different as the results are dependent upon the accuracy of the observation. The accuracy and choice of classification are important as the base for identifying causal factors. We studied 214 patients using three alternative methods of classification and discuss problems of classification of the postoperative psychopathological dysfunctions.


[Adhesion of restoration materials to hard tooth structures].

Adhesion occurs in dentistry in many situations. The demand for an adhesive restorative material becomes increasingly pressing. After a general treatment of the physico-chemical principles of adhesion the materials and technics for adhesion to dental enamel are reviewed. Only materials on a polymer basis are being developed for new indication areas and tried out in clinical investigations. Microretention to dental enamel obtained by etching with phosphoric acid, is the leading technic. As follows from a survey of clinical investigations on fissure sealants and adhesive restorations in front teeth, this technic yields the desired result only in the hands of well-trained researchers. Recently, Smith (1975) succeeded in developing a polymer system adhering chemically to dentine, but it is not yet available on the market. Whether this system is the answer to the demand of a truly adhesive restorative material, is doubtful due to the work of Hoppenbrouwers and Borggreven (1977).


[The dentistry of Adriaan van den Spiegel from Brussels (1578-1625-1978)].

Spigelius, born in Brussels in 1578 (as Harvey, his fellow, student in Italy) was the last great anatomist of the school of Padua. After his death in 1625 his disciple, Brucetius and his son-in-law, Liberalis Crema, published two years later his "Anatomy" and his "Embryology", illustrated with beautiful plates bought from the heirs of his master Casserio (1561-1619). The sinus maxillaris and the odontology of Eustachius are only mentioned in De humani corporis Fabrica libri X, not in De formato Foetu liber singularis. In order to appreciate the normality of the head he described four diameters of the skull and has been considered by Topinard as the father of craniometry. He also mentions the changes in the proportions of the body during growth and the effects of illness upon growth. His theory and practice of oral surgery are those of his master Fabrizio ab Aquapendente (1533-1619) and of his pupil Scultetus (1595-1648).


Some repair effectiveness coefficients as indicators of E. coli UV-resistance.

Mathematical studies of E. coli survival curves to UV (254 nm) lead to the definition of a photoresistance parameter - the "mean survival dose" (MSD) - to compare radiation resistances of genetically related bacterial strains. Based on this MSD-parameter some repair coefficients were proposed as indicators of the relative effectiveness with which every repair system recovers radiation lesions in cells. The theoretical values calculated for the proposed coefficients are in agreement with those which were obtained from experimental data presented in the literature.


Liquid holding recovery in E. coli K12. I - Substances released during buffer holding.

It is known that the incubation, in a buffer, of UV-irradiated E. coli cells results in viability increase, this phenomenon had been called liquid holding recovery (LHR). We have studied the cellular constituents release during LHR and verified that releasing rate is dose-dependent. LHR was also observed after nitrogen-mustard treatment and it is not blocked by caffeine. So, we suggest that LHR expression is not always a rec-gene dependent function and, probably, the survival increase could be explained by (a) DNA-repair, (b) reversible membrane damage and (c) cellular multiplication.


[Fetal macrosomy in alloxanized rats (author's transl)].

The aim of this work was to observe the starting of fetal macrosomy during the gestation of the diabetic rat and whether the sex of the fetuses has any influence on it. Lesions were produced in the B cells of the pancreas by the administration of alloxan on the 4th gestation day. The length and weight of the fetuses were not altered by this treatment before the 14th day of pregnancy, suggesting that fetal macrosomy should occur after this day.


Steric hindrance enzyme immunoassay (SHEIA); a novel method in enzyme immunoassay.

We have developed a new method for separation of antibody bound and unbound enzyme conjugates. The technique as applied to the assay of choriomammotropin involves the use of beta-D-galactosylamine bound to agarose to separate the unbound choriomammotropin-beta-galactosidase conjugates for antibody bound conjugates. When beta-galactosidase was conjugated with choriomammotropin using the N-hydroxy-succinamide ester of m-maleimidobenzoic acid the affinity of the enzyme conjugate to beta-D-galactosylamine attached to agarose diminished markedly following incubation with antibody. In a typical enzyme immunoassay of choriomammotropin, 5 microliter of swelled affinity gel per tube was required to precipitate unbound enzyme following one hour gentle shaking at room temperature. Choriomammotropin antibody was used at titer of 1:1,000. The standard curve for the assay was adjusted to cover a range of 0-10 mg/l with maximum sensitivity between 1-4 mg/l.


A controlled trial of tiaprofenic acid versus ibuprofen in rheumatoid arthritis.

Tiaprofenic acid, 200 mg three times a day, was compared with ibuprofen, 400 mg three times a day, in 41 patients suffering from rheumatoid arthritis and already receiving nonsteroidal anti-inflammatory drugs in a double-blind controlled study. The degree of disability expressed as functional class was significantly improved on tiaprofenic acid. There were no other significant differences from initial values on either treatment in any other clinical measure of therapeutic efficacy. Side-effects were few and minor and there were no significant differences between the drugs in this respect.


[Hepatitis virus B infection and hepatopathy after kidney transplantation].

Serological markers for hepatitis virus B (HBV) infection and the occurrence of hepatopathies were analyzed in 152 patients during the hemodialysis period and on average 3.8 years after receiving a renal allotransplant. At the beginning of hemodialysis, 25% of the patients showed signs of an ongoing or past infection with HBV (10% hepatitis virus B surface-antigen [HBsAG] positive and 15% anti-HBsAG positive). At the time of transplantation, 20% of the patients were positive for HBsAG and 25% had detectable anti-HBs. At the end of the study, 31% of the patients were positive for HBsAG and 25% had detectable anti-HBs. In 21 patients (14%) inflammatory liver disorders were observed: transitory hepatitis (7 patients), chronic persistent hepatitis (7 patients), chronic aggressive hepatitis (3 patients) and active cirrhosis (2 patients). Two patients had died in liver coma. All 21 patients with inflammatory hepatopathy had detectable HBsAG at the time of diagnosis, and all patients with chronic inflammatory liver disease were HBs carriers. In most of these patients the carrier state had been present for more than 3 years before diagnosis.


[Hyperglycemia and diabetic complications].

Are long-term complications secondary to diabetes or do they appear independently? This question has an important bearing, particularly for the physician and the patient who must achieve optimum control of hyperglycemia. Over the last 10 years, many epidemiological and biochemical studies have shown close links between hyperglycemia and the wide range of factors involved in the development of long-term complications.


[Demonstration of soluble parasite antigens, the corresponding antibodies and immune complexes in acute malaria].

Serum levels of malaria antigens, antimalaria antibodies, immune complexes and complement components have been followed up in 23 patients suffering from acute malaria infection and recovering under therapy. Malarial antigens in serum were detected by counterimmunoelectrophoresis: the peak was observed before therapy started and their levels rapidly decreased. Specific antimalarial antibodies became detectable 5--7 days after starting treatment in patients with a first infection. Immune complexes were detected in 21 of 23 sera with a peak level between days 5 and 9. A marked decrease of C4 and C3 was observed in the presence of normal levels of factor B.


[Inspection of 1 to 5-year-old amalgam, composite, and cast gold fillings].

On 103 randomly chosen patients composite-, amalgam-, and cast gold fillings were checked and examined after various criteria. Also, the gingival changes were noted and vitality tests made. As was to be expected, composites, particularly class 2-fillings, showed more loss of substance than amalgams. The latter, however, had a worsening marginal adaptation with increasing age. Secondary caries was generally more frequent in subgingival fillings. The quality of the material was of smaller importance than the marginal leakage. Inflammatory processes of the gingiva were more frequent with composites than with inlays. Gradually increasing discolorations were the rule. Very few teeth lost their vitality after treatment, irrespective of the bases (normal, direct and indirect capping).


[Endodontics--a literature review. Continuation of part II].

A survey of physical and biological properties of well-known root canal filling materials are discussed and the following conclusions were drawn: --No root canal filling material fulfils all requirements of an ideal sealer. Those materials, which perfectly seal the root canal and also show minimal periradicular tissur reaction, are recommended in Endodontics. --During setting time, all sealers are more or less toxic to the periradicular tissue. Materials which contain paraformaldehyde and lead exhibit a strong and persistent toxicity. --The tissue reaction of root canal filling materials is only slight when the root canal is underfilled. Ideally, in vital cases, the root canal should be filled to the dentine-cemental junction (approx. 1 mm short of the apex), in necrotic cases to the apical foramen. --Neither a root canal cement nor a guttapercha cone will perfectly seal a root canal alone. The combination of the two materials is recommended. --Silver cones are indicated only in narrow, tortuous canals. --Success of root canal therapy depends on various factors, primarily however on thorough root canal débridement.


[Therapeutic immediate denture, class II].

Without posterior support and because of dysfunction many people have very loose joints: their condyles are in a most retruded and downward situation. The occlusion cannot be stable in this relationship. The most retruded clinical position should not be used for prosthetic restoration. We must establish a therapeutic centric occlusion more anteriorly without increasing the vertical dimension. The amount of anterior condylar repositioning is determined by viewing the original TMJ tomographs. The position and the orientation of a normal occlusal plane can only be accurately determined by cephalometric analysis. This good occlusal scheme programmes the muscle coordination and maintains the anterior mandibular position.


[Tissue induction and mucogingival surgery: a review of the literature].

Most of the investigations reviewed in the present paper show that the connective tissue has an inductive potential upon epithelial differentiation. As for the investigations showing an epithelial predetermination, one must admit that they have been limited to particular tissue systems (for instance feathers and hairs) and that they could imply errors of manipulation or interpretation. As stated by Gilette: "Mesenchyme as the determinant is the favorite today, but perhaps only because experiments to demonstrate the opposite would be harder to assess" (Gilette, 1971). On the clinical point of view, one could draw an important conclusion from these investigations: at the present time, only the free or pedicle mucosal grafts including epithelium and connective tissue, or only connective tissue, are indicated to obtain a satisfactory increase of the width of attached gingiva.


[Material found on the cleaned diamond turbine drilling heads after injury cases].

Grinding of the hard tissues of the teeth with diamond points and airotor led to bullet-like flying off of part of the instrument. The causes were investigated: Unsatisfactory fixation in the turbine head, deficient material in the rotating instrument, unnecessary notches in the shaft resulting in reduction of diameter, and finally the so far uncorrected radial vibration of the rotating instrument. All of these causes may result in plastic deformation or breakage of the points.


[Dental examination of skulls of the early Middle Ages in Bial-Mett].

A systematic dental examination was made on 43 skulls from the 6th/7th and 8th/9th centuries which were excavated by the archeological service of the canton of Berne in the church of Biel-Mett. The examination consisted of the following parameters: Count, loss of teeth, caries (instrumental and radiological), calculus deposits, bone loss. The skulls were classified after age and compared with other findings. Generally speaking the results were comparable to findings of other excavations, but they are more detailed owing to more exact methods of examination. The examined population had lost about 23% of their teeth, had a relatively high caries incidence (30%) and a high caries morbidity. Most of the individuals had suffered from periodontal disease. High abrasion values point to the abrasive food then consumed.


Microscopic and submicroscopic studies on the peripheral nerve and the skeletal muscle of the female. cadaver found in the Han Tomb No.1.

The present paper deals with the microscopic and submicroscopic structures of the peripheral nerve of the lumbar plexus and the skeletal muscle of the m. psoas major of the ancient female cadaver buried about 2100 years ago, which was excavated from the Han Tomb No. 1 at Mawangdui (Mawangtui) near Changsha, Hunan Province. The connective tissues in the peripheral nerve and the skeletal muscle of the ancient cadaver were found well preserved. Under the electron microscope were observed the characteristic periodic bands of the collagenous fibrils as well as some axons and degenerated myelin sheath in the lumbar plexus. And in some of the better preserved nerve fibers, their axons and myelin sheaths are readily discernible. In the m. psoas major, cross striations are clearly visible in some muscle fibers. The remains of a blood vessel with only their connective tissues left were observed in the nerve of the lumbar plexus. Bacterial spores appeared in the two tissues.


Endocrine pancreas: three-dimensional reconstruction shows two types of islets of langerhans.

Three-dimensional reconstructions of islets of Langerhans, based on immunofluorescent staining of successive serial sections with antiserums to insulin, glucagon, somatostatin, and pancreatic polypeptide reveal a marked difference in the number of cells containing glucagon and pancreatic polypeptide depending on the anatomical location of the islet in the pancreas. The two types of islets are situated in regions of exocrine tissue that are drained by different excretory ducts. This demonstration contradicts the assumption that all islets in the pancreas are similar in their endocrine cell content.


Shelf reconstruction for hip dysplasia.

Shelf reconstruction of the hip has been successful in 12 patients, with an average of 14 years' follow-up. Revision has been done in two to again give relief of pain and continued stability. Average age at the time of oepration was 20 years.


Bacteriologic considerations in perforated necrotizing enterocolitis.

During a ten-year period, 61 infants with perforated necrotizing enterocolitis were managed by bowel resection, enterostomy, and intravenous antibiotics. Aerobic and anaerobic cultures were taken of venous blood, from the peritoneal cavity at operation, and of any subsequent wound and/or intraperitoneal infection. No significant differences between fatal and nonfatal cases were noted with respect to presence of anaerobes in the peritoneal flora (six babies with two deaths) or culture-confirmed bacteremia (73% of the total). However, peritonitis participated in by Pseudomonas aeruginosa (ten babies), or beta-hemolytic streptococcus (five babies) was -niformly lethal, as were complicating bacteremias due to P aeruginosa, beta-hemolytic streptococcus, and Staphylococcus aureus (two each). Anaerobic peritoneal isolates (all gram-positive cocci) were never noted if performation occurred before the eighth day of life; they did not appear to adversely affect survival. Based upon these data, antibiotic therapy should include either gentamicin or tobramycin, with penicillin, until subsequent culture reports dictate otherwise.


Evaluation and treatment of urinary candidiasis.

The incidence of genitourinary fungal infections is increasing, and because of their lethal potential, early diagnosis and treatment is mandatory. Candida is the most common urinary fungus and is manifest as renal involvement from systemic candidiasis, primary renal candidiasis, bezoar formation, cystitis, and as asymptomatic candiduria. The clinical status of the patient, serial urine cultures, excretory urogram, and serum candidal titers help to differentiate between the various disease states. Treatment is specific and is based on the clinical manifestation of the disease. Systemic candidiasis is treated with intravenous amphotericin. Fungal bezoars are best treated with oral flucytosine, ureteral and renal irrigation with amphotericin and, occasionally, operation. Cystitis is treated with oral flucytosine or amphoteric bladder irrigations. Asymptomatic candiduria is left untreated. A systematized evaluation and treatment regimen is presented.


Acute massive intravascular hemolysis and disseminated intravascular coagulation.

Two cases of acute intravascular hemolysis complicating acute disseminated intravascular coagulation were presented, one after normal delivery and the other after group A beta hemolytic streptococcal septicemia complicating acute myelomonoblastic leukemia. Neither case received heparin therapy. The first one survived while the latter succumbed. Intravascular hemolysis may not be a bad prognostic sign in such a condition.


Exchange transfusion in cerebral malaria complicated by disseminated intravascular coagulation.

A patient with cerebral malaria complicated by full-blown DIC, after failing to respond to other forms of treatment, was successfully treated by exchange transfusion. To the best of the authors' knowledge, this may be first reported case of full-blown DIC in malaria successfully treated by exchange transfusion.


A brief history of the Medical Faculty, University of Cape Town.

Outstanding events in the history of the Medical School, University of Cape Town, include the establishment of a full faculty in 1920, the move of the teaching departments from the Gardens to Observatory in 1926/1928, the opening of the Groote Schuur Hospital in 1938, the signing of the joint agreement with the Cape Provincial Administration in 1951, and the tremendous growth and research activities since that time.


The pathology of human cardiac transplantation: an assessment after 11 years' experience at Groote Schuur Hospital.

Over a period of 11 years, commencing in December 1967, 31 cardiac transplants, 10 orthotopic and 21 heterotopic, were performed at Groote Schuur Hospital. Two patients with orthotopic transplants have a long survival, 1 for 7 1/2 and 1 for 9 1/2 years, and 1 with a heterotopic transplant for 4 years. Eighteen patients have died, and autopsy was performed from 13 to 623 days postoperatively. Rejection of the donor heart was found in 61,1% and was the cause of death in 44,4% of cases. Infection, attributable to immunosuppression, was a common finding and consisted of extensive pneumonia, usually due to Klebsiella aerogenes and Pseudomonas aeruginosa (38,8%), herpesvirus infection (38,8%), cytomegalic virus infection (37,5%), aspergillosis and other opportunistic infections. A combination of cardiac rejection and infection accounted for most of the deaths. The cardinal microscopic features of acute rejection were interstitial lymphocytic infiltration and myocytolysis, while chronic rejection was typified by obliterative myo-intimal proliferation of coronary arteries, with concurrent lipid deposition in the major coronary arteries. These lesions resembled atherosclerosis and caused graft failure due to myocardial ischaemia. Ultrastructurally, severe myofibre damage was reflected in extensive loss of cytoplasmic myofilaments. The advantages of heterotopic over orthotopic transplantation are discussed.


Dissolution of gallstones--when and how?

Availability of bile acid therapy for gallstone dissolution adds another therapeutic choice for treatment of gallstone disease. Because dissolution is slow and eventual outcome uncertain, surgery remains the treatment of choice for most patients who have experienced symptoms clearly related to their gallstones. Patients with only dyspeptic or no gastrointestinal symptoms, especially if significant associated cardiac or pulmonary disease exists, may be candidates for bile acid therapy with chenodeoxycholic acid or its 7-beta epimer, ursodeoxycholic acid, when available. Fifty to 75 per cent of patients, depending on individual criteria, may anticipate complete dissolution. Radiolucent gallstones and gallbladder opacification are basic requirements for cholelitholytic therapy. Periodic assessment of laboratory parameters is necessary at routine visits and when unexpected symptoms occur. In a few patients, evidence of obstructive gallstone disease will develop during bile acid therapy and surgery will be required. The value of bild acid therapy for the relief of dyspeptic symptoms, the role of bile analysis, and optimal long-term therapy remain to be established.


Angiography in chronic/recurrent gastrointestinal bleeding: a nine year study.

Undiagnosed chronic/recurrent gastrointestinal bleeding, as defined, is a severe problem to those afflicted, both physically and psychologically as well as socioeconomically. During the past nine years, 60 such patients received aortography and panvisceral arteriography (that is, celiac, superior mesenteric, and inferior mesenteric arteriography) in a search for the lesions that may be responsible for the bleeding. Results of angiography were "positive" in 26 patients for a diagnostic yield of 43 per cent. Fifteen of the 26 patients with positive angiographic findings demonstrated arteriovenous malformations of the gastrointestinal tract. Two separate lesions were identified in three patients. This series is compared with other published series of angiography for chronic gastrointestinal bleeding. One difference from the other series is the demonstration of three patients with arteriovenous malformation of the gastric antrum. The diagnostic angiographic features of this condition are presented, along with the interestng finding of état mammelonné in two of the three patients. Another difference from the other series is the demonstration of four arteriovenous malformations involving the left side of the colon, whereas other series report none in this location. One possible explanation for this descrepancy is our routine use of inferior mesenteric arteriography in all cases of chronic gastrointestinal bleeding. Ten arteriovenous malformations of the colon are reported along with a review of the angiographic diagnostic features in this condition. The precise incidence of false-positive and false-negative diagnoses is unknown since surgery was not performed on all patients. However, each patient studied represented a total failure, by traditional diagnostic studies, to determine the cause of bleeding. The incidence of positive findings with angiography (43 per cent) in patients with undiagnosed chronic/recurrent gastrointestinal bleeding is sufficient to encourage the continued use of panvisceral arteriography in this condition.


The use of carcinoembryonic antigen in the clinical management of colorectal cancer.

Measurement of plasma levels of carcinoembryonic antigen, though not infrequently helpful in the mangement of patients with colorectal cancer, has serious limitations in terms of specificity and sensitivity. Many benign conditions may cause elevations of carcinoembryonic antigen, and even far advanced metastatic large bowel cancer may be associated with normal levels. Major treatment decisions should rarely, if ever, be based on plasma levels of carcinoembryonic antigen alone. Studies are currently underway to assess the value of serial levels of carcinoembryonic antigen in the early detection of recurrent disease with the hope of identifying patients who might be cured by secondary resections.


Surgical treatment of gastroesophageal reflux.

Most investigators agree that the most important goal in correcting gastroesophageal reflux is restoring or developing a competent lower esophageal sphincter. Although the sphincter can be incompetent in its normal intra-abdominal position and rarely a patient may have a competent sphincter in the thorax, generally the sphincter is much more effective in the positive pressure abdominal position. The choice of operative technique will depend upon the abnormal conditions present and the general condition of the patient. The thoracic approach is elected if there is associated intrathoracic disease warranting surgical correction, such as diffuse spasm of the esophagus, achalasia, epiphrenic diverticulum, or a pulmonary lesion requiring biopsy and possible resection. Very obese patients, patients with recurrent hernias, and patients with shortened esophagus are better managed by the thoracic approach. Patients with an essentially normal esophagus are treated with a Mark IV Belsey procedure. If shortening of the esophagus is present, a combination Collis-Nissen technique with fixation below the diaphragm is preferable. The abdominal approach is indicated when there is another intraabdominal disease known or suspected warranting surgical correction. This approach is also useful for the thin or poor risk patient. Usually, through an abdominal incision, we elect to use a modified Nissen fundoplication, with fixation of the fundoplication to the median arcuate ligament or the right crus of the diaphragm. The crural sling is returned to normal dimensions with interrupted sutures. Reflux in the absence of an hiatal hernia initially is treated medically. If symptoms are significant and intractable, a competent lower esophageal sphincter is restored, or developed by the modified Nissen procedure just described. Most reflux strictures at the esophagogastric junction are reversible by dilatation and restoration of a competent sphincter. Firm, fixed, fibrous strictures occasionally cannot be safely dilated. These may be managed by a Thal procedure to correct the stricture and a Nissen fundoplication to prevent recurrent reflux.


Clinical evaluation of long-term epidural monitoring of intracranial pressure.

Forty-two epidural sensors for measuring intracranial pressure were implanted in 38 patients over the last four years. The sensor is a passive device consisting of an inductance and a pressure sensitive capacitance resonant at about 50 megahertz. The study involved 17 cases of hydrocephalus, nine of pseudotumor cerebri, and the remainder included cases of cranial trauma, brain tumors, and aneurysms. Four of the sensors failed in patients and were removed. Two of these had to be replaced to continue the pressure monitoring. The intracranial pressure is still being monitored in 22 patients, while 15 have been lost to follow-up for various reasons. Fourteen patients have been followed for about a year, and four for two years. The baseline drift rate in most sensors is between 1 and 2 mm H2O per day, with a few having greater rates of drift. Calibration errors were found in some of the sensors after implantation. These errors were corrected by direct measurement of the cerebral spinal fluid pressure via lumbar puncture. The sensors have proven to be a valuable adjunct in the management and diagnosis of neurosurgical patients by simplifying the intermittent and continuous recording of intracranial pressure. This was so despite the presence of calibration errors and a drift which necessitated an occasional lumbar puncture for making corrections.


Pierre Adolphe Piorry (1794-1879): pioneer of percussion and pleximetry.

Piorry was born in Poitiers on 31 December 1794. As a medical student he served in the Napoleonic war in Spain. His teachers in medicine included Corvisart, Bayle, Broussais, and Magendie; he qualified in 1816 with an MD thesis: "On the danger of reading medical text books by the laity"! Laënnec's invention of the stethoscope (1816) and De l' Auscultation Médiate (1819) inspired Piorry to make an analogous contribution to the technique of percussion (which had been originally described by Auenbrugger in his Inventum Novum in 1761 and translated from the Latin into French by Corvisart in 1808). This led to Piorry's invention in 1826 of the pleximeter (le plessimétre) to help outline the internal organs (l'organographisme), which he described inDe la Percussion Médiate (1828). Piorry became renowned as a professor of medicine in many of the great Parisian hospitals (Charité, Pitié, and Hôtel Dieux). In 1832 he was appointed to L'Hospice de la Salpétrière, where he held a famous course of clinical lectures. He wrote prolificly on many aspects of medicine and published more than twenty books. He was, in addition, a poet of some distinction, and wrote a remarkable long poem Dieu, L'Ame et la Nature (1853). Piorry held his neologisms-for example, toxin, toxaemia, septicaemia, etc.-are still in use. This, together with the mixed reception that his advocacy of pleximetry received from his medical contemporaries, made him a controversial figure. He died on 29 May 1879.


Adverse external ocular effects of topical ophthalmic medications.

Medical and pharmacologic research of recent years has led to the development of many potent and efficacious topical ophthalmic medications. Unfortunately, many of these drugs are potentially toxic or allergenic, and their adverse effects have themselves become important external ocular diseases. This paper presents a classification of these adverse effects and provides a review of their etiology, pathogenesis, histopathology, diagnosis, and management. It is hoped that this information will be helpful to ophthalmologists in their efforts to anticipate, prevent, recognize, and treat drug-induced ocular problems and that it will serve to emphasize the importance of avoiding the ill-considered use of medications.


[Hereditary lysosomal storage diseases (author's transl)].

The literature on hereditary lysosomal storage diseases occurring in man and various domestic animals is reviewed. These forms of disease are usually recessively autosomally heritable and are reflected in partial or total deficiency of a lysosomal enzyme, resulting in accumulation of metabolites. The majority of these lysosomal storage diseases show a predilection for localization in the nervous system. As a rule, the main clinical features are neurological symptoms. The first symptoms are usually observed at an early age and the disease is marked by the fact that it is familial in character. Heterozygotes may be identified by controlled haematological studies in a number of these diseases. In domestic animals, these forms of disease may serve as models for human pathology and some may be of economic importance, such as mannosidosis of Angus cattle in New Zealand and GM1 gangliosidosis of Friesian cattle in Ireland.


[Reduction of the number of tetracycline-resistant strains of Salmonella in the Netherlands (author's transl)].

Since 1974, tetracycline resistance in salmonellae of human and porcine origin has decreased nation-wide in the Netherlands. This decrease had coincided with the ban on incorporation of tetracycline in animal feeds for growth-promotion.


Liver extract mediated mutagenicity of acrylonitrile.

The mutagenic activity of acrylonitrile vapours towards Salmonella typhimurium strains strictly depends upon the presence of a liver postmitochondrial fraction. The reversion rate varies according to the animal species from which the S9 fraction is obtained as well as to the pretreatment of the animals. The comparatively weak activating effect of the microsomal fraction and the inability of both SKF525A and carbon monoxide to inhibit the S9 mediated mutagenicity of acrylonitrile (ACN) suggest that the cytochrome P-450-dependent monooxygenases do not play a major role in the metabolic activation of ACN into a mutagenic intermediate (s).


Polystyrene embedding: a new method for light and electron microscopy.

Polystyrene embedments of histological specimens can be obtained with a solution of 1:14 polystyrene-toluene, 5% benzyl alcohol and 1% dibutyl phthalate, allowing the solvent to evaporate in polyethylene containers for 2-3 days at 58 C. The resulting blocks are easily cut into truncated pyramids, each containing a piece of tissue, which are then glued to a Plexiglas support. Drying is completed at 80 C for 20 hr. The pyramids can then be sectioned to produce thick sections with a steel knife or to produce semi- or ultrathin sections with a glass knife. A 10% paraldehyde solution is used to mount the light microscopy sections on a slide heated on a hot plate to 80 C; these can be treated with the same techniques used with paraffin sections. The results are of high quality. Semithin sections of tissues fixed for electron microscopy can be stained directly after mounting, or by a wider range of stains once the polystyrene has been removed by organic solvents. In electron microscopy, the ultrathin sections obtained with the usual techniques are highly electron beam-resistant and given acceptable results.


Improved imprinting technique for study of plant tissues.

The exposed surface of plant tissues is coated with nail varnish. When peeled off, the transparent coating film bears a replica imprint of the tissue. Transparent adhesive tape is used for lifting the film imprint and mounting it on a microslide without curling. By a similar method, an opaque sealant replica with an aluminum foil support may be prepared which can serve as a mold for obtaining a transparent secondary imprint useful for light microscopic studies. The replicas can be stored like herbarium specimens for future use.


Graded differential photoreceptor orientation: ramifications for ultramicrotomy of retina.

When sectioning small blocks of tissue from the retina of the eye, it is sometimes difficult to obtain sections which simultaneously cut squarely across the inner retinal layers and are on the long axis of the photoreceptors. This difficulty is, at least partially, due to the fact that the receptors tilt progressively relative to the tangent to the retinal curve at progressively more peripheral loci. Consideration of the graded differential orientation of the receptors indicates that, in order for the section to be simultaneously coaxial with the receptors and the inner retinal layers, the plane of the section must be parallel to and include the anterior-posterior axis of the eye, as is the case when the whole eye is sectioned through its center. It is illustrated that this criterion can be met for small blocks of retina if the block is excised along a parallel of the eye and the plane of section is perpendicular to the tangent to the retinal curve and the parallel. An approach which accomplishes this is described. Theoretical analysis suggests that distortion of apparent size of structures in the retina can become significant within a few degrees of the posterior pole if this condition is not met.


Pharmacology, toxicology and degradation of endosulfan A review.

This report presents a review of literature on organochlorine insecticide of the cyclodiene type endosulfan, which has been employed extensively for agricultural, domestic and public health purposes. It summarizes information on nomenclature and chemistry, metabolism and toxicity in mammals, birds, fishes and insects, degradation and metabolism in plants along with brief reference to the degradation in water and light. Unfortunately, because of lack of knowledge, a precise statement, in regard to the ecological implications and the quantitites of endosulfan now being used, is not possible at this time.


[Investigations on combined injuries, 26th communication: investigations on the changes in the state of resistance following sublethal whole-body irradiation (author's transl)].

The risk of a bacterial invasion by pseudomonas, e. coli, proteus, citrobacter and gaffkya via an open skin wound was investigated in combined injured mice (infliction of a skin wound and irradiations). Suspensions of different bacterial strains were applied on the wound and then the lethality was determined. Besides of apathogenic (citrobacter, proteus, gaffkya) and high pathogenic bacteria (e. coli and pseudomonas) an e. coli strain of the 0-Group 81 was found that seems to induce a decrease of lethality even after sublethal whole body irradiation.


Serum hormone levels during a post-implantation LH-RH induced luteolysis in the rat.

Daily administration of LH-RH (100 micrograms sc at 0900 and 1500 h) to rats over day 7-12 (D7-12) of pregnancy induced reovulation by D9 and a sustained decrease in uterine:fetal weight and vaginal bleeding by 0600 h on D10 of pregnancy. Serum hormone levels determined at 0600, 1200, and 2000 h over D7-12 of pregnancy revealed that luteinizing hormone (LH) was significantly elevated after each administration of LH-RH, while prolactin (PRL) was not significantly altered in any systematic fashion. An acute decline in serum progesterone at 2000 h on D7-9 following LH-RH administration was not sustained until after 0600 h on D10 when serum 20 alpha-dihydroprogesterone (20 alpha-hydroxy-4-pregnen-3-one, 20 alpha-DHP) in LH-RH treated animals rose significantly above control (2000 h, D10) and remained elevated throughout D11-12. Progesterone and 20 alpha-DHP values were reflected morphologically after D10 as the corpora lutea of LH-RH treated rats underwent luteolysis. A peak in serum estradiol levels in control animals was observed at 0600 h on D9. Serum estradiol-17 beta levels in LH-RH treated animals were similar to control except at 2000 h on D8 and D12 when LH-RH induced a significant increase. These observations suggest that subsequent to implantation in the rat, the temporal sequence of a decrease in progesterone secretion, luteolysis and pregnancy failure in response to LH-RH does not result from an increase in estradiol secretion attendant to reovulation.


Enzyme immunoassay of testosterone in plasma, with use of polyethylene glycol to separate antibody-bound and free hormone.

We describe an enzyme immunoassay for testosterone in which we use a testosterone-3-(carboxymethyl)oxime horseradish peroxidase conjugate as the label and an antiserum, raised in rabbits, to testosterone-3-(carboxymethyl)oxime-bovine serum albumin conjugate. Polyethylene glycol (Carbowax 6000) is used to separate antibody-bound and free steroid. The assay has a sensitivity of 12 pg/assay tube and satisfies the usual criteria of specificity, precision and accuracy. The results agree well with those obtained with a comparable radioimmunoassay.


[Materials testing demonstration of the suitability of a viscous plastic silicone elastomer for long-term functional impressions].

Comparative laboratory tests with elastomers as well as clinical trials showed that the visco-elastic silicone elastomer "Stefanat zähplastisch" (manufacturer: VEB Arzneimittelwerk Dresden, Leipziger Arzneimittelwerk) is suited for long-term dynamic impression. It is necessary to use a special, exactly dosed cross-linking agent and to apply the reactive material carefully.


[Evaluation of Berlin jacket crowns compared with plastic or ceramic jacket crowns].

34 jacket crowns of ceramic material, of plastic and of a combination plastic-ceramic material (Berlin jacket crowns), respectively, were clinically re-examined using a uniform scoring scale. The results obtained show that the Berlin jacket crowns can be ranked between the ceramic jacket crowns and the plastic jacket crowns.


[The model-cast immediate denture--a means for the treatment of patients with periodontal diseases].

The authors describe a method of immediate prosthetic care by means of a model-cast denture. It is mainly indicated for periodontally diseased dentitions which will thus be treated immediately, optimally and rationally.


Allograft viability determined by enzyme analysis.

Enzymatic analysis of the venous effluent of ischemically injured kidney failed to predict accurately the ability of an isochemically injured kidney to support life. Postoperative serum assay of lactic dehydrogenase (LDH) is of value in the assessment of the functional status of the kidney and correlates with response of the rejection episode to immunosuppression. However, by itself it cannot be a sole guide to withholding of therapy. Successful treatment is associated with a decline in LDH level, and failure to return to base line serves as a guide to irreversibility of the rejection reaction.


Effect of blood transfusions on survival of cadaver and living related renal transplants.

The effect of blood transfusion was analyzed in 194 first cadaver renal transplants and 86 living related renal transplants. The association of blood transfusion with HLA genotyping and poor risk recipients was analyzed. Exclusion of poor risk recipients improved graft survival among the transfused group of patients but not in the small subgroup of nontransfused recipients. No effect of blood transfusion was observed in the living related group. Improved graft survival was observed in both the haplotype-matched and nonhaplotype-matched transfused cadaver recipients. The haplotype-transfused recipients had grafts survival rates of 69 and 66% at 1 and 2 years, respectively. The greatest beneficial effect was seen in the double haplotype-transfused cadaver recipients with graft survival rates of 80 and 71% for the same period. The lack of beneficial effect of transfusion in the living related patients is felt to be a result of the fact that the maximum effect had already been achieved by a far superior donor-recipient histocompatibility than is able to be achieved in a large group of cadaver recipients.


Are the native kidneys responsible for erythrocytosis in renal allorecipients?

The development of erythrocytosis following renal transplantation has been reported to be caused by a number of factors. These include acute and chronic rejection, hydronephrosis and renal artery stenosis. In this study, seven patients were noted to have erythrocytosis with hematocrits ranging between 53.5 and 66%. Serum erythropoietin levels were elevated and ranged between 11 and 60 mU/ml with a mean of 31.9 mU/ml in six of seven patients. Selective catheterization of veins of native and transplanted kidneys in three patients revealed mean serum levels of 40.9 and 13.0 mU/ml, respectively. This suggests that excess erythropoietin is being produced from the diseased native kidneys. Bilateral nephrectomy in one patient cured erythrocytosis and dropped systemic levels of erythropoietin (EP) to 6.1 mU/ml. In four of the remaining five patients, hematocrits came down spontaneously to within normal over a 1- to 3-year period. Consequently, it appears that in a number of transplant patients the retained diseased kidneys, having lost all excretory and concentrating function, may remain capable of functioning as endocrine erythropoietin-producing organs.


[Metabolism of proliferating and resting cells].

This review concerns the modern trends and experimental approaches to the study of cell cycle (cell population kinetics, cell structure and functions at various steps of the cycle,, etc.) and their input into the current views of cell proliferation controls. The resting state of the cell is considered and metabolic features of proliferating and resting cells are compared. Evidence is presented that resting cells are metabolically active and less resistant to the damaging factors that it has been previously supposed. The importance of this finding for biology and medicine, especially for cancer chemotherapy, is discussed.


[Cytochemical and biochemical determination of  acid phosphatase activity in yeasts].

Optimal conditions of the cytochemical assay for acid phosphatase in protoplasts and whole cells of S. cerevisiae have been described. Dimethyl sulfoxide was used to increase the permeability of the yeast cell envelope. In the yeast cells, grown up to the end of the exponential phase, acid phosphatase is shown to be located mainly in the central vacuole and on the cell envelope surface. A considerable activity of acid phosphatase is demonstrable on the surface of the plasma membrane and within adjacent vesicles that represent, presumably, part of the endoplasmic reticulum. Acid phosphatase can be considered as a marker enzyme for yeast cell vacuoles.


[Polyploidizing mitoses and the biological meaning of polyploidy in liver cells].

The ontogenetic polyploidization of hepatocytes is regarded, within which normal mitoses are changed to polyploidizing mitoses, and diploid hepatocytes transform into polyploid mono- and binuclear cells. A new hypothesis is put forward of the biological significance of the liver cell polyploidy. The hypothesis takes into account a high level of spontaneous chromosomal aberrations in mitotic hepatocytes. The chromosome structural changes interfere with mitosis resulting in the chromosomal imbalance. Polyploidy bestows for hepatocytes a tolerance towards a chromosomal imbalance. Some implications of the hypothesis are discussed: unbalanced genome of hepatocytes after the treatment with mutagens and mitotic stimulators; the reasons of liver cell polyploidy differences in mammalian species; mechanisms of radioresistance of hepatocytes. Chromosomal imbalance of polyploid hepatocytes is assumed to be the basis for wome chronic liver diseases in man.


High-dose medroxyprogesterone acetate (MPA) treatment in advanced breast cancer. A review.

Medroxyprogesterone acetate (MPA) when employed at high doses (greater than or equal to 500 greater than or equal to 1000 mg/day i.m.) can produce objective remission with improved survival in about 30% of postmenopausal women with advanced breast cancer resistant to cytotoxic drugs and endocrine therapies. When administered to women not previously treated with chemotherapy, the objective remission response rate reached 40%. From available evidence, high dose MPA can be considered a useful agent in the treatment of advanced breast cancer in postmenopausal women with soft tissue, pulmonary, pleural or osseous involvement even when patients have become refractory to prior hormone and cytotoxic therapies. Early results suggest that the response rate can be increased in patients with estrogen and/or progesterone-positive receptors. It is note worthy that in a study conducted on postmenopausal women resistant to cytotoxic and/or hormonal drugs, the median duration of survival was 13.5 months, while CRs plus PRs did not reach the median at 24 months after starting MPA treatment. High dose MPA is essentially devoid of major side effects. Relief of pain, increase in appetite and body weight, and sense of well being are characteristic features of the improved quality of life under MPA treatment. However, a gluteal abscess (from 2% to 20% dose related) is the most frequent side effect. A promising area for future studies is combined therapy using hormonal and cytotoxic agents or alternating sequential combinations. Well-designed studies are needed to develop means for increasing the complete response rate and therefore survival. Recent studies of combined chemo- and hormonal (MPA) therapy have yielded objective tumor regressions of 53 to 80% with an increased rate of complete remissions and duration of response.


Adjuvant multiple drug chemotherapy for osteosarcoma of the extremity: a 6 year report.

Fifty-five cases of osteosarcoma of the extremities were treated between 1972 and 1976 with combination surgery and polychemotherapy (vincristine, adriamycin and methotrexate at medium doses) for 18 months. Their follow-up presently ranges between 30 and 80 months (mean = 48 months). Twenty-six patients remained free from disease signs, 2 showed local recurrence but no metastases, and 27 exhibited metastases (4 of these also had local recurrences). In 12 patients, the metastases appeared after the end of chemotherapy. Both metastases and local recurrences were more frequent in those patients submitted to segmental bone resection (7/8) than in those treated by more radical surgery (22/47). Comparison with a historical group (94 osteosarcoma patients treated with surgery alone at our Institute between 1960 and 1971) revealed that, during the follow-up period considered, the percentage of patients free from disease signs was higher in the group that also received chemotherapy. In addition, in this group metastatic appearance was delayed (mean = 15 months) as compared to historical controls (mean = 8 months). On the other hand, after the same kind of surgery, the rate of local recurrences and the time of their appearance was practically the same in both groups.


[New data on carbonic acid fixation in animals and man].

Recently a new enzymic carboxylation reaction has been discovered at the final-step of prothrombin and other proteins synthesis. The presence of the unique amino acid, gamma-carboxyglutaminic acid, is established and its structure is determined. The role of the acid is shown in Ca2+ fixation in the known proteins, playing an important role in the blood coagulation processes, and in some new proteins participating in the tissue calcification. Data are systematized on the necessity of vitamin K in the new reaction of the carbonic acid fixation under conditions of its in vitro simulation.


[Phytoecdysones--biologically active polyhydroxylated sterols].

Methods are described for detection, isolation and identification of phytoecdysones--hormones of moult and metamorphosis of insects and crustaceans produced by some plants. Much attention is paid to problems of seeking plant sources of ecdysones and to studies in their biological activity on various animal species, the activity being of importance for human practice. Hypotheses available in literature on the mechanisms of the ecdysone effect on the protein synthesis processes are discussed.


Relationship of prior hormonal therapy to subsequent estramustine phosphate treatment in advanced prostatic cancer.

The relationship of prior hormonal therapy to subsequent response on estramustine phosphate (Estracyt) was examined in 107 patients with advanced prostatic cancer treated in two different Phase II chemotherapy trials. In both trials patients with the longest prior hormonal treatment were the least likely to respond to estramustine phosphate. Patients in the series from the National Prostatic Cancer Project with a response classification to prior hormonal therapy had only a 26 per cent response to subsequent estramustine phosphate therapy, whereas 40 per cent of those with no prior response to hormonal therapy responded to estramustine phosphate. This latter group had the shortest average disease duration from diagnosis. The sample of prostate cancers studied appeared to include groups that were sensitive to both hormones and cytotoxic activity as well as to either of these two alone. These data support the contention that estramustine phosphate may act both as an estrogenic and a cytotoxic agent.


Adjuvant immunotherapy with bacillus Calmette-Guérin in prostatic cancer.

Ninety-two patients with histologically proved prostatic cancer were studied. Forty-six patients were treated with bacillus Calmette-Guérin (BCG) adjuvant immunotherapy, and 46 other patients, matched for stage and hormone therapy, served as controls. Survival from the time of histologic diagnosis was sixteen and one-half months longer (thirty-seven and one-half versus twenty-one months) in the BCG-treated patients. There was no mortality and only minimal morbidity. Changes in some immunologic parameters (white blood cell count, skin tests) suggest an immune response.


Necrotizing infection of scrotum.

Necrotizing infection of the scrotum (Fournier gangrene) rapidly spreads to adjacent skin with fever and toxemia and is life-threatening. Subcutaneous gas and a foul-smelling wet discharge from the skin are usually present. The infection is not cured with antibiotic therapy alone and requires immediate extensive debridement of all necrotic tissue. Repeated debridement each several days under general anesthesia is necessary until healthy granulation is present in the wound. Reconstruction with skin flaps or skin grafts shortens hospitalization and prevents the dense scar tissue and immobility of the tests that can occur with spontaneous epithelization.


[Bone alloplasty in the surgery of the locomotor apparatus].

The article is devoted to the treatment of diseases and damages of the locomotor system: intervertebral osteochondrosis (63 patients), scoliosis (34 patients subjected to 55 operations), fractures and false joints (270 patients), benign tumor of the bones (287 patients). The nearest and remote results were analyzed. The author recommends a wider use of allogenic bone tissues, sterilized in antiseptic solutions with the subsequent freezing.


Recurrent coliform mastitis in the dairy cow.

Daily monitoring of milk over a 120-day period for bacteria and neutrophil counts revealed that following experimental E coli mastitis, five out of 28 infections resulted in the development of a long continued and recurring condition. Intermittent periods of acute inflammation were observed in the gland, pyrexia was noted, and if bacteria were isolated they were always of the same serotype as the original infecting strain. Failure to isolate bacteria and the lack of overt inflammation during periods of remission suggested that the bacteria were not in the gland cistern but within gland tissue. In one animal antibiotic therapy with a drug which was active in vitro was ineffective in vivo. However another antibiotic proved effective.


Antibody coated bacteria in urine sediment from cattle infected with Corynebacterium renale.

Using the fluorescent antibody test, the presence of antibody-coated bacteria in 10 out of 17 urine sediment samples from cattle infected with Corynebacterium renale is described. These antibodies were mainly of the immunoglobulin class IgG, and to a lesser extent IgA. This finding is characteristic for infections of the upper urinary tract (pyelonephritis). In seven samples no antibody coating of the bacterial surface was detected. In these cases an infection of the lower urinary tract (cystitis) is suggested.


The pathogenesis of enteric colibacillosis in neonatal unsuckled calves.

The development of pathological lesions in the small intestine of neonatal calves is described. Seven newborn calves were challenged orally with a known enteropathogenic strain of E coli 0101k?(A) and killed at varying times after inoculation. Adhesion of bacteria to the mucosa of the small intestine was observed in all calves. A few organisms were seen in the distal small intestine at three hours after inoculation and thereafter adhesion progressed anteriorly along the intestine in calves killed from six to 36 hours. In these calves pathological changes occurred between six and 12 hours after inoculation. Villi were stunted and thickened and the epithelial surface was irregular. A further calf, anaesthetised from five-and-a-half to 10 hours after inoculation and repeatedly sampled from the distal small intestine, developed similar lesions abruptly at nine hours after inoculation. Villus and crypt lengths in the challenged calves were compared with those in three normal uninoculated control calves.


Detection of antibody against Mycoplasma mycoides subsp mycoides in cattle by an enzyme-linked immunosorbent assay.

The results of an enzyme-linked immunosorbent assay (ELISA) For the detection of antibody against Mycoplasma mycoides subsp mycoides are presented. Antibody was detected in the sera of cattle at least 19 months after recovery from an infection and at least 23 months after vaccination. Almost half the sera of some animals in an area of Nigera where contagious bovine pleuropneumonia is enzootic contained antibody. Antibody was rarely detected when the same sera were examined by other established serological tests, emphasising the sensitivity of the ELISA.


[New materials on the history of veterinary medicine in Bulgaria].

Several tens of ritual plates are preserved in Bulgaria on which elements of glorification are found of god Mithras who gained popularity particularly in the 1st-IIIrd century in the regions of Thrace and today's North Bulgaria, then provinces of the Eastern Roman Empire. Mithras seemed to be respected by slaves, soldiers, and merchants alike, but was also an exemplar to the Roman emperors, being considered by them as Sol invictus or Deo invicto. The central scene in all plates is that of Mithras tauroctonus (Mithras, the killer of bulls). This scene is likewise of interest to veterinarians as it shows that in such early epoch the people that lived within the territory of Bulgaria of today used a method for the felling of large animals, the elements of which--fixing the head and bending it backwards, fastening the thorax with a belt or another loop, loading the animal's back--are still existing and are used in a number of modern methods of felling (that of Hess, the Caucasian way of felling, the Chinese one of Dou-Chan-Than, etc.) Besides, the people of ancient time knew that ruminants have an incomplete upper dentition. They skilfully employed this to bring animals that had to be felled into an unusual nonphysiologic posture. Not sooner than 16 centuries prior to the preformists (the spermists) they supported the concept that the testes were the source of life.


[Radioisotope topical diagnosis of malignant lymphomas using gallium-67 citrate].

The diagnostic value of Ga-67 citrate scintigraphy was estimated based on the comparison of clinical and roentgenological findings, including lymphography, in 46 patients with lymphogranulomatosis and other malignant lymphomas. The results obtained indicated that scintigraphy with Ga-67 citrate is a valuable adjunct for diagnosing malignant lymphomas and lymphogranulomatosis in previously untreated patients and in the recurrences.


[Interferon-forming properties of the leukocytes in assessing the functional activity of the regional lymph nodes in cervical cancer].

In the present work the authors have employed their personal modification of the technic of interferon reaction of lymphocytes, which consists in using the lymphocytes isolated from regional lymph nodes but not from the peripheral blood as described in the literature. The titres of interferon produced in vitro by the lymphocytes of lymph nodes, removed during the operation in cervical cancer patients, were shown to correlate well with the clinico-morphological changes, indicating the rate of the regional lymphoid tissue response. The mentioned correlation speaks in favour of the prognostic value of the interferon reaction of regional lymph nodes lymphocytes in cervical cancer.


[Physiological requirements in foodstuffs and energy of infants in the 1st year of life].

The authors report their own and literature data on requirements for infants of over 30 food factors. It is suggested that certain age periods should be differentiated and the parameters of weight and height considered while summarizing materials on recommended rates of the principal food and energy requirements for children of the first year of life.


[Evaluation of the effectiveness of feeding infants with the new adapted products].

Feeding regimens involving the use of new foods, dry adapting additive and acidophilus mixtures of the "Malyutka" and "Malysh" types developed by the Institute of Nutrition, Academy of Medical Sciences of the USSR, were assessed from the results of investigations carried out with 500 infants. Recommendations for improving the composition of the above foods are given with a purpose of reaching the optimal formula of breast milk substitutes.


Skeletal scintigraphy.

Skeletal scintigraphy, using phosphates or diphosphonates labeled with technetium 99m, is a sensitive method of detecting bone abnormalities. The most important and most frequent role of bone scanning is evaluating the skeletal areas in patients who have a primary cancer, especially a malignant condition that has a tendency to spread to bone areas. The bone scan is superior to bone radiographs in diagnosing these abnormalities; 15 percent to 25 percent of patients with breast, prostate or lung cancer, who have normal roentgenograms, also have abnormal scintigrams due to metastases. The majority of bone metastases appear as hot spots on the scan and are easily recognized. The incidence of abnormal bone scans in patients with early stages (I and II) of breast cancer varies from 6 percent to 26 percent, but almost invariably those patients with scan abnormalities have a poor prognosis and should be considered for additional therapies. Progression or regression of bony lesions can be defined through scanning, and abnormal areas can be identified for biopsy. The incidence of metastases in solitary scan lesions in patients with known primary tumors varies from 20 percent to 64 percent. Bone scintigraphy shows positive uptake in 95 percent of cases with acute osteomyelitis. Stress fractures and trauma suspected in battered babies can be diagnosed by scanning before there is radiological evidence. The procedure is free from acute or long-term side effects and, except in cases of very young patients, sedation is seldom necessary. Although the test is sensitive, it is not specific and therefore it is difficult to overemphasize the importance of clinical, radiographic, biochemical and scanning correlation in each patient.


Recent advances in antidepressant drug treatment.

Psychiatric research has made remarkable advances in understanding the pathophysiology of depressive illnesses. Biologic depressions are now understood as neurotransmitter deficiency diseases. Certain forms of depression are treated with tricyclic antidepressant drugs, which increase the amount of available neurotransmitters. Complicating the clinical picture, however, is the problem of wide variability of levels of tricyclic drugs in the plasma of persons receiving the same dosage. Another problem is the apparent linear dose-response relationship of imipramine hydrochloride and its sister compound desipramine hydrochloride while amitriptyline and nortriptyline follow an inverted U-shaped dose-response curve. However, with newer, more sophisticated diagnostic methods, combined with monitoring of tricyclic drug levels in plasma, therapeutic efficacy can approach 90 percent. Available neurotransmitters also can be increased using monoamine oxidase (MAO) inhibitors. Although MAO inhibitors have been less popular than the tricyclic drugs, recent clinical research tends to support their efficacy. Distinct individual differences in the rate of metabolism of MAO inhibitors have been found. New methods are being devised to detect these differences and monitor directly the effects of these drugs. One of these methods, platelet MAO inhibition, shows some clinical promise. Tricyclic drugs and MAO inhibitors have recently been joined by lithium carbonate, which shows notable efficacy in removing acute manic-depressive symptoms as well as preventing their return during maintenance treatment. Its utility in treating cyclic depressions without mania is now being explored by researchers.


[The treatment of acute pancreatitis in Austria: results of a questionnaire].

The treatment of acute pancreatitis as currently practised in Austria was evaluated by means of a questionnaire mailed to all medical and surgical departments in Austrian hospitals. Fasting, analgesics and parenteral fluid therapy are applied routinely and proteinase inhibitors are used in nearly all hospitals. The efficacy of placing the pancreas at rest by withdrawal of oral fluids, nasogastric suction or antacids is variably assessed. Pharmacological inhibition of pancreatic secretion is achieved mainly by anticholinergics, whilst less often glucagon is prescribed. Antibiotic prophylaxis is widely applied. The main indications for surgery are complications and pre-existing biliary tract disease. These results are compared with the literature.


[Prostaglandin I2 (PG I2; prostacyclin) synthesis by human gastric mucosa (author's transl)].

The human gastric mucosa generates prostacyclin (22 +/- 6 ng PG I2/g). There is no age or sex difference in PG I2 formation by normal gastric mucosa. The properties of the substance are the same as reported in other tissues.


Determination of the biological parameters of bacterium-phage complexes.

The authors present a method of measurement and evaluation for continuous cultures of bacteria infected by virulent phages. By the comparison of the model describing the phage-bacterium interaction and their own experimental data they determined the following biological parameter values characterizing the interaction: the adsorption rate (mu), the expectation of the latency period (T) and its standard deviation ((sigma), the time required for lysis (d), the infection efficiency (eta) and the average burst size (C). The parameters were used for the determination of optimal cultivating conditions (maximum phage yield).


Effect of vagotomy on gastrointestinal hormones.

Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin are elevated after all types of vagotomy. The postvagotomy hypergastrinemia is due to the change in pH in the antral lumen or the gastric motility changes, both of which may lead to a proliferation of G cells. The reduction in pancreatic secretion after vagotomy is not due to changes in intestinal hormone release, but may be caused by the interruption of a postulated enteropancreatic reflex. Postprandial GIP release and serum insulin levels are not affected by vagotomy, but basal GIP levels are increased after vagotomy. Postprandial pancreatic polypeptide release is nearly abolished by vagotomy, but seems to normalize in the later postoperative course. These findings may be important for the interpretation of pathophysiologic changes after vagotomy.


Prostaglandins and serotonin: nonpeptide diarrheogenic hormones.

Prostaglandins and serotonin are vasoactive compounds with profound effects on the gastrointestinal tract. Both cause inhibition of gastric acid secretion (although serotonin stimulates gastric pepsin secretion), stimulation of intestinal motility, and conversion of small intestinal mucosa from absorption to secretion of water and electrolytes. Their effects on pancreatic and biliary function are still not clear. Although prostaglandins appear to elicit their effects primarily by a paracrine mode of action, and serotonin is primarily a neurotransmitter (neurocrine), it is clear that even under normal conditions both can function as humoral agents. For example, we have shown that serotonin plays a physiologic role as a humoral inhibitor of gastric acid secretion. However, the effects of these agents become more pronounced in patients with humorally mediated diarrheogenic syndromes. Serotonin (and related indoles, particularly 5-hydroxytryptophan) has been firmly implicated as a cause of diarrhea in patients with carcinoid syndrome; our recent studies suggest that the diagnosis can be more effectively made by measuring circulating immunoreactive serotonin concentrations than urinary excretion of 5-HIAA; that some circulating serotonin escapes hepatic inactivation and, thus, large intestinal tumors can cause carcinoid syndrome in the absence of hepatic metastases; and that large amounts of serotonin are produced by some noncarcinoid diarrheogenic tumors, including medullary carcinomas of the thyroid and tumors associated with the WDHA syndrome. A large number of tumors of probable neural crest origin, including medullary thyroid carcinoma, carcinoids, and tumors associated with the WDHA syndrome, secrete large amounts of prostaglandins, particularly PGE2. The clinical response of at least some of the patients harboring these tumors to inhibitors of prostaglandin synthesis (particularly indomethacin) suggests that prostaglandins play a role in the etiology of these diarrheogenic syndromes.


[Isosorbide-dinitrate in myocardial perfusion (author's transl)].

The effect of isosorbide dinitrate (ISDN) (10 mg sublingually) on myocardial perfusion during ischemic conditions was analyzed in 14 patients with angiographically severe coronary artery disease and typical angina pectoris, using the 201-Thallium-myocardial scintigraphy. All patients underwent two identical scintigrams with the same work load during bicycle ergometry; a control scintigram leading to angina and ST-depressions of greater than 0.1 mV was followed 4--6 weeks later by a scintigram after ISDN; all drugs -- except sublingual nitroglycerin -- were withheld for an entire week. -- 25 of 39 new or enlarged, exercise-induced defects (64%) were normalyzed after ISDN; 14 new or enlarged defects remained unchanged (p less than 0.0005). In the 11 patients, in whom ISDN led to complete abolishment of angina, 23 of 30 new defects (76%) were normalized against none in the 3 patients with persistent angina and ST-depressions. Quantitation of perfusion was attempted by calculating the average impulse rate (counts/min/matrix point): in those patients reacting favorably to ISDN average impulse rate decreased significantly especially in the normal area (p less than 0.001), resulting in a more homogeneous distribution of Thallium activity, indicating a marked reduction in local oxygen consumption.


Correlative morphological and cytochemical observations on the nucleoli and nuclear bodies during avian oogenesis.

A correlative morphological and cytochemical study has been made of the nucleoli and nuclear bodies in the growing oocytes of the crow (Corvus splendens) and common myna (Acridotheres tristis). The nucleoli show morphological and cytochemical changes during oocyte growth, which are described in detail. In young oocytes at diplotene stage, two to six nucleoli, which are attached to condensed diplotene chromosomes, show RNA, lysine-rich histones and some non-histones, the proteins contain S-S and SH groups. In subsequent stages of oocyte growth, the cortex of nucleolus also develops arginine-rich histones whereas the medulla shows lysine-rich histones. The significance of both morphological and cytochemical changes of nucleoli has been discussed in relation to oocyte growth. Seven types of nuclear bodies are described. They are composed of proteins and carbohydrates. Their shape, size and structure vary during different stages of oocyte growth. Finally, their material is transported into the ooplasm.


[Hemodynamic and hydrodynamic problems in kidney transplantation].

On the basis of general realisations and own experimental or clinical observations haemodynamic and hydrodynamic problems, respectively, of renal conditioning in the organism of the donor, the perfusion preservation and the phase of repeated blood supply are represented and discussed. It is shown that an improvement of the renal blood supply and of she flow of the urine in the donor with "dead brain" by alpha-adrenergic blockade or stimulation of beta-receptors is not sufficient for overcoming restrictions of the renal function. A pulsatile perfusion and the permanent opening of the vascular lumen when the medium changes between blood and perfusate are regarded as most favourable hydrodynamic prerequisites for the initial hypothermal lavation of blood. In continuous machine perfusion with oxygenated protein-containing solutions a dilation of the renal vessels takes place, so that the cortical perfusion is guaranteed also in low pressures. After the transplantation there exists a significant pathogenetic correlation between the total blood supply of the kidney and its early function.


[Structure of the neurons in the midbrain auditory center in the frog, Rana ridibunda].

Using rapid Coldgi technique, studies have been made on the structure of the nervous cells in torus semicircularis of the frog Rana ridibunda. 277 cells observed in frontal and sagittal sections were classified into 3 groups. 198 cells with an oval body had their basal dendrite spreading caudoventrally. The dendritic tree of these cells does not leave torus semicircularis. Nucleus laminaris and n. commisuralis usually contained simple cells of this type with one smooth basal dendrite. In the main nucleus of torus semicircularis, similar cells with additional horizontal or dorsal dendrites were found. Many cells of this type in the caudal part of the torus have spiny dendrites. 38 cells with large elongated bodies have one ventral dendrite which originates directly from the body and produces several ventro-lateral processes intersecting the efferent bundle in the tectum opticum. Long and thin dorsal dendrites pass through the laminar nucleus of the torus. These cells were found in the rostral part of the nucleus magnocellularis. In various parts of the torus, 17 multipolar cells were registered. It was not possible to classify 24 cells. Preliminary comparison of morphological and electrophysiological data showed that structural differentiation of the auditory center of amphibian midbrain reflects functional organization of this region.


[Preparation of an insulin-like substance from molluscs and its antiserum].

A substance with insulin-like activity was obtained from visceral organs (excluding foot, gills and mantle) of the freshwater bivalve molluscs Unio pictorum and Anodonta cygnea. Injecting this substance to guinea pigs, antiserum was also obtained. Using the obtained antiserum in immunostaining experiments, the cells which produce insulin-like substance were identified in the intestinal epithelium of the midgut in A. cygnea.


[Preservation of cholerogenicity in cholera vibrios in the incomplete L-cycle stage].

The work presents the characteristics of the forms appearing as a result of the incomplete L cycle of Vibrio cholerae obtained in experimental conditions after the cultivation of typical V. eltor strain, serovar Ogawa, for 5 months at room temperature in sterile river water without subculturing. The culture formed shaprly changed L-similar colonies, had decreased agglutinability and was resistant to diagnostic cholera phages, but retained its cholerogenicity for suckling rabbits. A suggestion was made concerning the possible epidemiological significance of such forms and the necessity of their detection in the course of bacteriological analysis for cholera.


[Transforming activity of R- and Lac-plasmids of clinical strains of Gram-negative bacteria].

The isolated plasmid DNA of clinical strains of Gram-negative bacteria were shown to have transforming activity when E. coli strain 0600 and S. typhimurium strain LT-2 were used as recipients. The frequency of transformation depended on the recipient strain and the character of the plasmids. The presence of deletion mutants was revealed among the transformants. Such mutants occurred with varying frequency, most often in S. typhimurium strain LT-20; the reason for this phenomenon is at present under discussion. The transformation of plasmids controlling lactose splitting and their conjugation transfer into recipient S. typhimurium strain LT-2 is possible only under condition of using recipient (R+). The possibility of the formation of the cointegrate (R and lac plasmids) in recipient S. typhimurium strain LT-2 is discussed.


[Antibodies to muscle fiber antigens in the cosmonauts after a space flight].

The study of serum samples, obtained from 15 cosmonauts before and after space flights, with the use of the indirect fluorescent method showed that in 7 cosmonauts antibodies to different elements of the human heart muscle appeared after flights. Strong and very strong luminescence of the elements of heart muscle tissue was detected in the cosmonauts after the third space flight. When studying the sera on sections of bovine heart muscle tissue, the reactions of the sera taken before and after flights were found to have no essential differences.


[Humoral and cellular immunity factors in peroral vaccination with an S. typhimurium antigenic complex].

The role of individual immunity factors in protection from S. typhimurium infection was studied on mice immunized orally in a single administration with an antigenic complex obtained by the treatment of bacterial cells with hydroxylamine. The oral administration of this preparation induced the systemic and local transformation of the organism, which was manifested by the accumulation of antibody-producing cells in the immunocompetent organs (spleen, mesenteric lymph nodes) and the increase of the phagocytic activity of macrophages in peritoneal fluid. Cellular immunity factors were found to be important for the development of resistance to salmonellosis caused by S. typhimurium after oral immunization with the antigenic complex.


[Comparative evaluation of the functional activity of different immunoglobulin classes in cholera].

The immunological activity of specific immunoglobulins in different forms of cholera infection was studied with the use of the indirect immunofluorescent method. The forms of cholera infection were shown to be related to the physico-chemical spectrum of antibodies: patients with the pronounced clinical symptoms of cholera produced serum IgM, including antigen -- antibody complex, more actively and in a greater amount; patients with faintly pronounced and asymptomatic infection produce highly active IgG. The competitive action of immunoglobulins of different classes in their simultaneous reaction with O antigen of Vibrio cholerae is shown. The mechanism of the competitive action of different immunoglobulin classes is supposed to play some role in the process of the sanation (with highly active IgM) or detoxication (with highly active IgG) of the organism.


[Use of the systems approach in modeling the growth dynamics of a microbial biomass taking into account the cell division process].

The possibility of using systemic approach in the construction of the mathematical model allowing for changes in the biomass and the number of cells is shown. Definite rules were followed in the process of construction, calculations were made with the use of a computer. The satisfactory coincidence of rated and experimental data was achieved (in this instance, E. coli M17 were used).


[State of the nonspecific humoral factors of the body's natural resistance in patients with suppurative and septic infections having various ABO system blood groups].

The results of surveying 140 patients with severe purulent and septic infections of staphylococcal etiology, when compared with the distribution of the blood groups (as classified according to the ABO system) in 180 healthy donors, revealed that generalized purulent infections occurred most frequently in patients with blood groups A (II) and AB (IV), and more seldom in patients with blood groups O (I) and B (III). The average content of lysozyme, complement and normal antibodies to E. coli, as well as the average level of general bactericidal activity in the blood sera of the patients were considerably lower than in the blood sera of healthy donors; at the same time content of lysozyme, complement and normal antibodies in the blood sera of patients having different groups of blood did not reflect the degree of their predisposition or resistance to staphylococcal infections. The general bactericidal activity of the blood serum was found to correlate with the degree of predisposition or resistance to purulent septic infections of staphylococcal etiology to a greater extent than other characteristics.


Ontogenesis of the LH-RH-containing neuronal elements in the hypothalamus of the rat.

LH-RH-containing neuronal elements were detected earliest in the median eminence and in the vascular organ of the lamina terminalis of newborn rats. The peroxidase-labeled antibody method was used. Since the synthesis of the gonadotrophic hormones starts already on the 18th day of intrauterine life in the rat, this finding does not support the view that LH-RH could have inductive effect on the differentiation of the gonadotropic cells of the anterior pituitary gland.


[Small angle X-ray scattering studies on the structure and symmetry of yeast pyruvate decarboxylase in solution].

The holo-enzyme of the pyruvate decarboxylase EC 4.1.1.1 isolated from brewer's yeast was studied by small-angle X-ray scattering. The point-group symmetry 222 deduced from electron microscopic investigations was confirmed for molecules in solution. The best approximation of the overall shape of the enzyme was reached by an homogeneous triaxial ellipsoid, with the half-axes of a = 2.47 nm, b = 5.08 nm and c = 8.0 nm. The ellipsoid is halved vertical to the a-axis, and both halves are turned from each other by about 30 degrees. As an explanation of the existence of four binding sites for Mg2+ and thiamine pyrophosphate on the dimeric molecule the hypothesis of a gene duplication is discussed.


[Analysis of coordinate systems of intracerebral structures and optimization of sterotaxic computations for the posterior longitudinal approach to the hippocampus].

In studying the three-dimensional interrelationship of the thalamic and temporal systems of co-ordinates it was proved that one of them cannot be used in calculating the stereotaxic co-ordinates of structures associated with the other. In combined stereotaxic operations it is necessary to construct combined independent systems of co-ordinates. The possibility of exact construction of the co-ordinate systems of intracerebral structures depends to a great measure on the positive contrasting of the ventricular system.


[Comparison between single-radial-hemolysis-test and indirect fluorescence-antibody-test for the serological diagnosis of influenza].

Two serological methods for the diagnosis of influenza were tested with sera of guinea pigs and compared. Up to now, both methods have only rarely been used in the diagnosis of influenza. The methods proved to be well reproducible and suitable for routine investigations. Correlation between antibody titres measured by SRH and FAT give a correlation coefficient of v = 0.75. The possible IgG-specificity of the SRH, indicated in the literature, is reported.


Tinea versicolor and Pityrosporum orbiculare: mycological investigations, experimental infections and epidemiological surveys.

In patients with tinea versicolor, Pityrosporum orbiculare was cultured from tinea versicolor lesions in 100%, from normal-looking skin in 80%, and from apparently healed lesions in 69%. P. orbiculare was isolated from normal skin in 85% of patients with seborrheic dermatitis and in 90% of volunteers. The best substrate for isolation of P. orbiculare was a peptone-glucose-yeast extract medium containing glycerol monostearate and Tween 80, overlaid with olive oil. Germ tubes were produced when P. orbiculare was incubated in an atmosphere containing air with 7% CO2. Cultures of P. orbiculare and P. ovale did not show any fluorescence in Wood's light. The in vitro activity of miconazole, clotrimazole, econazole, sodium omadine, and sodium thiosulphate against P. orbiculare was found to correlate to the good clinical effect of these drugs in tinea versicolor. In addition several substances used as solvents or in vehicles had an inhibitory activity against P. orbiculare in vitro. Inoculation with P. orbiculare under plastic occlusion on the glabrous follicle-rich inside of the rabbit ear resulted in a tinea versicolor-like lesion after I week in 3 of 4 animals. One week after inoculation with P. orbiculare under plastic occlusion, experimental infections similar to those found clinically in tinea versicolor were seen in 10 of 12 patients with a history of tinea versicolor and in 3 of 6 normal volunteers. It was not possible to produce experimental infections without occlusion. Spontaneous healing usually occurred. In a retrospective study of 232 patients and prospective survey of 48 patients regarding susceptibility factors in tinea versicolor a higher (10.4%) than expected (3.8%) connection to seborrheic dermatitis was found.