Sensitivity of Pseudomonas aeruginosa to sulphonamides and trimethoprim and the activity of the combination trimethoprim: sulphamethoxazole.

The activities of three sulphonamides and trimethoprim against strains of Pseudomonas aeruginosa have been studied. Sulphadiazine had most activity, sulphadimidine had little, and the activity of sulphamethoxazole was intermediate. According to their sensitivity to sulphamethoxazole, strains were divided into two groups: "highly resistant" (16%, MIC greater than 1000 microgram per ml) and "moderately resistant" (84%, MIC less than or equal to 1000 microgram per ml). The former were resistant on disk testing to Sulphatriad 300 microgram. Sulphamethoxazole and trimethoprim did not act in synergy against them. The moderately resistant strains were sensitive to Sulphatriad; trimethoprim and sulphamethoxazole showed marked synergy against them in agar-plate dilution tests. The concentrations of trimethoprim and sulphamethoxazole necessary for synergy lay for each drug within the range of concentrations at which they have been found in urine, and the ratio of their MICs when acting in synergy was similar to the ratio of their concentrations in urine. It is suggested that a disk containing trimethoprim and sulphamethoxazole in a ratio of 1 : 2 rather than 1 : 20 would be more appropriate when testing strains from urine for their sensitivity to co-trimoxazole.


A solid phase assay with radioactively-labelled antibody for the detection of Brucella abortus.

An assay for the detection of Brucella abortus is described. IgG from rabbit antisera against live brucellae or brucella extracts was chemically linked to cellulose to form a solid phase reagent capable of binding brucella antigens present in buffer solutions or serum. After washing away any unbound material the presence of bound antigen was revealed by incubation with radioactively-labelled anti-brucella antibodies. The assay was capable of detecting less than 100 pg brucella antigen in a 20 microliter sample. Experiments in which IgG of non-related specificity was used in place of anti-brucella IgG showed that the test was specific. Normal human serum had only a slight inhibitory effect but anti-brucella antibodies were strongly inhibitory if present in the test sample. The extent of this effect and its relationship to antibody titre was investigated in 12 sera from brucellosis patients.


Inhibition of different serotypes of Listeria monocytogenes by enterocins in solid and liquid media.

Twenty-one enterocinogenic strains of enterococci were examined for their ability to inhibit 51 strains of Listeria monocytogenes belonging to eight different serotypes; 50 strains of L. monocytogenes were uniformly inhibited on solid media and in broth cultures by strains of Streptococcus faecium. However, only four strains of L. monocytogenes were inhibited by strains of Streptococcus faecalis, S. faecalis v. zymogenes or S. faecalis v. liquefaciens. Enterocin E1A prepared from the supernant fluid of S. faecium strain E1 rapidly killed sensitive cells of L. monocytogenes but did not lyse them.


Reversion of Kellogg's colonial types of Neisseria gonorrhoeae in liquid medium.

Colonial type variation of gonococci is well known, but change from type 4 to type 4 to type 1 is rare except in vivo. By observing quantitatively subcultures from a new liquid medium it was possible to follow the day-to-day changes in the ratio of colonial types present. The results obtained showed that type 1 colonies could be derived from type 5 inocula even in unsupplemented media. In unsupplemented liquid medium, type 4 inocula did not revert to other types and indeed colonial type 4 appeared to be the final form of the organism before it died out. If, however, iron in the form of ferric citrate was added to the medium, reversion occurred and type 1 colonies rapidly came to predominate.


A simple method for determining bacterial susceptibility to aminoglycosides.

A method is described of determining the susceptibility of enterobacteria to four amino-glycosides by means of an antibiotic diffusion method. The results are exose obtained by a method that involved titration in agar plates and the use of a multi-point inoculator. A statistical analysis showed that the diffusion method gave accurate reproducible results. The antibiotic can be incorporated into paper disks, paper strips or agar ditches and the calculation converting the measured zones of inhibition to MIC values is easily performed. The appropriate equation is derived from another--obtained from observations on a single strain of known sensitivity--describing the diffusion of the antibiotic from the reservoir.


Contribution of mucosal chloride to chloride in toad bladder epithelial cells.

Epithelial cells were scraped from the bladders of toads of the species Bufo marinus obtained from the Dominican Republic. These epithelial cells exchanged their chloride virtually completely with 36Cl i; the medium within 60 min. Of this chloride, about 93% came from the serosal medium. The approximately 20 mmole/kg dry wt of chloride which equilibrates with 36Cl in the mucosal medium was still present when choline replaced sodium in the medium in the presence of amiloride (10(-4) M) and was almost all readily removed by rapid washing of the mucosal surface immediately prior to analysis. These observations suggest that little chloride of mucosal origin is truly intracellular. This conclusion is supported by the fact that after vasopressin the increased cellular chloride was not of mucosal origin.


Structure and organization of radial spokes in cilia of Tetrahymena pyriformis.

The structure and organization of radial spokes, the principal components between each of the peripheral doublet microtubules and the central sheath which surrounds the central pair of microtubules have been described in Tetrahymena pyriformis cilia. The radial spokes are grouped in triplets and are attached to the A-microtubule of each peripheral doublet at intervals of 200/280/360 A, the 200 A spacing being most distal to the base of the cilium. The radial spoke triplets are organized in the axoneme in a double helix with a pitch of 4,680 A. A method for determining the helical disposition by correcting for doublet sliding is presented.


An ancient divergence among the bacteria.

The 16S ribosomal RNAs from two species of methanogenic bacteria, the mesophile Methanobacterium ruminantium and the thermophile Methanobacterium thermoautotrophicum, have been characterized in terms of the oligonucleotides produced by digestion with T1 ribonuclease. These two organisms are found to be sufficiently related that they can be considered members of the same genus or family. However, they bear only slight resemblance to "typical" Procaryotic genera; such as Escherichia, Bacillus and Anacystis. The divergence of the methanogenic bacteria from other bacteria may be the most ancient phylogenetic event yet detected--antedating considerably the divergence of the blue green algal line for example, from the main bacterial line.


Clonal behavior of a rat liver cell line and its modification by repeated treatments with a carcinogenic polycyclic hydrocarbon.

A rat liver cell line, Lew A1, was isolated from W/LEW rats. It had the normal female karyotype in the lower passage numbers, but in the higher passages it was aneuploid. This line was passaged 65 times, produced rat serum albumin, and consisted of an apparently homogeneous population of typical epithelial cells. The cells also had high levels of the inducible aryl hydrocarbon hydroxylase enzyme complex. A series of experiments described here defined the normal clonal behavior of this line and its modification by repeated treatments with a carcinogenic polycyclic hydrocarbon, 7,12-dimethylbenz[a]anthracene. The results were discussed with particular reference to metastasis, preneoplastic changes, and neoplastic progression.


Transplantable mammary tumors in Wistar/Furth rats: development, antigenicity, and effect of hormone manipulations.

Transplantable tumor lines were developed from 7,12-dimethylbenz[a]anthracene-induced mammary tumors in inbred WF rats. Although the primary tumors regressed following oophorectomy, the growth of late generations of the transplantable lines was not affected by castration or by treatment with estrogens, androgens, and progesterone. This result coincided with a change in the morphology of the tumors from well-differentiated to poorly differentiated anaplastic tumors. The transplantable mammary tumors were antigenic in vitro as evidenced by stimulation of syngeneic lymphocytes in mixed lymphocyte-tumor cell cultures. However, prior sensitization by excision of a first tumor graft failed to protect the animals against a second challenge with cells from the same tumor line.


Oncornavirus-like particles in squirrel monkey (Saimiri sciureus) placenta and placenta culture.

Oncornavirus-like particles similar in morphology to type D particles were observed in 1 of 2 squirrel monkey (Saimiri sciureus) placentas. Intracytoplasmic type A particles, immature virus particles, and mature viruses with eccentric or occasionally centric nucleoids were associated with placental syncytiotrophoblasts. A spike layer typical of type B viruses was not detected in viral envelopes. Onvornaviruses, identical to those previously isolated from squirrel monkey tissues and similar to Mason-Pfizer monkey virus, were seen in cultures derived from the virus-positive squirrel monkey placenta cocultivated with a mink lung culture. The major morphologic difference between the in vivo and the in vitro squirrel monkey virus was in the nucleoid position of mature virus particles.


Selective hyperalimentation: a new look at an old problem.

Safe and consistently reliable parenteral hyperalimentation in the care of the critically ill or injured remains an unrealized expectation. Our experience with critically ill patients managed with standard 25% dextrose/4.25% protein hyperalimentation solution (S.H.A.) delivered through a centrally placed catheter demonstrated that S.H.A. was associated with a high catheter infection rate, fluctuations in hyperosmolar tolerance, unstable insulin requirements, and a high discontinuation rate. In retrospect this unsatisfactory experience resulted from the inappropriate assumption that a single type of nutritional support and delivery system could meet the varying metabolic requirements of the critically ill or injured. In an effort to reduce these complications, we have recently utilized a system of selective hyperalimentation in managing 25 consecutive patients. We now identify specific risk factors for groups of patients and use these factors to select the appropriate rout and solution. Selective hyperalimentation has resulted in a lowering of infusion complications and an improvement in completion rate, with satisfactory weight gain and protein response. These results suggest that our approach is sucessful in meeting the nutritional requirements of differing groups of critically ill patients without exposing upsuitable candidates to the potential risks of standard hyperalimentation.


[Essential diet in extensive cervico-facial surgery].

A prospective nutritional study was undertaken on 26 patients submitted to pharyngo-laryngectomy with pre-operative irradiation. Three diets were compared, given through a naso-gastric Levine tube. The first diet being the hospital blenderized diet, the second one Flexical, and the third one, Flexical Control. There was no significant difference between Flexical and Flexical Control, but the biological parameters and the clinical evolution militate in favor of a widespread use of the Flexical method. The authors recommend the use of controlled defined diet as compared to the hospital blenderized diet and the more sophisticated and more expensive method as the intravenous hyperalimentation.


Identification of the cell wall receptor for bacteriophage E79 in Pseudomonas aeruginosa strain PAO.

Bacteriophage E79 was shown to interact with the lipopolysaccharide (LPS) of Pseudomonas aeruginosa strain PAO. LPS isolated from an E79-sensitive, smooth strain inactivated the phage, exhibiting a Phl50 value (concentration of LPS that caused a 50% decrease in the titer of phage during 1 h of incubation at 37 degrees C) of 0.04 microgram/ml, whereas the LPS isolated from a rough mutant derived from the wild type showed no neutralizing activity towards E79. EDTA and sodium deoxycholate were demonstrated to abolish the neutralizing capacity of the smooth LPS. One E79 receptor site was shown to be equivalent to 10(-16) g of LPS.


Inhibition of lytic induction in lysogenic cyanophyces.

When the lysogenic strain SPIcts1 of the blue-green alga Plectonema boryanum carrying a temperature-sensitive mutation in the LPP2 prophage was heated at a nonpermissive temperature in the light, a lytic cycle occurred, with production of infectious viral particles. Inhibitors of transcription, translation, and photosynthetic functions interfered with this process and produced different effects when administered at different phases of the viral cycle. The presence of the inhibitors during the temperature shift did not allow a successful induction to take place; lysogens submitted to such a process produced a normal virus yield, however, when the drugs were removed and the temperature was shifted again. Incubation with the inhibitors during the early postinduction period reduced the virus yield; at later times, however, the inhibitory action rapidly declined. When cells were induced in the presence of chloramphenicol, incubated with actinomycin, and then grown in the dark, at either permissive or nonpermissive temperatures, virus multiplication was equally inhibited. These data indicate that: (i) provirus induction in lysogenic cyanophyces relies on the synthesis of early viral proteins; (ii) induction of mRNA is unstable and becomes rapidly inactivated when its translation is prevented; and (iii) inhibition of photosynthesis prevents the induction message from being expressed. It is suggested that the SPIcts1 prophage codes for a mutated repressor, which is reversibly inactivated at a nonpermissive temperature, and that the repressor must be inactivated at the same time that the message coded for by very early genes is translated, for a successful induction of the lytic cycle.


Transcription of the genome of bacteriophage phi 29: isolation and mapping of the major early mRNA synthesized in vivo and in vitro.

The phi29 early mRNA's synthesized in infected Bacillus subtilis were studied by using sedimentation velocity analysis, polyacrylamide gel electrophoresis, and hybridization of phi29 DNA fragments generated by the restriction endonuclease Eco RI. Viral RNAs synthesized in vivo in the resence of chloramphenicol were found to hybridize to Eco RI-A, -C, and -D fragments, but not to Eco RI-B and -E fragments, of the viral genome. Major early mRNA sedimenting as 16S material in neutral sucrose gradients was examined in detail. Radioactive phi29 RNA, purified by sucrose gradient centrifugation, was hybridized to either the Eco RI-A or Eco RI-C DNA fragment. The RNA was eluted from the hybrids and then tested for complementary hybrid formation with Eco RI-A and -C fragments. RNA eluted from the Eco RI-A fragment annealed only to the Eco RI-A fragment and not to the Eco RI-C fragment. Similarly, RNA eluted from the Eco RI-C fragment hybridized to the Eco RI-C and -D fragments. Viral RNAs synthesized in vitro using B. subtilis RNA polymerase hybridized to both Eco RI-A and -C DNA fragments. Furthermore, RNA initiated with [gamma-(32)P]GTP also hybridized to both Eco RI-A and -C fragments. These results indicate that there are at least two efficient promotors for early transcription on the phi29 chromosome. In addition, a low-molecular-weight RNA initiated with [gamma-(32)P]ATP was found to hybridize exclusively with the Eco RI-A fragment. Kinetic studies of phi29 mRNA synthesis during the lytic cycle have shown that viral RNAs hybridizable to the Eco RI-A and -C fragments are synthesized immediately after phage infection. On the other hand, mRNA specific for the Eco RI-B fragment was not synthesized for several minutes after phage infection. Based on the results of the in vivo and in vitro transcription studies, a transcription map of the phi29 chromosome is proposed.


Heat-inducible mutants of corynebacteriophage.

Heat-inducible mutants of temperate cornebacteriophage beta and gamma, called temperature-sensitive repression (tsr) mutants, were isolated and characterized. Lysogens carrying these mutants were induced at 38 degrees C, produced a normal or slightly increased yield of phage, and underwent extensive lysis at this temperature. In some cases mutation to heat inducibility had altered the UV inducibility of the phage, the changes ranging from loss to enhancement of this trait. Complementation tests showed that all five beta-tsr strains had mutated in the same cistron and suggested that these mutations were in the gene responsible for repressor production.


Bacteriophage production by doubly lysogenic Corynebacterium diphtheriae.

Parental and recombinant phage production by tandem, double lysogens of Corynebacterium diphtheriae was studied in strains in which the coupling of prophage markers and the order of prophage was established. The results from studies of mass lysates and single bursts showed that the recombinant class of phage, designated R1, was predominant in UV-induced lysates followed by the parental, P1 class and to a lesser extent the P2 and R2 classes. Single bursts of UV-treated cells contained phage from one to all four of the phage classes, and this appeared to reflect the action of two excision processes. The data indicate that recombinant phages R1 and R2 are formed by a process of general recombinational excision and that this is the primary event leading to phage production in both UV-irradiated and spontaneously induced double lysogens. This process, which depends on exchange between homologous genes and is reciprocal, accounts for the excision of R1 phage from the host chromosome. A second excision process, probably site-specific excision, also occurs in many of the same cells and accounts for the excision of P1, P2, and R2 phages. The significance of these results for the spread of toxinogenicity in strains of C. diphtheriae is discussed.


Studies of introital colonization in women with recurrent urinary infections. VIII. The role of bacterial interference.

The non-pathogenic aerobic bacteria in 97 quantitative introital cultures from 11 women with documented recurrent bacteriuria were compared statistically to those in 100 quantitative introital cultures from 10 control women with no history of bacteriuria. The colonization incidence of the non-pathogenic organisms was not statistically different for the 2 groups, except for gamma hemolytic Streptococcus (p equals 0.002). No strongly significant correlations were demonstrated between the colonization incidence of Enterobacteriaceae or enterococci and the colonization incidence of the common non-pathogenic organisms, when analyzed for the bacteriuric and control groups or when analyzed for the individual cultures of each subject. A quantitative analysis of the 197 individual cultures failed to establish correlations between the presence of the common non-pathogenic organisms and Enterobacteriaceae or enterococci. The susceptibility of the vaginal introitus to colonization by urinary pathogens cannot be explained by interrelationships between these pathogens and the normal aerobic vaginal flora.


Origin of seizures in elderly patients.

Among 50 previously well patients, aged 69 years or older, who had a first seizure, a cause could be identified in only 25 (50%). Cerebrovascular disease accounted for the seizures in 30% of the total group. Only one tumor was found. Treatable causes were found in 20%. In 25 patients (50%), a cause could not be identified. A total of 56% of the patients had focal motor seizures, and in 44%, the seizures were generalized. A definite cause could be established in 57% of those with focal seizure and in 41% of those with generalized seizures. These results are compared with previous surveys of adult-onset epilepsy and indicate a somewhat different etiologic distribution in elderly patients.


Comparison of erythromycin base and estolate in gonococcal urethritis.

A randomized double-blind trial of 152 men with gonococcal urethritis compared the therapeutic efficacy of erythromycin estolate and erythromycin base. Twenty-one of 86 (24%) men treated with the estolate and 15 of 66 (23%) treated with the base had recurrent or persistent gonococcal infection when seen after a 9-g course of erythromycin. The serum erythromycin activity among estolate-treated patients (3.57 +/- 0.84 microgram/ml) was nearly twice that for base-treated patients (1.76 +/- 0.80 microgram/ml). Our findings do not support routine use of erythromycin for treatment of pregnant, penicillin-allergic patients.


Parenteral nutrition with lipids.

Total parenteral nutrition with a peripherally administered fat emulsion as the major calorie source appears to be efficacious and safe. Such a regimen complements rather than replaces the glucose system an an important adjunct in patient therapy. The lipid system obviates the necessity for central venous administration, the major disadvantage of the glucose system, while the latter provides a greater caloric density.


Respiratory distress syndrome and the value of amniotic fluid phospholipids in predicting such complications before birth.

The amniotic fluid study of 80 samples from 40 patients, obtained by amniocentesis between 28 and 40 weeks of pregnancy, was carried out. It was noted that L/S (Lecithin/Sphingomyelin) ratio was significantly different at 36-38 weeks of pregnancy when compared with values in pregnancies of less than 36 weeks gestation (P less than 0001). No cases of RDS occurred when the L/S ratio was mature 4 or more. A brief review of recent developments in etiology of RDS are also presented.


A study of newborn infants at Jinnah Postgraduate Medical Centre, Karachi.

A study was carried out of 3165 newborn infants delivered consecutively from January to December, 1973 in the Department of Obstetrics, Jinnah Postgraduate Medical Centre, Karachi. A prematurity rate of 24.3% and a perinatal mortality of 96/1000 was observed. The incidence of congenital defects was 2.5%. Study of high risk infants showed an average fasting blood sugar in infants of diabetic mothers at 65.9 mg% and none had hypoglycaemia symptoms. A high prematurity rate was found in infants of mothers with Anaemia (39%), Toxemia (43%) and Jaundice (73%). The incidence of congenital malformations was 8.5% in the infants of diabetic mothers.


[Mechanism of nitroglycerin action].

Data are presented on the effect of nitroglycerin upon the intracardiac haemodynamics studied by means of echocardiography in normal individuals and in patients with ischaemic heart disease. Three types of changes in the intracardiac haemodynamics under the effect of the drug were revealed. The possible mechanism of action of nitroglycerin is discussed in the light of the obtained data.


[Indomethacin induced corneal deposits (author's transl)].

After a summary of corneal changes, caused by drugs (gold, Chloroquine, Phenothiazines, Amiodaron), a personal case of indomethacin induced deposits is described. The chief characteristic was was a ring-shaped formation of the grey-whitish lines in the epithelium. A retinopathy was not present.


[Studies of lysozyme activity in serum, urine and blood smears from patients with haematological diseases].

Lysozyme activity was studied in blood smears, serum, and urine of patients suffering from leukaemia or other haematological diseases. Increased enzyme activity was found in myelocytic, myelomonocytic and monocytic leukaemia and equally in secondary granulocytosis and polycythaemia vera. Reduced rates were found in lymphocytie leukaemia, malignant lymphoma with bone marrow involvement, and myelophthisic conditions. A rise in urinary lysozyme occurred when the serum level exceeded 50 microgram/ml. Abundant activities were found in myelomonocytic and monocytic leukaemias. Using the bacteriolytic method in blood smears, no enzyme activity was demonstrated in cells of acute or chronic lymphocytic leukaemia, in monocytic leukaemia however, almost all cells show strong reaction. In acute myelocytic or myelomonocytic leukaemia, the portion of positive cells changes from case to case depending on the degree of cell differentiation and maturation. In chronic myelocytic leukaemia there was no difference as compared to enzyme activity of myelocytes in bone marrow of control cases. Thus the bacteriolytic demonstration of lysozyme in blood smears may additionally contribute to distinction of different types of blastic leukaemias, and serum lysozyme also may allow more reliable insight into granulocytic and monocytic myelopoiesis than morphologic studies of blood or bone marrow smears can do, e.g. in agranulocytosis and pancytopenia.


Studies on alkaline phosphatase activity cultured cells from a patient with fibrodysplasia ossificans progressiva.

The cytoplasm of tumor cells from a subdermal nodule in a patient with fibrodysplasia ossificans progressiva (FOP) exhibited intense enzymatic activity in cryostat sections processed for demonstration of alkaline phosphatase. Nuclear heterochromatin and nucleoli, particularly in the area of the dense component, also showed strong reactivity. Finely minced blocks from the lesion of the patient with FOP revealed lighter reactivity which, in the tumor cells, avoided membrane limited spaces and appeared to be confined to hyaloplasm. Extracellular spaces disclosed very little or no reactivity and specimens from the patient's uninvolved skin lacked staining. The tumor cells from the subdermal nodule did not exhibit increased acid phosphatase activity. Cells (L-FOP) derived from a subdermal nodule and grown by tissue culture techniques also synthesized large amounts of prostaglandin E-like material and alkaline phosphatase. The amounts of prostaglandin E-like material synthesized by these L-FOP cells was reduced by more than 31 per cent by the antiinflammatory drugs indomethacin and sodium meclofenmate. Also, the production of alkaline phosphatase by these L-FOP cells was reduced by more than 40 per cent by ethane-1-hydroxyl-1,1-diphosphonate. Addition of prostaglandin E to nonlesion cells did not result in increased alkaline phosphatase activity.


Effects of the combination of tumor-specific and nonspecific immunization on tumor suppression.

The crushed whole Aoyama B cells attached to oil droplets were found to be most suitable for the adjuvant effect of Mycobacterium tuberculosis against tumor growth when judged by the criterion of effectiveness and a clinical application with minimal side effects. The immunogenicity of tumor cells was well stabilized and maintained with a suitable concentration of formalin; this was less than 1% and the optimum concentration was 0.05% or 0.1%. When the tumor cells treated with the optimum concentration of formalin were combined with suitable adjuvant, immunoprotection against the tumor progress was accelerated.


[The medical management of malabsorption (author's transl)].

A broad overview of the modalities available for the medical treatment of malabsorptions is presented with emphasis on practical applications. The more common disorders, such as sprue, lactase deficiency, and pancreatic insufficiency, are generally managed successfully with specific dietary and drug regimens. Nonspecific dietary therapy is available for patients to whom specific therapy cannot be offered.


Biosynthesis of prostaglandins.

Highly purified cyclooxygenase from sheep vesicular glands is stimulated by the presence of protoporphyrin IX compounds. This stimulation may be due to the conversion of an apoenzyme to the holoenzyme, and full activity is achieved when half of the enzyme subunits (70,000 daltons) bind heme. Also, one-half of the subunits appear to contain non-heme iron. The apparent molecular weight of the holoenzyme is approximately 300,000 daltons and is compatible with a complex of four 70,000 dalton subunits. Thus, we suggest that heme and non-heme iron may be attached to different 70,000 daltons subunits that make up an A2B2-type of peptide chain arrangement.


[Effect of EDTA on the activity of aminolevulinic dehydratase in vitro and in vivo].

To blood samples taken from persons who are not exposed to the effect of lead, ions Pb++ were added. Then lowering of the activity of aminolevulinic dehydratase (ALAD) in proportion to an amount of lead added was observed. Parallel introduction of ions Pb++ and EDTA prevented a significant lowering of ALAD activity. The persons who were exposed to chronic effect of lead, with a lowered activity of ALAD, were given EDTA, as a treatment. Significant increase in the form of doubled activity of the enzyme occurred in the period between 8-16 day of treatment.


[Amylase formation in a periodic and continuous culture of Bacillus subtilis].

The dynamics of alpha-amylase production by two strains of Bacillus subtilis (A32 and A32.6) was studied under periodic and continuous conditions of cultivation on a chemically defined medium and on a natural medium. In the periodic culture, the highest activity of the enzyme was found during the stationary growth phase. In the conditions of chemostat, as the dilution rate from 0.05 to 0.15 hr-1, the activity of amylase remained at the same, high level for a certain lapse of time and then decreased. The rate of the decrease of alpha-amylase activity depended on the dilution rate.


[Epiphase carotenoids of the blue-green alga Anabaena variabilia].

Epiphase carotenoids were studied in the cells of the obligate phototrophous blue-green alga Anabaena variabilis. Ten pigment zones were detected by column chromatography on alumina and by TLC on cellulose and Silufol UV-254 plates. TLC in the B layer and paper chromatography did not reveal all pigment zones obtained on a column. The data of TLC on cellulose and on Silufol plates confirmed the purity and individual character of the fractions obtained on a column. These data showed also that the pigments obtained upon the separation of the extract on a column were not the products of its interaction with an active adsorbent. Absorption spectra of the isolated pigments were determined in various solvents, and speculations were made concerning the structure of the carotenoids.


[Structure and cell division of the blue-green alga Plectonema boryanum].

Our data on the structure of the blue-green alga Plectonema boryanum, as well as the analysis of the data of other authors, show that its cells resemble bacterial cells in the basic features of their fine structure (the cell wall, cytoplasmic membrane, nucleoid, membraneous formations, ribosomal apparatus). Besides the organelles typical of blue-green algae, organelles similar to mesosomes and formations looking like lysosomes were found in Pl. boryanum. Data obtained in the course of the formation of cell partitions evidently speak in favour of the many-sided activity of the lamellae of the photosynthetic apparatus (the parachromatophore) of Pl. boryanum.


[Comparative study of the multiplicity of exoenzymes produced by different strains of Bacillus subtilis].

Molecular forms of two exoenzymes, subtilisin and alpha-amylase, produced by mutants of Bacillus subtilis were studied. The degree of the post-translational modification of subtilisin was less pronounced for P and M mutants than for R mutants. Some of the P and M mutants produced subtilisin having higher molecular weight and hydrophobicity as compared to the R mutants. This form of subtilisin may be the primary product of translation of the structural gene and therefore a precursor of subtilisin. Its appearance outside the cell may be due to the alteration in the cell surface structures in the P and M mutants and abnormal post-translational modification. The P and M mutants produced also differing exocellular proteins as compared to the R mutants, e.g. alpha-amylase forms with the higher isoelectric points.


[Carbonic anhydrase activity of phototropic bacteria].

The activity of carboanhydrase was assayed in seven species of phototrophous bacteria: three species of the Rhodospirillaceae genus, three species of the Chromatiaceae genus, and one species of the Chlorobiaceae genus. The activity of carboanhydrase was found in five species among seven. It decreased on passing from photoautotrophous to photoheterotrophous conditions of growth, and then to dark heterotrophous conditions, which correlated with the activity of the Calvin cycle in the bacteria. No activity of carboanhydrase was detected in Ectothiorhodospira shaposhnikovii and Chlorobium limicola, probably because Chl. limicola fixed carbon dioxide not in the Calvin cycle, but in the reactions of reductive carboxylation of organic acids.


[Characteristics of phages of spore-forming bacteria isolated from the soil].

Phages lyzing spore forming bacteria were isolated from soil, and their biological properties and fine structure were studied. The spectrum of lytic activity was determined as well as parameters of the intracellular phage growth. The burst size of the phage varies from 8 to 725 particles per infected cell, the latent period lasts 25-100 min for various phages. According to the data of electron microscopy, the phages are divided into three morphological groups. The phages Tg7, AR13 and BPP10 have a complex structure.


Carriage of non-toxigenic Corynebacterium diphtheriae by Australian Aboriginals.

A survey of 200 Aboriginals in Western Australia revealed five carriers of non-toxogenic Corynebacterium diphtheriae; four of these were variety mitis and one was variety gravis.


Isolates of Pseudomonas aeruginosa from Australian hospitals having R-plasmid determined antibiotic resistance.

Six hundred and fifty hospital isolates of Pseudomonas aeruginosa from Australian sources have been examined for high-level resistance to a number of antibiotics. Fifty-four strains were resistant to one or more of the antibiotics, and four of these strains carried as R-plasmid conferring resistance to streptomycin, tetracycline and sulphanilamide, and belonging to incompatibility group P-2. Possible reasons for the low incidence of R-plasmids in P. aeruginosa from Australian sources are discussed.


Language acquisition: the new synthesis.

Developments concerning the nature of language have taken place in the disparate disciplines of linguistics, ethology and neurology. It is not widely known that these developments have brought these fields of study into accord, and have helped clarify the mechanism of language acquisition in childhood. They carry practical implications important to the teaching of language and to the understanding of language disabilities. The conclusions have also led to the discovery of cranial vault asymmetries which promise insight into the evolution of language in man's prehistory. The learning of language has become better understood as a result of recent developments in the fields of linguistics, ethology and comparative neurology.


Insufficient conjugate glucuronidation activity: a possible factor in polychlorinated biphenyl (PCB) toxicity.

Considerable evidence indicates that phenolic and biphenolic compounds are detoxified and excreted primarily via conjugate glucuronidation in man. Since fetuses, neonates and certain enzyme deficient adults have significant functional deficiencies in their capacities to excrete toxic compounds via conjugate glucuronidation, it is predicted that these groups of individuals are biochemically predisposed to accumulate polychlorinated biphenyls (PCB's), a widely distributed and highly toxic environmental contaminant.


Biolized intrathoracic left ventricular assist device (LVAD).

The design of an intrathoracic left ventricular assist device (LVAD) is briefly described. The unique feature of the LVAD is that all blood-contacting surfaces are biolized, having either chemically treated natural tissues or protein coatings. The blood-contacting surface of the housing is glutaraldehyde-treated pericardium and is covered with natural rubber and polyurethane. Tri-leaflet valves fabricated from human dura mater are used at the pump inlet; glutaraldehyde-treated bovine aortic valves are used at the outlet. The pumping diaphragm, made of polyolefin rubber with a textured surface, is coated with gelatin and treated with glutaraldehyde. Anticoagulants are not used with this device. Extensive in vivo and in vitro testing in the development of the pumps led to the current configuration having good performance, long life, and improved blood compatibility.


The use of modified human umbilical cord vein in femoral popliteal reconstruction.

Glutaraldehyde-tanned human umbilical cord veins were employed for reconstruction of the femoral popliteal segment in 80 instances. The primary indication for surgery was imminent loss of limb. The cumulative patency to 20 months was 84.8 percent. The primary mechanism for graft failure was thrombosis usually due to progressive atherosclerosis of the distal circulation (6 cases). There were no instances of infection, dilatation of the graft or aneurysm formation. The data indicate that the results obtained when the glutaraldehyde-tanned umbilical vein in femoral popliteal location are comparable and perhaps even superior to those obtained with the saphenous vein. This suggests that this graft material will be applicable as avascular prosthesis in many instances and will provide for limb salvage and function in patients who face potential loss of limb.


The genetic organization of arginine biosynthesis in Pseudomonas aeruginosa.

Six loci coding for arginine biosynthetic enzymes in Pseudomonas aeruginosa strain PAO were identified by enzyme assay: argA (N-acetylglutamate synthase), argB (N-acetylglutamate 5-phosphotransferase), argC (N-acetylglutamate 5-semialdehyde dehydrogenase), argF (anabolic ornithine carbamoyl-transferase), argG (argininosuccinate synthetase), and argH (argininosuccinase). One-step mutants which had a requirement for arginine and uracil were defective in carbamoylphosphate synthase, specified by a locus designated car. To map these mutations we used the sex factor FP2 in an improved interrupted mating technique as well as the generalized transducing phages F116L and G101. We confirmed earlier studies, and found no clustering of arg and car loci. However, argA, argH, and argB were mapped on a short chromosome segment (approx. 3 min long), and argF and argG were cotransducible, but not contiguous. N-Acetylglutamate synthase, the enzyme which replenishes the cycle of acetylated intermediates in ornithine synthesis of Pseudomonas, appears to be essential for arginine synthesis since argA mutants showed no growth on unsupplemented minimal medium.


Comparative studies of RNA polymerase subunits from various bacteria.

The molecular structure of RNA polymerases from Escherichia coli, Salmonella typhimurium, Salmonella anatum,serratia marcescens, Aerobacter aerogens, Proteus mirabilis and Bacillus subtilis were compared based on:i) inhibition of the enzyme activity by treatment with antibodies against E. coli RNA polymerase subunits;ii) analysis of antibody precipitates by sodium ododecyl sulfatepolyacrylamide gel electrophoresis; and iii) analysis of antibody precipitates by urea-isoelectrofocusing followed by sodium dodecyl sulfate-slab gel electrophoresis in the second dimension. All the bacterial RNA polymerases examined cross-react equally with anti-E. COLI HOLOPOLYMERASE BUT EXHIbit different extents of cross-reaction with antibodies against individual subunits. Except for B. subtilis RNA polymerase, the molecular weight and isoelectric point of the enzyme subunits are close to those of E. coli polymerase. However, minor difference were found at least within the resolution of the techniques employed:S. anatum polymerase has sigma subunit larger than E. coli sigma subunit; P. mirabilis enzyme has sigma subunit larger in size and more acidic in charge, and alpha subunit smaller and more basic than corresponding E. coli subunits. The electrophoretic map of B. subtilis enzyme subunits is completely different from that of E. coli enzyme.


[Prescreening methods for gynecological cytology (author's transl)].

In cytological investigations to trace gynecological cancer a large number of preparations must be examined in order to discover a small number of positive and suspicious findings. In 1974, 5.5 million investigations were carried out in the German Federal Republic, of which 2% positive, 9.2% suspicious and 2.4% technically useless cytological results were obtained. 98.64% of the cytological results were negative. Consequently in different parts of the world efforts are being made to automate the preliminary microscopic sampling of the cytological preparations. False negative cytological findings must be no higher than in conventional diagnosis (without extraction error approximately 5%), while false positive cytological findings (in conventional diagnosis less than 1%) may be higher, because they can be classified correctly on subsequent assessment.


[Postpartum contraception: effect of lynestrenol during the lactation period (author's transl)].

167 women were treated with 0.5 mg lynestrenol/day for a period of 8-32 weeks immediately postpartum. The lactation periods of 67 of the women were observed during the stay in hospital (maximum 7 days) in comparison with a control group (n = 20) of untreated women in the puerperium. There was no quantitative difference in milk production between the lynestrenol-treated women and the control group. In order to exclude a possible thromboembolic effect the lynestrenol the thrombocyte aggregation was determined in all women at 4-weekly intervals as a measure of a thrombotic tendency. During the entire period of the investigation the mean PAT rating remained between I and II. Among the clinical parameters a raised amenorrhea rate of 21% and a larger proportion (39%) of breakthrough bleedings were notable. The responded easily to treatment.


[Anticonvulsants and simultaneous medication - a problem in pregnancy (author's transl)].

As more recent investigations have shown, many women regularly take drugs not prescribed by the doctor during pregnancy, in addition to those that are. It is not always a matter of diseases which require treatment. It is shown, with reference to a number of patients, that unproblematic longterm anticonvulsant therapy - with years practically free from attack - can be complicated by pregnancy. During an essential treatment with multiple drugs made necessary by the pregnancy, 6 attacks of grand mal were recorded in 6 months and sometimes very low serum DPH concentrations were found in spite of reliable, high doses of Zentropil.


[Patient's opinions on doctors' explanations (author's transl)].

An inquiry by means of a questionnaire among 1043 persons (566 in-patients, 269 employees of industrial firms, 208 teachers) revealed: 32.5% were "often not" and 26.5% were "nearly always" satisfied with the medical information provided by their doctors. They were mainly interested in the causes of complaints (77.7%), in the prognosis (66.4%), in the effect of the medicament (44.5%) and in the diagnosis, using technical terminology (37.7%). Nearly all of them wanted to know about the contents of the specialist's report: 35.5% would like to read the report for themselves and 61.4% wanted an intelligible explanation by the family doctor. In incurable malignant disease, 49.5% preferred the patient to be fully informed, whereas 24.4% wanted information about a serious illness which might lead to death. Other questions concerned the information of relatives and between doctors.


[Iron or combined iron-folic acid-vitamin B12 therapy during pregnancy? (author's transl)].

128 women with mild anemias below 12 g% Hb received 100 mg iron or 100 mg iron, 0.44 mg folic acid and 0.66 mg vitamin B12 daily from the 20th to the 24th weeks of pregnancy until confinement. With pure iron therapy the maternal hemoglobin, erythrocyte, hematocrit and serum levels rose significantly, whereas in the placebo group (37 pregnant women) they fell markedly. Iron-folic acid-vitamin B12 administration led to no improvement in the hemoglobin regeneration or in the serum iron. After 60 days' treatment with the combined iron preparation, a rise in the serum and erythrocyte folate levels had already been achieved in the pregnancy women.


[Hypertrophic cardiomyopathies (author's transl)].

Because of their rapidly changing hemodynamic inconstancy depending on many, sometimes competing, processes, hypertrophic cardiomyopathies present a clinical picture extraordinary among the cardiac diseases, with severely altered diastolic compliance of the left ventricle and a functional stenosis in the obstructive forms. They are of increasing importance for the doctor in hospital or general practive, particularly because they are among the very few diseases in which the usual cardiac therapy with digitalis or else the administration of sympathomimetics is contraindicated.


[Continuous monitoring of the pulmonary artery pressure in acute myocardial infarction (author's transl)].

The method of continuous pulmonary artery pressure (PAP) monitoring and its use in 66 patients with acute myocardial infarction is described. Measurement of PAP should be the first diagnostic step in hemodynamic monitoring and early recognition of left ventricular failure. In cases of elevated PAP and critical general state of the patient, monitoring should be extended by measuring pulmonary wedge pressure and cardiac output. Hemodynamic monitoring should be continued for 3 to 5 days, since some cases of acute myocardial infarction with increasing PAP up to the 4th day after the onset were recorded. With the safety precautions mentioned, neither threatening, arrhythmia, nor thromboembolic or septic complications were observed.


[Rheocardiography in the orthostatic test (author's transl)].

Cardiac output and peripheral flow resistance were determined rheocardiographically under resting conditions and in orthostasis in 175 patients who came for examination to clarify circulatory disturbances with suspected orthostatic dysregulation. The method was examined critically and compared with other procedures. Different modes of reaction in the cardiovascular system were portrayed and their importance for therapy is indicated.


[Clinical trial of Trental 100 in patients with peripheral arterial occlusive diseases (author's transl)].

The preparation Trental 100 was given to 73 patients in a vascular surgery department at a daily dose of 2-3 dragees over an average of 2-3 months. 51 of 67 patients with chronic arterial disorders of the lower extremities and 5 of 6 patients with circulatory disturbances in the brachial region improved, as measured by the walking distance, reactive hyperemia time, pain at rest and effect in tissue defects. Tests for objective tolerance showed no effects on the blood picture, liver and kidney functions and carbohydrate metabolism. In a few patients, subjective intolerance disappeared after reducing the dose.


[History-taking in neurology (author's transl)].

History-taking in neurology is particularly favored by the fact that the disease processes occur at or in structures which underlie direct sensation and perception. No-one can so exactly report on disturbances of seeing, hearing, feeling, smelling, tasting, and equilibrium as the patient himself. But the personality of the observer is particularly involved: Is he minimizing, dramatizing, or are there changes in the cerebral cortex? For this reason the statements of relatives have special importance, particularly in convulsions and in the matter of personality changes.


[Applied neurochemistry (author's transl)].

Metabolic disorders may also be accompanied by neurological symptoms. Diagnosis is ofter difficult because clinical opportunities are rare. But some things can be detected even by simple means. In particular, primary biochemical disturbances are discussed, insofar as they may have an unfavorable effect on the nervous system. Among these are hypoglycemia, hyperglycemia, cerebral nutritional disorders, phenylketonuria. Wilson's disease, folic acid deficiency and acute intermittent porphyria.


[Bioptic investigations of the nervous system (author's transl)].

Bioptic investigation of nervous tissue can be made by taking tissue samples of nerves, skin, muscle, rectum, dental pulp and brain. The choice of site for the biopsy depends on the results of previous clinical neurological, neurophysiological and biochemical investigations. Indications are: unexplained peripheral neuropathies, progressive degenerative diseases of the central nervous system and enzymopathies which are principally manifest in the nervous system (neurometabolic diseases). The result of a nerve tissue biopsy usually only leads to classification in a disease group (pathogenic unit) which only becomes diagnostically relevant in conjunction with the clinical data. In biopsies of the brain a virological examination should always be performed in addition to the morphological (light and electron microscopic) and biochemical investigation.


[Neuroophthalmological diagnosis today (author's transl)].

The standard investigations in neuroophthalmological diagnosis (inspection of the eye for accomodation, determination of visual acuity, perimetry, ophthalmoscopy) are compared with special methods of investigation. Echography and computer tomography in orbital diseases and fluorescence angiography as a differential diagnostic aid in pathological findings in the papilla are dealt with in detail.


[Reduced radiation sensitivity of hyperthyroid goiter with endocrine ophthalmopathy (author's transl)].

The therapeutic success of fractionated radioiodine treatment of hyperthyroid patients with and without endocrine ophthalmopathy is examined. To achieve a stable euthyroid metabolism, patients with endocrine ophthalmopathy generally need a greater number of treatments with a necessarily higher total dose of radioiodine and longer duration of treatment than hyperthyroid patients without endocrine ophthalmopathy. The average age, the average uptake of 131l and the serum concentration of free T4 were comparable in both groups of patients. A struma nodosa was more frequently found in the group of hyperthyroid patients with endocrine ophthalmopathy than in hyperthyroid patients without exophthalmus.


[Studies on the clinical application of peritoneography (author's transl)].

Peritoneography is the radiological presentation of the peritoneal cavity or a part of it. In 20 patients a water-soluble contrast medium (Urovison for infusion 30%, 500 ml) was injected after addition of indifferent infusion solutions, or the contrast medium was mixed with the ascitic fluid remaining in the cavity after abdominal puncture of patients with ascites. In all 20 patients the diaphragm and the liver or its right lobe, in 16 patients (50%) the spleen, in 8 patients (40%) the right kidney and in 5 patients (25%) the fundus of the gall bladder could be defined. The filling of hernial sacs, outlining extraluminal tumors and the subphrenic space are considered to be the most important clinical indications for this simple and harmless method investigation.


[The significance of intraoperative bacteriological findings in operations on the gallbladder and biliary tract (author's transl)].

The symptomless bacterial contamination of the biliary tree is apt to be the origin of general or local postoperative complications. The present retrospective study of 369 bilary operations with intraoperative bacteriologica investigations yielded the following results: septic wound complications were found in 9% of the cases with bacteriocholia against 3.5% in the cases with abacterial bile. In geriatric patients with complicated gallstone disease the bacterial contamination of the bile exceeds 50% of all cases. The importance of an adequate antibiotic treatment for this group, starting intraoperatively, is stressed.


[Allergic vasculitis with arthritis due to bactrim allergy (author's transl)].

A new type of Bactrim allergy is reported for the first time. purpura caused by allergic vasculitis together with arthritis occurred in a 71-year-old man. Thrombocyte counts and global coagulation were normal.


[The effect of Aspisol on platelet function after vascular surgery (author's transl)].

We found increased aggregation of thrombocytes in more than two thirds of the patients with vascular processes referred to us for vascular reconstruction. But even in patients with normal preoperative thrombocyte aggregation (control group), the aggregaiton is increased in three quarters of the cases portoperatively. Therefore in all vascular operations we have changed over to a therapy for the inhibition of thrombocyte aggregation according to the following scheme: intravenous injection of 2 ampoules Aspisol on the evening before the operation, 2 ampoules Aspisol in the morning and evening of the day of the operation and 1 ampoule Aspisol in the morning and evening on the 1st, 2nd and 3rd day after the operation, overlapping with 1 Colfarit tablet given orally 3 times a day from the 2nd day after the operation.


[Advances in sphygmomanometry (author's transl)].

Problems of the accuracy and reliability of Riva-Rocci's non-invasive method of measuring blood pressure always arise when the cuff does not fit well, i.e. with a very conical upper limb, adiposity or in neonates or patients in shock. From thorough clinical investigations it appeared that the cuff used for blood pressure measurements in adults and the few models for neonates and children are too inaccurate. The cuff must enclose the limb completely and have a minimum ratio of breadth to length of 1 : 3. An integral inflatable cuff unit has been developed and clinically tested in our laboratory during the last two years. It consists of a heat-sealed polyolefine film.


[Ultrasonic methods in the differential diagnosis of the "postcholecystectomy syndrome" (author's transl)].

The "postcholecystectomy syndrome" as a collective term for all upper abdominal complaints following cholecystectomy is a common clinical picture. For the purpose of clarification the easily practicable sonography offers itself in addition to conventional cholangiography and to endoscopic retrograde cholangiopancreaticography (ERCP). By means of echography, pathological changes in the upper abdominal organs can be detected or excluded. Chronologically, echography should be carried out at the beginning of diagnosis as an informative, harmless and rapid method. The most invasive investigations can then be omitted or performed specifically as required.


[Angiocinematography of cerebral circulatory disturbances using angiografin (author's transl)].

The arterial flow rate in the three superficial groups of branches of the middle cerebral artery was determined angiocinematographically in 37 hemispheres of 24 patients. In 10 hemispheres of patients with cerebrovascular diseases the arterial flow rate in the corresponding group of branches was lowered to a statistically significant extent. The importance of the choice of contrast medium is emphasized and that used in our investigations, Angiografin, dealt with in more detail. The diagnostic value of conventional determination of cerebral circulation time from serial angiograms is questioned and compared with the results of angiocinematographic investigation.


[Improvement of the preoperative localization technique in the surgery of hyperparathyroidism (author's transl)].

The possibility of preoperatively localizing overactive parathyroid adenoma by measuring the difference in parathormone levels in selective blood samples from the thyroid venous plexus and from the periphery (large veins) by radioimmunoassay has brought a decisive advance in parathyroid surgery. We report our experience with this preoperative localization technique, which we have used in 10 patients.


[Complications and lethality after kidney grafts (author's transl)].

Similarly good survival rates were obtained in 113 patients with kidneys transplanted from deceased persons as with patients on home dialysis. The retrospective study showed that fatal complications were not predominantly caused by septic diseases running fateful courses under immunosuppression, but by risk factors which were not recognized soon enough or were incorrectly treated. In our opinion, with careful preparation and supervision of these patients, even in the still unsatisfactory state of immunosuppressive therapy, the possibility exists of carrying out renal grafting without increased risk of mortality compared with dialysis treatment.


[Behavior of the serum titer after treatment with mebendazole in guinea-pigs infected with trichinella spiralis (author's transl)].

The behavior of the IFT serum titer in 80 guinea-pigs, experimentally infected with Trichinella spiralis, was tested before and after treatment with mebendazole for 6 months. For 14 consecutive days each animal was drenched with 40 mg mebendazole/kg bw on the 25th, 35th and 45th day after infection. After the 2 weeks therapy, living trichinella larvae were not found in any of the 3 treated groups of guinea-pigs. On the other hand even after 6 months viable larvae were found in the muscular tissue of the control animals. Within the first two months p.i. the titers were rising equally in both treated and untreated animals. Only then did the titer in the treated animals decrease markedly, whereas it fell gradually in the controls. After 6 months both groups were negative in the IFT.


[Viruses as causal agents of gastroenteritis in infants and young children (author's transl)].

Electron microscopic examination of stool samples from 195 infants and young children with acute gastroenteritis revealed rota virus in 31 samples (= 16%), corona virus in 44 samples (= 23%) and adenovirus in 13 samples (= 7%). Viruses were excreted for between 4 and 8 days in patients infected with rota virus and corona virus respectively. An outbreak of acute gastroenteritis in a premature baby unit with 24 cases is reported: corona virus was found in the stools of 15 infants. It is suggested that corona virus as well as rota virus may cause gastroenteritis in infants and small children.


[The frequency of chronic and terminal renal insufficiency in childhood. Results of an inquiry in Bavaria (author's transl)].

The frequency of chronic renal insufficiency in children and adolescents up to the age of 17 was found by an inquiry addressed to 6625 doctors practising in Bavaria. The survey extended over an observation period of 5 years (1969-1974). According to the results, the frequency of chronic renal insufficiency in the age groups stated was calculated to be 8.7 per million inhabitants. An incidence of 0.83 per million inhabitants per year is to be expected for terminal renal insufficiency. From these figures the annual admissions for dialysis of patients aged between 0 and 17 years in Bavaria can be calculated at 9-13. To cater for these children with terminal renal insufficiency, the capacity must be increased from the present 10 to about 30 dialysis places in the next 5 years.


[Bacteriological investigation of drains and catheters in pediatric surgery (author's transl)].

About 30% of 209 drains (wound drains, venous catheters, ureteral splints) from 92 pediatric surgical patients were contaminated with pathogens. 70% were sterile. E. coli and staphylococci were most frequently found. Wound drains after abdominal operations had the highest contamination rate at 70%, followed by ureteral splints with 50% and venous catheters with about 10%. Differences in the contamination rate in relation to the period of drainage could not be established. The following conclusions are drawn: 1. Giving antibiotics when pathogens have been detected in a wound drain is only recommended if this organism has also been found in other material from the patient. 2. If organisms are found in a venous catheter, a blood culture should always be carried out. 3. Antibiotic prophylaxis or topical treatment of the skin are not recommended. 4. Timely removal or changing of the catheter is the best prophylaxis against infection.


[Principles of treatment and nursing of children with diphtheria (author's transl)].

The principles of treatment of diphtheria are discussed: in the present epidemic situation, diphtheritic children must be admitted to a pediatric hospital. The children need at least 3 to 4 weeks, to a large extent strict, bed rest. The basic concepts of the treatment of both peripheral circulatory weaknesses and of myocardial damage are communicated. Glucocorticoids have proved their value in myocarditis. Prophylactic digitalization is to be rejected. Confirmed heart failure is a binding indication for digitalization. A causal therapy for para- and metadiphtheritic paralysis does not exist. All forms must be treated with antibiotics nowadays. In croup, tracheotomy must not be delayed too long. The nursing must be left the best staff only and requires, in addition to a fundamental knowledge of the disease picture, an exceptional empathy in the particular, especially psychic, situation of the sick children.


[Pentazocine--an addiction problem? (author's transl)].

Pentazocine dependencies are rare. In a period of 5 years, 60 were notified. The majority of these were not dependent. Of 46 utilizable notifications, 38 were false, 5 had taken pentazocine only temporarily or not at all. 19 received it for chronic or recurrent pains, 13 were polytoxicomaniacs, and 1 patient could not be classified. Only 8 cases could be referred to as pentazocine-dependent. The dose for addicts and polytoxicomaniacs was 11 ampoules daily on the average, almost three times as high as that for patients with painful diseases. Pentazocine dependencies are considerably less of a problem than those of opiates used up to now: withdrawal symptoms are slight, neglect and social dangers need scarely be considered. "Users" generally only turn to pentazocine when a painful disease supervenes. Dependency practically never occurs with oral administration.


[The structure of drug costs. A criticism of monocausal explanation (author's transl)].

Proceeding from the arguments of a recent publication, an attempt is made to establish whether a monocausal assessment is fruitful in the explanation of the development of drug costs in the statutory health insurance. The question is raised whether the price increase for drugs is in fact the decisive variable determining the costs. This is denied on the grounds of a differential analysis of the causative variables involved and it is shown what role, besides price and quantity components, the innovation or structure effect plays in the development of drug costs.


[Clinical trial of a combination preparation of clonidine and cyclothiazide (author's transl)].

Three dosage combinations of clonidine and cyclothiazide were tested in at least 20 patients each, under clinical (4 weeks) and oupatients (longterm) conditions, in order to find a suitable combination with fewer side effects than the single drugs with at least equal efficacy for the longterm treatment of hypertension. The combination of 150 mcg clonidine and 2.5 mg cyclothiazide (Dimapres) in the form of a scored oblong sugar-coated tablet seems to satisfy these demands best and to be an optimal combination of clonidine and cyclothiazide. It is an antihypertensive agent which has shown particularly good results in mild and moderate hypertension, as demonstrated by daily measurement of blood pressure and ergometric tests.


[The treatment of metastasizing hypernephroid (renal cell) carcinoma with medroxyprogesterone acetate (Clinovir) (author's transl].

15 patients with distant metastases of hypernephroid carcinoma were treated with medroxyprogesterone acetate (usually 300 mg daily by mouth). In 5 patients the metastases showed slower growth, remained stationary or regressed somewhat under this treatment. But a complete regression of metastases could not be obtained. The treatment was very well tolerated. Monitoring the transaminases and alkaline phosphatase during treatment is to be recommended.


[Social medical aspects of hypertension problems (author's transl)].

There is no doubt of the need of and benefit from consistent longterm treatment of "severe" hypertension. To realize this is the urgent task. In view of the poor results of the usually lax handling of therapy hitherto an attempt should be made to motivate suitable patients to prolonged active participation in the treatment as part of a special course of clinical therapy.


[Immunosuppressive treatment of multiple sclerosis. 4. Results of treatment with azathioprine and antilymphocyte globulin (author's transl)].

During the long-term treatment with azathioprine of 79 patients suffering from MS there was a significant reduction in the relapse rate; the course of the disease was also favorabley influenced. In about one third of the patiens afflicted with the chronic progressive form of MS, there was no further progression. After conclusion of the treatment its favorable effect lasted for 1 to 2 years; then the disease worsened, and the relapse rate increased again. Treatment with antilymphocyte globulin and/or thoracic duct drainage in 18 patients led to impressive improvement or a stabilization of the neurological signs in those with a relapsing course. The chronic progressive course of MS was arrested in about two thirds of the patients. The effect of the treatment lasted from one to several years.


[Research in the campaign against leprosy (author's transl)].

"Leprosy Relief through Leprosy Research" means that the results of research are made available for curing and eradicating the disease. The "Marinum Model" and the "planter test in mice" are, along with determination of serum activity in healthy test subjects, part of a complex of experiments for the assessment of the therapeutic value of an antimycobacterial substance. This replaces the "controlled studies" which, in their proper form, are scarcely possible for leprosy. With the recently developed forms of combination therapy, the duration of leprosy treatment is reduced to a few years. Because of the relationship of Mycobacterium leprae to Mycobacterium tuberculosis, certain types of combination therapy can be used in both diseases at the same time.


[Rescue helicopter services for emergency treatment at the scene of the accident (author's transl)].

During the last three years 3639 emergencies were dealt with using the rescue helicopter "Christoph 4" in Hannover. Of these, 89.3% were primary flights to the scene of the accident to give qualified first aid by a medical team. The average distance to the scene of the accident was 20.8 km with an average flight time of 8.5 min. 2688 patients were treated by the helicopter crew. 89.8% of the patients had injuries of a severity of NACA (National Commitee for Aeronautics) 3 and more. Intubation and artificial respiration was carried out on 293 occasions. Shock treatment with blood substitute was given in 1593 cases. 30 resuscitations at the scene of the accident were successful.


Sensitivity of wild type and recombination-deficient strains of Drosophila melanogaster to ultraviolet radiation.

The sensitivity of Drosophila melanogaster to ultraviolet light has been studied in wild type and recombination-deficient strains. Survival was measured as the proportion of irradiated embryos or larvae which developed to adult flies. In view of the fact that males of this species do not participate in meiotic recombination, emphasis was placed on the relative sensitivity of males and females. The results show that young wild type male larvae are more sensitive to UV radiation than are young female larvae. This difference in sensitivity, however, is not apparent in some recombination-deficient strains. In addition, young embryos of the recombination-deficient strain Df(3)sbd105/T(2;E)Xa are exceptionally sensitive to UV radiation.


Chromosomal effects of carcinogens and non-carcinogens on WI-38 after short term exposures with and without metabolic activation.

The human diploid fibroblast culture, WI-38 was analyzed for chromosomal damage after 24 h exposures to benzo(a)pyrene (BP), 3-methylcholanthrene (MCA), n-methyl-n'-nitrosoguanidine (MNNG), 4-nitroquinoline-1-oxide (4NQO), pyrene and caffeine. A low concentration of 4NQO (0.15 micron) and MNNG (1.9 micron) produced breakage and exchange figures. A relatively high concentration of caffeine (1300 micron) caused breakage. The other compounds (BP, MCA and pyrene) caused little or no increase in damage above the control levels. A 1-h pulse exposure of WI-38 cells to BP (40 micron) in the presence of a rat liver homogenate supernate (S-9) resulted in damage significantly greater than the untreated cells or cells treated with BP alone. 4NQO (0.25 micron) produced exchange figures after a similar 1-h exposure, but this effect was eliminated by the S-9. A much higher concentration of caffeine (10,300 micron) was required to cause breakage greater than control levels after a one hour exposure. The results indicate a possible short term in vitro human cell system for distinguishing carcinogens, procarcinogens, and noncarcinogens.


Clinical efficacy of meningococcus group A capsular polysaccharide vaccine in children three months to five years of age.

We performed field trials in the course of an epidemic in Finland to learn whether Group A memingococcal capsular polysaccharide vaccine protects infants and young children from meningitis. The first trial involved 130,178 children between the ages of three months and five years; 49,295 children received the vaccine, 48,977 received a control Haemophilus influenzae Type b polysaccharide vaccine, and 31.906 remained unvaccinated. No cases of meningitis or sepsis caused by Group A meningococci were seen in the first year of observation among the children vaccinated with meningococcal vaccine whereas six occurred among those vaccinated with the H. influenzae vaccine and 13 among those not vaccinated. In the second trial 21,007 children of the same ages received the meningococcal vaccine. No cases caused by Group A occurred among those vaccinated, although five to seven would have been expected within the year. Meningococcal Group A vaccine appears efficacious in young infants and children.


Association of Streptococcus bovis with carcinoma of the colon.

Two patients with colonic adenocarcinoma and Streptococcus bovis endocarditis suggested a possible association between the two. Non-enterococcal Group D streptococci were isolated from fecal cultures of 11 of 105 controls, 35 of 63 patients with carcinoma of the colon, seven of 25 with inflammatory bowel disease, four of 21 with non-colonic neoplasms and five of 37 with other gastrointestinal disorders. All such streptococci examined for lactose fermentation were S. bovis. The prevalence of S. bovis in fecal cultures from patients with carcinoma of the colon was significantly increased (P less than 0.001) as compared to that in controls, and also to all other groups (P less than 0.001). No other group had results significantly different from those of controls (P less than 0.05) although patients with inflammatory bowel disease were more frequently carriers. The carrier state was unrelated to age, hospitalization status, colonic stasis, gastrointestinal bleeding or recent barium-enema examination. The implications of this association are unknown.


Solubilizing effect of Trition X-100 on melanosome tyrosinase in hamster pigmented melanoma.

A study was made on the effect of Triton X-100 in different concentrations on the tyrosinase activity of two differently pigmented melanosome fractions of pigmented hamster melanoma, obtained by gradient centrifugation. Release of considerable tyrosinase activity was established spectrophotometrically in the supernatant of the treated melanosomes. The release of enzyme activity after treatment of the melanosome is probably due to a change in the permeability of the melanosome structures under the effect of the non-ionic detergent Trition X-100. A direct activating effect of Trition X-100 on the particulate enzyme should be excluded, since inhibition of DOPA-oxidase activity was established in the soluble tyrosinase fraction.


Immunofluorescent studies of urinary casts.

Immunofluorescent staining of urinary casts of patients with chronic glomerulonephritis or with acute renal failure was performed. Urinary and cast Tamm-Horsfall mucoproteins were purified by a modified McQueen's method. Rabbits were immunized by both of these materials to obtain antisera. The antigenic specificity of the prepared material was examined by Ouchterlony gel diffusion method and immunoelectrophoresis. Indirect and direct immunofluorescent staining methods were done using Tamm-Horsfall mucoprotein antiserum and FITC-GARG, FITC-labelled IgG, IgA, IgM, C3 and albumin. Hyaline casts of both chronic glomerulonephritis and acute renal failure demonstrated fluorescence with Tamm-Horsfall mucoprotein antiserum. The nature of the granular casts of chronic glomerulonephritis seemed to be different from those of acute renal failure because the granules of the former fluoresced for some serum protein fractions, but the latter fluoresced only for Tamm-Horsfall mucoprotein. The absence of fluorescence with epithelial casts for any serum protein fractions implied a different pathogenesis for epithelial casts as compared to granular casts, contrary to Lippman's assumption. A routine technique of immunofluorescent staining of urinary casts was developed. The interpretation of urinary casts should be more specific by this new technique.


Occult thoracic and sacral meningoceles.

Two cases of occult meningoceles are reported. The first case exhibited a combination of thoracic meningocele and neurofibromatosis with additional generalised osteomalacia. The second case was an anterior sacral meningocele. Based on these reports pathogenesis, diagnosis and therapy are discussed. The importance of myelography for the diagnosis of this condition and the indications for operative treatment are pointed out.


Plasma growth hormone and cortisol changes following limbic stimulation in conscious monkeys.

Electrical stimulation of the amygdaloid nuclei in conscious monkeys sufficient to produce after-discharge was found also to produce a prompt and usually large increase in plasma growth hormone (GH) levels if prestimulation values were low and stable. Plasma GH responses were observed to parallel and slightly precede changes in serum cortisol. Stimulation of the temporal tip of the hippocampus, just posterior to the amygdala, did not produce elevations of GH or cortisol despite the spread of after-discharge activity to the amygdala.


Temporal patterns of vasopressin release following electrical stimulation of the amygdala and the neuroendocrine pathway in the monkey.

To evaluate a possible role of the amygdala (Amyg) in the neural control of arginine vasopressin (AVP) release, adult female monkeys (Macaca mulatta) with electrodes chronically implanted in the Amyg, hypothalamus and pituitary gland were given 5% dextrose and water infusions and were stimulated electrically at these sites. Immediately before and after, and at 5, 10, 15 and 30 min intervals following electrical stimulation, blood samples were withdrawn from unanesthetized monkeys, through implanted cardiac cannulae, for radioimmunoassay (RIA) of plasma AVP and for plasma osmolality determination. In the Amyg-stimulated monkeys, plasma AVP rose rapidly to peak values at the end of stimulation followed by an abrupt post-stimulation fall to control levels in 30 min. A small yet significant rise in plasma osmolality was also observed. Electrical stimulation of the hypothalamus and the pituitary gland yielded a temporal pattern of plasma AVP rise and fall identical to that seen following Amyg stimulation. Blood sampling, precisely timed to the onset and end of the stimulus train, was important in capturing the rise and fall in plasma AVP. Stimulus intensity determined the magnitude of plasma AVP elevation at each of these sites, with the highest current densities yielding the highest levels of plasma AVP. It is suggested that the Amyg may be involved in the neural triggering of AVP release from the neurohypophysis.


Thyrotropin and prolactin response to intraspinal TRH administration in man.

The effect of intraspinal (i.s.) TRH administration of Prolactin (Prl) and thyrotropin stimulating hormone (TSH) serum levels was studied in order to verify the existence of a ventricular route in man for releasing factor delivery to the anterior pituitary, which has been previously reported in rats. Ten young male subjects were given 200 microgram thyrotropin releasing hormone (TRH) i.s. injections and Prl and TSH were measured by radioimmunoassay (RIA) before and at various times after TRH administration. In the same subjects, an i.v. TRH test was also performed. After i.s. TRH, a prompt Prl increase (peak values at 10-30 min and return to baseline within 150 min) and a delayed increase (3-5 h following TRH injection) were observed in 7 and 5 subjects respectively, while an early elevation in serum TSH occurred in 6 subjects and a late one in other 6. In two subjects, a biphasic response of both tropins was present. Prl and TSH response to i.v. TRH was within the normal range in all cases; no late rise of the 2 hormones was observed. A kinetic experiment with 125I-TRH was also carried out to elucidate the mode of i.s. vs i.v. TRH action. These results confirm in man data reported in animals which suggest that TRH can be transported from the cerebrospinal fluid (CSF) to the portal system and the hypophysis.


[Use of propanidid in bioelectrical brain activation].

The purpose of the study was evaluation of propanidid as an agent activating the bioelectric activity of the brain. Examinations were carried out in 200 patients. In patients with generalized epileptic seizures a positive result of activation trial was obtained in 92,8% of the cases. In cases of focal epilepsy, temporal or not temporal, administration of propanidid revealed or increased pathological focal activity all. Activation permitted also brain tumours to be localized more precisely. In patients with cerebraal circulatory disturbances the activating effect of propanidid was observed in 82,8% of the cases. The drug is suitable for outpatient practice and for follow-up examinations.


[Comparison between thiopental and brietal in the activation electrocorticographic records in epileptics].

For activation of electrocorticographic records the authors administered intravenously thiopental or Brietal to 86 patients undergoing operations for various types of focal epilepsy. Thiopental was administered either in intravenous drip infusion as 0.2% solution, or in a single injection of 2.5% solution. Brietal was injected as 1% solution intravenously. Thiopental activated electrocorticographic tracings in 56.3% and Brietal in 84% of the patients. In the conclusions the authors stress that both these agents may be used for activation of pathological discharges in ECoG in patients with epilepsy operated upon under general anaesthesia. Brietal seems to be better and it may be administered many times.


The intra-arterial injection of Iskedyl for hyperselective vascular exploration.

The development of spasm with the introduction of catheters into very small calibered arteries has tended to interfere with routine superselective catheterization. To overcome this problem the vasodilating drug Iskedyl, which containes raubasine 6.25 mg and dihydroergosistine 0.3125 mg in an ampule of 2.5 ml, has been injected into the artery being manipulated. The study was conducted on 112 patients undergoing hyperselective explorations of intracranial, thoracic, abdominal and peripheral arteries of small caliber and the results have been most gratifying and encouraging.


Phenylethylamine and cerebral blood flow. Possible involvement of phenylethylamine in migraine.

Phenylethylamine can initiate migraine-type headaches in susceptible individuals. Migraine sufferers have a reduced ability to deaminate all monoamines, but particularly phenylethylamine. Phenylethylamine readily crosses the blood-brain barrier and thus could be a mediator of the cerebrovascular disturbances seen in migraine attacks. Cerebral blood flow was measured in 15 anesthetized baboons by the intracarotid 133Xe clearance technique. Phenylethylamine (4 x 10(-7) moles.kg-1min-1) produced significant increases in cerebral blood flow (36 percent) and cerebral oxygen consumption (45 percent) during the first 40 minutes of infusion. In contrast, an increased phenylethylamine concentration (2 X 10(-6) moles.kg-1min-1) constricted the cerebral bed (cerebral blood flow reduced by 28 percent). The response of the cerebral circulation to hypercapnia was preserved during the infusion. Phenylethylamine thus is capable of producing in an experimental animal a pattern of cerebrovascular events similar to those seen in migraine.


Regional distribution of mast cells containing histamine, dopamine, or 5-hydroxytryptamine in the mammalian brain.

Brain mast cells were studied in mice, rats, rabbits, hamsters, guinea pigs, cats, cows, monkeys, and humans with use of a variety of techniques. They were localized by staining with Astrablau or by toluidine blue-induced metachromasia and characterized by their ultrastructural appearance and by the presence of histochemically demonstrable histamine (o-phthaldiadehyde fluorescence method). The identity of the fluorophore was secured by microspectrofluorometry. Mast cells in brain usually had a perivascular localization but were also found scattered in the parenchyma. The regional variations in the number of mast cells agreed with the histamine concentration as measured fluorometrically. The variation was in the order leptomeninges greater than hypothalamus greater than cerebral cortex = mesencephalon greater than cerebellum = brain stem. In addition to histamine, murine mast cells stored serotonin, whereas bovine mast cells contained dopamine, visualized histochemically by the formaldehyde technique.


Febrile convulsions followed by nonfebrile convulsions. A clinical, electroencephalographic and follow-up study.

103 patients with febrile convulsions followed by nonfebrile convulsions and 512 patients with febrile convulsions only (FC group) under 5 years of age at the first examination were analyzed from many aspects. A trimodal curve in distribution by age at onset of nonfebrile convulsions was seen: 2--3 years of age with occasional grand mal, 5--6 years of age with absence, and 12 years of age with awakening grand mal. Specific EEG abnormality was observed in 40% at the first examination (29% in FC group). Typical or atypical spike-and-wave complex, polyspikes, or continuous EEG abnormality were characteristic (slow wave burst with spike for FC group). Development from febrile convulsions into nonfebrile convulsions was detected in 17% among male and female patients. To identify an effective sign for the prediction of this development, the ratio between correct and incorrect prediction rates was analyzed. Specific paroxysmal EEG abnormality was increased over 3 years of age. EEG change due to aging and the significance of EEG reexamination were indicated.


Anorexia nervosa with acute tubular necrosis treated with parenteral nutrition.

A patient with nonoliguric acute renal failure secondary to acute tubular necrosis in conjunction with anorexia nervosa is described. Parenteral feeding at a critical time has salutory effects on the biosynthesis of new protein and thereby reduces many of the hazards of azotemia. The technique of estimating endogenous acid production is applied for the first time in a severely malnourished subject and documents the retention of dietary sulfur which presumably is retained in the formation of new tissue in the recovery phase.


Intrauterine transfusion. Safeguard or peril?

Questions have been raised whether intrauterine transfusion (IUT) results in a better survival rate than premature delivery and intensive newborn care. A 20% mortality for each IUT seems the basis for the query. Our method of IUT is described which resulted in 75% survival in nonhydropic babies overall with a 3.6% mortality for each IUT. In the last 5 years the survivors were 84.6% with a mortality rate of 2.2% for each  IUT. The results in hydropic babies are poor. Intrauterine transfusion by our method permits delivery of a more mature baby requiring much shorter hospitalization and reduced costs.


Rh immunoglobulin utlization after spontaneous and induced abortion.

To monitor the utilization of Rh immunoglobulin (RhIG), we reviewed the charts of 389 spontaneous and 1350 induced abortion patients treated in 1975 at a metropolitan hospital. The rate of ascertainment of Rh type was significantly higher for induced (99.6%) than for spontaneous abortion patients (95.1%) (P less than 0.001). Utilization of Rh immunoglobulin (RhIG) also was significantly higher for induced (98.9%) than for spontaneous abortion patients (80.6%) (P less than 0.001). Women at risk who did not receive RhIG after spontaneous abortion were mostly young, of low gravidity, and at gestational ages (mean 14.4 weeks) associated with substantial risks of Rh sensitization. Eradication of Rh hemolytic disease requires improvement in the system of identifying and treating patients who need prophylaxis.


Single versus fractionated doses of X-radiation and their effect on mammary carcinoma in the rat.

Selective destruction of neoplastic tissue by X-radiation, delivered as a single pulse or as a series of fractions, was investigated in transplanted DMBA-induced rat mammary tumors. Dosage was based on Strandqvist's fractionation curve, and compared with nominal standard doses. Tumor growth was most effectively inhibited when radiation was divided into three fractions. These results are consistent with predictions based on the NSD formula, rather than with the expected isoeffect of Strandqvist's curve. The higher doses of the three fractions were significantly more effective.


Survey of major blinding conditions in Qatar.

Qatar is one of the rapidly developing Gulf States. Its life style is rapidly changing from a seminomadic to a more settled urban one. This is the first study of the causes of economic blindness (6/60) in Qatar. It embraces 3,072 patients (70% males and 30% females). The most common causes in those under 40 years of age were trachoma, infectious diseases, retinal diseases, trauma and congenital malformations. After 40 years, cataract and glucoma occupy the second and third commonest causes after trachoma. Thus, a proper antitrachoma campaign will cut down the incidence of blidness by 50%. Control of individual behavior and antenatal caution in prescribing medicines can reduce the risk of trauma and congenital malformations. Cataract is not preventable, but early detection of glaucoma delays the damage of ocular tissues. This is the same with systemic disease.


Ocular phenotype in partial trisomy 10 q.

A list of the ocular signs of the partial trisomy 10 q, which is drawn up according to the literature, is not satisfactory as almost only the external appearance of the eyes and their adnexa is considered. The authors report the case of a child still living, whose visual function could be evaluated by subjective and objective (electrophysiological) methods.


Gonococcal tonsillitis. Report of a case.

Oral gonorrhea is not a commonly reported entity. One case of primary gonococcal tonsillitis in a 20-year-old Caucasian man is reported. The clinical and laboratory findings, differential diagnosis, and treatment of gonococcal infections are briefly reviewed.


Pulp effects of neodymium laser. A preliminary report.

A total of eight teeth from two rhesus monkeys were exposed to various amounts of neodymium laser radiation. The pulp response was found to be much less severe than that in a study of nineteen teeth previously reported for exposure to similar amounts of ruby laser radiation. If additional studies support this initial finding, it is suggested that a re-evaluation of neodymium laser-mediated procedures in vital teeth be initiated.


[Complement pattern in children with allergic-toxic exanthema--a contribution to differential diagnosis (author's transl)].

25 Sera from children with the clinical diagnosis: urticaria, allergic-toxic exanthema were examined for the complement components C3, C4 and C3-Activator. We applied the radial immunodiddusion. As controls served 50 helathy children and 25 children with morbili, rubeolae and scarlet fever. C3 was found to be decreased in 23 cases, C4 in 4 and C3-Activator in 19 cases  of urticaria. This indicates the possiblity for the differential diagnosis, but children of the control groups did not show any consumption of one of the described complement components.


"The intraureteric diverticulum", a manifestation of ureterocoele intussusception.

An ectopic ureterocoele may present as a diverticular-like structure at the bladder base appearing during voiding cystography. The radiological appearances are described and the mechanism of formation as seen in serial 70 mm film is discussed. The conventional intravesical filling defect of an ureterocoele may not be recognised when the bladder is filled by contrast medium. This sign of extra-vesical intra-ureteric invagination is only seen during voiding.


Effect of systemic antibiotics on the microbial flora of the external ear canal in hospitalized children.

The effect of antibiotic therapy and hospitalization on the external ear canal flora was investigated in 131 children. Fifty-eight percent of the patients receiving antibiotic therapy had Gram-negative bacilli or yeasts in their external ear canal, compared with 17% of the patients who were hospitalized for ten days or longer and only 3% of the patients who were hospitalized for short periods. Antibiotic therapy is the major factor in determining the colonization rate of the external ear canal with potentially pathogenic flora. Children under 1 year of age seem to be the most susceptible group to this shift of flora.


Amikacin therapy of exacerbations of Pseudomonas aeruginosa infections in patients with cystic fibrosis.

Amikacin, a new semisynthetic aminoglycoside antibiotic with activity against Pseudomonas aeruginosa, was used to treat 22 acute exacerbations of chronic pulmonary infections in 18 patients with cystic fibrosis. Patients ranged from 5 to 32 years of age and had mucoid P. aeruginosa isolated from sputum. The amikacin dose was usually 7.5 mg/kg every eight hours but was increased to 10 mg/kg and/or carbenicillin was added in selected cases depending on clinical course. Although P. aeruginosa was not eliminated from our patients' sputum except in two cases, there was a good clinical response in 19 of 22 courses. Significant improvement in chest x-ray films, spirometry, or arterial oxygen tension was documented in 11 of 17 courses. One instance of serum creatinine level elevation could not be attributed to this antibiotic. Two patients showed minimal (15 dB) unilateral high-frequency hearing loss on serial audiograms. Activity against many gentamicin-resistant strains and high blood levels are among the attractive properties of amikacin. Amikacin is clinically effective in treating Pseudomonas-associated pulmonary infections complicating cystic fibrosis.


[Iron metabolism during proteoenergetic malnutrition in children].

The iron stores are normal in marasmic kwashiorkor in kivu, but they notably decrease on re-feeding. On admission, the total iron binding capacity depends not only on the severity of the protein depletion but also on the iron stores. There exists an abnormality of the iron release from the stores; this cannot be attributed to the hypotransferrinemia or to the hypoceruloplasminemia, which are too moderate, nor to an ascorbic acid deficiency, but possibly to the inflammatory state which is a feature of kwashiorkor. The iron deficiency which occurs on re-feeding is not explained by abnormalities of iron absorption or by increased iron loss, but by the raised requirement for iron. Parental iron treatment alone is required to normalise the packed cell volume and the red cell volume after re-feeding.


Methylation of an adenosine in the D-loop of specific transfer RNAs from yeast by a procaryotic tRNA (adenine-1) methyltransferase.

tRNA (adenine-1) methyltransferase occurs in Bacillus subtilis. Eucaryotic tRNAThr and tRNATyr from yeast in which 1-methyladenosine (m1A) is already present in the TpsiC loop, can be methylated in vitro with S-adenosylmethionine and B. subtilis extracts. Each of the specific tRNAs accepts 1 mol of methyl groups per mol tRNA. The enzyme transforms into m1A the 3'-terminal adenylic acid residue of the dihydrouridine loop, a new position for a modified adenosine residue in tRNA. Both tRNAs have the sequence Py-A-A-G-G-C-m2(2)G in the D-loop and D-stem region. Other tRNAs with the same sequence in this region also serve as substrates for the tRNA (adenine-1) methyltransferase.


[Simultaneous determination of kidney glomerular and tubular partial functions with 99mTc-DTPA and 131I-hippuran using a partially shielded whole body counter].

The methodical prerequisitis and the clinical results-of simultaneous double-radionuclide determinations of renal clearances of 99mTc-DTPA (Sn) and 131I-Hippuran, using a partially shielded whole-body counter, are reported. Examination of the in vitro stability of the 99mTc-DTPA (Sn) complex by radiochromatographic separation revealed an unbound 99mTc fraction of 4.7%. The whole body measurement geometry was found over the non-shielded regions of the body to be independent of the various physiological distribution volumes of the clearance substances. The simultaneously determined clearances of 51Cr-EDTA and 99mTc-DTPA resulted in a strong linear correlation (r = 0.96; n = 20). The relation between serum creatinine concentration and 99mTc-DTPA clearance was approximately hyperbolic (r = 0.89; n = 154). In a group of normals (n = 102) the renal filtration fraction (FF - ClTc-DTPA/ClOIH) was 0.18 +/- 0.04. In a group of urological patients (n = 72) this fraction did not change appreciably before and after operations, whereas it was found increased to 0.25 and 0.24, respectively, in patients with diabetes and albuminuria or urinary tract infection (n = 37). The relative error of the clearance determination with a partially shielded whole-body counter was about 15% down to clearances of some 50 ml/min, and higher than 50% with clearances below 20 ml/min.


Traumatic injuries. Office treatment of fractures.

Fractures that can be successfully treated in the office are, in general, those that can be definitively diagnosed, have little or no displacement or can be adequately reduced through closed manipulation with use of local or regional anesthesia, and involve areas that can be securely immobilized for the period needed to achieve healing. X-ray films should be made before any treatment is given and again soon after immobilization to check on the status of reduction, if this was done, or on alignment, if the fracture did not require reduction. After the fracture has healed and the immobilizing device has been removed, convalescence is not considered complete until maximal function of the affected part has been regained. To this end, a vigorous program of reconditioning should be instituted.


[Schwannoma of the trachea: discussion of a case and review of the literature].

The authors report the case of a 71 years old woman admitted for severe asthmatic condition of recent origin. The chest X ray showed the opaque image of a tumour against the clearness of the trachea. Its benignity was confirmed by endoscopy. A complete surgical exerese is impossible because of the friable nature of the tumour but was attempted to relieve a worsening respiratory distress. A new intervention was necessary because of a mediastinitis; the patient died of renal insufficiency. Only one observation of schwannoma and 3 cases of tracheo-bronchial schwannoma were found in the literature. The nosological place of these tumours was debated particularly in their relation with Recklinghausen disease. Diagnosis was usually done only a few years after an endoscopic exploration. Some symptoms could nevertheless make up a "tracheal syndrome". Endoscopic exeresis of the tumour successfully tried on some cases should be attempted on a first step.


Genetic instability in Drosophila melanogaster: putative multiple insertion mutants at the singed bristle locus.

A series of eleven independent mutants at the X chromosome singed bristle (sn) locus of Drosophila melanogaster is described. All mutants descend from flies caught in the wild and bred in the laboratory. On the basis of their inordinately high spontaneous mutation frequency, ten of the mutants are classified as putative insertion mutants. Reversions to wild type occur at frequencies of 10(-4)-10(-3). Some reversions appear to be losses of the inserted element, others appear (by analogy with prokaryotes) to be changes in the orientation of the inserted elements. Consistent with the insertion hypothesis, some sn mutants generate what are interpreted to be deletions at the sn locus. In their mutational properties, the sn mutants are analogous to insertion sequence (IS) elements and bacteriophage Mu of Escherichia coli, but the precise nature of the insertion remains unknown.


Chronic intravenous dosing and blood collection in the unanesthetized monkey.

A procedure is described which allows chronic dosing and blood collection from awake monkeys. The procedure involves only minor surgical anesthesia and allows the same vein of the animal to be used several different times with home-cage recuperation periods intervening between sequential chronic catheterizations.