Modifications of glass microelectrodes: a self-filling and a semifloating glass microelectrode.

A simple and inexpensive method for constructing a double capillary was developed for preparing a self-filling glass microelectrode. The modified method uses a thin capillary instead of a bundle of glass fibers and fuses it to the outer capillary wall with flame before pulling the latter with a puller. The validity of the new electrode was proven by measuring the proximal cell PD of the rat kidney slices (mean of the stable cell PDs lasting longer than 30 min,--69 mV). A semifloating electrode was modified from the original floating electrode to be applicable to the in vivo kidney preparation whose pulsatile and respiratory movements had hindered yielding a stable cell PD. This electrode is constructed simply by replacing the shaft of the Ling-Gerard glass microelectrode with a length of flexible silcone-rubber tubing. The cell PD recorded by this electrode is found to be more stable and can withstand minor tissue distortion in mammalian kidney cells in vivo and also in such a contractile tissue as the secretory coil of the eccrine sweat gland.


Role of glucagon in mediating metabolic effects of epinephrine.

In order to separate direct effects of epinephrine on fuel metabolism from those mediated by glucagon, epinephrine (0.1 microng/kg-min) was infused for 120 min in 18- and 65-h fasted, nonanesthetized baboons with and without a concomitant somatostatin infusion. At both stages of fasting, epinephrine stimulated glucagon, secretion, and this was blocked by somatostatin. At 18 h, with epinephrine alone, glucose rose early and remained elevated throughout the infusion. In the glycogen-depleted 65-h fasted animals, there was attenuation of the early glucose rise, with glucose reaching a maximum level at 100-120 min. With somatostatin blockade of glucagon release in the 18-h fasted animals, a pattern of attenuated early glucose rise similar to that of the 65-h fasted animals occurred. Somatostatin also inhibited this early glycogenolytic response when the epinephrine dose was increased fivefold. The behavior of FFA, glycerol, and beta-hydroxybutyrate was unchanged by the addition of somatostatin to epinephrine at either stage of fasting. Thus, glucagon mediates the early glycogenolytic response to epinephrine, but not the delayed hyperglycemia and probably not the lipolysis.


Baroreflexive depression of oxygen consumption in the squirrel monkey at 10 degrees C.

Unanesthetized squirrel monkeys exposed to an ambient temperature of 10 degrees C showed elevations in total body oxygen consumption (VO2), arterial blood pressure (BP), and heart rate (HR) above values recorded at 28 degrees C. Further elevation of BP in the cold by intravenous infusion of phenylephrine was accompanied by immediate reduction in VO2, inhibition of shivering, and decrease in rectal temperature, as well as immediate reduction in HR. The magnitude of reduction in VO2 correlated with the magnitude of the concomitant baroreflexive bradycardia. When the pressor effects of phenylephrine were opposed by administration of diazoxide or phentolamine, the inhibitory effects of phenylephrine on both HR and VO2 were abolished. In animals previously subjected to bilateral sinoaortic denervation, both the bradycardia and depression in oxygen consumption normally associated with BP elevation were markedly reduced. These results suggest that elevation of blood pressuere can inhibit the thermoregulatory increase in total body oxygen consumption normally produced by cold exposure, and that this inhibition, like the concomitant bradycardia, is probably mediated via the sinoaortic baroreceptors.


Elevation of arterial blood pressure in the squirrel monkey at 10 degrees C.

Systemic arterial blood pressure, heart rate, and total body oxygen consumption were measured in seven unanesthetized squirrel monkeys exposed to ambient temperatures of 28 degrees C and 10 degrees C. At 28 degrees C, subjects sat quietly, the average mean arterial blood pressure was 116 +/- 16 (mean +/- SD, n - 7) mmHg, heart rate was 274 +/- 31 beats/min, and oxygen consumption was 14 +/- 1.4 ml/kg-min. At 10 degrees C, the animals shivered vigorously, the average mean arterial blood pressure was 139 +/- 16 mmHg, heart rate was 328 +/- 18 beats/min, and oxygen consumption was 31.6 +/- 3.9 ml/kg-min. Thus, the oxygen consumption more than doubled, the blood pressure rose by approximately 21%, and the heart rate by approximately 20%. Elevations in heart rate as well as systemic mean arterial blood pressure during exposure to low ambient temperature were probably mediated by sympathetic-adrenal discharges as well as by activity of skeletal muscles.


Renal cyst puncture and aspiration: a survey of complications.

Complications of cyst puncture and aspiration were analyzed in a survey of 5,674 cases reported by 84 institutions. The mean incidence of major complications was 1.4%. For institutions with extensive experience, the incidence of major complications was 0.75%. Minor complications occurred in probably 10% of all patients but were only detectable at institutions undertaking routine followup. Flexible and malleable equipment for puncture lessened the risk of major complications. Approach to lesions in the upper poles of the kidneys via an oblique pathway using fluoroscopic or ultrasound guidance decreased the risk of pneumothorax compared to direct introduction of the needle through the ultrasound transducer. The incidence of complications did not correlate with number of puncture attempts, gauge of puncture equipment utilized, or completeness of cyst evacuation.


Angiographic patterns of posttraumatic renal scarring.

Evaluation of 19 patients with a history of renal trauma revealed three angiographic features helper in the diagnosis of posttraumatic renal scarring: (1) a cup-shaped renal contour defect characterized by smooth margins, infolding of the renal cortex, and extension of the calyces to the edge of the defect; (2) occlusion of an extra- or intrarenal artery associated with a distal avascular zone of infarction; and (3) a grossly heterogeneous nephrogram characterized by scattered islands of renal tissue separated by broad or narrow avascular scars. Limited pathologic correlation suggests that the cup-shaped contour defect reflects subcapsular hemorrhage and that the mottled, heterogeneous nephrogram reflects a shattered kidney.


Advantage of intraarterial over intravenous vasopressin infusion in gastrointestinal hemorrhage.

Recent laboratory data have suggested equivalent therapeutic value of selective intraarterial or peripheral intravenous infusions of vasopressin in the control of gastrointestinal bleeding. However, recent experience in two clinical cases continues to support a therapeutic advantage of the selective intraarterial route and casts doubt on the applicability of the laboratory results to man. Until further data is accumulated, it is premature to discard the presumed therapeutic advantage of the selective intraarterial infusion of vasopressin.


Intraarterial analgesia in peripheral arteriography.

A pilot study involving 36 patients was undertaken to test the efficacy of combining 1% lidocaine with 60% methylglucamine iothalamate for relief of the severe burning pain often experienced during peripheral arteriography. Of 24 patients premedicated with meperidine hydrochloride and promethazine hydrochloride, 12 received lidocaine with the contrast medium and 12 did not. The remaining 12 patients were premedicated with diazepam and received lidocaine with the contrast material. By both subjective and objective criteria, those patients receiving lidocaine in the intraarterial injection of contrast medium suffered less pain. Optimum results were achieved for the lidocaine group receiving analgesic premedication. No adverse reactions attributable to the lidocaine were encountered. Subsequent to completion of the pilot study, more than 300 patients have been studied with similar impressive results of pain relief and safety.


Cholangiopancreatography and pancreatic cytology in carcinoma of the pancreas.

Twenty-three histologically proved cases of carcinoma of the pancreas were investigated preoperatively with endoscopic retrograde cholangiopancreatography and cytologic examination of pure pancreatic juice collected after secretin stimulation. In 12 cases in which radiology was highly suggestive of carcinoma, cytology confirmed the result in seven. When radiologic findings were equivocal, cytology was helpful in two of six cases. Cytology was most helpful in the patients in whom no diagnosis could be reached radiologically due to tumor invasion of the structures adjacent to the papilla. Malignant cells were found in all cases.


Radiologic manifestations of esophageal lymphoma.

Eight cases of esophageal lymphoma are presented. Contiguous involvement of the distal esophagus and stomach with narrowing and/or nodularity was the most common esophageal abnormality. Other appearances noted were an ulcerated mass, multiple submucosal nodules, and a pattern simulating varices. The spectrum of radiologic appearances with esophageal lymphoma is similar to lymphomatous involvement in the remainder of the gastroinestinal tract.


Retrograde prolapse of the lleocecal valve.

Retrograde prolapse of the ileocecal valve results when redundant mucosa produces prominent lips of the ileocecal valve. The prominent valve produces a filling defect within the cecum. With manual palpation or hydrostatic pressure of the barium column, this prominent ileocecal valve then prolapses in a retrograde fashion to produce a tapered defect of the terminal ileum. The pliable changing nature of this lesion is characteristic of a benign condition, and this combination of radiographic findings is pathognomonic of this normal variant. Two cases are reported with documentation by surgery and colonoscopy..


Computed tomography of abdominal paraaortic lymph node disease: preliminary observations with a 6 second scanner.

Eleven patients suspected of having tumor involving para-aortic lymph nodes were studied with the Varian 6 second whole body CT scanner. All patients had a pedal lymphangiogram; six were abnormal. In three of these six, CT provided clinically important information on the extent of disease which was not detectable by other radiographic studies. CT scanning improved on lymphangiographic interpretation when large bulky nodes were only partially filled and when whole chains of nodes failed to fill. In both situations, the enlarged paraaortic nodes were well delineated on CT. The internal architecture and morphological abnormalities of small well filled nodes were better portrayed by lymphangiography. In the four cases in which lymphangiograms were normal and the one case in which the lymphangiogram showed reactive hyperplasia, the CT scans were normal.


Computed tomography and obstructive biliary disease.

Forty-four patients with confirmed biliary diseases were studied to determine the value of computed tomography (CT) in the diagnosis of biliary pathology. The results indicate that CT is useful and highly accurate in differentiating between obstructive (surgical) and nonobstructive (medical) disease entities. Of the cases with proved obstruction, 88% were correctly identified. All of the nonobstructive cases had positive CT correlation. In addition, the underlying cause of the occlusion was determined in the majority of cases.


Serial scintigraphy of choledochal cysts using 131I-rose bengal and 131I-bromsulphalein.

Nine cases of congenital choledochal cysts are reported which were correctly diagnosed by 131I-rose bengal or 131I-bromsulphalein (BSP) serial scintigraphy. They were classified by scintigraphic patterns into two types depending on whether biliary obstruction was complete or incomplete. All but two showed incomplete obstruction. The correct diagnosis may be difficult to make by scintigraphy if complete biliary obstruction is present. In such cases the clinical findings and other diagnostic studies, such as angiography or ultrasound, should be carefully considered. Serial scintigraphy with 131I-rose bengal or 131I-BSP is nontraumatic, safe, and provides increased diagnostic accuracy. It is the examination of choice when choledochal cysts are suspected clinically.


Combined radionuclide and ultrasonic assessment of upper abdominal masses in children.

Two young adults and 22 children with upper abdominal masses were evaluated by hepatic scintigraphy and gray scale ultrasonography. Abnormal static scintigrams were subdivided into two groups on the basis of tumor vascularity as shown on the initial dynamic portion of the study. Ultrasonic evaluation resulted in four categories: uniformly densely reflective, densely reflective with internal sonolucencies, poorly reflective with some internal components, and sonolucent. Images of liver perfusion and radionuclide accumulation (scintigraphy) plus images of internal architecture (ultrasonography) allow accurate assessment of intra- or juxtahepatic masses. The combined information was more useful than that from either study alone.


Persistence of the fetal circulation: radiologic considerations.

Persistence of the fetal circulation is a recently recognized cause of severe cyanosis in newborn full term infants. Abnormally elevated pulmonary vascular resistance apparently stimulated by hypoxia, acidosis, and/or hyperviscosity results in cyanosis due to large right-to-left shunts through persistent fetal channels (patent foramen ovale and patent ductus arteriosus). Initial chest radiographs demonstrate clear lungs, decreased, normal, or mildly prominent pulmonary vascularity, and normal to moderately enlarged cardiac silhouettes. Angiocardiography, when required to rule out cyanotic congenital heart disease, demonstrates normal intracardiac anatomy, normal great vessel relationships, and right-to-left shunting across the patent foramen ovale and patent ductus arteriosus. Significant tricuspid regurgitation occurs in some of these infants, associated with variable right ventricular dilatation; the left ventricle is normal. The majority of babies with this condition ultimately survive. Treatment consists of intensive care including oxygen therapy and correction of acidosis. Vasodilators such as tolazoline may be helpful.


Effect of kilovoltage on detectability of pulmonary nodules in a chest phantom.

A partial chest phantom was constructed to examine the effect of kilovoltage on the detectability of pulmonary nodules. Four different energies were studied: 100, 150, 200, and 300 kVp. Nodule detectability improved with increasing energies up to 200 kVp, but improvement was relatively small and was accompanied by an almost equal rise in the number of false positive readings. Patient exposures were least at 200 kVp. There seems to be no advantage in a 300 kVp technique, since nodule detectability decreased and patient exposures increased at this energy.


Reliability of computed tomography: correlation with neuropathologic findings.

Findings on cranial computed tomography (CT) were correlated with autopsy findings in 58 cases with 129 lesions to determine CT reliability. When only CT scans of good quality were considered, there were no false positive cases. The number of false negative studies varied directly with lesion size: one of 42 lesions larger than 2.5 cm; four of 12 lesions between 1.5 and 2.5 cm; 12 of 15 between 0.5 and 1.5 cm; and all 21 of those smaller than 0.5 cm. Lesion size was undetermined in the remaining 18 casesbecause of the nature of the disease. While the series is small, these results suggest that the current detector threshold for CT may be in the range of 0.5-1.5 cm, although smaller lesions may be seen if there is substantial surrounding edema.


Subchondral cysts (geodes) in arthritic disorders: pathologic and radiographic appearance of the hip joint.

A comprehensive study of femoral heads of patients and cadavers with osteoarthritis, rheumatoid arthritis, osteonecrosis, and calcium pyrophosphate dihydrate deposition disease allows insight into the radiographic and pathologic appearance of subchondral radiolucencies in these disorders. The term geode, rather than cyst or pseudocyst, may be a more appropriate decription of these lesions. In osteoarthritis, goedes occur on the pressure segment of the femoral head in association with loss of articular space; in rheumatoid arthritis, they are initially noted at the chondro-osseous junction and subsequently involve the entire femoral head. In osteonecrosis, geodes appear in the necrotic segment of the femoral head. In calcium pyrophosphate deposition disease, geodes resemble those in osteoarthritis but are larger, more numerous, and more widespread.


Charcot's joint: two new observations.

The pattern of soft tissue calcification in the three cases presented suggests that the debris about a Charcot's joint may break out of the periarticular space and dissect along muscle planes. Follow-up films of one of the cases documents that such calcifications may be resorbed. The reason for selective involvement of certain muscle groups is obscure. To my knowledge, these observations have not been reported previously.


Myositis ossificans: diagnostic value of arteriography.

Myositis ossificans circumscripta is the heterotopic formation of nonneoplastic bone and cartilage in soft tissue. These benign lesions can mimic more serious lesions, both radiographically and histopathologically. Recognition of the benign character of myositis ossificans is imperative in order to avoid mutilating surgical procedures. Five cases are presented with emphasis on angiographic signs which differentiate this lesion from histopathologically similar lesions. Three of these are illustrated, along with an example of an osteosarcoma for comparison. The angiographic manifestations of myositis ossificans differ in the various phases of the disease. In the active stage, the lesions have numerous fine vessels causing a diffus stain. Malignant tumors such as osteosarcoma, extraosseous osteosarcoma, and fibrosarcoma, which are included in the differential diagnosis, often present clearly defined pathologic vessels as well as arteriovenous shunts, venous lakes, amputated vessels, invasion of large arteries and veins, and large abnormal draining veins. In the healing stage, the lesions are usually avascular, and there is no difficulty in differentiating this condition from malignant bone lesions with the sole exception of well differentiated parosteal osteosarcomas. In these cases, the plain radiographic features are most important in arriving at the correct diagnosis.


Odontoid fractures in metastatic breast carcinoma.

Six cases of odontoid fracture were recognized in patients with metastatic carcinoma of the breast. The clinical findings, radiographic diagnosis, and possible neurological sequelae are discussed. While pathologic long bone fractures are often aggressively treated, pathologic odontoid fractures are frequently not recognized despite their prognostic significance. Since patients with osseous metastasis from breast carcinoma may live for many months and undergo general anesthetic procedures that require neck manipulation, its recognition is clinically important.


Dose reduction in xeroradiography of the breast.

In a study of the effects of beam filtration on the entrance exposures encountered in xeroradiography of the breast, it was found that increasing the total filtration to 3.2 mm of aluminum reduced entrance exposures by a factor of three compared to the xeroradiographic techniques without added filtration. Changes in the processing parameters were found to restore much of the lost contrast observed when filtration was increased, resulting in clinically acceptable mammograms at reduced entrance exposures.


Computerized radiographic reporting in a community hospital: a consumer's report.

This report analyzes a 30 month experience with a commerically available mark sense form-based automated radiographic reporting system (RAPORT) in the diagnostic radiology department of a 400 bed general hospital. By using the system, five radiologists were able to completely formulate readable diagnostic radiology reports in 65% of all cases, thereby bypassing a transcriptionist and decreasing report turnaround time dramatically without sacrificing reporting time. Moreover, billing and statistical capabilities provided by the system were found to capture enough lost charges to pay for its entire cost. Trade-offs for these efficiencies included learning of a new code by the radiologist, certain changes in his reading habits, and acceptance of a limited, repetitive, and somewhat stilted jargon both by the radiologist and the referring physician.


Lymphography in the staging, treatment planning, and surveillance of ovarian dysgerminomas.

Ovarian dysgerminomas are distinguished from other ovarian neoplasms by their rarity, their predilection for metastases via lymphatic pathways, and their radiosensitivity and favorable prognosis. After the initial surgery, which provides the histologic diagnosis and defines the local extent of pelvic involvement, lymphography is the single most useful tool to determine whether retroperitoneal lymph nodes are involved. Results of the study guide the radiotherapeutic approach, including field size and dosage. In an unselected group of 31 previously untreated patients, 10 had positive lymphograms. The response to therapy and the detection of relapse of disease may be evaluated by monitoring the residually opacified lymph nodes with surveillance abdominal radiographs. If necessary, a repeat lymphogram can be performed. The 2 year survival rate of 84% for ovarian dysgerminomas is lower than that for testicular seminomas, probably due to later recognition of the tumor. Failuresare related to local extension or to hematogenous dissemination.


Cytochemical and immunologic of women treated for squamous cell carcinoma of the cervix.

A total of 126 individuals were tested for circulating T lymphocyte levels: 10 patients with stage I-III squamous cell carcinoma of the cervix before treatment; 65 women previously treated with radiation for stage I and II squamous cell carcinoma of the cervix; and 51 healthy age-matched controls. Percentages of aneuploid cells and DNA content in vaginal or cervical smears were determined in 94 patients. All patients with squamous cell carcinoma of the cervix had lower ratios and levels of circulating T lymphocytes than healthy controls. Cytologic and cytochemical DNA studies of vaginal and cervical smears revealed that these individuals had high percentages of aneuploid cells in cervical smears as well as high DNA values. Patients with no evidence of dysplasia had increased circulating T lymphocyte levels compared to pretreatment values, a lower number of aneuploid cells, and mean DNA values close to diploid cells. Based on cytologic and quantitative DNA studies of vaginal and cervical smears, postirradiation dysplasia was diagnosed in 17 of 65 women previously treated by radiation for squamous cell carcinoma of the cervix. No difference in the levels of circulating T lymphocytes between women with postirradiation dysplasia and women without this mucosal disorder and no evidence of cancer was found.


Superselective transcatheter embolization of traumatic renal hemorrhage.

Selective angiography is an established diagnostic modality in acute renal trauma [1-3]. Renal hemorrhage, once demonstrated by angiography, can then be treated by arterial embolization [4-5]. This paper describes the successful transcatheter management of a renal laceration in a patient with multiple injuries secondary to an abdominal gunshot wound. Adominal exploration had established that the renal hemorrhage could not be surgically controlled without performing a nephrectomy.


The effect of small bowel resection and subsequent precise antrectomy on lower esophageal function in rhesus monkeys.

The lower esophageal high pressure zone (HPZ) was characterized manometrically and reflux status determined in eight male rhesus monkeys. The studies were repeated six weeks and six months after 50 per cent distal small bowel resection. At the same time fasting serum gastrin and gastric inhibitory polypeptide values were assayed. In seven animals precise antrectomy with gastroduodenal anastomosis was performed and the studies repeated. HPZ pressure increased from 6.7 +/-0.67 mm Hg (+/-1 SEM) to 10.3 +/- 0.76 mm Hg at six weeks (p less than 0.005). At six months the pressure was 9.3 +/- 1.02 mm Hg (p less than 0.02) and after antrectomy 15.2 +/- 3.1 (not significant from 6 month value, p less than 0.02 from control). Serum gastrin and GIP values showed significant elevations at six weeks, but six month and postantrectomy results were not statistically different from control. Reflux episodes for the group were reduced at six weeks and six months. After antrectomy increased reflux was noted.


Antimicrobial systems of the surgical wound. II. Detection of antimicrobial protein in cell-free wound fluid.

Human wound fluid contains heat-stable proteins with moderate antibacterial activity against Staphylococcus aureus and Escherichia coli, and different heat-labile proteins with antibacterial activity against E coli. Blood serum also contains heat-labile antibacterial substances, but little heat-stable activity against Staphylococcus aureus. Both blood serum and wound fluid have bacteriostatic activity against S epidermidis, and early growth of Streptococcus fecalis occurs in serum and wound fluids. The concentration or activity of antimicrobial proteins increases during the first week in the fresh wound and then decreases as the wound matures.


Trabeculo-electropuncture in cynomolgus monkeys (Macaca irus).

Trabeculo-electropuncture (TEP) was performed in one eye of ten cynomolgus monkeys. In five control eyes, the TEP probe was inserted into Schlemm's canal and withdrawn without causing a spark discharge. In another five control eyes,a scleral window was produced and the canal was opened, but no probe was inserted. The gross facility of outflow was determined prior to the operation and 2, 6, and 18 weeks postoperatively. TEP had no longlasting effect on the facility. Gonioscopy five months after the operation revealed marked changes in the anatomy of Schlemm's canal in treated eyes and in control eyes subjected to probe insertion. Control eyes without probe insertion appeared normal. Six months postoperatively three monkeys were killed and the eyes investigated. Light and electron microscopy indicated that insertion of the probe with or without spark discharge resulted in the formation of dense bridges between the inner and outer walls of Schlemm's canal. At the sites of TEP, the trabecular meshwork was replaced by dense scar tissue containing irregular, fine fibrillar material, elastic fibres and large amounts of curly collagen. There were no intertrabecular spaces in the scar tissue. In one eye, one lesion was covered by a thin endothelium resting on a basal membrane. The results indicate that the failure of TEP in monkey eyes was due to the formation of dense scar tissue occluding the openings initially produced by the spark discharge.


Pharyngeal pouch as a cause of difficult intubation.

The presence of a lateral pharyngeal pouch may cause difficulty in recognising the glottis when awake intubation is undertaken. This is mainly because the orifice may open and close during phonation and therefore be mistaken for the glottis. A case is described and some aspects of relevance to the anaesthetist are discussed.


Discrimination between males and females by scent in Lemur fulvus.

Two captive male Lemur fulvus were presented with scents of conspecific males and females, outside the mating season. Both subjects sniffed male scents significantly more than female scents. Male and female scents did not elicit significantly different amounts of scent marking. None of the responses of either subject suggested any discrimination of sub-species by scent.


The influence of a history of a previous test on the prevalence and size of reactions to tuberculin.

Ten millimeters of more of induration to the Mantoux tuberculin test indicates present or past infection with Mycobacterium tuberculosis in the overwhelming majority of cases. Because a number of patients gave a history of a previous positive reaction that was not confirmed on retesting, we carefully evaluated, as part of a large tuberculin testing survey, 1,428 persons who claimed to have had a previous positive test. Of these, 606 (42.4 per cent) had a positive reaction on retesting. When compared to subjects with no history of a previous tuberculin test, this group had only a slightly higher percentage of large reactions (greater than 24 mm). The difference was not significant. This discrepancy between history and test results cannot be assumed to be due to technique or to anergy in the current testing because of appropriate controls. It probably reflects variability in the use of antigens, technique at the previous testing, or faulty recollection of the subject. Because presumption of tuberculosis infection may lead to further diagnostic or therapeutic decisions, it is recommended that all skin test histories be documented or confirmed by retest before consideration of further examinations or therapy. In those with a history of a previous reaction, very large reactions (greater than 24 mm) were only slightly more frequent (but not to a significant degree) than those without such a history; thus, a previous reaction history should not be sufficient to preclude retesting.


Experimental pancreatic islet transplantation.

Transplantation of isolated islets of Langerhans has been suggested as a treatment of certain forms of diabetes mellitus. Injection of 200-400 syngeneic pancreatic islets isolated by collagenase digestion into the pancreas or submandibular gland of diabetic rats rendered most of the hosts nearly normoglycaemic. Blood glucose determinations were monitored for 2 months after islet transplantation. Although intrapancreatic and intrasubmandibular implantation reduced hyperglycaemia and polyuria in these animals, consistent normal values were rarely achieved.


[Lateral diverticula of the pharynx (author's tranl)].

The authors describe two clear-cut cases of hypopharyngeal lateral diverticulum. They have found only 22 published cases. They discuss the nosological limits of the physiological pharyngeal expansions visible under high pressure pharyngography, those of kinetic pharyngoceles which are often forced hernias, finally, the very real but uncommon presence of true lateral diverticula. The passage of barium Therapeutic indications are discussed. The surgical technique is simple.


Applications and hazards of intravenous hyperalimentation.

The current technique of total parenteral nutrition (intravenous hyperalimentation) is relatively safe and efficacious, but will undoubtedly undergo change and modification as improved techniques and materials become available. With judicious application of the technique as a clinical therapeutic and investigative tool, new indications for general and specific total parenteral nutrition will likely expand and extend into every medical discipline. As relatively few of the potential applications for total parenteral nutrition have been thoroughly explored or exploited, the clinical and laboratory research possibilities appear to be virtually limitless. Thus, as increasing knowledge and experience are gained, application of total parenteral nutrition will inevitably be expanded and will become more specific, and the hazards will no doubt decrease.


[Method of membrane filtration for determining the sterility and microbial contamination of antibiotics].

During membrane filtration antibiotics belonging to different chemical groups are strictly absorbed on the filters. When the filters are put into liquid thioglycol medium, the residual amounts of the antibiotics on the filters did not prevent the growth of sensitive microflora experimentally added to the drug. When the filter was put onto solid nutrient medium, only resistant forms of the microbes grew as a rule on its surface, the amount of the grown microbes being 26--43 per cent of the added one. The sensitive microbes grew only in the amount of 0.3--1.3 per cent. Subsequently the residues of the antibiotic adsorbed on the filter inhibited the growth of the sensitive and partially resistant microflora.


[Tetracycline inactivation by magnesium sulfate in testing for microbial contamination by the membrane filtration method].

It was shown that the residual amounts of tetracyclines adsorbed on membrane filters may be inactivated by addition of 2M magnesium sulphate solution to the agar for placing the filters after filtration. The antibiotic inactivation increases the possibilities of the test for antibiotic sensitivity of the microflora present in the drugs and may be used in determination of microbial dissmination of non-injection tetracyclines.


Enzyme replacement therapy in Gaucher's and Fabry's disease.

Glucocerebrosidase and ceramidetrihexoside-alpha-galactosidase were obtained in a high degree of purity from human placental tissue. The enzymes were infused in Gaucher and Fabry patients, respectively. Following the administration of the proteins to supplement the genetically determined deficiencies, there resulted a specific reduction in the accumulated hlycolipids in the circulation and liver. These results indicate that enzyme replacement may provide hope for the clinical treatment of these disorders.


[Action of neotelomycin derivatives on bacillus magaterium cells].

The effect of neotelomycin derivatives on the cells of Bac. megaterium was studied. Derivatives with modification of one of the two active centers of the antibiotic molecule, i.e. the free alpha-amine group of the residue of asparaginic acid or hydrophobic triptophanic structure were studied. The derivative with modified indol rings of the residues of beta-methyl-and dehydrotriptophane induced the same though lower damages as the natural antibiotic: increased permeability of the cytoplasmic membranes, protoplast lysis, suppression of the dehydrogenase activity. The activity of this derivative was due to the free amino group and amounted approximately to 3 per cent of the activity of neotelomycin. The derivative with the free amino group of the asparaginic acid residue replaced by the benzoylic group showed a high antibacterial activity but had almost no effect on the membrane permeability and a very low lytic effect. The capacity of this derivative to inhibit the bacterial dehydrogenase activity remained relatively high. Possibly the free amino group of the asparaginic acid residue provided neotelomycin with the capacity for damaging the structure of the bacterial cytoplasmic membranes. No detectable damages in the membrane state after exposure to the benzoylic derivative, as well as its high antibacterial activity are evident of the fact that the mechanism of action of the benzoylic derivative on the cells was in principal different from that of the derivative preserving the free amino group. The triptophane structure was probably not only the center actively affecting the cell but also the factor that provided the antibiotic molecule with conformation most favourable for the action of the free amino group on the membrane structures.


Differential diagnosis between Streptococcus agalactiae and Listeria Monocytogenes in the clinical laboratory.

Streptococci of the group B (S. agalactiae) and Listeria monocytogenes resemble each other in many morphological and biochemical characteristics. Ten beta-hemolytic strains of each species were subjected to 26 tests commonly and easily performed in the clinical laboratory. Macroscopic and microscopic morphology on solid media showed differences only in the size of the colonies and in the length of the individual organisms. Among many other tests, hippurate hydrolysis and the CAMP reaction were positive in both species. In the presence of these two reaction, a negative catalase test and chaining in broth would make a presumptive diagnosis of S. agalactiae, while motility at 25 C, the presence of the Henry effect, and resistance to furadantin would be indicative of L. monocytogenes.


[Patterns of clometacillin circulation in the body of laboratory animals].

Distribution of clometacillin in mice, rats and rabbits was studied in comparison with some other penicillins. It was found that clometacillin was superior to all other penicillins used for comparison with respect to the circulation time in the blood after intravenous, intramusclar or intrastomach administration. As for the capacity for penetrating into the tissues from the blood, clometacillin was not inferior to ampicillin and benzylpenicillin and was superior to propicillin, though it was bound by the blood serum proteins to a greater extent than the other penicillins used for comparison.


Effect of penicillin on streptomycin production by Streptomyces griseus.

The correlation between the biosynthesis of the cell wall and the formation of streptomycin (SM) in Streptomyces griseus, influenced by a specific inhibitor of cell wall synthesis, was investigated. Penicillin, in subinhibitory concentrations (1 to 5 mug/ml), was added to cultures of S. griseus in different stages of its life cycle. The inhibitor decreased SM production, when young cultures were treated; however, there was an increase in SM formation when penicillin was added to older cultures. The explanation for these findings is discussed in detail.


Gardimycin, a new antibiotic inhibiting peptidoglycan synthesis.

Gardimycin, a new antibiotic, at 100 mug/ml, specifically inhibited cell wall synthesis and induced accumulation of uridine 5'-diphosphate-N-acetylmur-amylpentapeptide in whole cells of Bacillus subtilis. The antibiotic was active in a particulate enzyme preparation from Bacillus stearothermophilus: 60 mug/ml caused 50%, and 200mug/ml caused 100%, inhibition of peptidoglycan synthesis. Suppression of peptidoglycan synthesis was accompanied by parallel accumulation of the lipid intermediate. This mechanism of action is discussed in comparison with those of other antibiotics that are known to inhibit bacterial cell wall biosynthesis.


Chemically defined antimicrobial susceptibility test medium for Pseudomonas aeruginosa.

A chemically defined growth medium containing physiological concentrations of magnesium and calcium ions was utilized in a microdilution procedure for antimicrobial drug susceptibility testing of Pseudomonas aeruginosa. Determinations of growth end points were simplified by use of sodium citrate as a sole carbon source and bromothymol blue as a pH indicator. Growth of the test organisms was detectable by a change in the indicator color from green to blue after alkalinization of the medium due to citrate utilization. Minimal inhibitory concentrations of amikacin, carbenicillin, gentamicin, and tobramycin were determined on 100 recent clinical isolates of Pseudomonas. Parallel determinations using the microdilution procedure and a conventional tube-broth dilution technique incorporating Mueller-Hinton broth with identical magnesium and calcium content generally agreed within one twofold dilution. Modal minimal inhibitory concentrations for susceptible strains using the microdilution method were: amikacin, 6 mug/ml; carbenicillin, 50 mug/ml; gentamicin, 1.5 mug/ml; tobramycin, 1.5 mug/ml. This modified microdilution technique allowed rapid, definitive minimal inhibitory concentration determinations, using growth end points defined by a color indicator change.


Comparative trial of carbenicillin and ampicillin therapy for purulent meningitis.

A randomized therapeutic trial of carbenicillin (CB) or ampicillin (AMP) in purulent meningitis was performed in 86 pediatric and adult patients (41 Haemophilus influenzae, 22 Streptococcus pneumoniae, 13 Neisseria meningitidis, and 10 of unknown etiology). All isolates, incuding H. influenzae, were susceptible to CB and AMP. Median cerebrospinal fluid (CSF) antibiotic concentrations were 0.85 and 1.60 mug/ml for CB and AMP, respectively, during administration of daily doses of 400 mg/kg and 0.65 and 0.45 mug/ml, respectively, on daily doses of 200 mg/kg. Higher CSF concentrations, up to a median concentration of 4.5 mug/ml, were observed in patients with CSF protein concentrations >/=75 mg/100 ml. Clinical responses were equivalent on either antibiotic regimen. Among AMP patients (45), 8 had significant residua and 3 died; among CB patients (41), 5 had residua and none died. However, 38% of H. influenzae patients treated with CB had positive CSF cultures on day 1 follow-up lumbar punctures, compared with only 5.8% of AMP patients with H. influenzae. The significance of a delay of CSF sterilization among CB-treated patients is unknown, since there was no correlation between persistence of hemophilus organisms and the frequency of adverse outcome. AMP and CB are equivalent for the treatment of bacterial meningitis due to susceptible organisms.


Pirbenicillin: comparison with carbenicillin and BL-P1654, alone and with gentamicin, against Pseudomonas aeruginosa.

Minimum inhibitory concentrations (MIC) of pirbenicillin against 135 clinical isolates of Pseudomonas aeruginosa were one-fourth of those required for carbenicillin but two times higher than those for BL-P1654. Increasing the inoculum size produced an adverse effect on the bactericidal activity for all three antibiotics. This was more apparent for pirbenicillin than for carbenicillin, but less than the effect on BL-P1654. When concentrations of antibiotics likely to be achieved clinically were used, gentamicin increased the inhibitory and bactericidal effects of all three semisynthetic penicillins for the majority of isolates. Strains highly resistant to the aminoglycoside antibiotic, however, were inhibited no more by the penicillin-gentamicin combinations than by the most effective of the antibiotics alone.


Plasmid-mediated beta-lactamase production in Neisseria gonorrhoeae.

Several beta-lactamase-producing, penicillin-resistant strains of Neisseria gonorrhoeae were examined for R plasmids. Penicillin-resistant strains isolated from men returning from the Far East and their contacts contained a 4.4 x 10(6)-dalton plasmid in common. Transformation studies and the isolation of a spontaneous penicillin-susceptible segregant showed that the structural gene for beta-lactamase was part of the 4.4 x 10(6)-dalton plasmid. An additional penicillin-resistant gonococcal strain isolated in London was found to harbor a 3.2 x 10(6)-dalton R plasmid. Deoxyribonucleic acid (DNA)-DNA duplex studies revealed that the penicillin-resistant gonococcal isolates contained a significant portion (about 40%) of the transposable DNA sequence, TnA, which includes the beta-lactamase gene commonly found on R plasmids of the Enterobacteriaceae and Haemophilus influenzae.


Microbial formation of 4-thiouracil.

A soil organism identified as Streptomyces libani var. soldani was found to produce 4-thiouracil. The product was isolated in a yield of 150 mug/ml of filtered beer and characterized by C-13 magnetic resonance and high-resolution mass spectroscopy. The product has a broad antibacterial spectrum but low specific activity.


Pseudomonas aeruginosa strain isolated in France that carries a plasmid determining carbenicillin resistance.

A plasmid, R56Be, derived from a clinical strain of Pseudomonas aeruginosa isolated in France in 1973 has been studied. This plasmid confers resistance only to carbenicillin, and although freely transferable between unrelated strains of P. aeruginosa, its transfer from P. aeruginosa to Escherichia coli K-12 was undetectable. R56Be could not be isolated as covalently closed circular deoxyribonucleic acid, but the plasmid could be transduced intact by phage F116L. This suggests that its molecular weight does not exceed that of the phage genome (ca. 40 x 10(6)). In terms of its interaction with male and female sex-specific phages, its exclusion characteristics, and the main properties of beta-lactamase determined by them, R56Be is similar to the previously characterized plasmid RP1-1.


A cutaneous marker in the Hunter syndrome a report of four cases.

A report of four patients and review of the literature suggest that a cutaneous marker exists for the Hunter syndrome. All previously described patients with this eruption have been males with clear corneas. The distinctive lesions consist of firm ivory-white papules and nodules that may coalesce to form ridges or a reticular pattern. The papules are usually seen in symmetrical areas between the angles of the scapulas and posterior axillary lines, the pectoral regions, the nape of the neck and/or on the lateral aspects of the upper arms and thighs. These lesions are seen in both allelic forms and cannot be used to separate a benign from a rapid course.


Frequency of application on percutaneous absorption of hydrocortisone.

This study determines the percutaneous absorption of hydrocortisone when applied as a single dose or on a repetitive basis. Application was to the shaved ventral forearm of the rhesus monkey, an animal model in which some relevance to man has been shown. Absorption was quantified by measuring 14C in aliquots of urine over five days. There was no substantial difference in total absorption when 13.3 microng/sq cm was applied as a single dose or when the 13.3 microng/sq cm was applied three times, totaling 40 microng/sq cm. However, when 40 microng/sq cm was applied as a single dose, absorption was substantially increased over 13.3 microng/sq cm applied either once or three times. Additionally, when the skin was washed between applications to remove previously applied material in the three application experiment, there was a statistically significant increase over not washing the skin. The clinical importance of these results to man will await appropriate clinical studies.


Skin changes in short-bowel syndrome. Kwashiorkor-like syndrome.

An infant with short-bowel syndrome developed flexural desquamation and "enamel paint" skin in pressure-bearing areas. Hyperalimentation with amino acid and lipid solution was unsuccessful in correcting the malnutrition and skin changes.


Essential fatty acid deficiency in surgical patients.

Parenteral nutrition may protect patients unable to eat from malnutrition almost indefinitely. If fat is not also given EFAD will occur. This outlines a prospective study of 28 surgical patients on total intravenous fat-free nutrition to determine the developmental course of EFAD and the response to therapy. Twenty-eight patients ranging from newborn to 66 years receiving parenteral nutrition without fat had regular determinations of the composition of total plasma fatty acids and the triene/tetraene ratio using gas liquid chromatography. Physical signs of EFAD were looked for also. Patients found to have evidence of EFAD were treated with 10% Intralipid. Topical safflower oil was used in three infants. Total plasma fatty acid composition was restudied following therapy. In general, infants on fat-free intravenous nutrition developed biochemical EFAD within two weeks, but dermatitis took longer to become evident. Older individuals took over four weeks to develop a diagnostic triene/tetraene ratio (greater than 0.4; range 0.4 to 3.75). Therapeutic correction of biochemical EFAD took 7 to 10 days but dermatitis took longer to correct. Cutaneous application of safflower oil alleviated the cutaneous manifestations but did not correct the triene/tetraene ratio of total plasma fatty acids. These studies indicate that surgical patients who are unable to eat for two to four weeks, depending upon age and expected fat stores, should receive fat as a part of their intravenous regimen.


Bacteremia after upper gastrointestinal endoscopy.

During 24 months, 200 upper gastrointestinal endoscopies were performed on 193 patients. Blood cultures were obtained before and five and 30 minutes after the procedure using thiol (50 ml) and trypticase soy broth (100 ml) media. The mean endoscopic time was 34 minutes. Sixteen patients developed bacteremia (8%). Twelve groups of microorganisms were detected in positive blood cultures: Streptococcus (5 species), Lactobacillus sp, Veillonella alcalescens, Staphylococcus aureus, Staph epidermidis, Propioni-bacterium acnes, Corynebacterium acnes, and Bacillus subtilis. Seven patients had positive blood cultures at five and 30 minutes, eight at five minutes, and one at 30 minutes only. There was no clear correlation of bacteremia with the age or previous history of the patient, biopsy, active bleeding, endoscopic time, or findings. A follow-up study of all patients for six months to two years indicated no complications related to endoscopy and/or bacteremia.


Heterotopic ossification mimicking acute arthritis after neurologic catastrophes.

Three patients developed periarticular heterotopic new bone formation during the first two months after a CNS disorder. In each patient warmth, swelling, and tenderness around one or two joints initially resembled severe arthritis. Diagnosis was aided by roentgenograms of the involved areas that showed the ossification. While no treatment has been clearly demonstrated to interrupt the ossification and resultant contracture, a course of cautious physical therapy and antiinflammatory medication is probably indicated.


[Surgical treatment of obstructive cardiomyopathies by mitral valve replacement].

The authors present a series of 10 cases of OCM which were treated by replacement of the mitral valve. Mitral incompetence was present in all patients, and was major or massive in 7 of them. Direct surgery to the mitral valve area has demonstrated pathological lesions in the mitral valve mechanism in 7 patients. A formal indication for mitral valve replacement in the surgical treatment of cases of OCM therefore exists when there is major mitral incompetence, intraventricular conduction defect, cardiac failure, or failure of previous myotomy.


[New open heart technic of locating the bundle of His].

The use of a system of electronic potentials for locating the bundle of His during open heart operations has provided a means for localising the conducting pathways so that they are not damaged during surgery. The designing of a special apparatus for this purpose has made it especially suitable for use in man, and it increases the ECC time by only a few minutes. The apparatus consists essentially of electrodes designed specially for the purpose, a cardiac stimulator and a calibrated oscilloscope with an electrostatic memory. The effectiveness of this technique has been confirmed in a preliminary series of 15 cases.


[Hemodynamic effects of intravenous amiodarone in humans].

The haemodynamic action of I-V Cordarone have been studied in 20 subjects over a 15 minute period. Over the 15 minute period we studied variations in left pulmonary and ventricular pressures, in cardiac output, and in the paramaters of contraction VEC max, V max and Taylor's index. At a dose of 5 mg/kg there is a fall in peripheral resistance (1274 +/- 232 to 915 dynes/s/cm-5), and the measurements of contraction hardly vary. At a dose of 10 mg/kg, after an initial increase in output and a fall in peripheral resistance there occurs, after 4 minutes, an increase in left ventricular end-diastolic pressure (from 6 +/- 2 to 13 +/- 4 mmHg, P less than 0.01), and a lowering of contractility (VEC max reduced from 49.7 +/- 12.4 to 27.1 +/- 3.8, P less than 0.001). We have shown that the first phase of this response is due to the solvent (Tween 80), while the fall in contractility is due to the amiodarone. Doses above 10 mg/kg must be used with care, and only if there is no evidence of impaired cardiac function.


[Short-term outcome of a 1st myocardial infarct preceeded or not by a premonitory sign. Comparative study].

A comparative study of two groups of patients after their first myocardial infarction, distingusihed by the presence (group A, 149 cases) or absence (group B, 184 cases) of premonitory signs has shown no difference between the two groups in the short-term (5 weeks). The only differences were in the age (younger patients and in the larger number of anteriorly situated infarcts in the 45% of patients in this series who had premonitory signs.


[Closure of ventricular septal defects. Comparison of 2 technics].

To be correctly done, closure of a ventricular septal defect must be sound, and must also avoid damage to the conducting tissue. These two essentials are somewhat contradictory, since in order to avoid the bundle of His in its position along the postero-inferior edge of the ventricular septal defect (VSD) in the membranous septum, the sutures inserted into this region must be superficial, and therefore weak. It is for this reason that the published series continue to show evidence of a significant number of post-operative shunts and atrio-ventricular blocks, as much in the closure of isolated VSDs as in the treatment of Fallot's tetralogy. This paper compares two techniques of suturing the prosthetic material which is used to close the VSD: the classical technique, in which it is intended to avoid the bundle of His by working below it, on the right side of the interventricular septum, and a different technique in which the sutures are applied directly to the free edge of the interventricular communication.


[Infarction of the right ventricle. 1. Hemodynamic diagnosis; pathologic correlations].

70 patients with acute myocardial infarction were submitted to a full haemodynamic assessment at the onset of the condition. In 28 of them there was a disproportionate rise in the right ventricular end-diastolic pressure which could not be explained on the basis of a primary rise in left ventricular filling pressures; these were divisable into two subgroups: -- 19 infarcts without septal rupture, almost all with an inferiorly or posteriorly placed lesion (17); in these cases, an analysis of the curves shows, among other features, a syndrome of adiastole whose three forms (minor, moderate or severe) correlate well with the clinical features. Six cases died, and in four of those it was possible to study the correlation with the post-mortem findings: there were major lesions of the free wall of the right ventricle in 3 cases, but constrictive pericardial changes, the main differential diagnosis of right ventricular infarction, in the fourth. -- 9 cases of necrosis of the septum with rupture, of which only 3 had a syndrome of adiastole; three of these necroses were posterior, and post-mortem examination in two of them confirmed that there were indeed major lesions in the posterior wall of the right ventricle. It therefore seems that the diagnosis of infarction of the right ventricle is a haemodynamic one, and rests especially on the discovery of a syndrome of adiastole. Findings such as these are confined almost exclusively to posteriorly placed infarctions.


[Infarction of the right ventricle. 2. Prognostic and therapeutic aspects].

Infarctions of the right ventricle have a reputation for being innocuous which appears to be unjustified; in a group of 21 patients in whom the diagnosis has been based on the haemodynamic principles put forward in the previous paper, we have had 7 deaths. The prognosis appears to be determined by two types of complication: ruptures of the posterior septum (4 cases), which are very distinctive in their clinical and topographical picture; and haemodynamic complications (10 cases of decompensation) which are related fairly rarely with the lesion of the right ventricle (2 cases), but more often with an associated complication, especially hypovolaemia, in which state the involvement of the right ventricle seems to play a particularly major role in increasing the slowing of the circulation. The proposed treatment plan is aimed at the permanent establishment of an effective circulating volume in the uncomplicated cases; in cases with complications, the aims are twofold--filling of the vascular bed and vasodilators, either separately or simultaneously.


[The 6th heart sound].

The author describes a new sound in systole which he calls the V1th heart sound. This sound can be recorded in patients with pure aortic incompetence, but also in healthy subjects. It is not sufficiently loud to be heard on auscultation. It is visible only on the low frequency bands at 35 Hz, and rarely at 70 Hz. It is maximal at the apex and the endapex. It is characterised by 1 or 2 oscillations at the end of mesosystole and at the beginning or middle of end-systole. This sound may be physiological: it will then be of low amplitude, and further from the 2nd sound than in cases of pure aortic incompetence, in which it is pathological, and closer to the 2nd sound. The author puts forward two hypotheses for the origin of the VIth sound.


[Recording of the electrical activity of the sino-atrial node area during an experimental sinoatrial block in dogs. Arguments in favor of its sino-atrial origin].

The electrical activity of the sino-atrial node appears to be difficult to detect, and has not until now been recorded from the heart in situ. Recording of the electrical activity from the area of the sino-atrial node area was carried out in the dog after thoracotomy, using a unipolar electrode placed in the epicardium at the cavo-atrial junction area; it enabled us to demonstrate a slow potential, of low amplitude, preceding the atrial deflection. The particular relationships between this slow potential and atrial activity under differing degrees of sino-atrial block have led us to believe that this potential does indeed originate in the sinoatrial node. In the light of this experimental observation, an explanation is put forward for the difficulty which is usually experienced in obtaining any recording of the sino-atrial node potential, and for the ease with which this potential could be recorded in this case, and indeed in future cases with similar pathological problems.


[Myocardial infarct complicated by a posterior aneurysm of the left ventricle. Correction by resection and double coronary bypass. 1-year clinical and angiographic follow-up].

5 months after a posterior infarction, a man of 48 was found to have a posterior aneurysm with right coronary thrombosis and anterior inter-ventricular stenosis. A total treatment approach (resection of the aneurysm + double bypass graft) led to a stable clinical cure, which has been monitored one year later by ventriculography and coronary arteriography. The authors make the comment, however, that in this case surgery was more in the way of a safety measure than a necessity.


[Prinzmetal's angina. Histological study of peroperative coronary specimens. Apropos of 2 cases].

The results of histological examination of two coronary artery biopsy specimens removed at operation are presented. There were unusual findings, especially of a highly cellular and oedematous fibroblastic endarteritis, of the lack of calcification, and of the presence of marked medial sclerosis. These unusual histological findings are the result of solitary variable stenoses of the coronary arterial tree, and very different from the histological findings in the atheromatous lesions which are usually found when Prinzmetal's angina is super-imposed on lesions which are multiple and diffuse.


Comparative studies of several vaccinia virus strains by intrathalamic inoculation into cynomolgus monkeys.

From the comparative studies of the virulence of several vaccinia virus strains by intrathalamic inoculation into cynomolgus monkeys, the following results were observed. The CV1 virus was most virulent, the New York City Board of Health, Ikeda, EM63, and Lister viruses were slightly less virulent, and DIs and LC16 viruses least virulent. The characteristic findings were widespread inflammatory lesions in the meninges and choroid plexus which were closely associated with the replication of vaccinia virus, and parenchymal lesions which might be referred to a encephalopathy in the deceased monkeys. Meningoencephalitis was, however, ofter recognized in the monkeys sacrificed at 14 days postinoculation and those dying late.


Comparison between conventional systems and a newer system of combined cultures for isolation of influenza viruses.

The sensitivity of conventional systems was compared with the sensitivity of the newer system of combined cultures for the isolation of influenza viruses. Both systems were comparable. It was found, that certain isolates were obtained only by conventional systems, and conversly, others by combined cultures only. These results showed that the joint usage of both the conventional and newer systems resulted in a significantly higher isolation rate.


[Microscopic structure of the mesenteric lymph nodes of monkeys].

The structure and cytoarchitectonics of mesenterial lymph nodes were studied in thin histological sections by different methods. Under study were 5 rhesus monkeys and 3 hamadryas baboons. The square surface of different structural elements of the nodes (the cortical and medullary substances, follicles, the connective tissue framework, sinuses) occupied by them in sections was calculated and the amount of cellular elements was determined (%). Comparison of the data obtained in rhesus monkeys and baboons speaks of certain species-specific features of the organs under study. The morphological picture of lymph node sections in baboons (as compared with rhesus monkeys) might suggest earlier ageing of nodes in baboons.


Epilepsia partialis continua. A review of 32 cases.

Clinical, EEG, and autopsy findings were studied in 32 patients with epilepsia partialis continua. The seizures occurred at different ages and with diverse diseases of the brain. Facial and distal limb muscles were preferentially involved. Often, seizures suggested multifocal origin within a limited cerebral region, with low-amplitude, irregular, asynchronous contractions that could resemble other movement disorders. Twitching varied in rate, rhythm, intensity, and territorial extent continued sometimes for decades and was poorly responsive to therapy. Focal EEG abnormalities commonly consisted of discrete spikes, sharp waves, or slow-wave activity. Autopsy findings in eight patients showed consistent involvement of the motor cortex or closely adjacent areas. Clinical, EEG, and pathologic data favor a cortical origin of epilepsia partialis continua.


Inferior oblique myectomy, disinsertion, and recession in rhesus monkeys.

Twenty-one myectomies near the insertion, 22 disinsertions, and two recessions were performed. After healing was complete, each animal was sacrificed. Anatomical dissection showed the following:(1) in every disinsertion and myectomy case, the inferior oblique muscle spontaneously reattached itself to the sclera;(2) the site of reattachment following these two procedures varied widely, ranging from the original insertion site to other areas adjacent to the lateral rectus or inferior rectus insertions; (3) disinsertion and myectomy shortened the inferior oblique muscle to two thirds its normal length, while recession shortened the muscle to one third its normal length.


Testing thyroid function.

From the foregoing discussion, it is clear that no single test provides sufficient information to justify its use alone as a single screening test. In vitro tests have now replaced in vivo procedures in the vast majority of patients. Because of the frequency of abnormalities in TBP concentration, the estimation of total T4 should be accompanied by a T3 resin uptake to provide the free thyroxine index or alternatively, a normalized T4 test (Quantisorb or ETR) is  preferable. In patients with suspected hyperthyroidism, the initial laboratory evaluation should be an estimate of free T4 and a total serum T3 determination. Whereas the majority of hyperthyroid patients exhibit elevated free T4 levels, a smaller but variable percentage will exhibit only an elevated T3 level. The diagnosis mients where equivocal tests do not provide a diagnosis. In patients with suspected hypothyroidism, estimations of T4 and T3 provide evidence of diminished thyroidal secretion. The diagnosis should be confirmed by demonstration of an elevated TSH level. Normal or low TSH levels point to a diagnosis of pituitary hypothyroidism which can be confirmed by TRH stimulation. The finding of low normal or subnormal T4, normal T3 and elevated TSH levels suggest "compensated hypothyroidism". Estimation of thyroid autoantibodies may confirm the diagnosis of autoimmune thyroiditis. It is emphasized that the approach to testing thyroid function should be an adequate clinical assessment so that selection of the appropriate test(s) currently available leads to a diagnosis of great certainty in most cases.


Analog processing of vestibular nystagmus for on-line cross- correlation data analysis.

An analog processing circuit is described which allow accurate measurement of the phase relationships between input angular acceleration and resulting eye velocity. Vestibular nystagmic data are processed via analog technics to yield slowphase eye velocity. The turntable velocity input is cross-correlated with the eye velocity output, using a Nicolet MED-80 minicomputer system. The resulting correlograms are further processed to obtain precise phase information. Test data analysis shows a system resolution within 1 degree. Data from human and animal subjects are portrayed.


Performance in a 12-hour, 300-rad profile.

A discrete behavioral task was initiated to study the effects of a 300-rad variable dose rate exposure profile upon positively (food reward) and negatively (mild shock) reinforced groups of primates. Animals performed the task for 12 h. Performance decrements were readily apparent in 2 of 8 shock and 2 of 7 food animals, while delayed reaction times were found in 3 of 8 shock and 3 of 7 food animals. Of the 7 food animals, 4 exhibited emesis, while 1 of 8 shock animals vomited. Such information is useful to military planners who need guidelines to indicate potential aircrew nuclear vulnerability and survivability.


Labyrinth and cerebral-spinal fluid pressure changes in guinea pigs and monkeys during simulated zero G.

This study was undertaken to explore the hypothesis that shifts of body fluids from the legs and torso toward the head contribute to the motion sickness experienced by astronauts and cosmonauts. The shifts in body fluids observed during zero-G exposure were simulated by elevating guinea pigs' and monkeys' torsos and hindquarters. Cerebral-spinal fluid pressure was recorded from a transducer located in a brain ventricle; labyrinth fluid pressure was recorded from a pipette cemented in a hole in a semicircular canal. An anticipated divergence in cerebral-spinal fluid pressure and labyrinth fluid pressure during torso elevation was not observed. The results of this study do not support a fluid shift mechanism of zero-G-induced motion sickness. However, a more complete test of the fluid shift mechanism would be obtained if endolymph and perilymph pressure changes were determined separately; we have been unable to perform this test to date.


AME seminar program in the United States: genesis, goals, and cost-benefit reflections.

The practicing physician's requirement for continuing postgraduate medical education is generally accepted and has generated a number of postgraduate education  programs. In 1960, the FAA inaugurated a seminar program to serve the special educational needs of its approximately 7,500 designated Aviation Medical Examiners. These doctors, the majority of whom are civilian physicians representing almost every specialty, are charged with issuing or withholding the pilot's medical license to fly. Under the administration of coauthor Harris, the AME Seminar Program undergoes modification and change as improvements are suggested by accrued experience. Evaluation of data acquired from a variety of sources indicates that the AME does, in fact, need refresher training in civil aviation medicine. In helping fulfill that need, the AME Seminar Program is working effectively.


A clinical evaluation of four alternative telemedicine systems.

A comparison was made of four alternative telecommunication systems used in delivering primary health care to remote populations. The media were color television, black and white television, still frame black and white television, and hands-free telephone. The patient population was that of a large organization in a Canadian province, a major component of a societal system. Over 1000 patients who came to a clinic seeking medical attention were examined remotely by one of the four systems. In addition, they were examined in the physical presence of a doctor at the clinic. The diagnoses, patient management programs, etc., of the clinic physician were used as the basis for comparison. We found no significant differences in diagnostic accuracy, proportion of supporting investigations requested, e.g., laboratory tests and X rays, time taken for the diagnostic consultations and the effectiveness of patient management across the four communication modes. On the contrary, in some instances it was found that behavior across the modes was significantly similar. Even patient attitudes showed only a slight preference for the more sensory rich modes of communication. It was concluded that there is little to distinguish the effectiveness of the four telecommunication modes when used for remote diagnostic consultations. Therefore, the cheapest mode is the most cost-effective. Phase four of the research program will compare the effects of the two least costly modes, still frame television and hands-free telephone, in an operational system in northern Ontario.


Mucopolysaccharidosis III A (Sanfilippo disease type A). Histochemical, electron microscopical and biochemical findings.

This is a report of two brothers iwth mucopolysaccharidosis. The 8- and 10-year-old boys presented the characteristic clinical symptoms of the syndrome in their entirety. Both had a highly increased excretion of heparan sulfate in urine. The elder boy died and was autopsied and diagnosed as having Sanfilippo disease Typ A by a drastic reduction of heparan sulfate sulfamidase activity in organ extracts. Histochemically, highly water-soluble, sulfate acid mucopolysaccharides were demonstrated in liver, spleen, and cerebrum of the deceased child. Chemical analyses revealed a 12-fold increase of sulfated mucopolysaccharide in the patients liver and a 4.5-fold increase in the cerebrum when compared with normal controls. The sulfated polysaccharide consisted mainly of heparan sulfate, which was of low molecular size, heterogeneous in charge, and rich in its sulfamino hexose content. In addition, the gangliocytes of cerebrum and cerebellum had accumulated glycolipids. Electron microscopically the storage cells were overloaded with lysosomal residual bodies. The mitral valve was also involved in the storage process, which is a rare manifestation of the Sanfilippo syndrome. Acid mucopolysaccharides were deposited intracellularly as well as extracellularly in the mitral valve tissue. Polarisation microscopically there was found a change from normally positive to negative birefringence in the connective tissue ground substance of the mitral valve when containing stored mucopolysaccharides.


Acute myocardial infarction following gold sodium thiomalate induced vasomotor (nitritoid) reaction.

A vasomotor (nitritoid) reaction occurred following an initial injection of gold sodium thiomalate (GST; Myochrysine) in a 69-year-old man with rheumatoid arthritis (RA). An acute anterior wall myocardial infarction, documented by serial electrocardiographic and serum enzyme changes, developed immediately thereafter. A second patient, a 49-year-old man with RA and a history of GST-associated vasomotor reactions, was monitored clinically and electrocardiographically after GST administration. Sinus tachycardia developed and peripheral blood pressure fell within 2 minutes of injection, simultaneous with the onset of vasomotor symptoms. Vasomotor reactions from GST may compromise myocardial perfusion by their action on arteriolar smooth muscle, and thus result in peripheral vasodilatation, or they may act by adrenergic discharge initiated by such a reaction, and thus increase myocardial work and oxygen demand. Aurothioglucose (Solganal), rarely produces vasomotor reactions, and may be preferred to GST in elderly RA patients with concomitant cardiovascular disease or atherosclerosis.


Papular mucinosis with myopathy, arthritis, and eosinophilia. A histopathologic study.

A patient with biopsy-proven papular mucinosis, plus the characteristic IgG lambda light chain paraproteinemia, also developed a severe proximal myopathy, seronegative inflammatory polyarthritis, and marked eosinophilia. Muscle enzymes were elevated, EMG was compatible with polymositis, and muscle biopsy revealed an atypical necrotizing vacuolar myopathy. Synovial biopsy revealed an inflammatory synovitis with Class II synovial fluid. No mucin deposition was detectable in muscle or synovium. During 7 years of observation, corticosteroids and various immunosuppressive agents were successively administered with little benefit. Recently, weekly intravenous methotrexate and low-dose oral corticosteroids have resulted in clinical and laboratory improvement. It is suggested that the pathology in papular mucinosis may include serious rheumatic manifestations in addition to the cutaneous involvement.


Blood levels of the metabolites of glyceryl trinitrate and pentaerythritol tetranitrate after administration of a two-step preparation.

Blood levels and urinary excretion rates of glyceryl trinitrate- pentaerythritol tetranitrate, and their less nitrate containing metabolites have been determined in ten human volunteers after a single dose of a two- step preparation containing glyceryl trinitrate and pentaerythritol tetranitrate. Blood levels accounted for peak levels of about 40% of the glyceryl trinitrate and 0.4% of the pentaerythritol tetranitrate metabolites, respectively. Within the first 24 h post administration 22% of the glyceryl trinitrate and 19% of the pentaerythritol tetranitrate were excreted as nitrate metabolites, chiefly in form of conjugates. The determinations were obtained by gas chromatography on extremely inactive columns and electron capture detection by means of derivatives.


[The influence of etiroxat-HCl on iodine metabolism in man (author's transl)].

Investigation of the iodine metabolism in man during and after the ingestion of D,L-methyl-3,5,3,5-tetraiodothyronine-ethylester-hydrochloride (etiroxat-hydrochloride, Skleronorm) exhibited the following results: 1. After 20-40 mg of etiroxat the absolute iodine uptake of the thyroid gland was increased 3-7 times. There was indirect evidence that the incretion rate of thyroid hormones did not change. 2. The concentration of total iodine, T4(D), T4(RIA) and T3(RIA) was artificially increased by etiroxat for 2-3 months after cessation of its application. Therefore these parameters do not offer information on the concentration of thyroid hormones in the blood during this period of time. 3. Like other thyroid hormone analogues 40 mg etiroxat daily for 4 weeks blocks the TSH incretion induced by 200 microng TRH up to 1-2 weeks after cessation.


Regression of arteriosclerotic lesions in rhesus monkey aortas after regression diet. Scanning and transmission electron microscope observations of the endothelium.

Scanning and transmission microscopy were used to study aortic intima atherosclerotic lesions in Rhesus monkeys during both progression and regression phases. Scanning micrographs of severely atherosclerotic lesions showed areas of disjunctive endothelium and discontinuous basement membranes, frequently accompanied by red blood cells and other circulating elements adhering to the surface. Transmission micrographs also showed occasional areas of endothelial cell damage and loss with lipid-laden smooth muscle cells and foam cells beneath. Regressed lesions (affected by low-fat, low-cholesterol diet with or without  cholestyramine) showed endothelial changes suggestive of reparative processes. Scanning micrographs showed flattened residual lesions with continous endothelial lining, while transmission microscopy disclosed interdigitated intercellular tight junctions and frequently reduplicated basement membranes.


Effects of propranolol, minoxidil, and clofibrate on cholesterol-induced atherosclerosis in stumptail macaques (Macaca arctoides).

Propanolol, minoxidil, and clofibrate, three different classes of pharmacological agents used clinically in various conditions related to atherosclerosis, were shown not to have any intrinsic potentiating effects on the development of atherosclerosis in stumptail macaques fed an atherogenic diet. We did obtain, however, some results that suggest that clofibrate and propranolol may exert some beneficial actions.


Localization of lipase-like immunoreactivity in porcine adipose, aortic and myocardial tissue.

Lipase has been purified from pig adipose tissue and antibodies have been produced in rabbit. By indirect immunofluorescence and immunoenzyme techniques lipase-like immunoreactivity was demonstrated in the intima of pig aorta, in the endothelial cells of the myocardium and in plasma membranes of adipocytes and skeletal muscle cells. Lipase activity in extracts of some of these tissues was inhibited by the addition of anti-lipase antibodies. At least part of the immunoreactivity in the examined tissues is due to active lipases.


Studies on the absorption and disposition of meptazinol following rectal administration.

1 Rectal administration of the new analgesic drug, meptazinol, resulted in rapid absorption of the compound both in the monkey and in man. Peak plasma levels were observed within 0.5 h of dosing. 2 Absorption of the drug following rectal administration was extensive as shown by the recovery of 65-90% of the dose in the urine. 3 Despite substantial inter-individual variation in the observed maximum plasma concentrations of the drug, it was still evident that concentrations after rectal dosage were considerably higher than when the same dosage was given orally. 4 Elimination of the drug from plasma took place rapidly in an apparently mono-exponential manner in both species. The half-life of elimination in monkeys was 1.25 h and in man 2.0 h.


A test for mutation theory of cancer: carcinogenesis by misrepair of DNA damaged by 4-nitroquinoline 1-oxide.

Evidence for a mutation theory of cancer is presented by reviewing the experimental work on 4-nitroquinoline 1-oxide (4NQO) carcinogenesis. 4NQO almost completely mimics u.v. light and produces 4NQO-purine adducts on DNA. When 4NQO-treated cells are held in liquid medium under appropriate conditions, the 4NQO adducts disappear from DNA, in parallel to decrease of premutational damage in Escherichia coli, or pretransformational damage in cultured mouse cells. Post-treatment with caffeine greatly diminishes the yields by 4NQO of mutants in E. coli, malignant transformants in cultured mouse cells and tumour nodules in the lung of mice. Potentially tumourigenized stem cells in the lung remain sensitive to selective killing by caffeine for at least 5 days after 4NQO treatment, in spite of their DNA being apparently replicated, an indication that carcinogen-damaged DNA in the stem cell can be transmitted to its successive daughter stem cells for many generations. This peculiar characteristic is discussed as a possible lead to the crux of the mutation theory of cancer in vivo, and a model for carcinogenesis is proposed.


Morphology, growth characteristics and oestrogen-binding capacity of DMBA-induced mammary tumours from ovariectomized rats.

The morphology of 20 mammary adenocarcinomas induced by 7,12-dimethylbenz(a)anthracene (DMBA) in Sprague-Dawley rats was compared with their growth characteristics and oestrogen-binding capacity following ovariectomy. The capacity to bind (3H)oestradiol-17B did not appear to be related to the growth characteristics, time of appearance after DMBA administration, or time between ovariectomy and assay for specific oestrogen-binding proteins. Furthermore, different tumours appeared to have oestrogen-binding capacities unrelated to the percentage of neoplastic cells within the tumour, amount of inflammation, mast cell infiltration, or the presence of fluid-filled cysts. The only morphological features which appeared to be correlated with oestrogen-binding capacity were the number of mitoses and the lipid content of the tumour; that is, the oestrogen-binding capacity tended to be lower in tumours with moderate or large numbers of mitoses and in tumours with much lipid in the epithelial cells. Six of the 19 adenocarcinomas found prior to sacrifice either continued growing or remained static following ovariectomy, while the others underwent regression. In 5 of the regressing tumours a new growth phase was observed, usually beginning 2 months after ovariectomy. Tumours other thus osteosarcoma as well as fibroadenomas and Zymbal-gland tumours.


Role of host endocrine status in murine leukaemogenesis.

Permanent changes in the endocrine status of female SJL/J and CR mice were induced by masculinization, ablation of endocrine glands, inoculation of hormones, or feeding of the chemical carcinogen DMBA. All these procedures resulted in modification of the host hormonal milieu, as shown by blood hormone determination. Masculinization reduced drastically the onset of lymphosarcoma and increased the incidence of systemic neoplasms respectively in DMBA-treated female SJL/J and CR mice. Continued administration of gonadotrophins increased the incidence of systemic neoplasia in CR mice. A direct correlation is suggested between onset of lymphosarcoma or other tumours in mice and a specific shift to an abnormal hormonal environment.


An animal model to study iron availability from human diets.

1. The retention of ferric- and ferrous-iron was determined in guinea-pigs and monkeys using 55Fe and 59Fe. 2. The bioavailability of Fe from two typical Indian diets based on rice and wheat was determined in humans and monkeys using a 59Fe tracer and whole-body counting. 3. The retention ratio, ferric-Fe; ferrous-Fe was 0-90 in guinea-pigs and 0-33 in monkeys, indicating that monkeys absorb ferrous-Fe preferentially. 4. In monkeys retention of Fe from the test diets, as from ferrous ascorbate was lower than that in humans. 5. When food-Fe retention was expressed in relation to inorganic-Fe retention the value for retention ratio, food Fe: inorganic Fe in monkeys was similar to that in human subjects. 6. The results indicate that the monkey can be used as a model to study Fe absorption from human diets.


Histidine-200 alters inhibitor binding in human carbonic anhydrase B. A carbon-13 nuclear magnetic resonance identification.

We have previously prepared 13C-enriched NT-carboxymethylhistidine-200 human carbonic anhydrase B (CmHCAB) by reacting the native enzyme with 90% [1-13C]bromoacetate (Strader, D.J., and Khalifah, R.G. (1976), J. Am. Chem. Soc. 98, 5043). The 13C nuclear magnetic resonance signal of the enriched carboxylate of CmHCAB proved sensitive to active-site events, permitting, among other things, the determination of the microscopic pKa of the modified histidine. This report extends the study to the complexes of CmHCAB with the inhibitors iodide and azide. It is found that the pKa of histidine-200 is significantly increased when these inhibitors bind. A quantiative comparison of the iodide-induced pKa shift with literature data (Whitney, P. L., and Brandt, H. (1976), J. Biol, Chem. 251, 3862) showing that the binding of iodide is influenced by the ionization of an active-site group of pKa 6.1 allowed the clear identification of histidine-200 as the perturbing group. Other important implications of the magnetic resonance results are also discussed.


Solubility properties of alpha-reduced paramyosin.

It is now believed that the reduced form of alpha-paramyosin is that found in living adductor muscles of molluscs. We have studied the solubility of a preparation of alpha-paramyosin obtained under reducing conditions. In contrast to the solubility profile of beta-paramyosin, the alpha-paramyosin, the alpha-preparation showed a rapid, almost linear decrease in solubility over the ionic strength range 0.35-0.25 at neutral pH. Solubility in this range was further decreased by the presence of physiologically small amounts of calcium ion. Lactate ion, which can accumulate during anaerobic glycolysis in molluscan muscles, also decreases the solubility at a level of 50 mM. In addition, the type of paracrystal formed by alpha-paramyosin differs greatly from those of beta-paramyosin and paracrystal formed in the presence of lactate differs from those formed in buffer solutions. Reduced alpha-paramyosin is more sensitive to the above parameters than the preparations made without reducing agents. Moreover, the pH and ionic strength ranges in which greatest change in solubility behaviour occurs are physiologic, as are the calcium and lactate ion levels effective in increasing intermolecular interactions. A model is proposed for alpha-paramyosin in which the extra 5% presumably removed in beta preparations is a "sticky head" which protrudes from one end of the molecule and confers on it an increased tendency for interaction, particularly at physiological ionic strength. Such molecules would be capable of promoting interactions between thick filaments which contain them, providing a means of accounting for the pH dependent stiffness observed in glycerinated preparations of molluscan catch muscles.


5' -and 3'-terminal nucleotide sequences of Tetrahymena pyriformis 17S rRNA.

Ribonuclease T1 oligonucleotides arising from the 5' and 3' termini of the 17S rRNA of Tetrahymena pyriformis were isolated by the diagonal method of Dahlberg (Dahlberg, J. E. (1968), Nature (London) 220, 548), and their nucleotide sequences were determined. The base sequence of the 3'-terminal fragment is (G)AUCAUUAoh, which is identical to that found in other 17S-18S eucaryotic rRNA species. The nucleotide sequence of the 5'-terminal oligonucleotide is pAACCUGp, which is identical in length to that found in other eucaryotes and shows a partial but significant sequence homology to the 5' RNase TI oligonucleotides isolated from other eucaryotic species.


Enzymological properties and immunological characterization of alpha-galactosidase isoenzymes from normal and Fabry human liver.

1. A method is described for the rapid isolation of alpha-galactosidases A and B (alpha-D-galactoside galactohydrolase, EC 3.2.1.22) from normal human liver. 2. When the same method is applied to Fabry liver, most of the alpha-galactosidase activity is recovered in the fraction corresponding to normal alpha-galactosidase B. In agreement with Romeo, G., D'Urso, M., Pisacane, A., Blum, E., De Falco, A. and Ruffilli, A. (1975) Biochem. Genet. 13, 615-628) [18], a small amount of alpha-galactosidase activity is found in the fraction corresponding to normal alpha-galactosidase A. 3. The kinetic properties of the B-like activity from Fabry liver are similar to those of normal alpha-galactosidase B. In agreement with Romeo et al. [18], it was found that the kinetic properties of the A-like activity from Fabry liver are similar to those of normal alpha-galactosidase A. 4. Using antisera raised against normal alpha-galactosidase A and normal alpha-galactosidase B, it is shown that the normal alpha-galactosidase isoenzymes are immunologically distinct and that the B-like activity from Fabry liver is immunologically related to normal alpha-galactosidase B. Furthermore, the A-like activity from Fabry liver is immunologically related to normal alpha-galactosidase B and not to normal alpha-galactosidase A. 5. Normal alpha-galactosidase B is converted into an A-like form during storage. 6. It is concluded that the B-like alpha-galactosidase in Fabry tissues is identical to normal alpha-galactosidase B, and that the small amount of A-like activity found in Fabry material is due to a modified form of alpha-galactosidase B.


Purification and characterisation of prostaglandin endoperoxide synthetase from sheep vesicular glands.

The membrane-bound prostaglandin endoperoxide synthetase was purified until homogeneity, starting from sheep vesicular glands. The enzyme was obtained as a complex with Tween-20, containing 0.69 mg detergent per mg protein. No residual phospholipid could be detected. Prostaglandin endoperoxide synthetase appeared to be a glycoprotein, containing mannose and N-acetyl-glucosamine. No haemin or metal atoms were present. A molecular weight of 126 000 was found for the apoprotein by ultracentrifugation in 0.1% Tween solutions. The polypeptide chain without carbohydrate had a molecular weight of 69 000 as determined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. The pure enzyme displays both cyclooxygenase and peroxidase activity, thus converting arachidonic acid into prostaglandin H2. The isolated synthetase requires haemin, which possibly acts as an easily dissociable prosthetic group, and a suitable hydrogen donor to protect the enzyme from peroxide inactivation and which is consumed in stoichiometric amounts to reduce the intermediate hydroperoxy group.


Immunological properties of medium-chain acyl-thioester hydrolase and fatty acid synthetase from lactating-rabbit mammary gland.

The cytosol from lactating-rabbit mammary gland contains a medium-chain acyl-thioester hydrolase. This hydrolase terminates chain lengthening of the fatty acids synthesised by fatty acid synthetase so as to release C8:0 and C10:0 fatty acids which are characteristic of rabbit milk. The medium-chain hydrolase and the fatty acid synthetase present in this cytosol have been shown to be immunologically distinct. When fatty acid synthetase was purified from this cytosol it showed unexpected immunological reactivity towards antiserum raised to the medium-chain hydrolase. The precipitate formed was not due to fatty acid synthetase, but to medium-chain hydrolase contaminating the synthetase. However, the proportion of this medium-chain hydrolase which was recovered with the purified synthetase was too small to be detected by sodium dodecyl sulphate-polyacrylamide gel electrophoresis, and was too small to elicit an antibody response in sheep. Immunological techniques have shown that the medium-chain hydrolase appears in rabbit mammary gland between days 17 and 22 of pregnancy. This coincides with the onset of milk-fat synthesis. The medium-chain hydrolase could not be detected in the cytosol from lactating-rabbit liver.


Ligandin heterogeneity : evidence that the two non-identical subunits are the monomers of two distinct proteins.

Purified ligandin (Y-protein) a 46000-dalton protein, has been shown to consist of two subunit species (mol. wts. 22 000 and 24 000) on discontinuous polyacrylamide gel electrophoresis in sodium dodecyl sulphate. This technique was used to define further the nature of these subunits. The Y sulphobromophthalein-binding fraction of rat hepatic cytosol was shown to contain three major subunit bands designated subunit Ya, subunit Yb and subunit Yc in ascending order of size. Purified ligandin was found to comprise Ya and Yc subunit species, and also gave two bands on isoelectric focusing. The two subunit species in purified ligandin were partially separated by an additional purification step. Antiserum to ligandin reacted mono-specifically with the purified protein, as well as hepatic, renal and small intestinal mucosa cytosol, but gave lines of identity and partial identity with cytosol from testis, ovary and adrenal gland. The Y fraction of testis was found to contain only Yb and Yc species, while all three major bands were found in liver, kidney and small intestinal mucosa. Phenobarbital treatment increased the concentration of Ya and Yb in the liver, but had little effect on Yc. These findings suggest that the Ya and Yc ligandin subunits are the monomers of two proteins: YaYa and YcYc.


Comparison of four purified extracellular 1,4-beta-D-glucan cellobiohydrolase enzymes from Trichoderma viride.

Four electrophoretically distinct 1,4-beta-D-glucan cellobiohydrolase enzymes (exo-cellobiohydrolase, EC 3.2.1.91) from Trichoderma viride have been purified to homogeneity. Three enzymes (A, B, and C) were from a commercial T. viride preparation whereas the other (D) was from T. viride QM 9123 grown on cellulose in submerged culture. The enzymes were similar with respect to ultraviolet light absorption, amino acid and amino sugar composition, heat stability, molecular weight, specific activity, and carboxyterminal residues, indicating very nearly identical polypeptide portions. The enzymes also exhibited immunological cross-reactivity. The enzymes differed most in the content and composition of covalently bound neutral carbohydrate.


Parvalbumins from frog skeletal muscle (Rana temporaria L.). Isolation and characterization. Structural modifications associated with calcium binding.

Two parvalbumins have been isolated from the skeletal muscle of Rana temporaria L. Amino acid composition, tryptic peptide maps, isoelectric points, calcium content and ultraviolet as well as circular dichroism spectra have been determined. Investigation on antigenic properties revealed no antigenic determinants common to both components. The two protein molecules appear to belong to far related gene lineages. They are also different from the parvalbumins found in Rana esculenta muscle. Modifications of physical parameters, associated with calcium binding and dissociation are described. While antigenicity remained essentially unchanged, conformational changes were revealed by alterations of circular dichroism spectra.


[Heterogeneity of molecular forms of phenol oxidase from apple fruits].

Qualitative differences of a dimer (m.w. 60.000-70.000) and a monomer (m.w. 30.000-40.000) fractions of phenoloxidase (EC 1.10.3.1), isolated from fruits of two winter varieties of apples were studied. tthe fractions analysed differed markedly in their Km values and the Hill coefficients. The monomer fraction possessed a higher affinity for monophenols and is capable to accomplish the hydroxylation reaction more actively. The interrelation of these changes and the aging of fruits under storage conditions with resulting changes in their total metabolism is discussed.


Brain cholinesterase activities of birds from forests sprayed with trichlorfon (Dylox) and carbaryl (Sevin-4-oil).

Brain cholinesterase activities were determined in birds from forests sprayed with Dylox(2) at 1.13 kg/hectare (1 lb/acre - active ingredient [a.i.]) or Sevin-4-oil(2) at 1.13 kg/hectare (1 lb/acre - a.i.) for up to 5 days postspray. Of ten bird species evaluated from  the Dylox spray area, four species represented by six individuals had values which were depressed more than 2 standard deviations below the mean. Three of these activities (two species) were about 20% less than the mean. Of 12 species evaluated from the Sevin-4-oil spraying, three individuals representing three species had depressed values. One value was depressed greater than 20% below the mean. Half of the depressed activities were in canopy-dwelling birds collected on the day of spray.


Radiological aspects of the vertebral components of osteochondrodysplasias.

Analysis of the individual components of the vertebrae permits the radiologist to identify and understand the fundamental physio-pathologic growth mechanisms affecting shape, size and architecture which operated during development. The achievement of this goal is facilitated by systematically paying attention to changes of the vertebral end-plates, anterior and posterior aspects of the vertebral body, the vertebral rim, neurocentral junction and interpedicular distance. The dynamic changes noted in follow-up studies of the spine in certain dysplasias may reveal the developmental history of the vertebral complex. The dimension of time is an important factor, which the radiologist has a unique opportunity to exploit. Vertebral configuration permits radiological analysis and diagnosis.


A versatile and economic whole-body counter based on liquid scintillation detector modules.

A whole-body counter comprising rectangular liquid scintillator detector modules is described. Photomultipliers are used economically and the use of local shielding leads to a further reduction in cost. In conjunction with a moving bed, the modular arrangement provides a versatile system which allows high sensitivity static counting using all detectors, or scan counting using selected combinations of detectors. The total body potassium content of a standard man (140 g K) can be estimated with a statistical counting error of 2.2% in a counting time of 1000 seconds. Methods of using the counter for total body potassium and gastro-intestinal absorption measurements are presented.


Continuous-flow plasmapheresis in management of severe rhesus disease.

Eight patients with severe rhesus disease and expected fetal loss were treated by intensive plasmapheresis using a continuous-flow cell separator. Plasmapheresis was started at 16-27 weeks' gestation, and continued until planned intrauterine transfusion or until the infant was delivered or the rhesus disease became uncontrolled again. Altogether 24 to 2371 of plasma was exchanged over periods ranging from seven to 16 weeks. In seven of the eight patients the anti-D concentration fell during the period of plasmapheresis. Amniotic fluid spectrophotometry values remained below those recorded in the preceding pregnancy in six out of seven women. In five patients an attempt was made to control the rhesus disease by plasmapheresis alone, and two of these women delivered infants who survived. In the other three cases the infants died, one from the idiopathic respiratory distress syndrome and the other two in utero. These preliminary findings suggest that intensive plasmapheresis with a cell separator may reduce fetal haemolysis is delivered. Nevertheless, plasmapheresis may best be used to reduce haemolysis until intrauterine transfusions may be given more safely after 30 weeks' gestation.