Energy/protein index: III. Correlation with a biochemical parameter which reflects protein nutritional imbalance.

To establish the usefulness of the Energy/Protein index, a study was made to assess its correlation with a biochemical parameter able to detect marginal forms of protein-energy malnutrition such as the non-essential/essential aminoacid ratio. A simple linear regression model was proposed and tested in a sample of ninety-seven malnourished children, by means of analysis of variance. The model was satisfactory. A highly significant (p less than 0.001) correlation coefficient of r = 0.552 was found.


Rapid diagnosis of influenza A infection by immunofluorescence. Methodological problems and clinical material.

Indirect immunofluorescence (IF) on cell spreads from nasopharyngeal secretions (NPS) was used for the rapid diagnosis of influenza A infection and was compared with IF on monkey kidney cells infected by NPS. The clinical diagnosis of influenza A infection was confirmed by serology in 32 of 40 patients. In 27 of the 32 patients (84 per cent), the diagnosis was achieved by IF on cell spreads of NPS. In 13 of 15 (87 per cent) subjects with positive serology, the early appearance of influenza A  virus antigen was revealed by indirect IF on infected monolayer cells. No false positive specimens were found among serologically negative subjects by either method. Consequently, the reliability of IF on cell spreads of NPS is very similar to IF on infected cell cultures, but offers a much quicker diagnosis (3-4 h as compared to 1-3 d). Monovalent anti-human IgG FITC should be used instead of polyvalent anti-human Ig FITC, as the latter contains anti-IgA which may adhere to intracellular IgA in the epithelial cells of NPS and thereby cloak the viral antigen.


Infection of Clethrionomys G. glareolus Schreb. (red mice) with Mycobacterium tuberculosis and Mycobacterium bovis injected subcutaneously.

Groups of red mice were injected with doses from 10 mg to 10(-8) mg semidried culture of a strain of M. tuberculosis and with doses from 10(-1) to 10(-8) mg of a strain of M. bovis. Some animals were killed about 1 1/2 and 3 months after injection and the remainder lived until death occurred spontaneously. The number of tubercle bacilli in the organs was evaluated by microscopy of smears, in some cases by quantitative culture. Among the mice injected with M. tuberculosis in doses of up to about 2 million viable units, not one case of death occurred which could be attributed to tuberculosis. The autopsy findings consisted exclusively of lesions at the site of injection and in the regional lymph glands. Quantitative culture showed growth of a few viable units in the lymph glands, spleen or lungs, but no sign of progressive infection. Out of 10 mice injected with a giant dose of 3 X 10(7) viable units, only two died of tuberculosis. M. bovis provoked fatal tuberculosis in all animals injected with doses from 6.9 million to 7 viable units. Severe caseous lesions developed at the site of injection, in the lymph glands, in the lung, and often also in liver and spleen. The number of bacteria in the organs was enormous, particulary in the spontaneously dead animals. The survival times, which were dependent on dosage, varied from 51 to 159 days.


Effects of verapamil and nitroglycerin on contractile responses to potassium and noradrenaline in isolated human peripheral veins.

Isolated ring preparations of human vein were contracted by potassium (127 mM) and noradrenaline (1.8 X 10(-5) M). The potassium-induced contracture developed more rapidly and had a higher maximum amplitude than that produced by noradrenaline. Addition of phentolamine (10(-5) M) reduced the amplitude of the potassium contracture by 22% and abolished the noradrenaline response. Verapamil and nitroglycerin relaxed preparations contracted by potassium and noradrenaline, and, when added prior to stimulation, reduced the contractile responses to these agents. Both verapamil and nitroglycerin inhibited the contractile effect of noradrenaline more strongly than that of potassium. After immersion of the preparations for 30 min. in a calcium-free medium, the responses to potassium and noradrenaline were reduced to 21.3 +/- 2.5% and 7.1 +/- 0.8%, respectively, of the control. Addition of verapamil caused a further reduction of the response to potassium, but not of that to noradrenaline. Nitroglycerin caused a further reduction of the contractions induced by both agents. When the calcium concentration in the extracellular medium was increased from 0 to 4 mM, the contractile responses to potassium and noradrenaline returned to the control level. Both verapmil and nitroglycerin inhibited the contractile responses to calcium; the inhibiting effects of verapamil were significantly more marked than those of nitroglycerin. Tachyphylaxis to nitroglycerin was demonstrated on contractions induced by potassium, but not on noradrenaline-produced responses.


The composition and distribution of PCB in arctic fox (Alopex lagopus) caught near Longyearbyen on Svalbard.

Samples from 44 arctic foxes (Alopex lagopus), caught near Longyearbyen on Svalbard, were analyzed with respect to their content of PCB. Gas chromatographic-mass spectrometric investigations revealed that 7 PCB components constituted the main part of the total PCB present. These components were quantified individually. A moderate degree of PCB contamination was recorded. Calculated on a fat weight basis, the total concentrations of PCB in fat tissue and liver were about equal, but the relative amounts of most of the PCB components present were different in the 2 tissues. The total amount of PCB in brain, calculated on a fat weight basis, was significantly less than the corresponding concentrations in liver, kidney, muscle, and fat tissue. The special distribution trend observed in this study is related to the structure of the PCB components present and the arctic nature of the sampling area.


Chest wall recurrences after operation and postoperative irradiation of mammary carcinoma.

The frequency of recurrences in a material of 463 patients with mammary carcinoma following treatment by surgery with or without postoperative roentgen or cobalt irradiation to the operation area and regional lymph nodes is analysed. Postoperative irradiation to the operation area seems to prevent the chest wall recurrences even in stage I mammary carcinoma.


Computer program for central axis dose calculations for high energy photons.

A computer program is described for central axis dose calculations for 60Co and 6 MV photons. Fixed distance or isocentric calculations for regular or irregular fields can be performed. Corrections are made for wedges and blocking trays. Tissue-air ratios and percentage depth doses are calculated from scatter-air ratios eliminating the need for empirical formulas. Calculated tissue-air ratios and percentage depth doses for elongated fields agree to within 2 per cent with measured data, eliminating the need for tables of equivalent squares. Calculated values for irregular fields also agree to within 2 per cent with measured data.


Anti-inflammatory and PG inhibitory effects of phenacetin and acetaminophen.

Although acetaminophen and phenacetin do not inhibit PG synthesis when added directly to isolated rat platelets and when given orally, both drugs inhibit carrageenan-induced hindpaw edema--a widely used inflammatory assay method. It does not appear that the anti-inflammatory effects of these non-steroidal drugs (unlike other well-known non-steroidal drugs) can be explained on the basis of PG-synthetase inhibition.


Diagnosis of gynecologic pelvic masses by gray scale ultrasonography: analysis of specificity and accuracy.

A retrospective analysis of 251 proven cases of gynecologic masses was undertaken. Accuracy of gray scale sonography in determining the existence, size, location, and consistency of pelvic masses was approximately 91%. This is slightly higher than previously reported and could reflect increased accuracy of gray scale ultrasonography. Errors were primarily due to misinterpretation of loops of bowel, small lesions (2 cm or less in diameter), or poor technique. Since ultrasonograms are nonspecific, only rarely could a specific histologic diagnosis be made without accurate clinical information.


The effect of topically applied agents on ultraviolet erythema in guinea pigs.

It has been shown previously that ultraviolet erythema (UV) is partially the result of a local release of prostaglandins. We have studied the effects of different classes of pharmacological agents applied topically to the skin of guinea pigs and have found indomethacin and pirprofen, both prostaglandin synthetase inhibitors, to be highly effective suppressors of UV erythema. Our studies appear to further substantiate that prostaglandin synthesis and release may be the primary mechanistic process in the production of erythema and that the model itself can be predictive of both therapeutic and prophylactic effects of agents against sunburn.


Computed tomography of localized adipose deposits presenting as tumor masses.

Computed tomography can reliably differentiate fat from other soft tissues. As a result of this property, adipose deposits presenting as tumors can be discriminated from neoplasms. Five examples are presented in which surgery was obviated by CT findings.


Percutaneous aspiration of adrenal cysts.

Percutaneous needle aspiration was performed in three cases of cystic lesions of the adrenal gland which had been evaluated with nephrotomography, ultrasound, and angiography. The characteristics of the fluid aspirate were used as a guideline to further management. Two lesions were clearly benign cysts and were treated conservatively. The third lesion had a bloody aspirate and was surgically removed. The diagnostic evaluation of adrenal masses should follow a directed approach currently advocated for renal mass lesions.


Epithelioid sarcoma:radiologic and pathologic manifestations.

The radiologic and pathologic manifestations of epithelioid sarcoma are presented based on an analysis of five cases, and the literature is reviewed. This rare entity tends to orginate in the extremities and metastasizes primarily via the lymphatics. Although the lesion grows slowly, it recurs with high frequency. Males are affected three times as often as females. The differential diagnosis includes both malignant and benign entities. The natural history and methods of treatment are reported.


Calcifications and the therapeutically irradiated breast.

Mammograms of 81 patients who received radiation therapy to the breast were analyzed for patterns of pre- and postirradiation calcifications. Malignant calcifications may remain stable, diminish, or completely disappear following irradiation. The persistence of calcifications need not indicate residual cancer. Calcifications can develop following irradiation which are similar to either intraductal or secretory calcifications. Unusual calcifications may develop at the site of an irradiated cancer. It is important to recognize that benign calcifications can develop so that they will not be confused with recurrent malignancy.


Interstitial radiation in the treatment of carcinoma of the tonsillar region.

From 1964 to 1972, 69 patients were treated for carcinoma of the tonsillar region; all have been followed for at least 4 years. Sixteen patients (23%) had second primaries, and in 11 they were clearly the cause of death. No irradiated patient has died from primary recurrence after 2 years. The overall 3 year determinate survival rate (NED) for patients treated curatively was 63% (32/51). Twenty-four patients had interstitial implants after preliminary external radiation (usually 4,000 rad in 4 weeks). Local control (2+ years) was obtained in at least 82% (18/22); two clearly had recurrence. Of 12 stage I or II patients, 11 survived at least 2 years without evidence of disease; of 12 stage III or IV patients, seven did. Survival could have been improved by more aggressive management of neck nodes, as shown by results for the patients treated since 1969. While small superficial ulcers frequently occurred in the group with implants, all healed spontaneously in 1--6 months; there were no serious complications. The main advantages of implantation are reduction in serious complications and xerostomia.


Effect of ventilation images on observer interpretation of lung perfusion examinations.

Independent, random, and multiple evaluations by three observers of pulmonary perfusion scintiscans with and without ventilation scans demonstrated a 39% reduction in diagnosis of pulmonary embolism when ventilation scans were included. These findings suggest that four of 10 cases diagnosed as having pulmonary emboli on the basis of perfusion imaging procedures alone would have the diagnosis changed.


Imaging of experimental myocardial contusion: observations and pathologic correlations.

Myocardial contusions of variable severity were experimentally produced by an air-driven piston or serrated clamp in 29 dogs. Two 99mTc-labeled bone-seeking agents (99mTc pyrophosphate and 99mTc tetracycline) were used with cardiac scintigraphy to determine the sensitivity of these agents in detecting different degrees of myocardial damage. Results showed that 99mTc tetracycline was not a suitable scanning agent. 99mTc pyrophosphate produced positive scans in cases of complete (or nearly complete) transmural myocardial necrosis. Positive cardiac scans in clinical myocardial contusion may indicate the severity of the lesions and have prognostic significance.


Analysis of gas in vacuum lumbar disc.

In three cases in which chemonucleolysis with chymopapain was used for the treatment of back and sciatic pain, gas from the vacuum phenomenon of a degenerated lumbar intervertebral disc was recovered. In one of these, the gas analyzed by gas chromatography contained 90%--92% nitrogen.


Intraaortic counterpulsation balloon: radiographic considerations.

The intraaortic counterpulsation balloon is being used with increasing frequency in the setting of cardiogenic shock and/or high risk cardiac surgery. The radiologist should be aware of the normal function of this cardiac assist device, as well as its potential complications. The principal complications apparent on the plain chest radiograph are related to improper positioning of the balloon catheter.


Pulmonary sling in the adult.

Although an aberrant left pulmonary artery, usually called a pulmonary sling, is a serious anomaly in neonates and young children, it can be seen initially in adulthood. To date, all adult patients have been without symptoms or associated anomalies. Radiographic findings are somewhat different in adults, although at both ages a soft tissue mass is visible between the esophagus and the distal trachea. In adults, the anomalous left pulmonary artery is more likely seen as a right-sided mediastinal mass on the posteroanterior chest film. A pulmonary sling is apparently a benign and asymptomatic condition in adults.


Angiographic aspects of experimental nonocclusive intestinal ischemic injury.

An experiment was designed to fulfill the following aims: (1) to develop a model of nonocclusive intestinal ischemic injury compatible with survival for several days; (2) to determine the accuracy of angiography in diagnosing the presence and extent of intestinal ischemic injury; and (3) to determine the therapeutic and diagnostic value of intraarterial papaverine infusion. Experimental shock models were developed in the dog, and efficacy of the hypovolemic and normovolemic models was confirmed by gross and histologic evidence of intestinal injury in surviving dogs. No reliable angiographic signs of intestinal mucosal injury could be elicited. Angiographic abnormalities associated with the experiment were attributable to the shock itself and disappeared with the relief of shock. Infusion of papaverine into the superior mesenteric artery within 2 hr of the onset of shock prevented or ameliorated intestinal injury.


Double-blind comparison of iodipamide and lodoxamate using direct and drip infusion intravenous cholangiography.

Biliary tract opacification was assessed in a double-blind clinical study that compared iodoxamate with iodipamide. Both drip infusion and direct (bolus) intravenous cholangiography were used to administer the contrast agents. The infusion method with either agent produced better opacification than bolus administration. Regardless of method used, iodoxamate produced greater biliary tract opacification, fewer unexplained failures, and fewer contrast reactions. Neither agent was successful in patients with elevated bilirubin levels, nor did either agent alter hepatic, renal, or hematologic function.


Radiology of invasive amebiasis of the colon.

Entamoeba histolytica is a protozoan that is endemic in various parts of the world, including some areas of the United States. It may live in the large bowel in its cyst form without harming the host (commensalism) or, for as yet poorly understood reasons, invade the tissues as a trophozoite producing invasive amebiasis of the colon. In a review of over 3,000 cases of invasive amebiasis, the clinico-pathologic forms of the disease were: ulcerative rectocolitis (95%), typhloappendicitis (3%), ameboma (1.5%), and fulminating colitis and toxic megacolon (0.5%). Different radiographic patterns are seen in each clinical form with varying degrees of specificity. It is vitally important that this disease be included in the differential diagnosis of large bowel pathology even in nonendemic areas. Several referral patients who have received inappropriate therapy for inflammatory bowel disease with near disastrous results are seen at one of our institutions (Loyola) each year.


Inflammation and necrosis of the transverse colon secondary to pancreatitis.

A variety of radiographically demonstrable colon abnormalities associated with pancreatitis are illustrated. Extensive changes of either localized or diffuse inflammation are more common than has generally been appreciated. Localized changes may mimic carcinoma. Transverse colon inflammation secondary to pancreatitis may be appreciated on plain abdominal radiographs and to better advantage with a contrast enema. This pattern is distinctive and suggests a severe underlying pancreatitis. A water soluble contrast enema is recommended if there is any evidence of colon necrosis or fistula. Recognition of all of the changes of pancreatitis may lead to earlier management of the severe complications.


Improved radiographic detection of multiple gastric ulcers.

In more than 1,500 double contrast upper gastrointestinal examinations performed January through November 1974, 26 cases of multiple gastric ulcers were diagnosed. This represents 18.6% of the 140 patients who had a demonstrable gastric lesion, and 23.4% of the 111 patients who had either a single gastric ulcer or scar. This technique was developed in a country where gastric carcinoma is common, but in the United States its greatest usefulness will probably be in the detection of subtle mucosal defects such as multiple gastric ulcers, linear ulcers, and erosions. The sensitivity of the routine pharmacologically aided double contrast upper gastrointestinal examination is confirmed by the high incidence of multiple gastric ulcers found.


Gallbladder disease in cystic fibrosis.

In 84 consecutive patients with cystic fibrosis, oral cholecystography was abnormal in 39 (46.4%). The incidence of abnormal cholecystograms increased with patient age. The 26 patients with a nonvisualized gallbladder following double-dosage oral cholecystography were evaluated with intravenous cholangiography; 19 (70.3%) of these were abnormal. Ten patients were found to have calculi, an incidence of 11.9%. Awareness of the high incidence of cholecystographic abnormalities and calculi should be helpful in the evaluation of patients with cystic fibrosis, particularly since symptoms of abdominal pain are frequent in such patients and may lead to radiographic investigations.


Pyloroduodenal deformity due to liver malformation associated wtih omphalocele.

While congenital malformed and malpositioned livers are rare, they are relatively common in patients with omphaloceles. A malpositioned, malformed liver causing pyloroduodenal deformity and apparent pyloric obstruction in an infant or child with an omphalocele has not been previously reported. Thee such cases are described in which symptoms of upper gastrointestinal obstruction developed shortly after primary closure of the omphaloceles. Recognition of this condition at the time of primary closure of an omphalocele may allow consideration of additional procedures to prevent postoperative pyloric obstruction.


Diagnostic aspects of neonatal ascites: report of 27 cases.

Review of 27 cases of massive ascites found in the first month of life, usually immediately after delivery, revealed a broad spectrum of causes. Seven newborns had urinary ascites, five had bowel disease, three had cardiac arrhythmias, two had liver disease, and one each had toxoplasmosis, ovarian cyst, and chylous ascites. In seven cases the cause was never established. Physical examination, a planned sequence of radiologic examinations, and paracentesis for fluid analysis when necessary are the major steps in differential diagnosis. A systematic approach to the problem is proposed.


Subependymal germinal matrix and intraventricular hemorrhage in premature infants: diagnosis by CT.

Hemorrhage into the subependymal germinal matrix with rupture into the cerebral ventricles causes significant morbidity and mortality in premature infants. CT brain scanning was performed on eight premature infants on whom autopsy confirmation was obtained. Excellent sensitivity and accuracy in detecting germinal matrix hemorrhage and intraventricular hemorrhage were found. Germinal matrix hemorrhage appears as a parenchymal collection of blood adjacent to the foramen of Monroe and has a convex margin laterally. CT scanning of living premature infants is feasible in diagnosing nonfatal episodes of germinal matrix and intraventricular hemorrhage as well as subsequent development of hydrocephalus and porencephaly.


Widened sutures in childhood meningitis: unrecognized sign of an acute illness.

Disagreement exists over the time for sutural widening to occur with increased intracranial pressure in children. Twenty-four children ranging in age from 2 months to 4 years with acute meningitis had skull films upon admission to C. S. Mott Children's Hospital. Nine of the children had widened sutures on initial skull films. Sutural widening was documented as early as 2 days after onset of meningitis. Occasionally, skull films may help in the diagnosis of meningitis.


Acute bowing fractures of the forearm in children: a frequently missed injury.

Acute bowing of the bones of the forearm in children following trauma has only recently been recognized as a clinical and radiographic entity. This type of injury has been overlooked in the past because of lack of familiarity with the mechanical properties of curved tubular bones. Absence of a fracture line and the usual findings associated with a healing fracture on radiographs has contributed to the lack of recognition of this condition. The mechanism of injury, clinical and radiographic findings, clinical implications, and classification of these elusive childhood fractures are discussed on the basis of a study of 13 children.


Arthrography of the discoid lateral meniscus.

Twenty-seven cases of discoid lateral meniscus (DLM) were diagnosed during the course of 985 knee arthrograms; 19 had the classic discoid shape while eight were less large and believed to represent a forme fruste. Based on anatomic and arthrographic appearances, DLM was classified into six types. Criteria for the arthrographic diagnosis of intact and torn DLM are discussed. The wide variety of size and shape is believed to result from a combination of congenital and environmental factors. It is speculated that some may arise entirely secondary to trauma without congenital predisposition. Many undoubtedly remain asymptomatic: more than one-third of cases in this series were diagnosed incidentally during evaluation for symptoms and signs referrable to a torn medial meniscus.


Radiologic-pathologic correlations of small lung nodules with special reference to peribronchiolar nodules.

A radiologic and pathologic correlation has been made of small lung nodules. At necropsy 100 excised lungs were fixed and slices from them radiographed. The radiographs were used to select individual nodules for histologic study. Nodules in bronchopneumonia, acinonodose tuberculosis, chronic bronchiolitis, and simple pneumoconiosis due to ferric dust were shown to be located around inflamed terminal or respiratory bronchioles. Intraacinar infiltration was usually diffuse, but when nodules were seen, they occurred in peripheral airspaces with no relation to bronchioles. Hematogenous metastases showed distinctly marginated nodules, some truly intraacinar. Although each type of nodule can appear as an "acinar" or "subacinar" image on chest radiographs, this radiologic-pathologic study shows that they differ significantly in their relation to the airway structures.


Unusual radiographic features of Wegener's granulomatosis.

The classical radiologic manifestations of Wegener's granulomatosis are paranasal sinus disease and pulmonary nodules. A review of 31 clinicopathologically proven cases of Wegener's granulomatosis was undertaken to delineate some of the atypical radiologic presentations in this disorder. In 16 of the 31 patients a total of 18 atypical radiographic findings were demonstrated. These included lesions of the airways, parenchyma, pleura, and kidneys. We feel the "typical radiologic findings" of Wegener's granulomatosis should be expanded to include (1) endobronchial disease resulting in atelectasis of either a lobe or a complete lung, and (2) pleural disease with thickening or effusion which may be massive. While some of the rarer presentations are still not included, such a redefinition would cover more than 75% of our 31 cases.


Computer tomography of the anterior mediastinum in patients with myasthenia gravis and suspected thymoma.

Six patients with myasthenia gravis and suspected thymoma underwent radiologic investigation using plain chest radiography, conventional anterior mediastinal tomography, and computed tomography. All underwent exploratory thoractomy within 1 month of the radiologic workup. In three of the five cases that proved to be thymoma, CT yielded significant diagnostic information that bore directly on the management and/or prognosis of the patient. We therefore believe that CT may be a valuable adjunct in the radiologic investigation of the patient with myasthenia gravis.


Primary coccidioidomycosis in children presenting with massive pleural effusion.

Large pleural effusion as the presenting feature of coccidioidomycosis in childhood has not previously been reported and may cause significant diagnostic difficulty. Three children are described who required prolonged hospitalization and therapy with amphotericin B. Primary coccidioidomycosis should be included in the differential diagnosis of large pleural effusions in pediatric patients who have been in the endemic area. Such effusions suggest a severe form of the disease and may represent evidence of acute dissemination.


Furosemide-augmented intravenous urography: results in essential hypertension.

Giving an intravenous diuretic during urography (furosemide-augmented urography, vasodilated urography) causes renal swelling which is easily measured. Several investigators have used this observation as the basis of a screening test for renovascular hypertension. They found that normal kidneys enlarge in area by more than 10%, while kidneys with renal artery stenosis show a blunted size response, usually less than 5%. We used the technique in 46 patients with proven essential hypertension in order to further examine its potential usefulness in the hypertensive population. The 92 kidneys showed an average area increase of only 7.0% +/- 3.6% SD, and only 15% of the kidneys enlarged by more than 10%. Based on these observations we doubt that vasodilated urography will be valuable as a screening test for renovascular hypertension because of the high incidence of false positive and indeterminate results in patients without renal artery stenosis.


Ultrasonic evaluation of renal calculi.

Nine patients with radiographic evidence of renal calculi were evaluated with gray scale renal ultrasonography. A characteristic "sonic shadow" caused by the calculus was adequately demonstrated in each case. This paper discusses the advantage of ultrasound in evaluating the presence of nonopaque and opaque renal stones.


Pancreatic pseudocysts: unusual ultrasound features.

Three unusual cases of pancreatic pseudocyst are described in which primary renal or splenic pathology was simulated on ultrasound imaging. When an abnormal fluid collection is imaged in a patient with a history of alcoholism, a pancreatic pseudocyst should be considered and an amylase determination should be obtained on any aspirated fluid.


Sonographic evaluation of mesenteric and omental masses in children.

Masses in the mesenteries and omentum are often difficult to diagnose by conventional radiographic techniques. Gray scale sonography was a valuable adjunct to radiographic vector analysis in four children with such masses. Masses that are clearly separable from the liver and spleen and do not distort identifiable extraperitoneal structures are probably intraperitoneal. In children most cystic intraperitoneal masses are related to the mesenteries, omentum, ovary, or bile ducts. An anterior fluid collection with internal septa (which might be mistaken for loculated ascites) is the typical sonographic appearance of an omental cyst. Echogenic masses are more difficult to evaluate: careful study of the acoustical features yielded important information in cases of omental lipoma and rhabdomyosarcoma metastatic to the mesenteries and omentum.


A simple portable water bath for superficial ultrasonography.

A simple portable water bath device has been designed and adapted to the conventional contact B-scanner for examining superficial lesions. It is inexpensive, easy to construct, and convenient to use since the water reservoir is sealed. Small lesions (e.g., nodules in the thyroid or testis) are rapidly and clearly delineated.


Sonographic "parallel channel" sign of biliary tree enlargement in mild to moderate obstructive jaundice.

The criteria for the diagnosis of minimal obstructive jaundice (i.e., bilirubin less than 11.0 mg/100 ml) using sonography have not been established. A reliable diagnosis of obstructive jaundice with mild dilation of the bile ducts can be made by sonography when the "parallel channel" sign is seen. This sign is due to the simultaneous imaging of the dilated right or left main hepatic duct and the adjacent contiguous main portal vein branch. A prospective study of 86 patients showed this to be a highly reliable means of differentiating obstructive from nonobstructive jaundice when minimal duct dilation is present.


Postoperative biopsy of the common bile duct via the T-tube tract.

We describe our experience with the first reported cases of postoperative common bile duct forceps biopsy via a postoperative T-tube tract. Bronchial forceps biopsies were performed on two patients with fixed postoperative filling defects in the common bile duct. Because of possible complications, caution is recommended in employing this technique. Common bile duct diagnostic brushing and stricture dilatation, as well as choledochoscopy, are envisaged as further diagnostic and therapeutic tools for the radiologist.


Radionuclide liver spots: indicator of liver disease or a blood flow phenomenon.

Abnormal areas of increased uptake on liver scan have been controversial. While often said to be associated with superior vena caval obstruction, three distinctly different findings are possible: hot spot, warm spot, and no spot. All of these changes can be readily explained by distinct, separate anatomic venous collateral pathways. Four cases of superior vena caval obstruction with isotopic liver flow studies are presented. Anatomy of the venous collateral system is reviewed, and the potential significance of the liver "warm spot" is considered.


Acute gastric dilatation in neglected children.

Acute gastric dilatation occurred in five children suffering from parental neglect of deprivational dwarfism. Pathogenesis of acute gastric atony in the deprived child is related to structural and functional changes in the stomach due to chronic starvation, and the acute ingestion of a large meal. Radiographic recognition of acute gastric dilatation in a child who is not postoperative or intoxicated should suggest the presence of chronic starvation and child neglect.


Recurring hyperplastic gastric polyps following subtotal gastrectomy.

Mucosal polyps of the stomach are separated by histologic means into two major groups: (1) hyperplastic (or regenerative) polyps and (2) adenomas, including adenomatous polyps and villous adenoma. Hyperplastic polyps are not true neoplasms, but probably represent a reactive response to some form of mucosal injury. A little known but interesting manifestation of hyperplastic gastric polyps concerns their development, growth, and recurrence in the gastric remnant following subtotal gastrectomy. The clinical, radiologic, and pathologic findings in two cases of recurring symptomatic hyperplastic gastric polyps after subtotal gastrectomy are presented. It is proposed that reflux bile gastritis might have played an important etiologic role in the development of these recurring hyperplastic polyps.


Early lesions of Crohn's disease.

In its early stages, Crohn's disease may be manifested as small aphthoid ulcers. Because these ulcers are small and shallow, they are difficult or impossible to demonstrate on conventional barium-filled studies of the gastrointestinal tract. Using double contrast techniques, we have been able to demonstrate these early lesions of Crohn's disease in the colon, small bowel, and stomach. The aphthoid ulcers produce a "bulls-eye" or "target" lesion consisting of a small central collection of barium surrounded by radiolucent halo due to the granulomatous inflammation. The appearance is identical in the colon, small bowel, and stomach. The early lesions may be seen adjacent to or at a distance from a segment of more severe disease. In some patients, only these early lesions are found. The radiologic demonstration of these aphthoid ulcers allows for early diagnosis, facilitates differentiation between ulcerative and granulomatous collitis, and is important for planning appropriate therapy.


Severity of postmyelographic arachnoiditis and concentration of meglumine locarmate in primates.

Myelography with meglumine iocarmate, a dilute meglumine iocarmate solution, or gas was performed in macaque monkeys. Twelve weeks later the animals were examined myelographically and histologically for evidence of arachnoiditis. Arachnoiditis in the animals treated with dilute meglumine iocarmate and gas was significantly less than in those treated with meglumine iocarmate.


Normal movements of the cervical spine.

This paper describes a technique for analyzing movement of the cervical spine. The method consists of superimposition of two films representing the cervical spine in the end positions of the movement under investigation (e.g., flexion and extension). From tracings of selected structures, movement is represented in the form of movement diagrams. Knowledge of cervical spine dynamics is helpful in understanding muscle and ligament function as well as the shape of components in various postures.


Gross hematuria: a complication of intrapelvic cement intrusion in total hip replacement.

Four patients with gross hematuria and dysuria following intrusion of methylmethacrylate into the pelvic cavity after total hip replacement are described. This is a rare, benign complication which generally occurs 7-14 days after surgery and subsides promptly with symptomatic treatment. The diagnosis can be made on a simple radiography of the pelvis which shows the radiopaque cement as a mass intruding with the pelvic cavity. On the urogram it frequently abuts against or produces an extrinsic impression on the urinary bladder. This complication is very likely a result of the exothermal reaction during polymerization of the methylmethacrylate.


Bone scintigraphy in hereditary multiple exostoses.

Two adult patients with multiple hereditary exostoses, a skeletal disorder with recognized malignant potential, each demonstrated increased 99mTc diphosphonate uptake in an exostosis in which renewed growth had begun. None of the other multiple exostoses in either patient showed abnormal uptake. Histologic study of the lesions demonstrated chondrosarcoma in one case and benign osteochondroma in the second. Although bone scintigraphy nonspecifically identifies bone growth rather than malignant degeneration, it is more useful than radiographic bone survey in the periodic surveillance of adult patients with this disorder.


Caffey's disease: a case originating in the first metatarsal and review of a 12 year experience.

This paper describes an infant with Caffey's disease who presented with swelling of the first metatarsal shown as hyperostosis histologically. He then developed scapular sclerosis and new bone formation. The mandible became involved 26 days after onset. A review of a 12 year experience with Caffey's disease (33 patients) disclosed a definite decrease in the number and percentage of patients seen since 1968.


Angiographic diagnosis of benign and malignant splenic tumors.

Fifteen cases of benign and malignant nodular splenic tumors, including six cysts, one hamartoma, two hemangiosarcomas, five reticulum cell sarcomas, and one Hodgkin's disease, are presented with their arteriographic manifestations. The value of splenic arteriography is emphasized, since it may provide rather specific information in the diagnosis of benign and malignant nodular splenic tumors. Differential diagnostic considerations are also discussed.


Skin thickness in the therapeutically irradiated breast.

Skin thickening of the breasts of 22 women undergoing excision biopsy of a breast cancer and subsequent radiation therapy to 5,000 rad is considered. The skin thickness of the treated breast returned to normal in 17 of 22 patients studied. Of the 17, nearly 60% returned to normal in 2 years, over 80% in 3 years, and the rest by 4 years. The period of follow-up was less than 4 years in the five patients with residual skin thickening. The alterations in skin thickness are consistent with the histopathologic changes seen in radiation dermatitis.


Number of projections in mammography: influence on detection of breast disease.

A total of 491 cases of breast cancer were reviewed to evaluate the diagnostic importance of the three standard projections; craniocaudal, mediolateral, and oblique. With only one projection, 90% of the malignancies would have been detected; with two and three projections the percentages rose to 94% and 95%, respectively. Nonvisualization was due to either juxtathoracic position of the tumor or superimposition of dense tissues. A relation was found between the position of a juxtathoracic tumor and the projection in which it was visualized. The mean diameter of tumors not visible due to superimposition of dense tissues was smaller than that of the whole material. In breast screening programs, use of two projections, the oblique and craniocaudal, is recommended.


Petit mal epilepsy.

Petit mal epilepsy is primarily a disorder of childhood. It is a comparatively rare type of seizure and is relatively benign. It rarely causes demonstrable evidence of pathologic cerebral changes, except in patients who have frequent attacks of petit mal status. Patients with petit mal epilepsy are prone to develop major motor (grand mal) seizures. Therefore, concurrent administration of petit mal and major motor anticonvulsants is recommended.


New trends in the management of diabetic ketoacidosis.

The diagnosis of ketoacidosis can be rapidly confirmed by simple determinations of blood glucose, serum ketones and arterial pH. The initial hydrating fluid is isotonic saline, followed by half-normal saline with buffered potassium phosphate. As soon as the blood glucose drops below 300 mg. percent, 5% glucose is added to the infusion. Following an initial regular insulin dose of 20 u. intramuscularly or 10 u. intravenously, subsequent doses of 10 u. every hour are given either by intravenous drip or by injection deep into the deltoid muscle.


Histopathology of the conducting tissue of the heart in Chagas' myocarditis.

The conducting tissue of the heart was studied in 25 human cases of Chagas' myocarditis with a method which employs complete serial sections mounted on continuous transparent plastic tape. The pathological changes were correlated with electrocardiographic findings. The inflammation of the acute phase of Chagas' myocarditis, as seen in one single case, did not seem to interfere with conduction through the AV system. In chronic Chagas' myocarditis the conducting tissue showed extensive and variable changes: chronic inflammation, fibrosis, atrophy and fragmentation of specific fibers, extreme dilatation and tortuosity of veins, capillaries and lymphatics, fatty infiltration, and arterial medial and intimal fibrosis. A preferential involvement of the right bundle branch and the anterior fascicles of the left branch was observed and an excellent correlation with electrocardiographic abnormalities was found. There was also evidence presented that bundle branch block may be caused by disease proximal to the bundle branches. Complete AV block seemed to be the final result of the progressive inflammatory and degenerative changes involving the conduction system in chronic Chagas' myocarditis. Inflammation and fibrosis did also involve the sinoatrial node, Purkinje fibers, intracardiac nervous ganglia, and the contractile myocardium.


Nitroglycerin-induced improvement in exercise tolerance and hemodynamics in patients with chronic rheumatic heart valve disease.

Nitroglycerin reduces elevated left ventricular filling and pulmonary arterial pressures in resting patients with rheumatic valve disease and reduces symptoms when given over long periods to patients with primary myocardial disease. To determine whether nitroglycerin may prove effective therapeutically in ambulatory patients with heart valve disease, its effects on hemodynamics and exercise capacity were studied in 11 severely symptomatic adults who were already receiving optimal treatment with digitalis and diuretic agents. Seven had predominant mitral valve disease, one had predominant aortic insufficiency and three had equally severe mitral and aortic valve disease. Maximal exercise capacity was assessed with graded treadmill exercise after placebo and after nitroglycerin (0.5 mg sublingually) administered in random sequence to each patient. Exercise capacity (exercise time to limiting fatigue or dyspnea) increased from a mean of 8.3 minutes after placebo to 9.8 minutes after nitroglycerin (P less than 0.005). Eight patients were studied hemodynamically during further intense treadmill exercise. Pulmonary arterial pressure was significantly lower (P less than 0.05) after nitroglycerin than after placebo (mean 44 versus 56 mm Hg), but cardiac output was greater after nitroglycerin (5.0 versus 4.6 liters/min, P less than 0.005). Thus, nitroglycerin appears to increase exericse tolerance and improve the hemodynamic response to exercise in patients with heart valve disease and may be valuable in the long-term pharmacologic therapy of such patients.


Surface lipid composition in children with protein-calorie malnutrition.

The composition of skin surface lipid has been measured in a group of 21 children with the diagnosis of marasmic-kwashiokor. When compared to the values for healthy children of comparable age, the squalene content was significantly decreased (3.1% +/- 3.2% versus 9.8% +/- 3.6%) and the squalene/wax ester ratio was also significantly decreased (0.57 +/- 0.55 versus 2.13 +/- 0.91). Measurements of skin surface lipid also were made in five of these children after treatment. The altered values reverted towards normal. Since changes in the squalene content and the squalene/wax ester ratio of skin surface lipid can be correlated with other biochemical changes of protein-calorie malnutrition, the analysis of surface lipid, a procedure that is both convenient and non-invasive, can be of use in determining the nutritional status in field studies of malnourished subjects.


Trace metal profile of parenteral nutrition solutions.

Zinc, copper, iron, magnesium, and chromium were analyzed in commercially prepared total parenteral nutrition solutions of amino acid/protein hydrolysate, dextrose, lipid, and water from several manufacturers. Concentrations of each varied with both the manufacturer and the solution lot number, with the greatest differences observed for zinc (0.026 to 4.04 mg/liter) and iron (0.025 to 1.370 mg/liter). Since the consequences of prolonged total parenteral nutrition with trace-metal-deficient solutions are dependent upon the physical state of the patients, the duration of hyperalimentation and problems associated with trauma, it is recommended that the endogenous concentrations described be supplemented as needed for each patient. This need is difficult to determine, however, because little is known about the clinical effect of any trace-metal-deficiency state developing in patients receiving long-term total parenteral nutrition.


Spontaneous meningococcal peritonitis: a report of two cases.

Two patients with spontaneous bacterial peritonitis caused by Neisseria meningitidis are described. In both cases immediate diagnosis was possible by examination of the ascitic fluid. Meningococcal peritonitis supports the hypothesis that the hematogenous spread of bacteria into the ascitic fluid may be one of the mechanisms of spontaneous bacterial peritonitis.


Carrier detection in Sandhoff disease.

Three new cases of Sandhoff disease are reported. One infant was the second affected child in a large family. The parents, who were cousins, were part of a large kindred from an isolated community in northern Saskatchewan. We assayed total and heat-stable hexosaminidases in 38 other members of the kindred and found two distinct cohorts. Sixteen individuals had low total and low heat-stable hexosaminidase and were diagnosed as carriers of Sandhoff disease. The values for the remainder were within normal limits. In a retrospective study of data from more than 14,000 Ashkenazi Jews, who were screened for Tay-Sachs disease, six were identified as Sandhoff carriers. Our data indicate that carrier detection requires measurement of both total and heat-stable enzyme activity.


Pharmacist-managed patient assessment and medication refill clinic.

The effectiveness of a pharmacist in determining the appropriateness of prescription renewal for patients appearing at a hospital-based refill clinic was investigated. In part 1, data were collected on the clinic as it traditionally functioned with staff physicians evaluating the patients. In parts 2 and 3, data were collected with the pharmacist assuming the assessment function. In part 2, a physician reviewed the pharmacist's decisions before the patient left. In part 3, the pharmacist functioned without supervision and the physician reviewed patient records retrospectively. Physician agreement with the pharmacist's decisions was the primary criterion for determining effectiveness, and was found to be 99% in part 2, for a total of 105 patients. In part 3, physician agreement remained at the 99% level for a total of 106 patients. Patient waiting time was about the same in each part of the study because of clinic procedures beyond the pharmacist's control. A pharmacist can be cost-effective in this role if the task is combined with regular pharmaceutical functions.


Ultrastructural influence of reperfusing dog myocardium with calcium-free blood after coronary artery occlusion.

The ultrastructural effects of perfusing ischemic myocardium with calcium-free blood were determined in 12 dogs. In 6 dogs, the left anterior descending coronary artery was ligated for 45 minutes and was released for 5, 10, or 20 minutes. In 6 other dogs, the ischemic zone was perfused with blood free of calcium which was chelated with EGTA (ethylene glycol bis [B-aminoethylether-N,N'-tetraacetic acid] for 5, 10, or 20 minutes. After reperfusion with whole blood, the sarcomeres either were mildly contracted or formed contracted bands. The cells were usually pulled apart at the intercalated disk. The mitochondria were swollen and contained electron-dense deposits. Lanthanum was used as a marker for monitoring changes in cell membrane permeability and permeated into many ischemic myocardial cells. The hearts treated with calcium-free plasma showed well preserved morphology. Mitochondria were slightly swollen, their cristae were occasionally disrupted, and they lacked electron-dense deposits. No lanthanum leaked into these cells, with a few scattered exceptions. Even in the leaky cells, the mitochondria did not show any deposits. It is suggested that calcium overload plays a significant role in the pathogenesis of cell injury and that reduction in plasma levels of calcium, at least for a limited period may delay the onset of calcium overload and improve cell morphology. Alterations in the cell membrane are followed by lethal intracellular changes leading to events associated with cell death.


Immunoblastic lymphadenopathy presenting as respiratory insufficiency.

The clinical course of a patient is described who experienced respiratory insufficiency as the primary manifestation of immunoblastic lymphadenopathy. Respiratory symptoms preceded the enlargement of lymph nodes, improved spontaneously at first and then after steroid therapy. Subsequently these symptoms reappeared concurrent with lymph node enlargement. Hypergammaglobulinemia was noted with marked elevation of polyclonal immunoglobulin M.


Response to glucose loading of the lean squirrel monkey in unrestrained conditions.

The response of blood glucose (BG), free fatty acids (FFA), and insulin (IRI) to both intravenous (IVGTT) and oral (OGTT) glucose tolerance tests was evaluated in unrestrained, permanently catheterized squirrel monkeys. The mean glucose assimilation rate (K value) for 25 IVGTT was 7.75 +/- 2.84. FFA maximally decayed 54 percent from a mean basal of 1,008 +/- 221 mueq/l associated with a onefold increment inIRI from basal (7.5 +/- 3.5 muU/ml) at 2-5 min. No significant changes were found during intravenous saline loading alone. OGTT (4g/kg) produced peak BG levels at 15-30 min with an immediate FFA decrease of 63 percent and a onefold IRI increment. Carcass composition analyses from 17 animals showed a total extractable lipid content of 6.2 percent. The K value, significantly higher than previously reported, appears to fit well with that expected for the species. The rapid decrease in FFA and BG concentrations demonstrate an apparent high efficiency of a low IRI increment. The association of the low IRI after loading with a low triglyceride depot is discussed.


Effects of endogenous prostaglandin E on intestinal motility.

The role of endogenous prostaglandin E (PGE) in the regulation of intestinal motility in situ was studied in cats anesthetized with pentobarbital. The basal concentration of PGE in the ileum was found by radioimmunoassay to be 3.3 +/- 0.6 ng PGE per g wet wt (chi +/- SE, n = 12). Intramesenteric arterial infusion of acetylcholine (ACh) (100 microgram/min) increased intestinal motility, and PGE concentration rose to 6.7 +/- 0.8 ng/g. Intravenous infusion of indomethacin (4 mg/kg) enhanced spontaneous and ACh-induced motility and abolished the ACh-induced rise in ileal PGE concentration. We conclude that basal PGE synthesis limits the motility of the resting and ACh-stimulated cat ileum.


Endogenous prostaglandin E and contractile activity of isolated ileal smooth muscle.

The effects of endogenous prostaglandin E (PGE) on the contractile activity of isolated cat ileal muscle rings were studied. Force development in circularly oriented muscle fibers were recorded. The muscles contained a mean basal PGE concentration of 1 +/- 0.6 ng PGE per g wet wt (mean +/- SE) as measured by radioimmunoassay. Acetylcholine (ACh) or elevated potassium caused contractions and enhanced PGE concentration (P less than 0.05). Removing Ca2+ from high potassium solutions blocked contraction, but PGE concentration still increased (P less than 0.02). The prostaglandin synthetase inhibitors, indomethacin and 5,8,11,14-eicosatetraenoic acid (ETA) reduced PGE concentration in muscles (less than 50 pg PGE per g muscle) and increased the magnitude of contractions induced by either ACh or elevated potassium. Spontaneous contractions were observed in many tissues after inhibition of PGE synthesis. In conclusion, endogenous PGE limits spontaneous and depolarization-induced muscular activity in cat ileal circular muscle. Synthesis of PGE was increased by depolarizing stimuli whether or not contractions were blocked by the removal of external calcium.


Operative fluoroscopy and cholangiography. The use of modern radiologic technics during surgery.

Operative cholangiography as currently performed in many hospitals in the United States may be a cumbersome procedure yielding less than optimal information. For maximal accuracy and diagnostic yield, operative radiographic examination of the biliary tract should include fluoroscopic observation and aimed spot films. The advantages gained by using modern radiologic equipment and technics are increased image clarity, increased capability for functional assessment of a dynamic system, increased efficiency, and decreased radiation hazard. In a series of 100 patients undergoing operative cholangiography by our technic, only one retained stone was demonstrated by postoperative studies. Five anomalies of the ductal system were easily identified and possible injury to the anomalous ducts averted. Considering the morbidity and mortality attendant upon inadequate or inappropriate biliary tract operations, investment in the sophisticated equipment necessary for optimal operative radiography is small indeed.


[The immunofluorescence-microscopical evidence of insulin and glucagon in transplantated isolated Langerhans' islets in diabetic rats and dogs (author's transl)].

With the histochemical immunofluorescence technique were demonstrated the insulin and glucagon in the transplantated isolated Langerhans' islets in the liver at diabetic rats and dogs. Further on were tested the diabetic metabolic level with aid of clinico-chemical methods during the period of investigation (blood glucose, serum insulin, glucose tolerance test). It was found that after transplantation, 1 year by the rats and more than 8 weeks by the dogs, is existing a normoglycemic level. In the transplanted islets were seen a good immunofluorescence of insulin in the B cells and the glucagon in the A cells in all investigated stages.


Medical therapy of angina pectoris.

The pathophysiology of angina pectoris is best understood as an imbalance between oxygen supply and demand. The primary determinants of myocardial oxygen demand are heart rate, arterial pressure, heart size, myocardial contractility, and myocardial mass. The medical therapy of angina pectoris is directed toward reducing myocardial oxygen demand by reducing the workload of the heart and the specific determinants listed. The most common medications used in the treatment of angina pectoris are nitroglycerin and propranolol. Nitroglycerin reduces myocardial oxygen demand primarily by reducing heart size and arterial pressure. Propranolol reduces oxygen demand primarily by reducing heart rate. Medical therapy is generally effective in controlling the symptoms of angina pectoris in 80% or more of the patients and allows them to lead useful and productive lives.


Effects of androgen administration on sexual invitations by female rhesus monkeys (Macaca mulatta).

Pairs of adult rhesus monkeys of opposite sexes (12 pairs) were studied during 1-h mating tests (986 tests). Ovariectomized females received 5 microgram oestradiol intravaginally throughout to keep them attractive to males and maintain a relatively constant level of male sexual activity. Females were given subcutaneous silastic implants of testosterone to change their sexual receptivity. A threefold change in sexual invitations resulted from the implantation and removal of testosterone in the absence of any major changes in the behaviour of their male partners. These changes in invitational behaviour therefore reflected an action of the hormone upon an internal mechanism within the female subserving sexual motivation which was independent of changes in the behaviour of the male. Radioimmunoassay of plasma testosterone (109 samples) and plasma oestradiol (86 samples), and gas-liquid chromatography of vaginal secretions (306 samples), facilitated the monitoring of variables needed to interpret the results.


[Comparison of limited weight values and the sensitivity of analytical methods used for the detection of toxic atmospheric agents in working places].

This research has been carried out in order to estimate minimum sampling periods for the substances detailed in the VLP table given by the Italian Occupational Medicine Service and the Industrial Hygiene Group. These data take the following points into consideration: 1) sensitivity of the analytical method; 2) value and condition of sample at fulfilment of sampling periods; 3) sampling speed; 4) VLP, with special reference to ceiling value for very short exposure. As to dust the minimum period required is about 1 minute for numeric sampling, and 35 minutes for gravimetric sampling. 85% from the above-mentioned substances can be sampled at minimum periods which range from 1 to 5 minutes.


[Radiotoxicological surveillance of personnel occupationally exposed to the hazards of internal radiocontamination in a nuclear center].

At the Casaccia Nuclear Centre the personnel occupationally exposed to a risk of internal contamination from radioactive substances is controlled by means of periodic radiotoxicological analyses. About 30,000 analyses of natural uranium, enriched uranium, thorium, gamma emetters, plutonium, americium, etc. in urine have been carried out since 1962. In the case of accidental acute radiocontamination by inhalation, wound and ingestion, special control on urine, blood, feces, nasal swabs, etc. must be schedules. The results can be very useful to the medical staff in order to take the most suitable therapeutical measures or to calculate the body burden.


[Use of labeling with 3H6-thymidine in the study of the multiplication of lactobacillus casei immobilized in a polyacrylamide gel].

When 3H6-thymidine labelled bacteria (1.2 desintegration per cell/day) are immobilized in a polyacrylamide gel lattice, the decimal reduction time for their malic acid decarboxylase activity is extended to 38 days. Thus, the growth of bacteria in the gel lattice is very poor. The author has evaluated both the DNA turnover rate during the exponential growth phase for the free cells and the DNA specific activity of the population of immobilized cells. The viability of bacteria isolated from the gel lattice decreases with time, as does their thermal stability for malic acid decarboxylase activity. This activity is partially restored after 65 days. With respect to the protein, deoxyribose and ribose cell constituents, the protein/deoxyribose, protein/ribose and deoxyribose/ribose ratios fluctuats considerably with time. These fluctuations are more marked than those observed for the free cells during their different growth phases.


[Dyggve-melchior-clausen's syndrome (author's transl)].

An eight year old boy of first grade consanguinity parents, with important growth and mental retardation, generalized bone alterations and without corneal opacity nor mucopolysacchariduria is presented. All these features account on the syndrome of Dyggve-Melchior and Clausen.


Noninvasive chronic recording of auditory nerve potentials.

A system is described which allows repeated, noninvasive recording of auditory nerve responses in the cat to transient acoustic stimuli using a closed acoustic system. N1 responses to clicks are recorded from a stainless steel ring electrode at the end of a hollow earbar, the tapered end of which is made of insulating plastic. Acoustic stimuli are generated by a dynamic earphone coupled to the earbar. A calibrated probe microphone is also imcorporated into the earbar to measure sound pressure near the tympanic membrane. This allows better stimulus control than is available with free-field systems. To facilitate insertion of the earbar, meatoplasties were performed on all animals. Responses recorded with this system in anesthetized cats are described and compared with those recorded at the round window. Good repeatability of measurements is described for an animal population of 20 domestic cats over a period of several months. For some of these animals, response amplitude varied from one session to another, but response latency, especially for condensation clicks, was consistent. By comparing statistics of multiple measurement of both N1 amplitude and latency for rarefaction and condensation clicks, it is concluded that the N1 latency vs click-level function for condensation clicks provides the most reliable measure of the cat's auditory nerve function.


Effects of Eustachian tube ligation on auditory nerve responses to clicks.

Auditory nerve responses to condensation and rarefaction clicks were recorded from the external ear canal of cats using a closed acoustic system. Repeated control recordings from both ears formed a baseline for each of four animals used in this study. After a baseline had been established, the Eustachian tube on one side was ligated and serial recordings of N1 responses were performed for up to 140 days postligation. By comparing the shift which occurred in the N1 latency-vs-click level plots after ligation, the equivalent hearing loss was determined. In all cases where the Eustachian tube was successfully ligated, the loss was progressive for the first 20 days, then usually showed some transitory improvement. The loss stabilized after 60 days, varying from 15 to 40 dB in different animals. In addition to N1 recordings, serial tympanograms were also measured. These indicated negative middle ear pressure in the first two days postligation and the presence of middle ear fluid by one week postligation.


Serogenetic studies on the Kavango peoples of South West Africa.

The closely interrelated matrilineal Kavango peoples of the far north-east of South West Africa are probably the least known inhabitants of that country. Their traditional historical and cultural affinities appear to be with the peoples of southern Angola and south-western Zambia; the suggested relationships with the Ambo further west are not linguistically tenable, though there is evidence of gene exchange. The Kavango comprise the Kwangali, the Mbunza, whom they are in process of absorbing, the Sambyu, the Gciriku, the Mbukushu and the Kwengo. The last-named of these have hitherto been accounted "Black Bushmen", but the serogenetic investigation of these peoples described here discloses that the affinities of the Kwengo are with their neighbours the Mbukushu, and they must therefore be accounted Negro rather than San. Genetic distance calculations are compatible with traditional history and hence with the suggestion that all these peoples share a fairly recent common origin.


[Transferrin findings in Callithrix jacchus Linné, 1758 (Primates, Platyrrhina)].

This paper deals with the transferrin (Tf) polymorphism in the South American marmoset Callithrix jacchus. The transferrin bands of this species are positioned in the electropherogramme cathodal to the beta1C-globulin (C 3), s. Fig. 1. By means of the combined agarose gel immuno-electrophoresis 7 distinguishable phenotypes have been detected in 166 animals (s. Fig. 2). The formal genetic analysis of 28 matings with 48 youngs (cf. Table 1) leads to the assumption that at least 4 codominant alleles (Tf Cja, Tf Cjb, Tf Cjc, Tf Cjd) are existent at the autosomal Tf-locus in Callithrix jacchus.


Familial dysautonomia (Riley-Day syndrome). Temporal bone findings and otolaryngological manifestations.

Familial dysautonomia, or Riley-Day syndrome, is inherited in an autosomal recessive fashion and occurs almost exclusively in Jewish families. This disorder is characterized by a smooth tongue devoid of fungiform papillae and of taste buds, and is clinically associated with poor taste discrimination. An unsteady gait and dizziness on change in position are also common presenting symptoms. This study reports the histopathological findings of eight temporal bones from four patients with documented familial dysautonomia. For the control series, 13 normal temporal bones were also studied. The most striking finding in the dysautonomic patients was an extreme paucity of geniculate ganglion cells (P less than 0.001). A statistically significant reduction in the number of neurons was also found both in the superior and in the inferior divisions of the vestibular nerve (P less than 0.001). The paucity of the geniculate ganglion cells correlates well with the impairment of the taste in dysautonomic individuals, since the afferent fibers leaving taste buds of the anterior two-thirds of the tongue run via the chorda tympani and have their cell bodies in the geniculate ganglion. Furthermore, the reduction in the number of Scarpa's ganglion cells observed in the dysautonomic patients studied here could account for a poor response to caloric test, positional vertigo and an unsteady gait in this condition.


[The Paderborn calvaria--a diluvial Homo sapiens].

In the following work a morphognostic and morphometric analysis of a diluvial calvaria from Sande/Paderborn in Westfalia is presented. Besides the above, absolute dating by two methods (Radiocarbon- and Amino-acid-dating) was applied. The morphological comparison shows strong affinities to comparative material from the Upper Pleistocene like Cro-Magnon. The absolute dates support this morphological analysis. Both findings--morphological analysis and absolute dating--were done in separate analyses and will be documented separately in the following article.


Cytologic diagnosis of multiple myeloma and macroglobulinemia in effusions.

The presence of effusion in association with multiple myeloma or macroglobulinemia is an unusual finding which generally occurs late in the course of the disease. Occasionally, cytoligic detection is a diagnostic problem. In both conditions, the fluid is characrerized by a high specific gravity and high protein content. In myeloma, plasma cells at varying stages of differentiation are present, while in macroglobulinemia atypical lymphocytes and plasma cells resembling those found in the blood and bone marrow are seen. Generally, the diagnosis can be readily made on the basis of clinical features, characteristics of the fluid and cytologic findings. In difficult cases, additional procedures helpful in establishing a definite diagnosis include methyl green pyronine stain, fluid electrophoresis and electron microscopy.


Differentiation by electrophoresis and enzymoserology of proteinases, produced by strains of Staphylococcus epidermidis biotypes 1 and 4.

Electrophoretic and serologic characterization of extracellular proteinases from 111 isolates (80 biotype 1 and 31 biotype 4) of Staphylococcus epidermidis (coagulase negative) of human origin were conducted. Seventy-seven (60 of biotype 1, 17 of biotype 4) of the 111 proteinase-positive isolated of S. epidermidis were classified by serological differentiation of their proteolytic enzymes with known specific antisera. Thirty-two (18 of biotype 1, 14 of biotype 4 (isolates of S. epidermidis produced proteolytic enzymes that did not react with any of the known group antisera and were classified as NR (non-reacting). No classification of the enzymes of two other isolates was possible. The NR proteinase enzymes from the 32 cultures that could not be classified by serological differentiation with the known specific antisera fitted into one of three electrophoretic mobility patterns: NR1, NR2 or NR3. Seventy-eight isolates of S. epidermidis biotype 1 were placed into four proteinase sero-groups; 49 in F, 11 in B, 11 in NR2, and 7 in NR3. Thirty-one isolates of S. epidermidis biotype 4 were placed into one of two groups: 17 in C and 14 in NR. All enzymes tested migrated towards the anode at pH 8.6, and the order of electrophoretic mobility was NR3 greater than F greater than NR2 greater than NR1 greater than B greater than C.


[Penicillium chrysogenum mycelial productivity in the 1st phase of penicillin biosynthesis].

The course of the mycelium low productivity during the first phase of the usual two-stage process of penicillin biosynthesis was studied. It was found that the low productivity of the mycelium at the beginning of the fermentation process was probably associated with catabolic regression of the penicillin-producing system. The high specific growth rate registered in the experiments (0.06-0.08 hours-1) had no negative effect on the mycelium productivity. It was not possible to connect the productivity level with the mycelium age, because young and mature mycelium had the same producitivity levels at any developmental stage under the same conditions.


[Aeration conditions in the process of tetracycline biosynthesis. The role of organic acids].

The effect of the aeration conditions on the content of volatile acids in the fermentation broth was studied. It was shown that deterioration of the aeration conditions during the process of biosynthesis in both flasks and 750 1 fermentors resulted in decreased levels of the antibiotic accumulation and was accompanied by a simultaneous increase in the concentration of the volatile acids in the culture fluid. Under unfavourable aeration conditions the volatile acids present in the fermentation broth in higher concentrations than under the optimal conditions had no effect. It was shown that the volatile acid concentration may be used as a parameter for the control of the aeration conditions and as an index of normal biosynthetic process.


A counting method for determining the burst size of defective phages from Bacillus subtilis.

The defective phages of Bacillus subtilis cannot be counted by plating as they do not form plaques. In addition, counting under the electron microscope with latex spheres as an internal standard is not possible. The reliability of a method using Escherichia coli phage T4 as a substitute for the latex spheres has been tested and the results compared with those of other methods. Using this method, we determined the burst sizes of the defective phages PBS X, PBS Y and PBS Z under various conditions.


Rapid enumeration of Fecal Coliforms in water by a colorimetric beta-galactosidase assay.

The colorimetric beta-galactosidase assay is based upon the enzymatic hydrolysis of the substrate o-nitrophenyl-beta-D-galactoside (ONPG) by fecal coliforms. This technique provides an estimate of the fecal coliform concentration within 8 to 20 h. A 100-ml portion of test sample was passed through a 0.45 micrometer membrane filter. This filter was then incubated at 37 degrees C for 1 h in EC medium followed by the addition of filter-sterilized ONPG. The incubation was continued at 44.5 degrees C until a half-maximum absorbance (at 420 nm) was reached. The time between the start of incubation and the half-maximum absorbance was proportional to the concentration of fecal coliforms present. Escherichia coli (K-12) was used to measure the kinetics of substrate hydrolysis and the response time of different cell concentrations. High cell densities produced an immediate response, whereas 1 cell/ml will produce a response in less than 20 h. In field studies in which samples were taken from a range of grossly polluted streams to relatively clean lake water, a linear correlation between ONPG hydrolysis times and fecal coliform most-probable-number values was established. A total of 302 isolates randomly selected from positive ONPG-EC media, which were derived from 11 different habitats, were identified as E. coli (96.69 percent), Enterobacter cloacae (2.32 percent), Klebsiella pneumoniae (0.66 percent), and Citrobacter freundii (0.33 percent).


Plasma insulin and surgery. II. Later changes and the effect of intravenous carbohydrates.

Long-term hyperinsulinemia and improved glucose tolerance were produced postoperatively by intravenous feeding with glucose or sorbitol. Raised immuno-reactive insulin (IRI) values persisted eight hours after carbohydrate infusions although the basal plasma glucose concentrations had returned to control values. Plasma glucose curves were normal at this time but were associated with an increased IRI response. These findings suggest that insulin secretion is modified by glucose not only in the short term but also by a separate effect acting over many hours. The combination of starvation and low dose glucose infusion to simulate the hyperglycemia of operation also produced high IRI values but these were associated with a rapid fall in the plasma glucose curve. Starvation alone reduced basal values of plasma glucose and IRI, and the IRI response to glucose infusion was also reduced, despite the plasma glucose curve being at a higher level. It is suggested that the high values of IRI reported in the postoperative period are mediated by a long-term effect of the small but sustained rise in basal plasma glucose. This specific role of glucose in the long-term potentiation of insulin secretion make it the carbohydrate of choice for the intravenous feeding in postoperative patients.


Ethanol effects on active and passive Na+ flux in toad bladder.

Ethanol, like other anesthetics, has been reported to interfere with active Na+ transport in living membranes. In an attempt to elucidate the mechanism by which ethanol exerts this action, we tested in the toad bladder membrane: 1) the effect of ethanol on active Na+ transport, 2) the interaction of ethanol with vasopressin on Na+ transport, and 3) the effect of ethanol on passive Na+ flux. We found that, a) 1-500 microgram/ml of ethanol stimulated, and 10,000 microgram/ml depressed active Na+ transport; b) the combined effect of stimulating concentrations of ethanol and vasopressin, although suggestive of a positive interaction, might have arisen by chance (p = 0.08); c) depressant concentrations of ethanol failed to suppress the stimulation by vasopressin; and d) passive Na+ flux in bladders treated with ouabain and ethacrynic acid was not affected by ethanol (1-100 microgram/ml). These results indicate that ethanol in concentrations ranging from 1 to 10,000 microgram/ml does not block ATP/ATPase Na+ pump but apparently exerts a dose-dependent, stimulant-depressant effect on Na+ channels in the membrane.


Species differences in the metabolism of hycanthone.

The rate of excretion of labelled hycanthone has been determined in bile and urine from three strains of rats (Sprague-Dawley, hooded and Gunn), and from dogs, cats, rabbits and monkeys. Bile was the major route of excretion in all species; the half-life for excretion of total radioactivity ranged from 1.6 to 3.0 hours. Relatively little of the radioactivity was found in the urine, except in the monkey and notably in the cat. Most of the radioactivity in the bile and urine was found in conjugated form, or as polar metabolites; cat urine, however contained a high percentage of hycanthone and less polar metabolites. Some fifteen metabolites have been seen in bile, and/or urine, and nine from in vitro incubations with microsomal preparations. Five of these, including hycanthone, have been chemically characterized, and two others tentatively identified.


Pharmacodynamic study of a pyrophtalone: [methyl-2 (piperidino-2 ethyl-1)-1 dihydro 1-4 pyridylidene-4 yl]-2 indanedione 1-3. II. Mechanism of action.

The anti-inflammatory activity of the pyrophtalone derivative, [methyl-2 (piperidino-2 ethyl-1)-1 dihydro 1-4 pyridylidene-4 yl]-2 indanedione 1-3 or PpEtgammaL is not dependent upon adrenal gland stimulation. PpEtgammaL has an inhibitory effect neither on prostaglandin release after biosynthesis nor on prostaglandin synthetase. The reduced prostaglandin production, as result of drug action can be explained by impairment of substrate availability for this enzyme. There are several hypotheses, but according to the present results of our work, the most plausible one is an inhibition of unsaturated fatty acids release from cell membrane lipids.


[Presence of antibodies against Neisseria meningitidis in a sample of the normal population. Preliminary note].

The Authors refer the first results of a serologic investigation on the presence of antibodies for N. meningitidis in a normal population. The 36.70% and the 59.55% of positivity for N. meningitidis of serogroup A and B respectively are investigated.


[Stenosis of the trunk of the left coronary artery. Contribution of coronary arteriography and hemodynamic correlations. Apropos of 34 cases].

From a study of 34 cases, the authors have tried to define the characteristic features of this very specialised type of coronary artery disease. From the clinical standpoint, if the common combination of uncontrolled angina and a past history of myocardial infarction are taken as representative, the basal ECG can in no way differentiate the diagnosis; on the other hand tests on the bicycle ergometer appear to have a good indicative value. Coronary arteriography shows the sharply isolated character of the stenosis of the trunk which is part of the picture of diffuse coronary disease, and the frequency (2 cases out of 3) of total coronary occlusion. The haemodynamic findings are even more variable and unpredictable, and bear no relationship to the degree of trunk stenosis, to the index of the lesion, and to the number of occlusions. However, joint analysis of the index of the lesion and of the degree to which the coronary circulation is compensated or de-compensated allows a better interpretation of the haemodynamic picture.


[Are stenoses of the common trunk of the left coronary artery at the root of unstable angina?].

In a series of 200 cases of unstable angina who have had coronary arteriography carried out, a stenosis of more than 60% of the trunk of the left coronary artery was noted in 40 cases (20%). This sinister site of arteriosclerosis may be suspected in patients presenting with long-standing angina (mean for the group 44 months), an angina which has recently become worse, one which is not responding rapidly to rest and beta-blockers, and in particular one where there has been a previous infarction (50% of cases). Coronary arteriography shows that the lesions were more diffuse and more severe in the group with stenosis of the main trunk. Surgical prognosis becomes worse (31% mortality) because of the risk of vascular complications. Treatment by large doses of Propranolol improves the classically gloomy prognosis of these patients when treated medically.


[Isolated primary dissection of the right coronary artery].

A 59 year old female had unstable angina threatening infarction, together with Prinzmetal's syndrome in the postero-diaphragmatic area, and a transient second degree atrio-ventricular block. Selective arteriography revealed complete dissection, as an isolated and primary finding, in the right coronary artery. Operation consisted of dividing the coronary artery at the superior limit of the dissection, of suturing together the separated layers of the artery, and finally an end-to-end aorto-coronary bypass. The patient is living without any functional symptoms 15 months after the initial episode, but a follow-up arteriogram showed that separation of the two layers of the dissection was persisting. This condition has caused rapid or sudden death in 47 of the 51 reported cases, often occurring in females at the beginning of pregnancy. This mortality rate justifies early operation as soon as the diagnosis is made by coronary arteriography.


[Closed-heart mitral commissurotomy. Twenty years after].

In order to find out the long-term results of mitral valvotomy as a closed heart operation, the authors investigated the fate of patients who underwent surgery twenty years ago. In 1955, 148 mitral valvotomies by the closed technique were carried out in the Cardiovascular Department of the Broussais Hospital under the direction of Professor F. D'Allaines. There were 15 operative deaths (10 p. 100) and 12 late deaths of non-cardiac origin; only 55 of the patients could be traced for follow-up. After 20 years, 24 of them had still a good or moderate result, and 34 had a bad result. A study of the various characteristic features of the heart defect before operation, and of the operative findings, has allowed us to determine a certain number of factors which presage good immediate and long-term results. The authors have concluded that, if these factors are present, mitral valvotomy as a close technique, with its advantages of simplicity and economy, remains a perfectly valid operation.


[Auricular fibrillation with ventricular tachycardia. Surgical section of a left lateral bundle of Kent].

The authors report the case of a man of 22 years, with no previous cardiac history, in whom a Wolff-Parkinson-White syndrome was discovered during the course of this first episode of atrial fibrillation with a ventricular rate of 300-350/mn; investigation (vecto-cardiogram, intra-cavitory ECG) showed the presence of a short circuit of the Kent type, with a high permeability, and localised in the left lateral position; this was confirmed by pericardial cartography. After the surgical division of the accessory pathway, the electrical phenomenon of pre-excitation disappeared. The current possibilities of operating on cases of a Wolff-Parkinson-White syndrome justify carrying out a scrupulous electrophysiological study of each case, so that any accessory pathway can be precisely localised, and its refractory period determined; thus a pathway of preexcitation localised in the left lateral position, and having a short refractory period leading to a high ventricular rate under atrial fibrillation conditions, constitutes an indication for operation which may be urgent.


[Long term results of surgical treatment for aneurysms of the abdominal aorta].

A series of 100 consecutive patients operated on for an abdominal aortic aneurysm, whether cold or as emergency, but excluding those cases with circulatory collapse, has enabled us to define the post-operative prognosis after a follow-up of a maximum of ten years. The operative mortality of 12% was due essentially to coronary and renal complications. All of the survivors, except one, were available for review. Five years after the operation 64% were still alive, and the figure was 46% at eight years. These figures confirm the indication for systematic surgical treatment as soon as an aneurysm is discovered, unless any of the contra-indications which are discussed are present. The best method of following up small aneurysms (with a diameter of less than 6 cms) discovered in elderly subjects would be by echotomography.


[Multinodular hepatic angioma: a rare cause of neonatal asystole. A case and review of the literature].

The clinical findings in a case with a diffuse multinodular type of angioma of the liver are reported. The clinical picture was typical: the appearance after the first week of a severe congestive failure mimicking a congenital heart disorder, of the left to right shunt type, with gross hepatomegaly of the "vascular" type with a systolo-diastolic murmur, but with no cutaneous evidence of angioma. The very severe prognosis during the first months of life of patients with this malformation, as illustrated by the 58 deaths out of the 78 cases reported in the literature, indicated ligature of the hepatic artery before the age of one month. The satisfactory outcome (with a nine months follow-up) for this case, as for the three other operated cases in the literature, leads us to conclude that this operation is indicated after a detailed arteriographic examination has been made, and provided that the other anatomical conditions are favourable.


[Cardiac involvement in a lupus syndrome. Clinical and morphological study apropos of one case necessiting a double valve replacement].

A patient with disseminated lupus erythematosus developed mitral and aortic valve disease, requiring double valve replacement. The ultra-structure of the lesions of the endo- and myocardium are described, and their significance discussed.


[Reversible "experimental" human arterial hypertension after fortuitous ligation of an isolated polar renal artery of aortic origin].

During the course of an aorto-femoral bypass in a normotensive young man, an inferior polar artery arising low on the aorta, and supplying the right kidney, was ligated. The limited ischaemia (demonstrated by later arteriography) of the parenchyma at the pole of the kidney was responsible, during the following weeks, for severe hypertension with a raised level of circulating plasma renin, but one that was rapidly treatable. This finding, which was fortuitous but could be ranked as "experimental", demonstrates the important role of abnormal polar arteries and of the renal parenchyma in human arterial hypertension. Such may, for example, be the underlying disorder in cases of hypertension after the transplantation of a kidney with an "uncontrolled" polar artery arising from the aorta, for the so-called "pyelonephritic" hypertension in pregnant patients caused by defective blood supply in an inter-pyramidal artery and corresponding subcortical infarction of the kidney, and for curing hypertension in the adult when isolated polar arteries arising from the aorta and stenosed at their point of origin are reimplanted into the main renal artery.


[Massive mitral insufficiency due to spontaneous and isolated rupture of a posterior papillary muscle. Echocardiographic study, treatment by assisted circulation and prosthetic valve replacement].

The authors report a case of a patient of 72 years of age in whom the sudden onset of severe left ventricular failure led to the discovery of massive mitral incompetence. The diagnosis of rupture of the posterior papillary muscle of the mitral valve, which was suggested on clinical and echocardiographic grounds, was confirmed at operation. This was carried out after 72 hours of assisted circulation by counter-pressure, and consisted of a replacement by a prosthetic valve. The authors emphasise, in the light of this case, the importance of echocardiography by ultrasound in the early diagnosis of this type of acute mitral incompetence, clarify the signs, and emphasise the part played by assisted circulation with an intra-aortic balloon in the treatment of this condition.


[Endocarditis due to staphylococcus aureus during cardiomyopathy].

In a patient suffering from obstructive cardiomyopathy (IHSS), the onset of septicaemia due to staphylococus aureus was accompanied: 1. by the appearance of massive mitral incompetence and of cardiac failure; 2. by a marked reduction in the left intra-ventricular pressure gradient; 3. by acute reversible renal failure (interstitial nephritis); 4. by a glomerulonephritis with immune complexes deposits. After the septicaemia had been treated, replacement of the mitral valve by a disc prosthesis of Lillehei was carried out. Twenty months after the operation, the patient was completely asymptomatic, and catheterisation showed that the left intra-venticular pressure gradient had disappeared, as had the haemodynamic signs of cardiac failure.


Photooxidation reactions of diphenylcarbazide and their DCMU-sensitivity in thylakoids of the blue-green alga Oscillatoria chalybea.

Thylakoids of Oscillatoria chalybea are able to split water. The Hill reaction of these thylakoids is sensitive to DCMU. Diphenylcarbazide can substitute for water as the electron donor to photosystem II with these fully functioning thylakoids. However, the diphenylcarbazide photooxidation is completely insensitive to 3-(3,4-dichlorophenyl)-N-N'-dimethyl urea (DCMU) at high diphenylcarbazide concentrations. In with Tris-treated Oscillatoria thylakoids the water splitting capacity is lost and diphenylcarbazide restores electron transport through photosystem II as occurs with higher plant chloroplasts. However, also these photoreactions are insensitive to DCMU. If diphenylcarbazide acts in Oscillatoria as an electron donor to photosystem II the result suggests that diphenylcarbazide feeds in its electrons behind the DCMU inhibition site. This in turn indicates that in Oscillatoria the site of inhibition of DCMU is on the donor side of photosystem II.


Utilization of benzylpenicillin as carbon, nitrogen and energy source by a Pseudomonas fluorescens strain.

A bacterium which utilizes benzylpenicillin as carbon, nitrogen and energy source was isolated from a lake sediment. The organism was identified as a strain of Pseudomonas fluorescens with a GC content of 59.71 Mol%. After growth of the organism on a mineral salts medium containing benzylpenicillin, the derivatives benzylpenicilloic acid, benzylpenilloic acid and benzylpenicillenic acid were found in culture media. There was no indication that the phenylacetate side chain of benzylpenicillin is decomposed. In uninoculated culture media benzylpenicillin, benzylpenicilloic acid and benzylpenicillenic acid were demonstrable. The following compounds were found to be absent from inoculated or uninoculated culture fluids: D-penicillamine, L-valine, L-cysteine, benzylpenillic acid and 6-aminopenicillanic acid. The organism possesses penicillinase. Penicillin acylase was not demonstrable. The reaction product of penicillinase, benzylpenicilloic acid, supports only little growth. There is no growth on 6-aminopenicillanic acid with or without NH4Cl. Relatively little growth occurs on 6-aminopenicillanic acid in the presence of phenylacetic acid. The data indicate that the nucleus of the benzylpenicillin molecule is utilized as carbon, nitrogen and energy source. During growth a part of the substrate is destroyed into scarcely usable benzylpenicilloic acid; hereby the antibiotic is detoxified.


Hydrogen metabolism in the facultative anoxygenic cyanobacteria (blue-green algae) Oscillatoria limnetica and Aphanothece halophytica.

Two facultative anoxygenic photoautotrophic cyanobacteria, Oscillatoria limnetica and Aphanothece halophytica were found capable of CO2 photoassimilation using molecular hydrogen as electron donor in a photosystem I driven reaction. A. halophytica was also capable of evolving hydrogen from Na-dithionite reduced methylviologen in a light independent reaction.


A comparison of electron transport and photophosphorylation systems of Rhodopseudomonas capsulata and Rhodospirillum rubrum. Effects of antimycin A and dibromothymoquinone.

The photophosphorylation systems of Rhodopseudomonas capsulata and Rhodospirillum rubrum chromatophores have been compared in respect to the effects of artificial electron carriers [N-methylphenazonium methosulfate (PMS) and diaminodurene], reducing agents (ascorbate in particular), and various quinones in the absence and presence of the electron transport inhibitors antimycin A and dibromothymoquinone (DBMIB). In addition, the effects of both inhibitors on photosynthetic electron transport through cytochromes b and c has been followed. From the results obtained, it appears that in both organisms: a) ubiquinone functions as an electron carrier between the cytochromes, and b) both antimycin A and DBMIB inhibit cyclic electron flow in the segment...cytochrome b leads to ubiquinone leads to cytochrome c..., but at different sites. The systems apparently differ mainly in respect to the nature of the electron flow by-pass "shunt" that is evoked in the presence of PMS; thus, in R. rubrum, PMS catalyzes a shunt that by-passes both cytochrome b and ubiquinone, whereas in Rps. capsulata the PMS shunt seems to circumvent only ubiquinone.


Dimethyl sulfoxide as an electron acceptor for anaerobic growth.

The isolation from lake mud of a bacterium which can use dimethyl sulfoxide (DMSO) as an electron acceptor for growth is described. The isolate, called strain DL-1, was a small, gram negative, non-motile spiral. The sole product of DMSO reduction was dimethyl sulfide (DMS). Other electron acceptors used by the isolate included sulfite, thiosulfate, elemental sulfur, methionine sulfoxide, tetramethylene sulfoxide, nitrate, and oxygen (microaerophilically). Sulfate was not reduced and could not even be assimilated. Lactate or succinate could serve as electron donors, with acetate as the main product. Hydrogen could be used as an electron donor if acetate was present in the medium as a carbon source. The organism has a c-type cytochrome, and most likely uses electron transport phosphorylation during DMSO reduction. Cultures of Desulfovibrio sp., Escherichia coli, Pseudomonas aeruginosa, and Proteus vulgaris were tested for growth using DMSO as an electron acceptor, and only the Proteus strain grew. Both Proteus and strain DL-1 are versatile at coupling reductions with energy generation. There is a marked resemblance between strain DL-1 and the recently described sulfur-reducing spirillum of Wolfe and Pfennig.


Myxobacterial slime and proteolytic activity.

An extracellular protein-polysaccharide-lipide (PPL) complex from exponentially growing cultures of Myxococcus virescens was purified by phosphate precipitation and gel chromatography. The high molecular weight slime polymer appeared homogenous upon isoelectric focusing. The PPL complex exhibited proteolytic activity against gelatin and the activity was only partly reduced by heat treatment. The function of the slime polymer as protein denatured was studied. The complex formed micelles similar to anionic detergents and it inhibited the precipitation and coagulation of proteins by trichloroacetic acid. Lysozyme was totally inactivated when treated with the PPL complex. By gel chromatography binding studies, the PPL complex was found to bind lysozyme in the ratio of 1 to 5.8 (w/w). After separation of added protein from the complex the anticoagulation effect on the protein remained. The biological function of the PPL complex was demonstrated with hemoglobin. When all susceptible peptide bonds in PPL-treated hemoglobin were hydrolyzed by trypsin only 20% in the urea-denatured protein were attacked. The combined role of slime and proteolytic activity is discussed.


Mutagenicity and chromosomal aberrations as an analytical tool for in vitro detection of mammalian enzyme-mediated formation of reactive metabolites.

1. Incubation of trichloroethylene, 1,1-dichloroethylene, vinylchloride, tetra-chlorocyclopentadiene, the nitroso derivatives of the pesticides Carbaryl, Prometryn, and Dodin in the presence of metabolically active mouse liver microsomes and bacteria as target cells were mutagenic, whereas tetrachloroethylene, 1,2 cis- and transdichloroethylene, hexachlorocyclopentadiene, carbontetrachloride, chloroform, halothane, trichlorofluoromethane and styrene were not activated to mutagenic species. 2. In a similar in vitro test system using freshly isolated human lymphocytes as target cells dimethylnitrosamine induced chromosomal aberrations. 3. It is concluded from the experiments that submammalian or mammalian in vitro cell systems with metabolically active liver microsomes are not only suitable to screen for chemical mutagens but to demonstrate formation of reactive intermediates, which are short lived and cannot be detected by chemical procedure.


Dual role of glucuronyl- and sulfotransferases converting xenobiotics into reactive or biologically inactive and easily excretable compounds.

Glucuronyl- and sulfotransferases inactivate a wide variety of hazardous compounds, for example, phenols and dihydrodiols generated during the metabolism of polycyclic hydrocarbons. Our understanding of the firmly membrane-bound glucuronyltransferase is complicated because of their marked activation by membrane perturbants in vitro. Membrane perturbation also occurs in vivo, for example in liver injury caused by CCl4. Moreover, glucuronyltransferases are inducible by xenobiotics. Phenobarbital and 3-methylcholanthrene probably stimulate separate glucuronyltransferases. Sulfotransferases, located in the cytoplasm, often compete with glucuronyltransferases for the same substrates. The generation of 'active sulfate' (PAPS) from cysteine is more likely to be depleted in vivo than the formation of UDP-glucuronic acid generated from carbohydrates. Hence the proportion of sulfate ester/glucuronide may fall with increasing dose of the substrate. Sulfate esters and glucuronides of certain N-hydroxy-arylamines (N-hydroxy-N-acetylaminofluorene, N-hydroxy-phenacetin) are more reactive than the parent compound and bind covalently to cell constituents. Of the two conjugates, sulfate esters are more reactive and thereby more toxic than the corresponding glucuronides. Glucuronides may become toxic in the kidney and bladder where they are highly concentrated.


[Electron microscopic study of the dynamics of experimental pyocyaneus pneumonia in the presence of severe burn injury].

Under conditions of a severe burn trauma the experimental P. aeruginosa pneumonia is accompanied by marked destructive changes of all the elements of the hemato-aerial barrier and its increased permeability. At the same time, because of sharp inhibition of the intracellular lysis of bacteria in all elements of the pulmonary reticuloendothelial system, a long-term retention of the pathogenic microflora in the pulmonary tissue is observed. The combination of these factors results in microflora invasion of the blood channel of the lungs, and in this way the lungs acquire an important role as additional portals of entry of infection in severe burn trauma.