Cyst of the choroid plexus of the left lateral ventricle.

A cyst of the choroid plexus of the left ventricle is described. The cyst was lined by a choroidal epithelium and filled with cerebrospinal fluid. It produced an intermittent obstructive syndrome. The cyst was almost completely invaginated into the third ventricle, simulating an expanding process in the third ventricle. After microsurgical removal, the recovery of the patient was complete. Electronmicroscopy of the cyst wall is reported. Histological and neuroradiological features are discussed.


Successful treatment of a single cerebral metastasis from bronchogenic carcinoma.

Three patients with long-term survival after operations for a single cerebral metastasis from pulmonary cancer are reported as exceptions to the poor prognosis commonly associated with this disease. Evaluations at nine, five, and six years, respectively, after surgical treatment showed no evidence of recurrence. The pathology and the ramifications of computerized tomography and radiotherapy with respect to management of cerebral metastasis are discussed. In selected cases, aggressive treatment of both the primary and secondary lesions may result in prolonged and useful survival and even permanent cure.


Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region.

The topographic and internal anatomy of the sphenoid bone is reviewed with an emphasis on the relationships important to the transcranial and subcranial surgical approaches to the sphenoid sinus, sella turcica and cavernous sinus. A stepwise method of study and dissection is outlined. The equipment and materials needed for sphenoid bone dissection in the laboratory are reviewed.


Embolization and superselective angiography by means of balloon catheters.

Three types of thin flexible balloon catheters were made. One of them is a releasable balloon catheter, which is prepared for embolization of intracranial aneurysms, arteriovenous malformations and fistulas. The other two are nonreleasable balloon catheters that are utilized for temporary occlusion, catheterization, and superselective angiography of the intracranial arteries. These catheters are useful experimentally for the above mentioned purposes. Our clinical experiences with catheterization and superselective angiography with our balloon catheter are reported.


Continuing peritoneal lavage in high-risk peritonitis.

A total of 27 patients with peritonitis who were considered to have poor prognoses were treated with a continuing peritoneal lavage of 1.5% Dianeal containing gentamicin sulfate, cephalothin sodium, and lincomycin. Twenty-one patients survived (78%), and only two patients developed intraperitoneal abscesses. The major benefit was found in those patients with gross peritoneal contamination. Anastomotic integrity was not affected by the lavage.


The early results of reconstruction of the femoral artery with a Gore-Tex prosthesis.

An analysis is presented of the results of forty-one reconstructions of the superficial femoral artery using a Gore-Tex prosthesis. There were four complications and the results, when the boundary conditions were good, were comparable to those obtained from reconstruction with autogenous vein. Most failures occurred in patients in whom the branches of the popliteal artery were obliterated. We concluded that a Gore-Tex prosthesis is a reasonable alternative when autogenous vein is unavailable, but it is overly optimistic to expect any prosthesis to work in circumstances where a vein is unlikely to work.


Hypotension and hypertension as consequences of baroreceptor dysfunction following carotid endarterectomy.

Arterial pressure regulation is often labile following carotid endarterectomy. Hemodynamic data from 100 consecutive endarterectomies allowed definition of three distinct postoperative blood pressure responses. A hypotensive response (group I) affected 28 patients in whom mean arterial pressure decreased from 168 +/- 29/90 +/- 15 mm Hg before operation to 110 +/- 21/68 +/- 16 mm Hg after operation (P less than 0.001). Maximum hypotension occurred 5.3 hours after endarterectomy. The preoperative pulse, 80 +/- 9 beats/min, fell to a low of 64 +/- 12 beats/min after operation (P less than 0.001). A significant hypertensive response (group II) affected 19 patients in whom mean blood pressure rose from 160 +/- 29/87 +/- 15 to 223 +/- 32/110 +/- 22 mm Hg (P less than 0.001). Maximum hypertension was noted 2.3 hours after endarterectomy. This was unaccompanied by significant pulse changes. Fifty-three patients remained normotensive (group III). Their preoperative blood pressure (150 +/- 14 mmHg). Fluctuations in pressure did not correlate with age, indication for operation, or degree of ipsilateral and contralateral carotid arterial stenosis. Postendarterectomy hypotension and hypertension appear to represent transient baroreceptor dysfunctions.


Correlative evaluation of angiography and pancreatoductography in relation to surgery for cancer of the pancreas.

The results of preoperative angiograms and pancreatoductograms in 37 patients with cancer of the pancreas were correlated with each other, with the findings at laparotomy, and with survival times. Tumors which could not be detected by arteriography and/or pancreatography were resectable, except for those located in the uncinate process. Among the resectable tumors, those which were identified only by pancreatography were confined mostly to the parenchyma of the pancreas and were nearly 2 cm in size. Those patients were expected to have a long survival after total pancreatectomy. In contrast, those tumors which were diagnosed only by arteriography arose from the subcapsular portion of the gland or the uncinate process and showed macroscopic invasion to the capsule of the pancreas. These tumors, recurred within 1 year, despite total pancreatectomy. The resectable tumors showing both vascular and ductal invasion were more than 3 cm in size and extended far beyond the capsule of the gland, and patients with these tumors died within 1 year after operation. In this group no difference in survival time was seen among those treated by the Whipple procedure, those by total pancreatectomy, or those by resection of the total pancreas and the portal vein.


Hepatic cellular hypoxia in murine peritonitis.

Reduced oxygen consumption and lactic acidosis were observed frequently in patients with peritonitis. This study was designed to evaluate whether reduced oxygen consumption is secondary to deficient oxygen delivery or is a function of primary injury to mitochondria. Peritonitis was produced in rats by cecal ligation and perforation. Animals were killed at 2, 4, and 6 hours and agonally. Oxygen utilization was studied polarographically in isolated hepatic mitochondria with glutamate, pyruvate, and succinate substrates. State 3, state 4, respiratory control index (RCI), and ADP:O ratios were determined. Whole tissue and isolated mitochondrial ultrastructure were examined by electron microscopy. Systemic blood pressure and oxygenation were monitored. Hepatic tissue oxygenation was examined using a surface oxygen electrode. Peritonitis resulted in acceleration of state 3 respiratory rates and increased respiratory control indices at all time intervals. Maximal respiratory control was observed at 4 hours with all substrates. Whole tissue mitochondria demonstrated mild swelling and thinning of membranes and matrix. Experimental and control isolates showed similar orthodox-to-condensed conformational changes. Hepatic tissue oxygenation declined to less than 10% of control by 6 hours, while arterial Po2 was unchanged. The conclusions of this study are that lethal peritonitis results in (1) no primary injury to the hepatic mitochondria, (2) increased efficiency of hepatic mitochondrial oxygen utilization, and (3) reduced hepatic tissue oxygenation. The exact mechanisms of defective oxygen delivery require further study.


A combined approach to the noninvasive diagnosis of carotid artery occlusive disease.

A combined approach utilizing ophthalmosonometry (OSM), carotid phonoangiography (CPA), and ocular pneumoplethysmography (OPG) was applied to 31 patients with symptoms of carotid artery occlusive disease. Arteriograms were subsequently obtained in 70 of these patients, thus allowing the accuracy of each technique to be assessed in 140 carotid arteries. Both Doppler OSM and OPG correctly identified all complete occlusions of the internal carotid artery. However, greater than 50% stenoses were detected by OSM in only 52% and by OPG in 87%. Thus the cumulative accuracy in detecting hemodynamically significant lesions was 76% for OSM and 93% for OPG. The addition of CPA to OPG raised the combined accuracy of the two techniques to 98% for significant carotid lesions. The development of a regression line criterion for the OPG, in combination with CPA, permitted identification of 100% of patients with bilateral carotid artery lesions. However 75% of patients with symptomatic, ulcerating plaques were missed by all three tests, thereby emphasizing the need for angiography in appropriately symptomatic patients. The principal usefulness of noninvasive testing in evaluating patients with carotid artery occlusive disease is for: (1) asymptomatic bruits, (2) atypical, nonhemispheric symptoms, or (3) following carotid endarterectomy.


Successful management of popliteal arterial disruption in Ehlers-Danlos syndrome.

A review of the literature on Ehlers-Danlos syndrome with particular attention to vascular complications enabled us to outline an orderly diagnostic and therapeutic plan which has allowed salvage of an individual with a popliteal false aneurysm. In patients with Ehlers-Danlos syndrome and brachial, superficial femoral, or popliteal arterial disruption, the use of proximal tourniquet control to allow ligation of the disrupted artery under a no-flow, no-pressure situation is recommended. The ligations should be carried out with a large ligature or possibly with large hemoclips and/or reinforced with multiple fine atraumatic vascular sutures distally. These patients may be treated successfully for flexion contractures because of the laxness of their tissues.


Fibromuscular dysplasia of the external iliac arteries: surgical treatment by graduated internal dilatation technique.

A case of fibromuscular dysplasia of the external iliac arteries treated by graduated internal dilatation is presented. At follow-up extending to 7 years, the external iliac arteries are patent with no evidence of recurrent disease by arteriography, and the patient remains asymptomatic. The recently reported successes with percutaneous balloon catheter angioplasty offers a nonsurgical alternative in the treatment of external iliac fibromuscular disease. A consideration of balloon catheter angioplasty in future similar cases is suggested. If balloon catheter angioplasty is unsuccessful, the option of operation remains available.


A prospective study of Doppler pressures and segmental plethysmography before and following aortofemoral bypass. Implications for predicting success and for adopting a uniform method of classifying arterial disease.

To determine the clinical and hemodynamic changes associated with aortofemoral bypass, 44 limbs of 31 patients underwent segmental plethysmography (PVR) and Doppler pressures (DSP) before operation, immediately after operation, and again at 6 months. Prior to operation patients were separated by angiographic criteria into two groups: aortoiliac segment disease alone (AI) (n = 22), and aortoiliac and femoropopliteal segment disease (AIFP) (n = 22). At 6 months the two groups were subdivided into four groups based on relief (oSx) or lack of relief (+Sx) of symptoms. Before operation the only significant difference between the four groups was a higher thigh PVR and calf DSP in the AI + Sx group. Six month PVR values in AIoSx were improved nearly twofold over preoperative measurements at the thigh and calf, but at the thigh level only for AIFPxSx. DSP was increased at all three levels in both AI and AIFPoSx groups. No hemodynamic improvement occurred in either the AI or the AIFP + Sx groups. A derivative index of PVR (thigh-ankle/15 mm) or the FPomega was significantly lower in AIFOsSx before operation. There was a significant disparity between classification by hemodynamics and by symptoms prior to operation which lessened somewhat after operation. These studies suggest that success or failure can be predicted before operation in AIFP by FPomega, and arterial disease should be classified by a combination of symptoms, angiography, and hemodynamics.


Heparin-induced thrombocytopenia, thrombosis, and hemorrhage.

Twenty-two patients developed significant thrombocytopenia (5,000 to 96,000/cu mm; mean, 29,000/cu mm) while receiving prophylactic or therapeutic heparin. Seventeen of them developed serious thrombohemorrhagic complications which accelerated the deaths of six and contributed to the late death of one. Cessation of heparin therapy led to an immediate remission of the thrombohemorrhagic complications and thrombocytopenia, with no patient who was not already moribund dying, once appropriate therapy had been instituted. Platelet-count monitoring is recommended for all patients receiving heparin for more than 6 days, with cessation of heparin therapy mandatory for the successful management of patients with this disorder. Evidence is presented for an immunologic etiology for this disorder.


Protein malnutrition following intestinal bypass for morbid obesity.

Intestinal bypass surgery, performed for weight reduction in the morbidly obese patient, is frequently complicated by the development and hepatic complications. In 44 morbidly obese individuals, 55 inches of proximal jejunum were anastomosed, end to side, to 5 inches of distal ileum. All the patients were followed with body composition measurements, performed by multiple isotope dilution, prior to and at regular time intervals following bypass surgery. In 33 patients a decrease in body fat accounted for the entire postbypass weight loss, while the lean body mass remained normal in both size and composition. In these patients, at 1 year, body weights had decreased by 24.4 +/- 2.1%, while the body cell masses had decreased by 2.1 +/- 7.1%. In the remaining 11 patients, the postbypass weight loss resulted from a loss of both body fat and body cell mass. Their body weights at 1 year had decreased by 27.0 +/- 3.0%, while the body fat and body cell mass. Their body weights at 1 year had decreased by 27.0 +/- 3.0%, while the body cell masses decreased by 22.0 +/- 6.1%. Furthermore, their body compositions were characteristic of protein malnutrition with a contracted body cell mass and an expanded extracellular mass. Six of these 11 patients have required admission to hospital on 10 occasions because of malaise, anorexia, debilitating weakness, hypokalemia, and abnormal liver function. They were treated for 14.5 +/- 1.9 days with an intravenous infusion of amino acids without additional nonprotein calories. The body composition, initially characteristic of malnutrition, became normal. Their symptoms disappeared and hepatic function returned to normal. Subsequently a high-protein diet was required to prevent a recurrence of symptoms and to maintain a normal body composition. The data indicate that protein malnutrition developed in 11 of 44 patients undergoing jejunoileal bypass for weight reduction.


Sex, side, and severity in spontaneous malformations of fetal A/JKt mice, and their associations with each other and with fetal weight.

Cleft lip and palate (CLP) and open eyelid (OL) occur spontaneously in rather high frequencies in A/JKt mice, but vary greatly in their degree, laterality, and sex distribution. CLP occurs significantly more often in females, and OL even more often in males, than in the opposite sex. The female preponderence for CLP was largely if not entirely due to the increased rate of occurrence of left and incomplete forms of the defect, and to the excess in females heavier than the female median weight; whereas the male preponderance for OL could not be explained by any clear or major disparities of these sorts. CLP and OL occurred together more often than expected in individuals, but not in litters. There was no relation between the rate of defects in successive litters of the same female; nor was a relation detected between extent and severity of defect.


Prevention by diazepam of adverse effects of maternal restraint stress on postnatal development and learning in the rat.

Rats on days 12--14 of pregnancy were treated with restraint stress alone (9h daily), restraint stress plus diazepam (1 mg/kg, twice daily), diazepam alone, or left as untreated controls. Postnatal development and behaviour was assessed on a wide-ranging battery of tests. Offspring of mothers subjected to restraint stress alone were significantly retarded on a number of developmental measures including growth, ear-opening, cliff avoidance response, auditory startle response and mid-air righting reflex. When adult these offspring also showed significantly impaired learning ability in a swimming maze. However, the rate of development and learning ability in the restraint plus diazepam or diazepam alone groups was comparable to or slightly advanced of that in untreated controls. It is concluded that concurrent administration of a low dose of the tranquiliser diazepam during restraint stress prevents the adverse postnatal effects of maternal restraint stress.


Lectin teratogenesis: defects produced by concanavalin A in fetal rabbits.

Concanavalin A (con A) is teratogenic to rabbit embryos during gestational days 12--15. Intracoelomic injections of 40 microliter con A solution (4 microgram/microliter) were performed on rabbit embryos during gestational days 10--15. Control embryos received either 40 microliter of saline, sham injection or no treatment. Con A caused increased fetal resorptions on days 10 and 11, but malformation levels did not differ from controls. On days 12--15, con A produced craniofacial, trunk and limb anomalies. The highest percentage of malformation occurred on day 14. The defects were classified into four groups: (1) malformations of limbs including paw and digital dysplasias as well as fusions of the limbs to the head or body wall; (2) "closure" defects such as umbilical hernia, encephalocoele, exencephaly or ectopia cordis; (3) "contracture" defects such as club paws, extended knees, or clenched digits, which exhibited normal osseous and cartilaginous skeletons; and (4) miscellaneous, non-specific anomalies including fused or dysplastic sternebrae or ribs. Histologic analysis of selected 12-day embryos 4 to 18 hours post-injection was performed to ascertain potential sites of teratogenic action. At 12 hours ectodermal necrosis was observed in the limb buds adjacent to the apical ectodermal ridge. By 18 hours, the ectoderm had eroded, exposing the basal lamina to the amniotic fluid. Focal areas of mesenchymal necrosis were observed in association with the ectodermal erosion. The potential roles of amniocentesis and limb bud repair in the genesis of the malformations are discussed.


Tail anomaly lethal Tal: a new mutant gene in the rat.

A new hereditary tail anomaly (gene symbol Tal) in rats was found in the course of teratological studies with trypan blue. The characteristic feature of the tail anomaly was a short and kinked tail. The genetic analysis indicated that the tail anomaly was caused by an autosomal dominant gene and the homozygotes were lethal in the prenatal stage. The first sign of degeneration in the homozygous embryo appeared in the late egg cylinder stage. The phenotype of this mutant is similar to that of T-locus mutants in mice.


Folate antagonism following teratogenic exposure to diphenylhydantoin.

Previous studies have reported indirect evidence for the mediation of folate antagonism in the induction of malformations by diphenylhydantion. We have demonstrated that a teratogenic regimen of folate-deficiency and antagonism using 9-methyl PGA in the rat produces significantly decreased rates of oxygen consumption in the maldeveloping embryos. The present study reports similar reductions in oxygen uptake by mouse embryos from mothers treated with teratogenic doses of diphenylhydantoin, and documents a significant depression of the actual folate levels in such embryos. The differences are less significant with lower doses of diphenylhydantoin, and do not occur with a nonteratogenic dose.


The effect of the time of administration of chromium trioxide on the embryotoxic response in hamsters.

Prior work has demonstrated that chromium trioxide is embryotoxic in hamsters if administered to pregnant animals early on the eighth gestation day. The major manifestations are cleft palate and an increased frequency of resorptions. In the present study a single iv dose (8 mg/kg) of chromium trioxide was injected into pregnant hamsters at 8 A.M. on either day 7, 8, 9, 10 or 11 of gestation in order to determine the effect of altering the time of treatment on embryotoxicity. Fetuses from females treated with chromium or demineralized-distilled water were collected on day 15 of gestation and were examined for the types and frequency of external and internal malformations. The number of resorption sites was recorded. Cleft palate, the major malformation detected, was produced only when chromium was administered on days 7, 8, or 9 of gestation. Since the frequency of resorptions and the incidence of cleft palate varied with the time of treatment it is concluded that the time at which chromium trioxide is injected into the pregnant hamster does influence embryotoxicity. The results suggest that an interference with embryonic growth may be an important factor in chromium-induced cleft palate in hamsters.


Campomelic syndrome--possible role of intrauterine viral infection.

Two infants whose malformations fulfilled the clinical, radiographic and pathologic criteria of campomelic syndrome, were additionally found to have features suggestive of intrauterine viral infection. The presence of hydrocephalus and hydromyelia in both neonates and focal proliferative villitis in the placenta of one suggests that intrauterine viral infection may play a role in the pathogenesis of campomelic syndrome.


[Congenital tricuspid atresia in a premature foal (author's transl)].

A case of tricuspid atresia in a premature foal associated with large atrial septal and ventricular septal defects is reported. This anomaly is compared with other cases in horses as reported in the literature. As tricuspid atresia in horses is usually not diagnosed so that relatively few cases have been reported, a classification similar to that of human anomalies is not possible. It is suggested that the present malformation is due to abnormal development of the atrioventricular canal. The factors involved in the pathogenesis of this abnormal development are obscure.


[Renal failure caused by mercury and lead poisoning in the calf (author's transl)].

The renal lesions in three calves with mercury poisoning (phenylmercuric acetate) and two calves with lead poisoning are described. In addition of slight tubular degeneration, glomerulonephritis occurred in the animals with mercury poisoning. Moreover, uraemia, oedema and haemorrhages were present. Lesions of the brain not were found. In the animals with lead poisoning, chronic renal tubular changes and characteristic intranuclear inclusion bodies in the proximal tubular cells were observed. The juxtamedullary glomeruli showed proliferative mesangial lesions. In one calf, the cerebral cortex showed oedema, necrosis of neurons and an increase in glial cells.


[Heritable defects in dogs (author's transl)].

The introduction to this report contains a description of the development of breeds of domestic animals. The change-over from natural to artificial selection gives rise to disturbances of morphological, physiological and behavioural traits. The origine, incidence and diagnosis of heritable defects in various canine breeds are discussed. On this basis two tables listing heritable defects in dogs are presented.


Surgery of life-threatening ventricular tachyarrhythmias associated with ventricular aneurysm.

In 11 patients with left ventricular aneurysm and ventricular tachyarrhythmia unresponsive to conventional antiarrhythmic therapy surgical treatment was performed by resection of the aneurysm. One patient underwent epicardial electrophysiological mapping intraoperatively, and the site of earliest activation during tachycardia was established. One patient did 11 hours postoperatively. Three patients are cured from their tachycardia 3 to 22 months after surgery. Six patients have still persistent premature ventricular beats which are now controlled satisfactorily with antiarrhythmic drugs. Our results demonstrate the therapeutic value of aneurysmectomy in the treatment of related ventricular tachyarrhythmias. The practical relevance of intraoperative electrophysiological mapping procedures for localizing the origin of ventricular tachyarrhythmias is a subject which merits further discussion.


Organization of a cardiovascular surgical unit: conclusions of an opinion survey among the members of the European Cardiac Surgeons Club (ECSC).

This paper summarizes the opinions of 20 representatives of well-known European centers for adult and pediatric thoracic and cardiovascular surgery regarding the optimal structure and organization of such units. These opinions were collected by means of a questionnaire, and the answers were discussed by the members of the group. Statistical analysis showed a high degree of concordance on the following subjects: The population to be covered by a given center, the relationship between cardiac surgery and cardiology, the minimal number of operations to be performed, the surgical, anaesthesiological and nursing staff, the equipment level required, the surgical training and research, and the cooperation with other centers, Partial concordance of opinions was reached in other aspects, while on some topics widely divergent views were stated, depending, in part, upon regional differences. This material is discussed in detail and we hope it will serve as a guide for the future development in this field both within and outside of Europe.


Cardiac valve replacement. Problems solved and unsolved.

In this review the present state of cardiac valve replacement is summarized on the basis of the literature and personal experience in approximately 1500 cases, using various prosthetic models. Durability, hemodynamic performance at rest and during exercise, and thromboembolic risk are considered in particular and our choice of the various valve models is discussed on these grounds. The long-term durability has been significantly improved and has possibly been solved in the more advanced mechanical valves, while this question is still open in the present biological prostheses. Hemodynamic performance is considered less than optimal in all conventional mechanical prostheses and in the xenografts. Pressure gradients are abnormal in all mechanical as well as in stented biological prostheses, the latter being less likely to solve the problem of a narrow aortic root. The significantly lower incidence of thromboembolism and total valve thrombosis and the absence of anticoagulation accidents in patients with bioprostheses has tipped the balance for the present in favor of the latter, particularly in mitral valve replacement and certainly in all those patients in whom anticoagulation in impossible, unlikely, or undesirable.


Primary results with the new Hall-Kaster disc valve prosthesis in mitral position.

The Hall-Kaster central flow prosthetic heart valve was introduced in 1977 in an attempt to improve the hemodynamics of the disc valve prostheses. Towards this accomplishment, innovations in the tilting axis, the disc guidance mechanisms, and disc translational freedom cooperate to improve flow through both orifice segments of the open valve. The present study reports on the primary clinical and hemodynamic findings in the first 20 patients (mean age 57.6 years) with isolated mitral valvular disease, examined 3--4 months after insertion of the Hall-Kaster disc valve prosthesis. The hemodynamic findings displayed low gradients and high calculated valve areas (5). At rest, the mean diastolic pressure gradient across the smallest prosthesis used (O.D. 27) averaged 3.0 mmHg, vs. 2.6 mmHg across the largest valve sizes (O.D. 29--31). Calculated valve area was on an average 3.08 cm2 for the smaller valve, and 3.47 cm2 for the larger valves, which corresponded to an utilization of 81% and 77% of the orifice area measured in vitro. A comparison with earlier studies of mean diastolic mitral gradients with different mitral prostheses indicates that the Hall-Kaster disc valve represents an improvement towards a hemodynamically more efficient prosthesis for mitral valve replacement.


Intraoperative and postoperative hemodynamic studies in patients undergoing aortic valve replacement with the Hall-Kaster cardiac disc valve prosthesis.

Intraoperative and postoperative hemodynamic measurements in the first patients to receive the Hall-Kaster cardiac disc valve prosthesis in the aortic position demonstrated the principal hemodynamic pattern of this new mechanical valve. These hemodynamic studies demonstrated favourable transvalvular gradient values and a degree of flow area utilization of the valve orifice which was close to its theoretical maximum. The Hall-Kaster prosthesis thus presented improved flow characteristics in patients undergoing aortic valve replacement, which is considered of particular importance to the patients with a narrow aortic root.


Regional myocardial blood flow after hypothermic arrest and cardioplegia.

Malperfusion due to increased coronary vascular resistance is presumably one of the factors responsible for incomplete functional recovery of the heart after aortic cross-clamping. Myocaridal blood flow (MBF, radioactive microspheres) was measured before and after 60 min of hypothermic ischemia in 16 dogs on cardiopulmonary bypass. After ischemia the hearts were reperfused for 30 min. MBF was measured in the empty beating heart and in the isovolumetrically contracting ventricle loaded with enddiastolic volumes (EDV) of 10, 20 and 30 ml (intraventricular latex balloon).


Intramembranous particles in the form of ridges, bracelets or assemblies in arthropod tissues.

Non-junctional intramembranous particle arrays in the form of ridges, bracelets or rectilinear assemblies have been found by freeze-fracturing in the cytoplasmic half or P face of the plasma membrane in a variety of arthropod tissues. These tissues include both excitable cells, nerve and muscle, and such other cells as those from the intestinal tract, the tracheal system and the connective tissue. The intramembranous ridges are short rows of fused particles about 10 nm in diameter; comparable particles comprise the bracelets and the rectilinear aggregates, although the former are of lower profile. In cells sending out cytoplasmic projections during migration and development, for example, axons in embryonic, newly hatched or pupal tissues, tracheoles or fibroblasts, the intramembranous ridges are always aligned parallel to the longitudinal axis of the cellular process. The physiological significance of these may be that they play some role in recognition during development, perhaps by contact guidance. The ridges and rectilinear arrays found in the gut could also be involved in recognition and/or adhesion. In muscle, bead-like ridges are intimately associated with the transverse tubular system and may have a receptor function. Irregular and circular low-profile ridges occur in the tissues of the horseshoe crab, Limulus, and 'bracelet' forms are found in the inner membrane of insect pupal tracheae. The latter may play a part in the initiation and development of small tracheoles.


Innervation of the periarteriolar lymphatic sheath of the spleen.

During the course of a neurohistochemical and two independent electron microscopic studies of the mouse spleen, unmyelinated adrenergic nerves containing numerous dense core and lucent vesicles and devoid of neurolemma were observed adjacent to reticular cells and lymphocytes in the white pulp. Some of these nerves formed an intimate relationship with these cells. Since adrenergic substances have been reported to modulate the cell cycle of lymphocytes in vitro, these findings are suggestive of a neural influence on the cell cycle of lymphocytes in vivo.


Calcium containing lysosomes in the normal chick duodenum: a histochemical and analytical electron microscopic study.

Absorptive cells of the normal chick duodenum contain numerous supranuclear vesicular/vacuolar structures. By routine transmission electron microscopy, such structures are membrane bound and demonstrate a granular content. These vesicles appear to move laterally and eventually coalesce with the lateral plasma membrane (exocytosis). The granular contents are resistant to high temperature microincineration, thus revealing their mineral-containing nature. The granular vesicular matrix also stains intensely with osmium pyroantimonate EGTA chelation of pyroantimonate-stained vesicles selectively extracts the granules indicating a high concentration of calcium. X-ray microanalysis also demonstrates a significant intravesicular calcium localization. When tissues were incubated for the presence of acid phosphatase, the supranuclear vesicles were markedly positive for this lysosomal enzyme. A possible role for these calcium-containing lysosomes in the transcellular flux of calcium ions across the intestinal absorptive cell is discussed.


Annulate lamellae in human tumor cells.

Annulate lamellae have been found in a primitive neuroectodermal tumor, a metastatic cerebellar tumor, a testicular seminoma, a retinoblastoma and three melanomas. These annulate lamellae are arranged in stacked parallel arrays in the cytoplasm of tumor cells. The number of annulate lamellae observed to comprise a single stack varies from 2--4 in the seminoma tumor to 5--18 in the cerebellar tumor. Although the functional significance of annulate lamallae is still unknown, in many instances they have been found to be continuous with rough-surfaced cisternae of the endoplasmic reticulum and ribosomes have been demonstrated on the surface of annulate lamellae. This may suggest that annulate lamellae participate in protein synthesis.


Changes in distribution of nuclear pores during differentiation of the male germ cells.

Changes in number of nuclear pores in different states of physiologica activity have been reported, but little is known about changing patterns of distribution in the course of cell differentiation. Pore distribution in male germ cells was studied in freeze fracture preparations of immature and mature rodent testis. As in other somatic cells, pores were uniformly and apparently randomly distributed in Sertoli cell nuclei. The nucleus of gonocytes and spermatogonia showed varying degrees of pore clustering. Spermatocytes invariably exhibited very striking pore aggregation with close hexagonal packing in pore-rich areas, and large pore-free areas. In early spermatids, pores appeared to be randomly distributed. As the acrosome formed and spread over the apical pole of the nucleus, pores disappeared ahead of its advancing margin and became more concentrated in the post-acrosomal region. The relationship of pore complexes to the chromosomes and the role of the fibrous lamina are discussed. The question as to whether the changing patterns observed involve movement of pores within fluid nuclear membranes, or a dissolution and reformation of new pores remains unanswered.


The brain of the horseshoe crab (Limulus polyphemus). III. Cellular and synaptic organization of the corpora pedunculata.

The large, hemispherical mass of the Limulus corpora pedunculata consists of two highly branched lobes, each connected to the protocerebrum by a narrow stalk. About 10(4) afferent fibers enter through the stalks and make diverse, profuse, and often reciprocal contacts with several million Kenyon (intrinsic) cells and one another. The Kenyon cell axonal arborizations converge on a few hundred efferent dendrites. The afferent fiber types can be classified into five types. Type A forms the club-shaped core of glomeruli and circumglomerular annuli, and contains small flat vesicles, suggesting an inhibitory function. Type B terminates with bushy endings in glomeruli and is presynaptic to both Kenyon cells and to Type A terminals. It has clear round vesicles and is the presumptive excitatory input. Type C terminates on other afferents, in glomeruli, and rarely on Kenyon cell bodies, contains angular (neurosecretory) granules and is postulated to impart circadian rhythm. Type D terminates on Kenyon cell somata and the initial neurite segment (but not in glomeruli), and contains dense-cored vesicles. Type E terminates in peduncles on other afferents and Kenyon cell telodendria. It contains dense vesicles. The C, D, and E afferents have reciprocal synaptic connections with Kenyon cell axon terminals. Glomeruli thus receive three different inputs of presumptive inhibitory (A), excitatory (B), and neuromodulatory nature (C). Kenyon cells, increasing in number up to about 1 x 10(8) in the adult, show minor variations in their dendritic pattern and have only one rare variant cell type. Interactions between them occur primarily at their axonal boutons as they crowd around efferent fibers. The latter have large receptive fields, some of their large somata are located within the confines of the corpora pedunculata, and they receive input almost only from Kenyon cells. Numerical and directional details of the circuitry in the corpora pedunculata have been extracted by a combination of light and electron microscopy, serial sectioning, silver staining, and stereology. The corpora pedunculata appear to process primarily the voluminous chemosensory input from the appendages, an assumption that is supported by the major connections of the organ.


The fine structural effect of sialectomy on the taste bud cells in the rat.

Taste buds in the rat and other mammals share a secretory activity with their transduction function as taste receptor. The present work shows the effect of bilateral removal of the main salivary glands on taste bud cells' components related to secretion in the vallate papilla of the rat. In the sialectomized rats remarkable changes were evidence in the dark and intermediate types of taste bud cells, which are known to be the secretory components. Such changes involve hypertrophy of either the protein synthetizing machinery, the smooth endoplasmic reticulum or the Golgi complex. Lucent and coated vesicles associated to Golgi cisternae increased in number but the amount of dense-core vesicles (secretory vesicles) at the apical cytoplasm of cells decreased. Images of exocytosis of secretory products were observed. The hypertrophy of Golgi complex components was clearly detected with the OsO4 impregnation method for light and electron microscopy. Alteration in the acid phosphatase activity of taste bud cells was not observed in the sialectomized rats. These findings suggest that sialectomy stimulates the entire secretory cycle of dark and intermediate taste bud cells. The light taste bud cells, which are not engaged in secretion, are hardly affected by the treatment. Although taste buds in mammals are neuro-dependent structures, present evidence indicates that they are also sensitive to non-neural influences.


An ultrastructural analysis of the salivary system of the terrestrial mollusc, Limax maximus.

The bilateral salivary glands, ducts, and nerves of the giant garden slug Limax maximus control the secretion of saliva and its transport to the buccal mass. Each salivary nerve, which originates at the buccal ganglion, contains over 3000 axon profiles. The axons innervate the musculature of the duct and branch within the gland. The salivary duct is composed of several muscular layers surrounding an epithelial layer which lines the duct lumen. The morphology of the duct epithelium indicates that it may function in ion or water balance. The salivary gland contains four major types of secretory cells. The secretory products are released from vacuoles in the gland cells, and are presumably transported by cilia in the collecting ducts of the gland into the larger muscular ducts.


The structure and compositon of the love dart (gypsobelum) in Helix pomatia.

The love dart of the snail Helix pomatia is a four-bladed, hollow spicule of calcium carbonate. The calcium carbonate is largely in the form of microcrystalline aragonite, the crystals being not more than 0.5 micrometer in size but assembled into sheets or blocks of much greater size. Protein occurs in the dart structure as an external sheath, as a lining to the tubular core and as a matrix component of the mineral phase. Comparisons with the molluscan shell are drawn and a rationale for the architecture suggested.


Unusual association of 'chloride cells' with another cell type in the skin of the glass catfish, Kryptopterus bicirrhis.

A previously undescribed association of typical 'chloride cells' and a second distinct cell type are observed in the skin of the freshwater glass catfish, Kryptopterus bicirrhis. The second cell type is similar to the chloride cell in that it contains abundant smooth endoplasmic reticulum and mitochondria. However, its small size and greater electron density suggest it is a 'resting' or non-functional chloride cell. Together these two cells form a crypt which leads to the skin surface. They may constitute a specialized structure involved in the passage of ions across the skin of these fish.


Secretory activities of plasmatocytes and oenocytoids during the moulting cycle in an insect (Rhodnius).

Plasmatocytes in Rhodnius appear to be the chief source of the basement membrane (basal lamina) of the abdominal epidermis. The membrane increases three-fold in thickness while the cells are applied to its surface, from 4 to 9 days after feeding. At this time irregular deposits of membrane substance appear, applied to the membrane in the vicinity of plasmatocytes. Many small vesicles perhaps undergoing exocytosis are seen at the surface of the plasmatocytes in contact with the basement membrane (basal limina). The large granular inclusions of the plasmatocytes are dispersed and their contents appear to provide the substance of the basement membrane, which has the same staining properties as these inclusions.


Ultrastructural characteristics of Hydrilla leaf tissue.

The general anatomy and leaf ultrastructure of Hydrilla verticillata (L.f.) Royle, a submersed vascular hydrophyte, are reported. The transversely sectioned leaf consists of only two contiguous epidermal layers, and the single midvein is composed of three to four concentric layers of cells. There are numerous intercellular spaces throughout the tissue. Electron microscopy confirmed the presence of sieve elements in the mid-vein area. P-protein, plastid inclusions and branched plasmodesmata leading into the companion cells are all considered indicative of phloem-type cells. Plastid inclusions are cuneate and lack associated starch granules, characteristics typical of monocots. The outer wall of the lower epidermis protrudes into the cell. Plant cells with wall ingrowths are termed 'transfer cells' and, in aquatics, function in the absorption of solutes from the external environment. In addition to the lower epidermis, spiny projections of the leaf margin could be included in this category. There is a thick fibrous layer which appears to be part of the outer wall of the upper epidermis. Secretory vesicles containing polysaccharide empty into this layer and into the wall. Cell nuclei are distinctly polymorphic. The granal arrangement, presence or absence of starch and peripheral reticulum in chloroplasts varies.


Differential response of embryonic cells to culture on tissue matrices.

Cell responses to different natural substrates have been followed by scanning microscopy in order to evaluate the role of these substrates in morphogenesis. Matrix has been isolated then repopulated with suspensions of embryonic cells from chick skin, spinal ganglia, duodenal epithelium and heart. In some cases outgrowth from amphibian embryonic tissue was used. Basal lamina of the Xenopus tail may be exposed by freezing and thawing the tissue, or by EDTA treatment. The underlying lamella of orthogonally oriented collagen fibers may be exposed by use of trypsin or hyaluronidase. Trypsin causes more clumping of collagen fibers and a coarser texture of the matrix. On trypsin isolated basement lamella, nerve cell processes grow out on the surface and show no strong tendency to penetrate the lamella while skin mesenchymal cells commonly burrow among the collagen plies. Epithelial cells remain on the surface. On the basal lamina mesenchymal cells ruffle in early stages of culture, then flatten. Epithelial cells flatten rapidly on the lamina. These differences in cell response are in some cases closely related to cell behavior in vivo and suggest that cells show a selective response to the chemical composition of the substrate as well as to its physical conformation.


The effect of fibrin on cultured vascular endothelial cells.

The normal cobblestone monolayer architecture of cultured vascular endothelium becomes rapidly disorganized after contact of the cell layer with a fibrin clot. The cells of a confluent endothelial monolayer separate into individual migratory cells in 4--6 hr after contact with fibrin. The effect is reversible in that removal of the fibrin clot results in resumption of the normal morphology within about 2 hr. No other cell type tested exhibits the same change in organization when exposed to fibrin. A similar morphological change in endothelium does occur after the cell layer is overlaid with a collagen fibril gel but a gel of methylcellulose has no effect. It is proposed that the change in behavior of endothelial cells in response to contact with fibrin may represent a cellular component of fibrinolysis. The implications of this finding for the pathophysiology of disease states involving intravascular fibrin deposition are discussed.


Influence of the skin temperature on the axon reflex pilomotion produced by nicotine in human skin.

Intradermal injection of nicotine dissolved in normal saline in a concentration of 10(-5)g/ml produced axon reflex pilomotion, which was observed as goose flesh on the flexor surface of the forearm in human. The skin temperature was changed by immersing the forearm in a water bath at 22 to 45 degrees C. When the skin temperature was neutral as 32.5 degrees C, goose flesh appeared at about 5 sec and reached its maximal spread at about 25 sec, then it became smaller and disappeared at 1 min 30 sec. When the skin temperature was lower, its onset was delayed and its duration was longer. At higher temperature, time course of goose flesh was shortened. With a device of controlling temperature of receptor and effector portion independently, it was found that enhancement of goose flesh at lower temperature was due to a nature of the effector and the responsiveness of the receptor to nicotine was constant in a range from 20 to 40 degrees C. Reaction of the receptor to temperature was pharmacologically similar to that of autonomic ganglion.


Change in plasma renin activity by cold storage of plasma in normal subjects and patients with essential hypertension and primary aldosteronism.

The time courses of change in renin activity after cold storage of human plasma at -5 degrees C and pH 7.4 were examined in 5 normal subjects, 6 patients with essential hypertension and one female patient with primary aldosteronism before and after extirpation of the adrenal tumor. In the 5 normal subjects and 6 essential hypertensives, the gradual increase in plasma renin activity was observed until 10 days of cold storage. The same result was obtained in the case of primary aldosteronism. However, there was no increase in renin activity despite of cold storage for 10 days in plasma which was sampled from this patient 45 days after operation. These data indicate that a period of 4 days for cryoactivation of human plasma renin as has been reported by Sealey et al. is not sufficient to accomplish activation of renin by cold storage.


Heterogeneity of plasma insulin and triglyceride levels in obesity demonstrated by family study.

Fifty relatives of 7 families with high prevalence of obesity were investigated and the possibility was shown that there were three forms of familial obesity--normoinsulinemic obesity, hyperinsulinemic obesity and diabetic obesity. In normoinsulinemic obesity, both glucose tolerance and plasma lipids were normal with a few exceptions whereas in hyperinsulinemic obesity, mild glucose intolerance and manifest hyperlipidemia, and in diabetic obesity, blunted insulinogenic index and more advanced glucose intolerance with slight hyperlipidemia existed.


The effect of transureteroureterostomy upon conduction of peristaltic waves.

Transureteroureterostomy was performed in 32 adult dogs, and the results were evaluated by electroureterographic, roentgenographic and histological investigations. The results revealed no significant ill effect on ureteral and renal functions, indicating the procedure to be quite reasonable and clinically acceptable.


Hepatitis B antigens and antibodies in asymptomatic carriers and in chronic liver diseases.

88% of asymptomatic hepatitis B surface antigen (HBsAg) carriers and 97% of HBsAg positive patients with chronic hepatitis or non-alcoholic liver cirrhosis showed high titers of antibody to hepatitis B core antigen (anti-HBc). A high titer of anti-HBc, thus suggested to be an indicator of persistent hepatitis B virus infection, was found rarely in seronegative patients with chronic hepatitis, non-alcoholic cirrhosis, or alcoholic liver diseases. It was not revealed in idiopathic portal hypertension or Budd-Chiari syndrome. In asymptomatic HBsAg carriers of 20--29 years of age, hepatitis B e-antigen (HBeAg) was significantly more frequently found in males than in females. There were differences in sex ratio, age, and history of blood transfusion between B type and non-B type of chronic hepatitis and non-alcoholic liver cirrhosis.


[Therapy of the metastasizing adenocarcinoma of the thyroid gland using 131-I. Experiences with 103 patients from 1963 to 1977 (author's transl)].

Results of 131-I therapy in 103 patients with metastatic thyroid cancer are analyzed. Therapy included: elimination of the thyroid or residual thyroid in case of previous surgery by application of about 80 mCi of 131-I and hormone substitution. About two months later, the hormone substitution was stopped. exogenous thyrotropine wsa given and 150--300 mCi of 131-I were applicated. Two days later, the thyroid medication was reinstituted, and a week later, the patient was studied by scintigraphy and other measures. In case of an iodine-metabolizing tumorous tissue, further 131-I applications were given. In the patients with distant metastases, the ten-year survival rate is about 22%. Small masses of papillary cancer can be eradicated in the majority by means of 131-I, whereas large tumor masses (several 100 g), can not be eliminated by 131-I. In well-differentiated follicular cancer, the recovery rate obtained by 131-I is lower than in papillary cancer. Manifestations of follicular cancer with anaplastic parts, or follicular cancer with eosinophilic cells or Hürthle-cell cancers could not be eradicated by 131-I. Treatment-induced mortality lies between 2 and 3% and is acceptable in view of the recovery rate and the serious nature of the disease.


[The dosage for tangential pendulum irradiation of the thoracic wall using 60Co in surgically treated cancer of the breast and the irradiation of the parasternal lymph nodes (author's transl)].

The determination of the dose to the patient during excentric pendulum irradiation of the thoracic wall is described. The dose delivered in the course of irradiation is simultaneously measured at the patient's surface, using a measuring system with LiF-rods which was especially developed for this purpose. The value obtained has to be multiplied with a correction factor FK=0.96 in order to yield the maximum dose, being located at a depth of 2.5 mm below the skin. The accuracy of this method for determination of doses is discussed, and the deviations are shown not to exceed 5 or 6% of the total dose. The dosage by means of tube chamber measurement is represented as an alternative method. The parasternal lymph nodes are irradiated, in addition to the dose from pendulum irradiation, with a fixed field and employing a lead wedge, both lymphatic chains thus receiving a homogeneous dose.


[Scintigraphic examinations of the lymph before endolymphatic radionuclide therapy of the malignant melanoma of the inferior extremity (author's transl)].

Between 1974 and March 1977, lymph scintigrams were taken on 68 patients with operated malignant melanomas of the inferior extremity before submitting these patients to an endolymphatic radionuclide therapy. The authors wanted to prove that the lymph canals were undamaged in order to avoid unnecessary cutaneous irradiation damages in case of a subsequent additional therapy. 58 lymph scintigrams showed normal findings with a symmetrical transport of 99mtechnetium-sulfur colloid into the inguinal and iliacal lymph nodes of both sides. The ELRT could be accomplished successfully on all patients of this group. Ten lymph scintigrams showed pathological findings with evidence of activity in the wound region. The ELRT was cancelled in eight cases, and two essays had to be stopped without any success. Our experiences show that lymph scintigraphy with 99mtechnetium-sulfur colloid is a simple and reliable method to examine the lymph canals of the inferior extremities. In case of patholological findings, one can avoid to order unnecessarily the expensive radioactive substance for the endolymphatic radionuclide therapy. An alternative punction point to that on the instep which is ordinarily used can possibly be found by a repeated examination.


[An analytical method to calculate electron dose distributions. Part I: Method (author's transl)].

A method for the calculation of electron dose distributions is described. The dose distributions of stationary electron beams in water are represented by formulas for depth dose curves and transverse distributions. Curved surfaces, oblique incidence of rays, and inhomogeneities are taken into account by applying the law of distance and the method of equivalent thicknesses of water layers. A detailed program is given to calculate the electron dose distributions in that plane of the central ray which is at right angle to the theoretical circle plane of a 42 MeV betatron.


[Criteria for the optimization of geometrical dose distributions in radiotherapy (author's transl)].

The author has deducted biologic criteria for a relative optimization of geometrical dose distributions in radiotherapy. The numerical calculation is based upon, among others, the Ellis formula and the dependence on the volume of tolerance doses in healthy persons. The criteria are suited for being applied in computerized therapy planning. They can be integrated without any problem into existing program systems.


Observations regarding the x-ray beams from the Philips RT-305 therapy machine.

A Philips RT-305 X-ray therapy unit was found to produce beams of considerable asymmetry. This has been corrected by use of a small wedge-shaped symmetry filter, placed close to the X-ray tube. The symmetry filter has only a small effect on depth doses and half-value layers.


[Therapy planning at the CT (author's transl)].

A therapy planning system was installed in a computer tomography hardware. This configuration has some advantages for treatment planning: 1. CT-images and isodoses can be overlaid. 2. Using skin markers in the computer tomography the actual therapy can easily be checked. 3. This method offers a good method for recording isodoses and anatomic cross sections simultaneously.


[Fully automatical control of patient positioning--a new technique leading to exact and safe radiation therapy (author's transl)].

Any motion of the patient causing a displacement of the target volume or an immediate mechanical danger in the course of radiation therapy must be prevented. A new possibility for individual objective monitoring of patient movements, fully automatical, can be presented. Every significant displacement is releasing alarm and is detectable instantaneously. Normal respiratory movements or even the motion of the gantry do not cause a wrong alarm. Important displacements will interrupt the irradiation. Mechanical hazards to the patient thus are almost impossible. First experiences are reported.


[A device for immediate determination of focal depths during the localization with a therapy simulator (author's transl)].

Construction and capability of a measuring set-up are described which enables the direct display and storage of distances in a patient's body at arbitrary reference levels during the localization. The arrangement is characterized by a simple mounting immune from disturbances, and it exhibits a high measuring accuracy.


[Optimized treatment planning in 60Co therapy: application of a schedule for irradiation of the lateral lymphatic areas of the neck by means of a programmable pocket computer (author's transl)].

The present program for irradiation of the lymphatics at the neck is yielding good results with reasonable expenditure. The shape of the neck can be shown not to influence the isodose curves. Thus, it is possible to use a programmable pocket computer for calculation of the irradiation. An appropriate scheme has been established.


Immediate mechanical reactions of isolated human detrusor muscle on x-irradiation.

The mechanical activity (isotonic registration) of isolated detrusor (smooth) muscle preparations from the human urinary bladder (surgical material) is investigated. The preparations reacted on X-irradiation (50 kV) with an immediate dose-dependent tonic contraction at threshold-doses of 100 to 1000 R (1 to 3 kR/min). The contraction was either reversible, semireversible or persistent, and the basal muscle tone was elevated. A tachyphylactic reaction was observed. The phasic activity of the preparations was temporarily increased, then inhibited after irradiation. The radiation-induced changes of the human and guinea-pig detrusor muscle are compared and their possible relation to the functional disturbances of the urinary bladder after radiotherapy is discussed.


Direct evidence for the involvement of prostaglandin F2 alpha in the first step of estrone-induced blastocyst implantation in the spayed rat.

The effect of prostaglandin F2 alpha (PGF2 alpha) on blastocyst implantation in spayed rats has been studied. In preliminary experiments, the first implantation sites were observed 8 - 12 hours after a single injection of estrone in ovariectomized and progesterone-conditioned rats. Intraluminal instillation of PGF2 alpha into the right uterine horn 8 - 10 h after the estrone injection increased the number of implantation sites. Even treatment with PGF2 alpha without previous estrone injection induced the first step of blastocyst implantation as shown by uterine dye site reaction (Niagara-blue test). The results are discussed with regard to the possible role of PGF2 alpha in the regulation of the blastocyst implantation processes in the rat.


Synthesis and reduction of steroid C-20 alkylidene cyanoacetates.

The geometry of the condensation products between ethyl cyanoacetate and 20-ketosteroids (5 alpha-pregnane-20-one, 3 beta-hydroxypregn-5-en-20-one and 3 beta-acetoxypregn-5-en-20-one) was established by NMR spectra. Reduction of these steroid C-20 alkylidene cyanoacetates was shown to afford one of the two possible 20-C epimers, which seen to correspond to the 20 beta-methyl configuration.


Validation of a specific radioimmunoassay to measure plasma cortisol in the fetal sheep.

A procedure utilizing co-chromatography and complementary antiserum comparisons was employed to assess the specificity of a cortisol radioimmunoassay for use in the chronically catheterized fetal sheep preparation. Complementary antiserum comparisons is a technique by which two different cortisol antisera, prepared from conjugates attached at opposite ends of the cortisol molecule, were used to determine cortisol concentrations in the same ovine fetal plasma specimens. Results were not significantly different between the two groups, each measured by a different antiserum. This procedure may be used to assess assay specificity in any species in which steroid radioimmunoassays are being adapted.


Serum levels of progesterone, 5 alpha-dihydroprogesterone and hydroxy-5 alpha-pregnanones in the prepartum and postpartum equine.

Blood samples were collected from eight mares for ten days before and two days following parturition. Progesterone, 5 alpha-dihydroprogesterone and hydroxy-5 alpha-pregnanones were extracted from serum, separated by Sephadex LH-20 column chromatography and quantitated by radioimmunoassay. Progesterone levels ranged from 8.5 to 4.1 ng/ml among mares with normal parturition and decreased to 1.2 ng/ml after parturition. One mare with a retained placenta maintained the prepartal levels of progesterone into the postpartum period. 5 alpha-dihydroprogesterone increased to a level of 133 ng/ml at 80 hrs before parturition and began decreasing and reached a level of 9.2 ng/ml in the postpartum period. Levels of hydroxy-5 alpha-pregnanones were variable with a high of 1690 ng/ml and declined to a postpartum level of 60 ng/ml. The timing of the decline varied among the mares. The possible source and significance of these progestins remain speculative.


Disposition and metabolism of 16 beta-ethyl-17 beta-hydroxy-4-estern-3-one (TSAA-291), a new antiandrogen, in rats.

Matabolic fate of a new antiandrogen, 16 beta-ethyl-17 beta-hydroxy-4-estren-3-one (TSAA-291), was studied in rats. 14C-TSAA-291 intramuscularly injected as an aqueous suspension was absorbed gradually to give an increase in the plasma level which attained a plateau at 0.5 h, persisted till 8 h and then declined with an approx. half-life of 3.6 days. The drug was widely distributed in tissues, with the concns. almost equal to or higher than that in the plasma. The 14C-drug was eliminated mostly as metabolites within 10 days after dosing with higher activities found in the feces than in urine. Biliary 14C effectively underwent enterohepatic cycling. Biliary metabolites of TSAA-291 were characterized by the combined use of deuterium labeling and GLC-MS analysis. The metabolites identified were as follows: the parent drug, monohydroxy TSAA-291 having the additional hydroxy function in the steroid skeleton, 17 beta-hydroxy-16 beta-(1 xi-hydroxyethyl)-4-estren-3-one, 16 beta-ethyl-17 beta-hydroxy-5 beta-estran-3-one, 16 beta-ethyl-17 beta-hydroxy-5 alpha-estran-3-one, 16 beta-ethyl-5 beta-estrane-3 alpha, 17 beta-diol, 16 beta-ethyl-5 alpha-estrane-3 alpha, 17 beta-diol, 16 beta-ethyl-3 alpha-hydroxy-5 beta-estran-17-one and 16 beta-ethyl-3 alpha-hydroxy-5 alpha-estran-17-one. Monoketodihydroxy and/or trihydroxy metabolites were also detected in the bile.


A simplified method for freezing human blood platelets in glycerol-glucose using a statically controlled cooling rate device.

An inexpensive, statically controlled cooling rate device consisting of a cassette of aluminum plates and cardboard insulation in a plastic bag was used to freeze platelets in liquid nitrogen with glycerol-glucose as cryoprotectant. Depending on the thermocouple location, the cooling rate in the freezing bag varied between 22.1 and 38.6 C per minute, averaging 33.6 +/- 1.1 C per minute at the center. The post-thaw recovery of platelets frozen with this device and reconstituted in plasma averaged 88.6 +/- 11.7 per cent, compared to 86.1 +/- 9.9 per cent for nonfrozen, but otherwise identically processed platelets. 14C Serotonin uptake after 0.5-hour incubation was 95.9 +/- 1.9 per cent for fresh platelets in platelet-rich plasma, 92.7 +/- 4.4 per cent for nonfrozen processed platelets, and 81.4 +/- 11.8 per cent for frozen platelets, increasing to 85.9 +/- 7.7 per cent after one-hour incubation.


Ultrastructural alterations and phagocytic function of cryopreserved platelets.

Fresh human platelets and platelets cryopreserved in 4% dimethylsulfoxide were examined ultrastructurally before and after incubation in a suspension of latex particles. Cryopreserved platelets had fewer discoid forms than fresh platelets. The cryopreserved platelets had many sphered platelets containing an increased number of vacuoles; the sphered platelets were more electron-lucent margination and pallor of organelles. Phagocytosis of latex into vacuoles was markedly impaired in the cryopreserved platelets. The morphologic alterations suggested that the freezing, thawing, and washing procedures reduced the functional activity of platelets.


An analysis of surgical blood use in United States hospitals with application to the maximum surgical blood order schedule.

Excessive preoperative crossmatching can be limited with a maximum surgical blood order schedule (MSBOS) which is a list of the commonly performed elective surgical procedures performed in a hospital with the maximum number of units of blood which will be crossmatched preoperatively for each. The purpose of this study was to analyze the blood requirements of 535,031 surgical patients treated in 300 United States hospitals during 1974, and to suggest maximum preoperative blood orders including type and screen recommendations based on data derived from this large national patient sample. Such recommendations are offered for 63 common elective surgical procedures. Specific reference is made to blood utilization during hysterectomy, transurethral resection of the prostate, and cesarean section. A preoperative type and screen order is adequate for the vast majority of patients undergoing these latter procedures.


Failure to confirm specificity of samples containing a very high titer of hepatitis B surface antigen (HBsAg).

Two samples repeatedly positive for HBsAg by the AusRIA II screening procedure failed to be confirmed by neutralization with anti-HBs serum. Both samples could be effectively neutralized by the same anti-HBs sera if diluted 1:10, 1:50 and 1:100 prior to testing. It is suggested that the inability to neutralize was due to a very high concentration of HBsAg in these samples.


Clinical and serologic management of patients with methyldopa-induced positive antiglobulin tests.

Methyldopa can produce both a positive direct antiglobulin test and less commonly a positive indirect antiglobulin test. When the drug-induced antibody is present in the serum, it acts as a panagglutinin and reacts with all normal red blood cells; consequently crossmatch-compatible blood cannot be prepared. Although the methyldopa-induced antibody itself rarely produces hemolysis, difficulties can arise in previously unscreened patients in whom the panagglutinin may mask an unknown, pre-existing, and potentially hemolytic alloantibody. We report on our clinical and serologic management of 14 such patients for whom transfusions were requested.


Liquid and freeze-preservation of dog red blood cells.

After storage in the liquid state at 4 C for up to three weeks, washing with sodium chloride solutions, and storage in a sodium chloride-glucose-phosphate solution for 24 hours at 4 C, dog red blood cells had excellent post-transfusion survival. After freeze-preservation with 40% W/V glycerol at -80 C or with 20% W/V glycerol at -150 C, thawing, washing with sodium chloride solutions, and storage in a sodium chloride-glucose-phosphate solution for 24 hours at 4 C, dog red blood cells had satisfactory recovery values in vitro, acceptable 24-hour post-transfusion survival and long-term survival values, and normal oxygen transport function. Controlled addition and removal of the cryoprotectant, glycerol, helped reduce the amount of osmotic damage to the red blood cells and enhanced freeze-preservation. Osmotic damage can also be prevented by warming the dog blood to a temperature of 22 +/- 2 C prior to centrifugation to concentrate the red blood cells and remove the plasma. This step enhances removal of the cold agglutinins. Another processing step used by the authors was to add a sodium chloride solution to the dog red blood cells before adding the glycerol solution in order to eliminate rouleaux formation.


Long-term plateletpheresis in the management of primary thrombocytosis.

We attempted to control the platelet count of a patient with primary thrombocytosis utilizing long-term plateletpheresis therapy. The patient previously could not be controlled with chemotherapy, because of rapid development of leukopenia. Although intensive pheresis at the rate of four to five procedures per week produced rapid lowering of the patient's platelet count, continued therapy at the rate of two to three procedures a week failed to maintain these counts, and platelets gradually rose to pretreatment levels. We conclude that while plateletpheresis can produce acute lowering of elevated platelet counts, the rate of platelet production in primary thrombocytosis may be too rapid to allow for long-term control by pheresis alone, utilizing an acceptable treatment schedule of one of three procedures per week.


Autoimmune hemolytic anemia associated with IgG auto anti-N.

A second case of autoimmune hemolytic anemia mediated by an IgG auto Anti-N is described. The patient's red blood cells were sensitized with both IgG and complement. The serum antibody was not inactivated by 2-mercaptoethanol treatment, and reacted by indirect antiglobulin test at 37 C with monospecific anti-IgG. The IgG antibody eluted from the red blood cells and in the serum showed anti-N specificity. The patient was thought to have systemic lupus erythematosus. Following steroid therapy, the hemolytic anemia resolved with disappearance of the anti-N.


Serum opsonins and chemotactins in neutropenic oncology patients.

Serum opsonins and chemotactins, C3 and C5, were studied in neutropenic oncology patients. Our data indicate that these individuals possess normal serum chemotactins and adequate opsonin activity regardless of disease status or prior chemotherapy. Their sera should therefore support function of transfused granulocytes.


Differentiation of granulocyte antigens demonstrated by granuloagglutinins and granulocytotoxins.

Twenty sera containing granuloagglutinins along with granulocytotoxins were typed with 27 to 54 samples of granulocytes different donors. For the most part, positive results of the microgranuloagglutination test and microgranulocytotoxic test were not in agreement. The positivity of the agglutination test was more frequent (35.24%) than that of the cytotoxic test (18.9%). The statistical evaluation of the results for each serum in both test made by calculating the correlation coefficient showed the two types of antibodies to be independent, and to determine different antigens.


Immunosuppression with azathioprine, prednisone, and cyclophosphamide.

An immunosuppressive regimen consisting of azathioprine (AZ), prednisone, and intermittent i.v. infusions of 400 mg of cyclophosphamide (CY) in the first post-transplant month was prospectively compared with a no CY regimen. There were no significant differences in patient or graft survival, graft function, or infectious complications between the two regimens.


Detection of complement (c3d) coated cells in a newborn due to maternal anti-i.

A case of a positive direct antiglobulin test on a newborn's cord red blood cells caused by maternal anti-i is reported. The direct antiglobulin test was moderately positive using polyspecific antiglobulin reagent and monospecific anti-C3d, but negative using monospecific anti-IgG. The infant showed no clinical signs of hemolytic disease of the newborn.


Seventh allele of the HLA-C series (Cve).

Serum VE reacting with 29.8% of French individuals seemed to define the seventh allele of the HLA-C series as shown by serologic and genetic investigations. The gene frequency of Cve is 0.163.


[Delay of rat hepatocyte polyploidization in liver growth inhibition during hypokinesia].

Young rats, weighing 55-59g, after being for 10 days in conditions of limited mobility, show a retardation of body growth as well as that of liver growth. The decrease in the rate of organ growth is accompanied by a reduction of the cell proliferation and by a delay in polyploidization of hepatocytes in the liver of experimental rats.


[Cell population kinetics and the cell population mechanisms of the circadian rhythm of proliferative activity in mouse esophageal epithelium].

The dynamics of 3H-thymidine labeled mitosis and diurnal rhythm of proliferative activity was studied. The isotope was injected to BALB/C mice at the peak of diurnal rhythm of DNA synthesis activity of basal layer cells of oesophageus epithelium. It has been established that the increase in the mitotic index during 24 hours depends on the increase in number of cells being in S-period. The data show that the increase of mitotic index at diurnal rhythm occurs at the expense of 75% of new G0-cells which entered into the mitotic cycle, and of 25% of re-entering cells that had divided during the maximal mitotic activity a day before. It is found that the duration of mitotic cycle of cell population which entered into the mitotic cycle synchronously is almost equal to the period of diurnal rhythm of mitotic activity, i.e. 24 hours.


[Effect of early photic deafferentation on the neuronal development of the parietal area of the rabbit cerebral cortex].

It has been shown interferometrically that the neurons of laminae III-V of the parietal area in the cortex of visual deprivated rabbits manifest features of morphochemical underdevelopment (decrease in size and protein content in the neurons) in comparision with the normal ones. These changes resemble those in the visual area, but are less pronounced being definitely specific for each lamina. The reaction of the neurons of the cortex parietal area of rodents on the light deafferentation is discussed.


[Topography and the protein synthesis level in the large pyramidal neurons during sleep and wakefulness].

In the large pyramidal neurons of the pariental cortex of cat during the slow-waved phase of sleep in comparison to the state of awake, an uneven decrease of the level of 3H-leucine inclusion was established in  different functionally specialized zones of the cell. Using electron microscopy, a decrease in the number of polysomes and membrane-attached ribosomes was shown in the perinuclear zone of large pyramids in slow-waved phase of sleep. The results obtained suggest a decrease in the intensity of protein synthesis in comparison to the state of awake.


[Cell fusion in higher organisms under polyethylene glycol exposure].

An electron microscope study of higher plant protoplasts and human cell fusion was made using polyethylene glycol. The successive stages of proteoplast cell fusion, and the formation of intraspecific, interfamiliar, or interkingdom "hybrid" cells, and some details of their submicroscopic changes at the early stages of culturing are shown.


[Sister chromatid exchanges in bromine incorporation into DNA cytosine nucleotides. III. 5-bromodeoxycytidine as a DNA thymine precursor. The characteristics of the exchanges].

Cell movement through the mitotic cycle and sister chromatid exchanges (SCE) were studied in human blood lymphocytes cultured in the presence of 5-bromodeoxycytidine (BrdC, 0.05 mM) plus thymidine (dT 0.4, 0.8, and 1.0 mM). In controls, lymphocytes were cultivated in the presence of 5-bromodeoxyuridine (BrdU, 0.05 mM) and deoxycytidine (0.1 mM), or BrdC alone. All nucleosides were added to the cultures 28 hours prior to fixation and were maintained in the medium for 16 hours. As determined from percentage of metaphases of 1st to 3rd divisions, BrdC did not release from thymidine block. This fact leads us to conclude that BrdC in contrast to deoxycytidine does not serve as a cytosine precursor. No significant differences in the frequency of SCE and their distribution among chromosomes were found between cultures treated with BrdC and with BrdU.


[Total protein content and concentration in the neurons of the "mirror" epileptiform focus in the rat brain at the late stages of its existence].

The experimental lesion in rat brain was produced by the implantation of cobaltogelatin rod into the right parietalis anterior area. A quantitative measurement of total protein was made by microdensitometer in neurons controlateral to cobalt lesion at 112-115 days after cobalt implantation. In the experimental animals, protein content decreased in neurons of lamina III and V area parietalis anterior and the nucleus lateralis thalami by 6, 60 and 53%, resp. It has been concluded that different type neurons have different protein changes in response to paroxyzmal activity at late stages of epileptogenic mirror focus.


An investigation of the accuracy of the home address given by patients in an urban community in South India.

Studies were undertaken in three tuberculosis clinics in Madras, a large Indian city with a good civic organization, to assess the accuracy of address recorded routinely by registry clerks at the patient's first clinic attendance. The accuracy was poor, with 20% to 30% of the letters posted not reaching the patients. It was appreciably improved, by 10% to 20%, by supplementing the clerk's efforts with questioning by a motivated, experienced health visitor. An address card, a card on which the patient's address was recorded by the local postman or a literate neighbour, relative or friend, was returned by 90% to 94% of the patients, and the accuracy of addresses was found to be at least as good as that obtained with the health visitor. Even when all three sources of information were considered, the patient's home could not be traced in 3% of cases and was found with difficulty in 4%.


The development of tuberculosis in Afro-Asian immigrants.

Tuberculin testing and a chest x-ray have been carried out on 1492 Asian immigrants. Analysis has shown that the percentage tuberculin positive reactions does not increase with increasing length of stay in this country. Few arrive with active disease but after 3 months residence there is a steady incidence of tuberculosis morbidity. Apparently immigrants in the Harrow area arrive with past tuberculous infection, manifest only by a positive tuberculin test, and subsequently suffer endogenous exacerbation.


Preservation of mycobacteria at -70 degrees C: survival of unfrozen suspensions in transit.

Mycobacteria stored at -70 degrees C retain 100% viability and maintain their definitive taxonomic, serologic, immunologic, and pathogenic properties. When shipped at ambient temperatures, however, suspensions of all mycobacteria lose viability in transit, with those species having a narrow temperature range for growth (Mycobacterium tuberculosis and M. bovis) being most severely affected. In spite of these losses, all strains retain their definitive taxonomic properties. If care is taken in pre-testing and post-testing the microbial populations being preserved, mycobacteria are probably best shipped in the lyophilized state, and this procedure has been successfully used for several international studies.


The importance of finger clubbing in pulmonary tuberculosis.

Finger clubbing was observed in 21% of 70 adult Nigerian patients presenting with pulmonary tuberculosis. These patients had a significantly higher incidence of haemoptysis and they also showed a significantly lower body weight and serum albumin than those without clubbing. Their chest x-rays revealed larger cavities and at 2 months the mortality of the patients with finger clubbing (40%) was very much higher than of those without (5.5%). It is suggested that finger clubbing is of value in assessing patients with pulmonary tuberculosis because it helps to identify those with severe destructive disease.


[Lipid peroxidation, peroxidase activity and glutathione antiperoxide systems in rat tissues under conditions of high altitude hypoxia].

The content of lipid peroxides in rat tissues does not vary essentially under conditions of high altitude hypoxia. The peroxidase activity undergoes fluctuating changes with a significant increase in brain tissues. Among the enzymes of the glutathione antiperoxide system only the glutathione peroxidase activity shows a 5-10-fold decrease. As assumption is advanced that under conditions of hypoxia there occurs an inhibition of the glutathione antiperoxide system, which prevents the lipid peroxides level in tissues from falling.


[On the nature of rat hemoglobin heterogeneity].

Rat hemoglobin was fractionated by different methods. It is shown that the heterogenic system of hemoglobin includes six main fractions, the appearance of which is determined by 2 alpha- and 3 beta-similar chains. A subunit composition is established for hemoglobins certain fractions and their tetrameric structure is as follows: formula: (see text). A greater number of fractions when separating hemoglobin by high-sensitive methods is induced by its conformational changes. The surface of SH-groups of globin and the state of hem iron are found to be essentially significant in this process. The data are presented characterizing the isoelectric points, quantitative content of the fraction as well as of certain chains in the whole hemoglobin. A problem on the nature of the isolated subunits heterogeneities is under discussion.


[Anticoagulate activity of phosphatidyl-ethanolamine and phosphatidyl-serine deacylation products].

The water-methanol phase products obtained by slight alkali deacylation of a phosphatidyl-ethanolamine and phosphatidyl serine mixture, reveal a higher specific anticoagulating activity than the base mix. In the composition of the water-methanol phase glycerin, serine, ethanolamine, phosphoryl-serine, phosphoryl-ethanolamine, glyceryl-phosphoryl-ethanolamine and glyceryl-phosphoryl-serine were detected by the method of thin-layer paper chromatography. The only substance, glycerly-phosphoryl-serine, possesses an inhibitory activity. Therefore, anticoagulative activity of phosphatidyl-serine is not connected with the presence of the fatty acid residue in its molecule, it is due to the glyceryl-phosphoryl-serine residue. The further glyceryl-phosphoryl-serine degradation is accompanied by the disappearance of the anticoagulative activity.


[Content of 2,3-diphosphoglycerate in rat erythrocytes with hypoxia and administration of vitamin D preparations].

With acute hemic hypoxia a rise in the content of 2,3-diphosphoglycerate in the rat erythrocytes is rather pronounced. Under conditions of acute hypoxia (hyprobaric) hypoxia, with a less gravity of hypoxic affection the content is considerabley higher than in normalcy. Daily administration of the vitamin D preparations significant doses to animals causes a gradual rise in the level of 2,3-diphosphoglycerate in erythrocytes. The rise is more intense under the effect of vitamin D2 alchol solution than with administration of videin, a protein complex of vitamin D3.


[Quantitative determination of ceruloplasmin activity in rat tissues].

The suggested method consists in incubation of the homogenate of the tissue under study with a solution of 0.5% p-phenylene diamine hydrochloride. The forming stained products of the reaction are extracted with butanol. The extracts obtained is photometered at a wave of 582 nm. The activity of ceruloplasmin is expressed by arbitrary units per 1 mg of protein.


[Content of homocarnosine, gamma-amino butyric acid and histidine in brain tissue of different age normal rabbits and under hyperoxia].

The content of homocarnosine, gamma-amino butyric acid and histidine was studied in the brain of newborn, 1, 7, 14, 21 and 30-day rabbits in normalcy and under hyperoxia. For 30 days of the postnatal life the amount of peptide in the animal brain is 2.5, histidine 1.6, gamma-amino butyric acid--2.2 times as high. At the preconvulsive stage of oxygen poisoning the content of homocarnosine lowers sharply in the brain of rabbits of all age groups. The most considerable decrease is observed in the brain of 14, 21 and 30-day rabbits by 53, 60 and 85%, respectively. The content of gamma-amino butyric acid lowers only in the brain of 21 and 30-day animals by 39 and 47%, respectively; the content of histidine in these animals under hyperoxia, vice versa, increases by 10 and 25%.


[Effect of hydrocortisone on intensity of (3H)methionine incorporation into rat polyribosome and cytosol proteins in alloxan diabetes].

Alloxane diabetes decreases the intensity of [3H] methionine incorporation into total proteins of the liver cells polyribosomes and cytosol. Administration of hydrocortisone for seven days aggravate this disturbances and insulin injections level them. A combined administration of both hormones weakens the negative effect of hydrocortisone on the intensity of the amino acid incorporation and the glucose level in blood.


[Production of dry hemoglobin from erythrocytes of donor blood].

Parameters are developed for sublimation drying of hemoglobin 5-6% solutions obtained from erythrocytes of donor blood. Determination of methemoglonin concentration, oxygen-dissociation curves and studies in physiochemical and biological properties show that the hemoglobin obtained by the suggested method may be used for intravenous injection.


[Glutamate decarboxylase activity in the central structures of the dog brain visual analyzer in the early period of postnatal ontogenesis].

In puppies the first day after birth the glutamate decarboxylase activity in all the studied structures of the brain visual analyzer is the same. On the 12-16th day of the postnatal development it is higher in the corpora bigemina anterior and in the lateral geniculate body than in the optic cortex. The level of GABA formation with pyridoxal-5-phosphate added in the corpora bigemina anterior and lateral geniculate body reaches its maximum on the 21st day of the postnatal development and in the optic cortex (field 17) at the age of three months. The highest amount of asparaginic asic with pyridoxal-5-phosphate added is formed in the optic cortex (field 17) by the 45th day of development and in the corpora bigemina anterior and geniculate body by the 90th day of life.


[Effect of vitamins on permeability of cells, mitochondria and lysosomes under conditions of graviation overloading].

The gravitaiton overloading causes in experimental animals a decrease in stability of erythrocytes to NaCl hypotonic solutions and liver mitochondria to the effect of triton X=100. Under these conditions permeability of erythrocytes and leucocytes membranes as well as of the liver and brain mitochondria increases for [14C] nicotinate, [35S] lipoate, riboflavin and flavin mononucleotide, the total activity and the activity of the unprecipitable protinase of the liver cell lysosomas rise. Hydrocortisone, pyruvate, ATP, water- and fatty-soluble vitamins in the in vivo and in vitro experiments weaken the effect of overloading on the stability and permeability of the structures under study. Vitamin E applied separately and in combination with vitamin B, flavin mononucleotide and nicotinamide is more effective in this respect.


[The results of overloading of the lower extremity during sports (author's transl)].

Nowadays an increasing number of persons have to interrupt their training in competitive or recreational sports because of injuries resulting from overloading of the musculoskeletal system. At least 60% of all athletes who consult a department of traumatology do so because of recurrent micro-trauma. Sixty to eighty percent of all sports injuries and sequelae of overloading are located in the lower limb. The typical results of overloading of the musculoskeletal system during sports are: Inflammation of tendinous insertions, myopathies, peritendinitis, stress fracture, destruction of hyaline cartilage. The commonest of these are insertion tendinitis and destruction of cartilage. This reflects the disproportion between the ultimate strength of the connective tissues, which varies between individuals, and the loads actually imposed during physical training. In the last 7 years (1971-77) we have operated on 1278 knee joints, 63% of which had suffered damage to the cartilage. The etiology, prophylaxis, and medical and surgical treatment of chondropathies are therefore discussed in detail. Careful coordination of the various rehabilitation measures is especially important if a satisfactory therapeutic result is to be achieved.


Modification by dipyrone (noramidopyrine methanesulphonate) of stone-induced ureteric hyperperistalsis in the dog.

Implantation of a stone in the ureter of the dog by ureterotomy results in focal hyperperistalsis which is accentuated by administration of norepinephrine, and reduced by administration of phenoxybenzamine or isoproterenol. Administration of dipyrone reduces the hyperperistalsis, but this action does not appear to be that of either a beta-agonist of an alpha-antagonist.


Alloplastic replacement of the partially resected canine urethra by expanded polytetrafluoroethylene grafts. Preliminary results.

In 12 male dogs 3-8 cm of the penile urethra were resected and replaced by expanded polytetrafluoroethylene (GORE-TEX) grafts. Follow-up consisted of periodic urethrograms. Maximum observation time has been 12 months. Up to now, no major complications were noted. Tissue reactions were minimal and patency of all grafts was demonstrated during the follow-up period.


Ureterosigmoidostomy in rats: a model for the study of bladder tumour carcinogenesis and cocarcinogenesis.

A modified Coffey I ureterosigmoidostomy has been developed in rats as a model of urinary diversion for studying bladder carcinogenesis and co-carcinogenesis. Diverted and sham-operated animals were killed at 1, 3 and 6 months. Excretory urograms revealed minimal hydroureteronephrosis in most diverted animals. Upper tract bacterial colonisation was 9 times more frequent in diverted animals. Approximately one-third of the diverted animals had focal cortical scarring; however, renal function was normal in all groups as assessed by serum creatinine and electrolytes. These studies indicate that ureterosigmoidostomy in rats is a satisfactory model of urinary diversion for studying carcinogenesis.


Uromucoid excretion in normal subjects, calcium stone formers and in patients with chronic renal failure.

Using an electroimmunoassay technique for uromucoid in urine, the excretion of this protein has been studied in normal subjects, calcium stone formers and in patients with chronic renal failure. In the normal subjects there was no significant difference in daily excretion between males and females, but a positive correlation with urine volume was demonstrated for this group. No significant difference in daily uromucoid excretion was found between normal and stone forming subjects. In the presence of chronic renal failure uromucoid excretion was found to be reduced and correlated with overall renal function as assessed by creatinine clearance.


[Comparative studies of radioisotope uroflowmetry (author's transl)].

Radioisotope uroflowmetry allows continuous recording of urinary stream with determination of maximum and mean urine flow rate, duration of voiding and residual urine without urethral catheterisation. By the aid of twenty simulated tests and nine examinated patients the precision of this method was investigated by comparing our results with the findings of simultaneously recorded mictiographic measurement. The flow curves and the maximum flow rate show a high correlation.


[Problems in diagnosis and therapy of renal adenomas (author's transl)].

Diagnostic and surgical problems of renal adenoma are discussed on the basis of seven own cases and the literature. The surgical procedure should be based on exact histomorphological classification of the tumors, which can be classified as: "Benign adenoma", "adenoma with questionable malignancy", and "Malignant degenerated adenoma". The often recommended radical surgery in all cases of renal adenomas should not be necessary. Histological diagnosis is most accurate with serial sections of embedded tumor material. False positive results from intraoperative histomorphologic diagnosis of frozen sections are not here. The difficult preoperative diagnosis of renal adenomas could be improved by computed tomography and ultrasonography.


[Implantation of testicular prosthesis. Psychological aspects (author's transl)].

The crucial factor in assessing the indication for implantation of a testis prosthesis is the mental status of the patient. Age and psychosocial considerations must be taken into account. The susceptibility to disturbance following of the loss of a testis differs among individuals. Most of the commercially available products can hardly be distinguished from a normal testis. The findings of a questionnaire in 88 patients with 106 prostheses are presented, according to which substitution of the testis with a prosthesis is not a superfluous therapeutic procedure. The man suffering from his "incompleteness" will be glad to have the implant if it restores to him the feeling of genital intactness. The practicing urologist assesses the indications and answers the questions resulting from emotional and psychic aspects of sexuality. The surgeon selects the appropriate implant and decides on the route of access and type of implantation.


[Percutaneous nephrostomy under ultrasound guidance (author's transl)].

34 ultrasonically guided percutaneous nephrostomies were performed without complications. The procedure seems to be applicable in routine clinical use for temporary or permanent urine diversion in hydronephrotic kidneys. The simple technique the low complication and high success rate and independence of kidney function make the technique superior to the standard methods of the percutaneous puncture under radiological control.


[Ureteral drainage with the Gibbons indwelling ureteral stent (author's transl)].

The technique of endoscopically placing the Gibbons indwelling stent into the obstructed ureter is described. This technique offers several advantages, especially in managing poor-risk patients whose ureters are obstructed: 1. endoscopic placement of the ureteral stent is associated with less morbidity and mortality than supravesical diversion; 2. quality of life is much less reduced than in supravesical diversion; 3. it is readily reversible; 4 the ureteral stent does not interfere with subsequent operation and offers several advantages over PVC-splints and other materials used for long term ureteral drainage. The placement of an indwelling stent sometimes causes technical problems but complications are rare. 21 Gibbons indwelling ureteral stents have been placed in obstructed ureters of 16 patients at the age of 25--74 years. Our technique, indications, results and complications are described herein.


[The application of video techniques in urology (author's transl)].

Above all Videosystems have valuable applications in transurethral surgery for students, housestaff and established physicians in that they allow for better documentation and communication. This article describes a handy, inexpensive color T. V. camera which, though one of the smallest and lightest, produces good quality pictures. The paper also describes various applications of such a system.


[Proposal for surgical treatment of retroperitoneal fibrosis (author's transl)].

A new method of surgical treatment for retroperitoneal fibrosis is demonstrated on 3 patients. 31 months postoperatively the results are excellent. The operation is easy to perform, without complications and recurrences.


[Scanning electron microscopy of different materials after urine contact in vitro (author's transl)].

The nature of the surface of the used material is determining the complication rate in medium and long term application of nephrostomy and bladder catheters as well as ureteral splints. Tubings made of 8 different materials were irrigated for one to three weeks by means of an urolithic simulator, the pH-values from 5.8 to 7.0. Scanning electron Microscope showed good values with respect to silicon elastomer, teflon and ethylenacrylicacid copolymer. Considering technical and economical factors it seems to be proven that silicon elastomer and polyurethane are the most appropriate materials for splints and catheters, whereas rubber and PVC are less suitable for long time application.


Stage A2 prostatic carcinoma: should staging system be reclassified?

Seventy patients with clinically localized prostatic carcinoma were studied for histologic differentiation of primary tumor and the incidence of lymph node metastasis. Also the urologic literature was reviewed regarding the survival of such patients under similar treatment. The results indicate that clinically staged A2 tumors are more aggressive biologically than tumors staged as B1, reaffirming the need for a change in the current staging system. The authors propose reclassification of clinically unsuspected, diffuse carcinoma from the A to the B2 stage.


Adenocarcinoma of prostate: role of 17beta-estradiol and 5alpha-dihydrotestosterone binding proteins.

Presence of a specific 17 beta-estradiol-binding protein in prostates of patients with adenocarcinoma without hormonal manipulation prior to surgical resection has been reported by us earlier. The present study involves 40 patients with carcinoma of prostate analyzed during the period December, 1974, through June, 1978. Thirty-four patients had metastatic disease, 26 of these were manipulated hormonally after and 8 prior to receptor protein assay. The other 6 were in clinical Stage C and were subjected to transurethral resection alone. The study confirms our earlier report and outlines the role of 17 beta-estradiol (E2) and possibly 5alpha-dihydrotestosterone (DHT) receptor protein in hormonally responsive and refractory patients. Based on the preliminary findings it seems possible to classify the prostatic carcinoma similar to human mammary cancer for the purpose of selecting patients for endocrine manipulation or treatment with other available modalities.