Epidemiology of respiratory allergic disorders in a geriatric age group.

One hundred forty-eight patients with a respiratory allergic disorder between the ages of 60 and 84 were studied for one year. Emotional crises played an important role in the triggering of their symptoms. Heredity probably was as prevalent in this age group as in younger individuals. In most of the patients the first symptoms of their illness appeared in the years between 21 and 50. House dust was the most common allergenic factor in the causation of symptoms. This was favorable response and reduced the amount of supplemental medication required for symptom relief.


Possible indirect binding of IgE in house dust RAST.

House dust subfractions obtained in the course of purification exhibit increasing skin reactivity in allergic patients, which runs parrallel to both complement-consuming and RAST-binding capacity. Working with highly purified house dust allergen in RAST, the correlation with clinical parameters for house dust allergy was found to remain poor. In a large group of sera a significant statistical correlation was found between total IgE and allergen-binding IgE. Ultracentrifugation experiments demonstrated that IgE binding to allergen in RAST occurs in complex with an unidentified serum protein. These results suggests that IgE binding in house dust RAST is indirect and is mediated by another serum factor.


Bacterial isolates associated with epididymitis in rams from Idaho and eastern Oregon flocks.

Testicles from 47 rams with palpable lesions of epididymitis were subjected to bacterial culture. Of the testicles examined by culture technique, 49% were positive for bacterial growth. The 2 most frequent isolates were Actinobacillus actinomycetemcomitans (23.4% of the testicular pairs) and Brucella ovis (14.9% of the testicular pairs). Heretofore A actinomycetem-comitans has not been reported as a cause of epididymitis in rams.


Histopathologic features of the skin of hairless newborn pigs with goiter.

The skin of 15 hairless newborn pigs with parenchymatous goiter was studied histopathologically. Most of the lesions were in the hair follicles; follicles were scarce and reduced in size, contained slender hairs, and revealed a shortage of penetration into the hypodermis. Hair follicles in the immature stages, hair pegs, and germs also were recognized, with the thin epidermis lacking in keratinization. It was felt that these changes resulted from a retardation of cellular differentiation of the germinal layer. In view of these findings, skin lesions were regarded as hypoplasia of hair.


Characterization and identification of a bovine respiratory syncytial virus isolated from young calves.

Two identical viruses designated 371 and 375 were recovered from nasal secretions of 2 of 7 calves in a beef cow-calf herd in which calves (45 to 105 days of age) had signs of acute respiratory tract disease. The cytopathic, morphologic and physico-chemical characteristics of the isolates were those of bovine respiratory syncytial virus. Although a humoral antibody response to bovine respiratory syncytial virus was not observed, it was concluded that this virus probably had a part in the respiratory tract disease in these calves.


Xylazine-induced hyperglycemia in beef cattle.

Intravenous administration of xylazine to beef cattle (10 animals, 0.2 mg/kg of body weight) resulted in rapid onset (less than 15 minutes) of hyperglycemia. Plasma glucose values increased to 195 +/- 15 mg/dl and 305 +/- 10 mg/dl at 15 minutes and 3 hours, respectively. Concomitantly, plasma insulin concentrations dropped from 23 +/- 2 microU/ml before xylazine to 5.8 +/- 0.7 microU/ml and 2.4 +/- 0.3 microU/ml at 15 minutes and 3 hours, respectively. Parallel decreases (20%) were observed for percentage of hemoglobin, red blood cell number, and packed cell volume. Plasma urea nitrogen was significantly (P less than 0.01) incrased within 3 hours of xylazine administration (6.7 +/- 0.9 mg/dl vs 11.4 +/- 0.7 mg/dl). Marked changes in concentrations of plasma-free fatty acids were not observed. Alternative means of anesthesia must be considered in those instances in which biopsy material is to be used for studies of carbohydrate metabolism in vitro.


Corticosteroid-potentiated vascular responses of the equine digit: a possible pharmacologic basis for laminitis.

Spirally cut digital arteries and veins were mounted isotonically in organ baths containing oxygenated Krebs' Q-Henseleit solution. Twelve arterial and 12 venous preparations all contracted dose dependently when epinephrine, norepinephrine, serotonin, or histamine were added to the bathing fluid. Addition of hydrocortisone or betamethasone alone did not cause contractions in any of the tissues tested. However, when hydrocortisone or betamethasone was added to vessel strips that were partially contracted (40% to 60% maximal) by epinephrine, norepinephrine, or serotonin, each vessel strip invariably underwent an additional contraction. In venous and arterial strips, dose-response curves to epinephrine, norepinephrine, serotonin, or histamine were established in the absence and in the presence of corticosteroid. Effects of the amines, except histamine, were markedly potentiated. The degree of corticosteroid/amine potentiation was greater for epinephrine than for norepinephrine and greater in the digital vein than in the corresponding artery from the same animal. Betamethasone was more potent than hydrocortisone.


Critical test evaluation of butamisole against gastrointestinal parasites of horses and ponies.

A critical test was performed to evaluate the anthelmintic properties of an injectable butamisole formulation and to compare the efficiency with that of a commercially available piperazine-thiabendazole anthelmintic. The test was done in 10 horses and 15 ponies with naturally acquired parasitic infections. Butamisole was administered at the dose level of 2.5 or 3.75 mg/kg of body weight by either subcutaneous or deep intramuscular injection. Given at the dose level of 2.5 mg/kg, butamisole was highly effective (99%) against Strongylus vulgaris and moderately effective (49%) against Parascaris equorum. At the 3.75 mg/kg dose rate, butamisole was highly effective against both S vulgaris (97%) and P equorum (94%). Butamisole had limited efficacy against other parasite species. Signs of toxicosis, long-term swelling of the injection sites, or tissue damage were not seen after injection.


Canine distemper virus-associated hypocalcemia.

A retrospective study was done to correlate serum calcium concentrations and parathyroid gland ultrastructure to clinical, immunologic, and pathologic changes experimentally induced in gnotobiotic dogs by canine distemper virus (CDV). Dogs infected with CDV had significantly reduced serum calcium concentrations associated with ultrastructural evidence of parathyroid gland inactivity, degeneration, and viral inclusions. Although CDV-infected dogs exhibited neurologic signs, minimal lesions were present in the central nervous system. It is suggested that viral-induced parathyroid dysfunction may contribute to neutrologic disturbance of CDV infection.


Avian spirochetosis: natural transmission by Argas (Persicargas) sanchezi (Ixodoidea: argasidae) and existence of different serologic and immunologic types of Borrelia anserina in the United States.

A mild strain of Borrelia anserina was transmitted to chicks by an argasid tick identified as Argas (Persicargas)sanchezi Dugès, 1887. Disease was transmitted regularly to chicks less than 2 to 3 weeks old, and rarely to chicks 4 weeks old or older. This spirochete isolate was demonstrated to be immunologically and serologically diverse from an isolate obtained earlier in Arizona. This is the first report of transmission of B anserina by A(P) sanchezi and of the presence of different serologic and immunologic isolates of this spirochete in the United States.


Influence of ruminal insufflation on pulmonary function and diaphragmatic electromyography in cattle.

In 8 healthy, awake cows with permanent cannulated ruminal fistulas and carotid artery loops, respiratory mechanics, ventilation, and diaphragmatic electrical activity were studied before and during stepwise insufflation of the rumen with air pressure to 40 mm of Hg. We found that ruminal insufflation increased intraperitoneal, intrapleural, and transdiaphragmatic pressures and decreased lung volume and lung compliance. In individual cows with rumen insufflation there was an increase in pulmonary resistance, but this trend was not significant in the group. Peak expiratory flow rate was increased and peak inspiratory flow rate was unchanged. Inspiratory duration (Ti) decidal volume decreased slightly, breathing frequency decreased markedly, and minute volume decreased. When intraruminal pressure reached 40 mm of Hg, arterial partial pressure of carbon dioxide (PaCO2) increased (P less than 0.01) and that of oxygen (PaO2) decreased (P less than 0,01) and arterial blood pH decreased (P less than 0.02). Diaphragmatic electromyographic activity was increased, but mechanical effectiveness of the diaphragm was reduced at increased intraruminal pressures.


Characterization of endotoxin from the rumen bacterium Megasphaera elsdenii.

Phenol-water extraction of Megasphaera elsdenii, a predominant gram-negative coccus in rumens of cattle fed high-grain diets, yielded material that exhibited typical characteristics of endotoxin. The extract was lethal to mice and to chicken embryos, caused biphasic fever in rabbits, leukopenia in mice, and local and generalized Shwartzman reactions; and induced tolerance to the lethal effect of the endotoxin in mice. The material contained carbohydrate, protein, lipid, phosphorus, and 2-keto-3-deoxyoctonate, but no nucleic acid. The beta-hydroxymyristic acid was absent. Results imply that M elsdenii endotoxin has many biological and chemical characteristics common to enterobacterial endotoxin. However, the median lethal doses in mice and in chicken embryos, and minimal dose required to elicit a local Shwartzman reaction, indicate that M elsdenii endotoxin's potency is low, which may explain why the large gram-negative bacterial population in the rumen of cattle is generally innocuous.


Observations on the pathogenic effects of Nematodirus helvetianus in dairy calves.

Six Holstein-Friesian calves 3 to 5 months old, were used in a small-scale experiment to determine the pathogenic effects of the thread-necked strongyle Nematodirus helvetianus. Two calves were kept as controls and 4 were infected, 2 with single doses of 25,000, and 2 with 50,000 N helvetianus larvae. Observations made during the 8 weeks of the experiment found that N helvetianus is capable of producing severe pathologic changes in the intestine of previously healthy calves. At 38 days after infection, the calves infected with 25,000 and 50,000 larvae gained 32.9% and 72.4% less weight respectively, than their controls. An increase in total lymphocytes was observed with no significant change in hemoglobin concentration. Adult worms were found to penetrate the intestinal mucosa with considerable destruction, including tunneling. Rectal temperatures were elevated in infected animals. The prepatent period for N helvetianus in single infection was 18 to 19 days. A spontaneous expulsion of the adult parasites was observed in 1 of the calves exposed to 50,000 larvae. Worms recovered in this animal numbered 565, whereas the number of worms recovered in another calf infected with 50,000 larvae was 21,860.


Efficacy of Bordetella bronchiseptica bacterin in controlling enzootic atrophic rhinitis in swine.

The efficacy of a Bordetella bronchiseptica bacterin was evaluated in 2 commercial swine herds affected with mild and severe enzootic atrophic rhinitis (AR). In the 1st herd study, (mild AR), the degree of clinical AR, nasal turbinate evaluation, blood serum titer to B bronchiseptica antigen, and adjusted days from birth to 100 kg were determined for individual pigs. Bacterin inoculation reduced the incidence and severity of gross turbinate atrophy 57% and reduced clinical AR over 93%. Inoculated swine had an average blood serum-agglutinating titer greater than 1:2,793 and noninoculated (control) swine had an average titer of 1:112. Increased serum titer significantly (P less than 0.05) correlated with decreased degree of nasal turbinate atrophy. Inoculated and control pigs reached 100 kg in an average of 171 and 178 days after birth, respectively. In the 2nd study (severe enzootic AR), inoculated and control pigs were individually evaluated for clinical AR and total average daily weight gain. Inoculation reduced clinical AR over 90%. The total average daily gain for the inoculated and control pits was 435.84 g and 340.50 g, respectively. Inoculated pigs and control pigs reached 100-kg market weight in 184 and 238 days, respectively.


Vitamin D intoxication and the pathogenesis of vitamin D nephropathy in the dog.

Dogs given excess vitamin D (500 or 1,000 micrograms/kg of body weight each day for 1 to 3 weeks were observed for clinical and pathologic changes of increased blood pressure and of characteristic nephropathy associated with vitamin D toxicosis or hypercalcemia. Serum calcium and serum urea nitrogen (UN) increased throughout the treatment period, but serum phosphorus remained within the normal range. Plasma renin activity increased markedly. Blood pressure showed only insignificnat changes (P = greater than 0.05). Gross and microscopic examination of the kidneys suggested vascular-oriented changes with an ischemic basis. Glomerular vascular poles showed hypertrophy and hyperplasia of juxtaglomerular cells. Ultrastructually, an increase in the number of secretory granules was noticed in these cells. A hypothesis regarding the mechanism of renal injury during vitamin D toxicosis is presented.


Collateral vessel development, following unilateral chronic carotid occlusion in the dog.

Because much of the data base describing the physiology of cerebral circulation is based on experiments using the dog as a model and because the functional response to occlusion of arteries supplying the head have been shown to be different in man than in dogs, it is important that the growth and development of the extracerebral collateral circulation in dogs be documented. Using the techniques of corrosion casting, collateral vessel development was evaluated in adult mixed-breed dogs, following 4- and 8-week periods of unilateral ligation of the common carotid artery or the external carotid artery. Neurologic deficits or severe ischemia was not observed in any of the dogs during the postoperative period. Extensive collateralization occurred between the ipsilateral vertebral artery, regardless of the occlusion site. In addition, numerous collateral connections developed between the same vessel from the contralateral side. Two main patterns of collateral vessel organization consistently developed. Initially, a collateral network of highly tortuous superficial vessels predominated. With longer survival times after occlusion, deeper and more uniform-diameter direct-collateral vessels developed.


Effects of 1 alpha,25-dihydroxycholecalciferol on disuse osteoporosis in the dog: a histomorphometric study.

Disuse osteoporosis was produced in dogs by immobilization of the left rear limb in a plaster cast. The trabecular bone volume of the calcaneus was then determined following treatment with 1 alpha,25-dihydroxycholecalciferol for 4 weeks with oral dosages of 60 to 240 ng/kg of body weight. The trabecular bone volume percentage of the immobilized calcaneus was in direct relation to the dosage of 1 alpha,25-dihydroxycholecalciferol.


Hemolytic activity of Fusobacterium necrophorum culture supernatants due to presence of phospholipase A and lysophospholipase.

Culture supernatants of Fusobacterium necrophorum demonstrated hemolytic activity. The hemolysin(s), which was partially purified by ammonium sulfate precipitation, was temperature-dependent and heat labile. The spectrum of hemolytic activity against various erythrocytes included rabbit, human, and dog erythrocytes. Goats, sheep, and bovine erythrocytes showed only trace hemolysis. According to results of thin-layer chromatography, the hemolysin hydrolyzed rabbit erythrocyte phosphatidyl choline, phosphatidyl ethanolamine, lysophosphatidyl choline, and bovine phosphatidyl choline. Hydrolysis of egg yolk phosphatidyl choline, bovine phosphatidyl ethanolamine, cholesterol, 1,2-dipalmitin, 1,3-dipalmitin, sphingomyelin, or triolein was not detected by thin layer chromatography. A more sensitive procedure utilizing gas-liquid chromatography revealed that, of the substrates tested, the following were bein hydrolyzed: bovine and egg yolk phosphatidyl choline, lysophosphatidyl choline, alpha-palmito-beta-eleoyl-L-alpha lecithin and alpha-oleoyl-betal-palmitoyl-L-alpha lecithin. Substrates which were weakly hydrolyzed were bovine phosphatidyl ethanolamine, DL-alpha-hosphatidyl ethanolamine dipalmitoyl, 1,2-dipalmitin, 1,3-dipalmitin, and triolein.


Effects of lasalocid and monensin against experimentally induced coccidiosis in confinement-reared lambs from weaning to market weight.

Lasalocid and monensin were incorporated into pelleted feed and evaluated as anticoccidials in confinement-reared lambs from weaning to market weight. A total of 69 lambs were allotted to 3 equal groups that received unmedicated feed (100 mg/kg of food) or monensin-medicated feed (17 to 33 mg/kg). Each lamb was inoculated orally with a suspension of 24,000 oocysts (Eimeria spp) 24 and 52 days after the start of the experiment. Lasalocid and monensin were highly effective (greater than 99%) in eliminating oocysts of 5 species of ovine coccidia used in the inoculum. Treated lambs gained an average of 6 kg more weight (P less than 0.05) per animal than the untreated control lambs and consumed significantly (P less than 0.05) less feed for each kilogram gained. No statistical differences existed between treated groups (P greater than 0.05).


Correlation between the function and structure of the lung in smokers.

To study the relationship between morphologic changes and alteration of lung function, the excised lobes of 21 smokers and one nonsmoker who required lobectomy for small peripheral tumors were inflated and fixed in formalin, and measurements of bronchiolar narrowing and degree of emphysema were made. All patients had comprehensive pulmonary function tests (including diffusing characteristics, the single-breath N2 test, measurements of elastic recoil, and flow-volume measurements with air and helium) performed before lobectomy. Eight of the lobes excised from the smokers had emphysema of grade 15 or more, the greatest being grade 50. Lobes from 11 patients had evidence of airway narrowing. There were 6 lobes with both emphysema and airway narrowing. Pulmonary function was abnormal in some aspect in all lobes except that from the nonsmoker. Whereas the tests of diffusing capacity, particularly the fractional uptake of CO, correlated with the degree of emphysema, the tests of elastic recoil were not predictive of this early degree of emphysema. The degree of small-airway narrowing correlated with maximal mid-expiratory flow rate and the single-breath N2 test. The maximal flow/static recoil pressure curves were the most sensitive indicators of airway abnormality in the patients with emphysema.


Elastic recoil of the lung in cigarette smokers: the effect of nebulized bronchodilator and cessation of smoking.

The mechanical properties of the lung, forced vital capacity, flow-volume relationships, lung volume, and single-breath N2 curve were determined in 16 nonsmokers and 19 smokers. Pulmonary elastic recoil, Pst (1), was significantly lower at all lung volumes, as were flow parameters, whereas lung volumes were higher in smokers of both sexes. The variables derived from forced vital capacity and single-breath N2 were significantly different from nonsmokers in male smokers but not in female smokers. The inhalation of nebulized bronchodilator was attended by a significant decrease in Pst (1) and in upstream flow resistance in smokers. After cessation of smoking Pst (1) decreased to values similar to those seen after bronchodilator administration, whereas resumption of smoking led to reversal of the pressure-volume curve. The data suggest that the elastic properties of the lungs are altered in cigarette smokers, but the extent of the disturbance is masked by constriction of the alveolar ducts or peripheral airways while smoking, and that these are unmasked by the administration of nebulized bronchodilator or by cessation of smoking.


Changes in the forced expiratory spirogram in young male smokers.

Forced expiratory spirograms and peak expiratory flow were measured in 102 resident male medical students (60 nonsmokers and 42 smokers). Forced vital capacity; forced expiratory volume in 1 sec; forced expiratory volume in 1 sec expressed as a percentage of forced vital capacity; forced expiratory flows between 80 and 70 per cent, between 55 and 45 per cent, between 30 and 20 per cent, and between 15 and 5 per cent of the forced vital capacity; forced expiratory time for the last 0.5 liter of the forced vital capacity; and maximal mid-expiratory flow were determined from the forced expiratory spirogram. Peak expiratory flow, all forced expiratory flows (except the forced expiratory volume in 1 sec), and the ratio of forced expiratory volume in 1 sec to forced vital capacity were significantly lower, and forced expiratory time for the last 0.5 liter of the forced vital capacity was significantly higher in the heavy smokers (those who had smoked a lifetime total of more than 10,000 cigarettes) than the nonsmokers. The light smokers (those who smoked a lifetime total of fewer than 10,000 cigarettes) had values between those of nonsmokers and the heavy smokers. Thus, a definite dose-related response to smoking was seen. Flows at lower lung volumes showed greater percentage changes than flows at higher lung volumes. The forced expiratory flow between 30 and 20 per cent of the forced vital capacity was the most sensitive test for detecting abnormality in smokers. Among heavy smokers, 58 per cent had abnormally low forced expiratory flow between 30 and 20 per cent of the forced vital capacity, whereas only 47 per cent had abnormally low ratio of forced expiratory volume in 1 sec to forced vital capacity, and 32 percent had abnormally low maximal mid-expiratory flow. The results show that even subjects with short smoking histories may have changes in pulmonary function that probably reflect narrowing of small airways. Moreover, these changes can easily be detected by simple tests, such as evaluation of a forced expiratory spirogram.


Adaptation in human subjects to the effects of inhaled ozone after repeated exposure.

Single exposures to low concentrations of ozone (0.4 to 0.5 ppm) have resulted in decrements in forced vital capacity and specific airway conductance. To establish whether adaptation might occur with repeated exposure, 14 normal human subjects were exposed on 5 consecutive days to 0.4 ppm of ozone for 3 hours per day in an environmental chamber. Measurements of forced vital capacity and specific airway conductance obtained after exposure to ozone were compared to corresponding control values obtained during the previous week, when the same subjects breathed filtered air in the environmental chamber for 3 hours per day on 5 consecutive days at the same time of day. The forced vital capacity was significantly lower than the control value on the first 3 days of exposure to ozone, but there was no significant difference on the fourth and fifth days. Specific airway conductance was significantly lower than the control value on the first and second days of exposure to ozone; no significant difference was noted on the third, fourth, or final day. All subjects were symptomatic on the first and second days of exposure to ozone. Symptoms resolved thereafter, with only one subject remaining symptomatic on the final day of exposure to ozone.


Effect of low-level exposure to ozone on arterial oxygenation in humans.

We investigated the effect on arterial blood oxygenation of exposure to 0.2 ppm of ozone in purified air for 2 hours with intermittent light exercise and heat stress. Similar exposures to purified air alone provided control data. In 12 healthy volunteers, blood gases were measured before and during exposure via an indwelling brachial cannula. Six of these subjects and 6 other subjects underwent separate similar studies in which "arterialized" earlobe capillary blood was sampled. Arterial Po2 and alveolar-arterial Po2 differences varied significantly among different experimental conditions, but the variability was similar in the presence or absence of ozone. Small significant variations in body temperature were observed; these did not appear to be sufficient to affect blood gas measurements substantially. Over-all, we found no evidence for an adverse effect of the exposure to ozone on arterial oxygenation.


An epidemiologic study of a group of talc workers.

Chest roentgenograms, pulmonary function assessment by spirometry, respiratory symptoms, smoking history, and occupational history by questionnaire were obtained from 121 male talc miners and millers exposed to talc containing tremolite and anthophyllite asbestiform fibers. Ninety-three of the employees had worked in talc only at the plant under study. Symptoms were only slightly more prevalent in talc workers when compared to potash miners. Mean pulmonary function (forced expiratory volume in one sec, forced vital capacity, and maximal expiratory flow at 50 and 75 per cent of vital capacity) of talc workers was significantly decreased in comparison to that of potash miners. The prevalence of pleural calcification and pneumoconiosis in talc workers with 15 or more years of employment was higher than in potash miners. The prevalence of pleural thickening was 31 per cent in those who worked more than 15 years and was significantly increased as compared to that in potash miners. Workers with pleural thickening had decreased pulmonary function in comparison to those who did not. Decreased one-sec forced expiratory volume and forced vital capacity were associated with exposure to respirable particulate and asbestiform fibers.


The adaptive response of the rat lung after bilobectomy.

Rats 23 days of age were subjected to resection of the upper and middle lobes of the right lung. After 45 days of recovery, their lungs were fixed and the tissue was processed for quantitative light and electron microscopic analysis. Normal and sham-operated animals of identical age served as control animals. At death, the lobectomized rats had normal body weights and lung volumes; both the left lung and the remainder of the right lung participated proportionally in the restoration of the original lung volume. Air space, tissue and capillary volumes, and alveolar and capillary surface areas were as large as those of the control lungs. Tissue composition was slightly altered: the volume proportion of the interstitium was increased at the cost of the epithelium; endothelial volume density and air-blood barrier thicknesses were normal. Nonparenchymal structures had a smaller potential to adapt than the gas-exchanging parenchyma: the volume of conducting airways was smaller than expected for a normal lung. An analogous trend was observed for the larger blood vessels. Based on the recreated dimensions of the gas-exchange apparatus in operated animals, one can assume that the organ fully restores the conditions for adequate gas diffusion.


Isoelectric analysis of respiratory mucus from normal rats and rats exposed to tobacco smoke.

Various functions of the pulmonary defense mechanism, such as ciliary beat and mucous transportation, and free lung cells have been studied in many experiments. The protein composition of the bronchial mucus and its viscosity, however, have been the subjects of few investigations. We have used an isoelectric focusing technique for protein separation and estimated a total error of measurement (variation between animals and residual error) to compare the bronchial mucus of normal control rats and rats exposed to tobacco smoke. Significant differences in the composition of the mucus were found; in addition, the composition of serum differed in some respects. The isoelectric focusing technique can be useful for protein analysis of bronchial mucus.


Pleural-fluid kinetics in a patient with primary lymphedema, pleural effusions, and yellow nails.

We present the clinical findings in the thirteenth recorded patient with lymphedema, pleural effusions, and ungual dystrophy--the so-called "yellow nail" syndrome. The rate of pleural-fluid turnover was measured by using radioiodinated albumin to trace the efflux of fluid by lymphatics. The rate of pleural lymphatic flow was low in comparison to previous estimates obtained by the same method in a variety of other conditions. Such slow lymphatic flow is consistent with the postulate that accumulation of pleural fluid in this syndrome is due to defective lymphatic drainage.


Isoniazid prophylaxis among Alaskan Eskimos: a final report of the bethel isoniazid studies.

As a result of numerous trials, isoniazid prophylaxis was shown to be effective in preventing tuberculosis in many different populations and under a variety of conditions. However, the duration of the protective effect has been of some concern. In a previous report, the protective effect of isoniazid prophylaxis among Alaskan Eskimos was shown to persist through the fifteenth year after its administration. In this final report, the protective effect is shown to persist for more than 19 years. The magnitude of the effect is related to the amount of isoniazid taken. The results of the study are consistent with the hypothesis that the decrease in risk of tuberculosis produced by isoniazid preventive therapy is lifelong.


Documentation of pulmonary capillary permeability in the adult respiratory distress syndrome accompanying human sepsis.

Current evidence suggests that pulmonary edema accompanying human sepsis may result either from changes in the serum oncotic and hydrostatic pressures or an increase in the permeability of the pulmonary microvasculature. In this study, we compared the "clearance" of injected 131I-labeled human serum albumin from blood to bronchoalveolar secretions in intubated patients with pulmonary edema secondary to sepsis or myocardial infarction. A significantly increased mean +/- SE clearance of the radionuclide was seen in patients with sepsis (0.34 +/- 0.03 ml per hour) compared to those with myocardial infarction (0.043 +/- 0.008 ml per hour) (P less than 0.001), although both groups had similar degrees of edema on chest radiographs. Because the patients with sepsis had no severe decrease in serum oncotic pressure (18.4 +/- 5.0 mm Hg) or evidence of left heart failure, as determined by the pulmonary wedge pressure (11.0 +/- 6.8 mm Hg), we concluded that the genesis of the pulmonary edema in sepsis was due to an increase in pulmonary microvascular permeability, as measured by the increased clearance of 131I-labeled human serum albumin.


Predictors of mortality in chronic obstructive pulmonary disease. A 15-year follow-up study.

The relative usefulness of various initial findings in predicting survival is reported for 200 patients with chronic obstructive pulmonary disease who have been followed for approximately 15 years. After 5 years of follow-up, subjects 62 or more years of age showed a poorer survival rate than younger subjects. After controlling for age, the per cent predicted forced expiratory volume in 1 sec after administration of bronchodilator was the best indicator of prognosis. In subjects less than 65 years of age, the presence or absence of cor pulmonale further improved the prediction of subsequent mortality. Regardless of initial findings, however, there was wide individual variability in prognosis, and factors relating to this variability remain obscure. No difference in survival rate was noted between the 178 male patients who were enrolled in Chicago 15 years ago and the 100 similarly impaired men enrolled in Tucson approximately 7 years ago.


Acute lobar atelectasis: a prospective comparison of fiberoptic bronchoscopy and respiratory therapy.

To evaluate the usefulness of fiberoptic bronchoscopy for treatment of acute lobar atelectasis, 31 subjects were randomly allocated to fiberoptic bronchoscopy followed by respiratory therapy for 48 hours, or to respiratory therapy alone for the same period. No significant differences between groups with regard to restoration of volume loss were detected after the first treatment intervention, at 24 or at 48 hours (P greater than 0.20). Specifically, the mean percentage resolution of volume loss immediately after bronchoscopy (38 per cent) closely approximated that after the first respiratory therapy treatment in subjects who had not undergone bronchoscopy (37 per cent). An air bronchogram proved to be a predictor of delayed resolution for both groups. At 24 hours, 26 per cent of the air bronchograms demonstrated 83 per cent resolution (P less than 0.001). These results suggest that fiberoptic bronchoscopy does not add to respiratory therapy in the treatment of acute lobar atelectasis and that an air bronchogram predicts delayed resolution of collapse.


Malignant melanoma--an overview.

We have presented our experience in light of current practice in the management of malignant melanoma. Central to considerations of adequate management is the question of precise definition of the extent of the disease as determined by histologic evaluation, determination of the depth of penetration and assessment of the extent of spread. Wide surgical excision remains the most important consideration with perfusion therapy, in our view playing a key role in the management of extremity melanoma. Encouraging data for adjuvant immunotherapy continues to unfold. We present here a rational approach to diagnosis and management of malignant melanoma.


Significance of ankle blood pressure in the diagnosis of peripheral vascular disease.

Lower extremity blood pressure, an accurate indicator of peripheral arterial disease and a sensitive means of evaluating therapy, is easily determined by the Doppler detector either at the bedside or in the physician's office. In conjunction with the exercise tolerance test and the ankle to arm ratio, it permits the physician to follow the course of the disease and assess the results of therapy. The test may also detect and determine the extent of presymptomatic arteriosclerosis obliterans when present in the opposite limb.


Aspiration pneumonia: a ten-year review.

Aspiration pneumonitis is an important cause of many anesthetic and non-surgical deaths and complication. One hundred and eight cases from 1964 to 1974 were reviewed to study the factors associated with aspiration pneumonia. Forty surgical and 68 non-surgical patients were evaluated and compared. Predisposing factors included impaired consciousness, esophageal and neurological disorders, cardiac resuscitation, debilitation, presence of a nasogastric tube or tracheostomy. The most common findings in both groups were dyspnea, cough, cyanosis, fever, tachycardia, rhonchi, rales and wheezes. Sputa of 64 patients failed to reveal the precise etiologic agent. High mortality (30%) and morbidity were found in both groups even with optimum treatment. The causes of morbidity in both groups of patients were pneumonia, lung abscess, myocardial infarction, gastrointestinal hemorrhage, and pulmonary embolus. Prevention, with particular attention to high-risk patients and to factors influencing aspiration in groups of surgical and non-surgical patients, is the solution to the problem.


Studies in burns, XVI: The effect of surgical trauma on metabolic heat production.

As part of an ongoing study of the naturally-occurring skin lipid ethyl linoleate as an adjunct for reducing post-burn hypermetabolism and hyperevaporation, we have conducted a series of evaluations of metabolic heat production (M) using a clinical partitional calorimeter. In this article, we describe the metabolic chamber and its use in evaluating the change in M in pre- and postoperative patients. We determined that dry heat losses (radiation and convection) comprise the major components of heat loss in the "normal" and traumatized individual with intact skin. In the post-operative state, metabolic heat production increases significantly above the preoperative levels, the percentage of change being accurately described by a first order exponential equation. In the postoperative patient, possibly because of a physiologic shift in source of metabolic substrate, stored heat increases significantly. These data may be useful in allowing approximate correction of the metabolic heat equation when studying the burn patient where no "control" is attainable and where some approximation of the contribution of "pure" trauma must be made.


Thiamine deficiency in general hospital patients.

The production of sedoheptulose-7-phosphate in the red blood cells of 15 patients was found to be below the suggested normal value. This intermediate product of glucose metabolism is the result of transketolase activity for which thiamine pyrophosphate is one of the co-factors. Without thiamine, the transketolase reaction is inhibited. Some nonlocalizing symptoms, perhaps previously thought due to hypoglycemia, may be occasioned by faulty glucose metabolism at the cellular level from a relative lack of thiamine.


Chemoneurolysis of the canine gastric submucosa: modification of surgically-induced peptic ulcer formation.

Chemoneurolysis of the canine antral submucosa with 25% ethyl alcohol solutions reduced ulcer formation and increased the survival times in animals subjected to the Exalto-Mann-Williamson ulcer-producing procedure.


Catamenial pneumothorax: case report and a review of the literature.

Catamenial pneumothorax, a rare but well documented syndrome of recurrent perimenstrual pneumothorax, is being reported with increasing frequency, probably because of increased awareness. Its pathogenesis remains enigmatic but may be associated with hormonal influcences, including the prostaglandins. Its right-sided predilection remains a mystery. the experience of 42 cases in the literature as well as a new case is presented. A rational approach to this interesting syndrome is discussed. Ovulatory suppression should be attempted before thoracotomy and pleurodesis are considered.


Ambulatory surgery for pilonidal disease.

In conclusion, pilonidal cysts, sinuses, and abscesses appear to be acquired lesions, perhaps enhanced by the developmental presence of deep intergluteal clefts, dimples, or sinuses. The pahtophysiology depends upon physical invasion of hair, lint, and other foreign material into the subcutaneum and the formation of a foreign body reaction. Appropriate treatment is drainage of the infected cavity and removal of foreign material. Adherence to basic principles of treating surgical infection is necessary for a good result. Prevention of treatment failure demands a conscious attention by the patient to personal hygiene to avoid accumulation of debris and repeat occurrence of the pathophysiologic process. Adequate surgical management can be performed on ambulatory outpatients with tolerable discomfort. This method features a minimal loss of man-days and an acceptable recurrence rate. A major advantage is cost-effectiveness.


Chest disease presenting as an acute abdomen.

Four patients with primary disease in the chest are discussed, each coming to laparotomy. The final postoperative diagnoses were empyema, pulmonary tuberculosis, pulmonary embolism and bacterial endocarditis. These cases well illustrate the real risk of confusing an acute chest condition with an acute abdomen.


Gonococcal perihepatitis (the Fitz-Hugh-Curtis syndrome): a diagnostic dilemma.

Three case histories of patients who were treated for gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome) are reviewed. The incidence rate of this disease process is believed to be increasing, and a surgical consultation is often asked for in the evaluation of these individuals. The diagnosis of FHCS requires a high index of suspicion. However, if a patient has signs and symptoms of acute cholecystitis plus the recent onset of a purulent genitourinary infection, the diagnosis of FHCS is suggested. Confirmation of this diagnosis is obtained with the culturing of N. gonorrheae from urethral or cervical secretions. The clinical presentation may vary from a moderately symptomatic to an acutely ill individual. Most commonly there is an abrupt onset of sharp right upper quadrant pain. The finding of any degree of lower abdominal or pelvic tenderness in addition to the upper abdominal pain, should make one highly suspicious of pelvic inflammatory disease and concommitant FHCS. Although no deaths have been reported from this syndrome, it is important to make a prompt clinical diagnosis and commence appropriate antibiotic therapy. The currently recommended therapeutic regimen is procaine penicillin, 1,200,000 U, twice a day for 10 days.


Colitis and pseudomembranous colitis associated with cephazolin prophylaxis.

Three patients suffering from colitis associated with cephalexin therapy are reported. All had undergone surgery and had previously suffered severe associated medical problems. Their presenting symptoms included profuse diarrhea, vague abdominal pain, fever and leukocytosis, but all stool cultures were negative. In one case, a pseudomembrane was present; in another only acute inflammatory changes, and in the third patient, no proctosigmoidoscopy or biopsy was done. Cephalosporin therapy was halted and bowel rest as well as intravenous hydration were instituted. All three patients survived. Inasmuch as four cases of colitis associated with cephalosporin therapy have now been treated at UCLA Hospital, the authors believe that this diagnosis should be strongly considered when patients on cephalosporin develop diarrhea.


Rapidly spreading subcutaneous inflammation after "skin popping" in drug addicts.

A lethal rapidly spreading inflammation and necrosis of subcutaneous fat followed by progressive multiple organ failure is described in two drug addicts after subcutaneous injection of narcotics. The etiology of this process is unknown, but early recognition and extensive surgical debridement may prevent death.


Canine shock: irreversibility and coagulopathy.

Canine shock was experimentally induced by "superior mesenteric artery (SMA) occlusion followed by release:" two hours of occlusion produced reversible shock while four hours of occlusion caused irreversible shock. In both situations, the animals showed coagulopathy but the magnitude of same was more severe in animals with irreversible shock. The nature of coagulation changes was suggestive of intravascular coagulation. Histological changes showed widespread intravascular fibrin thrombi in the liver and the kidney in animals with irreversible shock and only limited local intravascular coagulation in the subcapsular region of the liver in those with reversible shock. The importance of diffuse intravascular coagulation in the irreversibility of shock was also corroborated by the "reversion" of shock by prior heparinization.


Treatment of hiatal hernia with esophagitis in a patient using esophageal speech after laryngectomy.

Severe reflux esophagitis occurring after total laryngectomy in a patient who has learned to communicate by esophageal speech represents a unique problem in management. It was anticipated that an antireflux operation might interfere with esophageal speech. A Nissen fundoplication resulted in complete resolution of signs and symptoms of reflux esophagitis without compromising esophageal speech. A comparison of pre- and post-operative speech functions suggests that more noticeable changes could result after an antireflux operation in the less proficient speaker and, therefore, only those patients with persistent and unresponsive reflux esophagitis should be operated upon.


Triplication of the gallbladder: review of literature and report of a case.

A case of triplication of the gallbladder is presented. This is the ninth case to be reported in the world literature. The triple gallbladder with a common cystic duct was found on single dose oral cholecystogram during the gastrointestinal evaluation of a man with hematemesis. No surgery was performed due to the absence of biliary tract symptoms and absence of pathology on roentgenograms. The embryology, anatomy, pathology, and clinical significance of vesica fellea triplex are discussed and the previous eight case reports are reviewed.


Heterotopic gastric mucosa of the small bowel with perforated ulcer.

A patient with heterotopic gastric mucosa of the small intestine with perforation of the ileum due to ulceration of the adjacent mucosa is presented. Twelve symptomatic and six asymptomatic cases from the literature are reviewed. The majority of patients presented with intermittent obstruction due to intussusception of the ectopic gastric mass. Hemorrhage or chronic blood loss anemia occurred in the three patients in whom ulceration was present, and one of these patients had an intestinal perforation.


Replacement of dislodged biliary catheters using angiographic techniques and the fiberoptic bronchoscope.

A method for replacing biliary tract catheters with angiographic techniques is described, along with clinical experience in its use. Situations which at first seem hopeless may in fact be simply resolved as in the first instance. We found the fiberoptic scope to be useful when the cannulation tract involves a segment of bowel.


An extended wear hard contact lens in aphakia.

In reviewing the literature, there are several reports of limited success with both hard and soft contact lenses for continuous or extended wear. Aphakia is the most common indication for continuous wear, especially in monocular aphakes who are unable to insert and remove their lenses for various reasons. Because of its unusual oxygen permeability, silicone is the logical choice of material for an extended wear lens. However, because of the problems in manufacture, as well as its hydrophobic characteristics, poor centering, and problems with proper edging, no silicone lens has had wide clinical application to date. This paper reports on a preliminary study in a group of 21 aphakic patients fitted with the Polycon lens made of a new material consisting of polymethylmethacrylate in combination with silicone. Although gas permeable, the oxygen permeability is probably not adequate to maintain corneal metabolism without some interchange of oxygen containing tears. However, a significant proportion of the patients were able to wear this lens for an extended period of time without removal.


Subconjunctival steroid injections for the treatment of chemically burned eyes.

We believe that the utilization of a subconjuctival steroid injection, where indicated, will be of great benefit in the hands of a clinician who treats chemically injured eyes.


The detrimental effect of aspirin on hyphema rebleed.

One hundred ninety-five cases of traumatic hyphema admitted to 2 medical centers over an 8 year period were studied in terms of factors effecting the rebleeding rate. It was found that aspirin given for analgesia had a detrimental effect on the rebleeding rate, and that dilating the iris offered some protection against this complication. This report is the second one to show association of higher rebleeding rate and aspirin.


Acute retinal pigment epitheliitis with macular edema.

A 34-year-old white woman developed acute loss of central vision in the left eye due to a multifocal inflammatory disturbance of the retinal pigment epithelium in the macula. Subretinal and intraretinal fluorescein leakage were noted in the acute stage. Vision subsequently improved to normal; however, residual spots of depigmentation remained.


Retinopathy in ophthalmologically asymptomatic patients with abnormal hemoglobins.

A study of 70 ophthalmologically asymptomatic patients with abnormal hemoglobinopathy (AS, SS, S Thal) is presented. A significant number of SS and S Thal group patients had visual acuity of less than 20/20. Retinal vein dilation and tortuosity was observed in 54% of S Thal and 83% of SS patients. Early stages of proliferative retinopathy were encountered in 7% of SS and S Thal patients in the study. The importance of routine ocular examination including meticulous binocular indirect ophthalmoscopy with scleral depression in asymptomatic patients with abnormal hemoglobin is stressed.


Retrobulbar cavernous hemangioma with slowly progressive proptosis.

Retrobulbar tumors may be difficult to diagnose by conventional ultrasonography. Cavernous hemangioma that developed unusually late in a 45-year-old woman with unilateral proptosis was accurately diagnosed only by computerized tomography (EMI) scan. The patient was successfully operated upon using the Naffziger approach, with good cosmetic result.


Necrotizing erysipelas of the eyelids.

A 72-year-old, healthy white woman presented with rapidly advancing necrotizing erysipelas of the upper and lower eyelids. There was no previous history of trauma or skin abrasions. The patient was treated with intravenous methicillin (Staphcillin) for 2 weeks and oral cloxacillin (Tegopen), for 1 week with intensive wound cleaning and debridement. After 3 months of continuous wound care, the patient has healed her wounds by second intention, with a moderate amount of lid contracture. Further surgical correction of the lower lid defect may be necessary.


Optic neuritis in a child with herpes zoster.

A 9-year-old black boy was admitted to the hospital for treatment of herpes zoster involving the trigeminal nerve distribution on the left half of his face. Consulting examination of his eye on the involved side revealed moderate iritis as well as papillitis and diffuse retinitis.


Dacryolithiasis.

The mechanism of dacryolith formation is obscure. Divisions of operative vs nonoperative, calcified vs fungal, and amino acid vs nonamino acid are reported but do nothing to elucidate their etiology. Jones' report on nonmycotic casts in northwestern climates, clearly points to more than one mechanism for formation. Fortunately, dacryolith formation is rare when compared to the incidence of lacrimal system inflammation. This case report is presented to emphasize the highly variable circumstances that surround dacryolithiasis.


Evidence for vasculitis in acute posterior multifocal placoid pigment epitheliopathy.

A case of acute posterior multifocal placoid pigment epitheliopathy is presented with the unusual feature of the exposure of deep choroidal vessels which filled with dye in the early phase of the fluorescein angiogram in the center of many of the placoid lesions. Visualization of these vessels with surrounding hypofluorescence implies nonperfusion of choriocapillaris presumably due to inflammation, rather than retinal pigment epithelial blockage. The pathology of acute posterior multifocal placoid pigment epitheliopathy is probably a vasculitis of the choriocapillaries, which causes transient occlusion of these vessels and the initial hypofluorescence in the typical lesions during angiography. In many lesions the ischemia is mild enough to cause only temporary disturbance of visual function with subsequent recovery. Only in the center of some of the lesions is the inflammation severe enough to allow for the findings observed in the case presented and to account for the permanent visual defects found in some patients.


Reversible blindness in optic neuritis associated with influenza vaccination.

A patient is reported in whom bilateral optic neuritis developed following an influenza vaccination. From complete blindness (absence of light perception) in one eye, the patient's vision returned to normal following steroid treatment.


Plasma renin activity and aldosterone determination in patients with pseudotumor cerebri.

A group of 6 women diagnosed as suffering from pseudotumor cerebri had measurement of their plasma renin activity and aldosterone levels at baseline, following plasma volume contraction by furosemide and after dexamethasone therapy. In each instance, the values recorded fell within the normal range and a normal renin-aldosterone axis is postulated.


Unusual presentation of ocular toxocariasis in friends.

Two cases of presumed ocular toxocariasis are reported in 19-year-old college students. One presented with an acute exudative intraocular inflammation, with marked peripheral eosinophilia, while the other had only minimal inflammatory changes of the disc and vitreous. Both had elevated Toxocara antibody titers by the enzyme-linked immunosorbent assay (ELISA) method. The simultaneous occurrence of ocular toxocariasis in friends and the early presentation and detection of their ocular lesions make these 2 cases interesting. The presence of positive laboratory data with only minimal clinical disease in one of the cases suggests that ocular toxocariasis may be more common than is usually appreciated.


The scintillating scotoma without headache.

Scintillating scotomas are frequently seen without an associated headache and in general should be considered a benign symptom. In this series of 10 patients with an age range from 25 to 72 years, there were 7 female and 3 male patients. With an average follow-up of 1 1/2 years there was no patient who subsequently developed migraine headaches or any persisting neurologic sequelae.


Ocular pain secondary to occipital neuritis.

Sixteen patients whose chief complaint was ocular or periocular pain were diagnosed as having occipital neuritis. All but one had significant relief of pain from one or more injections of an anesthetic in the vicinity of the greater occipital nerve. They were subsequently treated with anti-inflammatory measures. From these cases definitions of significant tenderness and success of treatment were developed. These observations form a basis for a current double-blind study designed to establish a relationship between ocular pain and occipital neuritis.


Intracerebral venous angiomas as a cause of exophthalmos.

Three cases of an infrequent cerebral vascular malformation, venous angioma, are reported. The first 2 of these cases, with the lesion in a supratentorial location, exhibited exophthalmos as a presenting symptom, together with palpebral or intraobital angiomatous formations, and also impairment of visual function. The first patient was operated upon and the "venous angioma" could be confirmed histologically. An angiographic follow-up of the same patient at an 18 year interval was also possible. The diagnostic work-up to be performed in cases of exophthalmos is discussed and the need for angiography is stressed.


The binocular confusion in unilateral aphakia.

The first 4 symptoms of binocular confusion concern primarily daytime vision and the fifth symptom concerns nighttime vision. Even with a conventional contact lens correction, symptoms of binocular confusion occur, especially with high optical aniseikonia for near or far distance. In addition, diplopia occurs in the presence of strabismus. The important result of our research is the fact that unilateral aphakes are severely disturbed by the 5 symptoms of binocular confusion described above. These disturbances can be eliminated completely with an appropriate spectacle-contact lens combination based on echometry and intraocular optics.


Uveal melanoma occurring as a fourth primary malignancy: case report.

A patient developed 4 separate malignancies over a 26 year period, the last of which was a primary choroidal melanoma. She demonstrated that despite previous malignancies, suspicious lesions should never be dismissed as being metastatic in origin, but should be thoroughly evaluated and treated accordingly.


Saccadic velocity measurements in Brown's syndrome.

Eleven patients with Brown's syndrome (12 eyes) had vertical saccades measured in the primary, adducted, and abducted positions. Upward saccades in all 3 positions were equal and within the normal average velocity range. There was no difference between upward velocities in the eyes with Brown's syndrome when compared with the opposite, normal eye. These findings are consistent with the restrictive etiology of Brown's syndrome and may be helpful in confirming the diagnosis in some patients.


Atypical drusen in pseudoxanthoma elasticum.

Forty-three patients with pseudoxanthoma elasticum were evaluated ophthalmologically. The fundus appearance was characterized by angioid streaks and mottling of the retinal pigment epithelium. Rock-like atypical drusen were present in the posterior pole or peripheral retina in 75% of the patients examined and were an integral part of this fundus picture. These drusen changed little with time and were seen in early stages of pseudoxanthoma elasticum. The histopathology of these drusen is unknown.


Aberrant lacrimal gland and pleomorphic adenoma within the muscle cone.

Aberrant lacrimal gland tissue within the muscle cone formed a pleomorphic adenoma (benign mixed tumor). Histopathologically, the lesion was identical to similar neoplasms originating from lacrimal and other salivary glands as well as from other serous glands of the body.


Silicone intubation of the lacrimal system: loop retraction as a complication.

Inadvertent retraction of silicone tubing after nasolacrimal intubation occurs with some frequency. This problem may be managed in sequential fashion with probing, dacryocystostomy or dacryocystorhinostomy depending on the needs of the patient at the time of occurrence and the original rationale for utilization of the technique.


Combined thermotrabeculocanalotomy cataract extraction.

The results of combined thermotrabeculocanalotomy-cataract extraction are reported on 9 cases, 7 of which are glaucoma cases controlled by medical therapy, one secondary glaucoma following chronic angle-closure, and one secondary glaucoma following trauma. The results were satisfactory both in terms of visual acuity and lessening reliance on medical therapy of the glaucoma following surgery. More importantly, the safety of the procedure is emphasized, which further indicates that the combined procedure should be considered as the procedure of choice when a cataract must be extracted in a patient with glaucoma.


Antihypertensive effect of prazosin in combination with methyldopa, clonidine, or propranolol.

Seventeen hypertensive out-patients, more or less unresponsive to previous treatment with antihypertensive drugs, were treated in a cross-over fashion with placebo, prazosin (Pz), methyldopa (MD), Pz + MD, Pz + clonidine (C) and Pz + propranolol. The antihypertensive responses to Pz 2 mg t.i.d. and MD 250 mg t.i.d. were poor, and only modest when the drugs were combined. The combination of Pz with low doses of C was about as effective as Pz + MD, and some patients failed to respond to it. Nor was the combination of Pz + propranolol effective in those cases but the addition of a diuretic produced good responses in all patients. Side effects were few. It is concluded that a combination of central and peripheral sympathetic blockade does not necessarily produce normotension, and that a diuretic added to this combination greatly improves the response.


Monoamine metabolite levels in cerebrospinal fluid and brain atrophy in lobotomized schizophrenic patients.

Baseline concentrations of homovanillic acid (HVA), 5-hydroxyindole acetic acid (5-HIAA) and MHPG in the cerebrospinal fluid (CSF) were determined in 67 lobotomized and 30 non-lobotomized patients with chronic schizophrenia. In addition, in 69 of these patients the degree of brain atrophy was assessed by a pneumoencephalographic (PEG) technique. There were no significant differences in the concentrations of the monoamine metabolites in the CSF between the two patient groups studied despite the fact that the group of lobotomized schizophrenics had significantly more central and cortical brain atrophy than the group of nonlobotomized schizophrenic patients. The amine metabolite levels were also unrelated to the subtype of schizophrenia, duration of illness, or degree of mental incapacitation.


Determination of specific airway conductance by a simplified plethysmographic procedure.

Attention is drawn to the fact, obvious for simple mathematical reasons, that in patients that airway obstruction the values for specific airway conductance (SGaw) calculated directly from the flow-pressure loop registered during quiet breathing with a constant-volume body plethysmography closely approximate the values obtained by the conventional plethysmographic method which includes temporary interruption of the airflow. The simplified procedure may be useful e.g. in serial determinations of SGaw in situations where simultaneous measurement of the lung volume is not considered essential.


Metoprolol in the treatment of supraventricular tachyarrhythmias.

Twenty one patients with either paroxysmal supraventricular tachycardia (group A), atrial flutter (group B), or atrial fibrillation (group C) were treated with intravenous metoprolol in the dose range 2--20 mg. Sinus rhythm was restored in 3 out of 6 patients in group A, 3 out of 7 patients in group B and one out of 8 patients in group C. In patients who did not convert to sinus rhythm a remarkable decrease in ventricular rate occurred in 3 patients with atrial flutter and 4 patients with atrial fibrillation. In patients with systolic blood pressure greater than 100 mm Hg but without an acute myocardial infarction the risk of hypotension necessitating treatment was small. Metoprolol appears to be an effective and safe drug in the treatment of supraventricular tachycardia.


Serum immunoglobulin abnormalities in patients with respiratory tract disease.

Serum immunoglobulin concentrations in patients representing four different categories of respiratory diseases are compared with each other and with an age related group of healthy voluntees. Natural immune stimulation of the respiratory tract results in a significant rise in serum IgA and IgG but not IgM. A comparision with their respective normal serum control values further indicates that the major increase is within the IgA class and, that although significant, the rise in IgG is relatively minor. The preferential serum IgA response observed in the patient population suggests that bronchial associated lymphoid tissue in the diseased lung is an important source of circulating IgA.


Gonococcal perihepatitis in a surgical ward.

Within a three-year period six female patients with gonococcal perihepatitis were encountered. In the acute stage they had clinical symptoms indistinguishable from acute cholecystitis. In all six patients the diagnosis was established by positive growth of Neisseria gonorrhoeae from cervix specimens. Evidence of previous gonococcal pelvic infection was disclosed in three of the patients. In two patients the gonococcal aetiology of the disease was suggested by papular skin lesion and arthritis. Of the annual mean number of patients admitted to the emergency ward with suspicion of acute cholecystitis within the same three year period, 2.6% presented with gonococcal perihepatitis. As the incidence of gonorrhoea is increasing, complications such as perihepatitis are seen more frequently among young female patients admitted to surgical emergency wards because of acute abdominal pains.


The effect of intravenously administered glycopyrrolate and orally given analgetic-spasmolytic combination preparation on the contraction of the human gallbladder.

The effects of intravenously administered glycopyrrolate 0.2 mg (n = 10, Group I) or one orally given analgesic-spasmolytic combination preparation tablet (n = 10, Group II) on the contraction of human gallbladder during control oral cholecystography were compared with patients without any medication (n = 10, Group III). Neither drug had any effect on the gallbladder contraction and, hence, their usefulness in a patient with pain caused by gallstones is questionable. Heart rates and blood pressures were constant in Groups II and III but in Group I glycopyrrolate occasionally caused slight tachycardia and elevated blood pressure. Only in Group I 2 patients had mild side-effects (anticholinergic).


Estradiol receptor assays in normal and neoplastic tissues. A possible diagnostic acid for tumor differentiation.

Estradiol (E2) binding activity was studied in several normal tissues and neoplasias of humans and experimental animals. Positive E2 binding was seen in 37 percent of breast primary malignancies, 50 percent of breast cancer metastasis to other organs, and 55 percent of breast cancer metastasis to lymph nodes. Two other tumors, renal cell carcinomas and thyroid adenocarcinomas, also had a high percent of E2 binding activity. No difference was evident histologically between the tumors which were positive and those which were negative. Elevated E2 binding activity was seen in normal liver and pancreas of rats and mice as well as in an experimentally induced acinar pancreatic carcinoma of the rats. These preliminary results indicate that the measurement of estradiol receptors should be extended to other neoplasias than breast cancer, and it may give some indication about the evolution and the hormonal controls of the tumors themselves.


Consequences of erythropoietin production by neoplasms.

Neoplastic lesions of the kidney and certain other organs are sometimes associated with increased erythropoietin and/or erythrocytosis in man and experimental animals. It seems likely that measurement of erythropoietin, although not specific, could be helpful in detecting renal neoplasms and in following the progress of treated tumors of the kidney and certain other organs. Increasing the sensitivity of the assay of erythropoietin in the exhypoxic mouse, a functional assay, or in an immunologic assay of specific protein concentration might aid in the early detection of yet another hormone marker of neoplasia.


Plasma changes in endotoxin and anaphylactic shock (ATP, ADP and Creatine phosphorus).

Decisive patterns have been demonstrated in plasma adenosine 5' triphosphate (ATP) levels in both endotoxin and anaphylactic shock which correlate with periods of low platelet counts, low arterial pressures and abnormal electrocardiograms. When these irregularities were occurring, the plasma ATP level was low; when improvement occurred, the plasma ATP level rose. Plasma ATP levels appear to be an index to the metabolic state of the animal. The plasma creatine phosphate (CP) level showed a tendency to decrease when the ATP level dropped in anaphylactic shock, although the CP level did not recover to the same extent as the ATP level. In endotoxin shock, the plasma CP level increased on an average of six-fold. It is proposed that this rise resulted from either CP mobilization from tissues, for the purpose of replenishing the energy deficient myocardial muscle, or possible leakage from damaged cells. Adenosine diphosphate (ADP) plasma values were measured in both anaphylactic and endotoxin shock. High initial ADP values were prone towards a more severe anaphylactic reaction and a shorter survival time in the endotoxin shock experiments.


[Use of antibiotics in selecting a nystatin producer].

The lethal and mutagenic effect of streptomycin and nystatin on Act. noursei, strain 408 producing nystatin was studied. The survival of the spores of strain 408 on the medium with streptomycin decreased with an increase in the antibiotic concentration. Streptomycin had a selective effect on the nystatin-producing organism decreasing the frequency of morphologically changed and low active variants and revealing highly active and antibiotic stable variants. The survival of the spores of strain 408 on the medium with nystatin (20,000 units/ml) amounted to 35 per cent. Nystatin had an inhibitory effect on the organism producing it which was evident from delayed growth and significant modification variation of the colonies, as well as from a marked increase in the number of the variants characterized by low antibiotic production.


[Action of polyene antibiotics on actinomycetes with a varying lipid makeup].

The effect of polyenic antibiotics, such as nystatin, levorin, amphotericin B and mycoheptin on 93 representatives of various species of the ray fungi was studied. It was shown that resistance of the actinomycetes to the polyens was connected with the absence or insufficient content of sterols (0.001--0.008 per cent in the dry mycelium). On addition of cholesterol to the nutrient media (100 microgram/ml) it was included into the membranes of some cultures and their sensitivity increased 2--60 times. Resistance of Actinomyces sp. LIA 0775 grown on the media with fats differing in their composition decreased 2--4 times. In these cases the culture lipids were characterized by lower content of phospholipids (35--45 per cent from the total lipids as compared to 70--80 per cent when grown on the control medium without fats) and significantly increased content of unsaturated fatty acids (3--4 times).


[Solubility of the sodium salt of novobiocin in ethyl alcohol mixtures with other solvents].

Solubility of sodium novobiocin in binary mixtures of ethyl alcohol with ehtyl acetate, methylene chloride, diethyl ether, carbon tetrachloride or n-heptane was studied. Deviation in the sodium novobiocin solubility from the additivity was observed depending on the nature of the second component of the solvent mixture.


Leydig cell tumors of the testis.

Leydig cell tumors represent approximately one to three percent of all testicular tumors. Whereas in experimental animals predisposing conditions include administration of chemical carcinogens, hormones and heavy metals, environmental or endogenous factors in man are presently unrecognized. Leydig cell tumors do not show preferential lateralization or tendency for bilaterality. The symptoms are related to the local effects or to hormones released into the systemic circulation. Laboratory findings are variable, depending on endocrinological activity. Typical tumors rarely exceed five cm in diameter, are brown on cross section and are composed of polyhedral cells with acidophilic, granular cytoplasm. Ultrastructurally, neoplastic Leydig cells resemble normal Leydig cells. Surgical ablation is curative for benign Leydig cell tumors.


The pathological classification of human mammary carcinoma: past, present and future.

The current classification of mammary carcinoma combines pathological and clinical information in order to define prognostically significant categories. Basic structural features are the anatomic unit of origin, either duct or terminal duct-lobule complex, and the presence or absence of invasion. Approximately 90 percent of carcinomas appear to arise from ducts. About one-fifth of invasive duct carcinomas have a better than average prognosis and distinct light microscopic structural patterns. Future study of biochemical markers may permit further refinement of the existing classification of breast carcinoma and lead to the identification of new prognostically significant categories in the heterogeneous group currently referred to as "ordinary" infiltrating duct carcinoma. However, a conservative approach should be adopted toward altering or abandoning the existing classification of breast carcinoma on the basis of immunocytochemical studies until there is an adequate opportunity to determine which, if any, markers are truly clinically relevant.


[Inhibiting action of egg albumin on the growth of coagulase-negative species of staphylococci].

The effect of various concentrations of native egg albumin on growth of three staphyloccal species was studied. It was found that addition of 25 per cent of the albumin to the medium prepared from dry nutrient agar inhibited growth of Staph. epidermidis and Staph. saprophyticus, had no effect on growth of Staph. aureus and promoted formation of a pigment by it. A mechanism of the albumin inhibitory effect is suggested. It is proposed that the albumin medium be used for differentiation of Staph. aureus and the coagulase-negative species of staphylococci.


Evaluation of three methods of protein analysis for serum and heart homogenates.

The Biuret, Ultraviolet and Lowry techniques for the determination of total protein content were compared in 31 samples of patient serum and in 30 rat heart tissue homogenates. Statistically significant differences were found to exist between values obtained with each method. Human serum and heart homogenate protein were both lowest when assayed by the Lowry procedure, while serum and homogenate values were highest with the Ultraviolet and Biuret method, respectively. Possible sources of these discrepancies are discussed. Although the Biuret method may not be as sensitive as the other two methods, it proved to be the most reproducible technique for determining total protein concentration in the particular types of samples used in this study.


[Structure of salmonellal transmissive resistance to antibiotics].

The structure of transmissive resistance to antibiotics was studied in 1260 Salmonella strains of 57 serotypes and R-plasmid resistance was found in the representatives of 13 (31.6 per cent) serotypes. The transmissive resistance correlated with multiple resistance to 4--10 antibiotics. The rate of occurrence of the transmissive R-plasmids was markedly higher in the bipathogenic serotypes. The structure of the R-plasmid resistance was most pronounced and diverse in S. typhimurium. It was usually revealed simultaneously with registration of the hospital infection. The plasmid with the determinants of resistance to erythromycin and benzylpenicillin was found only in this serotype. The nature of resistance and spectrum of transmissive resistance to antibiotics in Salmonella may serve as an additional epidemiological feature of the strains.


[Comparative characteristics of the antibioticograms and biological properties of the staphylococci isolated from patients with various eye diseases].

A total of 1488 examinations of the conjunctival content of patients with various ophthalmic diseases were performed within 5 years (1973--1977). 989 (66.4 per cent) cultures were isolated. Staphylococci were isolated in 79.2 per cent of the patients irrespective of the diagnosis. The plasma-coagulating strains were isolated in 43.6 per cent of the patients with acute conjunctivitis. The plasma-negative staphylococci were more frequent in chronic conjunctivitis (83.5 per cent). A total of 188 strains were studied according to 18 tests. Determination of the antibiotic sensitivity showed that the number of the benzylpenicillin and tetracycline resistant strains among the plasma-coagulating staphylococci was higher in the patients with acute ophthalmic diseases. In chronic conjunctivitis no differences in the antibiotic sensitivity of the plasma-coagulating and plasma-negative strains were noted. Similar antibiotic sensitivity of all plasma-negative staphylococci irrespective of the diagnosis was found. High biological activity of the plasma-negative staphylococci was shown: 74.1 per cent of the isolates possessed phosphatase, 59.8 per cent possessed protease and 88.4 per cent a lysozyme-like enzyme. The strains isolated in chronic conjunctivitis produced protease more frequently that those isolated in acute ophthalmic diseases.


Is breast cancer a result of endocrine targeting? (How women differ from rats or mice).

Parabiosis of female rats with castrate males or oophorectomized females produces carcinoma of the breast in the majority of intact females. When unilateral nephrectomy of each partner is added to the procedure, the incidence is 100 percent. Radioimmunoassays for luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, estradiol and progesterone have been performed on the sera of these rats. The pathogenesis of the breast carcinomas is discussed in the light of these results. An attempt to weigh various factors thought to be involved in causing human and experimental rat cancer of the breast suggests significant differences of a quantitative nature.


Ultrastructure of endocrine neoplasms.

The most common ultrastructural features of endocrine tumors are reviewed. The diagnostic applications of the electron microscope are illustrated by citation of case histories.


Effects of maternal administration of endoxan, vitamin A and vitamin B12 on the development of the fetal spinal cord of the albino mouse.

The effects of maternal administration of endoxan, vitamin A and vitamine B12 were studied on the cervical fetal spinal cord of the albino mouse. Endoxan caused dorsal and ventral herniation of the spinal cord, chromatolysis and degeneration of the neuroblasts together with neuroglial proliferation. Vitamin A and B12 resulted in an increase in the surface areas of both grey and white matter and an increase in the volume of the neuroblasts. The possible mechanisms concerned were discussed.


Nervous reactivity disturbances in patients with late post-traumatic encephalic syndromes.

A polygraphic study performed on 184 patients with late post-traumatic encephalic syndromes has shown marked nervous reactivity disturbances. The disturbances, estimated by testing for the electrographic components of the orienting reflex elicited by a repetitive auditory stimulus and for their habituation, were expressed by alterations in the intensity, resistance to habituation and sequence of habituation of the somatic, autonomic and EEG components. The character and severity of these disturbances depended on the mechanism behind the syndrome-inducing cranio-cerebral trauma, site of the impact and clinical picture of the syndrome.


Territrems, tremorgenic mycotoxins of Aspergillus terreus.

The tremorgenic mycotoxins isolated from Aspergillus terreus were given the trivial names territrem A and B instead of their previous designations of C1 and C2 respectively. High-resolution mass spectral data suggested the molecular formula of territrem A to be C28H30O9 and that of territrem B,C29H34O9. They were partially characterized by ultraviolet, infrared, proton magnetic resonance, and mass spectroscopy. The spectroscopic evidence indicated that their chemical structures were very similar. The procedures of purification were also revised for the complete separation of these two chemically related compounds.


Differentiation of aflatoxins from territrems.

Three methods were adopted for differentiation of aflatoxins B1 and B2 from territrems A and B. They were as follows. (i) Then-layer chromatography coupled with chemical confirmation. A significant decrease in the Rf value of trifluoroacetic acid-treated aflatoxin B1 developed in chloroform-acetone (85:15, vol/vol) was satisfactory in differentiating this toxin from the other three. (ii) High-pressure liquid chromatography monitored synchronously at two wavelengths, 365 and 335 nm. The ratio derived from this double-wavelengh detection could serve as an indicator of the presence of each toxin. (iii) Velasco's flurotoxin meter method, which is used for the determination of aflatoxins within the range of 0 to 50 ng/ml, was not significantly affected by territrems even when they were present in quantities at the microgram-per-milliliter level.


Spoilage of vacuum-packaged dark, firm, dry meat at chill temperatures.

The flora of vacuum-packaged dark, firm, dry meat included thred organisms not usually found on vacuum-packaged meat, Yersinia enterocolitica, Enterobacter liquefaciens, and Alteromonas putrefaciens. Y. enterocolitica did not affect the meat quality. Production of spoilage odors by E. liquefaciens could be prevented by addition of glucose or citrate to the meat. Greening of meat could be prevented by addition of glucose or citrate to the meat. Greening of meat by A. putrefaciens was not prevented by addition of glucose, as the organism degraded cysteine with the release of H2S even when glucose was present. To prevent greening, growth of A. putrefaciens must be inhibited by reducing the meat pH to less than 6.0.


Production of mycophenolic acid by Penicillium roqueforti strains.

Sixteen strains of Penicillium roqueforti Thom, isolated from blue-molded cheeses, were studied. In vitro, all of these strains produced mycophenolic acid, some on the order of 0.8 to 4 mg/g od dry culture. The greatest yields were obtained after 10 days of incubation of cultures at 15 degrees C. However, under some experimental conditions, mycophenolic acid was not alone responsible for the toxicity of culture extracts to chicken embryos.


Bactericidal effect of cysteine exposed to atmospheric oxygen.

Peptostreptococcus anaerobius VPI 4330-1 was exposed to atmospheric oxygen in a dilution bland (0.2% gelatin, salts, resazurin) solution. The organisms were rapidly killed when the solution contained cysteine. The organisms were effectively protected by catalase and horseradish peroxidase as well as by the metal ion-chelating agents 8-hydroxyquinoline and 2,2'-bipyridine. Superoxide dismutase increased the rate of killing of the organisms, whereas singlet oxygen quenchers and scavengers of hydroxyl free radicals did not protect the organisms from the toxic effect of cysteine. Hydrogen peroxide was formed when cysteine was exposed to oxygen in the dilution blank solution, and the reaction was inhibited by metal ion-chelating agents. The organisms were rapidly killed by 20 microM hydrogen peroxide in anaerobic dilution blank solution. The toxic effect of hydrogen peroxide in anaerobic dilution blank solution. The toxic effect of hydrogen peroxide was completely abolished by catalase and metal ion-chelating agents. These results indicated that hydrogen peroxide was formed in the dilution blank solution in a metal ion-catalyzed autoxidation of cysteine and that hydrogen peroxide was toxic to P. anaerobius VPI 4330-1 in a reaction also catalyzed by metal ions.


Spoilage association of chicken skin.

The bacterial succession on the skin of broiler chicken carcasses stored at 2 degrees C was traced, and the ability of representative isolates to produce off-odors was determined by using sterile leg and breast muscle sections. Off-odors were identified by olfactory and chemical means. The inability of peptone-iron agar to detect sulfide-producing strains was noted.


Emulsifier of Arthrobacter RAG-1: specificity of hydrocarbon substrate.

The purified extracellular emulsifying factor produced by Arthrobacter RAG-1 (EF-RAG) emulsified light petroleum oil, diesel oil, and a variety of crude oils and gas oils. Although kerosine and gasoline were emulsified poorly by EF-RAG, they were converted into good substrates for emulsification by addition of aromatic compounds, such as 2-methylnaphthalene. Neither aromatic nor aliphatic fractions of crude oil were emulsified by EF-RAG; however, mixtures containing both fractions were emulsified. Pure aliphatic or aromatic hydrocarbons were emulsified poorly by EF-RAG. Binary mixtures containing an aliphatic and an aromatic hydrocarbon, however, were excellent substrates for EF-RAG-induced emulsification. Of a variety of alkylcyclohexane and alkylbenzene derivatives tested, only hexyl- or heptylbenzene and octyl- or decylcyclohexane were effectively emulsified by EF-RAG. These data indicate that for EF-RAG to induce emulsification of hydrocarbons in water, the hydrocarbon substrate must contain both aliphatic and cyclic components. With binary mixtures of methylnaphthalene and hexadecane, maximum emulsion was obtained with 25% hexadecane.


Emulsifier of Arthrobacter RAG-1: chemical and physical properties.

The extracellular emulsifier of Arthrobacter RAG-1 was deproteinized by hot phenol treatment and purified by fractional precipitation with (NH(4))(2)SO(4). The active fraction, precipitating between 30 and 35% saturation [EF-RAG(UET) WA], appeared to be homogeneous by immunodiffusion and sedimentation analysis. EF-RAG(UET) WA had an intrinsic viscosity of 750 cm(3)/g, a sedimentation constant of 6.06S, a diffusion constant of 5.25 x 10(-8) cm(2) s(-1), and a partial molar volume of 0.712 cm(3) g(-1). From these data a weight average molecular weight of 9.76 x 10(5) and a viscosity average molecular weight of 9.88 x 10(5) were calculated. EF-RAG(UET)WA contained 46.7% C, 7.01% H, and 6.06% N. Titration of the nonreducing polymer gave a single inflection point (pK' = 3.05), corresponding to 1.5 mumol of carboxyl groups per mg. Direct estimation of O-ester and hexose content of the highly acidic polymer yielded 0.65 and 0.29 mumol/mg, respectively. Mild alkaline hydrolysis released fatty acids with an average molecular weight of about 231. Strong acid hydrolysis of EF-RAG(UET)WA yielded d-glucose (minor), d-galactosamine (major), and an unidentified amino uronic acid (major).


Metabolism of 3-chloro-, 4-chloro-, and 3,5-dichlorobenzoate by a pseudomonad.

Pseudomonas sp. WR912 was isolated by continuous enrichment in three steps with 3-chloro-, 4-chloro-, and finally 3,5-dichlorobenzoate as sole source of carbon and energy. The doubling times of the pure culture with these growth substrates were 2.6, 3.3, and 5.2 h, respectively. Stoichiometric amounts of chloride were eliminated during growth. Oxygen uptake rates with chlorinated benzoates revealed low stereospecificity of the initial benzoate 1,2-dioxygenation. Dihydrodi-hydroxybenzoate dehydrogenase, catechol 1,2-dixoygenase, and muconate cycloisomerase activities were found in cell-free extracts. The ortho cleavage activity for catechols appeared to involve induction of isoenzymes with different stereospecificity towards chlorocatechols. A catabolic pathway for chlorocatechols was proposed on the basis of similarity to chlorophenoxyacetate catabolism, and cometabolism of 3,5-dimethylbenzoate by chlorobenzoate-induced cells yielded 2,5-dihydro-2,4-dimethyl-5-oxo-furan-2-acetic acid.


Metabolism of (+/-)-N-(n-propyl) amphetamine by Cunninghamella echinulata.

(+/-)-N-(n-propyl) amphetamine (I), a secondary amine, was readily metabolized by Cumminghamella echinulata. The products included known C- and N-oxygenated mammalian metabolites as well as N-acetylamphetamine and were identified by gas chromatography and mass spectrometry.


Occurrence of Vibrio parahaemolyticus in Dutch mussels.

A study was carried out on the occurrence of Vibrio parahaemolyticus in Dutch mussels originating from the East Schelde Estuary. In a totol of 79 10-g tissue samples, 3 (3.8%) were found to contain V. parahaemolyticus. In a second survey, 6 out of 23 bags of mussels (26%) contained one or more strains of V. parahaemolyticus in 5-g tissue samples. The many limitations of current methodology used in such surveys are stressed. Positive samples can be missed because viable cells may die during refrigerated transport. Surviving cells also may not be detected because they have been sublethally stressed. In addition, the unreliability of the identification criterion of no growth in 10% NaCl was demonstrated.


Thermal stress of Pseudomonas fluorescens in complex media.

Pseudomonas fluorescens (P7) cells were stressed by incubation at 43 degrees C for 2 h. The stress induced a 9-h lag in replication after the return of the temperature of the culture to 25 degrees C. Stressed cells demonstrated a sensitivity to diluents and plating media during the recovery period. Data from utilization of selective inhibitors suggested that ribonucleic acid and protein, but not deoxyribonucleic acid, syntheses were required for recovery by the cells. The cells lost uracil- and leucine-labeled material as a result of the stress, further suggesting that ribonucleic acid and protein damage had occurred. Membrane damage was indicated by sensitivity to sodium dodecyl sulfate near the end of the lag period. Membrane damage was also suggested by the failure of cells to incorporate labeled material from the recovery medium. The lesions induced in this foodlike system are compared with those previously reported for a minimal media model system (Gray et al., Appl. Microbiol. 26:78-85, 1973; Gray et al., Appl. Environ. Microbiol. 33:1074-1078, 1977).


Fourteen-year survival of Pseudomonas cepacia in a salts solution preserved with benzalkonium chloride.

A strain of Pseudomonas cepacia that survived for 14 years (1963 to 1977) as a contaminant in an inorganic salt solution which contained commercial 0.05% benzalkonium chloride (CBC) as an antimicrobial preservative, was compared to a recent clinical isolate of P. cepacia. Ammonium acetate was present in the concentrated stock CBC solution, and served as a carbon and nitrogen source for growth when carried over into the salts solution with the CBC. The isolate's resistance to pure benzalkonium chloride was increased step-wise to a concentration of 16%. Plate counts showed 4 x 10(3) colony-forming units per ml in the salts solution. Comparison of growth rates, mouse virulence, antibiotics resistance spectra, and substrate requirements disclosed no differences between the contaminant and a recently isolated clinical strain of P. cepacia. The results indicate that it is critical that pharmaceutical solutions containing benzalkonium chloride as an antimicrobial preservative be formulated without extraneous carbon and nitrogen sources or be preserved with additional antimicrobial agents.


Mechanism of lethal action of 2,450-MHz radiation on microorganisms.

Various bacteria, actinomycetes, fungi, and bacteriophages were exposed to microwaves of 2,450 +/- 20 MHz in the presence and in the absence of water. It was found that microorganisms were inactivated only when in the presence of water and that dry or lyophilized organisms were not affected even by extended exposures. The data presented here prove that microorganisms are killed by "thermal effect" only and that, most likely, there is no "nonthermal effect"; cell constituents other than water do not absorb sufficient energy to kill microbial cells.


Mycological survey of selected health foods.

A survey was conducted to compare the total viable fungal content and the number of different mold species encountered in 10 types of health foods labeled organically grown and in the same foods without such a label. The foods were wheat flour, corn meal, brown rice, figs, split peas, pinto beans, soybeans, walnuts, pecans, and peanuts. Results showed no consistent difference in either the total viable fungal content or the number of different mold species encountered between the labeled and unlabeled foods. Two genera of yeasts (Rhodotorula and Saccharomyces) and 22 gener of molds, including more than 65 species, were encountered. The mold flora was dominated by Aspergillus glaucus, Aspergillus niger, Aspergillus flavus, Aspergillus candidus, Penicillium cyclopium, and Penicillium viridicatum. Isolates of the genera Alternaria, Cladosporium, Fusarium, and Helminthosporium also occurred in certain foods. At least 10 toxicogenic species of Aspergillus and Penicillium were encountered. A total of 87 cultures of these species, all isolated from health foods, were screened for laboratory production of their respective toxins. Toxin production potential of these 87 cultures did not differ from that of cultures of the same species isolated from conventional foods.


Nonlogarithmic death rate calculations for Byssochlamys fulva and other microorganisms.

Survivor curves for heat-resistant ascospores of Byssochlamys fulva exposed to lethal heat were nonlogarithmic. At lower heating temperatures, the log survivor curves were characterized by a shoulder plus an accelerating death rate; with increased temperatures, the rate approached logarithmic death. The formula (log No -- log N)a = kt + C was adapted to linearize these data. No and N are the initial and surviving numbers of organisms at the time t. The death rate is given by k, and C is a constant for a set of data. The a value is derived from the least-squares slope of a plot of log (log No -- log N) against log time and is used to linearize the thermal death rate curves. This formula permitted calculations of parameters analogous to those for logarithmic death (D and z). Use of formula is illustrated for selected nonlinear microbial death rate curves from the literature.


Ochratoxin A-induced iron deficiency anemia.

Ochratoxin A at 8 micrograms per g of diet, but not at lower doses, fed to chickens from 1 day to 3 weeks of age resulted in significantly (P less than 0.05) decreased packed blood cell volume and hemoglobin concentration without altering the number of circulating erythrocytes. Serum iron and percentage of transferrin saturation were lowered at 4 and 8 micrograms/g. Therefore, anemia was characteristic of severe ochratoxicosis of young chickens, and the anemia was categorized as a hypochromic-microcytic anemia of the iron deficiency type. These data indicate that ochratoxin A by itself does not cause hemorrhagic anemia syndrome of chickens and that an anemia caused by a nutritional deficiency can be elicited by a mycotoxin.


Phosphate and soil binding: factors limiting bacterial degradation of ionic phosphorus-containing pesticide metabolites.

Soils that had a high binding capacity for inorganic orthophosphate (Pi) had reduced capacities to bind ionic alkyl phosphorus compounds. Only ionic methylphosphonate (MPn) and ionic phenylphosphonate exhibited moderate binding. Pseudomonas testosteroni used either MPn or Pi as a sole phosphorus source and exhibited diauxic utilization of MPn and Pi. The utilization of MPn was suppressed in the presence of Pi. This suppression was abolished by a Pi-binding soil. The soil did not have a significant effect on the maximum rate of degradation of either MPn or the poorly bound ionic O-isopropyl methylphosphonate, whereas the amount of MPn (but not the amount of O-isopropyl methylphosphonate) metabolized was reduced in the presence of soil


Comparative study on the antimicrobial effect of 0.5% chlorhexidine gluconate and 70% isopropyl alcohol on the normal flora of hands.

A gloved-hand wash method was used to compare the antimicrobial effect of chlorhexidine gluconate alcohol emollient hand wash (HIBISTAT) with that of 70% isopropyl alcohol on the normal flora of the hands (81 subjects) under conditions designed to mimic use by surgeons. Results of the immediate postwash effects on the bacterial counts for all 3 tests days showed that chlorhexidine significantly reduced the normal flora of the hands. When compared with the base line bacterial counts, there was 85, 96, and 98% reduction with chlorhexidine treatment and 84, 93, and 90% reduction with alcohol treatment on days 1,2, and 5, respectively. The difference between chlorhexidine and alcohol treatments was not statistically significant on days 1 and 2, but was significant on day 5 (P less than 0.01). For delayed postwash bacterial counts (for persistent antimicrobial effects), the overall log means were 4.9943 and 5.4684 for chlorhexidine and alcohol treatments, respectively. The difference between the two treatments was significant (P less than 0.01). After the chlorhexidien treatment, there was no significant growth of bacteria over a period of 6 h when compared with the base line bacterial counts.


Catabolism of protocatechuate by Bacillus macerans.

An aerobic endospore-forming bacterium, tentatively identified as a strain (JJ-lb) of Bacillus macerans, was isolated by enrichment on 4-hydroxybenzoate (4HBA), using as an inoculum soil taken from a 50 degrees C Iadho hot spring. Enzymatic analyses of cells grown on succinate and 4HBA indicated that strain JJ-1b degrades 4HBA by way of the novel protocatechuate (PCA) 2,3-dioxygenase pathway. Purification of the PCA 2,3-dioxygenase by affinity chromatography allowed the first observation of the immediate ring fission product of PCA, namely, 5-carboxy-2-hydroxymuconic semialdehyde (CHMS; labmda max at pH 7.0 = 348 nm). An affinity column fraction was obtained that decarboxylated CHMS to 2-hydroxymuconic semialdehyde (HMS; lambdamax at pH 7.0 = 375 nm). Thus, conversion of PCA to HMS is accomplished in two steps, 2,3-fission of the PCA ring followed by enzymatic decarboxylation of the ring fission product, forming HMS.


Utilization of chlorobenzoates by microbial populations in sewage.

Microorganisms in sewage decomposed 3.4-dichlorobenzoate and m-, p-, and o-chlorobenzoates. As the substrate disappeared, populations capable of growing on these compounds proliferated. Neither 2,4-dichlorobenzoate nor 2,3,6-trichlorobenzoate was destroyed by the sewage microflora. The addition of glucose or benzoate and m-chlorobenzoate to the sewage did not promote degradation of 2,4-di- or 2,3,6-trichlorobenzoates. The populations responsible for the biodegradation of the chlorinated compounds were initially less than 100 cells/ml. During the metabolism of m-chlorobenzoate, 5-chlorosalicylate and 4-chlorocatechol were formed.


Salmonella species isolated from animal feed in Iraq.

Of 700 animal feed samples, 32 (4.5%) harbored Salmonella. The highest percentage of contamination was found in sheep feed and local protein. A total of 17 Salmonella serotypes were identified. The most frequent serotypes were Salmonella meleagridis. S. bornum, S. montevideo, and S. drypool. S. bornum was isolated for the first time in Iraq and from both local feed and its ingredients. The common somatic group found was that of Salmonella group C; then came groups E, G, B, and D. Three serotypes (S. enteritidis, S. california, and S. muenchen) seemed to form a link of infection among feed, food, patients, and carriers.


Production of 3-acetoxyscirpene-4,15-diol from anguidine (4,15-diacetoxyscirpene-3-ol) by Fusarium oxysporum f.sp. vasinfectum.

Growing cells of Fusarium oxysporum f.sp. vasinfectum (ATCC 7808) formed 3-acetoxyscirpene-4,15-diol from anguidine (4,15-diacetoxyscirpene-3-ol) by way of the intermediates triacetoxyscirpene, 3,4-diacetoxyscirpene-15-ol and 3,15-diacetoxyscirpene-4-ol. The new 3-acetoxy analog was found to be less active than anguidine and the other monoacetoxy derivatives when tested against a series of fungal strains and against HeLa cells in vitro.