What is the annual net flow of undocumented Mexican immigrants to the United States?

Senior government officials have claimed that in recent years an average of 1.4 million illegal aliens have entered the United States annually without apprehension. This conjectural figure does not take into account the fact that the net flow of immigrants is always less than the gross flow. In this paper, seven estimates are made concerning the net flow of undocumented Mexican immigrants to the United States in the period 1970--1975. These estimates are based on the growth of the population of Mexican origin according to the Current Population Survey. According to these estimates the annual net flow ranged from 82,300 to 232,400 persons.


Population growth, life-cycle saving, and international differences in steady-state optimal saving rates.

Life-cycle savings theories have been a seminal development in analyses of the relationship between rational savings patterns for individuals and the accumulation of wealth or capital at the level of the society as a whole. Applications of the theories in industrialized countries never investigated the significance of large differences in birth and death rates across societies. The strong demographic components of life-cycle saving analysis are here the center of focus. Illustrative general numerical applications of a modified version of the life-cycle approach suggest that mortality differentials comparable to those presently encountered among nations are consistent with very large differentials in steady-state optimal ratios of wealth-to-income. Specific application to Peru of the model estimated by Tobin for the United States indicates that high levels of mortality, current Peruvian birth rates, and Peruvian age-income profiles imply optimal rational savings rates far below those of the United States.


The impact of heterogeneity in individual frailty on the dynamics of mortality.

Life table methods are developed for populations whose members differ in their endowment for longevity. Unlike standard methods, which ignore such heterogeneity, these methods use different calculations to construct cohort, period, and individual life tables. The results imply that standard methods overestimate current life expectancy and potential gains in life expectancy from health and safety interventions, while underestimating rates of individual aging, past progress in reducing mortality, and mortality differentials between pairs of populations. Calculations based on Swedish mortality data suggest that these errors may be important, especially in old age.


A new technique to estimate infant mortality with an application for El Salvador and Colombia.

The paper presents new estimates of infant mortality for Colombia and El Salvador for the years 1950--1970. These estimates are obtained by using a technique which improves on Brass's method in that it suppresses the assumption of constant mortality and introduces instead assumptions about linear and nonlinear changes in mortality risks affecting various cohorts of individuals.


[Effect of urea on the mechanism of percutaneous permeation].

The influence of urea on the percutaneous permeation under different conditions of application and on the epidermal effectiveness of 5-fluorouracil (FU) as an example for water-soluble agents is reported. The proceedings of permeation of FU are accelerated by admixture of, or pretreatment with, urea and by increasing the hydration of the horny layer by pretreatment with NaCl. The effectiveness of FU on the epidermis is increased simultaneously. However, the permeation rate of FU is decreased by pretreatment with HTH as an example of a stabilized urea emulsion; on the other hand, the most favourable therapeutic effect is demonstrable. Therefore, the permeation of an agent may be both enhanced and inhibited by different modes of urea application. These findings appear to be important for both the optimization of topical treatment and the industrial medicine's point of view.


[Pityriasis lichenoides chronica--a new indication for PUVA therapy? (author's transl)].

2 patients with long-standing and wide-spread pityriasis lichenoides chronica were treated with orally administered 8-methyoxypsoralen and UVA irradiation (PUVA therapy). After 15--21 PUVA treatments the patients were completely cleared. 3 and 4 weeks after the initial PUVA treatment, phase recurrences occurred in both patients. In 1 patient the lesions appeared clinically and histologically as pityriasis lichenoides et varioliformis acuta.


Vegetant intravascular hemangioendothelioma of the skin. Report of 3 cases with a critical pathogenetic study.

3 cases of cutaneous vegetant intravascular hemangioendothelioma are presented, 2 of them corresponded to a pure form, whilst the other arose in a pyogenic granuloma. All lesions behaved in a benign fashion. In some cases these may mimic an angiosarcoma (Masson's pseudoangiosarcoma). The endothelial proliferation, which characterizes the lesion, is considered as a reactive phenomenon secondary to fibrin deposits originating from the destruction of the vascular walls of a hemangioma.


Cutaneous sclerosis in eosinophilic fasciitis.

Eosinophilic fasciitis is an additional clinical entity to many others manifested by sclerodermic changes in the skin. A case with this process is reported. It presents vast cutaneous sclerodermic changes associated with eosinophilia, signs of muscular exertion, and a massive inflammatory infiltrate involving the lower part of the dermis, subcutaneous tissue and the muscle fascia. Prednisone therapy was followed by rapid and marked improvement.


[Acquired nevoid telangiectasia (author's transl)].

Clinical and ultrastructural study of three cases of acquired nevoid telangioectasia: (1) angioma serpiginosum, (2) angiokeratoma neviformis, and (3) unilateral nevoid telangiectasia. Despite the clinical similarities, the ultrastructural aspects of these lesions are different, showing: (1) ectasia of arteriolar type, (2) budding of capillaries, and (3) ectasia of venular type. The physiopathological mechanism of these lesions seems to be different.


A case of multiple neonatal haemangiomatosis successfully treated by systemic corticosteroids.

A case of multiple neonatal haemangiomatosis is reported. The disease entity is rare and probably always combined with haemangiomas of internal organs. When visceral involvement provokes clinical symptoms (cardiac, cerebral, gastrointestinal), the spontaneous course often proves fatal. The prognosis seems to improve substantially if treatment with systemic corticosteroids is instituted. The patient reported, who had concomitant cardiac and gastrointestinal symptoms, recovered completely following corticosteroid treatment. It is concluded that steroid treatment is indicated without hazards in complicated cases of multiple neonatal haemangiomatosis.


Characterization of a cytoplasmic androgen receptor in the ram testis.

An androgen receptor has been characterized in the cytosol fraction of testes from hypophysectomized adult rams after in vitro labelling with [3H]testosterone. It can be distinguished from the testicular androgen-binding protein (ABP) and from the plasma 5 alpha-dihydrotestosterone-binding protein by electrophoresis on 3.25% acrylamide gels (Rx = 0.5) and on agar gels (anodic migration). It sediments in the 4S region in sucrose gradient containing 0.4 M KCl. Its complex with testosterone dissociates very slowly (t 1/2 = 29 h at 0 degrees C), and is destroyed by heating at 50 degrees C for 30 min and by pronase. Its relative affinities for steroids are 5 alpha-DHT greater than T greater than 5 alpha-androstanediols greater than cyproterone acetate greater than estradiol greater than progesterone. The number of binding sites is limited (about 20 fmoles/mg protein) and the apparent equilibrium dissociation constant (KD) is 5 x 10(-9) M.


Sequence complexity of bovine pituitary poly(A)RNA.

Poly(A)RNA extracted from the anterior lobe of bovine-pituitary tissue was transcribed into its complementary DNA with reverse transcriptase. This 3H-labeled cDNA was hybridized with its template RNA. Hybridization kinetics revealed at least 3 abundance classes with the highest abundance class consisting of only a few different sequences. Bovine-liver poly(A)RNA did not contain this highest abundance class when hybridized to the cDNA probe complementary to pituitary poly(A)RNA. This result suggested that the highest abundance class found in bovine-pituitary poly(A)RNA was specific for that tissue and most likely contained the mRNA sequences for the major pituitary hormones.


Effects of urine from pregnant and lactating female house mice on sexual maturation of juvenile females.

The effects of urine from pregnant and lactating female/mice on puberty in young females were examined. In Experiment I urine from pregnant or lactating females painted daily on the external nares of young females led to earlier sexual maturation than treatment with water or urine from singly-caged, nonlactating, multiparous adult females. In Experiment II urine from either pregnant or lactating females, injected daily into perforated plastic capsules containing cotton, effected earlier maturation in female mice caged with these capsules than did the urine of singly-caged females or water. In Experiment III the effectiveness of these treatments on reproduction per se was confirmed: young females reaching maturity earlier as the result of urine treatments were in fact ovulating and were capable of conceiving and bearing young. One explanation for the presence of the urinary pheromone(s) involves changes in hormone levels during pregnancy and/or lactation and urinary excretion levels of hormones, hormone metabolites, or chemical compounds which are hormone dependent. The pheromone excretion, triggered by external factors, may be a general signal to other females that environmental and/or social conditions are favorable for reproductive activities.


Developmental changes in the suckling behavior of hamster pups: a comparison with rat pups.

The suckling behavior of hamster pups was observed to undergo several transitions during the preweaning period. Pups 10 days of age and younger attached to the nipples of their anesthetized mothers and suckled. After 10 days of age, however, only animals which had been deprived of suckling (and food and water) reliably attached to their mothers' nipples. By 25 days of age, deprived pups no longer suckled. The pattern of response after nipple attachment also changed during development: pups younger than 5 days of age remained on 1 nipple after initial attachment, whereas older pups shifted from 1 nipple to another. The development of suckling in hamster pups resembles that in rat pups, although certain changes or transitions occur at different ages in the 2 species. These changes may provide important markers for neural and behavioral development in each species and for comparisons between the two.


Sleep-waking patterns in hypoxic kittens.

Kittens at 10, 20, and 40 days of age were made intermittently hypoxic in 10 or 7% oxygen chambers for either 3 or 8 days. Respiration, EKG, EEG, and neck and eye movements were recorded during hypoxia. Compared to 21% oxygen controls, hypoxic kittens had fewer and shorter epochs of active sleep, and longer epochs of quiet sleep. Some hypoxic kittens exhibited slow and labored respiration during quiet sleep and transitional epochs, which reversed during active sleep. Kittens that showed most pronounced respiratory changes or died had less active sleep than kittens that compensated adequately and survived. These results suggest that active sleep may be important for stimulation of respiration during infancy. Suppression of active sleep, augmentation of quiet sleep, or other disturbances to normal sleep-waking patterns during hypoxia, may increase the risk for hypoxic respiratory depression and death.


Sleep apnea in hypoxic and normal kittens.

Frequency and characteristics of apneas were studied in 10-, 20-, and 40-day old kittens during several days of exposure to 21%, 10%, or 7% oxygen atmospheres. Ninety-seven percent of all apneas occurred during sleep or at transitions between sleep and waking states. Hypoxic kittens, compared to controls, had greatly decreased apnea frequency, but other characteristics of apneas did not differ significantly. Apneas in both control and hypoxic kittens were normal, stereotyped events and were not considered to represent pathological processes. Evaluation of events preceding apneas indicated that a majority of apneas followed augmented breaths and/or brief arousals. We suggest that apnea, heart rate changes during apnea, and frequently concurrent transitions in sleep-waking state may be causally related to these pre-apnea events. The results of this study and a parallel study of human infants suggest that below-normal apnea frequency may indicate hypoxemia and may be associated with higher risk for Sudden Infant Death Syndrome.


Development of tonic immobility in the rabbit: relation to body temperature.

Tonic immobility was studied in rabbit pups varying in age from 1 to 30 days. During the 1st 2 postnatal weeks the rabbits were active in an open field, had difficulty walking and executing a righting response, lost body temperature rapidly, and had no, or only short durations of, tonic immobility. After this age they were less active, hopped and righted well, maintained core temperature, and showed increased durations of tonic immobility. Within the 1st 2 postnatal weeks cooling and warming potentiated; thereafter, cooling disrupted and only warming potentiated tonic immobility. The results suggest that rate of heat loss can act as a stimulus to block tonic immobility and increase activity in neonatal rabbits. With development, cooling produces shivering which can disrupt tonic immobility, whereas warming may raise movement initiation thresholds which can potentiate tonic immobility.


Lateral differences and head-turning responses to somesthetic stimulation in premature human infants.

Head-turning responses to somesthetic stimulation of the perioral region were studied at weekly intervals in 25 prematurely born infants. No regular changes associated with age were evident. The premature infants were more likely to turn towards than away from a stimulus; however, they were less so than are full-term infants. The infants were as likely to turn towards the stimulus when it was on the left as when it was on the right; however, they were more likely to turn away from a stimulus on the left than on the right. Comparisons with full-term infants indicated reduced lateral differences in responding. Such a reduction is in sharp contrast with the previous finding of marked postural asymmetry in a comparable sample of prematurely born infants. These data indicate a possible sequence in the development of head-turning responses to somesthetic stimulation and the assumption and maintenance of an asymmetrical head posture which consists of (1) a right-turning postural bias, (2) contralateral responding to somesthetic stimulation, (3) lateral differentiation of contralateral responding, (4) ipsilateral responding, and (5) lateral differentiation of ipsilateral responding.


Emergence of spontaneous alternation in the kitten.

Two studies are reported that describe the development of spontaneous alternation in the kitten. The first indicates that 3- and 4-week-old kittens do not alternate whereas animals 5 weeks and older do alternate. The second suggests that inability to discriminate maze arms is an unlikely explanation for the lack of alternation among the youngest animals. The approximate simultaneity between the onset of alternation (described here) and the maturation of the kitten hippocampus (described by others) is taken as support for the notion that hippocampal maturation may be related to the development of spontaneous alternation.


Developmental changes in open-field behavior in the kitten.

Seventy-eight kittens from 3 to 7 weeks of age were studied in an open-field arena. Three major age-dependent changes were noted: (1) the number of floor squares entered was markedly higher for 5- and 6-week-olds than for younger animals, and slightly lower for 7-week-olds than for 5- and 6-week-olds; (2) the tendency to backtrack from 1 square to a just-vacated square decreased with age, the largest change occurring between 4 and 5 weeks of age; (3) the within-session decrement in locomotion was largest for 3-week-old kittens but was smallest for 4-week-olds and increased monotonically with age thereafter. The results suggest a possible role of hippocampal maturation.


Effectiveness of insulin therapy on altered renal calcium transport in diabetic rats.

The uptake of 45Ca was measured in slices of kidney cortex from normal rats, streptozotocin-diabetic rats, and streptozotocin-diabetic rats treated early and late with insulin. Insulin therapy was performed such that blood glucose levels were controlled in half the treated diabetic animals but not in the others. Considerably earlier than evidence of nephropathy (i.e., proteinuria and increased BUN levels) in streptozotocin-diabetic rats, there was a significant decrease in active uptake of calcium by the kidney. Insulin therapy, begun immediately upon diagnosis of diabetes, maintained normal calcium transport even when blood glucose levels were not controlled. On the other hand, insulin therapy, begun 1 mo after diabetes was confirmed but before evidence of nephropathy, did not restore calcium transport to normal whether or not blood glucose was controlled. We conclude that this biochemical mechanism, which possibly may be implicated in the pathophysiology of diabetic nephropathy, is clearly influenced by duration of insulin deficiency and not by the degree in hyperglycemia.


Genetic selection for diabetogenic traits in Yucatan miniature swine.

Yucatan miniature pigs have been selectively bred for reduced and increased glucose clearance during an intravenous glucose tolerance test. Pigs with low glucose clearance rates (low K) have been selected through the F-5 generation. They have a significantly reduced rate of glucose clearance and a blunted peripheral IRI increase in response to the challenge. Through the F-5 generation, heritability of glucose tolerance is estimated at 0.26. Sporadic fasting blood glucoses in excess of 100 mg/dl are seen in later generations of this group. High glucose clearance pigs (high K) have been selected through the F-4 generation. They have significantly increased rates of glucose clearance and a greater increase in peripheral IRI than the low K animals. The estimated heritability for high K through the F-4 generation is 0.31. No evidence of fasting hypo- or hyperglycemia has been seen in the high K animals.


Physiologic responses of juvenile-onset diabetic boys to muscular work.

The cardiorespiratory and metabolic responses of juvenile-onset diabetic (Dia) and nondiabetic (Con) boys to light, moderate, and maximal treadmill work were investigated. No significant differences were observed between the Dia and Con subjects in cardiorespiratory responses to maximal and submaximal work. The mean values for the Dia boys during maximal treadmill work for ventilatory volume, oxygen uptake, heart rate, and lactic acid were 91.5 L/min, 54.9 ml/kg . min, rate, and lactic acid were 91.5 L/nin, 54.9 ml/kg . min, 198 beats/min, and 7.0 mM/L, respectively. In the Dia boys, maximal-, light-, and moderate-intensity work produced significant plasma glucose decreases (P less than 0.05) of 1.64, 3.23, and 7.2 mM/L, respectively. In the Con boys, the submaximal work bouts were performed without significant change in plasma glucose levels, but glucose levels after maximal work were elevated 1.58 mM/L. Light and moderate work in both groups produced no changes in plasma triglycerides, free fatty acids, or lactic acid. However, for the Dia boys, maximal work was associated with a significant increase of 0.36 mM/L in triglycerides.


Comparison of a colorimetric assay for glycosylated hemoglobin with ion-exchange chromatography.

Because levels of glycosylated hemoglobin (GHb) are increased in diabetes and reflect the previous metabolic control, clinicians and clinical investigators are finding increasing applications for measurements of GHb in diabetic patients. We report the characterization of a colorimetric assay procedure for GHb and compare its performance with that of a commonly used assay by ion-exchange chromatography. Although results of GHb determination by both methods correlate highly (r = 0.946, P less than 0.001), the two procedures estimate different glycosylated fractions. The colorimetric procedure is nonstoichiometric, requiring careful standardization of assay conditions, including the concentration of total hemoglobin in the assayed aliquot, to achieve precision and permit comparison of results. We characterized the effect of storage of hemolysates or packed erythrocytes on the subsequent determination of GHb by both methods. Determinations of GHb by the colorimetric method, but not by column chromatography, are reproducible on hemolysates or packed erythrocytes on the subsequent determination of GHb by both methods. Determinations of GHb by the colorimetric method, but not by column chromatography, are reproducible on hemolysates or packed erythrocytes stored frozen for at least 5 mo. A unique advantage of the colorimetric procedure is the capability to estimate GHb levels when variant hemoglobins, including fetal and sickle hemoglobins, are present.


Insulin-potentiating action of a synthetic amino-terminal fragment of human growth hormone (hGH 1--15) in streptozotocin-diabetic rats.

The hypoglycemic activity of the synthetic peptide fragment of human growth hormone, hGH 1--15, is insulin dependent, although it does not alter the circulating levels of plasma insulin in normal and diabetic rats. In severe diabetes induced by streptozotocin, the peptide had no effect on the basal levels of blood glucose, but enhanced insulin sensitivity during intravenous insulin tolerance tests in 16-h-fasted rats. Radioreceptor binding studies show increased binding of insulin by hepatic plasma membranes prepared from rats pretreated with hGH 1--15. These results suggest that the biologic action of the peptide is, at least in part, on insulin receptors of plasma membranes.


Higher levels of erythrocyte membrane microviscosity in diabetes.

Significantly higher levels of erythrocyte membrane microviscosity (MV) [n-: 5.22 +/- 0.17 (4.70--5.92), mean +/- SD (range), poise, N = 67, P less than 0.005] measured by fluorescence depolarization using 1,6-diphenyl-1,3,5-hexatriene as a fluorescent probe were found in diabetic patients when compared with normal controls [5.05 +/- 0.15 (4.70--5.29), N = 22]. No significant differences in MV existed between males and females, nor was MV significantly correlated with diabetic age, duration of diabetes, plasma cholesterol, cholesterol/phsopholipid ratios, and plasma lecithin:cholesterol acyltransferase activities. No significant difference in MV was observed between groups with or without diabetic retinopathy. There was, however, significantly higher MV [5.29 +/- 0.19 (5.00--5.92), N = 20, P less than 0.05] in the group with fasting blood glucose (FBG) greater than or equal to 140 mg/dl than that [5.19 +/- 0.15 (4.70--5.46), N = 47] in the group with FBG less than 140 mg/dl. The changes in erythrocyte membrane MV presented in this study appear to be related to the current metabolic control of diabetic patients and are considered to be one of the factors responsible for the reduced erythrocyte deformability in diabetes.


Gastric inhibitory polypeptide enhanced lipoprotein lipase activity in cultured preadipocytes.

Fat feeding stimulated the release of gastric inhibitory polypeptide (GIP) without concomitant insulin secretion. Since antilipolytic effects of GIP have been demonstrated and the uptake of triglyceride fatty acid by adipose tissue postprandially is a process reciprocally regulated with lipolysis, a stimulatory role of GIP on adipose tissue lipoprotein lipase activity may be present. After cultured preadipocytes were incubated for 2 h with GIP, the release of lipoprotein lipase activity into the culture medium and the total cellular activity present in acetone-ether powders of cells were measured. GIP stimulated significant increases in the lipoprotein lipase activity released into the culture medium and in cells. A dose response relationship was strongest for the effect of GIP on the enzyme activity in extracts of acetone-ether powders of the cells. The increased lipoprotein lipase activity produced by GIP could provide a mechanisms for clearance of chylomicron triglyceride after feeding in man.


Knee flexion deformities and genu recurvatum in cerebral palsy: roentgenographic findings.

Patients with cerebral palsy often have recurvatum or flexion deformities at the knee. To determine whether these are due to a bony or soft-tissue abnormality, four angles were measured on lateral roentgenograms of the knee: the femur-physis angle (angle 1); femur-Blumensaat's line angle (angle 2); tibia-plateau angle (angle 3); and tibia-physis angle (angle 4). These angles were measured for 45 patients with knee flexion deformities and for 31 with genu recurvatum. Values were also obtained from 204 normal lateral knee reoentgenograms. The age range for the whole series was from one to 22 years. Angles 2, 3 and 4 decreased from normal values with increasing age. The angulation of the proximal tibia, as measured by angle 3, is abnormal in patients with flexion deformities. Angles 2 and 3 were abnormal in cerebral-palsied patients with flexion deformities, while patients with genu recurvatum showed no significant bony abnormalities. These results suggest that treatment of flexion and recurvatum should be based on etiology.


Normal development and ear effect for contralateral acoustic reflex in children six to twelve years old.

This study investigated the acoustic reflex, which uses the ventro-medial brain-stem system, to determine laterality superiority with respect to age, sex, dominance for handedness, and their various interactions, 54 normal children and 21 normal adults were evaluated. No major effects for age, sex or handedness for the reflex were found, but the right ear appeared slightly more sensitive to broad-band white noise stimuli than the left, regardless of handedness. An age-handedness effect was also present which suggested that left-handed children mature differently from right-handed children in the acoustic reflex. Data on adults were inconclusive as to whether this maturity effect carried over into adulthood. The findings suggest that there was a laterality effect for the acoustic reflex using the ventro-medial brain-stem, which was thus brain-stem related rather than cortex-level related.


Separation at birth and the mother-child relationship.

Mother-child relationships were investigated between: (a) 32 mothers and their singleton children with birthweights of 2000g or less who had been separated immediately after birth for a minimum period of 17 days (index families), and (b) 32 control mothers and their singleton children, matched with index cases for type of residence, sex and month of birth, but who had not been separated at birth and whose birthweights were 2700g or greater. From interview, validated by questionnaire and semantic differential scoring, six of the index mothers, but none of the control mothers were assessed as having rejected their children. Comparisons were made between rejected and non-rejected index children. Rejection occurred more commonly in the low-birthweight group if the mother had been a teenager at the birth of her first child or of the study child, especially if she had not planned or wanted the pregnancy. The mothers of rejected children tended to have had poor relations with their own fathers, were unhappy with their life-style, and perceived their children as having difficult or unlikeable personalities. The rejected children were more likely to have had poor health, severe temper tantrums, and to cause their mothers concern over their poor appetite.


Long-term outcome in children with temporal lobe seizures. III: Psychiatric aspects in childhood and adult life.

One hundred children with temporal lobe epilepsy were followed into adult life. 85 per cent had had psychiatric problems in childhood. The occurrence of overt psychiatric disorder in adult life was low: of those survivors who were not gravely mentally retarded, 70 per cent were regarded as psychiatrically healthy. Overt schizophreniform psychosis has developed in 10 per cent of survivors. Males with continuing epilepsy and left-sided foci were at special risk: 30 per cent of such patients had become psychotic. No patient coded as having a right-sided focus in 1964 had become psychotic by 1977. Though 26 patients had had grossly disordered childhood homes, this factor had no significant relation to adult psychiatric disorder. Antisocial conduct marked the adult life of 12 patients. Their childhood codes showed that male sex, a focus contralateral to the preferred hand, and unremittent epilepsy marked this group. Low intelligence and childhood rages were also prominent. Treated neurotic and depressive illness was quite uncommon. Only five survivors have fallen into this category. Those patients escaping psychiatric ill-health are often notably extraverted and successful.


Functional studies in patients with the glucagonoma syndrome.

Four patients with glucagon-producing tumours of the pancreas were investigated. Fasting plasma glucagon concentrations ranged from 209--625 pmol/l. Plasma insulin concentrations were normal except in one patient, where the tumour also produced insulin (558 pmol/l). Intravenous glucose (25 g/m2) depressed the glucagon concentration in two patients, while no change was noted in the others. Intravenous arginine stimulated glucagon secretion in three patients, but not in the fourth. Intravenous somatostatin suppressed glucagon secretion in all three patients investigated. All patients had abnormally low plasma levels of individual amino acids; glucogenic and branched-chain amino acids were equally depressed. Surgical removal of the tumours led to complete recovery from dermatosis and the glucagon levels were normalized. Postoperative tests were performed in three patients. The alpha-cell responsiveness to iv glucose was restored. Glucose tolerance (Kg-value) was improved in one patient (0.73 to 1.65), persistently low in one patient (0.75 to 0.72) and impaired in the third patient (1.35 to 1.09). It is concluded that none of these functional tests will be of diagnostic value in cases suspected of glucagonomas. The results also show that glucose homeostasis is remarkably unaffected by the extreme hyperglucagonaemia of these patients and that hypoaminoacidaemia is an important consequence of chronic hyperglucagonaemia.


Effect of metabolic regulation on renal leakiness to dextran molecules in short-term insulin-dependent diabetics.

Renal clearance of dextran of two ranges of molecular size and glomerular filtration rate (GFR, 51Cr-EDTA) were measured in seven short-term insulin-dependent diabetics (mean age 25 years). Measurements were carried out in the same patient during good and poor metabolic regulation (plasma glucose, mean +/- SEM, 6.5 +/- 0.9 and 14.8 +/- 1.5 mmol/l, respectively). GFR was elevated in all patients during poor metabolic regulation (119 +/- 6 ml/min/1.73 m2, versus 99 +/- 2 ml/min/1.73 m2 during good control, p less than 0.01). The average renal clearance of dextran with molecular weights ranging from 25,000 to 35,000 and 35,000 to 45,000 increased during poor metabolic regulation from 14.8 +/- 0.8 to 19.8 +/- 1.8 ml/min/1.73 m2, and 5.2 +/- 0.3 to 6.8 +/- 0.6 ml/min/1.73 m2, respectively (p less than 0.05). The elevated GFR and renal dextran clearance found during poor metabolic regulation were normalized within one to three weeks of effective insulin treatment. This rapid reversibility can hardly be explained by the previously demonstrated enlargement in glomerular size and filtration surface area, since these alterations remain unchanged after more than one month of insulin treatment. The metabolic regulation did not influence the size-selective properties of the glomerular wall. Therefore, we suggest that the dominating mechanism involved in the GFR and renal dextran clearance alterations is functional, viz. increased filtration pressure.


Antitumor activity of marine bacteria, Vibrio anguillarum, in mice.

Antitumor activity of marine bacteria, Vibrio anguillarum P-B-1, against Ehrlich carcinoma cells in ddY mice was investigated. Ehrlich carcinoma cells were inoculated intraperitoneally (ip) into mice and V. anguillarum (1.0 mg/mouse) was administered ip twice before and 4 times after the tumor inoculation. Groups of mice administered V. anguillarum survived 80 approximately 90% and their mean survival was 54.0 approximately 56.0 days (range, 24.0 approximately 60 days) at day 60 after inoculation of 10(4) to 10(6) tumor cells against the mean survival of 16.4 approximately 22.3 days (range, 7 approximately 26) in the control group. When 2 x 10(6) tumor cells were inoculated subcutaneously (sc) mixed with 1.0 mg of V. anguillarum, the bacterial cells markedly suppressed the growth of tumor at the injection site; tumor did not grow in 30% of recipient mice and the inhibition rate of grown tumor in the rest of recipients was 69%. The consistently demonstrable antitumor activity of V. anguillarum was reduced by pretreatment of mice with immunosuppressants such as anti-thymocyte serum, hydrocortisone, or irradiation of X-ray. This fact indicates that the antitumor activity of V. anguillarum is mediated by immune response.


Carcinomas of the liver in female mice fed toluene-2,4-diamine.

B6C3F1 female mice fed 100 or 200 ppm of the aromatic amine, toluene-2,4-diamine, developed significant number of carcinomas of the liver. The carcinomas varied from well-differentiated to poorly differentiated. Treated mice also developed hyperplastic hepatic nodules, but cirrhosis was not observed. Hyperplastic nodules, carcinomas, and cirrhosis of the liver have been described in rats ingesting toluene-2,4-diamine.


Enhancing effect of clamping of the portal vein on the effectiveness of antitumor agents against lymph node metastasis.

An experimental study was made on the suppressive effect on lymph node metastasis of an antitumor agent administered during the clamping of the portal vein. When mitomyaneously clamped, a higher concentration of the drug was detected in the mesenteric lymph nodes compared to the conventional intravenous administration. The growth of mesenteric lymph node metastasis was markedly suppressed by the combined use of mitomycin-C and portal vein clamping. These results suggest that the procedure applied in the present study directs a high concentration of antitumor preparations to the lymph nodes in the portal vein region, and thus is a good method for the suppression of lymph node metastasis.


Significance of estrogen receptor assay in cytotoxic chemotherapy in relation to previous endocrine therapy of advanced breast cancer patients.

In 36 patients with advanced breast cancer, most of whom had been subjected to major endocrine ablation therapy such as bilateral adrenalectomy, correlation between the presence or absence of estrogen receptor (ER) in tumors and response to chemotherapy was investigated. Complete or partial response was obtained in 6 of 14 (42.6%) patients with ER-positive tumors and in 3 of 22 (13.6%) patients with ER-negative tumors (P = 0.1). The response to chemotherapy was not influenced by the concentration of ER in tumors. Distribution of the duration of regression readings and the survival time was not significantly different between the patients with ER-positive and -negative tumors. Some regimens which did not include adriamycin, such as MFC (mitomycin-C, 5-fluorouracil, and cytosine arabinoside) had a good effect on the ER-positive cases, whereas the response to regimens including adriamycin was not influenced by the ER positiveness of the tumors. In the classification of some clinical parameters of the patients, response of the patients with ER-negative tumors does not seem to be better than that of the patients with ER-positive tumors. Responses to the major endocrine ablation therapy and also to the subsequently carried out chemotherapy were influenced by the presence or absence of ER in tumors before the endocrine therapy.


Keratinization of transformed epithelial cells of the rat urinary bladder: its quantification and effect of various drugs.

In vitro and in vivo transformed epithelial cells of the rat urinary bladder keratinized well on a coverslip culture. Keratinization proceeded more rapidly in in vitro-transformed cells than in in vivo-induced bladder cancer cells. The grade of keratinization was estimated from the absorption spectrum of a papanicolaou-stained specimen which afforded two peaks derived from keratinized cells and viable cells. Using this semiquantitative method, effect of various drugs on keratinization was studied on 3 lines of in vitro-transformed epithelial cells. Vitamin A and its analogs prevented the keratinization in 2 out of 3 lines at dosage over 1 micrograms/ml, but other drugs such as vitamin C, E, and K, steroid hormones, cyclic AMP, polyamines, polyanions, and dimethyl sulfoxide were ineffective for preventing keratinization. Amino acid compositions of keratinized cells and viable cells were not fundamentally different.


Quantitative measurement of intestinal marker enzymes in intestinal metaplasia from human stomach with cancer.

Intestinal metaplasia in human stomach was distinguished macroscopically into sucrase-positive and trehalase-positive areas, and sucrase-positive and trehalase-negative areas, by location of these disaccharidase activities with TES-Tape. After location of these two areas with TES-Tape, tissues were taken from them for colorimetric measurement of sucrase, trehalase, leucine aminopeptidase (LAP), and alkaline phosphatase (ALP). Results showed that in the mucosa from sucrase-positive and trehalase-negative areas, trehalase activity was not detectable and the activities of sucrase, LAP, and ALP were lower than in sucrase-positive and trehalase-positive areas.


Potentiation of L1210 murine leukemia vaccine in vivo by levamisole.

Intraperitoneal inoculation of either levamisole or 2 x 10(6) cells of concanavalin-A (Con-A)-bound L1210 leukemia vaccine produced no cured mice after subsequent ip inoculation of 10(3) live L1210 cells. Combined inocluation of levamisole and Con-A-bound vaccine produced about 20% cure incidence but no prolongation of life span of tumor-bearing mice after inoculation of live L1210 cells. Combined inoculation of levamisole and Con A-free vaccine did not induce detectable immune resistance in mice. These results suggest that levamisole enhanced host response to cell-bound Con-A associated with immunogenic potency of the vaccine. Levamisole given intravenously and orally was as effective as that inoculated intraperitoneally in enhancing the induction of resistance in mice by Con-A-bound vaccine. Dose of levamisole was very critical for this enhancement, being effective at 0.38 mg/kg but not either at 0.75 or 0.19 mg/kg. Furthermore, levamisole restored immune resistance induced by a larger inoculum of Con-A-bound vaccine cells (10(7)) and impaired by cyclophosphamide.


Effect of aging on the development of gastric cancer in rats induced by N-methyl-N'-nitro-N-nitrosoguanidine.

This experiment was carried out to see the effect of aging on the induction of gastric carcinoma in rats by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Three groups of rats of 3 different ages, 6, 20, and 40 weeks old, were used. Comparison of incidence of gastric carcinoma in these groups revealed a significant difference. Tumor incidence of the gastrointestinal tract of rats were 94.7, 73.8, and 48.8%, resepctively, at 6, 20, and 40 weeks of age. The  incidence of adenocarcinomas of glandular stomach was also significantly decreased with the advance in age. However, there was a significant difference in the intake rate of MNNG per gram body weight between the young (6 weeks of age) and old rats for the first 25 weeks during the experiment which may account for the difference in tumor incidence between young and old rats. However, even when the young rats were administered a decreased amount of MNNG, same as that in old rats, they also showed higher incidence. From these results, it was concluded that the amount of MNNG ingested was not responsible for the decreased incidence of gastric adenocarcinoma in older rats. Aging might be the primarily the cause of low incidence.


Variation of two forms of DNA polymerase-alpha during a HeLa cell cycle.

HeLa cells contain two forms of DNA polymerase-alpha (P-I and P-II) with varied affinity to DNA, separable on a DNA-cellulose column. The activity of each form was followed during a cell cycle of synchronized culture of the HeLa cells. P-I was recovered from the nuclear extract and P-II from the cytoplasmic fraction. The P-I activity remained at a low level during M to G1 phase until a marked increase between late G1 and S phases, while P-II activity increased gradually throughout the period. Both activities attained their highest level at mid-S phase and then the P-I activity declined more rapidly than the P-II. Addition of hydroxyurea at mid-S phase inhibited the decrease of both enzyme activities. The enzyme activity of nuclear extract from S phase cells was not inhibited by mixing with extract from M phase cells. When the cytoplasmic fraction from M phase cells was chromatographed on a DNA-cellulose column, single activity peak was observed at the position of P-II. These results suggest that the decrease in P-I activity is neither due to the presence of an inhibitor nor to mere release of the enzyme from chromosomes.


Long-term experiment of maximal non-carcinogenic dose of dimethylnitrosamine for carcinogenesis in rats.

Studies were made on the maximal non-carcinogenic dose of dimethylnitrosamine (DMN) in rats. Groups of Wistar strain rats of both sexes, 6 weeks old, were given standard diet without DMN (group 1), or containing 0.1 ppm DMN (group 2), 1.0 ppm DMN (group 3), or 10 ppm DMN (group 4) for 96 weeks and then sacrificed for hematological, serum-biochemical, and histopathological examinations. After 96 weeks, the weights of the body and main organs in the different groups were not significantly different. The leucocyte count and blood urea-nitrogen (BUN) in group 4 were slightly increased, but other serum findings were not significantly different in different groups. Hepatocellular carcinomas were found in group 3 (1 male and 3 females), but not in group 2. Hemangioendotheliomas of the liver, adrenal adenomas, pituitary adenomas, interstitial cell tumors of the testis, ovarian tumors, and leukemia were also found. Pyelonephritis was found in both experimental and control animals, but no kidney tumors developed with these dose levels of DMN. These results show that on long-term oral administration to rats, 1.0 ppm DMN is the minimum carcinogenic dose, while a level of about 0.1 ppm DMN is non-carcinogenic.


Leucocyte-like motility of cancer cells, with reference to the mechanism of extravasation in metastasis.

The movement of rat ascites tumor cells of AH66F and Yoshida sarcoma cultured in an agar medium was analyzed. Contraction occurred at the frontal fringe of each cell, and the cytoplasm and nucleus seemed to pass through the site of contraction. Morphological changes observed were similar to that of the leucoycte.


Obstructive jaundice due to congenital stenosis of the ampulla of Vater.

Two infants who had obstructive jaundice due to congenital stenosis of the ampulla of Vater improved dramatically with sphincteroplasty. In one, the jaundice was complicated by hepatocellular dysfunction and mild biliary cirrhosis. Only a few cases of such an anomaly have been reported, mostly with different modes of clinical presentation.


A comparative study of esophageal varices by endoscopy and percutaneous transhepatic esophageal phlebography.

Twenty patients with portal hypertension due to cirrhosis were examined by esophagoscopy and percutaneous transhepatic esophageal phlebography. Esophageal varices were found in 18 cases at endoscopy and in 19 cases at esophageal phlebography. There was little correlation between the findings of the two methods with respect to the size and number of esophageal varices. At endoscopy the subepithelial and submucosal varices were reliably detected. At esophageal phlebography differentiation between intrinsic (i.e. subepithelial and submucosal veins) and peri-esophageal veins was not possible. Negative findings at esophageal phlebography do not rule out esophageal varices.


Use of tolazoline enahanced superior mesenteric arteriography to improve opacification of a cecal vascular ectasia: a case report.

The use of vasodilators to enhance venous opacification during superior mesenteric arteriography is well established. This is a report on the use of intra-arterial tolazoline hydrochloride during angiography to improve opacification of a cecal vascular ectasia which was poorly demonstrated on an arteriogram performed without tolazoline.


Mediastinal pancreatic pseudocyst.

The extension of a pancreatic pseudocyst into the mediastinum is a difficult clinical and radiographic diagnosis. The chest roentgenogram reveals a retrocardiac mass in a patient with nonspecific upper abdominal and chest complaints. Usually there is a preceding history of alcoholism or pancreatitis. The upper gastrointestinal series often demonstrates typical displacement of the distal esophagus anteriorly and to the left. The value of computed tomography is illustrated. Correct preoperative diagnosis is important for proper surgical treatment, since a mediastinal pseudocyst is best managed without thoracotomy.


Zollinger-Ellison syndrome presenting as esophageal stricture.

A case of Zollinger-Ellison syndrome in an elderly man who presented with dysphagia and subsequently developed esophageal stricture is described. This is an infrequent concomitant of the Zollinger-Ellison syndrome, especially as a presenting complaint. The literature on esophageal involvement in the Zollinger-Ellison syndrome is briefly reviewed.


Texture patterns in pancreatic sonograms.

In a retrospective study of 163 pancreatic sonograms, five internal echo patterns were correlated with the ultimate clinical diagnoses. Attention to the internal echo patterns of the pancreas can provide useful information in diagnosing pancreatic disease, including identification of abnormalities in glands of normal size and contour.


Ultrasound detection of a carcinoid tumor.

The intraluminal component of symptomatic malignant carcinoid tumors of the small bowel is typically small relative to the extension in the mesentery, and barium examinations are occasionally normal. This case report illustrates the diagnostic value of abdominal ultrasonography in the detection of extraluminal component of a carcinoid tumor.


Ultrasonographic-pathologic correlation of malignant hepatic masses.

Characterization of the source of hepatic malignancy would be useful in directing a patient's workup, saving time and expense. We attempted to correlate the echographic appearance of malignant hepatic masses with the pathologic (44 patients) or clinical (1 patient) diagnosis in 45 consecutive patients scanned to evaluate this problem. In 31 patients the lesions were hyperechoic (28) or predominantly hyperechoic with central lucency. Of these lesions, 25 represented metastases from adenocarcinoma of the colon (17), pancreas (6), or unknown origin (2). Six patients with metastatic adenocarcinoma had predominantly echolucent lesions. Of the 14 malignancies of other histologic types, 6 were largely hyperechoic and could not be distinguished from adenocarcinoma metastases. No correlations could be drawn between the ultrasound patterns and the tumor source in this diverse group fo malignancies. In eight patients receiving chemotherapy, sequential examinations failed to reveal any alteration in the echographic patterns of their lesions. These results indicate that the ultrasound appearance of hepatic malignancy lacks specificity in defining the organ of origin. Such factors as homogeneity, vascularity, or desmoplastic response may be more important than cell type in producing the echographic pattern.


Percutaneous transhepatic insertion of a permanent endoprosthesis in obstructive lesions of the extrahepatic bile ducts.

A Teflon endoprosthesis for permanent bile drainage was inserted in 13 patients following percutaneous transhepatic puncture and catheterization of the bile duct system. Twelve patients had extrahepatic cholestasis because of a malignant tumor, whereas one patient had chronic inflammation involving the hepatoduodenal ligament (secondary to Crohn's disease) with obstruction of the extrahepatic bile ducts. The drainage periods varied from 1 week to 8 months. The endoprosthesis was regarded as partially effective in seven patients whereas in six cases the drainage through the endoprosthesis was insufficient and external bile drainage through a percutaneous transhepatic catheter was necessary. Infection of the bile duct system during the drainage period with a percutaneous transhepatic catheter and/or bile duct endoprosthesis occurred in 10 patients. Spontaneous dislocation of the endoprosthesis occurred in varying degrees in five patients. One patient developed an intrahepatic aneurysm adjacent to the puncture tract and died because of liver insufficiency following therapeutic embolization of the aneurysm and most of the hepatic arteries by injection of gelfoam particles into the common hepatic artery. Patients in whom palliative treatment by insertion of a permanent bile duct endoprosthesis may be suitable were defined.


The small liver: a radiographic feature of fatal neonatal cirrhosis.

Newborns with neonatal cirrhosis may have confusing clinical pictures. The demonstration of a small liver on abdominal radiographs may be helpful in suggesting the diagnosis of intrauterine hepatic damage.


Gastrointestinal mucormycosis.

Mucormycosis is an acutely malignant fungal disease causing local thrombosis and infarction. Gastrointestinal infection most commonly occurs in diabetics or in the immunologically compromised. This case demonstrates the radiological appearances of the gastrointestinal lesion and prolonged survival with amphotericin-B therapy.


Superficial lesions in Crohn's disease of the small bowel.

Double-contrast examinations of the small bowel were compared with operative specimens obtained within 4 weeks after X-ray evaluation of 20 patients with Crohn's disease. Objective evidence of superficial lesions was submucosal edema and superficial ulcerations observed in the operative specimens. Edema was seen radiographically in 18 of 20 patients. Superficial ulcerations were seen radiographically in 8 of 14 patients. These ulcerations were either single with edematous edges or smaller, multiple, and more uniformly spread. The diagnosis demands a high-quality technique and even then the diagnostic accuracy is not always optimal.


Extent of inflammatory lesions in ulcerative colitis assessed by radiology, colonoscopy, and endoscopic biopsies.

Radiography of the colon with double-contrast technique was performed directly after total colonoscopy with multiple biopsies in 50 patients with ulcerative colitis. In two-thirds of the series the inflammatory lesions were found to be more widespread at colonoscopy than on radiography. Signs of colitis in an even larger part of the bowel were found on examination of the biopsies in half of the cases. The distribution of characteristic inflammatory changes seen at colonoscopy was also studied. The frequency of the lesions was found to be relatively low in the rectum and highest in the descending and sigmoid parts of the colon.


A complicated case of aortoduodenal fistula.

Aortoduodenal fistula may occur primarily as a complication of abdominal aortic aneurysm or secondarily after reconstructive surgery of the abdominal aorta. The clinical presentation may be occult, with the classic triad of mass, pain, and bleeding inapparent or overshadowed by signs of infection. A high index of clinical suspicion combined with radiographic and endoscopic examinations will establish the diagnosis.


[Surgical treatment of tubal sterility macrosurgery versus microsurgery? (author's transl)].

Results of surgical treatment of tubal sterility obtained via "microsurgery" are compared with those of "microscopic microsurgery", as far as it is possible at this stage. Preliminary resumé: Microscopic technique obviously produces better results in reanastomoses after sterilisation, whereas in the case of salpingostomies the results are similar to those obtained via "macroscopic microsurgery".


[Serum ribonuclease activity in patients with gynaecologic malignomas (author's transl)].

The aim of our work was to evaluate the diagnostic value of the determination of the ribonuclease activity in sera of patients with gynaecologic malignomas. We therefore developed an assay for ribonuclease activity. In the course of optimization of the assay conditions we investigated the applicability of 4 commercially available RNA-preparations as substrate and the dependency of the ribonuclease activity on salt-concentration. The ribonuclease activity of 42 representative female patients (12 controls, 11 with ovarian carcinoma, 10 with corpus carcinoma, 9 with collum carcinoma) is presented.


[The transvaginal pudental block for delivery with the jet injector (author's transl)].

A new method of transvaginal pudental block is described with a carbon dioxide jet-injector. During the second stage of labor and good anaelgesia of the perineum was obtained in 119 of 125 cases. No side-effects or complications were noted although the amount of local anaesthetic used was only 3 ml. for each side.


[Papillary adenofibroma of the uterus: fact or fancy? (author's transl)]].

This report deals with the morphological findings in the uterus of a 40 yrs old premenopausal woman, who complained of vaginal bleedings. Macroscopical and microscopical examinations revealed a hernia-like prolaps of a part of the wall of the tuba uterina across a hole in the myometrium of the fundus uteri. Vellios et al. (1973) describe a similar lesion but without paying attention to the prolaps of the tuba uterina into the cavum uteri. They interpretate the lesion as a papillary adenofibroma of the uterus and believe it to be the benign counterpart of the mixed mesodermal tumor of Müllerian duct origin. Based upon our histological findings we believe in a dysontogenetic or traumatic etiology of this rare lesion. The diagnosis of a papillary adenofibroma of the uterus therefore should only be made when the uterus and the adnexa in toto are available for histological examinations.


[Investigations into the hormonal regulation of the corpus luteum function in the human (author's transl)].

In estradiol micro-crystalline suspension was injected into the ovary containing the corpus luteum in women who underwent hysterectomy. The same complete luteaolysis is in women who did not have hysterectomies was obtained. The conclusion is drawn that the prostaglandins which are formed in the uterus have no influence in man on the regulation of the survival of the corpus luteum. As far as we know to date the high excretion of estradiol from the corpus luteum during the maturation of the corpus luteum forms an internal shuttle mechanisms for the survival of the corpus luteum which inhibits the biosynthesis of progesterone by estrogen and blocks the effect of the gonadatropins on the granulosa cells.


[Transitory increase of the thyroid stimulating hormone in the newborn after polyvinylpyrrolidon-iodine application during parturition (author's transl)].

A vaginal Polyvinylpyrrolidon-iodine application was carried out in 120 patients as a prophylaxis against infection. In nine infants there was an increase in the thyroid stimulating hormone, which disappeared after a few days. The possibility of a decrease in the conversion of 1-thyroxine to 1-triiodothyronine when there is an increase of r-triiodothyronine which cannot block the thyroid stimulating hormone sufficiently is discussed.


[On the incidence of knots in the umbilical cord (author's transl)].

The mechanisms of the development of knots in the umbilical cord are described. The different types of knots are enumerated. The causative factors for the development of a knot in the umbilical cord are discussed. This paper is based on a statistical evaluation of the deliveries of the Maternity Hospital of the University of Bonn from 1967-1970. These data have been adopted from the Author's M.D. Thesis of 1972. At the end of the paper the comparative anatomy of the umbilical cord complications is discussed.


[Labor and delivery, fetal and maternal risk following cerclage. A comparative study (author's transl)].

In a comparative study of the course of pregnancy and delivery of 357 patients who delivered live infants between 1966-1976 following cerclage operation were compared to a control group of 380 without cerclage who were matched in age, parity and delivery time to the group under study. The high prematurity rate in the pregnancies preceeding the cerclage of 28.4% decreased following the cerclage to 16.8% (p less than 0.001). The perinatal mortality was reduced from 21.5% to 5.6% (p less than 0.001). This effect was especially achieved by the lower incidence of deliveries of infants with a birth weight of less than 1500 grams (p less than 0.05). The difference to the controls regarding prematurity (8.2%) and perinatal mortality (1.6%) remained significant (p less than 0.001). An increased rate of malformations in the cerclage children was not noticed. The maternal risk is low and consists mainly of a increase of cervical lacerations (4.9%) and problems of wound healing (2.2%). The duration of labor and type of delivery, the type of third stage of labor, and the post-partum course were not different from the control group.


[Breast biopsies which failed to show cancer (author's transl)].

A review is presented on 520 patients who had biopsies of the breast which did not show cancer between 1972-1974. These patients are compared to 304 patients whose biopsies definitely showed cancer of the breast and 520 patients who came to the hospital because of well defined gynaecological disease such as uterine fibroids or uterine prolapse. Comparison of these groups regarding age, past history, indications for the biopsy showed that patients with a biopsy without proof of cancer are difficult to follow for diagnosis. Follow-up on these patients is difficult, however, it is important since up to 4% of these patients with previous negative biopsies later have cancer of the breast. A decrease of biopsies in favor of non-surgical diagnosis of breast lesions can only be recommended under optimal conditions. Under other circumstances the risk of cancer of the breast is high enough to justify a liberal indication for breast biopsies.


[A questionnaire with a new urge-score and stress-score for the evaluation of female urinary incontinence (author's transl)].

A questionnaire with a new stress-score and urge-score is being presented, which is designed to differentiate with high statistical significancy between stress-urinary-incontinence (urethral-insufficiency with negative urethral closure pressure on sphincterometry) and urge-urinary incontinence (motor-urge-incontinence with uninhibited detrusor contractions on cystometry). With these scores we expect to facilitate the diagnostic screening, to indicate the way of therapy and to avoid unnecessary surgery for urinary incontinence in cases of motor-urge-incontinence (detrusor instability, unstable bladder), as long as a urodynamic examination is not feasible on every incontinent women.


["Portio priming" in post date pregnancies and low pelvic score (author's transl)].

In 40 pregnant women who had exceeded term and presented "immature" portio uteri a priming with prostaglandin F2 alpha was carried out. A new procedure of local application using a portioadapter was tried. This synthetic adapter was inserted over the uterine cervix by means of vacuum suction, filled with a mixture of 15 mg PG F2 alpha and methyl-cellulose ether, left in place for 6 hours and then removed. The control examination after the removal of the adapter showed a highly significant improvement of the cervical score in the nulliparae as well as in the multiparae group. In 7 cases the PG-filled adapter was inserted twice. Two cases (5%) had to be considered therapeutic failures because of insufficient cervical maturation. The method described should not be interpreted as birth induction but should be understood to be a preparation for the start of planned artificial birth.


[Plasma concentration of PGE2, PGA2 and PGF2 alpha in the course of pregnancy (author's transl)].

Plasma levels of PGE2, PGA2 and PGF2 alpha were determined by radioimmunoassay in maternal cubital vein blood of 210 women and once during pregnancy. In the course of pregnancy plasma levels of these prostaglandins varied considerably: 0,09-1,83 ng PGE2/ml, 0,12-2,8 ng PGA2/ml and 0,04-0,5 ng PGF2 alpha/ml. At term (40 and 41th week) prostaglandin levels were found to be low and within a range of: 0,15-0,25 ng PGE2/ml; 0,12-0,23 ng PGA2/ml and 0,2-0,3 ng PGF2 alpha/ml. Determination of prostaglandin levels in numerous samples from different women during pregnancy did not show continuous changes nor in the pattern of the distribution of PGE2, PGA2 and PGF2 alpha.


[Localization of ovulation by contact thermography (author's transl)].

40 patients were examined by means of ELC-contact thermography in order to demonstrate hyperemic areas over the lower abdomen in relation to cycle day and localization of ovulation. Anovulatory women showed no change in the thermic pattern on repeated examinations. However, in 75% of infertile patients with proven ovulation marked hyperemia was demonstrated over one side of the lower abdomen at the time of ovulation and during the luteal phase. In 26 out of 63 recorded menstrual cycles intermenstrual dysmenorrhea was reported which corresponded with the localization of hyperemia 19 times. This simple and noninvasive method could therefore be used to demonstrate ovulation in infertile women. If artificial insemination is indicated in a patient with unilateral tubal stenosis this procedure could be limited to those menstrual cycles in which ovulation is demonstrated on the unaffected side.


[Cytologic diagnosis of malignant melanomas of the female genital tract (author's transl)].

From 1969-1978 3 primary malignant melanomas of the vulva and 2 metastatic melanomas of the cervix were detected among 148,000 gynaecological cytosmears. Two melanomas of the vulva were diagnosed primarily by cytology because melanin was found. In the metastatic melanomas the primary site was known in one case. In the other case the primary malignancy of the skin was detected when the cytosmear from the cervix was diagnostic of matastatic melanoma. The literature and the personal experience on the possibilities of the cytological diagnosis of melanomas are discussed.


[Computertomograph detection of a postoperative iliac retroperitoneal hematoma (author's transl)].

Following the operation of the fixation of the vaginal vault by the Williams-Richardson technique a retroperitoneal hematoma was diagnosed and localized in the region of right iliac muscle using computer tomography. The patient has been under heparin therapy because of suspected pulmonary embolism.


[Isolation and characteristics of partially purified procollagen mRNA from human fibroblasts].

Procollagen 27S mRNA was isolated from heavy polysomes of human embryo fibroblasts. This RNA directed the synthesis of collagenase sensitive polypeptides in wheat germ translation system and was active in reverse transcription.


[Genetic distance of the malarial mosquitoes, Anopheles beklemishevi and Anopheles messeae (Diptera, Culiccidae), and their intraspecific polymorphism].

Allele frequencies at enzyme loci have been studied in Finnish populations of two species of the Anopheles maculipennis complex: A. beklemishevi and A. messeae. A. beklemishevi is spread over central and northern Finland, whereas A. messeae is found in southwestern and central Finland. The allele frequencies of these two species exhibit both similarities and differences. The results indicate that the two species do not interbreed in the nature. The allele frequencies at two loci--Hydroxybutyrate dehydrogenase (Hbdh) and Superoxide dismutase-2 (Su-2)--are almost totally different and adult individuals of the two species can be reliably diagnosed by these allelic differences. The genetic distance, D, between A. beklemishevi and A. messeae is 0.35. This value is compared with corresponding distances between other dipterans studied.


[Sulfalene pharmacogenetics. II. The population genetic aspect].

Half-life of sulfalen, a new antibacterial drug, with the biotransformation, performed by means of microsomal acetyltransferase, has been studied in 53 individuals of Moscow Russian population. The absence of sex dimorphism for the trait studied is demonstrated. Distribution of individuals according to values of the pharmacokinetic parameter mentioned within the population is bimodal with the correlation of phenotypic frequencies of "rapid" and "slow" inactivators--72 and 28%. Possible causes of discrepancies between the observed sulfalen inactivator frequencies and similar data on isoniazid are discussed.


[Problems in the genetics of peptic ulcer. I. The nature of the inheritance and an analysis of different forms of the disease].

The analysis of literary data on the genetic investigation of duodenal ulcer is given. The investigation proper represents the analysis of 537 pedigree probands with various forms of duodenal ulcer and of 600 families of the control group. Basing on the analysis of distribution of frequency of forms of the disease, segregation analysis, as well as the distribution of forms of duodenal ulcer depending on the sex and age of the manifestation, the discrepancy is demonstrated of the opinion that duodenal ulcer is a monogenic disease, and a conclusion is drawn about the polygen conditionality of genetic component of various forms. The data have been obtained testifying in favour of a considerable heterogeneity of the duodenal ulcer and also the importance of the contribution to the genetic factors in the realization of different forms of the disease, which are approximately 60%. Some difficulties are illustrated, arising during the analysis of multifactorial disease, and the necessity is demonstrated of accounting its certain features (e.g. sex, the age of manifestation) during the interpretation of the results obtained.


[Genetic study of the resistance of mouse somatic cells to colchicine (high resistance level)].

The studies of the high level of colchicine resistance of mouse L cells have shown that two mutagens (EMS and NMM) do not induce cell variants resistant to 8 microgram/ml of colchicine in the population of mouse heteroploid L-53 cells (subline of L cells, the level of colchicine resistance 140) and that colchicine resistance of L-53 cells gradually diminishes when cells are propagated in non-selective conditions: after 1 month it diminishes 2-fold, after 3 month--9-fold. The extent of the decrease of the drug resistance was the same in 6 independent cultures obtained from the inoculum of 200 cells and in control cultures propagated by large quantities of cells. These data coincide with the results of the previous studies of lower level of colchicine resistance. In both studies the frequency of the occurrence of colchicine resistant variants in selective medium was about 2.10(-4). These data are consistent with the hypothesis that colchicine resistance of mouse L cells is not due to a gene mutation.


Age-related change in the reducible cross-link of human skin and aorta collagens.

Age-related changes in the reducible cross-links of soluble and insoluble collagens from the human skin and aorta were evaluated. Histidinohydroxymerodemosine decreased with age up to the fifth decade and then remained constant in the insoluble skin collagen but could not be detected in the insoluble aorta collagen. Dihydroxylysinonorleucine could be observed, if in a small amount, in the insoluble aorta collagen but not in both the soluble and insoluble skin collagens. Hydroxylysinonorleucine seemed to be present in only a small amount, although coeluting unknown substances made it difficult to evaluate correctly. Two unknown components decreasing with age were found; the one in the insoluble skin collagen and the other in the insoluble aorta collagen. Difference in reducible cross-link was indicated between the skin and aorta collagens.


In vivo and in vitro effects of alloxan on collagen characteristics of bone, skin and tendon of Swiss mice.

Alloxan diabetes in Swiss mice induced decreased levels of percent solubility of collagen in bone, skin and tendon both after 4 days (96 h) and 28 days of treatment. In vitro treatment of tissues with alloxan in physiological saline did not influence the cross-linking of collagen. It is suggested that in alloxan diabetes, metabolites formed in the tissues might accelerate aging of collagen.


The cellular aging of rat fibroblasts in vitro is a differentiation process.

Cellular aging of diploid rat fibroblasts in vitro occurs as the result of a three-stage differentiation sequence, taking place in the morphologically recognizable differentiating cell compartment of the fibroblast stem cell system. Simultaneously with an age-dependent morphological differentiation there is an age-dependent biochemical differentiation of the fibroblasts. In cell strains with the genetic background Lewis, the cellular differentiation state, the major histocompatibility complex composition (H-1) and the H-1 complex-controlled expression of endogenous type C viruses determine the ultimate fate of the senescent cell, leading either to cellular degeneration or to cellular neoplastic transformation.


The quality of verbal interaction in homes for old people.

Some 4,500 verbal exchanges among residents, and between staff and residents were recorded during structured observations in eight British purpose-built Homes for old people. These interactions were initially categorised as 'supportive/acceptive' or as 'other'. Subsequently, the 'other' data from four of the Homes was further classified as 'instrumental' and 'unclassifiable'. The participants in the exchanges were noted (resident or staff) as was the mental status assigned to residents ('confused' or 'rational'). The data suggest that interactions among residents are more likely to be supportive/acceptive than are those between staff and residents; that, similarly, interactions among rational residents are more likely to be supportive than those between rational and confused residents, or than those among confused residents. Interactions between rational and confused residents are more likely to be supportive than those among confused patients. Further, the data indicate that interactions between staff and rational residents, and between staff and confused residents do not differ in quality; predominantly, interactions between staff and residents are instrumental. These interpretations of the data are discussed in relation to the care of residents in institutional settings.


Performance on three cognitive tasks by patients with dementia, depression or Korsakov's syndrome.

Perception, attention and recall were measured in geriatric subjects and patients suffering from dementia, Korsakov's psychosis or depression. Dementia patients were unable to perceive, attend and recall; depressed patients were unable to attend; and patients with Korsakov's psychosis were unable to attend and recall. Perception, attention and recall were correlated in the normal group but not in any one patient group. Traditional assumption of the interdependence of these functions may not be applicable to these patients. Demented patients show a different pattern of cognitive disability than age-matched controls.


Disease at the carotid bifurcation: diagnosis by Doppler ultrasound imaging.

A non-invasive method for visualising the carotid bifurcation using continuous-wave Doppler-shift ultrasound and spectral analysis is described. The system is directional so that arteries can be visualised without interference by signals from adjacent veins. The technique uses a transducer attached to a position-sensing arm so that the position of arterial flow-velocities can be translated onto a storage oscilloscope. A two dimensional image of the carotid bifurcation is formed by moving the transducer along the length of each vessel while repeatedly scanning across the vessel lumen. The clinical application of this technique is illustrated by some specific cases.


Evidence for increased proteolytic activity in ageing human fibroblasts.

We have shown that ultrastructural changes accompany ageing in the human fetal lung fibroblast strain MRC-5. In order to further characterise these changes a method has been devised to prepare subcellular fractions from MRC-5 fibroblasts using a discontinous gradient of metrizamide preceded by a low-speed centrifugation. An investigation was carried out to compare subcellular fractions prepared from early-passage and senescent cells. Proteolytic activity associated with lysosomes and soluble proteolytic activity were found to be increased in senescent cells.


Fine structural changes in the liver of young and old rats as influenced by microsomal enzyme inducers.

When given orally to young and old rats, pregnenolone-16 alpha-carbonitrile, spironolactone, or phenobarbital, known microsomal enzyme inducers, caused an increase in smooth endoplasmic reticulum. Dexamethasone, while a potent microsomal enzyme inducer, did not cause smooth endoplasmic reticulum increase. In both untreated and treated old rats, there was dilatation and vesiculation of rough endoplasmic reticulum with occasional granular material present in vesicles. Cytoplasmic lipid droplets of various sizes were frequent. Some mitochondria exhibited polymorphism and a variation in matrical density. Lysosomes and autophagic vacuoles as well as lipid droplets of various sizes were frequent in all groups. These results show that microsomal enzyme inducers influence the subcellular structure of hepatocytes in old rats.


The proportion of ribosomes active in protein synthesis and the content of polyribosomal poly(A)-containing RNA in adult and senescent rat livers.

The proportion of ribosomes active in protein synthesis and the content of polyribosomal poly(A)-containing RNA are unchanged when adult and senescent rat livers are compared. Therefore, the decreased protein synthesizing activity of senescent liver microsomes observed previously is not due to a deficiency in total mRNA content.


Effect of ageing and occupational activity on active wakefulness.

44 people were recorded by a telemetric system during 8 h of daily occupational activity. 24 were factory personnel (12: mean age 37 years, and 12: mean age 53 years) and 20 were univeristy researchers (10: mean age 39 years, and 10: mean age 53 years). Recordings were made concerning EEG, EOG, EMG, and EKG. At 35 years no differences were observed. At 50 years the organization of wakefulness was different for the two occupational activity groups. Although stable for the moment seemed to play a prominent role in the modulation of wakefulness.


Use of a self-administered postal questionnaire when screening for health problems in the elderly.

The feasibility and value of conducting health screening programmes for elderly people using self-administered postal questionnaires is discussed in relation to the outcome of a community study of mobility problems in the elderly. It is argued that this procedure minimizes the work and expense involved in organising and carrying out such programmes.


Vitamin D status of residents of an old people's home and long-stay patients.

The vitamin D status of residents of an old people's home and long-stay patients was assessed by means of plasma 25-hydroxycholecalciferol (25-OHD) estimations. The residents of the old people's home had a higher mean plasma 25-OHD concentration than long-stay patients. Both groups had diets with vitamin D intakes of less than 2.5 micrograms (100 IU) per day and the conclusion is that solar exposure is the major determinant of the concentration of circulating 25-OHD.


Heart weight as a function of body weight in mammals.

Linear regression analysis was carried out on logarithmically transformed heart weight and body weight data in 104 mammalian species. It was shown that heart weight varies as the 0.98 power of body weight over essentially the whole mammalian weight range. The coefficient of correlation between heart weight and body weight is 0.99. Student's test was employed to compare the slopes of the several regression lines as between male and female animals, and as between terrestrial and aquatic mammals. In neither case were the differences in slope found to be statistically significant (df greater than 177, p less than 0.5).


Linear skeletal growth in male and female turkeys.

Growth in the maximum length of the skull, humerus, ulna + radius, carpometacarpus + phalanges, pelvis, femur, tibiotarsus and tarsometatarsus + phalanges was measured by dissection of male and female white turkeys taken at 14 day intervals from hatching to 20 weeks. In all skeletal units except carpometacarpus + phalanges, a greater rate of growth (P less than 0.01) was detected in males.


The effects of exogenous nutrients on growth of chick embryo brain.

The effect of an early addition of exogenous nutrients on brain growth has been investigated in chick embryo. The nutrients were introduced onto chorioallantoic membrane at day 6 or 7 of embryonal life, and the cerebral hemispheres examined at the end of neuronal proliferation for the following parameters: weight, DNA content (index of cell number) and protein content. L-Tryptophan produced significant inhibition, probably by creating amino acid imbalance and interference with the transport of other amino acids. D-Tryptophan (slower transport) was inactive. 5-Methyltryptophan produced significant inhibition, probably by causing deficiency of tryptophan utilization and of production of serotonin, which is a growth factor for early brain. Glycine stimulated brain growth, probably by conversion to glucose which is the main energy source for the embryo in this period. Brain weight and DNA were found to be significantly correlated with blood glucose level. It is concluded that, within genetic limits, early brain growth might be manipulated in both directions (inhibition or stimulation) by addition of proper nutrients during sensitive period of neuronal proliferation.


Muscle and adipose cell development in mice selected for postweaning growth rate.

Genetic selection for postweaning growth rate between 3 and 6 weeks of age resulted in significant changes in body weight, semimembranosus muscle weight, and epididymal fat pad weights. Body weights at 15 weeks of age ranged from 24.9 gm for the Low line (slow growth) mice and 59.4 gm for the High line mice (rapid growth). Total muscle DNA content was decreased in Low line mice and increased in High line mice when compared to Control mice (random bred). RNA to DNA and protein to DNA ratios were not significantly affected by growth rate selection pressure. Selection for high or low growth rate appeared to affect the development of muscle by altering the amount of DNA synthesized, suggesting that growth hormone status was altered by this type of selection. Adipose cell number was reduced in the Low line and increased in the High line when compared to Control mice. Adipose cell size was increased in High line mice when compared to Low and Control lines. The role of adipose cell development in supporting growth selection success is suggested.


Translation of messenger RNA from fetal and adult mouse kidney.

Polyadenylated mRNA was prepared from fetal, adult, and regenerating adult mouse kidneys. The polyadenylated portion is 2% of total RNA in the fetus, falls abruptly to 1% after birth, and returns to about 2% in the adult. In vitro translation of these mRNA's showed great similarities between 17 and 20 day fetal samples and between the normal and regenerating adult samples, but few similarities between the fetal and adult samples. The data do not support the hypothesis that renal growth following contralateral nephrectomy may entail the de-repression of genes active in the fetus but not active in the normal adult.


Interaction between mural thrombi and the underlying artery wall.

This communication describes the morphological changes which result from the induction of experimental thrombi in the artery wall of the rabbit and pig. The role of the platelet as the initiator of neo-intimal proliferation is stressed and the genesis of the cells contributing to such proliferation discussed.


In vivo and in vitro studies on endothelial regeneration.

Endothelial regeneration was studied in rabbit aorta after intra-arterial balloon catheterization. Most of the regenerated endothelium originated from existing branches which was assessed by the Evans-blue uptake pattern and confirmed by transmission and scanning electron microscopy. Glucocorticoid treatment enhanced re-endothelialization whereas hyperlipemic diet inhibited. Sera from minipigs fed an atherogenic diet consistently have less ability than sera from control pigs to stimulate in vitro the regeneration of wounded endothelium-like monolayers of 3T3-B cells. The deficiency is probably due to an inhibitor which appears and disappears with changes in the diet.


Platelet-lung in vivo interactions: an artifact of a multi-purpose model?

The simultaneous evaluation of platelet behaviour in vivo and of the accompanying bronchoconstriction in the guinea pig is described. Arachidonic acid induces bronchoconstriction, accompanied by, but independent from, thrombocytopenia, whereas collagen induces bronchoconstriction also accompanied by, but dependent from, thrombocytopenia. In both cases bronchoconstriction is due to cyclo-oxygenase metabolites of arachidonic acid. Use of potential inhibitors of thromboxane synthetase failed to reveal which of prostaglandin endoperoxides or thromboxane A2 is responsible for aspirin-inhibitive bronchoconstriction and thrombocytopenia. In contrast to PGE1 prostacyclin failed to interfere with bronchoconstriction by serotonin or by arachidonic acid, even though thrombocytopenia by the latter was suppressed. Bronchoconstriction by collagen, in contrast, was inhibited by nanogram doses of prostacyclin, confirming platelet-dependency. The combined bronchoconstriction/thrombocytopenia test in guinea pigs can discriminate sites of action of anti-inflammatory drugs, of agents which block specific platelet and/or bronchial receptors, which stimulate the cyclic AMP system, or generically which interfere with the mechanisms of bronchoconstriction and of thrombocytopenia.


Albumin-bound fatty acids, platelets and endothelial cells in thrombogenesis.

Changes in the types and concentrations of albumin-bound fatty acids in plasma have been related to subsequent changes in platelet and endothelial cell function both in vitro and in vivo. Fatty acids in the linoleate and linolenate sequences with the potential to act as prostaglandin and thromboxane precursors, seem to play a fundamental role in the homeostatic balance between platelets and endothelial cells. Variations in this balance may be directly related to the tendency to thrombosis.


Lipid metabolism, atherogenesis, and haemostasis in Eskimos: the role of the prostaglandin-3 family.

In Eskimos coronary heart disease is a rarity. This can partly be explained by their favorable plasma lipid levels. An additional factor seems, however, to be that in Eskimo food polyunsaturated fatty acids of the omega-3 series replace those of the omega-6 series. C20:5, omega-3 can be converted by the vessel wall to an antiaggregatory substance, whereas it has no proaggregatory effect on platelets. Consistent with these findings Eskimos were found to have a nearly 2-fold longer bleeding time than Danes. Platelet aggregability, too, was markedly depressed when exposing platelets from Eskimos to ADP and collagen.


Dietary fats and platelet functions in relation to atherosclerosis and coronary heart disease.

Results in animals and in man indicate that in many circumstances, lipemia is not closely related to the severity of atherosclerosis nor to the incidence of coronary heart disease (CHD) or the intake of saturated fats as observed in paired studies between farmers from Moselle and Var in France and from West and East Scotland. In rabbits, an increased response of platelets to thrombin occurs before any deposition of cholesterol, as a result of a saturated fat feeding. Under these conditions, the addition of alcohol to the drinking water decreases significantly both the platelet response to thrombin and the severity of atherosclerotic lesions without much affecting plasma cholesterol. In farmers from Moselle and Var (as well as from Scotland), platelet functions, namely the aggregation to thrombin and their clotting activity, i.e. PF3, are closely related to the intake of saturated fats, either as a result of the long-term feeding or of a 1 year change in the diet of Moselle farmers. Certain platelet functions appear to be the only blood parameter related to the incidence of CHD and significantly correlated on a group, as well as on an individual basis, with the intake of saturated fat, and inversely related with that of calcium. Saturated fats and calcium are known to be the two main dietary factors related to CHD. These results suggest that the intermediate link between dietary fats and CHD might be blood platelets rather than serum lipids, through an effect on both thrombosis and atherosclerosis.


The role of endothelial cells and subendothelial components in the initiation of blood coagulation.

The effect of collagen on isolated platelets, platelet-rich plasma and whole blood has been studied. Collagen failed to generate factor XIa-like activity in mixtures of isolated platelets, collagen and Ca++. Moreover, collagen added to whole blood or platelet-rich plasma containing 125I-factor IX and Ca++, also failed to form cleaved (activated) factor IX. In preliminary studies, lysed endothelial cells were found to enhance the formation of factor Xa and thrombin and to induce cleavage of 125I-factor IX in normal plasma, factor XII and factor-XI-deficient plasma even in the presence of antibody to tissue factor.


The vascular wall and fibrinolysis.

A survey is given of recent data pertaining to the presence of components of the fibrinolytic system in the vascular wall. Activators and inhibitors of fibrinolysis were shown to be present in the vessel wall, while activators were mainly found in the endothelial cells, and inhibitors in the media. Activators will be released into the circulation by a variety of stimuli. Among these stimuli are compounds formed or released during coagulation and thrombus formation, thus indicating how coagulation or thrombosis might induce increased fibrinolysis. Abnormal fibrinolytic activity in the vessel wall in relation to thrombosis is discussed.


Effects of acetylsalicylic acid, sulfinpyrazone and dipyridamole on platelet adhesion and aggregation in flowing native and anticoagulated blood.

The interaction of rabbit platelets with subendothelium of rabbit aorta was investigated under controlled blood flow conditions. Platelet adhesion and thrombus formation were compared after perfusion of native blood and of blood anticoagulated with citrate, heparin or heparin plus citrate. 15 mM citrate in plasma caused significant reduction of aggregation, thrombus volume and thrombus height; adhesion was concomitantly increased. Heparin (500 U/kg) had no significant effect on adhesion and thrombus dimensions. Treatment of rabbits with acetylsalicylic acid or sulfinpyrazone caused a significant reduction of thrombus volume and thrombus height in the presence of citrate. However, no significant effects were observed in native or heparinized blood. It is concluded that low citrate concentrations: (1) inhibit thrombus growth; (2) enhance thrombus breakdown; (3) therefore increase adhesion, and (4) strongly enhance a possible inhibitory effect of acetylsalicylic acid and sulfinpyrazone on thrombus growth.


Dosage in low-dose heparin prophylaxis.

We investigated whether the dosage of heparin injected subcutaneously for the postoperative prophylaxis of thromboembolism influences efficacy. We considered prospective, controlled or comparative, randomized studies in which heparin was administered in a dosage of 5,000 U b.i.d. or t.i.d. subcutaneously. In major surgical procedures in general surgery, gynecology, urology and chest surgery, 2 x 5,000 and 3 x 5,000 U of heparin/day lower the frequency of postoperative deep venous thrombosis from about 30% to about one-fourth and one-third that amount, respectively. With regard to orthopedic/traumatic surgery, in a study of only 40 patients, 2 x 5,000 U/day reduced the incidence of thrombosis by one-half. The use of the higher dosage resulted in a decrease in DVT in 5 of 7 reports, but the other two authors measured no prophylactic effect at all. Proof that subcutaneous heparin prophylaxis is also able to reduce the number of fatal postoperative pulmonary emboli has been produced only in the case of the higher dosage. In our own group of patients there is no correlation between body weight and frequency of hemorrhagic complications. In our patients there is no relation between malignant tumor as the primary disease and the occurrence of hemorrhagic complications. There is no evidence that the lower dosage causes fewer hemorrhagic complications than the higher dosage.


Heparin-antithrombin III binding. In vitro and in vivo studies.

Heparin antithrombin III binding was studied by crossed immunoelectrophoresis. In plasma and purified antithrombin III standard, multicomponent patterns were obtained with low concentrations of mucosal heparin. There is evidence that antithrombin III may bind more than one heparin molecule. At high heparin concentration (greater than 16 U/ml), single symmetrical peaks were obtained. Serum samples showed two antithrombin III peaks due to a decreased heparin binding of the slower peak (2.1-3.9 times), which was probably antithrombin III-activated procoagulant complexes. Heparin analogue (A 73025) also bound antithrombin III in vitro but the mobility of the peak was slower than with mucosal heparin and only a single peak was obtained in serum samples. Radioimmunoassay showed a decreased binding of antithrombin III antibody to heparin-antithrombin III complex. Venous occlusion to the forearm resulted in a slow second peak in the plasma. Heparin therapy gave rise to a double peak in the plasma antithrombin III profile and with continuous infusion, quantitative decreases were noted in all subjects studied, two of whom rethrombosed at the end of 7 days therapy.


Human platelet aggregation by thimerosal. Functional and ultrastructural studies.

Thimerosal, a sulfhydryl group inhibitor, produces in an aggregometer a decrease in optical density of normal platelet-rich plasma over a wide range of concentrations. Ultrastructural study shows that the decrease of optical density produced by thimerosal at low doses is due to a true platelet aggregation preceded by a release reaction, whereas the aggregometric curves recorded after addition of thimerosal at high doses can be attributed to marked alterations of platelet morphology. Electron microscopic study shows the presence of electron-dense material between plasma membranes after addition of a low dose, and the early rupture of membranes after a high dose. These findings support previous conclusions that thimerosal binds to plasma membranes. Thimerosal induces a release reaction, seen in ultrastructural study and revealed by measurement of 14C-serotonin release. Moreover, thimerosal-induced aggregation is independent of released ADP and of formation of intermediates of the arachidonate pathway. Thimerosal-induced platelet aggregation is inhibited neither by ADP removal nor by aspirin addition.


Serotonin uptake and release by platelets adhering to polyethylene.

Heparinized human blood containing platelets labelled with 14C-serotonin and 51Cr was exposed to a polyethylene surface by rotation in Chandler loops. Both uptake of platelets on the surface and platelet aggregation in the blood occurred. More 14C- than 51Cr activity accumulated on the surface. It was demonstrated that this was due to an active uptake of 14C-serotonin by the surface-adherent platelets, which also retained their capacity to exert a release reaction.


Effects of alcoholism on the family system.

Because the family is a system, the alcoholism of one member affects all the others, who develop defenses and symptoms parallel to those of the alcoholic. The authors describe the "survival roles" members adopt that allow the system to maintain its equilibrium and explain how this balance shifts as the family recovers.


Alcohol and the elderly: a review.

Because the older population will increase in the next several decades, the number of elderly alcoholics will grow. The author presents a review of research on alcoholism among the aged and concludes that social workers should focus their future research on identification and diagnosis of elderly alcoholics and effective methods of treatment.


Working in the schools with children of alcoholic parents.

Despite evidence that parental alcoholism has a serious effect on children, few resources are available to help children of alcoholic parents cope with their feelings. The author suggests that the school is the logical place to provide services, describes characteristics common to most of these children, and discusses ways in which school social workers can intervene.


Alcoholics Anonymous, alcoholism counseling, and social work treatment.

The authors suggest that the misunderstanding by many social workers of the particular values of Alcoholics Anonymous and the skills of alcoholism counselors can involve alcoholic patients themselves in the stress of reconciling different approaches to treatment. They call upon all who treat alcoholics to build mutual trust and cooperation on two assumptions basic to all forms of treatment-that alcoholism is a disease and abstinence is essential to recovery.


The decision group: beginning treatment in an alcoholism clinic.

The Decision Group was designed to fill the needs of individuals applying for treatment at an alcoholism outpatient clinic and to reduce time lost to the clinic as a result of broken appointments. The group succeeded in engaging patients in treatment, motivating them to accept identification as alcoholics, and maintaining high attendance. The author describes the group's accomplishments and suggests ways that future groups could avoid certain problems the Decision Group encountered.


Combating alcoholism in the workplace.

This article describes occupational assistance-employee assistance programs, which are designed to combat alcoholism in industry. The author, who administers various types of programs, describes the history, conceptual framework, and essential ingredients of a successful program. Relevant legislation, as well as implications for social work, is discussed.


Alcohol abuse programs in the military.

Human resource programs generally have a low priority in the military, but in 1971 the armed forces began a major program to control alcohol abuse. In 1980 the program will spend $50 million. This article discusses the program's successes and problems and the part social workers play in it.


Prevention and control of "drunk driving": lessons for social work.

This article examines efforts to prevent and control the widespread problem of "drunk driving" in the United States. Special emphasis is placed on one institutional mechanism-the Alcohol Safety Action Project-developed to deal with the behavior of problem drinkers.


Alcohol knowledge and practice issues.

Although problems related to the use and abuse of alcohol have social, psychological, and physiological implications, the treatment of alcoholism has received minimal attention as an area of serious practice by helping professionals. To encourage practicing social workers to sensitize themselves to these problems, this article summarizes important knowledge currently available in the field of alcoholism and explores issues concerning theory and treatment that are relevant to social work practice.


A psychrophilic strain Actinoplanes sp. 220.

The strain designated Actinoplanes sp. 220 differed in its characteristics from other strains of the genus Actinoplanes listed in Bergey's Manual (1974). The strain belongs to psychrophilic culture growing within the range of 0-30 degrees C. The optimal temperature for growth on yeast--malt agar is 10-23 degrees C. Cultures transferred at 23 and 28 degrees C differed in morphological and physiological properties, enzyme activity and pigmentation in standard media. Submerged culture transferred at 28 degrees C inhibited growth of Bacillus subtilis ATCC 6633 and ATCC 9945. LL-2,6-Diaminopimelic acid was chromatographically detected in the submerged mycelium of this culture. This compound was not found in the mycelium of the original culture transferred at 23 degrees C. The cultures did not substantially differ in the composition of other amino acids contained in larger quantities in the mycelium.