Polycystic echinococcosis in Colombia: the larval cestodes in infected rodents.

Described are the characteristics of the polycystic larval cestodes found in an endemic area of echinococcosis in the Easter Plains of Colombia and the tissue reaction evoked in infected rodents. Of 848 free-ranging animals examined, polycystic hydatids were found in 44/93 Cuniculus paca and 1/369 Proechimys sp. None of 20 Dasyprocta fuliginosa examined was infected, but hunters provided a heart with hydatid cysts and information about two additional animals with infected livers. Recognition of an endemic area of polycystic echinococcosis provides a means to investigate the life cycle of the parasites and to study the histogenesis of the larval cestodes in susceptible laboratory animals.


The prevalence of Trypanosoma catostomi in white sucker (Catostomus commersoni) from southern Ontario.

During the summer of 1975, 285 white suckers (Catostomus commersoni) from 10 localities in southern Ontario were examined for trypanosomes. Trypanosoma catostomi Daly and DeGiusti, 1971 was found in the blood of 11.6% of the fish examined using the haematocrit centrifugation technique. Infected juvenile fish (33%) and infected adult fish (4%) were found in 6 of 10 locations.


Haematology and blood chemistry of the black duck Anas superciliosa.

Some haematologic and blood chemical values have been determined for the black duck, Anas superciliosa, captured in the western fringes of Sydney. Data did not show evidence of sexual dimorphism.


Virologic and serologic survey for eastern equine encephalomyelitis and certain other viruses in colonial bats of New England.

To test the hypothesis that hibernating colonial bats serve as an overwintering reservoir host of eastern equine encephalomyelitis (EEE) and certain other arthropod-borne viruses in southern New England, 1128 bats of 4 species were collected from 1966 through 1976. Blood and tissue samples and ectoparasites from these bats were tested in suckling mice, wet chicks, and/or chick-embryo tissue cultures for virus. Rabies, the only virus isolated, was recovered from the brain, salivary glands, and brown fat of an apparently healthy adult male Myotis keenii found hibernating in western Massachusetts.


Newcastle disease in falcons.

Between March and October, 1975, 37 captive lanners (Falcon biarmicus abyssinicus) destined for exportation to Europe from Kano, Nigeria were examined for Newcastle Disease (ND) by the haemagglutination-inhibition technique in our laboratory. Twenty-one or 57% of the falcons showed high titres, presumably as the result of natural exposure to ND virus.


Value of postirradiation screening for thyroid nodules. A controlled study of recalled patients.

We determined the occurrence of palpable thyroid abnormalities in 214 persons with verified history of head and neck irradiation and in 243 concurrently examined, nonirradiated persons (control subjects). Examinations were performed by two physicians, each unaware of the medical history of the examinees and of the findings of the other examiner. Thyroid nodules, either single or multiple, occurred in 6.1% of irradiated persons and in 4.5% of control subjects (95% confidence interval of the difference, -2.6% to +5.7%). Thyroid enlargement without nodules occurred in 5.6% of irradiated persons and in 3.7% of control subjects (95% confidence interval of the difference, -2.0% to +5.8%). Thyroid cancer was detected in one irradiated and in two nonirradiated persons. Our controlled study did not find an excess number of thyroid abnormalities in previously irradiated subjects.


Long-term cloprednol use in chronic asthma.

Cloprednol is an oral synthetic glucocorticoid with a short serum half-life of 110 minutes. Twenty children who had chronic corticosteroid-dependent asthma were empaneled to study the effects of cloprednol for a period of 24 months. Three of these dropped out at the end of one year. Alternate-day doses of prednisone were replaced by equivalent daily 8 am doses of cloprednol. Ten of 17 patients had better control during cloprednol therapy than during previous prednisone regimens, and significant improvement was noted in peak expiratory flow rate during the study period (P less than .001). Long-term side effects were absent. Improvement in the degree of hypothalamopituitary adrenal axis responsiveness, based on fasting 8 am cortisol levels, was noted from baseline to the end of study period.


Zinc metabolism in sickle cell anemia.

Zinc metabolism was studied in 34 patients with sickle cell anemia in a steady state and in six patients during sickle cell crisis. The patients in steady state were found to have significantly lower plasma levels and higher urinary levels of zinc than the 50 healthy adults in the control group. During sickle cell crisis the plasma zinc levels dropped to a mean value of 0.54 microgram/microL. These results support the concept that zinc deficiency occurs in sickle cell anemia and that further drops occur in the serum zinc levels during sickle cell crisis.


Platelet and leukocyte counts in pregnancy.

Platelets and leukocytes in venous blood were counted with automated methodology in 23 women studied longitudinally throughout pregnancy and at six weeks after delivery. The average platelet count declined monotonically in a manner consistent with the gestational increase in blood volume. Total leukocyte count rose early in gestation and remained elevated, with neutrophils accounting for the changes. Absolute neutrophil counts during gestation were nearly twice those of the same women postpartum (5.76 vs 3.13/cu mm x 10(-3).) The monocyte count also tended to increase, whereas lymphocytes, eosinophils, and basophils declined in number.


Effect of elastic compression on venous hemodynamics in postphlebitic limbs.

To determine whether elastic compression alters the venous hemodynamics in the postphlebitic limb, we measured venous pressure patterns in 11 postphlebitic limbs with and without elastic compression stockings. Following cannulation of a dorsal vein of the foot, the patients underwent measurements of basal resting pressure, maximum percent decrease in venous pressure with exercise (delta VPex), peak systolic venous pressure during exercise (SVPmax), the amplitude of the pressure swing, and venous return time. Elastic compression did not alter basal resting pressure, delta VPex, or venous return time. By contrast, SVPmax decreased from 139 +/- 0.3 mm Hg to 11 +/- 8 mm Hg with elastic compression. If venous ulcers are related to the high pressure developed in the superficial veins during calf muscle systole, then elastic compression may be beneficial by decreasing systolic venous pressure and its subsequent deleterious consequences.


Treatment of vein graft stenosis by balloon catheter dilation.

Percutaneous balloon catheter dilation was used to treate 12 high-grade stenoses in ten autogenous vein bypass grafts since September 1978. Four lesions occurred in femoropopliteal grafts, seven in femorotibal grafts, seven in femorotibial grafts, and one in an axillofemoral graft. Balloon catheter dilation was successful and surgery avoided in 11 of the 12 lesions. Pedal pulses were restored in eight of the ten patients, and the pulse in a femorotibial bypass graft was improved in another. Postdilation arteriography demonstrated a substantial increase in luminal diameter, and ankle pressure indexes were improved in all successful cases. The tenth had an operative correction of the stenosis. There were no complications with the procedure. Percutaneous balloon catheter dilation appears to be an effective method of treating stenosis in autogenous vein grafts and a useful alternative to surgical revision.


Pleuropericardial reaction to treatment with dantrolene.

Chronic pleural effusion occurred in three patients, one of whom also developed acute pericarditis. A fourth patient developed both pleural and pericardial effusions. All patients had been receiving dantrolene sodium for at least two months. The pleural fluid was a sterile exudate with pleural and peripheral blood eosinophilia in all patients. No pulmonary parenchymal involvement was apparent. Pleural biopsy specimens showed nonspecific inflammation. Resolution of the pleural process was prolonged after dantrolene therapy was discontinued. Although a causal relationship between dantrolene and serosal inflammation remains unproved, this association in four patients warrants careful observation of others receiving long-term dantrolene therapy.


The breast reconstruction patient and her health insurance carrier.

To determine policies of health insurance companies regarding payment for breast reconstruction following mastectomy, we polled 50 companies selected at random, as well as every Blue Cross-Blue Shield company. To verify that insurance carriers' replies represented their practices, we polled 96 plastic and reconstructive surgeons in 47 states. Although most health insurance carriers claim to fully cover breast reconstruction following mastectomy for cancer, practices vary widely; many postmastectomy patients receive incomplete or no coverage for reconstruction. Two major reasons for discrepancies appear to be (1) inadequate coverage prompted by unrealistic conception of reconstruction on the part of carriers and (2) specific contractual exclusion. We suggest (1) educating lay and professional persons about breast reconstruction, (2) encouraging more realistic coverage from insurance companies, and (3) if necessary, legislative protection for the postmastectomy patient.


Hemoglobin A1c in normal and diabetic pregnancy.

The usefulness of determining hemoglobin A1c (HbA1c) levels during pregnancy was evaluated. In contrast to previous reports, the HbA1c values did not predict abnormal maternal glucose tolerance or infant birth weight. They did, however, correlate with long-term control of the diabetes of pregnant insulin-dependent patients. The slight decrease in HbA1c values observed as pregnancy advanced was secondary to improved control of diabetes.


Ethanol ingestion in children. A five-year review.

A five-year review at ethanol ingestions in children at Charity Hospital of Louisiana at New Orleans, revealed nine cases with blood ethanol levels in excess of 21.7 mmole/L (100 mg/dL); none resulted in death. We describe four patients in whom the blood ethanol levels were potentially life-threatening. In one case, we were able to follow the affected child's blood ethanol level serially; the rate of decrease was about twice that reported for an adult.


Early recognition of cutaneous melanoma.

Criteria for the early recognition of malignant melanoma include appreciation of variegation in color and irregularity of lesion border and pigment pattern. Application of these criteria should result in the diagnosis of cutaneous melanoma in its premetastatic surgically curable phase.


Plasma norepinephrine and dopamine-beta-hydroxylase activity in chronic renal failure.

To evaluate the activity of the sympathetic nervous system in chronic renal failure, plasma norepinephrine (NE) and dopamine-beta-hydroxylase (DBH) activity were measured by a radioenzymatic assay and a photometric assay respectively. The level of plasma NE was significantly higher in 14 patients with hemodialysis than in healthy individuals (p less than 0.001). The level of plasma NE fell significantly in 6 patients with hemodialysis receiving 0.30-0.45 mg/day of clonidine hydrochloride (a depressor of the sympathetic outflow from the central nervous system) (p less than 0.05). Systolic blood pressure was correlated with the level of plasma NE in patients with hemodialysis who were not receiving clonidine. They had high level of plasma NE and low level of plasma DBH activity. Therefore, this findings suggest that high level of plasma NE in chronic renal failure is caused not only by decreased urinary excretion, but also by increased overflow from the sympathetic nervous clefts.


A sensitive radioimmunoassay for the determination of plasma angiotensin II in human subjects.

A sensitive and specific radioimmunoassay for the determination of plasma angiotensin II was developed by using the antisera against synthetic angiotensin II in combination with labeled angiotensin II. This assay employs an acetone extraction procedure and detects as little as 0.8 pg per tube of angiotensin II. The mean (+/- S.E.) plasma angiotensin II concentration in 19 normal subjects was 14.4 +/- 1.8 pg/ml in a state of overnight fasting and recumbency. In 13 normal subjects, in whom 40 mg of furosemide was injected intravenously, plasma angiotensin II concentration before and after 30 and 120 minutes in an upright position was 14.6 +/- 2.2, 56.6 +/- 5.7 and 74.3 +/- 9.0 pg/ml, respectively. In 6 normal subjects, an infusion of isotonic saline, angiotensin II concentration reduced from 14.1 +/- 3.7 to 9.2 +/- 1.7 pg/ml. Thus, it was ascertained that the simplified radioimmunoassay method reported here using an acetone-petroleum ether extraction method was specific and highly sensitive.


Relations between disturbances in microcirculation and accumulation of lipids in the aortic wall.

For the purpose of unraveling the relations between disturbances in microcirculation and deposition of lipids in the aortic wall, 9 rabbits were fed a 1% cholesterol and 5% coconut oil at intervals up to 16 weeks, and 4 rabbits were used as controls. After microangiography of vasa vasorum, the same specimens were studied histochemically. The distribution of vasa vasorum became poorer on sacrifice by microangiography. However, it could not be thought that disturbances in vasa vasorum was a cause in the early deposition of lipids, because lesions were histologically mild in the greater parts of vasa vasorum. The sites of prediction for the vascular lesions were initially the branching part, and then the thoracic aorta. Thickness and numbers of the elastic lamina in the media decreased straightly in the distal direction, and the degree of intimal thickening and accumulation of lipids were parallel with the degree of the medial thickness. The intimal cells tended to be arranged radially with wide intercellular spaces in the cross section, suggesting the convenience for the passage of fluids. From the above facts, it may be reasonable to presume that the difference in severity of disturbances of microcirculation resulted in the difference in the site of predilection.


Escape from sodium and potassium retaining actions of aspirin-like drugs used in a patient with Bartter's syndrome. An analysis was done with regard to the mode of escapes from sodium and potassium retaining actions of aspirin-like drugs in a patient with Bartter's syndrome. In the indomethacin therapy of the syndrome, there was a delay in the initiation of potassium escape as compared to sodium escape, whereas no delay was seen in the ibuprofen therapy. This delay was probably related to the direct or indirect inhibition of sodium-potassium exchange in the distal nephrons. The course of aspirin therapy went midway between the above two. In the spironolactone therapy, the mode of escape was a mirror image of the one in the indomethacin therapy. Also, in a patient with rheumatoid arthritis, but without Bartter's syndrome, the escapes from the effects of indomethacin were seen. In order to understand the effect of these drugs on potassium excretion in Bartter's syndrome, some other intrarenal events, such as the influence on chloride transport in the loop of Henle leading to potassium conservation, may have to be considered.


Surgical correction of double outlet left ventricle associated with hypoplastic right ventricle: direct anastomosis of right atrial appendage and pulmonary artery.

This reports concerns a 9 years old boy, who had situs solitus and atrioventricular concordance with double outlet left ventricle, pulmonary stenosis, tricuspid stenosis, ventricular septal defect, secundum atrial septal defects and hypoplastic right ventricle. Previous Blalock-Taussig shunt was created at the age of 11 months. Total correction consisted of closure of atrial septal defect and tricuspid valve orifice, and direct anastomosis of right atrial appendage to pulmonary trunk. Though atrial pacing was required for the immediate post operative period, the patient regained sinus rhythm 3 days after operation. He is doing well at present, one year after the operation.


Open heart closure of atrial septal defect in a patient with idiopathic thrombocytopenia.

A case of atrial septal defect with idiopathic thrombocytopenia was successfully operated with the aid of heart-lung machine. The operation was performed under the administration of platelet rich plasma, fresh blood and adrenocorticosteroids before, during and after the operation. With the aid of these treatments, no severe hemorrhagic diasthesis was encountered.


Inhibition of dog renin activity by pepstatin A.

The inhibitory effect of pepstatin A, an isovaleryl pentapeptide isolated from streptmyces, was studied. Pepstatin A inhibited the action of dog renin on homologus substrate. The Ki value was 7.7 X 10(-7) M and the mode of the inhibition was non-competitive. Pestatin A suppressed angiotensin I generation in dog plasma. Dose-dependent hypotensive effect of pepstatin A was observed in rats with sustained increase in blood pressure during continuous infusion of dog renin. It is concluded that pepstatin A inhibits the dog renin activity in vitro and in vivo.


Relationship between molecular weight conversion and renin activity in dog renal renin.

A normal size form of renin, which seems to be a storage form in renin granules, changed neither in molecular weight nor activity by acidification to pH 3.0. High molecular weight (HMW) renin fractionated by gel chromatography from crude renal extract prepared with thiol group blockers was converted into normal size renin by acdification, accompanied with an increase in renin activity by about 50%. The molecular weight conversion by acidification appeared due to destruction or loss of binding ability of the renin binding substance which was present in the cytosol of renal cortical tissue. Renin and renin binding substance could combine into HMW renin at neutral pH in the presence of thiol group blockers and renin activity decreased.


Plasma catecholamines determination using high pressure liquid chromatography and their roles in blood pressure regulation and experimental hypertension in rats.

Plasma catecholamine levels have been used experiemtally and clinically as the indices of the sympathetic nerve activity. We measured plasma catecholamines using high pressure liquid chromatography in rats to assess the significance of plasma catecholamines as an index of the sympathetic nerve activity and its role in hypertension. Pentobarbital anesthesia depressed plasma catecholamine levels, especially plasma adrenaline. Sodium loading for 5 weeks suppressed plasma noradrenaline, while administration of furosemide (1 mg/kg) produced the elevation of plasma noradrenaline. Experimental hypertension, one-kidney and two-kidney types of Goldblatt hypertension and DOCA-salt hypertension, raised plasma noradrenalines both in acute and chronic phases. The infusion of pressor doses of angiotensin II suppressed plasma noradrenaline by the reflex mechanism. Sar1, Ile8-angiotensin II and SQ 14,225 did not suppress plasma cathecholamine elevation due to hemorrhage. L-Hydroxyldopamine produced elevation of plasma catecholamines in experimental nypertension and controls in rats. After adrenal demedullation, plasma noradrenaline was decreased by the administration of 6-hydroxy-dopamine. Acute reduction of circulating blood volume and blood pressure fall produced the elevation of plasma catecholamine, especially plasma adrenaline. In rats, the adrenal medulla plays an important role in the regulation of blood pressure.


Response of urinary noradrenaline excretion to reserpine administration in normal and hypertensive subjects.

Reserpine was administered in purpose to determine the "Noradrenaline store" in sympathetic nerve endings. The marked increase of urinary noradrenaline excretion was observed by reserpine 0.4 mg/day administration. Total amount of noradrenaline in urine for first three days of 0.4 mg/day of reserpine administration was considered as a good indicators of "Noradrenaline store". There was no difference of "Noradrenaline store" between normal and hypertensive subjects. The increase % of urinary noradrenaline was higher in labile hypertension than in established hypertension as well as in normal subjects. Though the relationship between "Noradrenaline store" or the increase % of noradrenaline and sympathetic nerve activity was not clear, it is suspected that the releasable noradrenaline in sympathetic nerve granule was higher in labile hypertension than in established hypertension or normal subjects.


[Clinico-antimicrobial evaluation of cefuroxime by observation of transitional change of micro-organisms in urine specimen (author's transl)].

Cefuroxime (CXM) was administered for 1 week to spinal cord injury patients with chronic complicated urinary tract infection and the transitional change of micro-organisms was observed. Bacterial counts and identification of isolated organisms were performed daily on the mid-stream urine for 1 week. MIC was also determined on the strains before and after CXM treatment. The results with 83 strains from 28 patients are as follows: 1. CXM's efficacy appears in line with MIC of strains. With the cases given 0.75 g twice daily intramuscularly, all the 14 strains with MIC lower than 50 micrograms/ml were eradicated, but 2 of the 14 strains were found re-growing, with only bacteriostatic action noted (in region of minimal inhibitory action). With the group of the cases given 1.5 g twice daily, all the 15 strains with MIC lower than 200 micrograms/ml were eradicated from urine 1 approximately 3 days after start of treatment (in region of bactericidal action). 2. At dose of bactericidal action CXM responded effectively with no relationship to organism species or bacterial count before CXM treatment. 3. Dose response was noted between the cases given 1.5 g daily and those given 3.0 g daily. 4. From the above result, we can presume appropriate doses in accordance with the disease conditions. From above observation, combined with correlation between organism species, bacterial count, MIC of strains, etc., CXM's efficacy was assessed quantitatively and objectively.


[Clinical experience with cefamandole in bacterial infections of children (author's transl)].

In order to evaluate efficacy and safety, cefamandole, a new cephalosporin, was given intravenously to 12 children with respiratory tract infections (11 cases) and urinary tract infection (1 case), who ranged in age from 2 months to 5 years old. Cefamandole sodium was administered 74 approximately 112 mg/kg/day in three or four equally divided doses by one-shot injection. The overall efficacy rate was 83.3% in 12 cases, i.e., good in 8, fairly good in 2, and poor in 2 cases. No adverse reaction was noted on any of our 12 cases.


[Fundamental and clinical studies on cefamandole in pediatric treatment (author's transl)].

Cefamandole (sodium salt) was administered to total 32 cases of bacterial infectious diseases of children, and in 3 cases, there were investigated of these absorption and excretion. The results are as follows; 1. Blood levels: Cefamandole was given intravenous dose of 25 mg/kg to 3 children. The blood level of 15 minutes after intravenous injection was 140.4 micrograms/ml in average, and 0.3 micrograms/ml in average at 4 hours after intravenous injection. T 1/2 was 13.9 minutes. 2. Urinary concentration: Within 6 hours after intravenous injection, 51.8% of the drug was recovered in average from the urine and the urinary concentration reached to 3,050 micrograms/ml in average (0 approximately 2 hours), 1,262 micrograms/ml in average (2 approximately 4 hours), 41 micrograms/ml in average (4 approximately 6 hours) after injection. 3. The drug was given 109 mg/kg/day (t.i.d. or q.i.d.) by intravenous route. The duration of administration was 11 days in average. The overall efficacy rate was 97%. In bacteriological results, excellent in 2, failure in 1, out of 3 strains. As side effects vascular pain was observed in 3 cases at the intravenous injection, and eosinophilia in 2 cases.


[Laboratory and clinical studies of cefamandole in children (author's transl)].

Laboratory and clinical studies of cefamandole (CMD), a new semisynthetic cephalosporin, were investigated and following results were obtained. 1) Absorption and excretion study following 25 mg/kg intravenous administration was carried out in pediatric patients. In 6 cases, mean serum levels of 116.7 +/- 24.0 micrograms/ml, 62.1 +/- micrograms/ml, 12.2 +/- 2.7 micrograms/ml, 2.9 +/- 1.1 micrograms/ml, 0.6 +/- 0.6 micrograms/ml and 0.1 +/- 0.2 micrograms/ml obtained after 15, 30 minutes, 1, 2, 4 and 6 hours administration. In 4 cases, mean urinary recovery of 68.2 +/- 17.2% (0 approximately 8 hours) was obtained. The mean half life of serum level was 0.36 +/- 0.08 hours. 2) The transfer of cefamandole was poor in infants with meningitis. 3) Cefamandole was given to 22 children with acute pyelitis (1 case), acute pneumonia (19 cases), and meningitis (2 cases). The dosage was 80.0 approximately 284.2 mg/kg/day, and it was divided into 4 approximately 6 times and given intravenous or intravenous drip. The duration of administration was from 3 to 17 days. The overall efficacy rate in 22 cases was 95.2%, i.e., excellent in 5, good in 15, poor in 1, and unknown in 1. In bacteriological examination, there were eradication of the organisms in 9 (52.9%), decrease in 4, unchange in 4 out of 17 strains. 4) Any noticeable adverse reaction was not observed.


[Clinical experience with ampicillin-cloxacillin (Viccillin S 'Meiji') by intravenous drip infusion in gynecological infections (author's transl)].

Ampicillin-cloxacillin (Viccillin S 'Meiji') by intravenous drip infusion was used in gynecological infections, with the following satisfactory results. 1) The drug was markedly effective in 2 out of 6 cases, effective in 4, being the efficacy rate 100%. 2) No abnormal laboratory findings and side effects were observed in our study.


[Clinical studies on apalcillin in biliary tract infections (author's transl)].

Clinical studies on apalcillin (APPC), a new broad spectrum semisynthetic penicillin developed in Japan, were carried out, and the following results were obtained. APPC was administered to three patients with serious biliary tract infections by intramuscular or intravenous injection at daily dosage of 2. Therapeutic responses were excellent in all cases, and no side effects and abnormalities of laboratory findings were observed. APPC was considered to be an excellent drug for the treatment of biliary tract infections.


[A case of Leptospira hebdomadis infection treated with piperacillin (author's transl)].

A 35-year-old male went fishing at the Agano River side in the suburbs of Toyosaka City, in August 1977. He was admitted to the hospital then with the chief complaints of high fever and severe headache on the 5th day of illness. Following the intravenous drip infusion of 12 g piperacillin for 6 1/2 days, he became afebrile within 2 days and recovered rapidly. Bacteriological examination disclosed none of significant data. Serum agglutinin reaction for leptospirosis, however, was positive in a titer up to 1:2,560 to L. hebdomadis, except for L. icterohemorrhagiae, L. autumnalis, L. australis and L. canicola.


Echocardiographic evaluation of right ventricular anterior wall motion in the Wolff-Parkinson-White syndrome.

Echocardiographic motions of right ventricular anterior wall (RVAW) were investigated in 71 patients with Wolff-Parkinson-White (WPW) syndrome. According to the criteria of Rosenbaum et al the electrocardiograms were classified as type A in 35 patients and type B in 36. Sixteen type B patients exhibited abnormal RVAW motion, which was characterized by an early onset of the posterior movement before S1 andl also by a premature peak formation before S2. A small step or hump nearly coincident with S1 was observed in 10 of these 16 patients. These findings seem to suggest that both contraction and relaxation of RVAW begin earlier than normal due to anterior right ventricular pre-excitation. RVAW motion was normal in all of type A patients. Echocardiographic investigation of RVAW motion appears to be useful in non-invasive estimation of the site of pre-excitation, especially in type B WPW patients.


Antiarrhythmic effects of L-penbutolol and DL-propranolol. Comparison of the effects of these two drugs on conductivity and excitability in canine heart in vivo.

The effects of l-penbutolol and dl-propranolol on A-V conduction, on excitability of ventricular muscle, and on ventricular tachycardia threshold in acute ischemia were compared, using anesthetized dogs. 1. L-penbutolol (100 microgram/Kg) and dl-propranolol (100 microgram/Kg) prolonged A-V conduction and reduced excitability of ventricular muscle significantly. L-penbutolol less prolonged A-V conduction than dl-propranolol. 2. Both l-penbutolol (50 microgram/Kg) and dl-propranolol (50 microgram/Kg) significantly prevented the lowering of ventricular tachycardia threshold in acute ischemia. These beta-blocking drugs are effective in the treatment of arrhythmia and l-penbutolol could be used safely, because of its weaker inhibition on A-V conduction.


Beneficial effect of diltiazem, a new antianginal drug, on angina pectoris at rest.

The effect of oral administration of diltiazem, a new 1,5-benzothiazepine derivative, on the frequency of anginal attack at rest was studied in 8 patients. Our own experience showed that diltiazem gave excellent results in patients with ST elevation (variant type) but its effect was insufficient in the patients whose ST segment was depressed during the attack.


Some observations on serum concentrations of digitoxin and digoxin.

Serum concentrations of digitoxin and digoxin were measured in 145 cases with various heart diseases receiving maintenance doses of digitalis. Digitalis toxicity was seen in only 2 cases (1.4%). Day-to-day variation of serum concentration while taking the same daily dose was small in digitoxin therapy (13.8%), but a considerable variation was seen in digoxin therapy (24.4%). Serum concentrations of both digitoxin and digoxin were measured in the patients receiving digitoxin, and there was a positive correlation between the two (r = 0.66, p less than 0.001). This fact suggested that the effect of digitoxin was the sum of the effects of digitoxin and its metabolite, digoxin. In the patients taking digoxin, digitoxin was not detected in the serum. Serum digitoxin level had a significantly positive correlation to serum albumin level, presumably because digitoxin was retained in serum in the bound form to albumin. Minimal effective level, 10 ng/ml, was however obtained with higher daily dose of digitoxin in patients with lower serum albumin.


Individual renin-aldosterone responses of clinically healthy young Japanese men to dietary sodium and posture.

Responses to the changes in dietary sodium and posture were investigated in 9 young clinically healthy Japanese males who customarily consumed a larger amount of salt than North Americans or Europeans of mixed white ethnic background. Plasma renin activity (PRA), plasma aldosterone concentration (PAC), and urinary aldosterone excretion rate (AER) differed at each end of 3- to 4-day spans on a "control", a high-salt and a low-salt diet and of furosemide administration. PRA and PAC, also determined during the upright position following the supine blood sampling, increased after only 1 hour of standing in each condition (p less than 0.05 or more). PRA and PAC were well correlated in all 4 conditions, regardless of the posture (r = 0.806, p less than 0.001). There were also highly significant correlations between the "supine" PRA or PAC and the preceding 24-hour AER (r = 0.869, p less than 0.001) for PRA; r = 0.855, p less than 0.001 for PAC). Correlation coefficients between PRA and PAC in 9 individual subjects ranged from 0.823 to 0.987. The estimates of constant and slope of the regression line between PRA and PAC varied from subject to subject. The renin-aldosterone axis in response to changes in dietary sodium and posture must be individually assessed.


Lysosomal hypothesis in evolution of myocardial infarction. Subcellular fractionation and electron microscopic cytochemical study.

Twenty-two cat hearts were perfused according to Langendorff technique and myocardial regional ischemia was induced by occlusion of left anterior coronary artery. Separation of particulate (bound) from soluble (free) fraction, and subsequent fractionation into plasma membranes, lysosomes, sarcoplasmic reticulum, and mitochondria were performed by sucrose density gradient ultracentrifugation. By ischemia for 60 min, particle-bound activity of cathepsin D decreased from 4.2 +/- 0.24 U/mg protein to 3.2 +/- 0.31 U/mg protein (p less than 0.01). Likewise, the particle-bound activity of beta-glucuronidase decreased from 11.9 +/- 0.92 U/mg protein to 6.2 +/- 1.28 U/mg protein (p less than 0.01). Accordingly, free/bound activity ratios of cathepsin D increased from 0.8 to 1.9 and beta-glucuronidase from 0.9 to 2.8, respectively. Conspicuous fall from 12.8 +/- 0.6 U/mg protein to 8.0 +/- 0.97 U/mg protein (p less than 0.01) in absolute specific activity of cathepsin D bound to the lysosomal fraction, presents definitive evidence of lysosomal release of the acid hydrolases during the early phase of myocardial ischemia. Electron microscopic observation of the ischemic myocytes revealed ultrastructural alterations of the lysosomes suggestive of autophagic degradation of various subcellular organelles.


Protection of chlorpromazine-induced arrhythmia by flavin-adenine-dinucleotide in canine heart.

To investigate the mechanism of chlorpromazine(CPZ)-induced ventricular arrhythmia, the changes in ventricular fibrillation threshold (VFT) were followed after intravenous injection of CPZ (1 mg/Kg) in dogs. Following injection, VFT was decreased to 56.6 +/- 5.4% (mean +/- SE) of the initial level. Since flavin-adenine-dinucleotide (FAD) combines specifically with CPZ in vitro, we investigate whether or not prior treatment with FAD prevents the CPZ effect. With FAD (2 mg/Kg), the CPZ-induced decrease in VFT was significantly cancelled (92.2 +/- 4.2% of the initial level). Mitochondria isolated from canine heart after CPZ injection showed a significant decrease in respiratory control index and ADP/O. Effects of CPZ on canine heart mitochondria were also well cancelled by prior administration of FAD. The findings suggest that the arrhythmogenic action of CPZ might be associated in part with impaired function of heart mitochondria. These results also suggest that FAD might be useful in the treatment of the cardiac disturbances associated with overdosage of CPZ.


A comparison of enzyme activity for energy production in the myocardium and conduction system.

Specific activities of enzymes in bovine hearts were measured. The enzyme activity ratios between the conduction system and the myocardium were 1.9 for G-6-PDH, 1.2 for PFK, 0.5 for total phosphorylase and LDH, 0.4 for GOT and MDH, 0.3 for SDH, 0.2 for Aldolase and CPK, and 0.1 for alpha GPDH. Approximate values for relative volume of Purkinje cells, nerve fibers and connective tissues in the conduction system were 30%, 8%, and 62%, respectively. It is concluded that activities of enzymes serving for anaerobic glycolysis in Purkinje cells are almost the same or slightly higher than those in the myocardium, and activity of enzyme for pentose shunt in the conductive tissue is higher than that in the myocardium.


Cross-sectional echocardiographic findings of left ventricular thrombi in a ten-year-old patient with cardiomyopathy.

Using cross-sectional echocardiography, left ventricular thrombi were easily found in a 10-year-old boy suffering from congestive heart failure resulting from long-standing endocardial fibroelastosis. Ten days after this procedure, the patient suddenly manifested the signs of acute embolic occlusion of the abdominal aorta and succumbed. Emboli removed from the aorta were histologically confirmed to be organized thrombi. Cross-sectional echocardiography was useful in the antemortem detection of left ventricular thrombi in this pediatric patient.


Distribution of colloidal carbon in lymph nodes of mice injected by different routes.

Systemic distribution of colloidal carbon injected by different routes was examined microscopically at 24 hr postinjection, After intravenous injection, carbon was mildly distributed in postcapillary venules of systemic lymph nodes, in addition to heavy deposition in the liver, spleen and bone marrow. Carbon was deposited also in lymphatic sinuses of mediastinal and pancreatic lymph nodes, indicating redistribution through the lymphatic route. In other extravascular injection routes, carbon was distributed predominantly in the lymphatic sinus, follicle and paracortex of regional lymph nodes draining from the injected sites, while a systemic distribution of a smaller amount was observed also in distally located nodes, liver, spleen or bone marrow. Distribution at postcapillary venules was observed also after intraperitoneal injection when the dose was increased. It was noted that different lymph nodes was involved according to the site of subcutaneous injection, either ventral or dorsal. After intradermal injection at the rightforefootpad, carbon was distributed more extensively in reticular tissues than injection at the leftforefootpad.


Serum proteins in breast cancer.

Thirty-nine women admitted to the Main Medical Center for biopsy of a lump in the breast has been followed sequentially for six months to determine whether a diagnostic profile of plasma protein changes occurs in early breast cancer, compared to non malignant breast disease, and whether plasma protein changes in breast cancer patients could be correlated with the spread of the tumor. Eighteen women had early operable breast cancer and twenty-one had benign breast disease. Each patient had 10 serum proteins measured preoperatively and post-operatively at three and six months. The patients with breast cancer had significantly higher levels of beta 2 glycoprotein preoperatively and ceruloplasmin at six months postoperatively than those with benign breast disease. There were a number of significant correlations between serum protein levels and the progression of breast cancer as measured by the clinical score. There were significant correlation with ceruloplasmin properatively and at three months postoperatively. Prealbumin and hemopexin showed correlations preoperatively: alpha 1 antitrypsin and beta 2 glycoprotein only correlated at three months postoperatively. Longer follow up will be required to establish the value of serum protein changes which could predict the development of metastases in patients with breast cancer.


Ultrastructural studies of elastase-induced experimental emphysema.

Experimental emphysema in the guinea pig was made by intracheal instillation of porcine pancreatic elastase in order to analyze the proteolytic factors related to the pathogenesis of pulmonary emphysema. Ultrastructural and morphometric studies were performed in the elastase-induced emphysema in vivo. The following results were obtained: 1) Ultrastructural studies in vivo revealed that interstitial edema and degradation of fibrous tissue already occurred 2 hours after elastase instillation. Subsequently we observed fragmentations of elastin and dissociation between elastic tissue and collagen fibers 2 days later. Apparent degradation and fragmentation of elastin was found after 7 days. 2) Morphometric studies by electron microscope on elastase-induced experimental emphysema showed significant degradation of elastin fragments. Thus, it was suggested the importance of elastolytic process on the pathogenesis of pulmonary emphysema.


Resealing of erythrocyte membranes after hypotonic hemolysis.

A new quantitative method to study kinetics of resealing of erythrocyte membrane, defined as the recovery of impermeability to dextran, was established. Erythrocyte membrane pre-labelled with 125I were incubated under various conditions. Sealed and unsealed membranes were separated using dextran density gradient centrifugation. Sealed membranes which are impermeable to dextran were recovered from the top of the centrifuge tube, while unsealed membranes were recovered from the bottom of the tube. Degree of resealing was calculated from the counts of 125I recovered from sealed membrane fraction. The resealing of membrane from human erythrocyte after hypotonic hemolysis was dependent on the incubation temperature. Resealing was rapid above 30 degrees C, while it was not observed below 20 degrees C. The process completed within 1 hr at 37 degrees C. Ionic strength of the medium is also an important factor which controls the resealing process. The effect of NaCl in the medium on resealing was biphasic. In the lower range of NaCl (0-50 mM) there was gradual decrease of resealing capacity. Above 50 mM, the capacity was again increased. The mode of resealing of sheep and rabbit erythrocyte membranes was rather different from that observed in human erythrocyte. Under the present experimental condition, these erythrocyte membranes did not reseal well. The immediate resealing, which is observed in human erythrocyte upon hemolysis in the presence of Mg++ or Ca++ ions, was observed neither in sheep erythrocyte membranes nor rabbit ones.


Lipid composition of brain in a patient with mental retardation due to encephalopathy in an infantile period and one due to homocystinuria.

The lipid compositions of brains of a patient with etiologically unknown encephalopathy (ECP) in an early infantile period and a patient with homocystinuria (HCU) were investigated. In the ECP brain the total lipid content and all lipid classes decreased and the degree of the reduction was more conspicuous in the gray matter than in the white matter. The ganglioside distribution was altered in the ECP brain and the ganglioside long-chain base composition was the infantile pattern. It was shown that damage inflicted on an immature brain leaves persistent effects on lipid metabolism in the course of future brain development, resulting mental and neurological dysfunction. The HCU brain retained almost a normal lipid composition. Among disorders of amino acid metabolism it was found that HCU did not significantly affect lipid metabolism in the brain.


A simplified assay for neutrophil chemotactic activity of lymphocyte culture supernatants.

A simplified assay was developed to determine the chemotactic activity of lymphokines for neutrophils in guinea pigs. The neutrophils migrated by chemotaxis to lymphokines through a nucleopore membrane into the lower compartment of the Boyden's chamber and were situated on the bottom cover glass. The number of the cells was counted directly under an inverted microscope. This method is simple, because the staining of the membrane can be omitted. It is also possible to follow the number of responding cells with the time lapsed in each chamber. Furthermore, the method was proved to be sensitive, quantitative and reproducible. The results obtained by this method were compared with those by the conventional methods.


Detection of antibodies in Schistosoma japonicum infections by a micro-technique of enzyme-linked immunosorbent assay (ELISA).

Antibodies in Schistosoma japonicum infections were successfully detected by micro-technique (0.3ml/well) of ELISA on polystyrene microtiter plates using peroxidase labelled anti-human IgG and 5-amino salicylic acid as conjugate and substrate, respectively. Serum samples collected from 22 proven patients in Leyte, Philippines showed titers of higher than 1:960 in 18 cases, 1:240 in 2 cases and 1:120 in 2 cases whereas titers of 22 proven negative sera collected in Tokyo were less than 1:15. Though the reaction was read by spectrophotometry in the present study, the difference of reactions between positive and negative sera was so clear as to be recognizable readily by visual readings.


Total internal mechanical work of ventricle assessed from quick release pressure-volume curve.

A method is proposed for direct assessment of the total internal mechanical work of the cardiac ventricle from a pressure-volume diagram. First, a quick release pressure-volume curve of the lumped series elasticity of the ventricle is recorded. Next, this curve is transcribed on a pressure-volume loop diagram of a contraction of interest in such a way that the quick release curve passes through the end-systolic pressure-volume data point of the loop. Finally, planimetry of the triangular area bounded by the quick release curve, the isovolumic relaxation segment of the loop and the diastolic pressure-volume curve gives total ventricular mechanical internal work performed on the lumped series elasticity of the ventricle during systole. This method is much simpler and more direct than the conventional analytical method which requires a relatively simple geometric model of the ventricle, a formula for series elasticity with appropriate stiffness constants and a series of mathematical calculations based on many unverified assumptions on the shape, structure and mechanical properties of the ventricle.


Non-uniform oxygen supply to the left ventricular myocardium by systolic perfusion of coronary artery.

The left anterior descending branch of the coronary artery (LAD) of anesthetized, open-chest dogs was perfused by intraventricular pressure (systolic perfusion) and aortic blood pressure (aortic perfusion) alternately. When the LAD perfusion was switched from aortic perfusion to the systolic one, the subendocardial PO2 decreased to 9.8 mmHg, on an average, in 1 to 2 min from the initial level of 18.9 mmHg obtained during the aortic perfusion. On total occlusion of LAD, the subendocardial PO2 fell to 4.5 mmHg, while the subepicardial PO2 showed no significant change. These results suggest that a small amount of oxygen is transported to the subendocardium during the systolic phase despite the impaired blood flow to the subendocardium and that the oxygen supply to subepicardium can be supported even though the LAD perfusion is restricted to the systolic phase.


Effect of transverse tubule-disruption on 14C-caffeine influx in frog skeletal muscle.

Effect of transverse tubule-disruption (T-disruption) on 14C-caffeine influx was studied using small bundles, consisting of 40 to 50 fibers, of frog semitendinosus muscle. The peak tension of caffeine contracture was inhibited by about 69% at 5 mM caffeine and by about 31% at 7 mM caffeine by T-disruption. In addition, the amount of caffeine influx in a small bundle was inhibited by about 52% at 5 mM caffeine and by about 28% at 7 mM caffeine by T-disruption, corresponding to the inhibition of the peak tension of caffeine contracture by T-disruption. These findings support our previous suggestion that caffeine enters the muscle fibers through the surface membrane and transverse tubuler membrane (T-membrane), and that the T-membrane contributes to the entry of caffeine more greatly at 5 mM caffeine than at 7 mM caffeine. Moreover, at 5 mM caffeine it was noted that there is a slight difference between the extent of inhibition of the caffeine influx and that of the peak contracture tension. From these results, it could be concluded that the inhibition of peak tension of caffeine contracture by T-disruption is mainly due to the inhibition of caffeine influx which occurs through the T-membrane and is partly due to the functional disturbance of the sarcoplasmic reticulum which is probably induced by T-disruption.


Receptive-field properties of cells in the dorsal part of the albino rat's lateral geniculate nucleus.

Receptive-field properties of 273 relay (principal, P-) cells of the dorsal lateral geniculate nucleus (LGd) were studied in urethane-anesthetized albino rats, in an attempt to see if there is some relation between the visual property and the conduction velocity of afferent optic nerve fibers. According to properties of the receptive-field center, P-cells were classified into two types, common (89%) and uncommon (11%). The common type consists of OFF-phasic, ON-phasic, ON-tonic and ON-OFF-phasic cells, while the uncommon type includes ON-inhibited, moving-sensitive, ON-OFF-inhibited, simple-cell-like and complex-cell-like cells. The mean response latency to single optic chiasm shocks increases in the order of OFF-phasic (1.94 msec), ON-phasic (2.35 msec), ON-tonic (2.87 msec), ON-OFF-phasic cells (3.04 msec) and uncommon type (3.18 msec). The mean size of the receptive-field center in each of the four common types was smaller than that in the uncommon type; 6 degrees--7 degrees vs. 11 degrees. From responsiveness to moving light spots with speeds faster than 25 degrees--30 degrees/sec, P-cells of the common type were divided into the fast- and slow-movement-sensitive cells. The ratio of occurrences of fast- to slow-movement-sensitive cells decreases in the order of the OFF-phasic (2.7), ON-phasic (2.4), ON-tonic (1.1) and ON-OFF-phasic types (0.06). The optic chiasm latencies were shorter than 2.5 msec in most of the fast-movement-sensitive cells while the reverse was true for most of the slow-movement-sensitive cells. From these findings discussions were made to point out that the rat LGd mainly consists of Y- and W-like P-cells and that the Y/W dichotomy of P-cells approximately corresponds to the previously established fast/slow classification.


Responses of the transmembrane potential coupled to the ATP-evoked catecholamine release in isolated chromaffin granules.

Using suspensions of chromaffin granules isolated from bovine adreno-medullae, the effects of Mg2+.ATP on membrane potential and catecholamine release across membranes of granules were investigated. The release of catecholamine was monitored by the measurement of changes in endogenous fluorescence of the amines, while the fluorometric method with 3,3'-dipropylthiadicarbocyanine iodide (diS-C3-(5)) was applied to the measurement of membrane potential changes. The catecholamine release brought about by Mg2+.ATP was found to obey Michaelis-Menten kinetics with Km-value for Mg2+ of about 0.15 mM and to be inhibited by dicyclohexylcarbodiimide (DCCD), an inhibitor of membrane-bound H+-ATPase. Concomitantly with such an amine release, depolarization of the granule membrane was observed to occur. The magnitude of this depolarization closely paralleled with the rate of the amine release and followed a saturation kinetics of Michaelis-Menten type with Km for Mg2+ of 0.21 mM and for ATP of 0.22 mM. Moreover, such a depolarization was competitively suppressed by DCCD. Based on these results, the role of the transmembrane potential change of granules in the catecholamine release was discussed.


Breathing rhythm-generation in the adult lamprey, Entosphenus japonicus.

1. The breathing rhythm-generation mechanism was studied throughout the entire body of the adult lamperey, Entosphenus japonicus, with the body fixed by a specially-designed holder. 2. After brain-stem transection, the rostral part (pontine area) and the caudal part of the medulla (Fig. 2) were found not essential for the generation of respiratory rhythm: the location of the medullary respiratory rhythm-generator was in the district limited by two cross-section lines (Fig.2). 3. Complete division of the brain-stem into two halves by midline section revealed that both of the two symmetrical halves could function independently with their own frequencies for 2 hr or longer. 4. Respiratory burst discharges were recorded from the isolated medial part of the medulla, preceded by a so-called diastolic slow depolarization. The forms of these neural activities resemble those reported in pacemaker cells in some crustacean heart ganglion. No periodic discharges correlating exclusively to the relaxation and/or resting period of branchial muscle were observed. 5. The reciprocal inhibition model was not necessarily considered a prerequisite for medullary respiratory rhythm-generation in the lamprey.


Influence of magnesium on the beta-inhibition of catecholamines in the uterine circular muscle of estrogen-treated rats.

The effects of Mg and isoprenaline on the uterine circular muscle of ovariectomized rats which were injected with estradiol for 2--6 days were investigated. The muscle strip exhibited an action potential that was composed of a spike and a plateau, and also exhibited a twitch-like contraction due to electrical stimulation. The duration of the action potential became longer when the treatment with estrogen was applied until the maximal effect was built up in 4--5 days. Both the duration of the action potential and the amplitude of contraction were reduced when isoprenaline was applied. When Mg (0.5 mM) was added to the bathing solution these beta-effects were progressively potentiated and the maximal effect was obtained in about 1 hr. An increase in membrane conductance was induced by the application of isoprenaline in a control Locke solution and it was further accelerated by exposure to Mg-containing solution. The possibility that the beta-action is potentiated by Mg ions which penetrated into the membrane is concluded.


Cortically induced inhibition of neurons of rat substantia nigra (pars compacta).

The effects of electrical stimulation of prefrontal cortex upon neurons of substantia nigra (pars compacta) in anesthetized rats were mostly inhibition without antidromic excitation. By studying nigral neurons in which the inhibition from caudate-putamen was antagonized by iontophoretic bicuculline, it was found in only half of them that the same drug also antagonized the inhibition from prefrontal cortex.


Treatment of drug-induced dystonic reactions.

Thirty-two cases of drug-induced dystonic reaction were treated by the author with diphenhydramine or benztropine mesylate, intramuscularly or intravenously, in a prospective, nonrandomized fashion. Recovery time with the two drugs was compared. Benztropine mesylate lessened recovery time in this case series. An epidemiological study of drug-induced dystonic reactions found that most of the patients were drug abusers. The commonest offensive agent in this case series was haloperidol. The most common dystonic reactions seen were buccolingual and torticollic.


Evaluation of paramedic programs using outcomes of prehospital resuscitation for cardiac arrest.

Two evaluation methods, one statistical and one comparative, were developed to assess the effectiveness of paramedic programs in King County, Washington. The outcome of hospital admission following prehospital cardiac arrest was used as a measure of effectiveness. In the statistical method, actual outcomes were compared with predicted outcomes. Predictive variables for admission were time from collapse to initiation of cardiopulmonary resuscitation and time from collapse to definitive care. Given knowledge of the predictive variables, the statistical evaluation enabled us to determine the probability of the outcome following cardiac arrest. In the comparative method, outcomes were compared with a standard in an adjacent community. Using this method, we identified program elements that could lead to improved outcome. Both evaluation methods are easily implemented.


Suicidal overdoses with hypoglycemic agents.

Suicide attempts using hypoglycemic agents are uncommon but are associated with a high level of morbidity and mortality. Their recognition is sometimes difficult and the duration of hypoglycemic effect is often prolonged. Two cases that illustrate the difficulties encountered in recognition and therapy are described. Effective therapy depends on adequate glucose supplementation to maintain euglycemia. Therapeutic intervention often must be maintained for several days. Glucocorticoids may be useful in difficult cases. Other modes of therapy, including glucagon, are unproven or controversial.


Treatment of acute phenothiazine reaction.

Dystonic reactions induced by phenothiazines are not uncommon, yet rapid relief of symptoms is still often delayed. We think that a test dose of diphenhydramine should be given for its diagnostic and therapeutic efficacy when phenothiazine-induced dystonic reactions are suspected. Differential diagnostic testing should then proceed. We present three typical cases and discuss the therapy and diagnosis.


Pneumomediastinum following the Heimlich maneuver.

The Heimlich maneuver appears to be a widely accepted technique advocated as a means of clearing an obstructed airway. Reports of complications have been few. We report a case of pneumomediastinum that occurred following the generation of increased pulmonary pressures during performance of the Heimlich maneuver.


Hereditary polyposis coli. II. Genetic counseling.

The problems of genetic counseling in hereditary polyposis coli (HPC)(taken as the type of the age-dependent dominant mendelian trait) are discussed in some detail. They are threefold: first to formalize, for purposes of decision, the total penalty (the "fardel") typically imposed by the disorder for each case, and how it may be modified by treatment; second, to determine the logical issues involved in making probability statements in the face of the uniqueness of each case; third, to use to best advantage the information on the pattern of onset to assess the probability that a person, at risk but not so far affected, does in fact harbor the gene. The third problem points up the need for a formal model of the pathogenesis and its implications for the pattern of onset and the sensitivity of the assessment to the assumptions of the model, especially where one has to rely on cross-sectional, as distinct from longitudinal, data.


Length of time between hospital admission and ventricular fibrillation or cardiac arrest complicating acute myocardial infarction: effect on prognosis.

We performed a community-wide study in metropolitan Baltimore to examine the prognostic role of length of time between hospital admission and ventricular fibrillation or cardiac arrest (VFib/CA) complicating acute myocardial infarction (MI). Risk of developing VFib/CA was particularly marked in the first few hours after admission to the hospital. We compared 128 patients experiencing VFib/CA within 48 hours of admission and 80 patients developing these complications after more than 48 hours. Patients with "early" VFib/CA exhibited a lower in-hospital case-fatality rate than those with "late" VBib/CA (67% versus 88%; p less than .01). Likewise, of patients discharged alive from the hospital and followed for as long as six years a greater proportion of the 38 with histories of "early" VFib/CA survived than of the 11 who had experienced "late" VFib/CA during hospital admission (.05 less than p less than .10). These results suggest that whereas "early" VFib/CA may reflect transitory myocardial electrical instability, "late" VFib/CA may indicate chronic instability and thus imply a poor prognosis.


Focal glomerulosclerosis and erythrocytosis.

A 22-year-old black male presented with erythrocytosis and proteinuria. The erythrocytosis was characterized by increased red cell mass, normal arterial oxygen saturation, and normal hemoglobin electrophoresis and oxygen affinity. There was no splenomegaly, and the white blood cell count, platelet count, serum uric acid concentration, serum B12 levels and leukocyte alkaline phosphatase activity were normal. Tumors of the liver, lung, kidney and cerebellum, which have been associated with erythrocytosis, were not found. The only associated disease was biopsy proven focal glomerulosclerosis. Renal vein thrombosis was excluded by renal venography and arteriography. This case illustrates the rarely reported association of the nephrotic syndrome and erythrocytosis. Other nephrogenic causes of erythrocytosis are mentioned, including renal cysts, tumors, renal artery stenosis and transplantation. The role of the kidney in erythropoietin production and possible mechanisms of nephrogenic erythrocytosis are discussed.


[Pharmacological and clinical study of the liquid drug form of nonachlazine].

A 1.5% nonachlazin solution containing substances which promote its absorption from the gastrointestinal tract increases coronary blood flow in cats 2--3 minutes after its administration into the stomach. After single administration this solution arrests a developing attack of angina pectoris in patients, improves the findings of spiroergometry, and in regular (3 times daily) medication prevents attacks of angina pectoris or makes them occurs less frequently in the very first 24 hours. The solution is most effective in patients with a high or moderate coronary reserve and affection of one or, in a lesser degree, of two coronary arteries. The solution does not cause a drop in arterial pressure, headache or dizziness.


[Assessment of the dimensions and dynamics of the necrosis zone in acute myocardial infarct].

In 165 patients with myocardial infarction admitted to the clinic within the first 24 hours of the disease, the size of the zone of affection and its dynamics in the immediate 4--5 days were appraised. Three methods were used for this purpose: cartographic analysis of the ECG in 35 precordial leads; vectorcardiography and serial determination of creatine phosphokinase activity (CPK) in blood plasma with calculation of the size of the necrosis in units of weight (grams). It is shown that ECG-cartography and serial determination of serum CPK activity are valuable methods in quantitative appraisal of the size of the necrotic focus in patients with myocardial infarction. Study of the ECG-cardiogram and vectorcardiogram in dynamics and analysis of CPK activity curves enables one to appraise the spreading of the zone of the necrosis in the first days of the infarction. According to the results of these methods, in most patients (68 to 82%) with macrofocal myocardial infarction the zone of the necrosis spreads in length and in depths in the first days of the disease.


[Microfocal myocardial infarct as a variant of exacerbation of ischemic heart disease].

The results of long-term (3- to 4-year) follow-up of 180 patients with microfocal myocardial infarction are analysed. The difference in the course and prognosis of primary and recurrent microfocal myocardial infarction is determined. It is shown that microfocal myocardial infarction as a form of exacerbation of ischemic heart disease is characterized by a complex of syndromes differing from the typical picture of marcrofocal myocardial infarction. As compared to macrofocal myocardial infarction, the course of the disease after microfocal myocardial infarction is characterized by more frequent exacerbations of coronary insufficiency and a greater tendency toward the development of recurrent myocardial infarction. In some cases, microfocal myocardial infarction heralds the development of macrofocal myocardial infarction with a severe course and high mortality rate, which provides the grounds for the conclusion that patients with microfocal myocardial infarction have a lower coronary reserve.


[Effect of the extent of the atherosclerotic lesion of the coronary arteries on the contractile capacity of the myocardium in ischemic heart diseases].

Myocardial contractile capacity was studied in 100 patients with ischemic heart disease who had suffered from myocardial infarction. All of them were subjected to electrocardiography, selective coronarography and left ventriculography. Depending on the entirety of the affection of the coronary channel the patients were grouped in four caterogies. The authors claim that determination of the entirety of the affection of coronary arteries in patients with ischemic heart disease who had suffered from myocardial infarction helps to judge the contractile capacity of the myocardium with a greater degree of credibility.


[State of the myocardial contractile structures in different areas of the heart in myocardial infarct complicated by cardiogenic shock and congestive circulatory failure].

In myocardial infarction, destructive changes develop in the contractile elements of the heart muscle in the peri-infarction zones. The degree and extent of the myofibril involvement depend on the clinical course of myocardial infarction, the drug therapy applied, and the distance from the focus of necrosis. The most marked destructive changes were in the prenecrotic zone of the myocardium in individuals with cardiogenic shock or severe congestive cardiac failure with clinical symptoms of glycoside intoxication. Gross focal contractures of myofibrils were found, which subsequently underwent fibrinoid necrosis. There were also areas of myofibril relaxation with dissociation of the actin fibers and destruction of the z-disks. The destructive changes in the myofibrils are due to a great extent to the effect of catecholamines, myocardial hypoxia, and glycoside intoxication. The disturbed orientation of the myofibril bundles in patients with recurrent myocardial infarction may play an essential role in the decrease of the myocardial contractile function and the development of extrasystolic arrhythmias.


[State of the microcirculation in myocardial ischemia and its alterations after depositing bioresorbing microspheres of Sephadex in the coronary bed].

It is shown that the diffusion capacity of the capillary channel diminishes in myocardial ischemia. In unchanged or increased capillary permeability this effect may only be explained by a functional shunt of the affected cardiac area. Intracoronary administration of a carrier of biologically active substances in the form of microspheres of modified Sephadex does not aggravate irregularity in the blood supply to the zone of ischemia, which is evidence of the adequacy of the organ reserves of the functional shunt in this situation.


[Importance of the radioimmune method of determining renin activity in the blood plasma for the differential therapy of hypertension].

The results of differentiated treatment of patients with hypertensive disease depending on blood plasma renin activity are analyzed. Sixty-seven patients with hypertensive disease and 14 healthy individuals (controls) were examined. Sets of the JCN firm (USA) were used. Persons with high, moderate and low renin activity were distinguished among patients with hypertensive disease. Differentiated therapy was applied depending on the activity of renin: in high renin activity obsidan was given, in low activity drugs of the saluretic group were used. Treatment proved effective in 60 patients (89%). High renin activity is a prognostically unfavourable sign.


[Arterial hypertension in psychopathological states of an endogenous nature].

The article describes the features and character of hypertension in certain psychopathological, mainly hypochondriac, states in an endogenous psychic disease. It is shown that the subjective pathopsychological state, the patients' complaints and functional vegetovascular disorders differ from those observed in patients suffering from true vascular diseases. The increase in arterial pressure in the patients studied follows earlier disturbances of the general condition. The dependence of the character of increase in arterial pressure and its tendency to stabilization on the acuity and urgency of senestopathy automatism is noted.


[Administration of the catecholamine precursor, L-DOPA, for evaluating their in vivo biosynthesis in hypertension].

The activity of the sympathetico-adrenal system was studied in 19 healthy individuals and in 40 patients with grade IB and IIA hypertensive disease. The excretion of free and conjugated forms of catetcholamines (adrenalin, noradrenalin and dopamine) and the precursor of their synthesis DOPA was determined. Comparison of these values in the control period and after per os administration of L-DOPA (levodopa) showed that administration of the precursor makes it possible to appraise catecholamine biosynthesis in vivo on the level of the intact organism. The results indicate that in patients with hypertensive disease of the early stages the production of dopamine is increased, whereas that of noradrenaline is reduced.


[Change in the state of the fibrinolytic and kinin blood systems under physical load in the rehabilitation period after a myocardial infarct].

In examination of the blood fibrinolytic and kinin systems in patients with myocardial infarction in the period of rehabilitation three groups of patients were distinguished according to fibrinolysis activity: high, normal and diminished. A positive correlative connection was noted between the activity of the fibrinolytic system and that of the kinin system. The character of changes in the indices of these systems in response to physical load depended on their initial level. Maximum increase in the fibrinolysis activator level was noted in the group of patients with low initial fibrinolytic activity, whereas in the group of patients with high initial fibrinolysis its activity after the load decreased. In assessment of the functional condition of the organism it is necessary to take into account both the initial activity of the fibrinolytic and kinin systems and the character of changes in their activity in response to physical load.


[Blood vasopressin and the kallikrein-kinin system in chronic ischemic heart disease].

The blood vasopressin content and kinin system activity were studied in 83 patients with chronic ischemic heart disease of various severity. It was established that the blood vasopressin concentration increases with an increase in the severity of the disease. A high degree of correlation between changes in vasopressin content and in components of the kinin system was revealed: increase in the concentration of vasopressin is attended by activation of the kallikrein-kinin system. The mechanisms of the interrelationship of the vasopressin and kinin content are discussed. It is suggested that vasopressin may play a role in the pathogenesis of chronic ischemic heart disease.


[Lipid peroxides and atherosclerosis. The content of lipid peroxidation products in the blood in ischemic heart disease].

It was established that the content of primary (acylhydroperoxide) and secondary (intermollecular "seams" in aminophospholipids) products of lipid peroxide oxidation in blood of patients with ischemic heart disease is increased against the background of hyperlipidemia and hypercholesterolemia. It is suggested that intensification of lipid peroxide oxidation may play a role in the pathogenesis of atherosclerosis.


[Use of phosphaden in treating chronic ischemic heart disease].

The pharmacodynamics and pharmacotherapy of phosphaden (adenosine-5-monophosphate), a Soviet activator of energy metabolism, were studied in patients with chronic ischemic heart disease. Functional and biochemical methods were used. It was established that phosphaden is an effective drug in the treatment of chronic ischemic heart disease. The results of clinical, functional and biochemical examination support this conclusion.


[Cardiomyocyte ultrastructure in nonextreme coronary insufficiency].

The ultrastructure of the contractile myocardium taken from different zones of the left and right ventricles of the heart was studied during dosed restriction of blood flow in the circumflex branch of the left coronary artery by 30 and 50%. It was established that the changes of the cardiomyocytes in this situation are displayed by a combination of two differently directed processes, destructive-dystrophic and adaptational, the severity of which is determined by the intensity of the unfavourable effect. The whole parenchyma of the ventricles of the heart is involved in the reaction and there are no intact zones.


[Cardiomyocyte-capillary system of the human heart normally and in acute myocardial infarct (a stereometric study)].

Stereometric examination of the cardiomyocyte-capillary system of 40 normal hearts and 20 with primary acute infarction was conducted. Constitutional features of structural organization of the myocardium and its capillaries were determined. It is shown that myocardial infarction was encountered relatively more frequently in hearts characterized by low index of capillary blood supply to the muscular fibers. Such types of spatially-quantitative organization of the cardiomyocyte-capillary system are considered to be a risk factor for the development of ischemic heart disease.


[Hemodynamic and ultrastructural changes in the acute stage of myocardial ischemia (an experimental study)].

The results of experiments on 38 dogs with acute myocardial ischemia are discussed. Hemodhynamics and contractile function of the myocardium were studied and the findings were compared with the data of myocardial structure in different time intervals. The authors claim that one of the first signs of myocardial contractile insufficiency is a change in the rate of myocardial contractility which becomes manifest against the background of disorders of rhythm. Electron microscopy at this moment is characterized by thickening of Z-disks. Before the onset of fibrillation the geometry of the cardiac ventricles changes, the ejection fraction decreases by 53%. The ultrastructure of the myocardium in this period is marked by stepped Z-disks and extensive damage to the mitochondrial cristae.


[Changes in the ischemic myocardium in experimental paired stimulation of the heart].

In dog experiments the dynamics of electrophysiological and morphological indices of the ischemic myocardium in sinus tachycardia was compared with that in deceleration of cardiac contraction under the effect of paired stimulation. Intensification of the damaging effect of a 40-minute occlusion of the coronary artery complicated by destructive changes of the cardiomyocytes was revealed after deceleration of the rhythm; in reperfusion of the ischemic area the effect of electrogram restoration was diminished, which was attended with deeper focal damage to the heart muscle.


[Possible metabolic mechanisms of coronary circulatory disorder in an intact area of the left ventricle in experimental myocardial infarct].

In dogs with experimental myocardial infarction the anterior descending branch of the left coronary artery was ligated and 1, 2, 3, 5, and 10 days later its circumflex branch was catheterized and perfused, and coronary circulation in the intact myocardial zone, systemic hemodynamics, the AMP content and the activity of enzymes catalysing adenosine metabolism were studied. In the intact myocardial zone resistance increases in the coronary vessels and neurohumoral regulation is disturbed, the beta-adrenergic and cholinergic reactions of dilation are weakened, alpha-adrenergic pressor effect of catecholamines on the cardiac vessels is manifested, and adenosine metabolism is disturbed. Disorders of adenosine metabolism are regarded among the possible mechanisms of coronary circulatory disorders in the intact zone of the myocardium.


[Current problems of glomerulonephritis (author's transl)].

Setting out with the theory of glomerulonephritis from Volhard and Fahr (1914) and the fundamental patho-anatomical examinations on this subject by Theodor Fahr (1925, 1934) the actual problems of glomerulonephritis are described. Progress in nephropathology and immunopathology which was partly conditioned by progress in the methodical fields has come to the result that, nowadays, an appropriate characterization of glomerulonephritic diseases is only possible by the synopsis of the three categories: Immunopathogenesis, pathomorphology and clinic. Each of these categories has its own classification. The nosology of the various GN types results from the (constant or variable) combination of the components of these three systems. By this means, some known types of glomerulonephritis were confirmed, some were newly defined, and new entities with variable clinical relevance were layed bare. Because immunopathogenetic events very often induce characteristic structural alterations in the glomeruli, it is the pathomorphological nomenclature which -- as pars pro toto -- still is the best suited for common interchange.


[Quantitative gated nuclear cardiography for noninvasive evaluation of left ventricular function].

In 43 patients with angiographically proven coronary heart disease and in 24 patients without heart disease, gated blood pool scintigraphy was done under resting conditions with 15 mCi 99mTcHSA in LAO projection.  Scintigraphic data were collected in list mode by means of a gamma camera connected to a computer system (Siemens 330). A cumulative scintigram sequence with a time resolution of 100 frames/s was constructed using several hundred heart cycles of equal duration. After background correction volume curves of the left ventricle were obtained and the following parameters were calculated: EF, dV/dt max,dV/dt min. In all patients with coronary heart disease, these parameters were reduced depending on the severity of the stenotic lesion. The changes of dV/dt min and to a greater extend of dV/dt max were more pronounced than those of the EF. These results are in keeping with invasively obtained data which show that a decrease of myocardial compliance is one of the earliest manifestations of CHD. Quantitative gated nuclear cardiography allows, therefore, noninvasive evaluation of left ventricular function even under resting conditions.


[Effect of BCNU on glutathione metabolism in human blood cells].

BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea) at therapeutical doses inhibits almost completely glutathione reductase of the patients' red cells and paltelets. Red cell glutathione reduction is diminished simultaneously. These changes are fully reversible in red cells and platelets derived in the following days after application of BCNU. Clinical signs of red cell perturbation after BCNU treatment have not been demonstrated. In vitro incubation of normal red cells with BCNU produces the same changes as i.v. injection of BCNU to the patients, but no reversibility is seen.


[Duration of biological activity of pindolol in uremics (author's transl)].

The duration of biological activity of pindolol following short and long term application was tested using a modified isoproterenol-sensitivity-test. Following a single dose of pindolol the beta-blocking activity in uremics was increased to twice the activity seen in normal controls. Following daily oral application of 10 mg Pindolol over a number of weeks the beta-blockade observed in patients with chronic renal failure was significantly stronger and the duration of action was 6 times longer than in normal controls.


[Flow sheets of urine samples in haemolytic uraemic syndrome. Examinations by analytic isotachophoresis (author's transl)].

In 29 urinary fractions of six children with haemolytic uraemic syndrome (HUS) a specific substance could be demonstrate during the acute phase of the disease by means of isotachophoresis. Urine tests in six patients with other kidney diseases and with uraemia and in seven healthy persons did not show this substance. From this, we assume that the substance demonstrated in the isotachogram has a direct correlation to the HUS.


[Renovascular hypertension. Prognostic value of renal venous renin determinations (author's transl)].

In the present study the effect of surgery on blood pressure was investigated in 35 patients with renovascular hypertension: 17 patients with fibromuscular hyperplasia (FMD) and 18 with atherosclerosis (ASS) of the renal artery. Patients with FMD were younger (31,8 years), showed a shorter duration of hypertension (1.8 years) and were prevalently female (82%), whereas patients with ASS were markedly older (48.2 years), showed a longer duration of hypertension (2.6 years) and were most often male (78%). In both groups of patients the intravenous urogram was positive in a comparable high percentage (FMD=64%, ASS=61%). Following surgical intervention 47%(n=8) of the 17 patients with FMD were cured, 47% (n=8) were improved and only 6% (n=1) showed insufficient reduction of blood pressure values. In ASS the respective values were 28, 55 and 17%. Consequently a good effect of surgery (cured and improved) was observed in 88.5% of all patients. Patients with ASS who failed to respond to surgery (n=3) showed a remarkable long duration of hypertension (7.0 plus or minus 1.4 years). Plasma renin activity (PRA) was determined preoperatively in both renal veins in all 35 patients. From these values the PRA-ratio (PRA affected/unaffected side) was calculated. In 27 patients PRA determinations were repeated following (15 and 30 min) intravenous injection of 40 mg furosemide. PRA-ratios of larger than or equal to 1.5 were considered to be significant. In 31 patients with unilateral renovascular hypertension PRA-ratios were correlated to the postoperative blood pressure reduction. No significant differences in mean PRA-ratios were observed between cured and improved patients. Furthermore, for the total group of 31 patients no significant correlations were obtained between PRA-ratios and postoperative blood pressure reduction. Our results do not support the widespread opinion that PRA determinations in both renal veins are useful to predict the effect of surgery in patients with unilateral renovascular disease. Therefore, from our experience this method should not be recommended as obligatory in the diagnostic work-up of renovascular hypertension.


[Demonstration of acetylcholine receptor antibodies in the serum of myasthenia gravis patients applying affinity chromatographically purified human acetylcholine receptor preparations (author's transl)].

Sera from 75 patients with Myasthenia gravis were tested for acetylcholine receptor antibodies using acetylcholine receptors from human skeletal muscle. From the crude Triton x-100 extract, which has so far been used for antibody tracing, a pure acetylcholine receptor preparation was obtained by affinity chromatography using alpha-Najatoxin-Sepharose 4B. When the purified 125J-alpha-Bungarotoxin-acetylcholine receptor complex was applied in a radioimmunoassay 80% of the Myasthenia gravis patients had acetylcholine receptor antibodies in contrast to none of the tested control persons. Inspite of using a pure acetylcholine receptor preparation, no clear-cut correlation was found between the amount of serum acetylcholine receptor antibodies and the clinical stage of the disease. When individual antibody titration curves were established, different reaction patterns were observed indicating either different antibody specificities in regard to antigenic determinants on the receptor molecule or differences in the antibody affinity.


Counteraction of cyanide poisoning by thiosulphate when administering sodium nitroprusside as a hypotensive treatment.

A 42-year old patient received a continuous infusion of sodium nitroprusside (SNP) at a dosage rate of 600 microgram/min for approximately four days. On the third day of treatment a dangerous high level of cyanide was measured in the blood. When an additional continuous infusion of sodium thiosulphate at five times the molar concentration of the SNP was given, this cyanide level dropped over a period of 7h to one-seventh of its initial value. The thiosulphate did not reduce the effectiveness of the SNP in lowering the blood pressure.


[Clinical, morphological and biochemical studies on muscle carnitine deficiency (author's transl)].

This report deals with two sisters who died with eight, respectively ten weeks under the signs of respiratory failure caused by progressive muscular weakness. Only an elevated cerebrospinal fluid protein was suspicious of an additional disturbance of the central nervous system. Muscle biopsy revealed a vacuolar myopathy. Histochemistry showed lipid storage, increased mitochondrial enzyme activity, and to a lower degree, glycogen accumulation especially in type I muscle fibers. Electron microscopy confirmed elevated lipid content in combination with increased, enlarged and abnormally structured mitochondria. Biochemical studies on muscle biopsy, in comparison with normal children, showed a significant decrease of carnitine content and an increased activity of carnitine palmityltransferase. Retrospectively from a clinical point of view this disease is suggestive of "systemic carnitine deficiency", even if some symptoms (hepatomegaly, cardiomyopathy) were not present and serum- and liver carnitine was not measured because the children died before the diagnosis of muscle carnitine deficiency was confirmed. The clinical picture of these two fatal cases is compared with another observation of muscle caritine deficiency. This child shows only a mild course of muscle disorder, but very similar morphological changes in muscle biopsy. Biochemically, there was a clear decrease in muscular carnitine, while the serum levels were in the normal range. The activity of muscular carnitine palmityltransferase was also normal.


[The significance of determining antibodies to acetylcholine receptor in myasthenia gravis (author's transl)].

The sera of 65 patients with myasthenia gravis (MG) were analysed for antibodies against the nicotinic acetylcholine receptor (ACh-R) using an immunoprecipitation assay (125I-alpha-bungarotoxin bound to human ACh-R as antigen). In 91% of MG sera elevated antibody titers were found ranging up to 500 times reference values. A control group of 77 patients showing various autoimmunological phenomena had ACh-R antibody concentrations within the reference range. The demonstration of antibodies against ACh-R provides a sensitive and highly specific tool for the diagnosis of MG. In addition, the test is helpful in following patients under treatment with immunosuppressive drugs or plasmapheresis. Antibodies against striated, smooth, or heart muscle (indirect immunofluorescence test) are much less sensitive and nonspecific for the diagnosis of MG.


Differential diagnosis importance of the creatine kinase isoenzyme pattern in delirium tremens.

Total CK and CK-MB (by the inhibition test, Merck-1-CK-MB) were measured in 33 patients which had to be admitted to the department of psychiatry due to acute withdrawal symptoms (predelirium, delirium) caused by chronic alcohol abuse. The results were evaluated together with the routinely performed laboratory determinations as well as clinical examination and morphologic investigations (ECG, X-ray examination of the thorax, EEG, CT). The results show that the CK-MB/total CK relationship represents also in these patients the most reliable parameter to discriminate elevated total CK values. In no but one case a substantial CK-BB release from the central nervous system could be demonstrated by the inhibition test. In 83% of the patients with elevated total CK activities it was possible to exclude an affection of the heart muscle (CK-MB portion below 6%). The CK-MB/total CK-quotient was clearly superior to the total CK/GOT relationship, by which a myocardial affection could be excluded in less than 40%. In four patients the CK-MB portion was above the critical decision limit of 6%: three obtained between 6% and 7%, one even 17%. The results suggest that the CK-MB/total CK-quotient may represent the most sensitive and reliable parameter of myocardial affection in patients with an alcohol intoxication and/or a delirium tremens.


Treatment of fulminant hepatic failure with infusions of Co-factors and mannitol and charcoal-hemoperfusions during Forty-one days.

The clinical course of a 26 year old female patient with acute liver necrosis and coma due to hepatitis B is reported. The disturbances of conciousness had improved. The patient survived 41 days after the beginning of the coma and developed liver cell regeneration and an acute post-hepatitic liver cirrhosis. As a grave complication a septicemia with aspergillus was observed. The patient died because of gastro-intestinal hemorrhage. At autopsy there were no signs of brain edema. The treatment consisted in: daily infusions with coenzyme A, nicotinamid-adenin-dinucleotide, alpha lipoic acid and cocarboxylase to improve the metabolic disorders and the clinical picture; mannitol intravenously to prevent and to treat cerebral edema; 33 charcoal-hemoperfusions to remove toxic substances of acute liver failure. Treatment of the aspergillus infection with 5-fluorocytosine and amphotericine B and infusion of concentrated ascites led to a decompensation of liver functions. From this observation the following conclusions can be drawn: after an acute viral hepatic necrosis, new synthetic functions and improvements of the disturbed intermediary metabolism in regenerated liver-cells can eventually be seen only after twenty-four to thirty days. With systematically applicated mannitol infusions it is possible to treat cerebral edema effectively.


Two survivors of severe paraquat intoxication by "continuous hemoperfusion".

"Continuous hemoperfusion" (8 h/day for 2--3 weeks) was performed in two patients suffering from severe paraquat intoxication. On account of paraquat plasma concentrations a fatal outcome due to pulmonary fibrosis would have been expected in both cases. However, both patients survived following "continuous hemoperfusion" therapy. Coated activated charcoal seems to have a higher affinity for paraquat than lung tissue.


[Neurochemical characteristics of rats during flight on the Kosmos-782 artificial satellite and after returning to earth].

The brain of rats flown aboard the biosatellite Cosmos-782 was sampled immediately postflight and taken under neurochemical study. It was shown cytospectrophotometrically that the absolute content of RNA decreased by 20% in the cytoplasm of cerebellar Purkinje cells and remained unaltered in glial cells-satellites, and that the protein content did not change. In the frontal cortex (homogenates) the concentration of sulfhydryl groups decreased by 26%, activity of nonspecific cholinesterase by 33%. The activity of the latter in the cerebellum also diminished.


[Effect of small gravitational loads on human water-salt metabolism and kidney function during prolonged immersion].

It was demonstrated that renal excretion of fluid, osmotically active substances and electrolytes could be reduced, using low gravitational exposures (+GZ). The degree and duration of water and electrolyte retention were different with respect to the experimental time. The major physiological mechanisms of the changes in fluid-electrolyte metabolism were: a decrease in the glomerular filtration rate and a change in water and ion transport in renal tubules.


[Change in the neuromotor apparatus after 45 days' hypokinesia].

Neurological and electromyographic examinations of 12 test subjects during a 45-day bed rest study were carried out. Symptoms indicating changes in the suprasegmentary innervation were noted. Shortening of the duration of potentials was shown by needle electromyography. A decline in the threshold of H-reflex and a change in the frequency parameters of EMG were seen. These data suggest a change in the functional state of the central and peripheral motor neuron during prolonged hypokinesia. Prophylactic efficiency of muscle electrostimulation is discussed.


[Role of interoceptive afferentation in the activities of the cortical portion of the visual analyzer].

The experiments on diplacin-immobilized rats showed that stimulation of gastric and rectal mechanoreceptors caused noticeable changes in the control and light-induced impulse activity of neurons of the optic cortex (field 17). The predominant pattern of cell reactions were tonic changes of impulsation. They included both stimulatory and inhibitory effects. The latter occurred mostly as a result of stimulation of gastric mechanoreceptors. Changes in the evoked activity of those neurons involved most frequently enhancement or inhibition of responses, contrasting and stabilization of short-latent responses, and their masking with neuronal noise. The paper discusses the functional importance of the above changes in the control and evoked activities of neurons of the optic cortex during interoceptive effects as well as possible central pathways of their realization in the optic cortex.


[Effect of acute hypoxia on specific and nonspecific brain systems in rabbits].

At a simulated altitude of 8500-9000 m, an increase in the amplitude of the early positive and negative phase of the thalamic-cortical evoked potentials, and a slight prolongation of the latent period were seen. Changes in the reticulo-cortical and hypothalamo-cortical evoked potentials included a pronounced inhibition of their negative phase. In the EEG slow delat-waves increased gradually, becoming the major rhythm. The presence of EEG signs of the development of inhibitory processes in the cortex suggested that the changes in evoked potentials were also a result of inhibition of cortical neurons. Hypoxia-adapted rabbits tolerated acute hypoxia much better. They exhibited less pronounced changes in the electric manifestations of the function of specific and nonspecific projection systems of the brain.


[Bioelectrical activity of the neuromuscular and sympathetic systems exposed to a constant magnetic field].

The experiments on an isolated frog neuromuscular preparation gave evidence that an exposure to stable magnetic fields of 1000-4000 Oe did not influence the time parameters, amplitude and pattern of the action potentials of the gastrocnemius muscle induced by ischiatic nerve stimulation with single impulses. Similar results were obtained from an analysis of electric responses of the upper cervical sympathetic mode to the stimulation of preganglionar fibers in in situ experiments on urethane anesthesized rabbits subjected to a total exposure of a stable magnetic field (500-3000 Oe). In addition, an exposure to a stable magnetic field of 4000 Oe brought about a decrease of the level of depression of the action potential of muscles after conditioning tetanus.


[Effect of strong, infralow-frequency magnetic fields on bone marrow cell division].

The effect of an infralow frequency magnetic field of 3-127 kOe applied for 1 hr on mitotic activity, frequency of chromosomal aberrations and number of bone marrow cells of mice was studed. The exposure of mice to fields of 3 and 8 kOe stimulated and to fields of 54 and 127 kOe inhibited mitotic activity. No increase in the frequency of aberrant mitoses in bone marrow cells was noted. The changes in the cell number were small (no more than 20%) and readily reversible.


Influence of visible light on organ weights of mice.

Hau:ICR mice separated by sex, were reared for 30 days under various fluorescent lamps: pink, blue, black UV, cool white and full spectrum. Body weights and absolute organ weights were compared. After light exposure, female body weights were not significantly different between any groups; however, a difference in male body weights was observed. Light affected the weights of the pituitary, adrenals, kidneys and prostate in male mice and the adrenals, thyroid and pineal glands in females. The weight of adrenal glands of both males and females were most sensitive to changes in lighting.


Respiratory measurements of unsedated small laboratory mammals using nonrebreathing valves.

The respiratory frequency, tidal volume, minute volume, oxygen uptake and carbon dioxide output of unsedated hamsters, rats, guinea pigs and rabbits were measured to obtain comparative data and to evaluate the performance of those species as unsedated subjects. The animals were trained to remain stationary and breathe through nonrebreathing valves while expired gas was collected and respiratory frequency was monitored. Measurements of dogs also were conducted to obtained comparative data by similar methods. Hamsters were readily trained and performed reliably during repeated trials. Rats and guinea pigs were more difficult to train and performed erratically. The rabbits' performance was intermediate between that of hamsters and the other species. The back pressures caused by the small animal nonrebreathing valves at estimated peak flow rates were either similar to or less than those encountered by dogs. Measured respiratory values were compared to values predicted by published equations based on body weight. Data from this study generally reflected species differences related to body weight and metabolic rate similar to those predicted by the equations, but values from the four smaller species also may have reflected differences related to behavior.


In vivo detection of rabbit atropinesterase.

The comparability of an in vivo rapid screening test for the presence of atropinesterase with an in vitro standard colorimetric test was assessed using 410 male and female New Zealand white rabbits. The results from both tests were in agreement in 405 of the 410 (98.8%) rabbits compared. One false negative and four false positive results occurred with the rapid screening test.


A simple technique for nonsurgical embryo transfer in mice.

A simple method was developed for nonsurgical transfer of mouse embryos which enabled transfer to both uterine horns. Embryos were picked up in a modified capillary tube and transferred through the cervix into each uterine horn of an unanesthetized mouse. A glass speculum was used to facilitate location of the cervix. The technique was found to be as successful (up to 60% of embryos transferred developed to term) as surgical methods yet was simpler and eliminated surgical trauma to the recipient mouse.


Metal-free housing units for trace element studies in rats.

Metal-free housing units fabricated from clear plastic and polystyrene egg crate panels were used to house rats for studies involving trace elements. The cages did not require bedding, were well ventilated and fitted into commercially available cage racks. Modifications of the basic design were made to provide both maternity and metabolism cages.