17beta-oestradiol and Enovid mammary tumorigenesis in C3H/HeJ female mice: counteraction by concurrent 2-bromo-alpha-ergocryptine.

Chronic administration of 17beta-oestradiol (via drinking water) or the oral contraceptive Enovid (norethynodrel and mestranol) (0-1 mg injected s.c. twice weekly) to nulliparous C3H/HeJ female mice, beginning at one month of age and terminating at 20 months (17beta-oestradiol) or 22 months (Enovid), significantly increased the incidence of mammary tumours over solvent-treated controls. Concurrent treatment of the steroid-treated mice with 2-bromo-alpha-ergocryptine (CB-154) (0-1 mg s.c. injected daily) significantly reduced mammary tumour incidence and mammary hyperplastic nodule development to the control level. CB-154 is an efficacious inhibitor of pituitary prolactin secretion. These results demonstrate that steroid-induced mammary gland dysplasias can be sharply reduced by chronic CB-154 treatment, and suggest that some of the mammary tumorigenic activities of oestrogenic steroids in C3H mice are mediated via an increased secretion of pituitary prolactin.


Purification of L-glutamate decarboxylase by affinity chromatography.

L-Glutamate decarboxylase (L-glutamate 1-carboxy-lyase, EC 4.1.1.15) from rat brain synaptosomal extract was partially purified by affinity chromatography. On further purification by DEAE-Sephadex A 50 and Sephadex G-200, L-glutamate decarboxylase was purified to greater extent. It was found that a single affinity chromatography by appropriate elution gave a highly purified protein giving a single band of high specific activity on polyacrylamide gradient gel slab electrophoresis with minimal contamination. Substrate specificity of the purified enzyme was modified in the presence of 6-azauracil or phenylalanine resulting in decreased specificity to L-glutamate and increased specificity to L-aspartate.


[State of the surface activity of pulmonary surfactant in rats at different periods after left-sided pneumonectomy].

The surface activity of the seven-fold washing of the right lung was measured on the modified Wilhelmy's balance after the leftside pneumonectomy in rats. It appeared to be normal (gamma min-23--24 dynes/cm) up to the 5th day, and at the remote postoperative periods. The intracellular edema of the air-blood barrier components and the release of the edema fluid into the alveolar lumen in the "vesicle" composition failed to influence the surface properties of the lung surfactant. A sharp increase of the alveolar dimensions on the 5th--7th postoperative day was followed by an increase of the surface-active properties of the lung washings (gamma-min-11--15 dynes/cm) and by the intensified secretion of the material of the osmiophilic lamellar bodies from the alveolar cells of the 2nd type into the alveolar lumen. The cytological mechanisms providing the intensified production of the surfactant in the hypertrophic alveoli are activation of the lipid synthesis in the alveolar cells of the 2nd type, their hypertrophy, and also the appearance of binuclear cells.


Antibody response to intravenous immunization following splenic tissue autotransplantation in Sprague-Dawley rats.

The response to intravenous challenge with sheep erythrocytes was determined in Sprague-Dawley rats following autotransplantation of splenic tissue into the subcutaneous tissue, peritoneal cavity, or a surgically created omental pouch. There was a marked rise in heterophil antibody titer following intravenous challenge in ten control animals, and no rise in titer in nine of ten asplenic animals. Heterophil antibody titers increased in all of the animals with transplants, but the response in some was less than that in control animals. Thus autotransplanted splenic tissue demonstrated immunologic responses similar to those of normal, intact spleen.


Long-term treatment of acromegaly with bromocriptine.

Seventy-three patients with active acromegaly were treated for three to 25 months with bromocriptine 10-60 mg/day. Seventy-one patients showed symptomatic and objective clinical improvement. This included reduction in excessive sweating, hand and foot size, and the number of headaches; improved facial appearance; and increased energy and libido. Abnormal visual fields became normal in two patients, one of whom had concomitant radiotherapy. Mean circulating growth hormone levels, obtained by averaging serial samples through the day, fell by more than 7 microng/l or became undetectable in 58 patients (79%) but did not reach normal values: only 15 patients had mean levels on treatment of 5 microng/l or less. Twenty-three patients were diabetic before treatment, and glucose tolerance became normal in 15 and improved in a further five. Provided the drug was started slowly side effects were minor when compared with the considerable clinical benefit obtained.


Teenage girls and venereal disease prophylaxis.

One of the main aims of venereal disease education is to encourage the use of prophylactic techniques by sexually-active persons. To do this educators must convey information about prophylaxis that is relevant. This study was designed to assess the knowledge, attitude, and behaviour regarding prophylaxis of a group of 200 American adolescent girls. The findings suggest areas of prophylaxis that should be emphasised and ways that might encourage the acceptance and use of prophylactic measures. The study showed there were some misunderstandings and that it was important, for example to clarify the relationship of the oral contraceptive to possible venereal disease infection. Education involving both the cognitive and affective domains was indicated by the partial acceptance of the use of the condom, particularly by persons who had more than one partner.


Behavioural and social characteristics of the patient with repeated venereal disease and his effect on statistics on venereal diseases.

The current study investigated personality characteristics and social circumstances in patients repeatedly infected with venereal diseases. An effort was made to identify characteristics that would differentiate a repeat patient (RP) from a non-repeat patient (NRP). Two studies were carried out. In the first, a group of patients from a venereal disease clinic in a large general hospital was first interviewed and then the patients were asked to complete a questionnaire. In the second study, an attempt was made to validate the findings from the first study by comparing data from RP and NRP venereal disease patients drawn from medical and social case histories from a second hospital. Results of both studies support the hypothesis that repeat patients are different from non-repeat venereal disease patients in terms of social and psychological characteristics. The significance of these findings is discussed.


A record system for contact tracing.

A system for recording information on patients and contacts was developed during a research project designed to measure the effectiveness of contact tracing. The record system has proved valuable in contact tracing, cross-referencing patients and their contacts, defining the characteristics of the patient and contact populations, and providing information for research and management. The value of a standardised system has been accepted by health workers who appreciate that its purpose is to increase efficiency and improve the care of infected persons. By October 1976 health workers in 16 clinics in the United Kingdom had started to use the system.


The hypertension detection and follow-up program: a progress report.

The NHLBI-supported Hypertension Detection and Follow-Up Program (HDFP) is a community-based program designed to assess the value of early detection and vigorous treatment of persons with high blood pressure of varied severity. HDFP staff members have measured the blood pressures of 158,906 persons in their homes or work places in 14 communities across the United States. Of those persons, 10,940 were found to be hypertensive in a two-state screening process and were enrolled in the Program. Half were referred on a random basis to sources of care in the community, and half were invited to the special Stepped-Care clinics sponsored by the HDFP. These clinics, in a vigorous attempt to normalize blood pressure for all these hypertensive participants, stress intensive follow-up and special attention to achieve compliance with treatment. More than 80% under Stepped Care are continuing on therapy after 2 years, and three-fourths of these have achieved desired normal levels of pressure. The majority of hypertensives found in this Program have less severe elevations of blood pressure, and even among them reductions in blood pressure were substantial because of the vigorous follow-up and special attention to compliance. The HDFP is continuing its efforts to find to what extent sustained treatment of those with elevated blood pressure can reduce mortality or complications due to hypertension.


Bioavailability of two hydrochlorothiazide preparations.

Eight healthy volunteers received hydro-chlorothiazide 75 mg as Dichlotride and Esiderx. Maximal plasma levels were significantly (p less than 0.05) higher after Dichlotride than Esidrex, 512 +- 189 and 376 +- 70ng/ml, respectively. However, the bioavailability of the two brands of hydrochlorothiazide did not differ significantly as judged by comparison of the AUC0 leads to 9h and AUC0 leads to chi, and the urinary recovery of hydrochlorothiazide during 48 hrs.


The infant food industry and international child health.

Declining breast-feeding, with accompanying increased marasmus and diarrhea, has occurred in developing countries because of many factors, including inappropriate health services, new urban life styles, and so forth. The infant food industry must bear a considerable burden of blame as a result of "unethical" advertising. Responses have most recently included various journalistic and legal actions. There is a need for revised roles for the infant food industry, and for mechanisms to monitor intrinsically harmful practices.


[Concentrations in serum and tonsils after infection of azidocillin (author's transl)].

Prior to tonsillectomy 57 selected patients were given 1 g azidocillin i.v. in the form of a 10% aqueous solution. Serum samples were drawn at different times after the injection and both the serum and the tonsils were examined for azidocillin activity. The results of examination of 133 serum samples and 111 tonsils were evaluated, in addition to 74 paired values for tonsils and serum. Serum levels attained a maximum of 230 microng/ml and remained within measurable range for at least six hours. Tonsil levels  reached a maximum of 17 microng/g and after three hours began to drop below measurable range. The quotient for distribution between tonsils and serum rose during the first hour to 20-25% (average approx. 10%) and was about 3-6% three to four hours after injection.


Gas-liquid chromatographic determination of captan and two metabolites in milk and meat.

A gas-liquid chromatographic (GLC) method has been developed for the determination of captan (N-trichloromethylthio-4-cyclohexene-1,2-dicarboximide) and 2 metabolites, tetra-hydrophthalimide (THPI) and tetrahydrophthalamic acid (THPMA), in milk and meat. The sample is extracted with ethyl acetate and is cleaned up by acetonitrile partition and silica gel chromatography where captan, THPI, and THPMA are separated. Captan is directly determined by GLC. THPI and THPMA are separately derivatized in an acetone solution of pentafluorobenzyl bromide. The resultant derivatives are purified separately on an Al2O3 column and quantitated by GLC, using an electron capture detector. Recoveries from milk samples fortified at 0.02-10 ppm ranged from 71 to 102%; recoveries from meat samples fortified at 0.04-10 ppm ranged from 75 to 99%.


A fluorescence detector for high-pressure liquid chromatography.

We describe a fluorescence spectrophotometer adapted with a micro quartz flow cell to record the output of modern liquid chromatographs. The optical system is double beam in that the light source variations are cancelled out by a second photomultiplier, thus enhancing the sensitivity of the technique. The emission spectra may be scanned by stopping the flow in the chromatographic column and scanning the fluorescence detector. Many specific applications have been studied: polycyclic aromatic hydrocarbons, several vitamins, porphyrins, methyl anthranilate, etc. These are studied in natural samples and it is shown that the specificity of the fluorescence detector frequently obviates the need for sample preparation. The sensivitity available with the fluorescence detector for fluorescing compounds is often much greater than is available with variable-wavelength ultraviolet spectrophotometers. We report picogram-level detectability in real samples for many of the compounds that we have studied.


Splenic vein thrombosis in patients with a normal size spleen.

The frequency of splenic vein obstruction secondary to pancreatic or retroperitoneal diseases has been only recently appreciated. The diagnosis is important because it frequently results in development of gastric and duodenal varices. It is often assumed that the diagnosis should only be suspected in patients with splenomegaly. This report describes 19 patients in whom splenic vein thrombosis was diagnosed by angiography although clinically unsuspected. In 11, the spleen was normal in size although extensive gastric varices were present. In 3 patients the presenting problem was massive hematemesis. Review of the upper gastrointestinal examinations in these patients showed thickened gastric or duodenal folds although in the absence of esophageal varices, the diagnosis was not made prior to angiography. More liberal use of angiography in patients with an appropriate clinical background, such as a history of pancreatitis, may lead to earlier and more frequent diagnosis of splenic vein obstruction. Varices that result from splenic vein obstruction can be cured by splenectomy.


Plasma thyroxine, 3,3',5-triiodothyronine and 3,3',5'-triiodothyronine during beta-adrenergic blockade in hyperthyroidism.

Plasma thyroxine (T4), 3,3',5-triiodothyronine (T3) and 3,3',5'-triiodothyronine (rT3) were measured in 16 patients with Graves' disease. Patients were studied under the following conditions: first without any treatment, then, during beta-adrenergic blockade with propranolol, and finally after euthyroidism had been attained by carbimazole. During propranolol T3/T4 ratio decreased, whereas T4 remained unchanged. After carbimazole T3/T4 ratio returned to its pretreatment value. rT3/T4 ratio showed opposite changes. These results suggest that peripheral conversion of T4 into T3 and rT3 in hyperthyroidism is, at least partly, dependent on the functional status of the beta-adrenergic system. Suppressed peripheral conversion of T4 into T3 during beta-adrenergic blocking agents may contribute to the beneficial effects of these drugs in thyrotoxicosis.


The effect of prolactin on the lecithin content of fetal rabbit lung.

1 mg ovine prolactin was injected intramuscularly into rabbit fetuses (24th day of gestation) located in one of the two uterine horns exposed by laparotomy (n = 12). Fetuses in the other uterine horn were injected with an identical volume of vector and served as controls (n = 13). 2 days later the fetuses were removed by a second laparotomy and sacrificed. Analysis of lung tissue composition yielded the following results: (a) the prolactin-treated group of fetuses showed 40% higher total lung phospholipid content (17.0 +/- 0.8 micronmol/g) than the control group (12.2 +/- 0.5 micronmol/g); (b) the prolactin-treated group had a 67% higher lung lecithin content (8.7 +/- 0.8 micronmol/g) than the control group (5.2 +/- 0.4 micronmol/g); (c) dipalmitoyllecithin accounted for 67% of total lung lecithin in the prolactin-treated group and 44% in the control group. These differences were statistically highly significant (P less than 0.001). However, between the prolactin-treated and the control groups, there were no statistically significant differences in body weight and length, lung weight, the ratio of lung weight to body weight, DNA, protein and, water content. These results suggest that prolactin might be a trigger of lung surfactant synthesis in the rabbit fetus.


[Isolation and identification of some metabolites of mephenoxalone (Control-OM) from human urine (author's transl)].

Mephenoxalone (5-(o-methoxyphenoxymethyl)-2-oxazolidone) is degraded by various routes in the human, and some is excreted unchanged. In the metabolism of mephenoxalone, the phenoxymethyl ether bond is cleaved; thus o-methoxyphenol (metabolite I) was identified in urine, and 3-amino-1,2-propanediol (IIa) was found after alkaline hydrolysis. Hydroxylation of the benzene ring produces a phenolic hydroxymephenoxalone (metabolite III), and demethylation converts mephenoxalone into demethylmepheonxalone (metabolite IV). Opening of the oxazolidone ring leads to the production of 1-(o-methoxyphenoxy)-3-aminopropane-2-ol(metabolite V). Urine contains two further substances: 1-(o-hydroxyphenoxy)-3-aminopropene (metabolite VI) and dehydromephenoxalone (metabolite VII). Metabolite VI may be an artefact. Compounds III, IV and VII could only be detected after acid hydrolysis and enzymic cleavage with beta-glucuronidase/aryl sulphatase, whereas V and VI were detected only after acid hydrolysis. Thin layer chromatography revealed three further metabolites, which were not identified.


Gonadal dysgenesis with Graves's disease.

Hashimoto's thyroiditis has previously been associated with gonadal dysgenesis. Recent evidence suggests that Graves's disease and Hashimoto's thyroiditis are disorders of cell-mediated immunity and may have a common genetic predisposition. However, patients with both Graves's disease and the Turner syndrome have been reported only rarely. Three such cases are presented and the relation among gonadal dysgenesis, Hashimoto's thyroiditis, and Graves's disease is discussed.


RDS and tracheal phospholipid composition in twins: independent of gestational age.

The surfactant phospholipids in the tracheal effluent of eight pairs of preterm twins were followed, serially. In four pairs only one of the twins had RDS; in the other four pairs both twins had RDS. Twins with and without RDS had markedly different surfactant phospholipids. Phosphatidylglycerol was absent in all twins with RDS. L/S ratios in tracheal effluent increased after birth in infants with and without RDS. With recovery from RDS, phosphatidylinositol increased. The study helps confirm previous studies of the necessity of the acidic phospholipids, PI and PG, in stabilizing lecithin, as well as that surfactant composition can be independent of gestational age.


Urine solute excretion in growing low-birth-weight infants.

Fifteen thriving low-birth-weight infants who weighed less than 1,950 gm at birth were randomly selected to study the urine solute excretion on two milk-based proprietary formulas, SMA or Formula 4. The results showed that urine oxmolality rose progressively with increasing caloric concentration and was 78, 111, and 163 mOsm/kg H2O on 67, 80, and 100 kCal/dl SMA, respectively. Formula 4 gave rise to significantly higher urine osmolality (133 mOsm/kg H2O) than SMA, when fed at the same caloric density of 67 kCal/dl. Although the dependence of urine solute excretion on dietary load was confirmed, the rapidly growing low-birth-weight infant appears to incorporate a larger portion of potential urine solute into growing tissues, than is the case in the term infant.


Comparative bioavaiability of four commercial quinidine sulfate tablets.

A comparative bioavailability study was performed using four commercially available, chemically equivalent brands of quinidine sulfate tablets. Two 200-mg tablets were administered to 11 different subjects following a completely randomized crossover design. Serum levels, urinary excretion data, and derived pharmacokinetic parameters were compared statistically. There were no statistical differences in the extent of quinidine absorption from the four brands of tablets as evidenced by the cumulative urinary excretion values and the areas under the serum level-time curves. Significant differences in the mean serum levels at 0.5 and 1 hr and differences in the peak times and absorption rate constants indicate that there was a difference in the absorption rate between Treatments A and D and C and D. A significant difference in the peak times also was noted for Treatments B and C. When mean disintegration times for the four tablet formulations were compared with their values for ka, tmax and mean serum levels at 0.5 and 1 hr, rank-order correlations were observed. A considerable degree of variability in quinidine elimination was noted, with half-life values ranging from 2.71 to 8.12 hr (mean half-life of 5.36 hr).


Endoscopic electrosurgical papillotomy and manometry in biliary tract disease.

Endoscopic papillotomy was performed in 13 patients after cholecystectomy for retained or recurrent common bile duct calculi (11 patients) and a clinical picture suggesting papillary stenosis (two patients). Following endoscopic papillotomy, ten of the 11 patients spontaneously passed common bile duct (CBD) stones verified on repeated endoscopic retrograde cholangiopancreatography (ERCP) study. One patient failed to pass a large CBD calculus; one patient experienced cholangitis three months after in inadequate papillotomy and required operative intervention. Endoscopic papillotomy substantially decreased the pressure gradient existing between the CBD and the duodenum in all five patients studied with ERCP manometry. Endoscopic papillotomy is a relatively safe and effective procedure for postcholecystectomy patients with retained or recurrent CBD stones. The majority of CBD stones will pass spontaneously if the papillotomy is adequate.


Diethylstilbestrol: recommended dosages for different categories of breast cancer patients. Report of the Cooperative Breast Cancer Group.

A total of 523 postmenopausal breast cancer patients with progressive disease were entered in a radomized, double-blind study of four dosages of diethylstibestrol (DES): 1.5, 15, 150, OR 1,500 MG/DAY. Higher dosages produced significantly (p less than .05) higher regression rates: 21% for the 1,500 mg dosage, 17% for the 150 mg dosage, 15% for the 15 mg dosage, and 10% for 1.5 mg dosage. Durations of regressions were similar regardless of the dosages used to induce them. Although the highest dosage produced the highest regression rate overall, selecting the best dosage or treatment of choice for each type of patient based on menopausal age and on dominant metastatic site would result in more regressions.


Compassion vs control. Conceptual and practical pitfalls in the broadened definition of child abuse.

A broadened understanding of child abuse has enabled practitioners to think of the parents of abused children not as evil murderers but as human beings caught in a complex web of social isolation and deprivation. Concomitantly, child abuse laws have changed dramatically in the last decade to include virtually all childhood physical symptoms of family crisis; physical, sexual, and emotional abuse and child neglect are now reportable by nearly all professionals who have contact with children. There has been a dramatic increase in case reports, but the services for which families become eligible do not approach the humane rhetoric and intent of child abuse legislation. Society and the helping professions are caught in a dilemma that we characterize and address clinically as compassion vs control.


Radiation exposure and thyroid cancer.

There are abundant experimental and clinical data to associate radiation exposure and thyroid cancer. The incidence of thyroid cancer increases with increasing doses of thyroidal radiation from 6.5 rads to 1,500 rads, but higher doses tend to destroy the gland and are associated with hypothyroidism rather than cancer. The peak occurrence of thyroid tumors is between five and 30 years after exposure, but a person may develop thyroid tumors as long as 50 years after irradiation. Multiple thyroidal lesions or disorders, including adenomas, thyroditis, and hypothyroidism as well as malignant neoplasms, can occur after radiation exposure. It is imperative, therefore, to study carefully all patients with a history of radiation exposure to the gland and to observe them carefully for life. Suggestions are made for the management of thyroid disease in these patients.


Infection and pheochromocytoma.

A urinary tract infection with possible septicemia and endocarditis developed in a 36-year-old man. The illness was complicated by pulmonary embolism, thrombocytopenia, hematemesis, hepatic dysfunction, paralytic ileus and accelerated hypertension. The latter finding suggested pheochromocytoma. Treatment with antibiotics and phenoxybenzamine hydrochloride was associated with notable clinical improvement. A chromaffin cell tumor was surgically removed above the lift kidney. Conclusively, a pheochromocytoma may mimic and be present in association with infection.


Parotid carcinoma and posterior fossa schwannoma following irradiation. Report of a patient treated in infancy for benign ear disease.

A 23-year-old man had received irradiation for a benign ear problem at the age of 1 year. Twenty year later, a malignant left parotid carcinoma and a right jugular foramen schwannoma developed. Earlier reports in the literature suggest that radiation can induce tumors in the head and neck. The localization of both tumors and the histological features of the parotid tumor suggest that they were radiation-induced.


Clinically suspected deep venous thrombosis of the lower extremities. A comparison of venography, impedance plethysmography, and radiolabeled fibrinogen.

To define the utility of new diagnostic approaches in patients with clinically suspected deep venous thrombosis of the lower extremities, 42 legs of 33 patients were studied by fibrinogen labeled with radioactivie iodine (125I) impedance plethysmography (IPG), and contrast venography. The clinical diagnosis was confirmed in approximately two thirds of the legs and patients. In venogram-positive legs, fibrinogen 125I was positive in 70%, IPG in 61%, and one of the two in 78%. In venogram-negative legs, fibrinogen 125I was positive in four (21%) and IPG was negative in all. It was found that the size, age, and location of the thrombus, collateral vein development, heparin sodium therapy, and technical-interpretive choices can influence both IPG and fibrinogen 125I results. The data demonstrate that the fibrinogen 125I and IPG procedures can assist physicians in the diagnosis of clinically suspected deep venous thrombosis of the lower extremities.


Benign breast disease and oral contraceptive use.

A random selection of 1,230 upstate New York childbearing women was used to examine the history of oral contraceptive use in women with a clinical diagnosis of benign breast disease. We found that 73 women who had benign breast disease had a reduced duration of pill use. When determining the reason for this reduction, we found that in a significant portion (P less than .05) of our benign breast disease cases, the women had been advised by their physicians to discontinue pill use for breast-related reasons. We then surveyed a large group of upstate New York physicians. One third of them considered benign breast disease a potential contraindication for starting oral contraceptive use. Nearly one half throught the development of benign breast disease to be a potential contraindication for continuing oral contraceptive use. It is premature to conclude that oral contraceptive usage protects against benign breast disease.


A cooperative study of hospital frequency and character of transient ischemic attacks. II. Performance of angiography among six centers.

Angiographic procedures were carried out on 36% of 1,328 patients suspected of having transient ischemic attacks (TIA). Among six participating centers, this ranged from 13% to 82%. This large difference might be related to the number of patients considered good surgical candidates and differences in the use of screening noninvasive diagnostic techniques. Arch studies, using catheter techniques, were performed most often. Although 13% of the patients had transient complications, permanent neurological deficits occurred in only 0.65%. Angiographic lesions were best correlated to clinical symptoms in those patients thought to definitely have carotid artery system TIA but were commonly seen in all other groups. Thus, clinical correlation was poor.


Myositis ossificans traumatica. Association with hemophilia (factor XI deficiency) in a football player.

A case report of an outstanding college football halfback with partial factor XI deficiency, recurrent ecchymosis, and myositis ossificans is reviewed. The association of multiple areas of myositis ossificans and partial clotting-factor deficiency has not been noted in the past. The importance of considering this diagnosis in participants in contact sports with the above findings is emphasized.


St Louis encephalitis. The 1975 epidemic in Mississippi.

In 1975, 229 laboratory-documented cases of St Louis encephalitis, 36 of which resulted in death, occurred in Mississippi. A total of 58% of these persons had encephalitis, 15% had aseptic meningitis, 21% had a febrile illness with no known CNS involvement, and 6% had other syndromes. Attack rates and case-fatality ratios increased with age. Although 60% of the cases occurred in a four-county area of northwest Mississippi, cases occurred in 42 of the 82 counties throughout the state. The epidemic erupted almost simultaneously, with variable intensity, in widely separated areas. Mosquito-control, measures were applied, but the results were not quantified.


Mucocutaneous lymph node syndrome. A case masquerading as Rocky Mountain spotted fever.

Mucocutaneous lymph node syndrome is a recently described entity whose principal signs and symptoms include fever, unresponsiveness to antibiotics, congested conjunctivae, reddening of the oral cavity, lips, palms, and soles, exanthem, edema, nonsuppurative cervical adenitis, and desquamation of the fingertips. Almost 7,000 cases have been reported in Japan. Analysis of the 39 cases reported in the United States reveals findings similar to those in Japan. United States cases, however, have had a higher boy-to-girl ratio (2:1), and age distribution peaks at a later time (3 years of age). We report a case with many characteristics of Rocky Mountain spotted fever, including a positive Well-Felix reaction. Some cases of mucocutaneous lymph node syndrome may be misdiagnosed as Rocky Mountain spotted fever.


Airborne contamination of fine-particle nebulizers.

To determine whether bacteria present in ambient air play a role in the contamination of fine-particle reservoir nebulizers, nebulizers were placed in operation in separate hospital locations having qualitatively and quantitatively different bacterial flora in background air. Nebulizers placed in a surgical intensive care unit that had higher numbers of bacteria and a predominance of Gram-negative organisms in background air had a significantly higher incidence of nebulizer contamination (33.0%) than did nebulizers placed in a non-patient-care area that had lower bacterial counts and a predominance of Gram-positive organisms (0%) (P less than .05). The present study indicates that airborne contamination of fine-particle reservoir nebulizers occurs when bacteria present in ambient air enter the nebulizer during its operation.


Blood pressure studies in 14 communities. A two-stage screen for hypertension.

the Hypertension Detection and Follow-up Program (HDFP) is a community-based national trial to determine whether special programs can improve the treatment for persons with uncontrolled hypertension and reduce morbidity and mortality in wide strata of these patients. A total of 158,906 persons, aged 30 to 69 years, were screened to identify those with a diastolic blood pressure (DBP) of 95 mm Hg or higher. Age-sex-race means and distributions of DBP at a first and a second screen and prevalence rates or actual hypertension by sex, race, and level of control suggest a recently increased awareness of hypertension with more widespread and effective treatment, especially among women, although blacks under treatment had their DBP controlled less frequently. The response to this program of screening and initial follow-up offers encouragement for improved community control of high blood pressure.


Chemotherapy for bronchogenic carcinoma. Methotrexate, doxorubicin, cyclophosphamide, and lomustine.

A combination chemotherapy (MACC) consisting of methotrexate, doxorubicin hydrochloride (Adriamycin), cyclophosphamide, and lomustine (CCNU) was given to 41 patients with stage III bronchogenic carcinoma, 34 of whom had disseminated disease. The objective response rate was 46% for all patients with a median actuarial survival of nine months. Response was seen in all cell types, including four of ten patients with squamous cell carcinoma, six of 17 with adenocarcinoma, and six of seven with small-cell anaplastic carcinoma. Prolongation of survival was apparent for patients of all cell types. Toxic reactions were moderate and allowed for easy outpatient use.


Medical interpreting for hearing-impaired patients.

Medical interpreting for deaf patients is a new dimension of the medical field. Medical interpreting allows for the fast, accurate, and complete exchange of medical information between medical professionals and their deaf patients. The exchange of accurate medical information is critical to the early diagnosis and treatment of medical problems.


Genetic damage from diagnostic radiation.

Using the data from the Tri-State Leukemia Survey and a mathematical model, the hypothesis that low levels of diagnostic radiation produce severe genetic damage that is expressed in the child of the exposed person as leukemia and other diseases is tested. It is estimated that for about 1% of the exposed persons who are affected by radiation, there is a 50-fold increase in the risk of leukemia and a five-fold increase in certain other diseases.


Hemolytic anemia in Wilson's disease. A report of three cases with transient increase in hemoglobin A2.

Three patients with Wilson's disease and initial manifestations of intravascular hemolysis also had transient elevations of hemoglobin A2. It is important to recognize such manifestations in establishing an early diagnosis.


Treating acute acetaminophen poisoning with acetylcysteine.

A patient ingested 15.6 gm acetaminophen and sought medical attention after seven hours. At that time, her plasma acetaminophen level was 217 microng/ml. Treatment with acetylcysteine was begun eight hours after the ingestion. The clinical course of this patient was characterized by a mild illness with a minor elevation of liver enzyme values. A number of factors predicted severe hepatotoxicity for this patient had she not received treatment.


Oral contraceptives and blood pressure.

Both cross-sectional and longitudinal analysis of data from 13,358 women showed that oral contraceptive use is associated with a slight but statistically significant (P lesser than .05) rise in mean blood pressure, which is reversible. The age-adjusted proportion of oral contraceptive users with a blood pressure over 140/90 mm Hg was about three times that on nonusers. These findings are caused by a uniform upward shift in the blood pressure distribution of oral contraceptive users compared to nonusers. Women continuing oral contraceptive use had no appreciably greater change in blood pressure between two visits than persistent nonusers. The clinical implications of a mild contraceptive-induced blood pressure elevation (systolic, 5 to 6 mm Hg; diastolic, 1 to 2 mm Hg) remain unsettled but disturbing.


Distribution pattern of metastatic bone disease. A need for total body skeletal image.

Distribution patterns of metastatic bone disease in 62 patients with soft-tissue cancers showed that 60% of bone lesions were located in the axial and 40% in the appendicular skeleton. Thirteen percent of the lesions were in appendicular regions not usually included in routine imaging studies. The majority of the metastatic skeletal lesions were clinically asymptomatic. The serum alkaline phosphatase level is a poor indicator of early bone metastases.


Mikulicz disease and subsequent lupus erythematosus development.

In a 12-year-old boy with clinical and histologic features of Mikulicz disease, systemic lupus erythematosus (SLE) developed two years later. Atrophic plaques and nodules in the skin along with substantial increase in salivary gland enlargement characterized the onset of SLE. There was lack of renal and joint manifestations, and no evidence of keratoconjunctivitis sicca or xerostomia was seen. Histopathologic changes in the skin lesions included mucinous infiltrates, chronic vasculitis, and dermal-epidermal junction findings typical of SLE. Direct immunofluorescene studies of skin lesions and normal-appearing skin showed granular deposition of immunoglobulins and complement at the dermal-epidermal junction zone. Level of anti-DNA antibodies was noticeably elevated, and the serum C3 value was depressed. The patient's response to systemic corticosteroid therapy was dramatic.


Shock lung with massive tracheal loss of plasma.

Fulminant pulmonary edema developed in two young, healthy adults within one hour after blood loss, hypolemic shock, and an anaphylactoid reaction to intravenous pyelogram dye. Pulmonary edema developed and they subsequently passed large amounts of edema fluid through the endotracheal tube. Massive loss of plasma-like fluid from the lung required frequent evacuation of the endotracheal tube and intravenous replacement with large amounts of albumin-containing fluids. Both patients were treated with a volume respirator, positive end-expiratory pressure, 100% oxygen, corticosteroids, and tracheostomy. Both patients recovered from massive pulmonary edema with very severe hypoxemia and, three months afterwards, had normal pulmonary function, blood gas levels, and no evidence of pulmonary injury.


Comparison of the productivity of women and men physicians.

Data obtained from random samples of 87 women and 95 men physicians in the Detroit metropolitan area indicate that, at the time of surgery, 84% of the women and 96% of the men were engaged in medical work. Only 7% of the women were not working because of reasons related to the traditional female role. Fifty-nine percent of the women and 87% of the men had worked full-time since medical school graduation. Fifty-one percent of the women, compared to 39% of the men were in primary care specialties. Since medical graduation, women physicians spent 90% as much time in medical work as did the men, despite the fact that most of the women had full responsibility for homes and families.


Venereal warts vs Bowen disease. A histologic and ultrastructural study of five cases.

Verrucous growths of the genitalia in young patients are usually condylomata acuminata. In five cases this type of genital lesion, viewed by light microscopy, showed dysplastic cellular changes of Bowen disease, a diagnosis that was further confirmed by electron microscopy. Bowen disease should be included in the differential diagnosis of verrucous lesions of genitalia in young people and should be ruled out by histologic examination.


Stylet injury syndrome.

Failure to properly use the stylet when withdrawing a spinal puncture needle may cause aspiration of a lumbar nerve root and adjacent arachnoid, thereby fixing the nerve in the epidural space. Root fixation may cause a painful syndrome, requiring laminectomy and replacement of the nerve root within the subarachnoid space. Since laminectomy is rarely performed at the lumbar puncture site, the frequency of the syndrome remains undetermined.


Overwork.

Overwork, ie, working beyond one's endurance and recuperative capacities, may be a hazard in certain personality types engaged in open-ended occupations. Some persons appear to lack an inner "governor" and for various reasons ignore the commonplace signs that inform one of the need for rest or recreation. If they are engaged in occupations that do not have a finite workday, they may at times exceed their bodies' ability to recover. Clusters of symptoms may then develop, some of which may mimic serious physical ailments. Treatment depends on diagnosing the extent of illness and eliciting the underlying causes. Correction involves enforced rest, therapy that may vary from counseling to hospitalization and specialized treatment, but that must include the reeducation of the person to be aware of and make provision for his physical and emotional needs.


Association between oral contraceptives and myocardial infarction. A review.

Analysis of the association between oral contraceptive use and the development of myocardial infarction in women less than 50 years of age shows that cigarette smoking is the most important factor in increasing the likelihood of myocardial infarction. This effect is independent of oral contraceptive use but oral contraceptive use also appears to be a risk factor; however, their use in the absence of other predisposing factors appears to have only a small effect on increasing the risk of dying from myocardial infarction. This small increase is of the same order of magnitude as the increased risk of death from thromboembolic disease. Oral contraceptive users more than 30 years of age who have other factors that increase the likelihood of myocardial infarction appear to have a substantially higher death rate.


Benign transient eosinophilia following intravenous urography.

Eosinophilia, a component of the allergic response, may occur after the use of iodinated radiographic contrast media for intravenous urography. A benign transient elevation in differential eosinophil count was seen in 21 of 101 patients following the injection of iodinated contrast agents for that purpose.


Intoxication caused by interaction of chloramphenicol and phenytoin.

A patient with a brain tumor and seizures who was receiving maintenance doses of phenytoin was given chloramphenicol on three occasions. Her neurological status was both complicated and obscured by the reoccurrence of phenytoin intoxication. Retrospective drug analysis showed a marked elevation of serum concentrations of phenytoin during each course of chloramphenicol.


The lymphographic findings in a case of lymphocytic lymphoma presenting as recurrent chylothorax.

A case of lymphocytic lymphoma is presented. The unusual mode of presentation as a result of bilateral chylothoraz is described. The value of lymphography in establishing the site of lymph leakage and in the establishment of the underlying diagnosis is demonstrated and discussed.


Biological significance of piezoelectricity in relation to acupuncture, Hatha Yoga, osteopathic medicine and action of air ions.

Piezoelectric properties of biological macromolecules such as proteins, nucleic acids and mucopolysaccharides are reviewed in this paper. It is indicated that the structural elements of the human body composed of these piezoelectric substances are capable of transducing a mechanical energy into an electric current. Such a transduction may be brought about by movements of an acupuncture needle, osteopathic manipulations; Hatha Yoga postures or action of negatively charged air irons. It is postulated that electric current induced by stimulation of the specific sites on the surface of human body flows towards the internal organs along the semiconductive channels of biologic macromolecules. Electric current induced either by the piezoelectric transduction or directly applied from an external source may in turn stimulate individual cells in the target organ. Involvement of electrical phenomena in regulatory mechanisms on cellular and molecular levels is discussed.


Decline of stomach cancer mortality rates in a high-risk geographical area.

An investigation on gastric cancer death rates per 100,000 population, by sex and age groups in Chile, covering a 34-year period (1941-1974), was made. The yearly change in gastric cancer mortality rates, calculated by linear regression analysis, for males 25-34 years of age (-0.043), P less than 0.00005), 35-44 (-0.381, P less than 0.00005), 45-54 (-1.340, P less than 0.00005), 55-64 (-2.080, P less than 0.00005), 65-74 (-0.602, N.S.), and age-adjusted death rates for persons aged 25-74 years (-0.959, P less than 0.0006) showed negative regression coefficients. The yearly change in gastric cancer death rates for females 25-34 years of age (-0.051, P less than 0.00005), 35-44 (-0.468, P less than 0.00005), 45-54 (-1.430, P less than 0.00005), 55-64 (-2.978 P less than 0.00005), 65-74 (-1.841, P less than 0.00005), and age-adjusted rates for persons aged 25-74 years (-0.991, P less than 0.00005) also exhibited negative regression coefficients, all being statistically highly significant.


Value of simultaneous T3, T4, and TSH measurements for management of graves' disease in children.

One hundred simultaneous determinations of serum T4 and T3 were performed during the course of treatment of 23 children and adolescents with Graves' disease. Five patients were previously untreated and six were experiencing relapse after treatment was discontinued. During relapse, increased T3 concentration is frequently present when serum T4 concentration is normal and T3 measurement is therefore more reliable for early detection of relapse. During therapy with thionamides, T4 measurement alone is often misleading in assessing adequacy of control achieved by therapy. Commonly, patients who clinically have hyperthyroidism have serum T4 concentrations within the normal range but continue to have elevated T3 concentrations (T3 toxicosis). Similarly, T4 can be suppressed into the hypothyroid range in the clinically euthyroid patient with either a normal or high T3 concentration. In these patients, determination of serum T3 often prevents premature reduction of thionamide dosage. When T4 and T3 concentrations do not clearly demonstrate presence or absence of hypothyroidism, measurement of serum thyroid stimulating hormone can be of value.


Pachyonychia congenita (Jadassohn-Lewandowski syndrome: case report.

We report an illustrative case of pachyonychia congenita, with a description of the presenting complaints, the associated physical findings, the rationale for surgical treatment, and the technical aspects of the surgical treatment.


Malabsorption in relation to abdominal irradiation and quadruple chemotherapy for lymphosarcoma.

A case of severe diarrhoea and steatorrhoea following chemotherapy and abdominal irradiation for lymphosarcoma, is described. Investigations demonstrated bile acid malabsorption, and treatment with cholesytramine and a low fat diet was successful. A questionnaire was sent to thirty-two subjects who had undergone similar treatment for similar pathology and failed to demonstrate any sustained alteration of bowel function. Additionally, nine of these subjects underwent a 14C-glycocholic acid test and no evidence of interruption of the enterohepatic circulation of bile acids was found.


The pathogenesis of peripheral aneurysms of the central nervous system: a subject review from the AFIP.

Most central nervous system aneurysms occur around the circle of Willis, and are congenital or arteriosclerotic in origin when in that location. Peripherally located aneurysms are either idiopathic or secondary to infection, tumor embolus (from choriocarcinoma and cardiac myxoma), Moyamoya disease, or trauma. The pathophysiologic features of these aneurysms are discussed.


[Correlation between gastrointestinal absorption and uptake of radioisotopes by the critical organs].

This study was undertaken to investigate the correlation between gastrointestinal absorption of radioisotopes and uptake by the critical organ during the same period using 85Sr, 109Cd, 131I and 203Hg as radioisotopes. When the distribution of 85Sr, 109Cd, 131I and 203Hg in mice were investigated by means of the whole body autoradiography, these critical organs were determined as follows; 85Sr: bone, 109Cd: liver, 131I: thyroid gland and 230Hg: kidney. When the correlation between the injected dose and the uptake dose by the critical organ of 85Sr, 109Cd, 131I and 203Hg were investigated, uptake dose the critical organ expressed as cpm per gram of organ was in direct proportion to the injected dose and that expressed as % of the injected dose per gram of organ was held constand in either case. When the coefficient of correlation between gastrointestinal absorption and uptake by the critical organ of 85Sr, 109Cd, 131I and 203Hg were calculated, a positive correlation was revealed in either case. It is concluded from the results obtained that in vivo or in situ method, gastrointestinal absorption of radioisotopes received a support from uptake by the critical organ during the same period.


[Study of distribution of 169Yb, 69Ga and 111In in tumor tissues by macroautoradiography; comparison between viable and necrotic tumor tissues].

The localization of 169Yb, 67Ga and 111In in tumor tissues was determined macroautoradiographically. 169Yb-citrate and 111In-citrate were injected intravenously to the rats subcutaneously transplanted Yoshida sarcoma and were injected intraperitoneally to the mice subcutaneously transplanted Ehrlich tumor. These animals were sacrificed 3, 24 and 48 hours after injection. These tumor tissues were frozen in n-hexane (-70 degrees C) cooled with dry ice-acetone. After this, these frozen tumor tissues were cut into serial thin sections (10 micron) in the cryostat (-20 degrees C). One of the slice of these sections was then placed on X-ray film and this film was developed after exposure of several days. On the other hand, next slice of these sections were then stained using the hematoxylin and eosin. From the observations of these autoradiogram and H-E stained slice, the following results were obtained. Concentration of 169Yb, 67Ga and 111In was predominant in viable tumor tissue rather than in necrotic tumor tissue, regardless of time after the administration. 67Ga and 111In were distributed uniformly in viable tumor tissue, but deposition of 169Yb was observed more avidly in viabl tumor tissue neighboring to necrotic tumor.


[Human proinsulin-C-peptide radioimmunoassay method; stability of the assay kit].

We have been studies time sequent stability each on standard human-C-peptide, human-C-peptide antiserum, 125I-tyrosyl human-C-peptide and the assay kit (all reagent) which is necessary in human proinsulin-C-peptide radioimmunoassay(RIA). Also we measured using this assay system, human proinsulin C-peptide in blood after oral administration of glucose to normal subject. Standard human-C-peptide and human-C-peptide antiserum were very stable on storage at 4 degrees C, 125I-tyrosyl human-C-peptide was unstable as compared with the former two, The stability of the assay kit was influenced by the stability of 125I-tyrosyl human-C-peptide, and was stable at 4 degrees C for ten weeks after preparation. Three lots of the assay kit prepared at different period showed almost same stability. We think this assay system using the assay kit is satisfactory in respect of stability. The measured values of human proinsulin-C-peptide in blood, using this assay system, showed insulin secretory reaction after oral administration of glucose.


[Trial preparation and evaluation of a 81mKr-generator for medical use].

A prototype 81mKr-generator consisting of an ion exchange column and some attachments for handling was prepared on trial. Parent nuclide 81Rb obtained by the reaction of 82Kr(p, 2n)81Rb was absorbed on the resin, and radionuclidic purity, sterility and apyrogenicity of the generator eluate were examined. Analysis of gamma-ray spectrum obtained with a Ge(Li) detector and a multichannel pulse height analyzer revealed that the nuclidic purity of the 81mKr in the eluate was 99.997-99.999% with 0.001-0.003% of 79Kr at the start of the elution. Sterility and apyrogenicity of the eluate were proved by J.P. sterility test and limulus test respectively. All results obtained show that the 81mKr-generator is very suitable for medical application.


[Tumor affinity of 99mTc-labeled radiopharmaceuticals, 99mTc-Sn-urokinase and 99mTc-Sn-mannitol].

Biolgic distribution of 99mTc-labeled fibrinolytic agent, urokinase, and 99mTc-labeled mannitol, which was obtained as a side-product in the preparation of 99mTc(Sn)-urokinase, have been studied in Ehrlich's tumor-bearing mice to get a promising indicator for the positive delineation of malignant tumor. The preparation of 99mTc-labeled radiopharmaceuticals, 99mTc-UK and 99mTc-Man, was made by the reduction with stannous chloride and labeling efficiency was examined by Sephadex G-25M gel chromatography and by silica gel plate thin layer chromatography. Labeling yield of 99mTc-UK by Sephadex G25M in 0.9% NaCl eluant was 13% and that of 99mTc-Man by TLC in 85% methanol solvent was over 95%. A higher uptake to the implanted solid tumor tissue in mice was found in 99mTc-Man than in 99mTc-UK, of which the excellent tumor accumulation was expected from the positive delineation of malignant tumor with 131I-fibrinogen, 131I-fibrinogen antibody and 125I-plasmin. The poor result in 99mTc-UK, however, may be attributed to the poor fibrinolytic activity of Ehrlich's tumor. In biologic distribution of 99mTc-UK was found high concentration for liver kidney and stomach. In the other hand, a higher tumor tissue uptake, a fast blood disappearance and a low concentration for different organs were found in biologic distribution of 99mTc-Man. Therefore, 99mTc-Man may be assumed as a more preferable 99mTc-labeled tumor localizing radiopharmaceuticals, to which it would be needed as absolute biologic characteristics that 99mTc-labeled compounds possess a high tumor uptake as well as a fast blood disappearance with a low uptake for different organs. However, the possible delineation with 99mTc-labeled fibrinolytic agents, including urokinase and streptokinase, may be promised for malignant tumors in human-subject, which generally have a higher activity in fibrinogenesis than in fibrinolysis.


[Remote system for the mass production of short-lived radioisotopes in a cyclotron. Development of the system and radioisotope production].

A system was developed for producing short-lived radioactive substances (11CO, 11CO2, 13NN,  13NH3, 18F-, 62Zn2+, 123I-, etc.) on a scale enough for clinical use, which could also be used for analyzing them rapidly and for investigating their production methods, with less received dose by workers. The system enabled us to produce remotely several tens mCi of of short-lived radioactive susbtances readily usable for clinical diagnosis, continuosly for radioactive gases, 11CO, 11CO2 and 13NN, or repeatedly at short intervals for radioactive aqueous solutions of 13NH3, 18F-, etc. Employing this system, the average received dose per month was reduced considerably.


[Production of 123I by alpha and 3He irradiation of natural tellurium].

In order to determine the optimum irradiation condition to produce 123I for nuclear medical use, excitation curves and thick-target yield curves were measured by means of stacked foil technique for alpha and 3He reactions producing 123Xe, 123I, 125Xe and 130I, both from natural tellurium. The 123Xe yields from natural tellurium are too low for routine production. However, by bombarding 76.5% isotopically enriched 123Te target with 30MeV 3He particles, 724 micronCi/micronAh of 123I would be obtained, whereas the level of 125I contaminat would be about 0.14%. 130Te contaminant in enriched 123Te target produces 130I alpha and 3He bombardment, although it has not been reported in the past. The 130I contaminant can be easily eliminated.


[Human proinsulin. C-peptide radioimmunoassay method. 125I labeling of human proinsulin. C-petide].

125I-labelled human-C-peptide was prepared by chloramin T method, enzymic method and active ester method, respectively. Using respective 125I-labelled human-C-peptides in human proinsulin-C-peptide RIA, we compared the binding (Bo/T%) to antibody, displacement by standard human-C-peptide, the recovery test and stability. The usable 125I-labelled antigen for human proinsulin-C-peptide RIA could be prepared by chloramin T method and enzymic method wich labelled 125I to tyrosyl human proinsulin connecting peptide, and active ester method which conjugates 125I-labelled active ester to human proinsulin connecting peptide. The differences among those 125I-labelled antigens was not observed in displacement (B/Bo%) by standard human-C-peptide and the recovery test. In the case of constant preparation of 125I-labelled antigen for RIA, the enzymic method was the best from the viewpoint the reaction ratio is stable and stability of Bo/T% is good.


The effect of route of administration on the anthelmintic efficacy of benzimidazole anthelmintics in sheep infected with strains of Haemonchus contortus and Trichostrongylus colubriformis resistant or susceptible to thiabendazole.

Observations of erratic anthelmintic activity of fenbendazole against known standardised thiabendazole-resistant strains of Haemonchus contortus and Trichostrongylus colubriformis in sheep were investigated. Fenbendazole at a dose rate of 10 mg/kg body weight was administered by oral, intra-ruminal or intra-abomasal routes, and was most effective against both resistant strains following intra-ruminal administration. In addition thiabendazole, oxibendazole, fenbendazole, parbendazole and mebendazole plus two unrelated compounds, levamisole and morantel tartrate, were used at one and a half times their suggested or recommended therapeutic dose rate against thiabendazole-resistant strains of H contortus and T colubriformis in sheep; each drug being administered by the intra-ruminal or intra-abomasal routes. Fenbendazole was more effective against both strains following intra-ruminal administration. Parbendazole was more effective against the resistant strain of T colubriformis following intra-ruminal administration. At the dose rate chosen for the other benzimidazoles used against these resistant strains, there was no difference in anthelmintic efficacy due to route of administration. Levamisole was highly effective against both resistant strains, irrespective of the route of administration. In the groups treated with morantel tartrate, the results obtained were difficult to interpret due to mortalities and a highly variable response in the surviving sheep. Fenbendazole, thiabendazole and mebendazole when used at their suggested or recommended therapeutic dose rate in sheep, were highly effective against known thiabendazole-susceptible strains of H contortus and T colubriformis following both intra-ruminal or intra-abomasal administration.


[Ventilation mechanics in the newborn. II. Dynamical measurements of the isolated lungs (author's transl)].

On 31 pairs of lungs from still borns and newborns and new borns of differing stages of maturation and age (23rd week of gestation up to the 24th week after birth), dynamical measurements within an artificial thorax were performed including systematical changes of ventilation types, particularly breathing frequency. In 12 pairs of lungs, surfactant activity was diminished. In these cases, a marked heterogeneity of ventilation and partly excessive increases of work of breathing correlated with the life span following birth could be shown, and some pathogenetical ways of cardiorespiratory failure as well as mechanisms of damaging late effects of the lungs following respiratory distress syndrome could be demonstrated. Moreover, by measurements of airway resistance it could be shown that in diseased and normal lungs of unmature infants the range of laminar flow is low due to the lability of the bronchial walls. A new method of valuation of the experimental data using the laws of alternating current (Heusinger) has been proven to be useful in the analysis of pulmonary mechanics.


Florid epithelioid cell and sarcoid-type reaction associated with non-Hodgkin's lymphoma.

Five patients suffering from non-Hodgkin's lymphoma associated with an intense infiltration of epithelioid histiocytes and even sarcoid-type granulomas in the involved tissue are described. A similar tissue reaction, at both involved and uninvolved sites, has been described in patients with Hodgkin's disease. The cause of this reaction may be immunological; its prognostic significance still awaits elucidation. In the case of non-Hodgkin's lymphomas, it may cause difficulty in diagnosis of lymphoma and hence may result in unnecessary delay in the initiation of therapy.


Hashimoto's thyroiditis and its relationship to other thyroid diseases.

The experience of the Medical University of South Carolina with Hashimoto's thyroiditis revealed an 8.3 per cent incidence of carcinoma. The most common type of carcinoma was an associated lymphoma. There was an additional 8.3 per cent incidence of a benign adenoma. Needle biopsy as a mechanism for diagnosing Hashimoto's disease, we believe, is inaccurate. A larger aliquot of tissue should be removed for the pathologist if there is a suspicion of an associated tumor. An open biopsy permits the pathologist to make an accurate diagnosis with a minimal amount of morbidity.


Total body irradiation in non-Hodgkin lymphoma and its effect on bone marrow and peripheral blood.

Patients with non-Hodgkin lymphoma have been treated with total body irradiation (T.B.I.). Very high remission rate is obtained in lymphosarcomas, but response in histiosarcoma is extremely poor. Bone marrow study suggests that marrow depression following T.B.I. is transient and complete recovery occurs provided the bone marrow is not already compromised by previous chemotherapy and radiation therapy. Extreme caution is required when T.B.I. is repeated as this may lead to progressive marrow hypoplasia.


Metabolism of 17beta-hydroxy-2alpha-methyl-5alpha-androstan-3-one in the rabbit.

The neutral urinary excretion products of 17beta-hydroxy-2alpha-methyl-5alpha-androstan-3-one from the rabbit dosed orally were investigated. Together with oxidation-reduction of the oxygen functions at C-3 and C-17 hydroxylation occurred at C-15, C-16, and at the 2alpha-methyl positions of the steroid nucleus.


Primary lymphosarcoma of prostate.

A case of primary lymphosarcoma of the prostate in a seventy-one-year-old patient is presented. He had palliative surgical treatment and radiotherapy but died seven months later of heart failure with signs of metastatic disease. Treatment of this condition should include surgery and irradiation. Only its early discovery might change the prognosis.


[Peridural anesthesia in operations for toxic goiter].

The authors employed peridural anesthesia in 92 patients with thyrotoxicosis According to their findings peridural anesthesia produced favourable shifts in the status of the cardiovascular system and ventilatory apparatus. Peridural anesthesia is considered to be a more acceptible method of anesthesiological provision in patients with toxic goiter than infiltrationanesthesia and intratracheal fluothane anesthesia.


[Molecular heterogeneity of blood and liver catalase rats with tumors].

By the method of gel-chromatography on sefadex G-200 and electrophoresis in polyacrylamid gel molecular forms of blood and liver catalase were isolated in rats with transplantable Pliss lymphosarcoma. Under study were changes in microheterogeneity of the enzyme, its activity and kinetic parameters in the kinetics of tumor growth. Quantitative and qualitative changes in the parameters under investigation were found already on the second day after tumor transplantation. These changes are enhanced with tumor progression.


[Tumors of the mesentery of the small intestine].

The clinical picture of solid tumors of the intestinal mesentery is varied and depends on the character of growth (benign, malignant), size and anatomical variants of tumor localization in the mesentery. Sometimes, the tumors concerned can induce pseudosyndrome of acute abdomen or inflammation of the adjacent organ secondary involved by tumor. Among complications induced by tumor are as follows: intestinal hemorrhage, peritonitis and acute or partial intestinal obstruction. The roentgenological picture of intestinal mesentery tumors shows some characteristic features. Eight observations of the author are reported.


Methods to purify and determine rubratoxins.

Rubratoxin were recovered from cultures of Penicillium rubrum after the mold grew in natural substrates, a semi-synthetic medium, and a glucosemineral salts broth. Substrates that contained rubratoxins were extracted with: diethyl ether, ethyl acetate-benzene, ethanol (100%), ethanol-acetone, acetonitrile, or diethyl ether with refluxing at 45 degrees C. Extracts were screened for rubratoxins by thin-layer chromatography. Some extracts were partially purified with a column of silicic acid using acetone as the eluant. Other extracts were purified (primarily removal of pigments) using columns of silica gel plus Celite and gradient solvent elution. Most rubratoxin B (1.9 mg/g or 0.77 mg/ml) was recovered when corn, rice, or glucose-salts broth were extracted successively with diethyl ether, ethyl acetate-benzene, and diethyl ether or when samples were adjusted to pH 1.5 before refluxing with diethyl ether at 45 degrees C for 1--4h. Most rubratoxin  A (0.1--0.15 mg/ml or 1.0 mg/g) was obtained from samples of corn extracted twice each with ethyl alcohol, acetone, and ethyl acetate; from glucose-mineral salts broth extracted with diethyl ether; or from yeast extract sucrose broth extracted with diethyl ether and refluxed for 4 h at 45 degrees C. Large amounts of fairly pure rubratoxin A (up to 400 mg) and rubratoxin B (greater than lg) were obtained with a combination of preparative thin-layer and column chromatography.


Analogues of human calcitonin. V. Influence of basic amino acids in positions 11, 17 and 24 on hypocalcaemic activity in the rat.

The influence of positions 11 and 24 on hypocalcaemic potency and duration of action was examined. These positions are respectively occupied by threonine and glutamine in HCT, but by the basic amino acids lysine and arginine in SCT. Replacement of threonine by lysine trebled the hypocalcaemic potency of HCT and slightly prolonged its duration of action. Substitution of arginine for glutamine reduced the activity to about one tenth. The simultaneous introduction of both basic amino acids yielded an analogue intermediate in activity between those obtained by the single substitutions. The analogue [Bmp1, Va18, Lys11, Arg24]-HCT displayed the same effects as [Lys11]-HCT.


Short time kinetics of deoxycorticosterone, deoxycortisol, corticosterone and cortisol during single dose metyrapone test.

In 4 young healthy males, serum levels of 11-deoxycortisol (S), cortisol (F), 11-deoxycorticosterone (DOC) and  corticosterone (B) were determined at short intervals after oral administration of 30 mg/kg of metyrapone (M) at midnight. 11-hydroxylase blockade was calculated from the formula (formula: see text). Significant blockade was demonstrable 15 to 30 min after drug administration. Maximum blockade (greater than 90%) was found between 2 and 4 a.m., and fell to 60-70% at 8 a.m. The profile of blockade was very similar in all the subjects, although the absolute early rise in steroid levels showed large inter-individual differences. The F level at 8 a.m. (only slightly suppressed under these conditions) is not a safe indicator of adequate 11-hydroxylase blockade.


Indirect evidences of prolactin involvement in precocious puberty induced by hypothalamic lesions in female rats.

The effects of 2-bromo-alpha-ergocryptine (CB-154) administration in maturing female rats with precocious puberty induced by hypothalamic lesions, as well as the milk secretion rate in these animals after their first parturition were studied. Treatment with CB-154 inhibited precocious vaginal opening induced by hypothalamic lesions. After the treatment with the derivative was terminated, the ovulatory response was not different from that of intact control rats. After their first parturition lesioned rats accumulate milk at a faster rate, following an initial depletion period than their non-operated controls. These results suggest than an alteration in prolactin release may be involved in determining the precocious puberty induced by lesions of the anterior hypothalamic area.


[Preventive effect of tribenoside in spontaneous arthrosis of the mouse].

Tribenoside, a D-glucofuranose derivative, was administered prophylactically over a period of ten months to six-month-old mice of the C 57 Black strain (Animal Breeding Unit, Sisseln), which are known to have a predisposition to spontaneous gonarthrosis. The preparation was given once daily for five consecutive days every other week in doses of 100 or 300 mg/kg p.o. At the end of the treatment period, serial sections of both knee joints were examined. In the placebo-treated controls, arthrotic lesions of varying severity were found in 97% of the specimens. In the animals given tribenoside in either dosage arthrotic lesions were significantly less frequent and less severe. The number of animals with bilateral gonarthrosis and of those with proliferative changes was also significantly or highly significantly smaller in the groups treated with tribenoside than in the controls. The only indication of a dose-related effect of the preparation was the fact that arthrosis of the most severe grade was present in fewer animals in the group treated with the higher dose. At present, the mechanism of action responsible for the protective effect of tribenoside demonstrated once again in these experiments cannot be clearly defined.


Effect of piperazine oestrone sulphate on serum lipids and lipoproteins in menopausal women.

Twenty menopausal women and 2 women with gonadal dysgenesis were treated with piperazine oestrone sulphate 1.5-3 mg dialy on a cyclical basis for a period of 6 months. Fasting serum lipids and lipoprotein esterified fatty acid indices (EFI) were estimated before starting treatment and after 3 and 6 months. There were small falls in serum cholesterol (significant at 3 months) and beta-lipoprotein EFI (significant at 6 months). Serum triglyceride and pre-beta-lipoprotein EFI rose significantly at both 3 and 6 months. Serum total phospholipid levels were reduced (significant at 6 months) with most marked changes in the sphingomyelin fraction. Other parameters were not significantly altered.


The role of follicle-stimulating hormone (FSH), in combination with luteinizing hormone (LH), in oestrogen-induced ovulation during the oestrous cycle in the rat.

Studies were undertaken to determine the role played by FSH in oestrogen-induced ovulation in 4-day cyclic female rats. About one half of the experimental animals receiving 10 microng oestradiol benzoate (OeB) subcutaneously, on the morning of dioestrus I, displayed luteinization or/and ovulation, when sacrificed on the morning of expected pro-oestrus. Pento-barbitone administered on dioestrus II at 18.00 did not prevent this action of OeB. A simultaneous LH and FSH surge was observed in the serum of half of the OeB-treated females killed by decapitation of dioestrus II at 17.30. The LH surge was decreased in OeB-treated females bled by cardiac puncture under pentobarbitone anaesthesia at dioestrus II at 17.30. This bleeding procedure almost completely suppressed the luteinizing effects of OeB. It was concluded that i) OeB caused a synergistic release of LH and FSH ii) bleeding by cardiac puncture as such may constitute a source of inhibition of OeB-induced luteinization.


Rat endometrium enzymes in 4-day oestrous cycle and early pregnancy.

The specific activities of lactate dehydrogenase (LDH) and its M-type (M-LDH), beta-glucuronidase (beta-GR), acid phosphatase (ACP) and alkaline phosphatase (AP) were determined. The specific activities of the enzymes (LDH, beta-GR) in the myometrium were lower and their changes less pronounced than in the endometrium. We, therefore, determined the enzymes in the rat endometrium only in further experiments. All enzymes react sensitively to the changes induced in the endometrium by endogenous hormones in the course of a 4-day cycle: pro-oestrus (P) is characterized by rather low enzyme activities, oestrus (E) by a peak of LDH and M-LDH and a rise of AP. In metoestrus (M) there is a peak of beta-GR, ACP and AP. Dioestrus (D) is characterized by a significant decrease in LDH and M-LDH and by elevated values of all the other enzymes. The values on the individual days of the 4-day cycle were compared with days 4-6 of pregnancy. The reason for this was that if the rats were not mated, they would, respectively, return to pro-oestrus instead of being 4 days pregnant, to oestrus instead of being 5 days pregnant, or to metoestrus instead of being 6 days pregnant. We found the following differences: on day 4 of pregnancy LDH and M-LDH were lower and ACP and AP higher than in P. On day 5 of pregnancy the LDH, M-LDH, beta-GR and AP were lower than in E. On day 6 of pregnancy the LDH, M-LDH, ACP and especially beta-GR, were lower than in M.


Evidence for a dopaminergic component in the series of neural events that lead to the pro-oestrous surge of LH.

The possible participation of dopamine in the neural events that lead to the pro-oestrous surge of luteinizing hormone (LH) was investigated utilizing a dopaminergic ergoline derivative (lergotrile mesylate). Administration of reserpine (2.0 mg/kg, ip) to rats on the day of pro-oestrus depleted brain dopamine and norepinephrine and prevented the LH surge and ovulation. Administration of legotrile mesylate prior to or at the same time as reserpine prevented the inhibitory effects of reserpine on LH release and on ovulation in about half of the animals. When lergotrile mesylate was given on the morning of pro-oestrus, the LH surge was advanced. The results indicate that there is a dopaminergic component in the series of neural events that precede the surge of LH on pro-oestrus, and that the dopaminergic stimulus precedes the LH surge by about 4--5 h.


Interaction of rifampicin treatment with pharmacokinetics and metabolism of ethinyloestradiol in man.

[6,7-3H]Ethinyloestradiol (50 microng) was administered intravenously to volunteers and the free extractable ethinyloestradiol in the plasma was measured. The compound showed a biphasic plasma decline. The half-life of the second phase was 7.5+/-1.7 (SD) hours. Administration of rifampicin (600 mg for 6 days) shifted the half-life of ethinyloestradiol to 3.3+/-0.9 h while the apparent volume of distribution for the second phase of elimination was not changed. When [2,4,6,7-3H]ethinyloestradiol (100 microng) was administered orally, some of the tritium was released by oxidative metabolism from the steroid and transformed to tritiated water (HTO) which equilibrated with whole body water. This portion, normally 7.17+/-1.66% of the tritium dose, was increased by previous administration of rifampicin to 10.62+/-2.27%. The initial rate of oxication of [2,4,6,7-3H]ethinyloestradiol was increased more than twofold by rifampicin treatment. The results are consistent with previous findings that rifampicin induces the oestrogen-2-hydroxylase in the endoplasmic reticulum of human liver, and explain the reduced effectiveness of ethinyloestradiol in oral contraceptives, if the patients are treated with rifampicin.


The relationship of sex steroids to uric acid levels in plasma and urine.

The effect of endogenous and exogenously administered oestrogens, androgens and progesterone on plasma and urinary uric acid and uric acid clearance was studied in a total of 65 healthy volunteers, including normal menstruating and post-menopausal women, girls with primary amenorrhoea and adult male subjects. A serial study throughout a full cycle in 3 women showed an inverse relationship between plasma uric and synthetic oestrogens produced a fall in plasma uric acid concentration through a uricosuric effect in most subjects of both sexes. Testosterone propionate caused a definite increase in plasma uric acid levels in post-menopausal women while endogenous testosterone changes due to Leydig cell stimulation produced no definite effect in male subjects. Administration of a progesterone preparation produced an effect similar to that of oestrogens in post-menopausal women. The evidence presented here supports ithe view that sex steroids play a significant part in uric acid regulation in biological fluids of both sexes.


Lack of acute effect of triiodothyronine on noradrenaline responses of isolated sympathectomized cat hearts.

The effect of 3-5-3'-triiodothyronine (T3) on chronotropic and inotropic responses to noradrenaline (NA) was studied on isolated heart preparations of cats sympathectomized with 6-OH-dopamine. Heart rates, left ventricular isovolumic pressure (P) and dP/dt were recorded, and concentration dose-response curves to NA were constructed. In the test series, T3 (0.01 and 0.1 microng per ml) was added to the perfusion medium. T3 did not affect the form nor the position of these curves. The results indicate that T3 does not have an acute effect on NA responses of symtropic effects of its own in these experimental conditions.


A re-assessment of the effect of thyrotrophin (TSH) on the tibial plate bioassay for growth hormone (GH).

The claim has been made that thyrotrophin (TSH) can augment the action of growth hormone (GH) to stimulate growth of the epiphysial cartilage plate of the hypophysectomized rat's tibia. The TSH induces its effect via secretion of thyroid hormones which in turn enhance the stimulatory action of GH. If this is true then the employment of the tibia test, whose endpoint is the increase in thickness of the epiphysial cartilage plate in response to GH present either in crude pituitary extracts or relatively purified preparations, which also are likely to contain modest or appreciable quantities of TSH, requires further examination. The present study utilized various fractions of crude pituitary extracts from intact and thyroidectomized rats that respectively contained appreciable quantities of GH or essentially no GH. Fractional aliquots of pituitary extracts from thyroidectomized rats were administered concomitantly with graded doses of exogenous GH to hypophysectomized rats to determine the point at which TSH in the extracts was sufficiently able to stimulate significant tibial plate growth when compared to recipients given GH alone. Purified GH and TSH were also administered in various doses to hypophysectomized recipients in a further attempt to delineate the dose range at which TSH augments the action of GH to promote significant chondrogenesis of the epiphysial plate. The results indicate that the enhancement of the GH effect on the cartilage plate by TSH was evident only when quantities above 100 microng bovine GH were co-administered with 100 mU bovine TSH. As little as 40 mU TSH augmented the growth effect of 400 microng GH on the cartilage plate, demonstrating that smaller quantities of TSH could potentiate larger quantities of GH. These data, therefore, suggest that extracts equivalent to not more than one-half of a normal adult rat's anterior pituitary gland should be administered to hypophysectomized rats for bioassay of GH. Fractions of glands greater than this may contain sufficient amounts of TSH to augment the appreciable quantities of GH already present.


A comparative study of iodine uptake by thyroid and thymus glands of male and female Sprague-Dawley rats of different ages.

The iodine concentrating ability of thyroid glands, thymus gland and skin in Sprague-Dawley rats was assessed by determining the tissue/blood radioiodide concentration ratios. Tissue/blood ratios are significantly affected by the age of the rats, however, thymus/blood radioiodide ratios never exceeded unity. The comparative uptake of 131I by thymus and thyroid tissue expressed as thymus/thyroid (%) for neonate animals was 10-16 times greater than those obtained for older rats. Moreover, the fraction of injected dose of radioiodide in thymus tissue never exceeded that of the thyroid or skin and paralleled the concentration of radio-activity in the blood. These results indicate that although neonate thymus tissue contains a significantly greater amount of radioactivity than the thymus of older rats, an active iodide concentration mechanism is not involved.


Influence of experimental hyperthyroidism on skeletal muscle metabolism in the rat.

In this study hind-limb perfusion was used to investigate the influence of thyroid hormones on some metabolic parameters in the skeletal muscle of the rat. Daily injection of 20 microng L-thyroxine (T4) per 100 g b. w. for a week caused a 25% increase in oxygen consumption. Further enlargement of the T4 dose had little additive effect. In the dose range 20--80 microng T4/100g b.w., no important changes occurred in lactate production or glucose consumption. Only at the highest T4 dose did the glucose consumption increase significantly. The most profound effect of T4 was on lipolysis. A daily dose of 20 microng T4/100 g b. w. gave a doubling of glycerol production rate, the maximum occuring at a dose of 40 microng T4/100 g b. w. Inactivation of the nervous system was without influence on the T4-induced increase in oxygen consumption. However, the T4-induced elevation of lipolysis disappeared after abolition of the nervous activity. This raises the possibility that the T4 effect on lipolysis in skeletal muscle is a potentiation of catecholamine effects. The T4-induced oxygen consumption increase might be dependent not on the lipolytic process but rather on other energy-consuming cell processes.


Experimental carcinogenesis in the thyroid follicular and C cells. A comparison of the effect of variation in dietary calcium and of radiation.

It is known that tumours of several endocrine glands can be induced by a combination of a physiological stress and radiation. It was decided to assess the effect of radiation and of changes in dietary calcium on the development of thyroid tumours in the rat. Three hundred rats were given either 0, 5 or 10 micronCi of 131I in their first day of life. Each of these groups was subdivided after weaning, and maintained on a diet that was either high, normal or low in calcium. The animals were killed at intervals up to 27 months of age, and the numbers of thyroid tumours recorded. Follicular tumours were first noted at 9 months of age, and their frequency increased steadily with age. The effect of radiation was highly significant, only one tumour occurred in a non-irradiated animal. There was a small increase in frequency in follicular tumours in the high calcium diet grown as compared to the low calcium diet group. C cell tumours were first noted at 9 months of age, and their incidence again increased with age. Significantly more tumours occurred in the radiated than in the non-irradiated animals. No significant variation occurred in relation to dietary calcium. It is concluded that an increase in dietary calcium, known to be mildly goitrogenic, may also be important in the carcinogenesis of follicular but not C cell tumours, and that radiation, known to be carcinogenic for thyroid follicular cells is also carcinogenic for C cells.


Transplantable thyroid tumour in rats: iodoamino acid distribution in successive tumour generations.

All first generation thyroid tumours in rats, produced by 3 micronc 131I followed by LID, were uniformly functional containing MIT, DIT, T4, T3, and in some cases, T'3. All fourth generation tumours were nonfunctional as tested. Second and third generation tumours were biochemically unpredictable, some containing all IAA including T'3, others only MIT, I-and a trace DIT. Degree of dedifferentiation and of autonomy did not necessarily correlate with loss of function. Results could be explained by postulating nodules with differing biochemical properties within individual tumours.


Atmospheric pollen in the area of Athens.

In this paper the results of an investigation on the pollen grains in the atmosphere of Athens, Greece, are presented. The work was carried out between June 1973 and August 1974. A gravity sampler, of the Durham type, was placed on the roof of King Paul Athens General Hospital. Slides covered with vaseline were exposed to the air for 24 h every day during the above-mentioned period. After staining , the pollen on each slide was counted in an area of 1.375 cm2 under a light microscope. The results obtained gave an indication of the approximate pollination period for each plant taxon and also the degree of pollen concentration over a particular area in Athens. Twenty-two types of pollen were found. Those that predominated are from Olea europaea (olive tree), Pinus Urticaceae, Plantago (plantains), Chenopodium (goose-foot), Rumex (docks), Eucalyptus and two as yet non-determined types. Most of them are found in the air duing the period March-July.


[Spore concentration in cities of the European Economic Community. II. Spores of Cladosporium and Alternaria].

A comparative account of Alternaria and Cladosporium spore concentrations in four cities in the European Economic Community (EEC), is given for the years 1973 and 1974. Sijilar volumetric air sampling methods were employed in each of the cities, and concentrations of 3000 Cladosporium spores and 100 Alternaria spores/m3 were taken as the threshold concentrations for clinical significance. With Cladosporium, although highest concentrations were observed in Brussels, the differences were less marked at the other stations. Highest Alternaria concentrations were reocrded in Brussels, followed by London, Leiden and Munich. During the 2 years studied, the average number of days with spore concentrations greater than the threshold value for Cladosporium were 59 in Brussels, 36 in Leiden, 38 in London and 46 in Munich and for Alternaria, 48 in Brussels, 13 in Leiden, 33 in London and 5 in Munich.


Bone-marrow eosinophilia in the mouse. I. Eosinophil leukocyte levels in untreated mice.

The number of eosinophil leukocytes in the bone marrow of untreated mice (Cpb:SE) has been shown to vary widely. A systematic investigation of this variability is reported here. The study was done a) within a group of mice, b) within groups of mice at roughly 3-month intervals, and c) within a group over a time course. The following are the most important results of this study: 1. Analysis of variance of eosinophils/1000 cells in 165 mice over a 35-day period showed that the results were consistent with the assumption that there are no changes during this interval (P is less than 0.05). 2. The number of eosinophils/1000 cells found in the various groups are not directly comparable; the mean number for the four groups investigated at intervals of about 3 months differed by a factor of up to 3. 3. On the basis of the variability found, the number of eosinophils/1000 cells in the bone marrow of a given untreated mouse in a group to be investigated cannot be reliably predicted. At a 99 per cent confidence level, the value would lie between 5 and 139.


Bone-marrow eosinophilia in the mouse. II. Eosinophil leukocyte levels in mice injected with egg-white and Freund's adjuvant.

In this article a study on the influence on bone-marrow eosinophilia in the mouse of a single injection of various concentrations of egg-white and incomplete Freund's adjuvant, together and separately, is reported. The combination of egg-white (1 per cent) and adjuvant gave a peak value of 158.3% eosinophil leukocytes on the 14th day after the injection; separately, neither one led to divergence from the results in untreated mice. The combination gave the greatest effect at 1.0 per cent and 0.1 per cent egg-white, a moderate effect with 10 per cent and 0.01 per cent, and negligible effects with 0.001 per cent. The interpretation of the results is discussed, with special attention to the relationship with the atopy syndrome in man.


Atopic allergy and serum IgE in randomly selected eight-year-old children.

The incidence of atopic allergy and serum IgE levels as well as specific IgE antibodies was studied in a randomly selected sample of 164 8-year-old children who were followed-up for 2 years. The total incidence of atopic disease was 18.9 per cent. Serum IgE levels were above + 2 s.d. for the age before the onset of atopic disease in seven of 11 children who developed an atopic disease during the observation period. The direct paper disc sandwich radioimmunoassay, PRIST, equalled the Phadebas IgE test for discriminating between atopy and non-atopy, but PRIST is preferred because of its simplicity. Actual or future atopic disease disease is most probable when the serum IgE is above the + 2 s.d. limit for age. Serum IgE levels below the geometrical mean for age are rarely found in atopic disease. An IgE determination with PRIST will give more discriminative information than the family history and is recommended for routine purposes when there is a history of possible atopic allergy in a child.


Monozygotic twins with temporal arteritis and ophthalmic arteritis.

Temporal arteritis - ophthalmic arteritis occurring in a pair of monozygotic twins, who were 72 and 77 years of age respectively at the onset of symptoms, is reported. It is pointed out that it is rare to see, as in the first case, an improvement in an already existing severely reduced vision, in relation to corticosteroid treatment. The importance of genetic factors in temporal arteritis is discussed; further it is suggested that a possible association of the disease with tissue type antigens be the object of further study.


Optic disc drusen and tumours of the chiasmal region.

Two patients with optic disc drusen and tumour of the chiasmal region are presented. The association of optic disc drusen and intracranial space-occupying lesion is probably a chance occurrence. In spite of the recognition of the optic disc drusen, certain findings indicate further examinations. Progressive loss of central visual acuity unexplained by retinal pathology is an indication for a neurological investigation. Bitemporal and homonymous hemianopic visual field defects as well as evidence of papilloedema warrant a neurological evaluation.


The ultrastructure of lens and iris in cerebrotendinous xanthomatosis.

The lens and an iris biopsy from a patient with cerebrotendinous xanthomatosis has been examined in the electron microscope. Subepithelial electron-lucent areas were demonstrated. The iris was normal. The lens changes were thought to be due to deposition of the specific cholesterol breakdown product inherent to this disease.


Atrophy of optic nerve fibres in compression of the chiasm. Prognostic implications.

A relationship between the degree of atrophy of retinal nerve fibres and visual field defect has been described in postoperative steady-state patients (Lundström & Frisén 1976). The same factors were studied prior to surgery in six patients with compression of the chiasm due to chromophobe adenoma. In five eyes the field defect was excessive in relation to the degree of atrophy. After surgery the visual field defects improved to a level corresponding to the degree of atrophy in these eyes. In the remaining seven eyes there was a close correspondence between the atrophy and the visual field defect already before surgery. The visual field defects remained unchanged in these eyes. Provided that atrophy does not increase after surgery, simultaneous preoperative evaluation of retinal nerve fibre atrophy and visual field defect allows an accurate prediction of prognosis for improvement.


Atrophy of optic nerve fibres in compression of the chiasm. Observer variation in assessment of atrophy.

Different observers' assessment of atrophy according to a semi-quantitative method was analysed. Five observers scored the degree of atrophy on magnified black-and-white fundus photographs from normal controls and from patients with chiasmal lesions of different severity. Four of the five examiners achieved a reasonably uniform assessment of atrophy. The results of the test prompted some modification in the grading system.


Normal values in clinical electrooculography. III. Numerical evaluation of two dimensionless EOG parameters.

The distribution of the Arden ratio (A) and another dimensionless EOG quantity (G) devised by Gliem (1971) in a sample of normal human subjects are presented. The minimum, median and maximum values for A are 148--241--449 and for G 34-88-167. A demonstrates a smaller degree of dispersion than G, the latter resembling in this respect the EOG potential parameters of the same sample. The average accumulation of errors due to inaccurate assessment of the included potential figures is almost equal in the functions of A and G. Divergencies between the figures from the present and earlier investigations are discussed together with the general advantage of dimensionless EOG parameters. It is concluded that the present investigation has not demonstrated the need to replace or supplement the Arden ratio by the Gliem quantity.


Pathogenesis of unilateral proptosis.

A series of 34 patients presenting with unilateral proptosis has been studied in order to evaluate the mechanism of proptosis. It is observed that symmetrical (axial) proptosis is usually the result of generalised increase in intraorbital contents and occurs in thyroid disease and with intracranial lesions lying remote from the orbit. Rarely, in myasthenia gravis, it may be caused by myogenic paralysis of the extraocular muscles. Asymmetrical proptosis is the result of localised increase in intraorbital contents, and this occurs with expanding lesions of the orbit and in lesions arising from neighbouring structures and enroaching the orbit.


Incidence of uveitis in Northern Finland.

The incidence of uveitis was studied among the 613 423 inhabitants of northern Finland in the year 1969. 120 new cases of uveitis were found with a total incidence rate of 19.6 per 100 000 population. The incidence was high in the age groups 20-59 years but low in the young and in older patients. The onset of uveitis was independent of seasonal changes and the occupation of the patients. The aetiology of uveitis remained undetermined in 81% of cases. Of the 120 patients 105 had anterior, 10 posterior and 5 generalized uveitis. The high incidence of anterior uveitis was in accordance wit the high frequency of the histocompatibility antigen B27 among Finns.


Aspects on the treatment of gliomas of the anterior visual pathway.

Partial excision of the glioma of the anterior visual pathway seemed to have no effect on the vision in 7 patients and had a negative effect in 2. These results support the opinion that no excision should be made in such tumours. However, the course of the disease in one exceptional patient raises doubts about the general validity of this rule. In this case the postulated chiasmal glioma proved to be an exophytic glioma arising in one intracranial optic nerve and compressing the other. Excision of the exophytic portion caused rapid and considerable improvement of vision in both eyes. Direct visualization by craniotomy was needed to separate this mode of growth from the common intrinsic growth of such tumours.


Ultrasonic findings in the vitreous body in patients with acute anterior uveitis.

The vitreous body of both the healthy and the affected eyes of 25 patients suffering from unilateral acute anterior uveitis was examined by ultrasound, and the results were compared with the optical observations made on the affected eye. In 14 eyes the optical examination of the vitreous body was impossible either due to exudation in the anterior chamber or to posterior synechias of the iris or to cataract. In 17 eyes the vitreous body was acoustically highly inhomogeneous, in three eyes slightly inhomogeneous and in five eyes no acoustic changes due to exudation were found. In cases of acute anterior uveitis, ultrasound examination often provides more information than optical examination by slit lamp. Ultrasound can also be useful in the treatment and follow-up of the disease.


Rod-cone interaction: some indirect evidence.

A group of diabetic patients were found to have losses in green-blue colour discrimination and significantly early transition times in dark adaptation. Analysis showed that the green-blue losses were significantly related to early transition time. Pre-receptoral factors cannot account for these results but selective degeneration of the blue cone mechanism can. The results are in agreement with a proposal of rod-blue cone linkage after Trezona (1970).


Immobilization of the eye. Evaluation of a new method in retinal detachment surgery.

Experiments on eye phantoms (closed chambers filled with suspensions of lipoid particles in water) have shown that saccadic rotational movements induce liquid currents flowing back and forth through a hole in a latex membrane mounted inside the chamber. It is postulated that rapid (saccadic) eye movements generate similar motions in the liquid vitreous, capable of moving a detached retina. Sixty-five non-selected eyes with primary rhegmatogenous retinal detachment were immobilized by traction sutures, usually for 2-3 days (range 1-5 days) prior to surgery. An almost complete "spontaneous" reattachment occurred in 45% of the cases, a partial reattachment (i.e. more than half of the detached area) was seen in 37%, but no reattachment took place in 18%. This rate of reattachment is higher than that obtained by bilateral eye patching and complete bed rest. Rapid (saccadic) eye movements are considered to be one crucial factor counteracting retinal reattachment. Eyes, in which preoperative reattachment is achieved, can be cured by simple surgical procedures and have a favourable prognosis.