Skin tumours in white South Africans. Part IV. Influence of occupation, sun sensitivity, colouring and associated skin tumours on the incidence of skin tumours.

Outdoor and industrial occupations in the southern Transvaal do not increase the incidence of any skin tumour excepting that of squamous cell carcinoma. However, they accelerate the onset of solar keratoses and squamous and basal cell carcinomas. A fair, sun-sensitive skin, red hair and blue eyes are more important factors predisposing towards the development of skin cancer. Unduly large numbers of seborrhoeic keratoses were found in association with polyps, and of intradermal naevi with both cavernous haemangiomas and lentigines. A high proportion of solar keratosis was found in both squamous cell carcinoma and Bowen's disease, and of basal cell carcinoma in superficial basal carcinoma, but the reverse associations were not significant.


Skin tumours in white South Africans. Part V. Treatment of skin tumours.

Dermatological methods of treating skin tumours, comprising curettage and electrodesiccation, simple excision and topical 5-fluoro-uracil, are described. Treatment of benign tumours was successful and recurrences were insignificant. Most skin cancers were treated by curettage and electrodesiccation. Cure rates with this method were 96.5% for basal cell, 94.2% for squamous cell and 100% for superficial carcinomas. Cosmetic results were satisfactory in 95% of cases. The indications for the different methods of treating skin tumours are discussed. It is concluded that curettage and electrodesiccation, in experienced hands, is a quick, effective and inexpensive procedure suitable for treating most of the skin tumours encountered in dermatological practice.


Failure of computerized tomography to differentiate between radiation necrosis and cerebral tumour.

Post-radiation cerebral necrosis simulating tumours was found in 2 patients by computerized axial tomography (CAT). The appearance was indistinguishable from that of a recurrent tumour in one patient and a glioma in the second. The significance of the scan findings was only realized after surgery and histological examination. The investigation appears to offer no assistance in differentiating between these conditions.


[Obstetrics and gynecology in the undergraduate medical curriculum].

In the present situation where medical curricula are being re-examined by many medical faculties, the importance of obstetrics and gynaecology in the undergraduate curriculum has come under intense scrutiny. Obstetrics and gynaecology form a major part of the general practitioner's work, and should therefore form a major part of his medical training. The subject also stresses par excellence the importance of communication with patients, preventive medicine and special responsibility of the medical practitioner to the community. Every department of obstetrics and gynaecology must examine the contents of the course presented to its students. We must move away from the old mechanistic approach and concentrate on those aspects which are important in a modern society--antenatal and postnatal care, preventive measures, family planning, and sexual and psychological problems of our patients.


Failure of naloxone to reverse peripheral transcutaneous electro-analgesia in patients suffering from acute trauma.

Transcutaneous electrical stimulation of the intercostal nerves innervating the site of fractured ribs in 6 patients produced subjective and clinical evidence of decrease in the pain experienced by the patients. This analgesia was not significantly modified by naloxone, a pure narcotic antagonist. The possible role of endogenous morphine-like substances in peripheral electro-analgesia in man is discussed.


Sheehan's syndrome presenting with hypothyroidism and hypo-adrenalism despite treatment with thyroxine and prednisone.

A 35-year-old patient with Sheehan's syndrome presented with hypothyroidism and hypo-adrenalism despite having received treatment with regular daily L-thyroxine (0,3 mg) and prednisone (30 mg) for the preceding 12 months. Replacement of the prednisone with 37,5 mg cortisone acetate resulted in satisfactory control of the disease. The observations suggest that large doses of prednisone may interfere with thyroxine treatment.


Osteitis deformans in the South African negro. A report of 3 cases.

Osteitis deformans is a relatively common disease in Caucasians, but rare in the indigenous people in Africa. Three cases of Paget's disease occuring in South African Negroes are reported here. Gene marker studies confirmed the absence of Caucasoid genes in these patients.


Trans-septal monitoring of left atrial pressure after cardiac surgery. An alternative method.

A simple, safe method for trans-septal insertion of a left atrial pressure line in 25 patients is presented. Complications have not been noted. Monitoring of left atrial pressure is often desirable after cardiac surgery. The conventional lateral approach is associated with the risk of haemorrhage after the cannula has been withdrawn. In an oversensitive heart manipulation might not be tolerated, precluding placement of the cannula.


The electro-encephalogram in childhood.

The electro-encephalogram (EEG) is a useful adjunct when clinical history and physical examination suggest the diagnosis of epilepsy, whether idiopathic, focal or petit mal. It may be helpful in separating the child with simple convulsions due to fever from the child whose epileptic dysrhythmia first finds outward expression while he is feverish. The real nature of disordered behaviour may be demonstrated by the EEG which shows specific evidence of temporal lobe abnormality. In many infective and metabolic disorders of childhood, the EEG has little if any diagnostic specificity, and there is real danger that a variety of entities, such as abdominal pain, aggressive behaviour or minimal brain dysfunction, may be incorrectly attributed to cerebral dysrhythmia on the basis of incidental EEG changes.


The effect of calcitonin on secretin-stimulated pancreatic secretion in man.

The effect of calcitonin on pancreatic secretion was studied in man. After steady-state secretion had been achieved with a constant intravenous infusion of secretin (2 microgram/kg/h), either calcitonin (0,16 and 0,32 microgram/kg/h) or 0,15M NaCl was infused over a period of 80 minutes. Calcitonin did not affect pancreatic volume output or bicarbonate concentration, but amylase concentration and output were significantly inhibited (P less than 0.025). The colour index in the duodenal juice was unchanged by calcitonin. No changes were observed in blood glucose or serum calcium concentrations.


Autonomic hyperreflexia. A serious complication of radiological procedures in patients with cervical or upper thoracic spinal cord lesions.

Autonomic hyperreflexia is a reflex response to visceral distension which occurs only in patients with spinal cord lesions above T6. The marked hypertension, which is an integral part of this reflex, may lead to severe morbidity, or even death. The mechanism whereby interruption of the sympathetic outflow from the spinal cord results in autonomic hyperreflexia is described, as well as the clinical signs and symptoms associated with this condition. The value of autonomic hyperreflexia as a clinical indicator of complications in patients with spinal cord lesions is stressed. The diagnosis and treatment of autonomic hyperreflexia which has occurred as a complication of radiological procedures are discussed.


Primary intracranial tumours in Black and Indian children, 1960-1975.

This report of cerebral tumours in 60 children admitted to the medical wards of King Edward VIII Hospital, Durban, shows that cerebral tumour is the commonest solid neoplasm in both Black and Indian children. There is a significantly lower incidence of cerebral tumour in Black children. No difference was apparent in age, sex ratio, site or histological types in our racial groups compared with studies in White children from other parts of the world.


[New statistical review of skin diseases in the Western Cape].

Statistics concerning dermatological disease in outpatients seen at the dermatology clinic at Tygerberg Hospital during 1975 are presented. The greatest number of patients suffered from bacterial, mycotic or parasitic infection. Acne also features high on the list. Except for the photodermatoses and acne, the difference in racial incidence of certain skin conditions, as published by Marshall and Heyl in 1963, is confirmed. More women than men were seen. This might be explained by the fact that, owing to working obligations, men often find it more difficult to attend outpatient clinics during the day. The greatest number of patients seen ranged in age from 20 to 60 years.


Incidence, contributory factors and costs of pressure sores.

Although pressure sores are an increasing problem in long-term medical care, the magnitude and costs of the complication are not well documented. In this article an investigation of the pressure sore problem in a general hospital is described. The incidence of patients with pressure sores was found to be 4,5% of the total patient population, with an additional 5,2% showing signs of skin discoloration from excessive or prolonged pressure. The majority of patients with sores were over 60 years of age, incontinent, immobile and White.


Population homeostasis.

Population size is controlled by forces more subtle than mere survival of the fittest in the face of an ever-hostile environment. The mechanisms whereby control is effected among animal populations have only recently been explored. Possible natural controls on human population size are examined.


Handling of highly infectious material in a clinical pathology laboratory and in a viral diagnostic unit.

The handling of potentially lethal and highly infective material in a routine clinical pathology laboratory and in a viral diagnostic unit is detailed. Extensive precautions were taken at each step of the receiving, processing and disposal cycle. Disposable protective clothing and apparatus were used whenever possible. Laboratory tests were limited to those essential for the clinical management and diagnosis. Technologists who handled infective material were limited to minimal numbers of experienced, non-pregnant, informed volunteers. They wore special protective clothing, including gloves, caps, gowns and masks. When possible, specimens were handled under special protective hoods. Potentially infective material was processed through automated apparatus, and care was taken to prevent contamination of its exterior. The effluent from the machines was collected into viricidal agents (glutaraldehyde, sodium hypochlorite). After processing, the machines were flushed extensively with viricidal solution. This procedure has caused no damage to the automated equipment and has been adopted as a routine laboratory safety measure. The protective procedures adopted were successful in that there was no outbreak of the viral infection among the associated laboratory workers.


Metabolism of synthetic human heptadecapeptide gastrin by the isolated perfused rat liver.

Synthetic human heptadecapeptide gastrin-1 (SHG-17-1) and rat insulin were perfused cyclically through the isolated rat liver in a plasma-free medium. Synthetic human gastrin did not disappear from the medium at either physiological or supraphysiological levels, whereas rat insulin was cleared rapidly. Chromatography of perfusion samples showed that the SHG-17-U was neither lysed to smaller peptides nor changed to the larger molecular weight species. The isolated rat liver apparently plays no role in the metabolism of synthetic human heptadecapeptide gastrin-I.


Failure of somatostatin to influence in vitro 35SO4 uptake into cartilage.

In an in vitro incubation system, somatostatin in concentrations of 0,2-250 ng/ml failed to influence the uptake of 35SO4 into porcine costal cartilage discs. This applied both to basal 35SO4 uptake (in the absence of serum) or uptake stimulated by 30% pooled normal human serum.


Acute febrile neutrophilic dermatosis (Sweet's syndrome). Four case reports.

Four patients with unusual features of acute febrile neutrophilic dermatosis (Sweet's syndrome) are reported. This syndrome is more common than is apparent from the small number of case reports. It has well-defined clinical and histological criteria, but may be considered within the erythema multiforme spectrum of reaction patterns. The clinical presentation and course can vary, as illustrated by these 4 case reports.


Anaphylactic-like reaction to hydrocortisone.

Two asthmatic patients with life-threatening allergy to intravenous hydrocortisone are described. A 21-year-old woman with chronic atopic asthma developed severe bronchospasm on 3 occasions after treatment with hydrocortisone. Allergy to hydrocortisone was only established on the third occasion. Skin prick tests with hydrocortisone (Solu-Cortef) gave a 5-mm wheal reaction and confirmed the allergy. Skin prick tests with methylprednisolone and dexamethasone elicited no allergic response. Allergy to hydrocortisone was also seen on 2 occasions in a 41-year-old man with asthma, although it was not proved by challenging him with intravenous hydrocortisone.


Radiology and the law in South Africa.

In terms of regulations gazetted in 1973, the Department of Health has control of the practice of medical radiology in South Africa. The regulations and the rules of the South African Medical and Dental Council that apply to radiology are discussed, and the legal position of workers is noted.


The adrenal cortex in hypercholesterolaemic rabbits: histochemical and electron microscopical changes.

The adrenals of rabbits on a cholesterol-rich diet for 35 days show histopathological changes, a marked increase in weight and a lowering in the ascorbate content. A focal increase in the neutral lipid and cholesterol content was noted mostly in the inner cortical zones; and a characteristic acid phosphatase-positive pattern in areas of infiltrating cells, and an alkaline phosphatase-positive reaction in heterophils in the infiltrated areas. Electron microscopy confirmed that the zona glomerulosa cells were relatively normal in hypercholesterolaemic rabbits, while necrosis and fibrosis were very obvious in the inner two zones. The cellular infiltrate was shown to consist of large, granular mononuclear cells, heterophils, eosinophils, stromal phagocytes, lymphocytes and plasma cells. The possibility that the reaction was of an immunological nature is considered. The morphology of the adrenals of rabbits which were on a cholesterol-rich diet for 35 days and on a normal diet for 6 weeks afterwards, was indistinguishable from that of those rabbits killed after 35 days on a cholesterol-rich diet.


[Universal coaxial anesthetic system].

A true universal co-axial anaesthetic system has been designed. This system may be used either as a Mapleson A circuit during spontaneous ventilation or as a Mapleson D circuit during controlled ventilation. Conversion to either system may be conveniently carried out by interchanging the pop-off valve and fresh gas inlet, without disconnecting the system from the patient. Resistance to flow of both tubes has been measured and was found to be within acceptable limits. The efficiency of this system in a Mapleson A arrangement was compared with that of a conventional Magill circuit during spontaneous breathing in 2 conscious volunteers. It was shown that no significant difference exists between these systems eith regard to rebreathing, and that the universal co-axial system may be used as efficiently and economically as the Magill circuit during spontaneous ventilation. The co-axial system can be easily connected to a circle system, combining the advantages of the two systems.


Failure of pyridoxine to suppress raised serum prolactin levels.

Pyridoxine has been reported as having an antilactogenic effect, presumably by suppressing prolactin secretion. We have measured serum prolactin levels during pyridoxine administration in two groups of hyperprolactinaemic subjects. In normal postpartum women, the postdelivery fall in serum prolactin levels did not differ significantly in treated and control subjects. In patients with chlorpromazine-induced hyperprolactinaemia and galactorrhoea, pyridoxine did not reduce the elevated levels. In neither group was milk production suppressed.


Q fever endocarditis: a report of 2 cases.

Two patients with Q fever endocarditis are described. Both patients demonstrated some of the characteristic features of Q fever endocarditis, i.e. the long course of the disease before diagnosis, persistently negative blood cultures, resistance to conventional antibiotic therapy and a dramatic response to tetracycline therapy. Complications included arteriovenous thrombo-embolism and hepatic enlargement, and 1 patient developed an immune complex form of glomerulonephritis. The possibility of Q fever endocarditis should be considered in all patients with infective endocarditis in whom blood cultures are negative and who fail to respond to conventional antibiotic therapy.


The cast syndrome--vascular obstruction of the duodenum.

Vascular obstruction of the duodenum has been reported as a consequence of the application of a cast or the correction of a spinal curvature following severe burn or combat injuries and complicating treatment of a fractured femur with balanced traction. This syndrome rarly develops more than a week after the application of a cast. An unusual case is reported in which the onset was delayed, but progressed rapidly to a fatal outcome. The pathogenesis, clinical features and treatment of this condition are reviewed. A high index of suspicion in patients at risk is essential as early diagnosis and prompt treatment are imperative.


The extended role of the nurse.

The improvement of the quality and quantity of primary health care is a major issue in southern Africa. The role of the nurse in the delivery of this care was examined at a workshop conference on 'The extended role of the nurse'. In this article in the conclusions of the conference are reported, and the problems identified in extending the role of the nurse in this field are discussed.


Four years' experience with South Africa's first mobile accident unit.

The mobile accident unit manned by medical staff is not a new concept, yet for a variety of reasons it has not been widely used. The first such service in South Africa was initiated by the author, and 4 years of successful duty have now been completed. Facts relating to our experience in this period are presented to illustrate the need for and the viability of such units. These facts and figures have been divided into 3 sections: incidents, patients and injuries, and treatment. The article is concluded with a discussion of the wider implications of using such a unit.


Cushing's syndrome and pregnancy: a case report.

The literature on Cushing's syndrome associated with pregnancy is reviewed, and a case of this rare association is reported. The patient had an adrenal adenoma. Investigations and interpretation of stimulation and suppression tests are discussed. Cortisol metabolism in normal pregnancy is referred to.


Portacaval shunt with arterialization of the portal vein by means of a low flow arteriovenous fistula.

A new operative technique was designed combining an end-to-side portacaval shunt with arterialization of the intrahepatic portal vein by means of a saphenous vein graft between the right gastroepiploic artery and the stump of the portal vein. The objective of this operation is to perfuse the hepatic portion of the portal vein with a low volume of arterial blood to ameliorate the adverse metabolic consequences of portosystemic decompression. The procedure was performed upon 18 patients with one operative mortality. The mean follow-up period is 15.4 months. The benefits of this operation are evident in the prevention of hepatic decompensation and avoidance of encephalophy, thus permiting unrestricted protein intake. The operation is well tolerated, and the operative mortality appears to be less than that following conventional shunting procedures.


Studies on the capillary permeability of experimental liver metastases.

By using a quantitative Evans blue technique, vascular permeability of Walker carcinosarcomas implanted in the liver was compared with that of the host liver tissue. Rats were sacrificed at intervals from one minute to 96 hours after the intravenous injection of the dye. Permeability activity curves were significantly different for tumors and normal liver. Permeability activity was lower in the tumor at one and five minutes, approximately the same in the tumor and liver from 15 minutes to one hour but, from two hours to 48 hours, the permeability activity was significantly higher in the tumor. The peak tumor-liver permeability activity ratio of 1.87 occurred at six hours, and the highest tumor permeability activity values were seen at 18 hours. Liver permeability activity, in contrast, increased gradually after dye injection, reading peak levels at 24 to 72 hours. At 96 hours, both tumor and liver permeability activity were lower and equal. The differences in permeability activity may be explainable on the basis of structural differences in normal and tumor vessels or may be due to chemical substances released as a result of the presence of the tumor. The differences in permeability activity of tumors and normal tissues may be an important factor in determining the effectiveness of diagnostic and therapeutic techniques.


The influence fo traumatic splenectomy on the volume of human platelets.

A rise in the blood platelet count and volume occurred in 11 patients following traumatic splenectomy. The pattern of the volume distribution, however, remained unchanged. This indicates an increased rate of platelet production, with the newly formed cells substantially larger than their preoperative counterparts, and can be interpreted in terms of a humoral factor of splenic origin that is able to exert its control over the bone marrow. The stable shape of the volume distribution, despite splenectomy, suggests the presence of an organ other than the spleen that is capable of maintaining the normal age distribution in the peripheral circulation, and the liver is proposed as a possible candidate for this role. The evidence, so far, has been circumstantial and further investigation will be required before definite conclusions can be drawn.


Carcinoma of the ovary and serum lactic dehydrogenase levels.

This report of a prospective study lends further evidence to a previous finding that serum lactic dehydrogenase levels are elevated in primary carcinoma of the ovary. Levels of this enzyme in the proper context appear valuable in the diagnosis, treatment and follow-up study of patients with primary carcinoma of the ovary.


Intraoperative assessment of arterial reconstruction by Doppler ultrasound.

The Doppler ultrasonic velocity detector is a simple, inexpensive and versatile device for intraoperative monitoring of the integrity and hemodynamics result of vascular reconstructive surgical procedures. With this instrument, an ankle-arm systolic pressure index may be obtained before and after aortoiliac and femoral reconstructive surgical procedures. If the ankle pressure index does not increase following aortofemoral bypass and a thromboembolic vascular accident has been ruled out, it is unlikely that the patient will be significantly helped by that procedure alone. The use of a sterile Doppler probe permits qualitative assessment of arterial velocity signals following femoropopliteal bypass, carotid endarterectomy and mesenteric or renal vascular procedures. The Doppler detector may also be used to assess periorbital flow dynamics following carotid endarterectomy. Selective intraoperative arteriography can be based upon the presence of residual flow abnormalities detected by Doppler ultrasound.


Comparison of wound strength in normal, radiated and infected tissues closed with polyglycolic and chromic catgut sutures.

Wound strength in the rectus muscle of rabbits is greater at any measured time interval when sutured with polyglycolic acid than when sutured with chromic catgut. This is true for both irradiated and nonirradiated tissues. No significant advantage is seen for either suture in nonirradiated bladder, although the trend favors polyglycolic acid. In irradiated bladders, a significant advantage is seen for polyglycolic acid at 15 days. In measuring repaired ureteral orifice size, only chronic catgut suture in nonirradiated rabbits caused marked edema and unreteral obstruction. Postoperative ureteral dilation with both materials resolved over a 90 day period. In the irradiated ureter, however, resolution of this obstruction appears to occur earlier and more dependably when polyglycolic acid suture has been used. Polyglycolic acid showed a trend for superior strength in urothelial wounds tested. The healing of bladder epithelium is usually completed in ten to 14 days. The entire bladder wound gains strength rapidly until day 21 and gains little strength thereafter. A suture material that does not increase the inflammatory response but lasts long enough for complete bladder healing is advisable. Using the criterion of wound breaking strength in our experimental work, polyglycolic acid was shown to be superior to chromic catgut suture material.


Propranolol for the preoperative preparation of patients with thyrotoxicosis.

Thirty patients with hyperthyroidism were were prepared for subtotal thyroidectomy with propranolol. Rapid control of thyrotoxic symptoms occurred in all, and there were no undesirable drug reactions. There were no instances of post-operative thyroid storm. The drug was as effective and safe in four patients who were pregnant as it was in the other 26 patients discussed. We consider propranolol to be the drug of choice in the preoperative preparation of most patients with thyrotoxicosis.


The effect of prosthetic gallstones on total bile acid pool size in dogs.

A reduction in total bile acid pool size was noted in nine of ten dogs after the implantation of inert prosthetic gallstones. Sham cholecystotomy without implantation of a prosthesis also produced a small decrease in bile acid pool size but was significantly less than the decrease noted with prosthetic stones. Bile acid ratios--cholic acid, chenodeoxycholic acid and deoxycholic acid--did not change after implantation of prosthetic stones. These findings raise the possibility that the small total bile acid pool size noted in patients with cholesterol gallstones is a phenomenon secondary to the pathologic state of the gallbladder.


Practical approach to laparotomy for staging in the management of lymphomas.

This study was designed to delineate the role of laparotomy for staging in the management of lymphomas and to determine the accuracy of nonsurgical staging procedures. Fifty-four untreated patients with diagnoses of Hodgkin's disease or non-Hodgkin's lymphoma had extensive physical, laboratory, roentgenologic, scintigraphic, nonsurgical and surgical staging evaluation. Forty-five out of 54 patients had clinical Stage I and II disease; clinical Stage IV patients were excluded. One out of eight enlarged spleens, 12 out of 46 normal spleens, none of four enlarged livers and four out of 50 normal livers were positive at laparotomy. None of the preoperative needle biopsies of the liver and iliac crest was positive for lymphoma. The pathologic stage was advanced in six out of 25 of clinical Stage I, six out of 20 Stage II and two out of nine of Stage III. 67Ga scanning and lymphography were accurate in 16 out of 30 and 24 out of 45 patients, respectively. There was no mortality, but morbidity was limited to atelectasis, thrombophlebitis and subphrenic abscess in three patients, respectively. Only when treatment regimen is stage-dependent and only if nonsurgical staging procedures have reliably failed to rule out disseminated disease, then laparotomy for staging indicated in localized lymphomas. Laparotomy for staging should not be done when the treatment plan is not altered by staging data or when there is a medical contraindication or when evidence of disseminated disease has been reliably and consistently obtained by nonsurgical methods as needle biopsies of the liver and bone, lymphography, scintigraphic studies and laparoscopy.


Two instances of bile reflux without acute pancreatitis.

In two patients in whom most of the bile and the pancreatic juice were mixed, one within the pancreatic duct because of a presumed injury to the ampulla of Vater and the other within the bile duct secondary to a tumor of the ampulla of Vater, there was no pathologic evidence of acute pancreatitis within the pancreas. This was true even though there was chemical evidence that trypsin in its active form passed through the pancreas. On explanation for this is that trypsin inhibitors contained in human bile and pancreatic juice may bind trypsin.


Perforation of the gastrointestinal tract in infancy and childhood.

Eighty-eight patients with perforations of the gastrointestinal tract in infancy and childhood, excluding those caused by appendicitis, are presented. Fifty-five patients were four weeks of age or younger. Fourteen of the perforations occurred during the first year of life and 19 occurred between one and 15 years of age. The locations of perforations by order of frequency were the ileum, rectosigmoid, stomach and duodenum. The causes in order of frequency were necrotizing enterocolitis, ulcers, unknown causes, Hirschsprung's disease, atresia of the small intestine, volvulus, trauma, gastroschisis and ventriculoperitoneal shunts for hydrocephalus. A high index of suspicion, aided by roentgenograms, is essential for an early diagnosis. The over-all mortality was 49 of 88 patients. No reduction in mortality was observed in the last ten years, despite improved surgical techniques and better antimicrobial agents. Early recognition and rapid transport of the child to a pediatric intensive care unit with better supportive measures plus antimicrobial agents effective against both anaerobic and aerobis bacteria should reduce this high mortality.


Steroid hypothermia.

A retrospective study of 17 episodes of septic shock was made. In most patients, intravenous treatment involving a 2 gram bolus of Solu-Medrol produced a precipitous fall in temperature within four hours. Accompanying the temperature change was an improvement in their general physical condition. The hypothermic effect usually lasted approximately 30 hours, after which the temperature would reach a level below the presteroid temperature or would return to the presteroid level. If the sepsis was overwhelming and the patient did not survive, thetemperature response was not as dramatic and lasted approximately eight to ten hours, with no clinical improvement.


The nature of the proteins of fat emboli released during total hip prosthesis.

Human fat emboli, released during total hip prosthesis contained less than 0.1 per cent proteins. Most likely, this was the result of absorption of the fat particle during in vitro procedures.


Transperitoneal relocation of the ileal stoma without formal laparotomy.

A method of transperitoneal ileal stoma relocation without formal laparotomy is described. Twenty of these procedures were performed during a ten year period. There was one postoperative failure. The barium stomal injection is a valuable aid in the peroperative diagnosis of possible underlying Crohn's disease. Transperitoneal relocation of an ileal stoma without formal laparotomy is a safe and useful method in selected patients.


Preservation of the pylorus in pancreaticoduodenectomy.

Further clinical observation and laboratory evaluation will be necessary before we can recommend this modification of the usual technique of pancreaticoduodenectomy to preserve the pylorus and distal part of the stomach in patients in whom the resection is performed for benign disease or for carcinoma of the distal part of the duodenum. However, we believe that the early results in the two patients described are encouraging.


Intraocular hemorrhages: a hemostatic therapeutic approach.

Our knowledge of the local hemostatic factors capable of playing a role in certain intraocular hemorrhages is reviewed as a background to therapy with agents active in hemostasis. Common to hyphemas and subretinal hemorrhages are some conditions which are apt to disturb hemostasis and result in recurrent bleeding. They are: 1) Dilution of blood by aqueous humor or subretinal exudative fluid followed by the formation of hemostatic plugs which are prone to spontaneous lysis; 2) Contiguity of certain structures, such as the iris and the choroid, which are extremely rich in fibrinolytic activators favoring premature dissolution of the hemostatic plug and thereby recurrent bleeding; and 3) Presumptive high local concentration of fibrin degradation products (FDP), which have an anticoagulant action and would counteract hemostasis in the event of rebleeding. Based on these observations, the use of fibrinolytic inhibitors for the treatment of hyphema and subretinal hemorrhages seems warranted. Hemostatic mechanisms in intraocular hemorrhages and their treatment with various agents are discussed.


Intraocular coccidioidomycosis.

A case of unsuccessfully treated coccidioidomycosis with intraocular manifestations is presented. Fever, skin lesions and a variety of constitutional symptoms dominated the clinical course. At autopsy there were extensive systemic dissemination and conspicuous intraocular lesions involving the uveal tract. The ocular and systemic features and the immunologic aspects of Coccidioidomycosis are discussed. Previously reported intraocular cases are reviewed and compared to our case.


Ophthalmic ointments.

The use of ointments as an ocular drug vehicle adds an important dimension to topical therapy. Ointments are well tolerated, fairly safe, and provide an excellent means for enhanced ocular contact time. In the case of certain antibiotics, this improved contact time yields increased ocular drug levels. However, experimental data indicate that corticosteroid ointments do not penetrate into the eye as well as do suspension preparations. This may relate to the binding of the drug to the ointment base and also to the particular steroid compound. Like other ophthalmic preparations, ointments may become contaminated. Ophthalmic ointments should not be instilled into eyes with open wounds. Instillation of ointments into postoperative eyes where wound closure is secure appears to be safe and effective.


[Possible methods of control of virus disease in swine today and in the future. II. Specific applications (author's transl)].

The four alternatives discussed in the previous paper (5), are applied to a number of virus infections which are common in pigs. The enzootic state of SMEDI enteroviruses, vomiting and wasting virus and parvovirus should be promoted by bringing the young gilts into close contact with the older sow population at a sufficiently early stage. There should preferably not be a change of herd for primiparous sows during pregnancy. In parvovirus infection, maternal immunity may be so prolonged that gilts will only be infected after the time of breeding. Therefore, mating should preferably be postponed until they are nine months of age, unless previous serological tests have shown that they are in a state of active immunity. Considering the present disease situation of swine fever in several continental West European countries and consequently they high number of existing virus sources, compulsory vaccination of sows and fattening piglets is recommended against this virus on an international scale for at least three years. This vaccination can be omitted only after the number of outbreaks has been reduced to a very low level. Vaccination is the only possible alternative left in the combat against Aujezky's disease. Caution is undoubtedly indicated in using live vaccines in these cases. So far, methods have not become available for the effective control of transmissible gastroenteritis and prospects are not encouraging. The possibility of eradication of transmissible gastroenteritis is discussed.


[Findings in an outbreak of salmonellosis due to S. dublin in veal calves in the province of Gelderland (author's transl)].

An outbreak of salmonellosis caused by S. dublin has been prevalent in the Province of Gelderland ever since the end of 1975. The clinical picture is marked by general disease and respiratory symptoms, variations in temperature and diarrhoea which was present in not more than approximately 20 per cent of the cases. The most satisfactory results of treatment were obtained on administration of a sulphamethoxazole trimethoprim compound and colistin. Mortality averaged 16 per cent, the flock continuing to be affected with the disease for six weeks. In addition to enteritis, septicaemia and pneumonia were outstanding features in post-mortem studies. S. dublin was detected particularly in the liver, spleen and kidney. The sensitivity pattern showed a marked decrease during the past six to seven years, particularly sensitivity to chloramphenicol, tetracycline and ampicillin. The greater part of the strains were only sensitive to colistin, furazolidone and a sulphamethoxazole trimethoprim compound. This increase in resistance is discussed, and it is attributed to mass administration of antibodies rather than to transfer of resistance due to R-factors.


[Scours in piglets during the first four weeks of life. Studies on the incidence and the effect of various features of management on the appearance of scours (author's transl)].

On 793 farms, studies were done on: --the incidence of scours on commercial farms. --The differences between groups of animals, such as the difference of age and the differences between litters of primiparae and multiparae. --Various features of herd management as factors in the incidence of scours, such as the size of the farm, the use of straw-bedding in the farrowing house, hygienic procedures, supplementary feeding and supply of drinking-water. Investigations were carried out during the periods of February and March 1975 and August and September 1975. The total number of litters of piglets taking part in the studies was 7,692. Some of the most important conclusions drawn from these studies were: --The incidence of scours was highest during the second week of life, namely in 34 per cent of the litters. --The litters of primiparae, scours was commoner than it was in litters of multiparae. This difference was most marked during the first week of life. --When straw-bedding was used in the farrowing houses, much fewer cases of scours were observed. --Supplementary feeding and supplying drinking water-during the first week of life resulted in a higher incidence of scours. --Hygienic procedures such as washing the sow and cleaning the farrowing house prior to farrowing reduced the proportion of litters showing scours.


[Fungus infection in a guinea pig as a cause of human infection (author's transl)].

A case of fungus infection in a guinea pig is reported which was found to have caused human dermatomycosis resulting from Trichophyton mentagrophytes infection. A number of diagnostic features are discussed.


[An unusual fracture of the elbow (author's transl)].

A case of long-standing lateral condylar fracture of an elbow in a dog is reported. The fracture resulted in peripheral neuropathy of the ulnar nerve. The previous history, the findings at operation, the stable osteosynthesis permitting weight-bearing and the post-operative course are discussed.


[Compensatory mechanisms of haemolysis after surgery with the heart-lung-maschine (author's transl)].

In 20 patients, suffering from various diseases, the extent of haemolysis and the correlation between the rate of haemolysis and various mechanisms of erythrocyte damage in the course of open heart surgery was studied. We investigated haemotological parameters, electrolytes, lactate dehydrogenase before, and 1, 3, 5, and 7 days after operation. Besides free haemoglobin, haptoglobin and haemopexin were determined 5 and 15 minutes after starting perfusior with the heart-lung machine and after finishing. The best index of haemolysis was free haemoglobin in the serum. With increasing duration of perfusion the rate of haemolysis increased. Compensating mechanisms were postoperative increase of haptoglobin and haemopexin.


[Severe mechanical haemolysis after correction of a partial atrioventricular canal (author's transl)].

Following correction of a partial atrioventricular canal and closure of the atrial septum defect with a Dacron patch a severe hemolytic anemia developed caused by moderate mitral insufficiency. The clinical postoperative course and the successful treatment by reoperation is described in detail. The Dacron patch was excised, the mitral cleft was closed by four single sutures, and the septal defect was covered with a pericardial patch. In the literature ten other communications were gathered reporting hemolytic anemias following correction of endocardial cushion defects with Dacron, Teflon, or Ivalon patches. Three of six reoperated patients died postoperatively. A woman died after correction with renal failure caused by severe hemolysis. In four patients hemolytic anemia was compensated and there was no need for reoperation. In consideration of our own experience and those reported in the literature we recommend pericardium instead of synthetics for closure of atrial septum defects of Foramen-primum-type.


Bronchogenic cysts: problems in diagnosis and management.

Bronchogenic cysts usually are easily recognized and treated. On occasion they can present problems in diagnosis or management. We have experienced four such cases. A two month old infant whose cyst drained transbronchially during induction of anesthesia; a nine month old infant with preoperative respiratory obstructive signs; an adult with preoperative respiratory obstruction and acute severe respiratory distress during positioning for thoracotomy; and a newborn with an opacified hemithorax associated with retained fetal pulmonary fluid. Awareness of these unusual problems with bronchogenic cysts allows for promt and accurate management and avoids delays and possible complications.


[Esophagopleural fistula; a rare complication after pneumonectomy (author's transl)].

This work deals with 8 own cases of esophagopleural fistula observed in 807 pneumonectomies with mortality rate of 37%. The pathogenesis as well as the treatment of esophagopleural fistulae based on world literature and own experience are discussed. The esophagopleural fistula is serious complication usually connected with pneumonectomy. Esophagography which should be done in every case after pneumonectomy ensures the diagnosis and before the operation shows any pathology of esophagus in its course and position. Small esophagopleural fistulae heal best after gastrostomy but larger ones require beside a double row suture of esophageal wall and additional covering with muscle flap.


[How effective is the interruption of the inferior vena cava for the prevention of recurrent pulmonary emboli?].

Analysis of results which have been obtained by interruption of the inferior vena cava for prevention of recurrent pulmonary emboli. The incidence of recurren emboli by means of the 3 possible methods ligature, plication and intraluminal filter is 6%, 5% or 2%. The incidence of fatal pulmonary emboli is 2%, 1% or 0,5%. There are no studies which do compare the effectiveness of operative procedures with the drug prevention. Both the operative and the drug prevention are not without mortality. Interruption of the inferior vena cava for the prevention of recurrent pulmonary emboli should be carried out in exceptional situations only as possibility of failure of anticoagulation.


[Spontaneous lysis of pulmonary embolism during angiography (author's transl)].

A case of spontaneous lysis of pulmonary embolism during pulmonary arteriography is reported. Moreover diagnostical and therapeutical problems are discussed, especially with regard to operative intervention in cases of discrepancy between symptoms and angiographical findings.


[Preoperative ventilatory function tests as an aid in assessment of operative risk of prosthetic heart valve replacement (author's transl)].

The operative risk of prosthetic replacement of the mitral valve in 97 patients and of the aortic valve in 126 patients showed a good correlation with the decrease in preoperative pulmonary function (p less than 0,01). The overall mortality rate reached 12,4% respectively 13,4% during the first 28 days after surgery. Depending upon the stage of ventilatory impairment the mortality rate varied between 0 to 50% in the mitral group and between 6,5 to 50% in the aorti group. The impairment of respiratory function is caused by the disturbed hemodynamic function demonstrated by a negative correlation between pulmonary artery pressure and vital capacity.


[Myocardial protection utilizing hypothermia and cardioplegin during surgical correction of congenital heart disease (author's transl)].

Our methods of myocardial protection are demonstrated in 846 patients subjected to open heart surgery for correction of congenital heart disease. They include body hypothermia and injection cardioplegia using magnesium-asparate-procaine. The spectrum of myocardial protection reaches from normothermia without cardioplegic arrest during short periods of extracorporeal circulation to profound body hypothermia with multiple injections of the cardioplegic solution in complex cardiac malformations. The results in 586 patients with left to right shunt, 140 patients with cyanotic cardiac malformations and 120 patients with congenital valve lesions are presented. Attention is directed to possible negative sequelae of overdosage of magnesium-asparate.


HLA polymorphism in Israel. I. Jews of Polish extraction.

One hundred and twenty seven randomly selected Polish Jews were studied for their HLA polymorphism. Gene frequencies exceeding 0.1 were detected for A1, A2, Aw19, B14, Bw16 and Bw17. Significant gametic association was observed for (A1, Bw17), (A2, B27), (Aw26, Bw16), (Aw19, B13) and (A28, B14). Although a predominantly Caucasoid population, the Polish Jews show greater resemblance to Middle Eastern rather than to Northern European Caucasoids.


HLA polymorphism in Israel. 2. Israeli Jews originating from Russia.

HLA typing of 123 Israel Jews of Russian origin showed a high frequency for HLA--A1, A2, Aw19 and B14, Bw16 and Bw35 of the A and B loci, respectively. The most frequently occuring haplotypes were (A1, B17), (Aw25, B18), (Aw26, Bw16), (Aw19, B13), (Aw23, B5) and (Aw25, Bw35). This study reveals a striking resemblance in the distribution of frequencies of HLA alleles and haplotypes between Russian Jews and two other East European Jewish communities (presented in this issue) of Polish and Rumanian origin.


HLA polymorphism in Israel. 3. Ashkenazi Jews of German descent.

Seventy-three random Jewish individuals whose families have lived in Germany for at least 4-5 generations, were typed for HLA antigens at the A and B loci. In comparison with other European populations, the frequencies of B7 and B12 are low whereas Bw35 is almost twice as frequent (21%). Among the uncommon associations found in the German Jews were: (A2, Bw21), (Aw25, B18), (A29, B14), (A28, Bw15). The frequent haplotype (Aw24, Bw35) was previously found, but only in Asia and in American Indians. Subdivisions of the subjects according to geographic regions within Germany point to differences in gene frequency between the groups.


HLA polymorphism in Israel. 4. Israeli Jews originating from Rumania.

The frequencies of 29 HLA antigens of the A amd B loci were studied in 130 Israeli Jews originating from Rumania. The antigens A1, A2, Aw19 and B14, Bw16 and Bw35 occurred with the highest frequencies. The most common haplotypes were (A1, B17), (Aw26, Bw16) and (A28, Bw22). These results are similar to those observed in Polish and Russian Jews.


HLA polymorphism in Israel. 5. The Moroccan Jews.

One hundred and forty one unrelated Moroccan Jews living in Israel were studied for their HLA polymorphism. Gene frequencies exceeding .1 were found for A1, A2, A3, Aw19, B5, B12, and B13. Significant linkage disequilibrium occurred for (A1, B8), (A2, B5), (A2, Bw21), (A3, Bw40), (A9, B7), (A10, Bw16), (A29, B18) and (Aw19, b14). they represent an intermediate population between Europe and the Middle East.


HLA polymorphism in Israel. 6. North African Jews from Libya.

Phenotype and gene frequencies of antigens at the A and B HLA loci were determined in a sample of 89 random Libyan Jews now settled in Israel. Most antigens at the A locus are within the range found in European populations while, at the B locus, the frequencies differ from Caucasoid populations: B7 is usually rare (1%), Bw35 is frequent (14%) and Bw40 very common with more than 10%. Thirteen percent of Libyan women whose sera were screened for the presence of HLA antibodies gave positive results. Some of them are elderly women, about 15 years or more beyond their last birth.


HLA polymorphism in Israel. 7. The Babylonian Jews.

One hundred and twenty three Iraqi Jews, now living in Israel, were studied for their HLA polymorphism. Gene frequencies exceeding .1 were found for A1, A3, Aw19, B5, B12, and Bw35. A28, B8 and B14 were relatively rare whereas Aw25 and Bw37 were not found at all. Significant gametic associations occurred for (Aw23, Bw21), (Aw26, Bw16), (A11, B5), (A28, B8) and (A28, B7). The Iraqi Jewish population was found to be typical of Asiatics and Middle Easterners.


HLA polymorphism in Israel. 8. The Armenian community in Jerusalem.

Gene and phenotype frequencies for the three HLA loci were determined for 90 random Armenians from the Old City of Jerusalem. Relatively high frequencies were found for HLA-A2, A3 and Aw24, while the lowest frequencies were those for Aw23 and Aw25. The major distinguishing antigen, when compared with European Caucasoids is Bw35 with a frequency of 22%. Two unusual associations between the B and C loci were observed: Bw 17, Cw3 and B7, Cw3. Another interesting association in Armenians, Aw32 Cw4, has previously been found only among Cochini Jews and Malay populations.


HLA polymorphism in Israel. 9. An overall comparative analysis.

HLA gene frequencies in 11 Israeli populations and nine other relevant populations were used to calculate genetic distances in a quantitative assessment of their similarities and differences. The shortest distance found is between Polish and Rumanian Jews, while the largest is between Russian Jews and Black Africans. Estimates of "average" distances within major population groups suggest that the Ashkenazi Jews (Poles, Russians, Rumanians and Germans) are a more homogeneous population than East European non-Jews or than Middle-Eastern populations (Arabs, Armenians, Lebanese and Turks). A cline of distances between Ashkenazi Jews and other Jewish communities parallels their geographic distribution; however, the relatively large distance between the two North African communities (Libyans and Moroccans) demonstrates that geographic proximity is not necessarily correlated with genetic similarity. The Jewish populations, especially the Ashkenazi, show a clear divergence from their neighboring non-Jewish populations, among whom they have lived for many centuries. There are indications in the HLA data of a common origin for the diverse Jewish populations.


Tissue typing of cells in culture. II. Histocompatibility typing of diploid fibroblastic cultures by the mixed hemadsorption (MH) test.

Skin fibroblasts derived from persons who had been HLA-typed by conventional lymphocytotoxocity tests were subjected to HLA-typing by the mixed hemadsorption (MH) test. The agreement between the two methods was good, provided sera for the MH test were carefully selected. Minor discrepancies found in this study can probably be corrected by further serum selection. There was no difficulty in typing late passages of cultured diploid cells (22 doublings) and in fact it was easier to type a culture at the 33rd doubling than at the 11th. Thus no signs of disappearance of HLA-antigens were seen in these tests.


Histocompatibility antigens in two American Indian tribes of French Guiana.

Two South American Indian populations were typed for HLA antigens. In each, the individuals typed were related and their genealogies were known. Determination of their genotypes was done; there seemed to be neither excess nor deficiency in homozygotes. The antigens observed, A2, A9, Aw19.2 (Aw30-Aw31), A28 for the first locus and B5, Bw15, Bw35, Bw40 for the second locus are in accordance with those previously described for other South American Indians. The two populations belong to the same primary linguistic family Tupi-Guarani and they live in the same geographic area, but there was no intertribal marriage until recently. Genetic drift can explain the differences observed.


Delta-aminolaevulinic acid metabolism in normal and lead-exposed humans.

The activity of the haem biosynthetic enzymes delta-aminolaevulinic acid synthetase (ALA.S) and delta-aminolaevulinic acid dehydratase (ALA.D) were measured in the peripheral blood of a group of lead workers and control subjects. The haem precursor delta-aminolaevulinic acid (ALA) was measured in blood and urine, whilst lead levels were measured in whole blood. The inter-relationships between all these parameters were examined and quantified. The results demonstrate that above a blood lead concentration of 2 mumole/l and below an erythrocyte ALA.D activity of 18 nmole ALA utlized/min/ml red blood cells (R.B.C.), Haem synthesis is depressed to such an extent that the activity of leucocyte ALA.S, the rate-limiting enzyme of haem biosynthesis, is increased by negative feedback.


The hepatotoxicity of 3-amino-1,2,4-triazole and carbon disulphide in phenobarbitone-treated starved rats.

In phenobarbitone-treated starved male rats 1 g/kg 3-amino-1,2,4-triazole produced moderate liver necorsis and increased the serum glutamic-pyruvic transaminase activity. If half an hour after the administration of aminotriazole animals were exposed for 4 h to 2.0 mg/l CS2, the necrotic damage in the liver was larger and the serum glutamic-pyruvic transaminase activity higher than in rats not exposed to CS2. Carbon-disulphide in phenobarbitone-treated starved male rats caused only a very slight increase in the serum transminase activity in spite of the widespread hydropic degeneration in the liver. These experiments indicated that increase in serum transaminase activity is the consequence of necrosis and not hydropic degeneration; aminotriazole is hepatotoxic in rats when microsomal enzymes are induced and the hepatotoxicity of aminotriazole and carbon disulphide is potentiated by the administration of the other compound.


Biochemical studies on phthalic esters. III. Metabolism of dibutyl phthalate (DBP) in animals.

The excretion, distribution and metabolism of DBP were studied in rats. More than 90% of the dose was excreted in the urine within 48 h following intravenous or oral administration, but the faecal excretion was low. Biliary excretion was remarkably higher than that in the faeces when DBP was given orally. No significant retention was observed in organs and tissues at 24 h after dosing. In vitro experiments showed that DBP was hydrolysed very rapidly to MBP by the esterase of rat liver microsome. DBP was found to be a strong inhibitor for the succinate dehydrogenase of rat liver. DBP and its metabolites, MBP and phthalic acid, did not produce any striking effect upon hepatic and serum enzyme activities in vitro. Urinary metabolites of orally ingested DBP were investigated in 3 species, namely, rats, hamsters and guinea pigs. MBP was a common major metabolite in all 3 species. A further increment was apparently excreted as the glucuronide in the rat, hamster and guinea pig together with a small amount of phthalic acid and unchanged DBP. Omega- or omega-1 oxidation products of MBP were also detected in the urine.


Studies on the uptake and metabolism of dibenz(b,f)-1,4-oxazepine (CR) by guinea-pig cornea.

The uptake and metabolic fate of the sensory irritant dibenz(b,f)-1,4-oxazepine (CR) have been investigated in intact cornea and corneal homogenates using 3H-labelled CR. The cornea metabolises CR to its lactam derivative (10,11-dihydro-10-oxo-dibenz(b,f)-1,4-oxazepine) by a process which appears to be located in the cell cytoplasm and which is easily saturated. Uptake studies with higher concentrations of [3H]CR (1 X10(-5) M) which saturate lactam biosynthesis, suggest that CR may bind, with low affinity, to sites within the corneal cells. The possible roles of CR metabolism and CR binding in chemical sensory irritation are discussed.


Toxicity of butylated hydroxytoluene in mouse following oral administration.

Male Swiss--Webster mice were given 400 mg/kg of butylated hydroxytoluene ([methyl-14C]toluene) by stomach tube. Radioactivity was measured in plasma, lung, liver and kidney from 0.5 h to 10 days later. Radioactivity associated with butylated hydroxytoluene (BHT) or its metabolites was highest in plasma and all tissues examined between 1 and 12 h after administration. After 24 h, less than 1% of the administered dose remained in the lung, kidney or liver. One day after BHT, DNA synthesis in lung increased and, on days 3, 4 and 5, was 6--8 times as high as in controls. DNA content of the lungs almost doubled. Synthesis and net increase of pulmonary DNA were dose-dependent. If BHT was given orally following injection of one single dose of urethane, adenoma formation in lung was enhanced. It is concluded that BHT, given by stomach tube and in doses higher than 100 mg/kg, produces extensive cell proliferation in mouse lung and acts as a promoting agent in adenoma development.


Percutaneous absorption of hexachlorophene in rats, guinea pigs and pigs.

A comparative study of the percutaneous absorption of hexachlorophene (HCP) was undertaken in rats, guinea pigs and pigs. [14C]Hexachlorophene ([14C]HCP) was applied evenly over the shaved back of the animals at a dose of 40 microgram/cm2 skin surface. Urine and feces were collected at 24-h intervals for 5 days from animals kept in metabolism cages. Different methods were used for quantitating the percutaneous absorption of HCP. This study showed that skin permeability to HCP decreased in the following order: rat, guinea pig and pig. The permeability characteristics of the pig skin to topically applied HCP were comparable to the published human data. We suggest that pig may be a suitable animal model for studying the percutaneous absorption of antimicrobial drugs.


Dimethadione-induced fetotoxicity in rats.

The fetotoxic potential of dimethadione was studied in rats given single daily oral dosages of 0, 54, 433 or 541 mg/kg on days 1--21 or 6--15 of gestation. No maternal toxicity was observed following treatment on days 6--15. When administered from days 1 to 21 only the highest dose (541 mg/kg) produced a significant reduction in maternal body weight gain. Dimethadione caused a dose-related decrease in fetal weight and an increased incidence of umbilical hernia, ecchymoses and subcutaneous edema. There were also increased incidences of non-specific skeleton defects which consisted of unilateral or bilateral wavy ribs, additional ribs (14th rib, uni- and bilateral), retarded ossification of calvaria and a wide variety of sternal defects. Specific defects were bent radius and ulna, and bent tibia and fibula which increased with increasing dosages of dimethadione. Fetal mortality and incidence of skeletal anomalies were higher when the treatment was given on days 1--21 of gestation than on days 6--15 of pregnancy.


Heme synthesis in the lead-intoxicated mouse embryo.

Incorporation of 55Fe and of [14C]glycine was studied in control embryos and mothers and in those which had received lead in the diet from day 7 of pregnancy. Incorporation of Fe into heme of embryonic liver which increases markedly for controls on day 17 of pregnancy was depressed greatly and showed no such increase in lead-intoxicated embryos. These embryos were retarded in growth but had normal heme concentrations in body and liver. Incorporation of glycine into embryonic heme and proteins was not affected. Data on incorporation in the mothers are also presented. It is thought that the impaired synthesis of heme in lead-intoxicated embryos limits their body growth during the late phase of pregnancy.


The effect of carcinogens on the nuclear size of HeLa cells.

The size of HeLa S-3 cell nuclei was measured after 1--3 days in culture. After exposure to carcinogens, nuclear size increased and the frequency distribution pattern of nuclear size changed. The optimal conditions for these changes were the use of concentrations of chemicals which had a low order of cytotoxicity and the measurement of nuclear size 48 h after pulse treatment of the cells for 30--60 min. These effects were not seen with non-carcinogens. The results obtained suggest that changes in nuclear size may be an index of chemical carcinogenicity.


Short-term toxicity of allyl alcohol in rats.

Groups of 15 male and 15 female rats were give 0 (control), 50, 100, 200 or 800 ppm allyl alcohol in the drinking water for 15 weeks. There were no effects attributable to allyl alcohol in the results of the haematological examinations or analyses of serum. There was a dose-related reduction in the fluid intake at all treatment levels in both sexes, while growth and food consumption were reduced in both sexes given 800 ppm and in males give 200 ppm. Males given 100 ppm or above and females given 200 or 800 ppm produced less urine than the controls in a period without water or following a water load. The only changes in organ weight that could be attributed to treatment were increased values for the relative weights of liver, spleen and kidney. All 3 organs were affected in both sexes given 800 ppm and the kidneys were also affected in both sexes given 200 ppm and in females given 100 ppm. No effects attributable to allyl alcohol treatment were seen at autopsy or in the histopathological examination. The no-untoward-effect level established in this study was 50 ppm of the drinking water, a level equivalent to an intake in rats of between 4.8 and 6.2 mg allyl alcohol/kg/day.


Repeated exposure to acrolein vapour: subacute studies in hamsters, rats and rabbits.

The subacute inhalation toxicity of acrolein was examined in 4 groups of 20 hamsters, 12 rats and 4 rabbits each, exposed repeatedly to acrolein vapour at concentrations of 0, 0.4, 1.4 and 4.9 ppm (6 h/day, 5 days/week) for a 13-week period. The most important effects found at the highest level included mortality in rats, ocular and nasal irritation, growth depression and histopathological changes of the respiratory tract in each of the animal species exposed. The aberrations in the airways consisted of destruction and hyper- and metaplasia of the lining epithelium accompanied by inflammatory alterations. Rats appeared to be the most susceptible of the species examined and showed treatment-related abnormalities even at 0.4 ppm, whereas this exposure level was found to be a no-toxic effect level in both hamsters and rabbits.


Absorption of paraquat and diquat from the airways of the perfused rat lung.

The uptake of paraquat dichloride (bis-N-[14C]methyl-4,4'-bipyridilium chloride) and diquat dibromide (N,N-ethylene-[U-14C]2,2'-bipyridilium dibromide monohydrate) from the airways and by the vasculature of the isolated and perfused rat lung (IPL) were studied. A semilogarithmic plot of the percent unabsorbed with time revealed a bi-exponential decay, suggesting at least two phases of removal of paraquat and diquat from the airways. The rapid initial process was similar for both herbicides. The slow component had at t1/2 of 355.98 min for paraquat and 75.03 min for diquat. This second process may represent the storage pool associated with the pulmonary toxicity of paraquat. When paraquat or diquat was presented to the capillary side of the lung, long-term storage was not evident. Uptake by the lung occurred from the pulmonary circulation with similar velocity. These data suggest that the energy-dependent uptake observed with lung slices probably represents airway transport and may be associated with cell membranes lining the alveolus.


Further investigations of indomethacin and intestinal ulcers in the rat.

The lower incidence of indomethacin-induced intestinal ulcers in fasted as compared to fed rats must be attributed to factor(s) other than changes in bile flow and composition. Experimental evidence and data in the literature rather suggest that the amount of food present in the gastrointestinal tract at the time indomethacin was given may influence ulcer formation by affecting the duration and degree enterohepatic circulation of this compound.


Inhalation toxicity studies on cigarette smoke. V. Deposition of smoke particles in the respiratory system of rats under various exposure conditions.

This paper describes a dosimetry experiment on rats which was designed to make a contribution towards the optimisation of exposure conditions for inhalation toxicology studies with smoke aerosols. The main conclusions drawn from the work are: (i) Under continuous exposure conditions the deposition of total particulate matter (TPM) in the respiratory system and carboxyhaemoglobin (COHb) levels in blood were linearly dependent on the concentration of smoke in the exposure chamber. (ii) Intermittent exposure gave relatively lower TPM deposition compared to continuous exposure, even after allowing for differences in actual exposure times. (iii) For arithmetically equivalent exposure levels, short exposure to high concentration gave greater TPM deposition than long exposures to low smoke concentrations. (iv) There was a good correlation between lower respiratory system (LRS) and lung deposition of TPM and blood COHb level for both continuous and intermittent exposure conditions. These findings are discussed in relation to the conduct of inhalation studies with tobacco smoke.


Effects of milk diet on gastrointestinal absorption of cadmium in adult mice.

Effect of milk diet on absorption of cadmium were investigated in a 6-week study. Forty adult male mice were divided into groups of 10 and treated with different foodstuffs (I: mouse pellets and deionized water; II: mouse pellets and water containing cadmium chloride: III: milk only: IV: milk containing cadmium chloride). The intake of cadmium and milk was regulated during the experiment to make sure that the animal groups received the same amounts of cadmium andmilk respectively. After 2 weeks the mice were exposed to a single oral dose via stomach tube of 109CdCl2, the fate of which was followed by whole body counting. A markedly higher whole body retention of 109CdCl2 was observed in animals given milk diet compared to other groups. Total cadmium concentrations in different organs measured by atomic absorption spectrophotometry were twice as high in milk-fed mice compared to mice fed on R35 mouse pellets.


Histopathological changes induced by quinalphos in the testes and liver of Indian dessert gerbils, Meriones hurrianae (Jerdon).

Single intraperitoneal injection of quinalphos (15 mg/kg body weight) produced several pathological changes in the testes and liver of the Indian desert gerbil, Meriones hurriane (Jerdon). The degenerative changes included testicular atrophy, reduction in tubular size and enlarged interstitium. In the spermatogenic cells, necrosis and karyopycnosis were observed. Hepatic cells revealed cytoplasmolysis, vacuolation and necrosis. The nuclei of the hepatocytes showed karyorrhexis and karyolysis.


The sensitization potential of some perfume ingredients tested using a modified draize procedure.

A modified Draize procedure was used to test 23 natural and 46 synthetic perfume ingredients for their potential to induce allergic contact dermatitis in guinea pigs. Fifty-three ingredients did not induce sensitization. Two synthetic ingredients showed a strong sensitization potential and 14 ingredients, 7 natural and 7 synthetic, showed a weak sensitization potential. The findings indicate that there is little risk of sensitization in man to most of these perfume ingredients.


[Radiotherapy of testicle tumors--results and consequences (author's transl)].

A report is given on 113 patients who had been irradiated because of testicle tumors and a part of whom had been submitted to an anterior lymphadenectomy. The five-year survival rate of the seminomas of all stages was 81% (n = 61) and that of the non-seminomas of all stages was 54% (n = 52). It has to be mentioned that the group of patients with seminomas of the stages T1-2N0M0 had a five-year survival rate of 100%, and those with embryonic teratomas of all stages had a five-year survival rate of 69%. With regard to these therapy results, it is recommended to carry out the radiotherapy of testicle tumors in conformity to the individual stage. A therapy scheme is presented.


[Experimental results from preoperative irradiation of renal adenocarcinoma (author's transl)].

Tissue samples were taken from the surgical preparations of 25 renal adenocarcinomas immediately after the operation, and cells were cultured. Between two and six weeks, the number of colonies per 10(6) sowed viable cells (not stainable with eosin) was determined. Eleven patients had not undergone preparatory treatment before operation, in three cases the branches of the renal artery were embolized, and eleven patients had been exposed to 800 up to 1600 rd TD delivered by 2 or 4 fractions in the course of two days prior to surgical treatment. Tumors without pretreatment or with preoperative embolization grew 32.6 and 41.7 colonies, respectively, per 10(6) viable cells, whereas the average yield from three tumors irradiated with a focal dose of 800 to 1100 rd was reduced to 7.1 colonies per 10(6) viable cells and in eight tumors exposed to a focal dose of 1200 or 1600 rd, even to zero. Therapeutical consequences are discussed.


[Cerebral arterio-venous malformations (avm): course of 18 cases treated by radiotherapy (author's transl)].

18 cases with large cerebral arterio-venous malformations, which were treated by high dose radiotherapy in the years 1940-1972 are reported. Radiation dose was 4000-6000 rd, single dose between 150 and 200 rd 5 or 6 times per week. Comparison of angiographic investigations and clinical symptomatology before and after treatment does not demonstrate a significant effect of high dose radiotherapy on large cerebral AVM. The own data are compared with untreated cases of AVM from the literature. Some other radiotherapeutic series from the literature show that some cases with small AVM may be cured by high dose radiotherapy.


Systematic optimization of the double-scatterer system for electron beam field-flattening.

The scattering foil widely used for field flattening in electron therapy produces a distortion of the electron spectrum which significantly reduces the slope of the descending part of the depth dose curve. It is already known that this effect can be drastically reduced by replacing the scattering foil by a two-foil scatterer. The second foil, fit with a radial thickness profile, acts as a compensator, attenuating the central part and enhancing the peripheral part of the beam by electron scattering. Calculations of the optimal foil combinations and radial thickness profiles are presented and numerical values of smooth (Gaussian) and three-step profiles for various field sizes are provided. The results are applicable to a variety of electron energies and scattering foil materials.


New individual tissue compensators for high-energetic photons. Part I. Principle and procedure.

Part I. The inhomogeneity of absorbed dose caused by irregular body surface contour in the treatment port for external photon radiation is shown as a problem. The discussion of the physical fundamentals and technical possibilities of missing tissue compensators leads to a practical solution. A new handy procedure is presented allowing easy and rapid preparing of geometrically minified as well as absorption- and stray radiation corrected individual compensators. The achievable dose homogeneity within the target volume is shown as better than +/-5%. Systematical errors are investigated for the different parameters. In Part II systematical preclinical tests and first practical clinical experiences will be discussed.


[Study of combined injuries (23rd communication) (author's transl)].

NMRI-mice which were whole-body irradiated, received two or three days later open skin wounds. While irradiation or wounding alone caused a mortality of 10 to 20% and 0% respectively, a combination of injuries caused 80 to 100% mortality. With regard to the as yet unexplained pathogenesis of this clinical condition, bacteriological examination of the skin-wound was undertaken. Staphylococci, lactobacilli and gramnegative bacilli were found on the wounds, and the bacterial concentration per cm2 wound area among animals with combined injuries was significantly higher than in controls. Covering the wounds with lint effected a distinct reduction of bacterial number as well as a reduction of mortality. A similar success of therapy was attained through local administration of antibiotics. A possible correlation between bacterial seeding and increased mortality is discussed.


Histochemical and ultrastructural changes in locally gamma-irradiated rabbit intestine.

The effect of local irradiation of a 50-cm long intestinal segment outside the abdominal cavity in rabbits has been studied. The rabbits were killed at 12, 24, 48 and 72 hours after irradiation. Activities of succinate and lactate dehydrogenase, acid and alkaline phosphatase and thiamine pyrophosphatase were studied histochemically in the irradiated intestinal segment and in the part of the intestine remaining in the abdominal cavity. The same material was studied electron-microscopically. Changes in enterocytes of the intestinal crypts were observed mainly in the mitochondria and in the form of a chaotic distribution of endoplasmic membranes and densely scattered ribosomes. In intestinal crypt cells, irradiation was followed by a depression in the activities of succinate and lactate dehydrogenases and alkaline phosphatase. These changes were related to postradiation damage, not to recovery.


On Macdonald's model for schistosomiasis.

An attempt is made to reconstruct the specifics of the model in Macdonald's 1965 paper based on some manuscripts. The resulting model is not conclusive as discrepancies occur between this formulation and Macdonald's results. Assuming the formulation is adequate, the values of parameters yielding Macdonald's standard situation are provided. A way of studying the equilibrium behaviour of the model is outlined. The mathematical nature of the properties observed by Macdonald is studied. The model is altered to admit aggregated distributions of worms in hosts and to permit different death rates of infected and uninfected snails. The dynamics are found to depend strongly on the death rate of infected snails.


Onchocercal lymphadenitis: Clinicopathologic study of 34 patients.

Clinicopathological studies on lymph nodes of 32 Africans with onchocerciasis--some complicated by hanging groin and elephantiasis of the genitalia--revealed atrophic lymphoid tissue, lymphoedema, chronic inflammation and fibrosis. We identified microfilariae of Onchocerca volvulus in nodes of 24 of 32 Africans (75%). There microfilariae were most numerous in the capsule and in the fibrous tissue of the medulla, but smaller numbers were also found within lymphoid tissue, in dilated lymphatics and in blood vessels. We believe that in Africians, antigens released from microfilariae of O. volvulus lead to the deposition of immune complex in tissues, which in turn causes inflammation and fibrosis and eventually obstructive lymphadenitis. This causes hanging groin and, possibly, also elephantiasis. A distinctive pattern of perivascular fibrosis contains "fibrinoid material" that we interpret as immune complexes involving microfilarial antigens. In contrast, nodes from two Yemenites with severe onchocercal dermatitis of the lower limbs (sowda) had hyperplastic follicles, minimal fibrosis and no microfilariae.


Mastomys natalensis as an experimental host for Leishmania mexicana mexicana.

Young multimammate rats (Mastomys natalensis) can be readily infected when inoculated intradermally with the amastigotes of Leishmania mexicana mexicana. Lesions appear at the site of inoculation in the second week of infection and continue to increase in size for the first month; amastigotes can be detected during this period. In the second month, lesions begin to decrease in size and it is more difficult to detect amastigotes. Three months after inoculation, the rats show no sign of infection. The results suggest that M. natalensis could be a useful laboratory host for immunological studies on dermatotropic Leishmania and for chemotherapeutic assays.


In vivo cercaria-schistosomulum transformation: inhibitory effect of oxamniquine.

High doses of oxamniquine (given intramuscularly) produced inhibition of cercaria-schistosomulum transformation following intraperitoneal injections of cercariae into mice. Cercariae, tail-less cercarial bodies, and schistosomula were recovered from the peritoneal cavity of drug-treated mice in numbers significantly different from those recovered from untreated mice. Since untreated animals induced transformation of almost all the injected cercariae, the data suggest the compound is active during the process of host-larvae adaptation.


Cutaneous leishmaniasis and leprosy.

Eight patients who had concomitant leprosy and leishmaniasis are described. Two patients with lepromatous leprosy had high resistance leishmaniasis, implying that the immune deficiency in lepromatous leprosy is specific to Mycobacterium leprae.


An indirect haemagglutination reaction for the demonstration of Schistosoma mansoni circulating anodic antigen.

Using the IgG fraction of a monospecific sheep antiserum against the circulating anodic antigen (CAA) of Schistosoma mansoni, an indirect haemagglutination reaction for the determination of this antigen was developed. This is the first time that an IHA has been applied to the detection of circulating antigens in parasite infections. The IHA proved to be highly sensitive; CAA levels up to 20 ng/ml could be measured. At the moment it appears to be the most sensitive technique for the determination of CAA levels. CAA could readily be detected in the sera of S. mansoni infected hamsters and in the immune complexes isolated from these sera, but never in sera from human schistosome infections.


Stability of faecal egg excretion in Schistosoma mansoni infection.

Stability of Schistosoma mansoni egg excretion was studied in 23 residents of a rural endemic area in North-east Brazil where the over-all prevalence rate was 87% and the peak geometric mean egg excretion was 308 eggs/ml (Bell method) in the 10 to 14-year-old age group. Stool examinations by the Kato method were performed for three to four consecutive days each month for three consecutive months. Both raw and transformed data showed significant stability of S. mansoni egg excretion from day to day and month to month in this population. A single Kato examination detected 68% of individuals who were excreting more than 400 eggs per gramme. Although S. mansoni egg excretion is stable over time, identifying individuals with high egg excretion in endemic populations requires sensitive quantitative methods.


Evaluation of hypertonic citrate flushing solution for kidney preservation using the isolated perfused rat kidney.

The isolated perfused rat kidney has been used to study the effects of cold ischaemia during ice storage. Tissue adenine nucleotide levels in freeze-clamped kidneys were closely correlated with their function after circulation had been reestablished in the perfusion circuit. The ATP content was depleted to a greater extent than total adenine nucleotide after 8 hr of cold ischaemia but both were considerably diminished after 24 hr. The model was also used to compare four solutions which are available clinically for preliminary flushing of organs in the ice storage preservation technique. The results indicated that for periods of 8 and 24 hr of cold ischaemia, renal function and adenine nucleotide content were significantly better maintained with a solution based on hyperosmolar citrate than with Collins, Sacks, or Perfudex solutions. This study confirmed recent observations of the clinical efficacy of citrate solution, while demonstrating how the isolated perfused rat kidney could be used for rapid screening of modifications in preservation techniques.


[Cytogenetic analysis of the 1-st cleavage division of rat embryos].

The chromosome number in 174 zygotes on the stage of the 1st cleavage division was counted. In 113 zygotes (64.94%) euploidy (metaphase with 42 chromosomes) and in 57 zygotes (32.77%) aneuploidy was found. Frequencies of spontaneous chromosomal aberration were 14.93%. 33 zygotes were hypoploid, 6 (3.44%)--hyperploid (with 43 and 46 chromosomes), and 3 (5.76%)--polyploid, 4 zygotes (2.29%) had structural anomalies of chromosomes. Hypoploidy may be often due to artifacts. Superovulation induced by gonadotrophin results in an increased polyspermia.


[Transport of the substance through thin membranes with narrow pores after the preceding stage of surface diffusion].

A model of the substance transport through thin membranes is discussed. Existence of a step of the surface diffusion of permeable particles is assumed preceding its entrance into membrane channel. An expression is given for the stationary flow, which has earlier been obtained for other transport models. It is shown that the permeant affinity to the membrane surface is the main condition for the validity of the scheme in question.


[Regulation of the commitment processes in the hematopoiesis].

Various methods of commitment regulation have been analysed on the basis of the mathematical model of the haemopoietic stem cell number dynamics. The starting point is the requirement on the system stability. The basic hypothesis is that of the intrinsic nature of the population commitment regulation. The analysis states that the commitment specific velocity increases with stem cell number. This way of regulation may be performed in the case the commitment takes place at Go phase of the cell cycle. The role of the committed precursor pool in providing the haemopoietic system reliability is discussed.


[Effect of various substances on cultured mammalian cell growth].

The effect of different home industry materials on the growth of Chinese hamster cells in culture has been studied. The plating efficiency of the culture and the ability to produce a monolayer were used as criteria. The materials under study can be divided into three groups: indifferent materials, those partially inhibiting the cell growth, and destructive ones. While constructing the apparatus for cultivation, the following materials are to chosen: titanium, molybdenum glass, plexiglass, polycarbonate, lavsan, polyethylene, fruorine films, pentoplast, silicon rubber, stainless steel, white food plate rubber, teflon, polymerized epoxy resin.


[Controlled cell cultivation. 2. Cultivation of mammalian cells and tissues in the perfusion chamber].

The results of biological testing of a perfusion chamber are presented. The chamber can be used for a prolonged cultivation of cells and tissues of different types on controlling the composition of nutrient medium and gas phase. The possibility is shown to apply the chamber for a prolonged cultivation and the observation of the behavior of live cells under different influences.


[Change in the shape and volume of the secretory cells of the mammae in the course of the secretory cycle].

Changes occurring in the acini due to oxytocin were studied using the vital photometry and the morphometric analysis of materials obtained by biopsy. At the initial stages of the functional activation, the secretory cells become cylindric, their volumes simultaneously increasing. A study of intercellular interrelations using the atropine blockade of cholinoreceptors, revealed the lack of activation of the secretory cycle which suggests the functional dissociation of contractile and secretory functions of the cell alveolar complex.


[Use of the method of double labeling with H3 and C14-thymidine for identification of cells in different periods of interphase].

For the identification of the position of individual cells in G1, S- and G2-periods of mitotic cycle in any heteroploid cell culture, it is suggested to use the Wimber and Quastler radioautographical method of double labeling of cells. It was shown that independent of the basal polidy of the cells by the successive impulse labeling of the cells with H3- and C14-thymidine with the time interval as long as G2 + M, the cells of the G1-period are unlabeled, S-cells are double labeled with C14- and C14 + H3, and G2-cells have only H3-label.


[Effect of mitomycin C on SPEV cell cultures].

Mitomycin C (in doses of 0.5-1.5 mkg/ml during 24-72 hours) significantly changes the ultrastructure and morphology of porcine embryo kidney cells (condensation of chromatin and the mitochondrial matrix, expansion of small channels in the endoplasmatic reticulum, total hypertrophy of the nuclei and cells). In the given case, mytomycin C sharply inhibits DNA synthesis and mitotic activity, considerably more weakly reduces RNA and protein synthesis, raises the activity of lactate and alpha-glycerophosphate-dehydrogenases. The disbalance of syntheses leads to protein accumulation in the cells, and general enlargement of nuclei and cells. As the action of the antibiotics increases, the ultrastructural changes progress and lead to the destruction of a considerable part of cells in the culture.


[Comparative study of the effect of supercooling and freezing on fungal cells].

Observations of the reactivation rate and subsequent growth in addition to the luminescence of cells subjected to supercooling and freezing at 15 degrees C suggested that the effect of supercooling is more significant than that of freezing. In supercooled suspensions, cells are more injured than in frozen ones and the number of injured cells increases more rapidly. Unlike the supercooled cells, the live cells from frozen suspensions maintain a higher growth activity for a longer time.


[Characteristics of synaptic and intracellular neuron activation].

Stimulation of the leech abdominal neural chain with electric pulses of 1 imp/sec frequency results in alterations in the activity of the Retzius cells in addition to an increased protein metabolism in the postactivation period. The direct stimulation produces a decrease in the cellular protein metabolism.


[Effect of colchicine on virus-induced interferon synthesis in chick embryo cells].

Colchicine, at a concentration of 5 X 10(-4) M (0.2 microgram/ml), inhibits interferon synthesis induced by theLee strain of influenza B virus in chick embryo cells, but it does not influence the release of preformed interferon from cells. The same drug concentration does not affect the overall synthesis of cellular RNA and protein. The inhibition of interferon synthesis by colchicine is a temperature-dependent process and is not manifested at 0 degrees C. Colchicine is found to be most effective when it is introduced into the medium at early stages of infection. It is suggested that colchicine inhibits the formation of messenger RNA for interferonogenesis.


[Cytochemical study of various stages of life cycle of Toxoplasma gondii. 11. oxidation-reduction enzymes in the parasites during developmental stages in cat's intestines].

Dehydrogenases of glycolysis, Krebs' cycle and pentose phosphate shunt were investigated in the intestinal stages of T. gondii. The "oval stages" appeared to display the activity of all the enzymes studied differing in this from merozoites and macrogametocytes. The macrogametocytes displayed very low, if any, activity of the enzymes studied, even the mature parasites. Immediately after fertilization, sharp shifts were observed in the oxidative metabolism of the zygote: from very low or negative it became moderate to strong. This may be suggestive of the changes in metabolic requirements of the zygote which is no longer an intracellular parasite. In this respect macrogametocytes and zygotes of Toxoplasma resemble the corresponding stages of chicken and rabbit intestinal coccidia of the genus Eimeria.


Behavior of a cell line derived from a mouse submaxillary adenocarcinoma during the initial 480 days in vitro.

A cell line was established from a transplantable adenocarcinoma, containing viral particles of the A and B type, drived from a tumor appearing spontaneously in the submaxillary region of a male mouse of the C3H/He strain. This line, after 480 days in vitro, did not change the original epithelial-like morphology, the viral expression, the membrane immunofluorescence and the degree of agglutination by various plant lectins. After 208 days of culture, the presence of up to 3 pairs of metacentric chromosomes appeared in about 55% of the cells. However, this change in the chromosomal pattern  was not sufficient, at least within the limits of our observation, to modify significantly the other parameters investigated, with the possible exception of the oncogenicity, which showed a modest decrease after 296 days of culture.


Effect of peptichemio upon localization of injected radiolabelled lymphocytes in the lymphatic organs of antigen-stimulated mice.

Increased localization (trapping) of lymphocytes occurs in lymphoid organs following antigenic challenge. The effect of peptichemio (PTC) upon lymphocyte trapping in lymph nodes and spleen was investigated: the results demonstrate that the drug diminishes trapping in lymphatic organs. The depression of lymphocyte trapping may provide at least one mechanism whereby PTC achieves it immunosuppressive effects.


Lymphangiomyoma of the thoracic duct with previously undescribed epithelial tubules.

A case of mediastinal lymphangiomyoma with tubules covered with epithelium is reported. The epithelium of these tubules is morphologically identical to that of the bronchi. It is the first time that epithelial, presumably pulmonary, elements have been described in an extrapulmonary lymphangiomyoma. It is concluded that the present case of mediastinal lymphangiomyoma suggests a hamartomatous malformation. Whether this applies in general to lymphangiomyomatosis still remains a matter of discussion.


Significance of ascitic fluid and peritoneal washing cytology in ovarian tumor diagnosis.

The results of the cytological test on 179 ascitic fluids and 88 peritoneal washes of patients suspected to have ovarian tumors are critically reviewed to illustrate the difficulties, limitations and future possibilities of this technique. Tissue correlation was available in all cases. The data was evaluated in order to obtain information as to the accuracy, sensitivity and specificity of cytological examination, both in ascitic fluids and in peritoneal washings. A correct diagnosis as to the ovarian tumor histotype was obtained in more than 80 per cent of the cases.


Combination chemotherapy with 1-methyl-1-nitrosourea and cyclophosphamide in metastatic melanoma.

Twenty one patients with advanced metastatic melanoma were treated with a combination of 1-methyl-1-nitrosourea (MNU) and cyclophosphamide. All the patients had not previously been treated with cytostatics. MNU in the dose of 4 mg/kg and cyclophosphamide in the dose of 8 mg/kg body weight was administered daily. The drugs were given in 6 day cycles. Objective response (greater than 50% tumor regression) was obtained in 8 (38%) of the 21 treated patients, with 2 complete and 6 partial remissions. The duration of remission was 2--12 months (M = 6.2 months). Injections of MNU caused nausea and vomiting in approximately all the treated patients. Combination of these drugs, however, produced myelodepression in 33% of treated patients. This combination of drugs showed antitumor activity in metastatic malignant melanoma, particularly in melanoma metastasis of the lung, brain and lymph nodes and needs further investigation.


Cocarcinogenic and irritant factors of Euphorbia esula L. latex.

The latex of (Euphorbia esula) has been found to contain highly skin irritant and inflammatory ingenol-3delta 2,4,6,8,10 pentene tetradecanoate and another factor, ingenol-3-dodecanoate, which is less irritating but which can be responsible for the cocarcinogenic activity exhibited by the latex preparation in the mice back skin experiment.


[X-ray-video amplifier photography: use in urologie X-ray diagnosis and renovasography (author's transl)].

Our experiences indicate that the 'urograph', in combination with the 100-mm sheet-film camera, represents an x-ray apparatus that is just about optimally suited to the needs of urologic x-ray diagnoses. Only in extreme situations is the range of movement of the tabletop in the direction of the head and feet insufficient. A major advantage of the camera, and the one which, above all, plays a decisive role in the urologic x-ray diagnosis of children, is that the amount of radiation can be reduced by about 1/2 to 1/3 that necessary with conventional photo techniques. Through optimal use of the apparatus, considerable time and personnel can be saved. In view of the additional fact that kidney angiographs can be performed with this apparatus, in combination with the 100-mm camera, with minimal problems, minimal time, and minimal stress for the patient, x-ray-video amplifier photography represents an important addition to urologic x-ray examination possibilities that today we can no longer afford to do without.


[Renal sonography--errors, pitfalls, and their sources (author's transl)].

Retrospective evaluation of sonographic diagnoses showed 14 false interpretations, proven by operation or renal angiogram. A classification of errors and pitfalls in renal sonography is attempted and the place of this method in the diagnostic plan in kidney diseases is discussed.


[Videocystometry (VCM)--a method for quantitative and qualitative diagnosis of refluxes (author's transl)].

Videocystometry (VCM) is a combination of videography and cystometry for the investigation of vesico-ureteral refluxes and is an accurate method of reflux classification that registers intravesical pressure and volume simultaneously after X-ray detection. We investigated 86 refluxes detected by micturating cystourethrography; 21 could not be confirmed, 14 disappeared with conservative treatment, and 10 underwent surgery, because their condition became worse during examination. Especially refluxes without primary indications for operation can be verified by comparative data. This facilitates the decision to continue conservative or operative treatment.


[Tantalum in diagnosing tumors of the ureter and renal pelvis. A preliminary report (author's transl)].

Differential diagnosis of small tumors of the ureter and renal pelvis is often difficult. Retrograde pyelogramm and tri-iodied contrast material is not effective in diagnosing small tumors and their surface condition. A retrograde pyelogram with a tantalum powder solution offers the following advantages: 1. Clearer representation of the tumor surface. 2. X-ray films show sharper contrast. 3. Small tumors could be seen that are not visible with routine contrast material. Preparation of tantalum solution and the technique of retrograde pyelogram are described.


[The bilateral nephrectomy in terminal renal disease (author's transl)].

45 cases of nephrectomy are reported. Mortality was 8.9%. Thirty-one had a drug-resistant, severe hypertension, three had infected kidneys, and in eleven cases nephrectomy was performed prior to transplantation. Although blood pressure improved in all patients, of the first group 24% died within one year after nephrectomy, which shows unsatisfactory prognosis of malignant nephrosclerosis. Only early nephrectomy can lead to better results. Routine nephrectomy before transplantation should be avoided. Indications for this group are discussed.


[Experiences with transcatheter emoblization in urology (author's transl)].

Transcatheter embolization of the kidneys and bladder is increasingly important. The main indication for embolization is persistent hematuria involving surgically nonaccessible renal and bladder cancer. Additional surgical management of the disease can be avoided. Another indication is the preoperative embbolization of the kidney which facilitates surgical procedure and possibly prevents tumor cell embolization in the venous circulation. The indication for embolization of bleeding bladder carcinoma is different and permanent arterial occlusion is only justified if other measurements fail.


[Retroperitoneal, non-chromaffin paraganglioma of the right kidney (author's transl].

A case of retroperitoneal, nonchromaffin paraganglioma simulating a hypernephroma of the right kidney is described. Prognosis and therapy of this rare tumor is discussed and the literature is reviewed.


[Urological Hodgkin's disease (author's transl)].

Manifestations and complications of Hodgkin's disease in the urinary tract can appear as alterations of the kidneys (stag's antlers type), compression and displacement of the ureter (ureteric type), or as chemotherapeutically induced cystitis (Endoxam type). All these complications were found consecutively in the case documented here. The diagnosis was made on the basis of the symptoms, the findings in the i.v. urogram, and cystoscopy; it was confirmed post mortem by the autopsy. In this advanced case of Hodgkin's disease, only the hemorrhagic cystitis warranted therapy.


[Examination of stenotic bladder neck using the Kishev balloon stretch test with the Foley catheter (author's transl)].

A 2-year study with 125 patients who suffered from symptoms suggestive of stenotic bladder neck with or without overlapping symptoms of 'abacterial prostatitis' is described. More than 200 balloon stretch tests were carried out in order to choose 125 patients for operation. With a knife electrode designed by one of us, two deep furrows were cut along the 5 o'clock and the 7 o'clock positions, which begin at the trigonum and continue through the entire bladder neck and the floor of the prostatic part of the urethra to the apex of the verumontanum.