The morphology of the cement gland apparatus of larval Pterophyllum scalare Cuv. & Val. (Cichlidae, Teleostei). Histological, transmission- and scanning electron microscopic studies.

The cement gland apparatus of newly hatched Pterophyllum scalare Cuv. & Val. was examined by histology, scanning and transmission electron microscopy. The whole organ is composed of three pairs of endoepithelial, ductless glands, which cause prominent elevations on the larval head and are found in a specific arrangement. Each single gland is represented by an aggregation of elongated, tubular secretory cells surrounding a pyriform acinus. It overlies a basal lamina and is covered by the outer layer of the bilaminar embryonic epidermis. Two different types of secretory cells can be distinguished. One type is restricted to the bottom of the cavity. It is characterized by multiform cytoplasmic protrusions, which project into the gland's cavity. The secretory granules contain a network of light filamentous material. The second type constitutes the side wall of the acinus. It does not develop any protrusions. The contents of the secretory granules is of very high and homogeneous electron density. The mechanism of extrusion is discussed for both cell types. All secretory cells show a strong PAS-reaction. In SEM a circular microridge pattern with attached mucus globules can be recognized on the larval epithelial surface.


Bovine olfactory and nasal respiratory epithelium surfaces. High-voltage and scanning electron microscopy, and cryo-ultramicrotomy.

High-voltage transmission electron microscopy and cryo-ultramicrotomy together with scanning electron microscopy and some conventional transmission electron microscopy of ultrathin sections have been applied to the mucous surfaces of bovine olfactory and respiratory epithelia. Distal segments of olfactory cilia tend to run in parallel and could be followed over distances up to about 30 micrometer using high-voltage electron microscopy. This technique and scanning electron microscopy showed that on average 12--13 of such cilia could be observed per nerve ending. After correction for obscured cilia this number becomes about 17. High-voltage micrographs and micrographs made from sections prepared with a cryo-ultramicrotome showed the presence of electron-lucent pockets inside the olfactory mucus. The latter technique also showed that the mucus itself is not fibrous, but rather a continuum varying in electron density. The mucus layer contains various granular structures. Ciliary and microvillar membranes appear thicker with cryo-ultramicrotomy than when the sections are prepared with conventional techniques. The cores of the axonemal microtubules in olfactory as well as in respiratory cilia are darkly stained with this technique. Vesicles present inside the nerve endings are also darkly stained. Dimensions and some other numerical values of interest in olfaction are presented.


Morphological changes in the rabbit ovary after active immunization to testosterone.

The role of testosterone in follicular development was investigated by immunizing female rabbits (mean wt 1.4 kg) to testosterone-3-bovine serum albumin (T-3-BSA). Controls received BSA. Follicular diameters and histology, and ovarian and uterine weights were recorded at intervals up to 11 weeks. At 5 weeks T-3-BSA ovaries did not differ from controls in either histology or follicular diameter (number of follicles greater than or equal to 1.0 mm were 12.5 +/- 3.4 and 17.0 +/- 1.0 for BSA and T-3-BSA treated animals respectively). By 8 weeks T-3-BSA animals had multiple cystic and hemorrhagic follicles. T-3-BSA ovaries contained more follicles greater than or equal to 1.0 less than 1.5 mm (27.3 +/- 3.1 vs. 15.3 +/- 2.9, p less than 0.01) and greater than or equal 1.5 mm diameter (5.8 +/- 1.7 vs. 0.4 +/- 0.3, p less than 0.005). At 11 weeks T-3-BSA ovaries contained more follicles less than 1.5 mm in diameter (5.0 +/- 0.9 vs. 0.9 +/- 0.3, p less than 0.001). Increased vascularization, some thecal hypertrophy and marked interstitial cell hypertrophy were characteristic of the T-3-BSA ovaries at 8 and 11 weeks. These results suggest that testosterone has a role in the regulation of follicular development.


Recent observations on the ultrastructure of human urothelium. 1. Normal bladder of elderly subjects.

An electron microscopic study of normal bladder urothelium of elderly patients ranging in age from 61 to 82 years has shown the occurrence of unusually thin regions consisting of either one or two layers of undifferentiated cells interspersed between 3--4 cell layers thick regions. A morphometric study has confirmed the existence of a pattern of cytodifferentiation in cells of the thick region. The generally microvillous nature of the luminal surface is attributed to incompletely differentiated cells that have come to occupy the superficial layer. The lack of thickened and/or asymmetric membrane plaques in luminal plasma as well as the dearth of characteristic precursor vesicles in the cytoplasm are also explicable in terms of a failure of normal cell differentiation. It is suggested that the unusual features noted are consequences of tissue ageing rather than prognostic of cancer. There are indications that the aged urothelium may be prone to increased leakiness and the bladder tissues may therefore be at greater risk from urine-borne chemicals and carcinogens.


The ultrastructure of guinea pig heterophil granulocytes and the heterogeneity of the granules.

The development of the heterophil granulocytes in the bone marrow of the guinea pig is described. During the maturation of these cells, three types of granule are formed, not only the azurophil and specific granules already described in other mammals but also a third type of granule referred to here as the nucleated granule. During the process of maturation of the cells, these three types of granule are formed successively. On this basis, two steps can be distinguished in the promyelocyte phase in which primary (nucleated and azurophil) granules are formed, i.e. an early and late stage, nucleated granules being formed in early and azurophil granules in late promyelocytes. Secondary (specific) granules occur first in myelocytes. In mature heterophils of the guinea pig the granule population is composed of about 85% secondary granules, about 10% azurophil granules, and about 5% nucleated granules. The changes in the granule population during the maturation process were quantified. The observations and calculations point to the occurrence of three mitoses: one in the early and one in the late promyelocyte and the third in the myelocyte.


Reversible peritubular binding of a cationic protein (lysozyme) to flounder kidney tubules.

Proteins filtered in the renal glomeruli are reabsorbed by the proximal tubule and catabolized in the lysosomes. On the basis of studies on isolated flounder tubules it has been suggested that, in addition to this catabolism, a transtubular transport of intact protein (lysozyme) also occurs. The present study demonstrates that significant amounts of lysozyme are reversibly bound to the peritubular side of isolated tubules. Electron microscopic autoradiography demonstrates that the protein is located in the basement membrane and intercellular spaces. After in vivo injection, 125I-lysozyme is mainly located in endocytic vacuoles of the first proximal segment, but also over the basal part of the cells. Since a significant peritubular binding of lysozyme is demonstrated in vitro, it is suggested that a similar binding of tracer protein originating from the peritubular capillaries might occur in vivo and that subsequent release of this protein in vitro might simulate transtubular transport. It is therefore concluded that release of tracer protein from isolated kidney tubules does not conclusively demonstrate transtubular transport of intact protein in experimental systems in which peritubular binding of protein can be demonstrated.


Development of innervation to the atrial myocardium of the rabbit.

The development of innervation to the atrial myocardium of rabbits from 20th day of gestation to 35 days postnatal was studied ultrastructurally by electron microscopy and by demonstration of catecholamines by histofluorescence. Special attention was directed to the first morphologic appearance of nerve fibers and terminals and the closeness of juxtaposition of terminals with myocardial cells. Adrenergic and cholinergic terminals were identified on the basis of their differential ability to take-up and store the "false adrenergic neurotransmitter" 5-hydroxydopamine. Adrenergic terminals were first encountered at 20 days of gestation whereas cholinergic terminals could not be positively identified until the 24th day of gestation. Throughout development adrenergic terminals were more numerous than cholinergic, about 71% of the terminals encountered being adrenergic. Many terminals approach closely (20-30 nm) to the sarcolemma of the muscle cells of the atrium. In many instances adrenergic and cholinergic fibers travel together in the same nerve bundle and are closely apposed without intervening Schwann-cell cytoplasm. Such a relationship could allow peripheral interaction between these fibers in the myocardium.


Electron microscopic study of the response of the adrenocortical X-zone in mice treated with sex steroids.

In the adrenal cortex of 23- to 27-day-old C3H/Tw female mice, the eosinophilic X-zone became increasingly increasingly undetectable after 3 injections of 100 microgram testosterone propionate (TP). Whorls of smooth endoplasmic reticulum (sER) and peculiar complexes of mitochondria and sER, characteristics of X-zone cell, were no longer present in mice given 7 daily injections of TP. The ordinary mitochondria, although reduced in number, became swollen and actually increased in percent area occupied. They had well-developed tubulovesicular cristae. The lipid droplets increased in size and number after 3 daily TP injections, but decreased after 7 daily injections. Rough endoplasmic reticulum and sER were reduced in area in mice receiving 7 daily injections. The X-zone also became indistinguishable from the zona fasciculata after 7 daily injections of 5alpha-dihydrotestosterone propionate. Injections of progesterone or estradiol-17 beta had no effect on the X-zone.


Cytochalasin B-induced changes in concanavalin A-activated lymphocytes.

Cytochalasin B (CB) administered simultaneously with a mitogenic dose of concanavalin A (Con A) interferes with the activation process. This interference involves structural alterations of cellular membrane which do not include a reduced Con-A-binding capacity. This conclusion is supported by the observation of deformities in both nuclear and cytoplasmic membranes in Con A-activated lymphocytes subsequently treated with CB. The high incidence of membrane blebs and pseudomyelin bodies in the cytoplasm points to a general effect of CB on the structural organization of membrane which may secondarily interfere with some specific event such as generation or transfer of signals for activation or cytokinesis.


Morphological studies of the stromal changes after artificial induction of the decidual reaction in rats.

Stromal changes during early oil-induced decidualization were studied. Rats previously sensitized with estradiol after an experimental delay were used. Among the initial stromal characteristics that developed after induction, the following sequence was found: ultrastructural alterations of stromal cell nucleoli, extracellular edema, and Pontamine Blue Reaction (PBR). The results suggest that stromal cell differentiation into decidual cells is initiated before the PBR becomes visible. This is in accordance with biochemical and morphological findings at blastocyst implantation. The appearance of an edema before the PBR furthermore suggests that also the increase in vascular permeability is initiated early and takes place slowly. The functional relationships between the vascular and stromal cell changes are, however, not determinable with the method used.


Tracing of neurosecretory neurons in crayfish optic ganglia by cobalt iontophoresis.

The axonal connections between the medulla terminalis ganglionic X-organ (MTGXO) and the sinus gland are traced by iontophoretic application of cobalt dye to the neurosecretory system in the eyestalks of the crayfish, Orconectes limosus. The MTGXO consists of about 15 large perikarya, forming a distinct subgroup of neurosecretory cells in the medulla terminalis and giving rise to a prominent fibre bundle. Additional axons reaching the sinus gland from the medulla interna, the medulla externa and the optic nerve are less conspicuous.


Ultrastructural, fluorescence microscopic and microfluorimetric study of the innervation of the axial complex in the sea urchin, Sphaerechinus granularis (lam.).

In juxtaposition with the contractile epithelia of the axial complex of the sea urchin, Sphaerechinus granularis, several types of nerve fibers with different vesicle populations were determined. Nerve terminals, filled with clear vesicles and dense core vesicles, form synaptoid neuromuscular junctions. Close to the somatocoelic epithelia of the axial and terminal sinus septa, numerous axon profiles form a nerve plexus. Among the epithelial cells covering the plexus, two types of nerve cells can be distinguished which presumably produce neurosecretory and aminergic granules, respectively. Monoamine fluorescence (formaldehyde-induced fluorescence, Falck-Hillarp technique) was analyzed microspectrofluorimetrically. The emission spectrum of the fluorophores occurring in the present material shows a maximum at 475 nm and is characteristic of catecholamines; the excitation maximum at 380 nm after formaldehyde treatment is typical of catecholamines at low pH only. Since the peak ratio (370:320 nm) does not change after HCl-vapor treatment, the fluorophores are likely to be indicative of dopamine.


Segmental and interganglionic projections from primary fibres of insect mechanoreceptors.

Projections of primary insect mechanoreceptor fibres in Locusta migratoria and Acheta domesticus are visualised with the cobalt intensification technique after axonal or dendritic filling with cobaltous chloride. Chordotonal proprioceptors of the locust mesothoracic thoracocoxal joint have typical segmental projections and more or less widespread interganglionic processes into the metathoracic, prothoracic and even suboesophageal ganglia. Similar observations can be made on locust abdominal chordotonal organs, from some of which all primary axons project into five preceding neuromeres or ganglia. From locust abdominal stretch receptors and cricket mechanosensitive sternal hairs single afferent axons extend through several ganglia. Locust campaniform sensilla and clavate hair projections of crickets terminate locally. It is concluded that many interganglionic primary afferents contribute to intersegmental control of motor coordination in insects.


Ultrastructural changes in the dermal chromatophore unit of Hyla arborea during color change.

The structural changes in the chromatophores of Hyla arborea related to changes in skin color were studied by electron microscopy and reflectance microspectrophotometry. During a change form a light to a darker green color, the melanosomes of the melanophores disperse and finally surround the iridophores and partly the xanthophores. The iridophores change from cup-shape to a cylindrical or conical shape with a simultaneous change in the orientation of the platelets from being parallel to the upper surface of the iridophores to being more irregular. The xanthophores change from lens-shape to plate-shape. The color change from green to grey seems always to go through a transitional black-green or dark olive green to dark grey. During this change the xanthophores migrate down between the iridophores, and in grey skins they are sometimes found beneath them. The pterinosomes gather in the periphery of the cell, while the carotenoid vesicles aggregate around the nucleus. The iridophores in grey skin are almost ball-shaped with concentric layers of platelets. A lighter grey color arises from a darker grey by an aggregation of melanosomes. The chromatophore values previously defined for Hyla cinerea are applicable in Hyla arborea, and the ultrastructural studies support the assumptions previously made to explain these values.


Amino acid transport in the rat exocrine pancreas. III. Effect of maximal and supramaximal hormonal stimulation in vivo.

Amino acid transport and incorporation have been studied in vitro in rat pancreatic lobules after maximal and supramaximal hormonal stimulation with caerulein. Incorporation into proteins was increased already after 30 and 120 min of maximal stimulation, but was decreased after the infusion of a supramaximal dose. Uptake of neutral amino acids was monitored using labeled leucine and alpha-aminoisobutyric acid (AIB). In the case of leucine the free pool was consistently reduced after maximal stimulation, while supramaximal doses led to an increase which could be potentiated by the addition of 2mM tetracaine. Using AIB, a significant increase in the intracellular pool was observed after maximal stimulation, conversely a decrease after supramaximal stimulation. Release of labeled leucine and AIB from preloaded lobules during incubation in the cold was significantly reduced after maximal secretory stimulation, but was found enhanced by 200 to 300 percent after supramaximal stimulation. No fine structural alterations at junctional complexes or at both the lateral and luminal plasma membranes were observed after maximal stimulation except an increased number of exocytotic figures at the luminal face. However, supramaximal stimulation led to progressive rarefaction of the tight junctional network and disintegration of the gap junctions. Concomitantly, an equal distribution of membrane particles on both faces of the plasma membrane together with a random occurrence of exocytotic figures were observed.


Ultrastructure of pheromone-producing eversible vesicles in males of Chrysopa perla L. (Insecta, Neuroptera).

During courtship, males of Chrysopa perla extrude from the genital aperture two eversible vesicles that bear approximately 50 sclerotized tubercles with a long, apical hair. Ultrastructural study reveals within each tubercle two juxtaposed subunits: a sensory subunit formed by a mechanoreceptor neuron, a glial cell, two enveloping cells, and a glandular subunit consisting of a glandular cell provided with an extracellular reservoir, a duct cell and an enveloping cell. The glandular-cell cytoplasm is characterized by extensive RER, a large amount of SER, probably involved in lipid elaboration, and voluminous myeloid bodies encircling the reservoir. The secretion is released to the outside by a cuticular duct that opens into the side of the tubercle. The function of the mechanoreceptor associated with the glandular subunit is discussed.


Presynaptic and postsynaptic organelles of synapses formed in cultures of previously dissociated mouse spinal cord.

This study describes some of the ultrastructural features of presynaptic and postsynaptic organelles at synapses developed in cultures of previously dissociated mouse spinal cord cells. Particular attention was paid to the agranular reticulum which is well developed at many presynaptic and postsynaptic sites, either in the form of simple tubules or cisternae, or more complex networks and often closely associated with mitochondria. In addition, the disposition of microtubules at and close to synaptic specializations is described. These and other features of synaptic zones, such as granular vesicles in presynaptic sites, are discussed in relation to cultures developed on feeder layers and synapses in vivo, and in relations to possible degenerative and regenerative events in the cell cultures.


Histophysiological studies on the corpus allatum of Leucophaea maderae. VI. Ultrastructural characteristics in gonadectomized females.

The ultrastructure of the corpora allata of 29 Leucophaea ovariectomized in the nymphal stage and maintained up to an adult age of 28 months was examined. In general, the subcellular morphology of these glands has much in common with that of normal female controls examined at the height of their activity. In addition, the most "typical" of the gonadectomy cases show certain distinctive features that are either absent or much less prominent in unoperated controls. Of primary interest is the striking abundance of smooth surfaced endoplasmic reticulum observed in many but not all of the castrates. Since this organelle is implicated in the biosynthesis of juvenile hormone, the factor normally responsible for yolk deposition, its increase, together with certain additional ultrastructural features, is indicative of an exceptionally high rate of hormone production. An explanation for the putative hyperactivity displayed to various degrees by the experimental animals may well be the constancy of the demand on their corpora allata, since removal of the ovaries abolishes the afferent signals in response to which, in the intact female, the brain turns off these glands during the long periods of gestation. That the synthetic effort may eventually level off, even in the absence of regular inhibitory stimuli, is suggested by the corpora allata of those castrates, the ultrastructure of which reflects moderate activity or possibly further regression.


Effects of acute cold exposure on the ultrastructure of the mouse pinealocyte.

Ultrastructural changes in pinealocytes were investigated qualitatively and quantitatively in mice exposed to low temperatures at 0 degree C or 5 degree C for 30 or 60 min. A quantitative estimation of the granulated vesicles of about 100 nm diameter in pinealocytes demonstrated that the number of these vesicles per pinealocyte in mice exposed to cold at 0 degree C or 5 degree C increased remarkably as compared with that of the controls. This finding indicates that cold stimuli may activate the formation of the granulated vesicles in pinealocytes. In mice exposed to cold at 0 degree C for 60 min, granulated vesicles were often found in gourps close to the plasma membrane of the pinealocyte cell bodies or processes, indicating the release of the vesicle content into the extracellular spaces. Additionally, the pinealocytes of the mice exposed to cold at 0 degree C for 60 min were characterized by the frequent occurrence of lysosome-like bodies and filaments. The development of these structures in response to severe cold may represent a depressed functional state of pienalocytes.


Colour receptors in the eye of the digger wasp, Sphex cognatus Smith: evaluation by selective adaptation.

Pigment granule migration in pigment cells and retinula cells of the digger wasp Sphex cognatus Smith was analysed morphologically after light adaptation to natural light, dark adaptation and after four selective chromatic adaptations in the range between 358 nm and 580 nm and used as the index of receptor cell sensitivity. The receptor region of each ommatidium consists of nine retinula cells which form a centrally located rhabdom. Two morphologically and physiologically different visual units can be described, defined by the arrangement of the rhabdomeric microvilli, the topographical relationship of the receptor cells with respect to the eye axes and the unique retinula cell screening pigmentation. These two different sets of ommatidia (type A and B) are randomly distributed in a ratio of 1:3 throughout the eye (Ribi, 1978b). Chromatic adaptation experiments with wavelengths of 358nm, 443nm, 523nm and 580nm and subsequent histological examination reveal two UV receptors, two blue receptors and four yellow-green receptors in type A ommatidia and two UV receptors and six green to yellow-green receptors in type B ommatidia. The pigments in cells surrounding each ommatidium (two primary pigment cells, 20 secondary pigment cells and four pigmented cone extensions) were not affected significantly by the adaptation experiments.


Fine structure of the pineal organ in the troglobytic fish, Typhlichthyes subterraneous (Pisces: Amblyopsidae).

The pineal organ of the blind, cave-dwelling fish, Typhlichythyes subterraneous, was examined with both light and electron microscopes. Like the eyes, the pineal in this troglobytic species was found to be regressed. Two cell types, photoreceptor and supportive cells, were described in the pineal epithelium. Although ganglion cells were not identified, small, unmyelinated nerve fibers were present. The photoreceptor cells had degenerated outer segments. Accordingly, it was suggested that the pineal in this species is not likely to function in photoreception. However, the presence of well developed Golgi bodies, clear and dense-cored vesicles, variable amounts of rough endoplasmic reticulum and glycogen particles indicated that both cell types are metabolically active and may play a role in secretion.


Phagocytosis of osteocytes by osteoclasts in femora of two week-old rabbits.

The osteoclast-osteocyte relationship at the endosteal surface of femora of two-week old rabbits was studied. Light microscopic observations suggest that during physiological resorption phagocytosis by osteoclasts of osteocytes takes place. Serial sections confirm that the cells are totally engulfed within the cytoplasm of the osteoclasts. Ultrastructural studies support these findings and indicate that the initial stage of phagocytosis of the osteocytes consists of the insinuation of an extnesion of the ruffled border into the osteocyte lacuna. These extensions are seen to make close contact with the osteocytes prior to their engulfment by the osteoclasts and their final digestion within phagosomes.


The integrated genome of murine leukemia virus.

The Southern gel filter transfer technique has been used to characterize the integrated genome of Moloney murine leukemia virus (M-MuLV) and the genomes of the endogenous viruses of the mouse. Study of 10 clones of rat cell independently infected by M-MuLV indicates a minimum of 15 integration sites into which the M-MuLV provirus can be inserted. No common integration site is observed among these clones. Clones productively infected by M-MuLV acquire multiple proviruses, whereas infected cells unable to produce virus contain only one M-MuLV provirus. Once established, the integrated genomes are stable for at least two years after initial infection. The use of M-MuLV probe allows detection of a spectrum of Eco RI-cleaved mouse DNA fragments containing endogenous MuLV genomes. DNAs of different inbred laboratory mouse strains yield similar patterns of provirus with each strain showing minor characteristic differences. In some instances, mouse cells infected by M-MuLV reveal additional proviruses beyond those seen in the uninfected cell. DNAs from three different M-MuLV-induced thymomas indicate, as in rat cells, multiple possible integration sites.


Isolation of separate mRNAs for alpha- and beta-tubulin and characterization of the corresponding in vitro translation products.

The messenger RNAs coding for alpha- and beta-tubulin have been isolated from embryonic chick brain. Although the mRNAs for the two tubulin subunits have been resolved on native gels, they are very similar in molecular weight (650,000 daltons) as judged by mobility on denaturing gels containing methy mercury. The mRNAs for beta- and gamma-actin have also been resolved on native gels, but migrate as an unresolved peak (molecular weight 6500,000-700,000 daltons) under denaturing conditions. Since the nonmuscle actins are substantially smaller proteins than alpha- and beta-tubulin, the large size of chick nonmuscle actin mRNAs suggests an unusually long untranslated region. Since tubulin and actin polypeptides are internal structural proteins, one would expect them to be synthesized only on free polysomes. Translation of mRNA derived directly from a purified membrane fraction or by puromycin release from that fraction, however, showed the synthesis of a small proportion of these proteins on polysomes that are membrane-associated. Peptide mapping has in all cases confirmed the identity of the products of cell-free synthesis with authentic alpha-tubulin, beta-tubulin and actin. Approximately 67% of the alpha- and 13% of the beta-tubulin chains produced by in vitro translation are competent for co-assembly into microtubules with added carrier microtubule protein.


The DNA sequence of sea urchin (S. purpuratus) H2A, H2B and H3 histone coding and spacer regions.

The DNA sequence of two cloned segments of the histone gene repeat unit of the sea urchin S. purpuratus has been determined. One sequence contains the contiguous H2B and H3 genes and their interdigitated spacer regions; the other comprises the H2A gene and flanking spacer sequences. Analysis of the coding regions reveals a methionine residue within the H2A protein. H2A, which generally lacks this amino acid, contains methionine only in a protein variant which is synthesized in early sea urchin embryogenesis. We thus conclude that the cloned DNA represents a set of genes which is active early in development. Codon selection is markedly skewed and similar for each of the three genes. The DNA sequences are co-linear with known histone protein sequences and-unlike several other eucaryotic genes-do not show any insertions in the coding regions. The spacer regions are relatively AT-rich although GC cluster are scattered throughout. Several short stretches of homology are found in regions both upstream and downstream from the protein coding segments. The conservation of these sequences and their location at analogous sites suggest that they are involved in gene transcription or in mRNA translation. No tandem or dispersed repeats were found, with the exception of the remarkable sequence having the structure located in the spacer between the H2A and H1 genes.


Nucleotide sequence of the J gene and surrounding untranslated regions of phage G4 DNA: comparison with phage phiX174.

A 290 nucleotide long region of the bacteriophage G4 genome including the end of the overlapping genes D and E, the entire gene J and the untranslated region between genes J and F has been sequenced and compared with the same region in bacteriophage phiX174. Deletions, insertions, duplications and single base changes in G4 relative to phiX174 have resulted in the following changes: the loss of the phiX174 overlapping gene Dtermination and gene J initiation codons, resulting in their separation by 32 untranslated nucleotides; the deletion of one third of the gene J coding region, so that the G4 protein is only 24 amino acids long compared with 37 amino acids in phiX174; and the establishment of a long untranslated region between G4 genes J and F, which despite many nucleotide changes retains the ability to form a stable hairpin loop in the same place and with the same geometry as in phiX174. The G4 overlapping gene E is longer than in phiX174 and extends beyond gene D. Sixteen nucleotides at the end of genes D and E in phiX174 are duplicated in G4 before gene J.


Electron microscopic analysis of replicating DNA of sea urchin embryos.

DNA was extracted from Paracentrotus lividus embryos at the third S phase afer fertilization and analyzed with the electron microscope. The most relevant structures observed in this actively replicating DNA are clusters of short, closely spaced microbubbles (about 0.1 micron long on the average), partially or entirely single-stranded molecules and few linear forks. Unexpectedly, no long eye forms were observed. The analysis of DNA purified from gastrulae and from adult somatic tissues has revealed the same structures, although at a low frequency. A quantitative analysis has been carried out to determine the size distribution and spacing of microbubbles. A number of control experiments have been performed to characterize these structures better. Various possiblities are discussed to account for the presence of the observed forms and the absence of larger eyes.


Differential expression of the gene for the large subunit of ribulose bisphosphate carboxylase in maize leaf cell types.

Mesophyll cells and bundle sheath cells, the dimorphic photosynthetic cell types in the C4 plant Zea mays, differ in protein composition. In particular, the large subunit of the chloroplast enzyme ribulose-1,5-bisphosphate carbocylase (EC 4.1.1.39) is found entirely or almost exclusively in bundle sheath cells. The DNA sequence coding for this polypeptide is contained in the chloroplast DNA of both mesophyll cells and bundle sheath cells. RNA complementary to this coding sequence has been detected in RNA from bundle sheath cells, but is almost or entirely absent from mesophyll cells. Similarly, translatable mRNA for this polypeptide has been detected in RNA from bundle sheath cells, but not from mesophyll cells. Portions of the 4200 base pair maize plastid DNA sequence Bam 9 outside the large subunit gene region appear to be transcribed in mesophyll cells. Thus differential gene expression at the mRNA level has been directly demonstrated to occur in these two cell types.


Muscle development in Caenorhabditis elegans: mutants exhibiting retarded sarcomere construction.

We have studied the structural changes within the body-wall muscle cells of Caenorhabditis elegans during postmitotic development. In wildtype, the number of sarcomeres progressively increases, and each sarcomere appears to grow in length and depth continuously during this period. In mature wild-type cells, the anterior-most body-wall muscle cells have 6--7 sarcomeres; the rest have 9--10 sarcomeres per cell. Twelve mutants in the unc-52 II gene exhibit markedly retarded sarcomere construction and progressive paralysis. Several unc-52 mutants, such as the severely paralyzed SU200, produced only 2--3 sarcomeres per body-wall muscle cell, while the other mildly paralyzed unc-52 mutants, such as SU250, build 3--4 sarcomeres per muscle cell. Other structures such as the pharynx and even the noncontractile organelles of the body-wall muscle cells do not appear to be structurally or functionally altered. The unc-52 body-wall sarcomeres become moderately disorganized as they are outstripped by cell growth; sufficient order is preserved, however, so that the majority of thick and thin filaments still interdigitate. The myosin heavy chains of SU200 body-wall muscle fail to accumulate normally, while the pharyngeal myosin heavy chains do not appear to be specifically affected. This biochemical result correlates well with the specificity of morphological changes in the mutant. A model is discussed in which the biochemical and morphological deficits are explained by a simple regulatory mechanism.


Identification and analysis of Dictyostelium actin genes, a family of moderately repeated genes.

Plasmid M6 has been shown to contain sequences complementary to two related abundant mRNA species which differ in length by 100 nucleotides and code for Dictyostelium actin. M6 complementary RNA was isolated by hybridization to immobilized M6 DNA and translated in vitro. The product is identical to major forms of in vivo labeled actin in both mobility on two-dimensional gels and two-dimensional fingerprints of tryptic peptides. Both plasmid M6 and a second plasmid complementary to the actin mRNA complementary region in M6, pDd actin 2 (McKeown et al., 1978), direct the synthesis in minicells of a number of similar polypeptides that are not seen in minicells containing other recombinant plasmids. Three of these polypeptides are similar in two-dimensional gel mobility to Dictyostelium actin and bind to DNAse I agarose. The repetition frequency of isolated restriction fragments from actin mRNA complementary plasmid M6 has been examined. The data from two different experimental approaches (DNA excess hybridizations using plasmid DNA as probe, and hybridization of plasmid probe to DNA blot filters of restriction enzyme-digested Dictyostelium DNA) indicate that the mRNA complementary region is reiterated 15--20 times. When an actin cDNA probe is used in the same experiments, the results suggest that the entire coding region is reiterated. When the two major actin mRNA species are separated and independently translated, each appears to code for one of the two major actin species. The results suggest that there are at least two different functional genes, and possibly more, for Dictyostelium actin.


Multiple, heterogeneous actin genes in Dictyostelium.

We have used an actin gene-containing restriction fragment of plasmid M6 (Kindle and Firtel, 1978) to select a second actin gene-containing plasmid which we have named pDd actin 2. This plasmid has been shown to contain two actin genes separated by 350 bp of nonactin DNA. When heteroduplexes are formed between any two of the three actin genes present in chimeric plasmids, the region of homology is 1100 +/- 100 bp. This is close to the minimum length required to code for actin protein. The 1100 bp region of intergene homology corresponds to the 1100 bp homology observed between M6 and the two actin cDNA plasmids pcDd actin B1 and pcDd actin A1 (Bender et al., 1978). We have no evidence for additional sequences common to either the 3' or 5' ends of the 1100 +/- 100 bp region of intergene homology. Thermal denaturation experiments show that different pairs of actin genes are diverged from each other by as much as 6--8%. There are two size classes of mRNA complementary to the three actin genes. These have lenghts of 1.25 and 1.35 kb as determined on methyl mercuric hydroxide-containing agarose gels. The possible linkage of these three actin genes to other actin genes is discussed.


The expression of keratin genes in epidermis and cultured epidermal cells.

Cultured human epidermal cells and human stratum corneum (callus) contain a number of keratins of different molecular size, but the size distribution is not the same in the two cases. To characterize these keratins in more detail, we compared them by amino acid analysis, immunological reactivity and one-dimensional peptide mapping (Cleveland et al., 1977). No differences in amino acid compositon could be detected among keratins of stratum corneum differing in molecular size by as much as 50%, suggesting that some repeating structure may be present in these molecules. Examination of polypeptide fragments produced by partial enzymatic hydrolysis showed strong similarities among all the keratins of stratum corneum and of cultured epidermal cells, even extending to the keratins of rodents; but the keratins of similar size, whether of stratum corneum or cultured cells, were more closely related than keratins of different size. This conclusion was supported by studies of the immunological reactivity of the keratins. How the epidermal cell generates a family of keratins is a problem of considerable interest. The differences in size and structure between the keratins of stratum corneum and cultured epidermal cells suggest that the epidermal cell can modify the expression its keratin genes.


Selective assay of monomeric and filamentous actin in cell extracts, using inhibition of deoxyribonuclease I.

A simple and selective assay for monomeric and filamentous actin is presented, based on the inhibition of DNAase I by actin. In mixtures of monomeric and filamentous actin, only the monomeric form is measured as DNAase inhibitor. The total amount of actin in a sample can be determined after depolymerization of F actin with guanidine hydrochloride. The assay is rapid enough to detect changes in the polymerization state of actin in vitro over time intervals as short as 3 min. Data characterizing unpolymerized and filamentous actin pools in extracts of human platelets, lymphocytes and HeLa cells are presented.


The isolation and characterization of linked delta- and beta-globin genes from a cloned library of human DNA.

A cloned library of large, random embryonic human DNA fragments was constructed and screened for beta-globin sequences using the cloned human beta-globin cDNA plasmid pJW102 (Wilson et al., 1978) as a hybridization probe. Two independent clones were obtained and then characterized by restriction endonuclease cleavage analysis, hybridization experiments and partial DNA sequencing. Each of the clones carries both the adult delta- and beta-globin genes. The two genes are separated by approximately 5.4 kilobases (kb) of DNA and their orientation with respect to the direction of transcription is 5'-delta--beta-3'. Both the delta- and beta-globin genes contain a large noncoding intervening sequence (950 and 900 bp, respectively) located between the codons for amino acids 104 (arginine) and 105 (leucine). Although the location of the large intervening sequence within the coding regions of the two genes is identical, the two noncoding sequences bear little sequence homology. A second, smaller intervening sequence similar to that found in other mammalian beta-globin genes was detected near the 5' end of the human beta-globin gene. The two independently isolated beta-globin clones differ from each other by the presence of a Pst I restriction enzyme cleavage site within the large intervening sequence of the delta-globin gene of one of the clones. This suggests that the human DNA carried in the two clones was derived from two homologous chromosomes which were heterozygous for the Pst I restriction enzyme recognition sequence.


The single-copy DNA sequence polymorphism of the sea urchin Strongylocentrotus purpuratus.

The single-copy DNA sequence difference between individual sea urchins of the species Strongylocentrotus purpuratus has been estimated by comparing the thermal stability of reassociated DNA duplexes from two individuals with that for DNA from an individual. Thermal stability was measured by hydroxyapatite thermal chromatography, S1 nuclease resistance after heating in a solvent which neutralizes the effect of DNA base composition, and spectrophotometric melting. One pair of individuals appear to differ from each other in about 4% of the nucleotide pairs of their single-copy DNA sequence. The differences in DNA sequence among individuals in local populations are not distinguishably smaller than those among populations as far apart as 2000 kilometers along the Pacific coast of North America.


Trans-complementation-dependent replication of a low molecular weight origin fragment from plasmid R6K.

A non-self-replicating segment (1370 base pairs) of plasmid R6K was cloned in E. coli and shown to trans-complement temperature-sensitive replication mutants of this plasmid. This segment contains the gene which codes for a protein required for initiation of replication of the plasmid, and was used as a helper in a functional assay for an origin of replication in R6K derivatives. A 420 bp fragment, derived from R6K DNA, was shown to carry a functional origin since it was capable of replicating as a plasmid in E. coli cells carrying the helper segment either on the host chromosome or on a plasmid Col E1 derivative. The copy number of the origin fragment in cells carrying the helper segment on the chromosome is essentially the same as the copy number of R6K. A model for the positive regulation of plasmid R6K replication is presented.


Lack of correlation between the decreased expression of cell surface LETS protein and tumorigenicity in human cell hybrids.

An analysis of the correlation between tumorigenicity and the loss of expression of the large external transformation-sensitive glycoprotein (LETS) was performed on human cell hybrids and their respective normal and tumorigenic parental cell lines. The distribution of cell surface LETS protein in a series of cell lines was examined by both specific immunofluorescent staining and by gel electrophoresis of lactoperoxidase-catalyzed, iodinated cell surface proteins. The tumorigenicity of these cell lines was assayed in nude mice. Although the series of cell lines studied provided a broad spectrum of LETS protein expression, both quantitatively and qualitatively, there does not appear to be a correlation between tumorigenicity and decreased expression of the LETS protein. In a series of transformed, nontumorigenic hybrids, the LETS protein expression was found to be altered with respect to both decreased organizational complexity and decreased content. These hybrids continue to express a number of other transformed phenotypes. Conversely, a number of tumorigenic hybrids continue to express relatively high levels of LETS protein when compared with nontumorigenic hybrids. Thus an alteration in LETS protein expression by itself, or in concert with a spectrum of other transformation properties, does not appear to be a sufficient requirement for tumorigenicity and lends further support to an apparent separate control of the transformed versus tumorigenic phenotype.


The existence of an insoluble Z disc scaffold in chicken skeletal muscle.

Extraction of glycerinated chicken skeletal muscle with 0.6 M potassium iodide leaves a framework of insoluble components within each muscle fiber. This framework is composed primarily of planes of in-register Z discs that have been thickened by the accumulation of material on both sides of each disc during extraction. Membrane vesicles, presumably remnants of the T system, remain surrounding the Z discs. When the framework is sheared in a blender, it is preferentially cleaved between Z planes, resulting in the formation of large sheets of interconnected, closely packed Z discs in a honeycomb-like array. Cleavage occurs in regions formerly occupied by the A bands, which have been weakened by the removal of myosin. The existence and stability of these planar Z disc arrays demonstrate the presence and strength of connections between adjacent myofibrils. SDS-polyacrylamide gel electrophoresis reveals that this framework consists primarily of actin and desmin, with lesser amounts of a few proteins including alpha-actinin, myosin and tropomyosin. Z disc sheets and KI-extracted myofibrils provide a distinct face-on view and side view, respectively, of the Z disc. In indirect immunofluorescence, these two views have revealed that desmin is present at the periphery of each Z disc, forming a network of proteinaceous collars within the Z plane. alpha-Actinin is localized within each disc, giving a face-on fluorescence pattern that is complementary to that of desmin. Actin is present throughout the thickened Z plane, while myosin and tropomyosin exist only in the insoluble residue that coalesces on both faces of each disc. We conclude that desmin, perhaps in conjunction with actin, is responsible for interlinking Z discs of adjacent myofibrils, and may thus serve as a mechanical and structural integrator of muscle fibers. Its hydrophobic nature and coincident distribution with the T system suggest that it may also be responsible for mediating filament-membrane interactions and anchoring the triad to the Z disc. Its collar-like distribution suggests that it may aid in maintaining the structural integrity of the Z disc and the actin filaments inserted into it.


Coincidence of the promoter and capped 5' terminus of RNA from the adenovirus 2 major late transcription unit.

During the late stage of adenovirus 2 infection, RNA chains are initiated at a site near coordinate 16 (Evans et al., 1977) and transcribed approximately 30,000 nucleotides to the far end of the genome at coordinate 100. Late mRNAs processed from these transcripts contain a common spliced tripartite leader (Berget, Moore and Sharp, 1977; Chow et al., 1977a) encoded at approximately 16, 20 and 27, and protein coding sequences which map downstream. This report maps the late promoter and the capped 5' end of nuclear and cytoplasmic RNAs from this transciption unit, and analyzes their structures. We show that nascent RNA chains pulse-labeled in vivo are initiated at coordinate 16.5 +/- 0.5 and contain the sequences intervening between the leader segments. We map the capped 5' terminus of late nuclear transcripts at a site between 16.4 and 16.6 by aligning T1 RNAase oligonucleotides from nuclear RNA with the DNA sequence of the promoter region. The structure of the first eleven residues of the capped 5' terminus of late mRNA was determined by direct RNA sequencing. This structure corresponds exactly to a DNA sequence at coordinate 16.4 and precisely positions the mRNA cap template within the promoter region. These results suggest that the promoter and the cap template sites are coincident, and that the initiating residues of the primary transcript are precursors of the capped 5' end of mRNA. Residues removed from transcripts by splicing were identified. These plus caps were detected in large polyadenylated nuclear RNA, indicating that capping and polyadenylation can occur on unspliced molecules. Residues retained in the mRNA first leader contain a nine residue sequence adjacent to the cap which is complementary to the 3' end of 18S rRNA, suggesting that the first leader functions in ribosome binding. Nucleotide sequences from the promoter region are compared with cellular counterparts. Strong homologies at cap sites and splice points suggest that for the noted cases, the virus and cell share closely related mechanisms for mRNA 5' end synthesis and splicing.


Steps in the processing of Ad2 mRNA: poly(A)+ nuclear sequences are conserved and poly(A) addition precedes splicing.

The conservation of nuclear Ad2 sequences during nucleocytoplasmic transport has been estimated from the accumulation of 3H-uridine in nuclear and cytoplasmic Ad2-specific RNA from the major late transcription unit. From 10-28% is conserved of the total Ad2 nuclear RNA synthesized from each of five regions of the genome that specify groups of 3' co-terminal mRNAs. The sum of the conservation of all the regions was equivalent to 100%, signifying the conservation of at least a part of each transcript or all of about one fifth to one sixth of the transcripts. The conservation of poly(A)+ Ad2 nuclear RNA is about 4 times greater than of total Ad2 nuclear RNA, approaching 100% conservation of poly(A)+ nuclear sequences. Since each mRNA contains three "spliced" sequences that are probably encoded only once per transcript, these data on conservation of the Ad2 sequences suggest that each transcriptional event from the 16-99 transcription unit gives rise to one of a possible 13-14  mRNA molecules with destruction of the remainder of the transcribed RNA. The portion which is conserved resides next to the region to which which poly(A) is added. Three models for the choice of poly(A) sites were considered: termination at the poly(A) site, cleavage shortly after synthesis of one of the sites before transcription was complete, and cleavage after completion of transcription. The first model was ruled out by the demonstration of equimolar synthesis over the 16-99 region. The second model is strongly supported because 3H-uridine label appears equally rapidly in the time range 2-10 min in each of the five 3' poly(A) addition sites, whereas chain completion before cleavage would lead to a faster appearance of label in the most promoter-distal site. Furthermore, briefly labeled RNA molecules extending from 16 to each of several poly(A) addition sites were the first poly(A)- terminated 3H-uridine-labeled molecules detected, demonstrating that poly(A) addition precedes splicing. The choice of which mRNA emerges from each transcriptional event would appear to depend upon first choosing one of five 3' mRNA ends followed by a 5' splicing event.


Size distribution and maturation of newly replicated DNA through the S and G2 phases of Physarum polycephalum.

The size distribution of newly made DNA and the dynamics of size maturation of progeny DNA molecules were studied in the synchronous S and G2 phases of Physarum polycephalum. Pulse labeling of DNA and analysis of the products on alkaline sucrose gradients showed that synthesis of primary replication units (which will also be referred to as "Okazaki" fragments) occurred throughout the S period. Pulse and pulse-chase experiments revealed a distinct pattern of size maturation. An apparently linear increase in molecular weight of progeny DNA molecules during the first hour of the S phase occurred at a rate of approximately 4-5 X 10(5) daltons per min at 26 degrees C, corresponding to the joining of 6-8 Okazaki fragments. The resulting 35-45S (1.1-2.2 X 10(7) daltons) DNA molecules may correspond to the Physarum "replicon." The further size increases of the newly made DNA appear to occur in steps, possibly reflecting a clustering of isochronous replicons along the chromatide. These observations are discussed with regard to mechanisms of DNA replication and size maturation.


[Bladder neck urethral obstructions of neurogenic bladder in children (author's transl)].

The study of 62 bladder neck and urethral obstructions among 210 neurogenic bladder in children, allow to give an urologic definition, corroborated by urodynamic exploration.--28 boys show lesions of external sphincer as described in traumatic paraplegia in adult. The treatment in external sphincterotomy: by perineal approach (5 cases : 1 success--4 failures), or retropubic (3 cases : 2 successes--1 failure) and mainly endoscopic (12 successes over 21 primary resections, and 8 successes over 10 repeated interventions). The results are given according to the obstruction, the continence and urinary upper tract. Ureteroneocystostomy il allowed by obstruction release. The pathogeny of obstruction is discussed according to the paralysis of the sphincter, as well as the therapy with the comparison between sphincterotomy and self-catheterism.--34 girls present 3 kinds of obstruction;--bladder neck dysectasia (5 cases) with obvious radiologic findings: YV plasty was done with in 2 cases ureteroneocystostomy;--posterior downfall of the bladder where intermittent catheterization provides excellent results;--pure urethral obstruction is also observed, like in boy's external sphincter lesion. Various types of therapy are discussed, specialy TV plasty extented to the urethral meatus, but in girls the intermittent catheterization which respects continence and which can be associated to an ureteroneocystostomy or a pharmacologic therapy is at present the most appropriate method.


[Hirschsprung disease. (Except total forms) (author's transl)].

This panel discussion was considered for paediatricians attending a specialisation conference. The study eliminates total colonictypes. The first part is devoted to clinical study of symptoms in neonates and enterocolitis. Two different types are advocated, due to different aetiologies : The first to obstruction. The second one to Schwartzman reaction similar as Necrotizing enterocolitis of the premature baby. The second part analyzes the methods of diagnosis. No discussion about pathology and X. Ray. Pellerin trust mainly pressure studies, while Carcassonne never operates on a cases without a biopsy, even if the manometry, is positive. About biopsy he used for 4 years now, the Helen Noblett device with great confidence. Polonovski discusses the differential diagnosis with so called pseudo and false Hirschprung. The third part gives the different trends of the authors in matter of treatment: --Pellerin studies the indications for nursing, while Jaubert analyses his series of Colostomies. -- The curative procedures are shortly discussed : Pellerin using the Swenson-Pellerin procedure, Jauber spliting himself between Senson and Soave, Carcassone using Swenson. Two series of immediate and late results are assessed that prove an improvement of the results with the experience of the surgeons.


Plasma ADP levels: direct determination with luciferase luminescence using a biometer.

A method is described for the determination of low plasma levels of adenosine-5'-diphosphate (ADP) using a Dupont Biometer to measure luminescence produced by the luciferin-luciferase reaction. Endogenous ATP is removed by incubation with luciferase. The remaining ADP is then quantitated, following its conversion to ATP, after incubation with creatine phosphate and creatine kinase. The mean coefficient of variation for 0.02 and 2.2 micromol/liter ADP standards were 2.1 and 1.8% respectively. The method has been applied to human and rabbit plasma. Human plasma ADP concentrations were found to be 0.13 +/- 0.025 (10) micromol/liter and rabbit plasma concentration were 0.07 +/- 0.05 (5) micromol/liter. Several other possible applications of the method are discussed.


Regression analysis in interlaboratory surveys: a case study with cholesterol and triglycerides.

1. A new interlaboratory survey design, that uses regression analysis to compare results from each laboratory with target values, was tested using cholesterol and triglyceride analyses. The fifty New Zealand laboratories involved showed considerable interlaboratory variation (CV = 8% to 27% for cholesterol, 13% to 113% for triglycerides), 30% and 40% of which was associated with systematic differences between laboratories. 2. End-of-period summaries using regression analysis confirmed the presence of systematic errors. These were either simple types caused apparently by incorrect standardisation (regression slope, B not equal to 1.0) or inappropriate blank correction (intercept, A not equal to zero) or complex types presumably due to nonlinearity or nonspecificity. Graphical display of results from each laboratory aided fault diagnosis and allowed the detection of between-run standardisation differences. 3. Method comparison studies were made: the only highly significant result being lower precision achieved by enzymatic cholesterol methods compared with other colorimetric methods.


The significance of the MB isoenzyme in patients with acute cardiovascular disease with a normal or borderline total CPK activity.

CPK MB isoenzymes were qualitatively identified using an electrophoresis method in 166 patients with acute cardiovascular disease during a six month period. Forty-three had total CPK activity in the normal or borderline range (0--75 U/Liter at the time the MB isoenzyme was first identified. Fifteen of these patients were diagnosed as having had a new acute myocardinal infarction (Group I) and another 15 as having had an old myocardial infarction (Group II). Diagnosis was based on electrocardiographic changes or autopsy findings. The remaining 13 patients were classified as "ischemic heart disease" (Group III) in the absence of strict electrocardiographic criteria or autopsy evidence of myocardial infarction. Nine of the 15 patients in Group I subsequently had elevations of their total CPK activity above 75 U/L. In contrast the total CPK activity of only one patient from Group II and Group III subsequently exceeded 75 U/liter. All 43 patients had evidence of cardiovascular disease. Our findings suggest that the detection of MB isoenzyme in the presence of a normal total CPK activity is a significant laboratory finding and is indicative of cardiac myofiber injury.


A high pressure liquid chromatographic determination of p-chlorophenoxyisobutyric acid and its comparison to a GLC and an ultra violet spectrophotometric method.

A rapid and reliable method for the determination of clofibric acid in serum using high pressure liquid chromatography has been elaborated and compared to a GLC and UV spectophotometric procedure. The limit of detection of the method is 0.3 micrograms/ml.


Quantitative determination of thiazides in urine by a sensitive colorimetric method.

Chloriothiazide and hydrochlorothiazide may be determined in urine by the Bratton-Marshall reaction after extracting with ethyl acetate and treating the extract with Florisil. Such treatment reduces the background color of the urine sample and eliminates interferences. The modified procedure is thus sensitive enough to determine both drugs in 24 hour urine specimens from patients receiving therapeutic doses orally.


[Amylase isoenzyme analysis in an amylase-producing tumour (author's transl)].

The plasma and pulmonary tumour are studied in a patient with lung metastasis. An abnormal and neuraminidase-sensible isoenzyme is noted both in plasma and tumour. Homogenates obtained from the tumour by two different mechanic disruption procedures denote an easier liberation for the salivary type isoenzymes than for pancreatic types. It is suggested that the salivary enzymes are synthesized in the cytoplasm during many inflammatory processes and secreted without cellular necrosis.


Automated measurement of urinary proteins.

We have investigated the automation of the trichloroacetic acid turbidometric method for the estimation of urinary proteins using a standard centrifugal analyser. Conditions of temperature, trichloroacetic acid concentration, sample and reagent volumes have been examined. The method requires 10 microliter of urine sample and results have been shown to be linear to 2.0 g per litre with undiluted specimens; higher levels of protein require dilution of the urine samples to obtain greater accuracy. The coefficient of variation at a level of 0.5 g per litre is 3.5% and at 1.0 g per litre is 1.3%; recoveries ranged from 98.9 to 108%. The estimation of urinary protein in 29 samples may be carried out in 5 min.


Serum dopamine beta-hydroxylase (DBH) activity in acute myocardial infarction.

Serial serum dopamine beta-hydroxylase (DBH) activities were determined in 32 patients admitted to the Coronary Care Unit with chest pain, 9 with acute myocardial infarction and 23 with other diagnoses. The values of DBH were elevated in both groups on day one. The acute myocardial infarction group showed a slower decline and reached a baseline plateau at day five when compared to the control group whose values fell significantly by day two. The reason for the quantitative difference between the two groups is speculative and may be related to changes in plasma volume. Increases in DBH are not specific for myocardial infarction but a nonspecific responses to stress.


Focal cerebral dysrhythmia--presenting as headache: report of a case.

A 14 year old girl developed persistent headache of 6 weeks duration, which she described as a feeling of pressure, accompanied by dizziness, nausea and vomiting. Her EEG showed focal slow waves arising from the right temporo-occipital region. All other investigations were negative. Other medication was ineffective but she responded well to standard anticonvulsant therapy, and her EEG abnormality became minimal. In a case with focal slowing and pain and other handicapping symptoms, which do not respond to other remedies, a trial of antiepileptic medication is indicated even in the absence of clinical seizures and/or EEG evidence of seizure activity.


EEG changes and serum cortisol levels in cushing's syndrome.

Thirty-three patients with Cushing's syndrome had baseline serum cortisol levels and EEG's prior to medical treatment. The EEG's were often normal or showed minor abnormalities consisting of mild slowing and disorganization of background activity, excessive fast activity, and minor paroxysmal changes with sharp waves and some small spike-waves. Of 30 not having intracranial tumors there was a general trend toward worsening of the EEG with increased serum cortisol levels.


Combined activation of the EEG with brietal and pentetrazol.

A group of 101 activations with Brietal and Pentetrazol are reported. Although Brietal proved to be of value in the investigation of all forms of epilepsy, with 55% positive results, there remained groups of patients in whom there was still a call for greater diagnostic precision. Pentetrazol was tried in 21 of these patients with 66% positive activation. It was found that the two agents together were successful in 72% of the patients. Both also add valuable negative evidence in suspected functional fits.


The usefulness of routine electrocardiographic monitoring in the EEG laboratory.

In two groups of 500 unselected general hospital patients, EKG abnormalities were found in the EEG lab in 7% and 18.6%. While the most common abnormality was premature ventricular contractions, a wide variety of serious and minor abnormalities were seen, in some instances of emergent nature. Cardiac disease was unsuspected in around 40% of these patients and confirmed in a majority of these when looked for. Depending on the EKG abnormality, hyperventilation was shown to have an adverse effect 9--50% of the time in patients with normal EKG's, it tended to produce an increase of heart rate, but this was not invariant and the change in heart rate was not related to air exchange or EEG change. It is easy for any EEG laboratory to record EKG with existing equipment, and the results of this study suggest that it should be incorporated as a routine procedure. Moreover, the data indicated that hyperventilation is not necessarily a benign procedure. It should be undertaken only after control EKG recordings and assessment of the patient's cardiac status, and performed with EKG monitoring.


The K-complex in thalamic depth recordings.

K-complexes were recorded from the thalamus in a patient having stereotaxic surgery for intractable stump pain. Two insertions were performed, one in the lateral and the other in the medial thalamus. It was found that, (1) very prominent K-complex activity was present at the depth electrode with relatively meager representation of these forms at the scalp; (2) the trailing spindle component of the K-complex was well displayed on the scalp, but the sharp and slow components were not readily visible in the scalp recordings, suggesting a multiple system response; (3) insertion into the lateral thalamus revealed much K-complex activity in contrast to the relatively little amount found with the insertion into the medial thalamus. These findings support earlier hypotheses of a subcortical origin, and specifically thalamic participation, in the K-complex formations.


Carbamazepine as a substitute treatment of single and compound seizures.

Carbamazepine is a suitable substitute for phenobarbital, primidone, and phenytoin, alone or in combination, when used in the treatment of generalized tonic-clonic or partial epilepsy. Seventy-five percent of 19 patients successfully transferred to carbamazepine and clinically their seizures were at least as well controlled during 18 months of observation. Carbamazepine, alone, is not a satisfactory substitute for drug combinations used in the treatment of compound epilepsy. Fifty percent of 18 patients were successfully transferred to carbamazepine but few of them were significantly improved during the 24 month follow-up. The gradual replacement of standard anticonvulsants with carbamazepine can be accomplished without seizure exacerbation, often with improved control and patient satisfaction. Unfavorable reactions usually are brief, provided serum levels are established between 5 and 12 micrograms/ml.


Hormonal correlates of normal and abnormal follicle growth after puberty in humans and other primates.

After the menarche, changing levels of gonadotrophins, prolactin and sex steroid hormones in peripheral blood are accompanied by ovulation and corpus luteum formation in one follicle, and atresia in the remaining follicles maturing during each menstrual cycle. Available evidence suggests that blood levels of steroid hormones reflect in large part the secretory activity of the ovary containing a pre-ovulatory follicle and most probably of that follicle itself (see Chapter 6). These steroid secretions and those of the corpus luteum coordinate hypothalamic-pituitary-ovarian function. Within the ovary, sex steroid hormones mediate effects of gonadotrophins and prolactin on follicle maturation and participate in determining the fate of individual follicles.


A dominantly inherited form of arthrogryposis multiplex congenita with unusual dermatoglyphics.

A father and daughter with arthrogryposis multiplex congenita and similar dermatoglyphic patterns are described. No evidence was found of chromosomal abnormality, neuropathy or myopathy, and there were no other affected family members. The findings are compatible with autosomal dominant inheritance.


The dermatoglyphic pattern of the trisomy 10p syndrome.

Dermatoglyphic findings are reported for six members of a family in which two patients have partial trisomy for the short arm of chromosome 10(p13 leads to pter) and there are two unaffected carriers of the balanced translocation t(5;10)(p15;p13). The patterns are compared with those of nine other published cases of trisomy 10p. The following dermatoglyphic features appear to be characteristic for the trisomy 10p syndrome: frequent whorls and a high total ridge count on the finger prints and on the palms, C-lines terminating in space 11 (2nd interdigitum), B-lines terminating in space 9(3rd interdigitum), axial triradii t'', high atd angles, abnormal creases on the palms and soles, and general dysplasia of the papillary ridges.


Renal dysplasia and asplenia in two sibs.

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver. This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.


Urinary tract malformation in the XYY male.

Phenotypic expression of the 47,XYY chromosome complement in man has been investigated mostly in terms of the central nervous system. Evidence is presented here to suggest that urinary tract malformation may  be a component of the XYY syndrome; this should be taken into account when counselling parents of children with this chromosome anomaly, and in making decisions when an affected foetus is diagnosed antenatally.


The effects of sympatholytic drugs on the cardiovascular response to tilting in anaesthetized cats.

1. Using cats anaesthetized with chloralose and urethane, comparison was made of the abilities of several antihypertensive and sympatholytic drugs to lower systemic blood pressure, and to depress the compensatory cardiovascular responses to bilateral carotid occlusion and to 45 degrees head-up tilting. Similar comparisons were also made of the effects of these drugs on the perfusion pressure of the vascularly isolated autoperfused hindquarters, and the response of this to carotid occlusion and tilting. The effects of bilateral vagotomy and haemorrhage on these responses were also studied. 2. It was found that hypotensive doses of both bretylium and guanethidine (3.0 mg/kg, i.v.) markedly depressed the ability of cats to restore their systemic blood pressure and to constrict their hindquarters vasculature during tilting. Both drugs depressed the carotid occlusion reflex in the systemic, but not in the hindquarters, circulation. Neither propranolol, 2.0 mg/kg, i.v., nor bilaterial vagotomy had any effect on these parameters and haemorrhage sufficient to cause marked hypotension was without effect on the systemic responses to carotid occlusion or tilting. 3. Clonidine (1.0, 5.0 and 25 microgram/kg, i.v.), xylazine (62.5, 125 and 250 microgram/kg, i.v.) and reserpine (0.5 and 2.0 mg/kg, i.v.) all caused considerable hypotension but had no effect on the response to tilting of the systemic circulation, apart from somewhat prolonging recovering time. The highest dose of clonidine moderately depressed the hindquarters perfusion pressure, and the response of this to tilting. 4. Clonidine (5.0 and 25 microgram/kg, i.v.) and xylazine (125 and 250 microgram/kg, i.v.) depressed the systemic pressor responses elicited by the ganglion stimulants DMPP and McN-A-343. This may indicate that the ability of clonidine to prolong the pressure recovery during tilt may be due to impaired peripheral sympathetic transmission. 5. It is concluded that drugs which significantly reduce the compensatory pressure reponses to tilting in anaesthetized cats may also cause postural disturbances in man, whilst drugs which merely prolong the period required for pressure compensation seem much less likely to cause serious clinical impairment of orthostatic reflexes. It appears that the cardiovascular response to bilateral carotid occlusion may not provide a good index of the integrity of orthostatic reflexes.


Conversion of angiotensin I to angiotensin II in sheep.

1. The methodology for measurement of angiotensin I in whole blood is described. 2. Angiotensin I was measured in arterial and venous blood samples from sodium-loaded, sodium-replete and sodium-depleted sheep. Venous blood concentrations were higher than arterial angiotensin I concentrations. Arterial angiotensin I concentrations increased with increasing sodium deficiency. 3. Angiotensin II was infused into six sodium-replete sheep, the blood concentrations of angiotensin II measured and the metabolic clearance rates calculated. The average value was 121 +/- 21 1/h. 4. Angiotensin I was then infused into these sheep and arterial and venous blood concentrations of angiotensins I and II determined. From this data and the metabolic clearance rate of angiotensin II, the degree of conversion of angiotensin I to II was calculated. The values varied in different sheep from 54 +/- 2% to 105 +/- 6% (n = 6).


Selective stimulation of intracardiac pre-ganglionic vagal fibres of the dog atrium.

1. Direct electrical stimulation (0.05 ms, 5.0 V and 30 Hz) caused negative chronotropic and inotropic effects on the blood-perfused, isolated dog atrium. 2. These negative effects of electrical stimulation were significantly blocked not only by treatment with atropine or tetrodotoxin, but also by hexamethonium, although hexamethonium did not modify the effects of injected acetylcholine. 3. These results suggest that direct electrical stimulation on the isolated, blood-perfused dog atrium readily causes a release of acetylcholine by excitation of parasympathetic pre-ganglionic fibers.


Focal sclerosing glomerulonephritis: a kinetic evaluation of hemostasis and the effect of anticoagulant therapy: a controlled study.

Seventeen children, 12 boys and 5 girls with histopathologic confirmation of focal sclerosing glomerulonephritis (FSG) presented with nephrosis (100%), hypertension (64.7%), intermittent hematuria (58.8%) and associated infection (82.3%). The coagulation-profile study in these patients revealed a hypercoagulable state characterized by significant elevation of fibrinogen and factor V concentrations and platelet count (P less than .002--.02). Increased blood viscosity (13.64 +/- 3.3 cp) was also noted in the patients (controls 10.8 +/- 0.9 cp). Determination of platelet half-life and fibrinogen half-life demonstrated that these were both shortened (P less than .001). Predominant shortening of platelet half-life was observed in 3 of the 4 patients during heparin therapy but this reverted to normal during therapy with the antiplatelet agent (Persantin). These findings signify the presence of a low-grade intravascular coagulation which perhaps occurs in the glomerular capillaries. Significant increments in creatinine clearance (CCr) and renal blood flow (RBF) were observed with treatment in the 9 anticoagulant-treated patients but not in the 8 control patients treated with prednisone and cyclophosphamide.


The nature of the pressor response to carotid artery occlusion in the hexamethonium-treated rat.

1. The blood pressure monitored from the cannulated right carotid artery and heart rate responses to occlusion of the intact left carotid artery were investigated in rats. 2. Hexamethonium abolished the response to ganglion stimulants but not that to carotid occlusion, although the time course and nature of the response were altered. 3. The pressor response to carotid occlusion in the presence of hexamethonium was not abolished by carotid sinus denervation, vagal section, tubocurarine, atropine, ethyl alcohol or an angiotensin II antagonist, but it was abolished by high doses of phenoxybenzamine. In six out of eight experiments the response was not abolished by cervical cord section. 4. It was concluded that the  pressor response to carotid occlusion in the presence of hexamethonium in the rat involves an adrenergic mechanism which is at least in part independent of the autonomic ganglia, and which is mediated by an agent liberated from the brain, possibly under conditions of cerebral ischaemia.


Left atrial receptor inhibition of cardiac efferent vagal activity in the dog.

1. The tachycardia produced by atrial receptor stimulation has been reported to be 'solely' due to an increased sympathetic activity, but not inhibitable by propranolol. We examined the effect of left atrial balloon inflation in chloralose-anaesthetized dogs on heart rate with and without propranolol (1.0 mg/kg) and on the activity in single cardiac efferent fibres of the vagus nerve. 2. Propranolol reduced the cardiac response to balloon inflation by one-third, but did not abolish the tachycardia. Efferent cardiac vagal activity was 3.8 +/- 0.4 spikes/s and 2.3 +/- 0.7 spikes/s prior to and during balloon inflation respectively. 3. It was concluded that the left atrial receptors produce a tachycardia by decreasing cardiac parasympathetic and increasing sympathetic efferent activities.


Toxic psychosis induced by phenothiazine administration in patients with chronic renal failure.

Adverse reactions to phenothiazines have not been commonly recognized in patients with chronic renal failure. We wish to report a characteristic acute psychosis as a complication of phenothiazine use in such individuals. Four patients with chronic renal failure requiring hemodialysis were given doses of chlorpromazine ranging from 100--1000 mg over time intervals varying from 2--7 days. All developed extreme restlessness, auditory and visual hallucinations, and episodes of belligerent behavior. A fifth patient treated with promethazine developed a similar psychosis. Each became ill shortly after the initiation of phenothiazine therapy. All improved slowly after cessation of the drug. Hemodialysis in four patients did not appear to affect the course of the illness. The use of phenothiazines in patients with chronic renal failure is cautioned.


Effect of some prostaglandin synthesis inhibitors on the antinociceptive action of morphine in albino rats.

1. Five prostaglandin synthesis inhibitors, indomethacin, diclofenac, mefenamic acid, ibufen and paracetamol, were found to inhibit the antinociceptive action of morphine without affecting the antinociceptive response of an equi-analgesic dose of prostaglandin E1. 2. Diclofenac was found to be the most potent and longest acting, whereas paracetamol was the least potent and shortest acting. Indomethacin, mefenamic acid and ibufen occupied an intermediate position, both in potency and duration of action. 3. The results suggest that prostaglandins may be involved in the antinociceptive action of morphine in albino rats.


Comparative studies on the effect of hemoperfusion and hemodialysis on the elimination of some uremic toxins.

This study, performed on patients with terminal renal failure, compares the changes in plasma concentrations of middle molecules, myoinositol, low molecular weight metabolites, and blood components during 4 hour periods of hemodialysis and hemoperfusion over a charcoal cartridge. After hemoperfusion there is a more marked decrease of adsorbable substances such as middle molecules, creatinine, and uric acid, whereas after hemodialysis there is a greater change in serum concentrations of myoinositol, urea, and electrolytes. The findings show that although hemoperfusion over a charcoal cartridge cannot replace hemodialysis in the treatment of chronic renal failure, it is effective as a complementary method, because of the better removal of some uremic toxins.


Intrarenal action of angiotensin II in restoring renal artery pressure after acute renal artery stenosis.

1. The renal artery of conscious dogs was acutely narrowed over 30 s to reduce renal artery pressure distal to the stenosis to 40 mmHg and the stenosis was maintained for 1 h. The distal renal artery pressure was rapidly restored to a plateau slightly below pre-stenosis values within 10--15 min. Rises in systemic blood pressure and plasma renin activity were small and transient. 2. This restoration was an active process, mediated by the intrarenal effects of angiotensin II (AII), since it was greatly diminished or abolished when the renal artery was narrowed in the presence of angiotensin I-converting enzyme inhibitor or angiotensin receptor antagonist (1-Sar-8-Ile AII). However, it was not diminished by 'total' autonomic effector blockade. 3. This angiotensin II-mediated restoration of renal artery pressure may be of homeostatic significance for the maintenance of glomerular filtration rate.


Lack of effect of bromocriptine on serum levels of calcium in the rat.

1. The effect of bromocriptine (a prolactin suppressant drug) on the serum levels of calcium was studied in the male rat. The drug was administered subcutaneously at a dosage of 100 microgram per 100 g body weight three times per day. 2. Chronic treatment with bromocriptine had no significant effect on the serum calcium levels. It appears that neither bromocroptine per se nor normal circulating prolactin levels exert any significant influence on blood calcium homeostasis.


Alport's syndrome representing as crescentic glomerulonephritis: a report of two siblings.

Hereditary nephritis is a disease presenting with hematuria, proteinuria, and systemic findings including ocular lesions and deafness. Renal failure frequently occurs in males who have the disease at a young age. We report the case of a female with hereditary nephritis who presented with the classic clinical and pathologic features of crescentic glomerulonephritis post-pregnancy. A sibling also had a comparable course. It is proposed that crescentic glomerulonephritis may be a heretofore unreported presentation of hereditary nephritis with terminal renal failure.


The "dialysis encephalopathy syndrome" without dialysis.

A patient with end stage renal failure is presented who developed a constellation of neurologic symptoms and signs indistinguishable from those described in the dialysis encephalopathy syndrome. In this patient the syndrome appeared before dialysis therapy had been instituted. This case suggests that "dialysis encephalopathy syndrome" may not be a complication of hemodialysis, but rather a rare complication of the uremic state.


Engineering considerations in the design of double-cup hip replacement prostheses.

The diameter of the femoral neck ought not to be reduced, and to provide sufficient ranges of motion without impingement requires the largest practicable articular surface radius and perhaps a less than hemispherical acetabular articular surface. Wear is less with plastic cups and metallic balls than vice versa, and wearing life requires some minimum acetabular wall thickness, which depends on the diameter of the articular surface. Fixation grooves etc. should not reduce the effective wall thickness in highly-stressed regions. In practice, a nearly hemispherical acetabular component will often protrude medially or (preferably) laterally; such a protrusion is unlikely to weaken the fixation but could cause impingement, and could be removed with no loss. The available volume is best used by having the thickest acetabular wall where the wear should be greatest. For the femoral component, the simplest internal surface, a flat-ended cylinder, is also the best. A part-spherical inner surface cannot easily be filled with cement, and a skirt surrounding part or all of the femoral neck offers no advantages and some disadvantages.


Slipped capital femoral epiphysis in a 35-year-old man (a case report).

This is a case report of a 35-year-old man with multiple open epiphyses and a slipping of the right capital femoral epiphysis. An endocrine evaluation revealed primary hypothyroidism. The patient was placed on hormonal therapy and an in situ hip pinning was performed to prevent further slip. The operation was successful. The symptoms disappeared and all of the epiphyses were closed within one year. In an adult patient presenting with slipped capital femoral epiphysis, endocrine dysfunction such as hypothyroidism should be suspected.


Limb length discrepancy and related problems following total hip joint replacement.

Limb lengthening is not uncommon after total hip replacement and may cause subjective problems for patients. We have studied 150 total hip replacements to investigate the operative change in limb length. A radiologic evaluation is used and is shown to be accurate. One hundred forty-four limbs were lengthened an average of 15.9 mm. Slightly less lengthening was observed if the greater trochanter was removed as part of the operative procedure. For subjective complaints 40 (27%) patients required heel lifts on the unoperated side to gain a satisfactory gait pattern. Partial sciatic nerve palsies also occurred in this series (3.3%) subsequent to total hip replacements. These palsies did not correlate with sex, lengthening of the extremity, or operative procedure, but did correlate with repeat surgeries and in all instances the condition resolved or improved.


Unicompartment total knee replacement: a 2--4 year review.

Unicompartment total knee replacement is a controversial operation. Conflicting reports indicate that there is unacceptable wear associated with loosening. To investigate the problem, 21 patients were examined 2--4 years after the operation. Eighty-one per cent of the patients were free of pain. None of the remaining patients had disabling pain. All patients demonstrated 90 degrees or greater range of motion with 91% of the patients' preoperative deformity completely corrected. There was a 19% evidence of X-ray loosening of the component which was consistently associated with the clinical symptoms of mild pain. Unicompartment total knee replacement is an acceptable alternative to high tibial osteotomy and relieves pain as well as corrects deformity.


Anterolateral rotary instability associated with chronic anterior cruciate insufficiency.

Patients with anterior cruciate tears identified by previous surgery were examined for anterolateral rotary instability of the knee. Twenty-four of 30 patients returning for examination had positive tests for anterolateral rotary instability using the techniques described by both Slocum and MacIntosh. The presence of anterolateral rotary instability was directly related to the attainment of full extension of the operative knee. Inherent ligamentous laxity and the degree of combined instabilities were thought to amplify the anterolateral rotary instability tests. Quadriceps rehabilitation, pes anserines transfers and semimembranosus transfers were thought not to influence anterolateral rotary instability.


A clinical follow-up of the pes anserinus transplantation for chronic anteromedial rotatory instability of the knee.

Twenty-seven patients with chronic anteromedial rotatory instability were treated by pes anserinus transplant with an 85% satisfactory result. Muscle rehabilitation is absolutely essential for a good result. Delay of surgery by prolonged conservative management may contribute to the development of degenerative changes in the medial compartment.


The patellar compression syndrome: surgical treatment by lateral retinacular release.

Patellar compression syndrome may be a manifestation of contraction of the lateral retinacular structures which consists largely of the lateral patellofemoral ligament producing a tethering action on the patella. This may produce parapatellar pain, particularly in activities requiring repetitive knee flexion. Minor patellofemoral incongruencies with pain, grating, and functional limitation may be found on examination but the patient does not demonstrate the problems of instability of marked congenital abnormalities often seen with other patellar problems. Forty patients underwent a simple release of the lateral retinaculum to decompress the patella in the patellofemoral groove. Follow-up was obtained in 31 patients at an average of 18.3 months after surgery. Twenty-four knees which had severe preoperative pain were converted to 6 with no pain, 4 with mild pain, 11 with moderate pain and 3 whose pain remained unchanged after surgery. Twenty knees with moderate preoperative pain were changed to 4 with no pain, 11 with mild pain and 4 whose pain remained unchanged. Thirty-seven of the 45 knees had lessening of the pain after the operation and 10 patients returned to unrestricted atheletic activities.


Knee synovectomy for rheumatoid arthritis.

Twenty-one patients with rheumatoid arthritis had 33 knees treated with synovectomy. They were followed for an average of 5 2/3 years postoperatively. At follow-up, patients with 58% of the knees had less pain, 15% more pain, 54% were satisfied, 39% had palpable synovitis, but all had lesser synovitis postoperatively, and 53% showed radiographic progression of disease. Motion was not lost. There were no significant complications. Better results can be anticipated in those patients whose knees show little or no destruction radiographically and no significant deformity at the time of operation. However, beneficial results can occur even in those with more advanced changes. Even though quality of results tends to diminish with time, the procedure offers sufficient benefits to continue its use.


Fractures of the tibial condyles: a preliminiary report on supplementary fixation with methylmethacrylate.

In severely displaced fractures of the tibial condyles, failure of the method of fixation may lead to disappointing results of open reduction operations. This problem may be successfully and safely treated by using methylmethacrylate (MMC) for internal fixation. In this series 6 of 7 cases achieved an acceptable result of fixation with MMC. This compares favorably to published series of fractures of this type treated by open reduction.


Arthroscopy of the knee under local anesthesia and controlled pressure-irrigation.

One hundred and forty-two arthroscopies under local anesthesia, using "high pressure" irrigation-suction technique were carried out in 137 patients. With this technique the duration of the examination was shortened, the endoscopic field of vision was enlarged (posterior horn of the menisci could be visualized in most patients), the manipulation of the scope inside the joint cavity was easier and safer. More patients could have been examined during one session. The arthroscopic accuracy verified at 51 operations, was 90.5%, which is an improvement on our previous experience with arthroscopy under general anesthesia, with tourniquet and the routine " drip" technique.


Painful medial bipartite patellae: a case report.

Bipartite patellae, though not unusual as an incidental roentgenographic finding, are rarely painful. This is a report of bilateral medial bipartite patella in a 20-year-old woman, which seems not to have been previously described in the literature. The symptoms were significantly relieved by an excision of the accessory ossification center.


An unusual cause of knee locking: a case report.

Intra-articular tumors of the knee joint causing intermittent locking are extremely rare. A 39-year-old woman with the complaint of joint locking had a pedunculated intra-articular mass and nodular synovitis.


Recurrent painful calf swelling associated with gout.

A 30-year-old man had a recurrent painful calf swelling associated with gout that mimicked thrombophlebitis and possibly muscle tear. This painful calf swelling occurred in the absence of a subjective history of arthritis of the knee. A constellation of clinical signs was highly suggestive that gout was the cause of the painful calf swellings. Patients with similar conditions, after careful exclusion of thrombophlebitis, might be spared unnecessary and potentially dangerous anticoagulation or surgical intervention by early diagnosis of gout.


Ischemic contracture in the lower limb.

Twenty cases of ischemic contracture in the lower limb demonstrate that the age distribution may be higher than that of patients with similar lesions in the upper limbs. Non-traumatic and traumatic causes are encountered equally frequently. Pain is one of the most important symptoms associated with long standing lesions. The ischemic lesion develops most frequently and severely in the anterior compartment of the leg. The functional prognosis is poor when both nerves are affected and when the deformity is severe.


Some anatomical and mechanical considerations relevant to the surface replacement of the femoral head.

The internal structure of the arthrosic and normal femoral heads are grossly different although both are roughly circular. In particular bone is destroyed or defective superolaterally in the former. The compressive strength of the femoral head depends upon the medial trabecular system which runs through the head at approximately 20 degrees to the vertical i.e. the plane of the resultant of the major loads borne by the hip. Ideally a femoral resurfacing prosthesis should be placed in this axis. The bone of the arthrosic femoral head can be sustained by blood reaching it within the neck. Thus vessels on the intracapsular surface of the neck need not be preserved.


Medial plantar neurapraxia (jogger's foot): report of 3 cases.

Entrapment of the medial plantar nerve in the longitudinal arch causes burning heel pain, aching in the arch, and deficient sensation in the sole of the foot behind the great toe. Long distance valgus running may cause such a disorder in a jogger and the condition usually responds to conservative measures which include a change in running posture of the foot, anti-inflammatory medications, and proper footwear. The name "jogger's foot" is selected for this clinical syndrome.


Untreated scoliosis in the adult.

Untreated scoliosis affects the quality of life and is a disabling disease in the adult. Most patients can expect back pain, particularly after the age of 30, and one in 4 may be disabled by it. The majority of adults are embarassed by their deformity. Women, in particular, are less likely to marry. Surgical treatment of the adult is difficult and hazardous, and is associated with socioeconomic problems not encountered in the adolescent. Scoliosis should be treated definitively before the end of the period of growth.


Osteotomy of lumbar spinous process to increase surgical exposure.

A unilateral laminotomy does not always give adequate exposure to disk, nerve or lateral recess. Bilateral laminotomy with removal of a spinous process may result in segmental instability. These problems can be overcome by osteotomy of one or more spinous processes. After doing this a unilateral or bilateral exposure can be obtained by retraction of the process. At the end of the operation the spinous process is replaced in normal alignment and appears to unite spontaneously to its base by bone.


Knee flexion test and sciatica.

Knee flexion of the leg when a patient with sciatica bends to reach the floor is objective evidence of lumbar spinal nerve root compression. Contralateral sciatic scoliotic list usually accompanies the finding, which should be known as a positive knee flexion test for sciatic spinal nerve root compression.


Undiagnosed bleeding states and medical treatment.

Relatively little attention has been placed in mild hemophilia in the orthopedic literature even though there are probably an equal number of patients with mild as compared to classic manifestations. Mild hemophilia and similar related conditions frequently are undiagnosed and may represent major problems and if associated with surgery, catastrophic results. Patients with milder bleeding diatheses may not have a diagnosis made until late in life. Mild hemophilia and hemophiloid conditions are defined and typical findings are given. Other causes of intra or postoperative hemorrhagic states are mentioned. Three case reports of mild Factor VIII and Factor XI deficiency, undiagnosed prior to the author's medical treatment, are presented. Knowledge of the typical historical findings, diagnostic methods, and proper treatment of patients seeking medical treatment with mild hemophilia, hemophiloid and similar conditions explaining hemorrhage following trauma and intra and postoperatively will help to prevent undesirable results as well as severe complications.


Hip arthroplasty by matching cups.

A total hip surface arthroplasty consisting of matching cups and uncemented prosthetic components is a noteworthy operation. The femoral cup obtains cylindrical support from the femoral head which is reamed in the shape of a cylinder. The acetabular cup is metallic with a polyethylene liner. It is mobile over the bone but its position is constrained by contact with the femoral cup and therefore "self-centering." On the femoral side, the cup must be placed strictly in the axis of the femoral neck. The main consideration in femoral head surface replacement is the vitality of the underlying bone. Necrosis was observed in the earliest clinical trials but there have been no cases of necrosis in the past 3 1/2 years. This is attributed to a more limited surgical approach in which only the anterior part of the gluteus medius is divided and all the posterior elements of the hip are preserved. The acetabulum is sufficiently reamed to receive the cup, which protrudes beyond the external margins of the acetabulum in all positions. Errors have been committed while perfecting the prosthetic material, but the results as determined by a 6 1/2 year follow-up on purely metallic cups are encouraging. Metal-polyethylene cups presently under investigation have almost a 2 year follow-up. The reaction of the acetabulum to an uncemented cup is not yet known. However, the existence of 2 sliding surfaces and the fact that the acetabular cup moves only during the extremes of hip movement, is reason to assume that if the acetabulum is not reamed to expose cancellous bone, the risks of protrusion are minimal or delayed. Total surface arthroplasty by concentric cups has been performed in 335 hips to date. The operation is especially recommended when osteotomy is no longer possible and disabling coxarthrosis is present in relatively young patients.