[Preservation of bread and pastry products in a controlled atmosphere].

Industrial soft pastries and the various breads are cereals products containing a humidity which is favorable to the development of mouldiness. Different or various methods of conservation has been attempted. One interesting approach to the problem is packaging in controlled atmosphere. It requires adequate machinery and suitable conditioning materials. Jardry-Buquet and Hayssen's machines are rapidly described as well as some of the packing film used for making air-tight bags. Bad results were observed with nitrogen, argon and a mixture of nitrogen-carbon dioxide. The satisfactory results obtained with the nitrous oxide for cakes (especially fruit-cakes) and for the bread with a mixture of ethylene oxide-carbon dioxide are: a good conservation for a period of 4 to 6 months in both cases. Organoleptic qualities of the products are not significantly diminished after eight weeks of preservation. The gases contained on the bags are analysed at different periods and the progressive disappearance of the nitrous oxide as well as the athylene dioxide was measured. The compounds derivated from these gases were researched on different extracts. No derivatives of the nitrous oxide were observed. From the ethylene oxide, the derivatives found in the bread are diethylene glycol and 2-chloroethanol; their concentrations are respectively 100 and 300 ppm in the case of 85 : 15 mixture, but decrease to a mere trace and 45 ppm in the case of 98 : 2 mixture. The measure of humidity, of peroxides and of the staleness of crumb are favourable for a good conservation.


[Preservation of meats in a controlled atmosphere].

Commercializing meat sets problems more particularly connected with its organoleptic and microbiological qualities. As these qualities, resulting from biochemical and microbial effects, develop during the storage, the conditioning must precisely help their controlling. After examining their factors, the Author analyses the processes of conditioning which he classifies in three categories according to the techniques used and the desired finality (need to store at -1 degree C + 3 degrees C). 1. Conditioning under a steam-proof and gas pervious (O2-CO2) film. Composition of the internal atmosphere permanently close to that of the normal atmosphere. No change in the bright red colouring at the surface (oxymyoglobin). Microbial growth slowed down by refrigeration. Limited storage (a few days). Comminuted meat trade. 2. Conditioning under a totally steam--and gas--proof film. Internal atmospheric air under reduced volume and pressure ("vacuum-packed" meats). Internal changes during the storage: reduced rate O2; increased rate CO2 (cellular and microbial respirations). Surface becoming darker (absence of oxymyoglobin). Growth of the germs arrested (pathogenic and spoilage). However development of microaerophilic and acidophilic germs (in particular the lactic B.). Storage possibly extended to 8 weeks. Re-apparition of the red colour after oxygenation (opened package). Wholesale meat trade. 3. Conditioning under a film with properties close to that of (2 degrees). Initial constitution of an internal "artificial" atmosphere increased in O2 and CO2 (gas injection). No change in the bright red colouring (oxymyoglobin). Growth of the germs arrested (pathogenic and spoilage). Selection of an acidophilic aerobic flora including lactic B. and microbacterium. Storage until 12-15 days. Comminuted meat trade.


Food irradiation in practice, present status in the Netherlands.

When an irradiated human food item is considered to be feasible for commercialization, two obstacles are still to be taken: governmental approval and consumer acceptance. The present Dutch situation is compared to recent developments towards approval of the technique by international authorities. The effect of this approval and of the remaining problems with respect to consumer acceptance on the Dutch market for food items is discussed. Three commodities are used as examples to demonstrate the present Dutch situation.


The influence of irradiation and packaging on the quality of prepacked vegetables.

During storage, transport and sale of prepacked vegetables, their quality deteriorates very quickly by microbiological decay, discolouration and desiccation. The experiments described were carried out with endive (Chichorium endiva L.) as a representative of the leaf vegetables. After processing (cutting, washing and drying), the product was packed in polythene bags without and with 4 perforations of 2 mm diameter. The endive was irradiated with 0 and 100 krad gammarays and afterwards stored at 10 degrees C, thus simulating the transport and sale temperature. The quality was studied on the basis of the following parameters. The gas composition in the bags, the microbiological composition, the Vitamin C (Ascorbic acid + Dehydroascorbic acid) content and the sensory quality. The experiments showed that the modified gas composition in the non-perforated bags, caused by the respiratory activity of the cut product, improved the quality. The low O2 and high CO2 content prevented discolouration, retarded the senescence and diminished the Vitamin C losses. The initial Total Viable Count of endive was 10(6) to 10(7) and the number of Enterobacteriaceae amounted to approx. 10(5) g-1 product, and increased in a couple of days to 10(8) and 10(7) g-1 respectively, resulting in decay of the product. The contamination with aerobic and anaerobic spores was low, viz. 10(1) to 10(2) g-1 and did not increase at 10 degrees C. An irradiation treatment of 100 krad reduced the Total Viable Count and the Enterobacteriaceae with 3-4 decimals, by which the shelf life increased with about 100% and almost all the Enterobacteriaceae were eliminated, so that the hygienic quality was improved. In prepacked endive nearly half of the Total Vitamin C content was lost within two days. The retention was strongly affected by the presence or absence of perforations; the effect of an irradiation treatment was slight.


[Intermediate moisture foods: polysaccharide and protein gels].

The aim of this study was to prepare concentrated foods (20-40 p. 100 water), edible as such, chemically and microbiologically stable, nutritionally balanced, and which could be used as meal substitutes (travel, camping, snacks, etc.). With high methoxyl pectins, it was possible to obtain a pectic gel (pH 3,5), similar to a fruit jelly, but containing 20 p. 100 d.w. protein, and less sucrose. Water activity (Aw) was 0,75-0,78, for a 25 p. 100 water content, as a result of adding glucose syrup and sorbitol. After 4 months storage at 20 or 38 degrees C in aluminium pouches, no mold growth was detected (even following prior inoculation) nor practically any change in flavor, texture of Aw. With low methoxyl pectins, gel foods richer in water (35 p. 100), softer, less acid (pH 4,3) and containing even less sugars have been prepared (26 p. 100 d.w. protein, 35 p. 100 carbohydrates, 15 p. 100 lipids). Aw was lowered to 0,84 by adding humectants (sucrose, glycerol, sorbitol, citric acid, sodium citrate and chloride). Starch gels (40 p. 100 starch/d.w.), of pH less than 4,5, containing proteins and lipids, were flavored with vegetale powders. For 30 p. 100 water and with humectants, Aw was 0,84-0,88. The texture changes more or less favorably with time according to the nature of the starch used. Using the technology of processed cheeses, protein gels were made with either of the following characteristics: 1. A reduced Aw (0,86, for 38 p. 100 water) by adding humectants, but with a soft texture similar to that of a processed swiss cheese; 2. The same reduced Aw, with a starch content of 26 p. 100/d.w., and a harder texture, comparable to that of Emmenthal cheese.


[Emulsified intermediate moisture foods].

A water-in-oil emulsion with IMF behavior has been studied within DGRST Grant Nr. 75-7-0406. The dispersion of a sirupy aqueous phase of known aw into a more or less hardened fatty continuous phase was looked into through its effects, particularly how the fatty phase would modify the water behaviour of the dispersed aqueous phase. The emulsion was conventionally prepared by a preemulsion of the syrup into the lecithinated fat, an homogeneisation till enough dispersion and a centrifugation to get rid of free fat. Lecithin has to promote sufficient fat incorporation, correct dispersion and a final viscosity allowing pumpability. To get a cold centrifugate of enough consistency implies an efficient dispersion but before all a judicious choice of the continuous fatty phase, making allowance of organoleptic properties and shelf-life stability. The water behaviour has been worked at on two model systems, of initial phase volume phi = 0,36, with an internal phase made of partially inverted sucrose syrup (aw = 0,79) and an external fatty phase of either refined soybean oil or hydrogenated palm oil (m.p. 42 degrees C). These models respectively retained after centrifugation 12,5 p. 100 oil and 19,5 p. 100 fat; sorption-desorption isotherms were determined by the saturated salt solution method both at 37 degrees C and room temperature, exhibiting that the solid fat content of the continuous fatty phase positively reduces the water transfer velocity from-and-into the syrup. Such a W/O emulsified structure with a prevalent internal aqueous behaves like a pasty IMF, inherently protected against outside relative humidity variations; it also leads the system to a better consistency.


[Intermediate moisture foods and water activity determination].

In order to define the concept of Intermediate Moisture Foods (IMF) some ideas concerning the water bonding state in foods are reminded: water molecules properties, polar groups of hydrophilic macromolecules, activity of water (aw); sorption and desorption isothermal curves. Between dried products (solids with friable and breakable texture) anv very hydrated products (meat or fresh fruits for example), the IMF are characterized by their high aw (from 0.65 to 0.90) and their generally soft texture. Some typical examples of traditional and new IMF are then given. The IMF alterations are induced by chemical (oxydation) or biochemical (enzyme), biological (micro-organisms) or biophysical (water migration) causes, each of them being controlled by aw, temperature, pH, and other parameters. IMF technology consists generally to formulate products, the aw of which are less than 0.9, with aw depressors. Precise measurements of aw are then one of the most important mean for controlling fabrication, the direct computation being generally impossible. A manometric reference method for determination of aw is described; it consists to measure directly the equilibrium water vapor pressure. This method is preferable to a dew point determination. Some practical methods are reported, in connection with their accuracy and facilities of use.


[Menkes' disease (new skin and hair ultrastructural abnormalities) (author's transl)].

The authors report the sixth case of Menkes' kinky hair disease. This boy has been observed for as long as 16 months, and he his still alive at the time of publication. This genetic, X linked disorder of copper metabolism is always fatal in childhood. Diagnosis is evoked when is noted the conjunction of progressive cerebral degeneration, seizures, with pili torti and monilethrix. It can be asserted with the very low copper and cerulo-plasmin blood levels. Recognition of the disease in utero might be possible. New findings in skin' electron microscopy and hair' scanning electron microscopy are reported here. And two RX scanner of the brain have been performed.


[Comparative analytical study of the effects of psoralens in vitiligo (findings in 70 patients) (author's transl)].

70 patients with vitiligo were divided into two groups. --one group of 40 patients: treated with trioxsalen and sun rays; --one group of 30 patients: treated with methoxsalen and sun rays. Both the first and the second drug stopped the extension almost similarity (87.5 p. 100 positive results for the first group and 86.6 p. 100 for the second one). For the first group the action on the repigmentation was more important but the latent period was longer. Neither group showed side effects worth mentioning. The factors that influence favourably vitiligo and improve the evolution are: --the situation on uncovered parts of the body; --the length of treatment; --the promptness of institution of treatment; --the necessity of a maintenance treatment; --the appearance of erythema which is necessary for repigmentation.


Equine leptospirosis with some clinical observations.

In a serologic survey on equine leptospirosis in Egypt, the following incidences of leptospiral serosensitivity were found: 1. Hospitalised horses 65/113 (57.5 %). 2. Hospitalised donkeys 90/125 (72.0 %). 3. Apparently healthy horses 21/72 (29.1 %). Sera of these animals were mostly reacting to serotypes butembo, pomona, icterohemorragiae, and grippotyphosa. Equine in Egypt are close animals to humans and may constitute a potential source of leptospiral infection. From the clinical point of view, it is very possible that ocular, hoof lesions and icterus in equines would be expected with leptospiral titres.


The effects of time and temperature of storage on the infectivity of third-stage larvae of Heligmosomoides polygyrus (= Nematospiroides dubius). 1. Effects on the development to the adult stage in mice.

The relationship between storage time and temperature on the infectivity of the third-stage larvae of Heligmosomoides polygyrus (= Nematospiroides dubius) was examined. Results showed that third-stage larvae lose their infectivity when they aged. This loss was steeper at 22 degrees C than at 4 degrees C. Results obtained at 15 degrees C seemed to be intermediate. Data also demonstrated that a maturation period was required for maximum infectivity. A longer maturation period was observed at + 4 degrees C than at 22 degrees C and the maximum was maintained for longer at 4 degrees C.


The effects of time and temperature of storage on the infectivity of third-stage larvae of Heligmosomoides polygyrus (= Nematospiroides dubius). 2. Studies on the fecundity of female worms as a function of the infectivity of the third-stage larvae.

In this study we examined the effect of infectivity of third-stage larvae on the fecundity of H. polygyrus female worms. Groups of 10 mice were infected with third-stage larvae which had been stored for different lengths of time at 22 degrees C. Results showed that the number of eggs laid by one female worm increased when the worm burden was smaller and decreased with a greater worm burden. Also, the egg-output of female worms growing in a similar population varied according to the level of infectivity of the larvae, with a low infectivity resulting in greater fecundity and vice versa. These results may explain the variations in egg-output which are recorded at different times of the year from the parasites of grazing animals. If this phenomenon is confirmed in other species of parasites, it will be important for epidemiological studies.


[Toxicity of ochratoxin A. 3. Effects during the initial stages of pregnancy in the rat].

Ochratoxin A administered by gastric tubing to pregnant rats at day 2 after mating increases the number of resorbtion sites. A high level of mycotoxin was found in the plasma of females and in the embryos (up to 5.6 p. cent of the total administered doses). At sacrifice time (day 10 after mating) no morphological defect was observed in the embryos.


Application of macroscopic autoradiography to large animals in veterinary pharmacokinetics: the distribution of sodium selenite labelled with 75Se in the pig.

Macroscopic autoradiography has been applied to large animals, such as pigs. It consists in carrying out slides of different organs in well definite conditions (slide thickness, exposure rate...). Then, it is possible to compare all results with optical densitometry techniques. We have applied it to the metabolic study of sodium selenite labelled with 75Se in pigs. Autoradiography and quantification of organs as a function of time showed that for activities below 10(5) counts per minute and per gram, we get similar results. So, it is possible to use Ullberg's technique with large animals. This is very interesting in veterinary drug metabolism studies where we must determine acceptable residual levels for human consumers.


Prognosis of diarrhoea in the newborn calf: statistical analysis of blood biochemical data.

Blood samples were taken from 55 diarrhoeic calves (neo-natal diarrhoea) at the time of the first therapeutic intervention. Eleven blood parameters were measured in these samples. The whole group of measurements were analysed by their principal components (tables 3 and 4). The results are expressed in visual form by Figures 1 and 2. The first principal axis corresponds to the acid-base balance while the second axis can be considered as corresponding to the catabolism. The discriminant analysis (table 5) shows that the parameter having the best prognosis value is the blood urea concentration. By adding two other easily measured parameters (the haematocrit and the blood chloride concentration) the probability of classifying correctly the calves into one or other of the groups dead or surviving is approximately 80%.


Semi-automated determination of hormonal iodine without incineration.

A sensitive semi automated technique for the determination of hormonal iodine is described. The thyroid hormones are isolated by means of a cation exchange resin (Dowex 50 Wx2). The iodine atoms are liberated from the organic molecules with bromine, without prior incineration or destruction (moidified Pileggi's method). Then, mineral iodine is measured colorimetrically with a Technicon autoanalyzer. This technique seems particularly adapted to a programme of standardisation because of its sensitivity and reproductibility. It is well adapted to the determination of circulating hormonal iodine of the ruminants, in which the concentration is lower than in man.


[Effect of the frequency of distribution of a protein supplement combined with a protein-free or low-protein diet on rat development. Nutritional effectiveness, body composition, liver nucleic acid and protein content, free plasma amino acids].

Irregular quantity and quality of food consumption is a common nutritional pattern in Marocco. Periods of liberal food supply due to a good harvest and festivals alternate with periods of more or less severe food shortage, resulting in a poor response to a high quality proteic diet taken from time to time. The object of this work was to study the effect of an irregular feeding sequence on the efficiency of food and the growth of the organism. Experiments on rats cannot be directly transposed to man, but are suggestive of the adverse effects of such a treatment. Discontinuity of protein intake leads to a decrease of its value as a complement for a poor basic diet, and this is more marked with the poorer diets and the longer intervals of complementation. Protein and energy retention decrease with the frequency of distribution of the protein supplement. Liver DNA increases when the supplementation is given with longer intervals; on the contrary the liver RNA decreases. The ratio RNA/DNA and proteins/DNA decreases still more. Blood amino-acids content depends on the composition of the diet and on the hormonal status of the organism.


Protoporphyrin (proto)-determined hepatopathy in a South African Jewish family.

A detailed study of a Jewish erythrohepatic protoporphyria (EHP)-affected family with a sibship consisting of 2 brothers and a sister, all of whom manifested protodetermined hepatopathy which varied from relatively mild hepatic involvement in the sister to a fulminant fatal illness in the eldest brother. The nature and course of his illness as well as the autopsy findings are described in detail. This sibship is also unique in that the 2 brothers and biochemical evidence of a severe degree of G6PD deficiency, while the sister was shown to be a carrier.


Psychomotor skills in depressed out-patients treated with L-tryptophan, doxepin, or chlorimipramine.

Psychomotor skills were measured in depressed out-patients during three-week double-blind treatment with 1-tryptophan (16 patients; 0.5--1.0 g t.i.d.), doxepin (13 patients; 25--50 mg t.i.d.), or chlorimipramine (13 patients; 25--50 mg t.i.d). The effect of depression on psychomotor skills was evaluated by comparing the results from the pre-drug scores (29 patients) with the respective performances of a matched reference group (20 healthy volunteers). Coordination, reactive skills and attention were impaired in depressed patients. The reaction times roughly correlated with the severity of depression, assessed both subjectively and objectively. During treatment with doxepin or chlorimipramine, but not with 1-tryptophan, the choice reaction times were shortened. The change in reaction times correlated with the amelioration of depression. When compared with the other treatment groups, doxepin impaired coordination, attention and flicker fusion discrimination. It is suggested that depressed out-patients with marked symptoms should be warned about driving. Treatment with doxepin is a contraindication to driving during the first two weeks or up to the time when amelioration of symptoms is recorded.


Loss of apical left ventricular contraction after closed mitral valve surgery.

28 patients with advanced mitral valve restenosis were studied by cardiac catherization on an average of 7.2 years after previous closed mitral valvotomy, performed using the Tubbs dilator technique. Loss of left ventricular apical contraction was noted in 17 of 31 left ventricular cineangiograms. In the other regions, only 2 cases of local anterior wall akinesia and 1 of posterobasal akinesia was observed. The extent of akinesia was rather small: from 4 to 21%, a mean of 10.1% of the left ventricular circumference. Though ejection fractions remained 21% smaller in those with regional left ventricular dysfunction than in those with normal contraction (p less than 0.005), no other clinical haemodynamic consequences were found. The mechanical trauma caused by insertion of the dilator seems to result frequently in focal contraction abnormalities of the left ventricle, but these are of minor degree.


Cholescintigraphy in the diagnosis of acute cholecystitis.

Technetium-99-m-diethyl-IDA (Solco HIDA) cholescintigraphy was performed on 50 patients with suspected acute cholecysitis. The final diagnosis was acute cholecytitis in 34 cases, other biliary tract disease in 5 cases and nonbiliary disease in 11 cases. A nonfilling gallbladder was regarded as indicative of acute cholecystitis. The sensitivity in detecting acute cholecystitis was about 90%, the specificity about 80%; the predictive value of a positive test was about 90% and that of a negative test about 80%. The false positives consisted of two cases of acute pancreatitis with normal gallbladders and one case of coincidental chronic gallbladder disease and duodenal ulcer. The false negatives were examined after one week's treatment. A severe common bile duct obstruction could be detected in cholescintigraphy, but a slight obstruction was not always distinguishable from conditions in which the bile flow was normal.


Plasma prolactin concentrations in women treated with low dose combination type oral contraceptives and in women using a d-norgestrel-releasing intrauterine device.

Plasma prolactin was measured in fourteen fertile women during a control cycle and during treatment with two different types of contraception. Ten of the women received a low dose combination type oral contraceptive, while the other four had a d-norgestrel-releasing intrauterine device (d-Ng-IUD) insereted. Plasma samples were corrected in the follicular and luteal phases during the control cycle and the treatment cycles in the d-Ng-IUD-group. In the oral contraceptive group, the samples were collected before treatment, three weeks, and again three months after the beginning of treatment. The results in the different grolups and the different phases of the cycles were compared, but no significant differences were found.


Paroxysmal beta activity in the pediatric electroencephalogram.

A total of 5,401 electroencephalograms performed in the Seizure Unit at Children's Hospital Medical Center over a 12-month period were analyzed for the presence of paroxysmal beta activity. Nine examples were found in patients under the age of 10 years, each of whom had a clinical seizure disorder. Seven patients showed abnormalities such as tumor, cerebral dysgenesis, or hydrocephalus on CAT scans or skull roentgenograms. Paroxysmal beta activity should be considered a manifestation of a seizure disorder. Furthermore, the finding of paroxysmal beta activity on an electroencephalogram in the young child should lead to further evaluation for a possible structural lesion.


Cerebral hemodynamics and metabolism in pseudotumor cerebri.

A comprehensive analysis of cerebral hemodynamics and metabolism was carried out in 14 patients with pseudotumor cerebri. Tracer techniques were employed to measure cerebral blood flow (CBF) and vascular reactivity to acute changes in arterial carbon dioxide tension and blood pressure, cerebral blood volume (CBV), and the cerebral metabolic rate for oxygen and glucose. There was a small reduction (p less than 0.01) in CBF (44 +/- 7 ml/100 gm/min; normal, 54 +/- 9) with normal vascular reactivity; an increase (p less than 0.005) in CBV (4.8 +/- 0.8 ml/100 gm; normal, 3.6 +/- 0.5), and normal cerebral metabolism. We conclude that an abnormality of the cerebral microvasculature is responsible for an elevation in CBV, but the intracranial hypertension can be explained only by tissue swelling due to an increase in water content. The relationship between the vascular abnormality and the tissue swelling remains to be defined.


Thyroid screening with triiodothyronine assay.

The relative independence of serum T-3 from changes in thyroid binding protein levels makes it a more effective screening test for hyper- and hypothyroidism than the T-4 assay alone. In fact, its efficiency is comparable to that of the free T-4 index.


Staphylococcus epidermidis biotype 4: epidemiological conclusions from five different typing methods.

There is presently no accepted method for marking individual strains of Staphylococcus epidermidis. Consequently, five parameters for distinguishing such strains were examined and compared for their epidemiological efficacy: biotyping, serotyping, proteinase grouping, aminopeptidase profiles and antibiograms. Both biotyping and proteinase grouping were of limited use in identifying a particular strain, although they were helpful in initially categorizing such strains. Antibiograms were least useful because of similarities in susceptibility patterns among isolates. Serotyping and amino-peptidase profiles provided the best means of identifying an individual strain for epidemiological use. The applicability of these typing methods was demonstrated during a one year epidemiological study at a chronic disease hospital.


Duchenne dystrophy: focal alterations in the distribution of concanavalin A binding sites at the muscle cell surface.

In 6 patients with Duchenne dystrophy, electron microscopical studies of concanavalin A (Con A) binding sites using the peroxidase labeling technique revealed a population of muscle fibers in which the reaction at the cell surface was irregular and patchy in areas larger than 0.5 mu. In 5 control subjects,  such focal alterations were not observed and the reaction appeared continuous and regular. The findings indicate focal abnormalities at the muscle cell surface of Con A receptors in Duchenne dystrophy.


Total red cell volume in healthy young males.

Regression equations of total red cell volume on body weight, body surface area, lean body mass, etc., are provided for a series of 79 normal male volunteer subjects. The regression of total red cell volume on a combination of height and weight provided the smallest standard error of the estimate and the largest correlation coefficient. The coefficient of variation was 1.6 percent between the first and second red cell volume determination in 31 of these subjects. The popular expression of total red cell volume in ml per kg remains unsatisfactory. It is recommended that a comparison be made between a measured total red cell volume and a predicted normal range derived from a regression using body surface area as the independent variable. A simplified graph is provided which clearly delineates normal from abnormal and should prove adequate for most clinical situations.


Peripheral nerve conduction in patients with a cervical rib and band.

In 14 patients with wasting of the hand due to a cervical rib and band, motor and sensory conduction studies on the peripheral parts of the median and ulnar nerves were helpful in establishing the correct diagnosis. The median nerve findings excluded carpal tunnel syndrome even when the clinical pattern of wasting in the hand suggested this diagnosis. Preservation of conduction velocity in the ulnar nerve excluded ulnar entrapment at the elbow; the reduced amplitude of the ulnar sensory action potentials (SAPs) indicated that the lesion was distal to the dorsal root ganglia. In 3 patients with ulnar SAP amplitudes that were low but not clearly abnormal, the level of the lesion was confirmed by a reduced response to intradermal injection of histamine on the inner side of the forearm.


Determination of fibrinogen in plasma.

This paper compares two specific, rapid, functional methods for the measurement of fibrinogen. Both methods demonstrate a high degree of reproduceability (thrombin clotting time CV = 3.7 percent, clot density rate CV = 7.6 percent). Measurement of plasmas from 20 patients by both techniques showed excellent correlation between the two methods with a correlation coefficient of 0.93 by least squares method. The initial dilution step in the thrombin clotting time method bypasses interference by small amounts of heparin or other inhibitors in jaundiced samples which may present a problem in the measurement of the rate of density development in the clot density method.


Neurological manifestations of hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease): report of 2 cases and review of the literature.

Two cases of hereditary hemorrhagic telangiectasia (HHT) with neurological involvement are presented. One patient had multiple vascular malformations including telangiectasias of the brain, medulla, and spinal cord and a berry aneurysm of the internal carotid artery; she also had a large cerebellar abscess, presumably reflecting the presence of a pulmonary arteriovenous fistula. The second patient had an idiopathic subarachnoid hemorrhage. In more than 200 reported patients with HHT involving the nervous system, 61% had lesions seondary to a pulmonary arteriovenous fistula (cerebral hypoxemia, paradoxical and septic emboli, and brain abscess). The findings emphasize the need for early surgical correction of such fistulas. In 36% of the patients with neurological involvement and HHT, vascular malformations of the brain and spinal cord were documented, and in 3%, portal-systemic encephalopathy was noted. Multiple lesions were frequent. HHT should be considered a generalized vascular dysplasia (universal or systemic angiomatosis), and not simply a benign mucocutaneous disease.


Vertical oculomotor apraxia and memory loss.

A case of vertical oculomotor apraxia with severe memory loss and hypokinetic inertia is described in a 34-year-old woman who was taking oral contraceptives. The eye movement disorder was limited to paralysis of voluntary vertical saccades; pursuit movements, reflex eye movement, and horizontal saccades were normal. Random involuntary vertical saccades documented by electronystagmography qualified this as a true apraxia. Similar cases from the literature have in common involvement of both medial thalami, a localization supported in this case by distinctive abnormalities on CAT scan. The clinical course suggested acute infarction, possibly due to embolism, in a territory supplied by the thalamosubthalamic paramedian arteries.


Hemifacial spasm and the facial nucleus.

Spontaneous and associated hyperkinetic facial movements and contracture which follow injury to the seventh cranial nerve (postparalytic hemifacial spasm) or arise without known previous injury (cryptogenic hemifacial spasm) are pathological motor phenomena not found in the distribution of other cranial or somatic motor nerves. The commonly expressed hypotheses of pathogenesis--aberrant regeneration and fiber excitation by false synapse formation (ephapses) at the site of injury--cannot account for all aspects of these phenomena or for the uniqueness of such movements to the distribution of the seventh nerve. The suggestion is made that the existing diversity of facial motor behavior, which encompasses voluntary, emotional, and especially automatic, associated, and reflexive movements, is based on a unique central organization that sets it apart from other motor groups. I hypothesize that because of this organization, the changes following axonal injury--which include selective deafferentation, glial response, axonal sprouting, functional reconnection, and hyperexcitability from dendritic spike generation--can unmask and augment automatic, associated, and reflexive movements already present in the facial neuronal network to result in facial hyperkinesia.


[Acitivity of the oxidoreductases of Actinomyces levoris strain No. 28 cultured on a medium with varying redox potential values].

When the levorin-producing organism Actinomyces levoris, strain 28 was cultivated on fermentation media under conditions of decreased oxidative-reduction values, a significant decrease in the processes of the culture multiplication and antibiotic production was observed. It was shown that the marked decrease in the catalase activity accompanied by a simultaneous increase in the dehydrogenase activity was one of the causes of the decrease in the processes of the culture multiplication and levorin synthesis. Addition of potassium chloride (0.2 per cent) stimulated the catalase activity and promoted the biomass increase and to some extent the antibiotic production.


[Use of the "Steritest" apparatus for testing the sterility of antibiotic preparations].

The efficiency of determining microbial contamination of artificially infected preparations of 8 antibiotics in ampoules and bottles and erythromycin eye ointment with the use of apparatus "Steritest" and "Millipore" was compared. It was found that "Steritest" had a number of advantages as compared to "Millipore" because of elimination of operations for preparing the apparatus for the assay, which prevented contamination of the apparatus with microorganisms from the environment. The time required for the assay with the use of "Steritest" was 2 times shorter and the amount of the tioglycol medium was 2 times lower.


[Drop method of determining micrococcal and staphylococcal sensitivity to egg lysozyme].

Two methods for determination of staphylococcal and micrococcal sensitivity to lysozyme, i.e. the method of serial dilutions in agar and the drop method developed by the authors were compared. The drop method is a modification of the procedure described by Kloos et al. Close correlation between these two methods (r = 0.97 +/- 0.018) was found. The regression curve providing determination of the lysozyme MIC with the drop method was plotted. The drop method is more simple and economical as compared to the method of serial dilutions in agar. It has an advantage in testing sensitivity of single strains.


[Sensitivity of bacteria of the genus Proteus to antibiotics and their combinations].

Sensitivity of 99 Proteus strains isolated from infants with gastro-intestinal diseases was studied by the method of serial dilutions on the Ploskirev's medium with respect to 19 antibiotics and some of their pair combinations. High resistance levels were registered with respect to penicillin and semi-synthetic penicillins, such as oxacillin, methicillin, ampicillin, as well as oleandomycin, erythromycin, lincomycin and oxytetracycline. The minimum inhibitory concentration for most of the strains was at least 128 gamma/ml. The Proteus strains were more sensitive to aminoglycosides, such as monomycin, neomycin and kanamycin, as well as carbenicillin, cephalosporine, streptomycin, levomycetin, chlortetracycline and novobiocin. Rifampicin, gentamycin and ampicillin combinations with gentamycin had a pronounced antimicrobial effect on Proteus.


[Detection of plasmids in actinomycetes that produce oxytetracycline and neomycin].

Crude preparations of DNA isolated from Act. rimosus 907, an oxytetracycline-producing organism and Act. fradiae 676, a neomycin-producing organism were analyzed with electrophoresis in agarose gel followed by electron microscopic analysis of DNA isolated from the gel. It was found that Act. rimosus and Act. fradiae contained ring molecules of DNA with the molecular masses of 37 . 10(6) and 59 . 10(6) dalton respectively.


[Pharmacological properties of water-soluble levorin].

The results of the study of the pharmacological properties of the preparation of 5 per cent levorin solution in 40 per cent sodium salicylate solution are presented. The toxicity of levorin contained in the preparation was studied in the acute experiment on its intraperitoneal administration to mice. It did not differ from that of sodium levorin. In concentration of 5000 units/ml with respect to levorin the preparation did not change the motion speed of the ciliated epithelium cilia of the frog esophagus when used in the form of aerosol. Innocuousness of the preparation used repeatedly for inhalation in the form of aerosol was studied. The preparation was innocuous in the doses 12 and 24 times higher than the therapeutic ones. When applied locally on the skin and the eye conjunctiva for 16-20 days the preparation in the respective pharmaceutical forms was innocuous. Absorption and distribution of the water-soluble levorin in mice treated with the drug intraperitoneally or inhalationally was studied. It was found that levorin contained in the preparation circulated in the blood in bacteriostatic concentrations after its intraperitoneal administration for 8 hours. When used as inhalation in the form of aerosol levorin was detected in the lungs and urine and circulated in concentrations exceeding the bacteriostatic ones for 12 hours.


[Antibiotic therapy of experimental intrauterine staphylococcal infection].

The experiments on gravid rats showed that generalized staphylococcal infection in the female rats resulted in intrauterine infecting of the fetus and had a negative effect on its antenatal development: increased embryonal death rate, decreased weight gain, etc. In case of staphylococcal septicemia the amniotic waters were a peculiar reservoir of the causative agent where it accumulated in larger amounts than in the fetus tissues. Efficiency of oxacillin in daily doses of 144 and 72 mg was shown in treatment of the rat intrauterine infection. High sensitivity of the infected embryons to higher doses of the drug was found.


[Effect of proteolytic enzymes on kanamycin pharmacokinetics in experimental suppurative infection].

The effect of the proteolytic enzyme trypsin on kanamycin pharmacokinetics in rats with experimental purulent infection was studied. An increase in the kanamycin serum levels after administration of the drugs in combination was observed as compared to the control. In a dose of 0.03 mg per animal trypsin had no effect on the kanamycin pharmacokinetics in the rats with experimental peritonitis.


[Characteristics of the polysaccharide-containing somatic antigens isolated from the K-1 strain of the plague microbe and its antibiotic-resistant variants].

Immunochemical analysis of 2 polysaccharide-containing structures of the lypopolysaccharide of the plague causative agent (main somatic antigen and lipopolysaccharide) isolated from K-1 strain and a number of its antibiotic resistant mutants was carried out. It was shown that development of resistance to streptomycin alone or its combination with monomycin did not cause detectable changes in the monosaccharide composition and serological properties of the cultures tested. More significant changes associated with development of complex resistance, i.e. K-1 (Strr leads to Penr leads to Tetr) were accompanied by a decrease in the content of hexozamine and serological activity of the main somatic antigen determining the O-specificity of the lipopolysaccharide. Defective changes in the monosaccharide composition and serological properties of both the main somatic antigen and the polysaccharide were observed in the yellow variant of the streptomycin resistant mutant K-1.


[Comparative pathomorphological study of the experimental action of carminomycin and rubomycin on the heart].

Comparative histological investigation of the toxic effect of carminomycin and rubomycin on the myocardium was carried out on mice BDF. It was found that the level of the morphological changes in the heart muscle depended on the antibiotic dose. The cardiotoxic effect of carminomycin was less pronounced than that of rubomycin.


In vitro studies with UK-18,892, a new aminoglycoside antibiotic.

The antibacterial activity of UK-18,892, a new semisynthetic aminoglycoside, was examined against aminoglycoside-susceptible and aminoglycoside-resistant clinical isolates of gram-negative bacilli and Staphylococcus aureus. UK-18,892 had a similar degree of activity to those of amikacin and kanamycin A against aminoglycoside-susceptible bacteria but was less potent than gentamicin against all isolates except Providencia spp. UK-18,892 was highly active against aminoglycoside-resistant bacteria, inhibiting 93% of the 268 isolates examined at 12.5 mug/ml. Amikacin was similarly active, whereas gentamicin inhibited only 14% of these isolates at 12.5 mug/ml.


Pharmacokinetics of cefaclor in patients with end stage renal disease and during hemodialysis.

A single 1.0-g dose of cefaclor administered to patients with stable end stage renal disease whose creatinine clearances were <5 ml/min produced a mean peak serum concentration of 48.3 +/- 19.8 mug/ml. The half-life was 2.3 +/- 0.3 h. Hemodialysis shortened the half-life of a similar dose to 1.6 +/- 0.3 h. Approximately one-third (340 mg) of the administered drug was recovered in the dialysate. Multiple doses of 500 mg every 6 h between hemodialysis sessions produced effective serum concentrations and no bioassay evidence of drug accumulation.


Recovery from aminoglycoside nephrotoxicity with continued drug administration.

To examine the nephrotoxicity of prolonged gentamicin administration compared to the effect obtained when a less toxic aminoglycoside is substituted during the course of treatment, we gave gentamicin (67.5 mg/kg per day) to rats for 21 days, gentamicin for 14 days followed by either netilmicin or tobramycin for 7 days, or gentamicin for 14 days followed by saline diluent. After initial tubular, necrosis, the animals recovered from renal injury whether the drug was continued or discontinued or another drug was substituted. These data are consistent with the observation that regenerating renal epithelium is resistant to continued or additional nephrotoxic insults. These findings suggest that improvement in renal function during aminoglycoside therapy cannot necessarily be attributed to the substitution of another aminoglycoside or other therapeutic interventions.


Pharmacokinetics of cefamandole in infants and children.

In infants less than 3 months of age, the serum concentration of cefamandole during therapy was higher and more prolonged than that in children older than 1 year. A dosage of 37 mg/kg administered intravenously at 6-h intervals provided a serum concentration in excess of the minimum inhibitory concentrations of common bacterial pathogens for 4 h, and in young infants for 5 h, after dosing.


Pharmacokinetics of azlocillin in persons with normal and impaired renal functions.

The pharmacokinetics of azlocillin, a new wide-spectrum antibiotic of the N-substituted group of ureidomethyl penicillins, was investigated in 10 subjects with normal and in 32 subjects with impaired renal functions. After intravenous injection of 2 g of azlocillin, serum concentrations of drug were measured microbiologically. The half-lives of azlocillin were 47 +/- 8.8 min in patients with normal renal function, and 293.3 min in patients with severely impaired renal function. The correlation of half-life to renal functions is shown by the equation: t/2 = 425.03.Cl(In) (-0.4509), where Cl(In) is inulin clearance. The volume of distribution of the azlocillin was 17.7% of the body weight. Protein binding was similar in patients with normal renal function and in those with severely impaired renal functions. The urinary excretion rate of azlocillin in patients with normal renal function was 64.8 +/- 8.8% in 24 h.


Pharmacology of intraperitoneal cefazolin in patients undergoing peritoneal dialysis.

Cefazolin was added to dialysis fluid in nine patients with renal failure undergoing peritoneal dialysis with 2 liters/h per exchange. With 50 mg/liter (three patients), the first measurable mean serum concentration was 3.7 mug/ml (range, 2.4 to 4.9 mug/ml) after three exchanges and was 30.3 mug/ml (range, 13.3 to 44.3 mug/ml) after 24 exchanges. After 18 to 24 more exchanges without cefazolin, the mean serum concentration was 12.3 mug/ml (range, 3.8 to 24.6 mug/ml). The mean concentration in the dialysis outflow was 26.9 mug/ml (range, 2.5 to 58.5 mug/ml). With 150 mg/liter (six patients), the mean serum concentration was 5.2 mug/ml (range, 3.6 to 7.8 mug/ml) after the first exchange and 8.4 (range, 6.1 to 14.0 mug/ml), 15.0 (range, 8.2 to 23.5 mug/ml), and 71.9 (range, 26.2 to 142.1 mug/ml) mug/ml after the second, third, and twenty-fourth exchanges, respectively. After 17 to 24 more exchanges without cefazolin, the mean serum concentration was 38.2 mug/ml (range, 15.4 to 65.7 mug/ml). The mean concentration in the dialysis outflow was 71.4 mug/ml (range, 21.9 to 150.8 mug/ml). After 1 g of cefazolin was given intraperitoneally with no more dialysis, serum concentrations rose by a mean of 62.5 mug/ml (range, 18.9 to 107.8 mug/ml). The maximum rise occurred within 2 h with two-thirds of the rise occurring within 30 min. During the subsequent 22 h levels dropped to 65.4% of the peak.


Effects of hypoxemia upon aminoglycoside serum pharmacokinetics in animals.

Hypoxemia causes significant alterations in aminoglycoside serum pharmacokinetics in adult rats and newborn rabbits. The aminoglycoside serum clearances were diminished in hypoxemic animals. Comparisons of intravenous and intramuscular administration imply a delay in uptake of drug from intramuscular injection sites under hypoxemic conditions.


Partial characterization of R-plasmids from Pasteurella multocida isolated from turkeys.

Pasteurella multocida, isolated from turkeys during an outbreak of septicemic disease ("fowl cholera"), was found to be resistant to tetracycline, streptomycin, and sulfonamides. Agarose gel electrophoretic analysis of DNA from these isolates indicated the presence of extrachromosomal elements. Plasmid DNA was isolated by cesium chloride-ethidium bromide density centrifugation. Escherichia coli was transformed to antimicrobic resistance with this DNA. Two plasmids were isolated. One of these plasmids had a buoyant density of 1.7158 g/cm(3) (56.9 mol% guanine plus cytosine) and a molecular weight of 4.4 x 10(6) and conferred resistance to tetracycline, streptomycin, and sulfonamides. The other, having a buoyant density of 1.7198 g/cm(3) (61 mol% guanine plus cytosine) and a molecular weight of 3.44 x 10(6), conferred resistance to streptomycin and sulfonamides. Streptomycin resistance was mediated by streptomycin phosphotransferase. Compatibility group testing indicated that neither plasmid belonged to any of 13 compatibility groups (of conjugal plasmids). Both plasmids were also found to be compatible with three small, nonconjugative resistance plasmids.


Antimicrobial susceptibility and selection of resistance among Staphylococcus epidermidis isolates recovered from patients with infections of indwelling foreign devices.

Twenty-seven isolates of Staphylococcus epidermidis from patients with prosthetic valve endocarditis or infected cerebrospinal fluid shunts were examined for susceptibility to antimicrobial agents. Subpopulations resistant to 20 and 100 mug of methicillin per ml were present in 63% of the isolates (methicillin-resistant isolates). Subpopulations resistant to 20 mug of nafcillin and cephalothin per ml were found in every methicillin-resistant isolate but with frequencies (10(-5.0 +/- 0.5) and 10(-6.4 +/- 0.9), respectively) which were not always detectable by susceptibility testing. Resistance to >/=1.6 mug of penicillin per ml was found in 80% of isolates. Cephalothin, cefazolin, and cefamandole were more active than cefoxitin or cephradine, and gentamicin was more active than tobramycin or amikacin; rifampin was the single most active agent against all isolates. There was no difference in susceptibility between prosthetic valve endocarditis and cerebrospinal fluid shunt infection isolates. Among methicillin-resistant isolates, the phenotypic expression of resistance to methicillin or nafcillin but not to cephalothin could be enhanced by 48 h of incubation with each drug. Isolates containing no methicillin-resistant subpopulations were killed by incubation with methicillin, nafcillin, or cephalothin. High-level resistance to rifampin emerged in both methicillin-resistant and methicillin-sensitive isolates after 8 to 24 h of incubation with this drug. The presence or absence of antibiotic-resistant subpopulations among S. epidermidis isolates and their selection during treatment should be considered when therapy is devised.


Susceptibility of anaerobic bacteria to ten antimicrobial agents.

The susceptibility pattern of 265 anaerobic bacteria from clinical isolates to 10 antimicrobial agents was investigated by the agar dilution technique. Penicillin G, in a concentration of 16 mug/ml, was active against most organisms, important exceptions being 12% of Bacteroides melaninogenicus and 24% of B. fragilis strains. The susceptibility of strains to ampicillin was similar to their susceptibility to penicillin G. Carbenicillin, at </=128 mug/ml, inhibited all but a few strains. Cefamandole was less active than the penicillins; 82% of B. melaninogenicus, 32% of B. fragilis, and 75% of Fusobacterium strains were inhibited by </=16 mug/ml. A trend towards tetracycline resistance was seen in many bacterial groups, especially Bacteroides, Fusobacterium, and Clostridium. All organisms were susceptible to chloramphenicol and clindamycin in concentrations of </=16 mug/ml and </=4 mug/ml, respectively. Erythromycin was less active than clindamycin against all strains tested. Metronidazole and tinidazole were active against most anaerobes, but resistance of a few strains in each group was encountered. The increased resistance of B. melaninogenicus strains to penicillin, and emergence of anaerobes resistant to >16 mug of imidazole per ml may have therapeutic implications.


Inactivation of metronidazole by anaerobic and aerobic bacteria.

The rate of inactivation of metronidazole in vitro was determined during the course of time-kill curves against anaerobic and aerobic bacteria in the stationary phase of growth. Metronidazole at a concentration of 10 mug/ml, as measured by bioassay, was rapidly inactivated in broth culture by susceptible anaerobic bacteria (minimum bactericidal concentration </= 3 mug/ml), and this correlated closely with its bactericidal activity. In contrast, the drug was neither inactivated nor had any bactericidal activity against a resistant strain of Propionibacteriumacnes (minimum bactericidal concentration > 1,500 mug/ml). Three of four aerobic bacteria also inactivated metronidazole, although at generally slower rates than the anaerobes, but this was not associated with a bactericidal effect against these organisms. The presence of aerobic bacteria in mixed cultures with Bacteroides fragilis did not, moreover, inhibit the bactericidal activity of metronidazole against the latter organism. However, the possibility still remains that, in vivo, aerobic bacteria capable of inactivating metronidazole could inhibit the action of the drug against anaerobes in mixed infections.


Susceptibility of anaerobic bacteria to sulfamethoxazole/trimethoprim and routine susceptibility testing.

The minimal inhibitory concentrations (MICs) of sulfamethoxazole and trimethoprim against 144 strains of obligately anaerobic bacteria were determined on Diagnostic Sensitivity Test agar (Oxoid) or in prereduced Diagnostic Sensitivity Test broth, both supplemented with sodium pyruvate (1 mg/ml), hemin (5 mug/ml), and vitamin K(1) (1 mug/ml). Fifty-eight percent of the strains were susceptible to sulfamethoxazole alone (MIC </= 16 mug/ml), only 12% were susceptible to trimethoprim alone (MIC </= 1 mug/ml), and 85% were susceptible to the combination of sulfamethoxazole plus trimethoprim (MIC </= 16 mug/ml) at a ratio of 19:1. All 45 strains of the Bacteroides fragilis group were susceptible to the combination. Synergy of the combination was often observed by a checkerboard MIC determination of 123 strains, usually most markedly when the ratio of the two components was near 1:1. However, there was also synergism at the ratio of sulfamethoxazole to trimethoprim of 16:1 in 61 (53.5%) of the 114 strains that could be evaluated for synergistic activity. When the strains were tested by the broth-disk test proposed by Wilkins and Thiel, modified by using prereduced Diagnostic Sensitivity Test broth instead of brain heart infusion broth and by using a smaller inoculum, there was over 90% correlation with the MICs. Poor results were found when the broth-disk tests were performed in brain heart infusion broth. There was very poor correlation between inhibition zone diameters by an agar diffusion method and MICs.


Amphotericin B and 5-fluorocytosine: in vitro effects on lymphocyte function.

The effects of amphotericin B, 5-fluorocytosine, and the combination of both drugs on lymphocyte function in vitro were investigated. Amphotericin B, alone or in combination with 5-fluorocytosine, significantly suppressed both spontaneous lymphocyte transformation and the response of lymphocytes to stimulation with streptokinase-streptodornase. 5-Fluorocytosine had no effect on spontaneous or antigen-induced transformation. Lymphocyte responses to the mitogens phytohemagglutinin and concanavalin A were not changed by exposure to amphotericin B, 5-fluorocytosine, or the combination of both drugs. T-lymphocyte receptors for sheep erythrocytes and B-lymphocyte surface immunoglobulin and receptors for complement were not changed by treatment with amphotericin B or 5-fluorocytosine.


Pharmacokinetics of netilmicin in patients with renal impairment and in patients on dialysis.

The pharmacokinetics of netilmicin were examined in 25 adult subjects, 7 normal subjects, and 18 patients with renal impairment. Five were dialysis patients who were studied on and off dialysis. Netilmicin, 2 mg/kg, was infused intravenously over 1 h. The peak serum concentration ranged from 9 to 11 mug/ml. The mean biological half-life of netilmicin for subjects with a creatinine clearance (Ccr) > 70 ml/min was 2.7 h, for those with Ccr > 25 < 70 ml/min it was 10 h, for those with Ccr > 4 < 25 ml/min it was 32 h, and for those who were anephric it was 42 h. Ccr was correlated positively with the elimination constant and the drug's serum clearance. It was negatively correlated with the drug's volume of distribution. The dialyzer clearance of netilmicin was positively correlated with plasma flow rate and was similar to values previously reported for gentamicin. Netilmicin behaves in a fashion similar to other aminoglycosides. Therapeutic guidelines are suggested.


In vitro activity of thienamycin.

The in vitro activity of thienamycin was tested against 135 aerobic and anaerobic bacteria. The compound was highly active against resistant gram-negative bacilli and penicillin-resistant Straphylococcus aureus. The antianaerobic spectrum of the drug seemed to be comparable to that of metronidazole.


High-performance liquid chromatographic assay of chloramphenicol in serum.

A new method for the analysis of serum chloramphenicol by reversed-phase, high-performance liquid chromatography (HPLC) is described. The method involves a preliminary extraction of 0.1 ml of serum with ethyl acetate containing an internal standard, chromatography with a reversed-phase C18 microparticulate column with an acetonitrile-acetate buffer mobile phase, and detection by measuring UV absorbance at 270 nm. Assay performance was compared with an existing microbiological assay. The HPLC method demonstrated both increased precision and increased sensitivity. The specificity of the HPLC method was also evaluated. The new method presents an alternative approach to the analysis of clinical specimens.


Flavobacterium meningosepticum meningitis: report of selected aspects.

Two patients developed meningitis due to Flavobacterium meningosepticum. Because of resistance to most available antimicrobial agents, intravenous and intraventricular erythromycin was administered to one patient. Subsequent development of resistance to erythromycin prompted the use of intravenous and intraventricular rifamycin, which eventually resulted in cure. Diagnosis of F. meningosepticum meningitis in the second patient was delayed, and appropriate therapy was not administered until 4 days prior to the patient's death. Of 82 previously published cases, only 4 occurred in adults. Therapy of meningitis due to this organism has been a difficult problem, and we suggest possible modes of therapy, based on our experience and a review of the literature.


Pharmacological evaluation of cefaclor in volunteers.

The plasma and urine concentrations of cefaclor were measured after oral administration of single and multiple doses to volunteers. Cefaclor was rapidly absorbed, rapidly excreted in the urine, well tolerated without toxicity, and failed to accumulate in the plasma with chronic dosing.


Nafcillin therapy for Staphylococcus aureus endocarditis.

Semisynthetic penicillinase-resistant penicillins are recommended for therapy of Staphylococcus aureus endocarditis, but evaluation of the efficacy and safety of individual agents has received little attention. At The New York Hospital, 11 heroin addicts and 5 nonaddicts were treated with nafcillin. The 11 addicts did well clinically, but four of the five nonaddicts had severe complications, and three of them died. Important adverse reactions to nafcillin occurred in two patients: one developed leukopenia, and one developed an extensive rash. Methicillin was employed to treat two heroin addicts and four nonaddicts. Five of the six patients were cured bacteriologically, but three patients developed nephritis and one patient developed an extensive rash. Nafcillin appears to be highly efficacious for the treatment of S. aureus endocarditis, yielding results at least equal to those obtained with other drugs. Because adverse reactions appear to occur more frequently with methicillin than with nafcillin, we regard nafcillin as the preferable penicillinase-resistant penicillin for the treatment of S. aureus endocarditis.


Single-dose doxycycline for cholera.

To determine the efficacy of single-dose doxycycline in the treatment of cholera, we carried out a randomized prospective trial in 65 patients. Treatment consisted of either a single dose of 200 mg of doxycycline (or 4 mg/kg in patients less than 15 years old) or multiple doses of doxycycline, 500 mg over 4 days (or 10 mg/kg in patients less than 15 years old). There were no differences between the groups in the volumes of intravenous fluid required, volumes of diarrheal stool, or durations of diarrhea. The mean duration of positive stool cultures for Vibrio cholerae was similar for the two groups, although in both groups several patients continued to excrete Vibrios in the stool for more than 3 days. Blood levels of antibiotic demonstrated that the doxycycline was absorbed in spite of the rapid transit time associated with severe diarrhea. These results suggest that although tetracycline remains the drug of choice for cholera, doxycycline is a reasonable alternative, and that a single dose of 200 mg (4 mg/kg in children) is effective clinically.


Combined activity of minocycline and amphotericin B in vitro against medically important yeasts.

The capacity of minocycline to enhance the activity of amphotericin B against Candida albicans, Torulopsis glabrata, Cryptococcus neoformans, and non-albicans Candida was examined in vitro utilizing a time-killing curve technique. Synergism was apparent at 4 h with 5 of 5 strains of C. albicans, 8 of 8 strains of C. neoformans, and 1 of 12 strains of non-albicans Candida. Synergism was apparent at 24 h with the remaining 11 strains of non-albicans Candida and all 5 strains of T. glabrata. C. neoformans was the most susceptible of the yeasts to the minocycline-amphotericin B combination; seven strains showed a 3-log or greater reduction in colony count in 4 h and all strains showed this reduction in 24 h at amphotericin B concentrations of 0.4 mug/ml or less in the presence of minocycline.


Antimicrobial susceptibility of flavobacteria.

Antimicrobial susceptibility patterns of 28 clinical isolates of Flavobacterium sp. were determined by standard disk diffusion technique and by antimicrobial dilution in agar. Rifampin, clindamycin, trimethoprim-sulfamethoxazole, cefoxitin, and vancomycin are among the antimicrobial agents which may be clinically useful to treat infections caused by flavobacteria. All 28 isolates were resistant to erythromycin with minimal inhibitory concentrations of 32 mug/ml or more. Currently recommended interpretive zones of inhibition by disk diffusion did not reliably predict antimicrobial susceptibility of the 28 flavobacteria isolates when compared with the agar dilution technique, and, therefore, a more direct measurement of minimal inhibitory or bactericidal concentration is recommended.


In vitro susceptibility of 30 strains of Chlamydia trachomatis to rosamicin.

A total of 13 of 30 clinical isolates of Chlamydia trachomatis were susceptible in vitro to 0.01 mug of rosamicin per ml. Only two of these strains were susceptible to tetracycline or erythromycin at this level. The results suggest that rosamicin may be useful for the treatment of chlamydial urethritis.


Penetration of clindamycin into decubitus ulcers.

Forty tissue samples, primarily of skin and bone, were obtained from 29 patients undergoing excision of decubitus ulcers after intravenous injection of 600 mg of clindamycin. Antibiotic concentrations exceeded 2.5 mug/g in 80% of the samples. In 50% of the instances, tissue levels were greater than those simultaneously present in the serum.


Production of xanthomegnin and viomellein by isolates of Aspergillus ochraceus, Penicillium cyclopium, and Penicillium viridicatum.

Fungal isolates from legumes were cultured on rice and examined for production of the toxic mold metabolites xanthomegnin and viomellein. Six of 14 Aspergillus ochraceus isolates produced from 0.3 to 1.3 mg of xanthomegnin per g and 0.1 to 1.0 mg of viomellein per g. One of nine isolates of Penicillium cyclopium produced 0.1 mg of xanthomegnin per g and 0.06 mg of viomellein per g. Three of nine P. viridicatum isolates produced from 0.4 to 1.6 mg of xanthomegnin per g and 0.2 to 0.4 mg of viomellein per g. This is the first report of xanthomegnin and viomellein production by A. ochraeus and P. cyclopium.


Isolation, purification, and antibiotic activity of o-methoxycinnamaldehyde from cinnamon.

o-Methoxycinnamaldehyde has been isolated and purified from powdered cinnamon. The compound inhibits the growth and toxin production of mycotoxin-producing fungi. The substance completely inhibited the growth of Aspergillus parasiticus and A. flavus at 100 microgram/ml and A. ochraceus and A. versicolor at 200 microgram/ml. It inhibited the production of aflatoxin B1 by over 90% at 6.25 microgram/ml, ochratoxin A at 25 microgram/ml, and sterigmatocystin at 50 microgram/ml. The substance also displayed a strong inhibitory effect on the growth of five dermatophytoses species, e.g., Microsporum canis (minimum inhibitory concentration, 3.12 to 6.25 microgram/ml). However, no antibacterial effect was observed at concentrations as high as 50 microgram/ml.


Ochratoxin A: isolation and subsequent purification by high-pressure liquid chromatography.

A purification method for ochratoxin A, using liquid-liquid extractions and a final cleanup by high-pressure liquid chromatography, is described.


Increase of radiation resistance of a soil microflora exposed to long-term gamma irradiation.

Soil microflora were exposed to long-term (18 months) gamma irradiation in an open-air facility at three different doses, 15, 150, and 1,500 krads/18 months. The radiation resistance increased at all doses when compared with the radiation resistance of the microflora from soil shielded from the irradiation with a lead wall.


Purification of the protein crystal from Bacillus thuringiensis by zonal gradient centrifugation.

A method is described for the large-scale purification of the Bacillus thuringiensis protein crystal by zonal gradient centrifugation. NaBr gradients are employed in a Beckman J21-B centrifuge equipped with a JCF-Z rotor.


Results of routine tests for the detection of dispersers of Staphylococcus aureus.

This article describes the routine for the detection of dispersers in relation to the contamination of the air in operating rooms and postoperative wound infections during 1968 through 1972. Out of 3,039 persons, submitted to a dispersal test, ,22 were dispersers (4%). Staph. aureus was found in scalp hair (21.5%) and beards (15.5%). Persons with skin lesions proved to be the heaviest dispersers. After taking measures to prevent dispersers from attending, we still found 18 dispersers in operating rooms. The number of Staph. aureus showed a sharp increase during their attendance. Dispersal in the air of the operating room by 9 dispersers was the cause of 19 postoperative wound infections. Two workers in the operating room, whose dispersal tests were negative, later caused two wound infections (temporary dispersers?). A continuous checking of operating rooms by sedimentation plates is definitely necessary in combination with dispersal tests.


Tube-inlay graft for abdominal aortic aneurysms. Technique and results.

The usefulness of the tube-inlay graft technique for abdominal aortic aneurysms has been tested in 74 consecutive patients. The operative technique is described. In nearly half of the patients this technique could be used. The other patients received a conventional bifurcation prosthesis. Especially in the patient with a ruptured abdominal aortic aneurysm the tube-inlay-graft technique, because of its simplicity, shorter operating time and less blood loss is to be preferred. Since introduction of the method, the mortality in ruptured cases decreased from 46 to 24 percent.


Pes anserinus transposition after Slocum and Larson.

A description is given of pes anserinus transposition after Slocum and Larson. The anatomy, diagnosis and surgical technique are briefly dealt with. In 1974 and 1975, 27 patients were operated on as described. Follow-up included 25 patients. All had a functional, stable knee, with very marked reduction of complaints.


Lymphangiectasia of the small intestine as an acute surgical problem.

Two cases of lymphangiectasia of the small intestine in elderly women are presented. The condition manifested itself in one case by a sudden perforation of the jejunum; in the other case by ileus of the terminal ileum. In both cases the disease process pursued a relentless course that ultimately led to the death of the patients. Elective surgery in patients with lymphangiectasia has been performed before. Acute surgery of lymphangiectasia of the small intestine with complaints of acute abdomen, obstruction or perforation as presenting signs of the disease has not been described previously.


[Practical use of the Möhr and Johnson formula for calculation of ideal weight. Preliminary observations on deviations from ideal weight in a group of 1,000 Sicilian adults].

Simplification of the operations required for the calculation of ideal weight in adults in accordance with the formula of Möhr & Johnsen is suggested. Preliminary notes on a group of 500 male and 500 female Sicilians aged 18-24 following determination of the Strömgren metrical index and somatotype, ideal weight, and a variation index of differences between the real weight and the ideal weight are presented. Leptomorphs were clearly predominant, particularly among the males. Assessment of the variation index values for each subject within the different somatotypes was followed by analysis of the frequency distribution of under-, normal, and over-weight subjects. Percent frequency was noticeably asymmetrical, with marked differences between somatotypes and the sexes, though there was a clear ratio between deviation and somatotype features. The overall percent frequencies without reference to somatotype were slightly more symmetrical and lay on a leptokurtic curve.


[Experimental toxicological and pharmacodynamic studies of a triple drug association (adrenaline, atropine and papaverine) with anti-bronchospastic activity].

The antibronchospastic value of the triple association adrenaline (1) + atropine (0,3) + papaverine (3) has been documented experimentally. Comparative investigations have been carried out with isoprenaline, metaproterenol, terbutaline and salbutamol. Toxicological and pharmacodynamic studies were done in the cardiovascular system and in vitro on certain muscles.


[Chromosome changes in ascitic effusions of neoplastic origin].

A chromosome study carried out on neoplastic cells from peritoneal effusion in 19 patients is presented. Clonal and sporadic chromosomal anomalies such as aneuploidy, pseudodiploidy, markers and minutes, were observed in all the cases examined. Chromosome analysis, compared with histological study, proved more useful in the diagnosis in two cases.


[Heterotropic hepatobiliary (and intestinal) elimination of uroiodate contrast medium in patients with Lightwood-Albright nephrocalcinosis].

Incidental hepatobiliary elimination of a urophilous preparation in a subject with nephrocalcinosis is referred to in an examination of the question of heterotopic opacisation. Stress is placed on the link between this phenomenon with coincident renal insufficiency, and on the need for lengthy controls to ensure its demonstration.


[Study of the DNCB skin test in patients with solid neoplasms].

The DNCB skin test was carried out on 47 patients with solid tumours. Fifteen deaths were noted among subject displaying a negative response and in 1/24 positives. A statistically significant relation was found between negativity and several blood chemistry parameters: increased IgG, positive PCR, inversion of the A/G ratio and the fall in peripheral lymphocytes. The method employed for the test is described.


[The rheumatic index. A new electrocardiographic parameter in evaluation of rheumatic activity].

A new index for the diagnosis of rheumatic activity by ECG is presented. By this method the TP/PQ ratio is considered and when lower than 1.10, it is significant for rheumatic activity. The results have been statistically processed by the T (Student) and the U tests, and highly significant.


[Chromosome changes in peripheral lymphocytes of patients with neoplasms not previously treated].

Changes in lymphocyte karyotype were noted in subjects with various forms of untreated cancer. Normalisation of the karyotype occurred within two months after removal of the tumour in 40% of cases. Since little is known about the genic background of lymphocytes in the presence of untreated neoplasia, it is felt that alteration of the peripheral karyotype can probably be ascribed to meiopragia closely linked to the fall in immunological surveillance, itself of considerable importance in the complicated problem of the origin of tumours.


Neurological abnormalities in patients treated for hypothyroidism from early life.

Neurological and psycholocial assessment was carried out on 30 patients aged 2.7 to 21 years (mean 9.4) who were being treated for hypothyroidism starting before the age of 2 years. Their IQ scores lay in the normal range (71--122; mean 92.4) but 77% showed at least one sign of impaired brain function. Clumsiness was found in 33%, behaviour disorders in 23%, speech disorders in 20%, learning disorders in 26%, squint in 53%, nystagmus in 10%, and minor motor disorders in 50%. Many showed several of these features and hypothyroidism in early life appears to lead to widespeard impairment of brain function. These neurological findings were equally common in patients in whom treatment started between 4 and 10 weeks of age and patients treated after 10 weeks, suggesting that early detection of hypothyroidism by neonatal screening may be of limited benefit. Children who have been hypothyroid in early infancy require careful assessment to prevent further visual, emotional, scholastic, or vocational difficulties.


[Current trends in drug therapy of cerebral ictus].

The following protocol was used in the management of 25 hospitalised patients with acute cerebrovascular episodes: 4 vials Hydergine per day (slow venous drip) during the entire stay in hospital, with glycerol, diuretics, papaverine, cituridine, etc., during the initial period. Good results were noted in 18 cases (72%), including complete or nearly complete recovery of mobility and marked improvement of the entire clinical picture. A modest result was obtained in 4 cases and a fair result in one. Two subjects died, one from cardiographic shock and the other from supravening deep coma. It is considered that the protocol described is definitely useful in the medical treatment of cerebral ictus.


Clinicopathological findings in patients with primary and secondary defects of neutrophil mobility.

Twenty-eight patients with defective neutrophil mobility were classified, largely on results of parent values, into primary (17)--mainly Shwachman's syndrome--and probable secondary (11). They presented with frequent infections and/or allergy and these symptoms were essentially similar in both groups. Neutropenia was virtually confined.  to the patients with Shwachman's syndrome. Diagnoses associated with secondary neutrophil mobility defects included hydrocephalus with shunt, cystic fibrosis, and immunoglobulin deficiency. The neutrophil mobility of nearly nearly all the patients studied increased when levamisole was added in vitro, but there was no clear evidence of clinical benefit when patients were given the drug.


[An unusual case of the coup-de-fouet syndrome. Eutrophic and cicatrizant effect of a preparation with a taurine base].

An unusual case of "pedrada" sindrome is presented. Skin ulcers were observed as late and persistent sequelae on the affected limb. This finding appeared to have no precedent in the literature. New suggestions are made with regard to the cause of the syndrome and excellent results obtained with a taurine preparation are reported. Prophylactic administration of taurine in the management of this syndrome is proposed.


Acute inflammatory bowel disease in childbood: a new disease?

Three children aged between 7 and 11 years, after an acute onset of diarrhoea and vomiting, developed protracted diarrhoea and severe loss of weight. None had been abroad. No significant aetiological agent was found. There was evidence of acute inflammatory disease on proximal small intestinal biopsy, and some evidence of more widespread gut involvement--of the rectum in Cases 1 and 2, and the terminal ileum in Cases 2 and 3. The disease resolved spontaneously and without relapse.


Proctosigmoiditis and coeliac disease.

Of 80 children with proved coeliac disease, 2 presented with an associated disease of the distal portion of the large intestine. In one child the family history and the extension, localisation, and characteristics of intestinal lesions made us suspect ulcerative colitis; in the other we made a diagnosis of milk-induced colitis.


Evaluation of the Sheffield system for identifying children at risk from unexpected death in infancy. Results from Birmingham and Newcastle upon Tyne.

The "at birth" system which is used in Sheffield to identify children likely to die unexpectedly in infancy, was tested retrospectively in Birmingham (83 cases) and in Newcastle upon Tyne (56 cases). The discrimination between cases and age-matched controls was poor in both cities. Analysis of the 8 factors used in the system showed that only 2 maintained significant case/control differences in Birmingham and Newcastle. Further investigation showed that other factors from maternity records showed significant case/control differences in these cities. Although the system used in Sheffield would not be of use in a prospective prevention programme in either Newcastle or Birmingham, the possibility of evolving an "at risk" system which might apply more widely is discussed.


Students' assessment of paediatric teaching and their opinions 7 years later.

A prospective study of the long-term validity of student assessment of paediatric teaching began during the period 1968--70. The students gave scores to the different parts of the course in a standard questionnaire. Between 6 and 8 years later the same students were given the same questionnaire to complete. 76 of the original 92 students responded. By this time most of them  were either principals in general practice, or senior registrars or consultants in hospital medicine. The 18 items in the paediatric course were given remarkably similar scores in the two questionnaires, and the popularity ratings of only 2 items had altered significantly during the 7-year interval. The doctor 6--8 years after the course seems more likely to appreciate the need for teaching about communication skills.


Alternating hemiplegia: complicated migraine of infancy.

Alternating hemiplegia in children is a rare form of "complicated" migraine. There are a number of similarities to seizure disorders and correct diagnosis may prove difficult. The clinical features of 6 patients with alternating hemiplegia are presented together with the results of electrophysiological, radiological, and biochemical studies. While there were a number of clinical similarities between the patients, extensive investigations failed to demonstrate significant abnormalities. Although a diagnosis of a seizure disorder was suggested at some time in all of the patients, in only 2 was it certain there was a fit. Headaches occurred in the eldest patient (although not always with a hemiplegic attach) while in the younger patients misery often accompanied their attacks. Intellectual status was impaired in 5 patients, although in 2 of these the cause was most likely to be perinatal difficulties. Response to various forms of treatment was generally not encouraging and concern is expressed that this alternating hemiplegia of childhood may carry an unfavourable prognosis.


Familial syndrome with panhypopituitarism, hypoplasia of the hypophysis, and poorly developed sella turcica.

Two sisters who died at the age of 2.5 years and 5 weeks are described. Both showed signs of panhypopituitarism. At necropsy, no hypophysis could be found in the first child and a rudimentary and partly ectopic hypophysis was found in the other. Both children had a flat, poorly developed sella turcica, and the sellar anomaly could be seen in skull x-rays. These patients represent a hereditary syndrome characterised by neonatal panhypopituitarism, hypoplasia of the pituitary gland, and flat sella turcica.


Concealed pre-excitation causing paroxysmal reciprocating atrioventricular tachycardia in infancy.

We report 3 infants with Wolff-Parkinson-White (WPW) syndrome who presented with life-threatening paroxysmal reciprocating atrioventricular tachycardia in their first month of life. The diagnosis was confirmed by electrophysiological studies at ages 2--4 years, but the characteristic ECG of pre-excitation has not been shown in one patient and was first recorded at 2 and 3 years in the other two. In 2 patients the tachycardia proved refractory to treatment with digoxin alone but responded to the addition of propranalol or verapamil. One of these infants was converted to sinus rhythm by DC countershock, giving time to reconsider his treatment with drugs. Digoxin is a well-tried treatment acting by slowing AV conduction and interrupting the re-entry circuit. However, it may act more slowly than other agents that act on the AV node--such as intravenous verapamil. Our patients illustrate the value of long follow-up as the diagnosis of WPW syndrome could not be made in infancy. Many infants who present with paroxysmal supraventricular tachycardia in infancy may have an inapparent bypass and be examples of the WPW syndrome.


Tetrahydrobiopterin therapy of atypical phenylketonuria due to defective dihydrobiopterin biosynthesis.

A patient with atypical phenylketonuria (defective BH2 synthesis), detected at age 6 months because of severe muscle hypotonia and serum phenylalanine of 20 mg/100 ml, had normal activities of phenylalanine-4-hydroxylase and DHPR in liver biopsy, but only 2% activity in the phenylalanine-4-hyroxylase in vivo test using deuterated phenylalanine. After IV administration of 2.5 mg/kg chemically pure tetrahydrobiopterin bishydrochloride (BH4 . 2HCl), serum phenylalanine decreased from 20.4 to 2.1 mg/100 ml within 3 hours. Administration of 25 mg BH4 . HCl and 100 mg ascorbic acid through a gastric tube decrease; serum phenylalanine from 13.7 to less than 1.6 mg/100 ml within 3 hours and it remained less than 2 mg/100 ml for 2 days.


Diagnosis of phaeochromocytoma after ingestion of imipramine.

An 11-year-old twin girl was admitted to hospital with a 24-hour history of profuse sweating, tachycardia, and hypertension after a single dose of imipramine. She was subsequently found to have a right adrenal phaeochromocytoma. To our knowledge, this is the first reported case of tumour provocation by imipramine.


Sucrase-isomaltase deficiency. A follow-up report.

Nine children with sucrase-isomaltase deficiency were assessed up to 10 years after diagnosis. All children continued to have episodes of diarrhoea associated with sucrose ingestion. Sucrose tolerance tests showed that malabsorption of sucrose persists into adolescence. Three older patients were unaware of their condition and were eating normal diets with unrestricted amounts of sucrose. They complained of gastrointestinal symptoms which improved after sucrose restriction.


Infantile spasms and HLA antigens.

21 new cases of infantile spasms were reported in 1976 from paediatric departments in Denmark. The connection between infantile spasms and the Lennox-Gastaut syndrome is mentioned, because of reports of a significantly higher incidence of HLA-B7 in children with Lennox-Gastaut syndrome. The HLA antigen distribution in 19 of the 21 children was compared with that of 1967 healthy adults. No difference in the HLA antigens was demonstrated between children with infantile spasms and controls, whether in the material as a whole, or in the cryptogenic or symptomatic groups. However HLA typing of children with infantile spasms should continue in the search for a potential genetic marker in this grave disease, particularly in view of the reported high incidence of HLA-B7 in children with the Lennox-Gastaut syndrome.


Familial neurodegenerative disorder associated with raised urinary vanillylmandelic acid.

We report a child who presented with a progressive neurological disorder associated with hypertension and paroxysms of irritability and sweating in whom an abnormality of catecholamine metabolism or excretion was demonstrated. An elder sister died at the age of 2 1/2 years with similar clinical symptoms but without blood pressure or catecholamine excretion being recorded. The exact mechanism of the disturbance of catecholamine excretion was not identified in our patient but some slight improvement in hypertension and arrest of his neurological deterioration was noted when he was put on a low tyramine diet. It is suggested that our patient may well suffer from a familial neurodegenerative disorder in which an abnormality of catecholamine metabolism or excretion is a feature.


Effects of long-term tobacco smoke exposure on whole blood viscosity in the rat.

The purpose of this study was to determine the effect of long-term tobacco smoke administration to rats on whole blood viscosity. Blood samples obtained from rats that had been administered tobacco smoke daily for a period of 10 wk and samples from normal cage control rats were placed in a cone-plate viscometer. Whole blood viscosities were measured at shear rates ranging from 23 to 230/sec. At every shear rate tested, blood viscosity from the smoke-treated animals was significantly higher than corresponding viscosities from the control rats. It is concluded that chronic tobacco smoke administration to rats increases the viscosity of whole blood, both at high shear rates where blood behaves rheologically as a Newtonian fluid and at low shear rates where blood displays non-Newtonian properties.


Family operational co-factors in the epidemiology of childhood lead poisoning.

A large-scale data base was derived from the New Haven Connecticut Childhood Lead Poisoning Prevention and Control Program. A subset of 918 children was examined to explore the associations of blood lead levels in these children and four family operational factors. Elevated lead in the children was positively associated with: (a) larger numbers of children under 6 yr in the family; (b) fewer parents at home; (c) fewer parents employed; and (d) lack of day care. Additional environmental, demographic, and socioeconomic factors in childhood lead poisoning and its control are under study.


Carbon monoxide exposure and auditory duration discrimination.

Two young adults performed an auditory duration discrimination task while sitting in an open office (i.e., without sensory isolation). The percentage of errors rose when carboxyhemoglobin (HbCO) readings of 3.2% or 4.7% were produced by a rebreathing method; there was a parallel but statistically insignificant trend at 2.0% HbCO. Analysis of the data by psychophysical measures, however, showed no significant changes of difference threshold, criterion value, or point of subjective equality. After the tape was rearranged to meet criteria of a constant interval, a balanced order of presentation, and psychological rather than physical equality of tone length, eight young adults performed the task better in an isolation booth than in an open office, scores in both situations being unaffected by increases of HbCO to greater than 8%. Further trials with five young adults compared responses before and after administration of 80 ml of CO (HbCO 4.92%); again, no effect of carbon monoxide was seen relative to control experiments. The error score of nonsmoking young adults can be increased by a level of HbCO as low as 3.2%. The likelihood of such a response, however, is markedly influenced by task difficulty, environment, and the arousal of the subjects. Furthermore, the nature of the functional disturbance remains uncertain; psychophysical measures show no significant impairment of auditory duration discrimination.


Effects of low levels of lead exposure on cognitive function--a review.

The relationship between low levels of lead and cognitive functioning in animals is reviewed. The data suggest that within animals lead can produce a massive disruption of learning ability while not affecting either morbidity or mortality. Concentration of lead appears to insidiously cause damage to learning function where extremely low doses disrupt the hard-to-measure higher levels of cognitive function. It is concluded that the current standards of lead concentration should be reappraised in terms of measures of damage to cognitive learning.


Sensory irritation of select experimental photochemical oxidants.

Groups of male Swiss-Webster mice were exposed to photochemical oxidant mixtures generated by reacting various hydrocarbons with nitrogen dioxide in the presence of ultraviolet light while their respiratory rates were monitored. The hydrocarbons used were 1,3-butadiene, 1-butene, cis-2-butene, ethylene, propylene, n-butane, and ethane. The initial hydrocarbon concentrations ranged from .4 to 18 ppm, with the initial nitrogen dioxide concentration being one-third that of the initial hydrocarbon concentration. New groups (four mice per group) were exposed for 5 min at 0, 1, 2, 3, and 4 hr of ultraviolet irradiation. Dose-response curves for each hydrocarbon were developed by plotting the maximum percent decrease in respiratory rate observed during the 4 hr of irradiation of each mixture as a function of the initial hydrocarbon concentration present. The percent decrease in respiratory rate in mice was chosen as an index of the sensory irritation of the upper respiratory tract for each mixture. The results showed that the potency of the photochemical oxidant mixtures generated from the hydrocarbons to be propylene greater than 1,3,-butadiene = 1-butene=cis-2-butene greater than ethylene. When ethane or n-butane was used, no decrease in respiratory rate was observed. These results are compatible with the data obtained in human volunteer studies. Guidelines for relating the  percent decrease in respiratory rate in mice to human reactions are presented.


Exposure to dust-borne bacteria in agriculture. I. Environmental studies.

In order to evaluate the exposure of agricultural workers to dust-borne bacteria, microbiological examinations of the air were performed in grain storing and processing plants and in animal houses. Large concentrations of viable microorganisms, ranging from 129.2 to 1289.9 thousands/m3 of air, were found in the rooms contaminated with grain dust and much lower in those contaminated with flour dust (22.6 thousands/m3). Bacteria predominated in the air of grain plants, whereas actinomycetes and fungi were less numerous. The most abundant bacteria were Gram negative rods of the species Erwinia herbicola. Large concentrations of air-borne microorganisms were also found in different animal farms, reaching 225.5 to 595.4 thousands/m3 in hatcheries and 7751.5 thousands/m3 in a broiler house. Staphylococci were most frequently isolated and other common organisms were Corynebacteria and Streptococci. It was concluded that high exposure to dust-borne bacteria creates a hazard to agricultural workers.


Plasma cholinesterase activity in early pregnancy.

A significant fall in plasma cholinesterase activity was observed in six healthy young women in the first 3 months of normal pregnancy. There was some evidence of return to normal pre-pregnancy levels in later pregnancy. No hypothesis is suggested to account for this phenomenon, although it seems possible that it may be the result of altered liver enzyme synthesis.


[Sudden death in the long term development of ischemic cardiopathy].

During five years or until death, we had under observation 74 patients who survived the acute phase of myocardial infarction, 66 patients with angor inestable, and a third group, also of 66 patients of the coronary unit, but whose cases didn't show evidence of their illness being due to myocardial infarction. The general features were similar in the three groups. The patients outliving myocardial infarction reached 69%; those surviving angor inestable, reached 79%, and the survivors of the no-coronary group, 92.5%. There were not significant differences among the three groups in mortality rate due to non cardial illnesses. The differences are in relation with sudden death; in the first groups, 14.8%, 10.6% in the second group, and only 1.5% in the third one. In the coronary groups half the total mortality was due to sudden death. Death was instantaneous in 26% of the cases and 52% occurred in less than two hours. All of these sudden deaths occurred out of the Hospital. Patients with antecedents of previous myocardial infarction showed from 3 to 6 more sudden deaths than those patients suffering a first myocardial infarction. The myocardial infarction patients who developed cardiomegaly afterwards registered two and a half more sudden deaths than those without cardiomegaly. Differences were highly significant; 28.5% sudden deaths in those patients with cardiomegaly and 8.4% in patients without cardiomegaly. These results show that the higher rate of sudden deaths is due to a more extensive myocardial damage. Arterial hypertension also constitutes and important risk of sudden death, even when it is properly controlled after the acute period.


[Exercise test and differential diagnosis of fetal arrhythmia].

The cases here reported show in the first place that external fetal ECG is useful to detect fetal distress and should therefore be included as a prenatal control from the second trimester of pregnancy on, specially in cases where there is a past history of fetal death of unknown origin, or a family history of congenital heart defects. A fetal tolerance test to exercise should also be done in those cases with a past history of fetal death, distress or whenever chronic fetal distress may be suspected to take place because of the presence of maternal pathology (endocrine, cardiovascular, or infectious diseases, etc.). Fetal tolerance test to uterine contractions should also be done whenever possible to evaluate the tolerance of these fetuses to uterine contractility during labor. More studies are needed to establish standard guides of this method for the practical obstetrical management of products of high risk pregnancies.


[Arterial hypertension in adolescents].

The clinical cases of 391 men and 609 women, adolescent all of them, are included in this study. T.A. values were obtained by the Korotkoff method and the lower figures in both measurements analized. The mean value for the men's cases were 112/72/67 and for the women's cases 105/71/67 respectively for K1, K4 and K5. The difference between the sistolic pressures is significant. Taking the mean men and 126/89/86 for the women. Such values might represent the higher values plus two standard derivations it was possible to obtain 139/92/88 for the normal limit. At higher values we found K1 at 1% for men and 10% for women; K4 at 1.2% for men and 5.7% for women; for K5 at 1.1% for men and 2.2% for women. There is a direct relation between obesity and higher figures in T.A. for K1 and K4 in both sexes (p.0.01). The use of too much salt influenced the coming up of K4 to (p.0.01).


Effects of glucose and some oral hypoglycemic agents upon the plasma glucose and immuno-reactive insulin (IRI) in normal and streptozotocin induced diabetic rat.

An investigation has been made to see the effect of oral hypoglycemic agants on the blood sugar (BS) and plasma Immuno-Reactive Insulin (IRI) in normal and streptozotocin diabetic rats. Plasma IRI was significantly reduced in a streptozotocin treated diabetic rat 8 weeks after streptozotocin injection. In normal rats oral administration of Sodium tolbutamide (TOL) and Glybenclamide (GLI) produced a significant fall in BS and a concurrent increase in plasma IRI, but phenformin (PHE) was without any effect on both these parameters. Unlike normal rats streptozotocin treated diabetic rats did not show lowering of BS and increase in plasma IRI following TOL and GLI. PHE, however, did produce a significant fall in BS. Oral glucose load did show a typical glucose tolerance curve and insulin release in normal rats. However, in the diabetic rats there was no significant increase in plasma IRI following glucose load. It is therefore concluded that streptozotocin treated diabetic rats differ from the maturity onset diabetic as regards the responses of TOL and GLI are concerned and this animal model can therefore be useful in differentiating the two types of oral hypoglycemic agents.


[Calculation of the arterial pulmonary pressure by using phonomechanocardiography. Correlation with the measurement by catheterization].

We are presenting a phonomechanographic study for the calculation of sytolic pressure of the pulmonary artery, following the method proposed by Burstin & Fishleder. Correlation is made of 287 patients with the pressure obtained from the registration of direct-catheterism in the pulmonary artery. We insist on the advantages of this method such as quicker accomplishment, easier calculation and harmless for the patient, and we are analyzing some of the physiologic mechanisms which participate in the calculation of the pulmonary systolic pressure. We concluded that it is a reliable method of a high degree of correlation uith the hemodynamic research, specially when both studies are contemporary.


Transport interaction phenomena between monoquaternary and polymethylene-bisquaternary amines in mouse kidney cortex slices.

The polymethylene-bisquaternary amine 14C-decamethonium accumulates in mouse kidney cortex slices incubated in Krebs-Ringer bicarbonate buffer (37 degrees C, pH 7.4) aerated with O2-CO2 95:5 v/v%. The accumulation rate was enhanced in the presence of monoquaternary amines which on the other hand depressed maximum accumulation ratio of decamethonium in the tissue. The stimulation phenomenon was apparently related to the intracellular concentration of monoquaternary amine since tissue preloaded with a monoquaternary amine took up decamethonium at an increased rate. This effect was due to an accelerated influx of decamethonium and not to inhibition of efflux since no decamethonium efflux was shown to occur in wash-out experiments. Flux stimulation may represent an interaction phenomenon of accelerative exchange diffusion type. Furthermore, various amines inhibited accumulation of decamethonium in a competitive manner. The study supports the idea that common steps are involved in cellular transport of monoquaternary and polymethylene-bisquaternary amines in the kidney.