Regulation of carbohydrate uptake and adenylate cyclase activity mediated by the enzymes II of the phosphoenolpyruvate: sugar phosphotransferase system in Escherichia coli.

The uptake of various carbohydrates and the synthesis of adenosine 3':5'-monophosphate (cyclic AMP) are subject to inhibition by sugar substrates of the phosphoenolpyruvate:sugar phosphotransferase system in Escherichia coli. The induced synthesis of the sugar-specific components of the phosphotransferase system was studied and correlated with the induction of regulatory interactions controlling glycerol uptake and net cyclic AMP synthesis. Activities of the Enzyme II complexes specific for glucose, fructose, and mannitol were measured both in vivo and in vitro. These activities were induced 8- to 40-fold by growth in the presence of the appropriate substrate-inducers. Cross inducer specificities were noted. Maximal inhibition of glycerol uptake and cyclic AMP synthesis by a sugar substrate of the phosphotransferase system required induction of the Enzyme II complex specific for that sugar and was abolished by mutations which destroyed Enzyme II activity. The inducer specificities of the regulatory systems and of the Enzymes II were found to be the same. A mutation which depressed the cellular activity of Enzyme I of the phosphotransferase system did not relieve sensitivity to inhibition. The results suggest that adenylate cyclase and several carbohydrate permeases are subject to coordinate regulation by a mechanism which depends on the catalytic activities of the protein components of the phosphotransferase system.


Syntheses of elongation factors Tu and G are under stringent control in Escherichia coli.

We have compared the synthesis of the elongation factors Tu and G at 30 and 36.5 degrees in three strains of Escherichia coli: NF314 (rel+valS+), NF536 (rel+valSts), and NF537 (rel-valSts). At the elevated temperature, the latter two strains continue to grow but suffer a partial deprivation of valyl-tRNA. As a consequence, the syntheses of stable RNA, Tu, and G are decreased in NF536; the syntheses of stable RNA, Tu, and G are increased in NF537. These results indicate that the syntheses of Tu and G are directly or indirectly under the influence of the rel gene.


Effect of estrogen on gene expression in the chick oviduct. Kinetics of initiation of in vitro transcription on chromatin.

The kinetics of initiation of in vitro RNA synthesis by Escherichia coli RNA polymerase on the chromatin template of chick oviduct was examined and compared to initiation on the template of deproteinized chick DNA. The formation of rapidly starting, highly stable binary complexes (RS complexes) between RNA polymerase and chromatin was an apparent first order process with a half-time (t1/2) of 9.4 min. By contrast, the t1/2 of formation of RS complex on chick DNA was 1.3 min. The apparent first order rate constants of RNA chain initiation from performed RS complexes were 0.57 s-1 for chromatin and 0.98 s-1 for DNA. Thus, although the formation of RS complex on chromatin was much slower than on DNA, the actual rate of RNA chain initiation on chromatin was similar to that on DNA. The effects of temperature on the formation of RS complex were examined. On chick DNA, both the rate of formation and the amount of RS complex formed decreased as the temperature of preincubation was lowered from 37 degrees to 0 degrees. On chromatin, the t1/2 of formation of RS complex was independent of temperature, and the amount of complex formed was only slightly affected at changing, temperatures. The kinetics of initiation on chromatin is consistent with the hypothesis that the rate-limiting step in the formation of RS complex is dissociation of RNA polymerase from nonspecific interaction with chromosomal proteins. Furthermore, chromosomal proteins seem to interact with initiation sites to facilitate the opening of the DNA strands required for RS complex formation.


The site of ribosome degradation in starved Escherichia coli cells.

An attempt was made, in starved Escherichia coli cells, to locate the site at which the process of ribosome degradation is initiated. Supernatant and rapidly sedimenting pellet fractions from exponentially growing and from carbon-starved cells were prepared, and the ribonucleic acids from these fractions were seperated by polyacrylamide electrophoresis and quantitated. The data indicated that 23 S, 16 S, and 5 S RNA are lost only from the pellet; and also that the low molecular weight RNA degradation products are confined to this fraction. Ribosomes from supernatant and pellet fractions were seperated on sucrose density gradients. The sedimentation profiles obtained indicated that pellet fractions of starved cells contain for the most part 50 S and 30 S subunits, whereas 70 S monosomes were most abundant in the supernatant fraction. In vitro measurements on RNA degradation in supernatant and rapidly sedimenting pellet fractions confirmed the in vivo data on the exclusive degradation of ribosomal RNA in the pellet. Based on these data and on previous observations, we suggest that the endoribonucleolytic attack which triggers ribosome degradation, occurs in free subunits attached to the rapidly sedimenting membrane fraction. Subsequently, the ribosome falls apart, and the small RNA pieces generated remain attached to the pellet fraction until their final degradation by the exonuclease.


Kinetic studies of inducer binding to lactose repressor protein.

The kinetics of binding of the inducer, isopropyl-beta, D-thiogalactoside to lactose repressor from Escherichia coli was studied by stopped flow rapid mixing techniques. Three different spectral probes for measuring changes in the conformation of the repressor were used: ultraviolet absorbance, fluorescence, and a reporter group, 2-mercuri-4-nitrophenol, in the visible region. Repressor can be reacted with this mercurial to modify two of the three free sulfhydryl groups per monomer without loss of inducer or operator binding activities. The observed first order rate constant for the reaction of repressor with 2-chloromercuri-4-nitrophenol at pH 7.5 and 20 degrees was found to be on the order of 0.1 s-1, an unexpectedly slow rate for this type of reaction. Once bound to repressor, the nitrophenol serves as a chromophoric probe to monitor changes in the surrounding environment. The binding of inducer to repressor causes a change in the absorbance of the bound 2-mercuri-4-nitrophenol moiety and exhibits a second order rate of 3.2 x 10(4) M-1 s-1. Similar rates were obtained when binding of inducer is monitored by changes in either the ultraviolet absorbance of fluorescence of tryptophan residues. Since the same rate of spectral perturbation is observed for different regions of the primary structure of the protein, the conformational change produced in response to inducer binding appears to be translated rapidly throughout the protein molecule.


Superoxide dismutase. Reversible removal of manganese and its substitution by cobalt, nickel or zinc.

The maganese-containing superoxide dismutase, from Escherichia coli, lost metal and activity when dialyzed against 20 mM-8-hydroxyquinoline and 2.5 M guanidinium chloride in 5 mM Tris-chloride buffer at pH 7.8. Subsequent dialysis against 0.01 m M McCl2, in this buffer, caused a restoration of manganese and activity. Reconstituted enzyme appeared identical with native enzyme, and removal and restoration of manganese could be repeated. Co (II), Zn(II), Ni(II), Mg(II), Cr (II), Cu(II), Fe(II), In(II), and Mo(VI), were tested for their abiltiy to replace manganese. None of these restored activity to apoenzyme. When present at a 100-fold molar excess over manganese only Co(II), Ni(II), and Zn(II) were effective as competitors of manganese. Co(II) was demonstrated to be tightly bound to the apoenzyme in place of the magnasese, with a stoichiometry of 1 Co(II) per molecule. In the cases of Co(II), Zn(II), or Ni(II), reconstituted enzyme; the metals could be removed and subsequently replaced by manganese, with restoration of catalytic activity. None of these metal cations exhibited superoxide dismutase activity. We conclude that manganese is essential for the catalytic activity of superoxide dismutase, and that the site which normally binds manganese can accommodate Co(II), Ni(II), and Zn(II).


Isolation and characterization of large transfer ribonucleic acid precursors from Escherichia coli.

Several transfer RNA precursors which accumulate in a strain of Escherichia coli temperature-sensitive for RNase P have been described. These precursors range from 135 to 690 nucleotides in length. Their tRNA content has been determined by digestion of the precursors to 4 S RNA, followed by Sanger fingerprint analysis of the purified 4 S material. Identification of some of these tRNAs, as well as an estimate of the number of copies of tRNA in each precursor has been achieved. Many of these precursor RNA molecules contain multiple copies of the same tRNA sequence, indicating a tandem arrangement of the corresponding tRNA genes in the E. coli genome.


Selective chemical modification of Escherichia coli elongation factor G. N-Ethylmaleimide modification of a cysteine essential for nucleotide binding.

Escherichia coli Elongation Factor G is inhibited ireversibly by the chemical modification of 1 cysteine residue with N-ethylmaleimide. At pH 5.2, this cysteine is approximately 130 times more reactive than beta-mercaptoethanol toward N-ethylmaleimide. Inhibition is not prevented by either the ribosome or GTP alone at concentrations approximately equal to that of Elongation Factor G, but in combination they reduce the inhibition by 50%. Increasing the stability of the Elongation Factor G-ribosome-GDP complex by the addition of fusidec acid, completely protects against N-ethylmaleimide inhibition. The modified protein cannot form either the Elongation Factor G-ribosome-GMP-P(CH2)P or the Elongation Factor G-ribosome-GDP-fusidic acidcomplex. However, the modification had no effect on its ability to form the Elongation Factor G-ribosome complex. These results suggest that the cysteine residue modified by N-ethylmaleimide is at or near the nucleotide binding site.


Properties of anthranilate synthetase component II from Pseudomonas putida.

The interaction of Pseudomanas putida anthranilate synthetase Component II (AS II) with glutamine, glutamine analogs, and iodoacetamide has been investigated in order to clarify the initial steps in the mechanism for glutamine utilization. AS II is alkylated and irreversibly inactivated by covalent attachment of approximately 1 eg of L-2-amino-4-oxo-5-chloropentanoic acid (chloroketone) or 1 eq of iodoacetamide. Alkylation of AS II by chloroketone involves initial formation of an enzyme-inhibitor complex having a Ki of 28 muM. Alkylation of AS II by iodoacetamide occurs without initial formation of a reversible complex. In both cases glutamine protects against alkylation and exhibits competitive kinetics. When anthranilate synthetase Component I (AS I) is associated with AS II, the second substrate, chorismate, enhances alkylation of AS II by chloroketone. Alkylation of AS II by iodoacetamide is unaffected by AS I and chorismate. These results suggest a role of chorismate-AS I complex to promote binding of glutamine to AS II or to facilitate conversion of an AS II-glutamine complex to the covalent glutamyl-AS II intermediate. This conclusion is supported by the fact that glutaminase activity of AS II, which requires formation of the glutamyl-AS II intermediate, is stimulated by AS I and chorismate.


Instability of the metacarpophalangeal joint of the thumb. Reconstruction of the collateral ligaments using the extensor pollicis brevis tendon.

Reconstruction of the collateral ligaments of the metacarpophalangeal joint of the thumb was performed for fourteen ruptures of the ulnar and two ruptures of the radial collateral ligament, one to eighteen months after injury. The extensor pollicis brevis tendon was used to reinforce the resutured ligament. Symptoms were relieved in all cases after follow-ups ranging from one to seven years, even in two thumbs with mild degenerative arthritis of the metacarpophalangeal joint.


The orthopaedic aspects of spinal muscular atrophy.

To clarify the role of the orthopaedic surgeon in the management of spinal muscular atrophy, the records of 130 patients were reviewed. Seventy-three had died. Of the remaining fifty-seven, fifty were re-examined. The clinical manifestations of the disease, particularly those giving rise to orthopaedic problems, were studied. At the time of review the average age of the patients was 11.5 years. Thirty-five could not walk and all had some degree of muscle weakness, more marked proximally and in the lower limbs. The most common medical problem was repeated respiratory infection and the major orthopaedic problem was scoliosis, often severe. Nine of the thirty-five patients with scoliosis had had spine fusion. Most of them suffered some functional loss in attaining spinal stability.


The effect of polymethylmethacrylate and antibiotic combinations on bacterial viability. An in vitro and preliminary in vivo study.

Polymethylmethacrylate itself has a slight, long-term bacteriostatic effect on the growth of staphylococci, but while polymerizing the heat of polymerization and possibly the elaboration of monomer can be bactericidal to many pathogenic organisms. Twelve antibiotics incorporated into polymethylmethacrylate cement retained their antibacterial activity for long periods in dry storage, but the antibiotics leached out of polymethylmethacrylate quite rapidly in vitro and in vivo. No antibiotic could be found after thirty-seven days in treated cement pellets placed in a rabbit thigh.


Immunohistochemical localization of alpha-amylase in barley aleurone cells.

Alpha-Amylase was localized in aleurone cells of barley using immunohistochemical methods. Anti-alpha-amylase antibody was produced by rabbits immunized with enzyme purified from malt diastase and Himalaya variety barley seeds. Immunoelectrophoresis showed that the antibodies to both antigens were immunologically similar, therefore, they were used interchangeably in the localization of alpha-amylase. Fluorescence of 8-10 mum sections of freeze-substituted and paraffin embedded, gibberellic acid (GA)-treated aleurone tissue incubated with rabbit anti-alpha-amylase IgG and rhodamine-conjugated goat-anti-rabbit IgG is localized in the cytoplasm, the nuclear region and the innermost portion of the cell wall. Cytoplasmic immunofluorescence is not associated with a specific organelle but rather is diffusely distributed. The fluorescence of the nuclear region, however, is intense and in thinner (4-5 mum) sections is associated not with the nucleoplasm but with the nuclear envelope and perinuclear region of the cytoplasm. Fluorescence of the cell wall is confined to the inner boundary of the wall corresponding to the resistant wall layer. The immunofluorescent properties of non-GA-treated cells are quantitatively different; fluorescence of these sections is low and diffuse and is particularly reduced in the nuclear region. Electron microscopy shows that GA-treatment results in the proliferation of endoplasmic reticulum (ER) in the perinuclear region of the cell. We suggest that the alpha-amylase localized by immunofluorescence in the perinuclear region of the cell is localized in this ER produced in response to GA treatment. Immunohistochemical localization of alpha-amylase in cells zonated by centrifugation also suggests that the enzyme is intimately associated with the perinuclear area.


Computer-based modeling in the teaching of steady-state enzyme kinetics.

Equations are derived for the steady-state treatment of enzyme reactions with one type of inhibitor, consisting of one reaction cycle or two connected cycles. Computerized stimulation programs are described which are designed to acquaint the student thoroughly with the behavior of enzyme systems. The user has freedom in the choice of parameters for the system, including up to three product-producing rate constants for the two-cycle system.


Hyperprolactinemic anovulatory syndrome.

The functional status of the hypothalamo-pituitary-gonadal axis was investigated in 127 women with anovulatory disease. Radioimmunoassayable circulating LH, FSH, and prolactin concentrations were measured. An attempt was made to localize the functional lesion by utilizing the following criteria: 1. Hypothalamic function: a) clomiphene test based upon hormonal parameters; b) recording of the pulsatile LH fluctuation (spiking) and of basal FSH. 2. Pituitary function: determination of the gonadotropin reserve by means of a standardized LRH test. 3. Ovarian function: a) measurement of plasma E2 and progesterone levels by RIA; b) gestagen bleeding test. All patients had amenorrhea of up to 14 years duration. A total of 17 hyperprolactinemic patients (13.4%) was found. Eight of these patients never experienced galatorrhea, in 7 only transient galactorrhea was reported, and in 2 cases galactorrhea persisted. All hyperprolactinemic patients were found to be clomiphene non-responders as well as nonspikers. The pituitary LH reserve varied from practically none to normal. Baseline LH was low whereas that of FSH was normal. In accordance with this observation E2 levels, with two exceptions, were found to be in the lower range of normal female concentrations. Thus, all but two patients exhibited gestagen withdrawal bleeding. In conclusion, the hyperprolactinemic anvoluatory syndrome is not necessarily associated with galactorrhea. In all cases of amenorrhea syndromes with or without galactorrhea, hyperprolactinemia should be excluded as it is very often associated with anovulation. The hyperprolactinemic anovulatory syndrome includes the following features: 1. gestagen withdrawal bleeding. 2. subnormal to normal E2 levels. 3. clomiphene nonresponsiveness. 4. LH-hypogonadotropism. 5. lack of LH secretory episodes. 6. FSH-normogonadotropism.


Translation of ovalbumin mRNA in Xenopus laevis oocytes. Characterization of the system and effects of estrogen on injected mRNA populations.

Ovalbumin messenger RNA (mRNAov) purified from hen oviduct was injected into Xenopus laevis oocytes. The oocytes were incubated in culture medium containing [3H]leucine. Analysis of the oocyte cytosol on Sephadex G-15O columns demonstrated a peak of radioactivity which cochromatographed with authentic ovalbumin. Radioactive protein contained in this peak was precipitated by ovalbumin antiserum, coelectrophoresed with ovalbumin on sodium dodecyl sulfate (SDS) and urea gels at pH 8.7, and eluted with the protein at the same pH (4.8) on CM-cellulose chromatography. Injection of increasing amounts of mRNAov was found to elicit a linear response in terms of ovalbumin synthesis. Moreover, there was linear incorporation of radioactivity into microinjected oocytes over a minimum period of 91 h. Less than 1 ng mRNAov was detected in this system. Ovalbumin mRNA activity was present in RNA preparations from chicks treated with estrogen but was undetectable in animals withdrawn from the hormone. This study constitutes an initial demonstration of a steroid hormone-induced alteration in mRNA population as assayed in intact viable heterologous cells.


Distribution of extravascular fluid volumes in isolated perfused lungs measured with H215O.

The distributions per unit volume of extravascular water (EVLW), blood volume, and blood flow were measured in isolated perfused vertical dog lungs. A steady-state tracer technique was employed using oxygen-15, carbon-11, and nitrogen-13 isotopes and external scintillation counting of the 511-KeV annihilation radiation common to all three radionuclides. EVLW, and blood volume and flow increased from apex to base in all preparations, but the gradient of increasing flow exceeded that for blood and EVLW volumes. The regional distributions of EVLW and blood volume were almost identical. With increasing edema, lower-zone EVLW increased slightly relative to that in the upper zone. There was no change in the distribution of blood volume or flow until gross edema (100% wt gain) occurred when lower zone values were reduced. In four lungs the distribution of EVLW was compared with wet-to-dry ratios from lung biopsies taken immediately afterwards. Whereas the isotopically measured EVLW increased from apex to base, the wet-to-dry weight ratios remained essentially uniform. We concluded that isotopic methods measure only an "exchangeable" water pool whose volume is dependent on regional blood flow and capillary recruitment. Second, the isolated perfused lung can accommodate up to 60% wt gain without much change in the regional distribution of EVLW, volume, or flow.


Effects of a marathon group on self-actualization and attitudes toward women.

This study investigated the impact of a 16-hour marathon session on levels of self-actualization and attitudes toward women both 1 day and 5 weeks after the group experience. Female undergraduates were assigned randomly to one of two marathon groups or to a no-treatment control group. Ss in both marathon groups experienced a significant shift toward increased independence or self-supportedness on both posttests. However, a differential group effect was found from separate comparisons of each marathon group with the control group reflected significantly shifts in attitudes toward women; Ss in one marathon group reflected significantly greater agreement with profeminist attitudes on the first posttest and experienced an even greater shift in that direction on the second posttest, while Ss in the other marathon group did not differ significantly from the control Ss on either posttest.


Surface immunoglobulin on activated human peripheral blood thymus-derived cells.

Human peripheral blood lymphocytes grown in vitro were stimulated with nonspecific mitogens and in mixed lymphocyte culture. The presence of IgM and thymus (T) surface markers on large and small lymphocytes was investigated by immunofluorescence and correlated with spontaneous rosette formation. All stimulated large lymphocytes formed spontaneous rosettes and all except pokeweed mitogen (PWM)-stimulated large lymphocytes had IgM and T markers. IgG, IgA, and light chain determinants were only detected on PWM-induced large lymphocytes. Thus, surface markers expressed on activated human lymphocytes may differ for different mitogens. IgM was always present on large cells which had the T markers, and it cannot be used to identify a lymphocyte as a bone marrow-derived (B) cell. Due to the overlap of surface markers, the classification into B and thymus-derived (T) cells ought to be restricted to functional phenomena of antibody-production or cell-mediated immunity.


The person in personality research: an laternate lifestyle case study.

The current crisis in personality research, with large-scale, objective, reductionistic, vs. individual, subjective, holistic paradigms, is seen as a real issue that reflects the prevailing schism between academic and professional, applied psychology. Each approach is seen as uniquely useful, but limited in its conception of man. A clinician-personologist approach that allows the combined implementation of the best of both traditions is proposed. A case study of a homosexual is presented as an illustration of this method, which also substantively provides a new perspective on man. Methodological considerations and refinements of this technique and closely related techniques also are discussed in the context of their relevance for both the "helping" orientation of professional psychology and the heuristic orientation of personology.


The accuracy of an automated MMPI interpretation system in a psychiatric setting.

This study indicates that the Lachar MMPI interpretation system is useful in this setting. Overall and specific paragraph accuracy for 98 psychiatric patients' reports suggest clinician acceptance, diagnostic utility, and the potential realization of time savings for the psychologist.


Laboratory tests of antifungal drugs.

The procedures evolved in the author's laboratory over the past 20 years for the microbiological assessment of antifungal drugs are described; methods are detailed for the estimation of the sensitivity of pathogenic fungi to therapeutic agents and for the assay of those agents in body fluids. The preparation and maintenance of stock reference solutions of the drugs, the culture media used, and the incubation temperature and time are discussed. Sensitivity tests by paper disc and by liquid titration for minimal inhibitory and cidal concentrations estimated are described, and the importance of standardized initial inocula is emphasized. Two groups of assay procedures are given, the liquid dilution and the agar diffusion methods, and suitable indicator organisms for both methods are named. The paper concludes with a discussion on the problem of differential assays when two antimycotic agents are in simultaneous clinical use.


Bacteriocine typing of Proteus.

A method of typing isolates of Proteus mirabilis and Proteus vulgaris is described based on the sensitivity of the organisms to bacteriocine. Twelve standard proteocine producing strains were selected from a large number of isolates tested, and from these liquid proteocine preparations were prepared. The sensitivities of 1805 isolates to these 12 preparations were then determined and none was found to be untypable. From the results a bacteriocine typing system has been developed.


Correlation between serological and immunofluorescence results in the investigation of brucellosis in veterinary surgeons.

Four serological tests and three immunofluorescence tests for IgG, IgM, and IgA were compared for value in the investigation of brucellosis in veterinary surgeons. No one serological test stood out over the others, and the immunofluorescence tests did not appear to have advantages over the serological tests. If a laboratory is limited in time and resources then the saline agglutination or the complement fixation test would be reasonably satisfactory. The 2-mercaptoethanol test and the antihuman globulin (Coombs' test) have no advantages over the other two and could be dropped. Immunofluorescence tests are not recommended for routine testing of brucellosis sera. The results and these recommendations apply to the 'vet' sera tested; it is reasonable to suppose that what applies to 'vet' sera will also apply to sera of those who work with or are in repeated contact with cattle and who will have had previous experience of brucella antigen, that is, dairy farmers, herdsmen, or slaughter house employees.


Slide haemagglutination test in hydatid disease: a correlative study of diagnostic procedures.

Human 0 erythrocytes, treated with 1% formalin and subsequently exposed simultaneously to hydatid protein antigen and 0.1% chromic chloride, acquire the property of agglutinating on a slide when brought in coontact with specific antiserum.  This constitutes the basis of the slide haemagglutination test, an easy, quick, sensitive, and specific procedure, usefull in the diagnosis of hydatid disease.


A method of studying the effects of reduced alveolar support on the sensibility to axial force on the incisor teeth in humans.

A method has been developed for measuring the threshold level of sensibility to axial pressures applied to the incisor teeth in man. Eight subjects were investigated, four with support reduced by up to 60% as a result of chronic periodontal disease. Reduced alveolar support appears to have no significant effect on the threshold of perception. All subjects had a lower threshold for the removal of force than for its application. Infiltration of local anaesthetic labially over the test tooth resulted in failure to feel forces previously recognised, thus confirming the role of the periodontal receptors in force perception.


Reduction of the incidence of new mastitis infections by "pre-squirting" teats.

"Pre-squirting" is a technique for flushing out the streak canal of a lactating cow while avoiding movement of milk from the teat back into the udder. When 500 colony-forming units of Streptococcus agalactiae were placed into the streak canal, pre-squirting before let down at succeeding milkings reduced the number of new udder infections. In contrast to this result, pre-squirting was not effective against challenging S. agalactiae placed into the teat cistern.


Oral manifestations in a group of blind students.

The blind population observed in this study exhibited a relatively low caries rate while the amount of plaque per subject was considered high. Although comparisons within the group were made, no significant differences were revealed when both PHP-M and DMF rates were tested against age and degree of blindness. The percentage of anterior fractures was consistent with recent estimates for the sighted population. Estimates of occlusion also showed close correlation with the general population. Maintenance of oral hygiene remains the most outstanding challenge in the care of blind patients. The problem of motivation as encountered in the sighted patient  is magnified here. Disclosing agents for staining plaque are not effective for patient education. Other senses, particularly that of touch, must be utilized when instructing the blind patient in oral hygiene methods.


Human figure drawings of gender-problem and school-problem boys.

In this study 19 boys aged 4 through 13 years referred for gender problems were compared with 35 similar-aged boys referred for school problems on variables derived from sets of human figure drawings. The results indicated that gender-problem boys, relative to school-problem boys, were more likely to draw female figures in response to a Draw-a-Person (DAP) instruction, were more likely to draw figures with good rather than average body proportion, tended to draw more articles of clothing on their figures, and tended to draw their female figures larger than their male figures. There were no differences between the groups in the frequency of emotional disturbance indicators, frequency of age-expected or age-exceptional figure details, and total number of body features. These results are discussed in terms of their implications for the validation of the DAP procedure, their contribution to an understanding of boyhood effeminacy, and their implications for the role of the DAP test as a clinical assessment procedure only in conjunction with other sources of information.


Clinical and physiological assessment of asthmatic children treated with beclomethasone dipropionate.

Forty-two perennial asthmatic children were selected for a 12-wk study using beclomethasone dipropionate. The groups included 21 steroid-dependent children (Group I) and 21 patients (Group II) whose disease was of sufficient severity that corticosteroid therapy was contemplated. All children received the drug in a dose of 100 mug 4 times daily. During the study, oral prednisone was withdrawn from the steroid-dependent children while other therapy was essentially unchanged. Group II children underwent a double-blind trial, receiving beclomethasone for 6 wk and placebo for 6 wk. Objective assessment of adrenal and pulmonary function was obtained at regular intervals. For the latter, total lung capacity and its subdivisions, airways resistance, maximum expiratory flow volume, and oxygen tension, were measured in both groups. In Group II static elastic recoil was measured also. For most tests the results were statistically significant. In both groups, 18 of 21 patients demonstrated an excellent clinical response, no evidence of adrenal suppression, and improvement in pulmonary function. Forty of 42 patients were followed for another 12 wk, and 19 of each group did well. After 20-24 wk of therapy, 16% of patients harbored monilia in their oropharynx, and 1 patient had clinical monilial stomatitis. Within the limits of the time of the study, beclomethasone dipropionate appeared to provide adequate clinical control in many chronic, severe, steroid-dependent and nonsteroid-dependent asthmatic children.


Feeding families and children--1776 to 1976. A bicentennial study.

The food heritage which Americans enjoy today owes its great diversity to the influences of many ethnic groups--the native Indians, Franciscan friars in California, Mexican-Americans, the British, the French, the Creoles, and later, northern Europeans and those of Mediterranean stock. Geography and climate in different parts of our large country and religious beliefs have also played a part in the development of our present-day, varied cuisine. In our colonial and pioneer days, most people raised their own food, but as our nation has become industrialized and urbanized, we find that now only 7 per cent of our population produces the food for our entire nation, and our consumers generally buy their food in stores. Even as late as the beginning of the twentieth century, infant feeding practices could be considered unscientific and primitive. Only in recent years have knowledge of metabolism and the rapid increase in nutritional science permitted progress in infant feeding. Problems of feeding families remain, nevertheless--different than in the early days of our nation--and their solution challenges American ingenuity.


Age distribution of patients with Parkinsonism.

The modal age at onset of the parkinsonian syndrome during the past thrity years is less than a decade higher than it was in the late 19th and early 20th centuries, suggesting that the same disease entity is affecting parkinsonian patients now as then. The evidence points to the existence of two distinct clinical entities: 1) parkinsonism secondary to encephalitis lethargica, which had its greatest influence on the epidemiology of parkinsonism between 1920 and 1945; and 2) classic parkinsonism, which has undergone little change in the past hundred years.


Thiothixene in the treatment of geriatric patients with chronic organic brain syndrome.

Thiothixene was used in a four-week double-blind placebo-controlled study of 42 geriatric patients with chronic organic brain syndrome (psychotic or nonpsychotic). The results, according to several rating measures, showed no significant difference between placebo and thiothixene. Side effects were mild and few. These data support the safety of thiothixene therapy for geriatric patients; however, there is no conclusive evidence of its efficacy in the treatment of chronic organic brain syndrome.


Daily vitamin C consumption and fatigability.

The increased prevalence of fatigue in persons with a low intake of vitamin C is mentioned only briefly in the literature. An analysis of the authors' data on vitamin C intake and fatigability in 411 dentists and their wives revealed a negative relationship. The mean number of fatigue symptoms among the low users of vitamin C was double that among the relatively high users of vitamin C. The mean difference was statistically significant.


Can hyperbaric oxygenation improve cognitive functioning in the organically impaired elderly?: a critical review.

The present article reviews experimental investigation concerned with the effect of hyperbaric oxygenation upon cognitive functioning in the organically-impaired elderly. The conclusion of the Jacobs et al. studies was that hyperbaric oxygenation in cases of chronic organic brain damage (regardless of etiology) leads to improvement in cognitive functioning and general behavior on the ward. Goldfarb et al. (1972) found no evidence to support this conclusion. A critique of the above studies indicates several methodological weaknesses. First, there are serious reservations concerning the makeup of the samples employed in the Jacobs et al. (1969, 1971, 1972, 1973) investigations: it is highly uncertain that most of the Jacobs et al. subjects were suffering from moderate or severe chronic organic brain damage. One reason for the discrepancy between the Jacobs and Goldfarb studies is that the subjects in the later study were more deteriorated and perhaps not as amenable to hyperbaric oxygenation. Secondly, the Bender-Gestalt Test and Tien's Organic Integrity Test have not been validated in an elderly sample. The gain evidenced on the Stockton Geriatric Rating Scale (Jacobs et al., 1969, 1971, 1972) may have little practical significance, and since the data were pooled across groups, the so-called falloff effect could not have been measured. Third, and most significantly, the experimental designs employed in the Jacobs et al., the Goldfarb et al., and the Jacobs followup investigations have such serious shortcomings that the findings must be regarded as inconclusive. Such factors as experimenter attention, testing effects, and familiarity with the experimenter could account for the change in cognitive functioning. Further, in the case of the Jacobs et al. study, the ward personnel may have treated the control group differently after learning that they were expected to improve. Additionally, the subjects in the Jacobs et al. study (1969) themselves may have heard about this prognosis and may have become more interested in performing well on the psychological tests. Thuse, there is no unambiguous evidence that hyperbaric oxygenation was responsible for the changes or lack of changes in cognitive functioning in the samples presented in these studies.


[Nomographical determination of brain wet weight of small mammals (albino rats) from weight of brain fixed in different ways].

Some nomograms have been designed, based upon albino rat brains, which are fixated by several liquids (Bouin, Carnoy, formaldehyde, Golgi-Cox according to Ramon-Moliner). These nomograms allow to determine the weight of fresh unfixated brains (HFG) in a simplified manner, if it was possible only to determine the weight of fixated brains (HT) by weighing.


Immunopathogenesis of autoimmune tubulointerstitial nephritis. I. Demonstration of differential susceptibility in strain II and strain XIII guinea pigs.

Autoimmune tubulointerstitial nephritis (TN) was induced in strain XIII and Hartley but not strain II guinea pigs after immunization with rabbit tubular basement membranes (TBM) in CFA. Strain XIII guinea pigs developed extensive autoimmune TN associated with high anti-TBM (aTBM) antibody titers and linear deposits of IgG along renal cortical TBM after immunization with 10 mug to 10 mg of TBM. In addition, autoimmune TN was passively transferred to strain XIII animals by the i.p. injection of aTBM sera obtained from actively immunized Hartley guinea pigs. In contrast, strain II guinea pigs did not develop autoimmune TN after active immunization (10 mug to 10 mg) with rabbit TBM in CFA, and only produced high aTBM antibody titers with the highest immunnizing antigen dose. At this dose (10 mg) the strain II animals demonstrated linear deposits of IgG along renal cortical TBM but did not develop autoimmune TN. Further, recipient strain II guines pigs did not develop autoimmune TN after passive transfer of aTBM antisera despite renal cortical tubular deposition of aTBM antibodies. Both inbred guinea pig strains produced antibodies reactive with rabbit and rat renal basement membranes. No evidence for differences in nephritogenic TBM antigens could be demonstrated betweed strain XIII and strain II TBM. These observations indicate that 1) genetic factor(s) influence the production of antibodies reactive to autologous TBM, 2) after the deposition of antibodies on the TBM, additional or related genetic factor(s) determine the full expression of this autoimmune renal disease, and 3) aTBM antibody deposition on renal TBM is not sufficient to elicit autoimmune TN.


The in vitro suppression of antigen- or mitogen-induced DNA synthesis by murine spleen cells after the addition of freshly prepared syngeneic cells.

The suppression of antigen- and mitogen-induced DNA synthesis by murine spleen cells in vitro was investigated. It appears that cultures receiving two signals exhibit marked suppression of DNA synthesis. The addition of KLH, PPD, Con A, PHA, or LPS to 72-hr-lod cultures of KLH-stimulated murine spleen cells resulted in the suppression of DNA synthesis assayed at 144 hr. When small numbers of freshly prepared KLH-PPD SC or NSC were added to these cultures at 72 hr the suppression of DNA synthesis was abrogated. However, the addition of larger numbers of KLH-PPD SC or NSC resulted in increased suppression of DNA synthesis. Large numbers of KLH-PPD SC or NSC could substitute for the second stimulant (KLH, PPD, Con A, PHA, or LPS) in suppressing DNA synthesis. The addition of fresh cells obtained from KLH-PPD-immunized mice were more effective in eliciting the subsequent suppression than were cells obtained from non-immunized mice. Cells obtained 30 to 75 days post immunization were most effective in suppressing DNA synthesis.


The immune response to dextran in BALB/c mice. I. Modification of "thymus-independent" response by the T cell mitogen concanavalin A.

Normal and congenitally athymic mice respond to immunization with dextran, thus indicating that the response is thymus independent. Athymic mice have lower plaque-forming cell (PFC) response than normal mice 3 days after immunization, but similar PFC response as normal mice by 5 days. Seven to 10 days after immunization, athymic mice maintain a high level of PFC response whereas the PFC response declines sharply in normal mice. Concanavalin A (Con A), added at initiation of in vitro culture, enhances the response of spleen cells from primed normal mice. Treatment with methyl-alpha-D-mannoside (MAM), a competitive inhibitor of binding of Con A, immediately after addition of Con A, abolishes the enhancement. Treatment with MAM, 3 to 6 hr after Con A addition, partially blocks the enhancement. The enhancing effect is dependent on the dose of Con A and the duration of in vivo priming before in vitro culture. Con A does not enhance the in vitro PFC response of cells from primed athymic mice. Supernatants from Con A-treated non-primed normal spleen cell cultures enhance the PFC response of "nude" cells, thereby indicating that enhancement by Con A is mediated through a soluble T cell product(s) with no apparent antigen specificity. Hydroxyurea, an inhibitor of DNA synthesis, blocks the enhancement by Con A of cells primed for 1 to 3 days. Release of hydroxyurea block after 19 hr incubation does not restore the PFC response, thereby indicating the responding anti-dextran PFC precursor cells are engaging actively in DNA synthesis. PFC response of primed cells taken at the peak of anti-dextran response (day 5) shows that they are less susceptible to the hydroxyurea block. Con A enhances the PFC response of cells primed for 5 days even in the absence of DNA synthesis.


An improved method for synthesising omega-stearoyldextran for the detection of plaque forming cells specific for the alpha-(1 replaces 6) determinant.

A method for synthesising omega-stearoyldextran for the detection of plaque forming cells specific for the alpha-(1 replaces 6) determinant is described. The omega-stearoyl derivative is obtained by reacting dextran with phenylboronic acid to give a 2,4-phenylboronate, which can be subsequently esterified in a pyridine solution with stearoyl chloride. Four different preparations of omega-stearoyldextran with increasing content of stearoyl were obtained. Chemical and immunochemical properties of these compounds are given.


The direct relationship of proinsulin-insulin hypersecretion to basal serum levels of cholesterol and triglyceride in myotonic dystrophy.

Excessive pancreatic insulin secretory responses to a variety of beta-cytotropic agents have been observed in 40 to 60 per cent of subjects with myotonic dystrophy; in addition, 25 to 30 per cent of affected persons manifest mild glucose intolerance, suggesting that circulating insulin may be biologically ineffective. To test this hypothesis, 8 men with myotonic dystrophy were challenged with a 100 gm. oral glucose load; responses were compared to an age, sex, weight-matched control group. Fasting serum immunoreactive insulin (IRI), cholesterol, and triglyceride levels in the myotonic group did not differ significantly from the controls. In contrast, fasting blood glucose and serum free fatty acid (FFA) levels in the myotonic group were significantly elevated above control, although still within the accepted normal range. Following oral glucose challenge, myotonic subjects exhibited mild glucose intolerance and excessive IRI response, but the FFA and serum alpha-amino nitrogen responses were comparable to control responses. Serum proinsulin was separated from insulin by gel filtration and quantitated by immunoassay. Overall, the proinsulin level in myotonic serum was not greater than the accepted normal level. The mean proinsulin level at the peak serum IRI response during the test was 18.6 +/- 4.1 per cent of the total IRI; 3 myotonic subjects responded with greater than 20 per cent proinsulin. The proinsulin secretory response correlated significantly with basal triglyceride (r = 0.972) and cholesterol (r = 0.794) levels but not with fasting glucose or FFA levels. Peak insulin response was also significantly correlated with triglyceride but not with cholesterol levels. Serum insulin-like activity (ILA) from myotonic dystrophic patients was assessed in vitro employing rat adipose tissue and skeletal muscle in the presence and absence of excess guinea pig anti-insulin serum. Comparison of suppressible insulin-like activity to immunoreactive insulin revealed that the mean biological recovery of serum insulin in these assay systems was 85 to 90 per cent, indicating that endogenous insulin was biologically active on both adipose tissue and skeletal muscle in vitro. We conclude that a biologically ineffective form of circulating insulin does not exist in myotonic dystrophy and that the pancreatic insulin response mechanism may be excessively sensitive, resulting in balanced hypersecretion of proinsulin and insulin. The highly significant correlation between proinsulin and serum triglyceride or cholesterol levels suggests that, in addition to insulin, proinsulin may also exert an important influence on lipid metabolism.


Sources of variance in the measurement of intrapulmonary killing of bacteria.

Sources of variability are described for a method used for the quantitative measurement of pulmonary resistance to inhaled bacteria in individual animals. Factors contributing significantly to variability include aerosol exposure chamber design, bacterial species used for aerosol challenge, location of animals in the chamber, and individual intrapulmonary bacterial killing rates. Laboratory error accounted for a small portion of the variance. The data demonstrate that with appropriate modifications in protocol, statistical design and analysis experiments can be performed with increased accuracy, thereby reducing the number of animals needed for each experiment.


Induction of transport of organic anions in Malpighian tubules of Rhodnius.

1. The ability of Rhodnius Malpighian tubules to transport organic anions such as p-aminohippuric acid (PAH) and amaranth depends on the physiological state of the insect. Unfed insects progressively lose this ability, but the transport mechanisms rapidly become activated after a blood meal. 2. This induction occurs in adults as well as larval instars and is not prevented by decapitation. 3. No increase in rates of excretion of organic anions follows a meal of Ringer's solution or a single injection of 0-1 mumoles of PAH into the haemolymph. 4. Accelerated PAH excretion is induced in insects fed (a) blood plasma alone or a suspension of red blood cells in saline, (b) solutions of serum albumin or casein, and (c) whole or diluted milk. 5. These results show that the ingestion of a protein-rich meal is sufficient to induce an accelerated transport of organic anions such as PAH and they suggest that this induction is not controlled by a hormone released in response to abdominal distension but depends instead on the continued presence in the haemolymph of some product of digestion of the meal.


Antibody response of rabbit blood lymphocytes in vitro. Kinetics, clone size, and clonotype analysis in response to streptococcal group polysaccharide antigens.

Peripheral blood lymphocytes (PBL) of rabbits previously hyperimmunized against streptococcal groups A and A-variant antigens were stimulated in vitro by the corresponding vaccines to produce group-specific antibody. This response was dependent on an optimal cell density (2 X 10(6) cells/ml), on the presence of antigen, it was specific and cross-reactive due to a shared rhamnose backbone of the two polysaccharide antigens, and it was highly selective, such that in a 42-55-day culture 1 out of 20 viable cells was a specific PFC. During the exponential increase of the antibody concentration at a constant number of PFC, antibodies were secreted at a rate of 2.4 X 10(4) molecules/s per cell until a plateau level of antibody (40 mug/culture) was reached. The microculture system was used to determine the minimal frequency of group polysaccharide-specific precursor cells in the blood. Independent of the time elapsed since the last immunization this frequency was 1-3 X 10(-5), i.e., in the range of 1-2.8 X 10(2) precursor cells per ml blood. This number was further used together with the clonotype analysis of the culture supernates to calculate the frequencies of precursors of major and minor clonotypes. A hierachy of persisting clonal memory precursor cells was found indicating that clonal dominance is determined by locked-in frequency patterns and therefore it is a phenomenon based on numbers of cells that respond to the antigen.


Amyloid-related serum protein SAA in endotoxin-induced amyloidosis of the mink.

The concentration of the amyloid AA-related serum protein (SAA) was markedly increased after endotoxin injections in mink, mouse, rabbit, and man. It was particularly studied during the development of endotoxin-induced amyloidosis of the mink. Protein SAA was markedly elevated in all mink 24 h after the first endotoxin injection but had fallen to relatively low levels before the onset of amyloidosis at about 4 wk. These results are consistent with SAA being a circulating precursor of the amyloid fibril protein, AA. However, both proteins may be derived by proteolysis from a common precursor.


Antipolysaccharide antibodies of restricted heterogeneity secreted by a single lymph node.

Immune responses which give rise to the synthesis of antibodies of restricted heterogeneity can be reproducibly induced in rabbits and mice by streptococcal polysaccharide antigens (1,2). While these reports have demonstrated clonotype restriction in the immune serum of rabbits and mice, they give little information with respect to the clontype restriction in a single reaction site of organized lymphoid tissue, for example a single lymph node. The kinetics of immune responses in lymph nodes in situ have been studied in sheep using a variety of antigens (3-6), and a substantial body of information is available on the changes in cell output, cell type, and the number of antibody-secreting cells which occur within the efferent lymph of antigen-stimulated lymph nodes. However, there is no information with respect to the amount and the heterogeneity of antibody that is secreted by the lymph node or cells within the efferent lymph. In the present report we have examined the temporal sequence of clonal restriction in the efferent lymph of individual sheep popliteal lymph nodes undergoing an immune response to the streptococcal group A-variant polysaccharide (Av-CHO).


Breath-alcohol analysis: uses, methods, and some forensic problems--review and opinion.

Breath analysis for ethanol, especially in respect to the forensic aspects, has been reviewed. Included are matters dealing with instrumentation, physiological factors involved in the elimination of ethanol via the breath, and, especially, the uncertainties in the calculation of a whole blood concentration of ethanol from the quantity found in breath. We believe that the conversion of a breath quantity to a blood concentration of ethanol, for forensic purposes, should be abandoned and that the offense of driving while under the influence of alcohol should be statutorily defined in terms of the concentration of ethanol found in the breath in jurisdictions employing breath analysis. The breath sample should be obtained and analyzed only with instruments having capabilities which would require some extension of present federal standards for evidential breath-testing devices. Events in early 1975 indicate that implementation of some of these proposals may soon be undertaken.


Anterior cervical discectomy with and without interbody bone graft.

Fifty-one patients with symptomatic cervical disc disease refractory to conservative management were allocated at random to one of two treatment groups. The standard anterior approach devised by Cloward was used for 25 patients, and radical discectomy and foraminotomy for the other 26. All patients were followed for 6 months or longer with interview, physical examination, and radiographic evaluation. There was no difference in the success rate between the two groups. The large majority (92%) of patients in both groups were pleased with results of their operation. Because of technical factors related to operative exposure of the spinal canal and nerve roots, we prefer the Cloward procedure for patients symptomatic from advanced spondylosis and reserve discectomy without bone graft insertion for those with minimal spondylosis or soft disc herniations.


Comparative evaluation of renal transplant rejection with radioiodinated  fibrinogen 99mTc-sulfur collid, and 67Ga-citrate.

The diagnostic accuracy, ease, and technical feasibility of imaging with 131I-or 125 I-fibrinogen, 99mTc-sulfur colloid, and 67 Ga-citrate in renal transplant rejection are compared. Radiofibrinogen data resulted from literature review, radiocolloid data from 125 studies in 52 transplant patients, and gallium citrate data from 24 examinations in seven renal transplant patients performed simultaneously with the radiocolloid studied. Specificity of graft labeling during rejection appears to be similar with radiofibrinogen, 99mTc-sulfur colloid, and 67Ga-citrate. For routine clinical use 99mTc-sulfur colloid surpasses radiofibrinogen and radiogallium because of its better imaging qualities with a permissible radiation dose, leading to better separation of positive and negative results. The 99mTc-sulfur colloid accumulates in areas of intravascular fibrin thrombosis in acute and chronic rejecting renal transplants. Hence, the mechanisms for accumulation of 99mTc-sulfur colloid and labeled fibrinogen in rejecting transplants would seem to be similar. Such physiologic properties as rapid blood clearance and such physical properties as short physical half-life combine to produce reliable graft visualization with adequate definition, thus favoring 99mTc-sulfur colloid as the single agent of choice for clinical evaluation of renal transplant rejection at this time.


Use of 99mTc-sulfur colloid in evaluation of renal transplant complications.

Technetium-99m-sulfur colloid (TSC) was administered to 45 renal transplant patients. No TSC accumulation was seen in normally functioning transplant kidneys. Accumulation of TSC was found in 89% of transplants with rejection, in 30% of transplants exhibiting acute tubular necrosis, and in 30% of transplants of patients with sepsis. Renal accumulation of TSC in various transplant complications diminishes the value of this technique for monitoring transplant rejection.


Glucose antimetabolites and hunger (theoretical article).

A decrease in the cellular utilization of glucose produced by several glucose antimetabolites and especially by 2 deoxy-D-glucose considerably stimulates food intake. An analysis of this phenomenon is presented in terms of the available experimental evidence. Experiments in which glucose antimetabolites have been administered so as to influence selectively the central and peripheral glucosensitive loci suggest a possible mechanism for the action of the substances. The mechanisms by which glucose antimetabolites and exogenous insulin induce cellular glucoprivation and the subsequent changes in food intake are compared and discussed.


Pathogenesis of diastematomyelia and spina bifida.

Three cases of spina bifida (SB) associated with diastematomyelia (DM) are described and possible differences in pathogenesis are discussed. The frequent simultaneous occurrence of both malformations and the possibility that the cord can be split above, at the level of or below the SB indicate a common pathogenesis for SB and DM. Splitting of the cord symmetrically, asymmetrically, bilateraly or even antero-posteriorly can be explained only by the existence of a destructive phenomenon which is responsible for the bifurcation of the neural tube or its anlage. The existence of such a phenomenon indicates that myelocele can develop due to re-opening of a previously closed neural tube. Meningocele may be a manifestation of early embryonic antero-posterior DM in which the anterior tubule develops into an almost normal spinal cord, whereas the posterior tubule provides the wall of the cystic sac of meningocele in which most or all the neural tissue undergoes fibrous replacement.


Recent advances in calcium metabolism. II. Disorders of calcium homeostasis.

Abnormalities of calcium and mineral metabolism are described in relation to the differential diagnosis, clinical characteristics, diagnostic procedures, and treatment of infants and children with hypocalcemia, hypercalcemia, rickets, chronic renal insufficiency, and other disorders of calcium metabolism. Understanding of the basic pathogenesis of each abnormality of calcium homeostasis is essential for the rational management of affected patients.


A retentive attachment for overdentures.

A technique is described that incorporates an extracoronal attachment within an overdenture to provide increased retention. This type of retentive attachment is easily fabricated. It's durability, simplicity, adjustability, and adaptability to a wide variety of situations make it most useful. The retentive attachment may be used with either removable partial dentures or complete dentures.


Stimulus-secretion coupling processes in brain: analysis of noradrenaline and gamma-aminobutyric acid release.

1. Brain synaptosomal fractions released both endogenous and exogenously loaded noradrenaline and gamma-aminobutyric acid (GABA) in response to calcium. Elevation of magnesium concentrations in the release media decreased the calcium-dependent release. 2. The release of noradrenaline and GABA occurred within 250 msec following the application of calcium. Following the initial response to calcium, release progressively decreased with continued application of calcium. GABA release declined more rapidly than noradrenaline release, consistent with a noradrenaline distribution having greater accessibility to the release process. 3. Sodium was required for the loading of noradrenaline and GABA into pools released by calcium. On the other hand, the presence of sodoium was not required for release from previously loaded pools. 4. Microsomal fractions did not exhibit calcium-dependent release of noradrenaline or GABA. Furthermore, exogenously loaded lysine was not released from synaptosomal fractions in response to calcium. 5. Barium and strontium, but not magnesium, stimulated noradrenaline and GABA release in the absence of calcium. The ordering of alkaline earth efficacies was barium greater than strontium greater than calcium. 6. Manganese inhibited calcium-dependent release of noradrenaline and GABA to a greater extent than magnesium. 7. Release, in response to 1 mM calcium, increased linearly with the log. [K+]0, suggesting that a voltage-dependent calcium inophore limits release. The slope of release vs. log. [K+]0 was greater for noradrenaline than for GABA. 8. For a given [K+]0 less than 55 mM, increases in external calcium concentration above 1 mM increased noradrenaline release but decreased GABA release. These data suggest that calcium can decrease its own permeation and that differences in the release process may exist for different neurotransmitters. 9. In the presence of the artificial calcium ionophore, A23187, both noradrenaline and GABA release increased linearly with the log. [Ca2+]0. The slope for noradrenaline release was greater than that for GABA release. 10. Stimulus-secretion coupling in brain is suggested to be regulated at the level of a voltage dependent calcium permeation mechanism. However, basic differences in the interaction of calcium with the release process may exist between the noradrenaline and GABA systems.


A technique for fabricating dies.

A technique for fabricating dies without using a die saw has been described. The technique saves the time consumed in sawing the dies and eliminates the hazards of using a die saw. It is particularly advantageous when little space exists between dies since the Zolnowski matrix band is thinner than the thinnest saw blade. The band can be easily placed in the tightest interproximal spaces and can be secured in place with a minimum amount of sticky wax. The technique can be used for crowns, fixed partial dentures, and indirect inlays.


Monistat cream (miconazole nitrate) a new agent for the treatment of vulvovaginal candidiasis.

Monistat Cream (miconazole nitrate 2%), a new fungicidal agent indicated for the treatment of vulvovaginal candidiasis, was evaluated in a comparative study with nystatin vaginal tablets (100,-000 units each). A total of 95 pregnant and non-pregnant patients were treated. Miconazole nitrate was administered once daily, at bedtime, for 14 days to 55 pregnant and non-pregnant patients. Overall, 74.5% (41 of 55 patients) were cured with one course of therapy. In contrast, of 40 nystatin-treated patients (both pregnant and non-pregnant) treated twice daily for 15 days, 22 patients (57.8%) were cured with one course of therapy. This difference in cure rates was statistically significant. Side effects were minimal and comparable in the two treatment groups. No recorded instances of birth defects were observed in infants born to mothers in either treatment group. Monistate Cream, in this study, was found to be a safe and effective drug in treating both pregnant and nonpregnant patients with confirmed candidiasis.


Current status of luteinizing hormone-releasing hormone in diagnosis and treatment of disorders in reproductive function.

The concept of the hypothalamic regulation of the function of the anterior pituitary was established by experiments involving the interruption of blood supply from the hypothalamus to the pituitary, transplantation of pituitary to sites away frm the hypothalamus and the effects of various lesion and electrical stimulation experiments with the hypothalamus. These experiments were the result of the concept proposed by Harris in 1937 that the pituitary gland may be controlled by the brain through substances carried to it by the portal vessels arising in the hypothalamus. The first direct evidence of the presence of a hypothalamic factor that could bring about the release of pituitary LH was provided independently in 1960 by McCann and co-workers and in 1961 by Harris and co-workers. The releasing factors and their physiological role was a subject of great interest, and porcine LH-RH was isolated by Schally et al. in 1971, followed by the isolation of ovine LH-RH by Guilleman and co-workers. The structure of the releasing factor has been established with no species differences between the ovine and porcine preparation and the decapeptide which has been synthesized. The use of LH-RH on various experimental animals has been done extensively, and evidence of the release of both LH and FSH has been obtained. In the absence of concrete evidence for a separate FSH-RH at this time, the above observation has led to the speculation that there is a single releasing factor that brings about the release of both FSH and LH. Both natural hormone from either ovine or porcine origin and the synthetic decapeptide have biological activity in the human. However, the rhesus monkey seems to be much less sensitive, and the question of a species difference has been raised. This subject has been reviewed in considerable detail by Schally and co-workers.


Inhibitors of the luteinizing hormone-releasing hormone based upon modifications in the 2, 3, and 6 positions.

[Leu2,Leu3,D-Ala6]-LH-RH (less than Glu-Leu-Leu-Ser-Tyr-D-Ala-Leu-Arg-Pro-Gly-[NH2) and [Val2,Leu3,D-Ala6]-LH-RH completely inhibited the release of LH and FSH induced by 0.3 ng/ml of medium of LH-RH on isolated rat pituitaries, at a dosage of 10 mug. [Leu2,Val3,D-Ala6]-LH-RH and [Val2,Val3,D-Ala6]-LH-RH also completely inhibited this response but were one-tenth as active as [Leu2,Leu3,D-Ala6]-LH-RH. All of the analogs were devoid of agonist activities. The incorporation of the D-Ala residue in position 6 into the [Leu2,Leu3]-LH-RH sequence, therefore, increased the inhibition potency as much as tenfold.


Synthesis of 5-substituted aminomethyluracils via the Mannich reaction.

An extension of the Mannich reaction, in which aminomethylation of the five position of uracil, is reported. Thus, primary and secondary alkylamines and primary aromatic amines containing ring-activating groups led to the title compounds 3-10. Compound 11 in which the aromatic ring contains the ring-deactivating nitro group was synthesized in an alternative way. All compounds were characterized by their elemental and spectral properties.


Induced abortion: epidemiological aspects.

Sir Dugald Baird sketches the history of abortion legislation in Great Britain from the beginning of the century. In his views the 1967 Abortion Act has been one of the most important and beneficial pieces of social legislation enacted in Britain in the last 100 years. It has, however, brought problems both of administration in the hospitals and to individual doctors and nurses, particularly when the patients are young single women and even schoolgirls. One of the consequences of the Abortion Act has been a fall in maternal mortality and perinatal mortality rates. Abortion does not seem to be followed by serious emotional sequelae. Nevertheless recent changes in sexual mores have introduced new and serious social problems which are discussed in relation to the role of the doctor in his relationship with patients seeking abortion.


Some observations on informed consent in non-therapeutic research.

The quality of the consent obtained from 41 volunteer subjects in eight experiments is evaluated. Five subjects (all physicians) gave informed consent; 22 subjects gave partially informed consent; and 14 subjects merely gave consent. It is argued that 'informed' consent is obtainable only from medically trained people, and that lip service to this concept in laymen should cease. The concept of medical competence should instead be introduced and a personal medical referee appointed to adjudicate on behalf of the volunteer.


Medical care evaluation: an old new idea.

The recent implementation of medical care evaluation (medical audit) systems in the nation's hospitals is a phenomenon of major consequence. The systematic measurement of the quality of patient care based on outcome data is becoming a part of the delivery of that care. Sixty years ago Dr. E. A. Codman developed and crusaded for a similar idea that seemed at one point to be on the threshold of widespread acceptance in U. S. hospitals, but for reasons other than lack of conceptual soundness the effort failed. In this article the author reviews the history of this early approach to the evaluation of patient care quality and suggests some lessons this historical episode holds for today's health care professionals.


The preparation, examination and analysis of frozen hydrated tissue sections by scanning transmission electron microscopy and x-ray microanalysis.

A method is reported for preparing, examining and analysing frozen hydrated tissue sections using transmission electron microscopy and X-ray microanalysis. Use of this method permits localization and measurement of water soluble or diffusible elements within the hydrated cell matrix. Since any change in total fresh weight of the specimen will affect the concentration of all components, great care has been taken to demonstrate that the mass neither increases nor decreases and to ensure that the tissue remains frozen-hydrated. Criteria for assessing whether or not the tissue remains frozen-hydrated are reported. After quench freezing, 1-2 mum thick sections of mouse liver were cut at 193 degrees K and picked up on a specially designed annular specimen holder covered with an aluminium coated nylon film. Using a transfer device which prevents contamination of the tissue sections while maintaining them at a low temperature (below 143 degrees K), the sections are transferred either to the vacuum evaporator cold stage or the scanning microscope cold stage. The tissue sections may be coated with an aluminium layer to improve electrical and thermal conductivity. The specimens are examined in the scanning transmission imaging mode and analysed using an energy dispersive X-ray analyser. Concentration of intra-nuclear and intra-cytoplasmic K, P, S and Cl are reported for mouse hepatocytes as ratios of the characteristic radiation to the continuum radiation used as a measure of mass. Ratios for all four elements were higher in the nucleus than the cytoplasm. Examples are given of this method as applied to plant and insect tissue.


A method of collecting and processing nematode larvae for electron microscopy.

A method is described using simple apparatus for separating and concentrating nematode larvae from host faecal material and a recommended procedure is given for processing the helminths for transmission electron microscopical examination.


The appearance of new structures and functions in proteins during evolution.

The likelihood of a de novo generation of classes of efficient proteins through neoformation of DNA, through modification of expressed DNA, and through modification of nonexpressed DNA is examined. So is the likelihood that newly formed inefficient enzymes be turned into efficient enzymes. The conclusions are that neither gene duplicates nor dormant genes represent promising materials for a de novo generation of protein classes, that (with exceptions) such generation is unlikely to have taken place in recent evolution, that new structural genes must nearly consistently derive from preexisting structural genes, and that new functions can be evolved only on the basis of old proteins. Conditions of protein evolution in prokaryotes suggest that the saltatory formation of protein classes is as unlikely in prokaryotes as in eukaryotes. Data on the history of a few protein classes are reviewed to illustrate the preceding inferences. The analysis leads to the hypothesis that most protein classes originated before the major elements of the translation apparatus of modern cells were fully evolved. If simple sequence DNA is turned into structural genes by evolution, this process (again with exceptions) is considered to have taken place only at that very remote period. A polyphyletic origin of proteins is thought to date back to the same era. It is proposed that the development of genic multiplicity and of marked structural and functional diversity of proteins may have come about in the earliest cells primarily through the independent generation of structurally different polymerases in different protocells, followed by cell conjugation and the subsequent use by enriched cells of supernumerary types of polymerase for evolving further functions. Functional growth, as it took place at early times, is briefly discussed as well as functional change. The foundations for new functional developments in old proteins are analyzed. In considering the evolutionary recovery of lost functions, aspects of cell differentiation and gene regulation are linked with the evolutionary picture. The distinction between eurygenic and stemogenic control of gene activity is used. Next to gene deletion, cell and tissue deletion is held to be an event of general evolutionary significance, through cell and tissue origination that presumably accompanies the restoration of a lost molecular function.


Evolution of 5sRNA.

The evolution of 5sRNA of 17 organisms ranging from human to bacteria has been studied using a sequence homology analysis. The evolutionary rate of 5sRNA genes has been estimated to be 2.2x10(-10) replacement per one nucleotide site per year. This value is about the same as that of cytochrome C or tRNA's (congruent to 2x10(-10)). A phylogenic tree of these organisms including both eukaryotes and prokaryotes has been constructed from the evolutionary distances (the rate of nucleotide substitution per site) data. The time of divergence of prokaryotes and eukaryotes was estimated to be greater than or congruent to 1.75x10(9) years ago and the branching order in eukaryotic kingdoms is consistent with the traditional order. Blue-green algae separated from the bacterial stem greater than or congruent to 1.3x10(9) years ago after eukaryotes had branched.


The history of inorganic nitrogen in the biosphere.

When in the primeval atmosphere ammonia approached exhaustion, bacteria resembling clostridia developed mechanisms for nitrogen fixation. The fixation was continued by the photosynthetic bacteria. In the later, oxidizing, atmosphere the combined activities of the nitrificants and the denitrificants could lead to a large-scale cyclic regeneration of free nitrogen. The possibility of a descent of the nitrificants from hypothetical photosynthetic bacteria, which used ammonia as electron donor, is discussed. The anoxygenic atmosphere contained no nitrate, and therefore neither nitrate fermentation nor nitrate respiration were precursors of aerobic respiration. This evolved from photosynthesis. In nitrate fermentation, nitrate serves only as an incidental electron acceptor; this process is merely an evolutionary sideline. Nitrate respiration evolved from aerobic respiration. While in present conditions the reaction of nitrogen with oxygen and water to give nitrate is exergonic and possibly occurs at a low rate, the antagonistic action of the denitrificants maintains the stationary concentrations of nitrogen and oxygen in the air.


Nephrolithiasis and nephrocalcinosis after renal transplantation: a case report and review of the literature.

Stone formation in renal allografts is rare. Although infection or renal tubular acidosis can predispose to calcium deposition in a renal allograft, hyperparathyroidism is usually an accompanying factor. Parathyroidectomy is recommended as the treatment of choice when stone deposition or nephrocalcinosis occurs after transplantation. The reported case demonstrates that aggressive therapy is also necessary to eliminate calculi from the urinary system to avoid mechanical obstruction, continued infection or renal paraenchymal damage.


Non-nutritive sweeteners and human bladder cancer: preliminary findings.

The non-nutritive sweeteners, saccharin and cyclamate, were not associated with the risk of human bladder cancer in a controlled investigation. The prior intake of such sweeteners in any and all forms was not greater or more prolonged among 209 recently diagnosed bladder cancer patients than among 209 otherwise similar patients without bladder disease. These findings were unaffected by case-control differences in diabetic histories or smoking practices.


Immunobiology of human bladder cancer.

The immune destruction of bladder cancer most likely results from an interaction of specific and non-specific cellular and humoral responses evoked by tumor-associated antigens. We are just beginning to comprehend the complex immune mechanisms operating to retard or facilitate tumor growth in patients with this disease. This understanding has led to renewed hope that the immune system may be manipulated for the benefit of the tumor-bearing patient. However, only a thorough understanding of the basic functions of the immune system in man will permit a rational approach to immunotherapy in patients with bladder cancer.


Observations on definitive cobalt 60 radiation for cure in bladder carcinoma: 15-year followup.

Radiation therapy will result in tumor disappearance in a select number of patients. However, it does not prevent local recurrence and, therefore, the patient continues at risk. Tumor recurrence was noted in more than half the patients in our series and more than 50 per cent of these patients experienced multiple recurrences. A functional bladder was maintained in nearly 60 per cent of the patients. Survival in 11 patients in category 1 with radiation therapy and subsequent non-ablative extirpative surgical procedures in 8 patients was equivalent to series treated by preoperative irradiation and cystectomy. In contrast the 14 patients in category 2 had a survival rate that was appreciably lower than that obtained with preoperative irradiation followed by cystectomy. There was a significantly increased morbidity associated with an open operation in the treatment of recurrence in the irradiated patient. We would advocate preoperative irradiation followed by cystectomy in the patients with high grade and high stage disease. The value of single versus adjuvant forms of therapy for patients with diffuse, rapidly recurring low grade and low stage disease would be determined best by a randomized prospective study. Evidence from this series suggests that irradiation improved over-all survival in this category.


Patch graft urethroplasty: a review with emphasis on use for strictures in the region of the membranous urethra.

A series of 40 patch graft urethroplasties is presented. The surgical technique, with versatility of the procedure and its application to repair of strictures in the membranous urethra are discussed.


Aminoglutethimide medical adrenalectomy for advanced prostatic carcinoma.

Complete adrenal suppression with aminoglutethimide has been accomplished in 7 patients with progressive stage D carcinoma of the prostate who had become refractory to orchiectomy and the administration of exogenous estrogens. A favorable response was noted in 3 patients. These preliminary results indicate that this agent may be as useful as surgical adrenalectomy in the treatment of progressive prostatic carcinoma. A brief discussion of the pharmacology of this agent, its mode of administration and the side effects are presented.


Early prediction of acute homograft rejection: urinary assay for polyribosomal-rich lymphocytes.

Urinary cytology from 29 pediatric renal homograft recipients was evaluated for the presence of polyribosomal-rich (pyroninophilic) lymphocytes during an 8-month period. Seven episodes of acute (cell-mediated) rejection occurred in 21 cadaveric renal recipients. No episodes of rejection occurred during this period in the living-related recipients. Each episode of rejection was associated with significant polyribosomal-rich lymphocyturia 5 to 11 days before the onset of clinical rejection as diagnosed by conventional methodology. In addition, significant lymphocyturia occurred 1 to 3 days before and simultaneous with a sustained elevation in serum creatine. Falsely positive assays demonstrating occasional to 1 plus (less than 10 per cent) ribosomal-rich lymphocyturia occurred in 10 of 29 patients. None of these falsely positive-reacting patients demonstrated acute rejection. In our experience the urinary assay for polyribosomal-rich lymphocytes proved to be an early indicator of acute rejection. It is hoped that by early institution of antirejection therapy based on this parameter homograft rejection may be aborted or its severity diminished.


Exstrophy of the bladder--an alternative method of management.

Sixteen bladder exstrophy patients were treated by diverting the urine into a non-refluxing colon conduit. There were 4 new, previously unoperated cases and 12 had been diverted earlier by ileal conduit. Subsequently, 11 conduits were detached from the abdominal wall and joined end-to-side to the rectosigmoid colon. This method has proved satisfactory to date but long-term assessment will be needed. This staged method of ureterosigmoid urinary diversion appears to be a satisfactory way to manage new patients with bladder exstrophy and patients who have been diverted previously by an ileal conduit. From our experience with non-refluxing colon conduits we conclude also that it is: 1) a better method than ileal loop for permanent diversion, 2) indicated for patients with an ileal loop who are not doing well and 3) useful in patients undergoing anterior exenteration, providing the option of joining it to the rectosigmoid if there is no recurrent disease or radiation proctitis.


Management of postoperative renal hemorrhage by transcatheter embolization.

A patient with uncontrollable postoperative renal hemorrhage was successfully treated by sub-selective injection of autologous clot into the renal artery. Followup arteriography 10 days later revealed persistent occlusion of the bleeding vessel with recanalization of all other vessels. This method is an effective alternative to an operation in cases of renal hemorrhage of diverse etiology not responsive to conservative management.


Preoperative vascular embolization as an adjunct to successful resection of large retroperitoneal hemangiopericytoma.

A large retroperitoneal hemangiopericytoma was resected successfully with the aid of preoperative control of the blood supply of the lesion with percutaneous intra-arterial gelfoam and ferromagnetic silicone embolization. We believe that this resection would not have been possible without this adjuvant technique. Future application of this combined technique will enable more aggressive surgical intervention in unresectable vascular tumors and arteriovenous malformations.


Noonan's syndrome associated with polycistic renal disease.

Noonan's syndrome is an eponymic designation that has been used during the last 8 years to describe a variable constellation of somatic and visceral congenital anomalies, which includes groups of patients previously referred to as male Turner's, female pseudo-Turner's and Bonnevie-Ullrich syndromes. It is now recognized that both sexes may show the stigmas of this condition and, unlike Turner's syndrome, there is no karyotype abnormality although there is often a familial pattern. The most commonly observed anomalies include webbing of the neck, hypertelorism, a shield-shaped chest and short stature. Congenital heart disease, principally pulmonary stenosis, and sexual infantilism often with cryptorchidism in the male subject are additional associated anomalies in this syndrome. Renal anomalies have been described rarely and usually consist of rotational errors, duplications and hydronephrosis. We report the first case of an infant who displayed many of the stigmas of Noonan's syndrome and also showed early evidence of frank renal failure secondary to renal dysplasia with cystic disease.


Successful allotransplantation of a kidney removed because of ureteral damage in an unrelated living donor.

The use of a kidney removed because of ureteral damage in an unrelated donor has produced a well functioning renal allograft in the transplant recipient. The kidney demonstrated calicectasis and hydronephrosis on an excretory urogram before removal of the ureteral cutaneous fistula. An excretory urogram performed 8 months after the renal allotransplantation of this kidney shows prompt function of a delicate collecting system without any residual calicectasis. This case emphasizes the need for us to explore the possible use of free kidneys removed from living unrelated donors for non-neoplastic diseases of the ureter.


Effective treatment of metastatic squamous cell carcinoma of the prostate with adriamycin.

A case is presented of a 67-year old man who experienced the sudden onset of prostatism and underwent a complete panendoscopy and transurethral resection of the prostate. Tissue from the right lateral lobe of the prostatic urethra revealed squamous cell carcinoma and a chest x-ray revealed bilateral pulmonary nodules. Tumor progression was observed. However, subsequent response to adriamycin has lasted more than 5 months after the carcinoma failed to respond to radiation, surgery or other chemotherapy.


Ultrasonic evaluation of pararenal masses.

The ease of performing ultrasonic examination and its noninvasive nature make it especially useful in seriously ill patients. We present 12 patients with lesions that can be identified by ultrasound, along with a discussion of the differential diagnosis. Ultrasonically guided percutaneous aspiration biopsy can confirm the diagnosis in selected patients.


Extensive urban outbreak caused by antibiotic-sensitive Shigella sonnei.

During 1970 and 1971, a large increase in the number of isolations of Shigella organisms (90% S sonnei) occurred among patients of Grady Memorial Hospital in Atlanta. Examination of strains isolated during this outbreak showed a marked decline in the frequency of antibiotic resistance, especially multiple resistance, from that which had been observed during the preceding three years, in spite of continued heavy usage of antibiotics. These findings are contrary to most recently reported experience, which has indicated a rapidly increasing incidence of antibiotic resistance, especially to ampicillin.


Streptococcal pharyngitis in children. A comparison of four treatment schedules with intramuscular penicillin G benzathine.

Four hundred children with streptococcal pharyngitis were treated randomly with single injections in groups of 100 each (1) with 600,000 units of penicillin G benzathine, (2) 1.2 million units of penicillin G benzathine, (3) 600,000 units of penicillin G benzathine and 600,000 units of penicillin G procaine, or (4) 900,000 units of penicillin G benzathine and 300,000 units of penicillin G procaine. Clinical response and severity of local reaction were judged in a double-blind manner at 24, 48, and 72 hours; throat cultures were taken then, and at 10, 21, and 42 days. Although the clinical response to 900,000 units of penicillin G benzathine and 300,000 units of penicillin G procaine was equal to 1.2 million units of penicillin G benzathine, the former cleared the streptococci more quickly, greatly reduced the incidence and severity of local reactions, and offered optimal therapy for streptococcal pharyngitis in the pediatric age group.


Trimethoprim-sulfamethoxazole therapy for shigellosis.

Twenty-eight infants and children hospitalized for severe shigellosis were treated orally either with ampicillin trihydrate (100 mg/kg/day administered in divided doses every six hours) or with trimethoprim-sulfamethoxazole (trimethoprim, 10 mg; sulfamethoxazole, 50 mg/kg/day in divided doses every 12 hours) for five days. Four patients with ampicillin-resistant shigellae continued to have diarrhea and positive stool cultures during therapy. Patients with susceptible shigellae treated with ampicillin and all patients treated with trimethoprim-sulfamethoxazole responsed promptly and comparably within an average of 1.6 and 1.7 days, respectively, until stool cultures were negative, and 3.1 and 2.9 days, respectively, until diarrhea stopped. Patients with ampicillin-resistant shigellae responded to treatment with trimethoprim-sulfamethoxazole. It is concluded that trimethoprim-sulfamethoxazole is the best currently available drug for treatment of shigellosis in areas where multiple antibiotic resistance of shigellae is common.


Bacterial contamination of skin used as a biological dressing. A potential hazard.

Bacterially contaminated skin used as a biological dressing on burn wounds can cause serious or even lethal infections, three examples of which are cited. Cadaver-skin allografts were frequently found to contain pathogenic bacteria. The frequency of infections due to the use of contaminated skin grafts on open wounds is unknown.


Contour restoration following simple or modified radical mastectomy.

With the increasing performance of modified radical mastectomy in the treatment of female breast cancer, satisfactory restoration of contour can be performed by a relatively simple procedure. In a large number of patients, this constitutes the optimal rehabilitation in the appropriate circumstances. It is hoped that with an increasing awareness of the possibility of this type of restoration, the procedure will be more widely applied.


Long-term metaproterenol therapy in asthmatic children.

The bronchodilator efficacy and safety of metaproterenol sulfate were evaluated by double-blind crossover tests against placebo at three intervals during a 90-day treatment period in 50 asthmatic children. One group of 25 patients was continuously treated with metaproterenol syrup, and the other 25 with placebo syrup. Pulmonary function tests showed statistically significant improvements in forced expiratory volume, forced expiratory volume in one second, and peak expiratory flow rate after metaproterenol administration as compared with those measurements after treatment with placebo. Biweekly global evaluations of responses to metaproterenol administration were consistently more favorable than responses to placebo. Tachycardia and blood pressure changes after metaproterenol administration were consistent with the pharmacologic properties of beta-sympathomimetic stimulants. Side effects during metaproterenol treatment were minimal and laboratory data remained normal.


Pneumoperitoneum. A complication of mechanical ventilation.

Pneumoperitoneum occurred in three adults receiving mechanical ventilatory support. Since the presence of a perforated viscus could not be confirmed by combinations of clinical, surgical, or autopsy findings in any of these patients, it appears that the free abdominal air in these patients was a complication of the ventilatory therapy. It is possible that such a complication may be more common than is currently recognized and thus should be added to the differential diagnosis of pneumoperitoneum.


[A semi-automatic electric keratome for lamellar corneal graft (author's transl)].

The demands on the precision of the operative incision are in lamellar keratoplasty much higher as in the total thickness graft. Besides the accurate limitation of the size of the graft, a lamellar dissection must be performed, by which the quality of the dissection must be as high as possible, in order to give an acceptable optical result. The depth of cut must be constant, and, above all, the surface of the cut must be absolutely smooth. A new semi-automatic, electrically-driven keratome with very exact micrometer -- adjustment allows for the first time a continuous cut without changing the direction of movement of the knife. A special construction allows use with the operation microscope, so that the surgeon can follow the whole cutting operation. With many illustrations the new instrument is shown in construction, function, and clinical application.


[Tissue culture investigations on the distinction between hereditary and sporadic retinoblastoma (author's transl)].

The growth pattern in tissue culture of cells derived from retinoblastoma is different for all cases with known heredity and most of the cases with unknown heredity. It is concluded that those of the latter, that show a growth pattern that is identical with that of the hereditary cases, represent the hereditary cases in the group with unknown heredity.


[Early keratoplasty after perforating injury of the cornea (author's transl)].

A report is given of experiences with early penetrating keratoplasty after perforating injury of the cornea, lens, and vitreous. 10x0-nylon through- and through sutures were used. The technique of operation and the results of treated cases are demonstrated with photos.


[Experiments on animals to investigate the suitability of perforating corneal sutures (author's transl)].

Injuries of the cornea in rabbits are treated with perforating sutures using non-traumatic material (nylon and silk 9-0). Postoperative examinations with fluorescein showed the absence of fistulas along the suture in all cases. Histological examinations of the lacerations and sutures three respectively five weeks after the operation did not reveal any epithelial growth in the anterior chamber nor endothelial growth in the suture canal. We believe, therefore, that the use of perforating corneal sutures no longer presents any risks, especially when materials of up to 15-0 are used which are readily available.


[A case of X/X translocation: t(X;X) (q26;p11)].

An eight-year old girl showing a X/X-translocation (45,X/46,Xt(X;X)(q26;p11)) is presented. Besides short stature and congenital heart-anomaly no other phenotypical abnormalities were present. In all cells containing the abnormal X-chromosome, the latter was late labeling as shown by autoradiography and BrdU-labeling.


[Computer-oriented documentation of quantitative and qualitative data in gastroenterology (author's transl)].

Computer-oriented documentation of quantitative and qualitative data obtained from patients with gastroenterological diseases is described as an example of a method when considering a relatively small number of patients. All qualitative and quantitative features are entered uncoded in a data booklet and subsequently on port-a-punch cards. After extensive computerized error check - and correction, as need arises, - the data are transferred to a data base and stored on magnetic disk. The ISIS information system, in conjunction with special routines provides access to the data in any combination desired. Analysis of the data, both on an individual and a statistical basis is thus facilitated.


[Blood coagulation factor XIII and fibrin stabilization (author's transl)].

Coagulation factor XIII (fibrin stabilizing factor, FSF) is detectable in plasma, platelets, placenta and various tissues. In the activated form FSF has the enzymatic properties of a transglutaminase and is capable of stabilizing fibrin by inducing covalent bondings between fibrin monomers. In patients with congenital factor XIII deficiency or acquired immune inhibitors of fibrin stabilization a severe bleeding tendency is evident. There is not yet enough information available concerning the significance of reduced FSF-activity as cofactor in hemorrhagic diathesis and wound healing disturbances in various disease states. There are some indications from experimental studies that there might be an influence of FSF on tumor growth and metastasis as well as arteriosclerosis. The quantitation of the enzyme by radiological and immunological techniques yield reproducible results. Fibrin in its stabilized or non stabilized form can be discriminated in polyacrylamide gel electrophoresis after reduction of fibrin clots.


Human glomerular smooth muscle (mesangial) cells in culture.

Glomerular smooth muscle cells were grown and subcultured from human glomeruli in vitro. These cells, stained with antiserum to smooth muscle actomyosin and examined by immunofluorescence, had brightly stained intracellular fibrils similar to those seen in smooth muscle cells. Actomyosin fibrils were altered by conditions affecting actomyosin in vitro. Glomerular smooth muscle cells lacked the antihemophilic factor and blood group antigens present in endothelial cells, and are, therefore, most likely derived from the smooth muscle cells of the glomerular mesangium. By radio-labeled amino acid  analysis, they synthesize a collagen differing from that of fibroblasts, and which probably differs from basement membrane collagen. Other cell types could be grown and subcultured using a different glomerular isolation technique, culture medium and method of subculture.


Nonessential role of neutrophils as mediators of hyperacute cardiac allograft rejection in the rat.

The presence of neutrophils within the graft has been widely emphasized as a characteristic feature of hyperacute rejection, and analogies have been drawn to the Arthus reaction, in which neutrophils are essential mediators of tissue damage.  To evaluate the role of neutrophils as mediators of graft destruction in hyperacute rejection, we studied a series of 16 heterotopic ACT strain rat cardiac allografts in skin-presenitized Lewis strain recipients, all of which recieved prior treatment with cyclophosphamide and methotrexate or heterologous rabbit antirat polymorphonuclear globulin.  Fourteen recipients showed significant depression in levels of circulating neutrophils prior to transplant, and neutrophils were not detected in 13 allogrates at the time of functional rejection.  There was no abrogation of hyperacute rejection in this series and the characteristic pattern of vacular and myocardial damage was not altered by the absence of neutrophils from the graft.  Although the possibility that neutrophil-derived agents may contribute to late graft destruction cannot be excluded, this study has shown that neutrophils are neither essential nor specific participants in hyperacute allograft rejection in this model.