[Mutagenic activity of benzonal].

Benzonalum mutagenic activity was demonstrated in a dominant lethal test on mice. The late spermatids stage proved to be the most sensitive in this respect. The benzonalum did not evoke any cytogenetic activity, that was shown by counting chromosome aberrations in metaphases of the bone marrow cells in vivo and did not induce gene mutations in tester trains of Salmonella typhimurium in vitro and in vivo (a host-mediated assay).


Phase-locked loop techniques applied to ultrasonic Doppler signal processing.

A new method of measuring blood flow velocity and acceleration using analogue and phase locked loop techniques is described. Instantaneous peak velocity, instantaneous mean velocity and acceleration can be obtained on-line and displayed on simple recording systems.


Measurement of ultrasonic exposure with radiation force and thermal methods.

It is the purpose of this paper to discuss briefly the factors that influence the interaction of the ultrasonic field and medium being irradiated, and to collect together the various techniques that have been suggested for measuring energetic parameters of the ultrasonic field. The calorimetric and radiation force methods are then discussed in more detail. The former is discussed as a technique whose capabilities have not been fully exploited while the latter demands attention both because of its simplicity and its controversial theoretical basis. Areas in which further work is needed are indicated in the summary and conclusion. It is hoped that the paper will be of practical use to workers in the field.


[The simultaneous management of rupture of the urethra and the symphysis (author's transl)].

The combined injury-rupture of the urethra and the symphysis--is no respecter of the surgical disciplines, urology and accident surgery. Therefore, a combined operating team from both specialties should simultaneously undertake primary care. First comes the restoration of urethral continuity. The retropubic approach favors the gaping pubic symphysis. A stationary osteosynthesis of the symphysis with an AO-tension band plate follows. In that way the urethra and its suspension apparatus are brought into the right position. Immobilization damage is avoided through exercise stability which allows early maximum stress of the patient. A persisting instability of the anterior pelvic girdle through shearing force is a risk in reconstructive urethral surgery. Simultaneous primary care is contraindicated in cases of irreversible shock and life-threatening injury where the need for surgery is urgent.


[Operative therapy of elephantiasis penis by skin transplantation (author's transl)].

From 1960 to date, there have been four cases of elephantiasis penis in the urologic clinic of the Katharinenhospital in Stuttgart, which were operated on by skin transplantation. The causes of elephantiasis penis are discussed, and the surgical procedure is presented in detail. Finally, the outcome as far as appearance and function are concerned, is discussed.


[Gas in the draining urinary tract (author's transl)].

A report of two cases of gas in the draining urinary tract. The authors discuss the possible pathologic mechanisms and review the literature concerning spontaneous intrapelvic gas, which has been described 11 times previously.


[Bilateral, synchronous and symmetric cancer of the ureter (author's transl)].

We report a case of bilateral, symmetric and synchronous cancer of the ureter. Diagnose, therapy and development are described. Finally follow the considerations concerning pathogenesis.


Testicular feminization syndrome: current clinical considerations.

The testicular feminization syndrome (TFS) in its complete form results in total feminization due to a nuclear inaction of androgens, and the female role should be supported with postpubertal orchiectomy to avoid the risk of malignancy. Incomplete forms of the syndrome (ITFS) include Type I n which some degree of masculinization may be observed, prompting earlier gonadectomy, and Type II or pseudovaginal perineoscrotal hypospadias (PPSH) which is always characterized by pubertal masculinization, necessitating management and support of these patients as males. Other intersex abnormalities which must be differentiated include true hermaphroditism, the Swyer syndrome, males with 17-ketosteroid reductase deficiency, and Reifenstein's syndrome.


Perirenal lymphocyst formation in renal transplant recipients: diagnosis and pathogenesis.

Perirenal lymphocyst formation occurred in 7 of 46 consecutive renal allografts which had survived at least one month. This complication developed from one to four and one-half months post-transplantation, resulted in a specific spectrum of clinical signs and symptoms, and was best diagnosed by a combination of intravenous pyelography and ultrasonic examination of the transplanted kidney. The lymph fluid is of recipient origin and its collection appears to be related to use of a high-dose immunosuppressive regimen and to a conscious decision to avoid the use of postoperative surgical drains. Surgical intraperitoneal marsupialization of the lymphocyst emerges as the clear treatment of choice for peritransplant lymphocyst formation.


Posterior urethral valves.

Twenty cases of posterior urethral valves are reviewed with the presentation of several illustrative cases. Review of the current literature regarding managment of patients is discussed.


[Plastic surgery in radiation necrosis in the region of projection/of large vessels].

The author reports his experience with treatment of 112 patients having various forms of hypospadias, operated upon after the Landerer technic in the V. I. Rusakov modification. In all patients good immediate results were obtained: the urethra was reconstructed along its whole length and the penis was straightened. The study of late issues in 93 patients revealed good results in 82 of them, satisfactory-in 7, and poor (distortion of the penis remained)-in 4 patients. Penial distortion in these cases was liquidated by means of the tunica albuginea plasty on the posterior aspect of the penis. The method employed would provide good immediate and late results in treatment of various forms of hypospadias.


[Roentgeno-bronchological observations in experimental autotransplantation of the lung and its lobe].

Roentgenological studies were conducted after 260 autotransplantations of the lung and its lobe, performed experimentally and observed in dynamics during the period up to 4.5 years. Following autotransplantation of the lung in an uncomplicated postoperative period within the terms up to 15 days an intensified and indistinct pulmonary pattern with the presence of small-foci shadows is observed. Further observations for a period up to 4.5 years revealed neither changes on the part of pulmonary tissues nor anatomical or functional changes in the bronchial tree and vessels. In later terms after ortho- and heterotopic autotransplantation of the lower pulmonary lobe changes due to resection of the upper and cardiac lobe were observed, being manifested in displacement of a portion of the intact lung upper lobe into the upper portion of the left pleural cavity. Following heterotopic autotransplantation of the lower pulmonary lobe in the site of the removed lung no changes in the autotransplanted pulmonary lobe were noted in later periods. The signs of mediastinal hernia were less pronounced than after orthotopic autotransplantation of the pulmonary lobe.


[Surgical treatment of ununited fractures and pseudarthroses of femoral diaphysis].

In the present communication the author reports his experience with operative treatment of 237 patients having unhealing fractures and pseudarthrosis of the femoral bone, using modern methods of osteosynthesis, osteoplasty and sanatorium-spa treatment. The results of treatment were studied in 230 patients. Good and satisfactory issues were observed in 202 patients (87.8%), poor--in 28 (12.2%).


[Surgery of occlusive lesions of the brachiocephalic trunk].

A detailed analysis of 33 cases of operations on the brachiocephalic trunk is reported. An experience with surgical treatment for occlusive lesions of the brachiocephalic trunk of various etiology to liquidate chronic ischemia of the brain has evidenced that in aorto-arteritis the prosthesizing of the brachiocephalic trunk with synthetic prosthesis yields the most favourable results.


[Multilayer dermatoplasty by means of autodermal strip in inguinal hernia].

The author suggests the method of plastic reconstruction of the posterior wall of the inguinal canal by means of an autodermal strip, the lower edges of the internal oblique and transverse abdominal muscle together with the transverse fascia being laced by an autodermal strip. Then, stitches of the latter are sutured to the ilio-pubic band posterior to the testicular cord with a simultaneous constriction of the inguinal canal deep ring. A medial aponeurotic leaf of the external oblique abdominal muscle is sutured to the inguinal ligament anterior to the testicular cord, while a lateral aponeurotic leaf of the former muscle is sutured to the medial one as a duplicature. Since 1971 eighty eight operations have been performed after the technic described. Late results up to 3 years were followed up in 80 cases. No recurrences were noted.


Neoplasms of mesenchymal origin in the spinal cord and nerve roots of three dogs.

Clinicopathological findings of three different neoplastic conditions involving the spinal cord and nerve roots in three dogs are described. One sarcomatous intra-medullary tumor closely associated with the vasculature was classified as a reticulum cell sarcoma of the spinal cord. The second case had massive and widespread neoplastic proliferation of reticulohistiocytic cells around the perineurinal vessels of many spinal nerve roots. The process was classified as a primary neoplastic reticulosis of the spinal roots. Multiple highly malignant tumors, infiltrating the spinal cord were found in one thoracic and several lumbosacral spinal nerve roots in the third case. These were considered to be anaplastic neurofibrosarcomas because of high collagen content, intact nerve fibers, whorl formation, and the tendency to palisade in some areas.


Problems, diseases and diagnoses: a personal view.

Diseases and diagnoses are familiar words in the veterinary vocabulary and we seldom give much thought as to how we use them; we are more concerned about the practical problems they imply. However, there are occasions when it is essential that we use familiar words and concepts in a way that leaves no doubt as to the logical implications of our statements. The growing interest in surveys, monitoring and the use of computerised systems for epidemiological purposes points to the need for this discipline. In order to air the matter this paper presents some personal opinions that were based on Scadding (1967) and subsequently moulded by experience when designing a computerised data bank.


Boar management.

Many boar problems result from an insufficient number of boars in relation to the number of sows in the herd, sexually immature boars, inadequately preconditioned or improperly managed boars. The following factors which determine optimum boar efficiency are discussed: (a) sexual development and mating behaviour, (b) selection, (c) preconditioning, (d) mating systems, (e) examination and culling.


[Blastomogenic effect following single and chronic exposure to a mixture of cesium-137 and strontium-90].

The rate of tumor incidence in different rhythms of rat stomach exposure to cesium-137 and strontium-90 was analysed. The correlative values of the administered nucleids activity were selected by analogy with their content in global natural fall-out. In single exposure to the concentrations of 400 and 100 mc/per rat of cesium-137 and strontium-90 mixture accordingly, osteogenic osteosarcomas developed approximatley 4 times as frequently as in chronic administration of the same radionucleids in concentrations of 2 and 8 mc/per rat, correspondingly.


[Influence of a diet enriched with polyunsaturated fatty acids on some indices of the metabolism and course of acute gastro-intestinal diseases in children in the 1st year of life].

The influence of new products "Vitalakt" and "Malysh", enriched with polyunsaturated fatty acids, on the evolution of acute gastro-intestinal diseases and the lipids metabolism characteristics (total lipids, cholesterol and its ethers, phospholipids, nonetherified fatty acids in the blood serum), as well as on blood serum, protein fractions was studied. A total of 137 children were examined and the diet of 87 of them included the new dairy products "Vitalakt" and Malysh". These new dairy mixtures have been found to exert a beneficial effect on the course of the disease, tended to normalize the blood serum lipids characteristics and to reduce dysproteinemia. All this warrants recommending the mixtures "Vitalakt" and "Malysh" to be included in the diet of infants in the first year of life, suffering from acute gastro-intestinal diseases.


[Alimentary osteopathies].

Alimentary osteopathies are classified into primary (with food deficient of Ca, vitamin "D", or of proteins) and secondary ones, that develop consequent to disturbed assimilation and absorption of these substances. Basic causes responsible for the development of alimentary osteopathies are listed and the pathogenesis of this malady is considered. The osteopathies are classified with respect to their causes, the prevalent form (osteoporosis, osteomalacia, or mixed forms) and according to the severity of the skeletal affection (latent stage, that of clinical manifestation and the stage with complications). A review of modern methods of diagnosis and therapy in dealing with alimentary osteopathies by using calcium, vitamin "D" and fluorine, as well as by applying other remedies (thyrocalcitonin, estrogens, androgens, anabolic hormones, diphosphonates) or measures (exercises, rehabilitation) is presented.


[Immunochemical and molecular biological characteristics of dysentery phages].

Molecular organization of DNA of six dysentery phages was studied for their classification. The pattern of glucosilation of their DNA was determined by an immunochemical method and the test of competitive hybridization established the degree of homology of these DNA in relation to T4 phage DNA. Four of the phages (DDVI, Zonne "Gorkyi" Zonne "Czechoslovakia", Zonne "Poland") were shown to belong to the group of T-even  phages by their pattern of DNA glucosilation and by their capacity to inhibit DNA T4X3H DNA T4 hybridization. According to these criteria, two other phages (Zonne "Ufa" and Zonne "Khabarovsk") do not belong to the group of T-even phages.


[Serological studies of antibodies to Epstein-Barr virus in infectious mononucleosis].

This is the first study in this country of sera from patients with infectious mononucleosis and other infectious diseases (control group) for determination of complement-fixing antibody to the soluble (S) antigen and of fluorescent antibody to the virus capsid antigen (VCA) of Epstein-Barr virus. It was established that the CFT and the immunofluorescence test could be used for diagnosis of infectious mononucleosis only on a limited scale because of the lack of complement-fixing antibody in patients early in the convalescent period  and because of the presence of complement-fixing and fluorescent antibody in a high per cent of patients of the control group.


[Preliminary results with a new non-steroidal antirheumatic drug (author's transl)].

Thirty patients with classical or definite rheumatoid arthritis were treated over a 4-week period with diftalone, a new non-steroidal antirheumatic drug. The daily dosage ranged from 500 to 1000 mg. A good objective response was achieved in 69% of the patients. Diftalone was well tolerated. Side effects were noted in 11.8% of patients on 500 mg diftalone daily and in 18.8% of cases treated with the highest dosage (1000 mg daily). The optimum daily dosage appears to be 750 mg.


[Humoral antibodies to Epstein-Barr virus in infectious mononucleosis].

A high level of humoral antibody to the capsid antigen of Epstein-Barr virus was found in sera from patients with infectious mononucleosis. For detection of antibody, the method of indirect immunofluorescence in fixed P3HEHR cells of Burkitt's lymphoma was used. Sera from normal subjects were also shown to contain antibody to the capsid antigen of Epstein-Barr virus, but the titers were 5--10 times lower than in the sera from infectious mononucleosis patients. The occurrance of high titers of antibody to EBV in the sera from patients with infectious mononucleosis is diagnostic for IM and may be used for practical purposes.


[The "narrow pelvis". Disproportion as a cause of complications for mother and infant during labor (author's transl)].

The modern examination methods for the recognition and supervision of high risk births in the area of perinatology have led to a real decrease in newborn morbity and mortality. Since, however, optimal conditions have not been reached at present, there is an urgent need for a wide reaching intensification of prospective diagnostic measures. The early recognition of disturbances in the mechanism of labor is the most important. The author shows on the basis of the most recent literature and his own experience that, even today, factors involved with the mechanics of labor play a chief role in disturbances during the course of labor which have unfavorable effects on the infant as well as the mother. The various irregularities were discussed in detail and supported with statistics. The importance of pelvic roentgenographic diagnosis was discussed in a separate section. The tremendous gains for mother and infant resulting from clarification were compared with the cited, but not confirmed, damage caused by these measures.


[Comparison between 2 steroid dosage forms in psoriasis and eczema].

This trial was designed to evaluate the clinical effect of a new Topical steroid, the desoximetasone (test name A 41 304 from Hoechst Aktiengesellschaft). A randomized, double-blind, right-left comparative trial has been carried out in 22 patients with atopic dermatitis and on 24 patients with psoriasis. As a comparative drug, a betamethasone 17-valerate preparation, being the strongest on the market, has been used. The new compound showed a better effect on both indications, the difference being significant (p less than 0,005) on psoriasis.


[Combined immunosuppression with vincristine sulfate and cyclophosphamide (author's transl)].

Following immunization against sheep erythrozytes, it is possible to induce a double-peaked antibody response curve in the serum of experimental animals (rats) by using vincristine sulfate (Vi). Immunosuppression is enhanced in thymectomised and sensitised animals during rechallenge following Vi/Cy, as compared to animals treated with cyclophosphamide (Cy) alone, and an attentuated anamnestic reaction is subsequently observed. Survival time of allogeneic skin grafts in colony bred and inbred rat strains could not be prolonged by using Vi/Cy, as compared to animals treated with Cy alone.


[The rat visual cortex. Cytoarchitecture and stereotactic parameters].

In the present investigation the visual cortex of the albino rat was analyzed. On the basis of cytoarchitectonic criterions we can demarced the area striata (field 17) from a medial (field 18) and lateral (field 18a) lying peristriatic area. There are differences in the cortical structure not only between the striate and peristriate areae but also between field 18 and field 18a. In this publication we also present the visual cortex in stereotaxic coordinates on the basis of the stereotaxic atlas of FIFKOVA and MARSALA. Stereotaxic informations belonging the different fields of the visual cortex of the rat are not yet known, but they are very helpful for experimental investigations in this region of the brain.


Infantile cortical hyperostosis.

Two patients from a family in Nauru with infantile corical hyperostosis are presented. A brief review is made of the main features of the disorder.


[The biosynthesis of aroma compounds by microorganisms. I. Formation of N-acetyl-amines by saccharomyces cerevisiae].

Only primary amines were transformed to secondary acetamides by Saccharomyces cerevisiae in anaerobic model fermentations. Secondary amines and L-amino acids don't form N-acetyl-amines. Maximal rates of acetylation were obtained with 2- and 3-methyl-butylamine as acceptors of the postulated aminacetylase-reaction. The rate of acetylation of 2-phenylethylamine amounted to 12%; n-heptyl- and n-octylamine were transformed only in traces. At the example of 2-methyl-butylamine the kinetics of the reaction and the influence of the pH-value, of different N-sources and different concentrations of 2,4-dinitrophenol on the rate of acetylation have been examined. The identification and the determination of the microbiologically formed volatile compounds have been realised by means of the gaschromatography, concerning the qualitative experiments under mass-spectrometrical control.


[On the complex formation of proteins with cu ions under acidic conditions].

In order to determine the influence of copper additives on the protein digestibility, the complex formation of proteins with Cu ions under acidic conditions (pH=2.2) was investigated. Isolated soja-protein (300 mg) resp. pepsin was mixed with 10 mumol (2.49 mg) CuSO4-5H2O and dialysed against low molecular complexing agents with increasing affinity towards copper ions. The experiments with soja-protein showed, that most of the Cu ions dialysed (97% of total Cu2+ content) without any addition of complexing agents, pepsin, however, had a lower percentage (83% of total Cu2+ content). The remaining copper ions in pepsin could only be removed by alanin and ammonium-tetramethylendithiocarbamate. Therefore it is concluded, that in the acidic range Cu ions only form complexes with pepsin, but not with soja-protein. This effect is due to the very low isoelectric point of pepsin. The determination of iron, nickel, and zinc in native proteins revealed, that at pH=2.2 iron and nickel are stronger linked to pepsin than to soja-protein; only zinc was loosely bound to both proteins.


[High pressure liquid chromatography in food chemistry (author's transl)].

High pressure liquid chromatographie tools are described. Analysis are shown which are interesting for food chemistry. Future possibilities are mentioned.


[Pathomorphology of intensive care treatment (author's transl)].

The pathologic consequences of intensive care treatment are manifested locally and generally. Local disturbances due to intensive care therapy are as follows: blood vessel injury, thromboembolism caused by catheterization, tracheal stenosis following tracheostomy and, most important, sepsis. The more general pathologic results of intensive care treatment are essentially brought about by shock. Shock-kidney plays a subordinate role today because it is a reversible state of renal insufficiency. In contrast, shock-lung leads to death in about 50% of the cases. The pathohistologic features of the initial stages are microthrombosis, perivascular edema and endothelial damage. These three characteristics are already apparent before hospital admission and institution of treatment. It is not yet clear to what extent the therapy augments the pathologic changes or leads to clinically manifested symptoms.


[Gold treatment of progressive chronic polyarthritis--a clinical study].

In an intraindividual series of investigation consisting of 30 patients with rheumatoid arthritis the effect of gold therapy (Aurothioglucose) has been proved controlling biochemical and clinical parameters. Controls of the function-index by Steinbrocker et al. have shown a significant improvement in comparison with the stage before gold treatment. Futhermore a significant decrease of erythrocyte sedimentation rate (Westergren) as well as a significant increase of albumins and a significant decrease of gamma-globulins in proteinelectrophoresis provoked by gold treatment could be demonstrated. Side effects during gold treatment were observed in 5 patients; therapy was stopped in 2 patients.


Genetic properties of RM 98, an R plasmid of Salmonella which determines sensitivity to the phage IKe.

An R plasmid of Salmonella, RM98, which determines sensitivity ot the phage IKe (IKeS) and confers resistance to ampicillin (Ap), streptomycin (Sm) and tetracycline (Tc) was studied for its genetic properties in Salmonella typhimurium and Escherichia coli, Transduction of RM98 by P22 in Salmonella yielded transductants of which some had acquired all the recognizable markers (Ap, Sm, Tc, IKeS and resistance transfer factor or RTF) associated with RM98. This transduction pattern resembles the P22 transduction pattern of IKe-specific R plasmids: R45, R46, R48, R205 and N3. Preliminary genetic analysis of RM98 has indicated that the determinants of IKeS and RTF are closely linked and the determinants of Ap and Sm are closer to RTF-IKeS than they are to Tc.


[Resistance to beta-lactam antibiotics and aminoglycosides in gram negative bacteria. 1. Molecular and genetic characterization of R-factors (author's transl)].

With frequent use of aminoglycoside antimicrobials and beta-lactam antibiotics in hospitals in the last few years, the number of bacterial strains resistant to these chemotherapeutics increased. Lately, strains of E. coli, Klebsiella, Enterobacter, Serratia, Proteus and Pseudomonas resistant to many antimicrobials (ampicillin, carbenicillin, cephalothin, chloramphenicol, gentamycin, tobramycin, sisomycin, neomycin, paromomycin, kanamycin, streptomycin, spectinomycin, tetracycline, sulphonamides) were isolated from patients of the university hospital in Zuerich. The resistant phenotype of two representative strains (Klebsiella pneumoniae 1 and Serratia marcescens 2) could be transferred by mixed cultivation to E. coli K-12. Multiple resistance of strain 1, and addition, could be transferred to Salmonella typhimurium, Serratia marcescens, Providencia, Proteus mirabilis and Klebsiella pneumoniae in varying frequencies. Transfer to Pseudomonas aeruginosa, however, could not be achieved. Spontaneous instability of resistance was observed in 0.15% of the cells of an overnight brothe culture and in 90% of the cells of a three months old culture. Conjugation, instability and the response to the sex phages MS-2 and If-1 suggested that resistance was mediated by a monomolecular R-factor, belonging to the fi+-type. This suggestion was confirmed by molecular characterization of the resistance plasmids. After transfer of the R-factors of K. pneumoniae 1 (R-FK 1) and Serratia marcescens 2 (R-FK2) into E. coli K-12, plasmid DNA was labelled with (methyl-3H) thymidine, and isolated by isopycnic centrifugation in cesiumchlorid-ethidium-bromide. Analysis of plasmid DNA then was carried out by sedimentation in a 5-20% neutral sucrose gradient together with reference plasmids of known molecular weights and sedimentation constants. The analysis revealed that R-FK1 had a molecular weight of 54 X 10(6) and R-FK2 of 50 X 10(6) daltons. The values were confirmed by contour length measurements of open circular forms with an electron microscope. A comparison of the sedimentation profile of labelled plasmid DNA from strain 1 and 14C-labelled DNA of E. coli K-12 (R-FK1) showed that the wild-type strain contained, besides the large resistance plasmid, at least two smaller "cryptic" plasmids. These smaller plasmid molecules were also found in antibiotic susceptible variants of strain 1, which did not contain the 54 X 10(6) dalton plasmid molecule, responsible for the resistant phenotype. The number of copies of R-FK1 in E. coli K-12 was determined to be 2, indicating stringent control of replication. It is discussed that the growing number of isolations of strains of Escherichia, Klebsiella, Serratia, Proteus, Providencia and Pseudomonas, exhibiting the same resistance phenotype, results from the spread of the R-factor described above among the hospital bacterial flora.


[Resistance to beta-lactam antibiotics and aminoglycosides in gram negative bacteria. 2. Mechanism of resistance (author's transl)].

In a preceding paper the genetics of resistance of 2 representative strains exhibiting resistance to beta-lactam antibiotics (ampicillin, catbenicillin, cephalothin) to aminoglycosides (kanamycin, neomycin, paromomycin, gentamycin, sisomycin, tobramycin, streptomycin, spectinomycin) and further antimicrobials (tetracycline, chloramphenicol, suphonamides) were described. This paper reports about the mechanism of resistance to beta-lactam antibiotics and aminoglycosides in these strains. Enzymatic extracts from K. pneumoniae 1 and Serratia marcescens 2 were produced by the osmotic shock procedure. Incubation of these extracts with aminoglycoside antibiotics, to which the strains are resistant, and ATP resulted in the total inactivation of the antimicrobials, as measured with a Bacillus subtilis assay. Analysis of this inactivation with the radioactive methods of Davies and his colleagues revealed that the kanamycins, neomycins, paromomycin and gentamycin A were phosphorylated. Because butirosin was not a substrate for the phosphorylating enzyme, it was concluded that the strain produced the neomycin/kanamycin phosphototransferase I. Furthermore, it was found that streptomycin and spectinomycin were adenylylated by the enzymatic extracts as well as gentamycin C1a, C1, C2, A, tobramycin, sisomycin and the kanamycins. This substrate profile indicated the presence of two adenylylating enzymes: streptomycin/spectinomycin-adenylyl-transferase and gentamycin-adenylyltransferase. After transfer of multiple drug resistance by conjugation from both strains into C. coli K-12, sonified extracts were prepared and examined for enzymatic activity splitting beta-lactam antibiotics. The relative rates of inactivation of benzylpenicillin, ampicillin and cephaloridine as well as the inhibitory effect of cloxacillin, but not of p-chloro-mercuri-benzoate on the inactivation of cephaloridine indicated that both strains produced a class III/type a (TEM type) beta-lactamase. It is discussed that the increasing frequency of gram-negative organisms form the university hospital with identical resistant phenotypes as the strains examined is the result of the spread of an R-factor among the hospital bacterial flora.


[Distribution of the isoenzymes of nucleases in group A Streptococci (author's transl)].

62 strains of Group A streptococci of different origin were cultured under comparable conditions. The supernatants of cultures of the same optical density were investigated in respect of their DNase activity. After electrophoretic separation in PAA gel, the distribution and activity of the four isoenzymes, B, D, A and C was determined. The total activity showed a near-random distribution, all patterns except B D A were found. DNase B was produced by all, DNase C by one half, DNase A by one third, and DNase D by one fifth of the strains. DNase B alone was found in three out of ten strains. The total DNase-activity and the distribution pattern in strains of the same M serotype but of different origin varied within a wide range. So a further biochemical differentiation of this strain seems to be possible.


Multiple drug resistance in Escherichia coli - an analysis of all-nation computer-processed data.

In a computer-assisted surveillance program, a one-year yield of nationally collected strains of E. coli, and separately of their enteropathogenic serotypes, were analysed for their biresistance to 10 frequently used antibacterials, and also their typical three-, four-, and five-resistance which occur most frequently. It was shown that, like in staphylococci (1), classical drugs: ampicillin, streptomycin, chloramphenicol, tetracycline, and kanamycin all show a significant degree of mutual selectivity. This was confirmed by analyses of comparatively large numbers of strains with higher complexity of multiple resistance. It is important and significant, for the regulation of further antibiotic policy, that the computer analysis showed a mutual devaluation of gentamicin and colistin antibiotics. Colistin-resistant strains of E. coli showed a high degree of resistance to gentamicin - far higher than strains resistant to any other drugs, even strains resistant to four or five classical drugs, vice versa, gentamicin-resistant strains were in more than 50% resistant to colistin - a value which is much higher than that of the very good effectiveness of gentamicin toward strains resistant to other antibiotics, even to five of them at once. This is another important observation, similar to one-way selectivity of oxacillin-resistant staphylococci by lincomycin resistance. Such findings urge for a special surveillance program for these crucially important antibiotics in the all-nation computer-assisted surveillance of the resistance to antibiotics in problem bacteria. Enteropathogenic strains of E. coli showed far higher resistance values not only for classical antibiotics, but also for kanamycin, nalidixin and septrin resistance.


Studies on group A (phage tail) bacteriocins of Serratia marcescens. V. Serological characterization of subgroup I and II bacteriocins.

Neutralization tests with rabbit hyperimmune sera revealed a close, if not identical, serological relationship among 7 group A (phage tail) bacteriocins of Serratia marcescens of subgroup I, and among 3 phage tail bacteriocins of subgroup II, respectively. On the other hand, subgroup I and II phage tail bacteriocins were found to be serologically unrelated, as determined with neutralization tests and Ouchterlony immunodiffusion experiments. Immunoelectrophoretic tests, employing a representive phage tail bacteriocin of each of the two subgroups, disclosed the electrophoretic mobility of bacteriocin no. 5 (subgroup I), whereas bacteriocin no. 16 (subgroup II) remained stationary. Thus, two additional differential criteria, i.e., differences in antigenicity and electrophoretic mobility, were obtained for the characterization of subgroup I and II group A (phage tail) bacteriocins of S. marcescens.


Studies on group A (phage tail) bacteriocins of Serratia marcescens. VI. Calcium ion-dependent biological activity of subgroup II bacteriocins.

The biological activity of subgroup II group A (phage tail) bacteriocins of Serratia marcescens against susceptible indicator cells was completely abolished on two defined, Agarose-containing media. The addition of 0.002 M CaC12 to these two media fully restored the lethal activity of these phage tails. Subgroup I phage tail bacteriocins, on the other hand, were found to have no requirement for divalent cations. These observations furnished an additional biological criterion for the differentiation of subgroup I and II phage tail bacteriocins of S. marcescens.


Semi-automatic apparatus for determination of the consistency of microbiological culture media and gel-forming substances (author's transl).

The gel strength is an important factor in the production and preparation of microbiological culture media on the basis of agar-agar, silicagel and gelatine. There is an evident interest in a standardization of this parameter which can influence the number and the form of the colonies, the results of antibiograms and other tests based on diffusion. The apparatus described can be used for simultaneous determination of the gel strength and the elasticity of microbiological and industrial gels. The construction consists of an electromotor-driven supporting table for the specimen and a pressure measuring device. In operation, the gel is moved vertically with a constant speed against the probe of the pressure device. The pressure exerted on the surface of the gel can be read from a dial connected with the probe as well as the pressure at which the surface of the gel is being disrupted (breaking point, gel-strength pressure). The apparatus can be purchased under the name Gelomat from Heinrich Bareiss, 7931 Oberdischingen, West Germany (see Fig. 1 and 2). The results of the measurements can be influenced by various factors such as concentration of the gelating compound, composition and pH of the solvent, time and temperature at which the gel is held before, during and after plate pouring, surface (dry or wet) and heigth of the gel sample, method of mesurement, etc. To account for all these factors, a standard method of measurement is described. The apparatus has a sensibility of ca. 2 g, can measure a gel strength between 0 and 200 g with the standard equipment, and has a standard deviation of less than 1.35 for microbiological agar-agar gels (see Tables 2-4). The time needed for one determination is 40-60 seconds. Compared with other instruments for the same purposes, the Gelomat has following advantages: Simple and handy use, good sensitivity and reproducibility, capability for simultaneous measurement of gel strength and gel elasticity. In the last 4 years, this apparatus has been used with good results in more than 10,000 routine determinations


Treatment of experimental oesophageal perforation.

Oesophageal rupture was induced in 18 dogs and the animals were divided into three groups according to the treatment of the wound. In the first group the wound was closed with the adhesive Histoacryl-N Blau and Surgicel, in the second group with the same adhesive and a collagen preparation, while the wounds of the third group was sutured. Because of the inadequacy of suturing half of the animals in the third group died, while in the other groups every animal survived the operation. The adhesive plus Surgicel provided the most satisfactory closure of the wound.


[Propranolol and arterial hypertension: study with frequent daily checking of blood pressure and serum levels after 1 week of treatment].

In order to establish correlations between serum levels of Propranolol, blood pressure in hypertensive patients and cardiac rate, these parameters have been recorded at three different times in a day and after a week. This study points out that therapeutic response is variable. However the patients may be classified into 4 groups. This classification and the value of serum levels of propranolol are discussed.


Compartments and suborgans of the ventricular myocardium.

Color-coded liquid plastic was injected intraparenchymally (not into the blood vessels) into more than 300 hearts of homeotherms--including dog, cat, sheep, beef, horse, mammalian dolphins, chickens, turkeys, etc. The organization of the hearts of all these species appears to be similar. After injection of a heart segment such as the right ventricular free wall, corrosion (digestion) of the heart in strong alkali releases the case of only this free wall, and of the lymphatic vessels which drain this segment. None of the injected plastic enters the left ventricular free wall or the septum. Color-coded injections reveal that injections into only the left ventricular free wall, followed by digestion of the heart releases a cast of only the left ventricular free wall. Injection into the septum produces a cast of only the septum. Injection into all three compartments provides a cast of the apex and midpoint of the heart. The colors and injections remain discrete--they never mix. This is evidence that fibrous supercapsules separate these three compartments. The casts prepared by injection into the middle or inferior parts of the ventricular myocardium show large lacunae at the base. Similar injection experiments show that the base of the heart consists of two discrete suborgans: the inflow tract or cushion (tricuspid and mitral rings, and their papillary muscles), and the outflow tract or infundibulum (muscular bundles inferior to the pulmonary and aortic outlets). Further studies showed that the septum consists of discrete right and left hemiseptae. These data support the hypothesis that the heart consists of three suborgans; the cushion, venter (pump), and infundibulum. Each suborgan consists of four compartmetns: its free right wall, free left wall, and right and left hemiseptae. These entirely separate twelve compartments of the ventricular myocardium are held together by strong fibrous connective tissues. Their function is coordinated by the atrioventricular conduction system. The present studies indicate that earlier studies which have indicated that the heart consists of one or two bandage-like, concentric wrappings may be incorrect. The significance of our findings is dicussed.


Orientation of the fascicles of the ventricular myocardium.

A new technique was developed to examine the arrangement of the fascicles of the myocardium. Liquid plastic was injected intramurally into the free walls and the septum of more than 300 hearts of mammals and birds. After the plastic hardened, the tissues were digested in alkali, thereby releasing a plastic cast which had been formed in the myocardium. The plastic plates formed in the heart were consistently perpendicular to the surfaces of the epicardium and the endocardium. Related studies have shown that each cluster or clone of muscle fibers is contained in a fibrous connective tissue capsule. The injected plastic is therefore confined to the trabecular (extracapsular) clefts which define the borders of the capsules. The casts show that the capsules containing the muscle fibers are arranged in the planes of great circles of the myocardial spheroid. These capsules are shaped as wedges with acute angles at the endocardium, and with dihedral angles less than 1 degree. Interventricular sulci interrupt and separate the capsules of the right free wall from the left free wall. Septal capsules are separated from but aligned with the long directions of the capsules of the adjacent free walls. These data challenge the currently accepted concept of the bandage-like arrangement of the myocardial fascicles. The significance of our findings with respect to myocardial function is discussed.


[Injuries of the peripheral blood vessels].

Success in surgical intervention depends primarily on the general practicioner who makes the early diagnosis, who also makes the temporary bandages against clotting and who quickly transports the patient to the nearest surgical hospital. The arrival of patient in the shortest time period; within 6 hours after the injury, could give a guarantee for a successful surgical intervention. At a combined injury of veins and arteries, it is necessary to give, besides the minuteness surgical technic, an anti-coagulative (anti-clotting therapy during the post-operative period. We are of the opinion that every surgical department should be able to handle injuries on the outer blood vessels, which means they should have a good knowledge of basic principles on the vascular surgery.


Billroth I gastric resection versus truncal vagotomy and pyloroplasty in the treatment of gastric ulcer.

Forty-five patients with benign gastric ulcers were treated by truncal vagotomy and pyloroplasty or Billroth I gastric resection in a randomized, controlled trial. Postoperatively, one Billroth I patient died. During the follow-up recurrence occurred in three patients treated by vagotomy, but in no Billroth I patient. The overall functional results according to the classification of Visick were slightly, but unsignificantly better after Billroth I than after vagotomy and pyloroplasty.


Migration inhibitory effect of cell-free supernatants from PHA-activated cultures of human mononuclear leukocytes.

A two-step test for the demonstration of phytohaemagglutinin (PHA)-induced production of migration inhibitory factor (MIF) was investigated. In the first step, human purified mononuclear leukocytes were activated by incubation with PHA for 1 h. Then the cells were washed thoroughly and cultured for 1 to 4 days in TC medium without PHA. In the second step, the MIF-activity of the cell-free culture supernatants was tested on non-separated human leukocytes. The migration inhibition reaction was demonstrated by the agarose migration technique. The supernatants might have been contaminated by PHA, but it was shown that such contamination would be unable to cause any appreciable migration inhibition of the indicator leukocytes.


Halothane anaesthesia and suxamethonium I: the significance of preoperative atropine administration. A double-blind study.

Preoperative administration of atropine was evaluated during induction of halothane anaesthesia with two administrations of suxamethonium 1 mg/kg body weight, 5 min apart. Sixty-eight healthy, adult patients were studied. They were divided into five groups according to dose and route of administration of atropine. ECG was continuously monitored. Serum potassium, pH, PaCO2, PaO2 and standard bicarbonate were measured at appropriate intervals. It was found that neither atropine 0.01 mg/kg body weight given intramuscularly 1 h beofre the anaesthesia nor atropine 0.01 mg/kg body weight given intravenously 5 min prior to induction protected against serious bradycardias (defined as heart rate below 20 beats per minute) following the second dose of suxamethonium. No serious brady-arrhythmias were seen in patients given either a combination of intramuscular and intravenous atropine in the above-mentioned doses or in patients given atropine 0.015 mg/kg body weight intravenously 5 minutes prior to induction. However, a decrease in heart rate to around 40-50 beats per minute occurred in some of these patients. Furthermore, these large doses of atropine caused an increase in heart rate during induction to more than 120 beats per minute in about 50% of the patients and to more than 140 beats per minute in about 25% of the patients. Our results suggest that preoperative administration of atropine does not protect against serious brady-arrhythmias following a second dose of suxamethonium, unless doses of atropine are used which cause tachycarida of considerable degree.


Urinary cytologic changes after radiotherapy of renal transplants.

Significant changes in the urinary cellular pattern can be attributed to renal allograft radiation, as distinct from those associated with immunologic rejection of the transplated kidney. These changes consist of nuclear multiplicity, wrinkling of the nuclear membrane, a "coffee bean" appearance of the nucleus, and increase in nuclear size, areas of decreased density and vacuolation of the cytoplasm, and perinuclear halos. The severity of the changes was categorized as "mild", "moderate", or "marked", according to the number of the above changes which were present, and was more evident in cells of transitional epithelial origin than of tubular origin. Some correlation was found between the severity of the cellular radiation changes and the survival time of the kidney.


Comparison of haemodynamic effects of pethidine and anileridine in patients with coronary-artery disease.

The circulatory effects of anileridine, a derivative of pethidine, have been little studied. Therefore we compared the haemodynamic effects of equianalgesic doses of pethidine (1 mg/kg i.v.) and anileridine (0.25 mg/kg) in matched patients requiring myocardial revascularization. Cardiac output was significantly increased 5 min after the administration of pethidine, mainly due to an increase in heart rate. A transient rise in the systolic pulmonary-arterial pressure was found after anileridine. No remarkable changes were found in systemic arterial pressures, central venous pressure, balloon-occluded pulmonary-arterial pressure, stoke volume, systemic or pulmonary vascular resistances and derived oxygen consumption. Further, 20 min after drug administration, there were no significant differences in any circulatory parameters between the two groups. One patient developed acute cardiac failure after anileridine, though as he had very severe coronary heart disease it remains an open question whether this was spontaneous or drug-induced. Since the rate-pressure product tended to increase after pethidine, this drug may not be considered an ideal analgesic for patients with ischaemic heart disease. Anileridine had less influence on this variable. Since the circulatory effects of pethidine seem to depend on the haemodynamic status of the patient, the haemodynamic properties of anileridine may also deserve further investigation.


Comparison of the effect of anileridine and pethidine on the intracholedochal pressure during constant fluid perfusion.

Anileridine and pethidine have a spasmolytic action on animal intestine. Pethidine is known to have a spasmogenic effect at the choledocho-duodenal junction of man, but there is no study of the effect of anileridine on the biliary tract. In the present study the effects of anileridine and pethidine on the intracholedochal pressure during constant fluid perfusion in man were compared. The maximal elevation of the choledochal passage pressure was significantly greater after anileridine than after pethidine. However, the difference between anileridine and pethidine seemed to be less than that reported previously between morphine and pethidine. The effect of anileridine was of shorter duration than of pethidine. Anileridine and pethidine are not ideal analgesics when the normal activity of the biliary ductal system has to be maintained in pain or during cholangiography.


E. coli growth inhibition by amniotic fluid.

Amniotic fluid samples were collected aseptically from 29 normal pregnancies, between the 38th and 41st week of gestation and checked for sterility in the laboratory, in order to investigate in vitro the effect of the liquor on the growth of E. coli. Brain Heart Infusion (B.H.I.) and Ringer solution were used as controls. E. coli cultures were inoculated in amniotic fluid, B.H.I., Ringer solution and amniotic fluid plus B.H.I. and incubated at 37degreesC for 48 hours. At 0, 1, 3, 6, 12, 24, 36 and 48 hours of incubation, surface viable counts were performed to estimate the number of E. coli viable cells. The growth of E. coli in B.H.I. started furing the 1st hours after inoculation and continued over 48 hours; in Ringer solution the mean growth curve and almost identical to that of B.H.I. In amniotic fluid the growth of E. coli began from the 1st hour of inoculation but the growth curve was much lower, became static in 24 hours and a permanent inhibition was observed thereafter. The addition of a small amount of B.H.I. in amniotic fluid enhanced the growth of E. coli, but the growth curve was lower in comparison to the curves of the two controls studied. In conclusion, after 48 hours of inoculation in amniotic fluid, 26 of the 29 cases showed bacteriostatic or bactericidal activity of the liquor upon the growth of E. coli.


Video display system for fetal and maternal monitoring.

Signals from different fetal and maternal monitoring equipment were combined in a video system. Analogue curves and digital figures were displayed on the same screen and included warning signals. Sweeps for different curves are selected individually. It is possible to show fast and slow changing parameters on the same screen. The system has great flexibility and signals from equipment from different manufacturers may be added easily.


Chorioangioma with hydramnios and intra-uterine fetal death.

Chorioangiomas are benign placental tumours derived from fetal vessels, that occur with a frequency of approximately 1%. Often they are associated with hydramnios and intra-uterine fetal death. Based on a case of multiple chorioangiomas with a fatal course for the baby, aspects of the pathogenesis of hydramnios are discussed. Future development in ultrasounc technology may facilitate antenatal diagnosis.


Escherichia coli O antibody content in milk from healthy Swedish mothers and mothers from a very low socio-economic group of a developing country.

The antibody content of milk from healthy Swedish mothers was compared with that of milk from mothers of a very low socio-economic group in a developing country. Antibodies of various immunoglobulin classes against E. coli O antigens were determined with the enzyme-linked immunosorbent assay (ELISA). The milk antibodies which mainly belonged to the secretory IgA class appeared in similar concentrations in milk from the two groups using E. coli antigens of Swedish as well as Pakistani origin. The secretory IgA antibodies could be demonstrated in the stool of the breast-fed infants of the undernourished mothers. Also the concentration of serum IgG and IgA antibodies to E. coli O antigens were similar in the Pakistani and Swedish mothers. The serum IgM antibody levels of the Pakistani mothers were higher, however, presumably due to a higher frequency of infections. It was noted that the milk production decreased considerably upon the hospitalization of the healthy and well-to-do Swedish mothers. The small milk volumes of the undernourished Pakistani mothers suggest that the lactation failure observed was mainly due to inadequate milk flow and not to decreased milk quality. The results indicate the necessity of studying the nutritional, psychological and social factors responsible for low milk yield and add yet another reason to stimulate prolonged breastfeeding.


Infections in preschool children in group day care.

Viral and bacterial infections in 20 children under 3 years of age were studied in a day centre for 12 weeks. Febrile illnesses were found on one occasion in each of 11 children but no serious infection occurred. Pneumococci types 6, 9, or 19 were isolated from all children but more often from those with rhinitis or cough. The individual child had an average of 2 viral infections. Adenovirus types 1, 2, 5, coxsackievirus type B5, herpes simplex virus or respiratory syncytial virus was isolated from 12% of the oropharynx swabs and 40% of the fecal specimens. When a virus was first isolated from the oropharynx, the children were asymptomatic or had only rhinitis in 73% of the cases which might indicate that the dismissing of symptomatic children is of limited value in controlling the spread of infections in a day care centre. Cytomegalovirus was recovered from 22% of the urine specimens. Carrier frequency of cytomegalovirus was 23% in 40 other children attending one of 13 different day care centers. Because asymptomatic cytomegalovirus infections apparently occur frequently among small children in Sweden, it seems reasonable not to take pronounced measures of isolating the children in the relatively few recognized cases of cytomegalovirus infections.


Pleural empyema in a newborn infant. An unusual cause of respiratory distress.

In a 2-day-old baby with symptoms of respiratory distress a right-sided pleural empyema caused by haemolytic streptococci was found. Possible sources of infection are discussed. The mother had purulent discharge from a tooth a few weeks before delivery, and this may have been the focus. The baby was treated with pleural drainage and ampicillin with good result.


Demonstration of adenovirus associated endonuclease.

In HEp-2 and amnion cell cultures infected with type 1 adenovirus the DNase activity of cell extracts was measured on 32P-labelled Escherichia coli DNA substrate. Enzyme activity was demonstrated by the acid soluble nucleotides released from the 32P-DNA and by the decreased sedimentation rate of labelled DNA. High DNase activity was measured in both adenovirus infected and in untreated HEp-2 cell extracts. Nuclease activity of the amnion host cells being much lower than that of HEp-2 cells, virus-associated endonuclease activity was successfully demonstrated in them. Purified type 1 adenovirus decreased the sedimentation rate of 32P-labelled E. coli DNA. The phenomenon is explained by the virion-associated endonuclease activity. Trypsin inactivated and anti HEp-2 IgG failed to inhibit the virion nuclease. An association between endonuclease and trypsin sensitive penton is assumed.


Segregation of Col Ib and drd7 into minicells.

The wild-type plasmid ColIb and its mutant drd7 derepressed in conjugation were transferred to Escherichia coli K12 P678-54 which produces minicells. Fertility functions of drd7 remained derepressed in the new host. P678-54drd7 transmitted the plasmid at a high frequency (28.6%) and it was effectively lysed by the phage If1. Significant amounts of 3H-DNA segregated from P67854Col+ into minicells dependent upon the presence of the plasmid. The depressed plasmid segregated more effectively into minicells than the wild-type plasmid. ColIb segregated into 2% whereas ColIbdrd7 into 8.4% of minicells. The difference in the frequency of segregation of the wild-type and the derepressed plasmid indicated different cell membrane attachment sites of each plasmid studied. Mini-drd7 were able to transfer the plasmid to E. coli Row at a low frequency (0.1%). Minicells carrying either of plasmid were capable to synthesize RNA and protein. RNA and protein synthesis were plasmid specific and the precursors were not incorporated into minicells without plasmids. Rifampin and chloramphenicol inhibited RNA and protein synthesis in minicells, respectively. The more effective incorporation of 3H-uridine or 14C-leucine into minicells harboring drd7 than ColIb resulted presumably from the high efficiency of the segregation of drd7 into minicells. Polyacrylamide gel electrophoresis of 3H-RNA has shown that plasmids in minicells were able to code low molecular RNA of 4s. No 16 or 23 ribosomal RNA was found in the profiles of de novo synthesized RNA in minicells.


Transformation of Escherichia coli by R404 factor DNA and properties of the transformants.

Three r-determinants (Cb Cm Cf) out of eight present in R404 factor were transferred in transformation of Escherichia coli by the plasmid DNA isolated from minicells. The r-determinants acquired in this way formed the replicon tr404-1 and were untransferable by conjugation unless another self-transmissible plasmid was present in recipient. The evidences are presented in support of hypothesis that the transfer events consist in infection of transformant cells with sex factor, recombination between tr404-1 replicon and the sex factor and finally transfer of the new formed structure to the host cells of the sex factor.


Antigenicity of bone tissue. I. Immunological and immunohistochemical study of non-collagenous proteins of the bovine cortical bone.

From powdered bovine bone cortex an extract has been prepared with 0.15 M NaCl and its collagen-free fraction obtained on DEAE-cellulose column was used for the immunization of rabbits. The non-collagenous protein fraction (NCP) produced against immune serum two precipitation arcs both on agarose double gel-diffusion and with immune electrophoresis. After decalcination in 10% EDTA PH 7.4, direct and indirect immune histochemical examinations were performed with fresh, freshly lyophilized, as well as with bones kept for three and six months at 20 degrees C, and the antigens were localized. Prolonged storage increased the antibody-binding capacity of the bones, whereas lyophilization decreased it. Fixation in cold acetone was suited best for immunohistochemical study of the cortical bones.


The effect of vascular perfusion fixation on the ultrastructure of the juxtaglomerular apparatus of the rat.

After fixation by low pressure retrograde perfusion the electron microscopic picture of the rat JGA was studied and compared with the picture obtained after fixation by dripping and immersion. The most conspicuous difference was the presence of the basal compartments of the macula densa cells, which might land electron microscopic support to the tubulo-glomerular feedback theory. Among the JG granular cells, desmosome-like connected structures were seen. Crystalline and granule in granules specific secretion forms were frequent in the epitheloid cells.


Modifying delinquent behavior: beginnings and current practices.

The beginnings of behavior therapy with delinquents are traced to the early 1960's when a number of case studies and demonstration projects were first presented. Current practices are reviewed in more detail. In institutions for delinquents, many token economies have gradually developed; their shortcomings and results are discussed. In clinic settings, several individual and group techniques are reviewed as they are currently practiced. A major trend is seen as being away from institutional and traditional clinic behavior therapy. Direct community intervention is seen as the most parsimonious mode for modifying and preventing delinquent behavior, and several model programs are described.


Current concepts in neuro-oncology.

Recent years have witnessed a significant resurgence of interest in neuro-oncology. This has largely been due to the use of new, potent neuro-oncogenic agents that have provided researchers with a growing body of data. New tools are being devised for the experimental study of brain tumors utilizing radiotherapeutic, chemotherapeutic, and immunological methods. In this chapter, selected observations on naturally occurring and experimentally induced nervous system tumors are discussed in relation to the following current areas of interest in oncology: (a) the somatic mutation theory of cancer and the additive mutagenic action of radiation and alkylating carcinogens; (b) the viral theory of cancer and the production of tumors by oncogenic viruses; (c) disturbances of immunological mechanisms concerned with tumor surveillance involving the central nervous system; and (d) the operation of epigenetic mechanisms in neoplastic systems, the applicability of these mechanisms to embryonal tumors of the central nervous system, and the development of suitable neural neoplastic models for the study of altered patterns of gene expression. Neural neoplasms are particularly suitable for the study of epigenetic phenomena because precise morphological, biochemical and antigenic markers exist which permit the various stages of divergent differentiation in neurocytogenesis to be clearly defined.


Recent advances in neurosurgical techniques - historical considerations.

1. The basic principles of neurosurgery have changed but not as radically as we might believe. 2. The most radical changes include a full facility of power tools, the aid of magnification techniques with excellent illumination, and the great value of shrinking agents, with less damage to the assaulted brain. 3. The surgeon has been aided by a reclassification of tumors and thus can estimate his surgical attack and prognosis more accurately. History has not proven the malignant gliomas amenable to long-term surgical results, and out hopes must lie in chemotherapy. 4. The ancillary disciplines of neuroradiology and neuroanesthesia have aided the surgeon immeasurably in the planning of his operation, but the final results still depend basically on the surgeon's ability and judgment in that difficult decision "should I go for broke or stop?"


Anesthesia for intracranial surgery with particular reference to surgery for neoplasms.

If good anesthesia is to be provided to the patient undergoing surgery for an expanding intracranial lesion, certain principles should be borne in mind. These principles include: 1. Careful preoperative assessment of the patient 2. Awareness of abnormal intracranial dynamics in the presence of an intracranial mass lesion 3. The importance of a smooth induction of anesthesia 4. Adequate depth of anesthesia and complete muscle paralysis before laryngoscopy and intubation 5. The choice of a maintenance technique that does not increase ICP and allows adequate CPP. Failure to adhere to these principles may lead to sudden increases in intracranial pressure, decreased cerebral perfusion pressure, and regional ischemia. In the closed skull, internal herniation of brain tissue through the tentorial notch or the foramen magnum may occur. External brain herniation, with increased bleeding and rupture of cerebral cortex, may occur after the dura mater has been opened if these anesthetic parameters are not controlled. Neuroanesthesia, therefore, plays an important role in the reduction of morbidity and mortality in the surgery of intracranial lesions of all types, including neoplasms - not only in the operating room, but also in the pre- and postoperative care of the neurosurgical patient.


Pharmacological principles of brain tumor chemotherapy.

In conclusion, I would like to reiterate the belief that curative therapy will require both CCNS cytocidal drugs and appropriately timed CCS agents. Lipophilic drugs will remain our most valuable drugs unless new agents appear that have very high therapeutic indices and can be given by prolonged or intermittent infusion. The lipophilic drugs have the advantages of greater penetrability of tumor cells and preferential partitioning in lipid membranes and cellular structures. Potentially, combinations of differently acting CCNS agents should maximize DNA damage and prevent DNA repair. Infusions of CCS drugs for 3 to 4 days, following an interval of 6 to 14 days after the administration of CCNS agents, should result in maximum damage to proliferating tumor cells, preventing cell division for 1 week and contributing another 1 log cell kill to the therapy.


Cummings Memorial Lecture - 1975. The market basket: food for thought.

The world food crisis is as critical today as when it was debated at the 1974 World Food Conference in Rome. Since the United States and Canada-and to a lesser extent, Australia and New Zealand-lead in the production of corn, wheat and soybeans, the North American "bread basket" has become the "market basket" of the world. For welfare, economic, and political reasons, our energies, resources, and deliberations must be expanded toward optimum production of wholesome food products. I do not recommend that we permit food additives in "questionably" safe or excessive concentrations in our agricultural products. I do recommend, however, that tolerance limits for food additives be established based on a comprehensive review of all contributing factors-the world food crisis and the rational interpretation of both positive and negative animal data as they relate to man. As Dr. Herbert Stokinger put it so aptly: "Avoid the establishment of unnecessarily severe standards." 2. Funds for research and teaching of food and nutrition should be greatly increased, so that all who can read and write may be made aware of the daily dietary requirements for the maintenance of good health. 3. Unsubstantiated scare tactics in publications of the scientific and lay press can only lead to well-intended but often emotionally-inspired restrictions, ordinances, and laws. Such decisions are likely to either under- or over-define the requirements and standards for food additives and other chemicals which are important to the well-being of the populace.


[Histologic and immunologic study of recurring endonasal polyposis in relation to desensitization therapy].

Ten middle-aged patients (7 males and 3 females) suffering allergic rhinitis and endonasal polyposis, were polypectomized and studied with allergoimmunologic techniques. Clinical evaluation preceded laboratory examinations consisting in routine data and electrophoretic study of serum proteins. These examinations were performed before and after one-year hyposensitization treatment. One patient revealed a hypogammaglobulinemia and received 800 mg of commercial human gammaglobulin every 28 days, during 3 months; subsequent proteinograms showed acceptable improvement of the initial value. Skin tests resulted positive in all patients particularly to house dust, micotic (Candida albicans, Trycophyton and Alternaria) and bacterial antigens (Gram positive and negative bacteria). Specific hyposensitization was performed throughout one year with weekly subcutaneous injections of the corresponding antigens. No autovaccine of nasal exudates was employed. All the polyps were divided into two parts; one half for histological study and the other half stored at -20 degrees C for protein determination using immunoelectrophoresis, polyacrilamide gel and radial immunodiffusion. Immunoelectrophoresis was performed with polyps homo-genate against an antihuman serum and showed two precipitin lines at alfa-1 and beta-1 globulin sites. Polyacrilamide gel revealed more lines in those runs belonging to post-vaccinated polyps than in those belonging to the prevaccinated group. Immunoquant polyps were checked against anti-A, anti-G and anti-M; only IgA was detected in polyps obtained at any time. These apparently contradictory results may be due to the different sensitivity of the techniques applied as well as the small amount of polyps homogenate and its low protein content. New polyps reappeared in three patients at six, ten and twelve months, respectively, from the beginning of the treatment. These patients were again polypectomized and histological and immunological studies were repeated.  They were fixed in Bouin, and paraffin sections of 6 to 10 microns in thickness, were submitted to hematoxilineosin, P.A.S. and toluidin blue techniques. These preparations were microscopically evaluated with a Carl Zeiss Photomicroscope with magnifications of 100, 250, 400 and 1,000 times. An important difference between the original and the recurrent histological images was seen. Meanwhile the former polyps were vascularly rich and cellularly poor, the latter appeared inversely composed. An abundant infiltrate of plasmocytes, lymphocytes and histocytes was the rule; it was regularly disposed but a preference to collect around the vessels was observed. The vessels seemed to be lesser in number and size though this observation must be checked with further investigations. The absence of eosinophils led us to support--in this case--the participation of an infectious mechanism in an allergic filed with high sensitivity to bacterial and inhalant antigens...


Simple method for computer-aided analysis of echocardiograms.

The use of echocardiography in the diagnosis and assessment of heart disease is increasing as greater familiarity is obtained with this noninvasive procedure. Quantitative evaluation of echocardiographic studies has heretofore required time-consuming manipulation of mathematical formulas. A simple method utilizing a sonic digitizing tablet has been developed for computer-aided analysis of M-mode echocardiograms. This device can convert a point located manually with a digitizing pen into X and Y coordinates and with use of the standard telephone network can communicate on a time-shared basis with a DECSYSTEM-10 computer. A program has been written to compute and type the results of standard calculations involving mitral valve motion and left ventricular function. The information can also be stored on disk by the computer for future use. This simple, relatively inexpensive system is valuable because of the ease with which it permits usually laboriously obtained information to be extracted from the standard echocardiogram.


Pathobiologic features of human candidiasis. A common deep mycosis of the brain, heart and kidney in the altered host.

In a review of 2,616 consecutive autopsies done at the University of Kentucky Medical Center over a 12-year period, 46 patients with complete postmortem examinations had tissue-verified candidiasis in two distinct patterns, with Candida albicans being most frequently cultured. Superficial candidiasis involving only lining surfaces was observed in 21 patients (46%). Usually, it complicated other lethal problems such as malignancy and bacterial sepsis. Nineteen of these patients (95%) had received antibiotics. No vessel invasion or deep organ involvement was evident in this group. The other pattern of candidiasis was a deep or systemic variety recognized in the remaining 25 patients (54%). It was characterized by deep parenchymal organ lesions usually involving the brain (52%), heart (48%), and kidney (80%), but any tissue seemed susceptible. Vessel invasion was seen in 8 patients (32%); intravenous lines were used in 13 (52%); and major operations were done in 16 (64%). All these patients were hospitalized for either benign or malignant conditions and were treated for bacterial sepsis with antibiotics for seven days or more. This investigation indicates that candidiasis occurs when the host's environment is altered primarily by antibiotic therapy. Candida then can colonize lining surfaces and from there could invade adjacent vessels and disseminate throughout the body.


Clinical and laboratory aspects of Yersinia pseudotuberculosis infections, with a report of two cases.

Yersinia pseudotuberculosis infections in two bacteriologically confirmed cases are described. A child was found to have mesenteric adenitis and an adult had septicemia. Invariably simulating acute appendicitis, mesenteric adenitis most often occurs in male children and adolescents. Septicemia with this organism usually affects elderly, debilitated patients, who frequently have chronic hepatic disease. The infrequent diagnosis of infection with Yersinia pseudotuberculosis in the United States is probably due to failure to consider it a human pathogen. Currently classified with the Enterobacteriaceae, Yersinia pseudotuberculosis in a non-lactose-fermenting, Gram-negative coccobacillus. It is sensitive to a wide range of antibiotics, including tetracycline and streptomycin, but usually is resistant to ampicillin. Yersinia pseudotuberculosis has a worldwide distribution in wild and domestic mammals and birds. Infections in man may result from direct contact with infected animals or their excreta.


Results of the College of American Pathologists mycobacterial surveys, 1973.

Results of the College of American Pathologists Surveys showed a significant improvement of participant performances between 1972 and 1973. Participants in the Special Mycobacterial Survey did much better in speciating mycobacteria than did those in the Comprehensive Microbiology Survey. It is likely that many of the participants in the Comprehensive Microbiology Survey were unaware of their option to select the extent to which they offer service and were evaluated.


A quantitative study of the growth of Candida albicans in vented and unvented blood-culture bottles.

Suspensions of four strains of Candida albicans of various concentrations were inoculated in equal amounts into paired vented and unvented vacuum blood-culture bottles. Inocula ranged from 10 to 10(7) organisms. After 48 hours, it was found that unvented bottles contained essentially the same numbers of organisms as the original inocula, whereas heavy growth was observed in vented bottles. When the previously unvented bottles were subsequently exposed to room atmospheric pressure and incubated, all, even those with the smallest inocula, showed heavy growth in two days. It is concluded that Candida yeasts do not multiply under the microaerophilic conditions in such containers, but survive with the capability of subsequent proliferation. To avoid the necessity of employing two bottles, it is suggested that Candida be sought when indicated by venting the container at 48 hours after anaerobic subculture and again examining and subculturing for Candida two days later.


Comparison of methods for differentiating among Serratia marcescens isolated from clinical specimens.

Serotyping, biotyping and antibiotic resistance patterns were found to give consistent results for routine hospital surveillance of Serratia marcescens isolates. Bacteriocin typing showed variation between trials and was considered too variable and time-consuming for routine hospital surveillance.


Response of plasma LH and FSH to synthetic LH-RH in children at various pubertal stages.

Fifty normal boys and 47 normal girls, aged 5 to 18 years, underwent a standard luteinizing hormone-releasing hormone (LH-RH) test (50 mug/sq m by rapid intravenous injection), and the plasma levels of LH and follicle-stimulating hormone (FSH) were determined. The results were analyzed separately according to the pubertal stages for each sex. A wide range of distribution of the individual measurements of the plasma gonadotropins throughout the LH-RH tests was found, but the mean values of the basal and peak levels showed a definite pattern for each sex at the different pubertal stages. Of particular interest was the sharp rise in basal plasma FSH level and its marked response to LH-RH in girls at the onset of puberty. The girls at this stage had the highest basal and peak FSH levels obtained at any pubertal stage in both sexes. It is concluded that the establishment of norms of LH and FSH response to a standard dose of LH-RH will be useful in evaluating normal and abnormal pubertal states in both sexes.


Cerebral palsy. A pediatric developmentalist's overview.

Exploration of the history, terminology, and classification of cerebral palsy reveals it as a complex entity. Criteria exist that may make early diagnosis and appropriate intervention possible. Dealing with patients who have cerebral palsy requires recognition of the associated problems and deficits. Comprehensive management usually requires a multidisciplinary setting, which is used to outline the contributions of many therapeutic modalities--developmental pediatrics, occupational and physical therapy, hearing and speech, psychology, social services, special education, ophthalamology, neurology, orthopedics and neurosurgery. The poor prognosis for full function within the community is recognized, as are areas of research that require investigation.


Reared in adversity: institutional care of children in the 18th century.

The earliest public pediatric care of the 18th century in this country took the form of "outdoor relief." Institutional care followed, first almshouses were built; then orphanages, hospitals, and dispensaries. Almshouses not only included workhouses but provided comprehensive medical services. Throughout the 18th century, people often referred to the almshouses as hospitals. As general hospitals, they rendered a variety of pediatric services to sick children, including the idiotic and hopelessly crippled, and the newborns delivered in the maternity wards; and they tendered services for well children, such as foundlings, abandoned children, and the children of destitute parents, placing infants in foster homes and indenturing older children for training in various trades and crafts. The voluntary hospitals, on the other hand, were for the "worthy" poor and limited their services to the insane and the curable sick. There were only two opened during the 18th century-the Pennsylvania Hospital in 1752 and the New York Hospital in 1791. The former excluded young children during the 18th century. Orphanages preceded the voluntary hospitals in point of time, offering many pediatric services to children, well and sick. Finally, at the end of the century, the independent dispensaries appeared, the first in Philadelphia in 1786. By the middle of this 20th century, practically all of them had been absorbed by hospitals. In these institutions, pediatric knowledge advanced and medical manpower developed even during the 18th century. By the end of that century, social movements began from which evolved the 19th-century concern for the welfare of children.


Gastric acid secretion.

Advances in the understanding of physiologic control of gastric secretion raise the hope that an effective nonsurgical therapy for peptic ulcer disease will be developed soon. This paper reviews these advances with special emphasis upon those aspects of hormonal control, cyclic nucleotide function, and histamine activity which may have therapeutic applications.


Descriptive epidemiology of neural tube defects, Rochester, New York, 1918-1938.

This study examines the secular distribution of births, sex, and age at death of 330 cases of anencephaly and spina bifida and 62 cases of "monstrosity" recorded on City of Rochester death certificates between 1918 and 1938. The results show that death certificates may be used as a source of data (with inherent biases) and that persons diagnosed as monstrosity had similar epidemiologic characteristics to those diagnosed as anencephalic during this period. In Rochester the rise in prevalence at birth of neural tube defects was similar to, and occurred at approximately the same years as, the rises reported in Boston and Providence.


The relationship of supplemental iodine to neural tube defects in Rochester, New York, 1924-1932.

The geographic distribution of infants born with anencephaly and spina bifida in Rochester, New York, in 1924-1932, was examined to test the hypothesis that iodine supplemented water may have reduced the prevalence of these defects. During this period the region had a high prevalence of iodine deficiencies. Comparing the prevalence of neural tube defects in an area with iodine supplemented water to one without iodine supplementation, we found no significant difference in prevalence at birth of neural tube defects. Because the prevalence rates for these defects in children of foreign-born parents (except the Irish) was low, we reexamined the data, excluding these cases. There remained no differences in rates. Iodine supplemented water thus appears to have had no effect on the occurrence of neural tube defects.


Shigellosis in custodial institutions. V. Effect of intervention with streptomycin-dependent Shigella sonnei vaccine in an institution with endemic disease.

A double-blind controlled field trial of live, oral, streptomycin-dependent Shigella sonnei vaccine was begun in an institution with endemic S. sonnei disease. Considerable unexpected child-to-child transmission of the vaccine strains inadvertantly caused the field trial to resemble a mass vaccination campaign. Although S. sonnei accounted for 90% of shigella infections from 1968 to 1971 and three-fourths of the cases occurred in the seven study cottages, S. sonnei disease disappeared following vaccination; epidemiologic features suggest a causal relationship. Clinical S. sonnei disease did not occur despite the detection by bacteriologic surveillance of carriers of virulent S. sonnei. Levels of hygiene remained compatible with transmission of shigella since 43 cases of S. flexneri 6 were seen. If the interpretation is correct, the disappearance of S. sonnei disease resulted from inadvertent "mass vaccination" and oral shigella vaccines may prove useful for control of endemic shigellosis institutions. Nevertheless, a properly designed controlled field trial, taking into account transmissibility of vaccine, in an institutional setting similar to Sunland is necessary to substantiate the role of oral shigella vaccines in control of institutional shigellosis.


Towards the simulation of clinical cognition. Taking a present illness by computer.

Remarkably little is known about the cognitive processes which are employed in the solution of clinical problems. This paucity of information is probably accounted for in large part by the lack of suitable analytic tools for the study of the physician's thought processes. Here we report on the use of the computer as a laboratory for the study of clinical cognition. Our experimental approach has consisted of several elements. First, cognitive insights gained from the study of clinicians' behavior were used to develop a computer program designed to take the present illness of a patient with edema. The program was then tested with a series of prototypical cases, and the present illnesses generated by the computer were compared to those taken by the clinicians in our group. Discrepant behavior on the part of the program was taken as a stimulus for further refinement of the evolving cognitive theory of the present illness. Corresponding refinements were made in the program, and the process of testing and revision was continued until the program's behavior closely resembled that of the clinicians. The advances in computer science that made this effort possible include "goal-directed" programming, pattern-matching and a large associative memory, all of which are products of research in the field known as "artificial intelligence". The information used by the program is organized in a highly connected set of associations which is used to guide such activities as checking the validity of facts, generating and testing hypotheses, and constructing a coherent picture of the patient. As the program pursues its interrelated goals of information gathering and diagnosis, it uses knowledge of diseases and pathophysiology, as well as "common sense", to dynamically assemble many small problem-solving strategies into an integrated history-taking process. We suggest that the present experimental approach will facilitate accomplishment of the long-term goal of disseminating clinical expertise via the computer.


Diagnosis of obstruction of the upper and central airways.

Patients with obstruction of the upper airways are often treated for long periods of time for other disorders. Correct diagnosis is important since treatment is quite specific. Such patients may present with a characteristic history and findings on physical examination. Certain physiologic tests such as flow-volume loops with and without helium help to prove the diagnosis. Patients with upper airway obstruction may also have sleep apneas and the sleep deprivation syndrome. Methods of diagnosis of upper airway obstruction are presented and three instructive cases are reviewed.


Extrarespiratory non-group A, non-group D isolates of streptococci.

The results of serologic analysis of 246 extrarespiratory isolates of streptococci (non-group A or D) obtained from pediatric patients are presented. Watson's double enzyme method was used to obtain the extracts of the organisms for Lancefield grouping. Ninety-two and six tenths percent of beta reacting streptococci were groupable; 77.8 per cent of gamma (nonreacting) were groupable; only 20.6 per cent of the alpha reacting streptococci were groupable. The majority of the groupable streptococci belonged to Lancefield group B (49.6 per cent), although significant numbers of group F (11.4 per cent) and group G (11.8 percent) were present. The significance of the organisms in a pediatric population is discussed.


Problems in pre-transfusion tests related to drugs and chemicals.

Ingestion of drugs can cause patients or blood donors to have a positive direct and sometimes indirect antiglobulin test. The most common cause of these positive reactions and immune hemolytic anemia due to drugs is the formation of red cell autoantibodies. These autoantibodies will react with the patient's own red cells and usually most other normal red cells in vitro without the drug being present. The prototype drug causing this type of reaction is alpha methyldopa (Aldomet). Other drugs cause positive antiglobulin tests by three different mechanisms, the drug antibodies reacting with red cells in vitro only in the presence of the drug. The first of these mechanisms causes positive reactions because the drug binds firmly to the red cell membrane, and antibody against the drug will combine with the drug on the membrane leading to IgG-sensitized red cells. The prototype drug for this mechanism is penicillin. The second mechanism involves chemical modification of the red cell membrane by the drug so that it takes up many proteins nonspecifically; the cephalosporins are the only group of drugs known to react in this fashion. The final mechanism involves the formation of an immune complex by the drug and its specific antibody. This immune complex will attach to cell membranes, usually activating complement in the process. Examples of drugs thought to operate by this mechanism are phenacetin, quinine, and quinidine. Some individuals have antibodies present in their serum that will react with chemical added to commercial blood bank reagents. Examples of these are antibodies to dyes added to ABO typing sera, antibodies to sodium caprylate in bovine albumin, and antibodies to chemicals added to red cell diluents, e.g., chloramphenicol, neomycin, and hydrocortisone. If these antibodies are present they can create problems in pretransfusion testing; in particular, they can present anomalies in ABO, Rh grouping, and antibody detection.


Results in treating 210 patients with detrusor overactivity incontinence of urine.

Eighty (72.7 per cent) of 110 patients with detrusor overactivity (in controlled and uncontrolled series) showed improvement with parasympatholytic drug (propantheline bromide or dycyclomine HC1) therapy. Twenty per cent of patients on placebo therapy showed improvement. When standard surgery improved bladder neck funnelling, detrusor overactivity was improved in 77.3 per cent of cases. Surgery failed to improve detrusor overactivity in 54.5 per cent of patients who showed no significant bladder neck funnelling. Bladder neck funnelling appears to be a cause of detrusor overactivity in some women. Results with medical and surgical therapy were not associated with significant change in bladder capacity.


Malignant nephrosclerosis during pregnancy and in the postpartum period (the uremic hemolytic syndrome).

Histologic, immunohistologic, and ultrastructural features are presented of two cases with malignant nephrosclerosis during pregnancy. Primary malignant nephrosclerosis emerges as a clinical entity which can be distinguished from toxemia of pregnancy in the midtrimester and post partum. The first description of malignant nephrosclerosis dates from 40 years ago, but only a few cases were reported associated with pregnancy. Although disseminated intravascular coagulation seems involved, the morphology is different from that of toxemia. Malignant nephrosclerosis reveals a close similarity to the hemolytic uremic syndrome. Early diagnosis by renal biopsy and proper treatment may prevent a lethal outcome due to progressive failure.


Reticulum-cell sarcoma of the cervix.

Four patients with primary reticulum-cell sarcoma of the cervix were described. One patient was treated with radical hysterectomy and lymphadenectomy. The pelvic lymph nodes contained metastatic cancer and the patient died shortly after disseminating disease. The other three patients were treated with external radiation and vaginal and intrauterine radium application. The complete work-up failed to reveal cancer outside the pelvis or evidence of systemic disease. Two of these patients had an exploratory laparotomy with biopsies of pelvis and para-aortic lymph nodes and of the liver. One of these patients had a splenectomy, with no evidence of disease. Both patients are alive with no evidence of disease 3 and 10 years after their treatment. The third patient treated by radiation therapy died 2 years later with no evidence of disease. The importance of complete staging work-up and the advantage of radiation therapy in the treatment of reticulum-cell sarcoma of the cervix is emphasized.


Vaginal reconstruction following extensive treatment for pelvic cancer.

Since 1970, 23 patients at UCLA and The City of Hope who have undergone extensive treatment for pelvic malignancy have had vaginal function successfully restored. A combination of methods, including split-thickness skin graft and the construction of an external vulvar pouch, is often necessary to obtain maximal functional results. The external vulvar pouch was very useful, although not as anatomically appealing as internal methods of reconstruction. In young patients who required an exenteration, a new technique using part of the anterior bladder fundus was developed. Preliminary experience with this method was promising. Among the gorup of 23 patients, there have been no overt failures. By combining restoration of rectal function with vaginal reconstruction, two major steps have been taken toward total rehabilitation of the patient undergoing extensive treatment for pelvic malignancy. Persistence, ingenuity, and planning by the surgeon are essential to obtain a maximum functional result for each patient.


Galactorrhea-amenorrhea: psychological interaction with neuroendocrine function.

Further substantiation of the interaction between psychological disease and the onset of galactorrhea-amenorrhea is presented in women who underwent intensive psychometric and neuroendocrine evaluation prior to the use of the dopamine against 2-Br-alpha-ergocryptine (CB-154). Normalization of a previously distorted psychometric test profile in each woman was accompanied by a profound decline in prolactin and an unexpected alteration in the peripheral concentrations of norepinephrine and dopamine-beta-hydroxylase. Cesation of galactorrhea and resumption of menses were observed in each instance.


Treatmen of keratomycosis with amphotericin B 0.15%.

Amphotericin B 0.15% was tolerated and effective in the treatment of fungal ulcers of the cornea. In a series of 12 ulcers, four from which Fusarium was cultured, all responded to medical treatment. The mean final visual acuity in 11 of the 12 eyes with an adequate follow-up was 20/40.


Internal vertical eyelid shortening to treat surgically induced segmental blepharotosis.

In a procedure to relieve segmental blepharoptosis after surgery for thyroid eyelid retraction and carcinoma, I applied a clamp to the internal eyelid tissues over the blepharoptotic segment, and excised the tissues held in the clamp. The procedure was successful in four patients.


An improved apparatus for mounting retinal vasculature.

An apparatus for mounting retinal vasculature substantially reduced the time required to mount the capillary bed, minimized trauma to the vessels, and consistently resulted in preparations that allowed maximal viewing of retinal capillaries.


Computer-assisted instruction of current concepts in aqueous humor dynamics.

A portable intraocular pressure simulator faciliated teaching the concepts of aqueous humor formation and drainage. The values of input factors, such as facility of outflow, episcleral  venous pressure, or uveoscleral outflow rate, were set by using dials on the front panel. The four computed outputs of the simulator-aqueous humor secretory rate, aqueous humor outflow rate, net filtration rate, and intraocular pressure-were displayed on individual meters.


Glucose concentrations and glycogen levels in the aqueous humor of fresh and refrigereated bovine eyes.

Glucose concentrations in the aqueous humor and its incorporation into epithelial glycogen were measured by adding glucose uniformly labeled with radioactive carbon to the anterior chamber of both fresh and stored bovine eyes (24 hours at 5 degrees C). Concentrations of exogenous glucose in the aqueous humor were higher in refrigerated eyes but declined as rapidly as those in fresh eyes. Furthermore, the epithelium retained the ability to incorporate the exogenous glucose into glycogen after 24 hours of storage at 5 degrees C. Addition of glucose to the aqueous humor of human eyes after refrigeration may increase epithelial retention on donor corneal buttons.


Hand function and tactile perception in a sample of children with myelomeningocele.

The purpose of this investigation were to study the relationships between hand function abilities and tactile perception, and the level of spinal cord lesion and status of hydrocephalus in a sample of 17 children with myelomeningocele. Fourteen children showed impaired hand function, and eight showed tactile dysfunction. Statiscally significant differences in hand function scores and graphesthesia scores were obtained for children with increased severity of hydrocephalus and high-level lesions. Of the 48 correlation coefficients computed between the hand function and tactile perception measures used, only one was statistically significant. This lack of correlation may indicate that hand function and tactile perception in children with myelomeningocele are unrelated factors. Clinical implications of impaired hand function and tactile perception were discussed.


A preliminary report on experienced closed-circuit television users.

In an attempt to describe the use and usefulness of closed-circuit televisions (C.C.T.V), a preliminary follow-up study of 27 veterans was undertaken by the Western Blind Rehabilitation Center. The veterans had been loaned C.C.T.V.'s by the Veterans Administration and represented a wide range of ages, backgrounds, and pathologies. On the basis of the present data, it is concluded that C.C.T.V. significantly improve the functioning of the majority of users and that this improvement appears to be a long-term benefit.


Contractile proteins in human cancer cells. Immunofluorescent and electron microscopic study.

The presence of contractile proteins in human cancer cells has been studied by means of: a) immunofluorescent staining using specific antibodies, and b) electron microscopy in order to detect the presence of cytoplasmic filaments. The tissues examined were: normal human skin, basal cell carcinoma of the skin, squamous cell carcinomas (of skin, oral cavity, and larynx), normal nonlactating mammary gland, and infiltrating mammary carcinoma with or without fibrosis. Normal tissues were negative after immunnoflurosescent staining of contractile proteins and contained no or minimal amounts of microfilaments as judged by electron microscopy. Tumor cells were strongly positive after immunoflouorescent staining for actin, myosin, light and heavy meromyosin but were negative for tropomyosin. Moreover, they contained prominent microfilaments (40 to 80 A in diameter) with some filaments (100 to 120 A in diameter) scattered in between. It appears that malignant cells contain an increased amount of contractile proteins, organized in the form of a filamentous apparatus, when compared to their normal counterparts. The study of the presence of contractile proteins in tumor cells may be of potential importance in evaluating malignant growth.