A preliminary report on a chemomechanical means of removing caries.

Extensive testing for the safety of the GK-101 solution was conducted with experimental animals. An Investigational New Drug permit was awarded by the Food and Drug Administration before clinical studies. Subsequently, two studies--one double-blind and one open--were conducted to determine the safety and caries-removing efficacy of a 0.05% solution of N-monochloroglycine (GK-101) on clinical subjects, as well as to study the technique for such  a procedure. In the double-blind study, the efficacy, as shown by ratings for caries removal, of GK-101 applied under pressure was significantly greater than that of the placebo solution of normal saline (P less than 0.01). Both treatment groups were comparable with respect to the age distribution, pretreatment intraoral examination results, and past history. No drug-related reactions were reported by patients in either group. On the basis of caries removal results in the open study, GK-101 solution, in conjunction with the pump system, was found to be effective as determined by the investigator. The caries in all but one of the 61 lesions treated with GK-101 was rated as "total removal" or as "almost total to total" removal. Approximately 77% of the patients treated with GK-101 experienced neither pain nor an odd taste. Any pain reported was always described as "slight" or "little." The drug is currently being further tested for safety and efficacy.


Homogenous and heterogenous bone implants preserved by formaldehyde: a histologic study.

Small bone sticks from a rat and a dog, fixed in formaldehyde from one to several weeks, were used as homografts and heterografts in defects created in the mandibles of rats. The animals were killed 30, 60, 90, and 150 days after the graft implantation procedure. Histologic study showed that although the homografts induced a distinct osteogenic activity and were incorporated by the host in less than 90 days, the heterografts behaved as foreign bodies and became encapsulated by connective tissue and remained unresorbed up to 150 days. Therefore, the clinical applicability of formaldehyde-fixed homografts should be considered.


Penetration of restorative resins into acid-etched human enamel.

In this investigation, the penetration of different resins into the etched enamel surface and the effect of their viscosity on the penetration of these materials were studied. Freshly extracted teeth were pumiced, rinsed, and dried. The enamel surface was etched by using a solution containing 50% phosphoric acid for one minute; in one group the teeth were etched for two minutes. A layer of enamel surface of another group of teeth was removed before etching; these teeth were etched for one minute. Three different resins--Nuva-Seal, Concise Enamel Bind, and Restodent--were applied to the acid-etched enamel surface for one minute. The Concise composite resin also was applied to the enamel surface of a group of teeth etched for the same period of time. Observations with SEM and polarized light microscopy showed penetration of all the materials into the etched enamel surface to be 5 mum to 10 mum, with a mean of 7 mum. There was no difference in the penetration of these materials despite their different viscosities. The removal of a layer from the enamel surface was not effective in the penetration of the materials.


Ultrastructural immunocytochemical characterization of the thyrotroph in rat and human pituitaries.

The beta chain of thyroid stimulating hormone (TSH) was localized in normal rat and human pituitaries with the unlabeled antibody--peroxidase-antiperoxidase complex technique and antisera to rat or bovine TSH beta. Araldite embedded tissues, immunoreactivity of TSH was best preserved after fixation with 1% glutaraldehyde or picric acid formaldehyde. In the TSH cells, the immunocytochemical stain was located on granules. However, there was a variation in staining of individual granules, and among the population of granules. Rat TSH cells were ovoid or angular to stellate, and contained granules ranging in size from 60-175 nm. The human TSH cell was polyhedral, and contained scattered granules of 150-300 nm diameter. In both species, granule distribution was either in 1-2 rows at the periphery, or scattered throughout the cytoplasm with some concentration in cytoplasmic processes. TSH cells in female rats in estrous contained more granules than those of other stages. TSH cells were distinguished from adrenocorticotropic hormone cells and luteinizing hormone cells on the basis of granule size and distribution, and cell shape.


Isolation of Shigella sonnei by fluid media.

Selenite F broth prepared in the laboratory from single ingredients was found to be significantly more efficient than nutrient broth in the isolation of Shigella sonnei from human faeces. It was more efficient than direct plating on deoxycholate citrate agar for diagnosisng Sonne dysentery in a local outbreak. The difference was significant. There was, however, no significant advantage for enrichment over direct plating when stools posted from Briston to Cardiff were examined. Laboratory prepared selenite F broth was preferable to the same medium purchased commercially from two different firms. The product of one frim was significantly better than that of the other. Two methods of sterilization of laboratory prepared selenite F broth were studied. Seitz filtered selenite was less inhibitory to the growth of samll numbers of Shigella sonnei. Sterilization by heating in free steam for  periods of 15 min and over impaired the ability of selenite F broth to allow multiplication of small numbers of Shigella sonnei.


Escherichia coli O 27 in adult diarrhoea.

Escherichia coli O 27 H 7 was found in 16 stool samples submitted during a Caribbean cruise (Cruise Z) by 29 patients reporting with diarrhoea. A retrospective search revealed E. coli O 27 H 7 in 11 of 20 and 2 of 14 stool cultures from patients on two previous cruises (Y and X respectively) and in a culture from fresh cream (Cruise Y). The repeated occurrence of E. coli O 27 H 7 in the absence of any other apparent cause suggested that this serotype may have been responsible for the diarrhoea. The results of pathogenicity tests suggested that this strain elaborated heat-stable (ST) enterotoxin. The possibility that food may have been the vector is discussed.


Klebsiella and Enterobacter organisms isolated from horses.

An account is given of K. pneumoniae capsule types occurring in horses, with particular reference to strains originating from the genital tract in the mare and the external genitalia of the stallion. A survey of the prevalence of K. pneumoniae and E. aerogenes strains in the preputial flora of healthy stallions is described. The majority of horses were found to be carriers of these organisms. The cultural characteristics of these preputial strains are described and compared with those of K. pneumoniae strains associated with epidemic metritis in mares. The epidemiological significance of certain K. pneumoniae capsule types is discussed.


Characterization of lymphocyte inhibition by supernatants of crowded lymphocytoblasts.

Crowded lymphocytoblasts produce a factor (or factors) that inhibits the response of peripheral blood lymphocytes to mitogens. This factor is destroyed by pepsin in 1 hr but not by neuraminidase. No activity was lost when the factor was incubated with packed human red blood cells, human lymphocytes, mouse spleen cells, or tissue culture cells. An antiserum was made to the factor which was capable of partially inhibiting its activity. The factor is active at about 25 mug/ml of protein. Maximal inhibition occurs if the factor is present for the duration of the culture period. This factor may play a regulatory role in the immune response.


Thyroid antibodies in spontaneous autoimmune thyroiditis in the Buffalo rat.

Thyroid antibodies in the sera of BUF rats are closely correlated with spontaneous thyroiditis; their detection may facilitate the study of this animal model of organ-specific autoimmunity. In a group of 115 retired BUF breeders (females older than 1 year), 26% had mononuclear cell infiltration of the thyroid and high titers of thyroid antibodies detectable by indirect immunofluorescence (IF) and chromic chloride passive hemagglutination (CCH). In contrast, low-titered thyroid antibodies were present in 9% of the rats that had normal thyroids. Sequential studies performed on a group of 76 neonatally thymectomized BUF rats showed that at 2 months 24% had high titers of thyroid antibodies detectable by IF and 8% by CCH and at 3 months these percentages increased to 27% by IF and 25% by CCH. When the rats were sacrificed at 4 months, at a time when spontaneous disease is not seen in untreated animals, 26% were found to have mononuclear cell infiltration of their thyroids. Approximately 75% of these rats with thyroiditis had been positive for thyroid antibodies at 2 months and 90% at 3 months. At sacrifice all of these animals had high-titered antibodies to thyroid antigens. In contrast, low-titered thyroid antibodies were present in 36% of the animals without thyroiditis. Intravenous injection of BUF thymus cells into neonatally thymectomized rats failed to reduce the incidence of thyroiditis and thyroid antibodies. Approximately 33% of these animals had both thyroid infiltration and serum antibodies, whereas 19% of those with normal thyroids had low-titered thyroid antibodies. Titers of circulating thyroid antibodies were closely correlated with the initial and intermediate stages of thyroiditis, i.e., animals with less infiltration had the lowest titers, whereas animals with intermediate levels of infiltration had high antibody titers. On the other hand, rats with a high degree of thyroid infiltration had relatively lower titers of thyroid antibodies. Direct IF of infiltrated thyroids revealed the presence of rat immunoglobulins in these organs, suggesting a possible direct or indirect role of autoantibodies in the pathogenesis of the disease. We attempted to detect delayed hypersensitivity by skin testing with thyroid antigens and observing reactions at 4, 24, and 48 hr. All of 123 rats were negative, 20% of which had thyroiditis and thyroid antibodies. No serum MIF activity was detected in rats with thyroiditis and those with normal thyroids. The absence of delayed hypersensitivity reactions in these experiments provides further support for the contention that spontaneous thyroiditis in the BUF rat may be antibody mediated.


Genetic control of ligand-induced events in B lymphocytes.

The early cycle of events which follows the binding of anti-Ig ligands to the surface Ig molecules of B lymphocytes was compared in several inbred strains of mice. Kinetic differences were found in the rate of surface Ig capping and absolute differences in extent were found for anti-Ig-induced B cell motility. These strain differences were not restricted to the B cell  surface Ig molecules, however, since capping by Con A of its receptor sites on B and T cells and random T cell motility were also affected. A genetic analysis of A and CBA mice revealed that each of the traits studied is probably affected by two gene differences between the two strains analyzed. The possible roles of microtubules and cyclic nucleotides in these genetic differences were also explored. Colchicine, which depolymerizes microtubules, raised the low capping and motile responses of CBA spleen cells to the high responses characteristic of A strain cells. This implies an excess of microtubular function in CBA cells. Raising the level of cyclic AMP also raised the low CBA capping response to the high A level, but did not differentially effect the motile responses of cells of the two strains. The possible significance and locus of action of these effects is discussed.


H-2 compatibility requirement for virus-specific T cell-mediated effector functions in vivo. I. Specificity of T cells conferring antiviral protection against lymphocytic choriomeningitis virus is associated with H-2K and H-2D.

Adoptive immunization of recipient mice preinfected with lymphocytic choriomeningitis virus (LCMV) is mediated exclusively by virus-specific thymus-derived lymphocytes, when assayed in a short-term transfer model. Protection, measured as reduction of LCMV plaque-forming units in spleens, is conferred only if donors of immune spleen cells and recipients share the K or the D region of the H-2 gene complex. I region compatibility is neither necessary nor sufficient. The F1 leads to Parent combination is as effective as a syngeneic system. Admixture of a 6-fold excess of immune allogeneic cells did not impair the protective effect exerted by syngeneic immune spleen cells in vivo. Furthermore, allogeneic spleen cells or target cells added in syngeneic systems in vitro did not allogeneicly inhibit or suppress cytolytic activity. H-2 mutant mice B6. H-2bf did not protect wild type H-2Kb B10.A(5r) or vice versa. Therefore, these mice define the gene(s) coding for the relevant cell-surface structure involved. These results are consistent with the idea that immune T cells, which are specific for virally altered cell-surface self structures impair virus growth in vivo either by lysing target cells, probably before infectious virus is released, or alternatively via activities exerted by lymphokines.


The T cell dependence of B cell differentiation induced by pokeweed mitogen.

The in vitro plasma cell response of human peripheral blood B lymphocytes to PWM was found to be dependent on the presence of T lymphocytes. B lymphocytes cultured alone with PWM did not respond with proliferation or differentiation into plasma cells. When T lymphocytes were added back to B lymphocytes before culture, the number of plasma cells of the IgM, IgG and IgA classes formed increased in proportion to the number of T lymphocytes returned. Allogeneic T lymphocytes from either peripheral blood or adult thymus could effectively substitute for autologous T lymphocytes. By comparing responses of B lymphocytes cultured with equal numbers of autologous or allogeneic T cells, it was found that the considerable variation in the magnitude of the plasma cell response from different normal donors was related to a quality of their T cells; T cells from high responders substantially enhanced plasma cell differentiation of B cells from low responders and vice versa. This T cell "helper function" was irradiation-resistant and was a property of thymocytes as well as peripheral T cells.


B cell differentiation induced by lipopolysaccharide. IV. Development of immunoglobulin class restriction in precursors of IgG-synthesizing cells.

Direct immunofluorescence was used to determine the classes of immunoglobulins expressed on the surface membrane and in the cytoplasm of newborn and adult B lymphocytes differentiating in response to LPS in vitro. In both newborn and adult spleen, a small proportion of IgM-bearing B lymphocytes also stained for IgG2; adult spleen contained an additional population of lymphocytes bearing IgG2 alone. Combined surface and cytoplasmic staining at intervals after culture initiation and demonstrated both IgM and IgG2 on the membranes of the earliest cells synthesizing cytoplasmic IgG2. At later stages the proportion of IgM-IgG2 surface doubles and of cells synthesizing cytoplasmic IgG2 which had surface IgM fell significantly. Detection of surface IgM on IgG2 precursors correlated with susceptibility of the IgG2 precursors to anti-mu-suppression over the first 3 days in cultures of newborn spleen cells. After 3 days when these cells no longer expressed surface IgM, 2gG2 responses were not suppressed although the IgM response was still inhibited. These results suggest that virgin IgG2 precursors may be B lymphocytes expressing both IgM and IgG2, and that "switching" involves the loss of IgM receptors as these cells proliferate and mature.


Guinea pig lymphocyte-derived macrophage aggregation factor: its separation from macrophage migration inhibitory factor.

Lymphocytes from guinea pigs having delayed hypersensitivity to horse-radish peroxidase (HRPO) when cultured in vitro with HRPO produce a large m.w. factor (greater than 100,000 daltons) that causes peritoneal macrophages from nonimmune animals to aggregate. The macrophage aggregation factor (MAF) can be separated from macrophage migration inhibitory factor (MIF) by gel filtration of active lymphocyte supernatants on Sephadex G-150. MAF is heat stable (56 degrees C for 30 min) but inactivated by trypsin. These data suggest that aggregation of macrophages in vitro by lymphokine-rich culture supernatants is not due to MIF but is caused by a separate large m.w. factor.


Characterization of macrophage migration inhibitory factor activity produced in vivo by a cell-mediated immune reaction in the guinea pig.

Peritoneal fluid from the abdominal cavities of guinea pigs having delayed hypersensitivity to horseradish peroxidase (HRPO) was obtained by a lavage technique before and after i.p. challenge with antigen. Macrophage migration inhibitory factor (MIF) and macrophage chemotactic factor activities were measured in peritoneal fluids from each animal. Chemotactic activity for macrophages was maximal 24 hr after i.p. challenge and was absent thereafter. MIF activity was maximal in peritoneal fluid 24 to 48 hr after challenge. Macrophages were present in greatest numbers in peritoneal fluid 24 hr after challenge and returned almost to control levels at 48 hr. Macrophages in 48-hr fluid were larger and exhibited more intense cytoplasmic staining for nonspecific esterases when compared to those in 0-hr fluid. The m.w. of MIF obtained from culture supernatants of HRPO-stimulated guinea pig lymphocytes and 48-hr peritoneal fluid were found to be virtually identical, 58,000 and 54,000 daltons, respectively. MIF from these in vitro and in vivo sources were similarly resistant to heating at 56 degrees C for 30 min but were both destroyed by incubation with isoluble trypsin.


Immunofluorimetric and combined immunofluorimetric cytophotometric and autoradiographic investigations on human myeloma cells.

Bone marrow cells from patients with myeloma were reacted with FITC- and/or TRITC-conjugated anti-heavy chain sera and/or TRITC-conjugated anti-light chain sera. A fluorimeter with electronic setter control and short-term excitation was used for quantitative determination of FITC- and TRITC-fluorescence.


Dermatitis herpetiformis: immunoelectronmicroscopic and ultrastructural studies of a patient with linear deposition of IgA.

Using immunoelectronmicroscopic techniques, we have demonstrated three distincet patterns of IgA deposition in the skin of patients with dermatitis herpetiforms. The least common of these patterns is the localization of reaction products to the lamina lucida. As this is the location of the immunoreactants in bullous pemphigoid and herpes gestationis and because the ultrastructural findings in our patient's early lesional skin differ from those usually seen in patients with dermatitis herpetiformis, we herein detail this patient's clinical, histologic, immunologic, and ultrastructural findings. The most prominent findings are (1) IgA deposition in the lamina lucida, (2) vesicle formation between basal lamina and the basal cells, and (3) fibrin-like material in the epidermis with showering into the dermis.


Activation of the alternative (properdin) pathway of complement by Candida albicans and related species.

Accumulations of neutrophilic granulocytes within the epidermis and beneath the stratum corneum of the skin are a prominent histologic feature of experimental and clinical candidiasis. The mechanism of cell accumulation was studied by standard chemotactic methods. Suspensions of viable or heat-killed Candida sp caused marked chemotaxis of human neutrophils in fresh serum. Culture supernatants of Candida sp were not chemotactic. Chemotaxis was dependent upon fresh serum, and could be abolished by heating the serum to 56 degress C for 30 min, suggesting that interaction of these organisms with a heat-labile serum factor generated a chemoattractant. Incubation of Candida sp with fresh human serum resulted in the conversion of the third component of complement and properdin factor B, as measured by immunoelectrophoresis. Conversion did not occur in serum chelated with EDTA, or heated to 50 degress C for 30 min (to destroy factor B). Conversion was present in serum chelated with EGTA (to deplete calcium), or genetically deficient in the fourth component of complement. By contrast, the three components of the kinin-forming system (Hageman factor, prekallikrein, high-molecular-weight kininogen) were not activated by Candida sp. We suggest that Candida sp do not release a chemotactic substance but, in the presence of serum, activate the alternative pathway of complement, generating chemotactic factors.


Factors affecting measurement of aryl hydrocarbon hydroxylase activity in mouse skin.

Mouse skin exhibits relatively high aryl hydrocarbon hydroxylase (AHH) activity when measured under optimal conditions. The enzyme is unequally distributed in the cutaneous layers with the highest concentration in the epidermis. Subcellularly, it is localized in the microsomal fraction. As much as two-thirds of the enzymatic activity was destroyed when harsh homogenization techniques were used during tissue preparation. Incorporation of the reduced pyridine nucleotide NADH into an incubation mixture containing NADPH increased epidermal AHH activity by one-third. When methods that maximize activity were employed, the AHH activities of skin of C57BL/6 inbred mice and of ICR Swiss random-bred mice were 5 to 10 times as active as lung tissue and about one-tenth as active as liver.


Role of B-lymphocytes in nonspecific resistance to Klebsiella pneumoniae infection of endotoxin-treated mice.

Lipopolysaccharides (LPS) of gram-negative bacilli are known to protect mice against unrelated bacterial infections and to be nonspecific mitogens of murine bone marrow-derived (B-) lymphocytes. For assessment of the role of these cells in the mechanism of LPS-induced resistance to infection with Klebsielia, various nontoxic mitogens were assayed. In contrast to LPS or lipid A, the nontoxic mitogens did not protect mice. Experiments were also performed with LPS in nude mice and in mice treated with immunosuppressants. Stimulation by LPS was decreased after administration of hydrocortisone or cyclophosphamide under conditions that inhibited the in vitro activation of lymphocytes by mitogens. Moreover, nude mice and mice treated with 6-mercaptopurine were more resistant to Klebsiella than were control mice.


Field trial of an inactivated Mycoplasma pneumoniae vaccine. I. Vaccine efficacy.

The efficacy of an inactivated Mycoplasma pneumoniae vaccine was evaluated in a double-blind study of 7,861 Marine Corps recruits at Parris Island, South Carolina. Vaccine was administered to half for the volunteers in a 1-ml dose by a jet-injection device, and phosphate-buffered saline was administered similarly to control subjects. Twenty-one vaccinees (5.3 per 1,000) and 43 recipients of placebo (10.9 per 1,000) were hospitalized with pneumonia; the incidence of illness among the two groups indicated a 51% overall protective efficacy for the vaccine (x2 = 7.49; P less than 0.01). The refined data for pneumonia due to M. pneumoniae showed 67% protective efficacy when serologic data were employed (x2 = 7.84; P = 0.005) and a 42% protective efficacy (x2 = 1.80; P greater than 0.10) when data from cultures for M. pneumoniae were employed. Vaccinees with pneumonia due to M. pneumoniae suffered no increased illness compared to controls, suggesting no hypersensitization with natural illness following the inactivated vaccine. Only when serologic data were analyzed did it appear that the M. pneumoniae vaccine protected against M. pneumoniae specific bronchitis (35% efficacy) but the difference was not statistically significant (x2 = 1.28; P greater than 0.20).


From the National Institute of Allergy and Infectious Diseases of the National Institutes of Health, the Center for Disease Control, and the Bureau of Biologics of the Food and Drug Administration. Summary of clinical trials of influenza vaccines--II.

These studies indicate that the high-risk and normal pediatric populations can be safely and effectively immunized with a two-dose regimen of the influenza A/New Jersey/76 virus vaccine. In addition, the studies have demonstrated important differences between split-product and whole-virus vaccines in the pediatric age group. Furthermore, reactogenicity from the whole-virus vaccine administered in the schedules employed was acceptable after the first dose and negligible after the second dose. More detailed examination of the data will undoubtedly yield additional information of importance to current and future use of inactivated influenza vaccines in children.


[Mechanical studies on the dental bridges by the finite element method. (1)--An abutment tooth model-- (author's transl)].

Biomechanical considerations are very important to design a prosthetic appliance; however, there have been no satisfactory quantitative studies of such problems, mainly because theoretical and experimental models are unable to represent exactly the natural conditions in the mouth. The finite element method has been successfully applied in each field of applied mechanics and found to be effective for the structural analysis of the biological systems, for it has the advantage of greater versatility for modelling. Accordingly, this analytical, computer-aided method was applied to the dental bridges to evaluate the loads transmitted to the abutment tooth and the stress distributions in the supporting tissues. As the preliminary study a two-dimensional model was constructed to simulate the tooth subject to a vertical and a horizontal load and a moment at the coronal portion. The stress distributions in the tooth and the periodontal membrane and the force distributions on the socket wall were calculated for three load conditions. The tooth mobility and the center-of-rotation position were compared with actual data available in some literatures and the characteristics of tooth support were discussed in terms of three spring constants.


[Mechanical studies on the dental bridges by the finite element method (2). --An idealized symmetrical bridge with a vertical load at the center of pontic-- (author's transl)].

The biomechanical behavior of bridge support was studied by the finite element method. An idealized bridge model was constucted by using the previously reported tooth model as the two-sided abutment teeth. Under a vertical load at the center of pontic the stress distributions were shown in the constituent elements. Forces transmitted to the abutment teeth were calculated from these distributions. The results obtained were compared with theoretical models based on the beam theory in engineering. 1) For the finite element model, moment M and horizontal force H are given by (see article) wherein P is load, B is flexural rigidity of pontic, L is bridge span length, and KM and KH are spring constants of the supports with respect to moment and horizontal force, respectively. 2) If it is assumed that a dental bridge is a rigid body, the moment is underestimated and the horizontal force is neglected. 3) According to the fixed-ended-beam model which allows neither movement nor deformation of the supports, the moment is overestimated in many cases. 4) According to the general-beam model which allows the vertical movement and rotation of the supports, the moment is underestimated because of the assumption that no forces are acting in the longitudinal direction of beam.


[Mechanical studies on the dental bridges by the finite element method (3). --Behavior of a posterior bridge model under various loads -- (author's transl)].

Forces and moment transmitted to the abutment teeth were numerically analyzed using a model for a posterior bridge. Three cases were chosen to investigate the influence of loading condition; a vertical (A) and a mesially inclined (B) load at the center of pontic and a vertical load at the abutment (C). The results obtained are as follows: Under the condition (A), as reported previously, both moment and force increase as bridge flexural rigidity is less or bridge span longer. When the load shifts to the abutment tooth, the moment slightly increases as flexural rigidity is greater or bridge span shorter, but horizontal force is scarcely transmitted to the abutment teeth. Maximum moment under the condition (C), however, is not so great as that under the condition (A) and the difference decreases among the moment values calculated from the present model and two theories of general-beam and rigid-beam model. Consequently, special attention should be given to the more flexible pontic which might very possibly cause injury to the abutment teeth under the first two conditions. Even though the resultant force is not very great, its supporting tissues with smaller surface area tend to be subject to higher stress.


[Mechanical studies on the dental bridges. (XII) theoretical development of load analysis on the abutment teeth (author's transl)].

Load analysis of abutment teeth have been treated as the two abutment teeth problems, which are subjected on the concentrated and distributed loading conditions. And we considered the numerical analysis for these problems. Abutment teeth are supported with elastic condition, which are normal deflection and rotational movements. This paper shows the theoretical development of the load analysis of these problems. These pontics are supported with the numberless abutment teeth. Example problems are shown the concentrated and distributed load at the one span of these pontics. Therefore, we do not show the numerical examples of these problems but theoretical development of apportionment loads of these abutment teeth are represented to be concerned for many problems in this paper.


[Biochemistry and prepared diagnosis of lung maturation (author's transl)].

The composition and structure of acellular alveolar material are described. Evidences as summarized that 1,2-dipalmityl-sn-glycero-phosphoryl-choline, depending of the presence of other components of the hypophasis, determines the surface tension of the air-alveolus interface. The foetal maturation of the lung is defined according to the Avery-Clements-Gluck theory, as a stabilisation of the alveolar lecthin production; and the dependence of the relevant enzyme activities on the stage of the pregnancy is discussed. Attention is drawn to the possibility of enzyme induction by medication; the biochemical and clinical aspects of the acceleration of lung maturation following glucocorticoid therapy are treated in detail. Finally, methods for the prepartal and postpartal characterisation of lung maturation,and especially the biochemical methods for the determination of lecithin in amniotic fluid, tracheal, and gastric secretion are discussed.


The dipslide in diagnosis of urinary tract infections.

Urinary tract infections (UTI's) are common in medicine. Symptoms may include fever, chills, frequency, and dysuria. Asymptomatic UTI's are also common, with a prevalence of one percent in school girls and ten percent in pregnant women. Pyuria, dysuria, and frequency may be absent in patients with UTI's or present in patients without UTI's. Therefore, a UTI must be bacteriologically diagnosed as greater than 100,000 organisms/ml, usually of a single organism, in a properly obtained urine specimen. The dipslide is a simple, convenient, inexpensive device for the quantitative diagnosis of a UTI. Culture media are layered on both sides of the dipslide, one medium allowing growth of all organisms and the other medium favoring growth of enterobacteriae. After immersion in a clean catch urine specimen, the dipslide is incubated for 24 hours at 37 C. Each urinary organism forms a colony "dot". The density of colony "dots" can be quantitated easily by comparison with standardized graphs. The dipslide is a highly accurate and sensitive tool that can be used for the diagnosis of UTI's, assessment of antimicrobial effectiveness, follow-up for presence of recurrence or relapse, and screening of high-risk individuals.


The role of calcium in the acrosome reaction: an analysis using ionophore A23187.

The role of Ca+2 in the acrosome reaction of echinoid and mammalian sperm was investigated using the Ca+2 transporting ionophore A23187. The ionophore induced morphologically normal acrosome reactions in both types of sperm (as assessed by electron microscopic observation of echinoid sperm and phase contrast microscopic observation of mammalian sperm). In echinoids, these reactions were immediate. In the guinea pig and hamster, ionophore significantly decreased the capacitation interval; early reactions were accompanied by activation of motility. Ionophore induced reactions were affected by sperm, ionophore and Ca+2 concentrations. Since both ionophore induced and natural reactions require extracellular Ca+2, it is suggested that an influx of Ca+2 represents the initial step of the acrosome reaction. Under natural conditions, the permeability change which results in Ca+2 influx may be induced in echinoid sperm by egg jelly and may occur in mammalian sperm during capacitation. Ionophore A23187 should prove an experimentally useful drug for further study of the acrosome reaction since its effect on cells is understood, it induces synchronous reactions in a high percentage of sperm, and it conveniently reduces the capacitation interval in mammalian sperm.


Characterization of measles viruses in establishment of persistent infections in human lymphoid cell line.

Human lymphoid cells (NC-37) were infected with attenuated measles vaccine virus (Schwarz, AIK-C, and CAM-70 strains), subacute sclerosing panencephalitis virus (Mantooth and Halle strains), neurovirulent TYCSA strain, and wild type virus (Edmonston and Toyoshima strains) at an input multiplicity of 0-01. These strains were divided into two groups by their capacity to establish carrier states. CAM-70, Toyoshima, and Edmonston strains did not set up persistent infections in NC-37 cells, whereas AIK-C strain induced chronic cyclic infection and the Schwarz, TYCSA, Mantooth and Halle strains could set up persistent infections and furthermore two types of persistent infections were recognizable. Cells persistently infected with Schwarz strain contained nucleocapsid structures in both nucleus and cytoplasm, and produced infectious virus of 10(4) to 10(5) p.f.u./ml over 100 days after the inoculation of the virus but the cap-formation of measles antigens on the cell membrane was seldom observed. However, in cells persistently infected with TYCSA strain, nucleocapsid structures were rarely observed in the nucleus, but the cap-formation of measles antigens on the cell membrane was often observed. The titre of carried virus was always higher than the number of cells in the range of 10(6) to 10(7) p.f.u./ml. Mantooth strain was similar to Schwarz strain and Halle strain was similar to TYCSA strain in the properties of their carrier states. These carrier states were stable and the cells grew normally for over one year.


Is there a reciprocal relationship between symptoms and affect in asthma?

This is a hypothesis-seeking case study. It is the product of naturalistic research on one asthmatic patient seen 212 times in individual psychotherapy over a period of 32 months. Both retrospective and prospective data were gathered, the prospective phase beginning about halfway into the therapy. Clinical vignettes are cited from which the following hypothesis was developed: there was a reciprocal relationship between the manifestation of physical symptoms and of affective reactions in this patient. In support of the possibility of testing this hypothesis, the therapist's observations and patient's report of physical and affective reactions each independently indicated a much greater incidence of one reaction or the other occurring separately than of both together. The occasional occurrence of both together indicates that the physical and the affective reactions are not mutually exclusive; therefore, the null hypothesis is also possible. A critique and synthesis of diverse literature ranging from psychoanalytic, group, and behavioral oriented clinical reports to human and animal physiological studies precede the presentation of the case study. The conclusion reached in reviewing the literature is that confirmation of the reciprocal hypothesis awaits further studies, but there is indication in the literature of support for such further study.


Electroencephalographic and clinicopathological studies on Creutzfeldt-Jakob syndrome.

The correlation between the appearance of the characteristic electroencephalographic abnormality, cardinal clinical manifestations, and neuropathological features was studied in four cases of Creutzfeldt-Jakob syndrome consisting of subacute spongiform encephalopathy and classical Creutzfeldt-Jakob disease. Consideration is given to the differences in the electroencephalographic findings between these two subgroups of the syndrome and on the underlying pathological mechanism.


Degranulation of chicken heterophil leucocytes during phagocytosis, studied by phase contrast and interference microscopy.

The dynamic aspects of degranulation of chicken heterophil leucocytes during phagocytosis have been studied by phase contrast and interference microscopy. Both standard (8 fps) and high-speed (400 fps) cine-photomicrographic recordings of this process under phase contrast are presented. Lysis of individual granules is usually completed in less than 60 milliseconds. During lysis of each granule a rounded phase dense body is ejected into the phagocytic vacuole. Measurements made by interference microscopy show that there is usually a substantial fall from a protein concentration of c. 100 per cent. w/v for intact granules to a concentration of 16 per cent. w/v for the vacuole resulting from their lysis; this can only be explained by a rapid intake of water into the granule matrix following membrane fusion. The intake of water that accompanies granule lysis causes swelling of the granule matrix, and is thought to explain the mechanism of ejection of the phase dense body. Granule lysis is not dependent on the intake of water, since occasional vacuoles have been observed which showed no fall in protein concentration relative to the intact granules. The membrane around the intact granule effectively excludes the entry of water into the concentrated hygroscopic granule matrix, but once membrane fusion occurs this barrier to the entry of water is usually lost.


Immunological and non-immunological phagocytosis by inflammatory macrophages, epithelioid cells and macrophage polykaryons from foreign body granulomata.

Inflammatory macrophages, epithelioid cells and macrophage polykaryons were obtained on the surface of round glass coverslips inserted into the subcutaneous tissue of mice and removed at different intervals. About 90 per cent of the macrophages and polykaryons express IgG, C and non-specific surface receptors, involved in phagocytosis, up to 15 days after coverslip implantation. In 21-day-old lesions, about 50 per cent of these cells lose the IgG resed with IgM and complement but do not incorporate these particles and are poorly phagocytic for glutaraldehyde-treated horse red blood cells. The ultrastructural study of these cells demonstrates that they are macrophages which have undergone epithelioid transformation. Whole-body irradiation of mice bearing implanted coverslips of 7 days duration reveals that 6 days after irradiation, the great majority of macrophages and multinucleate cells have acquired epithelioid characteristics. It is suggested that the loss of immunological receptors during epithelioid transformation in granulomas may protect bacteria and be disadvantageous to the host.


Application of fluorescent antibody technique to determine infectivity rates of Amblyomma americanium (L.) (Acarina: Ixodidae) salivary glands and oral secretions by Theileria cervi (Piroplasmorida: Theileriidae).

Salivary glands and oral secretion from individual field collected ticks, or ticks infected with Theileria cervi in the laboratory, were subjected to fluorescent antibody techniques to determine the reliability of the technique in the identification of T. cervi in either the oral secretion or salivary glands. Results indicated that the fluorescent antibody technique can be used with a reasonable degree of success in the identification of infected salivary glands or oral secretion. Oral secretion examinations gave fewer positive samples than when salivary glands from the same ticks were examined.


Pediatric annular pancreas: twenty years' experience.

Characterization of pediatric annular pancreas is provided by this analysis of 24 cases (22 neonates, 1 infant, 1 child). Salient observations include: (1) Presentation is affected by the degree of duodenal obstruction at birth and by coexistent anomalies. (2) Polyhydramnios usually accompanies complete high intestinal obstruction by annular pancreas. (3) Primary biliary interruption was not encountered and jaundice was not unusually prevalent. (4) There is a high incidence of associated anomalies. (5) Duodenal bypass by duodenoenterostomy was employed with excellent results.


Guide to research on the Rosenzweig Picture-Frustration (P-F) Study, 1934-1974.

Research on and with the Rosenzweig Picture-Frustation (P-F) Study and its precursors, 1934-1974, is presented. Investigations with the original versions of the P-F in English and the parallel, standardized versions in Europe, Asia and the Americas are covered. More than 500 articles and books are organized by topic in a Citation Index giving authors and dates. The available references for a given topic can then be readily located. The major topics include basic (construct) research, reliability, validity, and pragmatic applications. These applications pertain to developmental and individual differences, clinical disorders, antisocial behavior, personnel selection, counseling and therapy, educational and school psychology, cultural and socioeconomic differences, and experimental psychodynamics.


Studies on Plasmodium ookinetes. 1. Isolation and concentration from mosquito midguts.

In a method for isolating a relatively clean suspension of concentrated Plasmodium berghei ookinetes from infected midguts of Anopheles stephensi at appropriate times after the infective blood meal, the ookinetes are freed from the midguts by enzymatic digestion, and then concentrated by means of a BSA/renografin gradient. The mean number of ookinetes recovered/midgut was 152. More than 95% of the recovered ookinetes were viable by the criteria of motility, incorporation of adenosine and leucine, and appearance on light and electron microscopic examination. Trypan blue exclusion was not a valid criterion for viability. These ookinetes were not useful for in vitro studies of further development due to the presence of contaminating microorganisms. Our attempts to determine their potential for further development in vivo have similarly not been successful. Nevertheless, our ability to obtain large numbers of ookinetes at defined times during development now permits further studies on their structure, biochemistry, and physiology, as well as comparison with ookinetes formed in vitro.


[Arterial time of intravenous pyelography: initial results (author's transl)].

The authors consider that attention should be paid to the arterial time in intravenous pyelography in all patients who undergo the examination. Manual injection or an injector containing 80 to 100 ml of 38% iodine contrast medium set at a speed of 20 ml/sec, on the one hand, and films taken during the arterial phase on the other hand, are the two conditions necessary to obtain a satisfactory arteriogram. Slight abdominal compression and subtraction improve the definition of the films. 600 cases have been collected so far, in the exploration of 105 patients with hypertension, 17 cysts, 7 malignant tumours, extra-renal pathology and various nephropathies in which no indication for arteriography existed. Thus pyelographic arteriography made it possible to avoid renal arteriograms in almost all our patients. Only one selective and one complete arteriogram were necessary. Unusual arterial lesions in nonsurgical renal conditions may be seen (glomerulonephritis, nephroangiosclerosis...) and unexpected images in abdominal conditions with renal manifestations or in association with nephropathies (aneurysms of digestive arteries and the aorta, collagen diseases etc.).


[Cholesterol pneumonia in a child (author's transl)].

The case presented is that of a pneumonia due to cholesterol in a young girl of 13 years old. The clinical picture was that of severe progressive pulmonary fibrosis. On histology, a foreign body reaction around cholesterol crystals was found. The history enabled confirmation of the endogenous origin of this fatty infiltration.


[New cases of familial generalized cortical hyperostosis with dominant transmission (Worth's type) (author's transl)].

A case of two families with a total of 5 cases of generalized cortical hyperostosis of the cortex of the long bones is clinically latent. It is not accompanied by any osseous fragility and is usually discovered by chance. Mandibular hypertrophy can occur but is not constant. It must be differentiated from the recessive form described by Van Buchen, which is more severe and involves extensive and progressive osteocondensation which can lead to paralysis of the cranial nerves. The small number of cases published (23) leads one to suppose that its diagnosis is frequently missed, undoubtedly because it is mixed up with a minor form of osteopetrosis.


Blood pressure in the elderly.

The distribution of blood pressure levels in elderly patients is described and the evidence that higher levels are associated with morbidity at this age is reviewed. In the absence of definitive evidence about the results of treating hypertension in the elderly, the physiological factors that have to be taken into account are surveyed with particular reference to aggravating cerebral ischaemia.More potent hypotensive agents should be avoided in older patients and in practice the decision on whether to treat may depend more on the clinical context than on the level of the blood pressure itself.


Androgen receptors and the molecular basis for the action of antiadrogens in the ventral prostate.

In the rat ventral prostate, various antiandrogens can interfere with the normal formation of an androgen-receptor complex which appears to be required for androgen action. Some of the antagonists may act by inhibiting the enzymatic formation of 5 alpha-dihydrotestosterone or by competing with androgens for the binding sites on the receptors, whereby interacting with and altering the receptor molecules themselves. If the action of an androgen-receptor complex can indeed occur at the stage of gene transcription as well as in certain post-transcriptional processes, the molecular site of antiandrogen action may be in the nuclei and/or cytoplasm of the target cells.


Pregnancy complicated by maternal neural tube defect and an ileal conduit: a case report.

A case report is presented of a patient with severe neurologic defects associated with repaired meningomyelocele whose pregnancy was complicated in addition by prior urihary diversion and subsequent ureteral obstruction. The obstetric problem related to ileal conduits and the genetic aspects of neural tube defects are reviewed.


Phenylalanyl transfer ribonucleic acid synthetase from Escherichia coli B. Potent inhibition by analogues of N-benzyl-2-phenylethylamine.

A potent new class of inhibitors of phenylalanyl-tRNA synthetase from Escherichia coli B is described. N-Benzyl-2-phenylethylamine is a competitive inhibitor with respect to L-phenylalanine and appears to possess the structural features required for near-optimal binding. Hydrophobic substituents at the ortho position of either ring appear to be well tolerated, but substituents on both rings lead to large losses in binding. Poor noncompetitive inhibitors resllt from alkylation of the secondary nitrogen, further separation of the N-benzyl group from the nitrogen, or alkylation at the alpha position of the N-benzyl moiety. In contrast, placement of a methyl group at the 1 position of the 2-phenylethylamine moiety to give N-benzyl-D-amphetamine results in the most potent inhibitor yet described for this enzyme.


Phenylalanyl transfer ribonucleic acid synthetase from rat liver. Analysis of phenylalanine and adenosine 5'-triphosphate binding sites and comparison to the enzyme from Escherichia coli.

Inhibition of the ATP--PPi exchange reaction catalyzed by rat liver phenylalanyl-tRNA synthetase by structural analogues of L-phenylalanine and ATP has been examined and compared with data reported for the enzyme from E. coli. The phenylalanine binding sites are similar in the following characteristics. (1) The region that complexes the phenyl ring shows a strict requirement for the unsubstituted phenyl ring altough the rat liver enzyme is more tolerant in this respect. (2) The protonated amino group of phenylalanine is required for binding. (3) The region neighboring the binding site for the carboxylate of phenylalanine is diffusely hydrophobic. Unlike effects of these modifications on interaction with the E. coli enzyme, substitution of the carboxylate by hydrophobic groups leads to large losses in affinity for the rat liver enzyme. Although both enzymes bind D-phenylalanine very poorly, their relative affinities for the D isomers of phenylalanine analogues vary greatly. The most dramatic difference is observed with N-benzyl-D-amphetamine, which binds 24 000-fold tighter to E. coli phenylalanyl-tRNA synthetase than the rat liver enzyme. The affinity of rat liver phenylalanyl-tRNA synthetase for naturally occurring adenine compounds is similar to that of the E. coli enzyme, suggesting that the binding of ATP occurs via similar interactions. Adenine provides a major protion of the free energy of binding of ATP. The remainder may be viewed as the sum of detrimental interactions with the phosphate groups of ATP and a favorable contribution by the ribose moiety.


Polyglutamyl and polylysyl derivatives of the lysine analogues of folic acid and homofolic acid.

A series of Nepsilon-poly-alpha-glutamyl and Nepsilon-polylysyl derivatives of Nalpha-pteroyllysine and Nalpha-homopteroyllysine, analogues of the naturally occurring gamma-polyglutamyl forms of folate, was prepared and tested as substrates for dihydrofolate reductase and as substrates and inhibitors of thymidylate synthetase. Nalpha-Dihydropteroyl-Nepsilon-(tri-alpha-glutamyl)lysine was 1.8 times as active as Nalpha-dihydropteroyl glutamate (dihydrofolate) as a substrate for L1210 murine leukemia dihydrofolate reductase. N-alpha-Dihydropteroyl-Nepsilon-(di-alpha-lysyl)lysine was 1.2 times as active as dihydrofolate in spite of its strong positive charge. The most active compound tested, Nepsilon-(tert-butyloxycarbonyl)lysine, was 3.5 times as active as dihydrofolate. None of the enzymatically prepared Nalpha-tetrahydropteroyllysine derivatives tested was as active as Nalpha-tetrahydropteroyl glutamate (tetrahydrofolate) as a substrate for E. coli thymidylate synthetase. However, there was a progressive increase in activity with the addition of each alpha-glutamyl residue, the Nepsilon-(penta-alpha-glutamyl)lysine being 88% as active as tetrahydrofolate. Nalpha-Tetrahydropteroyl-Nepsilon-(di-alpha-lysyl)lysine was the most active thymidylate synthetase substrate of the polylysine derivatives, being 67% as active as tetrahydrofolate. Addition or deletion of lysyl residues resulted in diminished activity. It is noteworthy that substrate activity is retained in spite of the positively charged poly(amino acid) side chain. None of the enzymatically prepared tetrahydrohomopteroyl derivatives tested was as active as Nalpha-tetrahydrohomopteroyl glutamate (tetrahydrohomofolate) as an inhibitor of E. coli thymidylate synthetase.


Spinal dysraphism: genetic relation to neural tube malformations.

The families of 207 index patients treated for spinal dysraphism at The Hospital for Sick Children were studied to discover whether the condition was aetiologically related to the classical neural tube malformation--spina bifida cystica and anencephaly. The index patients had all had a tethered conus medullaris and one or more of a variety of anomalies of the spinal cord, vertebrae, or skin overlying the vertebral column. Of 364 sibs of index patients, 9 had an encephaly and 6 spina bifida cystica, a pro-proportion of 4.12%. This approximates to the proportion of sibs affected by neural tube malformations in the London region when the index patients themselves have spina bifida or anencephaly. It is, therefore, appropriate that the mothers of children with spinal dysraphism should be offered prenatal screening for neural tube malformations.


Acute respiratory, circulatory and pathological changes in the calf after intravenous injections of the galactan from Mycoplasma mycoides subsp. mycoides.

Twenty of 28 calves, 10-12 weeks of age when given intravenous injections of the galactan from Mycoplasma mycoides subsp. mycoides, showed transient apnoea, increased pulmonary arterial and decreased systemic arterial blood pressures, and increased packed-cell volume. Necropsy revealed haemorrhages associated with alveolar ducts and vessel walls, areas of pulmonary oedema, usually associated with the haemorrhages, dilated airways and, in some, capillary thrombosis. Animals that had shown changes in blood pressure and respiration in response to a dose of galactan did not react to a second dose an hour later. One goat tested died, four lambs were mildly affected and a cat and several rats and guinea-pigs did not respond. It is suggested that the galactan released biogenic amines that produced the effects listed. Immunological mechanisms were discounted on the grounds that only a small amount of antigenic material was injected at the time the reaction occurred, and neither serological nor skin tests produced any evidence of prior sensitisation to the galactan or a similar substance. A relationship between reactivity to the galactan and susceptibility to the natural disease has been suggested. This, together with the pulmonary oedema found in galactan-treated calves and in natural lesions of contagious bovine pleuropneumonia (CBPP), and the possibility that contraction of blood vessels could be an initiating cause of thrombosis indicates the role that galactan may play in the pathogenesis of CBPP.


Immunochemical investigations on lipopolysaccharides and acidic polysaccharides from serum-sensitive and serum-resistant strains of Escherichia coli isolated from urinary-tract infections.

Factors that may determine the variable resistance of urinary strains of Escherichia coli to the bactericidal activity of normal human serum have been analysed. No statistically significant difference was found in the amount of lipopolysaccharide (LPS) that could be extracted from serum-sensitive and serum-resistant strains by either the phenol-water or warm-saline techniques. The ratio of LPS O-side-chain sugars to core sugars was not found to be significantly greater in serum-resistant than in serum-sensitive strains. A sugar resembling D-glycero-D-mannoheptose was found in LPS from some of the strains; in one case the sugar was shown to be associated with the O-side chain moiety. Lipopolysaccharides from all but two of the strains contained the E. coli R1 core structure. No consistent difference was observed between serum-sensitive and serum-resistant strains in either the amount of acidic polysaccharide extracted or its red-cell agglutination-inhibiting activity; nor was a clear relationship found between sensitivity to serum and sensitivity to R-specific bacteriophages. It is concluded that no one mechanism of serum resistance explains the response to serum of the E. coli strains examined in this study.


Fimbriae and infectivity in Salmonella typhimurium.

A genotypically non-fimbriate (Fim-) strain of Salmonella typhimurium and a genotypically fimbriate (Fim+) strain derived from it by spontaneous mutation were compared for pathogenicity in mice. The two strains caused similar numbers of infections and deaths in groups of mice challenged by intraperitoneal inoculation, and nearly similar numbers in groups challenged by inoculation on to the conjunctiva, but the Fim+ strain caused many more infections (plus 26%) and deaths (plus 40%) than the Fim- strain when the inoculation was by mouth. Faecal cultures were made at intervals up to 120 days in the mice surviving after oral or conjunctival challenge and S. typhimurium was isolated more commonly from the animals challenged with the Fim+ strain (906 isolations from 384 animals infected out of 877 challenged) than from those challenged with the Fim- strain (614 isolations from 341 animals infected out of 877 challenged). The greater opportunity for faecal dissemination enjoyed by Fim+ bacteria may account for the preponderance of Fim+ over Fim- strains of S. typhimurium found in mammalian sources.


Development of concentric zones in the Proteus swarm colony.

Two main mechanisms of concentric ring formation in cultures of Proteus species are described. One of these is the classically accepted method, wherein rings are produced as the advance of the swarm stops and recommences. In the other, the ring is produced as a fold inside the colony. These are considered to be extremes of a spectrum of growth types, the common feature being that rings are formed by piling-up of growth, and this process is not always directly correlated with morphological change in the individual bacteria, or with cessation of advance of the swarm. The validity of the presently accepted theories of ring formation and swarming in general are thus called into question.


Carcinoembryonic antigen in histopathology: immunoperoxidase staining of conventional tissue sections.

A triple-bridge, indirect peroxidase-antiperoxidase method for demonstrating carcinoembryonic antigen (CEA) in frozen, ethanol-fixed or formalin-fixed, paraffin-embedded specimens was evaluated. Examination of 359 tissue specimens--234 malignant tumors, 37 benign neoplasms, 41 nonneoplastic diseased tissues, and 47 normal specimens--showed that CEA could usually be demonstrated in a group of cancers. We could detect CEA in carcinomas of the stomach, colon, rectum, pancreas, lung, and cervix. However, malignant tumors of the breast, prostate, kidney, larynx, brain, lymphoreticular system, soft tissues, and skin proved negative for CEA by the immunoperoxidase test. CEA could be detected in ethanol- or formalin-fixed sections. The only nonmalignant specimens showing CEA staining were a few benign tumors, the mucosae of some cases of colitis, and the resection margins of 2 cases of colon cancer; however, these were commonly very weak reactions. Measurement of tumor CEA content by radioimmunoassay revealed two causes for this relative specificity of the immunoperoxidase test for CEA:1) a quantitative difference existed in tissue CEA among the various specimens, and 2) the threshold for CEA staining in malignant specimens was usually above that in nonmalignant specimens. An analysis of the formalin-paraffin-treated sections showed that immunoperoxidase-tested CEA positivity reflected CEA levels in tissue of at least 3.0-5.0 mug/g; this permitted retrospective estimates of minimal tissue CEA concentrations in older histopathologic specimens by the immunoperoxidase reaction method. Formalin-paraffin-treated sections as old as 10 years still had demonstrable CEA. Although tumor CEA concentration correlated well with immunoperoxidase staining for CEA, plasma CEA titer did not necessarily reflect tumor CEA content. CEA positivity in primary and secondary tumors was strongly correlated; it was less strongly correlated with level of tumor differentiation.


Immunologic methods for the identification of cell types. I. Specific antibodies that distinguish between mammary gland epithelial cells and fibroblasts.

Antibodies were produced against intact mouse mammary epithelial cells and cleared fat pad fibroblasts; after appropriate absorption, two specific antibody preparations were obtained. The antimammary epithelial cell preparation did not appear to be strain- or species-specific. The antimammary fibroblast preparation recognized both mammary and fetal fibroblasts. These findings suggested that each cell type possessed distinct immunogenic components. These components were characteristic of each cell type and could be used to identify the respective cells by an immunofluorescence technique. Characterization of the antigenic component of mouse mammary epithelial cells demonstrated that this antigen was released during enzymatic cell dissociation and was regenerated underin vitro culture.


Active immunoprophylaxis and immunotherapy in two mouse lymphoma models.

Injections of appropriate numbers of irradiated tumor cells produced antibodies against tumor cell-surface antigen(s) in both syngeneic tumor models studied: the early transplant generations of the spontaneous L2 lymphoma in AKR/J mice and the chemically induced EL 4 lymphoma in C57BL/6J mice. No antibody was detected in normal or nonimmunized tumor-bearing mice. Tumor inhibitory or enhancing activity was not demonstrated by these antibodies. Immunoprophylaxis or cell-mediated immunity against the L2 lymphoma was not observed after injections of irradiated L2 cells and/or BCG into AKR mice. However, injections of irradiated EL 4 cells alone were effective in immunoprophylaxis against as many as 10(6) EL 4 cells and in immunotherapy against 10(2) EL 4 cells per mouse. The addition of BCG injections made immunotherapy with irradiated EL 4 cells effective against a load of 10(4) EL 4 cells/mouse, though BCG alone was not effective for immunoprophylaxis against EL 4 cells. Resistance to EL 4 could be transferred with viable syngeneic peritoneal or nucleated spleen cells. In both tumor models, an ongoing delayed hypersensitivity reaction to BCG alone apparently did not inhibit bystander tumor cells even when tumor cells were mixed before inoculation with viable BCG. In neither tumor model were concanavalin A-coated tumor cells more potent for immunoprophylaxis than were irradiated tumor cells alone.


Invasion and metastasis of a xenogeneic tumor in nude mice.

When aliquots of a malignant hamster tumor were transplanted to nude mice and to hamsters, the tumor showed 1) more rapid growth in the hamster, 2) local invasion and metastasis in both species, and 3) occasional spontaneous regression in the nude mouse.


Vascularization induced in the cheek pouch of the Syrian hamster by tumor and nontumor substances.

We tested fresh amelanotic and dry amelanotic melanoma tissue, gelatin, embryo and adult connective tissue, fresh and dry liver, fibrinogen, fibrin, pouch membrane, starch, dry hamster embryo and placental tissue, and glycogen in the transparent cheek pouch chamber of the Syrian hamster to explore the specificity of tumor angiogenesis and the mechanism that may selectively inhibit proliferation of blood vessels in the pouch membrane. Differences between the proliferations induced by tumor and normal tissues, various proteins, and polysaccharides were qualitative as well as quantitative. The glucocorticoid 6 alpha-methylprednisolone (MPS) decreased and sometimes totally inhibited the vascularization phenomenon. Dry tumor tissue induced capillary proliferation in seven of eight chambers 3 days after surgery; two of seven chambers of MPS-treated animals showed a reaction 10 days after the operation. MPS suppressed (in some cases only partially) capillary proliferation in chambers with implants of adult connective tissue, fresh liver, starch, or glycogen.


Tumor-associated macrophages as the primary source of lysozyme in the urine of mice bearing GPC-11, a transplantable reticulum cell sarcoma.

Large amounts of lysozyme accumulated in the serum and urine of (NZB X BALB/c)F1 mice with GPC-11, a transplantable reticulum cell sarcoma, type A. We separated GPC-11 cell suspensions on 20% Ludox HS gradients. (HS is one of the nine general grades of Ludox offered by du Pont de Nemours & Co., Wilmington, Del.) We did morphologic, functional, and biochemical experiments to detect oncogenic and enzymatic activity in each fraction. Oncogenic cells did not produce lysozyme. In contrast, macrophages associated with the solid tumor did produce lysozyme. The lysozyme purified from the GPC-11-associated macrophages resembled in size, electrophoretic mobility, and antigenicity the lysozyme purified from the urine of mice with the GPC-11 tumor.


Mutagenic activity of tryptophan metabolites produced by rat intestinal microflora.

The catabolism of tryptophan by rat intestinal microflora was studied for the production of mutagenic metabolites that might be involved in the etiology of colon cancer. Various tryptophan metabolites were assayed for mutagenic and comutagenic activity in the Ames bacterial test system. These included metabolites that were identified by thin-layer chromatography in cultures of rat fecal bacteria, other compounds structurally related to tryptophan, whole unfractionated mixed fecal bacteria culture filtrates, and concentrated solvent extracts. A total of 27 materials were tested with 5 Salmonella strains in the mutagenesis assay. Most substances were inactive, and only one compound, o-aminoacetophenone, which was unlikely to be produced in the intestine, showed weak comutagenic activity. Our results did not support the hypothesis that tryptophan metabolites produced by intestinal microflora are major etiologic factors in cancer of the colon.


Mantel-Haenszel analysis of Oxford data. II. Independent effects of fetal irradiation subfactors.

A Mantel-Haenszel analysis of fetal irradiation subfactors indicated that most of the "extra" X-rayed cases in the Oxford Survey of Childhood Cancers were radiation induced. First trimester exposures were rare but probably ten times more dangerous than later exposures. Ratios of observed: expected numbers of cancer deaths were lower for children with abnormal X-rays than for other X-rayed children, and lower for recent than remote exposures. The first of these differences was probably due to several antenatal conditions having positive associations with obstetric radiography and several causes of early (noncancer) deaths; the second one was probably due to a progressive lowering of film doses between 1940 and the present time. A rare cause of fetal irradiation (hydramnios), whose associations with congenital defects are well documented, led to the discovery that two faults in the International Classification of Diseases and Causes of Death have contributed to mistaken ideas about the etiology of childhood cancers: Neoplasms were not listed among the official causes of stillbirths, and cystic tumors of the kidneys and lungs of infants were not listed as neoplasms.


Effect of antibiotics on mice treated with cyclophosphamide.

The toxicity and therapeutic index of cyclophosphamide (CP) in NIH Wwiss and (C57BL X DBA)F mice were affected by the addition of different antibiotics to the drinking water. Penicillin G or Vancomycin increased the rat and number of deaths that followed parenteral treatment with CP; however, penicillin or Vancomycin alone produced no deaths. Both penicillin and Vancomycin changed the normal composition of the gastrointestinal bacteria, thus increasing the antibiotic-resistant coliform bacteria. Neomycin or gentamycin, with or without penicillin or Vancomycin, reduced the number of deaths that followed parenteral treatment with doses of CP lethal to 35% of the animals (LD35). Neomycin and gentamycin reduced the number of coliform bacteria recoverable from the gastrointestinal tract. The doses of CP against L1210 murine leukemia. The combination of CP (LD35) with the aminoglycosides produced several long-term survivors, apparently because larger doses of CP can be used with few drug-related deaths.


Relationship between intradermal tumor suppression and tumor immunity.

Intradermal (id) injection of three tumor-immune stimulant mixtures (LSTRA-BCG, 13762A-BCG, CaD2-Corynebacterium parvum) was superior to the sc site for suppression of tumor growth: Suppression of LSTRA-BCG mixtures was even less efficient after an ip or iv injectiouppression at all four sites. In the LSTRA-BCG model, the id site was not uniquely favorable for either the afferent or efferent limb of the immune response; the other sites produced equally effectiveimmunization or rejection of tumor challenge. We concluded that local suppression of tumor cell-immune stimulant mixtures was frequently more effective in the skin than at other sites, that local tumor suppression did not depend primarily on tumor immunity, and that afferent and efferent tumor immunity were equally efficient by the four routes tested.


Casein and 3-methylcholanthrene carcinogenesis in inbred C57BL/6Os female mice.

Groups of inbred C57BL/6Os female mice were subjected to one of the following -reatments: 1) subamyloidogenic administration of sodium caseinate (C group); 2) four intragastric intubations of 0.25 mg 3-methylcholanthrene (MCA) (MCA group); 3) a sodium caseinate injection followed by MCA (C-MCA group); or 4) MCA followed by a soidum caseinate injection (MCA-C group). During their life-spans, mice of the C group developed a significantly high incidence of neoplasms, especially histiocytic lymphomas, No myelogenous leukemia was observed in the C group, but it was seen in the MCA, C-MCA, and MCA-C groups. The occurrence rate of other neoplasms was significantly high in the C, MCA, and MCA-C groups, but it was not significantly high in the C-MCA group compared with the untreated group. Results suggested that sodium caseinate treatment shifts target organs in MCA carcinogenesis. In all treated groups, amyloidosis of a secondary type was observed at a significantly high rate in the following order of severity by treatment group: MCA, MCA-C, C-MCA, and C groups, MCA was obviously amyloidogenic with or without sodium caseinate adjuvant treatment; although the sodium caseinate treatment was subamyloidogenic, it elicited neoplasms, including neoplasms of lymphoreticular tissue.


Marlex mesh in gas gangrene.

Clostridial gas gangrene is a well recognized complication of traumatic and surgical wounds, and is associated with an overall mortality rate of 25% (5, 22). Gas gangrene of a limb results in a mortality rate approximately half that of gas gangrene of the trunk (4, 7, 8, 9, 11, 12, 13, 15, 16, 19, 24). Radical debridement and antibiotic therapy or high amputation of involved limbs are accepted traditional approaches to the problem. The role and value of hyperbaric oxygenation (OHP) remains controversial despite intense study over the past few decades. Patients with gas gangrene involving all layers of the abdominal wall as well as an extremity pose major resuscitative, operative, supportive, and rehabilitative problems. A report is presented of two such patients with comments on the therapeutic modalities employed.


Effects of indomethacin and nicotinic acid on E. coli endotoxin shock in anesthetized dogs.

The effects of single and multiple doses of indomethacin and multiple doses of nicotinic acid upon Escherichia coli endotoxin shock were studied in mongrel dogs anesthetized with sodium pentobarbital. Survival, cardiac output, plasma volume loss, and mean arterial pressure were measured. Untreated animals did not survive the procedure; animals treated with either multiple doses of indomethacin or nicotinic acid did survive for 5 hours after endotoxin. Plasma volume losses of indomethacin and nicotinic acid treated animals were substantially less (p less than 0.05) than in untreated animals. Arterialpressures of indomethacin-treated animals were greater than that of either nicotinic acid treated or untreated animals. No differences in cardiac output were noted in surviving animals.


The coverage of vascular repairs by muscle transposition.

The coverage of exposed arteries, repaired by suture or grafting, may present difficulties. The currently accepted methods have been reviewed, and the use of transposed muscle is suggested as a possible alternative method. Success is partly governed by adhering to important principles. An illustrative case report is presented.


Clinical and laboratory presentation of malaria: an analysis of one thousand subjects with malaria parasitaemia.

In the context of this study the ethnic origin of the patients revealed no noteworthy difference in the clinical reaction to the parasite; neither did age or sex of the patients. Any minor differences whcih appeared in length of history before seeking treatment and frequency of repeat attacks were more a reflection of the cultural pattern of response to illness (i.e. resort to traditional medicines) and the distance between the patient's home and the doctor rather than any altered response on the part of the host to the parasite. However, the fact that about 35 per cent of all the episodes had a history of eight or more days (about 10 per cent more than 30 days) suggest that more "malaria consciousness" is called for in what is after all an endemic malaria area. The value (and necessity) of repeated examination of the blood to detect the parasite is confirmed but it is also encouraging to note that in 84% of cases a single careful examination of the blood revealed the parasite. Since in 49% of our malaria episodes the patient was afebrile when the parasite was discovered, it is obvious that in outpatient practice especially blood should be examined when the patient presents for treatment, irrespective of the presence or absence of pyrexia. As always, a prerequisite to the diagnosis of malaria is an awareness of its possible presence.


Jaundice and hepatomegaly in primary malaria.

The hepatic manifestations were studied in 65 patients having uncomplicated primary attacks of vivax and falciparum malaria. Hepatomegaly due to a "non-specific reactive hepatitis" occurred in 57% of cases. Jaundice occurred in 15% of patients and was invariably associated with hepatomegaly. The clinical syndromes of jaundice and hepatomegaly in uncomplicated primary attacks of malaria have to be distinguished from those related to disorders like viral hepatitis, hepatic amoebiasis, typhoid hepatitis, infectious mononucleosis and Q fever. The causes for the jaundice and the pathogenesis for the hepatic lesions have been discussed.


Renal transplantation in patients with posterior urethral valves.

Abnormalities of the lower urinary tract are relative contraindications for kidney transplantation that have been overcome by corrective operations or construction of conduits. In our 2 patients with posterior urethral valves and defunctionalized lower urinary tracts kidney transplantation with ureteroneocystostomy and later resection of the valves resulted in satisfactory bladder function and normal voiding patterns. Therefore, urinary diversion was completely avoided.


[Renal autotransplantation or iliac transposition of the kidney after section of its vascular pedicle. Apropos of 2 personal cases. Review of 100 published cases].

Two cases of auto-transplantation of the kidney are presented. The first was carried out without prior planning during a ureterolysis procedure for retro-peritoneal fibrosis with a single kidney, by virtue of per-operative thrombosis of the renal artery. The second was used in the treatment of hypertension due to bilateral atheromatous renal artery stenosis with a lesion at the main bifurcation of the artery. In both these cases in which the surgical indication was related to the artery, the ureter was left intact. After 2 and 1 years respectively, the results are good. The important points of operative technique and tactics are emphasised. The order of the technique is important. It resembles that of homo-transplantation but in this case section and reimplantation of the ureter may be avoided. Preservation of the disconnected kidney is ensured by refrigeration with intra-arterial perfusion. Even if only for a short time, it consistently avoids the development of ischaemic tubulopathy. Ex-sito surgery, studied here in detail, is used in dealing with intra-hilar arterial lesions, tumours of both kidneys or a single remaining kidney, complicated cases of lithiasis etc. The results of the 100 known cases of renal auto-transplantation are analysed. They are good in 84 cases. The indications are discussed with regard to the different types of arterial, ureteral, neoplastic, traumatic and miscellaneous lesion.


Use of prophylactic antibiotics in urethral instrumentation.

A prospective study of 210 patients undergoing urethral instrumentation is presented. The patients were divided into 2 groups, receiving either amoxicillin or cephalexin. The postoperative incidence of infection and complications was compared to a control group of 110 patients receiving no antibacterial agent. Routine prophylactic antibiotics are recommended for patients undergoing urethral instrumentation. If the urine is infected at the time of instrumentation antibiotic therapy should be used according to the sensitivity studies.


[An accident related to a seat belt. Lymphocoele and extrinsic stenosis of the ureter in a transplant patient. Reparative surgery (author's transl)].

Trauma to a graft by a seat belt in a young adult, 18 months after transplantation. Drainage shortly after of a voluminous perirenal haematoma, abundant discharge of lymphorrhoea taking two months to resolve. Good recovery of the graft from both a radiological as well as biological standpoint. 4 years after the trauma, leucocytes in the urine associated with impairment of function of the graft. Discovery of a large hydronephrosis related to retro-peritoneal fibrosis. Ureterolysis with resection of the affected part of the ureter followed by anastomosis. Return to normal of renal function with disappearance of the hydronephrosis. Lymphocoele, a rare complication of renal transplantation, is discussed from three viewpoints: aetiopathology, diagnosis and treatment.


Cloacal exstrophy: 18-year survival of untreated case.

A patient is described who was 18 years old and attending high school when initially treated for cloacal exstrophy. The history, embryology and treatment of cloacal exstrophy are discussed, emphasizing that this congenital anomaly is compatible with a useful and happy life.


Malacoplakia of the prostate in an immunosuppressed patient.

Malacoplakia predominantly affects the bladder but occasionally involves other sites. The third case of malacoplakia of the prostate, occurring in a renal transplant patient who was receiving prednisone for immunosuppression, is reported. Modification of phagocytosis and the normal inflammatory response to bacterial infection by the steroid may have been of major importance in the genesis of malacoplakia.


Multiple tumors in a renal transplant recipient.

The case of a 54-year-old man who developed multiple epithelial tumors during his sixth year post-renal transplantation is reported. The tumors included keratoacanthomas of the forehead and neck, squamous carcinoma of the forehead, basal cell carcinoma of the cheek, multiple colonic adenomatous polyps and multiple ileal carcinoids. In addition, he had marked parathyroid hyperplasia in spite of good renal function, and pancreatic islet cell hyperplasia. Although there is a 5-6% incidence of de novo malignant neoplasms in immunosuppressed organ homograft recipients who were apparently free of cancer before and at the time of transplantation, multiple tumors are infrequent in these patients. A review of the literature reveals that this is the first case in which more than two cancers have occurred concurrently and it is also the first report of carcinoid tumors occurring in a transplant recipient.


Defibrination with ancrod in nephrotoxic nephritis in rabbits. In rabbits with nephrotoxic nephritis, defibrination with ancrod provided protection when administered during the autologous phase, after extensive glomerular fibrin deposition had occurred and crescents and renal failure were developing. When further glomerular fibrin deposition was prevented by defibrination, deposited fibrin was rapidly removed, indicating that glomerular fibrin-clearing mechanisms are retained in crescentic nephritis. Defibrination had no effect on the extent of glomerular C3 deposition or on the amount of proteinuria.


Effects of 25-hydroxycholecalciferol on bone lesions of children with terminal renal failure.

Quantitative histology was performed on serial iliac crest biopsies obtained from 14 children with terminal renal failure. A long-term study on the comparative effects of vitamin D2 and 25-hydroxycholecalciferol [25-(OH)D3], in five patients with severe lesions of osteomalacia and/or osteitis fibrosa, demonstrated the efficiency of 25 to 200 mug/day of 25-(OH)D3 and the lack of therapeutic action of 345 to 685 mug/day of vitamin D2. In nine subjects with normal roentgenograms or minimal skeletal alterations, the first biopsy taken at the beginning of intermittent hemodialysis showed evidence of defective mineralization and/or lesions of resorption. Four of these children were treated with 25-(OH)D3 (25 to 50 mug/day) and calcium supplementation orally (0.5 to 1.5 g/day); five children received calcium orally (0.5 to 0.75 g/day) alone. Aggravation of bone lesions during intermittent hemodialysis was observed in patients treated with calcium supplements alone. In subjects who were given 25-(OH)D3, mineralization improved and marrow fibrosis disappeared. However, as the two groups of patients were different in composition and in the manner in which they were treated, it is difficult to state whether the beneficial effects observed were solely attributable to 25-(OH)D3 administration. 25-(OH)D3 therapy induced severe intoxication in two patients. A rise in plasma calcium concentration to 11.0 to 11.5 mg/100 ml was observed in two other patients. It is concluded that: a) pharmacologic doses of 25-(OH)D3 are highly effective in healing bone lesions of children with terminal renal failure; b) such treatment requires strict clinical surveillance as 25-(OH)D3 intoxication may occur even in anephric patients.


[The first description of Loa-loa infestation of the eye by Pigafetta a historical error (author's transl)].

Contrary to common theory (Belding 1965), there is no reference to the African Eyeworm in Pigafetta's work. Philipp Pigafetta (1533-1603) translated the oral Africa report of the Portuguese Eduart Lopez into the Italian language. The de Bry Brothers published in 1597 the German version of this travel report, and in 1598 the Latin version followed.


[Suture technique for perforating keratoplasty (author's transl)].

The usual suture techniques in connection with perforating keratoplasty and the pulling direction of the threads are described. Especially unfavorable are the verticle factors with relation to the radial and diagonal continuous suture, which necessarily lead to a gaping of the inner and outer wound fissure. The double continuous diagonal suture (cross-stitch suture) seems to come closest to the goal of attaining as uniform a sealing of the wound fissure as possible with as small an amount of suture material as possible. This suture technique is therefore recommended for perforating keratoplasty.


[Primary care of injury of the lacrimal canaliculus (etiology, modified technics, results) (author's transl)].

An analysis is given of 68 cases with tearing of the lower lacrimal canaliculus regarding the type of accident. The following three types of operative procedures (modifications by the author) were described: canalicular intubation, canaliculonasal intubation, care of tearing of upper and lower lacrimal canaliculus - with reference to methods in use by other authors. Our results are communicated.


[Complete replacement of the conjunctiva by skingrafting and reconstruction of lidedges with tendograft (author's transl)].

Following total loss of conjunctiva and the superficial corneal layers after metalburns the bulbus was wholly covered over by the remaining skin. The lids were dissected from the globe and a shell was inserted carrying a Thiersch graft. At a later date the lidedges were strengthened by a tendon graft.


[One hundred years pilocarpine in ophthalmology (author's transl)].

In 1876 A. Weber introduced chemically from P. jaborandi isolated Pilocarpium muriaticum into the ophthalmological therapy. One year later it was used as a local drug to lower the intraocular pressure in glaucoma and replaced in the following years the extract of Calabar bean (Eserine). Clinical and pharmacological data are discussed.


[Pathogenesis and therapy of shock in children (author's transl)].

The severely disturbed microcirculation characteristic of any type of shock leads to typical functional impairments in vital organs such as heart, brain, lungs, liver, kidneys and gut which, in turn, exert an adverse influence upon the process of shock. The insufficient circulation primarily of the gut and the liver causes even those forms of shock which are not initially triggered by endotoxin to develop into the ominous endotoxin shock unless rapid and effective therapy interrupts this vitious circle. The prognosis of shock depends on early diagnosis nad treatment. Therapy should be initiated even before diagnosis of the underlying disease has been completed. The following therapeutic factors require special consideration: Volume substitution, prevention of cardial decompensation and of impending uremia, prevention and treatment of respiratory failure, direct treatment of the disturbed microcirculation by means of peripherally vasodilating drugs and if necessary, suppression of the intravascular coagulation by means of plateled aggregation inhibiting, anticoagulant and fibrinolytic drugs.


[Treatment of the dyspnea syndrome by continuous negative pressure (author's transl)].

It has been firmly established that CPTP is of great value in the treatment of IRDS and other respiratory insufficiencies. We believe that CPTP is best applied in the form of CNP. A method is described to safely and tightly close the CNP--chamber using self adhering plastic sheets.


[Cardiopulmonary adaptation to acute hypoxia (author's transl)].

The most important adaptive mechanism to acute hypoxia is alveolar hyperventilation which improves the oxygen uptake in the lung. The delivery of oxygen to the particular organs is regulated according to their vital function. An essential adaptive mechanism can not be observed above an inspiratory O2 partial pressure of 100 mm mercury, corresponding to an altitude of about 3000 m in normals. In contrast, in patients with cardio-pulmonary disturbances adaptive mechanisms take place at far lower altitudes. Especially in patients with arterial hypoxemia, pulmonary hypertension and occlusive vascular disease moderate hypoxia may lead to decompensation of an a priori unstable equilibirum.


Effect of a dental prosthesis on speaker-specific characteristics of voice.

Subjects were fitted with an experimental dental appliance which had the effect of lowering and retracting the alveolar-palatal contour. Recordings of subjects speaking without the prosthesis and with the prosthesis at two stages of speech adaptation were analyzed acoustically and by judgmental evaluation for the effect of the appliance in disguising the voice. Individual differences were found in the type and extent of sibilant anf vowel changes produced by wearing the prosthesis. Listeners made more errors on a speaker authentication task involving recordings obtained immediately after the unfamiliar prosthesis was placed in the mouth than on recordings made after a week of accomodation to the appliance, or recordings made a week apart when no prosthesis was worn.


Localization and organization of microfilaments and related proteins in normal and virus-transformed cells.

The localization and organization of actin-like microfilaments in normal, SV-40 and adenovirus transformed cells are determined by the coordinated use of light optical, electron optical and biochemical techniques. In adenovirus-type 5 transformed hamster embryo cells, microfilament meshworks appear to be the predominant organizational form of cellular action, while in normal hamster cells, microfilament bundles are prevalent. Differences between 3T3 and SV-40 transformed 3T3 cells are less apparent and may be related to the packing and intracellular distribution of microfilament bundles. Attempts at relating these ultrastructural changes in transformed cells to the images obtained following reaction with fluorescein-labelled myosin fragments and indirect immunofluorescence with smooth muscle myosin antibody are discussed. In several instances the fluorescence microscope images to not correspond to the ultrastructural observations. The results are discussed in terms of the possible relationships between alterations in cytoplasmic contractile elements and the abnormal behavior of transformed cells.


From Quonset hut to naval hospital. The story of an alcoholism rehabilitation service.

The history and treatment methods of the first Navy Alcoholism Rehabilitation Service are described.


The disease concept of alcoholism revisited.

The history of the conception of alcoholism as a disease is outlined. Recent opposition to that conception and the specific reasons therefor are discussed. On the basis that addiction constitutes a disablement in the medical sense, it is concluded that alcoholism is properly defined as a disease.


Drinkers and alcoholics in ancient Rome.

The history of wine making and wine drinking by the ancient Romans from earliest times to the fall of the Empire is reviewed. The drinking patterns as reflected in the works of contemporary authors indicate five periods of wine use and attitudes toward drinking.


Lymphocyte locomotion. I. The initiation, velocity, pattern, and path of locomotion in vitro.

The locomotive behaviour of human  lymphocytes in coverslip preparations of clotted autoplasma was studied at +37 degrees C. Lymphocytes isolated from peripheral blood or from the tonsils did not move prior to membrane activation by means of incubation with phytohemagglutinin (PHA). After PHA stimulation the locomotion of 19 lymphocytes was analysed by time-lapse fliming. The locomotion was random, as evidenced by a median locomotive index of 0.64 (Q1-Q3 0.04-0.75) and comparatively slow, median velocity 15 mum/min (Q1-Q3 12-18). The locomotion of 5 other lymphocytes was studied at high magnification. It is suggested that the characteristic polarity of wandering lymphocytes, indicating the direction of movement, can be utilized in the analysis of the lymphocyte traffic in tissue sections of post-capillary high-endothelium venules.


Lymphocyte locomotion. II. The lymphocyte traffic over the post-capillary venules analysed by phase contrast microscopy of thin sections of rat lymph nodes.

Thin sections of lymph nodes from 14 rats were examined by phase contrast microscopy as regards direction of lymphoctes with amoeboid movement configuration (AMC) relative to the basement membrane of post-capillary high-endothelium venules (HE-cenules). Out of 118 lymphocytes with AMC, 82 appeared to be on theyr way into the venule from the lymph node parenchyma. This observation suggests that the lymphocyte traffic over the HE-venules is bi-directional, with the main migratory stream of lymphocytes from the lymph node parenchyma into the post-capillary venules.


Economic analysis of an automated billing system for physicians' services.

An on-line Medicaid billing system for physicians' services was implemented and tested during a two and one-half year period in 100 offices throughout the State of +0.50,Alabama. Participating physicians represented 17% of all physicians in the state. The monthly volume of Medicaid claims entered through the system represented more than 50% of the statewide load processed by the Medicaid carrier. Users entered claims data on standard Touch Tone telephones equipped with Carddialers, and received instructions and data confirmation from the central computer facility via voice answer-back. Input time for the average claim billing for two separate services was less than one and one-half minutes and resulted in a reduction of clerical labor required for manual input by at least 50%. After a fee-for-service was inaugurated, the system workload remained at 86% of its load level before fee for service. Those physicians willing to pay for the billing service were high-volume users who had come to depend on the system and who appreciated the economics that the system had achieved for them in their office billing practices. An average claim consisting of two items of service could be billed at a cost of $0.50,, exclusive of user terminal rental ($6 per month per office) and the cost of data entry personnel (between $0.05 and $0.10 + 0.05 and $.10 per claim). Various algorithms have been offered for use in estimating an annual budget for an on-line billing system given alternative system configurations, methods of financing, annual volume of units of service, and the geographical nature of the population to be served. The tasks of preparing, processing, and storing insurance claims information have placed a costly and time-consuming burden on both providers of medical services and fiscal intermediaries. The unfortunate result is that the cost of submitting an insurance claim for professional medical services is a disproportionate fraction of the amount paid for providing the service. For general practitioners, who provide the largest number of individual services, this share may be more than one-fourth of the payment for most common services. Similarly, for the Medicaid or Medicare intermediary or for the insurance carrier, the cost of preparing and recording data from source documents is a large part of total processing costs. The objective of the On-Line Medicaid Billing System project was to demonstrate that it is possible to reduce the costs of submitting claims from the physician's office as well as to reduce the costs of data preparation in the carrier's system. This publication focuses on an economic analysis of cost effectiveness. Readers interested in system design, development, and on-line operation will find detailed descriptions in previously published reports.


[Preparation of biological specimens for the scanning electron microscope (author's transl)].

Three methods usually applied in preparing biological material for the scanning electron microscope were tested by the investigation of two species of amoebae with different content of water (Amoeba proteus, Vannella simplex). Air drying resulted in both the production of cell shrinkage and cell distortion. When the specimens were dryed from media with increasing vapour-pressure, more satisfactory preservation of surface structures could be obtained. The sequence of potency was: Ethanol, chloroform, isopentane, ethyl ether, freon 11 and freon 13. Short drying periods proved to be more favourable than long ones. Critical-point drying provided much better details of cell surface morphology in both amoebae species. However, some arteficial changes were still detectable as small breaks and destruction of the mucous layer. They must be attributed to the fixation and dehydration procedure. Freeze drying turned out to be superior to both air drying and critical-point drying. Specimens prepared by this method showed no visible differences in cell surface morphology compared to living cells. As a consequence of the relatively high content of water the preparation of A. proteus was more difficult than that of V. simplex.


[Enzymatic degradation of cell walls of yeast cells at different growth phases].

The enzymes of Actinomyces cellulosae were fractionated by precipitation with ammonium sulphate and gel filtration on Sephadex G-75. Fractionation yielded protease, beta-1,3-glucanase and an enzyme of a low molecular weight and unknown nature involved in lysis by 70% of yeast cells at early exponential growth phase without the participation of the other two enzymes. The protease did not accomplish lysis of the cells; beta-1,3-glucanase was involved in degradation of the cell walls of old yeast cells.


[Selection methods of nodule bacteria].

The aim of selecting nodule bacteria is to obtain stable and genetically pure strains with elevated effectiveness in the conditions of symbiosis with bean plants, sufficient viability and competing ability, which would survive in soil for a long time. The following methods have been suggested to solve this task: selection by plants using mutagenic factors; genetic markers; production of genetically homogeneous material; determination of the degree of persistance effectiveness in mutants.


[Conditions of yeast freeze-drying studied by methods of planning experiments].

The effect of seven factors on survival and residual humidity of yeast suspensions was studied during freeze-drying of Saccharomyces cerevisiae using methods of mathematical planning of the experiment. A multifactor experiment of the type 2(7-4) was realized, according to which all factors were varied at two levels. Adequate equations for regression were obtained to describe the process in the temperature zone above the eutectic point (from -10 to -15 degrees C) and below it (from -30 to -40 degrees C). The effect of the studied factors was found to depend on temperature of freeze-drying. The equations were used for optimizing freeze-drying by the method of "sharp ascending".


[Effect of pancreatic deoxyribonuclease on growth of Escherichia coli].

Cultivation of Escherichia coli K-12 on a medium containing pancreatic deoxyribonuclease at a concentration of 200 visc. units per 1 ml to 1000 visc. units per 1 ml stimulated growth of the cells but only at the lag phase of synchronous growth of the culture.