Fibrin degradation products in renal diseases.

Levels of serum fibrin degradation products (FDP) were determined in patients with acute nephritis, chronic nephritis, lupus nephritis and toxemia of pregnancy by the passive hemagglutination inhibition test. Serum FDP levels were less than 10 mug/ml in normal control adults, averaging 3.2 +/- 1.2 mug/ml. The incidence of serum FDP positive patients (more than 10 mug/ml) in those with acute nephritis, chronic nephritis, lupus nephritis and toxemia of pregnancy was 28%, 73%, 100% and 100%, respectively. Their serum FDP levels averaged 8.4 +/- 5.6 mug/ml, 16.0 +/- 5.9 mug/ml, 21.4 +/- 7.6 mug/ml and 35 mug/ml, respectively. Plasma fibrinogen levels, prothrombin time, partial thromboplastin time, euglobulin lysis time and platelet counts were within normal limits in serum FDP positive patients with renal diseases, indicating that there was no severe disseminated intravascular coagulation. All FDP positive patients with renal diseases of immunological origin demonstrated the deposition of fibrin within glomeruli with complement and immunoglobulin deposits. However, FDP positive patients with toxemia of pregnancy demonstrated fibrin depositions within glomeruli without complement and immunoglobulin deposits. FDP D fragments of urine from lupus nephritis patients showed no changes in immunoelectrophoretic patterns by heat treatment, indicating that urine FDP was derived from secondary fibrinolysis.


LH- and FSH-releasing activities of synthetic tetrapeptide and synthetic LH-RH in rats.

Changes in serum LH and FSH were measured following injection of synthetic tetrapeptide (Glu-Tyr-Arg-Trp-NH2) or synthetic LH-RH into the femoral vein of oophorectomized rats. A considerable secretion of LH occurred after injection of synthetic tetrapeptide although its LH-releasing activity was less prominent than that observed after injection of LH-RH. No appreciable FSH-releasing activity was noted following injection of the tetrapeptide. A significant rise of LH and an observable, but extremely modest, rise of FSH with an indistinct peak were noted after single injection of synthetic LH-RH.


Antigen inhibition on antibody forming cells at the level of effector cell.

In this study a possibility was examined that the specific antigen might inhibit antibody forming cells in order to know whether a non-T-cell-dependent mechanism of self-tolerance is present or not. If an autoantigen inhibits autoantibody forming cells, this inhibition may be one of the non-T-cell-dependent mechanisms of self-tolerance. Spleen cells from mice which were immunized with sheep red blood cells (SRBC) were incubated with SRBC and after an hour incubation erythrocytes added were removed. After 4 and 8 hr incubation, the plaques against SRBC were assayed by the plaque method. 1) After 8 hr incubation, SRBC reduced the plaque count to about 60% of the control aliquot incubating spleen cells with C3H mouse red blood cells. 2) This inhibition required 1% SRBC suspension, but despite increase in its concentration to more than 1% the degree of the inhibition remained constant. 3) This inhibition seemed to require neither T cells, macrophages nor the cells which display the cytotoxic activity in the antibody dependent cell-mediated cytotoxicity.


Chemical and biological properties of hot water extract from delipidated cells of Mycobacterium bovis strain BCG.

A water-soluble fraction was isolated from delipidated cells of Mycobacterium bovis strain BCG by extraction with hot water. Chemical analyses revealed that the above fraction presumably consisted of a peptidoglycan containing 5-10% of nucleic acids. When it was injected into guinea pigs with Freund's incomplete adjuvant plus egg white albumin as antigen, an increase of circulating antibody was observed as shown by the augmented titers of precipitin and hemagglutinin. The results of skin test and corneal reaction indicated that the fraction mentioned above induced delayed hypersensitivity to egg white albumin. Footpad reaction in mice demonstrated that the above fraction induced delayed hypersensitivity to sheep red blood cells. It was confirmed in addition that the adjuvant activity of this fraction was not due to the presence of nucleic acids. This adjuvant-active fraction was designated as HSA (hot-water soluble adjuvant.


A simple method to remove hemoglobin from antiserum.

Hemoglobin contamination in antiserum occurs frequently in immunohematology. The hemoglobin obscures the ring test for the observation of antigen-antibody reaction. A simple method to remove hemoglobin from antiserum is described in this paper. An appropriate amount of CM-Sephadex was added to antiserum containing hemoglobin and the mixture was packed into a cellulose tube, followed by dialysing against 0.01 M monobasic sodium phosphate solution (pH approx. 6). Equilibrating with stirring, the hemoglobin was completely adsorbed with CM-Sephadex so that hemoglobin-free antiserum was prepared without dilution of the antiserum. This method is useful for immunohematology.


[On the function-improving effect of rebasing].

The authors studied the rebasing technique of lower full dentures. For this purpose, they used the phonetic impression method according to the integral technique of Devin. From the results obtained it is concluded that the rebasing technique may be considered a rational, highly functional method.


[Tooth preservation and tooth extraction within the framework of prevention-oriented treatment planning].

The improvement in efficiency of prosthodontic therapy is linked to a strategic basic conception, the question of tooth preservation and extraction being of particular importance. The decisive criterion may consists in answering the question whether the step intended might contribute to structure preservation and function securing till old age or might be detrimental to these objective. The stomatologist may play a passive or an active role in the strategy of treatment.


[The surgical treatment of lower-lip carcinoma].

After a brief presentation of methods for the treatment of carcinomas of the lower lip, the author describes a new surgical technique which is a judicious modification to the procedure indicated by Webster and Bernard. Its principle consists in repairing the tissue defect resulting from the excision of the lower lip by the additional surgical removal of one or two soft tissue triangles from the region of the nasolabial fold and in achieving primarily, by means of horizontal relieving incisions at the base of the lip defect, an extension of the mouth aperture. Since 1973, this technique has been mainly used at the Clinic and Policlinic of Maxillofacial Surgery of the Warsaw Medical Academy. The results obtained were satisfying from the functional and the aesthetical point of view. Up to now, no recurrences have been seen.


[Our experiments with various preprosthetic surgical interventions].

Of 371 subjects hospitalized for preprosthetic operations during the years 1960-1972, 182 were re-examined on whom 228 preprosthetic interventions had been performed. The results obtained with vestibuloplasty associated with free skin transplantation, which had been executed mainly in the upper jaw, were very encouraging. To achieve a direct comparison of the method indicated by Schuchardt with the so-called buccal-inlay technique, both procedures have been performed simultaneously in a number of patients. Of the other preprosthetic surgical techniques, the plastic operation on the floor of the mouth yielded good results, too. If the relatively strict indications for the submucous vestibuloplasty according to Obwegeser were observed, this technique also proved satisfactory, whereas the results of the vestibuloplasty with healing by second intention and those of our restorative plastic operation on the alveolar crest were not satisfying.


[Scientific basis for impression taking with silicone elastomers].

Starting from the chemical and physical processes which occur during the cross-linking of silicones, the author represents the material and processing properties of these impression compounds. He reports above all of the results of utilizationoriented studies which evidence the effects of different conditions of processing on the behaviour during impression taking and on the impression itself. Conclusions are drawn as to the appropriate use of silicone impression materials.


Apolipoprotein localization in human cranial arteries, coronary arteries, and the aorta.

Apolipoproteins from human plasma high density (HDL), low density (LDL) and very low density lipoproteins (VLDL) were visualized in human arteries employing immunofluorescence techniques. Comparison between the localization patterns in extracranial and intracranial arteries and those in coronary arteries and the aorta was made. ApoA-I from HDL, apoB from LDL, and apoC-III from VLDL, as well as neutral lipid, were all localized to connective tissue and extracellular lipid pools in atherosclerotic lesions, and only to areas of intimal thickening in grossly "uninvolved" arteries. The degree of superposition of localizations was similiar in each vascular bed, and within the error resulting from the structural changes due to the focal nature of the atherosclerotic process. These results suggest a broad specificity in localization of apolipoproteins in most arterial lesions, and suggest that no differences in apolipoprotein accumulation exist between extracranial and intracranial arteries, coronary arteries, or the aorta. Variations in prevalence for atherosclerosis in each arterial bed must be accounted for on other bases.


Cerebral infarction in the Mongolian gerbil exacerbated by phenoxybenzamine treatment.

In a double-blind study, the effects of a large dose (20 mg per kilogram) of phenoxybenzamine (PBZ) on cerebral infarction were evaluated in 120 Mongolian gerbils. The left common carotid artery was ligated in 100 animals; a sham operation was done in 20 animals. One hour later, 25 animals were given 2 mg per kilogram of PBZ, 25 animals were given 20 mg per kilogram of phenoxybenzamine, and 50 animals were given 0.5 cc of nomal saline, all doses being repeated at 24, 48, and 72 hours. Five sham-operated animals were given 2 mg per kilogram of phenoxybenzamine, five were given 20 mg per kilogram of phenoxybenzamine and ten were given 0.5 cc of normal saline on the same treatment schedule. Morbidity and mortality were recorded for one week and then all surviving animals wer killed. All brains were studied for signs of infarction. Of the saline-treated animals, 32% had cerebral infarction and 81% of these died. Of the animals treated with phenoxybenzamine, 36% of those receiving 2 mg per kilogram and 68% (p less than 0.05) of those receiving 20 mg per kilogram had cerebral infarction and all of those with infarction died during the observation period. The animals receiving phenoxybenzamine had a larger stroke index than those treated with saline. The authors concluded that phenoxybenzamine is harmful in postischemic treatment of strokes.


Medical care in Ethiopia.

Ethiopia is one of the largest of the developing countries in Africa and it has features in public health which are common to all the underdeveloped countries--prevalence of communicable diseases and malnutrition, limited economic resources, numerous peasant agricultural communities, a large child population and shortages of trained staff and medical facilities. It is the purpose of this paper to trace the development of the health services in Ethiopia against this background and to outline the medical resources and methods of delivery of medical care which are evolving there. Although western medicine had been introduced into parts of Ethiopia by missionaries during the latter part of the last century, Swedish doctors and nurses having reached the Eritrean coast in 1866 (Ozanic, 1961) and although some of the hospitals in the existing health services date from the early 1900's onwards, all the major steps in establishing organised medical care have taken place within the three post-occupation decades from 1941-50, 1951-60 and 1961-70.


Studies on the resistance of malaria to chloroquine and to a combination of chloroquine and pyrimethamine in Peninsular Malaysia.

In vivo chloroquine resistance surveys, which allowed for detection of late recrudescing RI resistance, were conducted in three regions of Peninsular Malaysia, which were previously not recognized as having appreciable drug resistance. Among the 485 Plasmodium falciparum infections tested resistance rates ranged locally from 20% to 67% in those with parasitaemias over 1,000 per mm3, and 5% to 59% in all parasitaemias. The region found to have the most serious resistance was western Pahang. In one study a combination of chloroquine and pyrimethamine proved no more efficacious than chloroquine alone. Most of the resistance encountered was the late recrudescing RI type. There was no apparent correlation between drug resistance and Anopheles balabacensis as this species was not found despite intensive collections in two of the three main regions. There was no evidence of resistance among the 222 P. vivax and 35 P. malariae infections also tested.


Studies of immediate adverse reactions to different doses of a slow-release preparation of isoniazid.

'Double-blind' studies were carried out to assess the incidence of immediate adverse reactions to different doses of a slow-release preparation of isoniazid (matrix isoniazid). Individual doses of 30 mg/kg matrix isoniazid were well-tolerated but higher doses resulted in giddiness, the incidence being dose-related. The giddiness was characterized by a late onset and was usually present even at 24 hours. A few patients complained of gastro-intestinal symptoms. It is concluded that matrix isoniazid can be given to Madras patients in doses of 30-40 mg/kg without risk of an undue incidence of immediate adverse reactions.


A solid phase radioimmunoassay for pancreatic glucagon.

A solid phase radioimmunoassay procedure has been applied for the determination of glucagon and some variables of the assay procedure were studied. The sensitivity of the assay was 10 pg of glucagon for samples assayed in triplicate. This assay method which has a high precision and is technically simple as compared with other radioimmunoassays, was found to be suitable for studies on glucagon release in vitro.


[Biochemical mechanisms of skeletal muscle adaptation to increased activity].

The adaptation changes caused by the systematic muscular activity relate to morphology and functional properties of the muscular fibre subcellular structures, content and state of substrates and enzymes. There occurs not only an increase in the activity of enzymes but also a change in the ratio of the activities in polyenzymic systems. The increase in the enzymes activity is based on the substrate induction and derepression of the enzymes synthesis as well as changes in the isoenzymic spectra, sensitivity of the enzymic systems to hormones. All these changes are specific and determined by the functional profile of the muscles and character of the muscular activity. The energy supply of the adaptive synthesis of structural and enzymatic proteins, phospholipids and a more intensified synthesis of different substrates (glycogen, phosphocreatine) is based on regular changes occurring at rest determined by muscular activity and providing for a higher energy production during this period. Development and stabilization of the adaptation biochemical changes is under control of the chemical self-regulation of the metabolic cycles, neuro-trophic--somatic and sympathetic as well as of the endocrine regulation. At the different stages of adaptation its biochemical mechanisms have definite differences.


Kidney transplant from a patient with idiopathic hypercalciuria.

A case of renal transplantation is presented in which the donor had idiopathic hypercalciuria. The hypercalciuria persisted in the donor, but was not observed in the recipient. This fact suggests that, in this case, the cause of the hypercalciuria is the intestinal hyperabsorption of calcium ions.


Intubation macrodacryocystography and quantitative scintillography: the "complete" lacrimal assessment.

Intubation MDCG with subtraction provides excellent visualization of the lacrimal excretory apparatus. Quantitative lacrimal scintillography is the most useful method of assessing lacrimal excretory function. These two investigations are complementary and may be performed simultaneously. They provide a rational basis for diagnosis and management of disease of the lacrimal drainage system.


The extruding implant.

In both the treatment and prevention of implant extrusion, exacting surgical technique is necessary. The techniques involved are direct reimplantation of the implant, reinforcement of the tissue with patching and, for additional cosmetic revision, subperiosteal glass bead implantation or fornix reconstruction.


A new treatment for wrinkles.

A technique identified as threading is described for the treatment of wrinkles. Colorless 4-0 and 2-0 clear vicryl (Ethicon) has been threaded underneath the wrinkle for augmentation, and "basket weaving" has been applied to atrophic areas. As much as 40 feet of threads have been used at one time in the face. Complications are minimal, the results subtle, and the technique may be repeated. It is hoped that this concept will be developed further with the use of soft, colorless, nonabsorbable threading material (Prolene, Nurolon, Ethicon).


Composite pedicled rib flap for reconstruction of the mandible and face.

A new technique of bony and soft tissue augmentation to the mandible, face, and neck is presented. It consists of a composite soft tissue flap from the anterior chest, including two ribs attached and transposed without delay to the newly prepared tissue bed. The distal portion of this flap is de-epithelialized for soft tissue augmentation to the face. The ribs are wired to the mandible, and the flap is released in six to eight weeks. At that time, the proximal segment is de-epithelialized for further augmentation. The soft tissue mass is supported against gravity for three to four months with a chin strap. It is desirable to use this concept as a secondary procedure rather than associating it with the primary ablative technique. One can expect significant improvement in esthetics and contour from this technique.


Quadrangular rhytidoplasty.

A four-angled incision for the performance of rhytidoplasty has been utilized for the past 2-1/2 years. This approach has provided excellent results and is suggested as a flexible, cosmetic incision providing easy access to the temporal, malar, mandibular, and cervical integument.


Traction sutures in a tracheostomy using a ligature passer.

1. A history of tracheostomy is reported, indicating the relatively recent use of traction sutures. 2. The indications for a tracheostomy are listed. 3. The complications of a tracheostomy are mentioned briefly with emphasis on tube displacement and how this provides the rationale for the use of traction sutures. 4. The technique of placement of the traction sutures with the use of a new instrument, the ligature passer, is described. 4. An illustrative case is reported to demonstrate the significance of traction sutures.


The injured larynx: a new surgical procedure for repair.

This case illustrates an instance by which serious stricture of the subglottic lumen was repaired by a composite pedicle graft. A half circular portion of the normal clavicle cortical bone was incorporated in a regional full-thickness pedicle graft. A defect in the cricoid cartilage and adjacent tissues was thus repaired successfully, preserving the patient's physiologic integrity as to breathing, speaking, coughing, eating, and drinking.


The Gordon Wilson lecture: function of blood platelets and their role in thrombosis.

The role of platelets in thrombosis has been reviewed. The possible relationship between platelets and thrombosis, vessel injury and the development of atherosclerosis is discussed. The implications of our understanding of platelets in thrombosis and clinical complications of arterial disease is reviewed together with possible value if drugs which modify platelet function.


[Pulmonary reaction to foreign bodies].

The response of the pulmonary tissue in a continuous stay of foreign bodies in the lung is characterized by chronic inflammation of the pulmonary tissue, deformation of the bronchial tree, atrophic, hyperplastic and dystrophic changes in the ciliated epithelium and its metaplastic degeneration into multitratum squamous epithelium. Chronic inflammation of the lung would develop mainly in bronchial injury with a foreign body or in impaired bronchial patency. In localization of metallic foreign bodies extrabronchially their incapsulation usually occurs.


[Correction of mandibular defects with preserved homologous bone sterilized in ethylene oxide].

The authors have elaborated the technic for procurement of homografts from the lower jaw bone taken from cadaver-donors, without observing aseptic rules, with their subsequent ethylene epoxide sterilization in a portable chamber. Experimental studies have demonstrated that ethylene epoxide renders no negative effect on osteoplastic properties of the homograft, the rate of its reconstruction was dependent on the method of preservation. The results of osteohomoplasty for mandibular defects in 46 patients are summarized.


[Plastic correction of penetrating defects of the perioral region with flat epithelized skin flap].

For plastic replacement of penetrating defects of the adoral region the author suggests to use a flat epithelized skin graft formated proximal to the defect in the following regions: the nasolabial fold, chin, anterior chest surface and suprabrachial region. Such plastic material formated from non-free fatcutaneous graft and split dermatome transplant healing in conditions of burying has a bilateral epithelial cover.


[Primary dermoplasty with cervical pedicle flap after resection of locally spread mouth tumors].

In the paper the authors report their experience with application of a jugular fatcutaneous pedicled graft for primary reconstruction of defects of the oral mucous membrane following resection of localy spread malignant tumors under conditions of preliminary radiotherapy. Results of the plasty in 30 patients are reported. The technic of cutting out the graft is described.


[Study of bacterial allergy in acute appendicitis by the method of leukocyte migration inhibition in vitro].

Under study was the effect of various bacterial allergens on the migration of blood leucocytes from capillaries in vitro in 23 patients with acute appendicitis and in 18 healthy individuals. Bacterial allergens wound suppress leucocytes migration in all patients. Most frequently, sensibilization to allergens of hemolytic staphylococcus and hemolytic streptococcus was found. In 4 healthy persons this  methods indicated sensibilization to some allergens. The interaction of activity sensibilized lymphocytes and passively sensibilized polynuclears of the appendix with bacterial antigens is assumed to tigger the hyperergic reaction in acute appendicitis.


[Free dermoplasty in scalp wounds].

An analysis of treatment in 10 patients with scalp cranial wounds is reported. To find the optimum variant of free skin plasty in this kind of pathology experiments were carried out on 245 animals, on which basis the author recommends to use plastic reconstruction with full-thickness skin grafts, as being the most rational, placing them on the osseous bed treated up to the diploe, the adaptation of skin wound and graft edges and their fixation with sutures being absolutely imperative.


Fundamental aspects of ovum transfer in cattle.

Although it may ultimately be possible to fertilise ovarian follicular oocytes in vitro, superovulation and insemination are currently the only practical method for obtaining a supply of fertilised ova. It is likely that this will remain true for sometime to come. Pregnant mares serum gonadotrophin (PMSG) is almost universally used for inducing superovulation, and response to it has  recently been more reliably achieved by using, in addition, prostaglandin F2alpha to induce oestrus in superovulated donors. The recovery of fertilised ova from donors depends on the expected site of the ova within the genital tract, but both surgical and non-surgical methods involve suspending the ova in a stream of fluid which is collected into glass cups and examined microscopically. A variety of in vivo and in vitro environmental conditions affect the success of transfer of fertilised ova. These include the healthy state of the recovered ovum, the storage medium, the method and length of storage, the age of the ovum and the synchronisation of oestrus of donor and recipient.


Lamellar corneal transplantation in the horse.

Surgical correction of corneal opacities in horses has rarely been documented in detail and is still reported to be in the experimental stage. For this reason, studies of lamellar keratoplasty were conducted on the equine eye using a modified trephine with an adjustable inside quard for grafting of identical discs from the donor and the recipient cornea. Fourteen transplantations, seven with homografts and seven with heterografts, 15 and 9 mm in diameter, were performed. Sharp-edged, vertical, and regular outlined wound margins of the graft and host are essential for good adaptation and healing without tension. The details of instruments used, preoperative preparation, surgical technique, and postoperative care are described. Results indicated that this method is a feasible tool for the repair of corneal defects in the horse and may be usefully employed in an intention to restore vision.


[Biochemical identification of Salmonella and coli bacteria and their sensitivity to chemotherapeutic agents].

Strains of enterobacteria, isolated from pathologic material (dead pigs, birds, lambs, sheep fetuses, swab fecal samples from calves) were biochemically identified by the methods of Costin, Le Minor, and Eming. One-hundred forty of them proved to belong to Escherichia coli and 236 -- to Salmonella. The sensitivity of the isolated bacteria to antibiotics (ampicillin, streptomycin, tetracyclin, kanamycin, neomycin, chloramphenicol, erythromycin, oleandomycin polymyscin), sulfonamides (norsulfasol, sulfaguanidine, and sulfadimesine), and nitrofuran preparations (furazolidon and orafuran) was tested by the disk diffusion method. There was in a high per cent of the cases resistance to tetracyclin, erytromycin, oleandomycin, sulfanilamides, streptomycin, ampicillin, and comparatively well expressed susceptibility to polymyxin, furazolidon, orafuran, kanamycin, neomycin and chloramphenicol. Prevailing were the enterobacteria polyresistant to antibiotics, the observed resistance being expressed to 3, 4, 5, 6, and 7 antibiotics at the same time (out of all nine of them that were studied). The only exception were Salmonella typhimurium and Salmonella dublin which were resistant to 2 or 3 antibiotics only. In connection with the data obtained on the tolerance of enterobacteria to chemotherapeutics it is necessary to reevaluate the programmes for the prophylaxis and control of diseases in farm animals and birds caused by Escherichia coli Salmonella spp.


[Sensitivity of E. coli strains to Fredericq-type colicins].

Studied was the spectrum of sensitivity of various Escherichia coli strains to the standard types of colicine after Fredericq. The strains were isolated from dead and emergency slaughtered animals as well as from food products of animal origin. It was found that regardless of the type (colicinogenic and noncolicinogenic) and the origin of the strains almost a monotype spectrum of sensitivity is observed. With but few exceptions the strains proved sensitive to colicine of the types V, D, E+I, F, C, I, J+I, K, Sj, S3+I, S4 and S5. The similarity referred to substantiates the expedience in determining the type of colicine of bacteria in epidemiologic and epizootiologic studies.


[Study of the methods for detecting Salmonella in meat and viscera].

Studied were a toal 415 samples of viscera (musculature, liver, spleen, kidneys and a lymph node from skeletal musculature) taken from 83 emergency slaughtered pigs and cattle, and liver samples of 10 experimentally infected guinea pigs using direct immunofluorescent microscopy. All samples were preliminary kept in the tetrathionate-broth of Müller and Kaufmann, the broth for cultivation of Gramnegative bacteria, and in paraffin blocks, for 24 hours, in order to obtain more abundant growth of bacteria. The cultures were studied by the standard method of reseeding from liquid nutrient media at the 24th, 48th and 72nd hour. Highest per cent of correlation (89.4%) between the results of the immunofluorescence method and the cultural method was shown by enriching the growth in the tetrathionate-broth of Müller and Kaufmann. This suggests the use of immunofluorescence microscopy as a quick helpful method to detect Salmonella bacteria in the microbiologic inspection of meat.


[Clinical studies of an experimental suppurative surgical infection in cattle caused by Cornynebacterium pyogenes].

Studied were clinically and paraclinically six cattle manifesting an experimental suppurative surgery infection caused by Cornebacterium pyogenes, strain 1056. It was established that the infection assumes the course of septicaemia with metastases in the viscera, causing severe disturbances in the general condition and leading to death in most cases. Found were also anemia, leukopenia, that alternated with leukocytosis presenting nuclear shift to left, changes in the erythrocyte sedimentation rate in terms of more rapid settling out of r. b. c. The urine presented protein and sediment consisting of 8 to 10 or numerous erythrocytes, 5 to 6 or 10 to 15 leukocytes, single to 8-10 kidney epithelium cells. The rumen content became alkaline, and the infusoria count dropped.


[Developments in immunofluorescence (author's transl)].

This report presents a review of recent developments in immunofluorescence and their resultant applications. After a short introduction to the basic principles of immunofluorescence, this study deals with newer developments in utilizable fluorochromes, new methods in the production of antisera and fluorochrome-labelled conjugates and recent improvements in the optical system. In particular, the necessity of suitable characterization and examination in regard to the quality of the conjugates is described in detail. A separate chapter has been devoted to the rapidly-developing quantitative immunofluorescence technique and its application.


[Urology -- yesterday and today (author's transl)].

The developments in urology over the past 10 years both in regard to diagnosis and therapy are reviewed. The value of diagnostic procedures such as intravenous urography, angiography, isotope rhenogram and scintigram in tumours of the kidney and the significance of lymphangiography in the decision concerning the operability of tumours of the bladder, the prostate and the testicle are discussed. The importance of cytological examinations in the early diagnosis of cancer of the bladder and the prostate, as well as in the postoperative follow up of cases of bladder carcinoma is emphasized. Metabolic diseases such as renal calculus formation and renal hypertension are of great importance in regard to social aspects of medicine owing to their increasing occurrence. New urological equipment, as well as established instruments such as fibre optics and "Urat-I" for the treatment of bladder calculi, as well as cryotherapy of prostatic tumours is demonstrated. Coagulum pyelotomy is recommended for the treatment of friable stones in the renal pelvis and the calyces. This review of the current stand of development in the field of urology is coupled with proposals of a suitable training programme for future urologists.


[The effectiveness of autologous transplantation of spongy tissue of bone in accident surgery (author's transl)].

The use of autologous transplants of spongy tissue of bone has attained a standard place in the treatment of pseudoarthroses and of depressed fractures in the vicinity of joints. On the basis of experience gained during the implementation of this form of treatment at the Professorial Casualty Unit of the 2nd Department of Surgery, University of Vienna, during the years 1671--1974, guide lines are laid down for the achievement of a successful outcome of transplantation with a minimal complication rate.


[Renal transplantation in children (author's transl)].

During the past 2 years 7 children received kidneys from cadaveric donors. 2 transplants had to be removed because of irreversible chronic rejection and 1 recipient died on the 4th day after surgery. The remaining 4 recipients are doing well. In the evaluation of the results special emphasis is placed on the normalization of growth and puberty. The difficulties of psychosocial rehabilitation are stressed.


Mutagenesis in bacteriophage T7. I. Chemically induced mutagenesis.

The mutagenesis in phage T7 after MMS-, HNO2-, hydroxylamine-, 5-BUdR-, and 2-AP-treatment in relation to host controlled functions is investigated. There was no dependence of the induction of mutations on the character of the host strains (rec, hcr). A back mutation system (amber system) and a forward mutation system (host range system) have been used. Substances which cause mainly transitions from GC to AT do not lead or only rarely lead to reversions of the amber system; but chemicals producing transitions from AT to GC do so.


Mutagenesis in bacteriophage T7. II. UV induced mutagenesis.

UV induced mutagenesis of bacteriophage T7 was investigated by using a forward mutation system (host range system) and a back mutation system (amber system). The results indicate a dependence of mutation of T7 after UV irradiation only on the rec gene controlled functions of the bacterial host. The functions controlled by pol and uvr genes have no influence. Among other types of mutations UV irradiation leads to transitions from AT to GC.


[Clinical-pharmacological effective data on 3',4',-dipropionylhelveticosol].

In experiments of treatment carried out on 39 patients with cardiac insufficiency with tachyarrhythmia for the partially synthetic, new heart glycoside 3',4'-dipropionyl helveticosol the following clinico-pharmacological data of efficacy were approximately established on an average: level of full efficacy 2.7 mg, daily coefficient of disappearing 40%, coefficient of enteral absorption 30%, daily maintenance dose intravenously 1.1 mg and orally 3.7 mg.


[Intrathoracal tumor with accompanying hypoglycemia].

The number of the Doege-Potter-syndrome cases described above is less than one hundred. Even rarer are thoracic tumours with associated hypoglycaemia. The pathophysiologic mechanisms of the syndrome have not been fully elucidated as yet. There are also divergencies about the etiology of hypoglycaemia. Several hypotheses are under discussion. Even our observation shows the difficulty of discovering the genesis of tumour-conditioned hypoglycaemia.


[Pathomorphology of the duodenal stump after gastric resection (Billroth II)].

40 duodenal stumps formed following gastric resections according to Billroth II were studied. The most recent stump was 6 hours old, the oldest 35 years. With some exceptions the torus on the stump---due to the suture---disappears within one year and is replaced by a wide strip of scar tissue. Chronic inflammations due to foreign bodies, some with acute exacerbation, were proved histologically to persist even decades after the resection. These inflammations are closely related with the suture material and other foreign matter. In patients submitted to the Billroth II operation, lipomatosis in the pancreas occurred more rarely, whereas fibrosis set in more often.


[Motilin-range and analysis of its action].

Motilin is a polypeptide containing 22 amino-acids from the entero-chromaffin cells of the mucosa of the small intestine. Synthetic analogues (13-norleucine-motilin; 13-leucine-motilin) proved to be equal to the natural polypeptide in the biological aspects. Motilin primarily stimulates the motility of the upper gastrointestinal tract but inhibits gastrin evacuation. The contractile action of motilin does not take place by way of the nerves but through receptors on or in the smooth muscle cell itself. Motilin and cyclic adenosine-3':5'-monophosphate are functional antagonists in the contraction of the gastrointestinal musculature. Depending on the dosis, motilin increases gastric pepsin secretion and inhibits protein biosynthesis in the gastric mucosa itself. Radioimmunological motilin tests will help to determine which of the above-mentioned motilin actions are "physiological" and which of them merely "pharmacological".


[Summary of work session 1: Blood coagulation in gastroenterology].

Part I: Immunological assays of clotting factors in the diagnosis of liver diseases. The immunological determination of Antithrombin III is a good measure of the capacity of the liver to synthesize plasma proteins. Antithrombin III concentration in serum correlated significantly with the prothrombin time and the activity of cholinesterase. The immunological determination of factor VIII related antigen seems to be important for the early recognition of the transition of an acute hepatitis into a chronic course. While following uncomplicated acute hepatitis the level of factor VIII related antigen is normal after 40 weeks, it remains high in cases which become chronic. Immunological assay of factor XIII seems to be not very useful in the diagnosis of liver diseases. Part II: Management of coagulation disturbances in liver diseases. Except cases of hepatic coma the hemostatic abnormalities in chronic liver diseases are rarely severe enough that correction is necessary. Prothrombin concentrates are considered by most of the discussants as unnecessary and potentially dangerous. Transfusion of platelets is only neccessary when the platelet count is below 40.000 and surgery is planned. It is uncertain whether patients with chronical liver disease and laboratory signs of DIC benefit from heparin therapy. Although laboratory tests may be improved, prognosis, especially in cases of acute oesophageal bleeding, seems to be not changed by this treatment.


Deviated lysis: Transfer of complement lytic activity to unsensitized cells II. Generation of the activity by inulin and by antigen antibody complexes.

Deviated lysis (d.l.) activity, i.e. lysis of unsensitized cells by lytic C activity, was generated via the classical pathway of Cactivation (ag ab complexes) and via the alternative pathway (inulin). The activity was observed on the surface of the activating particles and in the fluid phase. The activity was relatively stable  at 32 degrees C. Its generation involved the C components C6 through C9 and possibly also C5.


Subpopulations of blood lymphocytes in patients with rheumatoid arthritis.

The peripheral blood lymphocyte subpopulations of 18 patients with rheumatoid arthritis were compared with those of 10 healthy donors using minor modifications of the mixed immunofluorescence and rosette test (1), rosette test using human 0 RhD erythrocytes coated with anti-RhD antibodies (2)and the miced rosette test (3). It was found that the percentages of lymphocytes exhibiting both immunoglobulin receptors and receptors for sheep erythrocytes, and lymphocytes with receptors for Fc part of IgG in the rheumatoid patients were increased. A hypothesis for the origin of these subpopulations is discussed.


Anatomical locus of the common enterobacterial antigen.

Cell walls, membrane vesicles and the soluble cytoplasmic components have been isolated from Escherichia coli 0:14 and Salmonella typhimurium and examined by electron microscopy as well as hemagglutination inhibition with heterologous antisera for enterobacterial common antigen (ECA). The outer and cytoplasmic membranes also were isolated and examined for common antigen. Although common antigen was present in the isolated surface structures it was not localized exclusively in these fractions. Additional experiments revealed that, whatever the nature of the integration of ECA of Kunin into the cell envelope, it is a much more stable association in E. coli 0:14 than in S. typhimurium.


Specific lymphocyte transformation in murine malaria.

Lymphoblast transformation tests were performed on convalescent rats and mice, after infection with Plasmodium berghei had been reduced to latency. Spleen cells from immune animals reacted in vitro to specific plasmodial antigen and not to control antigen produced from non infected RBC. The response in vitro was dependent on the concentration of the antigen and the time of exposure to it. A correlation was observed between the parasitaemia of the convalescent animal during its acute infection and the reaction in vitro: the higher the parasitaemia the higher the in vitro simulation.


Creutzfeldt - Jakob disease.

A description if given of a male patient in whom a diagnosis of Creutzfeldt-Jakob disease was made by brain biopsy. This is believed to be the first case of this syndrome reported from Papua New Guinea.


Deep vein thrombosis after renal transplantation.

Postoperative deep vein thrombosis has been demonstrated in four out of seven (57%) unselected patients undergoing homograft cadaveric renal transplantation, with pulmonary embolism in one. The diagnosis being made by using the combined 125I-fibrinogen and Doppler ultrasound techniques. The late onset of the deep vein thrombosis may be due to the heparin given interoperatively and postoperatively which acted as a prophylactic agent.


[Clinical significance of hydramnios from the view point of current medicine].

In the period from 1.1. 1970 to 31.3 1975 we found under 11876 deliveries in 56 cases polyhydramnios (= 0,47%). Deformities by the newborns we have had in 8,9%! A timely observation and therapy of the polyhydramnios are able to diminish the risk for mother and child. The therapy of choise is a frequently transbdominal amniocentesis after localization of the placenta. A partus praematurus we could'nt avoid generally. An compulsory fetal monitoring of this patients is necessary, because many of this deliveries are high-risk deliveries.


[Diagnosis, treatment and prognosis of threatened abortion].

After legislation of therapeutic abortion in 1972 number of spontaneous abortions decreased about 30 per cent. In this paper causes, pathologic diagnosis, other diagnostic procedures and treatment of threatened abortions are discussed. Cytogenetic and ultrasonic methods should be extended. The effect of treatment in threatened abortions is still now not sure.


[Problem of the relationship between pyelonephritis in pregnancy and ABO blood-group system].

In the present publication the attempt is made to show relationship between pyelonephritis and blood-group. A shift of the blood-group distribution in disfavour of blood-group O can be seen finding its expression especialy in the representation of the relationship between E. coli demonstration and blood groups.


[Early diagnosis of corpus-carcinoma. The Gravlee-Jet-Washer withdrawal method on--safety from iatrogenic lesions].

A short review is given about the development and method of cytology from the endometrium; the accuracy of aim and the advantage of the Jet-wash technique by Gravlee has been described. The practicability of obtaining the best material is discussed. Metastasis implantation by spreading the material is nearly impossible when accurate operating is done.


[Use of the antiglobulin test for the purpose of detecting antibodies to enteropathogenic bacteria in biological fluids].

Use of IHAT with the addition of antiserum to immunoglobulins G, M, A increased the frequency of detection of antibodies to enteropathogenic bacteria in various biological fluids (blood, saliva, human milk, feces). At the same time the antiglobulin test permitted determination of the immunological class of these antibodies. In the substrates where the antibodies were subjected to an intensive action of proteolytic enzymes there was seen a decrease of the efficacy of the modified IHAT, but by results it exceeded the common IHAT. Antiglobulin test with the addition of antisera to immunoglobulins G, M and A could be recommended for the immunological study of the blood sera and of the external secretions for the purpose of the most reliable detection and determination of the immunological class of antibodies to enteropathogenic bacteria.


[Heterogeneity of the population of pseudotuberculosis microbe cultures].

Use of the method of oblique illumination of the colonies permitted to detect four variants of pseudotuberculosis microbe differing by the character of fluorescence, and also by virulence, toxicity and immunogenicity. Strains isolated from sick persons, carriers and rodents were characterized by polychromatic character of fluorescence of the colonies, whereas strains isolated from the external environment were monochromatic. Since colonies with a different fluorescence had different biological properties it can be supposed that the properties of each strain as a whole were determined by its quantitative and qualitative composition as of a heterogeneous population.


[Antibody-containing cells in the mucosa of the large intestine of patients with acute bacterial dysentery].

The authors traced the dynamics of appearance, increase and disappearance of O-antibody-containing cells in the mucosa of the distal portion of the large intestine in patients suffering from acute Sonne and Flexner dysentery (aspiration biopsy of the mucosa). The antibodies were revealed by the indirect Coons method. The total number of cells per 1 mm2 of 4 mum of the mucosal section the number of lymphoid cells and the content of the antibody-containing cells in % per total cell count of the lymphoid tissue was calculated. It was revealed that the antibody-containing cells appeared on the 4th day of the disease, reached the maximum on the 7th--8th and disappeared on the 22nd--25th day. Cells of the plasmocytic series containing no antidysentery antibodies, were revealed in large amounts even at the remote periods (up to 6 months) after recovery.


[Feasibility of treating Sonne dysentery patients at home].

Results of studying possibility of treatment of 589 patients suffering from Sonne dysentery at home showed that their significance in the spread of infection was not greater than that of those treated at the hospital. Significance of the patients in the spread of infection in a family was determined by their age, severity of the disease, number and duration of excretion of the causative agent. It was concluded that patients with forme frustes or subclinical form of Sonne dysentery and also those revealed during the late periods of the disease could by treated at home.


[Contamination of fish by agents of botulism type F and differentiating it from type E].

A total of 1859 samples of fish and various sea animals were examined for contamination with causative agent of botulism. The cultural fluid of 4--5-day cultures of the samples was tested in the reaction of neutralization with the diagnostic antitoxic antibotulin sera. types A, B, C, E. The causative agents of botulism (types A--7,B--16, C--5, E--128) were revealed in 156 samples. The sera were diluted to the concentration of 1 IU/ml for differentiation of the toxins types B and F in the neutralization test. Of 128 samples which gave a positive reaction with the serum of type E, 75 were identified as type F. In connection with the aforesaid the authors recommended in all the cases of botulism of type E in man to carry out differential diagnosis between the causative agents of botulism of types E and F and, on the basis of these data, to solve the problem on the necessity of production of therapeutic antibotulin serum of type F.


[Comparative study of group A streptococcal antigens. II. Comparative characteristics of several physico-chemical and immunochemical properties of partially purified M-protein and cytoplasmic protective antigen].

The authors carried out a comparative physico-chemical and immunochemical study of antigen obtained from the fraction of streptococcus cytoplasm by precipitation with ammonium sulfate, and partially purified M-protein. They proved to be heterogeneous by molecular-weight characteristics when tested by the methods of sedimentation analysis, disc-electrophoresis in polyacrylamide gel, and gel filtration on Sephadex G-200. Results of immunoelectrophoresis and disc-electrophoresis pointed to the presence in these two antigens of significant structural differences. A common component in M-protein and the cytoplasmic antigen was revealed by the immunodiffuse test. Spectrophotometric data pointed to the fact that M-protein represented protein, and cytoplasmic antigen was chiefly a nucleoproteid.


[Kinetics of the immune response following syngenous transfer of bone marrow, thymus and spleen cells from donors under the influence of previously administered antigen].

The influence of the donor priming upon the recipient's immune response under conditons of syngenic transfer of nucleated cells of the bone marrow, thymus, spleen to the lethally irradiated recipients was studied, the recipients being immunized with sheep erythrocytes. A fall of total number of antibody-forming cells was observed in the recipients in priming. The number of hemolytic foci was increased the first day after priming in case of injection of the bone marrow cells from the intact donors and of the thymus cells from the immunized donors. On the third day of the experiment the number of these foci was three time less in comparison with the control. An increase of the hemolytic foci was discovered in the syngenic transfer of splenic cells affected by priming.


[Cytotoxic effect on L-cells of lymphotoxin obtained during hypersensitivity of the delayed type to streptococcal antigens].

A study was made (in vitro) of the cytotoxic action on the mouse L-cells of lymph otoxin obtained in cultivation with a thermostable fraction of streptococcus of the lymph node cells of guinea pigs with hypersensitivity of delayed type to the streptococcus antigens. The cytotoxic action was determined by the calculation of the number of the L-cells preserved in the monolayer after the action on it of a decanted fluid containing lymphotoxin. A marked cytotoxic action on the L-cells was produced only by decanted fluids obtained in cultivation of lymph node cells of guinea pigs sensitized by streptococcus culture with a specific antigen. In cultivation of lymphoid cells of the same animals with a nonspecific antigen (tuberculin) the decanted fluids produced no significant cytotoxic action on mous fibroblasts. The value of the cytotoxic effect depended on the dose of the thermostable fraction, with which the lymph node cells were incubated in the preparation of the decanted fluid, and also on the concentration of the lymph node cells in the initial suspension.


[Influence of mutation in the gene-suppressor su-str on the virulence of Salmonella enteritidis].

Virulent and avirulent cells resistant to streptomycin were revealed in the population of avirulent streptomycin-resistant mutant (obtained from the supressor revertant str-d S. enteritidis mutant) in seeding on a medium with streptomycin. Transduction analysis of the isolated avirulent and virulent strains demonstrated that mutation in the gene-suppressor su-str+ led to the loss of virulence. In connection with the presence in the genom of suppressor revertants of the streptomycin-dependent mutants two mutations (su-su+ and str-d), which irrespective of one another led to the loss of virulence, a conclusion was drawn on the stability of avirulent properties of such strains and on future prospects for their use in the capacity of living vaccines.


[Biochemical and genetic characteristics of enteropathogenic Escherichia coli and shigellae. IV. An electron microscopic study of pathogenic escherichia of serologic group 0124 and their recombinants].

Electron microscopic study of parental strains E. coli K12, E. coli 0124 : K72 (B17 and of recombinations demonstrated that their populations were nonhomogeneous and, along with the common ones, contained maxi- and mini-cells. By the character of flagellae and fimbria inheritance recombinations were distributed into two groups: similar to the donor and similar to the recipient. The data of electron microscopic determination of the flagellae and fimbria failed to coincide with the data on mobility and capacity to agglutinate erythrocytes in all the strains under study; this pointed to the nonhomogeneity of bacterial population in respect to these signs. There were revealed recombinations of E. coli O124 in which the majority of the population cells had flagellae, but proved to be immobile; this indicated a possibility of independent transfer of genes controlling the morphogenesis and the function of the flagellae to the  E. coli O124 recombinations.


[Allergenic fractions of bacteria belonging to the enteric family. VII. Characteristics of the intracellular proteins comprising the allergenic substrate of Escherichia coli using ion exchange chromatography].

A method of successive chromatography on Sephadex G-50 and G-100 and DEAE-Sephadex A-50 was applied for separation of the allergenic complex of E. coli intracellular proteins into a number of immunochemically different or significantly differing fractions with a definite set of antigens. Results of analysis of the fractions obtained in the tests of increased sensitivity of delayed type (ISDT) in vivo and in vitro corresponded to the view of the immunological polyvalency of the allergenic substrate of enterobacteria. Four groups of antigens were distinguished by the ratio of the activity indices in the skin reactions of ISDT and in the tests of specific inhibition of macrophage migration. Singificance of individual antigens in the formation of the allergenic profile of bacterial cells is determined by their quantitative content and the extent of the allergenic activity.


[Type specific antistreptococcal antibodies in the passive hemagglutination test].

The authors present materials of the elaboration of a method of obtaining stable erythrocytic diagnostic agents from semipurified preparations of type-specific antigens of the hemolytic streptococcus of the 1st, 4th, 12th and 18th serotypes. Adequate specificity and high sensitivity of the passive hemagglutination test was shown in examination of the sera of experimental animals. In the sera of healthy children the type-specific antibodies were revealed with a different frequency at various seasons of the year; this was in inverse correlation with the level of scarlet fever morbidity.


[Trial of the new chemical sorbed typhoid monovaccine P in a strictly controlled experiment].

A comparative study of the reactogenicity and immunologial activity of a new chemical sorbed typhoid monovaccine II, reference-vaccine (chemical sorbed monovaccine from tryptic antigens) and placebo-sorbent (hydroxy aluminium gel) was made under conditions of strictly gested monovaccine II, an equal capacity to induce formation of O- and Vi-antibodies, and also an accumulation of H-antibodies not induced by refrence-vaccine.


[Mechanism of the stimulating effect of protamines on the infectivity of DNA phages].

The interaction of styrin (protamine from sturgeon milt) with E. coli spheroplasts was investigated with the aid of the fluorescent probe--5-dimethylamino-1-naphthalenesulfonyl-chloride (DNS). Not less than 40% of the total (15 mug ml-1) DNA-protamine concentration was bound to spheroplasts. A part of the protein was found in the isolated membranes and inside the cell. There was a correlation between the binding of protein with spheroplasts and its biological action. The dansylation somehow decreased the protein stimulating activity in transfection.


[Interaction of different types of cells in production of anti-influenzal antibodies. IV. Stimulation of B-lymphocytes by several biologically active substances].

Various biologicall-active preparations such as extracts of syngenous and allogenous thymus and LP S of Gram negative bacteria were administered to sublethally irradiated mice ascertain a possibility of replacement of T-lymphocytes in the production of antibodies to influenza virus. It appeared that the function of T-lymphocytes participating in the production of antibodies to influenza virus in mice could be replaced by the administration to these animals of extracts of the syngenous and allogenous thymus and LP S of Gram negative bacteria.


Insulin response to glucose infusion in thermal trauma in rats.

The basal serum insulin level, insulin response and glycogen storage in the liver and skeletal muscle during a glucose infusion were studied 20-24 hours after experimental infliction of a burn in the rat. As was found in earlier studies, the liver glycogen storage was normal, while the storage of glycogen in the muscle was markedly inhibited. This inhibition cannot have been due to an absolute insuline deficiency, which has been discussed, as both the basal fasting level of insulin and the insulin response to glucose infusion were normal after the burn.


Comparison of Dexon and Mersilene sutures in the closure of primary laparotomy incisions.

The study is a comparison of Dexon (polyglycolic acid) and Mersilene (polyester) sutures when employed for the primary closure of the peritoneum and aponeurotic layer in primary laparotomy incisions. The material comprises 308 closures of abdominal wounds with interrupted 2-0 sutures (United States Pharmacopeia) in the aponeurosis and continuous 2-0 suture of the peritoneum. One half of the wound was closed with Dexon and the other half with Mersilene, so that the patient acted as his own control. No significant difference was found between the two materials as evaluated from the occurrence of wound rupture within 10 days and incisional hernia within 90 days of the operation. Suture granulomas occurred in 9% of the half wounds sutured with Mersilene. The present clinical investigation demonstrates that Dexon sutures are as reliable as unabsorbable material. Dexon is superior to unabsorbable material as suture granulomas were not seen when Dexon was employed.


The pancreatic alpha and beta cells responses to 1-arginine and insulin-induced hypoglycaemia in hyperthyroidism.

In order to assess the secretory capacity of the pancreatic alpha and beta cells in patients with hyperthyroidism, the plasma glucagon and insulin responses to 1-arginine and insulin-induced hypoglycaemia in 12 patients were compared with those in 6 normal subjects. The response of beta cell to hypoglycaemia was evaluated by measuring the decrease in plasma C-peptide immunoreactivity (CPR) level. There was a negligible rise in blood glucose and plasma insulin levels in the patients, whereas a significant increase occurred in normal subjects during the arginine infusion. Although no difference in the fasting plasma glucagon concentration between the two groups was found, 30 min after the beginning of the arginine infusion, the plasma glucagon levels rose to a peak of 252 +/- 35 pg/ml in the patients, a value significantly lower than 387 +/- 53 pg/ml in the normal subjects. The insulin-induced hypoglycaemia caused no significant difference in the peak values of plasma glucagon between the two groups. There was a sigificant difference in the peak values of plasma glucagon between the two groups; There was a significant fall in plasma CPR after the insulin injection in both groups but the per cent decrement was rather greater in the patients than in the normal subjects.


Are yeasts in vaginal smears intracellular or extracellular?

Using light microscopic cytodiagnosis the only thing that can be said about the position of the yeast cells in relation to the epithelial cells is that the epithelial cells and the parasite are very close to one another. It is not possible to say whether both elements are only temporarily projected above one another or in direct contact. This question can only be answered unequivocally with the aid of the electron microscope. It is possible to verify that the yeast cells, despite their size, are able to invade intact epithelial cells and are capable of reproduction within these same cells.


Enhancement of glucose-stimulated insulin secretion from isolated rat pancreatic islets by human insulin antibodies.

Isolated pancreatic rat islets incubated in vitro were used as a bioassay system for investigating the influence of human insulin antibodies on insulin secretion. Serum samples with different titres of insulin antibodies were obtained from juvenile diabetics after various periods of insulin therapy. The insulin secretion of isolated islets is enhanced by insulin antibodies and positively correlated to the measured antibody titres in serum.


Effects of androstenes, 5alpha-androstanes, 5beta-androstanes, oestrenes and oestratrienes on serum gonadotrophin levels and ventral prostate weights in gonadectomized, adult male rats.

The morphologic and metabolic effect of a single intracutaneous injection of homologous endocrine pancreas in Freund's complete adjuvant (CFA) was studied in 100 mice and compared with control groups which had been (1) immunized with murine insulin in CFA, (2) injected with CFA alone, or had (3) received no treatment. There were no differences between the control groups as regards the morphology of the pancreatic islets, and the glucose tolerance was normal. Mice immunized with islet homogenate exhibited morphological changes in the form of degranulation and cytoplasmic disintegration. These changes involved B-cells as well as A2-cells and were present from 7 to 18 days after the immunization. A significant reduction in glucose tolerance was observed 14 days after the immunization. Another characteristic finding in the islets from the immunized mice was the extravascular presence of mononuclear, agranular cells which on the basis of their morphological criteria appeared to represent lymphocytes.


Morphology of experimental, organ-specific insulitis of the mouse pancreas.

The morphologic and metabolic effect of a single intracutaneous injection of homologous endocrine pancreas in Freund's complete adjuvant (CFA) was studied in 100 mice and compared with control groups which had been (1) immunized with murine insulin in CFA, (2) injected with CFA alone, or had (3) received no treatment. There were no differences between the control groups as regards the morphology of the pancreatic islets, and the glucose tolerance was normal. Mice immunized with islet homogenate exhibited morphological changes in the form of degranulation and cytoplasmic disintegration. These changes involved B-cells as well as A2-cells and were present from 7 to 18 days after the immunization. A significant reduction in glucose tolerance was observed 14 days after the immunization. Another characteristic finding in the islets from the immunized mice was the extra-vascular presence of mononuclear, agranular cells which on the basis of their morphological criteria appeared to represent lymphocytes.


Hypothalamic-pituitary-testicular system following testicular X-irradiATION.

Testes of adult, male rats were exposed to a total dose of 1500 R of X-irradiation. Testicular weight decreased from day 8 after X-ray treatment. This decrease was, however, preceded by an increment of the testis weight on day 4 following treatment. X-ray treatment of testes was associated with significant increases in serum FSH. Testicular irradiation had, however, no effect on ventral prostate and seminal vesicles weights. Serum testosterone increased only on day 1, 2 and 4 after irradiation, while serum LH levels tended to increase from day 8 post-irradiation. These changes were not significant, however, when compared with non-irradiated controls. At 7, 13 and 20 days following 1500 R of bilateral, testicular X-irradiation, the hypothalamic-pituitary unit was still capable of responding to exogenous gonadotrophin releasing factor. Serum FSH may in male rats by regulated at least partly by circulating steroids of testicular origin and partly by an unknown factor of non-interstitial cell nature.


Comparison of buccal and nasal epithelial cells using a new cell development index and quantitative interference microscopy.

Cell area, cell dry mass, and three summary indices for tissue maturation were obtained for human buccal and nasal cells viewed in smears (five donors). The means for cell area and dry mass in the buccal smears were 3816 X 10(-8) cm2 and 2294 pg (1 pg=1 X 10(-12) g), respectively. The correlation coefficient for means of cell area and dry mass was r=0.03. The means for the three maturation indices used to characterize the cells viewed in buccal smears were: Cell Development Index (CDI), 486; Maturation Index (MI) 50.6; and Karyopyknotic Index (KPI), 0.028. The correlation coefficients for means were: CDI vs. MI, r=0.88; CDI vs. KPI, r=0.71; and MI vs. KPI, r=0.73. In the buccal smears, the cell types found most frequently were intermediate with round or oval nuclei, which altogether averaged about 90% of the total smear composition, while superficial cells (pyknotic ghost, and anucleate) comprised less than four per cent. In nasal smears, the means for cell area and dry mass were 867 X 10(-8) cm2 and 623 pg, respectively. The correlation coefficient for means of cell area and dry mass was r=0.74. The means for the maturation indices were: CDI, 816; MI, 91.2; and KPI, 0.79. The correlation coefficients for means were CDI vs. MI, r=0.93; CDI vs. KPI, r=0.97; and MI vs. KPI, r=0.85. In nasal smears, the anucleate cell type was found most frequently (about 75%) while intermediate cells with round or oval nuclei comprised approximately 13% of the total smear composition. When donor means for cell area and dry mass of buccal cells were combined for study, they were highly correlated (r=0.88). Similarly, when the maturation indices for buccal and nasal cells were combined for study, they were highly correlated: CDI vs. MI, r=0.99; CDI vs. KPI, r=0.99; and MI vs. KPI, r=0.99. Of the three indices, we believe that the CDI is the index best suited for use in studies of cell development because it is based on an inferred sequence of cellular and nuclear changes occurring during the maturation of epithelial cells. It provides a more detailed description of the cells observed in the smears. It also correlates highly in KPI and MI used in clinical and research efforts.


[Gonadotropin releasing hormone test: diagnostic significance and limits in menstrual pathology].

The serum gonadotropin response to LH-RH (100 mug e.v.) in a group of women with various types of amenorrhea was critically evaluated. Most patients responded to rapid LH-RH injection with a significant rise in plasma LH and FSH. In the authors' opinion this response is observed in healthy women as well as in those with lesions, even severe ones, of the pituitary, so that quantification of the response does not supply reliable information on diagnosis and prognosis. On the other hand, a negative response to the injection of 100 mug LH-RH does not necessarily imply a pituitary lesion but is often a sign of altered hypothalamic function which can be diagnosed and in some instances restored by clomiphene administration.


A reduction in multiple pregnancies following the use of a clomiphene citrate: human gonadotrophin sequence.

The results of stimulation with gonadotrophins at the Sterility Clinic (Crown Street) are presented. Two different techniques have been employed involving 86 patients. All patients have similar indications for treatment. All have received the same preliminary investigations and all have been treated previously with a minimum of three cycles of Clomiphene Citrate without satisfactory response (i.e. "clomid failures). Technique (1) involved 51 patients and consisted of daily injections of Human Pituitary Gonadotrophin (H.P.G.) followed by an ovulating injection of Human Chorionic Gonadotrophin (H.C.G.) and a follow up injection of H.C.G. on post-ovulatory Day 7 or 8. This technique had a pregnancy rate of 64 per cent and a multiple pregnancy rate of 34 per cent. Technique (2) involved 35 patients and consisted of 5 days priming with Ethinyl Oestradiol and Clomiphene Citrate together, followed immediately by daily injections of H.P.G., then an ovulating injection of H.C.G. and a follow up injection of H.C.G. on post-ovulatory Day 7 or 8. The results of this variation in technique were a pregnancy rate of 69 percent, a multiple pregnancy rate of 8 percent. It is suggested that the use of Clomiphene Citrate in the latter technique acts as a "buffer" against the more extreme ovarian responses to H.P.G. acting alone and has the apparent advantage of a higher pregnancy rate, a lower multiple pregnancy rate and a reduction in the number of foetuses in each of the multiple pregnancies.


The antagonist effect of naloxone hydrochloride after neuroleptanaesthesia during neurosurgery.

The effects of naloxone were studied in 82 patients undergoing intracranial surgery under general anaesthesia with fentanyl or phenoperidine. After the operation was finished the patients' alertness, sensitivity to pain, blood pressure, pulse rate, respiratory rate, tidal and minute volume were recorded parallel with arterial blood gas analyses prior to and immediately after the administration of varying amounts of naloxone i.v. in a single dose. These parameters were also repeatedly controlled for several hours in the postoperative period. The results show that a single i.v. naloxone dose of 1 mug/kg b.w. is effective in the rapid and definite reversal of the respiratory depression caused by the analgesics. This dose was neither correlated to the total amount of analgesics given, nor to the time period which elapsed between the last dose of the analgesic drug and the administration of naloxone. No side effects or complications were encountered when the indicated doses of naloxone were given. It is concluded that, even in a small single dose, naloxone effectively antagonises the respiratory depression caused by fentanyl and phenoperidine without totally eliminating the immediate postoperative analgesic effects of these agents.


Diazepam in emulsion form for intravenous usage.

Since aqueous solutions of diazepam were introduced into clinical practice, the problem has arisen of local vascular side effects after intravenous injection. A new preparation of diazepam as a lipid emulsion is presented. It was prepared by Vitrum and shows many similarities to Intralipid. A clinical trial was designed to study the incidence of pain in connection with the intravenous injection of diazepam and the incidence of subsequent thrombophlebitis. The preparation was used as a sedative to patients before gastroscopic investigation and as an inductor to general anaesthesia. In the material of 88 patients, thrombophlebitis was observed in 1.1%. Only 1 patient in the group of 314 patients studied complained of pain in connection with injection. The results observed were compared with previous investigations from the literature and with parallel control investigations. The new lipid emulsion form of the preparation was found to reduce significantly the incidence of local side effects involving the venous system. No significant difference in the therapeutic effect of the different preparative forms of the active substance was observed. The possible mechanisms involving the production of thrombophelbitis in connection with the injection of aqueous solutions of diazepam are discussed.


Breathing mechanics, dead space and gas exchange in the extremely obese, breathing spontaneously and during anaesthesia with intermittent positive pressure ventilation.

Breathing mechanics and gas exchange were studied in 10 extremely obese subjects (average weight 138 kg) prior to and during anaesthesia with mechanical ventilation. Breathing mechanics were analysed from measurements of transpulmonary pressure (during anaesthesia, trans-chest wall pressure as well) inspiratory gas flow and tidal volume. Gas exchange was studied by analysing inspired and from the Bohr equation, and the division into anatomical and alveolar dead space was arrived at by capnography. The patients were anaesthetised with neuroltpt agents and ventilated with an air-oxygen mixture. Lung compliance during spontaneous breathing was below normal and decreased further during artificial ventilation. Chest wall compliance measured during anaesthesia was within normal limits. Lung resistance was above normal during spontaneous breathing and increased further during mechanical ventilation. Total dead space was normal during spontaneous breathing and increased moderately during artificial ventilation, the increment coming mainly from alveolar dead space. A moderate hypoxaemia was recorded during spontaneous breathing, and the alveolar-arterial oxygen tension difference was slightly elevated. During anaesthesia this difference was markedly greater. It is concluded that the most probable reason for the relative hypoxaemia is right-to-left shunting.


Effect of glucose administration on the blood sugar and pancreatic islets of the frog, Rana tigrina.

Glucose evoked significant hyperglycemia in the frog, Rana tigrina, 0.5 h after the injection and it took a longer time to regain normoglycemia than mammals, thus exhibiting a low glucose tolerance. The islet tissue of injected animals showed degranulation and atrophy of beta-cells only, the alpha-cells remained almost normal. This damage suggests that the beta-cells of this frog are functionally like those of mammals and other vertebrates, and secrete insulin. A single dose of glucose was found incapable of producing permanent diabetes, and beta-cells damage was repairable at later stages. Excess of glucose in the blood seems to stimulate secretion of insulin by the beta-cells.


Protein synthesis in muscle cultures from patients with Duchenne muscular dystrophy. Calcium and A23187 ionophore dependent changes.

Muscle samples for cultures were obtained from the quadriceps by open biopsy under local anesthesia in five patients with early stage of Duchenne muscular dystrophy (DMD) and 10 controls. Primary cultures were grown in Eagle's Minimum Essential Medium (MEM) with 20 per cent fetal calf serum. After 4 weeks, cells were trypsinized, counted, subcultured for 5 days in MEM with 5 per cent horse serum and finally incubated for 4 h with (3H) leucine. Ttal protein synthesis showed a significant decrease (half of control values) only in muscle cultures from patients with DMD. Addition of calclium chloride alone or with A23187 ionophore normalized this defect in protein synthesis. By contrast, myosin heavy chain synthesis was measured and found normal in all paitents.


Penicillamine in multiple sclerosis. Therapeutic trial and design of uncontrolled pilot drug study.

Twenty-three patients with the chronic progressive or intermittent relapsing form of multiple sclerosis (MS) were treated with d-penicillamine over a period from 6 weeks to 12 months. Clinical effect was evaluated using Kurtzke's disability status scale with follow-up lasting from 7 weeks to 15 months. Fifteen patients remained unchanged, 7 became worse and 1 improved after the treatment. Administration of penicillamine to patients with MS resulted in an insignificant lowering of serum IgA, IgG and IgM levels. It is concluded that penicillamine neither prevented the occurrence of relapses nor slowed down the chronic progressive course of multiple sclerosis.


Tranexamic acid (AMCA) and late hyphaema. A double blind study in cataract surgery.

A double blind study of the effect of tranexamic acid (AMCA) on late hyphaema after cataract surgery is reported. A total of 244 patients were included in the study after strict selection. It was shown that the incidence of late hyphaema in the treated group was significantly lower at the 5% level than that in the placebo group. The conclusion is made that the fibrinolytic inhibitor tranexamic acid can be used therapeutically or prophylactically to decrease the risk for re-bleeding after ocular surgery.


Results of treatment in myelomeningocele.

A follow-up study was made in 48 surviving children with myelomeningocele, the material being derived from a time when all infants were operated upon in the newborn period without primary selection. The follow-up revealed several children with severe physical handicap, whereas relatively few were both physically and intellectually handicapped. The results were compared with two earlier published studies of which one from Sheffield comprised cases where selection had not been applied and the other from Edinburgh in which certain criteria had been set up as contra-indications to early closure of the lesion. The effect of a hypothetical selection applied to the Swedish material is discussed. It is recommended that a uniform system of assessment in grading of handicap is applied to facilitate a comparison between different follow-up investigations.


Group B streptococcal infection in the newborn. Criteria for early detection and treatment.

Recent reports indicate that the group B haemolytic streptococcus has now assumed a major role in neonatal septicaemia in the United Kingdom. Of particular concern are the absence of premonitory signs, the fulminating nature of the infection and the high mortality. 31 cases from which this organism was isolated during the first week of life included 5 cases of neonatal septicaemia, 4 of which proved fatal. An attempt was made (a) to identify the group of neonates at greatest risk and (b) to formulate guidelines for early detection and treatment. Study indicates the importance of apnoea as a sign of infection particularly in those infants who are preterm, of low birth weight and asphyxiated. There is need for aggressive bacteriological screening and early administration of antibiotics to prevent the high mortality from group B streptococcal infection.


Antibody-coated bacteria in the urine of children with urinary tract infections.

The test for antibody-coated bacteria in urine for the diagnosis of the anatomical level of urinary tract infections was evaluated in children with UTI. The ability of the test to differentiate between an upper and lower infection is influenced by the antiglobulin preparation used, since too sensitive an antiglobulin probably detects nonspecifically bound antibodies. Staphylococcal protein A seems to be well suited for use as an antiglobulin in this test. Using staphylococcal protein A all children with X-ray findings suggesting renal damage had antibody-coated bacteria in the urine, however, nine infants and 5 children and clinical symptoms of pyelonephritis had a negative test. Of 28 children with clinical symptoms of cystitis only one had a positive test. Of 50 children with asymptomatic bacteriuria 9 had antibody-coated bacteria in the urine; 41 had not. The findings indicate that the method might be useful in establishing the anatomical level of urinary tract infection and might also be useful for screening children with asymptomatic bacteriuria who risk developing kidney infections.


A study of Russell bodies in human monoclonal plasma cells by means of immunofluorescence and electron microscopy.

Five patients with a serum M component were shown to possess plasma cells containing Russell bodies. Four of the patients suffered from multiple myeloma, whereas the fifth probably had a different disease or was in a premyeloma stage. The Russell bodies stained blue with the May-Grünwald-Giemsa stain and were found both in the nuclei and in the cytoplasm of the plasma cells. Ultrastructural studies showed that the Russell bodies were osmophilic and those located in the cytoplasm were always situated within the cisternae of the rough endoplasmic reticulum. The intranuclear Russell bodies were always surrounded by a triple layered membrane, and some evidence was obtained that these bodies were first formed within the perinuclear space of the cells. Immunofluorescence studies using anti-L chain conjugates showed a positive marginate straining of the intranuclear as well as the cytoplasmic Russell bodies of the cells from all patients. Only one patient had cells with Russell bodies which also stained their location in the plasma cells. It is concluded that some plasma cells in multiple myeloma may produce an excessive amount of L chains which, in combination with a failure in the secretion of immunoglobulin molecules, may lead to the formation of Russell bodies.


The diagnostic value of determination of IgM antibodies against Mycoplasma pneumoniae by the indirect immunofluorescent antibody test.

The indirect fluorescent antibody technique for specific IgM  and IgG antibodies was applied to paired sera from 33 patients with a current M. pneumoniae infection, along with the complement fixation test. A roughly parallel increase in antibody titres in all the three tests was observed; the ratio of IgM/IgG titres was, however, higher in patients below 20 years of age than in older patients. Rises in antibody titres were regularly observed in spite of the fact that most of the patients were treated with tetracycline or erythromycin during the acute phase of the disease. Serum specimens from 15 other patients lacking clinical data of a recent M. pneumoniae infection, but with stationary complement fixation titres, all showed IgG antibodies with stationary titers and, with the exception of three patients, a negative IgM antibody test. Sera from 20 individuals lacking complement fixing antibodies were also without demonstrable IgG and IgM antibodies. Sampling of serum from 9 of the pneumonia patients was repeated. The last IgM positive sample was collected up to six months after onset of the disease and all were found to be negative in the IgM test 8 to 10 months after onset of the illness in these treated patients. The implications of these findings for the serological diagnosis of M. pneumoniae infections are discussed.


Comparison of cellular and humoral immunity against streptococcal and adult human oral mucosa antigens in relation to exacerbation or recurrent aphthous stomatitis.

Cell-mediated immunity (CMI) and humoral mediated immunity (HMI) against streptococcal and adult human oral mucosa (AHOM) antigens were investigated in patients with inactive and active recurrent aphthous stomatitis (RAS). The CMI and HMI were examined by means of the leucocyte migration test (LMT) and a double layer immunofluorescence (IF) technique. The CMI against Streptococcus sanguis strain 2A, streptococcus pyogenes strain M5, and AHOM was significantly increased in inactive and active RAS. Significant difference between active and inactive RAS was only demonstrated when Strep. 2A was used as antigen in the leucocyte migration cultures. Longitudinal observations in relation to exacerbation of RAS revealed significant changes in the migration indices (MI) when Strep. 2A and AHOM were used as antigens. Extracts of Strep. M5 and other tissues as kidney and uterus did not show any significant changes of MI in relation to the exacerbation of RAS. The IF-investigations detected significantly raised IgG antibodies against washed whole cells of Streptococcus sanguis strain 2A and Streptococcus pyogenes strain M5 in sera from patients with RAS. The autoantibodies in RAS belonged to the immunoglobulin classes IgG and IgM. The detected antibodies were able to blind serum complement (C3). The distribution of endpoint titres (EPT) against Strep. 2A, Strep. M5, and AHOM antigens did not differ significantly in patients with active RAS in relation to those with inactive RAS. Furthermore, the EPT against Strep. 2A and AHOM were not significantly changed in relation to exacerbation of RAS. The present investigations show that CMI and HMI against streptococcal and AHOM antigens are characteristic features of RAS and indicate that the CMI against Strep. 2A and AHOM is significantly increased in relation to exacerbation of RAS.


IgA levels and carrier rate of Haemophilus influenzae and beta-haemolytic streptococci in children undergoing tonsillectomy.

Studies of IgG, IgA, IgM and IgE in serum and of IgG, IgA and IgM in saliva were performed in 52 children undergoing tonsillectomy. The results revealed that levels of IgA in serum and saliva in the patients were significantly reduced as compared with levels in age- and sex-related healthy controls (p less than 0.001 and less than 0.025 respectively). Recovery of beta-haemolytic streptococci and Haemophilus influenzae from the removed tonsils was also well correlated with low IgA in serum (p less than 0.01). A considerable lack of IgA fluorescing plasma cells in tonsillar tissue demonstrated in an earlier study of the same patients was consistent with carriage of beta-haemolytic streptococci and Haemophilus influenzae (p less than 0.01). The significant decrease in serum- and saliva IgA was only found among the youngest patients in this study. The hypothesis is raised that the decreased level of saliva IgA influences the increased tendency at pathogenic bacteria to adhere to and colonize on the tonsil mucosa, and furthermore, the lack of IgA plasma cells in the tonsils supports the view that IgA prevents penetration of microorganisms through the epithelial surface, secondarily establishing an acute inflammation of the tonsils.


Hyperacute rejection of a kidney allograft may be caused by cytotoxic lymphocytes.

A case of hyperacute rejection of a kidney allograft is described in relation to the clinical, patho-anatomical, and immunological findings. An 18-year-old male was allotransplanted for the third time with a necrokidney from an unrelated HLA-A and B, full house identical and blood group ABO identical donor. Serological crossmatches performed with recipient sera harvested before and after transplantation were negative. In spite of this, the kidney suffered hyperacute rejection according to clinical and patho-anatomical criteria. The cellular, complement independent cytolytic capacity of recipient lymphocytes drawn before and after transplantation against donor lymphocytes was tested by the direct Cell Mediated Lympholysis (CML) test. This test was positive 24 hours after transplantation, whereas it had been negative before this. Lymphocytolysis was enhanced by inactivated recipient serum harvested before and after transplantation. These findings suggest that hyperacute rejection of a kidney allograft may be ascribed to presensitized, not necessarily circulating, effector lymphocytes either alone, or in concert with antibody(ies) not disclosed by conventional crossmatching.


Synergistic effect of alloantibodies or F(ab')2 and prednisone on murine split heart allograft survival.

Heterotopic grafting of split allogeneic mouse hearts across a strong H-2 barrier (A/Sn leads to A.CA) was used in a study of alloantibody or F (ab')2 induced enhancement. Strong specific binding of alloantibodies occurred in the graft. A marked synergistic effect on graft survival was observed after combined treatment of recipients with enhancing serum and prednisone. The highly dose-dependent enhancing effect of F (ab')2 was also strongly potentiated by supporting prednisone treatment. In vitro pre-incubation of the heart tissue with alloantiserum or F (ab')2 did not prolong graft survival; in contrast, C-mediated damage of the graft was suggested when serum was used.


Prolongation of xenograft survival by infusion of heterologous antibodies against recipient serum.

Survival or renal xenografts from rabbit to cat has been prolonged by several hours by injection of antibodies against cat serum into the recipient. In control experiments the transplanted rabbit kidney was rejected by the cat in a few minutes.


Clinical observations of the treatment of tardive dyskinesia with haloperidol.

In the present study, after briefly describing the clinical characteristics of the neurologic syndromes provoked by the neuroleptic drugs and most particularly of the syndrome of tardive dyskinesia, we refer to the incidence of this latter syndrome and to the results obtained with the administration of haloperidol for a period of 16 weeks in 10 patients suffering from it. From the detailed analysis of 300 chronic schizophrenic patients, we detected this complication in 10 cases, which gives an incidence of 3,3%. With the administration of haloperidol, on the other hand, we obtained an excellent reduction of both the frequency and the intensity of the peristomal movements in nearly all the patients. This reduction was more remarkable in 2 of the patients who had manifested certain complications of the syndrome, mainly a difficulty in swallowing, followed by a considerable loss of weight in the one patient and by an intense perplexity and a tendency towards suicide in the other. The continued suppression of the above dyskinetic phenomena during the whole period of the trial allows us to conclude that haloperidal may be recommended for the maintenance treatment of the syndrome of tardive dyskinesia.


Ambulant treatment of alcohol withdrawal symptoms with carbamazepine: a formal multicentre doubl-blind comparison with placebo.

One hundred male out-patients were treated for alcohol withdrawal symptoms with either carbamazepine or placebo in a double-blind, multicentre trial carried out a five Finnish A-clinics (alcoholism treatment centres) in different parts of the country. In both the carbamazepine and the placebo groups two thirds of the patients completed the 7-day treatment successfully, and the final treatment results were considered equally good in both groups. However, the withdrawal symptoms, especially the sleep disturbances, subsided faster in the carbamazepine group than in the placebo group. The change in the total symptom score from the first day of treatment to the second was significantly greater in the carbamazepine group than in the placebo group. The patients' ability to work improved significantly faster in the carbamazepine group.


An evaluation of the double-blind design in a study comparing lithium carbonate with placebo.

As part of a study of drug treatment of aggressive behavior to be reported separately, we have evaluated the double-blind procedure in a recently completed comparison of the efficacy of lithium carbonate versus placebo in modifying aggressive behavior in nonpsychotic incarcerated delinquents. We conclude that the side effects of lithium carbonate are sufficient to reveal the medication to most subjects receiving it. Thus, while the study staff could not identify lithium-receivers at better than chance levels, and while subjects who received placebo could not identify their medication at better than chance levels, subjects who received lithium could accurately identify it. On a weekly symptom check list there was no difference between lithium and placebo groups on average lithium target symptoms reported during 4-week pre- and postmedication control periods; however, lithium-receivers reported significantly more target symptoms every week medication was administered. Of 16 subjects who quit the study, 14 had received lithium and nearly all of those who gave reasons for quitting specified side effects, most often nausea. The methodological problems of using lithium in a double-blind design might be overcome by employing a "discontinuation" design, or, speculatively, a double-blind, cross-over design utilizing an "active placebo".


Gonadotropin response to synthetic gonadotropin hormone-releasing hormone (GnRH) in chronic schizophrenia.

GnRH stimulation tests were performed in 15 adult male chronic hebephrenic schizophrenics and 15 oligophrenic controls, matched for age and length of hospitalization. GnRH was given at doses of 50, 100 and 150 gamma to five subjects of each type, and FSH and LH levels in the blood were assayed at 0, 10, 20, 30, 60, and 90 minutes. The tests were performed twice in schizophrenics off therapy and after 10, 20 and 30 days of chlorpromazine therapy (4 mg/kg body weight/day, per os). The controls were not given chlorpromazine and were tested only twice. Schizophrenics showed relative increases in both FSH and LH which were greater than those of the controls, and the response persisted longer. Chlorpromazine had no effect on the test.


Piracetam-induced improvement of mental performance. A controlled study on normally aging individuals.

A double-blind, intra-individual cross-over comparison of the mental performance of 18 aging, non-deteriorated individuals during two 4-week periods of piracetam (1-acetamide-2-pyrrolidone) and placebo administration was performed using conventional and computerized perceptual-motor tasks. In a majority of these tasks the subjects did significantly better when on piracetam than on placebo, a finding consistent with ratings completed by two independent observers. The findings indicate new avenues for the treatment of individuals with reduced mental performance possibly related to disturbed alertness--a neglected group of psychiatric conditions.


The Tromsøo heart study. Methods and main results of the cross-sectional study.

The mortality from coronary heart disease (CHD) in Norway increased rapidly during 1951-70, the highest mortality rates as well as the most rapid increases being found in Northern Norway. Several surveys of CHD were then planned, one of them is reported here. All men, 20-49 years of age, living in the municipality of Tromsøo, Troms county, were called up for examination. In total, 6595 men, 74.4% of those invited, were examined. Cholesterol, triglyceride and Hb values, BP, body weight and height, the percentage of smokers, and cigarette consumption have been tabulated according to area, age, work schedule, health condition, physical activity and ethnic background. The results suggest that the relatively high mortality from CHD in Northern Norway is associated with high serum cholesterol concentrations as well as a relatively high prevalence of smoking. During the screening there were indications of changes in dietary habits in the municipality, presumably as a result of accompanying publicity.


The functional pattern of the transplanted kidney during the first year.

Prospective studies on kidney function have been carried out 1-14 months after transplantation in two groups of recipients of renal transplants. Both groups were characterized by immediate graft function. The first group had transplants from living donors, the second had received cadaveric kidneys. In the first group a functional maximum (as measured by 125iothalamate, creatine and 131I-hippuran clearances) was reached during the first three weeks after transplantation, approximating 70% of the donors' bilateral preoperative function. In the second group kidney function was constant during the period of study, the values being almost identical with those observed in the first group. At investigation 12-14 months after transplantation, the two groups were compared with the remaining cadaveric transplants carried out during the period of study, the latter being primarily graft anuric. Graft function in the primarily anuric grafts was found to be poorer than in those with initial function. Graft survival, too, was poorer at one year in the group characterized by primary graft anuria than in the other groups. Graft survival at one year was 68% in cadaveric kidney transplants with good initial function.


Complication rates of selective percutaneous transfemoral coronary arteriography. A review of 1094 consecutive examinations.

A review is presented of 1094 selective coronary artery studies during a 3-year period in which 7001 coronary artery injections were performed using the percutaneous transfemoral artery approach as described by Judkins. A total of 24 serious complications occurred, including 11 ventricular fibrillations, 5 asystoles or severe bradycardias, 3 acute myocardial infarctions and 5 cerebral vascular accidents. There were 5 deaths, giving an overall mortality rate of 0.46%. Causes of individual complications are analyzed. The incidence of serious cardiac complications did not differ significantly from that reported in the literature with the Sones technique. The Judkins technique is a simple and reliable method for selective coronary arteriography. In our opinion, the incidence of complications can be kept at an acceptably low level by meticulous examination techniques.


Psychological and social problems encountered in active treatment of chronic uraemia. II. The living donor.

Sixty-four kidney donors have been interviewed by a psychiatrist and given the Rorschach test 6 months-6 years after the transplantation. Twenty-three of these donors were also interviewed before the operation. In addition, each case was studied in detail at a case conference. On the basis of the data thus obtained, an analysis was made of the central dynamics of the donors' personalities, of how they had experienced the donation, and of how they had adapted to it. No psychic trauma was observed in 20 of the subjects, and in 5 of these the operation had apparently had a beneficial effect on their psychic well-being. That no trauma was observed in 8 additional donors was due largely to the effects of a multitude of other traumatic life experiences. Mild trauma had been experienced by 24 donors and moderate to severe by 12. In our study, the donation of a kidney to a sibling turned out to be more traumatic than the donation to a child, and a transplantation with an unsuccessful outcome was more often associated with psychic trauma to the donor than was a donation with a successful outcome. Psycho-social factors that substantially lessened the likelihood of trauma were: good inner resources, flexible defence mechanisms, good mental health and mild compulsive traits. Factors that favoured traumatization were: poor living conditions, interpersonal problems, limited inner resources, low self-esteem (narcissistic problems) and severe psychic deviancy. The results clearly show 1) that potential donors ought to be given adequate time not only to consider their decision but also to prepare themselves for the actural donation, and 2) that supportive help should be offered, both before and after transplantation, to donors whose psycho-social profiles reveal them to be vulnerable to traumatization.