Distribution and prevalence of Wuchereria bancrofti in various parts of Liberia.

A nightblood survey has been carried out in 82 localities situated in various parts of Liberia. A total of 8072 people have been examined for the presence of microfilariae of Wuchereria bancrofti and 403 (5.0%) have been found positive. However, the distribution of the disease was quite uneven. The infection was common in the coastal zone showing an average microfilaria prevalence of 9%, while in the forest belt among 5383 people living in rural areas only 109 (2.0%) were found to harbour microfilariae. In the savannah area out of 2198 people examined 209 (11.4%) persons were carriers of microvilariae.


A Mycoplasma from chronic caprine pleuropneumonia in Kenya.

A new mycoplasma was isolated from cases of chronic caprine pleuropneumonia in Kenya. It belonged to the species Mycoplasma mycoides being a member of Al-Aubaidi's Group 8. When inoculated into goats and sheep the organism caused pleuropneumonia and local subcutaneous lesions. The pleuropneumonia was not contagious. In contrast the organism was non-pathogenic in cattle.


[Effect of exogenous nucleic acids on the repopulation activity of deconserved bone marrow].

It is shown that exogenic nucleic acids (RNA, DNA) have a stimulating effect on the proliferative activity of the restored myelokaryocytes in the organism of the irradiated recipients. The stimulating effect depends on the type of nucleic acid, time of administration and dose of the preparation.


[Scintigraphic functional analysis with the gamma camera during renal perfusion (author's transl)].

The controlled progress of transplanted kidneys has already been useful. We have succeeded in finding a simple method to study the function of the renal parenchyma and the collecting system. This method was also applied to determine a flow volume relation during perfusion in comparison to impulse rates. In contrast the conventional parameters, which only describe a partial function of the organ, this simple method will deliver comprehensive information before transplantation.


Renin-angiotensin-aldosterone system in long-term renal transplant patients.

Seventeen anephric patients who constituted the subjects of this study received renal allografts between the years 1969 to 1973. The renin-angiotensin-aldosterone mechanism was evaluated in relation to either a normotensive or hypertensive clinical state in these subjects. Group I (Controls) were normotensive and on a normal diet; Group II were normotensive, on sodium restriction for five days, followed by saline infusion on the seventh day; and Group III were hypertensive, on similar sodium restriction for five days, followed by saline infusion on the seventh day. Glomerular filtration rates and levels of plasma renin and aldosterone, and the secretion rate of the latter were obtained on appropriate days. These studies confirm that an intact renin-angiotensin-aldosterone relationship exists in human renal transplant patients. The presence of high aldosterone secretion rate without hypertension is a new but unexplained finding. The lack of correlation of high aldosterone secretion rates in our normotensive and hypertensive patients suggests that aldosterone does not play a detectable or significant role in the pathogenesis of chronic or sustained transplant hypertension.


Nonstaphylococcal bacteria in renal cortical abcess.

Five cases of renal cortical abscess are presented, of which four yielded gram-negative pathogens. Along with a review of the recent literature, this suggests that nonstaphylococcal bacteria are a more common cause of this disease.


Sulfacytine in uncomplicated urinary tract infections. Double-blind comparison with sulfisoxazole.

A new sulfonamide, sulfacytine, was compared in a double-blind study with sulfisoxazole in 132 patients with uncomplicated urinary tract infections. At the doses used, 1Gm. per day of sulfacytine of 4 Gm. per day sulfisoxazole, bacteriologic success (decrease of pathogenic organisms from greater than or equal to 100,000 to less than or equal to 1,000 per milliliter of urine) was demonstrated in approximately 90 per cent of the patients. Clinical success (subsidence of the symptoms, frequency of urination, and dysuria, and reduction of pyuria from greater than or equal to 10 to less than 10 white blood cells per high-power field) occurred in 85 to 90 per cent. Six patients in the sulfacytine group and 9 in the sulfisoxazole group reported adverse experiences. Drug was discontinued or administration interrupted because of adverse experiences in 4 sulfacytine patients and 6 sulfisoxazole patients. Laboratory values generally remained normal, but 1 patient in each medication group had decreases in white blood cells that might have been attributable to drug. On the basis of this study sulfacytine appears to be an effective drug for the treatment of uncomplicated urinary tract infections.


Tuberculosis in wild badgers (Meles meles) in Gloucestershire: pathology.

The gross and histological appearances of the lesions of tuberculosis in 36 wild badgers found to be infected with Mycobacterium bovis are described. These badgers were examined over a period of two years during an investigation into the possible epidemiological association of tuberculosis in badgers and cattle. The possible significance of the lesions in transmission of M bovis to cattle and other badgers is discussed. The histological appearance of the lesions was considered to be indicative of a lesser hypersensitivity reaction than is seen in the bovine.


Hatchery problems--a field report.

A long term investigational, advisory and monitoring exercise with a major hatchery emphasised the multi-disciplinary approach adopted by the Agricultural Development and Advisory Service (ADAS) to raise the performance of the many aspects of chick production. These included an investigation of egg handling techniques from nest box to hatcher; the adoption by the hatchery of plastic setter trays; an improvement to incubator environment; an improvement in the overall hatchery hygiene programme and the introduction of a regular monitoring programme based on the examination of hatchery fluff. Collectively these improvements led to an improvement of approximately 10 per cent in hatchability over a two year period.


Free, autologous, skin transplantation in the horse.

Seven pieces of autologous skin were transplanted onto freshly created, full thickness skin defects on the limbs and back of a one-year-old, male, piebald, Shetland pony. The transplantations were completed in two operative sessions, the transplants on the left side were done in the first session and the right side in the second. The sizes of the transplants varied from 20 sq cm to 2 sq cm and their thicknesses from whole skin to very thin, split skin. Donor sites were both rumps and the right side of the neck. Six of the seven grafts and two thirds of the remaining graft, were accepted. Both whole thickness transplants grew hair, whereas no hair growth was detected at the 26th and 16th week following surgery on the split thickness transplants placed on the left and right sides respectively. The full thickness donor sites healed by granulation, contraction and epithelialisation. Healing at the split skin donor sites was rapid and uneventfull, epithelialisation being completed within one week and hair growth manifest by one month.


An outbreak of S typhimurium in sheep and its consequences.

An outbreak of Salmonella typhimurium in an upland sheep flock was characterised by rapid spread and heavy mortalities in ewes and young lambs. Clinical signs included diarrhoea and abortion. Abomasitis was the most striking and consistent post mortem lesion. Vaccination was the only control method that was apparently successful. Infection also occurred in the cattle, farm personnel, and a dog. Following the outbreak, pasture contamination and excreting cattle provided a reservoir of infection so that contamination of water courses and sporadic cases occurred over a year later.


[Sensitivity of 30 strains of E. coli isolated from calves to chemotherapeutic agents].

Escherichia coli strains were isolated from calves and were biochemically and serologically identified in terms of their sensitivity to antibiotics. An exclusively high frequency of sensitivity was established to sulfonamides (100 per cent), tetracicline, erythromycin, oleandomycin (86.6 per cent) ampicillin, and streptomycin (70 per cent). Well expressed was their sensitivity to nitrofurans, canamycin, neomycin, and polymyxin. It was demonstrated through serial dilutions that there exists a high level of resistance to sulfanilamides, oleandomycin, erytromycin, tetracycline, streptomycin, chloramphenicol (more than 512 mug/cm3). The prevalence of such polyresistand E. coli strains in calves is the reason for concern in the district of Haskovo.


[Nutritive action of flavophospholipol and virginiamycin on broiler pullets].

Studied were some of the aspects of the antibiotic treatment with flavophospholipol (moenomycin) as the preparation flavomycin, and virginiamycin (staphylomycin) as the preparation escalin in a premix form as an animal formula. It was found that the antibiotics tested acted as nutrients: they had a positive effect on the growth and feed conversion. They raised the production of meat and improved the quality of the meat product in terms of higher protein and mineral contents. They also influenced favorably the deposition of cyanocobalamin in the liver, the RNA: DNA ratio in the liver and pancreas, and the content of blood proteins. These antibiotics did not lead to the retention of residual amounts in the muscles and viscera. Both preparations proved useful for the practice. Flavophospholipol is of interest thanks to its easier dosing and positive effect on the cyanocobalamin and ubichinon deposition in the liver and partly as its stimulative action.


[Study of rapid methods for determining the biochemical properties of microorganisms. I].

Some express methods were tested comparatively in determining the biochemical properties of certain microorganisms in order to recommend the most effective of them to be used in the laboratory. Described is a disk method with which the term of cultivation is shortened by one to 5 hours, and the results obtained are clear and well distinctive. The data obtained are almost comparable with the results achieved using the methods provided in the Bulgarian State Standard. It is suggested to adopt the method referred to in the laboratory practice.


[Experimental abortions in mice and guinea pigs caused by Aspergillus fumigatus spores].

Experiments were carried out with a total of 82 laboratory animals including 56 mice and 26 guinea pigs. The possibility was tested to provoke abortions in them with the use of Aspergillus fumigatus spores introduced through the trachea, orally or vaginally. The mould was isolated on Chapek agar from an aborted bovine fetus. It was found that all three routes of infection lead to abortions setting in after three to five treatments on the 1st to 3rd day following the last introduction of spores. The pregnant mice and guinea pigs showed individual sensitivity to the infection.


[Stereotaxic amygdalo- and amygdalohippocampotomy in temporal epilepsy with manifest behavioral disorders].

Clinical results of stereotactical destruction in the amygdalar complex and, in certain cases, in the hippocampus show that this manipulation is very important for the correction of behavioral disorders in patients with temporal lobe epilepsy. SEEG studies demonstrated that in cases of epilepsy with paroxysmal affective states an epileptical electrical activity can be demonstrated in the amygdalar complex. Our investigations also show that stereotactical operations for epilepsy are more effective for the control of behavioral and emotional disorders, than for seizures. It was suggested that a combination of classical (resection) and stereotactical methods gives a new possibility for the surgical treatment of severe forms of temporal lobe epilepsy.


[Relation of antibody levels to Epstein-Barr virus to histological variant and clinical course of lymphogranulomatosis].

The indirect immunofluorescent test in fixed P3HR-1 cells showed the sera from patients with lymphogranulomatosis to contain high titers of humoral antibody to the capsid antigen of Epstein-Barr virus. Higher titers of antibody to EBV were associated with unfavourably running histological variants of lymphogranulomatosis. The lymphoid depletion variant was accompanied by high antibody titers to the virus and had a worse prognosis than the nodular-sclerotic variant with lower antibody titers but better prognosis. The level of antibody in lymphogranulomatosis was stable. No relationship between the antibody level and the stage and results of the therapy given was found. In sera from patients with reticulosarcoma and lymphosarcoma no significant rise of antibody titers to EBV was found as compared with a group of normal donors, while in acute leukosis there was a tend for a decline in antibody titers.


[The mechanism of plaque production by enteroviruses under bentonite overlay. Relationship between plaque production and the dynamics of intracellular virus reproduction and membrane potential of the host cell].

The association of plaque production under bentonite overlay with the cycle of intracellular reproduction of enteroviruses and the dynamics of the membrane potential of infected cells was studied. It was shown that by the time of termination of the intracellular enterovirus reproduction cycle (4 1/2-5 hours postinfection) bentonite particles were torn away from the cell surface. At the same time the membrane potential of the host cell began to decline progressively. The data obtained explain the character of morphology of virus plaques under bentonite overlay.


[The development of the radium division of the 1st gynaecology department into the radiotherapy department of the 1st and 2nd gynaecology departments, Vienna University (a review of the past 25 years) (author's transl)].

A historical review is presented of the foundation of the radium ward of the 1st Gynaecology Department of the University and its development into the Radiotherapy Department of the 1st and 2nd Gynaecology Departments of Vienna University. Altogether 8500 patients with gynaecological carcinomas were treated primarily by irradiation over this period and 75.000 post irradiation outpatient follow-up examinations were carried through. This report includes laudatory statements by Prof. Antoine, Prof. Gitsch and Prof. Kärcher on the 25th anniversary of the department.


[Detection of persistent infection of stable cell culture with an agent related to lymphocytic choriomeningitis virus].

The presence of a persisting agent related to lymphocytic choriomeningitis virus has been detected in a number of stable cell cultures of human and animal origin by means of the indirect immunofluorescence procedure.


[The development of gynaecological radiotherapy at the 1st department of obstetrics and gynaecology University of Vienna (a review of the past 25 years) (author's transl)].

The radiotherapy unit of the Ist Department of Gynaecology, University of Vienna, was founded 25 years ago and its direction was entrusted to me. The initial period was extremely strenuous and difficult, especially in view of the fact that in our country the radiotherapeutic specialist in general - and the specialist in gynaecological radiotherapy in particular - is confronted with many excellent, absolutely surgically-oriented colleagues. Hence, it was necessary to prove on the basis of our resultes over the years, that this form of therapy in gynaecology, all initial conditions being equal, is just as effective as surgery, or even the treatment of choice in certain forms of malignancy. As a measure of the success of radiotherapeutic managment in this field, it would not occur to any experienced gynaecologist today to treat, for instance, a case of vaginal carcinoma surgically or to be satisfied with mere tumorexcision in a case of carcinoma of the vulva. An attempt has been made in this paper to outline the different methods used in the treatment of various gynaecological tumours and to show that well-planned, individually-tailored, fractionated radium therapy, combined with conventional X-ray therapy brings therapeutic results, which compare favourably with the best in the world literature. A further improvement in the cure rate - at least in progressed cases - may be anticipated following the introduction of supervolt therapy. This report only deals with the contribution made in the course of treatment of more than 8500 cases of the radiotherapy unit of the Ist Department of Gynaecology, University of Vienna towards advancement of gynaecological radiotherapy.


[Toxoplasmosis investigation of pregnant women and newborn infants (author's transl)].

In the serological screening of pregnant women for the prevention of congenital toxoplasmosis a positive test with low titre in the first trimester indicates almost with certainty a preconceptional infection. The probability that such a result derives from a very recent maternal infection leading to fetal infection is about 5 in 39,000. In view of the very high extra expenses involved and the unnecessary anxiety induced in many thousands of pregnant women and the sparse results the serological control of women showing positive tests with low or medium titre in the first trimester is not recommendable. There is no indication that preconceptional toxoplasma infection, especially the countless infections of longer standing with low titres, damage the fetus or lead to habitual abortion. Practically only H. Werner and his Berlin group, succeeded in isolating toxoplasma from abortion material of women not primarily infected during pregnancy but then in 20% of cases and in serologically-negative women also. The late importation of such opinions to Austria is deeply regrettable and should not be allowed to induce uncertainty in physicians and anxiety in our women. Accurate studies in very large numbers of preconceptionally-infected women did not reveal a single case of prenatal damage or congenital infection. Hence, the serological control of newborn infants of preconceptionally-infected women is not indicated. High titres (SF) detected during the first trimester indicate only a very low probability of damage to the fetus. Desmonts and Couvreur found not one infected infant amongst the offspring of 191 women with high titres at the beginning of pregnancy.


[Prevention of stress reactions by influencing energy metabolism using the extracorporeal circulation as a model (author's transl)].

Following a brief discussion of the principles and pathophysiology of energy metabolism, the effects of high free fatty acid (FFA) levels upon the organism and the possibilities of preventing their accumulation are commented on. Furthermore, the question of whether extracorporeal circulation (ECC) is comparable to a stress situation is analysed. In a review of previous studies the concept is introduced that the prompt exogenous administration of adequate calories can inhibit the endogenous mobilization of energy in a stress situation. An attempt was already been made to demonstrate this point in relation to catecholamine excretion. The calories should primarily consist of easily-utilizable carbohydrates (concentrated glucose with high doses of insulin), a regimen enabling the administration also of fat emulsions as an additional source of calories even at an early stage. Patients with severe brain injuries received this treatment as from the first day of admission. Evidence that glucose metabolism impairment was successfully overcome after severe shock was obtained in 40 patients receiving glucose-insulin solutions. It was deduced from this study to prevent a stress reaction by the administration of an augmented dose of insulin before ECC. The blood levels of glucose, insulin, lipids (FFA, triglycerides, cholesterol) and heparin, as well as some routinely-determined parameters (coagulation, haematocrit, haemolysis, potassium) were studied in 31 adults undergoing open heart surgery for congenital or acquired diseases of the heart. The incidence of cardiac arrhythmias was also recorded. The metabolic influence of glucose-insulin administration on these parameters was studied in one group of the patients who received 250 ml of 33% glucose (82 g) along with 40 units of insulin-MC (24 U insulin/50 g glucose) over an average period of 80 minutes (0.9 g glucose/kg/h) before heparinization for the ECC, whereas the second group of patients served as controls. The following effects of the administration of insulin plus glucose before the period of ECC were demonstrated: Blood glucose levels were elevated throughout the infusion; within the period of ECC, however, these levels were similar to the control group. Insulin levels were distinctly elevated and remained significantly higher until after the ECC as compared with the controls. Hence, the stage of insulin suppression appears to be surpassed by these means.


[Morphology of transplanted liver. an experimental study (author's transl)].

Experimental orthotopic livertransplantation is a very difficult procedure (Largiadér). This is due to the difficult specific anatomy of the liver, the high sensibility of the liver against anoxia and the distrubance of blood coagulation during transplantation. This investigation demonstrates that ischemia does not only damage the livercells, but also the bile ducts. We could show that these changes on the bile ducts are responsible for a certain number of unsuccessfull results of livertransplantations. In basic experiments we could demonstrate that ischemia is the cause of bile duct changes. There is always a critical situation for the common bile duct, when we tie the hepatic artery and dissect simultaneously the common bile duct. To keep this changes to a minimum we pay attention to the following points: 1. Correct perfusion and cooling of the livertransplant. 2. Fast recirculation of the hepatic artery before performing portal anastomosis. 3. The dissection of the common bile duct near the duodenum to preserve collaterale vessels from the proprial hepatic artery considering the specific anatomy.


[Effect of polyene macrolide antibiotics on normal and cell wall deficient Escherichia coli W1655F+ cells].

The polyene macrolide antibiotics are active against yeast, fungi, and other eukaryotic cells, but are with a few exceptions inactive against bacteria. The resistance of bacteria against these compounds is usually explained by the absence of sterols in their cells, the target sites of polyene antibiotics. However, in our experiments with mycotrienin, nystatin, tetramycin, lucenosmycin, rimocidin, filipin, lagosin, flavofungin, flavomycoin, antibiotic 2814P, antibiotic 5001P, and candicidin it was demonstrated that bacteria may be susceptible to polyene antibiotics, too, if the wall-less stable protoplast type L-form of E. coli W1655F+ is used. The measured growth inhibition concentrations were comparable with those of typical antibacterial antibiotics. Our experiments have shown that the normal rod form and the wall-less L-form of E. coli W1655F+ contain traces of sterols in nearly the same concentration range. This means that the selective sensitivity of the L-form cannot be explained by higher sterol content of these cells in comparison to the resistant normal rod form cells. We assume that the bacterial cell wall is responsible for the resistance of the normal rod form by masking internal target sites.


[Virus-like particles in yeast protoplasts. I. Electron microscopic demonstration].

In ultrathin sections and negatively stained isolates from protoplasts of a strain of Saccharomyces cerevisiae showing abnormal morphology and degeneration phenomena the presence of virus-like particles within the cells could be demonstrated. The isometric particles have diameters of about 50 nm, the electron dense centre is surrounded by distinct envelope. Protoplastic containing up to 30,000 particles could be found. It could be demonstrated that there exists a correlation between the amount of particles and the degree of degeneration of the cellular substructure. Protoplasts with high titres of virus-like particles obviously undergo lysis. Plaque formation on agar plates could not be seen. It is concluded that the phenomena observed can be compared with cytopathological effects caused by viruses in other cell systems.


[The theoretical analysis of Fick's equation. On the centennial of the use of Fick's principle in physiology].

In the first section Adolf Fick's outstanding scientific performances are pointed out in their historical sequence, particularly the derivation of the laws of diffusion (1855) and the basic equation for determining the heart-minute-volume (Fm) by O2-absorption per time (V02) and arteriovenous O2-difference (AVD), known as Fick's Principle. The latter was derived theoretically in 1870 by Fick, but it found it practical employment by other investigators, in dog not before 1886 and in man not earlier than 1930. In the following two sections the universality of Fick's Principle is shown by explaining its internal relation 1. to Fick's first law of diffusion and 2. to the general law of solution. This is done by mathematical transformation of the relations (formulas)of the physical resp. the physiological standards (parameters). By analyzing the diffusion of a substance into a streaming fluid according to the first diffusion law, perfectly isomorphic equations to Fick's Principle (No. 7 and No. 9) are obtained by what Fick's formula as a determinant of the heart-minute-volume is just proved to be derivable from Fick's first diffusion law. Furthermore by transforming the trivial formula for the determination of substance concentration in a fluid provement is given, that Fick's Principle may be considered a variant of the solution theory. By this the internal relation of the so-called dilution respectively indicating methods depending on the Stewart-Hamilton-Principle to the original Fick's Principle is made visible. In the last section an attempt is made to produce a relation to 1. the so-called physical methods determining the minute volume which primarily are known as a measurement for stroke volume and frequency, and, besides that, 2. to Vierordt's equation, by which the heart-minute-volume is determinable from circulating blood volume and circulation time. This trial is made by equating the value of the minute volume given by Fick's Principle (VO2/AVD) with the product from stroke volume and beating frequency, and on the other hand by equating it with the quotient from circulating blood volume Qc and complete circulation time Tc (Qc/Tc). Finally, physiological arguments are derived from these relations, allowing an evaluation of the relative proportions in circulation adaption during muscular work of the magnitudes of changes in stroke volume, beating frequencies, or the O2-pulse.


[Results of the dye dilution technic in peripheral arteriovenous fistulas and hyperthyroidism].

Dye dilution curves (DDC) from 35 patients with arteriovenous fistulas and from 22 patients with hyperthyreoidism were performed and compared with results in 122 healthy subjects. In most cases Cardiogreen was injected into an antecubital vein during reactive hyperaemia. On the arterial side, dye concentrations were recorded by ear oximetry. The appearance time was shortened in most cases. During dilution time dye curves were interrupted by an early recirculation in hyperthyreoidism, whereas in 29 patients with haemodialysis fistulas this interruption was discrete and detectable only when compared with results after occlusion of the fistulas. Different shapes of dilution curves were observed: 1. in most cases DDC seemed to be normal or near normal, often with an accelerated indicator passage; 2. DDC with an interruption of the dilution limb by an early recirculation; 3. DDD, showing a hump of the dilution limb; 4. asymmetrical DDC or DDC with a flat shoulder of the dilution limb and without a recirculation wave. Patients with hyperthyreoidism and arteriovenous fistulas had no different shapes of dilution curves. The results are discussed with special reference to the DDC in patients with central left-to-right shunts.


Studies on the feeding of larval Argas persicus Oken.

The development of the lesions caused by Argas persicus larvae while feeding on chickens, their natural hosts, was followed using histological techniques. Penetration of the skin by the mouthparts was accompanied by rapid lysis of the cells of the epidermis and dermis within 100 mum of the mouthparts. A foreign-body reaction developed within 2 mm of the attachment and was characterized by rapid dilation of blood vessels, emigration of leucocytes, particularly heterophil leucocytes (heterophils) into the tissues and oedema. Haemorrhage developed near to the mouthparts and within 2 h of the start of feeding, erythrocytes were seen in the gut caeca of the larvae. Whole blood provides the diet of the larva throughout the entire period of feeding and unlike the situation described with nymphal and adult. A. persicus the blood is lysed immediately after ingestion. By 30 h the extra-vascular heterophils had migrated to the mouthparts around which they formed a loose, superficial, collar. Further emigration of heterophils into the tissues then ceased, although some were present in the blood being ingested. It appears that the heterophils mask the mouthparts so that they are no longer recognised as foreign by the host and thus provide an example of the concept of adaptation tolerance. But the development of lymphocyte and monocyte infiltrations in the dermis close to the mouthparts indicates that the immunological response of the host to salivary secretions is not suppressed. Oedema which develops around the site of attachment further protects the larvae from the host's predations.


[Arthropodan vectors of human parasites: their pathology and defence reactions (author's transl)].

Many infectious diseases of man are transmitted by arthropods. It is not known whether the carriers were primarily susceptible or insusceptible as the cycle first came into existence. Similarly so little is understood, why some arthropods are suitable vectors and other close relatives are not suitable. Only the hypothesis that the agents are original parasites and not at all commensals or symbionts can reasonably explain the evolution of the cycles. It is shown by means of numerous examples how the vector can be damaged by the parasite. Some organs of the vector might become unfunctional, the reproduction rate might be lowered and the vector itself may die. On the other hand the vector has at its disposal defence mechanisms which are according to our present point of view limited to the midgut barrier and the hemolymph reactions. Both components of the system, the vector and the parasite together are capable of change under the influence of the other. For example through the high mortality of the susceptible part of a vector population the resistant and the tolerant individuals will be selected. On the contrary harmful parasites cannot transmit their genetic information when their virulence is so high that the vector will suffer death. Due to this the parasites succumb to a selection pressure and only the careful treatment of the vector is rewarding. Besides this rough pattern of actions and reactions exists also the possibility of developing finer adjustments, with the "molecular mimikry" as a well known example.


[Application of the modified mixed cell agglutination reaction (MCAR according to Davidsohn) in forensic serology; MCAR on adhesive tape (author's transl)].

In view of serological sensitivity, specificity and simple procedure of reaction pattern the modified mixed cell agglutination reaction (Davidsohn's MCAR) proved to be a very useful test for typing ABO isoantigens in forensic medicine. Its sensitivity surpasses in some cases, where very small amounts of isoantigens have to be detected, that of the absorption-elution reaction several thousand times. The capacity to demonstrate the localization of antigens seems to be more reliable than the original test method. The modified Davidsohn's MCAR (MCAR on adhesive tape) is expecially recommended when isoantigens which are localized on the surface of microscopic objects including fingerprints, dust, hairs, and histological sections, have to be determined. The usefulness of our modification in forensic medicine and the conditions which are essential for the application, are discussed.


Mechanization of a micro complement fixation test for the serodiagnosis of human toxoplasmosis.

A description is given of a mechanized micro complement-fixation test for the serodiagnosis of human toxoplasmosis. Besides a reduction in the quantity of reagents by using a microplate a considerable advantage of the test is the mechanization of actually all steps. Examination of large numbers of sera can be realized in a relatively short period of time. In order to test the sensitivity of the micro CF test comparative studies were carried out with the macro CF test and the immunofluorescence (IF) test on 549 human sera. The micro CF test proved to be more sensitive than the macro CF test. The results obtained with the micro CF test were in better agreement with the IF test than those obtained with the macro CF test.


[Direct demonstration of Coxiella burnetii from air samples on slides coated with kraton 1107].

Inactivated Coxiella burnetti (strain Henzerling) was introduced into a sealed chamber in aerosol form and recovered on Kraton 1107-coated slides with the aid of slit samplers. Following auramine staining, the coxiellae could be demonstrated directly by microscopy. Under the experimental conditions chosen, the limits of demonstrability were initial Coxiella contents of 2.26 X 10(3) in 14 L or 3.6 X 10(5) in 1 m3 of air.


[Comparison of diverse methods for the cultivation of anaerobians, with special reference to the GASPAK system].

The frequent presence of anaerobic bacteria in clinical specimens requires the use of adequate methods for their detection. The GASPAK system, following closely the experiences made by BREWER, meets these requirements and has the additional advantage of easier handling when compared with other methods. Hydrogen necessary for binding oxygen in the anaerobe-receptacle, is produced chemically from a sodium borohydride plate over which only a certain amount of water needs to be poured for activation. A bar containing citric acid and sodium bicarbonate releases carbon dioxide at the same time. Small palladium-coated aluminium balls act as a cold catalyst. The hydrogen-carbon dioxide developer is supplied in disposable bags (Fig. 1). A strip impregnated with methylene blue is used as indicator. This strip is used only once. The GASPAK system was examined and compared with the anaerobe-receptacle by FILDES and MCINTOSH where a pressure-bottle feeds the hydrogen into the system, and the vacuum-process by ZEISSLER. Growth of several anaerobians from fresh clinical specimens and from some defined strains was used in the test (Table 1-4). The highest rate of growth was achieved with the GASPAK-system so that - even if one bears in mind that the other two methods do not undergo enrichment by carbon dioxide - this method for the cultivation of anaerobians can be recommended for use in routine laboratories.


IF-40. A new polystyrene microscope tray for immunofluorescent studies.

A polystyrene plate is described which was designed to replace microscope slides for routine immunofluorescent examinations. The plate has 40 flat indentations of 8 mm diameter. The plates can be sterilized and stored in plastic bags. They are well suited  for drop preparations or application of cryostat slices of biopsy and necropsy material, and tissue cultures can be grown directly in the indentations. When compared with glass microscope slides, which have long been used for these purposes, the polystyrene plates offer a variety of advantages. Cells can be grown directly in the indentations without washing or pretreating the trays in any way. The indentations prohibit mixing of samples or reagents and enable the use of smaller quantities of reagents. Up to 40 samples can be worked up simultaneously on one plate, or a plate rack can be used for the processing of up to 400 samples at once. The use of a special stage enables easy microscoping of all 40 spots without further handling of the tray.


[Different antibody tests (IgG, IgM) from children with chronical recurrent urinary tract infections (author's tranls)].

Different Antibody tests (IgG, IgM) were made from children with chronical and recurrent urinary tract infections with help of the indirect fluorescent method and were compared with the indirect hemagglutination test. The indirect hemagglutination gave absolutely higher antibody rest results, but the specifity of the immune fluorescence test is just as large. You can see the acute attacks of pyelonephritis in either the antibody response test or IHA test. It is quite important, in the beginning, to repeat the controlls of the antibody test, because the changes that could occure in the titer should be seen. The IgG antibody reactions rise slightly during the acute attacks of E. coli- and Enterococci reinfections.


A paraffin baiting technique that enables a direct microscopic view of "in situ" morphology of Nocardia asteroides with the acid-fast or fluorescence staining procedures.

The paraffin slide culture technique has provided a means of greatly increasing the effectiveness of the paraffin baiting procedure in the identification of Nocardia asteroides. This has been accomplished with paraffin coated slides rather than the conventional paraffin coated rods, which allows for direct microscopic examination of the "in situ" growth because of its flat surface. This microscopic examination is further facilitated by staining with Kinyoun Acid-fast Stain, or combines three important elements necessary for the identification of Nocardia asteroides, namely; "in situ" morphology, acid-fastness and Auramine fluorescence. The conventional paraffin coated rod only shows the ability of Nocardia asteroides to utilize paraffin as a carbon source, and tells nothing about "in situ" morphology, acid-fastness, and fluorescence with Auramine Fluorochrome.


[Water disinfection by means of chlorine: killing of aggregate bacteria (author's transl)].

Rising water demands ask for an increasing utilization of more or less contaminated surface water that has to be chlorinated prior to treatment. Especially during periods of lake bloom, the desired disinfecting effect is not achieved in spite of high concentrations of chlorine present. This is due to a coating of bacterial surfaces by substances such as algal products having a protective effect as demonstrated in experimental studies by the authors. Bacteria in a central position within bacterial aggregates as e. g. formed by the addition of flocculants in the process of water treatment, are also protected against the action of chlorine. In cases of inadequate filter backwashing, such aggregates may penetrate into clean water. Accumulations of bacteria in the shape of widespread growth may also form on activated carbon filters, ion exchangers, at walls of tanks under unfavourable hydraulic concitions, and in stagnant parts of supply pipes. Curves depiciting the kill of dyspectic E. coli differentiated by O-agglutination and S. anatum were exhibiting longer survival periods as compared with non-aggregate bacteria. For organisms differentiated by H-agglutination, kill was between these values. The killing rate was found to be a function of the oxidation-reduction poteential. Furthermore, survival times for E. coli and S. anatum were found to be different. It has been confirmed by these experiments that chlorine concentrations as common in the practice of water works frequently do not suffice to kill bacteria within aggregates and that a colony count does not permit conclusions as to the bacterial count if bacterial aggregates are present.


[Several biological properties of the surface antigens of the agent of pseudotuberculosis].

Capsular substance and extracellular proteins of the causative agent of pseudotuberculosis caused in the organism of guinea pigs a specific immunological reconstruction with the accumulation in the blood of antibodies in low titres, chiefly of macroglobulin type. The blood sera of these animals failed to protect the mice from lethal pseudotuberculosis infection in experiments of passive protection. Surface antigens of pseudotuberculosis causative agents produced a sensitizing action on the guinea pig organism; this was shown in vitro with the macrophages of the abdominal cavity of these animals. Extracellular proteins decreased the completeness of phagocytosis by neutrophilic leukocytes (demonstrated in vitro with the donor blood leukocytes).


[Transduction of streptomycin resistance in group A streptococci by virulent streptococcal phage CA1].

The author studied the Smr transduction in hemolytic streptococci, group A, by the virulent CA1 phage. This phage differed from the A12 and A25 by the spectrum of lytic activity and was affiliated to them serologically. In comparable experiments CA1 phage exceeded A25 phage by the transducing activity. Phage CA1 transduced the cultures of various serological types. The efficiency of transduction depended on the multiplicity of the infection (the optimum--0.1--0.03), the age of the recipient culture (the optimum--1--2-day) and the time of phenotypical expression (the optimum--2--3 hours). It was possible to increase the frequency of transduction by one order with the aid of UV irradiation. Still a theoretically possible output of the transducers determined by calculation was not reached because of some abortiveness of the process.


[Transfection of Escherichia coli using bacteriophage MS2 RNA].

The authors present materials for comparison of three methods of E. coli infection by the RNA of the MS2 bacteriophage. The cells accepted the RNA at the stage of spheroplasts (obtained with the aid of a lysozyme and EDTA) with the efficacy of up to 1.5 X 10(5) IC/mug of the RNA. Diethylpyrocarbonate was used as a transfection stimulant. The product of transfection was identical to the MS2 bacteriophage. The efficacy of transfection in the calcinated system and on the frozen-defrosted bacteria was lower than on the spheroplasts (10(2) IC/mug of the RNA) which was largely associated with the formation of "latent infectious centres". Formation of latent negative colonies was characteristic of bacteriophage MS2, but formation of these colonies was intensified when calcinated cells were used for transfection.


[Increase in resistance to UV-light in E. coli bearing the Hly plasmid resistance].

Hly plasmide of wild type and its derepressive (by transmission) mutant communicated to the E. coli cells an increased resistance to the action of ultraviolet rays. Hly plasmide failed to compensate the defects associated with the excision and postreplicative DNA reparation or the reparative DNA synthesis. Hly plasmide increased the resistance to the ultraviolet light in the lon--mutant in which the ultraviolet irradiation disturbed the process of cell division. It is supposed that the resistance to the ultraviolet light connected with Hly plasmide was caused by the influence of the plasmide on some stages of cell division following the ultraviolet irradiation.


[Enteral immunization with attenuated representatives of the family Enterobacteriaceae. Report 3. Comparison of the immunogenicity of the Sm-d-mutants of E. coli and the killed vaccine].

The authors present the results of a comparative study of the immunogenicity of the living (Sm-d) and killed E. coli vaccine which, in determination by such methods as the Vidal test, passive hemagglutination test, bactericidal activity, establishment of passive and active defence, proved to be the same in both vaccines. However, with the aid of Rauss and Ketyi's method, modified by the authors (determination of nonsuceptibility in enteral infection of the animals with intestine sterilized with streptomycin) it was possible to reveal the capacity of the living vaccine to depress the growth and the activity (reproducible and statistically controlled) of E. coli administered into the organism of the immunized animal for the purpose of infection. They were discharged with the feces for a definite period in 90% of control animals and mice immunized with the killed vaccine; this occured in less than 10% of the animals immunized with the living vaccine.


[New methods of determination of the functional peculiarities of autoantibodies in various types of autoimmune reactions].

Anderson's method (with our modification of Jerne's method) was applied in experiments on 574 albino female mice; a study was made of the affinity of autoantibodies in three groups of animals: intact, gamma (Co60) irradiated in a dose of 600 r, and with stimulation of auto-immune reaction by injection of a complete adjuvant (0.05 ml subcutaneously) or injection of living E. coli cells (subcutaneously 300 million) or hemostimulation (subcutaneously 0.1--0.3 or 0.5 ml of homologous blood). The maximal autoantibody indices were obtained in the irradiated mice, the least -- in the intact animals. Apart from the plaque-formation inhibition phenomenon, there were observed two more phenomena; these were an immune erythrocyte adherence to the immunocompetent cells and a marked increase in the formation of plaques of autoimmune hemolysis in the preparation with addition of diluted (1:10) lysate of erythrocytes obtained from mice with the administration of an adjuvant or homologous blood.


[Role of circulating antibodies and cellular factors in the pathogenesis of Staphylococcus induced rejection of skin autotransplants].

It was found that rejection of the skin autotransplant in the staphylococcus-sensitized animals was accompanied by regular changes in the titres of auto- and staphylococcus antibodies indirectly pointing to the antibody fixation on the rejecting transplant or to their neutralization with the antigens of the perishing skin transplant. In experiments with passive reproduction of the state of rejection in the intact syngenous recipients it was shown that the decisive role in this process was played by the cell factors, but not by the blood serum. The mentioned facts pointed to the role played by allergy of delayed type in the pathogenesis of rejection of skin autotransplants induced with staphylococcus.


Histochemical localization of hydrochloric acid in the stomach of two teleost fishes.

The localization of hydrochloric acid in the gastric glands of Ophycephalus punctatus and Heteropneustes fossilis has been examined histochemically. The fishes were force-fed with the Prussian blue reagents in a test meal and the distribution of the precipitate was examined at regular intervals. Maximum amount of precipitate was observed in the lumen and at the mouth of the openings of the gastric glands 12 h after feeding in Ophiocephalus and at 18 h in Heteropneustes. Pepsinogen granules were distributed in all the cells lining the gastric glands. No histochemical difference was observed in the cells lining the gastric glands, and all the cells were capable of producing both HC1 and pepsinogen.


Bacterial renal infection in rats produced by direct injection of bacteria into renal tissue--an experimental model.

A new method for producing an experimental model of renal infection in rats is described. It is based on a direct injection of a concentrated E. coli suspension either into both kidneys or only one of them. The method is simple and takes little time; the mortality of experimental animals is low. A focal acute purulent renal inflammation is elicited which tends to propagate towards the papilla. A significant renal infection persists at least over six weeks. The renal infection model is suitable for testing the antibacterial activities of drugs, as documented by the results of a therapeutical experiment with gentamicin and other agents.


[Relations between the macrophage electrophoretic mobility test and the rhodanide level in patients with malignant tumors, autoaggression diseases and after transplantation].

In patients with malignant tumors, autoaggression diseases and following transplantations the blood rhodanide level was found to increase; a correlation with the results of the MEM test was established.


[Local treatment of burns. Panoplie and choice of therapies (author's transl)].

The author revuew the pros and cans of topical treatments among the most effective at this time. He reports the experience acquired with some at the Hospital St Pierre in Brussels. By comparison with the literature he attempts to define an ideal therapeutic scheme.


[A simplified technique of skin transplantation (author's transl)].

A simplified technique of skin transplantation is proposed: local anaesthesia of donor site; use of a regular razor-blade for skin harvesting and use of donor site for preservation of residual skin grafts.


[Intraperitoneal sequestration of a radium loaded tube, following perforation of the uterus, and his surgical management (author's transl)].

The authors present a case of uterineperforation due to Radiumapplication and its surgical treatment: removal of the Radiumcontainer at laparotomy without postoperative complications.


[Bronchial carcinoma with positive mediastinoscopy. Review of 219 cases (author's transl)].

Mediastinoscopy was positive in 219 out of 605 cases of bronchial carcinoma (36.2%). The author analyses the age, sex, location of primitive tumor, histology, distribution of positive nodes and treatment used. Data on node involvement confirms the high malignity of the oat-cell carcinoma: though one of the rarest, this form accounts for 40% of mediastinal involvements. The data also confirm the lymphatic drainage of right side tumors (4% of crossing over) and the bilateral drainage of left side tumors (37% of crossing over). The proportion of involved nodes is 73%. In the 20 cases where surgical resection was performed this proportion is 58% and the involved nodes are largely located in the lower portion of the accessible mediastinum. Survival curves are drawn according to various parameters (location, histology, treatment). Review of the literature yields some general conclusions on the operability of bronchial carcinoma. According to belgian statistics bronchial carcinoma is the leading cause of death from cancer in the male. Probable survival for patients with positive mediastinoscopy is 7.5 months, extending from 4 months in untreated cases to 12 months after radio-chemotherapy. Prognosis was best in the 16 patients who survived the immediate postoperative period.


Pituitary LH and FSH secretion and responsiveness in women of old age.

The plasma concentrations and episodic fluctuations of immunoreactive FSH and LH as well as the pituitary sensitivity to LH-RH stimulation were evaluated in post-menopausal women. The subjects were divided into 4 groups according to age. Group 1: 60-70 years old (n = 11), group 2: 70-80 years old (n = 22), group 3: 80-90 years old (n = 31) and group 4: 90-100 years old (n = 8). Standards used in gonadotrophin radioimmuno-assays included the LER-907 preparation and a pooled post-menopausal serum. Since it was found that circulating gonadotrophins have an immunological pattern different from that shown by the pituitary preparation, the results were expressed in mIU/ml calculated accordingly to the immunological behavior of pooled post-menopausal sera. The mean (+/- SE) plasma levels of FSH (mIU/ml) were: group ): 105 +/- 9.5, group 2: 149.3 +/- 10.5, group 3: 124.8 +/- 7.1 and group 4: 149.4 +/- 25.3. The mean (+/- SE) plasma levels of LH (mIU/ml) were: group 1: 81.9 +/- 12.5, group 2: 95.4 +/- 9.9, group 3: 84.3 +/- 7.7 and group 4: 113.5 +/- 19.1. No statistically significant differences were observed among the 4 groups. One patient from each group was randomly selected in order to evaluate their LH and FSH episodic release as well as their pituitary responsiveness to exogenous stimulation. A pulsatile plasma pattern of gonadotrophin and a normal pituitary response to LH-RH injection were observed in the 4 patients studied. The results are interpreted as demonstrating that normal pituitary gonadotrophin function and pituitary reserve and responsiveness to exogenous stimulation are maintained in women of advanced age.


The effect of cyproterone acetate on the plasma gonadotrophin response to gonadotrophin releasing hormone.

Cyporterone acetate (100-150 mg daily) was administered to 8 male patients with excessive libido. Within 3 months a significant fall (P less than 0.02) in plasma testosterone was demonstrated. The plasma luteinising hormone (LH) and follicle stimulatin hormone (FSH) responses to gonadotrophin releasing hormone (LH/FSH-RH) were also significantly impaired (P less than 0.05). A direct correlation between the resting plasma testosterone level and the LH response to LH/FSH-RH was demonstrated (r = 0.743). It is concluded that the fall inplasma testosterone levels in patients receiving cyproterone acetate may be attributed to suppression of LH release, rather than an antiandrogen effect on the testis or hypothalamus.


Determination of the specific blood flow of the liver by inhalation of radioactive rare gases.

The technique applying the inhalation of radioactive rare gase is a new method to determine the specific blood flow of the liver. After inhalation of 133Xe, the course of activity is registered above liver and spleen as well as in the exspirated air. The perfusion is calculated from the resulting wash-out curves. The average value in healthy persons is 91 +/- 15 ml/100 g min. The reproducibility is 5 +/- 1%. The xenon wash-out is delayed in cirrhotic livers; the blood flow is significantly decreased and amounts to an average of 45 ml/100 g min. A delayed wash-out of xenon was also found in major fatty livers due to the high affinity of xenon to fat. The dependence of the partition coefficient on the fat content was investigated by Kitani and Winkler in homogenized liver tissue of different fat content. The question arises whether these in vitro findings can be transferred to in vivo wash-out curves. We therefore carried out first investigations on patients of known content of fat of the liver, applying a 85MKr-133 Xe-double measurement. According to results which have been achieved up to now, sufficient accuracy can only be obtained up to a fat content of 10%.


Hepatic blood flow and cardiac output after porta-caval anastomosis in the rat.

Investigations were performed in rats with portacaval anastomosis (PCA) in order to measure hepatic hemodynamics and cardiac output (CO) 3, 6, 14 and 28 days after operation under pentobarbitone anesthesia using the flow fraction distribution method (131I-MAA) of CO. The latter was calculated using Vierordt's principle from blood volume (BV) (125RIHSA-dilution method) and ICG-appearance time (ICG-AT) (ear-densitometry). Even 3 days after PCA CO was increased to 38.7 +/- 5.0 (SD) ml/min/100 g b.w. (normal 23.8), due to an increase of BV from 6.3 +/- 1.4 to 7.5 +/- 0.6 ml/100 g b.w. and a decrease of ICG-AT from 3.6 +/- 0.4 to 2.8 +/- 0.5 s. Arterial hepatic flow fraction of CO increased to 8.7 +/- 2.8% (control: 5.5 +/- 2.4%). Changes could be observed up to day 28. Hepatic blood flow per g liver tended to stabilize but was still decreased at day 28: 1.5 +/- 0.6 ml/min/g liver (control: 2.0 +/- 0.3). The typical hemodynamic changes in human liver cirrhosis can be reproduced by PCA alone. They are considered to be compensatory mechanisms for a reduced portal liver blood flow, which are not found to compensate completely.


Studies of Escherichia coli O antigen specific antibodies in human milk, maternal serum and cord blood. Acta Paediatr Scand, 65:216, 1976.--The quantity and class specificity of E. coli O antibodies in human milk, maternal serum and cord blood was determined by the enzyme-linked immunosorbent assay. The predominant Ig-class of these antibodies in milk was IgA. The initially high levels of antibodies decreased 10-fold during the first days, but there seemed to be a fairly constant daily production of IgA antibodies during the first two months of the nursing period. There was no obvious decline in antibody content from morning to night or during a meal. The ratio milk antibody/serum antibody was very high for IgA, suggesting a local production. The ratios for the IgG were all less than 1, suggesting a restricted transfer from the serum. Ratios around 1 for IgM did not exclude some local production. In umbilical cord serum the amount of IgG E. coli O antibodies was higher than that in maternal serum. Small amounts of IgM and IgA antibodies was also demonstrated in some cases. In milk as well as in serum there were antibodies against a wide variety of E. coli O groups, not only to the actual E. coli strain dominating the mother's gut flora.


Influence of maternal gut flora and colostral and cord serum antibodies on presence of Escherichia coli in faeces of the newborn infant.

From 29 healthy newborn infants and their mothers faecal, serum and milk specimens were obtained on several occasions from one to nine weeks after delivery. Predominant faecal E. coli were serotyped with regard to the O antigen and milk and serum were analysed for their content of E. coli O antibodies by the enzyme-linked immunosorbent assay. In five cases the babies acquired the same O serotype as was found in the stools of their mothers but in 12 out of 29 cases infant and mother never had any dominating faecal E. coli O type in common. There was no apparent correlation between the patterns of feeding and interchange of bacteria. Klebsiella/Enterobacter was the dominating facultative organism on at least one occasion in half the infants. The newborns received colostral IgA and transplacental circulating IgG antibodies against a great number of E. coli O serotypes. These antibodies did not prevent intestinal colonization, as judged from cultures of faeces.


[A controlled double-blind crossover study of the efficacy of mepiprazol (EMD 16.923) and of diazepam in the treatment of neurotic disorders].

After a preliminary encouraging trial of mepiprazol (EMD 16.923) on 8 patients, a double-blind cross-over study of mepiprazol and diazepam was performed in order to compare their effect in the treatment of neurotic disorders, particularly on various forms of anxiety.


The nitrobule tetrazolium (NBT) test in endemic benign (epidemic) nephropathy.

NBT test values in blood samples from 25 cases of endemic benign (epidemic) nephropathy (EBN) were high, i.e. more than 19% NBT-positive neutrophils, in 22 (88%) of the patients, intermediate, i.e. 13-19%, in two (8%) and normal in one patient (4%); in eight patients (32%) the NBT test values were 50% or more. The test values remained elevated, i.e. 13% or more, for more than one month after the onset of illness in three of ten patients on whom serial tests were performed. Among 18 patients with kidney diseases other than EBN and 16 with kidney transplant, high NBT test values, 20 and 22%, respectively, were found in two (5.9%), intermediate values in two and normal test values in 30 patients (88.2%). This paper is the first published report on NBT test values in cases of EBN. The test was rated to be of diagnostic value in patients in  whom EBN might be suspected, highly elevated test values (larger than or equal to 50% NBT-positive neutrophils) lending support to the diagnosis.


A controlled clinical trial of the immunosuppressive effect of extracorporeal irradiation of the blood in renal allotransplantation.

The immunosuppressive effect of extracorporeal irradiation of the blood (ECIB) in renal allotransplantation (RAT) has been investigated in a controlled clinical trial. A series of 101 uremic patients undergoing intermittent hemodialysis in preparation for RAT were allocated randomly to two groups; a treated group +ECIB (n=55), and a control group 0-ECIB (n= 46). ECIB treatment was given in the form of a fixed dose, with a transit dose of 400 rad and a cumulative dose of approximately 50 000 rad, both before and after RAT. A selective long-term lymphocytopenia was usually obtained, with no effect on immunoglobulins, complements or plasma proteins. Erythrocyte count was reduced in  the majority of cases, but this had no limiting effect on the implementation of treatment. The shortest survival times and most deaths occurred in the +ECIB group. The first rejection episode occurred later in the +ECIB group, but there was no difference between the groups in the number of rejections during the first two months or during the whole observation  period. There were more cases with two or more rejection episodes in the +ECIB than in the 0-ECIB group. There was no difference in graft survival, but shortest patient survival and most deaths after RAT occurred in the +ECIB group. It must therefore be concluded that the immunosuppressive effect of ECIB has no practical clinical relevance in RAT, and that ECIB given in the manner described involves the possibility of side-effects so serious that the method cannot be recommended.


Clinical trial with amantadine and pemoline in elderly patients.

In a controlled clinical trial, amantadine 400 mg daily, 200 mg daily and 200 mg daily given with 20 mg of pemoline daily were compared with placebo in the treatment of elderly patients suffering from involutional cerebropathy characterized by psychomotor slowing down. The results showed that amantadine 400 mg daily was superior to placebo but was associated with a high incidence of side-effects (37 per cent), amantadine 200 mg daily was not superior to placebo but when pemolint 20 mg daily was added the combination was superior to placebo and few side-effects were reported.


Kinetics of the reactive cell clones after immunosuppression and induction of tolerance: (1) inhibition of 19 S and 7 S plaque-forming cells in the primary and secondary immune response to sheep red blood cells by cyclophosphamide and 036.5122 (Asta).

The kinetics of the reactive cell clones after primary and secondary immunization with SRBC1) modified by cyclophosphamide and a newly synthesized cyclophosphamide analogue 036.5122 (Asta), have been studied. After primary immunization, both substances caused a severe and dose dependent depletion of 19 S PFC2). The 7 S PFC in the late primary response were only slightly inhibited by cyclophosphamide in low dose ranges, indicating, that sensitization could not be prevented by this substance. In contrast, 0.36.5122 was fully able to suppress 7 S PFC. Thus, treatment with 0.36.5122 after primary immunization can fully prevent the expression of the specific response. Experiments dealing with inhibition of a secondary immune response revealed that both test substances were able to strongly suppress the 19 S as well as the 7 S PFC. In general, 036.5122 demonstrates a higher suppressive potency, and the timing of its application for optimal suppression is less delicate than that of cyclophosphamide. 036.5122 was equally well inhibitory, whether given directly before or after antigenic challenge. The hypothesis is discussed, whether the immunosuppressive effect of 036.5122 given before antigenic challenge in the secondary immune response is due to cytotoxic damage of antigen reactive clones stimulated by persisting antigen.


Disaster at Buffalo Creek. Children of disaster: clinical observations at Buffalo Creek.

Most of the 224 children who were survivor-plaintiffs of the Buffalo Creek disaster were emotionally impaired by their experiences. The major factors contributing to this impairment were the child's developmental level at the time of the flood, his perceptions of the reactions of his family, and his direct exposures to the disaster. The author focuses on children under 12, describing their responses to fantasy-eliciting techniques and their observed behavior after the flood compared with developmental norms for their age and reports of their previous behavior. These children share a modified sense of reality, increased vulnerability to future stresses, altered senses of the power of the self, and early awareness of fragmentation and death. These factors could lead to "after-trauma" in later life if they cannot make the necessary adaptations and/or do not receive special help to deal with the traumas.


The effect of cycle length on cardiac refractory periods in the denervated human heart.

We have previously demonstrated that the transplanted human heart is functionally denervated. With the use of the extra stimulus technique during His bundle electrocardiography, refractory periods of the arterioventricular (A-V) conduction system were determined at several heart rates after pacing-induced changes in cycle length in eight patients who had previously undergone cardiac transplantation. Shortening of the cycle length was accompanied by a decrease in both the effective and functional refractory periods of the atrium. No consistent change in A-V nodal effective refractory period or functional refractory period could be demonstrated. Because A-V conduction was limited at shorter cycle lengths by the functional refractory periods of the atrium and A-V node, bundle branch refractory periods could be determined in three patients only at the longest cycle length studied. In four of the eight patients, atrial arrhythmias were produced at short cycle lengths with the introduction of early atrial extra stimuli. This may be due to a lack of vagal innervation of the atrium. These results contribute to our understanding of atrial arrhythmias.


The catecholamines in essential hypertension.

The evidence for involvement of the catecholamines and their metabolites in essential hypertension is presented. Labile and established essential hypertension should be considered individually in this respect, although they may exist separately or together. Labile essential hypertension is more related to increased secretion as well as increased response to and decreased retention of epinephrine rather than norepinephrine, whereas established essential hypertension is more related to similar aspects of norepinephrine release and metabolism. Whether pure epinephrine hyperresponsiveness, abnormal metabolism, and secretion evolves into the pure norepinephrine hyperresponsiveness and abnormal metabolism of uncomplicated established essential hypertension can only be proved by long-term longitudinal study. Such investigation would also be required to identify the evolution of mixed types of the disease.


Quantitative radionuclide angiocardiography: detection and quantitation of left to right shunts.

In 105 patients defection and quantitation of left to right shunts was performed using quantitative radionuclide angiocardiography. The radionuclide angiocardiograms were acquired and analyzed by a gamma camera interfaced to a digital computer system. Pulmonary to systemic flow (Qp/As) ratios were calculated by analysis of pulmonary time-activity histograms using a gamma variate model. All patients were studied with cardiac catheterization, left ventricular angiocardiography and radionuclide angiocardiography. The radionuclide method allowed precise detection and quantitation of left to right shunts with a Qp/Qs ratio of 1.2 to 3.0. There was good agreement between the Ap/As ratio calculated by oximetry at cardiac catheterization and radionuclide angiocardiography (r = 0.94). The information gathered with this nontraumatic method appears sufficiently reliable to be used in the management of patients.


Measurement of left ventricular mean circumferential fiber shortening velocity and systolic ejection rate by computerized radionuclide angiocardiography.

Recently attention has focused on ejection phase indexes as clinically relevant measures of left ventricular contractility. Using an Anger camera interfaced to a dedicated computer with injection of radionuclide (technetium 99m) into a wedged pulmonary arterial catheter we have developed a method for measuring left ventricular mean circumferential fiber shortening velocity and mean systolic ejection rate. For determination of mean fiber shortening velocity an area of interest coincident with the left ventricular minor axis is constructed and a time-activity curve obtained. In 31 atients radionuclide-determined values for mean fiber shortening velocity and mean systolic ejection rate correlated (r = 0.90, P less than 0.001 and r =0.98, P less than 0.001, respectively) with values for these indexes obtained from left cineventriculography. Left ventricular ejection fraction correlated with mean fiber shortening velocity and systolic ejection rate (r = 0.60, P less than 0.001 and r = 0.92, P less 0.001, respectively). No patient with a normal mean fiber shortening velocity or systolic ejection rate had a dimished ejection fraction. Because these radionuclide measurements do not require left heart catheterization, they can be frequently repeated.


Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity.

Twenty-seven patients with hypertension were randomly allocated to a 10 month crossover study. Treatment consisted of spironolactone (200 mg/day for 2 months), propranolol (320 mg/day for 2 months) and combined administration of both drugs at half the dosage. Between treatment periods placebo was given for 2 months. Fourteen patients were previously untreated. The average pretreatment blood pressure for the entire group was 188/114 +/- 16/7(mean +/- standard deviation) mm Hg supine and 188/118 +/- 20/9 mm Hg standing. Both spironolactone and propranolol reduced blood pressure significantly in both the supine and standing positions. Upright plasma renin activity was determined by radioimmunoassay of angiotensin I. The average initial level was 1.9 +/- 1.2 (range 0.4 to 5.0) ng/ml/hr. There was a close correlation between plasma renin activity and the effects of the drugs: With increasing renin level the response to propranolol was better whereas the opposite was true for spironolactone. The combination of spironolactone and propranolol decreased the blood pressure still further in the supine and standing positions, irrespective of initial plasma renin activity. All patients achieved a normal supine pressure. Blood pressure and plasma renin activity returned toward pretreatment values during placebo administration. It is concluded that pretreatment levels of plasma renin activity can predict the antihypertensive response to propranolol and spironolactone. The combination of the two drugs, which have different modes of action, will effectively reduce blood pressure in hypertension. The results support the concept that the renin-angiotensin-aldo-sterone system may be involved in primary hypertension.


Mitochorial form in hepatic parenchymal cells in rats of several ages.

Slices of livers from neonatal, 7-day-old and adult rats were fixed in osmium tetroxide or a formaldehyde-osmium tetroxide sequence and processed for electron microscopy. Mitochondria from neonatal hepatic parenchymal cells are pleomorphic. Disc-shaped forms are common. In 7-day-old animals, cylinders are the most numerous single form, discs are present but smaller, and spherical forms increase in number. In the adult, mitochondria are predominantly cylindrical in form. The average volume of neonatal mitochondria is greater than that of 7-day-old or adult mitochondria.


The use of imprint technic for rapid diagnosis in postmortem examinations. A diagnostically rewarding procedure.

An imprint method used as a means to provide rapid diagnosis at the time of postmortem examination is described. Although this method is not new, it has hitherto received relatively little attention in this country. The method is simple and as reliable as the frozen-section method, yet less time-consuming. Experience has shown that this technic can be employed in the diagnosis of cancer as well as nonneoplastic diseases. It is the intent of this communication to emphasize the usefulness of the technic and its wide application in postmoretn material. Smears so prepared can be readily interpreted by the general pathologist.


Semiquantitative determination of soluble fibrin monomer complexes by chromatography and serial-dilution protamine sulfate test.

Plasmas were prepared from blood obtained from rabbits and from healthy individuals and patients with thrombotic disorders. Gel filtration (Sepharose-4B) chromatography and the serial-dilution protamine sulfate (SDPS) test were performed on each sample. For healthy individuals and rabbits, a narrow fibrinogen peak was obtained on chromatogram and was associted with a negative SDPS test. After administration of thrombin or endotoxin to rabbits and in plasmas from patients with intravascular coagulation, major shifts to earlier effluent volumes occurred. These higher-molecular-weight derivatives corresponded to soluble fibrin monomer complexes (FM). Positive SDPS tests were found in these plasmas. There was a highly significant correlation between percentage area occupied by FM on chromatogram and SDPS test titer. It is concluded that the SDPS test is a reliable semiquantitative measure of FM that can be used clinically as well as in experimental animal models.


Hexachlorophene lesions in newborn infants.

Vacuolization of the white matter of the brain is produced by a number of disease entities and chemicals, including hexachlorophene. Brains of 135 stillborn infants and infants dying in the neonatal period were examined for vacuole formation in the white matter to determine if any hexachlorophene-like lesions could be found. A nonsignificant excess of vaculoes was found in infants bathed in hexachlorophene at birth compared with infants not bathed in it. Analysis of 11 brains for hexachlorophene showed that detectable levels were present in five, all of which showed vacuolization. None was detected in the remaining six, three of which also showed vacuolization. In two of these there was no hexachlorophene exposure.


Streptococcal control in grade schools.

Streptococcal infection has been reduced by some school-centered programs. This controlled study evaluates the relative effectiveness and cost of four different school programs: (1) Each day, throat specimens from children with sore throats were cultured. (2) Each week, all children were inspected and specimens from those with signs of pharyngitis were cultured. (3) Specimens from all students were cultured once each month. (4) Same as protocol 3, but students with positive cultures were excluded from school until they began receiving therapy. Schools using protocols 1 and 4 had substantial reduction in streptococcal prevalence. The monthly "all-student program" was most economical in terms of volunteer time, classroom interruption time, and money. The school culturing program may have contributed to a significant decline of rheumatic fever in the county during the study.


Esophageal perforation in the neonate. A review of the literature.

The clinical and roentgenographic findings in traumatic esophageal perforation in the newborn are specific enough to enable a diagnosis to be made rapidly. A case of this entity is discussed and the literature on this subject is reviewed. This case demonstrates that the diagnosis can be strongly suspected from the findings on the chest roentgenogram and confirmed by performing an esophagram.


The epidemiology and natural history of streptococcal pyoderma: an endemic disease of the rural southern United States.

In order to study the natural history of endemic pyoderma, the host and environmental risk factors to infection, the immunologic response and the risk of acute glomerulonephritis (AGN) a prospective study was done between June 29 and December 13, 1970 in 444 black children aged 2-6 years attending project Headstart centers in Holmes County, Mississippi. The weekly prevalence of pyoderma was about 40-50% during July and August but decreased to 4% during the last week of the study. "Pyoderma-type" serotypes of group A streptococci were isolated from about 70% of the skin lesions and similar serotypes were also commonly isolated from the pharynx. The seasonal prevalence and T and M typing pattern of most of the pharyngeal isolates mirrored the skin isolates. Many of the streptococci appear to belong to previously unrecognized M-types and one strain has been designated provisional M type 67 by the International Subcommittee on Pneumococci and Streptococci. Staphylococci were also isolated commonly from the skin lesions, especially late in their evolution. Despite an 80% incidence of streptococcal pyoderma during the summer months, only 3 children (0.67%) developed AGN; all of these children had clinically mild disease. The risk of a major outbreak of AGN in populations like these is substantial. Surveillance for clusters of AGN is indicated and widespread benzathine penicillin prophylaxis should be used in the event of an outbreak. Also, further research to determine the long term prognosis of clinically mild AGN and to detect useful laboratory markers of nephritogenicity are indicated.


An epidemic of gastroenteritis traced to a contaminated public water supply.

Between January 1 and March 15, 1974, approximately 1200 cases of acute gastrointestinal illness occurred in Richmond Heights, Florida, a residential community of 6500 in south Dade County. Over one-third of all families in the area had at least one member affected. The findings of 10 culture-proven cases of shigellosis among those who became ill and clinical signs and symptoms in the others suggest that most of the other cases that were not cultured may have been shigellosis also. Epidemiologic investigation showed that consumption of tap water was associated with illness in the initial cases of affected families. Evaluation of the Richmond Heights public water supply disclosed numerous inadequacies in both design and operation. One of the wells providing water to the community was continuously contaminated with excessive levels of fecal coliforms from a nearby septic tank, and a breakdown in chlorination on January 14-15 caused approximately 1 million gallons of inadequately chlorinated water from the contaminated well to be distributed to the community 48 hours before the epidemic began. Correction of deficiencies in the water plant was undertaken by the utility company; the residents of Richmond Heights were instructed to boil their drinking water or to use commercially bottled water pending completion of corrective measures. A FUll scale study is planned for all similar public water supplies in Dade County.


American hospital pharmacy: a bicentennial perspective.

The history of American hospital pharmacy is reviewed. The development of hospital and health care, the evolution of medical and pharmaceutical sciences, and the growth of pharmacy as a profession are described as prologue to the development of hospital pharmacy. The early development of hospital pharmacy in the 1920s and 1930s, the contributions of Edward Spease and Harvey A. K. Whitney, and the necessity of hospital pharmacy services are discussed. The clinical pharmacy movement is reviewed in terms of its potential for changing the nature of pharmacy practice.


Clinical use of digitalis glycosides.

The pharmacology of digitalis compounds is reviewed, and the clinical use of the cardiac glycosides is discussed with particular attention to the selection of patients for digitalis therapy and to a study of the usefulness of various methods to monitor digitalis therapy. The discussion includes pharmacokinetics, clinical considerations, and digitalis toxicity and its treatment. It is concluded that the digitalis glycosides remain the most useful and reliable drugs for producing a long-term increase in myocardial contractility. However, in view of the high frequency of toxicity, it is important to consider the possibility that these drugs may have been overused.


Use of androgens in chronic renal failure patients on maintenance hemodialysis.

The etiology of anemia associated with chronic renal failure, and the advantages and disadvantages of its treatment with androgenic agents, are reviewed. Clinical trials with the following types of androgenic agents are reviewed: 17-alpha-alkylated androgens, testosterone esters, and 19-nortestosterone derivatives. The studies indicate that androgens stimulate erythropoiesis in chronic renal failure patients. However, because of the risk of serious adverse effects, the use of these agents should probably be restricted to those patients who have or may become symptomatic.


Chemotherapy of tuberculosis.

Drug treatment of tuberculosis is reviewed. Factors influencing the choice of antituberculosis agents and antituberculosis regimens are discussed. The advantages of two regimens are emphasized--isoniazid and ethambutol, and isoniazid and rifampin. Short-term and intermittent therapy, and retreatment of previous infections, are discussed. The toxicity of isoniazid, ethambutol, rifampin and streptomycin is summarized. Other topics are the use of second-line drugs (aminosalicylic acid, pyrazinamide, cycloserine and ethionamide), hospitalization of tuberculosis patients, chemoprophylaxis, follow-up of patients with isoniazid prophylaxis, and the use of corticosteroids.


Acute infectious arthritis. A review of patients with nongonococcal joint infections (with emphasis on therapy and prognosis).

The clinical course of 59 patients with acute nongonococcal septic arthritis has been reviewed with special emphasis on the changing bacterial spectrum in recent years. The results of treatment were dependent on various factors, including the specific microbial agent and host defenses. Treatment should include parenteral antibiotics and drainage with needle aspiration, except in hips which should be surgically drained. Successful therapy requires rapid initiation of treatment and ongoing assessment of adequacy of response.


Successful renal transplantation in Wegener's granulomatosis.

Two patients with Wegener's granulomatosis, who were in complete remission secondary to cyclophosphamide therapy but who had end-stage renal failure, were treated with renal transplantation. Neither patient has clinical evidence of recurrent glomerulonephritis 10 and 28 months after receiving the renal transplants. Cytotoxic therapy has been proved to be highly effective in inducing and maintaining remission in patients with Wegener's granulomatosis; thus increasingly larger numbers of patients will be seen who, despite being maintained in complete remission, will have markedly impaired renal function due to previous acute damage. Renal transplantation can now be considered an acceptable alternative form of therapy in such patients.


Less frequently reported gram-negative fermentative rods.

The clinical significance and distinguishing characteristics of less frequently reported gram-negative fermentative rods (Pasteurella, Yersinia, Vibrio, Aeromonas and Plesiomonas, Enterobacter agglomerans, and Chromobacterium) are described. Increased awareness of these organisms, a knowledge of possible sites in which they cause infection, and identification criteria which will separate them from similar bacteria will prepare the clinical microbiologist for the isolation and identification of these "unusual" organisms.


Plasma levels of norepinephrine (NE) during the periovulatory period and after LH-RH stimulation in women.

In three normally cycling women studied daily from day 10 to 17 of the menstrual cycle, the levels of circulating norepinephrine showed a sharp rise preceding or concomitantly with the ovulatory LH surge. In two patients the norepinephrine peak took place 24 hr. previously to the LH rise and in the third one it occurred simultaneously. The simultaneous determination of ovarian hormones and norepinephrine showed no temporal correlation between this catecholamine and either estradiol or progesterone. On the other hand, after a single intravenous 100 mug dose of LH-RH, a significant rise in plasma norepinephrine, preceding the LH peak, was found in the four patients studied. The determination of norepinephrine at 3 minute intervals beginning one minute after LH-RH injection showed a significant rise in the amine levels ranging from 5 to 10 times in respect to basal values between 1 and 6 minutes after LH-RH stimulation. In these patients a second peak of norepinephrine occurred simultaneously with the maximal response of LH, which rose to peak levels after 18 minutes in one patient and after 24 minutes in the other. These findings are discussed with respect to the origin and role of increased amounts of plasma norepinephrine related to the LH surge.


The influence of aspirin on the course of induced midtrimester abortion.

Prostaglandins appear to mediate the uterine contractions of abortion and labor, and aspirin has been shown to be an inhibitor of prostaglandin synthesis. In this double-blind, placebo-controlled, prospective, and randomized study, aspirin was administered orally in doses of 600 mg. every 6 hours to patients undergoing induced midtrimester abortions with hyperosmolar urea and oxytocin augmentation. The mean injection-abortion interval was significantly prolonged by aspirin in nulliparous patients (aspirin 32.3 +/- 3.3 hr. vs. placebo 21.5 +/- 3.5 hr.) and no aspirin-treated nullipara aborted in less than 18 hours. There was no significant difference between treatment groups in the mean injection-abortion interval in the multiparous patients at the dose of aspirin used. The effectiveness of aspirin in the prolongation of the injection-abortion interval has potential therapeutic implications for the treatment of premature labor.


Antibiotic treatment of parturient women colonized with group B streptococci.

A prospective study was conducted among third-trimester parturient women with cervical or urethral colonization with group B streptococci to determine the influence of antibiotic treatment on subsequent colonizations among their infants. Cultures were obtained from dry swabs inoculated directly onto selective blood agar media containing neomycin and naladixic acid. Seventy-four women were found to be colonized among 1,098 cultured (7%). A significant reduction in colonization was noted among mothers treated with ampicillin within three weeks of completion of therapy. This difference was no longer apparent at delivery. There was likewise no difference in the colonization rate of infants in the treatment and no-treatment groups. The data suggest that additional measures must be undertaken to prevent maternal recolonization.


Tobramycin in chronic recurrent urinary tract infections.

A total of 32 adult patients of both sexes with chronic recurring urinary tract infections were treated with tobramycin in a daily dose of 1.2 mg/kg of body weight. They were randomly allocated to receive the drug at 8 or 12 hour intervals by intramuscular injection. The overall immediate disappearance of bacteriuria after therapy was 78.1 per cent; 15 days later, the cure rate dropped to 60 per cent. There was no difference between the two schedules tested. Tolerance to tobramycin was excellent. No reaction was recorded at the injection site; audiometry (performed in nine patients) and laboratory tests done prior to and after therapy did not reveal any hematologic, hepatic and/or renal toxicity, with one exception. In a patient with chronic renal failure (a patient with a solitary kidney infected with a pseudomonas sp.) there was a consistent elevation of blood urea in two separate courses of tobramycin, returning to normal within two weeks after stopping the therapy.


Case report. Failure of metronidazole in amebic liver abscess.

A 51-year-old man was treated with open surgical drainage and metronidazole for an amebic liver abscess. During therapy and while the original abscess was resolving, a second, noncontiguous amebic liver abscess developed. This second abscess eventually responded to emetine, chloroquine, and diodohydroxyquin therapy without surgical drainage. This unique case serves to document that new abscess may develop in the course of metronidazole therapy and illustrates the value of serial hepatoscanning in such patients.


Changing indications for keratoplasty.

We conducted a clinical and pathologic review of 1,057 recipient corneal buttons on file at the Wilmer Institute, to assess the incidence of corneal conditions treated with keratoplasty, and how these have changed (1941-1973). Regrafting was the most frequent indication for keratoplasty in the last ten years in this series. Some corneal diseases, such as inflammatory conditions, decreased in relative importance as an indication for keratoplasty, while others such as aphakic bullous keratopathy (including vitreous touch) and Fuchs' endothelial dystrophy increased.


Aminocaproic acid in the treatment of traumatic hyphema.

Of 59 patients with traumatic hyphema studied prospectively, 32 received aminocaproic acid, an antifibrinolytic agent, to prevent secondary hemorrhage. The remaining 27 patients received placebo in an identical manner. Of the aminocaproic acid-treated patients, only one (3%) rebled, while nine patients (33%) receiving placebo suffered secondary hemorrhage. The results of this study indicate a statistically significant reduction (P less than .01) in the incidence of rebleeding in patients treated with this drug.


Direct bonding: a clinical study using an ultraviolet-sensitive adhesive system.

One hundred twenty-four metal and seventy-three plastic brackets were bonded with an ultraviolet-sensitive adhesive system to all available teeth width the exception of maxillary first molars, which were banded, of ten orthodontic patients. Following approximately 7 months of orthodontic treatment, the relative adhesion of metal and plastic brackets in maxillary and mandibular arches and on anterior and posterior teeth was clinically and statistically evaluated. Metal brackets bonded in both maxillary and mandibular arches maintained a 95 per cent success rate, while plastic brackets bonded in the maxillary arch exhibited an 89 per cent success rate during the 7-month treatment period. The direct bonding system and brackets utilized in this clinical study can be confidently used in conjunction with banded orthodontic appliances to obtain the maximum in benefits from both banding and direct bonding. It is recommended that bands be placed on maxillary and mandibular molars and on any other teeth located posteriorly in the dental arch where isolation during bonding may be difficult. Plastic brackets should be confined to maxillary anterior teeth to minimize wing breakage. Torque requirements with plastic brackets may be effected with torquing auxilliaries off round arch wires.


The cytochemical demonstration of intracellular immunoglobulin. In neoplasms of lymphoreticular tissue.

An immunoglobulin-enzyme bridge technique has been employed for the selective localization of immunoglobulin-producing cells in spleen, lymph nodes, and lymphoreticular tumors fixed highly for optimal immunocytochemistry or processed routinely for surgical diagnosis. Immunostaining for immunoglobulin was encountered consistently in the specially fixed tissues and was observed in some of the surgical specimens in areas where presumably fixation was satisfactory. Many, but not all, of the tumor cells in histocytic lymphoma (reticulum cell sarcoma) of spleen and of brain stained for IgG, but none evidenced reactivity for IgM or IgA. In Hodgkin's tumors, the prevalence of IgG-reactive stromal immunocytes in or between tumor areas was greatest in the nodular sclerosing form of the disease, abundant in mixed cellular, and least in lymphocyte-predominant and lymphocyte-depleted types. Immunocytes showing reactivity for IgG greatly exceeded those staining for IgM or IgA. Hodgkin's tumor cells immunostained frequently for IgG, infrequently for IgM, not at all for IgA, and in one instance, stained for k but not for lambda light chains. Individual tumor cells failed to stain for more than one type of Ig or light chain. The proportion of Ig reactive vs. unstained tumor cells correlated with the prevalence of immunocytes in the different Hodgkin's categories. Reed-Sternberg cells differed in their fine structure in ways which possibly correspond with the presence or absence of Ig shown at the light microscope level. Tumor cells in Hodgkin's disease and reticulum cell sarcoma also disclosed argyrophilia and strong staining indicative of ribonucleic acid with a Schiff-methylene blue procedure.


Histological analysis of undecalcified thin sections of archeological bone.

Archeological bone often lends itself to histological analysis. Sections from bone samples approximately one thousand years old may show as much structural preservation as those only a few hundred years old; hence, it appears that the degree of preservation is not necessarily affected by time. Enough structure may be preserved to permit the diagnosis of metabolic disorders of bone which might go undetected by other methods. This type of analysis can be utilized to accept or reject individual remains suspected of being pathological on the basis of other less precise diagnostic techniques.


The law and the expanding nursing role.

Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities.


External peer review of skilled nursing care in Minnesota.

External peer review of each of the 8917 Medicaid patients in 228 Skilled Nursing Facilities in Minnesota demonstrated characteristics and needs of patients and produced documented recommendations for Medical Evaluation Studies to strengthen multiple aspects of treatment programs. As a whole, Medicaid patients were well placed and well cared for. However, wide variations were observed in individual facilities. Principal problem areas were those which prevail in all long term care facilities in this country: weakness of individualized treatment, weakness of restorative goal-oriented treatment, severe mental/emotional/behavioral disabilities, lack of strong leadership in medical and nursing professions, and weakness of psychosocial support programs.


Transfusion malaria as a consequence of the 1974 war between Turkey and Greece--two cases.

Two cases of transfusion induced Plasmodium malariae malaria that occurred in August and September 1974 in New York City were direct results of the outbreak of war between Turkey and Greece on the island of Cyprus in July 1974. The cases could be traced to two Greek immigrants with latent infection (one being the longest ever recorded) who independently donated blood after solicitation for people in need living in the country of their ancestors. In view of current rules for donor acceptability, attention should be directed domestically towards careful surveillance for an increased occurrence of transfusion malaria.


Chloroquine sensitivity of Plasmodium falciparum in Ethiopia. II. Results of an in vitro test.

Field trials were performed in two areas of Ethiopia with the Rieckmann in vitro test for chloroquine sensitivity of Plasmodium falciparum. Blood cultures from 82 test subjects showed growth of trophozoites to the schizont stage in control vials. Growth in test vials occurred in 21 cultures incubated with chloroquine at concentrations of 0.5 nanomoles or more per ml of blood. In vitro results confirm previous results obtained with an in vivo test.


Febrile illnesses resulting in hospital admission: a bacteriological and serological study in Jakarta, Indonesia.

A study of 741 Indonesian patients with fever was carried out in order to determine what serious febrile illnesses are prevalent in Jakarta. All patients were hospitalized primarily because of fever and were studied by bacteriological and serological methods. Bacteremia due to Salmonella typhi (150 cases), S. enteritidis (36 cases), or both (2 cases) was common in both children and adults. One S. enteritidis isolate was chloramphenicol resistant. Serological evidence of Salmonella infection was found in 130 additional cases without bacteremia. Serological evidence of arbovirus infection (94 cases) was common in children. Malaria was found in 12 adults, most of whom were probably infected outside Jakarta. Little serological evidence was found for rickettsial, leptospiral, Brucella, Toxoplasma gondii or a number of other infections. Clinical signs and symptoms in the febrile patients studed were generally nonspecific, and laboratory results reported were very helpful in establishing more accurate diagnoses.