Physical processes of tableting.

Shear deformation was shown to occur during the decompression of large compacts made by nonisostatic compression. Some materials undergo fracture when these shear stresses are developed. Other materials withstand these stresses but fracture upon ejection when the stress concentrations at the edge of the die are large. Failure to fracture seems to be related to the ability to relieve stresses by plastic deformation. A test was devised to measure this property, called the brittle fracture propensity.


Synthesis and PMR and mass spectra of potential metabolites and other derivatives of bis(2-ethylhexyl) phthalate.

The 3- and 4-hydroxylated derivatives of the plasticizer bis(2-ethylhexyl) phthalate and the monoesters derived from these hydroxylated derivatives were synthesized. The structures of the two 4-hydroxy monoesters were confirmed by lithium borohydride reduction to their corresponding hydroxymethylbenzoic acids, followed by cyclization of the reduced compounds to known phthalides. All compounds were characterized by PMR and mass spectra. The PMR data reiterate the difficulty in predicting chemical shifts in multisubstituted benzene rings.


Dissolution profile for multisized drug particles: new approximate expression.

New approximate expressions for the weight fraction undissolved were obtained using the Taylor series expansion. These approximations were tested using simulated data for multisized drug particle populations. The resulting calculations show that: (a) the approximations are not dependent on a knowledge of the analytical form of the particle-size density function, (b) the distribution effects are accounted for, but only a knowledge of the sample mean and standard deviation is required, and (c) the approximations (especially on a weight basis) lead to values within the limits of error in dissolution studies, thus posing the question of whether published exact experessions have practical value.


Thermal decomposition of 1,3-dimethyl derivative of phenobarbital in trimethylanilinium hydroxide.

Extensive degradation of the 1,3-dimethyl derivative of phenobarbital occurs when it is injected with trimethylanilinium hydroxide in methanol into a gas chromatograph. The application of mass spectrometry demonstrated that the major products are N-methyl-2-phenylbutyramide, N,N-dimethyl-2-phenylbutyramide, methyl 2-phenylbutyrate, N,N,N'-trimethylethylphenylmalondiamide, and N,N,N',N'-tetramethylethylphenylmalondiamide. The methyl group of the ester arises from the methanol solvent, whereas the methyl groups of the substituted amides arise from the parent compound or the methylating reagent. Tetramethylammonium hydroxide causes much more degradation than trimethylanilinium hydroxide under comparable conditions.


Use of pharmacological data for bioavailability and pharmacokinetic analyses.

The use of pharmacological responses such as pupil diameter for dosage individualization, bioavailability, and pharmacokinetic analyses is becoming more widespread. Attempts to use pupil diameter to assess morphine bioavailability illuminate the fact that multiple responses, nonlinearities, and the condition of the subject can produce misleading results unless the applicability of the method is confirmed.


Cytotoxic and tumor inhibitory agent from Polygala macradenia Gray (Polygalaceae): 4'-demethyldeoxypodophyllotoxin.

The chloroform fraction of Polygala macradenia exhibited activity against the P-388 lymphocytic leukemia and human epidermoid carcinoma of the nasopharynx test systems. The constituent responsible for this activity was a lignan, 4'-demethyldeoxypodophyllotoxin (C21H20O7). The identity was proven by elemental analysis; PMR, IR, mass spectrometric, and melting-point determinations; and preparation of a derivative.


Alkaloids of Glaucium oxylobum Boiss and Buhse, Population Ab-Ali.

Glaucium oxylobum Boiss and Buhse, population Ab-Ali,  was demonstrated to contain one major alkaloid, glaucine (0.7%), and two minor alkaloids, O-methylatheroline and predicentrine, in the aerial parts. The root also contains protopine. Glaucine and O-methylatheroline were detected for the first time in this species, and predicentrine was detected for the first time in the Glaucium genus.


Synthesis of 5,6-benzo-2-azabicyclo[2.2.2]octane derivatives as potential benzomorphan-type analgesic agents.

The synthesis of two N-substituted 5,6-benzo-2-azabicyclo[2.2.2]octane analogs of benzomorphan-type analgesics via benzyne addition to appropriate N-substituted N-alkyl-2-pyridones is described. Neither derivative possessed observable analgesic activity at the doses tested.


Micromethod for determination of meperidine in plasma.

A GLC method utilizing a flame-ionization detector is described for the analysis of meperidine in blood plasma. Meperidine is extracted with ether from plasma that has been made basic with sodium hydroxide. The ether extract is evaporated to dryness, and the residue is dissolved in carbon disulfide for GLC analysis. An internal standard, N',N'-diethylaminoacetyl-2,6-xylidine, is used to quantitate meperidine. The extraction efficiency from plasma is 85%, and as little as 0.05 microng of meperidine can be quantitatively determined in 1 ml of plasma.


A physiological and behavioural study in cats of the effect of early visual experience with contours of a single orientation.

1. Three kittens were reared in visual environments that consisted of stripes at one of three orientations - horizontal, right oblique, or left oblique. Two additional cats were reared as controls. One of these matured viewing right and left oblique stripes on alternate days. The other experienced a normal visual environment. 2. Following the completion of rearing, and after several weeks of normal visual experience, behavioural testing of the stripe-reared animals demonstrated a deficit in visual acuity for orientations which were not present in the early visual environment. No comparable deficit emerged for either of the control cats. 3. Following 1-3 years of further, normal, visual experience, each of the cats was shipped separately to California where single units were recorded from area 17 of the visual cortex and an effort made to guess the early visual history of each animal which was unknown to the experimenters. Cell samples from each experimental cat and the normal control cat allowed the physiologist to guess their early visual experience correctly. The control cat which matured viewing orthogonal sets of oblique stripes on alternate days demonstrated a bias for horizontal contours in his cell sample. In contrast to units recorded from normal cats, about 80% of which are binocular, only about 30% of the cells recorded from the stripe-reared animals could be influenced by both eyes.


Responses of isolated Golgi tendon organs of the cat.

1. The responses to stretch have been studied in living, isolated Golgi tendon organs (GTOs) from tail muscles of cat. Experiments were performed in vitro and consisted of subjecting single GTOs to controlled ramp-and-hold stretch while recording the response from their sensory axons raised in oil. 2. The threshold force required for sustained afferent discharge was measured directly, and found to be between 8 and 170 dynes at 24 degrees C for nine GTOs tested. Beyond threshold, the discharge frequency is approximately proportional to applied static tension over a wide range. Sensitivy to tension varies among different GTOs and appears to be inversely correlated with mechanical stiffness. 3. With impulse activity blocked by tetrodotoxin, graded receptor potentials could be recorded whose amplitude varied in proportion to applied static tension. All GTOs examined showed in addition a dynamic response, which became larger with increasing velocity of ramp stretch. This dynamic sensitivity appears in the receptor potential and is then augmentd by an apparent accommodative process at the impulse initiating site. 4. Based on the above findings, possible mechanical models are discussed for the sensory transduction mechanism.


Response of Aplysia statocyst receptor cells to physiologic stimulation.

1. The electrical responses of Aplysia statocyst receptor cells were investigated using intracellular micro-electrodes. These ciliated mechanoreceptor cells were stimulated by downward tilting about a horizontal axis. 2. Tilting so that the receptor cell was excited produced a depolarizing receptor potential which, if large enough, could generate action potentials. 3. Large fluctuations in membrane potential were evident during depolarizing receptor potentials and were reduced or sometimes absent when a cell was tilted upward. Power-density spectra of the noise voltage revealed that most of the energy added by downward tilt is contained in frequency components below 3 Hz. 4. Removing synaptic input to the receptor cells by cutting the statocyst nerve or adding excess Mg2+ to the bath did not abolish the increase in fluctuations caused by downward, excitatory tilts. 5. The depolarizing receptor potential was often associated with a decrease in membrane resistance as measured with constant current pulses using a bridge circuit. 6. Replacing most of the Na+ in the bath with either Tris or Mg2+ abolished both potential and resistance changes caused by downward tilt. These results indicate that an increased permeability to Na+ underlies the receptor potential.


Comparison of vagal and meat stimulation on gastric acid secretion and serum gastrin.

The gastric acid secreted per unit of serum gastrin concentration or per unit of gastrin delivered to the gastric mucosa was significantly greater during electrical vagal stimulation than during stimulation by meat extract in the pyloric antrum. There was no significant difference in the concentrations of big, big gastrin or Components I and II in gastric venous serum during the two forms of stimulation. There were significantly greater concentrations of Components II and IV in gastric venous serum during meat extract stimulation than during vagal stimulation. The gastrin in gastric venous serum when meat extract was in the pyloric antrum was comprised of Component IV in addition to Component III whereas gastrin in extracts of cat antral mucosa was predominantly Component III. Gastric acid secretion in response to vagal stimulation was greater than can be accounted for by the action of gastrin alone and cannot be explained by differences in the known gastrin variants in the circulation during the two forms of stimulation.


Correlative physiological and morphological studies of rapidly adapting mechanoreceptors in cat's glabrous skin.

1. A total of fifty-four mechanoreceptor afferent units with fast conducting axons in the tibial nerve innervating the glabrous skin of the hind leg were isolated in anaesthetized cats. 2. Twenty-six rapidly adapting units (RA), eighteen slowly adapting units (SA) and ten Pacinian corpuscle units (PC) were differentiated from each other mainly on the presence of the off response in RA and PC units to a ramp stimulation, the persistence of discharges of the SA units during steady pressure on the receptive field and the classical tuning curve seen in the PC units. A few PC units in the hairy skin were also studied for comparison. 3. Lamellated corpuscles were found histologically in the skin of the receptive field of RA units and identified as Krause's corpuscle of cylindrical type by their superficial location in the cutaneous tissue and their structure revealed by electron microscopy. 4. Physiological characteristics of RA units to various forms of mechanical stimulation were studied and compared with those of the other two kinds of units. SA units had the lowest critical slope among three groups and PC units the highest. 5. The discharge pattern of RA and PC units to a ramp stimulation was found to be time-locked, whereas with SA unites only the first spike appeared at a fixed latency from the start of stimulation. 6. Some RA units showed a tuning curve which was flat from 10 to 200 Hz. Those with narrowly tuned curves had a best turning frequency at around 20 Hz. They were easily differentiated from the SA and PC units. SA units were tuned best at 5 HZ or less, and PC units at around 200 HZ. 7. The relation between the indentation velocity and amplitude of the ramp and the spike discharges was analysed in eleven RA units. In most cases the relation between identation velocity and maximum instataneous frequency was found to be best fit with a power function although other kinds of functions (linear, logarithmic, and logarithmic hyperbolic tangent) could also fit the relation at the 1% significance level. The instantaneous impuse frequency in RA units in response to various indentation amplitudes showed a step function. 8. The "off" responses to a ramp stimulation in RA units were also analysed in detail.


The influence of the autonomic nervous system in the control of erythropoietin secretion in the hypoxic rat.

1. Erythropoietin has been measured in the serum of hypoxic rats that have been exposed to 6 hr of hypoxia, by use of a biological assay. 2. The effects of section of splanchnic, renal and sinus nerves on the concentration of Erythropoietin present in the serum ofthe hypoxic animals has been investigated. 3. Serum levels of Erythropoietin were reduced in the hypoxic animals immediately after cutting the splanchnic nerves, but unaltered one week after the operation. 4. The concentration of Erythropoietin in the serum of hypoxic rats was increased by the secretion of the renal nerves. Section of the sinus nerves abolished the effect. 5. Elevated levels of Erythropoietin were present in the sera of hypoxic rats immediately after section of the sinus nerves. The effect was still obtained when the animals were exposed to hypoxia 1 week after cutting the nerves, though in attenuated form. 6. The rise in the concentration of the hormone after chronic section of the sinus nerves was estimated as as 261% (fiducial limits 167-513, P = 0-05), by parallel line bio-assay. 7. The concentration of Erythropoietin in the serum of hypoxic rats was progressively elevated as the arterial PO2 of the animals was reduced. Section of the sinus nerves did not alter the secretion of Erythropoietin in these experiments.


[Ochronotic hip disease. Radiological and scintigraphic study (author's transl)].

A radiological and scintigraphic study of hte femoral head removed from a patient at the time of insertion of a total prosthesis of the hip in a patient with ochronotic rheumatic disease. The images obtained differ from those seen in aseptic osteonecrosis and confirm the hypotheses of Lagier, who has described several forms of arthrotic remodelling in ochronotic hip disease.


[Bone maturation in asphyxiating thoracic dysplasia and diastrophic dwarfism in the neonatal period (author's transl)].

The authors draw attention on the importance of the multicentric technique in the evaluation of bone maturation of asphyxiating thoracic dysplasia and diastrophic dwarfism in the neonatal period. They show the diagnostic and prognostic value of early appearance of the hip and wrist epiphyses.


[Lumbar epidural veins. Normal radioanatomy (author's transl)].

Epidural venous system of the human corps are injected by a fortacryl-minium mixture then dissected with detail. These study confirms existence of two longitudinal venous plexus: one anterior and internal, one another anterior and external. There is no posterior longitudinal venous plexus.


[An early neurological complication of lipiodol cisterno-myelography (author's transl)].

The migration of lipiodol injected sub-occipitally (to obtain a lateral cervical myelogram) into the posterior fossa resulted in a unusual immediate neurological complication involving a major vegetative syndrome, facial hemispasm, excruciating pain in the left ear and, finally, epileptic loss of consciousness. The most likely aetiological hypotheses are acute changes provoked in the arachnoid mater by the substance or an arteria embolism.


[A rare cause of spontaneous haemoperitoneum: rupture of an aneurysm due to fibromuscular dysplasis (author's transl)].

The authors report the case of a patient presenting with an acute haemoperitoneum. Angiography after surgery led to a diagnosis of fibro-muscular dysplasia. They stress the rarity of this aetiology in the development of haemoperitoneum, perhaps related to the small number of angiographic studies made after surgery.


[Carcinoma of the left colic angle presenting as an intrasplenic gas collection (author's transl)].

A 65-year-old man was hospitalised for a subocclusive state, fever, 15 kg weight loss and left abdominal pain. The plain abdominal film revealed gas in the left hypochondrium. Barium enema showed a stenosis of the left colic angle. On evacuation, a little barium entered the gas-filled cavity. Left colectomy with splenectomy was carried out. The pathologist found histological evidence of a small carcinoma of the colon invading the hilum of the spleen. An intrasplenic cavity had been formed at the site of contact. Thus an intrasplenic gas collection was the presenting sign of a carcinoma of the colon. Two colosplenic fistulae of similar origin have been reported in the literature; neither associated with similar radiological findings.


[New reinforcing screens using rare earth salts. Value in decreasing the incident dose (author's transl)].

New reinforcing screens using gadolinium oxysulphide make it possible to reduce the dose of X-rays necessary by 2 to 8 times. Loss of definition is appreciable only with the most sensitive combinations and is often compensated for by a decrease in kinetic blurring.


[Renal osteodystrophy in childhood. Comparison of histological and radiological findings (author's transl)].

We have examined radiologically the bones of seven children attained by renal osteodystrophy. A final score was established by syndrom: hyperparathyroidy, osteomalacia. The results are been confronted to the histomorphometrics studies. Numerous historadiological discordances appears: false radiologic findings 2/7, quantitative discordance of the lesions. Several conventional roentgenologic signs must be revalued after the priliminary histologic findings: cortical index, bone texture: osteomalacia, osteoporosis.


[Basal angle of the skull of subjects in the pediatric age (author's transl)].

Many opinions are expressed about the ontogenetical evolution of the basal angle of the skull. The authors present an analytical study with respect to age and sex and find that the basal angle decreases significatively with age, however the difference with the sex is probably not significative.


[The preponderant role of the radiologist in the prevention of recto-colonic carcinoma by the detection of polyps (author's transl)].

The adenomatous polyp is considered to be the precursor of recto-colonic carcinoma. The detection of polyps would appear to be ensured with maximum effectiveness by double contrast barium enema and the authors recommend the routine use of this technique for this purpose. The aim of the radiologist should no longer be merely that of the diagnosis of carcinoma of the colon and rectum, but also its prevention by enabling colonoscopic excision of glandular polyps.


[Is the presence of air in the small intestines pathological (author's transl)].

The authors examined 119 patients coming to the Radiological Department for various reasons excluding all abdominal pathology: road traffic accidents, rheumatological pain, oto-rhino-laryngological or ophthalmological causes. Two observers, working separately but comparing their results, concluded that there was air in the small intestines in 51 % of the patients, and that the presence of air in the small intestines was considerable in 6 % of the patients. The presence of air in the small intestines was noted in 40 % of outpatients and in 70 % of patients in bed.


[Cervical localization of a primary meningeal melanoblastoma].

The authors present a case of primary meningeal melanoblastoma localized in the cervical region, in a 47 year old woman. The intra and extradural, extramedullary tumor presented clinically and radiologically as a neuroma with central calcification. This case thus widens the possible causes of an intraspinal tumoral syndrome with radiological calcification.


[Pseudo-tumoral aspect of a post-traumatic digital synovitis].

A case is described of post-traumatic subacute synovitis of a finger exhibiting pseudo-tumoral appearance and radiographic bony changes. Arteriography showed non-malignant hypervascularisation suggesting a benign synovial tumour. Biopsy established a diagnosis of simple subacute synovitis. The swelling regressed spontaneously over the subsequent months. In the case of simple post-traumatic subacute synovitis differential diagnosis should take into account the possibility of villonodular synovitis which involves histiocyte proliferation.


[Fibrous polyp of the ureter: a report of one case].

Fibrous polyps of the ureter are rarely encountered: only twenty cases have been reported in the literature. They are nothing but pseudo-tumours, for they probably arise through a simple outpouching of the submucosa. The case reported was of a 60-year-old woman presenting with pain of the right iliac fossa associated with gross haematuria. The radiographic appearances were of a 14-cm long polyp, presenting as an intraluminal defect of the right ureter, with smooth edges and separated from the ureteral wall by a thin radio-opaque strip. It was attached by a very small area of insertion. Despite its size, the polyp caused relatively little obstruction. At surgery, the benign nature of this polyp was confirmed, as well as its invariably recurrence-free postoperative course.


[Percutaneous puncture of a hydatid cyst of the kidney].

The authors stress the value of percutaneous puncture in the case of hydatid cyst of the kidney, making possible opaque cystography -- the findings of which are characteristic, and cytological study of the fluid obtained. In addition, they report the safety of this method of investigation.


[Apparatus of contention for knee-arthrography (gaseous or mixed)].

Permits to maintain the articular gape that is necessary on the various angles of rotation of the joint, without the intervention of an assistant, to examine on a remove-operated table with centring on telescopy and eventually for tomo-arthrography.


Artificial insemination.

Artificial insemination with homologous (AIH) and heterologous (AID) samples is discussed. Specific emphasis is placed on the indications and timing of the procedure, the type of specimens available, the technique and the expected results. The legal and emotional ramifications of AID are discussed.


Nonenolizable podophyllotoxin derivatives.

To block epimerization and the resulting biological deactivation podophyllotoxin compounds, the lactone carbonyl group has been changed to methylene. Syntheses of several of these delactonized derivatives are described, all with modifications in the original lactone ring and some without the 4-hydroxyl group. Several biological assays show that most of the nonenolizable derivatives retain activity.


Synthesis of phenolic group containing analogues of porcine secretin and their immunological properties.

Syntheses by the conventional method are described of Nalpha-tyrosylsecretin, [Tyr1]secretin, and Nalpha-beta-(4-hydroxyphenyl)propionylsecretin. Secretin and [Tyr6]secretin were also prepared by the synthetic route identical with those employed for construction of the above analogues. Purification of secretin and the analogues was conducted by ion-exchange column chromatography on CM-Sephadex and gel filtration. Immunological reactivities of these analogues were examined in the radioimmunoassay system for secretin using two different antisera raised against synthetic secretin in rabbits. The tracers used in this study were [125I]-[Tyr1]secretin and [125I]-[Tyr6]secretin. The dose-response curves of Nalpha-tyrosylsecretin, [Tyr1]secretin, and Nalpha-beta-(4-hydroxphenyl)propionylsecretion were essentially superimposable upon those of natural and synthetic preparations of porcine secretin in the systems used, while [Tyr6]secretin showed discrepancy in the curve. In addition, biological activities of the synthetic polypeptides were compared with that of natural porcine secretin in term of exocrine pancreatic secretory response in anesthetized dogs.


Synthesis and anti-herpes simplex activity of analogues of phosphonoacetic acid.

The synthesis of monoesters (P and C) of phosphonoacetic acid (PA) is given. The carboxyl esters were prepared by two methods: the reaction of chloroacetates with tris(trimethylsilyl) phosphite, followed by hydrolysis; and by the acid-catalyzed esterification of PA with the appropriate alcohol. P-Monoesters of PA were prepared either by the reaction of alkyl[bis(trimethylsilyl)] phosphite with benzyl chloroacetate followed by deprotection or by the reaction of dimethylphenyl phosphite with benzyl bromoacetate followed by hydrogenolysis. Three aryl- (alkyl-)phosphinic acid derivatives are reported. The above compounds were evaluated for anti-herpes activity against HSV-induced DNA polymerase and in animals infected with herpes dermatitis.


Analgesic and tranquilizing activity of 5,8-disubstituted 1-tetralone Mannich bases.

5,8-Disubstituted 1-tetralone Mannich bases represent semirigid variants of classical (i.e., chlorpromazine) neuroleptic agents. 8-Chloro-5-methoxy-2-morpholinomethyl-1-tetralone exhibits neuroleptic potency in the thiothixene range in animal models. Of greater potential interest, however, is the analgesic potency of the 8-chloro-5-methoxy-2-pyrrolidinomethyl analogue which was in the morphine range. This compound did not induce tolerance nor was its activity reversed by naloxone. Structure-activity relationships of the series are discussed.


5,6,7,8-Tetrahydroquinolines. 5. Antiulcer and antisecretory activity of 5,6,7,8-tetrahydroquinolinethioureas and related heterocycles.

A series of thioureas derived from 5,6,7,8-tetrahydroquinoline, 1,5-, 1,6-, and 1,8-naphthyridiness, pyrido[2,3-b]azepine, and 7-azaindoline has been prepared and tested for antisecretory activity in the pylorus-ligated rat and protective activity against gastric erosions caused by cold-restraint stress. The thioureas exhibit different structure-activity relationships from the corresponding 5,6,7,8-tetrahydroquinoline-8-thiocarboxamides and these relationships are discussed. The activity of the thioureas is less affected by structural differences than the corresponding thioamides although they probably have the same mode of action.


The assessment of haemodynamic function of diseased and prosthetic heart valves in patients.

The paper deals with reasons why current methods of assessing the resistance to flow offered by heart valves in patients are unsatisfactory. A theoretical and simulation study suggested that a measure of energy or power loss per unit flow was likely to be of more use and subsequent clinical investigations have confirmed this. The computation can be readily carried out in a hard-wired parallel hybrid module for operating theatre or catheter laboratory use.


A method of gait analysis for daily orthopaedic practice.

A method of gait analysis is described which uses two-dimensional cinephotography, two glass platforms for 6-component force measurements of floor reactions and electromyography transmitted by radiotelemetry. It is used regularly on all patients needing lower extremity surgery for neurogenic gait disorders as a basis for planning and control of treatment. The cinephotographic pictures make the records easy to understand, a primary requirement for clinical use.


Tritiated thymidine incorporation into epithelial cells of normal-appearing colorectal mucosa of cancer patients.

A radioautographic analysis of the number and position of labeled epithelial nuclei after in vitro incorporation of tritiated thymidine ([3H]TDR) was carried out with 30 specimens of histologically normal colorectal mucosa from 26 patients, of whom 13 were being treated for rectal or sigmoid cancer and 13 were controls. A higher mean labeling index was found in the cancer than in the control group (9.8% +/- 1.2 and 7.9% +/- 0.9, respectively). Because of wide individual variations, this difference was not statistically significant. However, a highly significant upward shift of the proliferating cell compartment was observed in the cancer group, resulting in a specific modification of the [3H]TDR labeling pattern in 6 of 17 specimens. DNA synthesis predominated in the middle or middle and upper thirds of the crypts of Lieberkühn rather than in the lower third as observed in controls. The patchy alteration of epithelial cell renewal frequently accompanying colorectal cancer was suggestive of a defect in the regulatory control mechanism. This in vitro [3H]TDR incorporation assay could provide a valuable discriminatory parameter in studies of high-risk populations.


Zinc uptake in normal and leukemic lymphocytes: effect of poly-L-ornithine.

Phytohemagglutinin and poly-L-ornithine were tested for their ability to stimulate uptake of transferrin-bound zinc by lymphocytes from both normal donors and donors with chronic lymphocytic leukemia. The ratio of zinc uptake in poly-L-ornithine cultures to zinc uptake in phytohemagglutinin cultures was 0.9 +/- 0.3 for leukemic lymphocytes and 1.9 +/- 0.2 for normal lymphocytes. Results indicated that this technique may be useful in the diagnosis of chronic lymphocytic leukemia as well as in the assessment of the efficacy of chemotherapeutic regimens.


Cyclic Variation of DNA synthesis in human breast epithelium.

DNA synthesis in normal breast epithelium from premenopausal women was assessed by use of autoradiography. In parous women the labeling indexes decreased during the follicular phase of the menstrual cycle and increased to a significantly higher level during the luteal phase.


Nasopharyngeal cancer among young people in the United States: racial variations by cell type.

U. S. mortality and incidence statistics for nasopharyngeal cancer showed a fourfold excess risk of sarcomas in white children under age 10, and a fourfold to sevenfold excess of carcinomas in teen-age blacks. Mortality from nasopharyngeal carcinomas in young people was greater in the South than in the North, with the excess mortality in blacks linked to rural residence and low socioeconomic status. These and other characteristics of nasopharyngeal carcinoma in young persons suggested that environmental (perhaps infectious) agents are involved in this age group. These patterns contrasted with nasopharyngeal carcinomas developing after age 25, when the rates predominated in Chinese Americans. Nasopharyngeal cancer in the United States had three age peaks, with racial and epidemiologic distinctions that seemed to reflect different etiologies.


Regression of established intradermal tumors and lymph node metastases in guinea pigs after systemic transfer of immune lymphoid cells.

Strain-2 male guinea pigs with established intradermal (id) tumors and microscopic regional lymph node metastases were treated by systemic transfer of syngeneic peritoneal exudate (PE) cells from tumor-immune guinea pigs. This treatment produced complete regressions of established id tumor nodules (10-11 mm in diameter) and prevented the growth of lymph node metastases in 32 (80%) of the 40 treated animals. All untreated animals died with progressive id and lymphatic tumor growth. Lymph node tumor metastases that remained after id tumor excision were also suppressed by immune cell transfer. PE cells from guinea pigs immune to an antigenically distinct tumor line (line-1), BCG, or PE cells from nonimmune guinea pigs failed to produce tumor regression or prolongation of survival time. PE cells from allogeneic guinea pigs and from sheep immune to line-10 failed to transfer tumor immunity to strain-2 guinea pigs. The effectiveness of therapy was reduced by increasing the tumor burden or decreasing the number of transferred lymphoid cells. This study demonstrated that systemic transfer of cells from syngeneic immune donors could effectively eliminate tumors as well as early metastases.


Ultrastructure of N-dibutylnitrosamine-induced tumors of the urinary bladder in European hamsters.

European hamsters were treated sc with 0.025 the median lethan dose of N-dibutylnitrosamine. The induced neoplasms of the urinary bladder (transitional cell carcinomas and squamous cell carcinomas) were examined electron microscopically. Their ultrastructure indicated these tumors to be different developmental stages of the same type of tumor rather than two fundamentally different types of neoplasm.


Tumor x host cell hybrids in the mouse: chromosomes from the normal cell parent maintained in malignant hybrid tumors.

We investigated whether the malignancy of hybrids between normal and malignant cells could be correlated with the loss of specific genes borne by specific chromosomes from the normal parent cells. Tumors produced in mice by the inoculation of Cl.1D cells (an L cell derivative) contained tumor x host cell hybrids. Hybrid cell populations isolated from 14 tumors were injected into 123 mice, of which 108 (87%) developed tumors. Metaphases of growing hybrid cell tumors were analyzed by use of a trypsin-Giemsa banding technique. The chromosomes contributed by the host (normal) parent cell could be distinguished from Cl.1D chromosomes, since the latter exhibited morphologic differences due to rearrangements. In the 14 hybrid tumors analyzed, we found that any one of the chromosomes of the host cell might be present, which indicated that none of the chromosomes from the normal cell bore genetic information capable of suppressing the malignancy of Cl.1D cells. Absence of complimentation in the hybrids suggested that, even if the accumulation of several mutations were necessary for malignant tumor growth of Cl.D1 cells, none of these mutations is recessive.


Pigmented hyperplasia of epidermis following feeding of L-dopa to elderly rats.

In view of clinical data supporting a casual relationship between long-term L-dopa administration and recurrence of melanoma, long-term L-dopa administration to aged rats was performed to investigate its effect on the incidence of malignant melanoma. Of the treated animals, 11% showed local pigmented epidermal hyperplasia, compared with 0.5% of the control animals, but the number of expected melanomas was not increased by L-dopa treatment.


Virus-like particles in a case of human prostate carcinoma.

Two morphologically different types of intracisternal virus-like particles were observed electron microscopically in a biopsy specimen of human prostate cancer. Particles of one type were 150-200 nm in diameter and contained either an electron-dense core or two concentric inner layers. Particles of the other type were smaller, 80-100 nm in diameter, and appeared mostly in filamentous or chainlike formation. Both types of particles and budding were observed in endoplasmic cavities of epithelial tumor cells. The particles had ultrastructural characteristics that suggested a viral nature but were different from the known type B, type C, or type H (hamster type R) virus particles. This was the first election microscopic observation in prostate cancer of virus-like particles similar to those previously reported in a case of human breast carcinoma.


Effects of naturally occurring sugars on Ehrlich ascites tumor growth in mice.

The growth of Ehrlich ascites tumor cells in Swiss mice was modified by the addition of certain naturally occurring sugars to the drinking water or by ip inoculation of mice after infection. D-Mannose, D-ribose, and D-glucosamine produced the most striking antitumor effects, increasing significantly the survival rate in mice so treated.


Rationale developed by the Environmental Protection Agency for the assessment of carcinogenic risks.

The intent of the Environmental Protection Agency's "Interim Guideline for Carcinogen Risk Assessment" is to provide an evaluation of the evidence regarding suspect carcinogens that encapsulates judgments on the quality and adequacy of data, the likelihood that the agent is a human carcinogen, and an estimate of the magnitude of the cancer burden that could be ascribed to the agent if no regulatory action were taken. Every effort shoult be made to reduce environmental contamination by carcinogens to the lowest possible level; this view stems from uncertainties about qualitative and quantitative extrapolations from animals to man, the lack of evidence for a dose threshold, the great range of possible interactions among environmental carcinogens and cofactors, and the broad spectrum of human susceptibility. New knowledge in the field of carcinogenesis is developing, and modifications of the Environmental Protection Agency's "Interim Guideline for Carcinogen Risk Assessment" must be made periodically.


Non-typhosa Salmonella species: analysis of 94 isolations.

Despite rigorous control measures by local, state, and federal health agencies, salmonellosis continues to be one of America's most troublesome epidemiological problems. Salmonellosis, a reportable disease, is estimated to infect more than two million persons each year. However, only 10 to 12 percent of cases are actually reported. To study the impact of salmonellosis at Howard University Hospital, the authors made a statistical analysis of non-typhosa Salmonella isolated during a two-year period. The study emphasizes the epidemiological aspects of, and useful isolation and identification techniques for, non-typhosa Salmonella.


Crohn's disease in black patients.

The diagnosis of Crohn's disease in 13 patients (ten females and three males) at the Howard University Hospital during the ten-year period, 1965-1975, is examined. The most common presenting symptoms were right lower quadrant (RLQ) pain, diarrhea, anorexia, weight loss, and vomiting, while the most common physical finding was RLQ tenderness. Ileocolic involvement occurred most frequently. Eight patients had surgical resection. The most frequent operation was ileocolic resection with ileo-ascending colostomy. The chief indications for surgery were: (1) presumed appendicitis, (2) intestinal obstruction, and (3) internal fistulae.Crohn's disease seems to occur in blacks much less frequently than in whites. When compared to series of white patients reported by others, the series studied here has more females and more ileocolic involvement. In most other series, the greatest involvement is in the "ileum only" group.


Cross-racial foster home placement among native American psychiatric patients.

In Minnesota, about 0.5 percent of the general population are raised outside of their biologic homes. However, it has been estimated that 25 to 30 percent of all Indian children under the age of 18 years are currently living outside of their biologic homes. Clinical experience with adolescent and adult Indian psychiatric patients bears this out: about half of them have been raised in foster or adoptive homes.Seventeen American Indian patients who had been raised in non-Indian foster and adoptive homes were interviewed for five to ten hours each. Data were collected from the patients and social agencies regarding demographic characteristics, social coping, and current clinical problems. In addition, information obtained regarding their out-of-family placement included: age at placement, reason for placement, number of subsequent placements, and interracial and intraracial relationships during placement and subsequently during adulthood.This clinical sample shows a low rate of psychosis and neurosis, but a high rate of alcohol-related disorders, suicide attempts, and behavioral problems. While their education is average, their employment and marital status shows marked social disability. Most have had numerous childhood placements over a long period, all in white homes, and none have subsequently returned to their family-of-origin.These unfortunate human beings have been described by both whites and Indians in Minnesota as "apples": racially "red" or Indian on the outside, but culturally white on the inside. White groups do not accept them as whites because they are distinctively racial Indians, but they do not feel at ease in Indian communities since they were raised with white values and attitudes. While some of these people do indeed make successful adjustments in Indian or white society (or both) the results of this study show that many apparently do not.


Empty sella syndrome.

It is the primary purpose of this treatise to outline the essential differences between empty sella syndrome (ESS) and pseudotumor cerebri (PTC). An attempt is made to determine why these syndromes may coexist. A detailed case report is presented which emphasizes the definitive signs and symptoms that are found in patients having both of these syndromes, and differentiation is made between idiopathic and secondary ESS.


Cancer of the pancreas in blacks: a ten-year experience.

A ten-year retrospective study of cancer of the pancreas in black patients at Howard University Hospital is presented. A total of 68 patients was studied. The authors concluded that no form of treatment had significant effect in terms of survival in stages II, III, and IV disease.


Non-drug-related residues in tracer studies.

Factors involved in residue studies with radioactive tracers are discussed. Three types of metabolic management of 14C-labeled compounds are described. Intact incorporation into protein of chick muscle is demonstrated with L-O-ethyl-[14C]threonine. Retention of unchanged and quantitatively recoverable parent compound occurred with [14C]thiabendazole sprayed on oranges. The latter drug fed to animals was retained in tissue partly intact, but mostly metabolized to recognizable detoxification products, and ultimately to endogenous tissue components. The latter type of residue was termed a "nonmetabolite" residue. The extreme case of extensive metabolism to products structurally unrelated to the parent compound was illustrated with [14C]ronidazole administered to turkeys.


A prospective on covalent binding and toxicity.

In this paper are discussed (1) the three general mechanisms by which radioisotopes may be retained in animal tissues long after labeled drugs are administered, (2) ways of differentiating these mechanisms, and (3) possible relationships between the toxic effects of drugs and their metabolism. It is emphasized, however, that studies on the disposition of drugs should be coordinated with toxicity studies in order to make the results of bioavailability and pharmacokinetic studies more meaningful in setting limits for food residues.


Covalent binding of foreign chemicals to tissue macromolecules.

In vivo and in vitro covalent binding of foreign chemicals to tissue macromolecules via metabolic activation is described, using the analgesic acetaminophen as an example. Acetaminophen is metabolized through a variety of pathways. The arylating metabolite is formed by a cytochrome P-450 dependent N-hydroxylation process. The resulting hydroxamic acid is then conjugated with glutathione, and the resulting conjugate is subsequently excreted as the mercapturic acid in the urine. It is not until the glutathione concentration is reduced to about 20% of the initial concentration that covalent binding of acetaminophen to amino acids of proteins occurs and subsequent liver necrosis is seen. The extent of in vitro binding correlates with treatments that alter hepatic necrosis and in vivo binding, indicating that in vitro binding is a valid index of acetaminophen hepatotoxicity. A simple bacterial test system for detecting chemical carcinogens as mutagens is described.


Cambendazole and nondrug macromolecules in tissue residues.

The anthelmintic cambendazole is rapidly metabolized to at least 13 urinary metabolites. Radioactivity was found in liver for weeks after a single dose in cattle, but even at 3 days' withdrawal, cambendazole and metabolites previously identified in urine accounted for only a small fraction of liver radioactivity. The radioactivity was ubiquitously distributed in protein and nucleic acid fractions, and [14C] glutamic acid was identified, indicating incorporation of 14C into the endogenous pool. Part of the residual liver radioactivity at 7 days was convertible chemically to 5-nitrobenzimidazole, indicating a drug-related macromolecular residue. However, data from rats fed radiolabeled steer liver indicate that the residue is minimally bioavailable and therefore of substantially less toxicological concern than cambendazole itself.


Biliary excretion of cadmium in rat. I. Dose-dependent biliary excretion and the form of cadmium in the bile.

Biliary excretion of cadmium was studied in rats after intravenous injection of different doses of cadmium chloride (0.1-2 mg Cd/kg). The rate of bile flow was not affected by cadmium injection and cadmium was excreted into bile during the first 2 hr after injection. The biliary excretion of cadmium increased with increasing dose of CdCl2. Cumulative biliary excretion of cadmium for 5 hr was 0.065% of the administered dose for groups injected with 0.1 mg Cd/kg as compared to 16.9% of the administered dose for 2 mg Cd/kg. During the 5 hr experimental period, most of the cadmium in liver cytosol was bound to high-molecular-weight proteins and less than 10% was bound to the metallothionein fraction. The biliary cadmium was recovered as a low-molecular-weight compound (less than 4,000) in experiments with various doses of cadmium and no cadmium was attached to high-molecular-weight proteins or metallothionein in the bile. The low-molecular-weight cadmium complex in bile was partially characterized as Cd-glutathione by thin-layer chromatography and amino acid analysis.


The effect of 6-hydroxydopamine-induced hepatic sympathectomy on the early hyperglycemic response to surgical trauma under anesthesia.

A single intraportal injection of 6-OH-DA (50mg/kg) in rats results in a functional hepatic sympathectomy 6 days following the injection. Laparotomy and mild abdominal exploration under pentobarbital anesthesia resulted in elevated plasma glucose levels within 15 minutes as a result of activation of the sympathetic nerves to the liver and adrenal gland discharge. The hyperglycemic response to trauma was reduced by fasting. The hyperglycemic response was examined in untreated rats, 6-OH-DA pretreated rats, bilaterally adrenalectomized rats, and a group which had received 6-OH-DA pretreatment as well as bilateral adrenalectomy. In non-fasted rats the presence of intact sympathetic nerves or intact adrenals was sufficient to produce the hyperglycemia. To prevent the response both nerves and adrenals must be deactivated. The hepatic nerves are primarily responsible for the early hyperglycemic response to trauma in fasted rats while in fed animals the adrenals and hepatic nerves play a more equal role.


Venous thrombosis in acute spinal cord paralysis.

Radiolabeled fibrinogen, impedance phlebography and venogram surveillance were carried out in ten consecutive acute spinal cord paralysis patients. Nine patients had evidence of deep venous thrombosis by radiolabeled fibrinogen technique. Venogram confirmed the presence of venous thrombosis in seven. Impedance phlebography was positive in only four. Eight patients developed a positive radiolabeled fibrinogen test after a surgical procedure. One patient with extensive venous thrombosis had multiple pulmonary emboli.


An evaluation of the cuff characteristics and incidence of laryngeal complications using a new nasotracheal tube in prolonged intubations.

A series of 1,187 nasotracheal intubations, carried out from January 1973 to December, 1975, used a new tube. The design included a smooth tip, a cuff with a large area of contact, low pressure and a high residual volume, and a radiopaque line which is easily visible on chest X-ray. A secondary irrigating lumen opening distal to the cuff provides closed-system irrigation, measurement of airway pressures, and sampling of tracheal gases. In the 811 intubated nontracheostomized patients who survived, the overall incidence of significant laryngeal damage was 1%. In patients intubated in excess of 10 days the damage incidence was 10%, and we suggest that tracheostomy should be carried out at this time. No patients suffered from any known permanent laryngeal damage.


Gluteal compartment syndrome: case report.

A compartmental syndrome can occur in any space limited by fascia or skin. A case of a gluteal compartment syndrome is reported, apparently from prolonged pressure after a drug overdose. Clinical features were a painful expanding gluteal mass with sciatic nerve dysfunction. Fasciotomy of the tensor fascia lata and the overlying fascia of the gluteus maximus resulted in rapid relief of symptoms.


Use of the intra-aortic balloon support for refractory low cardiac output in myocardial contusion.

A patient with refractory low cardiac output and recurring ventricular arrhythmias resulting from myocardial contusion was treated with intra-aortic balloon counterpulsation. Use of the intra-aortic balloon resulted in an increased cardiac output and control of the ventricular arrhythmias. After 1 year the patient shows no sequelae of myocardial contusion, although he is still paraplegic.


Renal artery aneurysm presenting as a chest mass.

An enlarging mass in the right chest in a 25-year-old woman was found at operation to be a false aneurysm of the renal artery. Preoperative diagnosis was not made despite an extensive workup including arteriography. Successful resection was carried out via a posterolateral thoracotomy. Although vascular reconstruction was not feasible. The danger of rupture of such an aneurysm from an incisional biopsy is emphasized.


[Results of hyperthermia on the bladder carcinomas of the dog (author's transl)].

A study on the effects of hyperthermia on B.N.A. induced bladder carcinomas of the dog has been carried out since 1966. The hyperthermic treatment has been performed directly in the bladder using an original equipment especially designed. In a large majority of the animals definite cancericidal changes have been shown. The most favorable results were obtained in the treatment of carcinomas not infiltrating the muscular layer of the bladder. In these cases malignant recurrency was not shown up to five years after treatment. Good palliative effect is also refferred in the treatment of advanced bladder carcinoma of the man.


[A rare case of cavernous haemangioma of the bladder (author's transl)].

The authors report a case of haemangioma of the bladder treated by partial cystectomy in a young man aged 17 years and review the world literature. Less than 70 cases have been published up to the present time. In 30 per cent of cases, the presence of signs of vascular dysplasia of the limbs is also noted.


[A new case of leydigioma of the testis (author's transl)].

A new case of leydigioma, seen in a young adult, poses the problem of the long term prognosis of an apparently benign tumour of this type. The usefulness of routine complementary carcinological therapy associating radio-surgery and immunotherapy is discussed. In fact, such treatment was rejected in favour of strict surveillance, possible in a cooperative subject, involving clinical examination every three months and endocrine studies and a chest X-ray every 2 months.


Folded, concatenated genomes as replication intermediates of bacteriophage T7 DNA.

A complex form of bacteriophage T7 DNA, containing up to several hundred phage equivalents of DNA, arises during replication of T7. The complex was stable to treatment with ionic detergent, Pronase, and phenol. The complex form normally exists for only a short time, corresponding to the phase of rapid T7 DNA synthesis. It is then converted to shorter molecules, both concatemers and unit-size DNA. The complex was stable up to the temperature of denaturation of the bihelix. It consisted of a series of loops amanating from a dense central core, as shownby electron microscopy. The complex form is similar to the relaxed Escherichia coli folded chromosome ('nucleoid'). The loops contained an average of 0.7 to 0.8 phage equivalent of DNA. During infection by phage with an amber mutation in gene 3 (endonuclease), formation of the complex occurred normally, but its maturation to unit-size DNA blocked. Before treatment with phenol, the complex contained short fragments of newly replicated DNA. These were released as single-stranded pieces during phenol treatment. A pathway for T7 DNA replication is indicated in which the flow of material is from unit-size DNA to linear concatemers to the complex form, and then back to unit-size DNA by way of linear concatemers.


Electron microscopy of the segmented RNA genome ofLa Crosse virus: absence of circular molecules.

The three species of single-stranded RNA present in La Crosse virus were examined in the electron microscope. Because large amounts of contaminating cellular DNA are copurified with the virus despite extensive attempts to purify the virus, it was necessary to use procedures that eliminated the bulk of this DNA before the viral RNA was analyzed. When this was done, the modal lengths of La Crosse virus RNA were 0.4, 2.0, and 3.1 mum. These lengths correspond well to their known molecular weights of 0.4 x 106, 1.8 x 106, and 2.9 x 106. Under the denaturing conditions used to permit complete spreading of these single-stranded RNA molecules, no single-stranded circular molecules are observed. Therefore, the circular nucleocapsids present in La Crosse virus and some other bunyaviruses do not appear to be due to convalent linkage of the ends of the RNA genome.


Multiple copies of human adenovirus 12 genomes are integrated in virus-induced hamster tumors.

Tumors induced in hamsters by highly oncogenic human adenovirus 12 contain multiple copies of 90 to 100% of the viral genome in an integrated form.


Synthesis of Newcastle disease virus polypeptides in a wheat germ cell-free system.

We have isolated 18S RNA from cytoplasmic extracts of Newcastle disease virus-infected Chinese hamster ovary cells and tested its ability to direct protein synthesis in extracts derived from wheat germ. The products of the cell-free reaction directed by this RNA contain polypeptides that comigrate with NP, M,F, and 47K roteins from virions. In addition, the products contain a polypeptide (67K) that migrates on polyacrylamide gels slightly faster than the HN protein from virions. Tryptic peptide analysis of the cell-free products and proteins from virions confirms their identity.


[The therapeutic effect of doxycycline (Vibramycin) on pneumonia due to mycoplasma pneumoniae (author's transl)].

Tetracycline is expected to be as effective as erythromycin in the treatment of pneumonia due to Mycoplasma pneumoniae. In this clinical trial 12 cases with pneumonia due to Mycoplasma pneumoniae were given doxycycline (Vibramycin "Pfizer'), a long-acting derivative of tetracycline. Judging from time periods required for defervescence, improvement in symptoms such as cough and disappearance of shadows on chest X-ray, the therapeutic effect of doxycycline was excellent in 8 cases and good in 4 cases.


[The clinical studies on midecamycin granules in the otorhinolaryngological field (author's transl)].

Clinical investigation with a new macrolide antibiotic, midecamycin granules was performed with the results which may lead to the following conclusion. 1) Results of clinical treatment: When midecamycin granules were administered orally in 31 cases of representative infections in the otorhinolaryngological field, it was excellent in 7 cases, good in 20 cases, fair in one case and poor in 3 cases. When the cases in which it was excellent and good were considered together, good results were obtained in 27 cases, that is a ratio of effectiveness of 87.1 per cent. 2) Side effect: No side effect was shown with the oral administration of midecamycin granules.


[Effects of a proteolytic-enzyme preparation used concomitantly with an antibiotic in osteoarticular infections (author's transl)].

Studies were performed in 8 patients with osteoarticular infections to examine the concentrations of sulbenicillin in the venous blood and exudate following administration and the concentrations of the antibiotic in the exudate when serratiopeptidase was orally administered concomitantly with the antibiotic. The results of the examination indicated that the transfer of sulbenicillin into the exudate tended to increase when 30 mg/day of serratiopeptidase was concomitantly given for 6 days, though further examination was thought necessary by increasing number of subjects and elaborating on the methodology.


Abnormality of serum lipoprotein and spleen glycosphingolipids in a case of hereditary spherocytosis.

A patient with hereditary spherocytosis gave rise to lower levels of both erythrocyte and serum cholesterols and serum lipoproteins than normal subjects. Abnormal shape of the serum lipoprotein particles was observed by electron-microscopic examination as well as the spheroidal shape of red cells. Lipids of fresh spleen tissue of the patient after splenectomy for the treatment of splenomegaly were extracted, isolated and analyzed. Particularly, different glycosphingolipids were also chemically identified and analyzed. The total lipids accounted for 10.7% of the dry tissue weight and consisted of cholesterol (32.2%), simple lipids (5.4%),phospholipids (58.3%) and glycosphingolipids (3.6%). Particularly, the glycosphingolipids were composed of monohexosyl ceramide (9.0%), lactosyl ceramide (31.2%), digalactosylglucosyl ceramide (9.2%), globoside I (27.6%) and hematoside (23.0%). It was found that the globoside I and hematoside increased remarkably in the spleen of patient with hereditary spherocytosis and that monohexosyl ceramide contained not only glucosyl ceramide, but also galactosyl ceramide at the ratio of 4:1.


Early carcinoma in the periampullary region: report of two cases.

Two cases of early carcinoma in the periampullary region detected microscopically are reported. In Case 1, the carcinoma was found in part of an adenomatous polyp resected transduodenally. In Case 2, carcinoma was located within 1 cm from the main pancreatic duct hidden in the surrounding inflammatory tissue of the pancreatic head excised by radical pancreatoduodenectomy. Case 1 survived more than 3 years after the operation and Case 2 more than 5 years without any evidence of recurrence. The practical significance of such early carcinoma is discussed.


Aortic cannulation for cardiopulmonary bypass.

The surgical technique and complications of aortic cannulation for arterial return in total body perfusion utilizing oxygenator were presented based on our experience of 400 patients. Major complications encountered were laceration and bleeding (1 case), hematoma formation and bleeding (2 cases), and malpositioning of the catheter resulting in mild brain damage (1 case). All underwent re-operation with 4 survivals. Aortic cannulation is simple to perform, easy to maintian stability in cardiopulmonary bypass and with much less risk of retrograde dissection in all ages.


[Liver pathology in myocardial infarct].

Complex examinations of the state of the liver with the employment of biochemical and histochemical methods were conducted in 211 patients with myocardial infarction and in 69 dogs among which myocardial infarction was induced in 41. The examinations have demonstrated that in myocardial infarction protein, lipid, carbohydrates and pigment metabolism disorders develop in the liver, as well as those of the oxidative--reduction processes and the resulting changes in the liver structure. A comparison of the obtained data with the results of numerous investigations on the state of the liver in cases of various hypoxemic states indicates that in myocardial infarction the liver changes are predominantly determined by the developing hypoxia of the organ. This is due to the decreasing contractile capacity of the myocardium, to the involvement of the hepatic vessels into the atherosclerotic process, the microcirculation disturbances, the development of proliferative and sclerotic changes in the hepatic vessels. Of certain importance are also the general neurohumoral changes developing in the body during myocardial infarction, such as an excess of catecholamines in the blood.


[Heart valve prosthesis in children and adolescents with aortic valve insufficiency].

Aortic valve prosthetic replacement in children and adolescents helps to improve their haemodynamics, and favourably affects the course of the rheumatic process. The correction of the defect is indicated in the presence of appropriate subjective and objective symptoms of aortic valve insufficiency. The lumen of the aorta was so large in many children that it permitted the employment of prostheses for adults. Calcification of the aortic valve was found in 9 of the 31 patients, which contradicts the commonly accepted belief of a low incidence of calcification in this disease in children. Hospital mortality and postoperative complications rate did not exceed those in aortic valve replacement in adults. The comparatively fast reduction of the heart size and the positive dynamics of the functional parameters in children and adolescents may be due to the high plasticity of the cardiovascular system in this age-group.


[Surgical treatment of mitral valve stenosis under conditions of artificial circulation].

The problem of a surgical management of rheumatic mitral stenosis in open-heart procedures under extracorporeal circulation is discussed. The experience of 240 surgical corrections is presented: 139 open mitral commissurotomies, 101 prosthetic replacements of the mitral valve. The current status of the problem is discussed along with the problems of diagnosis, complications of mitral stenosis, and open-heart technique of surgery. On the basis of the obtained results the advantages of the open correction of complicated forms of mitral stenosis over the closed techniques are demonstrated.


[Heart valve prosthesis in mitral valve defects of patients with chronic circulatory insufficiency].

The data of long-term follow-up of 67 patients subjected to mitral valve replacement for severe heart diseases support the rationale of surgical management of chronic circulatory insufficiency in mitral disease. A prosthetic replacement of the mitral valve helps to return the majority of operated on patients to active live patterns. Improvements of the patients' state within 5 years after surgery was recorded in 58 cases, 9 patients died within 2 to 34 months. Actuarial statistics showed that the 5-year survival rate comprised 75.9% following prosthetic mitral valve replacement.


[Remote results of surgical treatment of mitral valve stenosis complicated by relative tricuspid valve insufficiency].

A total of 500 patients with mitral stenosis subjected to mitral commissurotomy were examined 1 to 14 years after surgery. Relative tricuspid insufficiency accompanying mitral stenosis was detected preoperatively in 104 patients (20.8%). The authors concluded that it was rationale to undertake mitral commissurotomy in such patients after careful preoperative preparation, and to treat them medically afterwards. The follow-up analysis demonstrated that good results of surgery were achieved in 32 cases (30.8%), satisfactory--in 60 (56.7%), poor--in 11 (10.5%). One patient died after surgery for mitral re-stenosis. A comparison of 2 groups of patients--Group 1 with mitral stenosis and relative tricuspid valve insufficiency, and Group 2 with mitral stenosis alone without tricuspid insufficiency--revealed that the late results were better in Group 1. To maintain the positive effect of surgery in all the cases preventive anti-rheumatism measures should be taken the year round.


[Relationship between the indicators of the lung rheogram and pulmonary artery pressure in mitral valve stenosis].

In 32 patients with rheumatic mitral stenosis a set of quantitative rheographic pulmonary data was compared with the values of pulmonary artery pressure obtained by way of pulmonary artery catheterization. The diagnostic value of the mean rate of slow filling (Vm.s) and of the Q--a interval was shown for the diagnosis of pulmonary hypertension, their introduction into everyday practice was substantiated. Appropriate regression equations for Vm.s and mean pulmonary artery pressure were compiled: y equals 83.7--94.x, and for the Q--a interval: y equals 4.46.281 300x. In mitral stenosis cases a reduction of the rheographic systolic index was established, as well as of the amplitude-frequency index and of the maximum rate of fast filling.


[Surgical treatment of solitary or common heart ventricle].

On the basis of 24 cases reported in the literature and 2 personal observations of the authors the indications for surgical correction of a single ventricle of the heart are discussed. Two different surgical techniques are described: 1) haemodynamic correction of the defect comprising a closure of the venous atrioventricular valve, oversewing the proximal pulmonary artery, and anastomosing the right atrium and the distal pulmonary artery; 2) radical correction--creation of the ventricular septum. The variants of the disease permitting a radical correction are indicated, the results of surgery, the causes of complications and mortality are discussed.


[Myocardial contractility during angina pectoris attack in ischemic heart disease].

The myocardial contractility function was studied with the aid of echocardiography in 42 male patients during dosaged physical exercises. The patients were selected so that at the peak of the exercises they developed an angina pectoris attack documented by ischaemic ECG changes. In some of the patients the changes were also observed during attacks of angina decubitus. Anginal attacks are accompanied by a reduction of the myocardial function. Haemodynamic reactions of two types were noted with myocardial ischaemia: type I reaction was observed in patients with ischaemic heart disease and practically normal values of the initial heart volume, and consisted in an increasing end-systolic and end-diastolic volumes, with the stroke volume remaining unchanged, and the ejection fraction somewhat decreasing; type 2 reaction was observed in patients with initially increased heart volumes, and consisted in a decreasing end-diastolic and stroke volumes, with an insignificant alteration of the end-systolic volume. The ejection fraction, being initially insignificantly decreased, tends to decrease further during the attack.


Normal renocortical blood flow in experimental acute renal failure.

Renal cortical blood flow of rats with postischemic, myohemoglobinuric, and mercury-induced acute renal failure was measured by the hydrogen washout technique using implanted platinum electrodes. Total renal blood flow was determined by venous cannulation in separate series of rats. The values obtained with the two methods were in excellent qualitative agreement (r=0.99, P less than 0.001), although venous cannulation gave values that were constantly lower than those calculated for whole kidney from the cortical flow rate and assumed cortical mass. Myohemoglobinuria produced by glycerol injection caused cortical blood flow to fall from a control value of 7.37+/-0.23 (SEM) ml/min X g of cortex to approximately one-half that value for four hours after injection (P less than 0.001). Flow rates 12 and 24 hr after glycerol injection were 85% (P less than 0.001) and 90% (P less than 0.05) of control, respectively. Cortical flow was reduced to 5.49+/-0.39 (SEM) ml/min X g of cortex four hours after release of one hour's total bilateral renal arterial occlusion (P less than 0.001), but rose to normal within 24 hr. Poisoning with 4.7 mg/kg of body wt of mercuric chloride produced a cortical blood flow value that was 30% higher than control 24 hr after injection (P less than 0.01), while a 12 mg/kg of body wt dose gave a normal flow value. Inulin clearance was severely depressed in all models at all study times. Thus, in contrast to human acute renal failure, marked renal cortical ischemia is not an essential feature of these different forms of murine acute renal failure.


Serum immune complexes in membranoproliferative and other glomerulonephritides.

Immune complexes were detected in the serum of patients with membranoproliferative glomerulonephritis (MPGN) Types I and II, systemic lupus erythematosus (SLE), and acute poststreptococcal glomerulonephritis (AGN) by sucrose gradient ultracentrifugation and by measurement of Clq binding activity (Clq-BA). Clq-BA was more sensitive in detecting complexes than was gradient ultracentrifugation. By gradient ultracentrifugation, the sedimentation velocities of the complexes in the three diseases were similar, ranging from 13S to 19S. This range corresponds to that observed by others in experimental chronic serum sickness nephritis. The complexes isolated by gradient ultracentrifugation always contained C3, usually IgG and C4, and in some patients with SLE and AGN, IgM. In MPGN, IgM and IgA could be present in glomerular deposits when not present in circulating complexes. In this disease also, serum complement levels were poor predictors of the presence of complexes. With increased Clq-BA, the levels of Clq, C4, and C2 could be normal or reduced and there was no correlation with C3 levels. With few exceptions, the clinical status of the patients with MPGN correlated well with Clq-BA.


[The pathophysiology of retinal artery and vein thromboses (author's transl)].

The retinal blood flow is autoregulated. Retinal metabolic changes following PaCO2 and PaO2 variations, variably affect the arteriolar resistance to flow. It is postulated that PGE1 may play the role of mediator in the control of retinal blood flow. Retinal vascular obstruction leads to a circulatory disorder, but immediately physiopathological mechanisms (more or less efficient) tend to compensate again the circulatory disorder. For example, after arteriolar embolism the retrograde plasma flow starts immediately and the cells increase their anaerobic glycolytic activity to produce sufficient metabolic energy. In the case of vein thrombosis, the retrograde drainage develops collateral microvessels whose draining efficiency depends on their number and the surface of the thrombotic area.


[Pathology of arterial and venous occlusive diseases of the retina (author's transl)].

A short synopsis is given on the pathology of the different arterial and venous occlusive diseases in the retina. Based on the author's material and the literature their causes and mechanisms as well as the local sequelae are described, discussed and abondantly illustrated.


[Chiasmal syndromes (author's transl)].

Chiasmal syndromes (characterized by bitemporal field defects, decrease of vision and simple optic atrophy) are not only caused by tumors within the chiasmal region, but also occur in inflammatory, toxic, demyelinizing and hereditary-atrophic processes of the chiasm, respectively the optic nerve. In the presence of classic bitemporal visual field defects the probability of a tumor within the sellar region is very great. Apart from the most frequent pituitary adenoma one has to consider the craniopharyngioma, the meningioma of the tuberculum sellae, the olfactory meningioma and the meningioma of the sphenoid wing. The specific symptomatology of these sellar, supra- or parasellar tumors is discussed. In the presence of atypical or incipient bitemporal visual field defects, as they occur also in the early stages of tumors of the chiasmal region, one has first of all to exclude all other possible causes for such field defects such as refraction scotomas, tobacco-alcohol-amblyopias, dominant hereditary optic atrophies, the uni- or bilateral optic neuritis and the intoxications of the optic nerves. In the differential diagnosis of tumors of the sellar region one has to consider infra- and supraclinoidal aneurysms, tumors of the chiasm (gliomas of the chiasm), the distant effect of a hydrocephalus of the IIIrd ventricle on the chiasm and the optochiasmatic arachnoiditis.


[Anesthesia in ophthalmology (author's transl)].

General anesthesia in ophthalmological surgery has become a great fashion. However there are still many problems especially in intraocular surgery. The eye with normal intraocular pressure generally needs no special technique. Most of the usual anesthesia produce a slight hypotonia with the exception of Succinylcholine, whose effect is contrary. Unfortunately this is not the case in eyes with pathologically increased intraocular pressure as in the different forms of glaucoma. Eye surgeons and anesthesists therefore look for solutions to this problem which in principle consist in the application of medicaments, which not seldom are rather agressive. The controlled hypotension by ganglion blockers, the curarisation in the state of being awake, the rapid perfusion of solutions with high osmotique effect (isolated or associated) represent such measures. The one has the disadvantage to be applied during so-called subvigile anesthesias where the security that the patient is asleep is rather doubtful; the other has the disadvantage that it requires a rapid perfusion of solutions with highly osmotic effect. It goes without saying that these conditions represent risks especially if one considers that the candidates for this type of intervention very often are senile persons with prearious cardiovascular equilibrium, with insufficient renal function and with insufficient arterial cerebral circulation. These are some of the problems which are to be discussed.


[Local anesthesia in ophthalmic surgery (author's transl)].

Although there is parctically no contraindication for general anesthesia and the risks for the patient have become considerably less, local anesthesia is still indicated for many ophthalmic surgical interventions. Here different factors have to be considered: The physical and psychological state of the patient, the nature of the intervention (above all cataract and glaucoma operations, as well as lamellar and perforating keratoplasties), the technique of the local anesthesia, the pre-medication, the relationship surgeon-patient, economic factors and possible complications of general anesthesia.


[General anaesthesia in ophthalmology (author's transl)].

General anaesthesia is aimed at calming the patient in the praeanaesthetic period, creating good operating conditions and ensuring a quiet post-anaesthetic recovery. A praeanaesthetic examination is necessary and special attention has to be given to the age and condition of the patient. Existant other deseases have to be treated and the anaesthetic technic has to be properly adapted to the kind of surgery. Modern anaesthetic drugs normally provide for these requirements and in particular to prevent the occurrence of the oculocardiac reflex.


Evaluation of a disposable water system during shipment of laboratory rats and mice.

The efficacy of a newly developed system for providing water to boxed rodents during shipment was evaluated. The system, composed of a water filled disposable plastic pouch and a disposable automatic drinking valve, was measured against two products commonly used to provide moisture during transit, canned gelled rodent diet and potatoes. The evaluations were made under conditions of both long (72-88 hour) and short (26 hour) duration trips using regularly scheduled commercial common carriers. Differences in body weight of shipped animals compared to that of non-shipped controls of the same age, and differences in body weight between groups were measured. Under all conditions investigated, rats and mice provided with the transit water system lost significantly less weight during transit than those provided with either of the other two water sources. The equilibration period (the time required to recover body weight lost during shipment) was found to be influenced by both the type of water source and the duration of transit. Under all conditions investigated, animals provided with the transit water system recovered more rapidly and had shorter equilibration periods.


Successful breeding of the laboratory-housed gibbon (Hylobates lar).

A cage was developed which included a squeeze wall for easy handling of the gibbon (Hylobates lar) and which provided gibbon breeding pairs with privacy from others of the same species. Females living in this environment displayed menstrual and vaginal eversion cycles averaging 30 days (range 22-44). Twelve compatible pairs produced eight live infants from 15 conceptions in a 33-month period. Two full term stillbirths, two abortions, and three current pregnancies accounted for the other seven conceptions. Monthly uterine palpations were performed and pregnancy could be detected as early as 27 days after conception. The compatibility of the mating pairs was determined to be the major factor in the natural breeding of gibbons in captivity. This was demonstrated by obtaining only 12 compatible pairs from 22 attempted pairings.


Thymectomy in the adult mouse: a new approach.

Adult mice were thymectomized using a retrosternal approach. The sternothyroid muscle was divided, the sternum was elevated, and the lobes of the thymus were removed by aspiration. The technique was used to thymectomize about 300 mice of several strains. The incidence of thymic remnants was less than 1% and losses from surgery were less than 10%.


Preparation of a chronic gastric fistula in the rat.

A stainless steel gastric cannula was surgically implanted in the rat forestomach to allow gastric secretion to be collected continuously without restraining the animal. When gastric collections were not being made, the cannula was closed with a plugging screw. Rats with these cannulas were easily maintained without special care or complications for 12 months.


Adaptation of the orbital sinus bleeding technique to the chinchilla (Chinchilla laniger).

The orbital sinus bleeding technique was used to obtain 1-3 ml samples of venous blood from chinchillas (Chinchilla laniger) within 1 minute. By monitoring food intake and body weight, this technique was shown to have no detrimental effects on the general health of the animals, but serial samples taken twice weekly over a period of 2 months did induce some degree of hemorrhage or occasional corneal opacity in some animals.


Heats of dissociation of mixture of poly(gamma-benzyl L- and D-glutamate).

The heats of dissociation of stacked side-chain benzyl groups in mixtures of various proportions of poly(gamma-benzyl L- and D-glutamate) have been measured by a differential scanning calorimeter. In order to obtain further information about the dissociation, the heats of solution of poly(gamma-benzyl L- and D-glutamate) were also measured by a twin micro calorimeter at 303 K. The agreement between the heat of dissociation obtained by DSC and that determined by the heat of dissolution is good. The average value of the heat of dissociation of stacking estimated by both methods is about 5 kJ/(mol of pairs of residue.


Block copolypeptides. 2. Viscoelastic properties.

The solid state structure of block copolypeptides of gamma-benzyl L-glutamate (G) and L-leucine (L) case from preferential solvents for G has been investigated by dynamic mechanical and wide angle x-ray diffraction techniques. The WAXD patterns show overlapping reflections characteristic of the individual homopolymers. Further evidence for a phase separated morphology is provided by the viscoelastic behavior. Representation of the dynamic elastic modulus in terms of the equivalent mechanical model suggests that phase separation of GLG-type polymers occurs with G as the matrix phase. In the reverse case, LGL-type polymers, it appears that some phase inversion has taken place.


Block copolypeptides. 1. Synthesis and solid state conformational studies.

Triblock copolypeptides of gamma-benzyl L-glutamate (G) and L-leucine or L-valine of high molecular weight have been prepared. The solubilites and solution conformation were determined and compared with random copolymers of similar composition as well as the appropriate homopolypeptides. Characterization of the secondary structure in the solid state was undertaken as part of an investigation into the solid state properties of this new class of materials. Infrared and solid state measurements indicate that the G and L-leucine blocks assume an alpha-helical conformation and L-valine blocks a beta-sheet structure. Polarized infrared measurements showed the chain axis in oriented films to be parallel to the orientation direction. Further solid state characterization of the tertiary structure and mechanical properties of the block copolypeptides will be reported in succeeding papers.


Consumer health education and the problem of television.

The ubiquity of television and its ability to reach low income people make it an attractive medium for health education. However, its present influence on health is largely negative due to misleading or inaccurate commercials and program material. Efforts to provide accurate health information on television are difficult because of the financial structure of the industry, a mutual suspicion of health and television people toward each other, and possible legal entanglements involving constitutional issues. This paper suggests four ways which health people should consider in seeking to influence commercial television. None involve legislation, none threaten First Amendment guarantees, and none threaten the profit structure of the industry.


Relationships between mental health treatment and medical utilization among low-income Mexican American patients: some preliminary findings.

The hypothesis that medical visits decrease as a function of mental health treatment was tested with a lower socioeconomic Mexican-American population. The number of medical and psychotherapy visits for all patients referred for mental health treatment during a specific period was obtained and analyzed in serveral ways to determine rate of medical visits as a function of psychiatric visits. Results indicated clear rejection of the hypothesis. Medical visits significantly increased rather than decreased. Factors which may account for these findings being opposite of previous studies are discussed and include previous poor medical service availability and socioeconomic differences in populations.


Coarctation of the aorta.

Coarctation of the aorta is a cause of hypertension that can present dramatically in the severely ill infant or appear incidentally in the asymptomatic young adult. Coarctation is easily detected and there is good evidence that the extremely poor natural history can be altered favorably by surgical correction. The elevated blood pressure can be lowered in the majority of patients, and there is every expectation that the incidence of known complications of coarctation can be decreased. However, in about three fourths of the patients, significant residual cardiovascular defects persist, with their potential for future problems as yet incompletely defined. For this reason, patients who have undergone surgery for coarctation will need to be followed carefully for an indefinite period.


[Clinical signs and therapy of familial polyposis of the colon and recutum (author's transl)].

Familial polyposis of the colon and rectum does always present an absolute indication for immediate total colectomy because of the predictable malignant degeneration. The patient concerned as well as his family have to be examined and treated if necessary. 12 such cases have been operated upon in the surgical Department of the University of Mainz Medical School. In 4 cases proctocolectomy with terminal ileostomy were performed, in 7 cases ileorectostomies. The procedure of mucosectomy with subsequent pulling of the terminal ileum through the colon (Hochen-egg and Reifferscheid) has been tried by us so far only in animals. Since a terminal, life-long ileostoma does present a considerable disadvantage for the mostly younger patients we did perform in most cases an ileo-rectal end-to-end anastomosis. This procedure can be looked upon as adequate cancer prophylaxis if control rectoscopies are performed regularly in cooperative patients.


[The blind-loop syndrome after side-to-side anastomoses of the gut (author's transl)].

The postoperative blind-loop syndrome can occur after side-to-side, end-to side or by-pass anastomoses of the gut and presents clinically as malabsorption syndrome. Pathogenetically, stasis or slowing of the bowel movements will cause a rapid increase of pathogenic bacteria in the small intestine. Malabsorption is characterized by 3 symptoms: Loss of weight, anemia, steatorrhoea. The method of choice for therapy is to perform a new, end-to-end, anastomosis of the intestine in order to re-establish a physiological situation. During the last 6 years 14 patients with malabsorption syndromes of varying degrees were operated upon: 6 had pure small intestinal anastomoses, 7 anastomoses between the small and large intestine and 1 patient had a side-to-side sigmoidal anastomosis. In all patients the side-to-side or by-pass anastomoses could be reversed.


[Surgical and medical treatment of Crohn's disease (author's transl)].

Regional enteritis does present therapeutical problems because of the unpredictable course of this disease. 162 patients were operated upon in the Surgical Department of the University of Mainz Medical School between 1964 and 1976. Medical and surgical treatment of these patients has been rather different due to the heterogenity of the patient group. Curative therapy of regional enteritis does not exist. Medical treatment is aimed at converting the active form of the disease into an inactive, 'burnt out' form. One therapeutic regimen widely used is the combination of salazosulfapyridin and corticosteroids, another regimen is the combination of azathioprine and prednisolone. Surgery is indicated when complications arise and after medical treatment has failed. The optimal approach is resection of the afflicted part of the intestine. Even after surgery prognosis is doubtful and depends upon the activity of the disease in each individual case.


Analysis of 4-methyloctanoic acid and other medium chain-length fatty acid constituents of ovine tissue lipids.

Medium chain-length (C6-C9) fatty acids in depot, intramuscular, kidney, and liver lipids from pasture-fed sheep and subcutaneous and intramuscular lipids from barley-fed sheep were analyzed with emphasis on the 4-methyloctanoic acid (hircinoic acid) content. Within individual animals, the level of hircinoic acid in the subcutaneous fat was usually higher than that either in the deeper depot fats or in the intramuscular fat. Variation of hircinoic acid levels between animals was greatest in the subcutanous fat and least in the perinrphric fat. There were usually higher levels of both branched and odd carbon chain fatty acids in the lipids of barley-fed sheep than in the corresponding lipids of pasture-fed sheep.


Determination of the absolute configuration at C-20 and C-24 of ergosterol in Ascomycetes and Basidiomycetes by proton magnetic resonance spectroscopy.

Samples of ergosterol isolated from Saccharomyces cerevisiae, Neurospora crassa, and Agaricus sp., and commercial ergosterol all displayed identical proton magnetic resonance (PMR) spectra at 220 MHz. From the effects produced on the doublet for C-21 by epimerization at C-20 and C-24 in sterols of known configuration, the absolute configurations at these positions in ergosterol were determined. The data demonstrate that ergosterol from both Ascomycetes and Basidiomycetes is the same and that at C-20 and C-24, the two H-atoms are on the alpha-side of the asymmetric carbon atoms and that C-22 is trans-oriented with respect to C-13 about the 17(20)-bond.


Delayed conversion of squalene to sterols during development of Pinus pinea seeds.

During germination of seeds of the gymnosperm, Pinus pinea, radioactivity from [2-14C]-mevalonate proceeded principally through the anaerobic reactions leading to squalene in the first 24 hr in both the haploid endosperm and the diploid embryo, and only with succeeding time (3-9 days) in both cases was label transferred to sterols in oxygen-requiring steps. The rates of turnover must be real and independent in the two tissues, since no consequential interchange of labelled lipids occurred between the endosperm and the embryo. Similar delayed conversion of squalene to sterols has been observed previously during germination of seeds of the angiosperm, Pisum sativum.


Fatty acids and sterols of Cronartium fusiforme basidiospores.

The hydrocarbons, fatty acids, and sterols of Cronartium fusiforme basidiospores were examined by gas chromatography and mass spectrometry. Trace quantities of aliphatic hydrocarbons were detected, but these were probably not fungal products. Principal nonsubstituted fatty acids were palmitic (11.7%), linoleic (17.2%), and linolenic (16.1%) acids; the predominant acid was 9,10-cis-epoxyocta-decanoic acid (40.7%). Four sterols were detected, three of which were identified as stigmast-7-enol (57.6%), stigmasta-5, 7-dienol (22.7%), and ergost-7-enol (16.0%). The fourth sterol (4%) is a C28 diene. Lipids of the aeciospores and basidiospores of C. fusiforme are compared.


[The construction of models intending spatial representation of complex vessel structures demonstrated by means of the mammalian glomerulus].

This report presents information about a method to construct a wax-sheet model of rat and human glomerula, able to be divided into several segments. Based on the wax model consisting of segments a glomerula model is developed, showing the axis of the glomerula capillaries formed by an ironwire. By means of this model it will be possible to follow the course of the capillaries precisely.


[Lactobacillus disciformans as the causative agent in a case of pleuro-pneumonia].

In an elderly patient with chest pains, cough, high fever and suspected pleuro-pneumonia, the aerobic cultures of the pleural fluid remained sterile while in the anaerobic cultures Lactobacillus disciformans was grown.


[Results of bacitracin sensitivity tests on 250 beta hemolytic streptococcal strains].

On blood agar plates prepared from tryptose blood agar base (Difco) containing 5% defibrinated sheep blood cultures were done. After overnight incubation plates were examined and beta hemolytic streptococci tested with Taxo A (Difco) disks. 234 of them came out sensitive.


[Salmonella serotypes isolated up to 1976, and their origins].

The salmonella serotypes isolated for the first time in this country during 1972-1976 and their origins are given. Other salmonella serotypes, isolated before 1972 were previously published in this bulletin.


[The fungi causing superficial mycoses found in and around Ankara].

In this research the agents in the specimens taken from 400 patients whose diagnosis were superficial cutaneous infection were investigated. The specimens were collected from the Dermatology Clinics of Hacettepe Hospital and Numune Hospital. As a result of our experiments we isolated T. mentagrophytes, T. rubrum, E. floccosum, T. schoenleini, M. canis, T. violaceum, M. audouini, M. gypseum. It is also established that beside C. albicans, other Candida species are also the causes of cutaneous fungus infection.


[Staphylococcal hemolysins and autovaccine applications in staphylococcal infections].

The pathogenicity of staphyloccocci, their antigenic structure, toxins, the pathology of the lesions they cause, their treatment, immunogenic applications, different materials applied in men and animals, methods of application and the results in general related to the main subject are given briefly. Staphylococal hemolysins, as alpha, beta, delta and gamma hemolysins of S. aureus, epsilon hemolysin of S. epidermis, their production, purification, physicochemical characteristics, their effects on different animals and tissue cultures, their antigenicity, the role of hemolysins in pathogenicity and virulance of staphylococci, the autovaccins we prepared against staphylococcal skin infections (acne vulgaris), the method of preparation, their clinical application and the results are given briefly.


Problem solving cases in teaching of applied pathology.

A "problem solving case" method of teaching practical pathology is described, illustrated and compared with more traditional teaching methods. This method offers many advantages-the most important being that it shows the effect of pathological lesions in an actual patient, thus emphasizing the relevance of pathology to clinical medicine. Other advantages are that self-assessmetn is encouraged; guidance is given on the depth of knowledge expected from a student; student response is favourable; no elaborate or expensive equipment is required; the method is economic in the use of staff time, and it is very flexible in use in terms both of time and place.


Teaching teachers in general practice.

A short, intensive, teacher training course for general practitioners is described. The assessment techniques used indicate that it went some way towards achieving predetermined goals. Set alongside the limited time available to practitioners for attending training courses, and the logistic problems of training an adequate supply of teachers, this experience suggests that short intensive courses may have an important role in professional education.


Performance criteria for evaluation of medical teachers.

Evaluation of medical teachers must be related systematically to individualized objectives that are derived from a specific statement of the goals of the medical school. This paper describes the application of management-by-objectives to the problem of assessment of performance of medical teachers. The approach provides for the identification of significant objectives and rates performance in relation to achievement of outcomes rather than of activites.


Research in human sexuality education.

Since human sexuality courses are relatively recent additions to most U.S. medical school curricula, there are no established procedures for evaluating the courses. The purpose of this study was to test medical students' attitudes toward concepts in sexuality before and after a 5-day sexuality course using the semantic differential. The concepts students rated were "my sexuality", "masturbation", "homosexuality", and "my role in understanding sexual problems". Post-test scores were subtracted from pre-test scores and analysed by multivariate analysis of variance testing for significant difference from zero. Ninety-six second-year medical students completed the pre- and post-semantic differential tests. The changes between the pre- and post-tests were significant at the 0-001 level for all four concepts with the concept "homosexuality" showing the greatest change. The study suggests the semantic differential may be an effective instrument in assessing attitude changes. It also suggests the teaching techniques used in human sexuality courses may be successfully applied to other areas of medical education.


Teaching models of abnormal infants.

A technique is described for the construction of life-size three-dimensional models of infants with external evidence of disease. The use of these for teaching and research purposes is outlined.


[The loss of exocrine pancreas-function following operation for pancreatitis (author's transl)].

In a follow-up-series on 37 patients, who had been operated on for pancreatitis, the effect of pancreas insufficiency on the well-being of resected and non-resected patients was examined. Analyses of fatcontent in feces, collected over a three day-period, revealed that all patients with chronic pancreatitis now had a maldigestion, in particular patients with duodenopancreatectomie. Pseudocyst-patients showed no maldigestion. Increased in the bodyweight in most cases could not only be explained by drug-substituion of encymes but was also due to the resection of the pain-producing area of the pancreas.


A theoretical analysis of the steady-state relationship between plasma concentrations of calcium and parathyroid hormone.

A theoretical consideration of the relationship between plasma concentrations of calcium and parathyroid hormone suggests that the reported negative correlations between these variables in normal subjects and in patients with secondary hyperparathyroidism, and the positive correlation in patients with primary hyperparathyroidism, may be fortuitous and do not necessarily imply fundamental differences in the negative feedback mechanism.


[Hodgkin's disease, stage IVb: survival for 12 years (author's transl)].

Long survival in Hodgkin's disease after diagnosis of the stage IVb is very rare. A 45-years old woman is reported on, who survived for 12 years after detection of Hodgkin's disease involving lymph node regions on both sides of the diaphragm, bone, and lung parenchyma, including night sweats and weight loss (stage IVb according to the Ann Arbor classification 1971). This unexpectedly favorable course is possibly due to a so-called host resistance.


A simple universal mechanism of use and conservation of energy: its application to movements of ions and other materials across cell, mitochondrial and other membranes and to oxidative phosphorylation.

A single simple mechanism by which all cells might both use energy to drive active transport to all solutes and also conserve energy in the form of adenosinetriphosphate (ATP) is descirbed. The basic assumption is that injection of energy results in a conformational change of the membrane which both generates transient highly-ordered water structures on its inside surface and changes membrane permeability. Ordered water is propagated through the cell by means of cooperative interactions with proteins, so that during the ordered period intracellular water is incompatible with small cations which require strong primary hydration, but has enhanced affinity for water-structure-breaking solutes. In animal cells cytoplasmic water is ordered by the activity of the plasma-membrane-bound transport ATPases. In mitochondria and bacteria the state of ordered water is identified with the energised state, which can be generated either by passage of electrons down the electron chain, or by ATPase activity. The mechanism is shown to be consistent with the observed transport activities of mitochondria and bacteria, and also provides a simple direct explanation of oxidative phosphorylation.