The Plasmodium lophurae (avian malaria) ribosome.

Ribosomes were isolated from Plasmodium lophurae by Triton X-100 lysis and ultracentrifugation. Plasmodium lophurae ribosomal subparticles, produced by treatment of ribosomes with puromycin, were separated by sucrose gradient centrifugation. The nucleotide base composition of P. lophurae ribosomal RNA (rRNA) from intact ribosomes and subparticels was low in guanine-cytosine content (approximately 37% G + C) whereas the rRNA of the host cell (duck reticulocyte) was considerably higher (64% G + C). The rRNA of the malaria parasite was typically protozoan, with sedimentation values of 25S and 17S. In vitro, free parasites and malaria-infected red cells incorporated radioactive adenosine into both the large and the small plasmodial subparticles; label was also recovered in the 25S and 17S RNAs. These results suggest that host ribosomes do not contribute to ribosome biogenesis in this malaria, rather parasite rRNA is the transcription product of plasmodial cistrons.


Carbohydrate effects of amino acid transport by Trypanosoma equiperdum.

Uptake of 14C-labeled alanine, glutamate, lysine, methionine, proline, and phenylalanine by Trypanosoma equiperdum during 2-minute incubations occurred by diffusion and membrane-mediated processes. Amino acid metabolism was not detected by paper chromatography of trypanosome extracts. Most of 18 carbohydrates tested for ability to alter amino acid transport neither changed nor significantly inhibited transport. Glucose, however, stimulated glutamate, lysine and proline transport; fructose stimulated lysine uptake and 2-deoxy-D-glucose increased phenylalanine and methionine absorption. No evidence was found that the carbohydrates acted by binding to amino acid transport "sites." Glucose inhibition of alanine, phenylalanine, and methionine uptake was linked to glycolysis. The rapid formation of alanine form glucose stimulated alanine release and, when glycolysis was blocked, glucose no longer inhibited alanine transport. Methionine and phenylalanine release was also stimulated by glucose. Glucose changed the ability of lysine, glutamate, and proline to inhibit each others' uptake, indicating that certain amino acids are preferentially absorbed by respiring cells. Analysis of free pool amino acid levels suggested that some amino acid transport systems in T. equiperdum are linked in such a way to glycolysis as to control the cell concentrations of these amino acids.


Cinemicrographic analysis of cytoplasmic and nuclear events associated with germinal vesicle breakdown in rat oocytes exposed to LH in vitro.

Cinemicrography, with Nomarski differential interference optics, was used to study the motion of cytoplasmic organelles and events leading to germinal vesicle breakdown (GVB) in rat oocytes perfused with a defined medium with or without LH. Initially, cytoplasmic organelles, 0-3--1-5 micrometer diam., appeared to move randomly and were uniformly distributed. A gradually increasing vigour of organellar movement, saltatory translocation of organelles and discontinuous convergent flow of groups of organelles around the nucleus were observed. Ultimately, most of the organelles, which possessed several properties indicative of lysosomes, accumulated around the nucleus. In the presence of 5--6 micrograms LH/ml perfusate, GVB was usually complete by 80 min, whereas in the absence of hormone, or in the presence of LH + antiserum to LH, GVB took up to 130 min. A sudden slight decrease in nuclear size, undulating activity in the nuclear envelope, and the appearance of intranuclear filaments indicated imminent GVB. The appearance of spherical bodies at the nucleolar surface, and the subsequent mobilization and collapse of the nucleolus in the nucleoplasm, were advanced events in the nuclear response. It is suggested that LH promotes GVB trought activation of lysosomes.


Effect of seminal prostaglandins on the metabolism of human spermatozoa.

Study of the effects of 19-hydroxy E prostaglandins on the metabolism of washed ejaculated human spermatozoa showed that these compounds depress the respiration of the spermatozoa, but do not affect the production of lactate. This effect is not seen with the prostaglandins of the E and F series.


Deciduogenic effect of prostaglandins in the pseudopregnant rabbit.

Intrauterine implants made of Silastic or wax and containing various additives, including prostaglandins (PGs), were used to characterize some of the factors involved in deciduogenesis in rabbits. Implants were inserted into uteri on Day 6 of pseudopregnancy and the response was assessed by light microscopy on Day 10. The surface area of decidual tissue in histological sections was employed as an index of the degree of decidualization obtained. PGE-2, PGF-2alpha and arachidonic acid each elicited a prominent decidual response, PGE-2 being most potent. Implants which released histamine or oestradiol-17beta had a very slight decidualizing effect in some females. Control implants and implants releasing dibutyryl cyclic-AMP had no deciduogenic influence. All implants, regardless of additive content, induced a symplasmic transformation of the uterine surface epithelium. It is concluded that PGs and the distension caused by the implant may be involved in deciduogenesis in the rabbit.


Effect of mepyramine, a histamine H1-, and burimamide, a histamine H2-receptor antagonist, on ovum implantation in the rat.

Systemic administration to rats of a combination of mepyramine, a histamine H1-, and burimamide, a histamine H2-receptor antagonist, over a period which included the time of implantation (late Day 5 to early Night 5), increased the number of blastocysts recovered from the uterus and reduced the number and intensity of Pontamine Sky Blue (PSB) sites obtained at autopsy on Night 5. Histological examination of the PSB sites taken on Night 5 from animals receiving the histamine antagonists revealed that the stromal oedema, which is characteristic of the attachment phase of pregnancy, had been inhibited.


Toxicity of exogenous fatty acid peroxides towards spermatozoa.

The toxicity of unsaturated fatty acids towards spermatozoa was shown to be directly related to their degree of peroxidation. The toxicity was manifested by an immediate arrest of motility and irreversible loss of respiratory and fructolytic activity. Repeated washing of spermatozoa, or the addition of fructose, lactate, or ATP, failed to restore these functions. The structural damage incurred as a result of the fatty acid peroxides was particularly evident in the acrosomal region. Partial protection from the adverse effects of these peroxides was provided by prior treatment of spermatozoa with dialysed egg yolk or milk, but tocopherol, albumin and mercapto-ethanol were ineffective. It is suggested that lipid peroxides or their degradation products, whether introduced exogenously or derived from the peroxidation of endogenous phospholipids in semen, constitute a potential hazard to the functional integrity of spermatozoa.


Damage to ram spermatozoa by peroxidation of endogenous phospholipids.

We examined the damaging effects on spermatozoa of endogenous phospholipid peroxidation brought about by aerobic incubation at 37 degrees C in the presence of 0-5 mM-ascorbic acid and 0-5 mM-FeSO4. As well as becoming immotile, such peroxidized spermatozoa also lost, through leakage, certain intracellular enzymes into the surrounding medium, on a scale resembling that produced by cold shocking non-peroxidized spermatozoa. Morphological observations revealed that peroxidation damaged the plasma membrane, particularly in the region of the acrosome. Further experiments showed that lipid peroxidation irreversibly abolished the fructolytic and respiratory activity of spermatozoa. The susceptibility of spermatozoa to peroxidation was greater when the cells were damaged before incubation with ascorbic acid and FeSO4. To some extent, peroxidation could be prevented, but not reversed, by the addition to sperm suspensions of dialysed egg yolk or dialysed bull seminal plasma. However, dialysed seminal plasma from ram, stallion or man had no protective effect.


Developmental effects of the uterine environment: dependence on fetal sex in rats.

Body weight was recorded as a function of intrauterine position for 20-day-old male and female rat fetuses from 83 normal litters. Male fetuses located in the middle of the uterine horn were invariably heavier than males located at the extreme ovarian or cervical positions, those at intermediate positions being intermediate in size. The mean body weight of male fetuses was inversely related to the number of fetuses present in the ipsilateral uterine horn. The body weight of female fetuses appeared independent of both intrauterine position and ipsilateral uterine occupancy. For both sexes, fetal body weight was inversely related to the number of littermates in the contralateral horn. Male fetuses were significantly larger than female fetuses under all but the most adverse intrauterine conditions. Therefore, random fluctuations in sex ratio may distort the true relationshp between mean fetal weight and intrauterine position, if the two sexes are not analysed separately.


The effect of PMSG dose on the incidence of chromosomal anomalies in mouse embryos fertilized in vitro.

Chromosomal analysis of first-cleavage mouse embryos obtained by fertilization of TO eggs with TO spermatozoa in vitro revealed that the incidence of polyploidy was proportional to the dose of PMSG given to the donor females. The dose-response was shown to be linear, with the level of polyploidy rising from 8-0% with a PMSG dose of 1-5 i.u./female to 20-8% with 10-0 i.u./female. A total of 64 polyploid embryos was found among the 452 examined and in all cases the polyploidy was the result of polyspermy or fertilization by diploid spermatozoa.


Qualitative and quantitative examination of the proteins of rat uterine luminal fluid during pro-oestrus and pregnancy and comparison with those of serum.

Rat serum and uterine luminal proteins at two distinct endocrinological stages were analyzed electrophoretically. The quantitative relationships between the major macromolecular fractions were calculated from the densitometer scans. At pro-oestrus there was a marked increase in the total luminal proteins which was probably not due to transudation of serum into the lumen because of the presence of large amounts of two proteins, of approximate mol. wt 125,000 and 130,000, which were not detected in serum. Quantitative estimates of proteins of different molecular weight fractions in the fluids showed that there were considerable differences between the three fluids, indicating that the hormones do not merely induce a free passage of serum proteins into the lumen. On Day 5 of pregnancy there was a considerable lower amount of protein in the uterine lumen and qualitatively these proteins differed from those in serum and the uterine lumen at pro-oestrus.


Radiolabelled rat uterine luminal proteins and their regulation by oestradiol and progesterone.

Radiolabelled uterine luminal proteins were obtained 6 h after instillation of 5--10 muCi [35S]methionine into the lumen of each uterine horn of rats. The proteins were analysed electrophoretically on 6% polyacrylamide gels and incorporation of the precursor into the separated proteins was estimated in 0-18 cm gel slices by scintillation spectrometry. Major incorporation was obtained on Day 5 of pregnancy in a group of proteins of approximate mol. wt 3 X 10(4), 4-5 X 10(4) and 5-5 X 10(4) and in proteins of mol. wt 8--10 X 10(4). During pro-oestrus, substantial incorporation of the precursor occurred in a group of protein of mol, wt 13-5 X 10(4), 12-5 X 10(4) and 7-5--8-0 X 10(4) and slight incorporation in proteins of mol. wt 4-5 X 10(4). These changes were mimicked in ovariectomized females by injections of appropriate steroids: progesterone and oestradiol were necessary to induce the proteins detected during pregnancy, oestradiol alone was able to reproduce the changes observed at pro-oestrus. The proteins in the lumen appear to be of uterine origin because radiolabelled serum proteins were not detected in the lumen after an i.p. injection of the isotope. Also, labelled proteins were detected in the horn receiving the isotope but not in the contralateral horn injected with saline. Cycloheximide, given i.p. simultaneously with the isotope but not in the contralateral horn injected with saline. Cycloheximide, given i.p. simultaneously with the isotope, suppressed synthesis of uterine proteins.


The progesterone content of rabbit uterine flushings.

A detailed study has been made of the progesterone content of uterine flushings taken from rabbits of different endocrine states. A high content of progesterone was recovered from the uterine lumen of pregnant and pseudopregnant rabbits. The amount of progesterone recovered in the flushings was not simply dependent on the concentration in the plasma, because plasma progesterone concentrations rose before detection of progesterone in the flushings and remained high after uterine progesterone content had fallen. Progesterone did not appear in the uterine fluid unless uterine protein was present. This was particularly evident in rabbits treated with progesterone in which, despite abnormally high plasma concentrations, little progesterone was found in uterine fluid until the protein content increased. After treatment of rabbits with oestrogen at the time of ovulation, uterine progesterone was present in higher amounts concomitant with an elevation of protein content although the peak values of progesterone and protein were delayed by 2--3 days. Plasma progesterone concentrations of about 5 ng/ml were necessary before progesterone appeared in the uterine lumen.


Selection of patients for Tuboplasty.

Nonoperative techniques for measuring tubal patency and interpretation of their findings can be misleading. Laparoscopic study of infertile women who have abnormal fallopian tubes should always be a prerequisite of tuboplasty. Observations must be accompanied by intrauterine injection of adequate amounts of dye and gentle tubal manipulations. These efforts will help eliminate attempts to reconstruct nonsalvageable tubes. Successful term pregnancy following tuboplasty is related to the extent of tubal damage as well as the operative technique and postoperative management.


Arthritis after jejunoileostomy for intractable obesity.

Joint symptoms developed in six of 33 patients (18%) who had jejunoileostomy as treatment for intractable obesity. These consisted of single or recurrent attacks of polyarthritis or arthralgias, primarily in large joints. The histocompatibility antigen, HL-A B27, was not present in these patients. Most attacks responded to simple analgesic agents, but a trial of tetracycline in one patient failed to relieve joint symptoms. This arthropathy seems to differ from that which has been reported after jejunocolostomy.


Free DNA in the serum of rheumatoid arthritis patients.

Seventy patients with classical or definite rheumatoid arthritis (RA) were studied in an attempt to correlate the serum levels of free DNA with other features. In 26 patients (37%), levels of DNA ranging from 100-540 ng/ml, with a mean of 187 ng/ml, were found. In additional seven patients with a mean of 257 ng/ml, low levels of anti-DNA-antibody were observed. The remaining of 37 patients (53%) had levels of 0-80 ng/ml in their sera, with a mean of 39 ng/ml. All three groups differed significantly (p less than 0.01) from the control group of 61 healthy individuals, who had levels of 0-80 ng/ml with a mean of 13 ng/ml. The high levels of free DNA were commonly found in patients with more severe symptoms who had active RA for less than 10 years, whereas patients with longer duration of disease showed lower levels of DNA. In addition, elevated DNA levels were found more commonly in patients seronegative for rheumatoid factor (RF). Other clinical features did not show significant differences among these patients. The implications of these findings to the pathogenesis of the disease are discussed.


"Independent assessor" and "pooled index" as techniques for measuring treatment effects in rheumatoid arthritis.

To conduct studies of therapy of rheumatoid patients at the primary care level two new assessment techniques were developed. The "independent assessor" (IA) was a nonmedical person trained to gather information using a questionnaire, a guided count of tender joints, grip strength, and blood tests. The "polled index" was a statistical device for summarizing all abailable information, constructed by transformation of various clinical measures of treatment effects to a common scale, based on standard deviation units. A validation study is reported, which involved 33 rheumatoid patients, each studied by four trained observers plus the IA, before and after 10 days of hospital therapy. Major gains in sensitivity and reliability were achieved by the pooled index. The IAs total assessment provided 84% of the information available in the pooled index, and was more sensitive and reliable than any other single clinical measure. The efficacy of a brief period of hospital therapy for rheumatoid patients was also strikingly demonstrated.


Conversion of discoid lupus erythematosus to mixed connective tissue disease.

The progression from discoid lupus erythematosus (DLE) to severe systemic lupus erythematosus (SLE) is rare. Two patients with DLE for five and 10 years eventually developed systemic involvement with clinical features of mixed connective tissue disease (MCTD). Both patients had high titer serum antibody to ribonucleoprotein (RNP) and epidermal nuclear staining on direct immunofluorescence of normal skin. Neither patient had renal disease but one patient developed pulmonary involvement. This observation suggests that patients with DLE and the Raynaud phenomenon may have a connective tissue disease subset characterized by anti-RNP, the immunologic marker for MCTC.


The fixed lupus hand deformity and its surgical correction.

In a prospective study of 125 patients with SLE, three females developed fixed hand deformities. All had arthritis for more than 10 years, and had been treated with a mean daily dose of 15 mg of prednisone. The hand deformities consisted of irreducible metacarpophalangeal (MCP) subluxation and/or dislocation without erosion or destruction of the MCP joints, resulting in hyperflexion of the fingers in the palm. Two patients had dislocation of the carpometacarpal joints in both hands. On patient developed reducible swan-neck deformities in the second to fifth fingers of both hands and a second patient developed Boutonniere deformities in two fingers of one hand and clinodactyly of both fifth fingers. Because the deformity at the MCP joints resulted from soft tissue contractures in the intrinsics and long flexors, and because the cartilage of the MCP joint was preserved, a joint replacement was not considered. Metacarpal osteotomy and shortening was performed to decompress the contracted soft tissues. At follow-up (18-96 months), the hands remained corrected and all patients were able to perform normal activities.


Antacid-induced hypophosphatemia: an unusual cause of "pseudo-myopathy".

A 69 year old man presented with painful proximal muscle weakness which clinically simulated polymyositis. Further evaluation revealed normal muscle enzymes and hypophosphatemia which resulted from unsuspected antacid abuse. "Pseudo-myopathy" is one example of the myriad of rheumatic diseases which may be mimicked by hypophosphatemia.


Serum immunoglobulin and complement interrelationships in juvenile rheumatoid arthritis.

Patients with juvenile rheumatoid arthritis (JRA) were compared with a matched control group for the presence and levels of IgG, IgM, IgA, IgE, IgD, C3, C4, and rheumatoid factor. In the majority of patients (86.1 to 94.4%) the distributions fell within the normal ranges of the control group. In JRA, older age appears to have a significant relationship for increased IgE levels. Levels of IgE and IgD do not appear to be related to the presence or activity of JRA. Significantly elevated levels of IgG, IgA, and C4 were found in active disease while elevated IgM levels are characteristic of the disease itself.


Dissecting popliteal cyst in a child with juvenile rheumatoid arthritis.

A 14 year old white female with juvenile rheumatoid arthritis developed the sudden onset of pain and swelling in the right calf. Arthrography revealed a dissecting popliteal cyst. Symptoms abated following an intra-articular injection of triamcinolone acetonide.


Bilateral protusio acetabuli following pelvic irradiation.

A 77 year old man developed bilateral protrusio acetabuli three years following pelvic irradiation for transitional cell carcinoma of the prostatic urethra. There was no evidence of metastasis or coexistent systemic arthritis. Aseptic necrosis of acetabular bone is the postulated etiology. Gross and pathologic evidence of aseptic necrosis of both femoral heads was observed. Vascular fibrosis was a prominent pathologic finding, as was eosinophilia of the synovial fluid and joint tissue. Protrusio appears to be an infrequently described complication of pelvic irradiation.


Treatment of Sweet's syndrome (active febrile neutrophilic dermatosis) with indomethacin.

Acute febrile neutrophilic dermatosis was first reported by Sweet in 1964. Sweet demonstrated the value of steroid therapy in these cases. Many authors have since confirmed the efficacy of steroids in treating this usually self-limiting, but often temporarily disabling, process. This case report and review concerns a patient with Sweet's syndrome in whom dramatic relief of severe arthralgias, myalgias, and painful skin lesions occurred using indomethacin. Steroids were not used because of the good response to an empiric trial of indomethacin and the likelihood of concurrent histoplasmosis.


Survival in polymyositis: corticosteroids and risk factors.

Thirty-one polymyositis patients treated with low-dose corticosteroid were age and sex matched with 31 polymyositis patients treated with high-dose corticosteroid. Although disease severity at onset of the study was similar in the groups, no statistically significant difference in survival was found. The death rate in each group was greater than normal. The presence of dysphagia or severe muscle weakness lessened the chances of survival. Controlled trials with other drugs should be carried out.


Hemarthrosis associated with sodium warfarin.

Three patients developed an acute hemarthrosis related to sodium warfarin. Synovial aspiration was well tolerated and necessary to substantiate the diagnosis. Prior joint disease was present in two but in only one was there a definite precipitating event, namely minor trauma. The prothrombin time was within the therapeutic range in two of the three. The acute synovitis subsided after the warfarin was discontinued. Joint function seems to have fully returned but long-term evaluation is needed.


Differentiation in human amniotic fluid cell cultures: I: Collagen production.

The collagen produced by differentiated cells cultured from human amniotic fluid was characterized in two ways. By chain composition and by 4-hydroxyproline:3-hydroxyproline isomer ratio, the collagen synthesized by F-type (fibroblast) cells was indistinguishable from that made by cultured fetal dermal fibroblasts. The predominant cells in young amniotic fluid cultures, termed AF-type, produced collagen with a lower isomer ratio, resembling that of basement membrane collage. The chain composition, as determined by chromatography on carboxymethyl cellulose, varied for different cultures of the AF-type, but the major pattern was consistent with that of basement membrane collagen. On the basis of these characteristics, F cells are of fibroblast origin, whereas most AF cells are of a different origin either endothelial or epithelial. Other evidence (Megaw et al., 1977) suggests an epithelial origin for AF cells.


Mild sickle-cell anaemia in Iran associated with high levels of fetal haemoglobin.

Sixteen subjects, with sickle-cell anaemia, all Iranians (ages 3 to 56 years), with very mild symptomatology are reported. Some of the subjects had been totally asymptomatic. Splenomegaly was noted in 9 cases. There was an increase in the mean level of fetal haemoglobin (18%); this is the probable explanation for the mild phenotype. In 29 subjects with sickle-cell trait, the level of HbF was also significantly raised as compared with normal (1-6% vs. 0-6%). The mechanism of increased synthesis of HbF is unknown. The findings are similar to those reported in the Shiite Moslems of Saudi Arabia suggesting that in these populations there is a genetically-determined ability to produce high levels of Hb F in the presence of the sickle-cell gene.


Genetic study of Welsh gypsies.

A South Wales gypsy kindred of Romany origin had a high incidence of phenylketonuria along with other recessively inherited disorders. There was a high degree of consanguinity (F = 0-017) with an excess of non-specific mental subnormality among known consanguineous matings. Phenylketonuria and a number of other recessively inherited disorders have been recorded from other Romany gypsy populations, but it is uncertain whether this results from a generally high gene frequency for the disorders or from consanguinity and other more local factors.


Genetic markers in Welsh gypsies.

Data  are presented on polymorphic genetic markers of 84 Welsh gypsies, members of an inbred population characterised by a high incidence of phenylketonuria and other recessively inherited diseases. Sixteen polymorphic loci were studied: the ABO blood group distribution was comparable to that of the surrounding population, the B gene frequency being 7-5%, a lower frequency than most earlier studies in gypsies. The haptoglobin 1 gene frequency (23-7%) was very different from that of the British population, resembling the frequency found in India and some previously reported gypsy groups. The data on Welsh gypsies for the various loci are discussed in relation to the known evidence for a number of European gypsy populations, and in relation to the genetic structure of these populations. It is concluded that genetic divergence has occurred in the European gypsies, and that this may have been accentuated by the dispersal, isolation, and inbreeding which have occurred during the present century.


Dermatoglyphs of Klinefelter's syndrome.

The dermatoglyphs of 28 Japanese with Klinefelter's syndrome [24 XXY; 2 XXYY; 1 XXXY; 1 XXXXY] were compared with 544 male and 129 female controls. These patients showed high frequencies of fingertip arches pattern, right third interdigital loops, right hypothenar patterns (Lr) and  line C terminating 0 in the right hand. The mean summed a-b ridge count of Klinefelter's syndrome patients was significantly lower than that of the male controls. We suggest that an increase in the number of X or Y chromosomes decreased the a-b ridge count in a similar way to the decrease in total finger ridge count.


Diabetes mellitus, diabetes insipidus, and optic atrophy. An autosomal recessive syndrome?

Twenty-one families were selected from the published reports in which the propositus had the triad of juvenile diabetes mellitus, diabetes insipidus, and optic atrophy. The data were consistent with the hypothesis of an autosomal gene which, in the homozygote, causes juvenile diabetes mellitus and one or more of diabetes insipidus, optic atrophy, and nerve deafness. Heterozygotes appear to have an increased probability of developing juvenile diabetes mellitus.


Three sisters with gonadoblastoma.

Three sisters with gonadoblastoma and an 46,XY karyotype are presented. This observation suggests that heredity may play an important role in the genesis of the tumour.


Inheritance of Ehlers-Danlos type IV syndrome.

The Ehlers-Danlos type IV syndrome is a severe disease with premature death from catastrophic tearing of large arteries and a tendency to intestinal rupture. These patients lack the genetically distinct type III collagen. Here evidence is presented that obligate heterozygotes have lowered levels of type III collagen in their skin and that their cultured fibroblasts produce less than normal amounts of this protein. The inheritance is autosomal recessive.


Bilateral absence of the kidneys and ureters. Three cases reported in one family.

Three infant boys with bilateral absence of the kidneys and hypoplasia of the lungs are described. Two of the infants were brothers and the third was a first cousin. They were born to 2 sisters whose husbancs were unrelated to their wives and to each other. None of the parents had renal problems. The occurrence of this syndrome in 2 male sibs is suggestive of an autosomal recessive inheritance pattern which has been previously described. An additional male first cousin born to the mother's sister is sugesstive of sex-linked inheritance for this particular family, an inheritance pattern not previously described.


Association of ABO blood groups and vitiligo.

ABO blood group frequencies of 1000 vitiligo patients were studied and compared with those of blood donors and local population. The relative risk of O was significantly reduced in patients in comparison with blood donors but not with local population. This can possibly be explained by the well-known preference of O group donors in the blood bank. On a review of other studies it was felt that there may not be any real association of ABO blood groups with vitiligo.


46,XX/47XX, + 14 mosaicism in a liveborn infant.

A liveborn infant with the complement 46,XX/47,XX, + 14 shared certain features in common with the following previously reported cases: (1) the one previously reported possible case of trisomy 14, (2) cases in which individuals had at least some portion of chromosome No. 14 in triplicate, and (3) cases of atypical D trisomy (Snodgrass category II). The common features include developmental retardation, wide flat nose with bulbous or wide tip, large mouth with turned down corners (some with protruding lips), short neck (some with redundant skin folds), low-set ears, retrognathia, digital anomalies (usually contractions and deviations), palatal anomalies, and cryptorchidism.


45,X/47,XYY mosaicism.

This paper describes and discusses the clinical and cytogenetic findings in an infant with an unusual sex chromosome abnormality 45X/47XYY.


Trisomy 22 mosaicism.

A child with many symptoms of trisomy 22 syndrome is described. The child showed a 46,XY/47,XY,+22 chromosome constitution. This is the first reported case of a trisome 22 phenotype with such a mosaic karyotype.


Ring chromosome 4.

A mentally and physically retarded boy with a 46,XY,ring (4) (p16q35) chromosome complement is described. Chromosome banding showed that the amount of chromosome material deleted from the ring chromosome 4 was minimal, apparently no more than the telomeres. Chromosomal aberrations appear to be restricted to the production of double-sized dicentric rings, and aneuploidy. The mosiacism resulting from the behavioural peculiarities of ring chromosomes is described as dynamic mosaicism. It is suggested that the clinical features associated with this ring chromosome are more likely to be the result of the effects of a diploid/monosomy 4/polysomy 4 mosaicism than to the deficiency of the telomeric regions of the chromosome.


Prenatal recognition of 4p- syndrome.

A fetus with the rare 4p- syndrome was detected by chromosome analysis of amniotic cell culture, and the pregnancy terminated. The fetus showed a number of the physical stigmata of the syndrome.


Vaginismus: a review.

Vaginismus includes both physical as well as psychological aspects that make vaginal penetration extremely painful if not altogether impossible. Aside from history, diagnosis rests on the physical examination. The causes for the condition range from the deeply psychological to vividly recalled genital experiences and may involve conditioned responses. Similarly, treatment methods range from surgery to simple muscle-strengthening exercises to elaborate psychotherapeutic intervention. More recently, behavioral methods have shown marked success. The most important considerations in therapy seem to be the patient's understanding of the problem and flexibility of approach.


Arousal, personality, and assortative mating in marriage.

It is known that there is significant assortative mating for intelligence. However, where personality is concerned, the picture is less clear, and where physiologically referenced individual differences are concerned, there is a negligible body of available research. A compound major individual difference variable having a putative physiological basis--arousal and the stimulation-seeking motive, which has not heretofore been investigated in studies of assortative mating--was the focus of the present study. In addition, three major personality dimensions--extraversion-introversion, neuroticism and psychoticism--were included for study. One hundred and two married couples in the housing complex of a large American midwestern university were tested on the arousal/stimulation-seeking and personality measures. Significant assortative mating (p less than .01) was found only for arousal/stimulation-seeking. The results for the other personality dimensions failed to confirm significant but slight assortative mating for neuroticism and psychoticism previously reported for British couples, but were in accord with the previously reported lack of any assortative mating for extraversion-introversion. The results were discussed in terms of further understanding the basis of assortative mating, with particular attention given to the likely role of biological cycles. Further research was outlined.


A contribution to the development of the behavioral-analytic sex therapy model.

If we work from the assumption that sexual symptoms are functional rather than dysfunctional, we can more fully exploit the opportunity for rapid uncovering therapy created by the symptom focus and the assignment structure of sex therapy. This objective is facilitated by an ego-analytic reevaluation of the way that the repression model is used in conventional uncovering therapy. To illustrate this ego-analytic strategy, it is applied in the hypothetical treatment of a couple who were not capable of or motivated for conventional uncovering therapy and for whom the bypassing appraoch of strictly behavioral sex therapy had failed.


A typology of intimate relationships.

A typology of marriages and other intimate relationships is offered based on seven behavioral profiles that partners can exhibit in their interactions with one another. The typology is relatively simple, based upon the main thrust of each partner's behavior in their dyadic system. The intrapsychic and biological factors that are forces in each partner's marriage contract differ for each behavioral profile. The profiles are subject to change as the couples' interactions change. There are 28 possible combinations of the two partners' profiles. These are determined by putting together the two terms that best describe each partner's behavior. The prognosis for the quality of each type of relationship in  the typology is discussed.


Echocardiogram of the pulmonary valve. Variability of the pattern and the related technical problems.

In order to examine the variability of the pattern due to the location and direction of the ultrasonic transducer, echocardiograms of the pulmonary valve were obtained from different precordial areas in 28 patients with various diseases and in 3 normal subjects. By higher positioning of the transducer, the diastolic slope became slower or upward and the 'a' wave became indiscernible, giving the pattern of pulmonary hypertension even in the normotensives. The anterior cusp was also detected by tilting of the transducer in some cases. Systolic time intervals (STI) of the right ventricle, however, were not influenced by the beam angle. The present data strongly suggests that the echocardiogram of the pulmonary valve should be carefully evaluated in the light of the spatial relationship of the echo beam and the valve in order to give the diagnostic importance.


Phono-, echo-, and electro-cardiographic correlation in the Wolff-Parkinson-White syndrome, with special reference to the split pattern of second heart sound.

Twenty-three cases with WPW syndrome were studied by means of phonocardiography, echocardiography, and electrocardiography. All cases showed the abnormal cardiac motion in echocardiography, which could be divided into 2 types; ventricular (V) type in which the posterior left ventricular wall showed the abnormal humps in the early and late systole (18 cases), and septal (S) type in which the abnormal hump was noted in the early systole in the interventricular septum (5 cases). The cases with V type echocardiogram showed either type A, B, or C, and those with S type either type B or C of ECG. All cases with V type had the splitting of second heart sound of a normal fashion and the IIA-IIP interval ranged from 0.015 to 0.08 sec with a mean of 0.0356+/-0.0157 sec. In contrast, those with S type showed either a reversed splitting of second heart sound (4 cases) or a single second heart sound (1 case), and the IIA-IIP interval ranged from 0 to--0.05 sec with a mean of --0.0250+/-0.0170 sec. No consistent relationship was noted between the ECG type and the split interval of second heart sound. There was the significant positive correlation between the IIA-IIP interval and the QRS duration in the cases with V type echocardiogram. In S type, these 2 parameters showed the significant negative correlation.


Recording of the fourth heart sound by the signal averaging method. Preliminary report.

The fourth heart sound was clearly recorded by using the signal averaging method. Furthermore, the simultaneous recording of the Doppler signal with the fourth heart sound was performed. Thus, it was demonstrated that the Doppler signal started after the P wave and followed by the fourth heart sound. In 2 cases, the effect of the double Master's test and taking a bath was studied on the computer averaged phonocardiogram. After the exercise, the amplitude of the fourth heart sound was increased, whereas after taking a bath it was almost unchanged. The above results show that the simultaneous recordings of a computer averaged phonocardiogram and Doppler signal that is associated with cardiac activity can greatly facilitate the interpretation of small vibrations such as the fourth heart sound.


Dopamine-beta-hydroxylase activity after acute myocardial infarction.

Serum dopamine-beta-hydroxylase (DBH) activities of 74 apparently healthy adults were not distributed normally, but skewed to the right. There were at least 2 subgroups in the distribution of DBH activity. Accordingly, 27 serial serum DBH activities following acute myocardial infarction were divided into 2 subgroups according to their activities on the 10th day or/and thereafter. The DBH activity was significantly elevated on the 1st day with average of 157% of the 10th day (p less than 0.015) in high DBH subgroup and also significantly elevated on the 1st and 2nd day with the average of 182% and 155%, respectively, of the 10th day (p=0.025 and p less than 0.05) in low DBH subgroup. There was no significant difference between the DBH activity of patients with anterior myocardial infarction and that of patients with inferior myocardial infarction. No significant correlation between the DBH activity and the coronary prognostic index was found. The observed elevation of the DBH activity on the 1st and 2nd day suggests an augmentation in the sympathetic nervous activity after acute myocardial infarction.


A correlative study on the changes of cardiac dynamics and myocardial energy liberation in blood-let dogs.

Blood-letting of 450 to 1,000 ml with or without saline infusion was performed in dogs. In some dogs, right atrial pacing was carried out during blood-letting. Heart rate and isometric time-tension index were measured as the indicators of chronotropism and inotropism, respectively. After 60 min of blood-letting, dogs were sacrificed and mitochondria were isolated from the left ventricular myocardium. Mitochondrial respiration was measured polarographically and respiratory control index was calculated. As blood-letting advanced, the hearts revealed negative chronotropism with negative inotropism. Mitochondrial respiration was suppressed. When heart rate was forced to increase with atrial pacing, the hearts showed positive chronotropism with negative inotropism. Respiratory control index of mitochondria was deteriorated, showing uncoupling of oxidative phosphorylation. In consideration with our previous study on the ischemic heart, it is concluded that uncoupling of oxidative phosphorylation appeared in hypoxic myocardium when cardiac dynamics shifted to positive chronotropism with negative inotropism, though suppression of mitochondrial respiration was revealed when cardiac dynamics altered to negative chronotropism with negative inotropism.


Cardiac function under myocardial ischemia.

The hemodynamic and metabolic changes, during coronary occlusion and during coronary perfusion with non-oxygenated solution, were studied in anesthetized dogs. Coronary perfusion with non-oxygenated Tyrode's solution was performed through a cannula inserted into the left circumflex coronary artery. Left ventricular peak systolic and end-diastolic pressure (LVSP and LVEDP) were measured, and peak LV-dp/dt/IIP calculated. Stroke volume was measured, and the changed of the local myocardial segment length were recorded by a strain gauge arch sutured on that portion of the myocardium perfused through the left circumflex coronary artery. The efflux of lactic acid into the venous blood from the myocardium perfused through the left circumflex coronary artery was calculated. After 10 sec of coronary occlusion, LVSP, SV, and peak LV-dp/dt/IIP declined; LVEDP elevated and a systolic bulge appeared on the local myocardial segment length curve. There was almost no change in these parameters during 3 min of perfusion with non-oxygenated solution. The efflux of lactic acid was more marked during the perfusion with non-oxygenated solution than during coronary occlusion. The delay of the depression of cardiac function during perfusion with the non-oxygenated solution could be related partly to the "wash-out" of metabolites, such as lactic acid, accumulated in the anoxic myocardium.


Effects of potassium chloride on isolated, blood-perfused canine atrial or ventricular muscle preparations.

The effects of potassium chloride were studied on pacemaker activity in the sinoatrial (SA) node and on contractility in isolated, blood-perfused atrial and left ventricular preparations of dogs, which were suspended in the bath and perfused with arterial blood from the carotid artery of the heparinized support dog. Potassium chloride given directly into the sinus node artery in a dose range of 100 micrograms--1 mg produced a dose-related positive chronotropic and a negative inotropic effect in isolated atrium preparations. Potassium chloride into the cannulated anterior descending branch of the left coronary artery caused only a negative inotropic effect in isolated ventricular preparations. A larger dose of potassium chloride caused temporary atrial or ventricular arrest. These effects of potassium chloride were not modified by pretreatment with atropine or propranolol.


Increase of hematocrit in experimental renal hypertension and its reversal.

Hematocrit can be increased in experimental animals with renal hypertension of two-kidney type. The present study showed that the increased hematocrit was returned to normal by removal of the clipped kidney. The left renal artery was clipped in 13 rabbits with an intact contralateral kidney, and a sham operation was performed in 10 rabbits as a control. After an interval of 10 weeks the left kidney was removed in all animals. Blood pressure, hematocrit, hemoglobin content, and erythrocyte count were rapidly increased and remained raised after clipping of the renal artery but they did not show any significant changes after sham operation. A transient but significant increase of reticulocyte count was found at the end of the first week after clipping of the renal artery. Removal of the clipped kidney was followed by a rapid return of hematocrit, hemoglobin content, and erythrocyte count to normal within 2 weeks. Blood pressure was also decreased but not returned to normal by removal of the clipped kidney.


Prognostic profile of fascicular blocks in myocardial infarction.

An analysis of 69 cases of bifascicular and trifascicular types of intraventricular conduction disturbances in myocardial infarction is presented. Complications, caused of death and the follow-up of unpaced cases for a year have been recorded. Pump failure and severe degrees of blocks with consequent ventricular asystole are the important caused of death. Recurrent pump failure with occasional outcome is more common in cases with RBBB and LAH than in other types of blocks.


[The pros and cons of haemoperfusion (author's transl)].

6 patients with severe self-poisoning were treated by charcoal-haemoperfusion in our centre up to now. In four of them (all suffering from sleeping drug overdosage) the treatment was successful. Two patients with intoxications by agrochemicals died in spite of haemoperfusion. Side effects of haemoperfusion were drops of blood pressure and platelet count, depletion of immune bodies, and adsorption of remedies. Up to now, the indication for haemoperfusion has to consider these secondary actions of encapsulated charcoal as inevitable.


[Dysfibrinogenemia. A new case: dysfibrinogenemia Giessen III (author's transl)].

A new case of dysfibrinogenemia is reported which shows no signs of a haermorrhagic diathesis (dysfibrinogenemia Giessen III). The abnormal fibrinogen was detected by only slight but characteristic alterations of some parameter of the coagulation analysis (prolonged clotting times after addition of thrombin, Reptilase and thrombin coagulase; low fibrinogen concentration determined by methods based on clot formation in comparison to the immunological fibrinogen determination; delayed fibrin polymerization). In addition, clinical features and diagnosis of dysfibrinogenemia are described in general.


[Elevated serum-sialyltransferase activity in human malignant diseases: a new diagnostic tool? (author's transl)].

Sialyltransferase activity was estimated in serum samples of patients with cancer and controls using immobilized asialo-fetuin as the acceptor and cytidine-5'-monophospho [14C] sialic acid as the donor. The data suggest that increased enzyme activity can be found in more than 80% of the samples from patients with malignant diseases.


[Serum lysozyme concentrations in patients with morbus Crohn before and after bowel resection (author's transl)].

Serum lysozyme (muramidase) concentrations were determined in five patients with Morbus Crohn before and after resection of inflammated bowel areas. The serum lysozyme activity which was elevated before surgical treatment in all patients fell to normal values after bowel resection within a few hours. Our findings suggest, that the elevated serum lysozyme reflects an increased lysozyme production in the inflammated bowel tissue.


[Biochemistry of metallocenes. III. Thymus-affinity for (103Ru)-ruthenocenyl-3-phenyl-propen-1-one].

103Ru labelled 1-Ruthenocenyl-3-phenyl-propen-1-one was administered to mice introperitoneally. The organ distribution was determined in liver, spleen, lung, muscle, blood, kidney and thymus. The highest concentration was found in the thymus-up to 22% of the injected dose/g with corresponding thymus to muscle ratios of up to 364:1. The consequences for nuclear medicine are discussed.


The fate of 14C-elastin in the peritoneal cavity of rats. I. Biochemical studies.

Degradation of elastin was studied in rats after intraperitoneal implantation of a suspension of 14C-elastin that had been prepared by labeling bovine elastin with 14C-formaldehyde. Most of the degradation of 14C-elastin, measured by releasing the radioactivity in urine and feces, occurred between 6 and 15 days after the implantation. During this period an increase of leukocytes and macrophages in the implanted site was observed. This followed a brief increase in neutrophils. Furthermore, an elevation of the elastolytic activity, measured by the 14C-elastin, was found in cell lysates of both macrophages and neutrophils, which were recovered by lavage of the peritoneal cavity. But the enzymatic activity was not found in the cell-free lavage. On the contrary, there was elastase inhibitor in the lavage, increased by the implantation. The mechanism of the elastin degradation in the peritoneal cavity was discussed.


Ultrastructural alterations in nutritional cardiomyopathy of selenium-vitamin E deficient swine. I. Fiber lesions.

Cardiomyopathy was produced in 38 weanling swine by feeding a semisynthetic diet deficient in selenium and vitamin E for 13 to 59 days. Pigs were killed for morphologic studies of the cardiac lesions at sequential times after development of the deficiency disease. Gross examination disclosed hydropericardium and scattered pale streaks and patches of necrosis in the myocardium, especially the left ventricle. Histopathologically, the lesions were scattered throughout the heart but were most severe in the atria. Ultrastructurally, the damaged fibers had many features of myofibrillar degeneration with hypercontraction bands, myofibrillar lysis, and mitochondrial swelling, disruption, and mineralization. Numerous macrophages appeared to have passed through focal disruptions in the external laminae of the muscle cells and engulfed sarcoplasmic and nuclear debris. Stromal collapse and mild fibrosis persisted as residual lesions in scattered areas of myocardium in pigs with long term deficiency. Although vascular lesions were present in the hearts of selenium and vitamin E deficient pigs, it was concluded that the fiber alterations developed independently of the vascular changes. The pathogenesis of this cardiomyopathy induced by nutritional deficiency is thought to be related to lack of protection by the selenoenzyme, glutathione peroxidase, and the antioxidant, vitamin E, from lipoperoxidative damage.


Ultrastructural alterations in nutritional cardiomyopathy of selenium-vitamin E deficient swine. II. Vascular lesions.

Selenium-vitamin E deficiency was produced in weanling swine by feeding a semisynthetic basal diet for 13 to 59 days. Pigs were killed sequentially for morphologic studies of the cardiac lesions. In hearts with vascular damage, gross hemorrhages were scattered in the myocardium and serosal surfaces. Light and electron microscopic study revealed myocardial arteriolar damage characterized by segmental fibrinoid accumulation in vessel walls and by scattered fibrin thrombi. Ultrastructural study disclosed extensive subendothelial and inner wall accumulations of dense granular deposits of serum proteins and masses of fibrin in arterioles in which dense deposits of fibrinoid were identified by light microscopy. Endothelial cells of these arterioles were loosely attached to each other. In arterioles with fibrin thrombi, the endothelium was disrupted. In mildly injured arterioles, increased endothelial permeability resulted in insudation of blood proteins into the vessel wall to produce accumulation of fibrinoid. In severely injured vessels, endothelial integrity was destroyed, smooth muscle cells were necrotic and thrombosis had developed. Initiation of these arteriolar lesions was apparently the result of lipoperoxidative damage to endothelial cell membranes that lacked protection by selenium-vitamin E.


Amyloid in polypeptide hormone-producing tumors.

The hormone content of 72 endocrine tumors was determined by immunofluorescence and their amyloid content was investigated. Seventeen of the 72 tumors contained amyloid. Amyloid was frequently found in tumors producing calcitonin, insulin, or growth hormone, but was rarely found in other tumors. Thus, there is a relationship between the occurrence of amyloid in an endocrine tumor and the type of hormone it produces. The reason for this is not known, but there is evidence that the amyloid fibrils contain proteins related to the hormone produced by the tumors.


Muscle protein synthesis in MED myopathy.

A fatal, rapidly developing progressive muscle disease of delayed onset in mice is produced by the effects of an autosomal recessive gene (MED). We recognize two stages of this disease. The earlier stage, observed between the 11th and 14th postnatal day, is characterized by structurally normal small myofibers, cessation of increase in body weight, and increasing muscular weakness, particularly of the hind limbs. The second stage is characterized by a spheromembranous degeneration of myofibers and almost complete cessation of voluntary movement. Previous studies have revealed neither anatomic abnormalities in neuromuscular junctions nor major changes in oxidative metabolism or electrolyte concentrations in striated myofibers in the early stages of the disease. In this paper we report investigations designed to determine whether the failure of growth of striated muscle in the first stage is due to a defect in muscle protein synthesis or, as has been found in muscular dystrophies, is due to an increased rate of degradation of muscle. We conclude that MED animals demonstrate a different kind of defect than that occurring in dystrophic mice. In MED mice, the failure of growth is primarily due to a diminished rate of protein synthesis.


Visual reinforcement of head-turn responses in infants under 12 months of age.

The effect of complex visual reinforcement (animated toy animal) on auditory localization responses of infants below 12 months of age was studied. Sixty infants served as subjects and each subject received 30 presentations of complex noise at suprathreshold level. After each response to an auditory signal, one-half of the infants (experimental group) received complex visual reinforcement and the other half (control group) received no reinforcement. The experimental and control groups were further subdivided into three age groups: four months, five and six months, and seven to 11 months. Visual reinforcement produced significantly more responses (head turn) than no reinforcement for the two older age groups. There was no significant difference between the experimental and control conditions at four months of age.


A hearing aid malfunction detection unit.

A system is described, the Hearing Aid Malfunction Detection Unit (HAMDU), that electrically checks for proper operation of several aspects of hearing aid function. HAMDU is a miniature, add-on device which performs a check of hearing aid operation about every half hour, and which indicates malfunction by means of a highly visible, electrically tripped indicator. Functions checked include battery voltage, gain, distortion and noise, and continuity of the receiver cord. In addition, the indicator will be tripped if the hearing aid is turned off. HAMDU is small, low in cost, can be adapted to most body aids, and has no effect on hearing aid performance. The primary features of the system are that the hearing aid is checked periodically throughout its use, and the aid does not have to be removed from the wearer. The unit is designed specifically for body type hearing aids worn by children.


Automatization of correct production at two levels of articulatory acquisition.

This study investigated the assumption that children who are in the process of acquiring correct production of a misarticulated phoneme are also in the process of developing automatization of correct production. Using the McDonald Deep Test of Articulation, children's articulation was tested under two conditions: Condition 1 without masking and Condition 2 with 85 dB SLP of competing speech masking. Children were classified into one of two levels of articulatory acquisition according to their performance during Condition 1. Children scoring below 80% correct were classsified as demonstrating low acquisition. Children scoring above 80% correct were classified as demonstrating high acquisition. Only children with /s/ or /r/ misarticulations were studied. Results indicated that the correct articulation of children demonstrating low acquisition was significantly more affected by the auditory masking than the correct articulation of those children demonstrating higher levels of acquisition. There was no significant difference in the performance of the children with the /s/ or /r/ misarticulations. The results support the concept that articulatory acquisition and automatization of correct articulation relate in a predictable manner.


Relationships between comfortable loudness levels for speech and speech discrimination in sensorineural hearing loss.

The primary purpose of this study was to investigate the relationship between the sensation level selected as most comfortable for loudness and intelligibility, and the sensation level at which maximum speech discrimination is obtained. An articulation function was generated at five sensation levels for 45 subjects with sensorineural hearing loss. Speech discrimination scores were also obtained at sensation levels corresponding to most comfortable loudness levels for loudness and intelligibility. Results indicated that most comfortable loudness, at least under the conditions of the present study, does not appear to be the level at which maximum speech discrimination is obtained. Therefore, the use of comfortable loudness as a single sensation level for testing a subject's maximum discrimination is not recommended at this time.


Bedtime soliloquies and linguistic competence in autism.

This study investigates the linguistic competence of an autistic child by means of her bedtime soliloquies. It suggests the usefulness of such monologues as a diagnostic tool and addresses the question of the interrelationship between echolalia and language development. Three bedtime soliloquies of an eight-year-old echolalic autistic child are analyzed along the dimensions of echolalia versus propositional speech, types of ungrammaticality produced, and analysis of connected discourse. The results are compared with those of a normal child reported earlier in the literature. The present analysis demonstrates the difficulties in the judgement of propositional versus echolalic speech. The types of ungrammaticality were found to be useful indicators of apparent differences between the acquisition process in the normal and the autistic child. They revealed that the autistic child may use specific linguistic strategies only minimally utilized by the normal child. The discourse analysis points up additional differences as well as similarities in the way the autistic subject organizes her utterances in connected discourse. It also shows that the autistic child has specific but limited linguistic competence. It is hypothesized that the autistic subject acquires more functional, useful language by a process of gradually breaking down echolalic patterns. In terms of therapy, these findings would support the use of echolalia as a basis for language training.


Treatment and generalization effects in an experimental treatment for a stutterer using contingency management and speech rate control.

An experimental treatment program for an adult stutterer, using contingency management and rate control procedures, is described. During laboratory sessions, a combination of both procedures resulted in maintained stutter-free speech within a target speech rate range. Bidaily recordings of the subject's speech across all nonlaboratory speaking situations, preceding and throughout the laboratory treatment, revealed no correspondence between laboratory and nonlaboratory speech behavior. Some positive and negative findings from this study are considered with respect to contingency management of stuttering.


Use of performance-intensity functions for diagnosis.

Performance-intensity (PI) functions for phonetically balanced (PB) word lists were obtained for a group of normal listeners (27 ears), and for two groups of patients with cochlear (89 ears) and retrocochlear disorders (eight ears). Listeners with normal hearing or cochlear disorders exhibited mild to moderate reductions in discrimination score as the speech level was raised above the PB maximum. In contrast, patients with retrocochlear disorders showed a pronounced rollover phenomenon, characterized by a rapid decline in performance as the speech level was raised above the maximum discrimination score.


Bioelectronic measurement of nasality in trainable mentally retarded children.

Fifty trainable mentally retarded children were evaluated with TONAR II, a bioelectronic instrument for detecting and quantitatively measuring voice parameters. Results indicated that one-half of the children tested were hypernasal. The strikingly high prevalence of excessive nasality was contrasted with results obtained from 64 nonretarded children and 50 educable retarded children tested with the same instrument. The study demonstrated the need of retarded persons for improved voice and resonance.


Split-half reliability of two word discrimination tests as a function of primary-to-secondary ratio.

Two clinical word discrimination tests, the Northwestern University Auditory Test No. 6 (NU-6) and the Modified Rhyme Test (MRT), were examined for internal consistency and for split-half reliability under varying primary-to-secondary ratios (P:S) in normal hearers. Although the statistical analysis indicated that half-lists could be used reliably for both discrimination tests at most P:S conditions, the wide variability found among individual listeners does not support the clinical practice of half-list testing in noise--at least not for normal-hearing listeners.


Children's perception of nasal resonance.

The purpose of this study was to investigate children's perception of nasal resonance in other children. A total of 120 elementary-school-aged children listened to four female children's voices with normal resonance to severe hypernasality and responded to a total of 20 questions. All children responded negatively to severe hypernasality in other children. The findings indicate that hypernasality warrants correction.


Alcoholism: a controlled trial of "treatment" and "advice".

Two groups of alcoholics received either one counseling session or several months of in- and outpatient treatment. One year later there were no significant differences in outcome between the two groups.


Consequences of social modification of drinking behavior.

Alcoholic patients who remained abstinent during a Fixed Interval Drinking Decision treatment program had fewer alcohol-related problems at a 6-month follow-up than those who drank during treatment. Pretreatment encouragement to remain abstinent may also have favorably affected the results.


Defensive style and treatment outcome among men alcoholics.

In a follow-up study of alcoholic patients, those with higher levels of denial had lower rates of rehospitalization and higher rates of treatment completion than those who relied on other defense mechanisms.


Life with Alcoholics Anonymous. The Methodist class meeting as a paradigm.

Alcoholics Anonymous meetings are found to be similar in structure and methods to Methodist class meetings.


Observing public drinking.

A reliable method of assessing alcohol comsumption in public bars by direct observation is described.


Social problems of alcoholics.

A comparison of abstainers and alcoholics showed that the latter were more often involved in social conflicts and breaches of social norms. The breaches of social values were as important as the drinking in society's definition of an alcoholic.


The relationship of availability of alcoholic beverages to per capita consumption and alcoholism rates.

A study of the relationship between availability of beverage alcohol and per capita consumption and alcoholism rates in the U.S.A. indicates that income and urbanism are more closely related to consumption and alcoholism rates than is availability.


A longitudinal study of onset of drinking among high-school students.

During the course of the school year 30% of high-school abstainers started using distilled spirits. The influence of intra- and interpersonal characteristics on beginning to drink is assessed.


Stereotyping by children of the effects of drinking on adults.

Responses on a semantic differential questionnaire indicated that 12-year-olds had formed stereotypes about the effects of alcohol on adults and that these stereotypes were generally negative.


Effects of furosemide on renal function after a single dose of ethanol.

The administration of furosemide 18 hours after a single ethanol administration demonstrated that loop of Henle sodium reabsorption was increased by ethanol.


Effects of acetazolamide on renal function eighteen hours after a single does of ethanol.

The administration of acetazolamide 18 hours after a single dose of ethanol demonstrated that ethanol stimulates proximal tubular sodium reabsorption.


Drinking motives and behavior in social drinkers.

A survey of 113 college students indicated that drinkers with mature motives for drinking (e.g., drank on special occasions) drank less than drinkers with immature motives (e.g., drank to increase self-confidence) and showed smaller increases 1 year later.


Alcohol withdrawal symptoms and drinking behavior.

Among 100 men alcoholics, most of the symptoms of alcohol withdrawal were relieved by further drinking.


Transatrial repair of ventricular septal defects with reference to their anatomic classification.

A consecutive series of 50 children undergoing elective operations for ventricular septal defect (VSD) is presented. Atriotomy was performed routinely. Repair of the defect through the tricuspid valve was attempted in all cases and achieved in 72 percent. There was a 24 percent incidence of right bundle branch block. All patients improved symptomatically after the operation. The mortality rate was 4 percent. The right atrial route is considered to be preferable as a primary approach and has no disadvantages.


Surgical closure of left coronary artery-left ventricular fistula: the second case reported in the literature and a review of the five previously reported cases of coronary artery fistula terminating in the left ventricle.

Surgical closure of a left coronary artery-left ventricular fistula in a 44-year-old black man is reported. The fistula was discovered by coronary arteriography after the patient was admitted to the hospital complaining of recurrent chest pain. The fistula was closed with cardiopulmonary bypass, ischemic arrest, and hypothermia, and there was an uneventful postoperative recovery. The previously reported five cases of fistulas terminating in the left ventricle that were closed surgically are reviewed. Four of these cases originated in the right coronary artery and one in the left coronary artery. Three of the six patients were symptomatic at the time of discovery of the lesion. Cardiopulmonary bypass was necessary in five of the six cases. One patient died in the postoperative period from intractable hemorrhage. It is recommended that coronary artery fistulas by closed upon establishment of the diagnosis because of the sequelae if they are allowed to remain open; these include premature atherosclerosis, aneurysmal dilatation of the coronary artery, and congestive heart failure.


Primary pulmonary hemangiopericytoma.

Hemangiopericytoma is a potentially malignant tumor of vascular origin. It usually is a solitary lesion and may arise in the chest or in extrathoracic areas. It is usually encapsulated. Microscopic features vary with the degree of differentiation of the individual tumor. The more differentiated variety exhibits abundant capillaries with open lumina surrounded by ovoid tumor cells; in the less differentiated tumors, the capillaries lack lumina and the tumor cells are spindle shaped. The prognostic significance of the microscopic pattern is controversial. However, prominent mitotic activity, necrosis, hemorrhage, and increased cellularity are ominous signs and are usually noticed in tumors that later exhibit malignant behavior. The larger the lesion, the more likely that it will be symptomatic. Treatment of choice is ample surgical resection.


Isolated mitral replacement with stent-mounted antibiotic-treated aortic allograft valves.

The results of valve replacement with a stent-mounted antibiotic-treated aortic allograft valve are reported in 129 patients with isolated mitral valve disease. Of these patients, 70 per cent were in N.Y.H.A. Class IV. The hospital mortality rate was 3.9 percent. The cumulative complication-free rate at 5 years was only 37 percent as 21 percent died late, a further 15 percent were alive following reoperation, 4 percent had an embolic episode, 4 percent were alive with important incompetence, and 20 percent had unimportant incompetence. Proved valve failure was due mainly to detachment of the aortic wall remnant of the valve from the pillar of the rigid metal stent (16 percent incidence at 5 years) and methods for preventing this complication are discussed. Because of these complications the use of this device in the mitral position has been discontinued.


Two-stage bilateral lung reimplantation in the dog.

A study of two-stage pulmonary autotransplantation was performed on 29 dogs; 12 dogs died after the first stage, which was always a right lung reimplantation, and 17 dogs underwent the second stage after varying intervals of time. In the group of six dogs operated upon with very short intervals between stages (2 to 8 days) there were no survivors. There were seven long-term survivors in the subgroup with an interval longer than 4 weeks, and they constitute the largest published series obtained with this particular procedure. The interval between operative stages was the only significant controlled variable, as only minor technical or operative differences were allowed to occur. Ischemia times of the lungs were usually quite short. The surviving animals were utilized for studies of the regeneration of the afferent pulmonary nerves (Hering-Breure reflex and effects of capsaicin) as permitted by a long follow-up period of up to 3 years.


Long-term effect of the superior vena cava-pulmonary artery anastomosis on pulmonary blood flow.

The long-term effects of the superior vena cava-pulmonary artery anastomosis were evaluated in 15 patients a mean of 8.5 years postoperatively. There were eight patients with tricuspid atresia and seven with other complex anomalies. Ten patients underwent 133xenon ventilation scans and 99mtechnetium perfusion scans in the upright and suprine positions. Perfusion scans showed decreased perfusion of the right upper lobe which improved in the supine position. Shunt flow, measured by thermodilution in nine patients, was a mean of 1.7 L. per minute per square meter, with a mean superior vena caval pressure of 8 mm. Hg and a resistance of 3.0 units. Right and left pulmonary venous saturations were 94 and 96 percent, respectively, showing little intrapulmonary shunting. Venous collaterals were the major cause for shunt failure. Six patients underwent a left Blalock-Taussig shunt and division of venous collaterals a mean of 6 years after the Glenn shunt and are all doing well. The superior vena cava-pulmonary artery anastomosis did not result in progressive pulmonary deterioration in the patients studied. The staged treatment of tricuspid atresia by the Glenn shunt followed by a systemic-pulmonary artery shunt and ligation of venous collaterals gives prolonged effective palliation.


Chondrosarcoma: a case report with left atrial involvement and systemic embolization.

A 26-year-old white man underwent amputation of the right lower extremity for a chondrosarcoma of the distal femur. Eleven years later, after a long symptom-free interval, he was hospitalized for rapidly progressive dyspnea, pleuritic chest pain, and hemoptysis resulting from a large pulmonary metastasis that had extended directly to the left atrium via the pulmonary vein. Within 24 hours of hospitalization, obstruction of the left commom iliac artery by tumor embolus necessitated embolectomy. This represents the second report of a metastatic chondrosarcoma involving the left atrium. The case presented clinically as an atrial myxoma and disseminated via the systemic circulation with a rapidly downhill course therafter.


Kindness pays dividends: the medical benefits of intercostal nerve block following thoracotomy.

Postoperative pain is an important factor in the management of children undergoing thoracotomy. Intercostal nerve block has been used in adult patients, but its applicability in the pediatric age group has not been previously evaluated. Eighty-nine children (85 girls and 31 boys) aged 6 months to 16 years (mean age 4.7 years) underwent ligation of a patent ductus arteriosus (PDA) through a left thoracotomy. Twenty-nine children received intercostal blocks with bupivacaine from the level of the second to sixth thoracic vertebrae. Sixty cases constituted the control group. The patients with intercostal block had fewer doses of pain medication postoperatively, 2.7 mean (0 to 9), than did the control patients, 3.9 mean (0 to 21). The mean hospital stay was shortened in the patients with nerve block, 5.1 days versus 7.3 days for the control group. No ill effects of bupivacaine were noted. We conclude that intercostal nerve block is a valuable procedure reducing the need for postoperative analgesia and shortening hospital stay.


The roles of ventilation and perfusion in lung metabolism.

The lung, like other viable organs, requires the adequate supply of oxygen and metabolic substrates for its functional and structural integrity. Therefore, we studied the metabolic and ultrastructural consequences in the canine lung following bronchial and/or pulmonary arterial occlusions. The results indicate that the lung can maintain its bioenergetic levels for 5 hours with either the ventilation or perfusion alone. Ultrastructural changes appear to precede metabolic alterations measured. When both the ventilation and perfusion were interrupted, rapid biochemical and structural deteriorations occurred, whereas the combinations of alveolar obliteration and hypoxemia, induced with low F102, produced intermediate damage. The implications of these findings on the pathogenesis and evolution of acute respiratory distress syndrome, on the lung preservation for transplantation, and on the rationale for membrane oxygenator support are discussed.


Induced hypothermia in dogs with acute myocardial infarction and shock.

Acute myocardial infarction with shock (AMI/S) was produced in 46 anesthetized "closed-chest" dogs by catheter injection of metallic mercury into the circumflex coronary artery. Twenty-four dogs were kept normothermic and 22 were maintained at 32 degrees C. Nine of the latter were rewarmed to 37 degrees C. and the experiments then were terminated, so that true survival time was arbitrarily shortened. Including these dogs, the survival time was three times longer than in the normothermic series (p less than 0.001). Hypothermia reduced heart rate (HR) by 34 percent, oxygen consumption by 38 percent, and myocardial oxygen consumption by an estimated 30 to 40 percent, while cardiac output (CO), stroke volume, and stroke work were unchanged. Left ventricular end-diastolic pressure (LVEDP) was reduced by 40 percent during hypothermia (p less than 0.05) and increased by 60 percent on rewarming. HR during rewarming increased substantially more than CO and thereby significantly reduced stroke volume.


The effect of dipyridamole on the thrombocyte count and bleeding tendency in open-heart surgery.

The effect of dipyridamole (Persantine) on the thrombocyte count and bleeding tendency in connection with open-heart surgery and perfusion was studied in 22 patients. A control series of 21 patients undergoing open-heart surgery was available. The treatment group received dipyridamole, 0.5 mg. per kilogram of body weight, in the beginning of cardiopulmonary bypass into the heart-lung machine and thereafter 10 mg. intravenously three times daily for 2 days. From the third day dipyridamole was administered by mouth, 75 mg. three times a day, until the patient was discharged from hospital. We found that dipyridamole had the effect of maintaining the thrombocyte count during cardiopulmonary bypass and the first and second postoperative days. Thereafter no significant difference was seen between the dipyridamole and control groups. The use of dipyridamole did not increase the postoperative hemorrhagic tendency. There were no significant differences in per- and postoperative blood loss and in bleeding and activated partial thromboplastin times between the groups.


Severe intravascular hemolysis after aortic valve replacement: reversal by left ventricular apico-abdominal aortic composite conduit.

Severe intravascular hemolysis developed following aortic valve replacement with a No. 17 Björk-Shiley prosthesis in a patient with a diminutive aortic annulus. At reoperation, a residual gradient of 54 mm. Hg and no evidence of perivalvular leak were found. A second left ventricular outflow tract between the apex and the supraceliac abdominal aorta was fashioned with a special rigid (Pyrolite) prosthesis and a heterograft valved composite conduit. The gradient was reduced to 5 mm. Hg and hemolysis was reversed. We have now created double-outlet left ventricles for primary or recurrent left ventricular outflow tract obstructions of various etiologies in 13 other pediatric and adult patients. The longest follow-up is approaching 18 months. All gradients have been sharply reduced and all patients are asymptomatic.


Scintigraphy of lymph nodes.

The basic considerations, pharmacology, techniques, and clinical results of lymphoscintigraphy performed after the interstitial application of radiocolloids or after i.v. injection of radiogallium or radiobleomycin are described. The advantages and disadvantages are summarized, and the indications are given.


Scintigraphy of the spleen.

The various radiopharmaceuticals and techniques of spleen scintigraphy are described. The indications for spleen scanning and typical examples of various diseases are given.


Surgical exploration of the abdominal lymphatic system in patients with malignancies.

In the management of selected patient with malignant diseases, laparotomy can be useful for determining the anatomic extent of disease in order to individualize appropriate intensive treatment. The decision to subject a patient to a staging laparotomy requires joint decisions by surgeons, radiation therapists, chemotherapists, and diagnostic radiologists, after a thorough preoperative abdominal evaluation has been made. The lymphangiogram is especially important for directing the surgeon to a single node of concern. Special efforts must be made to insure that the specific node in question is biopsied. The justification of such a surgical procedure assumes that definitive decisions in management of such patients will result in an improved prognosis. While this appears to be the case with Hodgkin's disease and lymphomas, studies are underway to prove this assumption in other neoplasms. For most patients, staging laparotomy presently represents an investigational procedure of value only in selected patients. The critical problem is how these patients can be identified.


Juvenile nephronophthisis and medullary cystic disease.

Juvenile nephronophthisis and medullary cystic disease are morphologically indistinguishable hereditary renal disorders. These diseases have been described independently but very likely are a single disease entity and occur as a juvenile-onset, autosomal recessive form and as an adult-onset, autosomal dominant form. We agree with this hypothesis and present here the clinical, laboratory, and pathologic findings of six cases of the juvenile-onset, autosomal recessive form, along with an analysis of the mode of transmission of these and other published cases of the disorder.


Concussion.

We have observed the effects of concussion on nonanesthetized rats and humans. We believe the phenomenon in both to be identical. There are four obvious stages to concussion and the recovery therefrom: fourth stage--visceral (respiratory) and somatic immobility; third stage--return of irregular visceral (respiratory) mobility with continuing somatic immobility; second stage--normal visceral mobility with impaired somatic mobility; and first stage--normal somatic mobility with impaired performance. Zero stage is complete normality. Our method of testing detects no lingering or permanent change after a single concussion. This proves only that we must continue with open minds on the question, "Does concussion always leave permanent brain damage?"


Middle ear effusions. Current concepts.

Current concepts of middle ear effusions in childhood including a discussion of etiology, diagnosis, and treatment are presented. We emphasize recent studies on the histochemical makeup of the middle ear, as well as the enzymatic and immunologic defense systems of that space. The mucociliary transport system is explained and recent literature is reviewed.


Primary intraorbital meningioma with intraocular extension.

Intraocular invasion of a meningioma primary in the sheath of the intraorbital portion of the optic nerve was noted in a 54-year-old woman with a 16-year history of visual loss. Seventeen additional cases of intraglobal extension of intraorbital meningioma were found in the literature. The clinical features and histopathologic findings of the total cases are compared and reviewed. We suggest that the mode of penetration is along the course of the posterior ciliary vessels as they penetrate the sclera.


Incidence of orthostatic hypotension in patients with primary affective disorders treated with tricyclic antidepressants.

Previous studies have indicated that postural hypotension is an uncommon event when tricyclic antidepressants are used in the treatment of depression, and other studies have indicated that postural hypotension is a possible predictor of positive therapeutic response to antidepressant therapy. In this study, 20 depressed patients with the diagnosis of primary affective disorders were hospitalized and treated with tricyclic antidepressants. All patients had been without medication for at least 2 weeks before the study began. Blood pressure recordings were made after a 5-minute resting period and then followed by another reading after the patient had been standing for 2 minutes. Our findings indicate that these patients with primary affective disorders developed significant orthostatic hypotension. It is our belief that orthostatic hypotension is a significant event in patients who have primary affective disorders treated with tricyclic antidepressants, and this sign should be looked for in all patients regardless of age or the presence of significant cardiovascular disease.


Status of tonsillectomy and adenoidectomy: 1977.

Tonsillectomy and adenoidectomy, performed either in combination or separately, still constitute the most common major operations performed in the United States. This report is an attempt to present briefly the current status of knowledge concerning the epidemiology and natural history of conditions for which these operations are performed, the incidence of the operations, and the type and qualifications of the physicians performing the procedures, a review of the problems of the previous studies designed to determine efficacy, an update of the current study being conducted in Pittsburgh, and, finally, what little is known of the morbidity, mortality, and costs of these procedures.


Use of computerized axial tomography of the head and neck region.

The use of the computerized axial tomography has been well received in the field of otolaryngology. Five cases are presented illustrating the capability of the total body scanner (Delta scanner) to contribute to radiologic diagnosis below the level of the base of the skull. The advantages of non-invasibility and three dimensionality are compared to the disadvantages of added cost, added radiation exposure, comparatively long exposure time and relatively poor detail. Because of the overall usefulness of this diagnostic tool, evolution of rapid scanning devices with greater detail is awaited with interest.


Safe use of epinephrine with halothane anesthesia.

A review of the anesthesia literature outlines safe limits for use of epinephrine with halothane anesthesia and adequate ventilation. Excluded from the safe category are patients with previous cardiac disease, hypertension, patients taking monoamine oxidase inhibitors and reserpine. Considered as safe is 10 milliliters of 1:100,000 epinephrine in 10 minutes and not more than 30 milliliters of 1:100,000 epinephrine per hour.


Results of conservative surgery for middle ear cholesteatoma.

A retrospective study was carried out to analyze treatment results for cholesteatoma at the University of Iowa Hospitals and Clinics. All patients undergoing primary surgical treatment from January 1, 1969 to December 31, 1973 were followed through October 1976. Treatment failures were based on the occurrence of postoperative cholesteatoma. The probability of being disease free for periods up to five years after original surgery was then estimated for each type of operation. Postoperative cholesteatoma occurred after atticotomy in 17%, intact canal wall mastoidectomy in 35%, and modified radical mastoidectomy in 9%. The postoperative cholesteatoma rate in the group having intact canal wall mastoidectomy was more than twice as high for those patients under age nine. The likelihood of being disease free five years after intact canal wall surgery was estimated to be 36% using the life table method. Disease recurrence was significantly higher after intact canal wall surgery compared to other surgical methods. The effectiveness of this method should be evaluated in a randomized, prospective manner to minimize patient selection and treatment bias.


Stapedectomy--fistula repair.

Perilymphatic fistulae have been proposed to occur most frequently on the short side of the graft in stapedectomized patients. The usual recommendation in fistula cases has been replacement of the entire prosthesis by a piston and tissue graft complex. In this case the stapedectomy had been performed, using a polyethylene Shea strut, 15 years previously. The air-bone gap had been closed during this entire period. A fistula was suspected after sudden hearing loss developed after barotrauma. At the time of exploratory tympanotomy, a fistula was noted on the long side of the oval window graft. It was elected to leave the polyethylene tube prosthesis in place because of its solid fixation, both laterally and medially. The fistula was closed by subcutaneous tissue graft.


The risks of major head and neck surgery in the aged population.

A review of 162 major head and neck operative cases for cancer in patients over age 70 from 1963-1973 are reviewed. The major and minor surgical complication rates and the rate of medical complications are compared to 552 similar procedures in patients under age 70, during the same time period. The operative mortality figures for each group, as well as the causes of death, are examined. A plea is made for aggressive therapy in the elderly, both in the surgical planning and in their pre- and postoperative care.


Air caloric test: irrigation technique.

The technique of using air to perform the caloric test is discussed. Greater temperature differences and larger volumes of air are needed to achieve stimulations equal to those caused by water irrigations. Special consideration must be given to the design and operation of air irrigation equipment. The effects of irrigating a wet canal and of misdirecting the air jet are discussed. A new air irrigation apparatus is described.


"Practical suggestions on facial plastic surgery--how i do it". Z-plasty repositioning of an anatomical unit.

The Z-Plasty was originally described in the writings of Hippocrates and since that time has developed into one of the most useful techniques in facial plastic surgery. Familiarity with its myriad of uses is invaluable to the practicing otolaryngologist. The basic technique of Z-Plasty consists in the design and transposition of adjacent triangular soft tissue flaps. Most common applications capitalize on the changes which occur during transposition to the common limb between the flaps. The resultant lengthening is used to provide needed tissue in areas of contracted scars and the change in direction is useful in camouflage of scars which cross skin tension lines. Additionally, displaced anatomical units such as the auricle, angle of the mouth or eyelid can be included in the flaps of the Z-Plasty to transpose them into a new anatomical position. Many congenital and acquired deformities can be corrected by this technique without loss of valuable tissue. The purpose of this paper is to illustrate the above principle utilizing two patients with congenitally displaced auricles.


Effect of dietary lipids on fatty acid composition of body lipid in rainbow trout (Salmo gairdneri).

Three isocaloric diets were prepared. Diet 1 (Control) contained 22% herring oil. In diets 2 and 3, a third and a half of the herring oil was replaced, respectively, by an animal fat (lard) which contained a high percentage of saturated fatty acids. Each diet was fed to duplicate groups of rainbow trout for 14 wk. The results of the feeding trial indicated that the concentration of the saturated fatty acids in trout body lipid did not increase despite the high concentration of these fatty acids in Diets 2 and 3. Fish growth, feed efficiency, mortality and the level of fatty acids deposited in fish body lipid and phospholipids are discussed.


The effect of various dietary factors on the size distribution of lymph fat particles in rat.

By means of cellulose acetate electrophoresis and measurement of radio-activity, lipoproteins (d less than or equal to 1,006) of lymph collected from rats fed a diet containing fats added to labeled fatty acids for 20-24 hr, have been separated into two kinds differing in their size. Fats with different saturated and unsaturated fatty acid content were tested: corn oil, lard, mutton tallow, tripalmitin, corn oil-lard mixture, and randomized palmitic-linoleic triglycerides. Factors studied were: (a) increased amounts of these fats given alone or included in a test meal; (b) added amounts of nutrients (other than fats) in the test meal; (c) adaptation to a diet containing 20% fat for 10 days. The major part of the labeled lymph lipid was always transported by the smaller particles. Size distribution of lymph fat particles was influenced by some of the factors studied. Generally, unsaturated fats produced higher amounts of larger particles.


[Relationship between the rates of blood and dialyzing solution flow and determination of the efficiency of the "artificial kidney" dialyzing apparatus].

A mathematical model of the process of dialysis and of dialyzer is described. In this model it is presumed that the blood and dialyzing solution are stationary and homogenous, the diffusion through the film proceeds separately for each of the components (urea, creatinine, etc), the rate of the substance migration is proportional to the difference in the concentration of the substance on both sides of the film, the processes of the substance migration through the film do not affect the flow of the dialyzing solution and of the blood, the concentration of the components partaking in the dialysis is constant across the thickness of the fluids layers and along the breadth of the dialyzer. Recommendation on the selection of correlation for the dialyzing solution and blood flow rates are given and the influence of the film permeability on the dialyzer's clearance is determined.


[Pulse rate counter with digital read-out].

An all-purpose pulse rate counter with digital read-out, devised at the All-Union Research Institute of Radioelectronic Medical Equipment, is described. The counter is intended both for a separate use and also as a part of a complex set of the patients monitoring apparatus, the ones for functional diagnosis, mass examinations of the population and for research work. In combination with a commutator the device permits creation of multichannel systems of control.


[Apparatus and electrodes for nerve stimulation].

To successfully accomplish stimulation of a nerve a portable stimulator with bipolar electrodes has been designed. The level of the nerve trunk resistance was found to comprise 6 kOm. The threshold pulsed current amplitude at which the effect becomes apparent lies within the range of 1-2 mA, with the threshold of the potential pulses amplitude amounting to 4-12 V. The construction of the electrodes is described and the block diagram along with technical characteristics of the stimulator are presented.


[Choice of working temperatures for cryo-instruments used for local destruction of biological tissue].

When utilizing low temperatures for irreversible destruction of affected biological tissues it is important that one should have a clear idea as to the boundary of necrotic alterations. The correlation between the depth of necrosis and that of freezing, the rate of the tissue congelation, the period of cryogenic action, the temperature of the cryoinstrument and its structural shape, all these factors are analytically interrelated and this enables it to establish optimal performance characteristics in congelation of different tissues. In most cases satisfactory performance characteristics in freezing biological tissues can be achieved by using liquid nitrogen.


[Optimization of production diagrams in automated control systems for medical technology industries].

An algorhythm for drawing up optimal production schedule graphs covering a shop floor (production area) over a planned period of output, based on the criterion of minimizing the total time for the workpiece treatment that may be applicable in the APCS of biomedical engineering industry, is set forth. In this connection the notions of a critical workpiece, critical equipment and of a conflicting situation are introduced, and the LRT rule, that plays a dominant role in combination with those of the SIO and MIN idle time, is applied. A relation intended to settle the conflicting situation in compiling the optimal schedule graphs is adduced and its solution for computerized programming is given.


[Energetics of the growth of methanol oxidizing yeasts].

The effect of aeration on the economic coefficient and the phosphorylating effectiveness of oxidation was studied during chemostat cultivation of the methanol oxidizing yeast Candida boidinii. Changes in the partial pressure of dissolved oxygen from 0.008 to 0.08 atm caused a decrease in the economic coefficient from 0.40 to 0.25 g of biomass per 1 g of assimilated methanol, and an increase in the uptake of oxygen. The value of P/O, calculated from the ATP balance for biosynthetic processes, decreased from 1.4 to 0.7. The maximum theoretical economic coefficient for the growth of C. boidinii on a medium containing methanol is 0.47 g of biomass formed per 1 g of assimilated methanol.


[Carbohydrate metabolism enzymes of purple sulfur-bacteria during growth in the dark].

Ectothiorhodospira shaposhnikovii, Chromatium minutissimum and Thiocapsa roseopersicina were grown in the dark under anaerobic conditions on media containing glucose or fructose and organic acids. Their cell contained the following enzymes of the fructose diphosphate pathway: phosphofructokinase, fructose diphosphate aldolase, and 3-phosphoglyceraldehyde dehydrogenase. The activity of fructose diphosphate aldolase was higher in the cells grown in the dark than in the cells grown in the light. The same enzymes of the tricarboxylic acid cycle were found in the cells cultivated in the dark on media containing organic acids as in the cells grown in the light, though the activity of some enzymes was lower. Only the activity of isocitrate lyase increased in the cells cultivated in the dark on a medium containing acetate.


[Cyanide insensitive respiration of Candida lipolytica yeasts].

The effect of rotenone, antimycin A, oligomycin, 2,4,-DNP, and various subtrates on the appearance of cyanide-resistant respiration of Candida lipolytica yeast was studied. Rotenone inhibited the development of cyanide-resistant respiration, but did not prevent its origination. Antimycin A and oligomycin increased the rate of the appearance of cyanide-resistant respiration. If the resting yeast culture was incubated with 2,4-DNP, glucose, or glycerol, the development of the alternative pathway of electron transport was inhibited. Such substrates as alpha-glycerophosphate, citrate, and D,L-lactate had no effect on the time of appearance of cyanide-resistant respiration. Therefore, in the stationary growth phase, an alternative, cyanide-resistant pathway of electron transport results from the inhibition of the rate of electron transport in the respiration chain.


[Search for actinomycetes that produce inhibitors of proteolytic enzymes].

The inhibiting activity of filtrates of the cultural broth against trypsin and chymotrypsin was studied among 66 actinomycetes. The highest activity against trypsin was found, after selection, in the following cultures: Act. janthinus 118, Act. violatus 125, Act. violaceus confinus 2476, Act. violaceus vicinus 1074. The antitrypsin activity was detected in the cultural broth of Act. janthinus 118 during the first day of its growth, and reached maximum by the third day. The inhibiting substance in the cultural broth is thermo- and pH-stable, is not extracted with organic solvents, and remains in the bag during dialysis. Apparently, the inhibitor (s) of trypsin produced by Act. janthinus 118 differes from trypsin inhibitors of microbial origin and low molecular weight which have been described so far.