Rosamicin in urethral and vaginal secretions and tissues in dogs and rats.

In animal studies we investigated the distribution of rosamicin in plasma and urethral and vaginal tissues in rats as well as in urethral and vaginal secretions in dogs. We found concentration ratios between urethral secretion and plasma of 1.9 and between vaginal secretion and plasma of 2.4. The rosamicin concentrations in urethral and vaginal tissue significantly exceeded the levels of all other tissues investigated. Because rosamicin could be valuable for the treatment of bacterial urethritis and the colonization of the vaginal introitus with fecal bacteria in women, it should be investigated clinically in this respect.


Simple method for elimination of aminoglycosides from serum to permit bioassay of other antimicrobial agents.

Cellulose phosphate powder can be added to serum to selectively bind aminoglycosides by ionic interaction without binding or inactivation of the penicillins, the cephalosporins, clindamycin, vancomycin, chloramphenicol, or trimethoprim. This simple, rapid technique permits the measurement of non-aminoglycoside antibiotics in the presence of aminoglycosides.


Correlation of netilmicin agar dilution and disk diffusion susceptibilities.

A study of 283 isolates of gram-negative bacilli revealed a good correlation (r = -0.74) between disk diffusion zones of inhibition and agar dilution minimal inhibitory concentrations. Regression analysis suggested that strains with zone sizes =/<11 mm should be considered resistant, but 34 of 45 strains resistant by minimal inhibitory concentration (including 27 strains of Pseudomonas aeruginosa) would have been called susceptible using this break point.


In vitro susceptibility studies with cefaclor and cephalexin.

The in vitro activity of cefaclor and cephalexin against clinical isolates of four bacterial genera was compared. Both agents had a similar range of activity, but cefaclor was significantly more active by weight than cephalexin for most isolates tested.


Susceptibility of organisms in the Mycobacterium fortuitum complex to antituberculous and other antimicrobial agents.

Of 21 antimicrobial agents tested in vitro, amikacin was the most predictably active against clinical isolates belonging to the Mycobacterium fortuitum complex; however, only 50% of strains studied were susceptible to clinically attainable concentrations of the drug.


Cytotoxicity and cell cycle specificity of homoharringtonine.

The plant alkaloid, homoharringtonine, isolated from Cephalotaxus harringtonia is cytotoxic to HeLa, KB, and L cells growing in monolayer cell cultures. This effect appears to be cell-cycle specific. In synchronized KB cells, protein synthesis was preferentially inhibited in the G(1) and G(2) phases (70 and 45% inhibition, respectively) as might be expected for a protein-synthesis inhibitor.


Ulceration and necrosis of the gastric wall after highly selective vagotomy.

With reference to the case-histories of nine patients with necrosis of the gastric wall and to other data culled from the literature, the hypothesis is advanced that occasionally the gastric ulcer may be the result of ischemia of the lesser curvature caused by the devascularization which is part of the HSV procedure, and that such an ulcer and necrosis of the gastric wall are both consequences of ischemia, differing only in degree.


Mortality of operations on gallbladder and bile ducts performed in a training hospital.

A study was made of the mortality rate from 990 operations on the gallbladder and bile ducts performed over a period of six years. The aim was to settle the question whether this mortality rate was affected adversely by the fact that the operation was performed in a training hospital. This was found not to be the case.


Hepatic dearterialization for carcinoid syndrome due to liver metastases.

The cases are described of three patients with a carcinoid syndrome resulting from hepatic metastases of a carcinoid in the distal ileal tract. Treatment consisted in resection of the primary tumor and of the regional lymph-node metastases, combined with dearterialization of the liver. Apart from rapidly transient disorders of hepatic function, no postoperative complications occurred. Dearterialization should be regarded as a palliative operation and would appear to be beneficial. Optimally effective dearterialization may be achieved with the aid of peroperative angiography after the standard procedure. This will reveal any collaterals and anatomical variants that remain to be occluded. Postoperative mitigation of symptoms is the best parameter for evaluation of the efficacy of the dearterialization.


Althesin (alphadione, CT 1341) a 'new' induction agent for anesthesia.

Althesin (alphadione) is a hypnotic agent introduced in the U.K. a few years ago by the firm of Glaxo. It is mixture of two steroids: alphaxalone 9 mg per ml and alphadolone 3 mg per ml, in solution in cremophore EL. After a concise review of the history of steroid anesthetics, the pharmacology of the new product is described. In a personal investigation, Althesin was used to induce anesthesia in 100 patients. The dose equivalent with thiopentone was determined first. It was found to amount to 52 microliter per kg corresponding to 3 mg per kg of thiopentone. A separate form was completed for each individual patient, to record the side effects, if any. The pulse and blood pressure were checked once a minute after the induction (for 5 minutes). In 8 patients the following parameters were recorded: plethysmogram, ECG, central venous pressure, pulse rhythm arterial pressure, stroke volume and cardiac output. Compared with thiopentone, Althesin is not significantly worse, but neither does it present any advantages where the circulatory parameters determined are concerned. In view of this and the recent publication concerning hypersensitivity  reactions, we have ceased to use this hypnotic agent in our department.


Spontaneous evacuation of an intestinal segment.

The case is reported of a man aged 73 years who evacuated an intestinal segment of 40 cm per anum. The resulting defect was bridged by a serosal canal of some 15 cm, perforation peritonitis did not occur.


Perforated perivaterian duodenal diverticulitis.

A case is described of gangrenous inflammation of a duodenal diverticulum, into the posterior wall of which, the common bile duct and pancreatic duct were found to open. Treatment consisted of resection of the necrotic diverticulum and restoration of continuity between the papilla of Vater and bowel by means of a pedicle graft from the anterior wall of the duodenum.


Lunatomalacia and its treatment with replacement by a silastic prosthesis.

In 11 patients with lunatomalacia, the lunate bone was replaced by a Silastic prosthesis. Follow-up periods varied from 7 to 25 months. Clincal results were good in 10 cases, 8 patients were satisfied with the outcome of the operation.


Spontaneous regression of plane warts after inflammation: clinical and histologic studies in 25 cases.

Based on clinical and histological studies in 25 patients, we have confirmed that plane warts show a characteristic phenomenon of spontaneous regression totally distinct from that described in common warts. This regression developed during various treatments in nine cases, and in 16 cases, it occurred spontaneously. In all the patients, there was a sudden and systemic onset of inflammation in every flat wart. Within two to six weeks, all the warts completely involuted. Histologically, there were variable degrees of epidermal changes depending on the stage of inflammation. However, a mononuclear cell infiltration with epidermal invasion was demonstrated in every biopsy specimen. This evidence further supports the earlier concept that this regressive phenomenon of plane warts is mediated by cellular immunity. It represents a natural experimental model of rejection of tumors induced by papovavirus in humans.


Recovery processes during regression of plane warts.

The regressing process of plane warts can be divided into two phases: initial changes of wart virus-infected cells that later result in degeneration of warts, and recovery phase in which degenerating warts are rejected from the level of the basal layer followed by regeneration of normal epidermal cells from the surrounding epidermis. Electron microscopic observations of recovery phase of wart regression showed (1) the epidermal lesion was clearly divided into degenerating wart possessing altered viruses and regerating epidermis; (2) melanocytes were demonstrated in degenerating warts; and (3) a new granular layer was evident beneath regressing wart in late recovery. Throughout the recovery process, infiltration of lymphocytes and macrophages was observed only in regenerating epidermis.


Flat warts undergoing involution: histopathological findings.

Patients with multiple flat warts were observed during the period of involution, shortly before regression of the warts. The histopathological process was characterized by mononuclear cell infiltration around subpapillary blood vessels, exocytosis of mononuclear cells into the epidermis, and a spectrum of degenerative epidermal changes that culminated in focal areas of necrosis within the epidermis. Lesions near the end stage of involution did not show the histopathologic features of flat warts. The mononuclear cell-associated injury to the epidermis resembles that seen in delayed cutaneous hypersensitivity responses and suggests that regression of flat warts may be due to a cell-mediated rejection reaction.


Solar urticaria treatment by inducing tolerance to artificial radiation and natural light.

Solar urticaria was treated by means of repeated exposures of the skin to fluorescent lamps or natural sunlight. Repeated exposures over a period of hours induce a state of tolerance in the skin so that urticaria fails to develop. The state of tolerance can be maintained with regular daily exposures, and treatment can lead to complete symptomatic relief. Determination of the action spectrum for urticaria is advisable in order to choose the correct fluorescent lamp for treatment.


Atopic dermatitis and tuberculin  reactivitiy.

Transient suppression of already established tuberculin reactivity by a wide-spread, allergic contact dermatitis as well as by primary irritant contact dermatitis has been recently reported. Similar transient suppression of tuberculin reactivity by the eczematous inflammation of atopic dermatitis is now shown to occur. Thus, when the dermatitis is active, atopic dermatitis patients show diminished tuberculin reactivity. While they are in remission, however, a significant increase of their tuberculin reactivity occurs. Before the onset of dermatitis, their tuberculin reactivity was normal. Healed patients showed normal tuberculin reactivity. The presence of dermatitis may play an important role in the diminished cell-mediated immunity in atopic dermatitis.


Beta carotene therapy for erythropoietic protoporphyria and other photosensitivity diseases.

We treated with high doses of oral beta carotene (Solatene) (15 to 180 mg/day) 133 patients suffering from erythropoietic protoporphyria (EPP), 27 patients with polymorphous light eruption, six patients with solar urticaria, three patients with hydroa aestivale, one patient with porphyria cutanea tarda, and two patients with actinic reticuloid to relieve the photosensitivity associated with these diseases. Eighty-four percent of the patients with erythropoietic protoporphyria increased by a factor of 3 or more their ability to tolerate sunlight. On the other hand, only nine of the patients with polymorphous light eruption, and one fifth of the patients with all of the other forms of photosensitivity treated showed similar improvement. We conclude that beta carotene is an effective treatment for EPP, but that other forms of photosensitivity will need empirical therapeutic study with beta carotene to determine the range of effectiveness, if any, of this compound in conditions other than EPP.


Immunosuppressants and prednisone in pemphigus vulgaris: therapeutic results obtained in 63 patients between 1961 and 1975.

Evaluation of the treatment in 63 patients with pemphigus vulgaris showed that six patients (9.5%) died of the consequences of high-dosage prednisone treatment, while 24 patients (38.1%) were free of lesions and not receiving treatment. Immunosuppressants (methotrexate, cyclophosphamide, and azathioprine) are of value in patients with severe pemphigus vulgaris since they often reduce the maintenance dose of prednisone required after high-dosage prednisone treatment. Immunosuppressants are of even greater value in patients in the early, stable stage of pemphigus vulgaris. Of 16 such patients initially treated with a combination of an immunosuppressant and maintenance doses of prednisone not exceeding 40 mg on alternate days, 13 at no time required treatment with higher doses of prednisone. The good results obtained with this method emphasize the importance of diagnosing and treating pemphigus vulgaris in its early stage.


Multiple osteolytic lesions in a patient with mycosis fungoides.

Skeletal lesions that were clinically significant and roentgenographically demonstrable developed in a patient with mycosis fungoides. Biopsy specimens from skin plaques and tumors and from a tibial tumor mass revealed an infiltrate of similar-appearing cells that were compatible with mycosis cells. Bone marrow involvement is not unusual in patients with mycosis fungoides with extracutaneous disease, but destruction of cortical bone in mycosis fungoides, as demonstrated by the patient in this report, is rare.


Bony lesions in systemic mastocytosis: scintigraphic evaluation.

Bone, bone marrow and gallium citrate Ga 67 scans were performed on a patient with systemic mastocytosis and bony involvement to evaluate their diagnostic value in such patients. The bone scan revealed increased tracer concentration in the involved areas. These abnormalities were less prominent than those on the roentgenograms, suggesting that only a part of the roentgenographic abnormalities were associated with reactive bone formation. Bone scanning may be less sensitive than roentgenograms to detect the full extent of the bony lesions of systemic mastocytosis. The bone marrow scan revealed a normal central marrow with peripheral marrow expansion. Possibly, the central marrow infiltration by mast cells was sufficient to interfere with its hemopoietic function to a degree that made it necessary to reactivate peripheral marrow tissue. There was no significant 67Ga accumulation in the bony lesions of systemic mastocytosis.


Nodular primary localized cutaneous amyloidosis.

An 83-year-old woman had nodular primary localized cutaneous amyloidosis. Several anetodermic, bullous-appearing lesions were observed. Biopsy showed massive amyloid deposition with destruction of elastic and collagen fibers, but no bullous formation. It was concluded that the amyloid deposition induced anetodermic changes creating the clinical appearance of bullae.


Apocrine cystadenoma of the penile shaft.

What is to our knowledge the first apocrine cystadenoma reported on the penile shaft is described. Of 96 previously reported apocrine cystadenomas, more than 90% were located on the face, ears, or scalp; the remainder occurred on the chest, axilla, or prepuce. Apocrine cystadenoma should be considered in the differential diagnosis of solitary blue, gray, or flesh-colored cystic nodules in those areas.


Localized mycosis fungoides with prominent epidermotropism: Woringer-Kolopp disease.

A patient had a single, large, sharply demarcated lesion on one leg. Under the mistaken diagnosis of malignant melanoma in situ, the lesion was excised and the area grafted in 1956. There has been no recurrence in the past 20 years. Histologic reevaluation led to a diagnosis of mycosis fungoides with pronounced epidermotropism of the cellular infiltrate. This case has close clinical and histologic resemblance with three cases published in Europe and regarded as a special form of reticulosis as first described by Woringer and Kolopp. Mycosis fungoides with marked epidermotropism is not always a benign localized disease but may be widespread and lead to death.


[Regression of haemangiomata in infants after x-ray treatment and mock-radiation (author's transl)].

In the years 1966-1969 100 haemangiomata which had developed in early childhood were prospectively investigated in a randomised study. Half of them were treated by soft X-ray radiation, the other half underwent mock-radiation as a control. 54% of the original group could be examined after 6 years. The results showed that the ratio of cure was similar in the both groups. The skin pattern of the incompletely cured haemangiomata was also comparable. The biological rule of regression of haemangiomata in early childhood seems not to be influenced by X-ray treatment. It is striking that X-ray treatment in dark-skinned children leads to a better therapy-result than in fair-skinned ones.


[Comparative investigations of depigmented and melanomatous lesions in gray horses of the lipizzaner breed (author's transl)].

The morphological substrates of pigmented and depigmented skin as well as the structural characteristics of spontaneously developing melanomas were revealed by clinical, light- and electron microscopic methods in gray horses (Lipizzaner breed) from the Vienna Spanish Riding School. On clinical investigations in a group of 31 older horses (more than 10 years old) 20 exhibited melanomas, whereas 23 younger animals (less than 10 years of age) had no evidence for visuable melanotic tumors. Concomitantly with the progressive graying of the hair a depigmentation of the skin was frequently observed. Light and electron microscopic studies of skin biopsies revealed that in pigmented areas melanin is produced by DOPA-positive melanocytes and stored in form of large single melanosomes within keratinocytes. In depigmented areas melanocytes and melanosomes are completely lacking, but a high number of indeterminated cells is present in the basal layer. Melanotic tumors from the root of the tail, the lips, the perianal region, the sholder and intestinal lymph nodes exhibited either encapsulated nodules or diffusely infiltrating melanomatous structures similar to blue nevi in the dermis. Junctional activity could never be observed. A differentiation between melanin-producing tumor cells and melanophages was difficult in light microscopy but possible according to ultrastructural characteristics.


[On eosinophilic hepatopathy in eosinophilic reticular hyperplasia of the skin (author's transl)].

An eosinophilic pattern of hepatopathy is described and discussed in a female patient with atopic eczema and with eosinophilic reticular hyperplasia of the skin (combined with marked blood eosinophilia). Contrary to the hitherto known opinion a participation of intern organs in the case of reticular hyperplasia seems to be possible.


[Inhibition of ultraviolet irradiation response of human skin by topical phlogostatic compounds (author's transl)].

By adaption of the model of UV dermatitis in human skin a test procedure has been developed, which facilitates realistic assessment of topical contrainflammatory activity of steroidal as well as non-steroidal compounds. Six typical skin drug agents exhibited reaction inhibition effects (percent of theoretical maximum) as follows: hydrocortisone = 7%, bufexamac = 11%, oxyphenbutazone = 15%, indometacin = 21%, flumethasone pivalate = 43%, fluocinolone acetonide = 44%.


Plasma levels of triamcinolone acetonide as determined by radioimmunoassay after topical application.

In this paper a method for the radioimmunological determination of triamcinolone acetonide (TAAc) in plasma is described. The antiserum used in the radioimmunological determinations showed high specifity for TAAc; the minimal detectable amount was 0.2 ng. The course of the plasma concentration-time curve of TAAc after intravenous injection into rats was analysed. The concentration of TAAc in the blood of the patients after topical application of the drug is very low. No detectable amount of TAAc was found in the blood of out-patients. Hospitalized patients treated with TAAc under plastic occlusion showed plasma levels ranging from 0.8 to 3.4 ng/ml. This level remained constant throughout the treatment.


Scanning electron microscopic and X ray microanalysis study of the mineral deposits in pseudoxanthoma elasticum.

A skin biopsy of a 37 year old man with typical lesions of pseudoxanthoma elasticum (P.E.) associated with angioid streaks (Groenbald-Strandberg Syndrom) was examined with a scanning E.M. (SEM) and a SEM provided with a X ray micro-analyser. The SEM provided with X ray microanalyser enabled us to see the correspondence between the crystalline deposits and a calcium salt. The potassium, sodium and magnesium analysis of the specimen permits us to verify that the P.E. dermis is rich in K and poor in Mg.


[Comparative histological and autoradiographic investigations on benign oral leukoplakias (author's transl)].

Proliferation was studied in 18 patients with benign oral leukoplakias of the buccal mucosa by in vitro labelling with 3H-TdR. Identical investigations were performed in clinically normal mucosa of the same patients. Significant differences were found between the LI of both groups. On the other hand the total of labelled cells per 100 micron length of the basal membrane was approximately equal in leukoplakias and normal mucosa. In the majority of cases the LI was increased in leukoplakic regions whereas the number of labelled suprabasal cells was lowered compared to normal. These findings are supposed to be a consequence of shifting of epithelial keratinization to the lower stratum spinosum. From that results an increased proliferation in the basal cell layer.


[Zinc distribution disorder in psoriasis (author's transl)].

In 64 patients with psoriasis and in 54 persons without any skin disease the amount of zinc was estimated in plasma and in the erythrocytes using atomic absorption spectrophotometry. The findings showed an elevated plasma level and a lower zinc content of blood erythrocytes in psoriasis. Both values were statistically significant. No relation was found between these changes and the percentage skin surface covered by psoriatic lesions. The disturbed distribution of zinc in psoriasis may be due to disturbances if histidine metabolism or to changes of the permeability of the cell membranes associated with this skin disease.


A multiclass, multiresidue analytical method for pesticides in water.

A procedure is reported for the multiclass, multiresidue analysis of pesticides in water. Compounds are extracted from water with methylene chloride, and the extract is concentrated by an evaporative technique utilizing reduced pressure and low temperature. Compounds are segregated into groups using a column of partially deactivated silica gel and sequential elution with four different solvent systems. Carbamate residues, converted to their 2,4-dinitrophenyl ether derivatives, are gas chromatographed via electron capture detection as are the parent compounds of the organohalogen compounds. Organophosphorus compounds are determined by gas chromatography using a flame photometric detector. Recovery studies were conducted on 42 halogenated compounds, 38 organophosphorus compounds, and 7 carbamates. Fifty-eight of 87 compounds tested produced recoveries in excess of 80%; another 13 compounds yielded recoveries exceeding 60%, while the recoveries on the remaining 16 compounds fell below 60%.


Urinary excretion of paranitrophenol and alkyl phosphates following ingestion of methyl or ethyl parathion by human subjects.

Nitrophenolic and alkyl phosphate metabolites of methyl and ethyl parathion in the urine of human subjects soon after doses of 1 to 4 mg have been ingested. Particular alkyl phosphates can serve as specific indices of absorption of the respective parathions. Paranitrophenol and diethyl thiophosphate are rapidly eliminated in the urine, while excretions of dimethyl phosphate, and particularly diethyl phosphate, are more protracted. Cumulative excretions of paranitrophenol and alkyl phosphates exhibit sufficient dose-dependence at convenient intervals following parathion ingestion to encourage use of metabolite measurements in estimating occupational absorption of the parathion insecticides.


Airborne and surface residues of parathion and its conversion products in a treated plum orchard environment.

Airborne pesticide residues were collected both within and downwind from a parathion-treated plum orchard by high volume sampling through XAD-4 macroreticular resin. Levels of paraoxon in excess of 100 ng/m3 were found in orchard air, along with parathion, during the early days of two 21-day sampling studies. Paraoxon:parathion ratios in the orchard air were relatively constant, averaging ca. 0.5 for days 1 to 21 following treatment. Likely sources of airborne paraoxon include vaporization and dislodgement from soil and leaf surfaces, and chemical conversion of parathion in the air. Support for the latter came from observation of an increased paraoxon:parathion ration in air samples collected downwind from the orchard. Atmospheric conversion of parathion to paraoxon, accelerated by sunlight, was indicated by both field and laboratory studies. Overall dissipation of parathion from the orchard air, soil, and leaf tissue proceeded to a considerable extent through breakdown to paraozon under the dry climatic conditions of these studies. Eventual conversion to the relatively stable breakdown product, p-nitrophenol, was indicated from analysis of air in the orchard vicinity.


Partial saturation of rat liver Cd-binding proteins by Cd2+ in vivo.

Liver Cd-binding proteins (Cd-BP) were isolated from rats chronically treated with 109Cd-labeled CdCl2 for ten days. Fractions purified using Sephadex G-75 and DEAE-Sephadex were characterized and found to be similar to those isolated by other investigators. Cd-binding was not saturated in any of the preparations and significant amounts of Cu and Zn were also found bound to the proteins. The percentage of saturation of Cd-BP1, and Cd-BP2 was independently determined by atomic absorption spectrometry and spectroscopy at 254 nm. These results indicate that the fraction of binding sites unoccupied by Cd on Cd-BP approaches 20% in vivo.


Toxicity of dieldrin to bobwhite quail in relation to sex and reproductive status.

In a study of dieldrin toxicity to breeding and nonbreeding bob-white quail (Colinus virginianus), breeding birds of both sexes on long photoperiods were more susceptible to dieldrin poisoning than nonbreeding birds, although some differences were not statistically significant at the .10 level. Shortened photoperiods caused gonadal regression, weight loss, and additional mortalities among dieldrin-treated birds previously in breeding condition. Dieldrin did not influence food consumption, body weight, or egg production until about a week or less before death of individual birds. Dieldrin brain residues were higher among birds that died during the study than among survivors sacrificed at its termination. Among those that died, neither dieldrin treatment level, reproductive status, nor sex seemed related to brain residue levels. Nevertheless, within those factors, levels were slightly higher in the birds that died later in the test.


Tri-O-tolyl phosphate neurotoxicity: lack of evidence for autoimmunologic involvement.

Studies on the involvement of autoimmunity in the pathogenesis of tri-O-tolyl phosphate (TOTP) induced neurotoxicity in chickens were conducted. Immunosuppressive therapy including gamma-radiation and drug treatments was utilized to determine its effects on the neurotoxic syndrome. Whole-body gamma-irradiation up to 1020 roentgens failed to show any consistent protection from the TOTP induced paralysis. Therapy involving prednisone alone or in combination with 6-mercaptopurine and antilymphocyte serum likewise indicated no protection. Stimulation of humoral and cellular immunity by TOTP was investigated. Complement fixation, precipitation tests, splenic migration inhibition, and skin tests did not indicate stimulation of autoimmunity toward nervous tissue or liver. The present investigation was unable to demonstrate primary involvement of an autoimmune nature in the neurotoxicity produced by TOTP in the chicken.


The chronic toxicity of 3-chloro-4-methyl benzamine HCl to birds.

3-Chloro-4-methyl benzamine HCl (DRC-1339), an avian toxicant, was fed to five species of birds for periods up to 120 days. The 30-day LC50 of uniformly treated feed for starlings was 4.7 ppm and the 90-day LC50 was 1.0 ppm. The 28-day LC50 for coturnix was 18 ppm. The 30-day LC50 for pigeons was less than 100 ppm. Pheasants fed diets containing 2% DRC-1339 baits diluted to a rate of 286 ppm of DRC-1339 died within 22 days. Bobwhite quail fed similar diets suffered some mortality at levels as low as 2.9 ppm, but most survived 10 times this dosage level for the 120-day test period. Application of the Kenaga "Index of Chronicity", resulted in the conclusion that DRC-1339 was cumulatively toxic to birds. Reproduction in coturnix was adversely affectd by treatments at 10 ppm of DRC-1339 and above. Reproduction in pigeons was adversely affectd by a treatment of 25 ppm. In coturnix, DRC-1339 caused an increased incidence of egg breakage and decreased both egg and live chick production. In pigeons, DRC-1339 caused an increase in the proportion of infertile eggs. Reproductive ability to first generation offspring was not affected when parent coturnix and pigeons were fed DRC-1339. These data emphasize the need for care in the use of DRC-1339. The bait should be used only as registered and care exercised in storage and disposal of unused baits to avoid poisoning of nontarget species.


Mercury and the estuarine marsh clam, Rangia cuneata Gray. I. Toxicity.

Mercury is relatively toxic to Rangia when exposed to initial high concentrations (1 to 6 ppm) followed by low sustained levels (0.013 to 0.432 ppm). Acclimation to low salinity (2 o/ooS) lessens the toxic effect of mercury. Actual concentrations of mercury causing 50% mortality (LC50) in 96 hr are 122 ppb in 2 o/ooS and 58 ppb in 15 o/ooS. Rangia's ability to survive acute mercury exposure (0.87 +/- 0.15 ppm) is enhanced by low level (8.56 +/- 2.54 ppb) contamination followed by a brief period (9 days) in clean sea water.


Dislodgeable residues of ethion in Florida citrus and relationships to weather variables.

Five different treatments of ethion on Valencia orange trees were compared for decay rates and for ethion monoxon and ethion dioxon production under different environmental conditions. The oxon metabolite levels observed were low and always below the residue level of ethion itself. There were no significant differences in the decay rates of ethion between treatments. A model of ethion decay utilizing environmental variables as a time base is presented. This model explains 94% of the variation observed in ethion decay during very wet and very dry periods in Florida. The application of these results and general experimental approach to worker safety reentry standards is discussed.


Mercury induced cardiovascular abnormalities in the chicken.

Juvenile chickens were either chronically exposed to 300 microgram/ml of Hg in the drinking water (chronic dosage--CD) or acutely exposed to either 3 mg of Hg/kg body wt (acute low dosage--ALD) or 12 mg of Hg/kg body wt (acute high dosage--AHD) administered intramuscularly for five consecutive days. Only the CD and AHD treatments retarded normal growth. Relative heart weights were increased by the CD treatment, decreased by the AHD treatment, and remained unchanged during the ALD treatment. Relative aorta weights were increased by the CD treatment but decreased by the AHD treatment. ECG analyses revealed a consistent decrease in the amplitude of the R-S and T waves with the greatest effects present in the acute (ALD and AHD) treatments. Histological examination revealed that Hg caused myocardial histopathological changes characterized as a myocarditis with polymorphonuclear and lymphocytic infiltration and fatty degeneration. It is concluded tha Hg causes cardiovascular disturbances in chickens even when administered at levels which do not inhibit normal growth.


Shell thinning and reproductive impairment in black ducks after cessation of DDE dosage.

Captive black ducks (anas rubripes) were fed dietary DDE [1,1-dichloro-2,2-bis (p-chlorophenyl)ethylene] at 10 ppm (dry weight; about 2 ppm on a natural diet basis) for 2 breeding seasons, then untreated feed for 2 succeeding years. Residues of DDE in the carcasses of adults declined 90% during the 2-year clean-up period. Following 2 years of dietary DDE, mean residues in eggs reached 64.9 ppm. Even after 2 years on clean feed, DDE residues in the eggs averaged 6.2 ppm or 9.5% of the mean DDE level reached after 2 years on treated feed. Shells of eggs from treated hens were about 20% thinner than shells of eggs from controls. Stoppage of DDE dosage resulted in progressively thicker shells, yet even after 2 years on untreated feed hens laid eggs with shells about 10% thinner than control hens. After DDE was removed from the diet, DDE residues in the eggs decreased, shell thickness increased, and reproductive success improved. Hens previously exposed to DDE, but then fed clean feed for 2 years, still produced significantly fewer surviving ducklings than did control hens.


Photochemical transformation of the DDT and methoxychlor degradation products, DDE and DMDE, by sunlight.

DDE and DMDE, degradation products of the pesticides DDT and methoxychlor, rapidly undergo an unusual photoisomerization in solution when exposed to sunlight. The isomerization involves the exchange of a vinyl chlorine and an ortho aromatic hydrogen. Other photoproducts identified were corresponding benzophenones and 1,1-diaryl-2-chloroethylenes. Quantum yields for the reactions were measured and then used to compute sunlight photolysis half-lives for DMDE and DDE. Although both compounds absorb only the short-wavelength ultraviolet component of sunlight, their photolysis was found to be surprisingly rapid. During summer at latitude 40 degrees N, the photolysis half-lives near the surface of a water body are one hour and one day for dissolved DMDE and DDE, respectively. Photolysis of the DDE photoisomers is about an order of magnitude slower than that of DDE, suggesting that they may accumulate under environmental conditions. The DDE photoisomers photocyclize to form chlorinated dibenzofulvene and dichlorofluorenone. Neither DDE nor its photoisomers photoreact in solution to form PCB's. The environmental significance of these results is discussed, and its is suggested that the persistence of DDE in inland surface waters may be related to its tendency to sorb onto sediments and biota where not light is present.


Acute toxicities of Cd2+, Cr+6 Hg2+, Ni2+ and Zn2+ to estuarine macrofauna.

Static acute toxicity bioassays were conducted at 20 degrees C and 20 o/33 salinity with CdCl2-2 1/2 H20, K2CrO4, HgCl2, NiCl2-6H2O, and ZnCl2 using adults of starfish, Asterias forbesi; sandworm, Nereis virens; hermit crab, Pagurus longicarpus; softshell clam, Mya arenaria; mudsnail, Nassarius obsoletus; and mummichog, Fundulus heteroclitus, a fish. Concentrations (mg/L metal) fatal to 50% of the organisms in 168 hr ranged from 0.004 (clam) to 0.8 (mummichog) for mercury; 0.7 (clam, worm, crab and starfish) to 40.0 (mummichog) for cadimium; 0.2 (crab) to 52.0 (mummichog) for zinc; 0.7 (sandworm) to 44.0 (mummichog) for hexavalent chromium; and 13.0 (starfish) to 150.0 (mummichog) for nickel. Biocidal action was restricted to a relatively narrow range for all species-metals combinations tested: i.e., mean LC-75/LC-25 rations for individual metals at 168 hr ranged between 2.82 (Zn) and 6.02 (Cd); for individual species this ratio extended from 2.76 (fish) to 4.46 (clam). It appears that acute toxicity evaluation of potentially hazardous metals in saline environments requires utilization of at least several representative species from divergent taxonomic and ecological niches.


Partition distribution of insecticides as a critical factor affecting their rates of absorption from water and relative toxicities to fish.

Loaches, Misgurnus anguillicaudatus (Cantor), a common fish in Taiwan, were treated with DDT, dieldrin, and monocrotophos by continuous exposure in aqueous solutions (or suspensions) and by injection. DDT and dieldrin were 150 and 220 times more toxic, respectively, than monocrotophos, to the fish exposed in aqueous solutions (24-hr LC50), but only 1/9 and 1/4 as toxic as monocrotophos by injection (24-hr LD50). Results of GLC analyses indicate that, at the end of 24-hr exposure, 96.5% of DDT, 92.7% of dieldrin, and 14.3% of monocrotophos were absorbed by loaches from aqueous solutions. The initial rates of absorption for DDT and dieldrin were about 10 to 20 times faster than that for monocrotophos. The large differences in relative toxicity may be due to partition distribution which in turn caused differences in absorption, as DDT and dieldrin are lipophilic and monocrotophos is hydrophilic. Statistical analysis of the relationship between fish toxicities and partition coefficients supports the present finding. The coefficient of correlation is 0.70 between parition coefficients (benzene/water) and toxicities to fish (rainbow trout) of 12 organophosphorus insecticides, 0.74 between coefficients and corrected fish toxicities, and 0.96 between partition coefficients and corrected fish toxicities for organophosphates only. Results of analyses are significant at less than 1% probability level. Similar correlation was also obtained between partition coefficients for hexane/water and toxicities of 8 organophosphorus and 5 organochlorine insecticides to rainbow trout.


Lead accumulation rates in tissues of the estuarine teleost fish, Gillichthys mirabilis: salinity and temperature effects.

Tissue-specific lead accumulation rates were determined in the estuarine teleost fish, Gillichthys mirabilis, as a function of four variables; sea water lead concentration, duration of exposure to lead, salinity, and temperature. Distinct tissue-specific accumulation rates were found. Spleen, gills, fins, and intestine accumulated the greatest amounts of lead; liver and muscle accumulated the least lead. Decay of lead from tissues of lead-exposed fish was observed only for gills, fins, and intestine, tissues which all possess an outer or inner covering of mucus. Our data suggest that the rapid turnover of lead in these mucus-covered tissues is a result of lead complexing with mucus and subsequent loss of lead when the mucus layer is sloughed off. In spleen and vertebrae, lead levels continued to rise in fish returned to natural (unspiked) sea water from lead-spiked sea water. The rate of lead accumulation was dependent on both the holding salinity and the temperature. Fish held at high temperature accumulated lead more rapidly than fish held at low temperature. The rate of lead accumulation was inversely proportional to the salinity of the medium. Both of these environmental effects on lead accumlation rates could be significant in estaurine habitats where lead concentrations, salinity, and temperature are all apt to vary seasonally.


Lead effects on tissue and whole organism respiration of the estuarine teleost fish, Gillichthys mirabilis.

Oxygen consumption rates of whole fish and isolated gill tissue were measured using specimens fo Gillichthys mirabilis exposed to lead-dosed sea water for varying periods of time. Whole organism oxygen consumption was significantly higher in lead-exposed fish than in those held for equivalent periods of time in non-leaded sea water. In vitro gil respiration rates were virtually identical for control and lead-exposed fish. Lead-exposed fish were also extremely more active in the aquaria than the control group. These findings suggest that lead-induced metabolic changes may derive more from lead effects on central nervous system coordination of activity and metabolism than from direct effects of lead on intermediary metabolism enzymes in each cell.


Mass fragmentgraphic determination of diisopropyl napthalene and phenyl xylylethane, and the environmental contamination from them.

The water or sea contamination of diisopropyl naphthalene and phenyl xylylethane in hydrocarbons, which have appeared as alternatives for polychlorobiphenyls, was examined in some areas of Japan. A mass fragmentgraphic technique was applied for rapid determination of trace amounts. In sea mud, 0.019 to 0.16 ppm of diisopropyl naphthalene was found, and a few ppm in fish, but no phenyl xylylethane was detected in any samples. The necessity for continuous survey for contamination by new chemicals and the availability of the mass fragmentgraphic method for difficult microdetermination by gas chromatography, using an electron capture detector, are emphasized.


Rheumatoid synovial cells from intact joints. Morphology, growth, and polykaryocytosis.

Synovial cell lines were isolated by instillation of trypsin or chymotrypsin into intact knee joints of patients with persistent rheumatoid effusions resistant to conventional therapy. Morphology and growth in the primary phase were compared with rheumatoid cells isolated from excised synovium and nonrheumatoid synovial cells obtained from intact joints of cadavers or amputated limbs. Cell populations from all sources included varying proportions of macrophage-like and fibroblast-like cells, with only 1-3% multinucleated cells. In medium supplemented with calf serum alone, rheumatoid cells from intact joints showed negligible changes in morphology. However, in the presence of nonrheumatoid, autologous rheumatoid or homologous rheumatoid serum a rapid increase occurred in size of the macrophage-like cells and numbers of polykaryocytes, including some giant syncytial cells. These effects were directly proportional to serum concentration and were identical in fresh or heat-inactivated serum. In most of these rheumatoid cell lines no multiplication occurred, regardless of serum type or concentration. In rheumatoid synovial cells from excised synovium, human serum induced both polykaryocytosis and rapid growth of fibroblasts. Nonrheumatoid synovial cells grew rapidly but few polykaryocytes developed, mostly with less than 6 nuclei. Evidence of viral infection in rheumatoid synovial cells was sought by electron microscopy after stimulation of polykaryocytosis by human serum. In one of the cultures many cells were found with intranuclear particles possessing characteristics of the adenovirus group.


Local synovial synthesis of oligoclonal measles virus antibodies and of smooth muscle antibodies in a case of atypical rheumatoid arthritis.

A patient with atypical rheumatoid arthritis (RA) and local synovial synthesis of oligoclonal IgG in an arthritic knee joint is described. Measles virus-specific antibodies isolated from the synovial fluid (SF) were carried by oligoclonal IgG proteins but constituted only a fraction of the total oligoclonal IgG of the SF. Smooth muscle antibodies were markedly increased in the SF compared with the serum and were associated with an electrophoretically restricted fraction of IgG. The results indicate that a local synovial synthesis of measles virus-specific antibodies and of smooth muscle antibodies occurred within the affected joint in our patient.


Carpal instability in rheumatoid arthritis and calcium pyrophosphate deposition disease. Pathogenesis and roentgen appearance.

The roentgen appearance and pathogenesis of carpal instability are described in an evaluation of patients and cadavers with rheumatoid arthritis and calcium pyrophosphate deposition disease. Dorsiflexion (16%) and palmar flexion (8%) instability occurs in rheumatoid arthritis, particularly in patients with moderate to advanced disease. Navicular-lunate dissociation frequently accompanies dorsiflexion instability and results from involvement of the interosseous ligament between the two bones by rheumatoid pannus. Carpal instability and navicular-lunate dissociation also accompany pyrophosphate arthropathy, resulting from calcific deposition and cystic degeneration of ligamentous structures.


Comparative study of tibial (single) and tibiofemoral (double) osteotomy for osteoarthrosis and rheumatoid arthritis.

Osteotomies on 101 knees in 79 patients were assessed either prospectively or retrospectively. High tibial osteotomy was performed in 54 knees (27 with rheumatoid arthritis (RA) and 27 with osteoarthrosis (OA)) and double (tibiofemoral) osteotomy in 47 knees (25 RA and 22 OA), and were assessed prospectively in 46 and retrospectively in 55. Using a subjective assessment, 65% showed some improvement--70% of the single and 60% of the double osteotomies. Of the four groups (OA single or double, RA single or double), OA knees having a single osteotomy improved most frequently (74%), and OA knees having a double osteotomy least frequently (50%). Significant improvements in pain score and angular deformity were recorded. The mean range of movement of the operated knee was significantly reduced, and was particularly evident in those knees having a double osteotomy. We conclude that double osteotomies tend to have a higher incidence of complications, including impaired movement, and are not more efficient in relieving pain than single osteotomies in either OA or RA.


The painful heel. Comparative study in rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthrosis.

This study presents the frequency of severe and mild talalgias in unselected, consecutive patients with rheumatoid arthritis, ankylosing spondylitis, Reiter's syndrome, and generalized osteoarthosis. Achilles tendinitis and plantar fasciitis caused a severe talalgia and they were observed mainly in males with Reiter's syndrome or ankylosing spondylitis. On the other hand, sub-Achilles bursitis more frequently affected women with rheumatoid arthritis and rarely gave rise to severe talalgias. The simple calcaneal spur was associated with generalized osteoarthrosis and its frequency increased with age. This condition was not related to talalgias. Finally, clinical and radiological involvement of the subtalar and midtarsal joints were observed mainly in rheumatoid arthritis and occasionally caused apes valgoplanus.


Pericardial effusion and mitral valve involvement in systemic lupus erythematosus. Echocardiographic study.

Echocardiography was used in 30 women and 2 men with systemic lupus erythematosus (SLE) in order to determine the incidence and severity of pericardial effusion and mitral valve involvement. 31 patients showed normal thickness of the mitral valve leaflets, only one patient showed irregular thickening of the leaflets suggesting the presence of vegetations. Mitral valve motions were normal in all patients. These results indicate that myocardial and valvular involvement in SLE is usually not severe enough to result in haemodynamic abnormalities. Pericardial effusion was found in 2 patients who were symptom free, whereas 4 of the patients with a past history suggestive of pericarditis showed no echocardiographic evidence of pericardial effusion. These suggest the transient nature of pericarditis in SLE, and the value of echocardiography as a diagnostic tool in detecting clinically inapparent lupus pericarditis.


Eosinophilic fasciitis. Case report and review of the literature.

Eosinophilic fasciitis is a recently described rheumatic disease, some 20 cases having been reported in abstract form. Previous descriptions have stressed the localized nature of skin involvement, the absence of visceral changes or Raynaud's phenomenon, an association with hypergammaglobulinaemia and eosinophilia, and a good response to corticosteroid therapy. The most conspicuous feature of this entity has been a massive thickening of the subcutaneous fascia, when an adequate (skin down to muscle) biopsy has been performed. We report another case conforming to these general features, with the exception that Raynaud's phenomenon was a prominent symptom. A critical review of the literature suggests that eosinophilic fasciitis should tentatively be regarded as a variant of scleroderma.


Discordance for ankylosing spondylitis in monozygotic twins.

Three monozygotic twin pairs, each over the age of 45 years, with ankylosing spondylitis are described. In two pairs there is discordance for this disease and in the third pair there is a marked difference in the severity of this disease. These findings provide evidence that environmental factors are necessary not only for the initial development of ankylosing spondylitis, but possibly also for determining its future severity.


Sulphated glycosaminoglycan synthesis in normal and osteoarthrotic hip cartilage.

The in vitro sulphated glycosaminoglycan metabolism and uronate content of human aged and osteoarthrotic hip articular cartilages have been examined. Cartilages were sampled from nonfibrillated weight-bearing areas and cultured in Dulbecco Modified Eagle's medium with 35SO4. Uptake of 35SO4 was corrected for total sulphate concentration and related to uronate levels after papain digestion and dialysis. The levels of uronate in these tissues varied between 0 - 96% and 2 - 26% dry weight and did not correlate with either osteoarthrotic grading or sulphated glycosaminoglycan metabolism, irrespective of the source. Glycosaminoglycan metabolism of intact hip articular cartilage from clinically defined osteoarthrotics appears, from these results, to be comparable to that derived from nonsymptomatic hip joints from individuals of similar age. Sodium salicylate was found to depress sulphated glycosaminoglycan metabolism in osteoarthrotic cartilage.


Plasma uric acid and plasma albumin in healthy subjects.

In healthy male subjects there was a positive correlation between plasma uric acid and plasma albumin (r = 0 - 43, P less than 0 - 005, n = 49) when repeated measurements of both variables were used for each subject. Changes in plasma albumin induced by in vivo ultrafiltration were not accompanied by changes in plasma uric acid. The correlation of plasma uric acid with plasma albumin cannot be attributed to protein binding of urate. The two variables are probably related indirectly through a common association with an unknown factor or factors.


Effect of D(-)penicillamine on chronic experimental arthritis in rabbits.

Preliminary observations on the effect of D(-)penicillamine on chronic antigen-induced experimental arthritis in rabbits are reported. Daily oral administration of penicillamine, at a dose equivalent to that usually administered to rheumatoid arthritis patients, diminished the arthritis in 2 out of 3 animals as assessed by both measurement of joint circumference and histological examination.


Effect of excising Freund's adjuvant granuloma on subsequent development of experimental allergic arthritis.

Rabbits were immunized with antigen in Freund's complete adjuvant. Several weeks later the granuloma which developed was excised one day before joint challenge with antigen. The subsequent development of experimental allergic arthritis (EAA) was not affected, which argues against the chronicity of the disease being maintained by continuous recruitment of mycobacterial debris to EAA joints.


Reflux control following gastroplasty.

A Belsey gastroplasty was performed on 135 patients, 132 of whom were available for follow-up. Despite a low incidence (1.5%) of anatomical recurrence, the operation failed to control reflux effectively, and the incidence of continued reflux is 44.6%. Because of this failure to control reflux, a Nissen fundoplication has been added to the gastroplasty tube. In a group of 78 patients, radiological recurrence has occurred in 1 patient, with no patient experiencing symptoms of reflux. Manometric comparison between the Belsey and Nissen gastroplasty shows more effective tone elevation of the high pressure zone and a more effective decrease in disordered motor activity of the lower esophagus.


Life-threatening hemorrhage from inadvertent cervical arteriotomy.

Catastrophic hemorrhage followed accidental puncture of the carotid artery or its branches during attempted preoperative insertion of flow-directed balloon-tipped pulmonary artery catheters in 2 patients who underwent open cardiac procedures. Direct repair of two carotid artery lacerations was necessary in 1 patient; the second patient slowly resorbed a large extrapleural hematoma without surgical intervention. This experience suggests that patients experiencing such seemingly innocuous but potentially disastrous arterial injuries should not be heparinized, and that any procedure involving cardiopulmonary bypass should be postponed for several days to allow safe healing of the laceration.


Subclavian steal syndrome in the pediatric age group.

Four pediatric patients with subclavian steal syndrome (SSS) are described. One patient with congenital SSS had persistence of the lesion following surgical repair of coarctation of the aorta due to a gradient across a hypoplastic aortic arch. In 3 patients SSS developed on an acquired basis as a sequel to corrective operation, for coarctation in 1 patient, and interrupted aortic arch in 2 patients. Contributory factors included hypoplasia of the aortic arch, anatomical variation of the origin of the vertebral artery, and discrete recoarctation involving the ostium of the subclavian artery. Treatment was by vertebral artery ligation in 3 patients and by prosthetic patch arterioplasty in the patient with recoarctation. The 4 patients remain asymptomatic on follow-up of 16 to 25 months.


Low-cost daily pacemaker monitoring system.

To reduce the cost of pacemaker monitoring, we developed an inexpensive cardiac pacemaker interval monitor that detects electromagnetic radiation of the electrical pulse generated by an implanted pacemaker. The pulse interval is timed by logic systems and a piezoelectric crystal. Pulse interval is computed to the nearest 0.1 msec. The device is battery powered and can be used at home by the patient to monitor pulse interval daily with little cost after the initial expenditure. The unit may also be used by the physician to detect the stability or constancy of random variation of the pulse interval. From a daily record of measurements of the pulse interval, limits are set by the physician to predict impending battery exhaustion. Eight patients have been monitored for up to 24 months.


Early and late results in pulmonary atresia.

The early and long-term results following surgical treatment of 24 infants with pulmonary atresia with an intact ventricular septum were reviewed. Pulmonary valvotomy was the operation most often performed, and we came to realize that this was effective when the preoperative right ventricular angiogram had shown an open conus up to the atretic valve. By contrast, no infant without a patent conus survived pulmonary valvotomy. We suggest that this subgroup of patients (8 of the 24 in this series) should have a systemic-pulmonary shunt followed later by reconstruction of the right ventricular outflow tract. Diminutive right ventricles will grow and dilate if a reasonable passageway is formed from right ventricle to pulmonary artery. Thus the long-term results have been excellent when this has been carried out, with normal right ventricular pressures and appearance on angiography in 7 patients followed up to 13 years.


Simplified management of chylothorax in neonates and infants.

A simplified method for managing chylothorax in neonates and infants is presented. Use of an elemental diet markedly reduces the volume of the chyle leak while supporting total caloric intake. Either prolonged drainage or reexploration often can be avoided by the use of the described regimen.


Local nerve block anesthesia for peroral endoscopy.

Local glossopharyngeal and superior laryngeal nerve block anesthesia for peroral endoscopy was performed on 500 patients (313 bronchoscopies, 162 esophagoscopies, 25 combined bronchoesophagoscopies). The technique allows easy insertion of rigid and flexible scopes or awake tracheal intubation of conscious patients. Glossopharyngeal nerve block causes temporary abolition of the gag reflex and loss of tactile sensation over the posterior third of the tongue and the lateral and posterior wall of the oropharynx and hypopharynx. Superior laryngeal nerve block results in loss of tactile sensation over the posterior surface of the epiglottis and the mucosa of the larynx and upper trachea. Ten of the 500 patients (2%) had an inadequate glossopharyngeal block, and 4 of the 313 patients who had a bronchoscopic examination had an inadequate superior laryngeal block. In the remaining patients, excellent anesthesia was obtained with good patient acceptance and minimal morbidity.


Chronic interstitial pneumonitis with fibrosis after long-term therapy with nitrofurantoin.

Nitrofurantoin has been used widely as a urinary antiseptic. That it may cause pulmonary infiltration, and even fibrosis, has not been recognized universally. The literature contains 24 cases of interstitial pneumonitis with fibrosis. The results of treatment are summarized, and a new case is reported in detail.


Subxiphoid anterior mediastinal exploration.

A new surgical technique for anterior mediastinal exploration is described. The technique involves application of a Carlens mediastinoscope by means of a subxiphoid incision. The procedure provides complete exploration of the anterior mediastinal compartment and allows the surgeon to obtain a positive biopsy of the tumor or its lymph node metastases without sternotomy.


[Direct fetal electrocardiography].

The advancement in bioelectronics applied to medicine has made possible to carry out, with a high degree of fidelity, the study of the electrical events of the fetal heart. One of the methods in use is the direct or internal method, which offers the advantage of enabling the clear recognition of the different phases of the electrocardiogram, even during labor. An analysis of some parameters of the direct fetal electrocardiogram was carried on in normal term fetuses and whose mothers were in good health, and the parturition was normal. The parameters studied were: heart rate, P-R interval duration, the P wave, the QRS complex, the ventricular activation time, the P-R segment behaviour, intraventricular conduction, and RS-T and T wave changes. The first five items were submitted to statistical analysis for the calculation of the mean value, standard deviation and standard error. The practical application of the results is discussed in terms of deductive approach to the direct fetal electrocardiogram. It is concluded that the method is valuable for the prompt recognition of fetal distress mainly during labor.


[Plasma catecholamines; values in normal subjects and its use the localization of pheochromocytoma].

The results of plasma catacholamines obtained from a group of 79 healthy subjects, 35 females and 44 males varied from 2.4 to 26.5 ng/100 ml of plasma. There was no statistical difference due to sex or age. The value of plasma catacholamines in blood samples taken from catheterizations of inferior vena cava in patients with Pheochromocytoma was useful in the localization of the neoplasia in 4 cases which were studied. The maximum values coincide with the side or site of the localization of the neoplasia in the 4 cases. The clinical diagnosis of pheochromocytoma was suspected in the other three cases which were not catheterized and in those in which the clinical suspicion was evident. One of these cases was operated on and the tumor was found in the right adrenal gland. The other two patients have refused catheterization as well as the exploratory surgery. One of these is controlled with adequate medication while the other has refused all treatment.


[Renin-angiotensin-aldosterone system in the treatment of essential hypertension with a beta-adrenergic blocker: sotalol].

The administration of beta blockers has been useful in the treatment of essential hypertension. The anti-hypertensive effect of the beta-blocker sotalol was evaluated in 28 patients with essential hypertension. In all of the patients a determination of urinary aldosterone and plasma renin activity, before and after, three months of treatment with sotalol was done. In the pre-treatment tests, five patients (18%) had elevated renin values, in 13 (6%) renin was normal, and in 10 (36%) the renin activity in plasma was low. Treatment with sotalol caused normalization or significant lowering of diastolic pressure in the majority of cases with high or normal plasma renin. Patients with low plasma renin activity had less satisfactory results with the drug. Since there was no correlation between the lowering of arterial pressure and the degree of depletion of renin, we can conclude that anti-hypertensive mechanism of sotalol does not come from the decrease in secretion of renin. However our results suggest that patients with high renin respond better to treatment with sotalol, than cases with low renin levels.


Interactions between alcohol and other drugs on open-field and temperature measurements in gerbils.

Open-field activity and rectal temperature were measured in mongolian gerbils treated with alcholol (1 and 2 g/kg) only and when alcohol was combined with bemegride (20 and 40 mg/kg), DH-524 (20 mg/kg), or d-amphetamine (8 mg/kg). None of the purported antagonists normalized the alcholol-produced changes in the open-field test, nor did they reverse the alcohol-induced hypothermia. However, alcohol offered protection against bemegride-induced convulsion and death. When compared with pervious data (1) it is suggested that alcohol is differentiated from pentobarbital and diazepam on the basis of their interactional effects with bemegride.


Alcohol-discrimination in gerbils: interactions with bemegride, DH-524, Amphetamine, and delta9-THC.

Male gerbils were trained to discriminate the effects of an injection of alcohol (1.0, 1.5, and 2.0 g/kg) from the nondrug condition in a T-shaped maze. The formation of the discrimination was related to the training dose used, the high dose (2 g/kg) being the most rapidly discriminable condition. After having reached a criterion of performing 8 correct first-trial choices out of 10 consecutive training sessions the animals were tested for possible generalization or antagonism with bemegride, DH-524, d-amphetamine or delta9-THC. The results suggested that neither of these drugs substituted for alcohol, nor did the drugs reverse or antagonize the alcohol-discrimination, i.e. the gerbils choose the nondrug associated position of the T-maze after single injections of the test-drugs whereas combinations of alcohol and the test-drugs resulted in responding appropriate for the alcohol-(training)-condition.


Some aspects of the pharmacology of butibufen, a non-steroidal anti-inflammatory agent.

The anti-inflammatory, analgesic and antipyretic properties of butibufen, a non-steroidal compound, were assessed by a battery of standard tests. It activity as an anti-inflammatory agent was equivalent to ibuprofen and phenylbutazone. Butibufen was within the potency range of ibuprofen as an antipyretic and analgesic agent and greater than that of acetylsalicylic acid. The compound possesses the advantage of a low order to toxicity. Its ulcerogenicity was much lower than that of phenylbutazone. Therefore, butibufen appears to offer potential safety and efficacy in the treatment of rheumatic diseases.


Pharmacology of a new non-steroidal, anti-inflammatory agent: 6,11-dihydro-11-oxodibenz [b, e] oxepin-2-acetic acid (HP 549).

HP 549 is an orally effective non-steroidal anti-inflammatory agent with moderate analgesic and antipyretic activity. It is active in adjuvant-induced polyarthritis when given prophylactically or therapeutically. HP 549 also inhibits carrageenan-induced paw edema in the rat, an activity which is not altered by adrenalectomy. The analgesic activity of HP 549 was demonstrated in phenylquinone writhing. However, HP 549 produced variable results in the Randall-Selitto analgesia test. The anti-pyretic activity of HP 549 appears to be weak. HP 549, unlike other pharmacologically active anti-inflammatory drugs, does not produce gastric irritation at effective doses and is 45 times less ulcerogenic than indomethacin. Also the acute therapeutic indices for HP 549 are more favorable than for indomethacin.


An analysis of the characteristics of the adrenergic neurone blocking action of dimethylphenylpiperazinium.

An analysis of the characteristics of the adrenergic neurone blocking action of 1,1-dimethyl-4-phenylpiperazinium (DMPP) was undertaken using rat isolated vasa deferentia. DMPP (1 X 10(-6) to 1.5 X 10(-5) g/ml) reduced progressively the contractile response to transmural stimulation (TMS) in a dose-dependent manner without inhibiting the response to exogenous norepinephrine. The DMPP-induced inhibition was not reversed by washing but could be antagonized by dexamphetamine in a concentration which did not by itself affect the response to TMS. Among other sympathomimetic amines tested, it was seen that methamphetamine, ephedrine, phenylpropranolamine and mephentermine were effective in antagonizing DMPP-induce inhibition. High calcium (5 mM) reversed but did not prevent the DMPP-induced inhibition. DMPP reduced preferentially responses to high frequencies of stimulation without affecting those to low.


Effect of chronic treatment with propranolol on blood pressure and cardiovascular reactivity in spontaneously hypertensive rats.

Young SHR were treated with propranolol (16 or 64 mg/kg per day) from 6 up to 14 weeks of age. Systolic blood pressure was significantly lower in SHR treated with propranolol (64 mg/kg) than in untreated SHR; no effect was seen in SHR treated with 16 mg/kg. The hemodynamic characteristics of the hindquarter vascular beds did not significantly differ between untreated and propranolol-treated SHR. Adult SHR were given propranolol (64 mg/kg per day) from 5 up to 8 months of age. Moderate reduction of systolic blood pressure was observed from 2 to 3 months of propranolol treatment. The cardiovascular pressor response to noradrenaline decreased in propranolol-treated SHR, while the decreased responsiveness was not found after pithing.


Sensitivity of different segments of rabbit aorta to acetylcholine and isoproterenol.

In order to determine whether or not reserpine-induced supersensitivity was affected or reflected in differences in sensitivities to acetylcholine and isoproterenol in different segments of the rabbit aorta, segments of aorta, taken at two different distances from the arch, were tested for their sensitivities to these two agonists. Sensitivity and maximum responses to acetylcholine were lower in the more distal segment. Sensitivity to isoproterenol of the segments was not different while the maximum responses were lower in the more distal segment. Reserpine-induced supersensitivity to both agonists was similar in both aortic segments.


Mechanism of the hypotensive action of prazosin.

The mechanism of action of prazosin was studied in anesthetized rats by comparison with the peripherally-acting anti-hypertensive agents, indoramin, hydralazine and diazoxide. Hydralazine and diazoxide retained full hypotensive potency after ganglionic blockade with pentolinium or alpha adrenoceptor blockade with phentolamine. Hydralzaine and diazoxide also attenuated angiotensin II pressor responses. In contrast, the hypotensive activity of prazosin was completely abolished, and that of indoramin was almost abolished by either pentolinium or phentolamine pre-treatment. Neither prazosin nor indoramin caused impairment of angiotensin II responsivity, but each was shown to possess alpha adrenoceptor blocking properties. Both agents antagonized the pressor action of norepinephrine and reversed responses to epinephrine. Thus, while hydralazine and diazoxide act directly upon the vasculature by mechanisms independent of sympathetic vasomotor tone, prazosin, like indoramin, acts as an alpha adrenoceptor blocking agent.


Effect of indomethacin on the responses of resistance and capacitance vessels to noradrenaline in working skeletal muscles in the dog (1) (2).

The effect of indomethacin upon the responses of resistance and capacitance vessels to noradrenaline (NA) in working skeletal muscles of the dog's hind leg was investigated. Responses of the resistance and the capacitance vessels of NA (0,1-0,5 microgram/kg injected into the femoral artery--i.f.a) were reflected as the changes in peripheral vascular resistance and in tissue volume respectively, and determined during and following exercise before and after indomethacin (1-1,5 mg/kg i.f.a.). Muscular exercise was induced by sciatic nerve stimulation of 6 min duration. The results show that indomethacin potentiates constrictor effects of NA in both pre-and postcapillary sections of the muscular vascular bed during and following exercise. An augmentation of NA effects is significantly greater in the capacitance than in the resistance vessels. Potentiated constrictor responses to NA are also maintained longer in the capacitance than in the resistance segment during the postexercise period. The results suggest that endogenous prostaglandings are involved in a local vascular response to exercise within both pre-and postcapillary segments of the muscular vascular bed. Their role in the capacitance vessels of the limb may be related to a local inhibiton of sympathetic activity, reduction of postcapillary resistance and facilitation of the venous outflow.


Comparison of the antiarrhythmic activity of quinidine and quinine.

A comparison was made between the effects of quinidine and quinine on experimental arrhythmias and on cardiac electrophysiologic parameters. Both drugs raised ventricular fibrillation thresholds, reversed aconitine-induced atrial fibrillation, decreased ouabain-induced abnormal ventricular beats, and increased atrial refractory periods and His-Purkinje conduction time. In contrast, only quinidine antagonized acetylcholine-induced atrial fibrillation. In addition, quinidine increased ventricular fibrillation thresholds and atrial refractory periods for a longer time period than quinine. These observations are discussed in terms of choosing an appropriate model for testing new compounds with suspected quinidine-like activity.


Effects of atropine on paraoxon-induced alterations in brain acetylcholine.

Rats were treated acutely (one day) and chronically (seven days) with atropine, paraoxon, or both, and brain levels of acetylcholine (ACh) were determined to elucidate possible mechanisms underlying adaptation to chronic cholinesterase (ChE) inhibition. In acutely treated animals, atropine had no effect on free ACh, but decreased bound ACh levels. Conversely, paraoxon increased both free and bound ACh. Atropine pretreatment totally prevented the paraoxon-induced rise in free and bound ACh. In chronically treated animals, atropine decreased total ACh content after the initial injection, with no further changes upon subsequent administration. ACh levels increased during the first three days of paraoxon treatment, but latter injections (days 4-7) did not produce further alterations. Daily pretreatment with atropine prevented the paroxon-induced increase in ACh levels on days 1-3, but could not prevent the paraoxon-induced rise in ACh on days 4-7.  Results are discussed in terms of a possible neurotransmitter accumulation, occurring under conditions of chronic ChE inhibition, that may regulate the mobilization, storage, and release of ACh.


N-(4-Acetamidophenyl)-anti-tricyclo [4.2.2.025-] deca-3, 9-diene-7, 8-endodicarboximide (1)--a chemically novel anticonvulsant.

The present report describes the activity of a dicarboximide in various test procedures in mice believed to define the therapeutic efficacy to compounds as antiepileptic agents. Comparative studies with diphenylhydantoin, phenobarbital and trimethadione have shown the profile of activity, potency and duration of action of the dicarboximide to closely resemble diphenylhydantoin. This dicarboximide is chemically novel in relation to presently employed therapeutic agents and could offer promise as a new class of agents with potential value in the treatment of convulsive disorders.


Effect of sexual steroid hormones and of clomiphene on the behavioral response to L-dopa in mice.

The scope of the present work was to ascertain the effects of some steroid hormones on the behavioral response of mice to L-Dopa. The drugs considered were: testosterone, mesterolone, cyproterone, estradiol, progesterone and clomiphene. The male sex steroids, having either androgen or antiandrogen properties, were able to potentiate the behavioral effect of L-Dopa in mice, while female sex steroids failed to demonstrate this activity. Clomiphene proved to be the most active in enhancing the behavioral effects of L-Dopa in mice.


The effect of cocaine and D-amphetamine on punished responding.

Various dosages of d-amphetamine (0.1, 0.5, 2.5 mg/kg) and of cocaine (5.0, 20, 40 mg/kg) were administered i.p. to each of 7 rats trained in an experimentally induced conflict procedure. Sessions were 1 hr in duration and consisted of five 12 min periods; responding was reinforced with food on a F124 sec schedule of reinforcement during each period; however, in periods 2 and 4 each response was followed by the application of footshock. Significant increase in responding did not occur in any period following any of the pretreatments. Cocaine (5.0, 20 mg/kg) and d-amphetamine (0.5, 2.5 mg/kg) significantly decreased responding in both punished and unpunished periods. Following these treatments the rate of responding in punished and unpunished components was not significantly different. This suggest that psychomotor stimulants may not selectively increase anxiety, at least at dosages which are not at the same time anorexic.


Electrocardiogram in evaluation of resistance to antihypertensive therapy.

The effect of blood pressure control on the evolution of electrocardiographic evidence of left ventricular hypertrophy was investigated 50 patients with hypertension who were followed up for an average period of nine years. Blood pressure response to treatment was determined both from casual office readings and from weekly averages of twice daily home readings. Changes in the ECG, judged from both alteration in QRS voltage and in ST-T segment, were related to the degree of arterial pressure control. Usually, both home and office arterial pressure responded similarly to antihypertensive therapy, but when there was a difference, electrocardiographic changes correlated best with home prssure averages. Reduction in maximum precordial QRS voltage (Sv1+Rv5-6) correlated best with changes in home systolic pressure (r = .460; P less than .001), but correlation with diastolic pressure variation either at home or in the office did not attain statistical significance (P greater than .10). The present data stress the importance of home pressure measurements in the management of some patients with hypertension and provide evidence that casual office readings may sometimes misjudge the effectiveness of antihypertensive therapy.


Hypercalcemia and primary hyperparathyroidism. Prevalence in patients receiving thiazides as detected in a health screen.

Twenty patients being treated with thiazides were found among 95 subjects (21%) with hyercalcemia verified in repeated determinations in a health screening of 15,903 persons. There were 1,034 patients treated with thiazides in this total health screening. The prevalence of hypercalcemia in the patients treated with thiazides in this total health screening. The prevalence of hypercalcemia in the patients treated with thiazide (1.9%) was considerably higher than the prevalence of hypercalcemia found in the entire health-screened population (0.6%). The thiazide treatment was withdrawn in the 20 hypercalcemic subjects after an examination, and the patients were observed at intervals during a follow-up period of one year. The necks of 14 were explored during or after the follow-up period because of an initial serum calcium level greater than 3.0 mmole/liter or persistent hypercalcemia. Parathyroid adenomas were seen in all patients receiving surgery. Single adenomas predominated in surgical findings. The finding of the present high number of patients with primary hyperparathyroidism may be associated with elevated blood pressure resulting in thiazide treatment after detection.


Adult hemolytic-uremic syndrome. Familial variant.

We describe here a family with hemolytic-uremic syndrome culminating in renal failure and severe hypertension in the involved male adults. Members of this family developed a microangiopathic hemolytic anemia, progressive renal failure, the onset of elevation of blood pressure, and an untimely death in young adulthood. One affected family member has survived the initial crisis. The family history presents further evidence for an autosomal dominant pattern of inheritance of hemolytic-uremic syndrome with presentation in adulthood.


Infertility in patients with hyperprolactinemia from a pituitary adenoma. Effect of transsphenoidal pituitary adenectomy.

Four patients with infertility caused by a prolactin-secreting pituitary adenoma underwent transsphenoidal pituitary adenectomy. Preoperatively, in three patients prolactin level was elevated and gonadotropin levels were depressed. In one patient, prolactin level was elevated, and gonadotropin levels were normal, although no rise in gonadotropin levels was noted after clomiphene citrate therapy. In another patient growth hormone level was elevated. Pituitary function was otherwise normal in all patients. The patients underwent transsphenoidal pituitary adenectomy and postoperatively the first three showed normal prolactin and growth hormone levels. The fourth has not yet been reevaluated. Spontaneous pregnancy occurred in all four patients without manipulation shortly after surgery. We suggest that transsphenoidal pituitary adenectomy is a successful and low-risk approach to infertility secondary to prolactin-secreting pituitary adenomata.


Hepatic dysfunction in acute measles infection of adults.

Hepatitis has rarely been recognized as a complication of acute measles infection. Two adult patients are reported in whom abnormal liver function was a prominent clinical feature during acute measles infection. Hepatic function returned to normal in both patients as the measles infection resolved. Hepatitis may be a salient clinical manifestation of acute measles infection of adults.


Treatment of fungal meningitis with miconazole.

Twelve patients with fungal meningitis (ten cases were due to Coccidioides immitis, two were from Cryptococcus neoformans) were treated with brief courses of intravenous (IV) miconazole. Eleven patients, including patients with severe, chronic disease, had been treated unsuccessfully with amphotericin B. Four patients also received miconazole injected directly into the CSF. The drug was well tolerated by any route, with mild reversible side effects. After IV administration the miconazole concentration in the CSF rarely exceeded the minimal inhibitory concentration (MIC) of the infecting organism. Intra-CSF administration of 20 mg generally produced levels above the MIC for 24 hours. Five of ten  patients with coccidiodial meningitis responded clinically. Of these five, four received only IV miconazole; three relapsed after therapy was stopped. Miconazole appears promising as a treatment of fungal meningitis, but trials of longer duration might prevent relapse.


Cough. A comprehensive review.

An understanding of the anatomic, physiologic, and pathophysiologic aspects of cough is necessary to appropriately diagnose and treat patients with cough. In the majority of persons, cough that is acute and self-limiting is usually secondary to a viral upper respiratory tract infection; cough that is chronic and persistent is usually due to chronic bronchitis or postnasal drip. In the remaining persons, to determine the cause of cough, it is necessary to systematically consider anatomic locations were receptors and afferent nervous pathways are located. Definitive treatment of cough depends on determining its precise cause and then initiating specific therapy for the underlying disorder. Only when the cause of cough remains unknown or when cough performs no useful function and its complications represent a potential hazard to the patient, should symptomatic treatment be considered. Combination cough preparations should not be prescribed.


Disseminated Herpesvirus hominis 2 infection following drug overdose.

Fatal disseminated herpesvirus hominis type 2 infection developed in a 24-year-old woman with psychiatric disease. The primary site of virus entry appeared to be the upper respiratory tract, although the cervix and anus could have been primary sites. Dissemination of infection was facilitated by steroid therapy. An endotracheal tube may have increased spread to the lower respiratory tract and an intrauterine device may have aided spread to the uterus. Intranuclear inclusion body-bearing cells in the respiratory secretions should alert the clinician to possible herpesvirus disease, local and disseminated, even in the nonimmunecompromised patient.


Primary hyperparathyroidism and benign monoclonal gammopathy.

Three patients had primary hyperparathyroidism and monoclonal serum immunoglobulins. Although multiple myeloma was suspected in each case, subsequent evaluation was consistent with a "benign monoclonal gammopathy". Parathyroid adenomas were removed from two patients. The three patients are presented and compared to the four other cases that have been reported previously. The association between primary hyperparathyroidism and benign monoclonal gammopathy is discussed in terms of possible pathogenetic mechanisms. Primary hyperparathyroidism should be suspected in patients with hypercalcemia and benigh monoclonal gammopathy, as well as in other conditions, like multiple myeloma, that are known to be associated with hypercalcemia.


Prothrombin complex concentrate.

A hemophilliac with a factor VIII inhibitor was bleeding massively from an extensive surgical wound. After ten days of unsuccessful management by conservative measures, he was given a single infusion of prothrombin complex concentrate (Konyne). Bleeding stopped immediately and the wound healed without further recurrence of bleeding. Although the activated partial thromboplastin time shortened following the infusion, the exact physiologic mechanism whereby these concentrates bypass the need for factor VIII clotting activity is unknown.


Acute renal failure after use of diesel fuel as shampoo.

After washing his hair with diesel fuel a 28-year-old patient developed acute renal failure (ARF) and oliguria requiring hemodialysis. The patient recuperated completely. In the absence of other causal factors, we believe that the absorption of the diesel fuel components, either through the respiratory tract or through the skin can be considered to be the cause of the ARF. In spite of the extended everyday use of petroleum distillation products, cases of acute intoxication are infrequent. Even rarer are cases in which these products occasion ARF.


Allergic laryngospasm on initiating oral propranolol therapy.

A 29-year-old woman suffered acute laryngospasm on taking the initial dose of propranolol hydrocholoride for the treatment of hypertension associated with a hyperdynamic circulatory state. Hypersensitivity to the tartrazine additive used as a stabilizing agent in oral propranolol appeared the likely cause of anaphylaxis, although a direct hypersensitivity to propranolol itself could not be excluded.


Mitral valve prolapse and conduction defects in Ehlers-Danlos syndrome.

A case of type 3 Ehlers-Danlos syndrome with associated mitral valve prolapse, right bundle-branch block, and left anterior fascicular block was studied, including His bundle electrocardiography and echocardiography. Mitral valve prolapse and HV prolongation were reported. The present study suggests that the basic underlying collagen defect in this syndrome is responsible for these findings, and that the association may be more widespread in the syndrome than currently acknowledged. The possibility also is considered that the connective tissue abnormalities of Ehlers-Danlos syndrome involving the heart may be the cause of some cases of idiopathic conduction system disease or valvular insufficiency.


Life-threatening ventricular tachyarrhythmias in delirium tremens.

Ventricular irritability and ventricular fibrillation developed in an alcoholic patient who had withdrawal seizures and delirium tremens; he was successfully resuscitated. Potassium and magnesium level were low; therefore replacement of these electrolytes was carried out, as well as intravenous administration of lidocaine hydrochloride; however, ventricular tachycardia developed again and required countershock. No further arrhythmias occurred after additional potassium chloride and procainamide hydrochloride therapy was given. Hypokalemia and possibly hypomagnesemia are implicated as important factors in the development of ventricular ectopy. Delirium tremens is a potential medical emergency, and in the presence of low potassium and/or magnesium levels, or ventricular irritability, patients with this condition should be treated expectantly in an intensive care unit, with close monitoring and aggressive therapy for life-threatening arrhythmias.


Factitious Bartter's syndrome.

A 29-year-old man had a six-month history of fatigue and hypokalemia. Gastrointestinal losses of potassium were not judged significant. The patient denied ingestion of licorice, large quantities of laxatives, or diuretics. Clinical and laboratory findings were consistent with Bartter's syndrome in the adult. Normal blood pressure, hypokalemic alkalosis, and hyperaldosteronism, with insensitivity to the pressor effect of angiotensin infusion, were present. Another major finding in Bartter's syndrome, juxtaglomerular hyperplasia, was not demonstrated because plans for renal biopsy were cancelled when thiazide was detected in the urine, utilizing chemical extraction and spectrophotometry. Surreptitious ingestion of diuretics must be excluded in any adult patient in whom a diagnosis of Bartter's syndrome is considered.


Hepatorenal syndrome. Recovery after peritoneovenous shunt.

The renal failure in the hepatorenal syndrome is unusual because the kidneys are histologically normal and the renal failure may be "functional." Hemodynamic studies indicate that increased renal vascular resistance and decreased renal blood flow may be the primary abnormalities leading to renal failure in some cases. This report describes a patient whose renal failure resolved after placement of a peritoneovenous shunt. A major advantage of this device is that it can be inserted with the patient under local anesthesia with minimal surgical risk. Further studies are needed to define the role of the peritoneovenous shunt in the hepatorenal syndrome.


Primary acquired hypogammaglobulinemia and regional enteritis.

We had a patient with primary acquired hypogammaglobulinemia (PAH), nodular lymphoid hyperplasia, giardiasis, and the subsequent development of regional enteritis (RE). The case is of interest because the development of regional enteritis in a patient with PAH has not been previously reported, to our knowledge. The interaction of hypogammaglobulinemia and RE is discussed from an immunologic point of view. The report adds RE to the many known bowel diseases associated with PAH.


Heroin-associated rhabdomyolysis with cardiac involvement.

A heroin addict had rhabdomyolysis with cardiac involvement. The patient was admitted with edema of the right leg and oliguria. Admission diagnoses were right illofemoral thrombophlebitis, acute renal failure, and heroin addiction. Urinalysis was strongly positive for "blood" in the absence of hemolysis or marked hematocyturia, and a diagnosis of rhabdomyolysis was made. Peritoneal dialysis succeeded in lowering blood urea nitrogen and serum potassium levels, but the patient died on the fourth hospital day. Postmortem examination disclosed focal myocardial myolysis, diffuse rhabdomyolysis of the right soleus muscle, and acute renal tubular necrosis. Direct toxicity or hypersensitivity to heroin or an adulterant is considered in the pathogenesis of myolysis.


[Incidence of Mycoplasma ovipneumoniae in sheep].

Out a total number of 19 mycoplasma strain from diseased sheeps, 5 strains were used for further investigations. The 5 strains were differentiated as Mycoplasma ovipneumoniae. The relation between mycoplasma findings and the disease is discussed.


[Binding relationships of fatty acids in lipid A of lipopolysaccharides from Pasteurella multocida].

Each glucosamine disaccharide of lipid A from Pasteurella multocida contains 2 mols myristic acid and 4 mols hydroxymyristic acid. 3-hydroxymyristic acid was identified as fatty acid with amide linkage. Every 2 mols of glucosamine have linked to them 1 mol myristic acid, 3-hydroxymyristic acid, and 3-myristoxymyristic acid. The results so far obtained reflected the structure of lipid A of enterobacteriaceae.


[Antiglobulin test -- preparation and evaluation of antiglobulin sera].

After demonstrating the principle of antiglobulin reaction, preparation and evaluation of antiglobulin sera as well as the procedure of the antiglobulin test (agT) are described. Possible error sources are indicated and a central preparation of a highquality antiglobulin serum and its examination by government authorities is suggested,


[Studies on muscle-meat quality in swine. 1. Incidence of poor quality as well as influence of slaughtering and refrigeration].

The pork quality of M. longissimus dorsi of 1,010 pigs for slaughter in one pork production unit was determined on 17 slaughter days. Measurements taken for that purpose included pH 45 minutes post mortem, pork brightness 24 hours post mortem, and drip loss 24 hours post mortem. The following results were recorded: 1. Quality gaps in terms of PSE pork were recorded from 21.9 per cent of the pork samples stored under cold store conditions. 2. The percentage of cutlet pieces was reduced considerably (10.9 per cent) by shock cooling (-10 degrees C to -18 degrees C over 1.5 to 2.5 hours). This shows the importance of cooling. 3. The differences recorded between mean values were attributable mainly to nonsystematised environmental conditions, with such variation having been effective not only on the day of slaughter. 4. Close correlations were found to exist between drip loss and pH-value as well as between drip loss and pork brightness, while the relationships were less close between pH-value and brightness.


[Influence of Pasteurella multocida and Pasteurella-multocida endotoxin on the blood-coagulation-analytic parameter after experimental administration in calves].

Experimental administration to calves of Pasteurella multocida or the application of an endotoxin preparation of the strain produced continuous decline of thrombocytes, disorders in thrombocytic functions, and the development of hypofibrinogenaemia. The changes recorded as well as the clinical symptoms and pathologico-anatomic findings are interpreted as endotoxin shock.


[Studies on Salmonellosis in the calf. 5. Clinical testing of Smd-Salmonella-dublin vaccine for oral administration].

The oral vaccine, prepared on the basis of streptomycindependent mutants for administration to control S.-dublin infection, was clinically tested on 2,210 calves of 22 herds. The experimentally obtained findings regarding good tolerance and sufficient effectiveness of oral live vaccines were thus confirmed under field conditions. Good effectiveness of the oral vaccine was reflected in the recorded decline of clinical salmonellosis cases and of calf losses due to salmonellosis, and it was established also by bacteriological identification of S. dublin in faecal samples, histological sections, and material obtained from emergency slaughter carcasses. A comparison between this oral vaccine and "Mellavax" an imported vaccine for subcutaneous adminstration with good effectiveness, revealed superiority of the oral vaccine by almost all criteria of action. Particular importance was attributed to the significant reduction of the number of Salmonella-excreting animals (faeces) following oral immunisation. The oral vaccine against Dublin salmonellosis of calf was disembargoed for production in 1975 under the name of "Salmonella-dublin Live Vaccine Dessau".


[Bordetella-bronchiseptica pneumonia in the swine].

Bordetella have been frequently detectable from lesioned lung material of swine as well as from the upper respiratory tracts of clinically intact animals. Pneumonia, different in extent, was produced in primarily specific pathogen free pigs by intratracheal and intranasal application of eight Bordetella isolates. Moderate to medium manifestations of focal pneumonia with scattered speckles developed, with severity depending on dosage and mode of infection. Histologically, they were characterised by vascular lesions and fibroblastic proliferation. This type of pneumonia thus was differentiated by the above characteristics from pneumonia caused by heamophils and Pasteurellae. Under conditions of natural exposure, Bordetella pneumonia can be expected to develop primarily due to defective host-patasite relationship. Bordetellae, in this context, are considered only conditionally pathogenic. Bordetellal infection will have to be taken into consideration in differential diagnosis whenever checks are made on pigs in industrialised units.


Psychopathology in adopted and nonadopted daughters of alcoholics.

This report completes a series of studies conducted in Denmark comparing drinking patterns and psychopathology in adopted and nonadopted children of alcoholics. Sons of alcoholics had higher rates of alcoholism than controls, whether raised by their alcoholic parents or by foster parents. They did not have more psychopathology otherwise. Daughters of alcoholics, adopted and nonadopted, had a higher rate of alcoholism than was the expected frequency in the general population, but so did controls in the adopted group; neither group had higher rates of other psychopathology, eg, depression. However, daughters of alcoholics raised by their biological parents had significantly more depression.


Family structure and the mental health of children. Concurrent and longitudinal community-wide studies.

This study provides a map of variations of families and some of the core relationships between types of family and the mental health of children. Family types in a poor, black urban community were defined in terms of the adults present at home. The resulting taxonomy is based on two populations: half of the community's 1964 first-grade children and families and the entire 1966 first-grade children and families. Eighty-six family types were found, falling into ten major classes. Family type was found to be strongly related over time to the child's social adaptational status (SAS) and his or her psychological well-being. The results suggest that (1) mother alone families entail the highest risk in terms of social maladaptation and psychological well-being of the child; (2) the presence of certain second adults has important ameliorative functions--mother/grandmother families being nearly as effective as mother/father families, with mother/stepfather families similar to mother alone in regard to risk; and (3) the absence of the father was less important than the aloneness of the mother in relation to risk.


An outcome study of group therapy.

Outcome research in a group therapy program was conducted with therapists in training who had little prior experience with group therapy. Significantly greater improvement over an initial three-month period was found for treated patients when compared with control patients on a multivariate combination of five outcome criteria. Some, but not all, of the five separate criteria indicated such a difference. Only slight, nondifferentiating improvement was found for target symptoms. Significantly greater improvement over the three-month period on the multivariate combination was also found for treated patients who had begun therapy during the second year of the program when compared with treated patients who had begun therapy during the first year of the program. Finally, significant improvement over the three-month period on the multivariate combination was found for both treated and control patients.


Ward treatment milieu and posthospital functioning.

Two units of seven and 14 state hospital wards were used in a study to explore possible relationships between some socio-cultural aspects of ward environments and outcome of treatment as assessed by time out of the hospital after discharge. Confounding variables such as pretreatment characteristics, length of hospitalization, and community of discharge make conclusions from many such studies tenuous. Methods were derived and are here described in detail that reduce the influence of some of these variables. Within unit 2 (14 wards), a vector of social structure that differentiated the wards and consisted of two highly correlated factors on the Ward Atmosphere Scale was found to be significantly associated with outcome. Those wards seen by both patients and staff as lower in the allowance of expression of anger and aggression and higher in order and organization (only staff's perception) had better outcomes. The wards of unit 1 were homogeneous both in outcome and in staff and patients' assessments of order and organization and freedom to express anger and aggression.


Seasonality of schizophrenic births in the United States.

The birth months of persons later diagnosed as schizophrenic were studied. Data were collected from 19 states on 53,584 schizophrenics born between 1920 and 1955. The controls were the general births in the same states for the same years. A highly significant peak in schizophrenic births was found from December to May, most marked in March and April. The seasonality was stronger in New England and the Midwest than in the South. Previous studies of schizophrenic births are also reviewed. The cumulative evidence would appear to establish more firmly a winter and spring seasonality of schizophrenic births in northern Europe and the eastern United States. Selection of patients, nutritional factors, environmental factors, genetic factors, and infectious agents are discussed as possible etiological explanations.