Variation of DNA polymerases-alpha, -beta. and -gamma during perinatal tissue growth and differentiation.

The activities of the three known DNA polymerases-alpha, beta-, and -gamma were determined in rat brain neurons, cardiac muscle and spleen, and were correlated with the rate of cell proliferation during perinatal development. In neurons and cardiac muscle, which stop dividing before birth, DNA polymerase-alpha activity drops sharply from a high level with the approach of term and disappears at approximately two weeks postnatal age. In contrast, alpha-polymerase activity is almost absent in spleen during late gestation, when the rate of cell division is low, and increases abruptly after birth with the sudden onset of cell proliferation. These data give further evidence for an involvement of DNA polymerase-alpha in DNA replication. DNA polymerase-beta and -gamma activities show essentially no correlation with the rate of cell division. Thus, these enzymes are probably responsible for repair type processes rather than for DNA replecation.


Complex mitochondrial DNA in Drosophila.

The larval mtDNA isolated from D. virilis, D. simulans and D. melanogaster exists in complex molecular forms in addition to the simple monomeric circular form. The frequency of circular dimers and oligomers is highly elevated in apparently normal larval tissues. These complex forms of mtDNA are separable on agarose gels. Hind III restriction endonuclease and electron microscopic analyses used in the present study have revealed that circular dimers are simply the circular concatemers of two monomeric circles which are arranged in a head-to-tail structure with no detectable heterologous regions such as insertions or deletions. The electrophoretic patterns of Hind III digested mtDNAs of D. simulans and D. melanogaster (sibling species) are identical and distinguishable from that of distantly related species, D. virilis.


Inhibition of pancreatic ribonuclease by 2'-5' and 3'-5' oligonucleotides.

Forty different oligonucleotides were investigated as possible inhibitors of the depolymerizing activity of RNase A. The strongest inhibitors among the diribonucleoside 2'-5' mono- phosphates were: G2'-5'G, C2'-5'G and U2'-5'G, and among the diribonucleoside 3'-5' monophosphates: ApU, ApC and GpU. Of the eight trinucleotides investigated, ApApUp, ApApCp and ApGpUp were the strongest inhibitors. All four dinucleotides studied (ApUp, ApCp, GpUp and GpCp) were very strong inhibitors, ApUp being the strongest one. The results show that the nature of the various bases in the oligonucleotide has an effect on the degree of inhibition, and that the 3' phosphomonoester group increases the binding of the oligonucleotide to RNase A. These inhibitors can be used in physicochemical and biochemical studies of ribonuclease.


Removal of 5'-terminal m7G from eukaryotic mRNAs by potato nucleotide pyrophosphatase and its effect on translation.

The procedure for isolation of nucleotide pyrophosphatase (E.C. 3.6.1.9.) from potato has been modified to yield an endonuclease-free preparation purified 2300-fold. The enzyme was used for specific cleavage of pyrophosphate linkages in the 5'-terminal cap (m7GpppN) of several eukaryotic messenger RNAs. Enzymatic removal of 5'-terminal pm7G from reovirus, rabbit globin and Artemia salina mRNAs resulted in an almost complete loss (greater than 80%) of their template activities in a cell-free protein synthesizing system from wheat germ. Incubation with nucleotide pyrophosphatase did not decrease the translation of phage f2 RNA in an Escherichia coli cell-free system.


Methylation of nucleosomal and nuclease sensitive DNA.

The proportion of cytosines methylated in the DNA of nucleosome oligomers and of core particles appears indistinguishable from that of total nuclear DNA from CHO cells. However the DNA in nucleoprotein which is initially released from nuclei by treatment with very low levels of micrococcal nuclease and the first 10% of material rendered acid soluble by treatment of nuclei with DNase I are enriched 2 fold in their content of 5 methylcytosine. (Cessation of hydrolysis by nuclease occurs concomitantly with precipitation of nucleosomal core particles).


Mercurated nucleotides: assessment of a new tool to study RNA synthesis and processing in isolated nuclei.

Mercurated pyrimidine nucleotides have been used to study RNA synthesis and processing in isolated nuclei from mouse L cells. 5-mercuridine triphosphate (5-Hg-UTP) or 5-Hg-CTP are accepted as substrates by the purified RNA polymerases (I + III) and (II) from mouse cells, respectively, as well as by the enzymes still bound to the nuclear chromatin. In nuclei, RNA synthesis in the presence of Hg-UTP is reduced to 60-70% of a control. 30-60% of RNA labeled in vitro with (3H)UTP in isolated nuclei is not retained on sulfhydryl sepharose columns. Sucrose gradient analysis reveals a size distribution of the non-bound RNA similar to non-mercurated control RNA. Hg-RNA is found in a single peak from 4-10S. Chase experiments indicate that this RNA is the original transcript. It is argued that Hg-nucleotides may cause premature chain termination. Methylation of RNA in vitro by S-adenosyl methionine ((3H)SAM) is reduced to 75% of controls in the presence of Hg-UTP. Only 6% of the methyl groups appear in Hg-RNA. Polyadenylation is reduced as well. 15% of poly(A) (+)RNA are found in control assays whereas only 1% of Hg-RNA carries a poly(A) end added in vitro. These results limit the use of mercurated nucleotides for studies of nuclear RNA synthesis and processing.


Structure of transcriptionally-active chromatin subunits.

Rat liver chromatin is organized into regions of DNA which differ in degree of susceptibility to attack by the endonucleases DNase I and DNase II. The most nuclease-sensitive portion of chromatin DNA is enriched in transcribed sequences. This fraction may be separated from the bulk of chromatin by virtue of its solubility in solutions containing 2 mM MgCl2. Both transcribed and nontranscribed regions of chromatin are organized into repeating units of DNA and histone, which appear as 100 A beads in the electron microscope. The length of DNA in the repeat unit is the same for these two classes of chromatin (198 +/- 6 base pairs in rat liver); however, the subunits of active, Mg++-soluble chromatin differ from the nucleosomes of inactive regions of chromatin in several respects. Active subunits are enriched in nascent RNA and nonhistone protein and exhibit higher sedimentation values than the corresponding subunits of inactive chromatin.


Purification of cDNA complementary to sea urchin histone mRNA.

Complementary DNA (cDNA) was transcribed from a polyadenylated sea urchin histone mRNA preparation isolated by density gradient centrifugation. By hybridization, this cDNA was shown to be extensively contaminated (85% of hybridizable cDNA) with DNA complementary to RNA derived from the large ribosomal subunit. Purification of a mRNA specific cDNA fraction was achieved by hybridization of purified rRNA to cDNA followed by fractionation on hydroxyapatite. After further purification to remove nonhybridizable cDNA our purified cDNA showed only 8% hybirdization to rRNA.


A theoretical study oh the effect of "bound" water on the proton chemical shifts of the nucleic acid bases.

Computations are performed on the proton chemical shifts due to hydrogen bonding between the purine and pyrimidine bases of the nucleic acids and water molecules of their first hydration shell. The water molecules should produce measurable shifts essentially for protons of the bases located close to the site of interaction. For the imino protons of the bases G-N1H and U-N3H participating in hydrogen bonding, the calculated delta delta is larger for the interaction of a base with a complementary base than for its interaction with water. Base pairing will thus produce a downfield shift in water but the measured delta delta due to pairing in this solvent will be smaller than in an inert solvent. Also, the chemical shift difference between G-N1H and U-N3H in water will be larger if the molecules are engaged in pairs than if they are not.


Fluorination of 6-methyluracil and its nlcleosides.

6-Methyluracil and its perbenzoylated 1-(beta-D-ribofuranosyl) and 1-(2-deoxy-beta-D-ribofuranosyl) derivatives afford on treatment with elemental fluorine in acetic acid solutions, the corresponding derivatives of 5-fluoro-6-methyluracil and 5-fluoro-6-fluoromethyluracil. The free nucleosides have been obtained from the protected derivatives by methanolysis. The CH2F linkage in 5-fluoro-6-fluoromethyluracil derivatives is stable towards hydrolysis and nucleophilic agents.


Principles of genetics applied to medicine.

Genes and environment interact continuously throughout life, from the moment of conception, to regulate and affect all aspects of human structure and function. The normal rules of mendelian inheritance, ie, the transmission of genes over the generations, are usually best studied by observation of abnormal mutations, especially in plants and animals under precise breeding conditions. The study of such didactic models as the guinea pig crosses discussed here is a prerequisite to an understanding of mendelian genetics in man and the terms used in other articles to appear in this series.


Sudden infant death syndrome. The disease and its survivors.

Sudden infant death syndrome (SIDS) is a peculiar entity in that the self-condemning reactions of the surviving family go far beyond the death itself. The parents should be helped to understand that SIDS is a disease, even though the mechanism of death is not known, and that it is neither preventable nor predictable. Surviving siblings should not be excluded from the mourning process and should be reassured about their good health and blamelessness in causing the death. If parents defer having another child until the grief process is complete, the psychologic environment for subsequent children will be healthier.


Office gynecology. Diagnostic survey of the infertile couple.

The diagnostic survey of the infertile couple usually takes about three months. After semen analysis, the husband is referred for general and urologic examination. The wife is given a general physical and pelvic examination and returns during the next two months for ovulation studies. Tubal patency tests are also performed and may in themselves be therapeutic.


Acute renal failure after low-dose irradiation. A complication of chronic lymphocytic leukemia.

A middle-aged woman received low-dose irradiation for treatment of chronic lymphocytic leukemia: 1,000 rads to the spleen in four sessions over four days and 400 rads to each abdominal quadrant in eight sessions over eight days. Three days after the last irradiation session, acute hyperuricemic renal failure developed and conservative treatment was begun, with use of hydration, forced diuresis, alkalization, and short-term peritoneal dialysis. Uric acid levels were carefully monitored. Renal function promptly returned to normal.


Septic shock in a pregnant or recently pregnant woman.

Septic shock may be classified clinically as primary (reversible) or secondary (irreversible). Primary shock is further distinguished as early ("warm-hypotensive") or late ("cold-hypotensive"). Infected abortion, chorioamnionitis, or pyelonephritis of pregnancy calls for appropriate measures directed toward preventing septic shock, including administration of huge doses of antibiotics. If septic shock ensues, extirpation of the nidus of infection becomes a primary consideration. Surgical extirpation should be carried out if possible, and as soon as possible. Besides antibiotics, patients with septic shock may require glucocorticoids, vasomotor drugs, digitalis, and heparin. Careful monitoring is essential.


Inappropriate secretion of antidiuretic hormone. An overview of the syndrome.

The syndrome of inappropriate secretion of antidiuretic hormone is characterized by production of less than maximally dilute urine in the presence of hypotonic plasma. It may be secondary to malignant disease, central nervous system disorders, or pulmonary disease, among other conditions, or it may be idiopathic. Manifestations are those of water intoxication, eg, confusion, fatigue, nausea, headache, and neurologic signs. The pathogenesis is not completely understood. Restriction of fluid intake to obtain a negative water balance is effective treatment.


Chronic nonspecific diarrhea. Behavioral aspects.

In an attempt to demonstrate an association between chronic nonspecific diarrhea and behavioral problems in young children, structured interviews were conducted to elicit from parents a detailed history of behavior from birth. Problems relating to sleep, crying and irritability, digestion (excluding diarrhea), activity, and discipline were significantly more frequent or severe in the group of 16 youngsters with chronic nonspecific diarrhea than in the control group of children with no symptoms of this disorder. Also more common in the index group were a definite family history of gastrointestinal problems and the presence of certain specific emotional responses.


Hearing loss. The physician's responsibility.

Hearing loss is a very important and common problem in the United States, affecting 13 to 14 million people. It is primarily a medical problem, requiring diagnosis and, when indicated, treatment by a physician, preferably in collaboration with an audiologist. History taking is the most important part of the diagnostic process, followed by a physical examination with special attention to the head, neck, and ears. The primary object of the workup is to exclude all possible extrinsic causes of hearing loss. Intrinsic or genetic deafness is a diagnosis of exclusion. After the hearing loss has been classified as congenital or delayed and as genetic or nongenetic, a differential or working diagnosis can be made in all cases and a specific diagnosis in most cases. The hearing loss must then be identified as stable, progressive, or fluctuant over time. Follow-up at least every two years is important to check for possible changes in status.


A simple and rapid method for the isolation of cholesterol from spinal cord of cattle.

A method is described for the large scale isolation of cholesterol from cattle spinal cord. Cholesterol is released from the lipo-protein by drying the wet tissues with calcium oxide. This treatment appears to prevent the extraction of polar lipids with acetone, which reduces the lipophylic properties of the solution and thus provides a method for almost exclusive extraction of cholesterol. The further role of calcium oxide is also discussed. The method evolved is simple, rapid and eliminates several previously required steps.


Differential RNA metabolism in rat brain cells fractionated by zonal centrifugation.

Combined fractionation and RNA metabolism studies were made on homoiogous cell types (neurons and glia) banded from rat brain cerebral cortex and hippocampus tissue at 40,000 rev/min for 50 minutes in a Beckman Ti 14 zonal rotor loaded with a discontinuous methyl cellulose (Methocel) and sucrose density gradient. Comparisons were made on the cellular fractions recovered from animals intracisternally injected with 15 muCi tritiated cytidine (3HCR) RNA precursor one hour before sacrifice and tissue cellular filtrate preparation. Immediate 3H pool-correction of extracted 3HRNA from the three cellular Bands recovered made possible a mathematically valid measure of 3HCR-precursor incorporation into RNA of the different cell types. Comparison of the cellular 3HRNA data by analysis of variance revealed the occurrence of differential tritium labelling of RNA in the same cell types banded from different brain regions. In particular, an important advance was demonstrated by the procedures developed in these studies for the quantitative cellular assay of brain in vivo (differential) RNA metabolism.


Isolation of viruses by electro-extraction of infected plants.

The isolation of viruses from infected plant material by a process termed electro-extraction appeared to be a convenient and simple method of obtaining viruses in a fair state of purity. The method has the advantage over the conventional methods of virus purification that the infected plant tissue is not disintegrated and that organic solvents such as chloroform and butanol are avoided. The procedure used was demonstrated on the extraction of tobacco mosaic virus (TMV) from infected tobacco and turnip yellow mosaic virus (TYMV) from chinese cabbage plants. To obtain the virus it was found advisable to freeze and thaw the plants prior to extraction.


Chromatographic separation and purification of secretory IgA from human milk.

Defatted and decaseinated human milk was concentrated and was fractionated on a preparative DEAE cellulose column. Elution with various concentrations of sodium chloride in Tris-HCl buffer (pH 8.0, 0.01 M) resulted in fractions that were rich in either secretory immunoglobulin A (SIgA) (0.1 M NaCl) or free secretory component (SC) (0.05 M NaCl). The fractions, which were eluted with 0.10 M NaCl from the preparative column, were further fractionated on a G-200 Sephadex column. Repeated fractionation on this column resulted in a single purified fraction, which contained very high SIgA activity and showed immunological cross-reaction with both SC and serum IgA. Additional studies indicated that this fraction was homogeneous as shown by immunoprecipitin and disc gel electrophoresis. Injection of this purified SIgA into rabbits resulted in the production of monospecific antisera.


Leucine aminopeptidase from swine kidney: purification, molecular weight, subunit and amino acid composition.

A homogeneous leucine aminopeptidase was obtained from mixed breed swine kidneys by means of chromatography on a special column. After coupling an inhibitor, N-sulfanilyl N'-butylcarbamide, to Sepharose 6B, the derivative did not absorb the enzyme, but absorbed a non-enzymatically active protein. The enzyme showed a single band on disc-gel electrophoresis. The molecular weight of the enzyme has 320,000 daltons. In 6 M guanidine solution containing 0.5% 2-mercaptoethanol at pH 8, the enzyme exhibited a molecular weight of 53,000 on equilibrium centrifugation. A similar value, 54,000, for the subunit of the enzyme was found on SDS-gel electrophoresis. The amino acid composition of the enzyme is also reported.


Purification and characterization of a cardioexcitatory neuropeptide from the central ganglia of a bivalve mollusc.

We have purified a cardioexcitatory substance, previously designated peak C, from ganglia of the Sunray Venus clam, Macrocallista nimbosa. Low concentrations (10(-9)-10(-8) M) of this substance not only excite the isolated clam heart, but also produce tonic contractions of the isolated radula protractor muscle of the whelk, Busycon contrarium. These two muscle preparations have therefore been used as a parallel bioassay for peak C. Peak C is inactivated by proteolytic enzymes, has an isoelectric point greater than pH 10 and has an ultraviolet absorption spectrum similar to that of phenylalanine. On thin layer chromatograms, peak C separates into two components; one of these is probably a partially oxidized form produced during purification. Both components react with ninhydrin and with the Sakaguchi reagent for guanidino groups. The amino acid composition of peak C is Phe2.00Met0.81Arg1.12. N-terminal analysis, one round of Edman-dansyl degradation, and tryptic digesting are consistent with the identification of Macrocallista peak C as a tetrapeptide amide: Phe-Met-Arg-Phe-NH2 (FMRFamide).


The use of borohydrides of alkaline metals in the volumetric analysis of medicaments.

The possibility and conditions of determination of weak acid type medicaments were examined, using aqueous and non-aqueous sodium borohydride volumetric solutions. The process and control of titration were carried out potentiometrically and visually using acido-basic indicators. It was shown that for practical applications sodium borohydride aqueous solutions are more suitable. Analytical methods of determination for medicaments from the group of sulphonamides and barbiturates and their sodium salts, for phenylbutazone and kebuzone, salicylamide, nalidixic acid and theophylline were elaborated. All results were in good agreement with methods used in CsL 3, or other alternative methods. The advantages of the proposed method are good stability of sodium borohydride volumetric solution and insensitivity of titrated systems to CO2 from the atmosphere, which is unavoidable with alkalimetric titrations in aqueous and non-aqueous systems. An hypothesis has been suggested to explain the probable reactive mechanism of determination, supported by results obtained with the proposed analytical methods using a medium of suitable organic solvents with a maximum content of ca. 15% water near the final point of titration.


A paper chromatographic method for separation and determination of synephrine in injectable solutions.

A new analytical method using ascending paper chromatographic technique was developed for identification and quantitative determination of residual synephrine in fresh and deteriorated samples. This method was found to be stability indicating; one to five degradation products have been successfully separated from drug samples subjected to accelerated stability testing at 60 degrees C for 3 months.


Effect of vehicles on the spermicidal potency of certain drugs.

Different spermicidal drugs were formulated into ointments, creams, pastes and jellies and tested for their spermicidal potency on human sperms adopting a modified in vitro technique. Of the formulae tested, those incorporated in Carbopol 934 of polyethylene glycol base exhibited the most prevailing spermicidal activity.


Partial body calcium determination in bone by proton activation analysis.

The feasibility of a new method for in vivo regional bone calcium measurement has been studied in phantoms using the 160 MeV Harvard cyclotron, Advantages include the capability of measuring bone calcium directly directly in a well defined anatomical region (such as one or several vertebrae) and restriction of the dose to the immediate region of interest. Proton activation of 40Ca (97% natural abundance) produces radionuclide 38K. Its 2-17 MeV gamma ray (T 1/2 = 7-71 min) is detected by a NaI counter. Separation of this activity from room background and interfering nuclides, 14O and 34Clm, proceeds by decay curve analysis. Phantom studies showed the dependence of 38K activity to be highly linear with calcium content (r= 0-998). Non-linearities with dose did not appear below the 20 rad level. The precision of measurements on a phantom with two calf vertebrae exposed to 2-4 rad was 3% and was mostly limited by counting statistics. System reproducibility on phantoms given a high dose proved better than 0-5%.


In vivo determination of nitrogen using Pu-Be sources.

A mehtod of measuring body nitrogen by neutron capture gamma analysis is described. The neutron flux is provided by four collimated 5 Ci Pu-Be sources, placed to give a bilateral irradiation of the subject. The 10-83 MeV thermal neutron capture gamma rays from 14N are detected by two heavily shielded 5 in X 4 in NaI(Tl) detectors. Results indicate a reproducibility +/-3% (1 SD) for a 10 min irradiation of the chest area, while giving a radiation dose equivalent of 50 mREM.


Monte Carlo calculations of the energy response of lithium dosemeters to high energy electrons (less than 30 MeV).

Monte Carlo calculations of the energy response of LiF dosemeters have been carried out to help resolve the discrepancy between the measurements of Holt, Edelstein and Clark (1975) and those of Paliwal and Almond (1975) and others. It is concluded that the assumptions used by Holt et al. are largely responsible. They assume, in converting energy deposition in an air-filled ionization chamber to energy deposition in water, that as electrons penetrate a medium they are monoenergetic and the energy is given by Harder's expression (ICRU 1972). The assumption gives poor results as the stopping power for electrons in air is strongly energy dependent, and the energy spectrum has been significantly broadened. The Monte Carlo calculations are also used to criticize the electron cavity theories of Almond and McCray (1970), Burlin, Snelling and Owen (1969) and Holt et al. (1975), and to suggest as an alternative a slightly modified version of the Bragg-Gray theorem.


Thermoluminescent response of LiF (TLD-100) to 5-30 keV electrons and the effect of annealing in various atmospheres.

The response of single crystal and extruded ribbons of TLD-100 to 5-30 keV electrons was investigated. If annealing is done in a vacuum, the sensitivity of TLD-100 single crystals to these electrons and the resultant glow curve are essentially the same as when irradiation are carried out with 137Cs gamma rays. All discrepancies in sensitivity can then be accounted for by the higher LET of electrons. The commonly used 'standard annealing' at 400 degrees C for one hour produced a change in the glow curve shape and a loss in sensitivity in contrast to the vacuum anneal results. Diffusion of hydroxyl ions into the sample during air annealing is believed to be the primary cause for this change. These results explain the source of the 'dead layer' proposed to explain the variation with particle size of the luminescent efficiency of X-ray irradiated TLD-100 powder and the low TL efficiency from low energy electron irradiations. With the use of the vacuum annealing procedure, the same sensitivity and reproducibility can be achieved for the dosimetry of low energy electrons and other shallowly penetrating radiation as is currently achieved for the dosimetry of X-rays.


Annealing characteristics and nature of traps in A12O3 thermoluminescent phosphor.

Thermal annealing characteristics of the glow peaks from 200 to 650 degrees c in Al2O3 thermoluminescent (TL) phosphor have been studied. All the glow peaks show exponential decay and follow first-order kinetics. The trap depths and frequency factors for the glow peaks have been determined from their isothermal decay and from their initial rise. The trap depths, E, obtained for different glow peaks (peak temperature Tm) can be approximated by the relation E(eV)=Tm (K)/325 and the corresponding frequency factor, s, varies from 10(14) to 10(16) s-1. The measured values of E, s and Tm for the glow peaks are shown to be consistent with the equation for glow peak temperature. The annealing characteristics and actual high temperature irradiations show that the 250, 475 and 635 degree c peaks can be used for elevated temperature dosimetry up to 150, 300 and 440 degrees C respectively. It is suggested that surface defects related to Si impurity in Al2O3, propagated into the lattice on high temperature treatment close to the melting point, are responsible for the TL traps. The trapped charges responsible for TL are shown to be electrons by photostimulated thermoluminescence studies under the F centre excitation in this phosphor.


Graphite-mixed CaSo4: Dy teflon TLD discs for beta dosimetry.

The thickness of commonly employed thermoluminescent dosemeters (TLDS) is responsible for the problem of energy dependence in beta dose estimation in situations where this thickness is comparable to the range of beta particles in the TLD material. The effective thickness of solid TLD discs can, however, be reduced by use of some additives which would reduce their transparency to the TL light. The incorporation of various amounts of graphite powder into 0-8 mm thick CaSO4: Dy Teflon TLD discs has been investigated. This has considerably reduced their energy dependence for beta rays with Emax values ranging from 0-4 MeV to 2-27 MeV. Addition of graphite also results in sharp glow curves thereby minimizing the heating time during TL measurements. Significantly, graphite was also found to reduce the non-radiation-induced TL signal and this helps in low dose measurements.


Comparison of two independent methods for determining the neutron/gamma sensitivity of a dosemeter.

Results obtained with two independent methods for measuring the n/gamma sensitivity of non-hydrogenous dosemeters are compared for the neutron beam produced by 8.3 MeV deuterons on beryllium. In one method, a pure neutron field is simulated by taking the difference between measurements made at diffrent angles in a mixed field with an isotropic gamma-ray component. In the second method, the mixed (n+gamma) beam is purified by lead filtration. An assumption in the lead filtration method is that the background radiation is invariant under three different beam conditions. This assumption was found not be be valid in our experimental arrangement; and caused the values obtained for the n/gamma sensitivity to be systematically high. A modification was made in the lead filtration method so that the dosemeter response to background could be determined for each beam condition. Good agreement was obtained between the results of the spectral difference and modified lead filtration methods.


The formulation of tissue substitute materials using basic interaction data.

An analytical procedure has been developed for the formulation of tissue substitute materials for use with photons and electrons. This method, called the basic data method, is based upon interaction data and enables two-component substitutes to be formulated with radiation characteristics within specified limits. Another feature of the procedure is the ability, once a primary material has been chosen, to select the best corrective additives from a library of compounds. The theoretical aspects are discussed followed by a discussion of the practical applications of the method.


Evaluation of image quality in tomographic imaging.

Modulation Transfer Functions (MTF) for tomographic imaging with linear, circular, hypocycloidal and spiral motion are given. They may be determined experimentally from tomographs of slits or line pair test patterns. In some cases calculation of the MTF from the blur pattern by Fourier transformation is possible. All tomographic MTFS show the same oscillatory behaviour as MTFS of focal spots, resulting in spurious structures and contours in the tomogram. A quantity named signal/spurios signal ratio (SSR) is introduced as a figure of merit. Effective exposure angles are determined from the MTF and compared with the commmonly used 'geometric' exposure angles which result from maximum tube elongations.


Contrast in computerized transverse axial tomography of brain.

A study of contrast in photon transmission tomography of brain is presented. Quantitative evaluation of linear attenuation coefficients due to photo-electric, Compton and pair creation effects suggests that the use of photons of a few MeV considerably improves the contrast between white and grey brain matter. The patient dose at different photon energies is calculated.


Quantitative evaluation of the depth effect in Muehllehner's tomographic camera.

A set of computer programs written for Clincom allow the evaluation of the depth effect in Muehllehner's tomographic camera using MTFs and specificity as well as new quantites. The depth effect of the camera is compared with that of a rectilinear scanner.


Clearance of lead-212 ions from rabbit bronchial epithelium to blood.

The absorption of 212Pb ions from bronchial epithelium to blood has been investigated in anaesthetized rabbits. The 212Pb ions were introduced by intubation either into the trachea or into smaller, more distal bronchi. Removal from lung was followed by external gamma-counting. Mucociliary clearance to the GI tract was blocked by tracheostomy. Two distinct phases of clearance from bronchial epithelium to blood were observed. Approximately 20% of deposited 212Pb is rapidly absorbed with a half-time of about 4 min, the remainder with a biological half-time of about 9 h, irrespective of the site of instillation in the bronchial tree. Two hours after deposition, the 212Pb remaining in lung was found to be partitioned between mucus and the bronchial epithelium, with a substantial but minor fraction in the epithelium. Uptake of 212Pb in the skeleton was estimated to be about 20% of the 212Pb entering the blood circulation. Removal by the kidneys, at 25%, was comparable with skeletal uptake. These results are compared with previously published work using rodents, dogs and man which demonstrated either rapid or slow absorption but not both phases occuring together.


A feasibility study of the use of fluorescence bronchoscopy for localization of small lung tumours.

The possible use of fluorescence bronchoscopy for localization of bronchogenic tumours at the carcinoma in situ stage has been investigated. The target lesion is 80 micrometer thick with a mass of 250 microgram, containing 250 pg of haematoporphyrin derivative. The injected haematoporphyrin-derivative is preferentially taken up or retained by a malignant tumour, and can be detected in small amounts by its red flourescence under illumination by violet light. Previous clincial trials were successful in detecting tumours, but the instrumentation was only marginally adequate, the fluorescent compound was not standardized and no measurements or calculation of sensitivity were made. In this work, a fibreoptic bronchoscope system with a 200 W mercury vapour lamp, special violet-transmitting light conductor, sharp cut-off blue and red filters and three-stage image intensifier tube was designed and assembled. Measurements in vitro indicate the design objectives were met, and test on tumours are in progress.


An intravenous isotope method for measuring regional cerebral blood flow (rCBF) and volume (rCBV).

The regional cerebral blood flow (rCBF), intial slope index (ISI), transfer time (th) and volume (rCBV) were measured simultaneously in 43 hospital patients using a 133Xe intravenous injection method and quantitative dynamic 99Tcm brain scintigraphy. The measurements were made with a gamma camera and the data processing interfaced with a small digital computer. The following mean values and standard deviations were obtained from 50 control hemispheres standardized to the age of 40 years: (formular): see article. Good agreement was found between the blood flow values determined from the intra-arterial and intravenous injection techniques.


Objective determinations of sensibility in the upper extremity. Part I. Median nerve sensory conduction velocities.

Distal sensory conduction velocities were determined in 109 normal median nerves. A significant decrease in sensory conduction velocity was noted with increasing age. Latencies increased with age but this relationship was not significant in men. Variables which contribute to the wide range of normal conduction velocities are discussed, and the need for each clinician to establish his own testing procedure is stressed. An additional method for assessing sensory function is suggested.


Objective determinations of sensibility in the upper extremity. Part II. Application of cutaneous stimuli in control subjects.

Sensitization statements were read to two groups of normal subjects to determine whether quantifiable thresholds for pressure, electrical, or tactile stimuli could be altered. Significant reductions in perception thresholds were observed for pressure and digital pulsed stimulation, but not for stimulation to the discomfort threshold, or two point discrimination. These data seem to suggest that increased sensitization is related to the ease of stimulus applications and the comparative simplicity of sensory processing.


Objective determinations of sensibility in the upper extremity. Part III. Application of cutaneous stimuli in patients with peripheral nerve lesions.

Quantitative values for pressure, electrical, and two-point touch stimulation were examined in five patients with peripheral nerve injuries of the ulnar or median nerves. Analyses of profiles generated for each stimulus application in each patient participating in this preliminary study suggest that, following the reading of a sensitization statement, pressure and electrical shock threshold values are clearly reduced compared to similar measurements in the unaffected limb. Values obtained prior to the statement indicated progressively reduced thresholds, however. Changes in sensation appear to precede significant improvements in sensory nerve conduction velocity. Limitations in the sensory testing techniques as well as suggestions for improving its validity are discussed.


A procedure for facilitating physical therapy research.

A procedure for facilitating research by physical therapists in a multidimensional practice setting is presented. The article addresses the need for physical therapists to be aware of research opportunities, and provides them with a means for action when such opportunities occur. The developmental sequence of events is described starting with conceptualization and moving through current utilization of the procedure.


Motor conduction of the anterior interosseous nerve.

Motor conduction examinations of the left anterior interosseous nerve were performed on 25 healthy women. The purposes of this study were to determine the optimal position for placement of the active recording electrode, and to report normal motor conduction values for the anterior interosseous nerve. The anterior interosseous nerve (branch of the median nerve) was stimulated proximal to the elbow and the evoked responses were recorded from three sites over the flexor pollicis longus. The optimal site for placement of the active recording electrode was over the lateral distal one-third of the anterior surface of the forearm at a point representing the distal 38% of the length of the forearm. A latency of 4.0 msec and an amplitude of 2.5 mv may serve as the limits of normal values for motor conduction of the anterior interosseous nerve and for action potentials of the flexor pollicis longus muscle, respectively.


NMR in cancer: XVII. dewar for a 53-inch superconducting NMR magnet.

A giant nitrogen-jacketed liquid-helium metal dewar built in this laboratory is described for housing 53-inch superconducting magnet used in the human FONAR experiments. This dewar is 10 feet tall, 6 feet wide, 18 inches deep, and weighs 1 1/2 tons. It consists of the main magnet hoop connected through a demountable gooseneck to a liquid helium reservoir tank.


NMR in cancer: XVIII. A superconductive NMR magnet for a human sample.

A 53-inch superconducting magnet built in our laboratory for human-size NMR is described. It was made from .026 inches superconducting wire laid on a 2.5-inch piece of channel bar that had been rolled into a 53-inch diameter circle and butt-welded at the ends.


Hemoglobin-oxygen equilibrium at different hemoglobin and 2,3-diphosphoglycerate concentrations.

Hemoglobin-oxygen equilibrium curves at constant pH, ionic strength, and temperature were determined (a) on 2,3-DPG-free solutions at various hemoglobin (Hb) concentrations, (b) on solutions at various Hb concentrations but constant 2,3-DPG/Hb molar ratio, (c) on solutions at constant hemoglobin concentration but various 2,3-DPG/Hb molar ratios, and (d) on hemolysates at various Hb concentrations. Under all conditions the shape of the equilibrium curve was the same (n = 2.62 +/- 0.04, 33 experiments). Half-saturation pressure (P 1/2) did not change with increasing Hb concentration in case (a), whereas P 1/2 was linearly related to Hb concentration in case (b). In case (c) at 200 g/l Hb, P 1/2 increased sharply as 2,3-DPG/Hb molar ratio increased up to 0.4 but changed little as the ratio was further increased up to 1.5. This behavior is very different from that observed in diluted (5 g/l) solutions. P 1/2 of the hemolysates was also linearly related to Hb concentration but the slope was about twice that for case (b). These results cannot be explained by linked function theory or by a dimer-tetramer equilibrium. It is suggested that intermolecular interactions in the presence of organic phosphates may be responsible for the observed changes in Hb affinity for oxygen.


A glycoprotein fraction "modulator" of norepinephrine effects in vivo.

The effects of a fraction (Part A of Fraction 8) of a glycoprotein isolated by Lee on the physiological effects of norepinephrine have been studied by measuring the spontaneous activity of Purkinje cells of rats. Fraction A appears to be a "modulator" of norepinephrine because (1) it potentiated the effects of exogenous and endogenous norepinephrine by increasing the amplitude of the response, (2) it significantly prolonged those effects beyond average duration, (3) its effects disappeared only gradually, (4) in the concentrations tested (physiologically available concentrations and up to 20 times greater), it lacked neurotransmitter effects of its own. The effects of Fraction A on endogenous norepinephrine were concluded from (a) its effects on the intact Purkinje cell, (b) its effects on Purkinje cells deprived of norepinephrine content by 6-OH-dopamine or alpha-methyl-paratyrosine, and (c) its effects on Purkinje cell activities induced by stimulation with rectangular pulses of the afferent noradrenergic inhibitory neurons.


Effect of histamine upon the dynamics of carbon dioxide.

The dynamics of carbon dioxide in both gastric and peripheral circulation of rat were studied using H14CO3--. In the absence of histamine infusion the peripheral venous/arterial ratio Vp,/A rose from less than 1.0 to almost 1.2 while the gastric ratio VG/A fell from initial values of about 2.4 to 1.2. Steady histamine infusion speeded approach of both ratios to 1.2. During transient conditions after beginning or end of histamine infusion both ratios were initially depressed to values near zero. The ratios then both rose, showing damped oscillations with a twenty-minute period. The data show a marked effect of histamine on both peripheral and gastric CO2 dynamics, even though in the resting state the two circulations have very different dynamics.


In vivo response of ornithine decarboxylase activity to growth hormone as demonstrated by oxidation of L-ornithine-1-14C in hypophysectomized rats.

An in vivo response of ornithine decarboxylase activity to growth hormone has been demonstrated. In hypophysectomized rats, found to oxidize ornithine at rates comparable to those of normal rats, an acute treatment of growth hormone 4 hours before injection of L-ornithine-1-14C caused a 39% increase in the peak specific activity of carbon dioxide and a 24% increase in the 14CO2 recovered in 5 hours. However, response was not observed when growth hormone was administered chronically rather than acutely.


Protoporphyrin IX sensitized photohemolysis: stoichiometry of the reaction and repair by reduced glutathione.

Protoporphyrin IX acts as a sensitizer in the photohemolysis of bovine erythrocytes by binding to a limited number of membrane sites. The cholesterol-specific antibiotic lucensomycin competes with protoporphyrin in binding to the membranes. The possibility of cholesterol peroxidation as a primary event in photohemolysis is supported by the repairing effect of exogenous cholesterol and by the increased susceptibility of the photosensitized erythrocytes to lucensomycin. Glutathione, if present within the erythrocyte, postpones the onset of lysis; if added after irradiation, it may repair the membrane damage and prevent hemolysis. This effect appears to be related to a redox reaction (possibly involving glutathione peroxidase) between reduced glutathione and the cholesterol peroxide molecules.


Transaminase of L-cysteine in rat liver mitochondria.

Transamination of L-cysteine in rat liver was examined. Specific activity of the reaction in mitochondria was found higher than that in cytosol. The mitochondrial reaction was shown to be catalyzed by two different enzymes. The first was active with 2-oxoglutarate and inactivated by heating at 60 degrees C for 10 minutes; the activity was protected from heat inactivation by the presence of 2-oxoglutarate. The second enzyme was active with pyruvate and more stable than the first under heat treatment; 2-oxoglutarate had little protective effect on this second enzyme. The two enzyme activities were separated by heat treatment and ammonium sulfate fractionation.


NMR in cancer: XVI. FONAR image of the live human body.

The FONAR technique that achieved the first chemical image of the live human being is described. Color and black-and-white video images of a cross-section through the chest at the level of the eighth thoracic vertebra were generated. The imaging showed the heart and mediastinum in the midline between the left and right lungs with the heart encroaching on the left lung space as it does at this level. Also seen was the descending aorta just left and anterior to the vertebral body.


The male rhytidectomy.

More men are undergoing rhytidectomy now. This operation is specifically different in the preoperative planning, the surgical procedure, the postoperative complications, and the final results (compared to rhytidectomy in females). Large hematomas occurred in our male patients more than twice as often as in females.


Management of the silicone-injected breast.

Our experiences with 28 patients who had a history of liquid "silicone" injections of the breasts has led us to recognize a typical clinical picture. Several years after the injections, the patient may develop hard, lumpy, tender breasts which make the detection of breast cancer impossible. Mammograms are generally inconclusive. Despite the reluctance of the patients and surgeons, the conservative approach is a subcutaneous mastectomy with possible subsequent reconstruction.


The palmar approach for the visualization and release of the carpal tunnel. An analysis of 429 cases.

A review of 429 cases of carpal tunnel syndrome in 329 patients confirms the prevalence of this entity among disorders of the hand. Three symptoms are almost diagnostic--daytime numbness, nighttime pain, and morning stiffness of the fingers. The diagnosis is confirmed by findings on physical examination. A relatively simple technique is presented for the exposure and release of the median nerve, using a longitudinal incision in the palm and stopping short of the wrist skin. Limiting the incision to the palmar skin results in an inconspicuous scar, while still providing adequate exposure for a complete anatomical release. An epineural neurolysis of the median nerve was performed in each case, resulting in improvement in the symptoms in all but 4 of these 429 patients.


Cocaine concentrations in the blood during rhinoplasty.

After applying 5% or 10% cocaine to the nasal mucosa, blood concentration were measured in 9 patients undergoing rhinoplasty and in 6 unoperated controls. The concentrations in the unoperated persons were lower than in those undergoing rhinoplasty, and lower concentrations were found after 5% solutions in both groups than in those exposed to 10% solutions. There was no correlation between the strength of the solution used and the degree of bleeding or the success of the anesthesia. One patient developed symptoms of toxicity within two minutes of a 5% cocaine application to his nasal mucosa. The cocaine concentrations in his blood were the highest seen in our studies, and we cannot explain this.


Meralgia paresthetica: a complication of iliac bone procurement.

A rare complication of iliac bone graft procurement is described, in which the lateral femoral cutaneous nerve can be injured during the procedure, or it can be entrapped in healing scar after the closure. The surgical anatomy of this nerve is described, as is the pathophysiology and the treatment of the lesion. Suggestions are made as to means to avoid this complication.


Early surgery for isolated craniofacial dysostosis. Improvement and possible prevention of increasing deformity.

We describe our experiences with craniofacial surgery at less than 9 months of age in 8 patients with isolated craniofacial dysostosis. We believe that the early release (preferably before the age of 6 months) of the constricting forces in bound or underdeveloped areas of bone will allow subsequent better development of these faces. The molding and expansile influences of the rapidly developing brain and eyes can exert a greater effect on facial growth. The operations are easier and more rapidly performed than those in older children, and no distant bone grafts are necessary.


Evaluation of a simplified water mattress in the prevention and treatment of pressure sores.

Using a simplified pressure-measuring device, we determined the pressures under 4 anatomical sites in 11 human subjects to compare 3 commercially available sleeping surfaces. The 3 surfaces tested were a water mattress, a water bed, and our standard hospital bed. There were no significant differences in the recorded pressures of the water mattress and the water bed, except in the region of the scapula. Both the water mattress and the water bed were found to be superior to our standard hospital mattress. The advantages and disadvantages of this water mattress are discussed. The concept of using a water mattress seems to be an affordable approach to preventing pressure ulcers.


Velopharyngeal insufficiency in hemifacial microsomia.

One-third of a group of 18 patients with hemifacial microsomia demonstrated velopharyngeal insufficiency of a significant degree. The ones with velopharyngeal insufficiency tended to have more severe soft tissue and skeletal deformities of the maxillary-malar complex, associated with a total unilateral palatal paralysis. Cinefluoroscopy was not helpful in diagnosing the velopharyngeal insufficiency. Fiberoptic nasopharyngoscopy, in contrast, proved to be an excellent diagnostic tool. We suggest that patients with hemifacial microsomia have a careful, periodic speech evaluation as an essential part of their overall management.


A comparison between K-wire and compression screw fixation after arthodesis of the distal interphalangeal joint.

Thirty patients underwent arthrodesis of the distal interphalangeal (DIP) joint for various injuries. Fixation with K-wires was compared to fixation by compression screws. The screw method came to be preferred by us, principally because the immobilization time was significantly less and the patients returned to work more quickly. The success rate of fusion and the time required for it were about the same.


[Masked subdural hematoma in alcoholics].

Nineteen cases of subdural hematomata in alcoholics are discussed to show the special diagnostic problems that the psychiatrist is faced with when dealing with such a disease picture. Although it is relatively easy to show that subdural hematomata in alcoholics are usually of traumatic origin, yet there is the difficulty of the psychiatrist being confronted with the task of giving medical attention to patients where, anamnestically, the trauma is of secondary importance only, and where psychopathological phenomena are a prime consideration. This syndrome, which is characterized by a fluctuation in consciousness and impulsion, psychomotor retardation, and baseless exaltation, may be regarded as suggesting the presence of a subdural hematoma in a person addicted to the use of alcoholic beverages in excess, even if the medical history of the patient is free from any traumata.


[Alpha rhythm during open eye derivation in infantile brain damaged and normal children].

1. The behavior of the occipital alpha rhythm during open-eye derivation was studied on nine- to twelve-year-old boys of normal intelligence, of whom ten were free from brain injuries and eleven had been suffering from brain injuries in early childhood. 2. There was observed a marked tendency of the alpha index to differ in dependence upon the time of testing, the cause of which was believed to be a weakness of vigilance on the part of brain-injured children. 3. Application of this simple method of examination to group comparisons makes it possible to neurophysiologically determine an important part of chronic cerebropsychic axis syndromes.


[Course of the liquor cytology in central nervous system mumps manifestations under various therapeutic regimens].

A total of 156 children with mumps meningitis and mumps encephalitis were, under 5 different regimes of therapy, subjected to continuous liquor cytology. It has been found that the "aminophenazone" group showed the best results so far as both the time required for normalization of the total number of cells and the differential evaluation of the liquor cytogram was concerned. Administration of plasma, corticosteroids, or chloramphenical gave less satisfactory results from the point of view of liquor cytology, the possible causes of which are discussed in detail.


[The increase of alcoholic delirium in our area since 1972].

There has been a considerable increase since 1972 in the number of delirium alcoholicum patients admitted to our hospital. On the other hand, the number of chronic drinkers admitted for disaccustoming treatment has remained relatively constant during the past several years. The majority of patients are under 40. The relapse rate is rather high. The lethality rate is low in the case of treatment with clomethiazol. The purpose of this report is to incite workers at other clinics to analyze their respective patient stocks in order to discover supraregional causal factors, if any.


Psychological characteristics of patients with amyotrophic lateral sclerosis (ALS).

Previous research has suggested that patients with amyotrophic lateral sclerosis (ALS) demonstrate similar psychological characteristics that distinguish them from the medically ill populations, and that these findings may bear etiologic and prognostic importance. In this report, a larger sample was studied and the prior findings were not replicated. Specifically, ALS patients were not found to have a more internal locus of control, or to use denial as a defense more than a group of patients with inoperable neoplastic disease. Although dysphoria was frequently found in ALS patients, only 22% demonstrated clinical depressive syndromes.


Comparison of illness episodes in a pluralistic setting.

Episodes of illness in two different groups of women of the Highlands of Chiapas, Mexico, were compared using a longitudinal-panel design. The data reported are part of a larger study that concentrated on family units from representative cultural groupings of this region. The method of procedure facilitated the retrieval and analysis of different types of symptoms that have salience in the native medical perspectives of the people. Queries regarding symptoms dealt with illnesses that had occurred during the preceding 2 weeks. The duration, in days, and the proportion of an illness taken up with the various types of symptoms were compared in the two groups. The way the women perceived the severity of illness was also analyzed. Group differences in these parameters were observed and discussed. The method of procedure, which reflected a holistic and integrated view of disease, proved flexible, useful, and was easily applied in a field setting.


Psychogenic purpura: report of a case.

Autoerythrocyte sensitization, a disease characterized by recurrent and painful ecchymoses, was renamed psychogenic purpura by Agle and Ratnoff in 1968. The patients, usually female, share certain described personality characteristics. The case is reported of a 20-year-old woman who had suffered from the disease since age 12. She was treated for 3 years in intensive psychotherapy resulting in a complete remission of her symptoms of bleeding.


[Behaviour of "haemorrhage times" in hypocolinesterasic subjects after administration of acetil-salicylic acid (author's transl)].

The competitive action of acetil-salicylic acid with respect to colinesterasi is demonstrated. The A. proposes a routine dose of this enzyme in the preparation for surgery with a high haemorrhage risk, such as tonsillectomy.


Family size and malnutrition in Santo Domingo.

A case-control study of 82 urban Dominican women with a malnourished child and 82 women with a well-nourished child of the same age, sex, and neighborhood of residence revealed that the women of the control group had significantly lower parity and also had fewer living children. More women in the case group had used contraception at one time. Nevertheless, the prevalence of current contraceptive use was identical in the two groups. More women in the control group had undergone one or more spontaneous or induced abortions. Although the women in both groups were selected from the same neighborhoods, there is evidence to suggest that the the women in the control group may have had higher family incomes. The higher incomes could well account, at least in part, for the difference in parity between the two groups as well as for the difference in nutritional status in the preschool children of the mothers of these groups.


[2d-generation Technicon Autoanalyzer: determination of blood sugar without dialysis and predilution of the sample].

It's presented a simple modification of the method GOD/PERID in the automatized determination of glycemia. This modification excludes dialysis and introduces the prediluition of the specimen before the reacting mass. Experiments have been carried out with a sperimental manifold and with the reagents Glucosio Test and Glu-cinet Sclavo. From the results it comes out that the essential characteristics of the method are: a) a good precision and ripetition of the results; b) the possibility of using both biological and chemical standards to calibrate the instruments without alterating the results; c) a smaller use of reagents due to the use of small quantities of reagents.


[Application of cytologic vaginal test at the end of pregnancy (author's transl)].

The AA. reviewed the clinical course and the vaginal smear of 146 pregnant women (supposed at term or near term) handled during 1974 and 1975 in the Town Hospital of Cremona. They looked for correlation between the first one and what was inferred form the second one: in order to assess if the vaginal smear during late pregnancy is practically useful in predicting the time of delivery or--at least--the maturation level of the foetus. After reviewing their own results and after considering the results of some other writer, they conclude that the vaginal smear in late pregnancy is scarcely useful because it yields only generical signs liable to broad interpretation.


[Serum immunoglobulins in otitis and otoantritis in infants].

In 46 breast-fed children affected with otitis or otoantrite, it was investigated on the role of seric immunoglobulines which necessarie are in e transitory lacking period. In the 50% of the tested cases in has been checked a lack of IgG particularly remarkable, beyond the limits of range of the values specific in the breastfed child. As e conclusion, the lack in gammaglobulines is a factor which favours the rising of infection.


[Study of skin reactivity to tuberculin and sensitins of atypical mycobacteria (with special reference to M. africanum in Somalia)].

Skin testing with antigens from M. tuberculosis (PPD-S) and various atypical mycobacteria was carried out in Somalia among 170 patients with active tuberculosis. Percentage of positive reactons (5 mm or greater) was 70,58% with PPD-S, 60,0% with the antigen from M. africanum and M. scrofulaceum, 56,47% with the antigen from M. xenopei, 10,58% with the antigen from N. otididis and 4,50% with the antigen from N. farcinica. The percentage of subjects in whom the reaction with the antigen from M. africanum was greater than with PPD-S was 10,58%; more precisely in a percentage of 16,0% the skin testing from M. africanum was positive against a negative reaction to PPD-S, meanwhile in a percentage of 8,33% both skin tests were positive, with a greater reaction for a M. africanum test. As far as other antigens are concerned at least one of these tests was greater on the 28,23% the PPD-S one.


[Hypersecretion of calcitonin in hypocalcemic syndromes and in stimulation of the autonomic nervous system].

The AA., on the basis of their recent studies, offer a new hypothesis on the role of calcitonin, as a regulator of phosphorus metabolism. In addition the AA. confirm the clear interrelationship between calcitonin and other hormones as gastrin and autonomous nervous system.


[Determination of urinary estriol in pregnancy. I. Comparison of the gas-chromatographic and colorimetric methods].

The gas-chromatographic method is confronted with the amply used colorimetric method in the determination of the urinary oestriol. The two methods give practically the some results, even so the gas-chromatographic is to be preferred for its specificity, for salvaging accuracy, and for the possibility to receive hormonal profiles with only one determination.


[Determination of urinary estriol in pregnancy. II. Normal levels with the gas-chromatographic method].

We carried the values of the oestrioluria received examining n o 755 samples of urine of women with normal pregnancies using the gas-chromatographic method. The gas-chromatographic method makes possible a "fascia" of normal values superimposable to those received from others AA. with the colorimetric method in the first months of pregnancy, where we have a major tendency to the dispersion of the values in the last months of pregnancy.


[Rapid determination of creatinine in the blood and urine by 1st-generation Autoanalyzer].

Two procedures for the determination of serum and urinary creatinine by first generation AutoAnalyzer have been positively tested. These methods enable to perform these analyses by cam 60 and 100 respectively, in order to make the influence of carryover neglectable. Very regular peaks with clear-cut resolution can be obtained. The range of concentrations which can be reliably evaluated corresponds to 0,5-10,0 mg/100 ml for serum and to 20-500 mg/100 ml for urine, for this analysis neither diluition nor the dialysis of the sample are required.


Fibrous mediastinitis: a late manifestation of mediastinal histoplasmosis.

Fibrosing mediastinitis is an uncommon manifestation of histoplasmosis that occurs primarily in younger patients. Findings include tracheobronchial narrowing, compromise of the main pulmonary artery and veins, and circumferential narrowing of the esophagus. The initial chest radiograph is often diagnostic, although additional studies including tomography and angiography help clarify the extent and severity of the disease process.


The role of the radiologist in coronary angiography.

Radiology chiefs at hospitals with open heart surgery programs were queried to ascertain both current and desired degrees of participation by radiologists in coronary angiography. While current participation is limited, respondents indicated a desire to achieve increased active participation. Opposition of cardiologists and a shortage of trained cardiac radiologists were perceived as principal factors impeding increased participation. Over two thirds of the respondents felt additional cardiac radiology training programs are needed and many indicated that positions were available in their departments for a trained cardiac radiologist.


Extra- and intrasplenic artery aneurysms in portal hypertension.

Extra- and intrasplenic arterial aneurysms have occasionally been encountered in cases of portal hypertension both with and without cirrhosis. The exact pathogenesis is speculative; however, it is postulated that hyperkinetic splenic circulation, probably related to hepatic arterial insufficiency or hypoplasia, constitutes the primary pathogenic mechanism. Other factors such as splenomegaly and hormonal influence may be contributory.


Problems in the diagnosis of adrenal tumors.

The angiographic findings of cortical nodular hyperplasia, adenolipoma, and intracaval extension of recurrent pheochromocytoma were correlated with the pathological findings. Adenolipoma was angiographically similar to other adrenal neoplasms, adding difficulties to its differential diagnosis. Two cases of cortical nodular hyperplasia showed possibly pathognomonic patterns of discrete vascular cortical accumulations of contrast media which represent capillary malformations within the hyperplastic nodules. Intracaval extension of recurrent pheochromocytoma was found to be similar to other tumors which invade veins.


The roentgen diagnosis of pelvic extraperitoneal effusion.

Extraperitoneal, perivesical pelvic effusions may be hemorrhagic or uriniferous, the latter resulting from extraperitoneal rupture of the bladder or disruption of the posterior urethra. The effusions may be recognized on anteroposterior radiographs of the pelvis by (a) displacement of the bladder (small effusion); (b) obliteration of the normal soft-tissue anatomy within the pelvis (moderate effusion); and (c) upward displacement of the pelvic ileal loops and extension of the effusion into the flank stripes (large effusion). Perivesical effusions most frequently accompany anterior pelvic arch injuries, i.e., double vertical and Malgaigne fractures and fractures involving, or separation of, the pubic symphysis.


Percutaneous fine needle aspiration biopsy of the pancreas following endoscopic retrograde cholangiopancreatography.

Fine needle aspiration biopsies were performed in 9 patients with suspected pancreatic malignancies demonstrated and localized by endoscopic retrograde cholangiopancreatography (ERCP). The biopsies were positive in 7 of 8 patients with pancreatic carcinoma and there were no complications. ERCP is an accurate method for diagnosing pancreatic cancer which may be confirmed safely and easily by fine needle aspiration biopsy.


Calcaneal abnormalities in articular disorders. Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and Reiter syndrome.

The calcaneus of normal control patients, and those with rheumatoid arthritis, ankylosing spondylitis, psoriasis, and Reiter syndrome was studied. Pathological abnormalities of the plantar aponeurosis, Achilles tendon, and retrocalcaneal bursa account for the radiographic alterations. In normal individuals, lateral radiographs show the thickness of the Achilles tendon to be not greater than 8 mm; the retrocalcaneal bursa creates a radiolucency which extends at least 2 mm below the superior surface of the calcaneus. In patients with any of these 4 articular disorders, Achilles tendinitis produces thickening of the tendon, and retrocalcaneal bursitis obliterates the normal radiolucency.


Radiographic diagnosis of quadriceps tendon rupture.

Traumatic rupture of the quadriceps tendon is an uncommon knee injury which occurs in the elderly, and/or the obese, and in those with underlying systemic disease. Ten patients with 13 ruptures have been seen at the Massachusetts General Hospital in the last nine years. Clinically, the patient is unable to actively extend the knee. On the lateral view of the knee there is loss of normal quadriceps outline and a soft-tissue mass with calcification representing the retracted quadriceps tendon. Most patients have a hemarthrosis. The clinical diagnosis is often overlooked, and the radiologist could be the first to suggest the diagnosis.


The use of prostaglandin E1 for enhanced visualization of the splanchnic circulation.

A single bolus injection of prostaglandin E1 (5-7.5 microgram) into the superior mesenteric, hepatic or pancreatico-duodenal arteries was employed as a pharmacoangiographic aid in 22 patients. Good quality arterial phase and greatly enhanced portal venograms were obtained. No significant complications were observed. The authors found the technique useful in diagnosis of primary and metastatic lesions in the liver and pancreas.


"Blind" femoral angiography.

Analysis of a series of 352 femoral angiograms revealed that "blind" cannulation of the femoral artery distal to an occluded aorta or iliac artery is technically feasible in most patients. The vessel is usually patent even when the pulse is absent. Blind cannulation is not necessary for satisfactory peripheral angiography in all cases, but it is useful whenever visualization of the peripheral circulation is unsatisfactory following aortic injection. There were no apparent complications from the use of the technique.


The diagnosis of breast cancer in mammograms by the evaluation of density patterns.

Standard mammograms from 33 patients with surgically proved adenocarcinoma or fibrocystic disease were analyzed with a scanning microdensitometer and computer. A quickly computable number called the linear mass ratio is introduced. This simple ratio discriminated correctly between the 16 adenocarcinomas and 17 fibrocystic lesions of the study, all cases in which diagnosis had required biopsy.


Mammographic parenchymal patterns and the prevalence of breast cancer.

An investigation of the relationship between breast parenchymal patterns and breast cancer prevalence in a large referral population is presented. Mammograms were assigned to one of four categories according to our interpretation of Wolfe's classification. Cancer prevalence for the four patterns was similar when uncorrected for age,, and was very high compared to that in the general population. Under age 50, the prominent duct pattern (P2) was associated with a very high relative cancer risk and DY carried a smaller increased risk. After age 50, prevalences for the patterns were nearly equal. Relationship between these findings and epidemiology of breast cancer are discussed and suggestions made for utilizing parenchymal patterns to guide examination frequency.


Exposures to patient and personnel in computed axial tomography.

Distribution of radiation exposure circumcranially for patients undergoing brain scanning with EMI computed tomographic equipment was measured using thermoluminescent dosimeters. The exposures are found to lie in the range of 1-5 R depending on position relative to tube motion. The maximum exposure of 5 R in CT scanning lies between the estimated exposure of 1.2 R for skull radiography and approximately 10 R for angiographic examination. Measured exposures are reported corresponding to locations of the patients' eyes, thyroid, chest and gonads, and at various locations in the vicinity of the unit.


Intradiploic neural heterotopia. A rare calvarial defect.

Two proved cases of intradiploic neural heterotopia of the skull, a rare cause of calvarial defects, are presented. The literature is reviewed. Common radiographic characteristics include an intradiploic rarefaction, a well-defined margin with or without sclerosis, a lobulated appearance with normal intervening bone, or a cluster of multiple lytic areas with normal bone between them.


Evaluation of early myocardial ischemia with thallium-201 in the pig.

Thallium-201 was found to be a reliable agent for detecting decreased myocardial perfusion in domestic pigs 1-4 hours after acute coronary occlusion. Substantial variation in myocardial-to-liver count ratios and diagnostic quality was observed in serial images performed in 3 normal pigs, although areas of 1-4 hours-old myocardial ischemia produced by acute circumflex coronary artery ligation in 6 pigs could be reliably detected by in vivo 201Ti imaging. After intravenous 201Ti administration, the animals were sacrificed and sections of normal and ischemic myocardium were counted in a scintillation well counter. The activity in the ischemic area in pigs averaged 12% of the activity in the normal area, and varied over a narrow range; in dogs the activity averaged 62% of normal, and varied over a wide range. The pig was a more consistent model than the dog.


Three dimensional imaging of the myocardium with radionuclides.

Transverse sections of the distribution of 129Cs and 201Ti in the human myocardium were obtained using 36 and 72 views of the thorax with a large field of view Anger camera. The cardiac cycle was divided into 100-msec intervals to obtain motion images of an average cycle of the beating heart. At least 300,000 events must be detected for each cardiac phase of each section for quantitative work. Over 8 million events from the upper thorax must be accumulated in gated studies if three or more sections are obtained for 8 intervals of 100 msec to 150 msec.


Radionuclide venography in the diagnosis of deep vein thrombosis.

Radionuclide venography (RNV) is a safe and simple procedure for the diagnosis of deep vein thrombosis. Its results correlate well with those of contrast phlebography. Both contrast and radionuclide venography were done for 103 patients, with an overall accuracy in diagnosis of 95%. RNV may also be used to assess the status of pulmonary perfusion. In this series, many clinically unsuspected emboli were diagnosed.


Hepatoadenoma and focal nodular hyperplasia: pitfalls in radiocolloid imaging.

Both hepatoadenoma and focal nodular hyperplasia must be considered in the differential diagnosis of right upper quadrant pain or mass in young women taking oral contraceptives. Three new cases are presented, and the radionuclide scan findings of 35 additional cases reviewed. There is great variability in the radiocolloid liver scans of these entities. Hepatoadenomas often develop along the inferior margin of the liver, and may therefore go undetected by radiocolloid imaging.


Neonatal small left colon syndrome: its relationship to aganglionosis and meconium plug syndrome.

Neonatal small left colon syndrome is a cause of functional colon obstruction in newborn infants, with a high association of maternal diabetes. There has been much confusion regarding its relationship to meconium plug syndrome and aganglionosis. Six cases of aganglionosis (2 in infants of diabetic mothers) were encountered in which the radiographic findings were identical to small left colon syndrome, indicating the need for caution in dismissing aganglionosis solely on the basis of a small left colon seen radiographically in a newborn infant with colon obstruction. Small left colon and meconium plug syndrome are overlapping entities in the total spectrum of functional intestinal obstruction in newborn infants.


Neonatal intussusception. Report of 12 cases.

Twelve cases of neonatal intussusception are presented and another 25 taken from the literature are reviewed. Intussusception in the first month of life is a distinct clinical and pathological entity, presenting as bowel obstruction in the first days and usually led by a tumor. In the past, a high mortality rate has been related to late diagnosis. The barium-enema examination is diagnostic.


A spectrum of diseases of the thyroid gland as imaged by gray scale water bath sonography.

A method of performing gray scale thyroid echography with a 3.5 MHz focused transducer and an open water bath is described. A preliminary echographic classification of abnormalities and representative echograms illustrating various thyroid disorders are presented.


The reliability of echocardiography in the diagnosis of infective endocarditis.

The echocardiograms of 17 patients with proved infective endocarditis were surveyed to assess the reliability of echocardiography in this disease. Vegetations were present on 20 valves (11 aortic, 7 mitral, 2 tricuspid) at surgery or autopsy. Echocardiography correctly identified the abnormality in 11 valves. There were 8 valves with false-negative studies of which only one examination was technically inadequate. One false-positive echocardiogram was found. A negative echocardiogram does not exclude infective endocarditis. The size of the vegetation is not the only consideration in its detection echocardiographically. False-positive and false negative studies are discussed.


Gray-scale ultrasonography of the normal female pelvis.

The pelvis was evaluated with gray-scale ultrasound in 45 normal females, important aspects of instrumentation, changes in scanning techniques, and pitfalls in the identification of various normal anatomical structures are described, and normal ranges of uterine size and ovarian volume are reported.


The accuracy of retroperitoneal ultrasonography in Hodgkin's disease and non-Hodgkin's lymphoma.

Three hundred and thirty-six B-mode ultrasound examinations of the retroperitoneal region were performed on 179 patients with Hodgkin's disease or non-Hodgkin's lymphoma; histological confirmation was available in 56 patients. Ultrasonography was correct in predicting retroperitoneal periaortic lymph node involvement in 87.5% of cases. Node size was correctly predicted 98.2% of the time, and nodes 2 cm or larger in diameter were detectable. Ultrasound was more accurate than physical examination, and as accurate as gallium-67 imaging and lymphography in disease detection. The combination of ultrasound and gallium imaging gave the best accuracy of detection (97%).


Current status of clinical pion radiotherapy.

An RBE for acute skin reaction to peak pions, for a specific fractionation scheme, has been established at 1.40-1.44. The time of development of acute skin reactions varied in 2 patients with 30 metastatic skin nodules treated with doses varying from 1,175 to 1,951 peak pions and 2,350 to 3,901 rads of 100 kVp x rays. The reactions reached their peak approximately one week apart at all dose levels with both forms of radiation. No untoward effects have been seen in epidermis or subcutaneous tissues as late as 169 days after the start of treatment. All nodules disappeared and have not returned 169 days after treatment. There is a strong suggestion that the response of thick tumors is sensitive to the proportion of high LET radiation deposited at various levels in the tumor.


Biological aspects of high LET radiation therapy.

Biological information suggests that high LET radiations could be used advantageously in radiation therapy. The radiation responses of cells and tissues are described in general terms with respect to the following aspects of high LET radiations considered for therapeutic use: spatial distribution of biological effect, oxygen enhancement of cell lethality in mixed LET radiation beams, dependence of oxygen enhancement of cell lethality upon the microscopic distribution of energy loss, gain factors due to relative biological effectiveness alone, and recovery from sublethal cellular damage. It is concluded that there is no single advantage to the use of high LET radiations in radiation therapy, but that combinations of advantages may exist for different radiations and different tumor-normal tissue combinations. Cases in which inverse gain factors occur are to be avoided.


The use of photogrammetry in tissue compensator design. Part I: photogrammetric determination of patient topography.

The surface topography of a patient can be determined by photogrammetry before beginning radiotherapy. The source light of the therapy unit or simulator is used to project a grid pattern onto the patient, and this is then photographed together with control points consisting of miniature light bulbs mounted on a frame suspended from the wedge slot of the therapy machine. When the photograph is projected onto a graphics terminal for data entry into a computer, the three-dimensional topography of the patient's surface can be reconstructed as a two-dimensional matrix of discrete points. A computer algorithm can then design a tissue compensator to fit the individual patient.


The use of photogrammetry in tissue compensator design. Part II: experimental verification of compensator design.

A computer algorithm for designing sheet lead tissue compensators is described. Corrections are made for scatter within the radiation field as well as the shape of the patient for the mantle fields used in treating Hodgkin's disease. The method was tested experimentally with a phantom and found to be clinically acceptable. The advantages of employing this technique with parallel opposed fields are emphasized.


Preliminary studies using electron radiography for mammography.

An electron radiography mammography system was used for phantom studies and to obtain 230 craniocaudal view patient studies, of which 140 were compared to xeroradiographs for their ability to visualize 7 features of diagnostic importance. The average exposure of the electron radiographs was 89 mR. The technique was considered equal or superior to xeroradiography in 58% of the compared diagnostic features, while patient dose was reduced.


Potentiation of radiation effects in hypoxic HeLa cells.

HeLa cells were irradiated with two doses of gamma rays: the first dose was delivered under hypoxic conditions and the second dose was delivered under oxygenated conditions. Increased inactivation of cellular proliferative capacity as a function of intervening time was obtained when hypoxic conditions were maintained between doses. Hypoxic protection from ionizing irradiation can be counteracted by manipulating postirradiation conditions.


Enhancement of radiation effect on mouse intestinal crypt survival by timing of 5-fluorouracil administration.

There is a marked dependence of mouse crypt survival on the sequence of combined drug-radiation treatment and on the time lapse between irradiation and drug administration. When 5-fluorouracil is administered 6 hours after irradiation or later (up to 18 hours postirradiation), crypt survival drops significantly.


Barium enema examination using a remote controlled positive and negative contrast media inflator.

In a series of 30 patients, barium enema examination of the colon was performed via a remote controlled air and contrast media inflator. With this apparatus, introduction and elimination of air and barium into the colon can be accomplished at a freely adjustable rate of injection by remote control. Fluoroscopy time is significantly reduced and the operator is not exposed to radiation.


A modified lateral projection for anterior and posterior lips of the acetabulum.

The standard lateral positions of the acetabulum in injured patients may induce additional trauma. The authors devised a lateral projection which is more comfortable to maintain than the standard views and is potentially less dangerous.


Catheter therapy: fluoroscopic monitoring of deliberate embolic occlusion.

In the deliberate embolic occlusion of arteriovenous malformations (AVM's and vascular tumors, complications can occur when emboli pass into arteries supplying normal structures. Maximum safety and precision is gained by direct fluoroscopic visualization of the occlusion process done by suspending the particles in a contrast agent and monitoring the ever-decreasing vessel runoff. The technique has been useful in the treatment of intra- and extracranial AVM's and tumors.


Participation by radiologists in coronary angiography.

Coronary angiography is one of the few radiologic procedures which remains largely under the control of another medical specialty. There are several contributing reasons, none of which justify continuation of this situation. A more active role for radiologists in performing coronary angiography is urged.


The wound healing of the liver after thermonecrosis. Autoradiographical investigations with 3H-thymidine on rats.

Histological and autoradiographical studies were performed on the liver of rats after local thermonecrosis. The results were compared with those after local cryonecrosis. After thermocoagulation (740 degrees C/4 sec) each animal received an i.p. injection of 3H-TdR (2.5 micronC/1 g body weight). The survival times ranged from 12 hours to 30 days. In the HE stained histological slides the morphological changes and the percentages of the cells in the granulation tissue and in the stripping film autoradiograms the percentages of radioactively labeled fibroblasts and hepatocytes were determined. After 12--24 hours the thermonecrosis is complete with leucocytic demarcations. Five days later widespread granulation tissue develops in the marginal zone of the necrosis. 20 to 30 days after thermocoagulation small necrotic parts are still seen in the center sorrounded by a fibrous scar. Autoradiographically the highest percentages of labeled epithelial and mesenchymal cells are observed between the second and the third postoperative day. Four weeks after thermonecrosis there are still increased cellular proliferative activities. Therefore, it can be stated that the inflammatory resorptive woundhealing processes following thermonecrosis in the liver are maintained much longer than after other physical injuries especially after cryonecrosis.


Cardio-respiratory synchronisms: synchrony with artificial circulation.

Rabbits with an artificial cerebral circulation can synchronize their respiratory rhythm with the pump stroke. There is evidence that the responsible kybernetic system is of a very elementary nature. The efficacy of the system is considerable and the experimental set-up as a whole offers itself as a model to search for drugs to increase the synchronizing potentialities.


[Morphologic investigations on the toxicity of orally applied CDCA in the liver, gastro intestinal tract, kidney and adrenal gland of the rat (author's transl)].

Light- and electron microscopic alterations of the liver and light microscopic findings in the gastro intestinal tract, the kidney and adrenal gland of 80 female Wistar-Rats under CDCA therapy are reported. CDCA was applied by means of an endopharnygeal tube over a period of 60 days in doses of 150, 250, 500 and 1000 mg/kg body weight. The organs were examined at different times. We compared the achieved findings to results obtained already beforehand by light- and electron microscopy after application of 20, 50 and 90 mg/kg body weight and day: Up to a dosage of 90 mg/kg morphological changes of the liver were only visible electron optically, from 150 mg/kg onward they could be seen light optically as well. After 60 days a cirrhosis-like picture had developed. The lethal dose was established at 1000 mg/kg. There were no pathological alterations in the gastrointestinal tract and no definite ones in the kidneys. The adrenal glands were unchanged.--Since there are in the rats, in spite of potent mechanisms of detoxication of CDCA and LCA, even at low doses morphological alterations to be seen, the existence of other toxic, at this moment still unknown metabolites is being discussed.


Clearance and dialysance of 3H-aldosterone in vitro.

Using an "in vitro dialysis" with different dialyzers, a significant decrease in 3H-aldosterone concentration was seen. From the decrease of 3H aldosterone elimination parameters were calculated. Half time of elimination was 21,5 min, the mean clearance of all dialyzers averaged 32.2 ml/min. The dialysances of 3H aldosterone evaluated with dialyzers of different surface areas were correlated with the surface areas of the dialyzers. From the results can be concluded, that besides individual influences of regulation, haemodialysis influences aldosterone concentration in plasma by physical factors.


The circulation in liver tissue and experimental liver metastases before and after embolization of the liver artery.

Simultaneous measurement of cardiac output distribution with 86Rubidium and 57Cobalt-tagged microspheres in rats implanted with liver tumors by intraportal injection of sarcoma cells enables quantitation of arterial and portal tumor circulation. The portal circulation was found to be increased in small tumors as compared to the liver, but as the tumor grew there was a decrease in the portal tumor circulation. When the tumor growth became massive even the total liver circulation was reduced, as measured with 133Xenon wash-out. All the tumors had increased arterial circulation. This arterial hyperperfusion was changed into ischemia when the liver artery was occluded through embolization with degradable microspheres.


(3-14C) coumarin distribution in rat tissues after the injection of a single dose.

Experimentally it has been shown that coumarin is a very effective therapy in the treatment of high protein oedemas. This study reports on the distribution of a single dose of 3-14C-coumarin in rats. Blood levels of coumarin were always much lower than those of the tissues at similar times. The half life of 3-14C-coumarin and its labelled metabolites was found to be about 43 hours. This ties in fairly well with the optimum frequencies of the administration of the drug which was found to be 24 hours. At this time, skin and muscle levels (the tissues most effected in lymphoedema and in thermal oedema) were maximal.


Repeated corticosteroid injections into knee joints.

The effect of intra-articular injections of corticosteroids repeated over a period extending from four to 15 years on the radiological appearances of knee joints affected by rheumatoid arthritis and osteoarthritis has been studied. In 65 cases, the X-ray films of 15 showed no deterioration, 38 showed minimal or moderate deterioration, 10 showed marked deterioration and only 2 showed gross deterioration. The results do not support the contention that repeated intra-articular injections of corticosteroids will inevitably lead to rapid joint destruction. The authors are of the opinion that intraarticular injections of corticosteroids, if used judiciously, have an important part to play in the management of chronic arthritis.


Can chronic and self-perpetuating arthritis in the human be caused by arthrotropic undegraded microbial cell wall constituants? A working hypothesis.

Although the aetiological agents responsible for the initiation of rheumatoid arthritis in the human are not known, the possibility that the disease is of bacterial origin has been considered. The bacterial factors involved may be small fragments of undegraded wall components which persist for long periods within macrophages and trigger the active release of lysosomal enzymes which cause tissue destruction. The failure to identify such wall components in diseases tissues may be due to the lack of adequate sensitive techniques to detect minute amounts of these wall components, shown to trigger chronic destructive arthritis in laboratory animals. Two models of arthritis caused by mycobacterial and streptococcal wall components are described and the possible role played by immune responses, to the persisting bacterial factors, in the pathogenesis of human arthritis is discussed.


Arthritis with sigmoid volvulus and HL-A B27.

A 43-year-old male developed seronegative polyarthritis after a short attack of diarrhoea. For about two years before he had experienced intermittent abdominal pain, distension and constipation. Laparotomy showed a chronic sigmoid volvulus for which sigmoid colectomy was performed. Post-operatively he had no further bowel symptoms, no further arthritis and there was radiological improvement of involved joints. Tissue typing showed HL-A B27 antigen.


Dysphagia due to vertical subluxation of the axis in rheumatoid arthritis.

Two patients with rheumatoid arthritis developed swallowing difficulties. These were mild in one case but severe in the other. Associated pyramidal tract signs and striking upward translocation of the dens made it seem probable that dysphagia was attributable to medullary compression despite the absence of other bulbar features. A history of dysphagia may therefore have serious implications for patients with rheumatoid disease.


Voluntary isometric muscle strength of patients undergoing rehabilitation following fractures of the lower limb.

Isometric muscle strength was measured in 32 servicemen recovering from fractures of the lower limb. At the time when patients were admitted for rehabilitation there were marked reductions of strength in the injured limb of muscles acting at the hip, knee and ankle joints. Marked improvement of strength occurred during rehabilitation, but there were still significant differences between the limbs at the time of discharge from the rehabilitation unit.


Ankylosing spondylitis: klebsiella and HL-A B27.

A search for the presence of Klebsiella-Enterobacter spp. and Yersinia enterocolitica in urine and faeces of 63 patients with ankylosing spondylitis was conducted because these microorganisms have been demonstrated to cross-react immunologically with HL-A B27 positive lymphocytes. The patients were graded into three groups on the basis of disease activity. Klebsiella spp. were found in the faeces of 13 (93%) of the 14 patients with 'active' disease, 10 (48%) of the 21 patients with 'probably active' disease and in one (4%) of the 28 patients with 'inactive' disease. Positive cultures were also obtained in 47 (38%) of 124 controls. It is suggested that the presence of Klebsiella spp. in faecal cultures may be associated with 'active' disease in patients with ankylosing spondylitis.


[Roentgenologic symptomatology of cardiomyopathies (author's transl)].

In a material of 162 patients with different types of cardiomyopathy it was found that the standard chest radiograms could give important contributions to the diagnosis of the disease. The two main groups hypertrophic and other cardiomyopathy could in most instances be separated from each other. Nearly all patients had an abnormal chest radiogram when first studied. A positive roentgen diagnosis no standard chest examination supports a clinically suspected diagnosis of cardiomyopathy and should be possible in at least 80% of the patients. Angiocardiography can always provide the diagnosis in unclear cases and gives details of anatamy and function of the left and right ventricles in patients where surgical intervention of an intraventricular obstruction is contemplated.


[Roentgen features and clinical clues to differential diagnosis of diffuse interstitial pulmonary fibrosis (author's transl)].

Diffuse interstitial fibrosis and secondary honey comb transformation of the lungs represent a serious irreversible condition resulting from numerous affections of heterogenous origin. Yielding, finally, a rather uniform scar pattern the courses of lesions afford, at all events, a merely phasic diagnosis of the underlying processes from the roentgenologic point of view. Any opportunities for tracing up etiologic factors and exerting therapeutic influence, if at all, will be restricted to initial stages of the, otherwise, impetuous development. The roentgen finding may give rise to suspicion in various respects, yet its features are, in principle, indifferent as to etiologic conclusions. Hence, the x-ray pattern requires thorough supplementay informations of detailed history, clinical data, laboratory and bioptic results, as well, in order to gain a chance for substantiate diagnosis and successful management. The topics concerning differential diagnosis are discussed with regard to various interstitial diseases of the lung and, especially, to the field of immunbiologic reactions.


[Gougerot-Sjögren syndrome, connective tissue diseases and autoimmune pathology].

Each of the following conditions has a 4 to 6 percent frequency of association with the Gugerot-Sjögren syndrome: systemic lupus erythematous, scleroderma, autoimmune liver disease (simple biliary cirrhosis and chronic active hepatitis), and Hashimoto's thyroiditis. Association with a nodular periarteritis and a polymyositis is very much more unusual and should be discussed on account of the existence of myositis and the vascularity peculiar to the Gougerot-Sjögren syndrome. Very many true or supposedly autoimmune diseases have been reported in association with the Gougerot-Sjögren syndrome: mixed connectivity, atrophying polychondritis, Reynolds' syndrome (scleroderma plus simple biliary cirrhosis), thrombotic thrombocytopenic purpura, thyrotoxicosis of simple hypothyroidism, and total or partial lipodystrophy. The lacrymal and salivary condition is almost constant during systemic lupus erythematosus, scleroderma, simple biliary cirrhosis and mixed connectivity. From the point of view of autoimmune pathology, the Gougerot-Sjögren syndrome might constitute either an autonomous condition when found in isolation or represent the exocrine glandular expression of a dysimmunitary disease with which it is associated.


Biosynthesis of chondroitin sulphate in cartilage regenerated from perichondrium.

In a rabbit's ear cartilage an experimental defect was lined with a perichondrial flap and in a rabbit's trachea a defect in two tracheal cartilages was reconstructed with a free autogenous graft of aural perichondrium. Outgrowth of new tissue, morphologically indistinguishable from cartilage was observed within 4 weeks. In cartilage defects not bridged by perichondrium, no regeneration of cartilage occurred. Inorganic 35SO4, administered in vivo, was incorporated into the newly formed tissue. The labelled product was isolated and identified as chondroitin sulphate. The results support the view that authentic cartilage may be regenerated from the perichondrium.


[Muscular lesions in Gougerot-Sjögren syndrome].

The authors review the literautre and then proceed to analyse a series of 16 cases of Gougerot Sjögren Syndrome. The electromyogram (EMG) was abnormal on only 2 occasions. Histologically inflammatory aspects could be seen on 4 occasions with perifascicular atrophy in one case. Atrophy of II fibres was present in 7 cases together with signs of disorganization of the mitochondrial reticulum and images of mitochondrial aggregates. Under the electron microscope minor anomalies were particularly visiole and the internal structure was normal as often as not. Overall it is possible to distinguish forms of a subacute polymyositis type (4 cases), and a pauci-inflammatory myalgic type proximal to the scappular predominance (4 cases), in which the mitochondrial anomalies are commonest. Another "infraclinical" group shows no other frankly pathological changes. Finally in 3 cases the "dry" syndrome is strictly free of any muscular attack.


Zinc resorption from zinc-tape during wound healing. An experimental study in rats.

In the rat zinc is resorbed from excisional wounds treated with adhesive zinc-tape. High levels of zinc compared to those in gauze-treated controls were found in serum, granulation tissue and pancreas. An increase of serum copper was also found during the process of wound healing, but increase in serum copper was probably due to an elevation of ceruloplasmin in serum.