Murine colon adenocarcinoma: syngeneic orthotopic transplantation and subsequent hepatic metastases.

Syngeneic murine colon adenocarcinoma (MCA-38) cells were transplanted in the submucosa of distal colon, proximal colon, cecum, ileum, jejunum, and duodenum of male C57BL/6 mice, with local lymphoid follicles used as points of entry. The tumor grew best at the cecum and led to liver and mesenteric lymph node metastases in 8 and 9 weeks, respectively, after transplantation. Histologically, a local inflammatory reaction involving polymorphonuclear leukocytes was observed within 48-72 hours following transplantation; after this time, the microscopic tumor foci began to grow progressively. Mononuclear lymphoid cells of the gut-associated lymphoid tissue did not infiltrate the progressively growing tumor; however, polymorphonuclear leukocytes were constantly observed at the tumor periphery in the lamina propria. The studies indicated that orthotopic transplantation as a model system can provide a means of examining the role of the local immune response as a focus of host resistance and as a factor in metastatic tumor spread. The findings also suggested the usefulness of this model in immunotherapeutic and chemotherapeutic studies of secondary hepatic disease.


Bile acids: co-mutagenic activity in the Salmonella-mammalian-microsome mutagenicity test: brief communication.

Of 30 bile acids tested, none was mutagenic in the Salmonella-mammalian-microsome test with indicator strains G46, TA1530, TA1535, TA1536, TA1537, TA1538, TA98, or TA100. However, when lithocholic acid or one of its conjugates was tested with suboptimal amounts of 2-aminoanthracene and phenobarbital-stimulated rat liver homogenate, enhancement and co-mutagenesis were observed if TA1538 was the indicator strain.


Effect of levamisole on malignant experimental neurinoma grown subcutaneously in a young rat: brief communication.

Levamisole, a drug that stimulates the immunologic defenses of the host, was tested on the experimental malignant neurinoma grown subcutaneously in young female inbred CDF rats in 3-month trial. The drug resulted in prevention of tumor growth in 80% of the treated animals, whereas tumors grew in 100% of the controls. After discontinuation of the drug, none of the animals in the treated group showed evidence of tumor growth upon clinical and pathologic examination 1 month after drug treatment was terminated. Treated animals failed to show any side effects related to levamisole upon clinical and pathologic examination.


Levamisole, a drug that stimulates the immunologic defenses of the host, was tested on the experimental malignant neurinoma grown subcutaneously in young female inbred CDF rats in a 3-month trial. The drug resulted in prevention of tumor growth in 80% of the treated animals, whereas tumors grew in 100% of the controls. After discontinuation of the drug, none of the animals in the treated group showed evidence of tumor growth upon clinical and pathologic examination 1 month after drug treatment was terminated. Treated animals failed to show any side effects related to levamisole upon clinical and pathologic examination.


Diallylnitrosamine: a potent respiratory carcinogen in Syrian golden hamsters: brief communication.

Diallylnitrosamine (DAN), one of the few nitrosamines tested thus far that has not induced neoplasms in rats, caused a high incidence of respiratory tract tumors in Syrian golden hamsters treated sc with single or weekly doses of the compound. The effect was dose-dependent. The nasal cavity, larynx, and trachea were the most affected by DAN; most drug-induced tumors at those sites were adenocarcinomas and papillary polyps.


Transection of the descending thoracic aorta secondary to blunt trauma.

In the last ten years, 22 patients with transection of the descending thoracic aorta were seen at the Ben Taub General Hospital. Five patients with massive left hemothorax died shortly after admission. Among 17 patients in whom proximal and distal control could be achieved, three died in the operating room; three died within 30 days of operation, and one patient died of sepsis more than 1 year postinjury: ten patients are longterm survivors. Partial pump bypass was utilized in six patients, and in one a heparinized shunt was used intraoperatively. Dacron tube grafts were used in 12 cases, and primary repair was accomplished in three. One patient was paraplegic on admission, and two others in whom this was not established before operation were found to have this complication postoperatively. One patient with an infected false aneurysm 1 year after operation underwent resection of the distal aortic arch and Dacron graft with extensive extravascular bypass procedures. Patients with transection of the descending thoracic aorta die if proximal control is not achieved before rupture of the hematoma. Successful repair of this injury requires aggressive diagnostic and surgical management.


The salvageability of patients with post-traumatic rupture of the descending thoracic aorta in a primary trauma center.

If uniform early diagnosis is accomplished, two thirds of patients with rupture of the proximal descending aorta seen at a primary trauma treatment center are potentially salvageable. Currently the survival rate is only one half of this optimum figure (31%). One third of 39 patients with acute rupture of the proximal descending thoracic aorta studied had lethal concomitant injuries and were unsalvageable. Twenty-six patients were potentially salvageable; twelve (46%) survived. Eight potential survivors (31%) died because their aortic rupture was not diagnosed or because it was not promptly diagnosed. Eighteen of the potentially salvageable patients (69%) underwent aortic repair; two thirds survived. Aortic rupture was uniformly diagnosed earlier in the more critically injured patients and thus they underwent aortic repair earlier. One half of the 12 patients in whom thoracotomy was instituted within 6 hours of admission survived; six patients who underwent aortic repair more than 6 hours after admission survived.


Impact trauma of the human temporal bone.

A cooperative study between the Department of Otorhinolaryngology and the Highway Safety Research institute of the University of Michigan was designed to study temporal bone fracture produced in cadavers subjected to realistic automotive impact situations. Utilizing sled and piston impact configurations frontal and parietal impacts were noted to produce ipsilateral and contralateral fractures of nine temporal bones in seven cadavers. The impact velocities varied between 18.1 and 25.0 mph. Using standard otologic microsurgical techniques, the temporal bones were dissected and numerous gross and microscopic injuries to middle and inner ear structures were found. The authors conclude that extensive comminuted fracture of the human temporal bone is seen with realistic crash situations of low velocity, and that lateral impact which produces a longitudinal fracture with a posterior fossa comminution is associated with disruption of the cochlea and facial nerve, as well as of middle ear structures. The classical transverse fracture of extensive skull trauma lies medial to these structures and does not involve the otologic contents of the human temporal bone. Associated brain and skull injuries are also described.


The use of a fiberoptic intracranial pressure transducer in the treatment of head injuries.

A 3-year experience of intracranial pressure monitoring of head-injured patients with a fiberoptic system, and the basic mechanics of the system are discussed. In the overall study, 46 patients were monitored for up to 32 days. There were no infections. Thirty-three patients had elevated pressure, and 16 of these patients required treatment of their elevated pressure. The pertinent findings in intracranial pressure monitoring that may indicate the need for, and the response to, therapy for increased intracranial pressure are also presented. The data obtained from monitoring indicate that intracranial pressure monitoring can also be an aid in the attempt of determine the prognosis of the patient.


Nerve grafting in the repair of complicated peripheral nerve trauma.

Peripheral nerve trauma has been a challenge to surgeons, with significant advances in the surgery of repair occurring in major wars. The standard method of treatment involving wide mobilization and end-to-end suture to close traumatic gaps in peripheral nerves has not produced consistently acceptable results, particularly with large gaps. However, with the recent development of microsurgical techniques and instrumentation, the method of interfascicular nerve grafting has been applied to selected patients with trauma problems of the peripheral nerve, by resecting and autogenous nerve grafting at staggered levels to distribute scar formation, followed by plaster immobilization for 3 weeks. Ten patients are reported, with motor nerve recovery ranging from M2 to M4 and sensory recovery, S2-S4 (See Table I), based on Seddon's classification (11).


Traumatic rupture of the right hemidiaphragm.

Six cases of traumatic rupture of the right hemidiaphragm are reviewed with emphasis on diagnostic features and operative treatment. In one (Case 6), a mass lesion was seen in the chest 2 years after the initial injury and was repaired through a right thoractomy incision. There were no deaths. Of the five cases operated on soon after the initial injury, two were approached initially via right thoracotomy incisions and both required second incisions for injuries below the diaphragm. Three ruptures of the right hemidiaphragm were successfully repaired through laparotomy incisions without extension of the incision into the chest. Laparotomy is the preferred approach for rupture of the right hemidiaphragm during the acute phase, because exposure is adequate and life-threatening injuries below the diaphragm can usually be dealt with through the same incision.


Ski injuries.

A group of 147 injuried skiers seen in the emergency room of a midwestern hospital was studied. There were almost twice as many males as females, and lower-extremity injuries outnumbered upper-extremity injuries two to one. Leg injuries tended to occur in beginners whose bindings failed to release. Upper-extremity injuries were prevalent in better skiers whose bindings released properly. Frequent binding checks only slightly improved the likelihood of proper binding function.


Effect of isometric handgrip exercise on left ventricular function in the patient with artificial cardiac pacemaker.

The cardiovascular effects of isometric handgrip exercise were determined with a nonivasive method in the patient with artificial pacemaker. The arterial blood pressure was measured with mercury manometer as well as cardiac output by the dye dilution method with Indocyanin green before and after handgrip exercise. Isometric handgrip exercise produced a significant increase in the left ventricular ejection time, the left ventricular ejection time/the preejection period, the ejection time index/the isometric contraction time, the arterial blood pressure and cardiac output and a significant decrease in the preejection time and the isometric contraction time. Cardiac output was increased more remarkably in the negative Master two step test group than in the positive Master two step test group. There was found a significant positive relationship between the increase in cardiac output and P wave rate upon handgrip exercise.


Plasma dopamine-beta-hydroxylase activity in normal young men: its responsiveness to manipulation of sodium balance and upright posture.

Plasma dopamine-beta-hydroxylase (DBH) activity was examined in nine healthy young adults. DBH activity at rest had a wide range, near 0 to 44 I.U./L. When sodium depletion was performed by dietary sodium restriction and diuretic, the activity was significantly increased. With dietary sodium loading, it was decreased. The change in DBH activity was significantly correlated with that in hematocrit. When subjects were erected, the enzyme activity was elevated in situations regardless of sodium balance. Blood pressure and pulse rate were changed by manipulation of sodium balance and postural change. However, the change in DBH activity did not correlate with them. Plasma renin activity (PRA) was determined concomitantly in the same plasma with DBH. The change in PRA had a direct correlation with that in DBH activity. Furthermore, the change in mean arterial pressure induced by infusion of angiotensin II analogue seemed to correlate with DBH activity change by sodium depletion. When the values of DBH activity in each individual were compared throughout the study, it was observed that the biggest variance in the activity of each individual was significantly correlated with the basal activity. In longitudinal study of individuals, plasma DBH activity could be a useful index for estimation of sympathetic activity.


[Therapeutic effect of pipemidic acid trihydrate on urinary tract infections (author's transl)].

Twenty-seven cases of urinary tract infection were treated with daily dose of 1.5 g of pipemidic acid trihydrate. Duration of drug administration varied between 7 and 28 days. The patients were consisted of acute cystitis (10), underlying disease (5) and complicated infection after long period catheterization (12). Following results were obtained: 1. Organisms cultured before treatment were sensitive to pipemidic acid trihydrate. 2. First and second classes of patients were cured by the treatment, however, patients having indwelling catheter were not changed on the view of culture. 3. No serious side effect was observed including hepatic and renal function, and blood.


[Syphilotherapy with amoxicillin, a synthetic penicillin (author's transl)].

Amoxicillin, a synthetic penicillin preparation, was given to 25 cases as an antiluetic. As for 13 cases of them, one year or more have passed since the treatment finished. 1. A daily dose of 1,000 approximately 1,500 mg of amoxicillin was continuously administered for 4 weeks, as one course. After each course finished, administrated was stoped for 2 approximately 4 weeks for examination of results of TPHA estimation, and then another course was started. 2. Effective rate in 13 cases reached about 40%. The remaining 12 cases are now under treatment. 3. Exanthema, a side effect, was observed in one of 25 cases.


[Clinical studies with minocycline intravenous instillation. Chemotherapy in patients with renal impairment (author's transl)].

In the present studies, we had an opportunity to review the effects of minocycline intravenous instillation for the treatment of moderate disorder of renal functions. No accumulation of minocycline was observed in the repeated administration of this drug instilled intravenously up to 7 days in the patients with moderate disorder of the renal functions. Also, no particular abnormality was observed in the tests of the liver, kidney and hematology. For patients with moderate Ccr 30 approximately 60 ml/min, as entered into the present study, the usual dosage of minocycline intravenous instillation for less than 7 days would not cause adverse reaction on renal functions.


[Clinical evaluation of intrathoracic tissue bactericidal antibiotic level (author's transl)].

Thirty-one patients who were performed thoracotomy for the disease of the chest, were administered sulfobenzyl penicillin 5.0 g for an hour during their operation. Antibiotic levels of serum and intrathoracic tissues (a piece of lung parenchyma, pleura, pulmonary hilar lymphnode, fatty-tissue and chest wall muscle) were determined, and an evaluation of bactericidal effect was discussed. In this study, we found that antibiotic levels of lung tissue with infectious or inflammatory disease were remarkably high compared with the levels of bronchogenic carcinoma. This means that a high concentration of sulfobenzyl penicillin to infectious intrathoracic tissues is effective against post-operative infection.


[A study on midecamycin granules in acute respiratory diseases in infants (author's transl)].

We have undertaken some basic and clinical studies on midecamycin granules with following results: 1) After ingesting of 4 g of midecamycin granules, peak blood levels (1.51 microgram/ml on an average) appeared at one hour in infants, detectable amount lasting for 6 hours. 2) Urinary excretion within 6 hours ranged from 1.1 to 2.7% of the drug dosed. 3) In the treatment of a total of 19 acute cases, consisting of 9 cases of tonsillitis, 7 cases of lacunar tonsillitis and 3 cases of bronchitis, midecamycin was found effective in 79% of the cases. 4) In all the 3 cases of pneumonia due to Mycoplasma, response to midecamycin was assessed as excellent. 5) Hepatic and renal functions tests performed in cases treated with the drug for a prolonged period (40 approximately 50 mg/kg for 13 approximately 18 days) revealed no undesirable effect, indicating that midecamycin can be administered continuously to younger infants with infections.


[Comparison of absorption and excretion of doxycycline capsules and tablets (author's transl)].

By cross-over method between two formulations of capsules and tablets of doxycycline, serum levels and urinary excretions were compared in humans. No difference was found between the results with both formulations.


[Studies on the in vitro bactericidal effects of cephalexin against Staphylococcus aureus (author's transl)].

The effect of cephalexin on the numbers of viable cells was studied. Two strains of Staph. aureus and 6 strains of Escherichia coli at their logarithmic phase were exposed to various concentrations (1 approximately 4 MICs) of cephalexin for 1 approximately 24 hours in vitro. The numbers of viable cells were determined by the colony-counting method during and after the exposure of cephalexin. The following results were obtained: 1. When exposure time was short (3 hours or less), the numbers of viable cells were not decreased even at the high concentration (4 MICs). And more exposure time (4 hours or more) was needed for decreasing the number of cells. 2. "Concentration" was not strong influencing factor for decreasing the numbers of cells as compared with "Exposure time". 3. From the point of decreasing the numbers of cells for 12 hours, 4-hour exposure to 1 MIC was more effective than 2-hour twice exposure at 4-hour nonexposure interval to 4 MICs of cephalexin.


Precordial mapping in acute myocardial infarction.

Serial precordial mapping was done in 30 patients with acute anterior myocardial infarction, 27 transmural and 3 subendorcardial. The sum of ST elevations in the 48 lead map was designated as sigma ST. Normal sigma ST was calculated as 27.1+/-3.1 in males and 14.3+/-2.8 in females. In infarction it was 100.4+/-58.2 in males and 84.8+/-50.9 in females on the 1st day of admission. Sigma ST was elevated on day 1 and tended to fall gradually. In 6 patients it was normal by day 7 and in 7 it was still abnormal by day 21. This fall roughly correlated with fall in SGOT and CPK levels. Significant elevation of sigma ST occurred in 14 of 27 cases after day 1. In 10 of 27 cases significant re-elevation occurred on day 4 or after i.e. when the patient was outside the ICCU. In 10 of the 14 re-elevations there was pain or worsening of clinical picture and in 12 there was re-elevation of SGOT. This elevation presumably implied infarct extension. There was a tendency to more arrhythmias in the patients with higher sigma ST and of the 4 deaths in the series 3 had very high sigma ST and high levels of SGOT. The patient with the highest sigma ST 295 died in cardiogenic shock. The number of risk factors was found to be higher in the high sigma ST group.


Congenital heart disease in high school and college students.

The prevalence and relative frequency of congenital heart disease in high school and college students were investigated during the period April 1970-March 1976. Forty congenital lesions were found among 13,127 subjects which shows a rate of 3 per thousand. The ratio of congenital lesion to rheumatic heart disease was 4/1. Ventricular septal defect was the most common defect, found in 30% of all lesions followed by atrial septal defect (20%) and patent ductus arteriosus (17.5%). The prevalence and relative frequency in those investigated differed only slightly from the results obtained among children. The possibility of spontaneous closure of ventricular septal defect during adulthood strongly suggested itself when compared with our previous data on post middle age subjects.


Correlation between areas of ventricular preexcitation and types of WPW QRS patterns by means of computer simulation of ventricular activation sequence.

Computer simulation of the ventricular activation sequence of the WPW syndrome was attempted by producing fusion beats in which localized ventricular myocardium was activated earlier than the "normal excitation". It suggested that the site of pre-excitation was; i) at the posterior or the lateral free wall of the left ventricle adjacent to the A-V groove in type A, ii) at the antero-lateral base of the right ventricle in type B, and iii) at the posterior paraseptal region of the right ventricle in type C. A mild degree of pre-excitation at the left ventricular postero-lateral region will result in type B QRS complexes.


Cross-reactive HLA antigens in B27-negative Reiter's syndrome and sacroiliitis.

Proposed mechanisms to explain the association of HLA-B27 with Reiter's syndrome (RS) and ankylosing spondylitis (AS) include abnormal immune response genes linked to HLA or a direct role for HLA antigens in disease pathogenesis. Our studies provide indirect evidence to support the latter hypothesis. Seventy-nine patients (44 with RS, 27 with AS and 8 with idiopathic sacroiliitis [SI]) were evaluated clinically and by HLA phenotyping. Of the 10 patients with RS who were B27-negative, 7 (70%) had another B locus antigen that was immunologically cross-reactive with B27 (B7-group antigen). These included B7 in two, BW22 in four, and BW42 in one. Four of eight patients with sacroiliitis alone had B27, but the remaining four all had B7. Two B27-negative AS patients had no B7-group antigens. Thus, 69% of B27-negative patients had cross-reactive HLA antigens.


[The effect of euthyscope- and occlusion therapy in cases of convergent strabismus. Comparative, prospective examinations (author's transl)].

1. 63 children with strabismus and amblyopia (average age 7 years) were chosen at random to be treated either with occlusion or with the Euthyscope followed by occlusion. No significant difference was apparent after comparison of both forms of treatment. 2. Six more children were occluded for several months without success and were then treated for two months with the Euthyscope followed by further occlusion. In four of these cases pleoptic treatment proved to be temporarily successful. 3. In addition, 14 children with microstrabismus and amblyopia, and 17 children with amblyopia ex anisometropia showed a distinct improvement of the visual aciuty after occlusion. An 18-year-old patient with microstrabismic amblyopia achieved normal visual acuity. 4. Euthyscope treatment was used in amblyopic patients who had lost their good eye. In the case of an 18-year-old patient the distant visual acuity increased to 0.6. The increase in the near vision and the speed of reading continued to improve for several years. 5. Papilla-Macula-Relationship: 47 amblyopes were compared with 8 anisometropic and 16 microstrabismic patients as well as with 32 normal subjects. In these groups no significant difference in the papilla-maculadistance was apparent. 6. Refraction: In amblyopic eyes there were no significant refractive errors between fixing and non-fixing eyes. Conversely, in patients with microstrabismus and those with anisometropic a significant difference was found.


[The treatment of squint-amblyopia with eccentric fixation (author's transl)].

The author used Deller and Brack's method in the treatment of twelve patients with squinting amblyopia and eccentric fixation. The high percentage of good results obtained supports the value of this method.


[On ketamine-monoanaesthesia for operations for strabismus in childhood (author's transl)].

In 58 children below the age of 12 with strabismus operations were performed under anesthesia with Ketamine. Continuous and discontinuous modes of application were selected with varying premedication. Blood-pressure and pulse-rate, the occurence of oculo cardial reflex (OCR) and narcotic requirement were registered and discussed with regard to premedication and specific modes of application.


[Ocular symptoms in Rubinstein-Taybi-Syndrome (author's transl)].

Two cases are reported with the following symptoms: broad thumbs and toes, typical facial abnormalities with beaked nose and hypertelorism. In addition the first child had microcornea, polycoria and subluxation lentis, the second a dacryostenosis. In both cases there were anomalies of refraction and strabismus. A detailed description of the classical findings is also included.


[Osteitis deformans cranio-orbitalis (Paget's) in a young patient. Operation and clinico-pathology study (author's transl)].

Among the cranio-facial anomalies involving the orbit, Paget's disease is of particular interest due to its progressive evolution and clinico-pathological characteristics. In this article a case of Paget's disease (juvenile type) with orbital expansion in a young woman of 27 years is presented. The onset of clinical symptoms were recorded at the age of 15 years progressing to optic atrophy and blindness in one eye and visual deterioration on the other. The peculiarity of this case lies on the early onset of clinical symptoms due to elective in volvement of the skull and sparing of the facial bones. The surgical decompression (removal of the roof of the orbit and upper wall of the stenosed optic canal) was successful in controlling the evolution to optic nerve atrophy in the seeing eye.


[A comparison between pneumatography and tomography (tomodensitometry) for examination of the visual pathway (author's transl)].

The author describes the possibilities of x-ray examination of the extra- and intracranial parts of the visual pathway. After a survey of pneumatography of the orbit a comparison with pneumoencephalography and tomodensitometry (EMI-scanner) is made. Tomodensitometry must be regarded as a significant advance in neuroradiological examination because it is not dangerous and easy to perform. The indications for complementary pneumoencephalography are discussed in detail.


[Determination in the spectral curve of relative luminous efficiency (author's transl)].

The determination of the maximum in the spectral curve of relative luminous efficiency can be done with a simple procedure. Two colours having the same ordinate on the curve are alternatively presented at a rate under the critical fusion frequency. They do not flicker if the subject is normal. They flicker on the contray if the maximum is displaced. We developed a simple apparatus which is proposed.


[Study of zonular area (author's transl)].

The author presents a set of colored pictures which permits to delimitate 3 kinds of zonular fibers. 1. Short anterior fibers. 2. Short posterior or medial fibers, and 3. long posterior fibers. Describe also 3 irregular rings where the zonular fibers are firmly attached to the hyaloids and vitreous. 1. The Wieger's or Egger's ring. 2. The ciliary ring, and 3. the ora serrata ring. The first one attached to the posterior capsula, the second to the ciliary processes and ciliary body and the third to the peaks of the ora serrata. They are the 3 anterior support of the vitreous body. The 2nd is movile by the action of the circular ciliary muscle which acts like a diaphragm suspended from the flexible spur. When contracts relax the zonular fibers but pull the spur and trabeculum and would move the dense basal vitreous to the center pressing the fluid central vitreous.


[Capillaries of the macula and fovea of the human retina (author's transl)].

The occurrence of atypical vascularisation of the macular-foveal zone in 20 eyes of 17 patients is described. The significance of this fluorescein stereoangiographic finding is discussed.


[Removal of intraocular tumors and cysts by deep lamellar resection (author's transl)].

A series of 28 cases is presented in which a relatively simple surgical procedure of deep lamellar resection of adjacent cornea and sclera is used to remove malignant or possibly malignant growths of the iris root, ciliary body and interior choroid and epithelial cysts and downgrowths. The technique was developed from the early trabeculectomy operation and has been used during the past 16 years. It was used to remove 16 epithelial implantation cysts, 2 benign tumors of the chamber angle, 7 malignant melanomas of the iris root, 1 malignant melanoma of the choroid and ciliary body and 2 epithelial downgrowths.


[Mild resistant chronic conjunctivitis (sub-clinical allergies) (author's transl)].

Cases of persistent conjunctival irritation not associated with any recognised cause, can be a source of annoyance to Ophthalmologists. A series of cases were investigated from the allergy angle (none of the patients showing the usual pattern of allergy) and a proportion were found to have possible allergic factors present.


[Goniotrepanation with scleral flap: recommendations for the microsurgical operation method (author's transl)].

After more than five years' experience with goniotrepanation the improved details of the micro-surgical technique operation of are explained.


[Changes in cataract extraction in 10 years (author's transl)].

A statistical survey has shown how within only 10 years in the University Eye-Clinic in Hamburg-Eppendorf the cataract operation has undergone a multifaceted change. This is true expecially for the type of incision, and with increasing importance the planning of combined operations (antiglaucoma operations, corneal transplant) and the introduction of the suction technique for cataracts in children and young patients and for congenital dislocation of the lens.


[Development of ophthalmological working procedures (author's transl)].

The work at a university clinic is characterized by teaching, research, and care of in- and out-patients. The combination of these basic tasks needs appropriate organization. To obtain optimal efficiency, the size and power of the single compartments, the teams working there are personal intentions of their members, and other special factors must be considered. Apart from local differences some basic outlines can be drawn characterizing the typical problems of an eye clinic taking into consideration its special matters. Moreover, the continuous clinical and scientific progress has to be taken in mind in order to create organizational forms feasable for change and adaptation. In this paper we present our considerations concerning the arrangement of our own clinic, and the experience gained in respect to the development of working methods. Some examples are given in order to demonstrate the realization of close conjunctions between the various parts of the clinic, and, likewise, the increase of efficiency of different methods and techniques gained by those means. This gives general ideas of the solution of some actual problems in a university eye clinic.


[Orthokeratology. Technique - possibilities - limits (author's transl)].

The vornea is because of its refraction, its structure and accessibility the easiest variable component of the optic eye system. Flat fitted, barely flexible contact lenses exercise by their small central clearance a considerable pressure on the corneal apex and will therefore bring about a reversible clearance of the central corneal topography. Orthokeratology therapeutically uses this effect in order to temporarily reducing, changing or eliminating a refractive error. This is of a particular interest in the case of a keratoconus. Orthokeratology is not without danger because too high pressures have a weekening effect on the corneal trophic and resistance.


[Herpes therapy and prophylaxis. II. Results of a survey of practicing ophthalmologists (author's transl)].

Between December 1975 and April 1976, 2,300 ophthalmologists in the Federal Republic of Germany and West-Berlin were asked about their experiences with different forms of therapy and prophylaxis for herpetic eye diseases. 15 questions were answered by 965 ophthalmologists (42%). The answers not only reflect their preferences and experiences, but could also initiate a new evaluation of many diagnostic, therapeutic and prophylactic methods.


[Change in the gravitation level as a stressor].

Animal (rats, mice) experiments have shown that a gravity change within the range of +/- 1 g relative to the Earth gravity field (zero g in space flight, increased gravity in centrifugation experiments) results in the development of similar reactions--growth delay, involution of lymph organs, lymphopenia. These are classic signs of stress reactions. Centrifugation experiments have demonstrated that the stress-effect of increased gravity can be counteracted by intermittent pretraining on the centrifuge. With respect to the literature data and the authors' own experimental findings, the ratio of specific and nonspecific components in animal responses to gravity changes as well as the contribution of animal reactivity and resistance to these responses were discussed.


[Characteristics of the water-salt metabolism and functional state of the kidneys in members of the crew of the 1st "Saliut-4" expedition].

The paper presents the results of studying fluid-electrolyte metabolism and the renal function in A. A. Gubarev and G. M. Grechko after their 30-cay orbital flight. On the R + O day renal excretion of fluid, sodium, potassium and osmotically active subtances decreased. Renal excretion of calcium and magnesium postflight was higher than preflight. Similar, although better pronounced, changes were seen during provocative tests with a water load. One of the factors causing changes in the renal transport of electrolytes postflight could have been an alteration in the ionic composition of the serum, especially a decrease in the potassium concentration and an increase in the calcium and magnesium content. Disorders in the relationship between the function of osmo- and ion regulation systems and dissociation in the renal excretion of individual ions after the 30-day flight that were distinct during tests with a water load seem to be associated with metabolic changes during and after flight rather than with hemodynamic changes.


[Biomechanical criteria of artificial gravitation].

On the basis of the pertinent literature data and their own findings the authors formulate the basic biophysical criteria that should be taken into consideration while developing an artificial gravity system. These criteria can be used to define the range of variations of the main parameters of artificial gravity systems that should be permissible in terms of normal life activity and performance of consmonauts. The numerical values of the parameters should be considered as theoretical guiding lines for the advanced development of artificial gravity systems.


[Use of the method of selective catheterization of the heart and major vessels in biomedical research with the participation of healthy persons].

The paper discusses the application of direct techniques to the study of circulation--catheterization of the heart and central vessels in biomedical experiments with the participation of healthy volunteers and during examinations of pilots, athletes, etc. The experiments showed high informativeness and reliability of the techniques and demonstrated their applicability to the study of gravity effects on the circulation and metabolism of different organs of healthy men as applied to aerospace and clinical medicine. These investigations allow clinical modelling of hemodynamic and metabolic changes that may develop in various organs and tissues in weightlessness, development of pathogenetically substantiated countermeasures against its adverse effects, formulation of certain requirements for artificial organs whose function should be as close as possible to that of natural organs of a healthy man. The paper presents the protocol and results of the first study of the effects of short-term simulated weightlessness on the circulation and metabolism of various organs of a healthy man: brain, heart, lungs, liver, kidneys, and musculoskeletal formations of the lower limbs.


[Morphological manifestations of the functional shifts in the hypothalamo-hypophyseal neurosecretory system and kidneys of rats exposed to the action of space flight factors].

The hypothalamic-pituitary neurosecretory system and the kidneys of rats flown for 22 days and sacrified on the R+1 and R+26 days were studied morphologically. By histological, histochemical and morphometric measurements an increased activity of the hypothalamic-pituitary neurosecretory system and the juxtaglomerular apparatus of the kidneys was shown. The changes were reversible and by the R+26 day returned to normal. The above changes can be induced not only by space flight effects but also by readaptation to 1 g.


[Effect of the orientation of the head in the gravitational field on the intensity of caloric nystagmus].

The relationship between the intensity of the vertical and horizontal caloric nystagmus and the head orientation in the gravity field was studied experimentally. The positions in which the nystagmus reached the highest intensity were identified. The experimental results showed that during caloric stimulation the major contribution to the excitation of semi-circular canals was made by the convective flow of the endolymph which was dependent on the head orientation relative to the acceleration vector. The caloric tests can induce stimulation of vertical semi-circular canals which is comparable to that of horizontal canals in its strength.


[Basic purposes and results of a radiobiological experiment on the "Kosmos-690" biosatellite].

In 1974 the USSR carried out a rat experiment aboard the biosatellite Cosmos-690 equipped with a gamma-emitter. On the 10th flight day rats were irradied with doses of 220 and 800 rad. During the subsequent 10 days radiation damage developed. Similar experiments simulating the flight profile, except for weightlessness, were conducted on the Earth. The resulting data were compared. It is concluded that a short-term (up to 20 days) flight did not modify essentially the radiobiological effect.


[Basic results of the medical research performed during the flight of 2 crews on the "Saliut-5" orbital station].

The paper presents the results of medical examinations of the cosmonauts B. V. Volynov, V. M. Zholobov, V. V. Gorbatko and Yu. N. Glazkov during their 49- and 18-day flights aboard the orbital station Salyut-5. During the prolonged 49-day flight the cosmonauts developed symptoms of asthenization and fatigue. The medical monitoring of the cosmonauts showed increased blood filling of the head veins, increased arterial pressure and cardiac output. No significant changes were noted in the bioelectrical or contractile function of the myocardium. By the end of the flight the 49-day crewmembers showed a 4.5--7.0 kg decrease of body weight. They displayed a decline of orthostatic tolerance. This was especially marked in V. M Zholobov. Postflight biochemical changes were as usual but in the 49-day crewmembers they were more distinct. B. V. Volynov and V. M. Zholobov had moderate counts of protein and cell elements in the urine. It is concluded that space crewmembers ought to adhere strictly to their work-rest cycle and perform actively pressigned exercises.


Structure of a juxtaglomerular cell tumor: the presence of a neural component: a light and electron microscopic study.

A 15-year-old girl with hypertension, markedly elevated plasma renin activity, and normal aortogram had a well encapsulated tumor nodule removed from the right kidney. Following surgery, the plasma renin activity and blood pressure became normal and have remained so for the past 12 months. The tumor consisted of juxtaglomerular cells filling the interstitium between endothelium-lined vascular spaces. Electron microscopy disclosed the presence in the interior of the tumor, of unmyelinated nerve bundles with varicosities containing the small, densely cored vesicles characteristic of adrenergic nerves. Nerve terminals were in contact with the juxtaglomerular tumor cells. No basement membrane material was interposed between the nerve endings and the tumor cell; the width of the gap between the two plasma membranes was approximately 150 A. The presence of sympathetic fibers in the juxtaglomerular cell tumor underscores the close biologic relationship between the sympathetic and renin systems.


Haematological profile in leprosy. Part I--general findings.

Haematological studies in 904 adult leprosy patients with different types of leprosy, in various stages of the disease and treatment are described. Haemoglobin, packed cell volume, serum albumin and serum iron are significantly lower among lepromatous leprosy patients as compared with non-lepromatous patients. The serum B12 levels were significantly higher among the lepromatous group. Acid fast bacilli have been demonstrated in skin smear negative leprosy patients with indeterminate and tuberculoid leprosy, suggesting occurrence of bacillaemia in these groups of patients.


Regularity of dapsone intake by leprosy patients attending urban treatment centre.

Dapsone/Creatinine in urine ratios were determined in statistically randomised samples of 965 leprosy patients attending out-patient department of Acworth Leprosy Hospital and 44 inmates of the Hospital. The percentage of irregularity in DDS treatment was found in 43 and 22.6 respectively in out-patients and inmates of the Hospital. The need to assess the possible response for irregularity in treatment is stressed and the hazard of infectious cases remaining without treatment or with incomplete treatment is pointed out.


[Study of the pulsation method for the hygienic treatment of underwear].

Hygienic processing of the underwear in a device combining mechanical treatment, forced pumping of the washing solution and wringing by compressed air can be used under special conditions. The basic parameters of the engineering process have been determined, viz.: the number of washing baths, temperature of the water, time of processing, etc.


Liver function in leprosy.

Thirty eight patients of leprosy were classified on the basis of clinical and biopsy findings into 10 lepromatous (all reactional), 20 tuberculoid (7 in reaction) and 8 dimorphic (5 in reaction). The liver function tests--serum proteins, albumin/globulin ratio, fractions in paper electrophoresis, serum glutamic pyruvic transaminase (SGPT) and thymol turbidity tests--and the serum cholesterol was estimated in each patient. The abnormalities were a reversal of the albumin/globulin ratio in all the three groups and an increase in beta/globulin fraction in the lepromatous group, but total proteins were within normal limits. The thymol turbidity test showed moderately elevated levels in all three groups. SGPT was slightly raised in a few cases. Only a single patient with tuberculoid leprosy showed serum cholesterol to be over 250 mg per 100 ml.


[Importance of the "knocking" symptom in detecting peptic ulcer in flight personnel].

In order to diagnose peptic ulcer, the "percussion" symptom in the right hypochondrium at the inhalation level was used in the flying personnel, aged 19-45. Peptic ulcer, specifically duodenal ulcer in the acute stage was diagnosed in 75 persons and in the remission stage-in 69 persons. The control group consisted of 29 healthy subjects. The diagnostic importance of this symptom was shown. It was found in 29.3, 14.5 and 3.4% of cases, respectively. In 8 subjects who concealed complaints or showed an atypical development of the disease there was a sharp response to "percussion" that suggested peptic ulcer which was confirmed by X-ray studies.


Role of the membrane potential in serum-stimulated uptake of amino acid in a diploid human fibroblast.

The Na+-dependent accumulation of alpha-aminoisobutyric acid (AIB), measured in normal growing and quiescent (serum-deprived) HSWP cells (human diploid fibroblast), was found to be twofold higher (AIB/in/AIBout = 20-25) under the normal growing conditions. Serum stimulation of quiescent cells increases their AIB concentrating capacity by approximately 70% within 1 hr. These observations suggest that the driving forces for AIB accumulation may be reversibly influenced by the serum concentration of the growth medium. Addition of valinomycin (Val) to cells preequilibrated with AIB causes an enhanced accumulation of AIB, suggesting that the membrane potential can serve as a driving force for AIB accumulation. After preequilibration with AIB in 6 mM K+, transfer to 94 mM K+ with Val results in a marked and rapid net loss of AIB. The effect of Val on the accumulation of AIB is greatest in quiescent cells, with the intracellular AIB concentrations reaching those seen both in Val-stimulated normal cells and in Val-stimulated serum-stimulated cells. By adjusting [K+]0, in the presence of Val, the membrane potential of growing cells can be matched to that of quiescent cells or vice versa. When this is done, the two accumulate AIB to the same extent. Hence the AIB accumulating capacity is characteristic of the membrane potential rather than of the growth state. In summary, these data suggest that the accumulation of AIB in HSWP cells is influenced by changes in membrane potential and that a serum-associated membrane hyperpolarization could be responsible for the increased capacity for AIB accumulation in serum-stimulated cells.


The cephalosporins.

Cephalosporin antibiotics are bactericidal against most gram-positive cocci and many gram-negative bacilli of clinical importance. They are relatively nontoxic but share with penicillins a tendency to elicit hypersensitivity reactions. They are indicated in certain instances for treatment of infections in patients with penicillin allergy and are frequently chosen as one of the agents in an empiric program in life-threatening infections. Cephalosporins should not be used in infections caused by group D enterococcal streptococci, Pseudomonas aeruginosa, or Bacillus fragilis, Newer cephalosporins soon to be available have a somewhat wider gram-negative spectrum; however, as with all members of this family of drugs, in vitro susceptibility must be established.


Vancomycin.

Vancomycin, a useful bactericidal antibiotic for selective clinical infections, is the therapy of choice for serious staphylococcal infections when the penicillins and cephalosporins cannot be used. The antibacterial spectrum of vancomycin also covers other gram-positive cocci and bacteria and gram-negative cocci. Vancomycin is given intravenously in most cases, usually in a dose of 1 g every 12 hours in patients who have normal renal function. The indications for vancomycin therapy are as follows. 1. Serious staphylococcal infections in patients who are intolerant to the penicillins and cephalosporins or when the organism is resistant to the commonly used bactericidal agents. 2. Streptococcal endocarditis in patients intolerant to penicillin G; in enterococcal infections, it is used with an associated aminoglycoside. Vancomycin is not used alone in enterococcal endocarditis. In nonenterococcal (Streptococcus bovis) and viridans streptococcal endocarditis, vancomycin may be used alone if the minimum bactericidal concentration is less than or equal to 10 microgram/ml; otherwise, it is combined with an aminoglycoside. 3. Other serious infections caused by organisms resistant to the commonly used agents such as corynebacterial endocarditis. 4. Acute staphylococcal ileocolitis, for which vancomycin is given orally or orally and intravenously if indicated. Vancomycin is relatively nontoxic; the predominant toxic response is neurotoxicity, but this is rarely seen if the serum levels are 30 microgram/ml or less.


Tetracyclines, chloramphenicol, erythromycin, and clindamycin.

Tetracyclines are active in vitro against most urinary tract pathogens, Chlamydia, Mycoplasma pneumoniae, Brucella, rickettsiae, and Nocardia. Chloramphenicol is used primarily for anaerobic infections, Haemophilus influenzae meningitis, and infections due to Salmonella typhi. Erythromycin is active in vitro against M. pneumoniae, Streptococcus pneumoniae, and group A beta-hemolytic streptococci. Erythromycin may be used as prophylactic therapy for subacute bacterial endocarditis and for recurrence of acute rheumatic fever in patients who are allergic to penicillin. Clindamycin should be used only for the treatment of anaerobic infections. Tetracycline may cause gastrointestinal upset; phototoxic dermatitis; hepatitis, especially in pregnant females; discoloration of teeth and bone dysplasia in the human fetus and children; and suprainfections, especially oral and anogenital candidiasis. Tetracycline should be used with caution in patients with renal insufficiency. The most important toxic effect of chloramphenicol is bone marrow suppression, which is dose related and idiosyncratic. The incidence of undesirable side effects associated with the use of erythromycin is low. Gastrointestinal irritation is the most common; cholestatic hepatitis may occur with erythromycin estolate. Pseudomembranous colitis is the most important toxic effect associated with clindamycin.


Pleuropulmonary manifestations of ankylosing spondylitis.

In published reports, the incidence of pleuropulmonary involvement in ankylosing spondylitis varies from 0 to 30%. A review of the records of 2,080 patients with ankylosing spondylitis disclosed 28 who had pleuropulmonary manifestations that we believe are typical of those associated with ankylosing spondylitis (an incidence of 1.3%). Among these 28 patients, the most common abnormality was upper lobe fibrobullous lesions. Five had aspergillomas and two had infections-one caused by Mycobacterium kansasii and one by Mycobacterium avium. Three patients had transient pleural effusion of an exudate with normal sugar content. Two had nonspecific pleuritis, found on pleural biopsy. Thoracotomy for aspergilloma was followed by bronchopleural fistula in one of two cases--approximately the ratio found in the literature.


Pyloric antral mucosal webs.

The current literature on pyloric antral mucosal webs was reviewed. In addition, seven patients in the Mayo Clinic experience with pyloric antral mucosal webs are reported on. In recent years, four patients with significant obstructive symptoms thought to be caused by a mucosal web have had the diagnosis confirmed at surgery and have had excellent results from a variety of surgical procedures.


A sporadic case of pneumonia due to legionnaires disease.

A recently recognized sporadic case of "legionnaires' disease" occuring in Minnesota is described. The patient, a previously healthy 58-year-old woman, became seriously ill with progressive pneumonia in the spring of 1977. Her illness was unresponsive to the usual antibiotics (penicillin and cephalothin) prescribed for community-acquired bacterial pneumonia. Treatment with doxycycline appeared to be effective. Diagnosis was made by special serologic studies performed at the Center for Disease Control, Atlanta. As reported in the epidemic form of the disease, no secondary cases were noted in family, associates, or hospital workers exposed to the patient during her acute illness. This disease may be more common than has previously been recognized, for serologic test for the unusual bacterium have only recently become available.


Congenital papillary tumor of the tricuspid valve. An unusual cause of right ventricular outflow obstruction in a neonate with trisomy E.

A trisomy E neonate had congenital cardiac anomalies that included a ventricular septal defect, a bicuspid aortic valve, and a congenital papillary tumor of the tricuspid valve. The large papillary tumor was responsible for severe intermittent pulmonary outflow obstruction. The cause and pathogenesis of these rare papillary tumors are unknown, but they are probably related to the more sessile varieties of congenital valvular dysplasia. The life-threatening obstruction to blood flow caused by the congenital valvular tumor probably can be alleviated by simple surgical resection. This type of tumor should be considered in the differential diagnosis of atypical forms of outflow tract obstruction.


Organizational socialization of hospital employees. A comparative view of occupational groups.

As the delivery of high-quality medical care becomes increasingly dependent on the attitudes and behaviors of health care workers, more analysis of personnel programs designed for hospital employees is needed. This research examines the organizational socialization of hospital employees--the ways in which employees are attracted to, recruited by, and developed and trained within hospitals. Using interview and questionnaire data collected from one hundred eighteen hospital employees (nurses, nurse's aides, radiology technologists, tradesmen, and accounting clerks), the research first identifies three distinct stages of socialization and specifies the activities engaged in by employees at each stage. Secondly, the research identifies four variables as possible outcomes of the socialization process (general satisfaction, mutual influence, internal work motivation, and job involvement) and empirically links important aspects of the socialization process to those outcomes. Finally, some differences between the experiences of professional, paraprofessional, and nonprofessional workers are identified and explained, and implications for the conduct of hospital socialization programs are drawn.


British postgraduate medical training and inpatient medical care in the United Kingdom.

British postgraduate medical training practices are reviewed. Because of the method of appointment and the type of positions available, there is a tendency toward fragmentation of training experience and of doctor-patient association in the early period of training. The commitment of the National Health Service to provide junior hospital staff to each senior clinician taking care of patients, combined with the scarcity of senior positions in the National Health Service, tends to increase the influx of junior trainees from outside Great Britain. These immigrant physicians are frequently responsible for the bedside care of patients, but they have only a minimal hope of progressing to a permanent senior post in the National Health Service. As a result, patients receive a good deal of the care from clinician-trainees who will never qulify at the top level of British medicine. On the other hand, the organization of the inpatient training program provides a high degree of flexibility for the trainee, and a better chance to follow patients through the vicissitudes of their disease than does the American system.


Foreign medical graduate performance--a review.

Numerous factors have adversely influenced appraisals of the competence of foreign medical graduates. The statistical design of some comparative studies has been weak. Language and cultural backgrounds of foreign graduates have varied. Foreign physicians who have complete school at various times in the past have been graded according to a test designed to be taken during the fourth year of American medical schools. Licensing examinations and grading have varied from state to state. To reach reliable conclusions, matched samples of adequate size must be studied under controlled conditions.


A nurse rehabilitator's impact on patients with myocardial infarction.

A nurse rehabilitator, supplementing routine physician/nursing coronary care unit (CCU) care, was found to be effective in increasing the return to work rate (p less than .05) and decreasing smoking (p less than .05) in a randomized trial of 102 patients with acute myocardial infarction (MI). These outcomes were thought to be due to the nurse rehabilitator's efforts in increasing patient knowledge of heart disease (p less than .01) and individual counseling.


Private practice in the public sector: a unique relationship among local government, physicians, and health care consumers in Cincinnati.

Because of health care inequities that still persist under federal and state sponsorship plans, many local government agencies are starting to consider ways of directly providing medical services to the poor. Over 100 years' experience with direct provision programs in the City of Cincinnati, however, have been ultimately counterproductive. A unique three-way contract developed by the Board of Health, a private multispecialty physicians' group and a consumer advocate organization has recently allowed Cincinnati to implement a delivery system that integrates mechanisms for prepaid public health care into a fee-for-service private group practice, all within the context of a community-based neighborhood health care facility. While it is still too early to make a full evaluation of this public health care group practice model, there are already indications that is services will be superior to those offered in Cincinnati's traditional public clinics.


Two measures of nurses' attitudes toward abortion as modified by experience.

Random samples of nurses in two states which differed in abortion statues were sent questionnaires. Content areas included experience with 12 specific nursing activities associated with abortion, willingness to participate in the same activities, and extent of agreement with statements related to abortion. Attitudes toward abortion were inferred from the willingness-to-participate items and from the agreement section. These two measures correlated highly suggesting a common underlying dimension. However, the two samples differed significantly in extent of agreement but did not differ in willingness to participate. These results were interpreted as supporting the position that attitudes derived from items using situational contexts might bear a better relationship to behavior. The findings also suggest that abortion facilities can probably be staffed without violating personal preferences since so many expressed willingness to participate in at least some of the activities. Comparison across the two samples suggest that increased experience or even the potential for experience with abortion patients tended to increase the favorableness of attitudes toward this issue.


An outcome evaluation of counseling services provided by abortion clinics.

With the reduction in need for elective abortion as a long-term goal, the effectiveness of abortion clinic counseling programs provided at the time of elective pregnancy termination is evaluated using post-abortion contraceptive behavior as a measure. Using eight, free-standing abortion clinics located in Chicago, Illinois a control group design is employed in order to examine the hypothesis that patients attending clinics which provide a structured, comprehensive birth control counseling session at the time of their abortion will show a higher use rate of effective contraceptive methods than those patients attending clinics which do not provide such information. Results support this hypothesis. The differences are particularly noticeable in the subpopulation of teenagers with no preabortion history of contraceptive use.


Lipid synthesis in cultured human embryonic fibroblasts.

We describe here the pathways by which human embryonic fibroblasts synthesize lipids. In these studies, we quantitated the phospholipds by their phosphorus content and by their acyl components. These determinations defined both the chemical composition of the cellular membranes as well as their metabolic turnover. Using radiolabeled precursors, we have shown (a) synthesis of the glycerol moiety via glycolysis and the action of glycerokinase, (b) utilization of both exogenously added and endogenously synthesized fatty acids, (c) synthesis de novo of phosphatidyl choline and phsphatidyl ethanolamine from their base precursors, and (d) the methylation of phosphatidyl ethanolamine yielding phosphatidyl choline. Dividing cells synthesized phosphoglyceride more rapidly than cells in the stationary phase. However, considerable turnover of cellular lipid did occur in the stationary phase.


Effect of contraceptive steroids on arginine-stimulated glucagon and insulin secretion in women. III. Medroxyprogesterone acetate.

The effect of medroxyprogesterone acetate (MPA) on basal circulating lipids, arginine-stimulated glucagon and insulin secretion, and glucose tolerance was studied in normal women. After 5 days of oral MPA treatment (10 mg/day), there was a small but significant decline in basal circulating triglycerides. No changes were observed in fasting plasma concentrations of cholesterol, free fatty acids, glucagon, insulin, or glucose; in the plasma glucagon, insulin, or glucose responses during L-arginine infusion; or in the plasma insulin or glucose responses during oral glucose tolerance tests. There was no correlation of any of these parameters with the observed decline in fasting plasma triglyceride concentrations. These results confirm previous reports of no consistent changes in lipid or glucose homeostasis in women using derivatives of 17alpha-acetoxyprogesterone derivatives for contraceptive purposes, and suggest that MPA may be a suitable alternative for those women who develop hyperlipemia or glucose intolerance when they use contraceptive agents which contain derivatives of ethinyl estradiol and nortestosterone.


Triiodothyronine and thyroxine content of desiccated thyroid tablets.

Triiodothyronine (T3) and thyroxine (T4) were measured by radioimmunoassay in Pronase hydrolysates of four lots each of 1- and 2-grain tablets of desiccated thyroid (Thyroid, Armour) and thyroglobulin (Proloid, Warner-Chilcott). The methodology used was verified by studies of tablets containing known quantities of T4 and T3. One grain of desiccated thyroid contained 12 +/- 1 and 64 +/- 3 microgram (mean +/- SD) of T3 and T4 per tablet, respectively (T4/T3 molar ratio, 4.3). A 1-grain tablet of thyroglobulin contained 16 +/- 2 and 55 +/- 5 microgram of T3 and T4, respectively with a T4/T3 ratio of 2.9. Two-grain tablets generally contained twice the quantity of T3 and T4 in the 1-grain preparations. The variation in T3 and T4 content between the four lots of each tablet strength for each product was 10% or less. These estimates of T3 and T4 content are 1.5- to 2-fold greater than those previously published. This difference probably results from the more sophisticated methodology now available which does not require chromatographic separation of T3 and T4 or iodometry. Using calculations based on published estimates of T4 and T3 absorption and of the T3/T4 potency ratio, it would appear that the T3 content of desiccated thyroid and thyroglobulin provide approximately 39% and 51%, respectively, of the thyromimetic activity of these two medications.


Fructose-induced hyperuricemia in essential hypertension.

A rapid intravenous fructose load was given to nine normouricemic essential hypertensive and eight control subjects. The following increase in plasma uric acid concentration was significantly higher in hypertensives than in controls. There was no significant difference in urinary excretion of urate between the two groups. Since the increase in uric acid concentration brought about by fructose is most probably due to an increased metabolism of preformed purine nucleotides, it is suggested that essential hypertensive patients have a higher than normal "pool" of purine nucleotides.


Development of fasting hyperglycemia in uremic rats.

Rats which had been fasted for the previous 24 hr were subjected to either sham surgery, bilateral nephrectomy, or bilateral ureterotomy. The fast was continued for another 24 hr before the animals were decapitated and blood was obtained for determination of serum glucose, insulin, and urea nitrogen levels. A moderate but statistically significant (p less than 0.02) fall in serum glucose levels occurred in rats made uremic by bilateral nephrectomy. In contrast, rats made equally uremic by bilateral ureterotomy developed a significant (p less than 0.001) elevation of both serum glucose and insulin levels. The combination of hyperglycemia and hyperinsulinemia suggested that insulin resistance had developed in these rats, and this was confirmed by demonstrating that the hypoglycemic effect of exogenously administered insulin was attenuated in rats following bilateral ureterotomy as compared to sham-operated rats. Unilateral ureterotomy did not lead to the same metabolic response, and the difference in serum glucose levels between sham-operated and bilaterally ureterotomized rats disappeared when a 5% glucose solution was substituted for tap water as the rat's drinking water. It is suggested that the coexistence of fasting and metabolic acidosis led to increased renal gluconeogenesis in rats subjected to bilateral ureterotomy, and the combination of increased renal glucose production and insulin resistance was responsible for the development of fasting hyperglycemia.


Fate of tobacco mosaic virus after entering the host cell. III. Partial uncoating.

Diminutive viral RNAs recovered from tobacco leaves inoculated with 32P-TMV were investigated. At 3.5 hr after inoculation, most of the viral RNA without coat protein revealed two peaks after sucrose density gradient analysis of SDS-extract from 12,000 X g leaf pellet. The first peak appeared between bacterial ribosomal RNA of 16 S and 5 S and the second peak was around 5 S. These two peaks were digestible with RNase and they appeared as early as 5 min after inoculation. These diminutive RNAs seemed to be derived from partially uncoated parental virus by abscission of their naked RNA tails. The active formation of these diminutive RNAs and their early appearance after inoculation seemed to indicate that most of the inoculated TMV received incomplete uncoating.


Studies on the pathogenicity of Yersinia enterocolitica. I. Experimental infection in rabbits.

Analysis of the pathogenicity of Yersinia enterocolitica was performed with an experimental model successfully produced in rabbits by intraduodenal inoculation with strains isolated from various sources. Pathogenic strains easily penetrated the epithelial linings of the intestinal mucous membrane into the target reticuloendothelial tissues of the intestine, such as the lamina propria and lymph follicles, where they multiplied within mononuclear cells and produced granuloma. Granuloma, in severe infections, underwent necrobiosis and sometimes progressed to ulceration accompanied by colony formation of the organisms. In mild infections, granulomatous lesions were localized in lymph follicles and never progressed to ulceration. Nonpathogenic strains were rapidly excreted without penetration of epithelial linings. Y. enterocolitica should be within the category of invasion type enteropathogenic bacteria such as Shigella and Salmonella. Pathogenic behavior of Y. enterocolitica is discussed in comparison with that of Shigella and Salmonella.


Studies on the pathogenicity of Yersinia enterocolitica. II. Interaction with cultured cells in vitro.

Analysis of the pathogenicity of Yersinia enterocolitica was performed by means of cell culture studies on the interaction of the organisms with HeLa cells and rabbit peritoneal macrophages based on observations of the pathogenic behavior of the organisms in vivo (II). The pathogenic strains, which successfully produced experimental enterocolitis in rabbits (II), had the ability to penetrate HeLa cells and to survive or multiply within the macrophages. The nonpathogenic strains, lacking the ability to produce pathological changes in rabbits (II), failed to penetrate HeLa cells, except for one strain, and also to survive totally or multiply within the macrophages. It was evident that the abilities of the organisms to penetrate epithelial linings which serve as the barrier of intestinal mucosa and to survive or multiply within the host cells appears to be closely related to the pathogenicity of Y. enterocolitica.


[Possibility of using light of different wavelengths for growing Chromatium vinosum in heterotrophic conditions].

The photoautotrophic purple sulphur bacterium Chronatium vinosum was found to be capable of heterotrophic growth under anaerobic conditions at the expense of light energy. No growth was detected under anaerobic conditions in the absence of light. The energy of monochromatic red light (715, 726, 739, 776, 815 nm) and green light (534 and 535 nm), as well as of green luminescent light (a broad maximum at 500-560 nm, a peak at 520 nm) and white light, was used by the bacterium for the growth under anaerobic conditions in the presence of acetic acid as a sole source of carbon. The rate of biosynthesis of the cellular matter, proteins and pigments (bacteriochlorophyll and carotenoids) was different depending on the spectrum: light having wavelengths of 534, 535 and 715 nm was favourable, and infrared light having a wavelength of 815 nm was most effective. The heterotrophic growth of the bacterium depended also on the intensity of light, the optimum energy being 14-10(3)-20-10(3) erg/cm2/sec.


[Properties of the respiratory system of Endomyces magnusii at different stages of development].

The respiration activity and the cytochrome content of the cells of Endomyces magnusii were studied during growth on a medium with 0.6 per cent sucrose. The rate of oxidation, the ration between the activities of respiration and fermentation, the quantitative content and molar ration of cytochromes remained almost the same in the course of growth. Only cytochrome oxidase was involved at the terminal stage of oxidation in the course of growth: the respiration of the cells was inhibited by 90-95 per cent by cyanide, but was resistant to the action of salicyl hydroxamate which was an inhibitor of an alternative pathway of oxidation. Mitochondria from cells harvested at the middle of the logarithmic growth phase almost did not differ in parameters from mitochondria relative to the stationary growth phase: they were tightly coupled and had the theoretical effectiveness of oxidative phosphorylation typical of oxidation of NAD-dependent substrates. All the three points of energy coupling are supposed to function at the earliest phases of growth. Endomyces magnusii differs from other yeasts in following characteristics: the absence of glucose repression, a high constant level of respiration activity, the maximum effectiveness with which the coupling apparatus functions at the earliest phases of growth, and the absence of alternative oxidation pathways.


[Relation of proteolytic activity to the ability to assimilate higher n-alkanes in Pseudomonas denitrificans].

A correlation between proteolytic activity and the ability to assimilate higher n-alkanes was found while studying proteolysis of gelatin by 284 paraffin-negative mutants of Pseudomonas denitrificans. The mutants were produced by a paraffin-positive strain capable of gelatin proteolytis, but not growing on glucose. If assimilation of the oxidized derivatives of higher n-alkanes, viz. alcohols and aldehydes, is interfered with at a genetical level, the percentage of mutants possessing extracellular proteolytic activity decreases (44 per cent of the mutants have lost the activity) whereas the percentage of mutants capable of glucose assimilation increases. Proteolytis of gelatin can be used as a test for a preliminary selection of strains to be employed in industrial synthesis of the oxidized derivatives of higher n-alkanes, as well as in the control of stability and homogeneity of a population under industrial conditions.


[Physiological and biochemical properties of Actinomyces kurssanovii, active producter of chitinase].

Chitinase biosynthesis by Actinomyces kurssonovii 75 was studied under conditions of periodic cultivation in a laboratory fermenter. The activity of components of the chitinolytic complex correlated with the growth phases of the culture. The activity of chitobiase (beta-N-acetylglucoseaminidase) predominated in the cultural broth in the exponential growth phase of the culture; it decreased later by 40-50 per cent, while the activity of chitinase became maximum. The biosynthesis of chitinolytic enzymes by the growing actinomycete was accompanied with a rapid hydrolysis of demineralized crab shells, and a gradual increase in the pH of the medium to 9.0. A chitinolytic preparation obtained from the supernatant of the cultural broth of Act kurssanovii hydrolysed ground chitin by 70-80 per cent during 5 days. Fe2+ and Ca2+ ions increased the activity of the preparation by 25 and 30 per cent respectively; Mn2+ ions decreased the activity by 40 per cent.


[Amino acid composition of Actinomyces mycelium].

The mycelium of actinomycetes cultivated on different media contained 15-16 amino acids of an identical qualitative composition. The percentage of amino acids depended on the composition of a growth medium. Under conditions of our experiments, a chemically defined medium was most favourable for the synthesis of the following amino acids: alanine, hystidine, glutamic acid, leucine, and valine.


[Membrane composition of Actinomyces hygroscopicus in the course of growth and development].

The membranes of actinomycetes do not differ from the membranes of other prokaryotes in the content of lipids, proteins, carbohydrates, and RNA, Lipids are represented mainly by phospholipids, particularly by phosphatidyl ethanolamine, cardiolipine, and phosphatidyl glycerol. The fatty acid composition of phospholipids does not change in the course of growth, and is represented by 80 per cent with branched fatty acids having 15-17 carbon atoms. Over 20 fractions are found in proteins isolated from the membranes of actinomycetes grown for 1-3 days and studied by means of electrophoresis in polyacrylamide gel, and only 7-8 fractions, in the membranes of actinomycetes cultivated during 5-7 days.


[Coccoid cells and spheroplasts in cultures of the genus Thermus].

The formation of capable of self-reproduction coccoid cells, and of spheroplasts, was studied in the cultures of Thermus ruber and pigmentless Thermus sp. by light and electron microscopy. The primary origination of cocci might be due to non-uniform or multiple cell division. Spheroplasts can be produced either from coccoid or from rod-like cells as a result of autolysis of the glycopeptide layer of the cell wall. The spheroplasts of the cultures belonging to the Thermus genus are characterized by osmotic stability and a peculiar appearance due to a strongly developed periplasmic space and the eccentric arrangement of the protoplast in it.


[Morphogenesis and function of gas caps on spores of anaerobic bacteria of the genus Clostridium].

Contrary to other bacteria, those belonging to the genus Clostridium have their formation of vacuoles being strictly confined to the stage of spore production. In Clostridium, gas vacuoles are formed in the intraexosporial space, i. e. in the cytoplasm between the exosporial membrane and spore coats. Gas caps, being conical accumulations of gas vacuoles, impart increased floatation to spores and favour therefore their distribution in nature. Consequently, Clostridium species have ecological advantage if they can form gas vacuoles. The function of the exosporium and specific rod-shaped appendices of spore coats is discussed.


[Formation of prototrophic colonies during crossing of deficient mutants of Aspergillus niger].

Deficient mutants of Aspergillus niger were obtained under the action of high doses of mutagens, viz. nitrosomethylurea, ethyleneimine, UV and gamma-rays, and their combinations. If the mutants to be crossed were derived from one and the same strain, prototrophous colonies of heterokaryons grew on a minimal medium, the frequency of their formation being 2-10(-7)-5-10(-7). If the mutants were obtained from different strains, heterokaryons appeared only in 40 per cent of crossings. Heterokaryons derived from mutants characterized by a low activity produced more acids. Heterokaryons obtained by crossing mutants with a high and a low activity had a higher productivity than a parent with a low activity, but a lower productivity than a parent with a high activity.


[Electron microscopic study of spore formation in Actinomadura verrucosospora].

The formation of spores was studied with a morphologic type of the Actinomadura genus, Acd. verrucosospora (Nonomura a. Ohara, 1971. Spore formation begins with the division of a hypha by cross-partitions which, as a rule, appear as monolayered on cross-sections, thus differing from sporulation septae found in other actinomycetes. The structure and shape of septae change in the course of spore formation: first, they consist of one layer and have the same thickness as the cell wall; later, they consist of several layers and their thickness is uneven (the shape of dumbbels). In the course of spore maturation, thick regions of the septae are destroyed. Mature spores are characterized by the presence of vacuoles, the thichened cell wall and outer sheath; the latter bears rounded structures arranged in conglomerates which resemble grapes. The process of sporogenesis and the structure of spores in Actinomadura verrucosospora differ from those in other species of the Actinomadura genus (Williams et al., 1974; Soina et al., 1975); therefore, this genus of actinomycetes is heterogenous.


[Relation of cell wall growth and conjugation to the cell division cycle in Schizosaccharomyces pombe].

The growth of the cell wall to Schizosaccharomyces pombe was studied by fluorescent microscopy and time-lapse microcinematography. The growth of individual cells was found to be bipolar and sharply asymmetrical. The two poles had different sequence of growth which depended on the functionation of the cell cycle. Findings concerning the growth of the poles were used for investigating the topography of the surface of zygotes. The formation of conjugation protuberances was not related to a certain pole and did not depend on its growth state. Some aspects of the cell cycle dependence of the cell wall growth and conjugation in Schizosaccharomyces pombe are discussed.


[Polylysogeny in Bacillus thuringiensis var. Galleriae cultures].

The culture of Bacillus thuringiensis var. galleriae was shown to be polylysogenic. As has been found earlier, the culture has a phage with the original structure of particles whose tail possesses a special substructure called a "collar". The phage was described in detail as a phage of Bac. thuringiensis 1-97 with a "collar". Further studies of the culture of Bac. thuringiensis var. galleriae 1-97 has shown that it also contains another phage which differs sharply from the first one in the morphology of particles, the spectrum of lytic action, and other properties. Electron microscopy of the cultural fluid of the Bac. thuringiensis var. galleriae cultures has revealed in them the presence of different amounts of the particles of both morphological types found in the strain 1-97. These data suggest that the cultures of Bac. thuringiensis var. galleriae are polylysogenic. The methods for the isolation of the new phage are described.


[Change in phage sensitivity in Rhizobium meliloti transformants].

Cultures of Rhizobium meliloti were studied in order to test their phage resistance. Seven variants of the modification of phage resistance were found among the transformants under study, and an attempt was made to interpret them.


[Production of isolated colonies in Blakeslea trispora].

The effect of several compounds on the growth of Blakeslea trispora producing beta-carotene was studied on solid nutrient media. The paramorphous action was manifested by beta-ionone in the presence of sunflower oil. L-sorbose and beetroot pectin. Continuous growth of the fungus was changed into colonial growth by using a bilayered wort-agar medium. Mutants of Blakeslea trispora having compact type of growth have been isolated.


[Lactobacilli of freshwater fishes].

Normal microflora in the intestinal tract of fishes inhabiting fresh-water reservoirs includes lactic bacteria. The number of the bacteria depends on the animal species, the composition of food, the age, and the season. The highest number of these microorganisms (hundreds of millions per gram of the intestinal content) is found in carps. Enterococci are most often encountered in fishes inhabiting ponds: Streptococcus faecalis Andrewes a. Horder, Str. faecium Orla-Jensen, Str. bovis Orla-Jensen. Lactobacilli are more typical of fishes in water reserviors: Lactobacillus plantarum (Orla-Jensen) Bergey et al., L. casei (Orla-Jensen) Hansen a. Lessel, L. casei var. casei, L. casei var. rhamnosus, L. Casei var. alactosus, L. leichmannii (Henneberg) Bergey et al., L. acidophillus (Moro) Hansen a. Mocquot, L. Fermenti Beijerinck, L. cellobiosus Rogosa et al., L. Buchneri (Henneberg) Bergey et al. The content of lactic bacteria varies in water reservoirs; their highest content is found in ooze (tens of thousands per gram).


Possible usefulness of screening for hyperlipidaemia.

Screening for coronary risk factors is one approach to the prevention of premature coronary disease. Its usefulness will depend on the effectiveness with which identified risk factors can be dealt. This report describes the operation of a Risk Evaluation Service that screens for hypertension and hyperlipidaemia and offers dietary advice to individuals found to be hyperlipidaemic. It was found that 33% of men and 36% of women weighed more than 10% above ideal body weight. Serum cholesterol values of 6-4 mmol/l. (250 mg/100 ml) or above were found in at least one-quarter of men and women above the age of 40 years. Hypercholesterolaemia, defined in this way, responded readily to appropriate dietary advice (75% of men and 64% of women attained normal cholesterol levels in four to six weeks: mean pretreatment cholesterol level being 7-2 mmol/l. and 7-4 mmol/l. for men and women, respectively, mean post-treatment cholesterol level being 5-9 mmol/l. and 6-4 mmol/l. respiectively). The response was less impressive for cobined hyperlipidaemia and hypertriglyceridaemia (about one-half attained normal values in four to six weeks), possibly owing to insufficient time for adequate weight loss to have occurred. These data confirm the high prevalence of hyperlipidaemia in middleaged Australians and suggest the simple dietary conselling will frequently correct hypercholesterolaemia at least in the short term.


[Microbiological characteristics of Lake Turali].

The Turali Lake is a salt-water reservoir. The high salt content of water and ooze determine the microflora of the lake. The total bacterial number is lower in the summer than in the winter when the salt concentration in the lake decreases. The highest number of bacteria and sapropnytes is found in the spring. As a result of the high salt concentration in the water and ooze of the Turali Lake, the following physiological bacterial groups are partly or entirely absent: Azotobacter, Clostridium pasteurianum, hydrocarbon-oxidizing, methanol-producing and sulphate-reducing bacteria.


Elevated serum alkaline phosphatase level may aid in the diagnosis of pancreatitis.

Ten cases of pancreatitis with elevated serum alkaline phosphatase (SAP) levels are reported. Patients with chronic or relapsing pancreatitis may at times develop increased SAP levels, either with or without definitive biochemical evidence of pancreatic disease. SAP estimation may assist in establishing a clinical diagnosis in cases of abdominal pain in which pancreatitis is suspected.


Evaluation of automated multiphasic health testing of referred patients by general practitioners.

Seventy-eight general practitioners provided clinical follow-up reports on 752 patients whom they had referred to the Shepherd Foundation, Melbourne, for automated multiphasic health tests (AMHT). One or more new diagnoses were reported in 270 cases (36%). The yield of new diagnoses made as a result of AMHT was a function of sex, but not of age or pre-referral status. Additional useful information relevant to a previously known diagnosis was reported in 234 cases (31%) and other benefits in 185 cases (25%). Patients were significantly reassured in 623 cases (83%) while disadvantages were reported in 41 cases (5%).


[Electrophoretic characteristics of the protein composition of mutant forms of pea nodular bacteria].

A water-soluble protein fraction was studied by gel electrophoresis in the parent and mutant forms of the nodule bacterium Rhizobium leguminosarum. The composition of this fraction changed under the action of NTG. Changes in the composition of protein components in the mutants as compared with that of the parent strain are caused presumably by their modified specificity.


Traumatic basal subarachnoid haemorrhage.

A case of traumatic basal subarachnoid haemorrhage and fractured mandible following a blow to the neck is described. The characteristic findings exhibited were diastasis of the atlanto-occipital joint with subluxation of the right side of the first cervical vertebra, in the absence of a demonstrable abnormality of the cerebral circulation.


A mechanism of tumourigenesis: retrodifferentiation and reontogeny in cancer and its clinical significance.

A general theory for the origin and maintenance of the neoplastic state in tissues is presented. Cancer is described as a disease of abnormal cell and tissue differentiation, and its underlying cause is identified in the process of blocked reontogeny. Data are presented which support this hypothesis and show the striking similarities at the molecular level between neoplastic, embryonic and regenerating tissues. The hypothesis suggests that numerous potentially useful (in the clinical sense) proteins, all of them members of early development, may be associated with neoplasms. It is suggested that research aimed at extending the identification and measurement of these proteins will make a significant contribution to the clinical management of cancer and may lead to the development of easy and cheap screening techniques for the early diagnosis of neoplastic disease in man.


Changes in the circulating thyroid hormones during anaesthesia and thyroid surgery.

The circulating thyroid hormones were found to respond to general anaesthesia and surgery of the thyroid gland in a similar manner to that reported with general surgery. When compared with the preoperative plasma concentration, the post-operative thyroxine levels showed a significant rise, whereas the triiodothyronine level fell.


Poor diagnosis of cystinuria in New South Wales.

The case histories of 33 stone-forming cystinurics were analysed with respected to the time taken for the diagnosis of cystinuria to be made. Stone analysis showed that 17 patients were diagnosed at the  time of first stone formation, but the other 16 patients were not diagnosed until they had suffered repeated episodes of calculi. There were 25 episodes of renal colic in 14 patients before any stone formation, and there was no case of cystinuria diagnosed as the result of a search for the cause of the renal colic.


Group education after myocardial infarction: Is it effective?

An analysis of the results of a study of a group of post-infarction patients who had received group instruction concerning the nature of myocardial infarction, compared with patients not so instructed, is presented. Contrary to expectation, anxiety levels as measured by the Catel IPTA Anxiety Scale were significantly higher in patients who experienced group education. Regardless of this finding, patients were subjectively appreciative of education.


Agranulocytosis due to dapsone.

A case of agranulocytosis due to dapsone administered for the treatment of acne vulgaris is described. Agranulocytosis has previously been reported after administration of dapsone for other dermatological disorders, leprosy, and prophylaxis against falciparum malaria. The frequency of agranulocytoses when dapsone was used for malaria prophylaxis in United States servicemen in Vietnam was sufficient to result in its withdrawal from use for this purpose. Caution should therefore be exercised in the administration of dapsone for conditions for which less toxic agents are available.


Sport: assessing the risk.

Studies on the incidence of sports injuries are an integral part of sports medicine. A survey of three sports medicine journals showed a paucity of information in this area. In view of the need for well designed studies, a series of guidelines for studies is presented.


Results of treating childhood Cushing's disease with pituitary irradiation.

To determine the usefulness of conventional pituitary irradiation in childhood Cushing's disease, we reviewed the results of this treatment in 15 patients. Twelve were cured (mean plasma cortisol of less than 10 microgram per deciliter and 24-hour urinary 17-hydroxycorticosteroid excretion of less than 7 mg per gram of creatinine) within 18 months, and 10 of the 15 were cured within nine months. Three failures required bilateral adrenalectomy. Growth resumed in 12, with adult heights of 156 to 166 cm. Sexual development proceeded normally in all 15, with normal secondary sexual characteristics and sexual function, and demonstrated fertility in four married adults. Intellectual function appeared normal. Basal and stimulated hormone levels were normal, except for subnormal (5 ng per milliliter or less) growth hormone levels after hypoglycemia in one of 12 patients. There were no complications of therapy and no progressive pituitary enlargement or hyperpigmentation. Pituitary irradiation is safe and effective therapy for childhood Cushing's disease.


Prenatal diagnosis of Duchenne's muscular dystrophy.

Two pregnancies at risk for X-linked recessive Duchenne's muscular dystrophy were studied at 18 and 20 weeks. Fetal blood was obtained by placental aspiration for measurement of plasma creatine phosphokinase activity. Activity in the first fetus was 96 IU per liter, as compared to a control range of 0 to 150 IU per liter in 16 pregnancies not at risk for the disorder. The pregnancy continued, and the infant was normal after birth. In the second fetus creatine phosphokinase activity was significantly elevated to 540 IU per liter (P less than 0.001). Fetal blood also showed considerable hemolysis, an unusual observation in placental blood sampling. After abortion, examination of fetal muscle by light, phase and electron microscopy showed characteristic features of Duchenne's muscular dystrophy, including wide variation in muscle-fiber diameter and reduction in the number of fibers per fasciculus. These cases illustrate the potential usefulness of fetal plasma for prenatal diagnosis and, specifically, of creatine phosphokinase activity for diagnosis of muscular dystrophy.


Idiopathic hemochromatosis. Demonstration of recessive transmission and early detection by family HLA typing.

We studied iron overloading and HLA types in 24 sibships of patients with idiopathic hemochromatosis, of which 15 had at least two subjects with overt forms. HLA types of 84 unrelated patients were also investigated. Among siblings there was a significant association (P less than 0.0001) between the presence of hemochromatosis and the possession of the same two HLA haplotypes. The fact that overt forms of hemochromatosis depend on the presence of two specific homologous chromosomes strongly supports a recessive mode of transmission for the overt disease. The haplotypic equilibrium demonstrated in the unrelated patients group is another supporting argument. The lod-score value (2.239 for theta = 0.005) in six families available for study further supports the conclusion that a hemochromatosis gene is closely linked to the HLA-A locus. HLA typing in families with hemochromatosis could provide a means of early detection of subjects at risk before appearance of any sign of iron overload.


Functional capabilities of steroid-recruited neutrophils harvested for clinical transfusion.

To determine whether steroids exert a direct inhibitory effect on neutrophil function, thus contraindicating their use to increase granulocyte yields for white-cell transfusions to infected neutropenic patients, we gave normal donors a single intravenous dose of dexamethasone (4 mg per square meter of body-surface area). Approximately two hours later the absolute neutrophil count increased from an initial value (mean +/- 1S.D.) of 3800 +/- 1400 to 5700 +/- 2400 per microliter. Granulocytes were then collected by discontinuous-flow centrifugation and tested. Viability (98.4 per cent), the percentage of neutrophils capable of phagocytosis (97.6), particle accumulation (12.3 candida per phagocyte), fungicidal activity (1.08 "ghost" yeast cells per phagocyte), the percentage of bacteria killed (97.7) and chemotaxis (119 per cent) did not significantly differ from observations in nontreated paired controls. The functional competence of neutrophils used for granulocyte transfusions was not altered after short-term exposure of these healthy donors to steroid medication.


Genetics of juvenile diabetes mellitus. A recessive gene closely linked to HLA D and with 50 per cent penetrance.

We investigated the genetic predisposition to juvenile diabetes in the families of 31 index cases in relation to the inheritance of the HLA system. The diabetes-predisposing gene was found to be recessive because the diabetic sibs in index cases shared both their HLA genes with a significantly increased frequency. Penetrance was estimated at 50 per cent because half the HLA-identical sibs in index cases were diabetic. These conclusions fit with published observations that the risk to sibs of patients is about 100 per cent, when both parents are normal. In three informative cases of recombination within HLA the predisposing gene traveled with the HLA D segment of the recombinant haplotype. We prepared tables for the computation of risks to relatives, based on the hypothesis of recessivity, HLA linkage and 50 per cent penetrance.


Identification of a nondeletion defect in alpha-thalassemia.

The molecular defect that has been demonstrated in alpha-thalassemia is the deletion of the alpha-globin structural genes. Since thalassemias are composed of heterogeneous groups of disorders, other types of defects could also result in alpha-thalassemia. We studied a Chinese family in which analysis of the mode of inheritance of alpha-thalassemia-1 and hemoglobin-H disease suggests a lesion that is not due to structural-gene deletion. Molecular hybridization studies with synthetic radioactive DNA's complementary to alpha-globin mRNA sequences show that in addition to the usual deletion defect, a nondeletion defect produces the phenotype of alpha-thalassemia-1. The combination of the deletion and non-deletion defects results in hemoglobin-H disease and not homozygous alpha-thalassemia associated with hydrops fetalis.


Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction.

Since the last comprehensive review of anticoagulation in acute myocardial infarction four additional randomized control trials have been reported. The overwhelming majority of all trials favored anticoagulation. Rates of thromboembolism were higher in the control, and hemorrhagic complications in the anticoagulated group. Pooling of all randomized control trials gives mean case fatality rates of 19.6% for the control and 15.4% for the anticoagulated group, a relative reduction of 21% (P less than 0.05 or less than 0.001, depending on the analytic method). Five of six randomized control trials reported "no effect" because the difference favoring anticoagulation was not statistically significant. However, sample sizes in these "negative" papers were too small to protect against missing a 21% reduction in true case fatality rate due to anticoagulation (beta greater than 0.10). All patients who present no specific contraindication should receive anticoagulants during hospitalization for infarction.


Three-dimensional model of membrane-bound ribosomes obtained by electron microscopy.

A low-resolution three-dimensional man has been obtained from crystalline arrays of membrane-bound eukaryotic ribosomes. It shows both ribosomal subunits to be adjacent to the membrane surface, attached to it by a part protruding from the large subunit.


Evidence for a sensitising pigment in fly photoreceptors.

Many photoreceptor cells in invertebrates have a dual-peak spectral sensitivity. Evidence is presented that in fly photoreceptors the ultraviolet peak is due to a photostable pigment that absorbs light quanta and transfers the energy to the blue-absorbing visual pigment.


Nucleotide sequences of 5'-terminal ribosome-protected initiation regions from two reovirus messages.

Sequences for two reovirus ribosome-protected fragments are presented. Comparison with four other reovirus initiation sites reveals only two common features: the 5'-terminal sequence m7GpppGmCUA, and (located 15-33 nucleotides from the cap) the sequence AUGG. Both the cap and the AUG codon are included in the 40S-ribosome protected region from all six reovirus messages.