Osmotic flow through the placental barrier of chronically prepared sheep.

An electromagnetic flow sensor was placed on the distal aorta of sheep fetuses in utero, and catheters were placed in a femoral artery and the common umbilical vein. Catheters were also placed in a carotid artery and a uterine vein of the pregnant ewe. Three days postoperatively maternal plasma was hyperosmotic with respect to fetal plasma by all methods: +5.8 +/- 1.4 SE by vapor-pressure osmometry, +2.2 +/- 0.7 SE by freezing-point depression osmometry corrected for bicarbonate loss; and +3.26 mosmol/liter by chemical measurement of plasma constituents. Maternal or fetal plasma was made hypertonic in vivo by infusion of concentrated solutions of mannitol, sucrose, or NaCl. Transplacental water flux was calculated from placental blood flows and arteriovenous differences in water content of the blood. The apparent osmotic conductivity of the placenta was 61 ml2-mosmol-1-kg-1, but this value should be divided by an unknown reflection coefficient to yield the true osmotic conductivity. Separate measurements were made of the placental diffusional permeability of Na+ and Cl- in five chronically prepared sheep fetuses: PSNa+ =0.20 +/- 0.04, PSCl- = 0.27 +/- 0.04 ml/(min-kg fetus). There was a highly significant positive regression between (total) placental permeability and fetal weight.


Water and electrolyte acquisition across the placenta of the sheep.

Fetal plasma is known to be hyperosmotic with respect to maternal plasma. Although some solutes are actively transported across the placenta and occur in higher concentrations in fetal than in maternal plasma, the total concentration difference is reversed by an opposite difference in the concentrations of electrolytes. Calculations on the basis of the Kedem and Katchalsky equations for a homogeneous membrane demonstrate that active solute transfer and a physiologically plausible hydrostatic pressure difference account for the known rates at which water and electrolytes are accumulated in the fetus. Best estimates of the membrane parameters (per kilogram fetal weight) are PSNa, Cl = 0.23 ml-min-1-kg-1, LpS = 5-10(-6) cm5-min-1-kg-1-dyne-1, and sigma NaCl approximately equal to 0.5. (where PS is the permeability-surface area product, LpS is the filtration coefficient, or sigma is the Staverman reflection coefficient). The driving forces for water and electrolyte transfer (active transfer and hydrostatic pressure) are not used as regulators. Rather, electrolyte permeability, which is the major constraint on fetal growth, and which continuously increases during gestation, makes possible the exponential increase in fetal weight during gestation.


Effect of sex difference and pregnancy on the normal reactive hyperemia curve.

The 10-min reactive hyperemia reaction was studied in a group of normal males, 10 normal females, 10 females in each trimester of pregnancy, and 10 females 6 wk postpartum. Sex difference had a marked effect on the hyperemic reaction, in that 5 and 15 s after release of circulatory arrest, the mean forearm blood flow in normal males was significantly reduced below that of normal females. During pregnancy there was a shift in the reaction of the pregnant female toward that in the normal male. In the 1st trimester of pregnancy, 5 s after circulatory arrest the mean forearm blood flow was diminished below that of the normal female; in the 2nd and 3rd trimesters at 5 s, the reaction was significantly diminished below that of the normal female. At 6wk postpartum, the reaction was essentially the same as in the nonpregnant female. Although these changes may be explained by a hormonal difference, they portray that there may be a marked difference in vascular reactivity due to sex difference only.


Right ventricular performance during ischemia: an anatomic and hemodynamic analysis.

This study in the pig was designed to characterize right ventricular (RV) contractile responses during infarction involving three areas of the heart--anteroseptal, anterolateral, and inferoseptal. Porcine coronary architecture was studied from multicolor vinyl casts. Distribution of blood supply to ventricular myocardium and papillary muscles was defined by intra-arterial dye injection. High-fidelity pressure and flow data were measured simultaneously in both ventricles following ligation of approximately equal lengths of the anterior descending, left circumflex, or posterior descending arteries. In the three groups, weight of myocardium involved by the occluded artery was comparable and there was significant depression of left ventricular performance, more pronounced in the two anterior infarcts. However, in anterolateral infarction, despite the obligatory drop in RV flow, there was no significant alteration in RV end-diastolic pressure (EDP), peak rate of rise of RV pressure (dP/dt), or time-to-peak developed dP/dt. In contrast, with both anteroseptal and inferoseptal infarctions there were significant alterations in all RV contractile parameters, at increased levels of RVEDP, signifying a primary depression in RV contractile state. With inferoseptal infarction, further occlusion of the right coronary near its origin produced a more exaggerated and selective RV contractile abnormality and, in half of the animals, varying degrees of acute tricuspid insufficiency.


Influence of the burn wound on peripheral circulation in thermally injured patients.

Simultaneous measurements of resting leg blood flow and surface and rectal temperatures were made in 45 studies of 9 normal subjects and 28 burn patients. The patients had burns from 3-86% of the total body surface with leg injury ranging from 0-87.5% of the leg surface. In the patient group, blood flow was essentially normal in the uninjured legs, increased in a curvilinear manner with the size of the leg burn, and approached a plateau of 8.0 ml/100 ml-min as the percent of leg burn exceeded 60%. Increasing the leg surface temperature by 5 degrees C increased blood flow in patients with burned and unburned extremities to the same extent as in normal subjects. Increased peripheral blood flow following thermal injury is directed primarily to the burn wound. Variations in surface temperature modify this peripheral vascular response to injury.


Radioimmunoassay of unprocessed sheep blood extracts to follow angiotensin metabolism.

The acceptability of radioimmunoassay to determine the levels of compounds antigenic to anti-angiotensin antibodies, in unprocessed methanolic blood extracts, was established for sheep blood. This approach was used to follow the clearance of antigenic compounds after administration of angiotensins I and II and fragments of angiotensin II in anesthetized sheep. The organs supplied by the systemic circulation and also the lungs effectively removed angiotensin I, but the removal of octapeptide occurred only in the peripheral tissues. The blood concentrations of compounds reacting with the anti-angiotensin II antibody always increased with passage of angiotensin I through the pulmonary circulation but not with passage of angiotensin II. The results indicate that factors other than efficiency of removal by the tissue is important in establishing blood levels. The sites of administration and of sampling were shown to be important in relation to ratios of the concentrations of antigenic material. There was a similar uptake of both hormones in the kidney; the relative inability of angiotensin I to reduce renal blood flow, therefore, does not result from a failure of uptake.


Cost, utilization, and utilization review of mental health services in a prepaid group practice plan.

The author describes the utilization review process, utilization patterns, and service cost of the Mental Health Service of the Health Insurance Plan of Greater New York (HIP). He finds that a mental health care delivery system within a health maintenance organization offers the advantages of sophisticated utilization review procedures, reduced cost per mental health incident, and a low utilization rate and low cost for psychiatric hospitalization. However, the HMO's return-to-function treatment goals may be too limited for the minority of patients who would benefit only from long-term intensive treatment. He recommends that cost accounting be based on cost per illness rather than cost per service.


Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group.

The authors identified 46 cyclothymic probands from a random pool of 500 psychiatric outpatients and prospectively followed them over a 2-3 year period. They used 50 bipolar patients with a definite history of mania and 50 patients with personality disorders as control groups. Although 66% of the cyclothymic outpatients had previously received the diagnosis of hysteria or sociopathy, their pedigrees were similar to those seen in classical bipolar manic-depressive illness; furthermore, 44% of the cyclothymic group experienced  brief hypomanic episodes while taking tricyclic drugs, and 35% developed full-blown hypomanic, manic, or depressive episodes during drug-free follow-up. The authors conclude that these findings provide evidence for a cyclothymic-bipolar spectrum.


Clinical pharmacology of phencyclidine toxicity.

Phencyclidine appears to be unique in action compared with other psychedelic drugs, and its effects are less dependent upon the individual's personality than are the effects of LSD or mescaline. The authors discuss the sensory, psychological, and behavioral symptoms of phencyclidine intoxication. Most cases are of short duration and the only treatment necessary may be observation together with minimal stimulation and diazepam. However, prolonged and severe behavioral disturbances, exaggeration of preexisting thought disorder, and serious medical complications commonly occur and must be considered in the treatment plan.


Rape: power, anger, and sexuality.

Accounts from both offenders and victims of what occurs during a rape suggest that issues of power, anger, and sexuality are important in understanding the rapist's behavior. All three issues seem to operate in every rape, but the proportion varies and one issue seems to dominate in each instance. The authors ranked accounts from 133 offenders and 92 victims for the dominant issue and found that the offenses could be categorized as power rape (sexuality used primarily to express power) or anger rape (use of sexuality to express anger). There were no rapes in which sex was the dominant issue; sexuality was always in the service of other, nonsexual needs.


Problems for women in psychiatric residency.

Some of the basic problems confronting women in psychiatric training are reflected in four major areas: supervision, administration, research, and peer relationships. The authors recommend a residency seminar on female psychology, flexible-schedule residencies, inclusion of more women in all phases of the profession, reeducation in female psychology for supervisors, more research opportunities, the availability of male and female mentors, and training program encouragement of peer support; these suggestions would help overcome the problems and improve training programs for women and men.


Psychiatric disturbances associated with Erhard Seminars Training: II. additional cases and theoretical considerations.

In a previous article, the authors reported on 5 individuals who developed psychoses after participation in Erhard Seminars Training (est). Two additional cases are reported, and the combined case material is discussed in terms of group and psychodynamic theories. The authoritarian est leadership style may mobilize in trainees an overdetermined and pathological reliance on identification with the aggressor. Such a mechanism may be central to the production of psychiatric casualties, particularly in individuals with defective ego boundaries. Future controlled research is necessary to ascertain the rate of occurrence of psychiatric disturbances associated with est and to test the authors' hypotheses.


Success rates in psychiatry and neurology certification examinations.

The authors traced the progress of a sample of 200 psychiatrists and 150 neurologists on the ABPN examination. Overall success rates were high-64% of psychiatrists and 75% of neurologists became Board-certified. Performance on the written exam was a significant predictor of outcome for both groups-88% of psychiatrists and 94% of neurologists who passed Part I on their first try eventually obtained certification. Given the criticism that has been directed toward the oral exam, it was interesting that only 10% of psychiatrists and 5% of neurologists failed to become diplomates because of difficulties with Part II. Future research will deal with the validity and reliability of the oral exam.


An examinee's perspective on Board certification.

The author reviews the objectives, sources, preparation, and test-taking strategies commonly used by successful candidates for the certification examination of the American Board of Psychiatry and Neurology, Inc. He suggests that examinees can benefit from the preparation process as well as increase the probability of passing by adopting these strategies.


From board candidate to rookie examiner.

The author describes his experience as a candidate for the American Board of Psychiatry and Neurology, Inc., examinations one year and as an oral examiner the next. He discusses the oral examination process, listing the errors most frequently made by candidates.


Neurology in the psychiatry Boards.

On the basis of his experience as an examiner, the author discusses the problems encountered in assessing psychiatrists' abilities in clinical neurology for certification by the American Board of Psychiatry and Neurology. Hoping to stimulate discussion among trainees, training programs, and the Board, he outlines five paradigms designed to survey neurological knowledge and skill potentially needed by psychiatrists in various situations; these are reduced to specific topics on which Board candidates should be questioned. Relationships between training and examination expectations are discussed.


Thyroid function and growth hormone secretion in amitriptyline-treated depression.

The authors studied changes in indices of thyroid function prospectively in a group of 11 patients given amitriptyline to treat depression. The drug caused no significant alteration in these indices, but scores on the Hamilton Depression Rating Scale improved significantly. In another group of subjects with depression, the stimulation of growth hormone secretion by L-dopa was unaffected by amitriptyline therapy.


Anniversary reactions masquerading as manic-depressive illness.

The authors suggest that many patients diagnosed as having manic-depressive illness, depressed type, may in fact be experiencing anniversary reactions--time-specific psychological and physiological reactions to a past trauma. They report three cases of cyclic depressive disorder, two of which were first diagnosed as manic-depressive illness, depressed type. Careful, complete interviewing and attention to temporal sequence led to the correct diagnosis of anniversary reaction.


Urinary catecholamine metabolites in hyperkinetic boys treated with d-amphetamine.

The authors studied the excretion of 3-methoxy-4-hydroxyphenyl glycol (MHPG), normetanephrine (NM), metanephrine, and homovanillic acid in 7 hyperactive and 12 control children. MHPG was lower but NM was significantly higher in hyperactive children than in controls. Administration of d-amphetamine for 2 weeks depressed the levels of MHPG, NM, and metanephrine. The authors suggest a decreased central norepinephrine activity, which may be secondary to the interruption of norepinephrine fibers in the medial forebrain bundle.


In vitro half-life of 14-C-tryptamine in whole blood of drug-free chronic schizophrenic patients.

The authors found higher in vitro 14C-tryptamine half-lives in the blood of 10 drug-free chronic schizophrenic patients than in the blood of 13 mentally normal control subjects. This finding was negatively correlated for both groups with platelet MAO activity. Repeated determinations of in vitro 14C-tryptamine half-lives over a period of 5 months were positively correlated for the patients, although some blood samples showed statistically significant variability.


The Hearst trial and the confidentiality of residency records.

Review of the Hearst trial transcript reveals that the subpoena Dr. Joel Fort's residency files met with very little effective resistance on the part of the hospital that had trained him. There are few legal mechanisms to stop such a subpoena. The only truly effective solution may be the abstraction and destruction of residency files once the residency has been successfully completed.


Suicide among police.

The author presents and comments on recently acquired police suicide data from several cities in the United States and from the Metropolitan Police Department of London and on extensive archival police suicide files. He also explores some of the psychosocial factors that may affect the high incidence of suicide among people who actively specialize in police work.


Inhalant abuse in an Indian boarding school.

The authors describe inhalant abuse among children in an American Indian elementary boarding school. They discuss the initial interventions made to control this problem, such as providing a lower adult-child ratio and improving staff morale and child management skills and developing a volunteer program to improve the quality of the children's experience after school hours. They suggest that such preventive efforts be made early to interrupt the destructive cycle of dependence on external agents.


Health beliefs and smoking patterns in heart patients and their wives: a longitudinal study.

Smoking patterns of 205 male patients were examined over a period of eight years after a primary myocardial infarction. Smoking data from their wives at one year after the heart attack were also examined. A marked, persistent reduction in smoking was found among the men. Smoking patterns of wives remained essentially unchanged. Smoking patterns before the heart attack were not related to demographic variables, except for the associated between smoker-nonsmoker status and social measures. Conceptions of susceptibility, threat, and power of prevention drawn from theoretical models on preventive health behavior were employed for analysis. High proportions of husbands and wives reported belief in smoking as important in the etiology of the heart attack, and in possibilities of prevention. Specific beliefs concerning threat, susceptibility, and prevention were not found to be related to the massive drop in smoking behavior among the men nor to stability in pattern among the wives. Alternative explanations are reviewed.


A survey of local public health departments and their directors.

In 1974 a questionnaire was mailed to the nation's local health officers. Responses were received from 1,345, at least 68 per cent of all local health departments. The present paper presents selected summary data from respondents concerning the health departments, their jurisdictions, organization, finance, functions, staffing, and about the training, salaries, and other characteristics of local health officers. Health departments are extensively involved in rendering health services, including direct personal services (25 per cent of all departments). For many services the health department is the sole provider of essential services in the area of jurisdiction. These services include ambulatory care (8 per cent), maternal and child health (48.5 per cent), home care (44.8 per cent), and family planning (38 per cent). The major constraints to improvement and expansion of programs are perceived as limited financial support, insufficient staff, and inadequate facilities.


Statutory authorizations for the work of local health departments.

A study of public health statutes of the 50 states identifies 44 specific services or functions that are assigned to local health departments by all or some of the states. Authorizations are most commonly assigned conjointly both to local and state health departments; exceptions are identified. Data suggest striking inconsistencies between what local health departments are authorized to perform and the services they actually render with regard to a selected group of programs that involve personal health services. The full scope of authorizations for local health departments is not revealed by examination of public health statutes. For this reason, among others, development of up-to-date health codes for all states would be beneficial.


Chemical mutagenesis: an emerging issue for public health.

Chemical mutagens are recognized as prevalent in the environment and a potential threat to the health of future generations. This paper presents an overview of chemical mutagenesis as an issue for public health. Several problems in the determination of risk to human populations are discussed, including difficulties of extrapolating scientific data to humans, the latency period between exposure and recognizable genetic damage, and the large number of chemicals which must be tested. Test systems are described. Possibilities of control through federal regulation are discussed.


What kinds of people do not use seat belts?

In the course of a Community Mental Health Epidemiology study conducted in Washington County, Maryland between December, 1971 and July, 1974, interviews were conducted with randomly selected adults in a weekly systematic sampling of households. In a subsequent re-interview of 1009 respondents who had family cars with seat belts, nearly 47 per cent said they did not use them. Non-use of seat belts was significantly higher among females and among persons with less than high school education or low income. Non-use of seat belts was also higher among those who felt that their station in life as measured by the Cantril ladder was unsatisfactory, who felt powerless to change at least some aspects of their lives, and who were infrequent church attenders. Significant associations were also found with infrequency of two other preventive health behaviors, dental checkups and Pap tests. Among young adults the tendency seemed to be for marriage to increase the non-use of seat belts among females but to decrease non-use among males.


Head and spinal cord injuries: a pilot study of morbidity survey procedures.

This paper describes a pilot case-finding survey which allowed statistical resolution of a number of methodological issues facing researchers who conduct such surveys. The pilot study for a national survey assessing the incidence, prevalence, and economic impact of head and spinal cord injuries, was conducted in eight geographically representative country sites and involved a study of field procedures in several different types of medical facilities. The scope of this paper is limited to the study of procedures used in hospitals. It concluded that: (1) inexperienced field staff were as productive as experienced field staff for activities such as listing discharges and abstracting patient records; (2) field staff familiarity with facility record systems was associated with success in securing hospital cooperation; (3) endorsements by national chapters of relevant professional and health-related associations were sufficient for securing hospital cooperation; and (4) neither hospital characteristics (e.g., size) nor the degree of participation by cooperating hospitals was associated with any significant differences in field staff productivity.


A perspective on the significance of pandemic influenza.

The identification in February 1976 of a new strain of influenza virus led to the enactment of unprecedented federal legislation to minimize the impact of a potential outbreak of pandemic influenza in the fall and winter of 1976-1977. This legislative program does not, however, represent a commitment of federal resources to deal with the more general, longstanding problem of epidemic influenza. This paper presents a series of estimates of the impact and economic consequences of influenza. By including periods of interpandemic as well as pandemic disease, the estimates offer a broadened perspective of the magnitude of the influenza problem. The estimates show that while the proportions of pandemic influenza can be singularly impressive, the cumulative effects of interpandemic outbreaks are generally of greater consequence. The paper discusses the implications of these estimates and the 1976 legislation for the support and implementation of federal policy on the use of influenza vaccine. While the commitment of resources in support of public policy cannot alone guarantee successful implementation, it must be considered an essential prerequisite for dealing with both interpandemic and pandemic influenza.


A large outbreak of foodborne salmonellosis on the Navajo Nation Indian Reservation, epidemiology and secondary transmission.

In September 1974, the largest outbreak of foodborne salmonellosis ever reported to the Center for Disease Control--affecting an estimated 3,400 persons--occurred on the Navajo Nation Indian Reservation. The responsible agent was Salmonella newport and the vehicle of transmission was potato salad served to an estimated 11,000 persons at a free barbecue. The cooked ingredients of the potato salad had been stored for up to 16 hours at improper holding temperatures. The magnitude of the outbreak allowed us to study secondary transmission by calculating the rates of diarrheal illness during the 2 weeks following the outbreak in persons who did not attend the barbecue and by examining the results of stool cultures obtained after the outbreak. We found no secondary transmission. We conclude that a health official should monitor food preparation and service at large social gatherings and that person-to-person transmission of salmonellosis probably does not normally occur even in settings considered highly conductive to cross-infection.


Fire victims: medical outcomes and demographic characteristics.

The medical outcomes and demographic characteristics of all victims of fires identified by The Baltimore Fire Department during a 14-month period in Baltimore City were studied. Fifty-nine per cent of victims suffered minor injuries, 25 per cent required hospitalization and 16 per cent were fatalities. The majority of survivable injuries were due to burns, while the majority of deaths were due to pulmonary injury and carbon monoxide intoxication. Deaths occurring at the scene of the fire or during the first 24 hours were predominantly due to carbon monoxide. Exposure to fires was more likely to result in deaths in the very young and very old. Evidence from autopsy protocols suggests that alcohol was a contributory factor.


Rubella in Seattle-King County Washington.

Assessment of the results of rubella hemagglutination-inhibition tests from women of child-bearing age in Seattle-King County suggests no community susceptibility problem except among women age 19 in 1976. Within this cohort 23 per cent were susceptible, probably because these women were too young to experience a full exposure to natural rubella prior to introduction of rubella vaccine and too old to be immunized against rubella in the elementary schools in 1970. Follow-up of women under age 25 who were seronegative for rubella antibody indicated that one-third subsequently received rubella vaccine.


Prognostic effect of tobacco and alcohol use in patients with oral tongue cancer.

A retrospective case analysis shows that patients with oral tongue cancer who have chronically used tobacco and alcohol have an increased incidence of death due to tumor, due to a second primary cancer, and due to intercurrent disease when compared with patients with oral tongue cancer who have never used tobacco or alcohol. This difference is not explained by a difference in tumor staging, patients' ages, or type of treatment received.


Management of "localized" oral cancer.

We have outlined the clinical manifestations of "localized" malignant lesions of the intraoral cavity, their clinical behavior after intraoral excision, and their control rate employing intraoral excision as primary therapy. We must keep in mind that these small "localized" cancers are potential "killers" and the five year mortality from disease in our series was 25 per cent. This mortality may decrease with (1) more careful selection when patients are included in the "localized" lesion group and (2) earlier use of composite procedures in questionable cases.


Correlation between prognosis and degree of lymph node involvement in carcinoma of the oral cavity.

Accurate histologic determination of lymph node metastasis is most important in predicting prognosis in patients who undergo radical neck dissection. In this study of 340 determinate patients, the five year survival was 75 per cent when lymph nodes were histologically negative, 49 per cent when one lymph node was positive, 30 per cent when two lymph nodes were positive, and 13 per cent when three or more nodes were positive. Other factors useful in predicting prognosis are, to some extent, the level of lymph node metastasis in the neck, and the presence or absence of capsule penetration and soft tissue involvement. Those patients with metastasis to three or more lymph nodes had a five year survival of 13 per cent and belong to a high risk group. In this high risk group among those who died, the incidence of recurrence in the neck was 72 per cent, and the incidence of distant metastasis  was  70 per cent. When autopsy was performed, more still were found to have distant metastasis, 75 to 80 per cent. Most of these high risk patients already have systemic dissemination of cancer at the time of their initial therapy; therefore, the addition of a systemic form of adjuvant therapy, such as chemotherapy and/or immunotherapy, is justified.


A physiologic approach to the problems of simutaneous bilateral neck dissection.

A number of physiologic derangements have been observed resulting from the management of head and neck cancer with resection and simultaneous bilateral neck dissection. A protocol evolved to minimize morbidity from these complications was used on seventeen patients. Eleven are alive and free of disease and there was no mortality.


Results of BCG adjuvant immunotherapy in 100 patients with epidermoid carcinoma of the head and neck.

One hundred patients with advanced, recurrent, or metastatic squamous cell carcinoma of the head and neck were treated with chemotherapy and BCG as adjuvant immunotherapy. The overall response rate was 35 per cent, and the median duration of response was seventeen weeks. BCG does not prolong duration of remission or survival time.


Construction of a pseudolarynx after laryngectomy and radical neck dissection. A preliminary report.

Voice rehabilitation is a major problem after laryngectomy. A new method to construct a pseudolarynx after total laryngectomy by suturing the trachea to the hyoid bone is described. The surgical technic is relatively simple. Patients are able to speak in the immediate postoperative period without intensive therapy. The quality of speech is good. Aspiration of liquids is a common problem, but in time patients learn to swallow with minimal or no aspiration. This procedure could be utilized in selected cases for good voice rehabilitation after total laryngectomy.


Unusual problems in parathyroid surgery.

Although parathyroid surgery is difficult because of the smallness of the glands and the variability in their location and number, a surgeon who is well versed in the embryology, gross anatomy, pathology of the glands, and the fine points of gross identification of normal and abnormal tissue should be able to identify these glands in most instances. In a review of 122 cases during a two year period, pathologic change was found in 96 per cent, even though 11 per cent were secondary cervical explorations and the mediastinum was entered by a sternal split approach in only two cases. Although the abnormal glands were found in varying locations and ten were outside the usual areas of search, all were consistent with failure to descend or excessive descent and with a relationship to anatomic structures having similar embryologic origin. Sophisticated localizing procedures such as arteriography and selective venous sampling for parathormone are rarely necessary.


Concomitant hydroxyurea and irradiation. Clinical experience with 100 patients with advanced head and neck cancer at Pennsylvania hospital.

One hundred outpatients with proved advanced epidermoid carcinoma of the head and neck underwent complete treatment with concomitant hydroxyurea and irradiation therapy. Seventy-three patients exhibited complete regression of the tumor. All patients became candidates for operation after completion of combination therapy, although not all patients accepted surgery.


Morbidity and mortality of mandibular resection for malignant disease.

Twenty-nine per cent of patients undergoing mandibular resection had an entirely uncomplicated postoperative course. Local complications occurred in 54 per cent and systemic complication in 35 per cent. Increasing the extent of resection or an additional procedure, such as radical neck dissection, increased the local complication rate. Operation in fully irradiated tissue produced an increase in the proportion of life-threatening complications. Systemic complications were responsible for 80 per cent of the postoperative deaths.


Metastases to lymph nodes of the head and neck from an unknown primary site.

Sixty-four patients with a metastasis to the head and neck from an unknown primary site were reviewed. Survival as a function of cell type, stage of disease, and mode of treatment was analyzed. Survival correlated best with stage of disease prior to treatment.


Mucosal melanomas of the head and neck.

Only 3 per cent of all melanomas arise in the mucosa of the head and neck region. Melanomas of mucosal origin in this series differed from their cutaneous counterpart in that size of the primary lesion did not influence prognosis. Regional lymph node metastases were infrequent and did not seem to influence prognosis. Nearly all the primary lesions on microscopic review showed the presence of intralesional lymphatic and blood vessel invasion. Local recurrence at the primary site was the most common cause of treatment failure, in spite of seemingly adequate surgical resection. Surgical treatment offers long-term cure to only a limited number of patients.


The number of nuclei in adult rat muscles with special reference to satellite cells.

The number and the size of different populations of nuclei were studied in skeletal muscles and in the diaphragm of male Wistar rats of 200-250 g weight. Nuclei on cross-sections were counted and classified by electron microscopy, their incidence was corrected for their different lengths, and the number of nuclei per mm3 of muscle was determined by light microscopy. The total number of nuclei per mm3 was 5-10(4) in the superficial part of the anterior tibial muscle, it was 10-10(4) in the soleus, and it was 15-10(4) in the diaphragm. Half of the nuclei were localized inside muscle fibres. The incidence of satellite cell nuclei on cross sections was 4% of muscle nuclei in the anterior tibial muscle, and 8% in soleus and diaphragm. The number of satellite cells per mm3 muscle were 900, 4,900, and 5,300 in these muscles. More than half of the satellite cells were closely associated with a capillary. In the anterior tibial muscle, and in 1-micron sections no satellite cells could be identified by light microscopy. In the soleus muscle and in the diaphragm, satellite cells were more rich in cytoplasm and many were visible in the light microscope.


Differentiation of olfactory receptor cells in organ culture.

Presumptive olfactory mucosa was excised from the heads of rat fetuses in the eleventh and twelfth days of gestation and explanted in organ cultures. At the time of explanation, the presumptive olfactory cells were recognizable by their long narrow apical processes and basally located nuclei. However at this stage they were in an early phase of differentiation as indicated by the large numbers of free ribosomes and virtual absence of microtubules and cilia in the apical cytoplasm. After three to eight days in culture, there was a progressive increase in the total number of cells in the epithelium. Differentiation in olfactory receptor cells was detectable by the appearance in the apical processes of axially oriented microtubules and centrioles or basal bodies, some of which generated cilia. At their basal ends, the cytoplasm narrowed into axons and bundles of these axons, arranged in the unique manner of olfactory nerve axons, entered the connective tissue. Olfactory receptor cells, as defined by morphological criteria, differentiated under suitable organ culture conditions in the absence of any tissue from the central nervous system.


A technique for the dry preservation of functioning orthopaedic specimens.

A method is presented by which fresh anatomical material may be preserved in a dry state while maintaining joint function and motion. This method could be likened to the tanning of the tendons and ligaments directly on the bones. Mastery of this technique has allowed the preservation of not only the tendinoskeletal system, but also the nervous, vascular, and endotracheal systems as well. While some skill in dissection is necessary, a large amount of the dissection can be done by chemical methods. The actual processing of the specimen is easily done with materials that are readily available. When finished, the specimen is dry, flexible, essentially odorless, and extremely durable. This method can be utilized for material ranging from simple osseous specimens to highly sophisticated dissections. These specimens have been found to be of exceptional advantage in teaching by demonstrating function as well as spatial relationships.


Intercellular junctional complexes of the rat seminiferous tubules: a freeze-fracture study.

This paper provides a description of the intercellular junctions in the rat testis, as observed using the freeze fracture technique. These intercellular junctions were categorized into four general types: Sertoli cell tight junctions, myoid cell tight junctions, gap junctions, and "heterogeneous junctions." The Sertoli cell tight junctions had a mean depth of 3.1 micron in the basal to apical direction, and contained 25 to 50 (average: 36) parallel rows of particulate sealing elements. The myoid cell tight junction was neither continuous nor extensive, but focal in nature. Interestingly the sealing elements of this junction, like those of the Sertoli cell tight junction, were quite particulate in nature. Typical gap junctions were observed between Sertoli cells where they were intercalated between the parallel rows of the Sertoli cell tight junction. The most interesting observation was the identification of gap junction-like structures, in various stages of formation, on germ cell membrane fracture faces, both in the basal and adluminal compartments. Lastly, the unusual "heterogeneous junction" was observed on large membrane fracture faces in close proximity to cells in the adluminal compartment, presumably between Sertoli cells. These junctions appeared to consist of both tight and gap junction elements.


The aberrant course of the cutaneous component of the ilioinguinal nerve.

The ilioinguinal nerve was dissected in 196 adult human cadavers. A normal pattern of distribution, consistent with modern textual descriptions, was defined in 60% of inguinal regions. In 35% of the inguinal regions a previously undescribed aberrant course for the cutaneous component of the ilioinguinal nerve was observed in which it is incorporated within the genitofemoral nerve, entered the inguinal canal at the deep inguinal ring, coursed within the cremasteric layer and emerged into the subcutaneous tissue at the superficial inguinal ring on the dorsal side of the spermatic cord or the round ligament of the uterus. The cutaneous component of the ilioinguinal nerve is most frequently found on the ventral surface of the spermatic cord or round ligament during inguinal hernia operations thus an unrecognized aberrant course of this nerve within the spermatic cord is particularly susceptible to accidental trauma.


Sarcoplasmic reticulum in the conducting fibers of the dog heart.

The ultrastructure or sarcoplasmic reticulum (SR) was studied in the conducting fibers of the dog heart. A dense network of sarcoplasmic tubules occurred in well preserved cytoplasmic areas. Some of the tubules extended into large sacs filled with finely filamentous material. The sacs often appeared in subsarcolemmal apposition connected to the sarcolemma by electron dense projections. The flattened cisternae of SR occurred beneath the sarcolemma in the myofibrillar region of the cell. Long flattened cisternae only partially apposed to the sarcolemma were quite common in one specimen. Sarcoplasmic reticulum was continuous throughout the interfibrillar spaces surrounding each myofibril. At the level of the Z-line the SR formed a quasi tubular flattened structure surrounding the Z-line and closely adhering to it.


Lidocaine treatment of experimental cutaneous lesions from potassium chloride injection.

Potassium chloride (KCl) given subcutaneously in high concentrations causes necrosis of skin, possibly from vasoconstriction around the injection site. The authors studied guinea pigs given subcutaneous injections of various volumes and concentrations of KCl and observed the severity of the cutaneous lesions. In further experiments, therapeutic agents were injected subcutaneously 10 minutes after KCl infiltration. The severity of cutaneous lesions was not affected by various volumes of KCl of the same concentration, but was correlated positively with increasing concentrations of the salt when concentration was varied. Dextrose, 5%, and sodium bicarbonate, 1 M, had no effect on the cutaneous lesions caused by KCl, while hyaluronidase, 150 U/ml, lessened them. Lidocaine, 1%, a vasodilator, eliminated cutaneous lesions caused by KCl. Kcl-induced lesions may be due to vasocontriction, which can be relieved by lidocaine.


Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane.

The effects of various plasma concentrations of lidocaine on nitrous oxide anesthesia in man and halothane requirements in the dog were studied. The response to incision of the skin was observed in 20 patients who were anesthetized with nitrous oxide, 70% inspired, and oxygen, 30%, plus various plasma levels of lidocaine. In addition, changes in the MAC of halothane in dogs were observed at various levels of lidocaine. In both circumstances lidocaine concentrations of 3 to 6 microgram/ml decreased anesthetic requirements approximately 10 to 28%. At clinically common concentrations of lidocaine, significant decreases in anesthetic requirements should be anticipated.


Arousal reactions during anesthesia in man.

Power-spectrum analysis of the electroencephalogram and inhaled-exhaled concentrations of halothane (when used), nitrous oxide, and carbon dioxide of 36 patients during surgical operations under general anesthesia were monitored. Electroencephalographic arousal reactions were detected in 24 patients and these were accompanied by irregular respirations in nine patients. Cardiac arrhythmias occurred following an arousal reaction in eight patients. The authors conclude that this electroencephalographic arousal phenomenon occurs frequently and deserves further investigation to define its clinical implications and how it might be avoided.


A simple method for gas chromatographic determination of lidocaine in tissues.

A simple gas chromatographic method for the determination of lidocaine in tissues is described. Lidocaine is extracted from the tissue samples using liquid nitrogen. The recoveries of lidocaine from brain, liver, and muscle were 98.6, 99.8 and 89.1%, respectively. Results were reproducible to within 1.0% of lidocaine administered.


Blood viscosity factors in evaluation of submaximal work output and cardiac activity in men.

Sixty-two male subjects, including patients with postmyocardial infarction, angina, other disorders, and normals, were studied by exercise testing on the bicycle ergometer, including exercise ECG, and by in vitro determination of blood viscosity, plasma viscosity, aggregation of red cells, and other factors. Significant correlations were found between the blood viscosity factors on the one hand, and different terms describing physical fitness and cardiac functions on the other. In all correlations an elevation of blood viscosity factors led to lower fitness or lower cardiac efficiency; and a decrease of blood viscosity (or plasma viscosity, or compound viscosity product) was associated with better fitness and higher cardiac efficiency. Similarly, ECG ST-segment depression was proportional to increase of blood viscosity factors. All these highly significant correlations were found within a very narrow range of hematocrits, while the hematocrit value itself was not significant in this study.


Phantom sweating.

Phantom sweating is a sensation in which the patient feels that sweat is about to burst out of skin pores, but in which sweating never actually occurs. In a series of 100 patients undergoing bilateral upper dorsal sympathectomy for palmar hyperihidrosis, 82 patients were specifically questioned and 48 (59%) reported phantom sweating. Phantom sweating started soon after the operation, was triggered by the same stimuli that caused hyperhidrosis preoperatively, lasted for a few seconds, and tended to diminish with time. In an average follow-up of 18 months, the phenomenon disappeared in 11 patients (23%). Phantom sweating is probably a symptom of residual sympathetic activity.


Bartter's syndrome: an overview.

Bartter's syndrome, which is characterized by hypokalemic hypochloremic alkalosis, renal juxtaglomerular hyperplasia, elevated renin and aldosterone, and normal or low blood pressure, has been ascribed to a variety of etiologies. Most recently, the prostaglandins have been in the forefront of the pathophysiologic discussion. Two cases with appropriate renal biopsies are reviewed, as are the clinicopathologic pathways. It is important that strict criteria be applied, and confirmation by renal biopsy is urged.


A comparative study of allergens of canine origin.

Among 115 children and young adults studied, 52 had current and 25 had past household exposure to dogs, totaling 77 subjects. Of 53 with clinical hypersensitivity to dog, 32 had a history of exposure, 34 positive cutaneous reactions and 15 RAST positive results. Of 62 without clinical hypersensitivity, 45 had a history of household exposure, 24 positive cutaneous reactions and 6 RAST positive results. Cutaneous tests were not done on seven individuals. The major type of clinical symptomatology to dogs was ocular and nasal, 40 of 53. Thirty-two of 53 patients developed asthma exacerbations alone, or in combination with other manifestations, upon dog exposure. Dermal reactions were urticaria is six and contact eczema in two subjects. RAST inhibition results suggested that in vitro testing may be more useful when allergens from specific dog breed extracts are characterized.


Lymphocyte response to grass pollen antigens: a correlation with radioallergosorbent test and effect of immunotherapy.

The deoxyribonucleic acid (DNA) synthetic response of cultured lymphocytes to grass pollen antigens was significantly higher in 66 untreated atopic patients than in 15 non-atopic subjects (p less than 0.05). There was no correlation between the DNA synthetic response and the specific IgE antibody level as measured by radioallergosorbent test in the 81 subjects (r= 0.13; p greater than 0.2). The effect of immunotherapy on proliferative lymphocyte response and specific IgE antibody response to grass pollen antigens was evaluated prospectively in 22 atopic patients. The DNA synthetic response to grass pollen antigens was significantly reduced after immunotherapy (p less than 0.01) but the specific IgE antibody level did not change significantly.


Induction of anti-timothy pollen reaginic antibodies and their cross-reactivity in the rat.

Anti-timothy pollen reaginic antibody produced in rats cross-reacted with a large number of grass pollen antigens (Orchard, June grass, perennial rye grass, velvet, meadow fescue, red top and broncho grass), but did not react with Bermuda, brome and Johnson grass.


Ethical considerations in the practice of allergy.

The great effort of specialty societies to maintain post-graduate education on a high level should be complemented by an equal effort to promote high ethical standards. In the practice of allergy by non-allergists the same ethical and scientific guidelines should be observed as by allergists and it should be the responsibility of the societies to see to it that our specialty offers the patient care based on knowledge but most of all on common sense and commitment.


Serologic studies on porcine strains of Haemophilus parahaemolyticus (pleuropneumoniae): agglutination reactions.

Fifteen strains of Haemophilus parahaemolyticus (pleuropneumoniae) represented by 6 American isolates, 6 Swedish isolates, and 3 reference strains of Nicolet's serotype 1, 2 and 3, were used in serologic studies by agglutination and agglutinin-adsorption tests. By whole cell-agglutination tests in rabbit antiserums, 3 additional serotypes, 4, 5, and 6, were identified. All strains had strong serotype-specific agglutinating properties. Occasional weak cross reactions could be eliminated by appropriate adsorptions without effect upon type-specific reactivity. The Swedish isolates were assigned to serotypes 2, 3, 4, and 6, and the American isolates, to serotypes 4 and 5. All European isolates were distinct from 5 of the 6 American strains. An American culture isolated from a steer and another from a lamb were identical in their agglutination reactions with the porcine isolates of serotype 5. The serotyping of isolated strains is important in the epizootiologic and immunologic studies of H parahaemolyticus infections.


Contrast study of the gastrointestinal tract in the goat (Capra hircus).

Radiographic anatomy of the gastrointestinal tract of the goat (Capra hircus) was studied. Intraluminal contrast medium was used to evaluate the mucosal surfaces of stomach and intestines, and extraluminal contrast medium was used to evaluate the serosal surfaces of organs in the peritoneal cavity.


Oncogenic and nononcogenic bovine adenoviruses and guanine-cytosine content of their DNA.

Bovine adenoviruses types 1, 2, and 3 were purified and concentrated by polyethylene glycol precipitation and CsCl density-gradient centrifugation. The efficiency of recovery of infective particles was 64 to 80%. The guanine-cytosine contents of DNA of the nononcogenic types 1 and 2 and the highly oncogenic type 3 were found to be 62, 61, and 48%, respectively--a pattern similar to that of nononcogenic and oncogenic human adenoviruses.


Influence of Ostertagia ostertagi and Cooperia infections on the energetic efficiency of steers fed a concentrate ration.

Studies on effects of subclinical parasitism (low worm burden) in full-fed and maintenance-fed steers indicated that over a short interval low worm burdens do not have a statistically significant effect on the efficiency of energy utilization. In full-fed steers, energy retention tended to be higher in steers with lower worm burdens (mean 95.8 Ostertagia, 12.5 Cooperia) than in those with higher worm burdens (mean 677.5 Ostertagia, 201.8 Cooperia). Maintenance-fed steers generally had larger numbers of Ostertagia ostertagi and Cooperia spp than did the full-fed steers.


Application of the direct leukocyte-migration agarose test in cattle naturally infected with Mycobacterium paratuberculosis.

Four cows with persistent diarrhea and complement-fixing antibodies to johnin were examined, using the leukocyte-migration agarose test (LMAT) with johnin as the specific antigen. The diagnosis of paratuberculosis (Johne's disease) was microscopically verified at necropsy. As control animals, 3 healthy cows and 3 cows with disease other than paratuberculosis were examined, using LMAT. The migration indices in the group of cows with paratuberculosis were significantly lower (less than 0.001) than those in the group of control cows. Furthermore, the migration zones of the unstimulated peripheral blood leukocytes in the former group were significantly smaller (less than 0.001) than those of the control group.


Cell-mediated immunity related to challenge exposure of cattle inoculated with virulent and attenuated strains of Anaplasma marginale.

Cattle which were given virulent Anaplasma marginale as a premunization procedure or were vaccinated with live attenuated or killed anaplasma preparations were challenge inoculated with virulent A marginale. Exposure of cattle to virulent or attenuated A marginale, which induced a strong and lasting cell-mediated response as measured by the leukocyte migration-inhibition test, protected against the development of high parasitemia, anemia, and clinical signs of disease after challenge inoculation with virulent A marginale. Cattle which were vaccinated with killed anaplasma preparations that induced transient and low-level cell-mediated responses were not protected against the development of severe anemia after challenge inoculation, although postchallenge parasitemia seemed to be controlled.


Demonstration of bacteriocin activity in bovine and bison strains of Pasteurella multocida.

Of 33 strains of Pasteurella multocida examined, 14 showed bacteriocin activity and 17 were susceptible to bacteriocin. The activity was increased by about twofold if the cultures were induced with ultraviolet radiation; however, no increase in bacteriocin activity was observed if the potential producer strains were induced with mitomycin C. The bacteriocin activity of potential producer strains was increased if CaCl2 was incorporated in the medium. The patterns of bacteriocin susceptibility indicate that these substances may ultimately contribute to a typing scheme for the species. An extra-chromosomal genetic element was not detected when a potential producer strain was not detected when a potential producer strain was tested by the dye-buoyant density gradient method. This fact suggests that the genetic material responsible for bacteriocin activity in P multocida is located on the host chromosome proper.


Temephos collars for control of fleas on dogs and cats.

Efficacy of polyvinyl chloride collars containing temephos [0,0'-(thiodi-4,1-phenylene) 0,0,0',0'-tetramethyl bis-(phosphorothioate)] was elevaluated in dogs and cats against the cat flea (Ctenocephalides felis). Over a period of 42 weeks, collared (treated) and control dogs were experimentally infested with 100 fleas 23 times, and control and treated cats were similarly infested 20 times during a 41-week period. Flea populations on treated dogs were reduced by 80% or more for at least 36 weeks. Initially, flea reduction by 80% occurred within 1 day, but in dogs wearing the same collars for 26 weeks, this reduction occurred in 3 to 6 or more days. Only during the first 2 weeks of wearing the collars were all fleas killed on all dogs within a 6-day period after infestation. Residual efficiency was lowest on highly active dogs and greatest on inactive dogs. The residual efficiency on cats was somewhat better than on dogs. At the end of 41 weeks, collars on cats reduced the flea population by 85 to 90% within 1 to 5 days following infestation. Collars on cats, as on dogs, were 100% efficacious only during the first 2 weeks of the trial.


Half-life of cephaloridine in dogs with reduced renal function.

Various degrees of renal insufficiency were produced in 9 dogs by nephrectomy, or segmental ligation of the branches of the renal artery, or both. The serum half-life of cephaloridine, measured after a single intramuscular injection, increased progressively as renal function decreased. In dogs with 85% reduction in renal mass, serum half-life was approximately 3 times that of control dogs. To prevent accumulation of cephaloridine in dogs with renal dysfunction, a modified dose schedule was established on the basis of these experimental results.


Dose response, prevention, and treatment of a transplantable lymphoid tumor.

Transplantable lymphoid tumor (TLT) cells in doses ranging from 10(2.43) to 10(6.80) were transplanted into 3-week-old chicks. A total of 199 chicks in 31 dosage groups was included in this 2-year study. Overall mortality was nearly 100% and analysis of the results revealed no significant differences in mortality among the groups. A significant (P less than 0.001) linear relationship existed between log10 of the TLT cell dose and mean survival time. Serum obtained from chickens which survived TLT growth, regression, and challenge inoculation was administered to chicks 4, 7, or 11 days before TLT induction. Of the chickens in each of these 3 groups, 80 to 100% survived compared with 0 to 20% in those given control serum. In chicks with actively growing TLT that were treated with 2 injections of plasma from TLT-resistant chickens, mean survival time was lengthened and survival was increased by 36%. Lymphocytes from resistant chickens or plasma od and survival was increased by 36%. Lymphocytes from resistant chickens or plasma or lymphocytes from control chickens did not affect survival time or percentage of survival. In the present study, results demonstrated a similarity to the TLT model studied 30 years ago and established the usefulness of this model in the study of serum immunotherapy.


Investigation of the vascular supply of the pectoral muscles of the domestic turkey and comparison of experimentally produced infarcts with naturally occurring deep pectoral myopathy.

Naturally occurring deep pectoral myopathy in 9 chickens and 6 turkeys was reviewed. The arterial blood supply to the pectoral and supracoracoid muscles was studied in normal mature turkey hens by preparation of arterial casts following perfusion with methyl methacrylate. Also, a latex-perfused turkey was dissected and the blood vessels supplying these muscles were identified. Six mature turkeys (under general anesthesia) were subjected to unilateral surgical obstruction of selected cranial and caudal pectoral arteries and veins and then were euthanatized and necropsied at various postsurgical times. tin 2 of the turkeys, infarction of pectoral and supracoracoid muscles was produced. Gross and microscopic examinations of these infarcts revealed that they were very similar to the lesions of deep pectoral myopathy.


Scanning electron microscopy of trachea and bronchi from gnotobiotic pigs inoculated with Mycoplasma hyopneumoniae.

Areas of trachea and right apical and right dorsal diaphragmatic bronchi from gnotobiotic neonatal pigs were examined by scanning electron and transmission electron microscopy at 7, 13, and 21 days after pigs were given intranasal inoculation of Mycoplasma hyopneumoniae. Similar areas were examined by scanning electron microscopy from 2 noninoculated neonatal pigs. Tracheal and bronchial lesions were observed in all inoculated pigs. Severe bronchial lesions were in grossly affected lobes. Early infection consisted of mycoplasmas on ciliated epithelial cells. As the interval between inoculation and euthanasia increased, mycoplasmas and leukocytes on the tracheal and bronchial surfaces became more numerous and fewer cilia remained.


Experimental surgical technique to induce mediastinitis in cats.

A surgical technique was developed to induce mediastinitis in cats. A left paracostal approach was the most successful for deposition of material into the ventrocaudal mediastinum without rupture of the delicate serous membranes.


Possible source and control of trauma-induced glucagonemia in dogs.

Plasma concentrations of glucose, insulin, and glucagon were studied in 10 adult mongrel dogs given (intravenous administration) a large dose of glucose (1g/kg of body weight) both before and after partial (50%) pancreatectomy. A proportional decrease in plasma immunoreactive insulin was observed in partial pancreatectomized dogs. Peak insulin response decreased from presurgery concentrations of 71 +/- 14 muU/ml (mean +/- standard error of the mean) in the dogs before surgical operation (presurgical value) to 52 +/- 6 muU/ml 1 or 4 days after surgical operation. Partial pancreatectomized dogs also showed a reduced plasma glucose removal rate. Fasting plasma concentrations of glucagon, on the other hand, increased by about 80%, from 253 +/- 25 pg/ml to 460 +/- 43 pg/ml 24 hours after operation. Despite an increased glucagon concentration in the dogs after partial pancreatectomy, plasma concentrations of glucagon responded (decreased) to large gulcose dosage administration. Plasma glucagon concentration returned to presurgical value by the 4th postsurgical day.


Equine cerebrospinal fluid: reference values of normal horses.

Cerebrospinal fluid (CSF) samples were collected from the atlanto-occipital (AO) and lumbosacral (LS) subarachnoid spaces of 24 horses and 21 ponies that had no clinical evidence of neurologic disease. Depth of needle insertion, pressures, refractive index, rapid reagent strip test (protein, glucose, blood, pH) results, cell counts, content of protein, glucose, sodium, potassium, chloride, calcium, phosphorus, urea nitrogen, and cholesterol, and activities of creatine phosphokinase, aspartate transaminase, lactic dehydrogenase, and alkaline phosphatase were determined. The resulting clinical reference values obtained were discussed in light of the published normal values for CSF from horses, other animals, and man. White cell counts in CSF were found to be from 0 to 6/microliters. Values for protein content were distributed between wider limits than previously reported values. The LS-AO difference is proposed as a criterion for clinical evaluation of CSF protein content. Ponies were found to have more protein in their CSF than did the horses, and CSF from the LS site contained more glucose than that from the AO site. The CSF electrolyte composition was similar to that of previous reports. Enzyme activities in equine CSF are reported for the 1st time.


A technique for chronic, extraluminal measurement of uterine activity.

The construction, calibration, and surgical placement of a device for monitoring uterine motility are described. The device, a linear stretch gauge, consisted of a length of flexible tubing filled with mercury and connected at both ends to copper wire leads. An increase in the length of the mercury-filled tubing caused a change in resistance. This change was quantitated, using a modified Wheatstone bridge circuit. In in vitro test, the stretch gauges demonstrated linear response in millivolt output to elongation over a range that was comparable to physiologic responses observed with the gauges placed in vivo. If surgically placed around 1 uterine horn, stretch gauges responded to uterine contractile events with specificity and sensitivity. Calibration of the device at time of placement permitted monitoring for possible increases in uterine circumference.


Wound complications.

An analysis of the wound complications in a six-month period on the Surgical Service of the University of Washington Hospitals is presented. A total of 9.9% of these patients had wound complications of one type or another, singly or in combination. The importance of their record and analysis in the total care of the surgical patient is emphasized.


Varices of the common bile duct as a surgical hazard.

In the case of a 78-year-old woman with three common duct stones is reported. The most striking finding at operation, was extensive varices of the common duct. There was no evidence of varices elsewhere nor of an arteriovenous fistula. The varices are assumed to be idiopathic or a unique manifestation of a chronic cholangitic venous disorder. The situation, although unique, is readily recognized. Methods of management directed at avoiding intraoperative bleeding are suggested.


Solitary pulmonary paraganglioma: case report and literature review.

Solitary pulmonary paraganglioma is rare; this is only the eleventh reported case. The tumor grows slowly and may reach a diameter of 9 cm. The treatment includes local resection or lobectomy according to the size and location.


[Viridicine: a bacteriocine from "Aerococcus viridans" (author's transl)].

Viridicine, a new bacteriocine, was extracted from whole cells of Aerococcus viridans by repeated washings with Tris-HCl 5 X 10(-3) M pH 8,1, NaCl 1 M. A crude preparation of the macromolecule was not inactived by heating for one hour at 50 degrees C and was sensitive to the action of protease, lipase and catalase. The molecular weight was about 100,000. A large number of Gram-negative and Gram-positive bacteria were sensitive to viridicine action.


The state of eye hydrocircular system in view of age pathology and open-angle glaucoma.

With age the eye drainage system undergoes a number of changes because less favorable conditions arise for intraocular fluid reflux. The manifestation and extent of these changes were closely connected with the manifestation of arteriosclerotic affection of the cardiovascular system. The changes in eye drainage passages in persons with pronounced complicated arteriosclerosis and advanced open-angle glaucoma were identical in character and comparable in the manifestation. The changes in eye drainage passages in persons with pronounced arteriosclerosis and open-angle glaucoma did not have the character of isolated trabecular lesion or lesions of Schlemm's canal or intrascleral tracts, but they were detected in all these sectors. The obtained data indicate that the changes in the eye drainage system connected with age pathology an open-angle glaucoma took place and were more pronounced in the superior sectors of the eye, gradually spreading downward. The conditions for intraocular fluid reflux along the primary tracts being deteriorated, its reflux appears to increase through the uveal tract.


Noninfectious posterior chorioretinopathies: curious multifocal and contiguous disorders.

A history of the 2 syndromes, acute posterior multifocal placoid pigment epitheliopathy and geographic helicoid peripapillary choroidopathy is presented. A complete review of the literature is beyond the scope of this presentation, but the major contributions in recent years are cited. A more complete bibliography may be obtained from our sources. Four cases are presented, each of which fulfills some of the criteria for both syndromes. It is hypothesized that both entities may be variants of one disorder with an obscure etiology.


[Analysis of various groups of denitrifying microflora in Senegalese paddy soils (author's transl)].

Dentrifying mesophilic and thermophilic bacteria were looked for in rice paddies of Senegal by culturing samples in medium with high concentrations of nitrate or nitrite (5 g/l) as respiratory substrate. These cultures revealed the existence of two populations. 1) a population of denitrifying mesophiles which tolerate high concentrations of nitrite, these organisms being mostly spore-formers and relatively numerous in these soils; growth studies showed them to be very diverse: a) "nitrite-dependent" bacteria unable to reduce NO-3; b) bacteria highly nitrite-tolerant with rapid growth on 5 g/l nitrite; c) bacteria slightly nitrite-tolerant with weak or no growth on more than 3 g/l nitrite; d) NO-tolerant bacteria which use nitric oxide as respiratory substrate for growth; e) N2O-deficient bacteria unable to grow on nitrous oxide; 2) a population of denitrifying thermophilic spore-formers which are numerous in some soils and tolerate nitrite more or less well. Measuring of the denitrifying activity of washed cells demonstrated that, in general, cells grown anaerobically on nitrite show much more activity than cells grown anaerobically on nitrate. This nitrite-tolerant population seems fairly heterogeneous, but it consists mostly of spore-forming species of the genus Bacillus.


Hemophilus orbital cellulitis and panophthalmitis simulating mucormycosis.

A 47-year-old uncontrolled diabetic presented with proptosis, pain, immobility of the globe, and a perforated corneal ulcer. The clinical impression of mucormycosis was erroneous. Hemophilus aegyptius was grown from the orbit, the vitreous and oropharynx. This is believed to be the first report of panophthalmitis due to this organism.


A rapid test for dark adaptation.

With the known relationship between defects in dark adaptation and vitamin A deficiency, liver disease, and retinal degenerative changes, the development of a practical and simple test of dark adaptation has taken on some importance. Standard dark adaptation testing instruments are somewhat impractical, expensive, and not generally available. Therefore a simple, in expensive test for evaluation of dark adaptation is desirable. Using established standards of macular dark adaptation, a test was designed that appears to be relatively simple, reasonably accurate, and rapid. The test and equipment are described.


[Denitrification in a sporulating thermophilic bacterium].

Denitrification in a thermophile isolated on nitrite containing-medium (5 g/l) was studied by means of Warburg respirometry and gas chromatography. This strain seems to denitrify nitrite more rapidly than nitrate. Extracts of cells grown anaerobically on nitrate have dissimilatory nitrate reductase (type A); extracts of cells grown aerobically without nitrate have raised levels of the two types of nitrate reductase A and B. The optimal temperature for enzyme A activity is 60 degrees C. Nitrite reductase activity was measured using yeast extract as electron donor. For nitric oxide reductase activity, yeast extract is as efficient an electron donor as sodium lactate. Nitrous oxide reductase activity was found only in the 4 000 g supernatant showing the particulate nature of the enzyme. A mixture of FAD, FMN and NADH served as electron donor. Using acetylene as an inhibitor of nitrous oxide reduction in both whole cells and extracts, we showed that this gas is an intermediate compound in the reduction of NO to N2.


Intravitreal injections by a Dermojet syringe.

Dermojet is a spring-loaded device that injects a high velocity microspray capable of perforating the globe. An accidental intraocular injection of triamcinolone acetonide from a Dermojet syringe by a dermatologist is reported. The lack of untoward effects led to experimental intravitreal injections. The Dermojet syringe was used for intravitreal injections in 7 rabbit eyes with normal saline as the vehicle in 6 and India ink in one. There were no irreversible effects attribute to the injection noted clinically or histopathologically. While modification and further animal experimentation with this device are in order, it should not be use on human eyes at this time.


Rna syntheses in BHK21 cells infected by rabies virus.

In BHK21 cells infected by rabies virus, viral RNA syntheses are detectable from the first 4 hours till at least 20h after the adsorption period. Cellular RNA syntheses are not inhibited by the virus. The viral RNA syntheses are 10 times lower than syntheses induced in infected cells by VSV. They are also slower since the maximum is between 8 and 12h after infection. At least 3 categories of molecules are synthesized: 1) short (+) molecules sedimenting between 8 and 25 S, and possibly at 30 S; 2) partially or totally double-stranded structures sedimenting between 25 and 35 S; 3) (+) and (--) molecules of the genome length. The relative amount of these 3 categories of molecules does not seem to vary during the viral cycle.


Changes in the choriocapillaris associated with senile macular degeneration.

The choroids of 107 postmortem aged eyes were used in this study. Twenty-six eyes were from patients with a clinical history of senile macular degeneration. Five eyes had early or questionable evidence of this condition. The remaining 76 eyes were from normal-aged patients. The choroids were processed by the trypsin digestion technique of Kuwabara and Cogan, as modified by Friedman, Smith and Kuwabara. This study was limited to the choriocapillaris. The most important changes noted in eyes with senile macular degeneration were: (1) thickening and irregular shape of the intercapillary septa; (2) narrowing of the lumen of the capillaries; (3) diminution or loss of cellularity of the capillaries; and (4) basophila of the macular area. The possible effects of these changes on the transport of oxygen and metabolites from the choriocapillaris to the outer layers of the retina are discussed.


HLA antigens and keratoconus.

Significant associations have been found between the HLA antigens or haplotypes and certain diseases and deficiencies. These associations have opened up new areas of clinical investigation. In man, associations have been shown between the presence of Hodgkin's Disease and a number of cross-reacting HLA types (BW5, BW15, BW18), between systemic Lupus erythematosus and HLA type BW15 in Caucasians and BW35 in blacks, between HLA B37 and ankylosing spondylitis in Caucasians, between HLA B8 and gluten-sensitive enteropathy and between HLA B13 and psoriasis, a disease having a strong hereditary element. In ophthalmology, Shin and Becker have shown that the prevalence of HLA B7 and B12 antigens was significantly higher in patients with primary open-angle glaucoma than in the non-glaucomatous population. The purpose of this communication is to report the presence of HLA B27 antigen in the mother and two siblings with keratoconus.


[Rapid detection of rabies antibodies by immunoenzymatic assay].

The antigen is a semipurified tissue culture virus, and peroxidase conjugated anti-human immunoglobulines are used. When sera from immunized humans are evaluated by this procedure, the values obtained show a good correlation with seroneutralization titres. The detection of antibodies by this method is earlier than by seroneutralization.


Hypotelorism and optic disc anomalies: an ignored ocular syndrome.

Hypotelorism, decreased interpupillary or interocular distance, deserves a wider recognition. Its association with anomalies of the optic disc is emphasized. This association appears to be a well defined ocular syndrome and may be considered another helpful clue in the differential diagnosis of the so-called pseudopapilledema from true papilledema.


Intraocular lens implantation in children.

The intraocular lens offers an additional parameter to be considered for the visual rehabilitation of children with traumatic or infantile cataracts. The disadvantages of aphakic spectacles or contact lens have committed many of these eyes to the status of visual cripples. Bearing in mind all of the complications and the lack of long-term follow-up, the IOL warrants careful consideration for use in this group of cataract patients. In this series of 27 patients with a maximum of 18 months' follow-up, it is concluded that the IOL may be successfully implanted and that, thus far, no eye has been made worse than the patients preinsertion status.


[Vascularization of the laryngeal cartilages; true clinical importance (author's transl)].

The authors specify the role of the ossification process of the larynx cartilages. Only the epiglottis may be considered as a cartilage. The use of microangiography made it possible to describe some peculiar features of the microvascular pattern. The vascular patterns of the thyroid, cricoid and arithenoids cartilages are similar to one another; the cartilage and its two perichondriums must be considered as a complete whole. The epiglottis shows a peculiar vascular pattern. The authors insist upon the important role of the vascular pattern in pathologic studies.


[Epidermoid cysts of the mandible (author's transl)].

The authors present three cases of epidermoid cyst of the mandible, one of which had undergone malignant change. These cysts are rare. They are most often situated at the angle of the jaw and present as a deep swelling of the cheek. The only treatment is excision, the authors advising the external approach which gave them the best results.


Congenital cricopharyngeal achalasia.

Fifteen infants with congenital cricopharyngeal achalasia are reviewed. Although most of the patients had symptoms at birth, the diagnosis was frequently not confirmed until later in the first year of life. While four of the infants had only cricopharyngeal achalasia, 11 had associated diseases related to the central nervous system. Those patients without associated diseases improved spontaneously with conservative management; most of the infants with other abnormalities also improved, although their clinical progress was slower and more complicated. In three of the patients, the symptoms were persistent and there were two deaths related to associated diseases. Cricopharyngeal myotomy was performed on two children with only moderate improvement in symptoms. Congenital cricopharyngeal achalasia is more common than formerly recognized. When suspected, an esophagram with tele- or cineradiography is essential to confirm the diagnosis. Esophageal motility studies will quantify changes and also evaluate lower esophageal dysfunction not easily identified on esophagrams.


Laryngotracheoesophageal cleft: the anterior approach.

Laryngotracheoesophageal cleft was reported by Richter in 1792 after he examined an infant at autopsy and found a common lumen of esophagus and laryngotrachea. The next case was not noted until 1949 by Finlay. A recent review shows 40 cases in the world literature to date. Successful surgical approaches to some of these problems have basically employed a lateral pharyngotomy technique. In the case presented herein, the exact pathology was obscured by a severe tetralogy of Fallot and recurrent pneumonitis from a suspected high H-type tracheoesophageal fistula. The length of this cleft prompted an anterior approach with laryngo-fissure, cricoidotomy, and division of four tracheal rings for a complete and successful repair. Thorough endoscopy of all infants suspected of any laryngeal anomaly would yield an earlier diagnosis and opportunity for reconstruction of the cleft.


Esophageal papillomatosis: case report.

An unusual case report of asymptomatic multiple esophageal papillomas associated with pedunculated hypopharyngeal papillomas that presented as laryngeal obstruction in a 2 1/2-year-old boy who underwent resection and irradiation of a retroperitoneal neuroblastoma at the age of nine months. Barium swallow and esophagoscopy confirmed the presence of multiple asymptomatic lesions involving the upper two-thirds of the esophagus. Biopsy confirmed the hypopharyngeal and esophageal lesions to be similar in nature.


Fatal complication from an alkaline battery foreign body in the esophagus.

Foreign bodies and alkali burns in the trachea and esophagus are potentially fatal. Some camera batteries contain 45% potassium hydroxide electrolyte which can leak and cause liquification necrosis upon tissue contact. This report describes a case of an alkali battery foreign body in the esophagus with a subsequent fatal course which was masked by steroid therapy. A discussion of corrosive burns of the esophagus, their etiology, clinical course and pathology is presented.


Physiologic differentiation of upper and lower airway obstruction.

Usual lower airway obstruction and fixed upper airway obstruction can be differentiated physiologically by means of the flow-volume curve. Normally, maximal flow decreases nearly linearly as lung volume decreases during expiration. In lower airway obstruction, this decrease is greatest at the beginning of expiration resulting in a curve that is concave upward. In fixed obstruction (stenosis) flow is constant throughout the initial part of forced maximal expiration and throughout virtually all of inspiration. This results in a plateau or flat curve which is characteristic and different from the curve in obstruction of lower airways. Cases in which this differentiation is clinically important are discussed.


Idiopathic subglottic stenosis.

A 2 1/2-year-old child was found to have subglottic stenosis with no obvious etiology. He initially responded well to dilatation, injection of triamcinolone and intermittent stenting of the airway, but four months later developed a marked, unyielding subglottic stenosis requiring tracheostomy. He had a gradual good response to dilatations and injections with triamcinolone and acquired a good subglottic lumen. However, he developed a recurrence following an episode of croup. Systemic steroids were added to the regimen leading to gradual resolution of the stenosis and successful decannulation. The embryogenesis of subglottic stenosis and the correlation with the known anatomy and histology are discussed. Subglottic stenosis may be congenital, traumatic, inflammatory, neoplastic or neurogenic. An additional group of patients has no obvious etiology and are classified as idiopathic. Treatment consists of various combinations of stents, systemic and intralesional steroids, dilatations and various operative procedures in the more refractory cases.


[Clinical and statistical analysis of the side effects and complications of antibiotic therapy].

A total of 4936 side reactions and complications in 2311 patients subjected to antibiotic therapy were analyzed. The drug allergy was of the allergic nature in 79.9 per cent of the cases, in 6.03 per cent of the cases it was of the toxic nature and in 6.03 per cent of the cases the drug allergy had a toxico-allergic genesis. Dysbacterioses and candidoses were diagnosed in 7.22 per cent of the cases. The complications were lethal in 0.9 per cent of the patients. The complications due to the antibiotic therapy may be arranged in the following descending order: penicillin (51.56 per cent), tetracycline (18.03 per cent), streptomycin (11.5 per cent), levomycetin and sintomycin (11.07 per cent), macrolide antibiotics (5.43 per cent). Affections of the skin and its appendages, nervous system and gastro-intestinal tract were most common. The penicillin side effects were characterized by more frequent skin allergic reactions amd neuro-psychic impairments. Tetracyclines caused more allergic reactions than it was usually considered. Streptomycin was characterized by high shockogenic properties, neurotoxicity and hematotoxicity. The toxic complications were most often caused by aminoglycosides. They were evident clinically from ototoxic and nephrotoxic reactions. General causes of complications due to antibiotic therapy are discussed.


[Antibiotics and the macroorganism (the causes and the mechanism of occurrence of side effects].

The main types of side reactions due to antibiotic therapy are described. The antibiotic groups most often being the cause of side reactions are presented. Dependence of the toxic (organotropic) effect of antibiotics on the therapy scheme, age and pathological changes in the mechanism of their excretion is indicated. The biochemical mechanisms of the side and selective effects of antibiotics are discussed.


[Modern principles for studying the organotropic side effects caused by antibiotics].

For prophylaxis of the organotropic side reactions in antibiotic therapy it is important to determine correlation between the drug blood level and the effect level. The study of this correlation under experimental conditions provides determination of the maximum permissible concentration of the antibiotic in the blood. When the antibiotic side effects are diagnosed in clinics it is advisable to determine as exact as possible the peculiar properties of the drug pharmacokinetics in the respective patients.


[Some features of the side effects of antibiotics in bronchopulmonary diseases].

A total of 1838 cases treated with antibiotics were analyzed in a pulmonological clinic. The antibiotics were used because of acute pneumonia, exacerbated chronic pneumonia, active inflammatory processes in cases with infectious allergic bronchial asthma and other bronchopulmonary diseases. Levomycetin (21 per cent), benzylpenicillin (14 per cent), oletetrin, erythromycin, semi-synthetic penicillins, aminoglycosides and other antibiotics were used most often. The antibiotic side effects were registered in 1.4 per cent of the cases, the allergic complications being 4 times more frequent than toxico-metabolic complications. The main path for prevention of the antibiotic side effects was rational antibiotic therapy. The antibiotic choice should be guided by the following considerations: process localization, patient's age, causative agent species, its antibiotic sensitivity, antibiotic pharmacokinetic characteristics in the organism of the patient, character of the antibiotic side effects on the macroorganism.


Pulmonary migraine.

Although it is not uncommon in bronchoesophagological practice to be consulted in cases of unexplained atelectasis, patients presenting with painful atelectasis are indeed rare. Three such cases will be described. The first case, previously unreported, for which Dr. M. E. Avery suggested the term "pulmonary migraine" is that of a 14-year-old Caucasian female with a history of recurrent "asthma" chest pain, atelectasis and migraine headache. On investigation there was demonstrable spastic obliteration of the lumen of a lobar bronchus. Two similar cases are described.


[Diagnosis of anaphylactic shock caused by antibiotics].

A total of 277 cases with anaphylactic shock due to the use of various antibiotics were analyzed. Anaphylactic shock due to penicillin (38.2 per cent), streptomycin (19.8 per cent), combihation of streptomycin with penicillin (16.9 per cent) or bicillin (15.2 per cent) was most frequent. The causes of the diagnostic mistakes are shown and the clinical signs of the main typical form of the drug anaphylactic shock are descrifed. Four variants of atypical clinical picture of anaphylactic shock, i.e. hemodynamic (collaptoid), asphyctic, cerebral and abdominal were classified. Examples of diagnostic mistakes are presented. It was shown that the drug allergological anamnesis was not always considered in the therapeutic practice.


[Toxicity and side effects of antibiotics in radiation sickness and during the use of aminothiol group radioprotective agents].

It was shown in experiments on mice, rats and rabbits that resistance of animals in the state of acute radiation sickness to severe intoxication by aminoglycoside antibiotics, such as streptomycin, dihydrostreptomycin and monomycin did not significantly change. The exception was kanamycin the toxicity of which during the period of the acute state of radiation sickness increased by 30 per cent. The use of cystamine and merkamine before irradiation or their administration to non-irradiated animals resulted in lowering of the antibiotic tolerance by 1.5--2 times. The above aftereffects of the radioprotectors was observed within 3--12 days after their use and was most pronounced for the combination of cystamine and streptomycin. The acute toxicity of tetracyclines did not significantly differ at various stages of radiation disease and at the background of cystamine use. No significant cumulation of the toxicity of aminoglycoside antibiotics and tetracyclines or signs of adaptation in the healthy and irradiated animals was observed on prolong treatment with therapeutic doses. Cystamine had no effect on the tolerance of the antibiotics on their prolonged use.


Coccidioidomycosis of the larynx in infants and adults.

Coccidioidomycosis is a fungal disease endemic to the southwestern United States. The primary form of the disease is relatively benign and many patients, after exposure by inhalation of the sapyrophytic form of the organism, convert from negative to positive skin testing without significant clinical symptoms. The less common disseminated form represents a serious life-threatening disease and can present with granulomatous changes in the larynx. The authors' experience with disseminated coccidioidomycosis presenting in the larynx of adults and infants successfully treated with amphotericin B are presented and discussed.


[Methodological bases for the hygienic standardization of antibiotics].

For determination of the maximum permissible concentrations of antibiotics it is necessary to develop some specific approaches conditioned by the peculiarities of the biological effect of antibiotics in addition to the use of the general principles of the hygienic rationing of the factors of the production environment. It is advised to determine the thresholds of the specific antibacterial and allergen effect of antibiotics in the acute experiment in addition to the threshold of the general toxic effect.


[Actinomyces chromogenes var. graecus var. nov., a producer of a new hexaene antibiotic].

Actinomycete LIA-O832 was isolated from a soil sample of Greece. By its antimicrobial spectrum, morphological and cultural properties the actinomycete was most close to Act. chromogenes but differed from the latter by the antibiotic and physiological properties. The actinomycete was classified as Actinomyces chromogenes var. nov. The culture produced an antibiotic complex including 4 antibiotics, i.e. a tetraen antibiotic primaricin, a new hexaen named grecomycim and 2 non-polyenic antibiotics, one of which was close to kikumycin and the other was close to aksenomycin. The physico-chemical characteristics of the antibiotics are presented.


[Effect of triterpene glycosides on RNA biosynthesis in a yeast cell culture of Saccharomyces carlsbergensis].

The effect of triterpen glycosides of cauloside C from Caulophyllum robustum, theasaponine from Thea sinensis ahd stichoposide A from Stichopus japonicus on multiplication and biosynthesis of RNA in the cells of a 7-hour culture of Saccharomyces carlsbergensis was studied. It was shown that cauloside C, theasaponine and stichoposide A in concentrations of 7.5 gamma/ml inhibited multiplication of the yeast cells by 65, 10 and 90 per cent respectively. The summation RNA of the yeast cells is divided into 3 zones on Sephadex G-100. The glycosides induced no pronounced changes in the chromotographic profile of RNA. Biosynthesis of the transport and ribosomal RNA were inhibited to the same extent. Triterpen glycosides inhibited the biosynthesis of RNA at the stage of 14C-uridine in corporation into the nucleotide pool of the yeast cells.


[Comparative experimental study of the antileukemia activity of carminomycin and rubomycin].

The antileukemic activity of karminomycin and rubomycin was studied comparatively in parallel experiments with respect to 4 strains of transplantable leukemia, i.e. acute non-differentiated leukemia La, acute lymphoblast leukemia, L-1210 and P-388 and subacute lymphoblast leukemia No. 8 CRIHBT. The doses used were adequate by their toxicity. The tests of the therapeutic effectiveness were: an increase in the life time of the animals treated as compared to the control ones, a decrease in the leukocyte count and the number of the blast cells in the peripheral blood, a decrease in the leukemic infiltration of the organs and tissues of the animals treated. It was shown that karminomycin was more effective in the studied leukemia strains when it was used in the doses with equivalent toxicity. The more pronounced antileukemic activity of karminomycin was especially evident from histological examinations, which showed lower infiltration of the organs and tissues of the mice treated with karminomycin by the leukemic cells as compared to the animals treated with rubomycin.


Effect of monensin on rumen metabolism in vitro.

The effect of Monensin (Rumensin, Eli Lilly & Co.) in incubations with mixed rumen microorganisms metabolizing carbohydrate or protein substrates was investigated. Monensin partly inhibited methanogenesis and increased propionate production, although the effect was not always statistically significant. Incubations with substrates specific for methane bacteria suggest that inhibition of methanogenesis by Monensin was not due to a specific toxic action on the methanogenic flora, but rather to an inhibition of hydrogen production from formate. Total and net microbial growth were considerably decreased by addition of Monensin, although the amount of substrate fermented was not altered, resulting in lowered values of microbial growth efficiency. In incubations with casein, Monensin lowered protein degradation in line with a lowered ammonia production, whereas a slight accumulation of alpha-amino nitrogen was observed. The results suggest that besides an influence of Monensin on the rumen carbohydrate fermentation pattern, another reason for the beneficial effects observed in vivo might be decreased food protein degradation in the rumen, altering the final site of protein digestion in the animal. Also, the possibility of a decrease in rumen microbial growth efficiency has to be considered when using Monensin as a food additive.


Effect of coumarin on growth and metabolism of Pythium.

Coumarin concentrations that inhibited growth of Pythium sp. rapidly decreased the rate of incorporation of [14C]glucose into the mycelium. Coumarin also reduced drastically the carbohydrate and protein content of the cytoplasm and, to a lesser extent, the amino acid content and cell wall fraction. Enzymes related to the metabolism of cell wall polysaccharides were not affected during early exposure to the inhibitor. The possible mechanism of coumarin action via inhibition of glucose uptake is discussed in the light of the present findings.


Effects of enrichment media and incubation conditions on isolating salmonellae from ground-meat filtrate.

Forty-eight combinations of enrichment media, secondary enrichment, incubation times and temperatures, and atmospheres were examined for their efficacy in recovering different serovars of Salmonella that had been inoculated into ground-meat extract. Variations included three selective-enrichment media, two (37 and 43 degrees C) incubation temperatures, two (24 and 48 h) incubation times, two (aerobic and anaerobic) incubation atmospheres, and secondary enrichment to two of the selective-enrichment media. The ratio of Salmonella to other microorganisms was 10: greater than 1,000,000. One-hundred and twenty-four tests were conducted for each enrichment under each condition of incubation. None of the methods recovered Salmonella in more than 60% of the trials. Salmonella typhimurium was recovered most frequently of the serovars tested; S. abortusovis was recovered least frequently. There was considerable variation in the results obtained by the different methods, but there was a statistically significant advantage in the 43 degrees C incubation temperature. Secondary enrichment in tetrathionate broth showed a statistically significant advantage over secondary enrichment in selenite broth. Secondary enrichment into a different medium from the primary enrichment also was advantageous.


Academic manpower in dermatology.

A survey showed that there were 338 strict or geographic full-time dermatologist faculty members in the United States. Ninety-six percent of these 338 faculty members were located at the 72 schools of medicine with residency training programs in dermatology or at the 21 approved residency training programs in dermatology, not affiliated with colleges of medicine. The 42 schools of medicine without approved residency training programs in dermatology reported only 11 full-time dermatologist faculty (3% of the total). Women constituted 7% of the faculty, while foreign medical graduates constituted 9%. More than one third of faculty were trained at the institution in which they currently serve. Approximately one third were likewise trained at four major teaching institutions.


Dermatologists for the nation. Projections of supply and demand.

Because inappropriate supply of physician specialists involves unnecessary human suffering or waste of human resources and because free market forces are ineffective in the medical sector, deliberate planning of supply is necessary. A model projecting the future supply of dermatologists was formulated on the basis of current residency capacity, which produces 250 dermatologists annually, and current experience regarding life expectancy and retirement. The model implies that an equilibrium supply of 8,800 dermatologists, or three per 100,000 population, will be realized early in the 21st century. A number of methods were used to estimate the demand for care, and, under conditions of general access, three dermatologists per 100,000 appear to be appropriate. Thus, maintaining current training capacity seems to be prudent, but because of many unknown and unpredictable factors, periodic reassessment is necessary.


Photocontact dermatitis to halogenated salicylanilides and related compounds. Our experience between 1967 and 1975.

We evaluated the role of the halogenated salicylanilides and related compounds in the development of photocontact dermatitis between 1967 and 1975 as seen at the University of California, San Francisco clinic. During this period positive photopatch tests to at least one of these chemicals were detected in 98 patients. Prior to 1967, tetrachlorosalicylanilide and the brominated salicylanilides were the most common offenders. Declines occurred in number of patients with positive photopatch tests and patch tests to these agents as well as the number of patients tested to these agents during this period; ie, almost three times as many people were tested and four times as many had positive photopatch tests in the last six months of 1967 as compared to the first nine months of 1975. The most striking reduction in numbers of patients with positive tests occurred after 1968, but the most notable reduction in the total number of positive photopatch tests occurred after 1970. We concluded that these results were most likely due to removal from the market of the more potent photosensitizing chemicals and increased physician familiarity with the disease process.