Secondary phase nystagmus--revisited.

A prospective clinical study of secondary phase nystagmus (SPN) is presented. The tracings of 200 patients referred for ENG evaluation and eight normal control subjects were anlyzed under all caloric conditions, within a prolonged postirrigation tracing time frame. The spontaneous direction reversal (SPN) was observed in a majority of the control subjects under all four conditions. The occurrence of post-caloric SPN in the patient group varied considerably among various diagnostic categories. However, SPN was observed far less frequently in the total patient group as compared to the control group. Thus, the absence of SPN may be taken to be a general indication of vestibular pathology.


Acinic cell tumors of salivary gland origin.

The acinic cell tumor of salivary gland origin, once thought to be benign, is now known to be an incidiously slow growing malignant neoplasm with lethal potential. While the degree of malignant behavior of individual acinic cell tumors is notably variable, all must be treated with aggression. Traditional and current methods of treatment are reviewed; and, in conjunction with the tumors herein reported, guidelines for managment of this uncommon malignancy are suggested. Four cases have been reviewed in detail and critically analyzed. The pathology, including features of both light and electron microscopy, in included--particularly in relation to the oncocytoid areas identified in from 10% to 40% of the parenchymal cells of our tumors. Since an accurate histopathologic diagnosis is the first step in the establishment of a proper treatment plan, pitfalls in histologic diagnosis have been stressed.


Composite resection in the elderly: a well-tolerated procedure.

The advisability of surgery in the elderly must be weighed against continued nonoperative care. The gloomy prospects of the patient with uncontrolled carcinoma of the head and neck led to the development and wide application of the composite resection for control of carcinoma of the oral cavity. The risks involved in this major undertaking in the elderly have not been previously reported. To this end a retrospective study of charts of patients over the age of 64 were reviewed and complications categorized. A representative group of younger patients were similarly reviewed for comparison. Wound complication rates were similar in the two groups, however the elderly were more likely to suffer associated medical problems which tended to be of a more serious nature. An overally complication rate of 29% was encountered with a mortality of 4%.


Vocal and social situation of laryngectomees.

A summary of progress of surgery and rehabilitation showed that the vocal and social situation of the laryngectomee in the world is very poor. To improve this situation, a world survey on the state of laryngectomees and a world Congress in Quebec City in 1974 were organized. Consequently, a special section of l'Hotel-Dieu de Quebec was organized to stimulate the vocal rehabilitation of the laryngectomees, and the global statistics now show that the percentage of success has increased from 54% to 83%.


Cervical angiofollicular lymph node hyperplasia.

A three-and-a-half-year-old male with cervical angiofollicular lymph node hyperplasia is presented. Only 185 cases of this lesion have ever been described. The greater majority of these (80%) were located in the mediastinum. This case represents the youngest patient ever described as having such a lesion, especially located in the neck. The history, etiological theories, and pathology of this problem are discussed.


Combined effect of 3', 4'-dideoxykanamycin B and potent diuretics on the cochlea. (A scanning and transmission electron microscopic evaluation).

In investigations on the action of DKB (3' 4'-dideoxykanamycin B), and aminoglycoside type drug, on the inner ears of mice and guinea pigs by means of scanning and transmission electron microscopy, it was evident that the action of DKB against the inner ear is similar to that of kanamycin. When the same type of investigation was performed using the diuretics furosemide and ethacrynic acid, changes were observed in the stria vascularis. When DKB and ethacrynic acid, which show no long lasting defects when given independently, were administered concurrently in the same doses, a very high level of degeneration was found in the organs of Corti of guinea pigs. From the above results, it is evident that when two or more types of ototoxic drugs are administered concurrently, they have a potentiating action on the ear and care should be taken clinically concerning this point.


"Practical suggestions on facial plastic surgery--how i do it". Management of the dog ear deformity.

The dog ear is a common skin deformity resulting from attempted closure of unfavorably shaped defects or from transfer of many local flaps. Prevention is possible in many instances and surgical correction is usually feasible when the deformity appears.


[Absorption and malabsorption of fat and bile acids (author's transl)].

The current concepts of normal fat absorption and the entero-hepatic circulation of bile acids are being reviewed with emphasis on the steps which are clinically important. Based on an understanding of normal physiology, diseases associated with steatorrhea can be classified according to pathogenetic mechanisms. In some diseases the pathogenesis of the steatorrhea is not understood. Malabsorption of fat and bile salts can have characteristic consequences such as nutritional deficiencies, diarrhea, hyperoxaluria with nephrolithiasis, and cholelithiasis. For quantitative assessment of steatorrhea chemical analysis of fecal fat is necessary.


[Intestinal protein assimilation and losses in man (author's transl)].

The total quantity of endogenous plus exogenous protein digested and absorbed in the normal gastrointestinal tract in man is in excess of 150 mg per day. Total fecal nitrogen indicates net losses of less than 10% per day in health. Malabsorption and maldigestion both contribute to a decrease in assimilation of exogenous and endogenous proteins. Abnormal serum protein losses across the gastrointestinal tract may be totally recovered if the leak is small and proximal in the intestine. Specific defects in amino acid absorption are often compensated by intact peptide absorption.


[Absorption and malabsorption of vitamins (author's transl)].

Vitamins are absorbed by different mechanisms ranging from simple diffusion for most of the water soluble vitamins to more complex processes in the case of vitamin B12, folate, and the fat soluble vitamins. These processes are discussed. Malabsorptive disorders result in significant deficiency of only these latter vitamins which require specialized digestive or transport mechanisms. The underlying disease also determines which, if any, deficiency is likely to occur. The effects of different types of pancreatic, biliary, and intestinal disease on vitamin absorption are discussed.


[Diagnostic approach to the patient with malabsorption (author's transl)].

Malabsorption is eminently treatable, by specific therapy of the underlying disease in the majority of cases, or, at least, by correction of developing nutritional deficiencies. We, therefore, owe our patients that we will not rest until a diagnosis is established. The large majority of patients can be diagnosed with techniques available to most practicing physicians and general hospitals. In the rare instance where a diagnosis cannot be reached, the physician should not hesitate to refer the patients to a center spezializing in gastrointestinal diseases.


[Small intestinal biopsy--technique and diagnostic value (author's transl)].

The commonly used instruments for obtaining small bowel biopsies, their use and the examination of the biopsy particles by magnifying lens, light microscopy and histochemistry are presented. Based on biopsy findings, diseases of the small intestine are classified as follows: 1) diseases with diagnostic biopsy abnormalities which are excluded by a normal biopsy; 2) diseases which can be diagnosed by positive biopsy findings but cannot be excluded by a normal biopsy; 3) nonspecific mucosal abnormalities; and 4) diseases with normal architecture of the intestinal mucosa.


[Idiopathic intestinal lymphangiectasia with hypoproteinemia. Unusual combination of complete diagnosis and ineffective therapy (author's transl)].

This case illustrates the difficulties which occasionally are encountered in diagnosing and treating small intestinal diseases. The delay in diagnosis was due to the fact that symptoms started in 1950 but the disease was not described until 11 years later. Once the diagnosis was established, there was an unexplained failure of response to appropriate therapy.


[Blood perfusion of the liver under physiological and pathological conditions - mechanisms and clinical importance (author's transl)].

It has been shown, that measurement of total hepatic blood flow is not of great diagnostic value: normal functioning of this organ is dependant on blood flow only to a minor degree and diseases of the liver usually go along with only minor changes of total blood flow. There are two reasons for this phenomenon: 1) liver cells are able to extract oxygen from blood exhaustively 2) regulation of hepatic arterial blood flow is almost autonomous and compensates well for changes of portal venous blood flow and changes of extrahepatic arterial circulation. Thus normal hepatic arterial blood flow is the most important factor as far as prognosis of shunt operations is concerned. The manifestation of portal-systemic encephalopathy in addition depends not only upon the amount of portal-venous blood bypassing the liver, but also upon arterial blood flow, since urea synthesis is located primarily in zone 1 of liver microcirculation, which is supplied in the first line by the hepatic arterial system. Reduction of portal venous blood flow plays a rather minor role as compared to reduction of arterial flow; it does mean however a considerable loss of important nutritive and trophic factors for the liver.


[Hepatic insufficiency - clinical picture].

Hepatic insufficiency results from extreme derangement of liver cell function. Pathophysiology and clinical picture of this syndrome are briefly discussed; the latter correlate rather poorly with laboratory data - the poorest correlation existing between clinical picture and bioptic findings. Acute hepatic insufficiency may occur in the course of every pathological process involving the liver, it does however arise most often in severe viral hepatitis with widespread disintegration of liver cells and in toxic liver damage. Chronic hepatic insufficiency is typical for the final stages of cirrhosis of the liver. Measurement of coagulation factors has proved to be the best prognostic parameter in hepatic failure.


[Clinical picture and therapy of portal-systemic encephalopathy (author's transl)].

The clinical syndrome of portal-systemic encephalopathy is caused by far advanced cirrhosis of the liver in most cases; it is characterized by increasing drowsiness, disturbances of mentation, flapping tremor and hyperreflexia. An early diagnosis can be established by testing writing and drawing abilities. Increased occurrence of spider nevi, a dry, deep red tongue, and hemorrhagic lesions of skin and mucous membranes are symptoms of incipient hepatic insufficiency. The syndrome is initiated in most cases by excessive intake of protein or alcohol, by intestinal bleeding, by diuretics, or by intercurrent infections. Therapy has to include elimination of causes, reduced intake of protein, enemas with acetate buffer solution and oral medication with lactulose, bifidum milk, and certain amino acids in order to lower hyperammoniemia; in serious cases neomycin has to be given. At the same time a normalization of fluid and electrolyte balance has to be achieved; replacement of potassium is especially important, when hypokalemia and alcalosis are present. In general prognosis of portal-systemic encephalopathy however is serious, depending primarily upon the fact, whether or not sufficient functional hepatic parenchyma is present.


[Renal disorders in hepatic insufficiency - pathogenesis and therapy (author's transl)].

Renal failure in patients with acute or chronic hepatic insufficiency may be caused by prerenal factors (diuretics, hemorrhage), acute renal failure (shock, toxic tubular necrosis) or concurrent primary renal disease. Prerenal (functional terminal or circulatory) insufficiency to the kidneys seems to occur spontaneously; it is characterized by progressive reduction of glomerular filtration rate and renal plasma flow due to vasoconstriction and increase of intrarenal arterial resistance; the pathogenetic mechanisms of these changes are unknown. Reduction of effective plasma volume is especially important. Attempts at pharmacologically influencing renal blood flow have failed up to now. Increase of plasma volume and furosemide medication are therapeutic procedures worthwhile trying. Hemodialysis is indicated only, if restitution of liver function can be expected.


[Hepatic failure and disorders of coagulation (author's transl)].

Disorders of coagulation are part of the clinical syndrome in hepatic failure. The pathophysiology of these disorders is discussed; analysis of coagulation defects in hepatic disorders does not help in differential diagnosis of hepatic diseases in the proper sense, but it is of considerable prognostic value. Therapy of hepatic diseases is discussed taking into account the pathophysiology of hepatic disorders; success of any therapeutic approach however is very limited, because of the bad prognosis of the underlying disease.


[Occurrence of liver cell necrosis during surgery; histological findings of specimens obtained by biopsy during laparotomy (author's transl)].

Liver biopsy specimens were taken in 350 patiens during laparotomy and examined histologically. In 27.7% of all cases liver cell necrosis with invasion of granulocytes could be demonstrated, however only when biopsies were taken at least 45-60 min after start of surgery. There is no clear evidence, that the occurrence of this type of necrosis depends on the method of narcosis, the age of the patient, the severity or duration of the underlying disease, on the presence of cholangitis, cholestasis or fatty infiltration of the liver. Cell necrosis occuring during surgery arises primarily in the centrolobular areas as single cell necrosis; in rare cases however confluent and extended necrotic changes may occur. Etiology, pathogenesis and significance of the lesions are discussed. The frequency of other changes of the liver diagnosed inadvertently during these investigations is discussed as well.


[Epidemiology of primary carcinoma of the liver in Austria (author's transl)].

29 348 in patients were treated from 1945-1975 on a gastroenterological ward; 1 892 (6.47%) of these patients had cirrhosis and 183 (0.63%) carcinoma of the liver. In the groups of patients who died, resp. came to autopsy percentages were considerably higher: 17% resp. 25.6% had cirrhosis, 4.9% resp. 13% had primary carcinoma of the liver. Analysis of these data shows, that the incidence of both diseases is increasing. This seems to be due in the first line to increasing alcoholism, and only to a lesser degree, at least in Middle Europe, to viral hepatitis. Taking into account other data published in Austria concerning absolute and relative incidence of primary carcinoma of the liver it can be stated, that this malignancy ranges among the 10 most frequent tumor diseases already.


The succulent Euphorbias of Nigeria. II. aliphatic diterpene esters of the latices of E. poisonii Pax. and E. unispina N.E. Br.

Methanol-preserved latices of E. poisonii and E. unispina were examined for irritant principles. Six esters of the parent diterpene 12-deoxyphorbol were identified by spectroscopic and chemical methods. Three were the aliphatic esters 12-deoxyphorbol-13-(2-methyl-butyrate), 12-deoxyphorbol-13-angelate and 12-deoxyphorbol-13-isobutyrate, and a further three compounds were the 20-acetyl equivalents. Isobutyrate esters were absent from the latex of E. unispina, an observation of possible value in the identification of these two similar species.


Microbial transformations of natural antitumor agents. IV. Formation of N-(2)-nor-d-tetrandrine by Cunninghamella blakesleeana (ATCC 8688a).

Microbial transformation experiments have been conducted with the antitumor alkaloid, d-tetrandrine. The alkaloid is selectively demethylated at the N-(2)-position by Cunninghamella blakesleeana ATCC 8688a. The biotransformation reaction is highly selective and uncomplicated by side-product formation. N-demethylation of the alkaloid using methylchloroformate is not regio-specific. Procedures used in screening microorganisms for their abilities to yield metabolites of d-tetrandrine are evaluated.


Alkaloids of thalictrum. XX. Isolation, identification and structural elucidation of the alkaloids of the root of Thalictrum longistylum.

A study of the alkaloids of the roots of Thalictrum longistylum DC. resulted in the isolation of 12 alkaloids plus an artifact, 8-trichloromethyldihydroberberine. The 12 alkaloids were berberine, columbamine, jatrorrhizine, magnoflorine, methothalistyline, N-desmethylthalistyline, oxyberberine, palmatine, thalibrine, thalifendine, thaliglucinone, and thalistyline. Of these alkaloids, methothalistyline, N-desmethylthalistyline, and thalistyline are new compounds and with thaliglucinone possess hypotensive activity in dogs and rabbits. Methothalistyline, N-demethylthalistyline, thalistyline, and thalibrine were found to be active against Staphylococcus aureus and Mycobacterium smegmatis with with thalistyline being most active (50 microgram/ml).


Antineoplastic agents. 51. The yellow jacket Vespula pensylvanica.

An ethyl alcohol extract of the yellow jacket Vespula pensylvanica Saussure was found to inhibit growth of the murine P388 lymphocytic leukemia cell line. Separation of a ligroin fraction guided by bioassay led to characterization of the cytotoxic constituents as oleic acid (1a) and palmitoleic acid (1b). Evidence was also found for the presence of palmitic acid and the sterols sitosterol, campesterol and cholesterol.


Cesalin--an anti-neoplastic protein.

An anti-neoplastic protein was isolated from the endosperm of the seeds of Caesalpinia gilliesii by extraction with water, dialysis and precipitation by ammonium sulfate or acidification. The precipitated protein mixture was separated by column chromatography into three principal proteins, one of which, termed cesalin, inhibited the growth of Walker 256 carcinosarcoma. There is an associated carbohydrate with the cesalin that can be largely removed by chromatography on hydroxyl apatite; the remaining carbohydrate (about 0.3%) is a hexosan. Cesalin, molecular weight 110,000, migrates as a single component by polyacrylamide gel electrophoresis at pH 8.3, but in a denaturing system containing sodium dodecyl sulfate three bands were observed. The correspond to protein sub-units of approximately 30,000 daltons. Anti-tumor tests in rats showed 70-80% inhibition of Walker 256 growth at a dose of 80 microgram/kg/day of cesalin.


Cocculitine, a new abnormal Erythrina alkaloid from Cocculus laurifolius.

Cocculitine, C18H23NO3, mp 142-143 degrees, [alpha]25D+93 degrees (MeOH), a new abnormal Erythrina alkaloid has been isolated from the leaves of Cocculus laurifolius and has been assigned structure 1 on the basis of spectroscopic studies and chemical correlation.


Catharanthus roseus tissue culture: the effects of medium modifications on growth and alkaloid production.

A number of nutritional factors as well as the growth factors 2,4-D and IAA were studied to determine their influence on growth and alkaloid formation in Catharanthus roseus suspension cultures. The optimal 2,4-D concentration for growth and alkaloid production was 1 mg/liter. With IAA, both 0.5 and 2.0 mg/liter in media produced tissue growth comparable to tissue receiving 1 mg/liter 2,4-D; however, qualitative and quantitative differences in alkaloid production were observed. Media formulations containing 2,4 and 6% sucrose showed proportionate increases in cell yield with increased sucrose, but concomitant decreases in alkaloid production. Suspension cultures in media containing 2, 5, and 10 times the normal level of phosphate exhibited little change in growth or alkaloid production. When thiamin HCl, yridoxine nicotinic acid and inositol were deleted from the medium, the tissue continued to grow well through the 24 month duration of the experiment; however, alkaloid production was altered quantitatively and qualitatively.


Resolution of molecular species of intact serine and ethanolamine phosphatides by argentation chromatography of their trifluoroacetamides.

An effective resolution of intact phosphatidylserines on the basis of unsaturation has been achieved by conventional argentation thin layer chromatography (TLC) following trifluoracetylaction. The trifluoroacetamides are prepared by treatment with trifluoroacetic anhydride or N-methyl-bis-trifluoroacetamide. The acetamides are resolved with chloroform-methanol-water (65:25:4, v/v/v) on Silica Gel G containing 20% silver nitrate. Subfractions with 0-6 double bonds per molecule were obtained for the phosphatidylserines of pig and ox brain, pig erythrocytes, rat liver, and rabbit skeletal muscle. The preparation of trifluoroacetamides is also advantageous for the silver ion fractionation of phosphatidylethanolamines. The method is applicable to metabolic studies of molecular species using radioactive precursors of neutral lipids, phosphorus, and nitrogenous bases.


Specific distribution of fatty acids in the triglycerides of rainbow trout adipose tissue. Influence of temperature.

In the trout, the unsaturated fatty acids are preferentially located in the beta-position and the saturated fatty acids in the alpha-position of triglycerides. This fatty acid distribution is retained even with diets containing lard. The fish are, therefore, able to modify completely the fatty acid distribution of dietary triglycerides. There is no retention of the beta-monoglyceride structure during the biosynthetic processes. However, the modification of the dietary fatty acid distribution by the trout seems to be more difficult at 18C than at 10C.


Brunfelsia hopeana I: Hippocratic screening and antiinflammatory evaluation.

Hippocratic screening, in rats, of the whole root and extracts of Brunfelsia hopeana administered intraperitonially indicated that the whole root has CNS depressent activity and that the chloroform extract (F) which contains the basic or 'alkaloidal' fraction concentrates this activity. Extract (F)  at an oral dose level of 100 mg/kg, was equally effective (w/w) as phenylbutazone in reducing carrageenin-induced pedal edema in rats.


Non-methylene-interrupted and omega4 dienoic fatty acids of the white shrimp Penaeus setiferus.

The total lipid fatty acids from the white shrimp Penaeus setiferus were found to contain several unusual dienoic fatty acid species. These included two methylene-interrupted species: delta 11, 14-C18:2 (18:2omega 4) and delta 13, 16-C20:2 (20:2omega4). Also found were several non-menthylene-interrupted dienoic fatty acids including delta 7, 11 and delta 7, 13-C20:2, delta 7, 13-C21:2, delta 7, 13, delta 7, 15, delta 9, 13, delta 9, 15,, and delta 7, 17-C22:2. Many minor C20:2 non-mentylene-interrupted dienes were found but could not be unequivocally characterized.


Antitumor plants. IV. Constituents of Simarouba versicolor.

beta-Sitosterol, epilupeo, amarolide-11-acetate, amarolide-2,11-diacetate, ailanthinone and glaucarubinone have been isolated from S. versicolor. The cytotoxic and antileukemic activities of extracts of this plant are due chiefly to glaucarubinone.


An investigation of Sophora secundiflora seeds (Mescalbeans).

The seeds of Sophora secundiflora (mescalbeans) have been purported to have hallucinogenic activity because of their past use in certain Native American ceremonies during which visions were experienced by those consuming the seeds. Chemical analysis of mescalbeans revealed the absence of detectable amounts of tryptamine derivatives; however, two additional quinolizidine alkaloids, epi-lupinine and delta5-dehydrolupanine, were isolated. Thus far, seven quinolizidine alkaloids have been detected in mescalbeans and quantitation of these constituents showed that the major alkaloid present is cytisine (o.25%). The toxicity of mescalbeans in mice (oral LD50 1.4 g/kg) is only partially attributable to the known alkaloid content. In addition, the ethnobotanical reports regarding the Native American use of mescalbeans were reviewed. No unequivocal evidence was found in this study to support the proposal that mescalbeans are hallucinogenic.


Glyceride metabolism in the myopathic hamster.

Analysis of plasma lipids of 30- and 185-day-old BIO 82.62 myopathic hamsters and age-matched normal controls revealed a decrease in only the concentration of cholesteryl esters of 185-day-old diseased animals. Measurement of lipoprotein lipase (LPL) activity in heart, muscle, and adipose tissue showed no difference between the activity of the enzyme in the heart and muscle of the cardiomyopathic hamsters and that of the age-matched controls. In adipose tissue, however, LPL activity was depressed in the diseased animals in both age groups. No difference was found in the activity of hormone sensitive lipase. Incorporation of sn[U-14C] glycerol-3-phosphate into total lipids was found to be depressed in homogenates of heart, muscle, and adipose tissue but unchanged in liver homogenates of diseased animals. It was concluded that the decrease in the capacity to synthesize glycerides, rather than limiting substrate concentrations, could be the cause of the decrease in the lipid content in some tissues of the cardiomyopathic hamster.


Biological and phytochemical investigations of Dianthus barbatus cv. "China Doll" (Caryophyllaceae).

From the aerial parts of Dianthus barbatus cv. "China Doll", two saponins (barbatosides A and B) were isolated and shown to have analgesic and anti-inflammatory activities. The aglycone of each saponin was identified as quillaic acid. The glycone of barbatoside A consisted of rhamnose, arabinose, fucose, xylose, galactose, glucose and one unidentified sugar; whereas the glycone of barbatoside B contained arabinose, fucose, xylose, mannose, galactose, glucose and three unidentified sugars. Astragalin, kaempferol-3-O-beta-D-sophoroside, D-pinitol and L-leucine were also isolated.


Kinetics of a micelle specific palmitoyltransferase isoenzyme of rabbit mammary gland.

Palmityl-CoA: monopalmityl-sn-glycerol 3-phosphate palmitoyltransferase [EC 2.3.1. -] in rabbit mammary gland microsomes is composed of two isoenzymic species. The alpha form (LPAT-alpha) is active with monomeric substrates and inhibited by micelles while the beta form (LPAT-beta) is active only with micelles. By combining the effects of time, temperature, and Tween 80 which selectively inhibited LPAT-alpha, the substrate saturation curve for the LPAT-beta isoenzyme has been successfully determined. Both theoretical and experimental curves are in good agreement.


Type and amount of dietary fat affect relative concentration of cholesterol in blood and other tissues of calves.

Sixteen male Holstein calves consumed by nipple a reconstituted milk containing nonfat dry milk and either soybean oil or tallow for 24 weeks. Calves fed milk in this manner (with no dry feed) are functionally nonruminants because the milk bypasses the ruminoreticulum. The fat in these diets contributed about 30% of total dietary calories. The calves consuming soybean oil milk had significantly greater amounts of cholesterol in blood plasma and adipose tissue than did the calves consuming tallow milk.


Composition of O-alkyl and O-alk-1-enyl moieties in the glycerolipids of the human adrenal.

A comparison of human adult and fetal adrenals with respect to their levels of glyceryl ether lipids and other lipid components is reported. Fetal glands contained significantly lower levels of alk-1-enyl phosphoglycerides and of cholesterol. Neutral glyceryl ether diesters, and ethanolamine and choline phosphoglycerides were isolated from adult adrenal tissue. The composition of the O-alkyl glycerol groups in these lipid fractions was obtained by means of gas chromatography of the trimethylsilyl ethers and diacetyl derivatives; O-alk-1-enyl glycerols were analyzed as their diacetates. About one-half of the alkyl and alk-1-enyl glycerol moieties present in glyceryl ether diesters contained hydrocarbon side chains with 20, 22, or 24 carbon atoms. Long hydrocarbon chains (C19-24) were also found in the O-alkyl glycerol moieties present in the total lipids of fetal adrenals.


Diester waxes from skin lipids of the feet of biotin depleted and biotin supplemented turkey poults.

The neutral lipids of the skin from the feet of turkey poults fed a biotin supplemented or a biotin deficient diet consist mainly of triacyglycerols, and of mono- and diester waxes. Diester waxes from both groups were characterized as fatty acid esters of erythro-2,3-alkanediols. A comparison between fatty acid composition of the two groups, however, revealed the following significant differences. Biotin deficient birds showed a fairly high concentration of very long chain fatty acids (C36-C40) which were completely absent in biotin supplemented birds. Further, almost one-third of the fatty acids of diester waxes in biotin deficient birds were unsaturated while those from biotin supplemented birds were predominantly (96%) saturated.


The preparation, gas liquid chromatography, and some physical and chemical properties of certain higher aliphatic 2,4-diketones--a new lipid class.

Fourteen saturated aliphatic 2,4-diketones, ranging in chain length from C7 to C25, and one unsaturated compound, delta12-2,4-heneicosenedione, were prepared by Claisen acylations of the appropriate methyl ketones, and their gas chromatographic behavior was studied. Mixtures of these diketones were resolved on columns containing UCW98 or Carbowax 20M stationary phases. Their methoxime and 2,4-dinitrophenylsemicarbazone derivatives were resolved on OV-17 and OV-1 stationary phases, respectively. Since higher homologous aliphatic 2,4-diketones have been found in mammalian tissues, they constitute a new lipid class.


Role and mechanism of peripheral fatty acid mobilization in 2-mercaptoethanol-induced fatty liver.

2-Mercaptoethanol-induced fatty liver involves an increased free fatty acid mobilization which is primarily due to an inhibition of free fatty acid reesterification in adipose tissue. Furthermore, increased free fatty acid mobilization as well as fatty liver induction are not induced by 2-mercaptoethanol per se but result most probably from 2-mercaptoacetate through oxidation of 2-mercaptoethanol.


Cysteine adds to liquid hydroperoxide.

Cysteine reacts with linoleic acid hydroperoxide to yield several products, some of which were identified as fatty acid-cysteine adducts. The addition was catalyzed by ferric chloride (10(-5) M) by initiating free radical reactions. When isomerically pure 13-hydroperoxy-cis-9,trans-11-octadecadienoic acid and cysteine were reacted in 80% ethanol under N2, the major adducts were 9-S-cysteine-13-hydroxy-10-ethoxy-trans-11-octadecenoic acid (I) and 9-S-cysteine-10,13-dihydroxy-trans-11-octadecenoic acid (II). When the reaction included both isomers of the hydroperoxide (13- and 9-hydroperoxide) and air, an adduct of 9-oxononanoic acid and cysteine also was isolated. Additional experiments gave information about possible mechanisms of I and II formation.


Metabolism of arachidonate and stearate injected simultaneously into the mouse brain.

The metabolism of a polyunsaturated and a saturated fatty acid in brain membrane phosphoglycerides was examined by injecting simultaneously a mixture of 14C-arachidonate and 3H-stearate into the mouse brain and isolating the microsomal and synaptosomal fractions at 1-40 min after injections. Both types of labeled fatty acids were utilized more readily in the microsomal than the synaptosomal fractions in brain. However, labeled arachidonate was incorporated more rapidly into membrane phosphoglycerides than was stearate. In both subcellular fractions, the relative specific radioactivity (3H and 14C) of diacyl-glycerophosphorylinositol (diacyl-GPI) was higher than other types of phosphoglycerides such as diacyl-glycerophosphorylcholine (diacyl-GPC) and diacyl-glycerophorylethanolamine (diacyl-GPE). Furthermore, the apparent rates of incorporation of radioactivity into diacyl-GPI was more rapid for the 14C-arachidonate than for the 3H-stearate. Results of the experiment have demonstrated obvious differences in metabolism between stearate and arachidonate in brain. The more rapid transfer of arachidonate to diacyl-GPI is probably due to the presence of an acyl transferase system specially active for the transfer of arachidonyl groups to diacyl-GPI.


Effect of tibric acid on hepatic cholesterol synthesis in rats.

Male albino rats were administered various oral doses of tibric acid daily for 1 week. Serum cholesterol and triglyceride levels were reduced, but total liver content of cholesterol, phospholipids, and triglycerides was increased. Tibric acid treatment suppressed the incorporation of both [14C] acetate and [3H] mevalonate into cholesterol by liver homogenates.


Arylsulfonate esters of fatty alcohols as hypocholesterolemic agents. I: Oleyl and linoleyl p-toluenesulfonates.

Cholesterol levels of both plasma and liver of cholesterol-fed rats are lowered by feeding linoleyl and oleyl esters of p-toluenesulfonic acid. A structural specificity exists, since the effect is not observed with similar amounts of sodium p-toluenesulfonate nor with linoleyl methanesulfonate. Effective levels of these arylsulfonates do not alter liver to body weight ratios and maturation, nor reduce plasma cholesterol in normocholesterolemic rats.


Reliability and reproducibility of maximal oxygen uptake measurement in children.

Maximal aerobic capacity of 66 ten year old ice hockey players was measured on a treadmill twice over a 4 to 5 month period. This time approximated mid (T1) to post (T2) competitive season. The results of these VO2 max tests were grouped according to the presence or absence of a plateau in the oxygen uptake (less than 2.1 ml/kg-min) during the last work loads before fatigue. The mean values for T1 and T2 were not significantly different for any of the measurements made; the reproducibility was considered to be high. The reliability of the measures varied with the presence or absence of a plateau at maximum, for example; VO2 max, plateau r = 0.74, no plateau r = 0.27; heart rate, plateau r = 0.92, no plateau r = 0.40. The differences between the mean values for the "double plateau" group when compared to the "no plateau" group were not significant for VO2 max, HR or VE. The differences were significant for the post-exercise blood lactate and respiratory exchange values at T2 only; the "double plateau" group reached higher values in each case (R = 1.00 vs 0.92; blood lactate 6.5 vs 5.4 mM/1).


Characteristics of skeletal muscle in competitive cyclists.

Muscle samples from the vastus lateralis and maximal oxygen uptakes were obtained from 22 male and 7 female competitive cyclists. 19 untrained males, and 10 untrained females. Eleven of the 22 male cyclists were designated elite cyclists (Group A) on the basis of their success in national and/or international competition. The remaining 11 male cyclists (Group B) were also trained but had not achieved the same level of competitive success. Significant mean differences (P less than 0.05) between Groups A and B were found for VO2 max (67 and 57 ml/kg/min), malate dehydrogenase (MDH) and phosphorylase (PH), in biopsied muscle. No differences were evident between Groups A and B for % slow twitch (ST) and % fast twitch (FT) fibers, or in area FT or ST. Nor was there any difference in the mean activities of succinate dehydrogenase (SDH) and lactate dehydrogenase (LDH) between the groups. Significant correlations were found between VO2 max and SDH, VO2 max and MDH, and between SDH and MDH. These data also indicate that an extremely high percentage of FT or ST fibers may not be a requirement for success in competitive cycling as has been found in earlier studies on sprint or endurance running.


The effect of bicycle seat height variation upon oxygen consumption and lower limb kinematics.

VO2 was obtained for 10 women bicycling on rollers at 3 saddle heights (SH), 95, 100 and 105% trochanteric height. Kinematic patterns described by the hip, knee, ankle and foot were discerned from one pedal cycle at each of the 3 SH. Subjects cycled on a Fuji Dynamic 10 10-speed bicycle, at 60 rpm, (a work load of 799 kpm/min was applied by a tensioning belt from a bicycle ergometer) until they reached steady state. Expired air was then collected and cine films were taken during gas collection. The 100% SH was most efficient, mean values for 95, 100 and 105% SH were 1.69, 1.61 and 1.74 lit/min, respectively. Kinematic patterns showed no variation in the range of motion (ROM) at the hip, values at the dead centers (DC) did change. The ROM at the knee varied from 69 to 82.9 degrees, 95 to 105% SH, values at the DC varied also. Plantar flexion (PF) at bottom dead center increased by 10% from 95 to 105% SH. Foot angle showed no significant variation with increasing SH. The major adaptations to increases in SH are found at the knee and in ankle PF.


Anthropometric and physiologic profile of a cyclist -- age 70.

The purpose of this investigation was to gain insight, through measuring various performance, cardiopulmonary, and anthropometric parameters, to the upper functional limits for man in the eighth decade of life. The subject holds age-group record times for 16.1, 40.2, 80.5, and 171.4 km. Remarkable aerobic power was exhibited while cycling on a bicycle ergometer depicted by high values for VO2 max 4.7 1/min (STPD) and 59.9 ml/kg BW-min (STPD), VE 159 1/min (BTPS), O2 pulse 0.36 ml/kg/beat and heart rate max 166 beats/min. VO2 max is the highest value reported for a man over 70 years of age. To provide inference to the aging process and to training, comparisons were made with data from the normal population of similar age and with data from young and endurance athletes. Cardiopulmonary data and body composition measures equalled that for similar age athletes and were comparable to younger endurance athletes. The findings have significant implications in determining upper functional standards for well-trained older males.


Perceived exertion associated with breathing hyperoxic mixtures during submaximal work.

The effect of an enriched inspired oxygen concentration on perceived exertion (RPE) was investigated while running at two submaximal treadmill loads. Twelve males (VO2 max = 49.3 ml/kg-min) worked at 50% and 80% VO2 max, breathing either air or 80% O2-20% N2 in random order using a single blind technique. Subjects were evaluated while running for 10 min and during a 20 min recovery. Heart rate (HR), ventilation (VE), respiration rate (RR), tidal volume (VT) and RPE were measured before, during and after work. Blood lactate was measured 1 min after work. Oxygen concentration did not statistically affect HR, VE, RR or VT during exercise or recovery. At both loads, RPE at the end of exercise was significantly reduced breathing the hyperoxic mixture. At 50% VO2 max, mean RPE decreased from 11.2 breathing room air to 9.6 breathing 80% O2 and, 80% VO2 max, from 13.8 to 11.7 (P less than 0.01). Blood lactates were significantly reduced breathing 80% O2; from 23.4 mg to 13.3 at 50% VO2 max and from 55.5 to 36.5 at 80% VO2 max (P less than 0.01). The RPE correlated with lactate (r=0.64) at the end of work. Results indicate that during moderate and heavy work RPE is significantly affected by the inspired O2 concentration and there is a significant relationship between RPE and blood lactate.


A note on the determination of angular velocities in human motion studies.

Often the study of sports activities involves a reduction of film data to determine displacements, rotations, velocities and accelerations. Many researchers use the change in position of the projection of a body segment onto a plane of interest (usually the film plane) to determine the component of angular velocity in the plane. This techanical note illustrates that the determination of angular velocity components in this manner leads to erroneous values except in some special cases.


Effects of exercise on the severity of isoproterenol-induced myocardial infarction.

The effect of exercise on the severity of isoproterenol-induced myocardial infarction was studied in male rats. Ninety-three rats were randomly divided into three groups. The exercise-isoproterenol (E-1) and exercise control (EC) groups exercised daily for thirty days on a treadmill at 1 mph, 2% grade while animals of the sedentary-isoproterenol (S-I) group remained sedentary. Eight animals were assigned to the sedentary control (SC) group which remained sedentary throughout the experimental period. Forty-eight hours after the final exercise period, S-I and E-I animals received a single subcutaneous injection of isoproterenol (250 mg/kg body weight). Animals of the S-I group exhibited significantly (Pp less than 0.05) greater mortality from the effects of isoproterenol than animals of the E-I group. Serum CPK activity for E-I animals was significantly (p less than 0.05) greater than for animals in the S-I and EC groups twenty hours following isoproterenol injection. No statistically significant differences were observed between the two isoproterenol treated groups for severity of the induced lesions, changes in heart weight, or heart weight to body weight ratios. The results indicated that exercise reduced the mortality associated with the effects of large dosages of isoproterenol but had little on the severity of the infarction.


The effects of ephedrine on the physiological and psychological responses to submaximal and maximal exercise in man.

The purpose of this study was to determine whether a single full therapeutic dose (24 mg) of ephedrine taken orally has any effect upon physical performance and fitness. Twenty-one healthy males, aged 19-30 years, were tested on three occasions within three weeks using a double-blind modified crossover design. The effects of ephedrine were determined by comparing the differences between drug and control conditions using paired t-tests. The test battery included measures of muscle strength, endurance and power, lung function, reaction time, hand-eye coordination, anaerobic capacity and speed, cardio-respiratory endurance, and responses to maximal and submaximal effort, including maximum oxygen intake, ratings of perceived exertion and speed of recovery from effort. Despite a slight stimulating effect on blood pressure and on exercise and recovery heart rates, 24 mg of ephedrine had no effect on any of the measures of physical work capacity. Ephedrine had no effect on lung function of healthy young men, but may have assisted the learning of certain simple psychomotor tasks.


[Comparative evaluation of acute and subacute toxic action of aniline and O-isopropoxyaniline].

The comparison of acute and subacute toxic action of aniline and o-isopropoxyaniline (o-IPA) has been carried out. In the course of acute experiment, the following results were obtained: DL50 values for aniline and o-IPA established for rats after administration by stomach-tube were--0,45 g/kg and 0,84 g/kg, after intraperitoneal administration--0,34 g/kg and 0,23 g/kg, after superficial coating of the skin surface--0,67 g/kg and 2,20 g/kg body weight, respectively. O-IPA, similarly as aniline, exerts a methemglobinopoietic effect. The both substances have local irritant effect on the skin and the eye of rabbit, causing reactions of middle degree of intensity. The examinations of aniline and o-IPA, performed after Lima's method, have revealed no comulataive action. During the 6 months exposure consisting in administration to animals of doses amounting to 1/10 and 1/2 of DL50 value by stomach tube, changes in the picture of peripheral blood were found as well as statistically significant increase of phenol red urine excretion, the inhibition of body weight increase and statistically significant increase of relative and absolute weight of liver and spleen. The both compounds damage the liver and kidneys parenchyma. The degree of liver injury is greater due to aniline action, o-IPA, however, has a stronger action on the excretion of renal cortex epithelium. In the spleen, a similar type of changes was observed, but the number of erthroblasts and reticuloendothelial system cells as well as the degree of hemosyderine deposition in this organ was greater after aniline administration. These results demonstrate that the toxic character of o-IPA and of aniline is similar, but the changes provoked by o-IPA are less intensive.


[Experimental evaluation of the action of petroleum on rat kidneys].

The male Wistar rats were exposed to the vapours of arabic petroleum Abu-Dhaki Zakum at concentration 1500 mg/m3 during 12 weeks, 6 times weekly per 90 minutes daily. The biochemical examination of blood serum (urea, creatinine), daily diuresis, general urine examination as well as histopathological and histological kidneys examinations have revealed no deviation from the normal state.


[Epidemiological studies of peptic ulcer in coal miners. II. Effect of occupational factors].

In the part I the effect of social and life factors on the development of peptic ulcer in miners has been analysed. Now, in the same population of 8302 miners composing the crew of three coal mines, an evaluation of the role of occupational factors has been performed on the basis of inquiry and documentation data of the outpatient department. It was found that the frequency of peptic ulcer is more dependent on years of employment than on age. The percentage of peptic ulcer cases among the underground crew and this working on the surface did not reveal distinct differences. Only in miners, working underground a shortest time, it was less than in the analogous groups working on the surface. Among miners performing the longest time very arduous work, the frequency of peptic ulcer is less than in the remaining crew. The psychical burden and the paid by the job system as well as night shift work influence the increase of patients. These results demonstrate that in the mining the peptic ulcer hazard is augmented by similar factors as in other industries, the effect of underground work however has not been observed. The conditions of mining induce miners suffering from peptic ulcer to avoid more burdening job and this is why percentage of ill miners is less among those whose work is more arduous.


[X-ray changes in the osteoarticular system in sawyers].

X-ray test of the osteo-articular system of upper limbs was carried out on 1231 saweyers and 272 controls as well as 50 intellectuals. Three x-ray tests were carried out on 207 sawyers and on a control group of 95 workers, to assess the progression of osseous changes. The same types od changes were found in sawyers and control group workers; besides similar frequency in the examined parts of the upper limb was found in them. The most frequent changes are: osseous cyst, osteoporosis degenerative-deformative changes and calcar of the ulnar. The greatest amounts of changes were observed in the bones and joints of the hand and next in elbow joint and acromioclavicular joint. It was observed that amoungst the sawyers and the control group workers, the greatest amounts of changes occur after 2 years of work. Progression of osseous changes after 3-4 years of work was observed in 30,9% sawyers and 12,6% control group workers.


[Increased diuresis and urinary output of glycosaminoglycans in workers exposed to hand-transmitted vibrations].

The volume of urine andurinary output of glycosaminoglycans (GAG) have been investigated daily during 8-hrs shift (5:00 a.m. to 1:00 p.m.) within five consecutive days (from Monday to friday) in 24 workers exposed to hand-transmitted vibrations (hand-formers) and in 20 control not exposed workers. Total amount of GAG was determined by carbazole reaction. The average 8-hrs volume of urine was significantly higher in hand-formers than in control workers. Total average 8-hrs volume of urine amounted to 550+/- +/-194 cc in hand-formers and 430+/-180 cc in control workers. The average 8-hrs urinary output of GAG was also higher in hand-formers than in control workers, but the difference was statistically significant in first, fourth and fifth day of investigation. The total 8-hrs output of GAG was in the average 4.34+/-1.86 mg in hand-formers and 3.38+/-1.44 in control workers with the difference significant at p less than 0.001. The results of the investigation suggest that vibration transmitted to the body could be accompanied by increased urinary output of some connective tissue components which might be of interest in evaluation of exposure.


[Occupational exposure to xylene of workers employed in paint shops].

The paper presents results of evaluation of exposure to xylene of workers employed in paint workshops of the Agricultural Machines Factory "Rofama". The evaluation has been made basing on the measurements of urinary methylhippuric acid. It was found that spray painting exerts the most harmful effect on the health of workers exposed to xylene.


Turnover and recycling of glucose in man during prolonged fasting.

The effect of prolonged (3-5 wk) fasting on tracer-determined glucose turnover and of recycling radioactive glucose has been examined. We followed the specific activity of plasma glucose after the simultaneous administration of 1-14C-glucose and 3-3H-glucose. The rate of glucose turnover decreased during prolonged fasting. Recycling of radioactive glucose was estimated by two different techniques: (1) the appearance of 14C in positions 2 to 6 glucose was measured; (2) the difference in the slopes of specific activity decline for 1-14C-glucose and for 3-3H-glucose was calculated. The two methods of estimating the radioactive recycling gave results similar to each other. The amount of glucose recycled did not change during prolonged fasting. However, in view of the decline in glucose production during fasting, the proportion of glucose production which was represented by recycling increased. Based on weight and urinary nitrogen loss an estimate of the glucose production from amino acids and glycerol was obtained. The difference between the rate of glucose production from the contribution of amino acids and glycerol and that estimated by radioisotopic techniques was much larger than the measured rate of recycling. This finding suggests that either a large exchange of 12C with 14C occurred in some glycolytic intermediates or that a hitherto unknown source of carbon for glucose production appeared during prolonged fasting.


Metabolic acidosis in the vitamin D-deficient chick.

In vitamin D-deficient chicks raised from age 1 day on a vitamin D-deficient diet, hyperchloremic metabolic acidosis accurred at 3 wk and persisted. Within 24 hr of administration of vitamin D, the acidosis and hypocalcemia were attentuated; during the subsequent 72 hr the severity of the metabolic acidosis but not that of the hypocalcemia was further attenuated. That further attenuation occurred despite hypocalcemia of unchanging severity and presumed continuing secondary hyperparathyroidism suggests the possibility that vitamin D deficiency may be a requirement for the expression of metabolic acidosis. Since in vitro and in vivo studies suggest that subphysiologic values of media and blood pH, respectively, are attended by reduced production of 1,25-(OH2D3, the most biologically active vitamin D metabolite known, the occurrence of acidosis in vitamin D deficiency may compound its metabolic consequences. The possible effects of acidosis must be considered in interpreting results of investigations of vitamin D metabolism in vitamin-D-deficient chicks.


Evidence for an accelerated adaptation to starvation in chronic uremia.

During a 72-hr period of starvation plasma levels of glucose and immunoreactive insulin fell to a greater extent, and alanine, free fatty acid, and glycerol concentrations were higher in fasted chronically uremic rats than in nonuremic controls. These changes, in conjunction with a significant increase in the uremic group's activity of phosphoenolypyruvate-carboxykinase, the rate-limiting enzyme in hepatic gluconeogenesis, after only 12 hr of fasting suggest that alterations in glucose metabolism in uremia may contribute to an exaggeration and acceleration of the metabolic consequences of starvation.


Glucagon, insulin and glucose response to physiologic testing in normal and massively obese adults.

Ten normal adults and ten nondiabetic massively obese subjects were studied following 4--7 days on identical diets. Intravenous arginine challenge resulted in similar glucose and glucagon responses and threefold greater integrated insulin responses in the obese when compared to the normal subjects. Following oral glucose, glucagon responses were similar, whereas both basal and integrated insulin values were higher in the obese subjects. Basal and integrated insulin concentrations were greater during intravenous glucose testing in the obese subjects, whereas similar glucagon suppression was observed in both groups. Hourly blood samples obtained during a 24-hr period revealed that the obese glucose profile differed significantly from the normals. Insulin values were two- to four-fold higher in the obese subjects, whereas no significant difference was observed in the glucagon concentrations. The nadir and peak glucagon concentrations for both groups occurred at 8:00 a.m. and 8:00 p.m., respectively, and were positively correlated with plasma amino acid values, and were similar in both groups.


Elevation of plasma glucose and glucagon after tryptophan ingestion in man.

To evaluate the effect of tryptophan on blood sugar in man, we have orally administered 10 g of this amino acid to 14 normal subjects and determined their plasma levels of glucose, insulin, glucagon, and growth hormone for 4 hr after the load. Seven of the subjects also received a placebo. Tryptophan intake was followed by a slight but significant elevation of glycemia (maximum increment: 11% above basal values at 180 min, p = 0.02). This elevation of plasma glucose was accompanied by a clear rise of glucagon levels (peak: 60% at 140 min, p = 0.0007) and by increased concentrations of circulating insulin and growth hormone. Placebo administration did not significantly modify blood glucose or any of the hormones measured. In contrast to the reported hypoglycemic effect of tryptophan in rats, our data indicate that this amino acid increases plasma glucose in man. Given that tryptophan appears to possess the capability of eliciting glucagon secretion, its effect on blood glucose can be reasonably attributed to an enhanced glycogenolysis and/or gluconeogenesis provoked by its release of this hormone.


Mechanism of glucose intolerance during fasting: differences between lean and obese subjects.

Oral glucose tolerance tests were performed on 14 lean and 14 obese nondiabetic subjects before and after a 6-day fast. In addition, insulin tolerance tests were performed on 8 lean and 8 obese subjects before and after starvation. Both in lean and obese subjects glucose tolerance deteriorated during starvation, but much more so in the lean population. During fasting, insulin elevation after a glucose load was significantly delayed in lean subjects but not in the obese. Circulating levels of factors known to affect glucose tolerance, such as glucagon, growth hormone, free fatty acids, and ketone bodies were higher in fasting lean than in fasting obese individuals. In normals fasting resulted in a significant decrease of the blood glucose response to insulin injection, whereas in fasting obese subjects glucose response was unchanged. The results obtained suggest that the effect of fasting on insulin release and insulin sensitivity was more pronounced in lean than in obese subjects, which resulted in greater deterioration of glucose tolerance in the lean population.


Biochemical expression of the galactosemic defect in lymphocytes and the effects on glycoprotein synthesis.

Incorporation of radioactive galactose, fucose, mannose, glucosamine, and N-acetylmannosamine into acid-precipitable glycoproteins of purified peripheral blood lymphocytes froom three patients with congenital galactosemia, their healthy parents, and control subjects have been measured. In the galactosemic lymphocytes, the incorporation of galactose into acid-precipitable glycoproteins was less than 7% of values obtained with controls and the presumed heterozygotes. The incorporation of other sugars into the glycoprotein fraction did not differ significantly from normal. Attempts to demonstrate a deficiency in cell-surface galactose groups proved negative. Galactosemic lymphocytes responded well to galactose-binding mitogens and were fully sensitive to a galactose-binding toxic lectin. We conclude that a defect in the galactose-1-phosphate uridyl transferase pathway to uridine diphosphate-galactose does not affect appreciably normal carbohydrate chain assembly in galactosemic lymphocytes. However, we cannot rule out minor changes which might account for the decreased responsiveness to serotonin in an experimental animal model of galactosemia. The approaches used in this paper may be useful in detecting other inborn errors of carbohydrate metabolism.


Effect of renal fuels on p-aminohippurate transport in rat renal cortical fragments.

The effects of the major renal fuels were studied, i.e., lactate, citrate, palmitate, glutamine, and glucose, at concentrations near those found circulating on the in vitro accumulation of p-aminohippurate (PAH) by rat renal cortical fragments. Only lactate and citrate were found to increase PAH uptake significantly. Noting that 10% v/v normal rat sera enhance PAH accumulation, we studied the renal fuels at 10% circulating concentrations and found that all fuels combined had stimulation comparable to 10% v/v sera. Lactate and the stimulator in normal sera are located in the same Sephadex G-25 fraction of sera. Both lactate, the major renal fuel, and normal sera stimulate the influx and inhibit the efflux of PAH. We conclude that the stimulators to PAH transport in normal sera are, at least in part, renal fuel organic anions.


[Effect of microelements on formation of acids and ethyl alcohol by Saccharomyces carlsbergensis yeasts].

The effect of Fe, Zn, Mn, Pb, Al, Cu, and K on the synthesis of pyruvic, alpha-ketoglutaric and total volatile acids and ethanol was studied in the process of fermentation of 6 per cent maltose solution by Saccharomyces carlsbergensis 776. Experiments were conducted using techniques of their mathematical planning. Fe, Pb, and Mn at concentrations of 15.0, 0.5, and 1.5 mg/litre, respectively, had a positive effect on the synthesis of pyruvic acid whose concentration in the medium increased by 3.3 mg per 100 ml to become equal to 43.3 mg per 100 ml. Fe3+ at a concentration of 15 mg/litre had a negative effect on the synthesis of alpha-ketoglutaric acid. The synthesis of volatile acids depended on the presence of Fe, Zn, Pb, Al, and K. Fe and Al at concentrations of 15 mg/litre favoured the synthesis of volatile acids by 2.72 mg/litre. In the presence of Zn (1.5 mg/litre), Pb (0.5 mg/litre), and K (15 mg/litre), the content of volatile acids decreased by 4.48 mg/litre and became equal to 14.94 mg/litre. Zn at a concentration of 1.5 mg/litre inhibited it.


[Pure culture of bacteria using chromates and bichromates as hydrogen acceptors during development under anaerobic conditions].

A pure bacterial culture utilizing chromates and bichromates as oxygen donors during growth on organic substances in anaerobic conditions was isolated from active ooze of sewage and industrial wastes containing a weak solution of chromates. A medium for growth of the bacterium was selected, and its morphological and cultural properties were studied. Chromates and bichromates are reduced only in anaerobic conditions by the bacterium or active ooze containing it, the hexavalent chromium becoming trivalent. The culture does not belong to any known species and has been therefore classed as Pseudomonas dechromaticans.


[Effect of inoculum material on biosynthesis of proteolytic and amylolytic enzymes of Aspergillus tarricola].

The effect of inoculation material on biosynthesis of proteolytic and amylolytic enzymes was studied with Aspergillus terricola H-20. The highest yield of proteolytic enzymes was found with the inoculation material obtained on oatmeal flakes with single shaking of the substrate. The highest number of viable conidia was detected by the sixth day of the growth; they favoured the synthesis of both proteases and amylases. The maximum yield of proteases was found when the density of inoculation was 6-10(6) conidia per 1 ml of the medium. The proteolytic activity of the fungus decreased after storage in a physiological solution at +4 degrees C for over 5 days; the amylolytic activity decreased if the conidia were kept under these conditions for two days.


[Several properties of the extracellular vesicles of Candida tropicalis yeasts grown on n-alkanes].

Vesicles with a high content of phospholipids were found when Candida tropicalis IBFM-303 was cultivated on n-alkanes. The vesicles were extracellular, and their inner content had a fine-grained structure confined within a monolayer membrane. The number of the vesicles increased in the course of growth and depended on the concentration of n-alkanes in the medium. When the vesicles were added to an inoculate of C. tropicalis IBFM-303, the growth of cells decelerated and the biomass yield decreased. The paper presents experimental results concerning the chemical composition and the activity of some enzymes of these extracellular structures.


[Concentration of polyvalent metals following a change in the metabolism of Chromatium vinosum].

The composition of polyvalent metals (Fe, Mn, Cu, Ti, Ni, Co, V, Cr) was compared during photoheterotrophous and autotrophous growth of Chromatium vinosum. A comparatively high content of Mn and Cr, i. e. metals whose amount increases in the course of evolution of photoautotrophous organisms, is typical of the bacterium after autotrophous growth. An increase in the concentration of Ti, i. e. a metal involved in the reduction reactions of the cells, is characteristic of photoheterotrophous growth. As metabolism changes, differences are found in the content of protein, lipophilic substances, thioesters, flavin, and in the hydrogenase activity. These differences are discussed with respect to the role of polyvalent metals in metabolism of Chromatium vinosum.


[Degradation of cellulose by micromonospores].

Sodium benzoate is suggested as an inhibitor of cellulose decomposing bacteria and fungi for detecting and counting micromonospores. Cellulose decomposing micromonospores were found in the zone adjacent to the roots of winter wheat and maize; their number, cellulose decomposing activity, morphological, physiological, and antagonistic properties were determined. Pasteurization of the material taken from colonies grown on cellulose is recommended for isolation of pure cultures.


[Influence of aeration and phosphorus concentration in the medium on growth of S-, R- and M-forms of Mycobacterium lacticolum in mixed cultures].

S, R and M forms of Mycobacterium lacticolum were compared. The cells of the R form had the highest requirement in aeration and phosphorus, whereas the cells of the M form, the lowest requirement. The content of oxygen in the medium and the concentration of phosphorus almost did not affect the viriability of these forms. On a medium containing n-hexadecane, the cells of the R form possessed selective advantages under favourable growth conditions, i.e. when the content of oxygen and phosphorus in the medium was high, whereas the cells of the M form had selective advantages under unfavourable conditions of growth when it decelerated as a result of a low concentration of oxygen and phosphorus in the medium. These correlations changed on a medium containing carbohydrates.


[Ultrastructural organization of trichomes of a new group of multicellular gram-negative bacteria].

Peculiar trichome multicellular gram-negative bacteria were found in several types of soil, and were isolated as pure cultures. The bacteria are characterized by the following properties: (a) the presence of large regions of the periplasm, 200-300 nm thick, in the cells, the volume of the periplasm being greater than that of the cytoplasm; (b) a peculiar structure of multicellular trichomes in which the cells are surrounded by a common cell wall and a common periplasmic space; (c) a specific structure of trichome septa formed by membrane leaves and including no material of the cell wall; (d) the ability of protoplasts to divide within the trichome cell wall; (e) the ability to grow under anaerobic conditions. Therefore, these organisms belong to a new group of trichome multicellular bacteria.


[Complex spherical bodies of Thermus ruber].

Thermus ruber produces complex spherical bodies during its growth on liquid organic media. These bodies are similar to those formed by T. aquaticus. Giant spheres of T. ruber can reach 30 mc in diameter. They may originate by two pathways: (1) from cell aggregates or (2) by local separation of the outer layer of the cell wall which accompanies bending of a cell or a bundle of cells (threads) in the form of a hook, a loop or a vibrio. In both cases, the spheres grow as a result of cell multiplication under the common outer layer of the cell wall. Their growth on a potato-peptone broth is favoured by an addition of DL-alpha-alanine at a concentration of 10 mcg per 1 ml. Apparently, these complex spheres are sort of swimming bladders which are formed by an organism to occupy horizons with favourable oxygen regime during their growth in an aqueous medium. When the spheres are incubated under stationary conditions for a long time, they become setaceous and transform into coils.


[Infrared spectrum of yeast cell walls].

Infrared spectra of whole cells and cell walls were studied with Schizosaccharomyces pombe, Endomyces magnusii. Rhodotorula rubra, and Candida lipolytica. Qualitative analysis of the spectra and comparison of the spectra recorded for the cells and for their walls led to a conclusion that, contrary to the common viewpoint, an ir spectrum of the whole cell of any yeast species was determined by the components contained in the cell rather wall than by all components of the cell.


[Comparative cytomorphologic study of strains of Aspergillus terricola in the process of biosynthesis of proteolytic enzymes].

The cytology and morphology of three strains of Aspergillus terricola were studied in the course of synthesis of proteolytic enzymes. The level of the enzymes in the cultural broth was highest during the growth of the diffused mycelium, and was accompanied with specific cytodifferentiation of the fungal hyphae. The contact between the hyphae of the producing culture and the growth medium is presumed to be important for biosynthesis of the enzymes.


[Serologic properties of mutants of Rhizobium trifolii and their interrelationship with effectiveness].

UV and gamma irradiation of Rhizobium trifolii, strains 347a and 311a, produced their mutants with changed antigenic properties and effectiveness. The extent of changes of antigens did not depend on the dose of irradiation because mutants that completely lost antigens typical of the parent strains were obtained at different doses of UV and gamma rays. No correlation was established between the antigenic properties of the mutants of Rhizobium trifolii and their effectiveness.


[Cultivation of Candida tropicalis yeasts on coal substrates].

The optimum conditions have been established in order to obtain aquaeous extracts of oxidized coal. Coal substrates seem to consist of aromatic polycarboxylic acids and unsaturated aliphatic compounds. Candida tropicalis was adapted to coal extracts, and about 2 g of absolutely dry yeast biomass had been obtained from 600 ml of the substrate in the conditions of a laboratory fermenter. The amino acid composition of the biomass was determined.


Contractile potentials of vascular chambers outside the heart: their possible role in helping to power the circulation.

While the cell is the basic biological unit, the contractile chamber follows closely in fundamental importance. Understanding the heart, the circulation and other systems in the body requires one, first, to recognize that common factor and basic unit, the contractile chamber. The heart is just one of many organs composed of contractile chambers. Some individuals do survive, despite a period when their hearts appeared to be doing little or nothing. Cases are cited which illustrate this seeming discrepancy between cardiac delinquency and patient's longevity. Some extra-cardiac propulsive mechanism must be identified to explain such cases. The extrapericardial vessels contain muscles which must have a dynamic role in the circulation of blood, supplementing, complementing, and perhaps even replacing cardiac action. In addition to transplants, and artificial hearts, the possibilities of enhancing the role of the extra-cardiac circulatory mechanisms (already provided by nature) should be studied.


The importance of intracellular volume in the control of vascular volume.

The effect of change in extracellular (interstitial) volume on vascular volume (VV) is mediated through interstitial pressure. Since the effect of swollen or shrunken cells on interstitial pressure should be identical to that of changes in interstitial volume on interstitial pressure, it would be appropriate to consider that intracellular volume (ICV) as well as extracellular volume (ECV) contributes to control of VV. Total body water rather than ECV, therefore, should be considered as the fluid volume which regulates VV. Support for these conclusions has been provided by theoretical analysis of the factors that regulate capillary fluid exchange. In further support of this hypothesis, clinical examples are described, in which renal salt retention was observed despite increases in ECV (ICV was markedly decreased), and in which renal salt loss occured despite decrease in ECV (in the presence of increased cell volume).


Hippocrates recycled.

Medical education in the United States has at least three serious deficiencies: its focus on medical under-graduate education rather than on medical education as a continuum throughout the career of a physician; its failure to recognize the basic incompatibility of highly sophisticated medical research and the education of the practicing physician; and its extremely high cost. The Hippocratic concept of preceptor education as an alternative has much to recommend it in replacing the present system, which underwrites the cost of student education through research grants and subsidies, but greatly neglects the continuing education of the practicing physician.


Mutation selection and tumour progression.

It is proposed that tumour progression results from the increased mutability of tumour cells and that this mutability leads to the acquisition of a large number of 'neutral' mutations having no significant effects under physiological conditions but capable of lethal expression under different conditions. High temperatures often lead to expression of neutral mutations and this could provide a mechanism for the observed thermosensitivity of tumour cells, and a rational basis for the use of hyperthermia in cancer treatment.


Diagnostic accuracy would be improved by developing more categories of "non-disease".

Studies on the ways in which doctors think have shown the importance of intuitive processes in the formulation of a diagnosis. They have also suggested that intuitively generated diagnoses are used to aid the memory of relevant clinical facts during a clinical consultation. Only some symptoms and signs can be ordered into or subsumed under a diagnostic label. Others, which have not been thought of as constituting a disease, will tend to be lost from memory. If a diagnosis were to be thought of, not as the label of a disease but as a mental construct by means of which data are ordered and remembered, that is, as an invention whose utility is to be judged by the degree to which clinical thinking is facilitated, it would become reasonable to develop diagnoses to cover larger areas of clinical phenomenology. Some examples of the usefulness of such diagnoses of "non-disease" are given ant it is suggested that clinical thinking might be improved by the wider use of the concept.


Thalamic neuron theory: a hypothesis concerning pain and acupuncture.

A new theory is proposed to explain various pain phenomena hitherto unexplainable. It is hypothesized that neurons in the thalamic region are responsible for the generation of most pain, particularly in chronic pain states. It is also hypothesized that the thalamic neurons are organized according to a master scheme representing a homunculus in the fetal position. Various painful conditions and the treatments of them including the trigger points phenomena, neurosurgical techniques, acupuncture and acupuncture anesthesia can be explained on this basis.


Positive feedback in the living process: the role of ATP in ischaemic cell death.

Some essential functions of the organism--the continual replacement of its own component parts, the ability to make or to procure the things that it needs--are seen to be positive feedback effects. Because of its foundation of positive feedback, the process has an underlying tendency to become unstable. The borderline between life and death may be understood in terms of the opposition between destabilising (positive feedback) and stabilising (control) effects. A dynamic hypothesis of cell death in ischaemia is suggested, in which the critical change need involve no damage to enzymic machinery. It may be possible to revitalise dead cells by relatively simple measures.


Do aflatoxin and polycyclic hydrocarbon carcinogens delete genes in the regions of chromosomes acted on by steroid hormones?

The hypothesis is proposed that: 1. Aflatoxin B1 and polycyclic hydrocarbon carcinogens bind to the regions of DNA to which steroid hormones bind and cause the deletion of genes in these regions. 2. The deletion of these genes may be responsible for a reduced number of ribosomes bound to the endoplasmic reticulum. 3. This may be the cause of the increased number of free hydrolytic enzymes in many tumour cells. 4. The free lysosomal enzymes in many tumour cells are responsible for many changes in these cells such as changes in cellular and intracellular membranes, reduction in level of cyclic AMP, loss of contact inhibition of growth, glycolysis under aerobic conditions, and damage to chromosomes of tumour cells.


The possible role of enkephalin in the mechanism of acupuncture analgesia in man.

On the basis of recent research on the presence and function of an endogenous peptide with opiate-like activity present in the brain, and the developing understanding of the physiological mechanism of acupuncture analgesia, it is postulated that the analgesic effects of acupuncture are mediated through the action of this substance on the neural mechanism(s) of pain inhibition.


Acute pulmonary failure: treatment with extracorporeal oxygenation.

Extracorporeal membrane oxygenation (ECMO) support is a logical means of providing time for the acutely damaged lung to heal. To be successful, the lung pathology must be reversible. There are four extracorporeal cannulation methods that can be used. Each method has its advantages and disadvantages depending upon what one wishes to accomplish; each has been successful. But ECMO in unselected patients with severe acute respiratory insufficiency is only 15-20 percent successful. The limiting factor for success is the potential reversibility of the lung pathology. Therefore, much attention is now being focused on identifying those patients who have reversible disease and would benefit from ECMO. Because serious bleeding is the biggest potential risk of ECMO therapy, antithrombogenic surfaces are being developed.


The roles of prostaglandins and calcium accumulation in muscular dystrophy.

There is good evidence that abnormal calcium accumulation may be a final common pathway of muscle degeneration in the muscular dystrophies. Prostaglandins are able to promote calcium entry into cells and excess prostaglandin activity coupled with a defect in intracellular calcium release could cause toxic accumulations of calcium in intracellular organelles such as mitochondria. Serotonin stimulates prostaglandin synthesis while tricyclic antidepressants inhibit calcium release from intracellular organelles thus possibly accounting for the models of muscular dystrophy reported using this combination. The prostaglandin/calcium hypothesis can account for the effects of vitamin E, steroids and local anaesthetic-like drugs in muscular dystrophy. Since many drugs already in clinical use for other purposes can be used to control prostaglandin synthesis or action this hypothesis has immediate potential clinical applications.


Artificial heart driven by an automatic driving system.

Thrombi formation within artificial ventricles is caused by the effects of biomaterials, stagnation areas, and major turbulences. During systolic and diastolic cycles, stagnation area increase in hearts that are properly designed. Stagnation areas may also occur in properly designed artificial hearts that are not working with a maximum stroke volume. The ellipsoid heart avoids stagnation areas and major turbulences because all the inside surfaces have an adequate washout with blood. The optimum washout of these surfaces is obtained by driving the heart with a constant maximum stroke volume. The cardiac output is regulated according to Starling's law by adjusting the frequency according to the venous return.


Evaluation of novel sorbent systems for joint hemodialysis and hemoperfusion.

Hemodialysis is not very effective at removing middle molecular weight species and certain drugs such as salicylates and barbiturates. Carbon hemoperfusion is ineffective in removing urea and water, even when coated microparticles can be generated. To use the advantages of hemodialysis and carbon hemoperfusion without their disadvantages, cuprophan tubular membranes and fibers containing activated carbon have been manufactured. A device called the Hemocarbodialyser, consisting of a sorbent and dialyzing carbon membrane wound onto a coli dialyzer, has been evaluated by the authors. From preliminary results, the Hemocarbodialyser has been shown to be efficient at removing vitamin B12, has high ultrafiltration, and has high dialysance of creatinine and uric acid. The use of activated carbon and aluminum oxide fibers was also evaluated, indicating that fibers containing sorbents, as well as the Hemocarbodialyser, may have clinical importance in the near future, when joint hemodialysis and hemoperfusion is required in hepatic failure, uremia, and acute poisoning.


Development of urethral occlusive techniques for restoration of urinary continence.

Three models of an artificial sphincter for treatment of urinary incontinence are described. Each of the models shares the two basic features of a cuff that encircles the urethra and a totally implantable hydraulic system for volitionally inflating the cuff to control the flow of urine. The models differ in the means by which pressure in the cuff is maintained below safe operating limits. In one model, pressure is regulated by a pressure-relief valve. This model has a clinical success rate of 66 percent over 5 years. The success rate has been increased by improvements in mechanical design, surgical technique, and patient selection. In another model, cuff pressure is regulated by means of a balloon which inflates at constant pressure as fluid is pumped into the balloon and cuff simultaneously to occlude the urethra. In the third model, pressure is also controlled by a balloon. To void, fluid is pumped from the cuff into the balloon. It then automatically flows back to the cuff through a fluid resistance to reestablish continence. Clinical trials of the balloon-regulated models are currently in progress.


Automatic quantitation of venous hemodynamics with an electrically calibrated strain gauge plethysmograph.

Strain gauge plethysmography has permitted noninvasive quantitation of altered venous hemodynamics in the legs of patients with venous disease. A new plethysmograph has been developed which avoids previous problems of mechanical calibration of gauges and the necessity for a recorder for calculating blood flows. This instrument permits accurate electrical calibration of mercury-in-Silastic gauges which are effectively at the corners of the Wheatstone bridge and are supplied by constant current for linear output. A timer and follow-and-hold circuit allow automatic calculation of rates of change in limb circumference and, thus, blood flow, from a panel meter. The accuracy of the automatic versus the graphic methods of quantitating venous outflow and reflux flow was determined in 20 normal subjects. Venous outflows were 15.1 +/- 0.5 (mean +/- 1 S.E.M.) and 15.9 +/- 0.4 cc/min/100 cc by automatic and graphic methods, respectively (r = 0.96, p less than 0.01). Reflux flows were 2.1 +/- 0.2 and 2.3 +/- 0.2 cc/min/100 cc by the automatic and graphic methods, respectively (r = 0.93, p less than 0.01). This plethysmograph may prove to be a simple, rapid, and accurate device for evaluating altered hemodynamics in venous disease.


A prospective study of gastric and oesophageal carcinoma.

A prospective study of carcinoma of the stomach and oesophagus has been carried out for 2 1/2 years. Seventy-three cases of carcinoma of the stomach, and 16 cases of carcinoma of the oesophagus have been documented. For carcinoma of the stomach, operability rate was 72-6% and resectability rate was 41-9%; overall survival was poor, 20-9% at 12 months. For those who underwent resection, survival at 12 months was 45-5%. No cases of early gastric cancer are among those studied. For carcinoma of the oesophagus, four patients had a resection, and only one has survived for more than 12 months. In the clinical sphere there is a need for early endoscopic as well as radiological investigation of dyspeptic symptoms. In the research field there is a need for studies of chemotherapy in combination with surgery in the initial treatment of gastric carcinoma.


A comparative study of several polymers for use as intravenous catheters.

The widespread use of long-term intravenous catheters has produced some concern on the part of the clinician with respect to morbidity and occasional mortality associated with their use. Fourteen polymer surfaces were evaluated in experimental animals in this study. Several of the materials are commercially available; the others are experimental. In all, 160 catheters were placed in the femoral and jugular veins through side branches. The catheters were evaluated in terms of thrombosis, phlebitis, and periphlebitis, using an arbitary grading system. Scanning electron microscopy and light microscopy were employed to document the results. The most successful catheter materials were next evaluated in man, using the same experimental parameters. It is our belief that the observed thrombosis associated with morbidity is largely due to the surface characteristics of the catheter materials. These characteristics are largely surface phenomena related to the interactions between the tissue and catheter material. In this study, we have attempted to determine whether there are any significant differences in thrombogenicity and/or long-term function between the several currently available catheters. Based on this study, ethylene acrylic acid appears to be the most nonthrombogenic surface of the material tested.


Psychiatry and convulsant therapy.

Because electroconvulsive therapy is an empirical and widely used treatment in modern psychiatry, there is a tendency for it to be applied without sufficient concern for the patient. In view of the critical attitudes which prevail in certain areas of society towards physical treatments generally, it is important that the medical profession maintains an objective and self-critical view of these therapies. The paper describes a small survey in an inpatient mental hospital which inquired into the attitudes of patients receiving electroconvulsive therapy. The principal areas of concern were found to be associated with the accompanying anaesthesia, subsequent memory defects, fear of pain and, above all, the anxieties associated with waiting for the treatment. Suggestions are made which could minimize these problems.


A miniature segment-length strain gauge arch for the assessment of myocardial function.

A miniature myocardial segment-length strain gauge arch utilizing solid-state strain gauge elements is described. The arch weighs 0.25 g, has a frequency response flat to 30 Hz, requires simple circuitry, and is stable in situ for periods exceeding 6 hours. Its miniaturization and ease of insertion offer distinct advantages over similar devices previously described. Miniature arches have been applied simultaneously to multiple sites to assess left ventricular function in dogs. The response of these arches to a variety of interventions indicates that this device may be used to follow localized segment-length and velocity changes. The study also clearly demonstrates that the orientation of strain gauge arches with respect to muscle fiber direction in the ventricular wall qualitatively and quantitatively affects the recorded segment-length alterations.


Vasectomy: irrigation with euflavine.

Two hundred men who had undergone vasectomy during which euflavine 1:1000 solution was used as a spermicide have been followed up for a year. In most cases the spermicidal effect was complete, but there were two definite and two probable instances of failure. Introduction of an irrigant may possibly increase the otherwise extremely low incidence of spontaneous recanalization when Schmidt's diathermy technique is used for vasectomy.


Brain damage and abnormal behaviour in children.

Behavioural problems in children with suspected brain damage may present considerable diagnostic and management problems. Methods of assessment are still imprecise and minor degrees of brain damage are seldom detectable. Data from clinical studies highlight the interrelationship between environmental and organic factors in the pathogenesis of disturbed behaviour. Children from large families of low socioeconomic status, who are subject to parental neglect, are particularly susceptible to the development of psychiatric disorder in the presence of brain damage.


The cost of medical education.

As the result of another study which identified the indirect costs at a large teaching hospital in which Monash University has established a clinical school, it has been possible to estimate the cost per annum for each medical student. This is the sum of direct university costs ($4,617), Tertiary Education Assistance Scheme ($1,200) and indirect costs ($44)--in aggregate therefore $5,900 (rounded). Thus the cost of the six-year course for each student is approximately $35,500.


The forgotten factor in the evaluation of vesicoureteric reflux.

Vesicoureteric reflux is an important factor in pyelonephritic scar formation, but the radiological demonstration of reflux is often difficult. The influence rate of urine formation on radiological assessment of vesicoureteric reflux was studied in 21 patients. After an intravenous injection of 20 mg of frusemide, reflux was reduced or abolished in 19 of the 21 patients. In three patients, vesicoureteric reflux had not been demonstrated at an earlier examination under conditions of normal hydration, but cystourethrograms in the dehydrated state demonstrated reflux. Hydration is an important factor in assessing both the presence and degree of vesicoureteric reflux, and the incidence of false-negative results is reduced by preliminary fluid restriction. Decisions about whether reflux should be corrected surgically are usually based on the degree of reflux. Standardization of the rate of urine formation during micturating cystourethrography is therefore essential.


Laboratory utilization in group general practice.

A survey was made of laboratory utilization in a busy group general practice for a one-month period. Approximately 10% of all patients seen in the period were referred for laboratory investigations. The majority of patients were females. Data are presented on abnormal results, laboratory area utilization and report time expectations. The pilot study suggests that there is a demand for local laboratory services in practices where four or more doctors are practicing, but other factors involved require investigation and assessment.


Pregnancy in diabetic women.

Pregnancy in 207 diabetic women managed at a diabetic antenatal unit over a six-year period (1970 to 1976) resulted in a perinatal mortality of 16 (7-8%). One hundred and fifty-nine women (70%) were receiving insulin before pregnancy and 20% had evidence of diabetic microangiopathy. Still birth was twice as frequent as neonatal death, and severe respiratory distress syndrome was uncommon, resulting in only one death. Bad control of diabetes was associated with a poor prognosis. This was contributed to be lack of cooperation, anxiety and poor knowledge of diabetes. The accurate assessment of gestation and maturity, the monitoring of fetal-placental function, careful blood glucose level control, and an understanding of neonatal physiology have contributed to a reduction in fetal mortality. Close cooperation between an obstetrician, physician and neonatal pediatrician experienced in the problems encountered in the management of pregnant diabetic women is essential if the best results are to be obtained.


Bilateral optic neuritis in childhood.

A 12-year-old male presented with a one-day history of visual failure. The clinical features were consistent with bilateral optic neuritis. Treatment with prednisolone resulted in visual function returning to normal. Bilateral optic neuritis in childhood is an uncommon condition. The aetiological factors differ from those of the adolescent and adult with optic neuritis. The childhood condition is not associated with the high risk of developing demyelination disease at some later stage.


Psychiatric units in general hospitals.

Psychiatric units in general hospitals will, increasingly, play a larger part in the delivery of psychiatric services to the community. Australian units are compared with those in England and Wales. It is very difficult to envisage the widespread adoption in Australia of large comprehensive district general hospital psychiatric units similar to those planned for Britain. A current challenge to existing psychiatric units in the large teaching hospitals in the capital cities of Australia is whether they will take on a catchment area responsibility, or remain independent of any plans for regionalization of psychiatric services.


Adenocarcinoma of the colon presenting as anaemia.

All patients with adenocarcinoma of the colon treated surgically at the Austin Hospital over a five-year period were reviewed to determine the relevance of anaemia in diagnosis. It was found that one-fifth of the patients presented with symptoms of anaemia to the doctor of first contact, and of these, one-third had an unwarranted delay in diagnosis (mean delay 13 months).


Cervical smear frequency pattern at an Australian screening centre.

The frequency of cervical cytology screening in a group of 1966 women in an Australian setting is presented. Of women "at risk" of carcinoma of the cervix, 91-8% have had at least one previous cervical Papanicolaou (Pap) smear examination. Of the women who had never had a previous smear examination, 19-8% were taking oral contraceptives and 58% were parous.


Changing trends in mortality from malignant melanoma.

Five-year survival rates for both men and women treated at the melanoma clinics at St Vincent's Hospital and Sydney Hospital and at Royal Prince Alfred Hospital were found to have gradually improved over a 26-year time period. It is concluded that the improved survival rates do not result from changes in the sex ratio of the patients presenting for treatment, their age or the site distribution of their primary lesion. It is suggested that a change in the biological nature of malignant melanoma  may have occurred over this time period. Such a change, if proven, would cast doubt on the value of investigations in which historical controls are used to monitor the effects of changes in therapy.


Landry-Guillain-Barré-Strohl syndrome. A study of 302 cases.

Three hundred and two cases of Landry-Guillain-Barré-Strohl syndrome (LGBSS) are studied and relevant literature is reviewed. The existing diagnostic criteria appear not in keeping with the histopathological and immunological findings of this condition, hence some modifications have been suggested. The role of steroids in the treatment of this disorder is critically examined, and no benefit is found to be gained from their use.


Severe illness with anxiety following a reputed magical act on an Australian aboriginal.

A case of extreme anxiety is described in an Aboriginal man who believed he had been subjected to magical influences. It is hypothesized that extreme anxiety accompanied by a refusal to eat or drink (the latter feature being part of the Aboriginal belief system under these conditions) is part, or all, of the mechanism of death from magical influences.


DDAVP in the treatment of diabetes insipidus: a clinical study.

In three cases of established cranial diabetes insipidus, the effectiveness of the new vasopressin analogue 1-desamino-8-D-arginine vasopressin (DDAVP) in controlling diabetes insipidus is demonstrated. A single dose of 20 micrograms of DDAVP given intranasally had an antidiuretic action from 16 to 24 hours in the three cases, and 10 micrograms given twice daily intranasally was effective in controlling the diabetes insipidus with no side effects. All the patients preferred this form of therapy to their previous treatment.


Acinetobacter septicaemia following prolonged intravenous therapy.

A 76-year-old man developed septicaemia during the infusion of stable plasma protein solution (SPPS) which was subsequently shown to be contaminated with Acinetobacter anitratus. Septicaemia persisted for four days despite change of the intravenous cannula and administration of an appropriate antibiotic. Clinical improvement occurred only when the entire intravenous line, (infusion bottle, airway needle, giving set and intravenous cannula), all of which grew Acinetobacter, was replaced. Contamination of the SPPS probably occurred in the ward via a contaminated giving set and airway needle, which had been in use for one week. This case illustrates the importance of following accepted guidelines for infection control in intravenous therapy.


Community health in the University of Melbourne.

After changes to the curriculum of the University of Melbourne Medical School, a Department of Community Health has been established. Undergraduate teaching will be carried out in the first, third, fourth and sixth years of the course. Although an introduction to primary care will occur in first year, the teaching emphasis in the preclinical years will be in the behavioural sciences, epidemiology and social medicine. Primary care as a clinical subject will be taught in fourth year with electives available in the sixth year.


A study of the effects of hyperbaric oxygen on the experimental spinal cord injury.

The degree of motor recovery in sheep with a controlled contusion to the thoracic spinal cord is compared with the recovery in sheep treated with hyperbaric oxygen and confirms the results of a preliminary series previously reported. The degree of central cord cystic necrosis and degeneration in the surrounding white matter is compared in the control and treated animals. The improvement in motor recovery and in the degree of cord degeneration after treatment with hyperbaric oxygen suggests that ischaemia plays a significant role in the experimental animal with a contusion injury to the spinal cord.


Poisoning by carbamate pesticides.

In recent years the number of carbamate pesticides registered for use in New South Wales has increased. Some of the newer carbamates are very toxic and have cholinergic properties similar to those of the organic phosphates, though the effect is of much shorter duration. Because of this, separate tests for plasma and red blood cell levels of cholinesterase should be conducted as soon as possible after exposure in order to obtain meaningful results. A typical case of carbamate poisoning is described in which both plasma and red blood cell cholinesterase values were lowered. The substitution of a liquid pesticide formulation for the original powder formulation has reduced the operator inhalation hazard in the case of methomyl.


Evaluation of the nitroprusside test for the diagnosis of cystinuria.

Because of the wide acceptability of the nitroprusside test for the diagnosis of cystinuria, an analysis of 525 consecutive urine tests performed at this laboratory was undertaken, the nitroprusside test result being correlated with the urinary cystine excretion as determined by paper chromatography, high-voltage electrophoresis and chemical tests. It was found that the nitroprusside test clearly separated urine samples into categories of cystine excretion within the normal, heterozygote and homozygote range (P less than 0-001). However, 7 (1-33%) urine specimens from homozygous cystinurics gave a negative nitroprusside result. If properly performed on a concentrated urine specimen, this test is a very accurate means of diagnosing cystinuria (expected error approximately 1%), but it is not infallible.