The otological aspects of palatal myoclonus.

Palatal myoclonus with its concomittant objective tinnitus is often a missed diagnosis and poses a problem to the clinician in separating it from other middle ear anomalies. The etiology and symptomatology is outlined, but as suggested by our case presentations are not always diagnostic. The anatomical pathways of palatal myoclonus are traced, and its etiological complexities are realized when any locus or pathology along these tracks may create the characteristic chronic rhythmic contractions. We have experienced excellent results in determining a differential diagnosis of palatal myoclonus from other middle ear problems by the correlations of impedance audiometry with our clinical findings. Although the etiology is not defined the target structures can be separated from this test method and, therefore, enable more specific therapy.


The protean clinical features of polymorphic reticulosis (lethal midline granuloma).

Confusion surrounds the entity known as "lethal midline granuloma". Partly responsible is the lack of specificity in this term. "Polymorphic reticulosis" has been used as a term to describe the morphology of the disease. Thirty-two cases illustrate the protean features of this disease. Although it commonly presents in the head and neck, other sites such as the lungs, kidneys, skin, and gastrointestinal tract may be involved, either alone or in conjunction with lesions of the head and neck. Clinically, it is easily confused with Wegener's granulomatosis. Histopathologic differentiation, however, is both feasible and important. Wegener's granulomatosis is treatable with steroids with or without cyclophosphamide; polymorphic reticulosis confined to one site responds to irradiation. In polymorphic reticulosis, thhe best results of treatment are obtained in localized lesions of the upper airway treated early with irradiation; a poorer outcome is associated with multifocal involvement, which necessitates systemic therapy.


Geniculate neuralgia: diagnosis and surgical management.

Pain in the ear is a common complaint for which patients consult their otolaryngologist. A rare cause is geniculate neuralgia, which has also been called tic douloureux of the nervus intermedius. In its most typical form, it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain may also be of gradual onset and of a dull, persistent nature, with occasional sharp, stabbing pain. The diagnostic features and two new surgical techniques for its treatment are described. Afferent sensory facial nerve fibers are shown to pass not only through the nervus intermedius, but also through the main motor trunk of the facial nerve. Excision of the nervus intermedius and/or of the geniculate ganglion by the middle cranial fossa approach without the production of facial paralysis, in any of 15 cases with geniculate neuralgia is reported. Use of these new techniques, sometimes in combination with selective section of the Vth cranial nerve, has been successful in relieving the pain of geniculate neuralgia.


Laryngeal problems following infant esophageal surgery.

This paper focuses on vocal cord paralysis in children after operation for tracheoesophageal fistula and/or esophageal atresia. We reviewed the charts of 65 children who were operated upon for congenital esophageal atresia and/or tracheoesophageal fistula during a period from 1964 to 1974. Ten of these children manifested laryngeal symptoms. Five had laryngeal paralysis. Two were untreated. One was treated with cordectomy and stent. Two were treated successfully with the Thornell arytenoidectomy, one of these being done without a tracheotomy in place. Mention is made of a third case of bilateral vocal cord paralysis due to hydrocephalus treated successfully by the Thornell procedure. Follow-up laryngoscopy was done on 21 children without laryngeal symptoms whiich revealed two previously unsuspected vocal cord paralyses and one vocal cord paresis which cleared.


Effects of head blow on the development of hearing loss.

The effects of the direction and intensity of the head blow and the effects of the lapse of time after a head blow on the development of hearing loss were studied in guinea pigs. The electrical responses from the right inferior colliculus (ER) and from the left round window (CP) to acoustic stimuli were measured. The elevation in threshold of the ER in the presence of normal CP in guinea pigs after a head blow suggests that the site of the lesion is central to the cochlea.


A new functional approach to the surgical management of Pierre Robin syndrome: experimental and clinical report.

A functional and simple surgical method for treating the respiratory distress of the neonate affected by Pierre Robin syndrome is described. The base of the tongue is placed in an anterior position via a buried wire suture tied around the body of the hyoid. The method proposed in this paper fulfills the following: 1. It is physiologic since the infant is able to suckle and maintain its nutrition by preserving the function of the mobile portion of the tongue for deglutition. 2. Maintenance of the "pushing" action of the tongue stimulates growth of the mandible. 3. The anchoring wire is not exposed in the oral cavity and the risk of tissue breakdown and infection is eliminated. 4. This technique utilizes the stronger fibrous portion of the mid-tongue rather than muscle which "gives" more readily under pressure. 5. The shortest distance from the base of the tongue to the mid-hyoid provides the best mechanical advantage. 6. The suture, if need be, may be tightened at subsequent periods of time. Under Ketamin (Ketalan) anesthesia the tip of the tongue was held in the forward position. An 18 gauge stainless steel wire was inserted via a large curved needle through the midline of the posterior-most portion at the base of the tongue. The needle was directed anteriorly and inferiorly to emerge below the mid point of the inferior border of the hyoid bone. The opposite end of the wire was then tunneled submucosally to the anterior portion of the base of the tongue at foramen caecum, and directed inferiorly to emerge above the superior border of the mid-portion of the hyoid bone. Through a small skin incision opposite the body of the hyoid bone, both free ends of the wire were tied under tension around the body of the hyoid while pulling the base of the tongue forward. The skin incision was closed with a single nylon suture. A prosthetic obturator was used to close the cleft palate. The outcome was satisfactory with no morbidity.


Microscopic characteristics of the acoustic tumor in relationship of its nerve of origin.

The microscopic characteristics of a 0.9 cm vestibular schwannoma en bloc resected with its nerve of origin which occurred in a 54-year-old white woman presenting with a two-year history of a unilateral progressive sensori-neural hearing loss is described. The tumor originated in the inferior vestibular portion of the vestibular division of the VIIIth cranial nerve just medial to the internal auditory canal meatus at approximately the level of the glial-non-glial junction. The tumor demonstrated two distinctly different, yet simultaneous, modes of involvement with its nerve of origin: 1. inseparable cellular continuity; and 2. peripheral compression of the remainder of the nerve within the tumor capsule. Despite only slight microscopic continuity of the nerve histologically, electronystagmography showed no unilateral weakness on bithermal caloric testing, and pure tone and speech audiometry was only moderately depressed.


Sjögren's syndrome and serous otitis media.

Extrasalivary lymphoid abnormalities in Sjögren's syndrome are well described. Patients have been found to have lymphoid infiltration of many organ systems. The nature of the lymphoid abnormalities constitutes a spectrum ranging from benign to malignant disease. A case of an elderly patient with long standing Sjögren's syndrome is presented because of the unusual manifestation of a benign lymphoid mass in the nasopharynx producing unilateral eustachian tube obstruction and serous otitis media. Serous otitis media associated with Sjögren's syndrome is recognized, but to our knowledge in previous cases an extrasalivary lymphoid abnormality has not been implicated as the underlying pathology.


Structure of some intact lipids of petrel stomach oils.

The stomach or proventricular oils from 16 species of petrel have been analyzed and the carbon number distributions of the wax esters, triglycerides, and diacylglyceryl ethers are reported. The wax esters have been fractionated further into less and more polar species. To determine whether any intermolecular specificity existed, carbon number distributions for each lipid class were calculated, assuming random esterifications. The tirglyceride and diacylglyceryl ether compositions observed were all found to aggree closely with those calculated. The wax esters from three petrel species were found to have greater proportions of the middle range species with carbon numbers 34-38 than calculated. However, most of the lipids examined had random structures which have been found to be characteristic of marine sources. The results in general support the belief that the oils are derived directly from dietary sources rather than synthesis by the proventricular glands.


Vitamin e, cholesterol, and lipids during atherogenesis in rabbits.

Rabbits were fed diets including cholesterol and 10% butterfat to determine whether polyunsaturated butter (9% 18:2) would be less atherogenic than normal saturated butter (3% 18:2) when fed for 12 weeks. The cholesterol diets alone, 0.5% or 2%, produced aortic plaque development, and plasma cholesterol increased 20 times, lipids increased 10 times, and vitamin E increased 5 times. The inclusion of both fat and cholesterol in the diet produced a synergistic effect, doubling these values to 40 times for cholesterol, 20 times for lipids, and 10 times for vitamin E. The higher circulating levels of cholesterol caused increased tissue levels of cholesterol. With 2% cholesterol and fat, liver and aorta cholesterol increased 10 times, heart 4 times, and muscle cholesterol 2 times. The lower 0.5% dietary cholesterol load was successful in limiting the amount of tissue cholesterol increase. Liver, aorta, heart, and muscle levels of cholesterol were only about half the concentration attained when 2% cholesterol was fed. It was concluded that there were no differences in plasma or tissue cholesterol, vitamin E, or atherosclerosis attributable to the polyunsaturated nature of the diet. The 10% butterfat diets alone, whether saturated or unsaturated, did not induce aortic plaques and did not increase blood or tissue cholesterol, lipids, or vitamin E. Our results suggest that the lipid mobilizing effect is mediated by cholesterol, probably by conversion to bile acids and a stimulation in intestinal absorption.


Site of bile acid absorption in the rat.

Bile acid absorption was measured in the small intestine of the rat using 91Y as a nonabsorbed reference substance. Some 50% of the secreted bile acids were absorbed in the proximal half of the small intestine. In situ incubations of ligated intestinal segments into which tauro(14C-carbonyl)cholic acid was introduced confirmed the considerable uptake of bile acids in the jejunum. The situ experiments indicated that serosal transport is the limiting stage of bile acid absorption in the jejunum but not in the ileum. Increasing bile acid concentrations in the in situ experiments did not affect the percentage disappearance of dose from the jejunum but reduced the percentage mucosal uptake in the ileum. It is concluded that, in the rat, the proximal small intestine is as important in the absorption of bile acids as the distal small intestine.


Specific inhibition of hepatic fatty acid synthesis exerted by dietary linoleate and linolenate in essential fatty acid adequate rats.

Dietary linoleate and linolenate were investigated for their ability to specifically inhibit liver and adipose tissue lipogenesis in meal-fed (access to food 900-1,200 hr), essential fatty acid (EFA) adequate rats. Supplementing a high carbohydrate diet containing 2.5% safflower oil with 3% palmitate 16:0, oleate 18:1, or linoleate 18:2 did not affect in vivo liver or adipose tissue fatty acid synthesis. However, 18:2 addition to the basal diet did result in a significant (P less than 0.05) decline of liver fatty acid synthetase (FAS) and glucose-6-phosphate dehydrogenase (G6PD) activities. When the safflower oil content of the basal diet was reduced to 1%, the addition of 3% 18:2 or linolenate 18:3 significantly (P less than 0.05) depressed hepatic FAS, G6PD, and in vivo fatty acid synthesis by 50%. Addition of 18:1 caused no depression in hepatic FAS activity but did result in a significant (P less than 0.05) decline in liver G6PD activity and fatty acid synthesis which was intermediate between basal and basal +18:2- or +18:3-fed animals. Adipose tissue rates of lipogenesis were completely unaffected by dietary fatty acid supplementation. Similarly, the addition of 3 or 5% 18:3 to a basal diet for only one meal resulted in no change in lipogenesis relative to that in animals fed the basal diet. The data indicate that, like rats fed EFA-deficient diets, dietary 18:2 and 18:3 exert a specific capacity to depress rat liver FAS and G6PD activities and rate of fatty acid synthesis.


Valve dynamics.

Flow between two contiguous elastic sheets (valve leaflets) generates one of two types of behavior. At low pressure differences, e.g. 1 cm H2O, the sheets part slightly and the fluid passes silently between them. The aperture under these silent conditions varies with the square of the length of the orifice, the transvalvular pressure difference and the kinetic energy, divided by the thickness of the leaflets. At higher transvalvular pressure differences the downstream end of the bicuspid valve alternately closes and reopens (flitter), and functions as an acoustic oscillator. The recurrence rate of flitter varies with the tension on the leaflets and inversely with the thickness. The threshold of the onset of flitter varies with the product of the pressure and the square of the length of the valve aperture, divided by the wall tension and thickness. The significance of these data in the onset of the flitter and of the recurrence rate is discussed in terms of the production of sounds and murmurs at the heart valves, vocal cords and other sites.


[Oxidation and assimilation pathways of methylated amines in Arthrobacter globiformis].

The oxidation by Arthrobacter globiformis B-175 of tertiary, secondary, and primary amines is catalyzed by specific induced enzymes. Trimethylamine is oxidized to dimethylamine via trimethylamine N-oxide by monooxygenase and demethylase. Dimethylamine is converted to methylamine by another monooxygenase. Methylamine is oxidized to ammonia and formaldehyde by aminoxidase. Formaldehyde is assimilated via ribulose monophosphate cycle, which is confirmed by the presence of hexose-phosphate synthase and by the early and predominant formation of radioactive sugar phosphates during short-term incubation of the cells with labelled methylated amines. Hexose-phosphate synthase was also found in two other strains of A. globiforms (B-126, B-53) which assimilated methylated amines. This methylotroph contains the enzymes of the Krebs cycle which seems to be involved in the synthesis of organic acids. The participation of ammonium nitrogen in anabolic processes is accomplished by reductive amination of alpha-ketoglutarate, glyoxylate, and pyruvate.


[Raffinose metabolism in Gluconobacter oxydans].

Metabolism of raffinose has been examined in experiments with the growing culture and washed cells of Gluconobacter oxydans L-1. Degradtion of the trisaccharide was found to be catalyzed by levansucrase, levan being synthesized, and melibiose and small quantitites of fructose being liberated in the reaction. Melibiose is not hydrolyzed and is not used by the bacterium as a source of carbon, but is oxidized to melibionic acid. Fructose is assimilated by the bacterium in constructive metabolism, being oxidized to gluconic, 2-ketogluconic acids and 5-ketofructose.


[The multiphase character of methane fermentation of cellulose].

An enrichment culture producing methane from cellulose was studied. The culture is a system of changing microbial populations realizing various pathways of methane formation. This change of microbial associations is expressed in three phases of growth; each phase is characterized by its maximum of methane production. The first maximum is related to accumulation and utilization of propionic acid. The second maximum is due to methane formation from acetate by Methanosarcina. One of the possible pathways regulating the methanogenous ecosystem is the action of concentrations of the main metabolites--glucose and the products of its fermentation.


[Isolation, purification and several properties of the extracellular RNA-ase of Bacillus amylozyma].

RNase has been isolated from the cultural broth of Bacillus amylozyma 9a. The dynamics of accumulation of this exocellular enzyme was studied during the growth of the bacterial population, and the optimal conditions for production of the RNase were determined. The enzyme was isolated and purified as follows: precipitation with ammonium sulphate, dialysis, thermal treatment of the enzyme solution, chromatography on DEAE- and CM-celluloses. The enzyme has been purified by 274 times; its specific activity is 3300 units. The preparation contains no DNase, PDEase, and PMEase. The following physical and chemical properties of the enzyme has been studied: molecular weight, thermostability, pH otimum, activation with metal ions.


[Amino acid regulation of L-asparaginase formation in Bacillus mesentericus].

The role of amino acids in regulation of L-asparaginase formation was studied in Bacillus mesentericus 43A. Asparagic acid and, to a less extent, asparagine repress biosynthesis of the enzyme. Glutamic acid, glutamine, and other 15 studied amino acids, added separately at a concentration of 10 or 20 mM to the growing culture, have no effect on the activity of the enzyme. Addition of a combination of all 18 amino acids, each at a concentration of 4 mM, to the culture represses the activity by 64%; addition of an acid hydrolysate of lactoalbumin (10 g/litre) represses the activity of the enzyme by 80%. A mixture of amino acids without asparagic acid and asparagine also displays a strong repressing action. Amino acids formed from asparagic acid--lysine, methionine, and isoleucine--do not repress biosynthesis of the enzyme, neither together nor separately. Ammonium nitrogen also does not participate in regulation of asparaginase formation. The cumulative repressing action of amino acids is supposed to be manifested via the mechanism of catabolite repression.


[Pyruvate- and alpha-ketoglutarate dehydrogenase activity during yeast growth on glucose and hexadecane].

The activity of pyruvate- and ketoglutarate dehydrogenases (PDH and KGDH) was determined in the cells of Candida lipolytica and Candida tropicalis during the exponential phase of their growth on glucose and hexadecane. The activity of PDH in the cells growing on hexadecane was found to be lower than in the cells growing on glucose. The activity of KGDH was almost the same in the cells cultivated on hexadecane and glucose. The results obtained are discussed with respect to different pathways of degradation of glucose and n-alkanes, and a decreased requirement in thiamine during growth of the yeast cells on n-alkanes.


[Chitinase formation by actinomycetes in deep cultures].

Actinomycetes were cultivated in the medium containing demineralized crab shells as a source of carbon. Chitinase was found in filtrates of the cultural broth of all 44 studied strains. The activity of the extracellular chitinase was determined both by decomposition of ground chitin (CHI-activity) and colloid chitin (CHI-activity). The ratio between CHI and CHX in filtrates of the cultural broth of the most active nine strains varied from one to two.


[Thermophilic nitrifying bacteria from hot springs].

A culture of thermophilic nitrifying bacteria was isolated from geothermal springs of Kamchatka (50-86 degrees C, pH 6.3-7.5) AND Tajig SSR (50-85 degrees C, pH 7.3-8.5). The culture oxidizes ammonium nitrogen at 40-70 degrees C. It resembles Nitrosomonas europea Winogradskyi by its morphology. Dimensions of the cells vary within 0.7-0.9 X 0.8-1.4 mcm. Each cell has a polar flagellum whose diameter is about 140 A. This is the first description of thermophilic nitrifying bacteria belonging to the genus Nitrosomonas.


[Carotenoids synthesized by a culture of a mutant actinomycete strain].

Several pigments (beta-, gamma-carotenes and lycopene) have been isolated from the culture of the mutant strain of Actinomyces sp. 2 var. PIII related to Actinomyces chrysomallus. The pigments were identified by the position of maxima and absorption of light by the pigments within the range of 400 to 520 nm, and also by chromatography in several solvent systems, the results were compared with standard samples and literature data. The total yield of the carotenes during cultivation in flasks was 0.744 mg/g of dry mycelium; the content of beta-carotene was 0.590 mg/g.


[Alpha-ketoglutaric acid transamination of synthetic omega-amino acids in bacteria].

Bacteria utilizing synthetic lactams and omega-amino acids contain enzymes involved in transamination of epsilon-aminocaproic, zeta-aminoenanthic, eta-aminocaprilic acids with alpha-ketoglutaric acid. Natural and synthetic omega-amino acids are not inductors of the synthesis of corresponding transaminases. A strain of Pseudomonas dacunchae has been selected; it possesses an elevated activity of transamination of synthetic omega-amino acids, including zeta-aminoenanthic and eta-aminocaprilic acids.


[A flavinogenic mutant of the yeast Pichia guilliermondii with impaired iron transport].

A mutant of the yeast Pichia guilliermondii was produced by means of UV; the mutant was capable of riboflavin overproduction in the presence of high concentrations of iron in the medium. The content of total and non-hemin iron and cytochrome c, and the activity of catalase, were lower in the cells of the mutant than in the parent cells, while the activity of riboflavin synthetase was higher. The content of iron in the cells increased when the mutant was cultivated on media with citric acid, siderochromes of Klebsiella aerogenes, Neurospora crassa, Rhodotorula glutinis, cultural broth of Pichia ohmeri, and autolysate of brewer's yeast, whereas the flavinogenous activity of the cells decreased. Rotenone inhibited respiration of the intact cells of the mutant producing elevated amounts of riboflavin; therefore, flavinogenesis was not regulated by non-hemin iron on the first segment of the respiratory chain. Overproduction of riboflavin in the mutant of Pichia guilliermondii was proved to be a recessive property.


[An electron microscopic study of Nocardia rubra growing in a medium containing phenol].

Changes in the cytoplasm were detected in the ultrastructure of Nocardia rubra 80 growing on a medium containing phenol: the cytoplasm aggregated to yield inclusions with different electron density, having round shape and granular structure. The inclusions are surrounded with bright zones. Cells were formed, which resembled bacterial endospores by their formation and structure; however, typical refractive spores with envelopes and cortex have not been detected.


[The influence of growth conditions on the composition of free amino acids in cells of staphylococcus and its pigmentless mutant].

The qualitative and quantitative composition of free amino acids was studied in the cells of Staphylococcus aureus, strain 209-P, and its pigmentless mutant B-6 grown in aerobic and anaerobic conditions. Aerobiosis stimulated accumulation of dicarboxylic and hydroxy amino acids, alanine and leucine, and pigment biosynthesis in the cells of Staphylococcus aureus. One amino acid has not been identified. The content of free amino acids was different in the cells of the parent strain and its mutant grown in anaerobic conditions.


[Fine structure of the vegetative and spore-forming hyphae of Micropolyspora fascifera].

Changes in the fine structure of the hyphae were studied in the course of spore formation by Micropolyspora fascifera. Sporulating hyphae differ from vegetative hyphae by a less dense cytoplasm, a large zone of the nucleoid with distinctly fibrillar structure, and a thin layerless cell wall. Spore formation is accompanied with autolysis of the vegetative hyphae, which consists in vacuolization of the hyphae and appearance of a large number of tubular membrane structures within them. Spores are formed, like in Actinomyces spp., by simultaneous division of the hyphae with septa; the structure of sporulating septa is similar to that of the fragmenting mycelium in Nocardia; the structure of mature spores is similar to that in some Actinomyces spp. Therefore, M. fascifera differs from other Micropolyspora spp. not only by the chemical composition of the cells (the presence of nocardiomicolic acids) but also by their structure. Taxonomic position of the species is discussed.


[The nature of the luminescence of the heliomycin producer Actinomyces enissus].

Luminescence of Actinomyces enissus synthesizing heliomycin is caused by the action of UV; it is multicoloured, mosaic, and changes in the course of growth. Multicoloured luminescence is due to formation of substances with various colours of luminescence (antibiotics heliomycin and resistoflavin, coproporphyrins I and III, riboflavin, etc.); its mosaic character is caused by the presence in the population of variants with difference in the component composition of luminescent substances and the degree of differentiation of colonies.


[A parasitological study of cockroaches (Blattidae)].

All kinds of arthropoda can find a suitable environment to grow and spread in this country because of its mild and subtropical climate. Arthropods are harmful to men, animals and plants in many ways. The most important role the arthropods play is in carrying germs and parasites. Cockroaches are widely spread in Turkey, they transmit bacteria, viruses, protozoa and helminths mechanically and biologically. Because of their close contact with human beings, these insects encouraged us to make parasitological investigations. In the hindgut of cockroaches we found three nemethod species; Suifunema caudelli, Galebia aegyptiaca, and Hammerschmidtiella diesingi.


[The bacterial flora of decubitus ulcers and the effects of ultraviolet light on this flora].

Decubitus ulcers, their treatment, the effect of UV light on bacterial flora of these ulcers, different effects of UV light according to the wave length, the UV lamp used in experiments, and the bacterial flora of wounds in different phases are explained. From 21 patients, with decubitus ulcers under UV treatment, 974 samples were collected before and after UV treatments. These samples were cultured on blood agar plates by the isolation method in 5 steps. After 24 hours incubation, the colonies were counted at each step and then identified. It has seen that bacterial flora decreased gradually from 1 MED, up to 6 MED of UV exposure. (MED = Minimal eritemal dose = about 1 minute) From 6 MED up to 20 MED the rate of decrease remained almost at the same level as in 6 MED. The number of colonies at each step before and after UV exposures were compared with each other. Only the averages of first steps in every MED, their standard errors and (P) values are shown in table III. The ulcers showed higher granulation tissue and faster healing parallel to the effect of UV light on bacteria. In cultures from 974 samples, pseudomonas was most commonly found, followed by diphtheroides, hemolytic staphylococci, non-hemolytic staphylococci, Gram (--) micrococci, proteus, mima (only in two patients), candida, saprophytic staphylococci, neisseria, haemophilus, and aerobic spore-forming bacilli.


[Studies of Yersinia pestis in wild animals captured in Ankara, Konya and Nevsehir].

No Yersinia pestis could be isolated, by culturing and by inoculations to 1212 guinea-pigs and 150 mice; from 623 citellus, 41 Mus musculus, 55 Microtus, 442 Meriones, 70 Rattus rattus, 56 turtle, 89 hare, 1 hamster, 1 hedgehog, 1 sea snake, altogether 790 dead, 589 alive, i.e. 1379. wild animals captured in Ankara, Konya (Karapinar), Urfa (Akçakale) and in Nevşehir. In 141 sera taken from citellus captured alive, and in 174 sera taken from guinea-pigs inoculated with spleen, liver and kidney suspensions of wild animals, 1/20 - 1/80 agglutination titers (one of the sera from a guinea-pig inoculated with hare organ suspension) were obtained. These findings, probably were due to Yersinia pseudotuberculosis, because this organism was isolated from citellus captured in Ankara and Konya.


[First isolation of S. newlands serotype in Turkey].

Authors report the first isolation of Salmonella newlands serotype in Ankara from the stool culture of a patient with acute gastroenteritis.


[Total number, biomass and production of bacteria in the water of the subtropical and equatorial-tropical regions of the Pacific Ocean].

The total number and biomass of bacteria were determined by capillary microscopy in 168 samples of water taken from different horizons (0-5,000 m) in the subtropic and equatorial-tropic regions of the central part of the Pacific Ocean (135 degrees and 150 degrees w. long) and the western half of the Indian Ocean (65 degrees e. long). In most cases, 1 ml of water contained dozens and hundreds of thousands of the cells whose biomass was several or dozens milligrams per 1 m3. Layers with a high content of bacteria were encountered not only in the surface zone but also at large depths. In the euphotic layer (0-200 m), the mean value of the bacterial biomass was similar to that of phytoplankton in mesotrophic waters of tropic divergences and subpolar zones. Vertical distribution of the total number of the microorganisms was found to be similar to distribution of saprophytic bacteria studied earlier.


[Biogenic elements and sulfate reduction in a flooded oil carbonate stratum].

Biogenous sulphate reduction and accumulation of secondary H2S were caused by the action of pumping waters with a low content of mineral elements on carbonate collectors with a high concentration of relict H2S during long periods of time. The amount of sulphates, phosphates, and ammonium nitrogen in water from layers of various mineralization is sufficient for active sulphate reduction. Sulphates and phosphates are eliminated from rocks of layers with diluted waters. The maximum increase of SO42- in waters was 1545 mg/litre, that of HPO42- was 0.34 mg/litre. The amount of ammonium decreases with mineralization of the layer waters, remaining within the range of 129-7 mg/litre. The content of CO2 and HCO3- increases in diluted waters to 197 and 695 mg/litre, respectively, correlating with biogenous processes. The highest number of sulphate reducing bacteria (dozens of thousands of the cells per ml) was found in water with mineralization of 19 g/litre. Curves for the content of SO42-, HPO42-, NH4+, and CO2 have a common maximum in waters of the Polaznensky deposit with a salinity of 62 g/litre.


[First isolation of S. zanzibar in Turkey].

Author reports first isolation of a Salmonella zanzibar serotype from the stool culture of an 8 year old boy with gastroenteritis in Ankara.


[The number and respiratory intensity of bacterioplankton in the South Ural lakes].

The rate of oxygen assimilation by bacterioplankton was determined in the course of vegetative period in nine lakes of the Southern Urals. A correlation was established between the respiration rate and the presence of easily oxidizable organic substance in water within one lake. The optimum concentration of bacteria was found in the lakes when their activity was maximal. An increase or a decrease of this concentration results in a decrease of oxygen assimilation by a bacterial cell. The highest rate of oxygen assimilation by a bacterial cell was detected in mesotrophic lakes (2.0-10(-11) mgO/hr), being lower in oligotrophic and eutrophic lakes (0.9-10(-11)-1.0-10(-11) mgO/hr).


[II. The process of spontaneous bacteriolysis in water and micropredator bacteria].

In her conference presented in Public Health School in Ankara in June 1975, the author summarizes the present knowledge on spontaneous bacteriolysis process in water and gives information on the bacteria which are thought to be mostly responsible for auto-purification of water, with special emphasis on Bdellovibrio bacteriovorus strains.


[A comparison of complete and incomplete antibodies by Middlebrook-Dubos, Boyden and Coombs hemagglutination tests in man].

The antibodies in the sera of 160 tuberculous persons and in a control group of 100 healthy persons were investigated by Middlebrook-Dubos (M-D), Boyden hemagglutination and modified M-D antiglobulin methods. By the M-D method 88% of the sera from 135 persons with lung tuberculosis, and 57.1% sera from 21 persons with other organ tuberculosis gave positive results. In the control group of 100 persons 11% were positive, while all of PPD negative persons remained negative. By Boyden method 90% of 135 lung tuberculosis, 57.1% of 21 with other organ tuberculosis and 4% of the control group gave positive results. In 91.2% of 80 persons with lung tuberculosis, tested with modified M-D antiglobulin method, found incomplete antibodies. The difference in control groups (11%, 4%), and in persons with active tuberculosis (88%, 90%) indicates that the serological tests are just as significant as other diagnostic methods.


[Anaerobic bacteria isolated from appendices and appendicitis cases].

Anaerobic bacteria were isolated from 17 of 40 normal appendices and appendicitis cases in Ankara. In both cases gram positive, nonsporulating, and gram negative organisms were isolated. Gram positive cocci were only isolated from appendicitis cases. The bacteria isolated from appendicitis are usually like the anaerobic bacteria of the colon flora. All anaerobic bacteria in appendix flora can cause appendicitis in suitable conditions.


[Diagnosis of human hydatidosis by hemagglutination and complement fixation (Weinberg) tests].

397 sera were tested by passive hemaglutination and weinberg reactions to diagnose hydatid cysts. 5 of 211 sera (2.53%) gave positive and 206 sera (97.63%) gave negative results by passive hemagglutination test, whereas in weinberg reaction 204 of them (96.68%) were negative and 7 (3.32%) anticomplementary. 13 sera (14.13%) from another batch of 92 sera gave negative results and 79 of them (85.87%) remained negative by passive hemagglutination test, when 6 of them (6.52%) were positive and 96 (93.48%) negative by weinberg reaction. 56 (91.80%) of 61 sera taken from patients operated on for hydatid cysts gave positive and 5 (8.20%) of them negative by passive hemagglutination test. 29 (47.54%) were positive, and 32 (52.46%) negative by weinberg reaction. In another batch of 15 sera taken from patients, 3 were positive and 12 were negative by passive hemagglutination, 2 were positive and 13 were negative by weinberg test. When the two tests are compared, passive hemagglutination test gave better results both qualitatively and quantitatively than weinberg so that it may be preferred in laboratories having improved facilities.


[The results of copro parasitological investigations in two poor districts in Ankara].

542 stools were examined for intestinal helminths. 97 of them showed parasitic infestation. The number and percentages of the species found are shown below, Ascaris lumbricoides 39 7.4%, Hymenolepis nana 24 4.4%, Enterobius vermicularis 16 3.0%, Taenia saginata 4 0.8%, Trichuris trichiura 12 2.2%. The helminthological diagnosis is based on the enrichment methods of flotation.


Myasthenia gravis: An embryologic and phylogenetic perspective.

Myasthenia gravis is a rare disease with unique clinical features. These include (1) progressive fatigue on exertion, most evident clinically in the muscles of the head and neck (2) a definite relationship of the disease to the thyroid, parathyroid and thymus glands. A hypothesis is advanced with correlates these facts on the basis of a common embryologic origin of these glands and the branchial arch muscles. A corollary is that the muscles of the head and neck differ from the somatic musculature in some as-yet-unidentified manner, for example, pharmacologically. A plea is made for comparative studies between the two.


Determination of ventricular volume from changes in wall thickness.

A new method of measuring left ventricular volume is proposed which utilizes ventricular wall thickness at end systole and end diastole to estimate the ejection fraction. These measurements plus stroke volume allow the calculation of ventricular EDV. Although data from angiocardiographic studies have been used to validate the method it appears that the same data can be derived from ultrasound studies. The use of ultrasound methods would allow long term monitoring of ventricular volume changes during the course of a disease process. The proposed method appears to offer a more consistently accurate means of measuring EDV than previously suggested ultrasound methods. Comparison of EDV data calculated from angiographic and wall thickness measurements reveals the two methods to be statistically identical. In patients with a normal myocardium or valve lesions the correlation between the two methods is 0.97 with a standard error of 21 cc. There is a significant loss of accuracy when estimating ventricular volume in patients having diagnoses compatible with ventricular asynergy. An alternative method is suggested which may improve estimates of ventricular volume in these patients.


The fundamental characteristics of individual development.

Individual development in the course of a generation has an unidirectional, irreversible, "closed", predominantly structly-determined, predominantly autoprogrammed, autoreproducible character. The characteristics of individual development differ in terms of its processes, stages, types and orders. Ontogenesis and ageing of the organism represent the principal processes of individual development. Individual development has three main stages (progressive stage, "plateau" stage and regressive stage). The types of individual development may be grouped into two categories: elementary and complex. The complex types result from the combining in different ways of the elementary types. Similarly, orders of the generations of individual development and hierarchical orders of individual development may be differentiated. Between the processes, stages, types and orders of individual development certain "combining" relationships may appear. The processes, stages and types of individual development as well as their mutual relationships serve both development and stability.


Catch 22 in the NIH peer review system.

The per review system for the assessment of research proposals is widely respected by working scientists. Nevertheless two problems associated with the operation of this system by the US National Institutes of Health are identified. First the scientist has no control over which committee will review an application and it may be considered by a quite inappropriate group. Second analysis of the committee composition suggests that in some of the groups several members are not active scientists and therefore not the "peers" of the applicant.


Cancer mortality correlation studies. I. Statistical associations between cancers at anatomically unrelated sites and some epidemiological implications.

Reported age-corrected cancer mortalities in different countries and in the USA were systematically correlated with the female breast cancer mortalities in order to establish the extent by which cancers at other sites are affected by regional and temporal variations of exogenous factors controlling the etiology of and/or mortality from cancer of the female breast. Some of the most common human cancers are directly correlated with breast cancer, with a high degree of statistical significance. Genuine inverse associations are rare, and only a few of the major neoplastic diseases appear to be uncorrelated. The results suggest that the human cancer mortality is controlled by exogenous factors which vary over space and time. These factors are as yet unidentified but are probably related to diet.


An occupational health approach to anaesthetic air pollution.

The principles of occupational health practice as applicable to operating theatre staff are stated. Operating theatre air was samples for halothane at three Sydney hospitals--one in which a scavenging system was in operation and two without such a system. A method giving time-weighted average concentrations over the period of sampling was used. Anaesthetic techniques varied for adults and children. The scavenging system was found to be highly efficient. Less than 0.1 ppm of halothane was found in the air of one theatre in which a flow rate of 4 litres per minute with 0.5% halothane and controlled ventilation were being used for routine anaesthetics in adults. In another theatre in which paediatric surgery was being performed, the anaesthetic technique utilized a flow rate of 6 litres per minute with 0.5% halothane and a T-piece, and the air was found to contain 0.8 ppm of halothane. Concentrations of up to 8 ppm were found in unscavenged theatres. Other possible occupational hazards of the environment, such as exposure to X-rays, viral infection and aerosol sprays, are mentioned. These may be significant.


Cancer: restriction of chemical energy by fatty acids as the common pathway whereby various anti-tumour procedures selectively damage malignant cells in situ.

Harmful effects may be inflicted upon cancer cells in vivo by a variety of means, for example, by the administration of bacterial endotoxins or alkylating agents, and by radiation treatment. These different procedures appear to act on tumours indirectly, and are also capable of inducing shock. The suggestion is made that the deleterious actions on cancer cells are mediated by the tissues of the host, and involve raising the levels of non-esterified fatty acids (NEFAs) in the plasma. Fatty acids may restrict the availability of chemical energy within cancer cells in at least two ways, either by modulating the activity of the mitochondrial adenine nucleotide translocase through the agency of their coenzyme A derivatives (LCFACoAs), or by uncoupling oxidative phosphorylation through the activation of phospholipase A2. The effectiveness of fatty acids in the former respect is theoretically and qualitatively examined on the basis of the affinity constants for LCFACoAs of the translocase and of certain enzymes concerned with beta-oxidation. The development of a new form of cancer chemotherapy by selectively harnessing and stimulating the lipotropic response of the host to a tumour is discussed in terms of the administration of fatty acids which possess specific properties while as the same time raising plasma NEFA concentrations and maintaining them at an elevated level.


Chronic bronchitis in Victoria, New South Wales and Queensland.

A study of chronic bronchitis was carried out on 195 ex-servicemen from Victoria New South Wales and Queensland. Exacerbations of chest symptoms were commonly found and chronic bronchitis was in important cause of haemoptysis. Weather conditions, especially cold weather, affected chest symptoms and early age of starting to smoke affected the incidence of severe bronchitis. The clinical profiles of the cases studied were similar to those in some of the reports from Canada and Britain.


Surgical relief of post-herpetic pain by excision of scarred skin.

This paper deals with the problems of post-herpetic pain. The various modes of treatment which have been tried for its relief are discussed as is our experience of excision of the scarred area of skin. The procedure has been found to offer worthwhile pain relief to a significant number of patients.


The relationship between measles virus infection and subacute sclerosing panencephalitis (SSPE).

On theoretical grounds we propose that the essential step in the development of subacute sclerosing panencephalitis (SSPE) after measles virus infection involves a reverse transcriptase-mediated change to a DNA form, probably brought about by co-infection with a leukovirus at a critical point in time. We further suggest that this new DNA then replicates either as the core of a new slow virus or as a membrane-attached viroid exhibiting a form of non-structural integration with host cell DNA resembling that found with the herpes viruses.


Dynamic electrocardiography, the electromechanical S wave: the problem of the contradictory converse.

Two basic hypotheses concerning an electromechanical S wave of the electrocardiogram during exercise have been expanded to five to include the effect of recovery which should produce converse changes. Four hypotheses have been supported and the fifth contradicted. An attempt has been made to analyse the ensuing dilemma and a conclusion is reached that either the electromechanical hypothesis is in error or a new hypothesis, which predicts an increase in the cardiac end-diastolic volume after exhaustive exercise, must be proposed. This new hypothesis is commonly accepted by physical educationalists but appears to be rarely discussed in physiological texts.


The mortality of exchange transfusions.

A prospective study of the effect and mortality of exchange transfusion was carried out in the Kandang Kerbau Hospital, Singapore. Altogether 140 exchange transfusions were performed on 122 infants. The exchanges were done for hyperbilirubinaemia due to "idiopathic" jaundice, ABO haemolytic disease, and glucose-6-phosphate dehydrogenase deficiency. Eight infants deteriorated during the exchange, in three of whom the procedure had to be terminated prematurely. Two deaths occurred two days after the exchange--the procedure being partly responsible in one case; necrotizing enterocolitis was present in addition to the kernicterus. Exchange transfusion is not without hazards, and should be performed carefully with close monitoring of the clinical status of the infant during and immediately after the procedure.


A comparative investigation of cervical cytology in Central Australian full-blooded aboriginal women.

The results of cytological screening of a group of full-blooded Aborigines are compared with the results of a similar study of women attending a teaching hospital cytology clinic. Abnormal appearances were found in the smears of four of the 430 Aborigines and 73 of the 1,069 women attending the clinic. The actual incidence of unsuspected dysplastic change was 0.23% for cervical dysplasia among the Aborigines and 0.75% for dysplasia and 0.84% for carcinoma-in-situ in the metropolitan group. Comment is made concerning the difference in appearance of the cervix in the two groups.


Aminophylline injection and theophylline tablets: Acute response in partially reversible chronic airway obstruction.

Intravenous injections of aminophylline (250 mg) and tablets of theophylline (Neulin) (400 mg) were given, on separate occasions, to 10 patients with partially reversible severe airway obstruction. The dose of aminophylline was shown to be inadequate on the basis of the unsatisfactory plasma theophylline levels and a poor ventilatory response. Two hours after oral administration of theophylline, a mean plasma theophylline concentration in the optimal range (10 to 20 mug/ml) was reached, and a consistent improvement in the mean forced expiratory volume in one second (FEV1) occurred. A further large improvement in FEV1 after inhalation of salbutamol showed that the improvement in ventilation with the theophylline tablets, although consistent, was less than maximal.


Thoracoomphalopagus diagnosed before delivery.

Twins may be dizygotic or monozygotic. Of the monozygotic twins, 25% to 30% are dichorionic and 70% to 75% are monochorionic. Whilst all the dichorionic twins are diamniotic, very occasionally some monochlorionic ones may be monoamniotic; some of these may be conjoined. A case of conjoined twins was diagnosed during pregnancy. The two girls were delivered by elective classical caesarean section. They were joined together from just above the xiphisternum to the umbilicus and were successfully separated. Recent literature is reviewed.


The conservative management of chronic renal failure.

The management of patients with chronic renal failure is complicated and demanding for both physician and patient, but is frequently rewarding. When specific treatment of the underlying cause is not possible, therapy is aimed at making the maximum use of existing nephrons and preventing further loss of nephrons through hypertension and infection. Careful attention to salt and water balance is necessary, and all patients and all drugs prescribed must be considered with care. Special problems exist with regard to anaemia, bone disease, pericarditis and hyperkalaemia. An important aspect of care at this time is the education of patients about the next major phase of management, dialysis and transplantation.


Physical examination in ischaemic heart disease.

Physical examination can yield valuable diagnostic clues in a patient suspected of ischaemic heart disease. Examination during chest pain is especially informative. The haemodynamic abnormalities which accompany angina pectoris may precipitate elevation of blood pressure, pulsus alternans, pulsus bigeminus, abnormal precordial pulsations, a fourth heart sound or a systolic bruit; all of these may subsequently disappear with cessation of the anginal attack. Careful technique of examination, especially in detecting a fourth heart sound, is essential.


Mens rea for a traffic breach successfully sustained on medical evidence.

A case is described in which a patient was accused of a serious breach of the Traffic Act and in which, on medical evidence, he was found to be in a state of dissociation and ataractic, which led to successful defence of mens rea.


Multiple primary cancers in patients with malignant melanoma.

The incidence of second primary tumours not related to the skin in patients with malignant melanoma was determined. This was compared with the corresponding incidence of a first primary tumour in the general age-matched population. The available data indicate that, in patients with malignant melanoma, there exists a predisposition to developing a second unrelated cancer.


Congenital renal tract malformations. A comparison of two consecutive autopsy series during an eleven-year period.

In a previous paper, a significant recent increase in the incidence of congenital renal tract malformations discovered in perinatal autopsies at the Royal Women's Hospital, Brisbane, was reported. In an attempt to throw some light on the cause of this increase, both the types of renal tract malformations and the associated abnormalities in other systems observed during the past 15 months were compared with those observed in the same institution during the preceding nine years; no significant differences were detected. However, when these groups were compared with similar studies elsewhere, there were obvious differences in both the type of renal tract lesion discovered and in their associated anomalies.


Further studies on the "curry kidney".

The Fijian Indian is a prolific renal stone former, whereas the native Fijian living in the same climate is not. An excessive intake of curry has previously been suggested as the cause of this extensive stone formation in the Fijian Indian. Metabolic studies in these patients have not revealed any other biochemical abnormality which might cause nephrolithiasis. Nearly half of the Fijian Indians who meet violent and sudden deaths have evidence of nephrocalcinosis. These findings add further weight to the theory that an excessive intake of curry is nephrotoxic.


Myelofibrosis in Western Australia: an epidemiological study of 29 cases.

Survival figures and other epidemiological features are described for 29 patients with myelofibrosis living in Western Australia during the period 1959 to 1963. These patients form part of a larger series of 509 patients with leukaemia and allied disorders. The diagnostic incidence rate was found to be 0.5 per 100,000 population, the mortality rate was 0.4 per 100,000 and the prevalence 1.8 per 100,000. Comparison with related myeloproliferative disorders shows that myelofibrosis occurs somewhat less frequently than chronic granulocytic leukaemia and considerably less so than polycythaemia vera. The sex ratio indicates a small male preponderance and the age distribution is similar to that in other descriptions. Survival times for all patients accord with those reported in the literature, but this series showed a marked female advantage in survival. Findings in other series are described.


Giant leiomyoma of the stomach.

A giant smooth muscle tumour of the stomach was excised in a 58-year-old man. Although small leiomyomas are not rare, the giant gastric leiomyoma is not common, and may present diagnostic and operative difficulties. It is an essentially benign tumour, unlike the "bizarre" leiomyoma or leiomyoblastoma.


Vasa praevia.

A case of vasa praevia is presented in which the condition was recognized by palpation at the time of routine amniotomy, and delivery was expedited by lower segment caesarean section. The condition was accompanied by velamentous insertion.


Staffing crisis in preclinical medicine.

The proportions of medical graduates on the staffs of the preclinical departments of Australian medical schools have declined dramatically in recent years. It is now extremely difficult to attract medically qualified applicants to positions in these departments. The present proportions of medically qualified staff now fall short of the levels regarded as "educationally desirable" by Australian preclinical departmental chairmen, at a time when the curricula of most of our medical schools are being reformed so as to include more medically relevant courses in the preclinical disciplines. The cause of the problem is that there are serious disincentives, of both salary and career prospects, to the choice of a career in preclinical medicine. Methods of removing these disincentives are discussed in this paper.


Teaching the behavioural sciences to medical students: some observations on Australia.

Despite a climate generally favourable to the teaching of the behavioural sciences, many Australian medical school programmes seem to be hampered by the lack of trained faculty teachers and demographic and epidemiological data. Consequently, they teach what is feasible rather than what is relevant. The persistence of this trend will inhibit programme modification toward greater relevance.


Treatment of paraplegic sheep with hyperbaric oxygen.

The results of the use of hyperbaric oxygen therapy to control the onset of paraplegia after recent spinal cord injury in sheep are described. This preliminary report suggest that hyperbaric oxygen therapy instituted within two hours of the injury will result in improved motor recovery.


Antibody responses to influenza virus subunit vaccine in the aged.

Elderly patients were immunized with one dose of subunit influenza virus vaccine, and their antibody responses were compared with those in a group of younger adults. Antibody responses in the aged compared favourably with those in the younger group.


Studies with prazosin--a new effective hypotensive agent. I. Open clinical study of prazosin in combination with other antihypertensive agents.

The use of prazosin, a new antihypertensive agent, in combination with other conventional antihypertensive agents, in a hospital outpatient clinic setting, was studied in a mixed group of 104 hypertensive patients. Prazosin effectively lowered the lying and standing blood pressure in the majority of patients whose blood pressure was uncontrolled or poorly controlled before the introduction of prazosin. Blood pressure control was adequately maintained in patients who were given prazosin because of the occurrence of side effects of other antihypertensive medication. No significant change in renal function attributable to prazosin was found in patients with normal or impaired renal function.


Experience with prazosin in the treatment of patients with severe hypertension.

The efficacy and safety of prazosin, a new vasodilator antihypertensive agent, used mainly in combination with other hypotensive medication, was evaluated in 50 hypertensive patients, 28 of whom had left ventricular hypertrophy and 28 of whom had renal impairment. In 44 cases this agent was introduced because of an inadequate response to, or side effects from other agents. In 38 cases (76%) there was a satisfactory response, the diastolic blood pressure being reduced to 100 mm Hg or less. The blood pressure of the whole group of 50 patients was reduced by an average of 31/20 mm Hg. The mean duration of therapy was 6-6 months. Side effects necessitating withdrawal of prazosin occurred in only three cases. Plasma renin activity was reduced to 25% of the control value in a group treated with prazosin alone.


Stroke in Melbourne. A study of the relationship between a teaching hospital and the community.

A prospective study of stroke admissions to the Royal Melbourne Hospital was planned to provide baseline information before the introduction of Medibank. One hundred and seventy patients admitted consecutively over a six-month period were followed until either three months had elapsed since admission, or death had supervened. Although over half the cases (57%) came from areas close to the hospital, the remainder come from a wide area embracing most of suburban Melbourne. Of the cases expected from the local areas, less than one-third were admitted to the Royal Melbourne Hospital. Expected demand for admission to hospital from the north-west region was calculated and the dependence of the community upon the private sector demonstrated.


Successful use of thiothixene in two cases of pathological jealousy.

Two cases of pathological jealousy are presented and their successful treatment with thiothixene is discussed. Evaluation of the projection mechanism is also presented.


Head injuries--what happens to survivors.

The head injury syndrome is a series of psychological characteristics observed in survivors of traumatic head injuries referred to a hospital-based rehabilitation centre. Severe cases of head injury syndrome are readily identifiable as cases of organic dementia. In less florid cases patients easily pass for normal in routine consultation situations, but upon expert psychometric assessment, elements of the head injury syndrome can be demonstrated. Such patients exhibit a high propensity to fail to live up to the normal expectations of their work and domestic environment, and suffer repeated failures and social difficulties which are the direct result of the head injury syndrome. This leads to breakdown of work and family life, increasing frustration, loss of confidence, and final disintegration of the affected personality.


Trigeminal neuralgia: induced remission without surgery, and observations on its aetiology.

A case is described in which trigeminal neuralgia was controlled primarily by a programme of mandibular relaxation. The symptoms and the success of the management were consistent with the hypothesis that trigeminal neuralgia is caused by chronic compression of the trigeminal nerve and surrounding tissues in the vicinity of the temporomandibular joint. The triggering of attacks appears to be a result of stimulation of individual pain receptors associated with neurons in which transmission thresholds have been reduced by cumulative nerve damage. Extracranial and systemic trigger factors, of cervical and abdominal origin, are described. The conservative management involved mandibular relaxation, avoidance of flatulence and constipation, occasional use of an acrylic occlusal splint, and when necessary, use of Dilantin in prescribed amounts.


A survey of new physical methods in the treatment of asthma.

The introduction of some new physical methods has considerably improved the writer's treatment of asthmatic children. These methods include an endeavour to attain nasal breathing, together with slow, deep "sleep breathing", and a system of eight or ten physiotherapy exercises which are described in detail. Since their adoption the consumption of aerosol bronchodilators has fallen dramatically.


Single-dose evaluation of a new enteric-coated aspirin preparation.

The bioavailability of a new enteric-coated tablet of aspirin (Ecotrin, Smith, Kline and French) was evaluated after single doses to eight volunteers. One tablet was administered to each subject on four occasions--twice after a light breakfast, once after a heavy breakfast and once after pretreatment with metoclopramide. The study utilized non-invasive techniques. The rate of absorption of aspirin was estimated by the time course of concentrations of salicylate in saliva, while the total bioavailability was determined by the recovery of total salicylate in urine. The urinary recovery of aspirin from all 32 trials was 575 +/- 25 mg (mean +/- standard error), representing 89% +/- 4% of the administered dose. The different treatments did not significantly alter the urinary recovery. The absorption of aspirin from the enteric-coated tablets was delayed and slow. Absorption was retarded by a heavy meal and hastened by pretreatment with metoclopramide. The effect of metoclopramide is consistent with the release of aspirin in the small intestine. Overall, the single-dose tests indicated satisfactory functioning of the enteric coating.


The gastrectomy cripple: results of jejunal loop interposition.

The use of an interposed antiperistaltic jejunal loop between the stomach and the duodenum in the treatment of severe postgastrectomy nutritional disorder is described in two patients. Both patients had a gratifying return of digestive comfort and a striking increase in weight after the interposition operation. Several aspects of operative technique are described. This procedure should be considered in any patient suffering from this disorder.


[Plasmocytoma. A clinical and statistical survey (author's transl)].

Analysis of the case-records of 61 patients with plasmocytoma revealed an equal sex-distribution with a mean age of 58.6 years. The most common initial symptom of the disorder was ossary pain. The diagnosis was confirmed by bone marrow cytology, demonstration of paraproteins in serum and urine and the characteristic radiological changes. Renal insufficiency, immunodeficiency syndrome, fractures and neurological defects complicated the clinical course in many patients.


[Citrate values in the whole blood of patients with malignant tumors of various locations].

Based on reports on elevated concentrations of 2-oxoglutarate in the blood of human subjects with tumors of various locations, data are presented on the concentration of citrate and pyruvate in the whole blood of 41 patients with malignant tumors (mainly of the female breast and of the digestive tract), 30 patients with benign surgical diseases and 12 healthy subjects. Adopting a level of significance of 2P=0.10 differences of concentration were found between the following collectives: (1) The mean value of citrate for the patients in tumor stage T4 was decreased by 23%, compared with healthy persons, and by 19%, compared with patients with benign surgical diseases. (2) The mean value of pyruvate for the patients with malignant tumors was increased by 40%, compared with healthy subjects and by 17%, compared with patients with benign surgical diseases. (3) The maximum of the pyruvate concentration was reached in tumor stage T3, where an increase of 52% was noted, compared with healthy subjects. (4) The pyruvate value of the patients with tumors of the digestive tract was increased by 34%, compared with healthy subjects. With regard to the total group of patients with malignant tumors, even with a low level of significance, no differences in citrate values were found as compared with the control groups. Thus the results do not indicate a disturbance of the citric acid cycle in the organism of tumor bearing hosts in general.


[Objectivation of psychic alterations in patients after hypophysectomy (author's transl)].

17 patients who had undergone transfrontal hypophysectomy were compared as regards their performance in the MMPI Saarbrücken and the Rosenzweig-Picture-Frustation Study with an equal number of patients who had undergone comparable head surgery. The results suggest that the psychic alterations revealed in these tests may be regarded as unspecific consequences of the operative method.


[Cytologic identification of follicular carcinoma of the thyroid by fine needle aspiration biopsy (author's transl)].

The cytologic detection of follicular carcinoma is a main problem of fine needle aspiration biopsy of the thyroid. Benign conditions of the thyroid showing microfollicular structure as follicular adenoma, nodular hyperplasia in adenomatous goiter and adenoma-like proliferations induced by antithyroidal drugs are to be distinguished from follicular carcinoma. Surgical biopsy should be performed, when cytologic findings indicate follicular proliferation of the thyroid.


[Consumption coagulopathy in a patient with metastatic renal carcinoma (author's transl)].

Chronic disseminated intravascular coagulation with secondary hyperfibrinolysis occurred in a patient with metastatic renal carcinoma. In the beginning the treatment with heparin was successfull. Heparindosage up to 35 000 E/day could never suppress this process completely. The value of determining thrombintime, concentration of fibrin splitting products, coagulation factors II, V, VII, IX, X and XIII, antithrombins II and III in controlling heparintherapy is discussed. Besides thrombintime and platelets the determination of fibrin splitting products is another substantial factor in controlling treatment of chronic intravascular coagulation. The patient died of myocardial rupture with heart tamponade, caused by a great intramyocardial metastasis.


[Eosinophilia and sarcoma of the small intestine (author's transl)].

Eosinophilia occurs as a concomitant sign in multiple diseases of different etiology. Especially its occurrence in malignant diseases is still unknown. In three cases of primary sarcoma of the small intestine a constant eosinophilia is described. In one case this pronounced eosinophilia was present long before the final diagnose was made. The eosinophilic count was highest in the presence of clear symptoms of obstruction and normalized after surgical removal of the tumor. In one case a relapse was indicated by an increasing eosinophilic count. It is difficult to diagnose the sarcoma of the small intestine especially in its early stage because of the lack of typical symptoms. Concerning the described cases it is therefore pointed out, that in connection with undifferentiated abdominal complaints an obscure eosinophilia should be considered to be due to sarcomatous small bowel disease.


[The importance of mammography in the early diagnosis of breast cancer (author's transl)].

Mammography has been performed routinely preoperatively over the last 5 years on 278 patients with breast tumors. In 85 per cent the radiographic findings showed an exact correlation to histologic results. In 12 per cent there was only a partial correlation, in only 3 per cent the mammograpic findings could not be verified by the pathologist. The purpose of this paper is to emphasize that mammography should be considered as the prime diagnostic procedure in the diagnosis of breast disease. The examination of the breast should therefore always be followed by mammography, especially in women at risk and elderly patients. In this connection we would also like to stress the vital cooperation between the radiologist and surgeon both pre- and intraoperatively. and intraoperatively. In summary we would like to emphasize the importance of possibility to achieve a better survial rate in these patients.


[Endoscopical retrograde cholangio-pancreaticography (author's transl)].

Our experience with the ERCP is based on the results obtained in 140 cases. This method has brought important advances for the diagnosis of biliary and pancreatic affection and is indispensable for the exact differential diagnosis of obstructive jaundice, diagnosis of the stenosis of the papilla Vateri, the chronic pancreatitis and pancreas cysts. Regarding the necessary precautions, this method is associated with low risk in skilled hands in relation ot its informational value.


[Thrombocytopenia in hepatitis-B-antigenemia (author's transl)].

Determination of hepatitis-B-antigen and thrombocytes in 1488 cases of liver diseases, 173 of whom had been treated with immunsuppressive drugs. There was no significant relation between hepatitis-B-antigenemia and thrombocyte-count, nor could an influence of the immunsuppressive therapy be evaluated. The thrombocyte-count was correlated with high significance only to the degree of the liver injury.


[Serum gastrin levels in patients with changes of gastric or duodenal mucosa (author's transl)].

The mean concentration of gastrin in serum was determined in healthy fasting persons (n = 27), it amounted to 56.8 pg/ml (SD = 19.8 PG/ML). The values of gastrin in serum of patients, who were grouped by endoscopicbioptic criteria of antral mucosa and who exceptionally showed diffuse inflammation of gastric mucosa, amounted to 73.2 pg/ml in patients with mild superficial gastritis (n = 24), to 73.4 pg/ml in those with severe superficial gastritis (n = 55), to 82.3 pg/ml in patients with chronic atrophic gastritis (n = 11) and to 70.7 pg/ml in those with chronic atrophic gastritis and intestinal metaplasia (n = 17). The concentration of serum gastrin in patients with additional pathological processes of gastric or duodenal mucosa was also determined. Patients with gastric resection according to Billroth II (n = 15) revealed gastrin values of 47.8 pg/ml, those with duodenal ulcer (n = 5) of 58.5 pg/ml, with gastric ulcer (n = 50) of 61.3 pg/ml, with polyps in stomach (n = 10) of 109.6 pg/ml and with neoplasms of the stomach (n = 27) of 77.7 pg/ml. Gastrin values were not correlated to age or sex. The difference between the mean gastrin concentrations of the mentioned groups of patients however is not marked enough and the range of values is too wide to characterize those groups by specific gastrin levels. The determination of gastrin in serum of fasting patients is not helpful for diagnosis of gastritis without antibodies to intrinsic factor or for diagnosis of certain localized pathological conditions in stomach or duodenum obviously.


[Postoperative treatment of patients after pancreatectomy. Closely meshed monitoring of blood sugar (author's transl)].

A report is presented on the postoperative treatment of 4 patients who had undergone duodeno-pancreatectomy because of chronic pancreatitis. When the patients co-operate well satisfactory metabolic compensation can be achieved with small doses of insulin. Replacement of the pancreatic enzymes with the appropriate preparations can be particularly well monitored by means of the fat content of the faeces. The substitution of vitamins A, D, K, and B12 parenterally at intervals of several weeks is also advisable as a safety measure. A method is described for the closely meshed monitoring of the blood sugar. This method is suitable in co-operative patients who are capable of collecting capillary blood for achieving a particularly good control of the metabolic state.


[Influence of ornithin-alpha-ketoglutaric acid on fatmetabolism in patients with cirrhosis of the liver (author's transl)].

Formation of endogenous toxins through protein metabolism and detoxification through liver are described. In chronic hepatic insufficiency (cirrhosis of the liver), with failure of liver metabolism, levels of endogenous toxins in plasma and tissue, i.e. ammonia, phenol-derivatives and free fatty acids, rise. Plasma levels of ammonia and free fatty acids are both dependent on the Krebs cycle. This interaction and mutual dependance was examined clinically through application of amino acids that lower plasma ammonia level. Di-L(+)ornithin-alpha-ketoglutaric acid was able to lower ammonia levels in patients with liver cirrhosis. The difference between pre- and postinfusion levels of ammonia was significant, this corresponds to the observations of other authors. In addition we found a fall in levels of free fatty acids, triglycerides, and cholesterol. This effect on fatmetabolism was also observed in patients with no evidence of incipient or manifest hepatic insufficiency. The biochemical basis and the clinical implications of these findings are discussed.


[Bilrubinemia after administration of nicotinic acid (author's transl)].

Nicotinic acid concentrations in the serum over 80 mug/100 ml induce at the start of high dosage nicotinic acid therapy an acute rise in bilirubin to 1-3mg/100 ml serum. Even after postprandial administration there are clearly raised bilirubin concentrations in the serum. After treatment for 1 week with 0.5 g nicotinic acid daily by mouth the bilirubin increase is no longer detectable. The increased bilirubin concentrations in the serum are apparently the result of a transient inhibition of glucuronyl-transferase and is not a symptom of an acute liver disorder. When starting high dosage nicotinic acid therapy, therefore, disorders of the bilirubin metabolism and liver function must be excluded by differential diagnosis in doubtful cases. Further investigations are necessary to see whether the high concentrations of nicotinic acid in the serum cause competition with other drugs for the bilirubin-specific glucuronyl-transferase.


[Weight reduction by a high protein, low carbohydrate diet (author's transl)].

A standardized high protein, low carbohydrate diet was tested in 128 overweight patients over a period of 12 months. Under this regimen a weight reduction of up to 38% of the original body weight was observed. Apart from the weight reduction there was a normalization of the blood pressure, blood lipids and blood glucose. The diet is easily adapted to out-patient care and is exceptionally well tolerated by the patients.


[Hemoperfusion with coated activated charcoal for treating acute poisoning by remedies, plant protectants, and fungi. I. Remedies (author's transl)].

Hemoperfusion with coated activated charcoal is a novel procedure for treating acute poisoning. It enables the elimination of both, water-soluble and liposoluble toxins. Hemoperfusion with coated activated charcoal has proved to be superior to hemodialysis in the treatment of barbiturate or bromocarbamide poisoning both under experimental conditions as well as in the ward. Analogous statements may be made for the therapy of glutethimide poisoning. Methaqualone, on the other hand, could not be eliminated sufficiently well in animal trials. Intoxications by "mild" analgetics, such as paracetamol and acetylsalicylic acid, may be treated successfully with hemoperfusion. Treatment of acetylsalicylic acid poisoning is equally effective with hemoperfusion as with hemodialysis. Prospects for the success of hemoperfusion in treating intoxication from tricyclic antidepressants and neuroliptics are slight. It is simply the danger of antidepressant poisoning that justifies using this method of treatment in the first few hours after ingestion in order to reduced the flow of the psychopharmaceutical substance into the tissue.


Butandioldehydrogenase in Vibrio parahaemolyticus.

396 strains of V. parahaemolyticus, 345 originating from Togo and 51 from Japan, were submitted to the study of butandiol dehydrogenase (BDH). It was found that 52.3% of the strains were BDH-positive and 44.2% BDH-negative. An intermediate group characterized by weak reactions amounted to 3.5% of the strains. The distribution of this enzyme parallels to a certain degree the results of serotyping. Positive reactions have been found in all or most strains belonging to serotypes 03K29, O4K8, 04K12, 04K55, 05K15, and 012K19, whereas strains of serotypes 03K5 and 04K10 gave negative reactions. In serotype 05K17 both properties were found in nearly equal proportions. The test of BDH, which can supplement serotyping in characterizing strains of V. parahaemolyticus, can be applied as an aid to epidemiological studies.


Some properties of coagulase-negative deoxyribonuclease-producing strains of staphylococci from human infections.

Twenty-seven coagulase-negative and deoxyribonuclease-positive staphylococci were isolated from more than 3000 specimens from human infections. The strains were tested by conventional biochemical tests and by simple agar plate assays for production of different extracellular enzymes and toxins. Three strains were lysed by S. epidermidis phages and 7 strains by S. aureus phages. All strains produced thermolabile nuclease but only 21 strains produced thermostable nuclease. The investigated strains belonged to a heterogeneous intermediate group sharing characters of S. aureus and S. epidermidis. Tests for production of coagulase and thermostable nuclease should be used in the classification of these intermediate strains in diagnostic bacteriology.


Suppression of growth of Vibrio cholerae in the intestine of immunized mice.

In ligated intestinal loops of actively immunized adult mice, growth of V. cholerae 569B was suppressed approximately seven fold when compared to bacterial growth in non-immune animals. Similarly, growth of V. cholerae 569B was reduced in mice immunized with a hybrid vibrio strain, NCV569B-165, which shares only flagella antigens with V. cholerae 569B. Immunofluorescence studies of intestinal loop contents and intestinal sections indicated that, in non-immune mice, vibrios coated the intestinal mucosa. In contrast, the intestinal mucosa of immune animals was almost free of bacteria. The vibrios were found agglutinated in the intestinal lumen contents of immune animals. It was concluded that immunization suppressed the growth of V. cholerae in the intestinal lumen and the possibility that bacterial agglutination mediates this growth suppression is discussed.


Mononuclear cell content of human solid tumors.

The mononuclear cell content and mononuclear cell function of human solid tumors were determined. Twenty-eight primary, and 17 metastatic solid tumors, including 6 lymph node metastases, were obtained from 45 patients. Cells were released from the tumors by mincing, scraping, and sieving. Analysis of the cellular content was determined by light microscopy, and tumor lymphocyte function was determined by stimulation of blastogenesis with PHA, PWM, Con-A, MLC, and SLO. A median of 3.3 X 10(7) tumor cells with 12.5% viability was obtained per gram of tumor, and a median of 7.8 X 10(6) lymphocytes with a viability of 96% and 0.35 X 10(6) macrophages with a viability of 85% was also obtained per gram of tumor. Significant lymphocyte responses to various mitogens and antigens were obtained in 31-40% of the tumor lymphocyte preparations. From 9.4% to 23% had vigorous responses with a stimulation index greater than 10. Primary tumors contained significantly more lymphocytes than metastatic tumors; thus, the percent lymphocytes in primary tumors was 13.5% compared to 5% for metastatic tumors. In contrast, some of the lymphocyte responses were significantly greater for metastatic tumors than primary tumors. These data suggest that the direct study of lymphocytes infiltrating primary and metastatic tumors may be a useful approach to understanding tumor immunity in man.


Persistent infection of tissue culture cells by RNA viruses.

In this paper, the characteristics of cultured cells persistently infected with RNA viruses, other than leuko viruses are described. The roles that the host cell, interferon, virus mutants and defective interfering particles may play in the establishment and maintenance of persistent infection are discussed. It is proposed that the interaction of viruses with certain types of host cells can lead to persistent infection. The differences in virus-host interactions may be attributable to differences in membrane properties of various cells. Defective interfering particles may play a role in the establishment of persistent infections in cells which normally undergo lytic virus development. Mutant types of virus appear to be prominent in the virus released from persistently infected cells, but the role that various mutants play in the maintenance of persistent infections remains unclear.


Pharmacokinetic considerations in the design of optimal chemotherapeutic regimens for the treatment of breast carcinoma: a comceptual approach.

Pharmacological data are currently available for a number of antineoplastic agents which have shown clinical activity in advanced breast carcincoma. Preclinical data reveal a relationship between therapeutic response and certain pharmacokinetic parameters such as time of effective cytotoxic exposure (Teff) and the product of concentration with time (Cxt). We have attempted to apply human pharmacologic data to get estimates of these parameters for 6 active agents in breast cancer, to relate them to response rates, and to suggest a method for estimating the role of individual drugs in a multidrug combination. The response rates for 6 single agents were obtained from literature review and related to estimates of Teff and Cxt. The Cxt-response relations for single drugs were linear for cyclophosphamide, 5-fluorouracil, and thiotepa; exponential for vincristine; and relatively flat for methotrexate and cytoxine arabinoside. Most Teff values for the active single agents clustered about 15 hr/dose. From the graphs of response rate vs Cxt, the individual contribution of each agent in a combination study was estimated to arrive at a predicted response rate. The predicted response rates for the combination studies correlated with the actual response rates determined in the clinical study, for 6 of 6 nonrandomized studies and for 12 of 14 randomized studies analyzed. In 2 studies, deviations from the predicted response rate were attributed to differences in study design or analysis. There was no correlation between Teff and predicted response rate. Analyses of pharmacokinetic data may be useful to simulate combination chemotherapy studies to predict the effectiveness of clinical trials in breast cancer. Since the pharmacologic data were not obtained for any of the agents in the actual clinical trials done, we can only speculate on the usefulness of this method. We would encourage the prospective collection of this data in future clinical trails.


The influence of sequential chemotherapy and radiotherapy on mitogen-induced lymphocyte transformation in patients with acute lymphoblastic leukemia.

Although these studies do not allow a definitive differentiation between the relative influence of chemotherapy and radiotherapy on mitogen-induced lymphocyte transformation, the data suggested both radiotherapy and chemotherapy can cause depression; however, radiotherapy may have a more pronounced effect. The relationship between the absolute peripheral blood lymphocyte count and phytohemagglutin and pokeweed mitogen-induced lymphocyte transformation was also analyzed. These data revealed that patients who are receiving or who have received intensive therapy may have normal peripheral absolute lymphocyte counts with impaired lymphocyte transformation. Serial studies of lymphocyte transformation were evaluated in 10 children with acute lymphoblastic leukemia who received both chemotherapy and radiotherapy.


Mitomycin C in large infrequent doses in breast cancer.

Seventy-one women with far-advanced breast cancer resistant to standard chemotherapeutic agents were administered mitomycin C using an intermittent high dose schedule. One group consisted of 54 patients with measurable metastatic tumor; a second group consisted of 18 patients with nonmeasurable osseous metastases. Objective response rate in group 1 was 26% for an average duration of 2 1/2 months. Subjective response rate in group 2 was 44% for an average duration of 3 months. Response and toxicity data were similar to those of studies employing the less convenient protracted low-dose schedule. Prior treatment with other alkylating agents did not adversely affect response. Further investigation into the role of mitomycin in combination chemotherapy programs is recommended.


The disparity of the size of the liver as determined by physical examination and by hepatic gammascanning in 504 patients.

The liver extended a minimum of 5 cm inferior to the right costal margin in 51% of the 504 patients studied. In 53% of these patients, experienced, mature physicians declared that the liver was not palpable on physical examination. In 3% of the cases, a mass was palpated which was believed to be liver by the examining physician but was found to be extrahepatic upon scanning and laparotomy. The unreliability of physical examination in determining whether or not the liver extends inferior to the costal margin in many instances is demonstrated.


Hodgkin's disease in children.

From 1921 to 1973, 106 children with Hodgkin's disease under the age of 17 years were seen at Roswell Park Memorial Institute and were analyzed retrospectively. Evaluation was separated into three eras: 1921-1949 (early era), 1950-1964 (middle era), and 1965-1973 (recent era). In the early era, suboptimal radiation therapy was employed. In the middle era, radiation therapy techniques were improved, and single-agent chemotherapy was introduced. In the recent era, multiagent chemotherapy routines were frequently used; aggressive external megavoltage radiation therapy became routine in conjunction with improvement in staging procedures. The best survival was observed in the recent era where five-year survival of 96% was noted in early stage disease. Favorable prognostic features included: younger age group (5-9 years), female sex, lymphocytic predominant histology, early stage disease, and complete response to therapy. Nodular sclerosing and mixed cell types had an equal prognosis. The concept of involved area radiotherapy along with combination chemotherapy appears a reasonable approach in children and should be tested in a randomized study against more extensive radiotherapy techniques in early stage disease.


Comparison of voltage-divider, modified Ardran-Crooks cassette, and Ge(Li) spectrometer methods to determine the peak kilovoltage (kVp) of diagnostic x-ray units.

This report describes several different techniques that have been used to determine the peak kilovoltage (kVp) of single- and three-phase diagnostic x-ray units operating in both the radiographic and fluoroscopic mode, from 60 to 110 kVp, using (1) a voltage divider with oxcilloscope display; (2) a voltage divider and special summing amplifier with digital display of the voltage utilizing a multichannel analyzer; (3) a version of the Ardran-Crooks cassette technique; and (4) a Ge(Li) spectrometer method. Each technique presents a distinct advantage: Method (1) enables the waveform to be viewed directly; method (2) is probably the most accurate and reproducible technique; method (3) has the greatest ease of operation; and method (4) provides the ability to visualize the x-ray spectrum.


Xeroradiography and ionography: new technologies to replace the x-ray film.

Novel methods of radiogram imaging are described and compared with conventional means. They include: xeoradiography, low- and high-pressure ionography and liquid phase ionography. The possibility of real time operation is considered also. Of these systems, xeroradiography is already in use for a limited range of applications. High pressure gas ionography shows great promise and practical systems may be expected to appear in the near future.


Cardiac output measurement by thermodilution: methodologic problems.

In clinical practice, thermodilution technique for cardiac output measurement is generally applied to the right heart (injection of a saline cold bolus in the right atrium, temperature measurement downstream in the pulmonary artery). This technique is well adapted to repetitive measurements using a single catheter. However, its validity is dependent on several methodologic requirements: quantitation of the indicator, control of the catheter's dead-space effect, conservation and mixing of the cold bolus, accurate measurement of small thermal gradients. Calculations from the thermal dilution curve must be adapted to possible baseline shifts. All these different methodologic aspects are studied. Several solutions (heat exchanger, automatic injection, calculation method) are proposed. Comparison between an automatic thermodilution device and dye dilution has been performed successfully.


Absorption-edge fluoroscopy using a three-spectrum technique.

We have recently reported on a 1-kVp, two-filter image subtraction method for visualizing low concentrations of elements like iodine which have K-shell absorption edges in the diagnostic x-ray energy range. However, in the application of this technique to human thyroid imaging, superimposed images due to variations in tissue and bone thickness presented serious difficulties. In this paper, a technique is described for implementing a 3-kVp, three-filter approach. Using carefully chosen spectra and logarithmic image processing, images are produced which are compatible with our previously described two-stage storage-tube subtraction device. Proper manipulation of the resulting difference images results in a final absorption-edge image in which only the element of interest is visualized, with unwanted background images suppressed. Computer calculations are presented to illustrate the relative sizes of difference signals arising from the element of interest and from tissue and bone backgrounds. Phantom studies using iodine concentrations as small as 1 mg/cm2, with variations of 10 cm of tissue and 2 g/cm2 of bone, suggest that the theory is sound and that, with straightforward apparatus modifications, images of good quality should be possible.


In vitro study of hemolysis induced by flow-regulated and pressure-dependent flow pumps.

In vitro experiments showed that a pressure-dependent flow pump which "obeys Starling's law" (with flexible tube stretched on vertical rotor) was less hemolytic than a classical flow-regulated pump (with pump inset occluded between a rotor and a stator). The degree of hemolysis obtained with fresh human blood was higher with blood from chronic respiratory patients than with blood from normal donors. Also, the hemolysis was less with fresh heparinized blood than with stored ACD blood, and less with normal blood than with diluted blood. Comparing hemodialysis pumps with ECC pumps showed that hemolysis tripled with the pressure-dependent flow types and was 30 times higher with the classical pumps.


Display of the vectorcardiograms with a new complementary loop of formula Z = f (square root X2 + Y2).

It is important in vectorcardiography to be able to determine the position and magnitude of a given vector, e.g., the left maximum spatial vector, or the vector occurring 20 ms after beginning of QRS, etc. In this aim the authors present besides the three classical planar projections , a fourth curve of Lissajous, known asthe "modulus curve" and which corresponds to the formula Z = f (square root X2 + Y2). In general applications, this curve is very simple to use, and several examples of application are given. The technical realization, which involves no great modification of standard equipment, is described.


Dose measurements in the build-up region for cobalt-60 therapy units.

The dose in the build-up region for four different Cobalt-60 therapy units was measured. It was found that, for large collimator openings and relatively short SSDs, a new dose peak occurs at a depth very much smaller than 0.5 cm. The dose at this peak is a function of collimator openings and SSDs and, in some extreme case, could be 15% or more higher than the dose at the conventional peak dose of 0.5 cm. The new dose peak is probably due to electrons produced in the source capsule and the part of the collimator close to the source; it can be almost eliminated by a filter placed just below the collimator.


Feasibility study: in vivo neutron activation for regional measurement of calcium using californium 252.

The feasibility of using a collimated 252Cf neutron source to measure regional changes in skeletal calcium was tested because in vivo regional activation of diseased bone should offer advantages over the more widely reported total-body calcium measuring techniques. Regional activation allows examination of discrete regions where the greatest changes in calcium content occur. Additionally, a simpler radiation facility is required for regional studies. Using a 5.5-mug 252Cf source, thermal neutron flux and absorbed dose were measured in a tissue-equivalent phantom. Detection efficiency of 49Ca gamma rays for conditions simulating regional activation were measured using a 29-cm-diameter X 10-cm-thickness sodium iodide detector. These in vitro measurements indicate that a collimated 252Cf source can be used for regional neutron activation of the lower spine and legs. Preliminary calculations indicate that a 1-3-mg source provides adequate count rates for statistical accuracy with a bone marrow dosage acceptable for human patients and normal subjects.


Quality control in clinical chemistry: the essential steps.

Assurance of the quality or reliability of test results is the responsibility of the laboratory and the concern of the veterinarian who uses these results in the diagnosis or treatment of animal patients. Quality assurance can be produced only by implementation and continuing maintenance of a quality control program to monitor the daily performance of the laboratory. Quality control programs usually are multifaceted and may be comprised of one or several optional components. An essential ingredient in any program designed to provide quality assurance is the "quality-awareness" of those who perform the tests or make clinical use of the test results.


Tumor localization and beam monitoring--electrofluorotomography.

Methodology and instrumentation are presented which are potentially capable of presenting fluoroscopically derived transverse axial body sections for use in radiation-oncology treatment planning and beam monitoring. These combine the methods of Takahashi for generating transverse axial tomograms with electronic radiography, electrofluorotomography, and a contouring program for extracting body and tumor contours in a digital format. The system will also be capable of assuring both initial and day-to-day beam alignment.


A method for the isolation of phage mutants altered in their response ot lysogenic induction.

Phage lambdacl+ gives clear plaques whereas phage lambdacIind- gives turbid plaques on a lawn of a mutant strain of E. coli K12. This strain, called STS, carries mutation spr in a tif sfi genetic background. I hypothesize that upon temperate phage infection, STS bacteria spontaneously inactivate phage repressor by the same mechanism involved in normal lysogenic induction which results in obligatory lytic growth of lambda+. The use of the STS mutant facilitates the isolation and genetic analysis of phage mutants with an abnormal response to lysogenic induction.


The effect of nitrosoguanidine upon DNA synthesis in vitro.

Both the polymerase and the exonuclease activities of DNA polymerase III are inactivated by treatment with nitrosoguanidine. The treatment of the DNA template with the mutagen does not affect the template in supporting DNA synthesis. No effect of nitrosoguanidine upon fidelity of replication in vitro was detected.


Molecular evolution of 5S RNA.

Based on the comparative analyses of the primary structure of 5S RNAs from 19 organisms, a secondary structure model of 5S RNA is proposed. 5S RNA has essentially the same structure among all prokaryotic species. The same is true for eukaryotic 5S RNAs. Prokaryotic and eukaryotic 5S RNAs are also quite similar to each other, except for a difference in a specific region. By comparing the nucleotide alignment from the juxtaposed 5S RNA secondary structures, a phylogenic tree of nineteen organisms was constructed. The time of divergence between prokaryotes and eukaryotes was estimated to be 2.5 X 10(9) years ago (minimum estimate: 2.1 X 10(9).


Induced mutagenesis in Ustilago maydis. I. Isolation and characterization of a radiation-revertible allele of the structural gene for nitrate reductase.

A UV-revertible mutant of the nar1 structural gene for nitrate reductase was isolated in wild-type (nar+ nir+) Ustilago maydis. It proved to be vigorously revertible by gamma rays as well. Genetic analysis revealed that the strain carried a single, nonleaky, recessive allele (nar1-m) with an unusually high spontaneous reversion rate (approximately 3 X 10(-5)/div.). Reliable reversion frequencies were determined with a special agar medium that reduced the normally high level of residual growth observed on nitrate minimal agar. Radiation-induced reversion frequencies in the homozygous diploid were approximately twice those in the haploid. Following crosses to wild type, two revertants (one spontaneous and one UV-induced) were found to map at nar1. Although the molecular basis of nar1-m reversion is not known, available data suggest that some form of point mutation is involved.