Comparison of metabolic, temperature, heart rate and ventilatory responses to exercise at extreme ambient temperatures (0 degrees and 35 degrees C.).

Eight male subjects exercised on a bicycle ergometer for one half to one hour at loads demanding 52 to 59% of Vo2max on two separate occasions, once with ambient temperature held at 0 degrees C and once in a 35 degrees C environment. Throughout exercise and during recovery in a 25 degrees C environment, measurements were made of oxygen consumption, ventilation, heart rate, muscle-rectal-skin temperatures, and blood lactic acid. In the hot condition significant increases in heart rate, blood lactates, sweat loss, muscle, rectal and skin temperature responses were observed. At 0 degrees C Vo2 was significantly elevated during exercise over that in the 35 degrees C condition. Despite the elevated Vo2 response in the cold, higher body temperatures measured in the heat were associated with a significantly higher (P less than .025) recovery Vo2 (x = 866 ml), which was of the magnitude predicted by the van't Hoff-Arrhenius relationship.


Evaluating the effects and feasibility of an at work stairclimbing intervention program for men.

Thirty healthy men, aged 17.5-64.0, were assigned to matched treatment and control groups an evaluated on selected anthropometric and cardio-respiratory measures before and after a twelve week at work stairclimbing intervention program. The only significant change in the treated group was a decrease of rear calf skinfold thickness. There were no significant changes within the control group, nor were differences between groups significant when taking the entire treatment group into account. When the treatment group was dichotomized according to the amount of weekly stairclimbing, the subgroup which climbed stairs the most showed significant aerobic improvements. The Baseline VO2 max was not significantly related to either pre-program stairclimbing habits or aerobic power improvements. A significant relationship was observed between baseline % body fat and pre-program stairclimbing. The correlation between pre-program and in-program stairclimbing was statistically insignificant. The experiment showed that 5500 kgm/day stairclimbing (approximately 25 flights for a 70 kg man) could result in significant improvement of maximal aerobic power.


Responses to exercise of paraplegics who differ in conditioning level.

The purpose of this study was to evaluate the cardiopulmonary function and body composition of sedentary and highly active paraplegics. Four age-matched groups of men (n = 41) were studied: wheelchair-bound sedentary (WS), wheelchair-bound athletes of international caliber (WA), able-bodied sedentary (NS), and able-bodied athletes of national Israeli teams (NA). Although of similar height, WS were significantly (p less than .05) heavier and more obese (skinfolds) than WA and NS. Maximal oxygen consumption (VO2max arm), as measured during arm ergometry by direct open circuit spirometry, was significantly lower in WS (19.58 plus or minus 5.53 ml/kg per min) than in WA (35.00 plus or minus 7.55). The latter had significantly higher VO2max arm than did NS (25.79 plus or minus 3.98). However, no significant difference was observed between WA and NA (38.05 plus or minus 6.25). A similar trend, favoring WA over WS, was shown for maximal minute ventilation and maximal oxygen pulse. Functional lung volumes (FVC, FEV1.0, MBC) did not differ significantly between WA and WS. Heart rates at submaximal work loads were higher in WA than in NA, but markedly lower than in WS. Clear-cut conclusions can be obtained only by a longitudinal study, but these data suggest a marked decrement in cardiopulmonary functions, related to the oxygen transport system, in men whose lower limbs have been immobilized for years. A reversed trend is shown for paraplegics who regularly activate their upper limbs and trunk muscles.


Tension decline during isometric contractions without visual cues.

Subjects tried to maintain 15%, 30% and 50% maximum voluntary contraction (MVC) of their handgrip for 60 sec and 70% MVC for 30 sec. When the subjects watched the tension record, they could maintain the contraction for the required time. However, without visual cues (uncued), the tests resulted in a tension decline. Ae-alpha t described the tension decline in the 15% tests, Be-beta t the 70% test, while the form in the 30% and 50% tests was Ae-alpha t + Be-beta t. In all cases alpha and/or beta were found to be dependent on the starting tension. The electrical activity obtained from surface electromyograms did not increase during the uncued tests which would be expected if muscle fatigue were involved in the tension decline. Instead the electrical activity was directly proportional to the decline in tension suggesting that the fall in tension was not due entirely to muscle fatigue. 15% MVC uncued tests in which fatigue is known not to be a factor also showed a tension decline. Precooling the hand in an attempt to alter sensory input produced no systematic change from the original uncued tests, indicating that sensory information from the hand was probably not a major factor in the tension decline. It is suggested that during the uncued tests the fast component of the tension decline may be related to a sensory adaptation involving the Golgi tendon organs. The slow component is due to forearm muscle fatigue which is related to the ischemia produced during the isometric contractions.


[Current problems of the technical equipment of clinico-diagnostic laboratories].

A list of the required minimum of devices and apparatus used at present at clinico-diagnostic laboratories of medical establishments of diverse profile and capacity is presented. Future prospects for providing clinico-diagnostic laboratories with processing equipment are discussed.


[Artistic construction of medical equipment].

Through efforts of general designers, technologists and exterior feature designers of the Central Design planning-technological bureau "Medical Equipment" over 240 different pieces of medical apparatus and instruments have been created. The process of creating exterior design features includes collection and analysis of the information, compiling a survey note in which the purpose of the exterior designing and the present-day state of the prototypes of the object under consideration, as well as the possible unification of individual components and subassemblies are set forth. Medical requirements and limitations conditioned by the capabilities of the manufacturing plant are studied and the optimal demands as to the operation and use of the piece of equipment under construction are educed. In designing medical items, beside technical and service demands, and physiology are also taken into consideration. Great attention is paid to an effective method of compounding subassemblies and components, ensuring the technological rationale and unification of the most structural elements.


[Standard technological process for the assembly of corrective glasses].

An analysis and generalized experience of work done by the Soviet and foreign optical departments formed a background for working out a technology of assembling corrective spectacles and for drawing up a list of the equipment with due consideration for the output of the optical aids determined by the numerical strength of the population to be serviced.


[Tester for measuring the parameters of implanted and external electrocardiostimulators].

To realize medical control over parameters of cardiostimulators a tester has been devised that makes it possible to exercise control over the principal parameters of implanted and external cardiostimulators, such as the amplitude, polarity and the pulse recurrence frequency, as well as the amplitude and frequency of switching on and off of the monitored stimulators, resistance of electrodes and the voltage of power supply batteries.


[Methodical evaluation of the technological construction of medical instruments and apparatus at early stages of their designing].

A procedure permitting it to develop major outlines and make a quantitative appraisal of the technological effectiveness of products at early stages of their designing is proposed. The quantitative assessment of the technological effectiveness of the products is done by using a single dimensionless overall index that varies from 0 to 1, this facilitating a comparative evaluation of this effectiveness. The use of a specially plotted chart helps greatly cut down the time needed for determining the overall index.


[A cryo-irrigator].

A stomatological cryoirrigator intended for the treatment of precancerous affections of the oral mucosa and dental pulp through reproduction of local cryonecrosis is described. The cryoprobe helps obtain an oriented capillary jet of a liquid cooling agent. The design of the cryoirrigator ensures a graded delivery of the cooling agent and also the possibility of controlling its supply. It is liquid nitrogen that is used as a cooling agent.


[Characteristics of the design of power supply devices for radiodiagnostic apparatus].

Basic features specific for the X-ray power supply facilities feeding modern roentgenological units, which became necessary after the introduction of automatic exposure, decreasing-load conditions and X-ray image intensification relays. Classification of the feeding devices, depending upon the purpose of the apparatus is presented and recommendations for the adoption of suitable patterns for the main circuitry of the apparatus and methods of its calculation are given.


Amyloidosis: review of 236 cases.

From 1960 through 1972, 236 cases of amyloidosis with histologic proof were found. The amyloidosis was primary (without evidence of preceding or coexisting disease) in 132 cases (group 1) and associated with multiple myeloma in 61 (group 2). Secondary amyloidosis appeared in 19 cases (associated with rheumatoid arthritis or osteomyelitis in two-thirds of them). There were 22 patients with amyloid localized to a single organ (bladder, lung, skin, or larynx in more than half of them). Two patients had familial amyloidosis. In group 1 and group 2, the most common presenting symptoms were fatigue, weight loss, edema, dyspnea, light-headedness or syncope, and paresthesias. Symptoms of the carpal-tunnel syndrome were frequent. The liver was palpable in almost 50% of the series, but splenomegaly was an initial finding in less than 10%. Macroglossia was recorded in 26% of group 2 and in 12% of group 1. Enlargement of submandibular structures was noted in about 10% of cases; and purpura, particularly around the eyes, was a significant feature. Substantial numbers of the patients had carpal-tunnel syndrome, nephrotic syndrome, congestive heart failure, sprue, peripheral neuropathy, or orthostatic hypotension. Approximately 50% of patients had renal insufficiency at the time of diagnosis. Proteinuria was found in more than 90%. A monoclonal protein was found in the serum of 49% of group 1 and in 74% of group 2. Monoclonal proteins were found in the urine of 35% and 81%, respectively. Only 12% of patients in group 1 had no monoclonal protein when both serum and urine were analyzed, and all patients of group 2 had a monoclonal protein in the serum or urine when both were analyzed. Lambda light chains were more common than kappa. None of the patients in group 1 had more than 15% plasma cells in the marrow, whereas more than half of group 2 had more than 15% plasma cells. Roentgenograms showed no evidence of skeletal disease in 94% of group 1, but 50% of group 2 had skeletal abnormalities. Rectal biopsy was positive for amyloid in 84% of cases. Kidney, liver, and carpal-tunnel biopsies were positive in 90% or more. Follow-up of all 193 patients in groups 1 and 2 revealed that 80% of group 1 and 97% of group 2 had died. The median survival was 14.7 months in group 1 and 4 months in group 2. Cardiac failure was the most common cause of death, accounting for 30% of the fatalities. We also reclassified all cases by the method of Isobe and Osserman (105), which is based on clinical patterns: pattern I--principal involvement of tongue, heart, gastrointestinal tract, muscle, nerves, skin, and carpal ligaments; pattern II--principal involvement of liver, spleen, kidneys, and adrenals; and mixed pattern I and II. This analysis failed to reveal predictive value in the clinical pattern classification, and did not discern the survival differences between primary amyloidosis (group 1) and amyloidosis with myeloma (group 2). Consequently, for the present we prefer the classification used in this study.


Manifestations of hypothalamic obesity in man: a comprehensive investigation of eight patients and a reveiw of the literature.

Eight patients are presented in whom obesity developed in association with documented hypothalamic lesions. These lesions included trauma, inflammatory disease, an aneurysm of the internal carotid artery, and five cases of tumor. Detailed metabolic studies were performed in four patients with hypothalamic obesity and in five age- and weight-matched patients with essential obesity(i.e., obesity with no definable etiology). Fasting insulin concentrations were significantly higher in the patients with hypothalamic obesity. During a seven-day fast the insulin levels in patients with essential obesity decreased by 24 to 48 hours, whereas patients with hypothalamic obesity showed a variety of changes; In three out of four of these patients with hypothalamic obesity there was no evidence for hyperplasia of the fat cells. Basal oxygen consumption, body composition, and metabolism of adipose tissue did not differ between the patients with essential obesity and those with hypothalamic obesity. There was no difference in activity of the enzymes in the glycerophosphate cycle. Our data on eight patients with hypothalamic obesity were compared with data on patients in literature. Most cases of hypothalamic obesity occur with space-occupying tumors arising at the base of the hypothalamus. However, trauma, inflammatory diseases, and leukemia are also associated with hypothalamic obesity. Patients with hypothalamic obesity rarely weigh more than 140 kg.


The effect of glucose on the growth hormone response to glucagon and propranolol-glucagon in normal subjects.

The mean (+/- SE) peak level of serum growth hormone (GH) after intramuscular injection of glucagon in ten normal adult men was 15.1 +/- 2.1 ng/ml; glucose infusion suppressed the mean peak GH to 9.6 +/- 3.7 ug/ml (p less than 0.05). Pretreatment of eight of these subjects with propranolol caused a modest increase in the mean peak GH after glucagon (19.4 +/- 2.8 ng/ml) but did not improve the mean peak GH after glucagon when glucose was infused (8.7 +/- 2.8 ng/ml). Individual analysis of the peak GH showed that glucose infusion did not uniformly suppress the peak GH after glucagon; in seven subjects the peak GH was suppressed but in three it was not. (1) The GH response after glucagon is usually due to a fall in serum glucose after the initial rise in serum glucose induced by glucagon. (2) Nevertheless, since glucose does not consistently inhibit the GH response after glucagon, a second mechanism probably exists by which glucagon stimulates GH secretion. (3) Glucose completely suppresses the propranolol-induced increase in the GH response to glucagon; an adrenergic mechanism may be involved in the control of GH secretion by glucose.


Heterogeneity of plasma glucagon immunoreactivity in normal, depancreatized, and alloxan-diabetic dogs.

Filtration of basal plasma from normal, alloxan-diabetic, and depancreatized dogs on Bio Gel P-10 yielded four glucagon-immunoreactive fractions. One of them appeared in the true glycagon area with the glucagon-125I (3500 mol vt). Of the other three, one appeared in the void volume (greater than 20000 mol wt), another just before the insulin-125I (congruent to 9000 mol wt), and the last one close to the salt peak (less than 2000 mol wt). The increase of total plasma glucagon immunoreactivity observed in depancreatized and alloxan diabetic dogs was mainly due to an increase in the 3500 and 9000 molecular-weight fractions. Arginine infusion in depancreatized dogs caused an increase in the 3500 molecular-weight fraction. Somatostatin or insulin infusion in depancreatized and alloxan-diabetic dogs resulted in disappearance of the 3500 molecular-weight fraction.


Effect of contraceptive steroids on arginine-stimulated glucagon and insulin secretion in women: I-Lipid physiology.

To evaluate the effect of contraceptive steroids on endogenous glucagon and insulin secretion, theta-arginine was infused intravenously in normal young women before and during selective steroid treatment. The effect of the combination of an estrogen derivative (mestranol), plus norethindrone (Norinyl, Syntex) was compared to the effect of ethinyl estradiol alone and to norethindrone alone. All three steroid schedules resulted in suppression of aminogenic insulin secretion. However, glucagon secretion was reduced only with ethinyl estradiol alone or the combination of mestranol plus norethindrone. In accordance with previous reports, treatment with an ethinyl estradiol derivative alone or in combination with norethindrone resulted in a tendency for elevated serum lipid concentration, while norethindrone alone resulted in a significant reduction in serum lipid concentration. These observations suggest an inverse relationship between aminogenic glucagon secretion and serum lipid concentration as influenced by contraceptive steroids. It is suggested that the metabolic effects of these steroids may be mediated in part by the associated alterations in pancreatic hormone secretory capacity.


Inhibition of ketogenesis by ketone bodies in fasting humans.

Although there exists some indirect evidence that circulating ketone bodies might inhibit their own production rate, the direct demonstration of this homeostatic feed-back phenomenon is still lacking. The present work aims at demonstrating the operation of this control mechanism in human fasting ketosis. Six obese subjects, who fasted 2-23 days, were given a primed constant i.v. infusion of 3- 14C-acetoacetate for 4 hr. After a control period of 2 hr, unlabeled sodium acetoacetate was administered as a primed constant i.v. infusion at the rate of 0.688-1.960 mmol/min until the end of the study. During both periods, the rates of inflow of ketones were estimated from the specific activity of total ketones measured under near isotopic steady state conditions. During the control period, total ketone concentration amounted to 3.98-9.65 mumol/ml and production rates of total ketones ranged between 1.450 and 2.053 mmol/min. The levels of free fatty acids, glycerol, glucose, and insulin averaged respecitvely 1.30 mumol/ml, 0.11 mumol/ml, 74 mg/100 ml, and 5.2 muU/ml. The administration of exogenous ketones during the second phase of the study induced a 47%-92% increase in total ketone levels. During this period, the endogenous production of ketones (calculated as the difference between total inflow rate and acetoacetate infusion rate) amounted only to 67%-90% of control values. Among other factors, this inhibition of ketogenesis was probably partially related to the direct antilipolytic effect of infused ketones. Indeed, there was a concomitant fall in FFA and in glycerol levels averaging respectively 13.5% and 17.3%, without significant changes in peripheral insulin concentrations. Our results demonstrate that during fasting, circulating ketone bodies exert an inhibitory influence on the rate of ketogenesis. This mechanism might play an important role in preventing the development of uncontrolled hyperketonemia during starvation.


Neuropsychiatric relapse following acute carbon monoxide poisoning--the contribution of electroconvulsive therapy.

Four cases are described in which, after apparent recovery from deliberate acute carbon monoxide poisoning, the administration of electroconvulsive therapy was associated with a relapse, with subsequent neuropsychiatric impairment. It is suggested that, as electroconvulsive therapy could aggravate acute cerebral damage, its use during recovery from acute carbon monoxide poisoning should be abandoned.


Adenocarcinoma in a Barrett oesophagus.

A case of adenocarcinoma developing at the squamocolumnar epithelial junction of a Barrett oesophagus is reported. This rare tumour was remarkable because of the youth of the patient and because of the signet-cell cytological pattern of the neoplasm. It is postulated that both the columnar epithelial lining of the lower part of the oesophagus and the malignant change are a consequence of long-standing oesophageal reflux.


Prostaglandin F2alpha given by continuous transcervical extra-amniotic infusion combined with intravenous oxytocin infusion for therapeutic termination of mid-trimester pregnancies.

Prostaglandin F2alpha administered by continuous transcervical extra-amniotic infusion, and supplemented with oxytocin, given intravenously, to induce therapeutic abortion during the second trimester in 50 cases. This method was successful in all cases and has the advantages of being technically simple and requiring only a small dose of prostaglandin. The main hazard is intrauterine infection, which can be prevented by preliminary bacteriological investigation of the cervix and appropriate prophylactic antibiotic therapy. Prostaglandins are not yet available in Australia for general medical use. Our experience with prostaglandin F2alpha administered in the manner described indicates that it has an important part to play in gynaecological therapy.


Chlormethiazole in status epilepticus--three cases.

Despite the use of barbiturates, phenytoin sodium and diazepam given intravenously, status epilepticus continued in the three cases described until chlormethizaole (Heminevrin) was administered, when rapid resolution of the status occurred.


Diet and atherosclerosis.

Diet and atherosclerosis are closely linked, both aetiologically and therapeutically. The aetiological association can be demonstrated most satisfactorily in animal experiments. In human beings the evidence must necessarily be more indirect and is largely based on dietary trials and epidemiological surveys linking the intake of cholesterol and saturated fat with morbidity and mortality from coronary disease. A modifying influence which has gained increasing recognition over recent years is the individual response to a given diet. This variability appears to be largely genetically determined, certainly in the defined primary hyperlipidaemic states, and possibly within the normal ranges of serum cholesterol levels. A change in food habits should be fully utilized therapeutically in any form of hyperlipidaemia, whether as a primary preventive measure before clinical diseases of atherosclerotic origin become manifest or in secondary prevention to delay further morbidity and mortality. With good dietary adherence, lipid levels may return to normal and there may be additional favourable effects on intravascular thrombosis. Many problems remain to be solved on the public health issue of advising changes in the national diet. A number of countries in which an atherogenic diet is habitually eaten have decided in favour of such a recommendation. Public education, identification of persons at risk and provision of readily available skilled medical and dietary counselling should constitute a national health project with rewarding long-term results.


Controlled trial comparing co-trimoxazole and methenamine hippurate in the prevention of recurrent urinary tract infections.

To study the effects of continous low doses of antibacterial agents after eradication of bacteriuria in patients with recurrent urinary tract infection, 31 patients with documented recurrent urinary tract infection were allocated alternately to treatment with either co-trimoxazole (400 mg of suphamethoxazole and 80 mg of trimethoprim each night) or methenamine hippurate (1 g each night). The majority of patients (79%) had underlying radiological abnormalities of the renal tract, but normal renal function (the mean serum creatinine level was 1.05 mg per 100 ml). During the study the incidence of bacteriuria and pyuria was significantly lower in the co-trimoxazole-treated group. Patients receiving co-trimoxazole also had fewer acute clinical episodes of urinary tract infection than patients receiving methenamine hippurate. There were no significant side effects from either drug. Two patients with frequent recurrences of infection developed renal calculi. No change in creatinine clearance or maximum urinary concentrating ability was observed over a follow-up period of four to 30 months (mean 10.4 months). Co-trimoxazole is an effective agent in the prophylaxis of urinary tract infection in this highly susceptible group of patients, and in the doses used was superior to methenamine hippurate.


Meningiomas: treated and untreated.

Meningiomas are frequently amenable to total resection. On review of a 10-year series of these tumours in Western Australia it was found that 18 out of total 78 were undiagnosed during life. Analysis of the present series is undertaken as well as comparison with other series in the literature in respect of the overall clinical picture. It is suggested that, in cases of gradual psychological deterioration, the presence of a benign intracranial space-occupying lesion ought to be excluded.


Inflammatory changes in the cardiac conducting system in sudden infant death syndrome.

A case is reported of a sudden death syndrome in an infant in which there was evidence of inflammation in the atrioventricular conduction system and the right atrial wall


Psychological disturbance in Darwin evacuees following cyclone Tracy.

The incidence and course of psychological reactions following natural disasters has been based on clinical impressions in the past. In the present study, 67 survivors of cyclone Tracy who had been evacuated to Sydney were studied by an objective test, the General Health Questionnaire, which has been found to be a reliable and valid instrument in determining non-psychotic psychological disturbance. Fifty-eight per cent of these Darwin evacuees scored as "probable psychiatric cases" when tested five to eight days after the cyclone. Psychological disturbance increased with age and was more pronounced in females.


Psychiatric disturbance with acute onset and offset in a Darwin evacuee.

A case of transient situational disturbance in a Darwin evacuee is presented in order to place on record the nature of and the circumstances associated with a "breakdown" following the patient's evacuation form Darwin as a result of cyclone Tracy. The apparently gross behavioural disturbance was rapidly resolved after the involvement of a number of people willing, and apparently able, to provide help, without resort to hospitalization or medication.


The effects of mandatory seat belt wearing on the mortality and pattern of injury of car occupants involved in motor vehicle crashes in Victoria.

Compulsory seat belt wearing, first introduced in the world in Victoria in 1970, has effectively reduced the number of deaths and injuries for car occupants involved in motor vehicle crashes, whilst those for the unprotected pedestrian and pedal and motor cyclist have continued to increase. This legislation does not apply to children under the age of eight years, only 5.5% of whom travel restrained in motor cars, and their death and injury patterns remain unchanged. Seat belts offer the most remarkable protection for car occupants involved in frontal-impact collisions. However, a high percentage of car occupants who are the recipients of a side impact in a collision receive serious multiple injuries, particularly chest and pelvic injuries, and seat belts offer little protection except that head injuries are less common when a seat belt is being worn. Compulsory lateral strengthening of motor vehicles must be introduced in Australia. Ten per cent of car occupants admitted to hospital after frontal-impact collisions show injuries directly attributable to the wearing of seat belts. These include fracture of the clavicle, bruising and fracture of the sternum, cardiac tamponade, abdominal contusions and bowel lacerations. Seat belts, to be fully effective, must be fitted correctly. There is definite room for improvement in seat belt design.


The pattern of injuries in 470 pedestrains killed in road accidents.

A survey is presented of injuries received in 470 road accidents involving fatal injuries to pedestrians. A comparison is made between the absolute incidence of fatal major injuries in pedestrians and that in the occupants of vehicles. Whereas head and chest injuries in combination are also major causes of death in pedestrians, the greater frequency of traumatic lesions of the spine and lower extremities in pedestrians was to be expected. As in the case of car occupants, the contribution to death of aspirated blood and vomitus was extremely high.


The diaphragm in chest radiology.

In roentgenograms of the chest, it was observed that there was an increase in the difference between the right and left domes of the diaphragm in the right lateral views when compared with the difference present in the posteroanterior views. A difference of 3-5 cm in posteroanterior views and 5-0 cm in the right lateral views, could be considered normal values. The greater difference in the levels of the domes of the diaphragm in the right lateral views was confirmed in a study using hepatic models. Factors responsible for this radiological distortion have been outlined and the clinical significance of this phenomenon in respect to elevation of the right dome of the diaphragm has been discussed.


Major abdominal bleeding in chronic pancreatitis.

This case report concerns a patient with chronic pancreatitis which led to extensive retroperitoneal haemorrhage from a rupture of the abdominal aorta. The rarity of this complication is emphasized, but other reported instances of bleeding in association with chronic pancreatitis are commented upon.


Acute epididymitis attributable to chlamydial infection -- preliminary report.

Two cases of acute epididymitis are described in which there was found to be a significant rise in the titre of antibodies to the chlamydial group of organisms. It is suggested that chlamydial infection is a cause of acute epididymitis.


Determinants of prescribing of psychoactive drugs by general practitioners.

Precise data on levels of prescribing of psychoactive and other drugs by general practitioners have recently become available in Australia (Rowe, 1973a, b; Bridges-Webb, 1972). However, there has been little or no research into possible determinants of prescribing behaviour, for example, age, social background, work load, the nature of the practice, education and colleague networks. Nor have the attitudes, expectations, values or information levels of general practitioners been studied. The overseas literature in this field is confusing and scanty. There would seem to be good reason to investigate these aspects in Australian practices. A pilot study carried out in Canberra in 1972 suggests that a short structured questionnaire administered in a face-to-face interview could provide the necessary data.


Analysis of suppurative otitis media in children: aetiology of non-suppurative otitis media.

A comprehensive analysis of 2,347 children with discharging ears seen between 1969 and 1972 in New Mulago Hospital, Kampala, is made. The reasons for the rare occurrence of non-suppurative otitis media are given. Finally, some suggestions are made about the aetiology of non-suppurative otitis media in the light of these findings.


Severe alimentary bleeding associated with hookworm infestation in aboriginal infants.

Four infants are reported who manifested severe alimentary bleeding associated with evidence of massive acute hookworm infestation. The need to remember this parasite as a possible cause of melaena in infants in areas where it is endemic is stressed, as treatment is simple and effective.


Which asthmatic patients should be treated by hypnotherapy?

Certain patients with bronchial asthma can benefit, often greatly, from hypnotherapy. This report is based on a retrospective analysis of 121 asthmatic patients who were treated by hypnotherapy. Hypnotic techniques and treatment procedure are described. Of the total number, 21% had an excellent response to treatment, becoming completely free from asthma and requiring no drug therapy. A further 33% had a good response, with worthwhile decrease in frequency and severity of the attacks of asthma, or a decrease in drug requirements. About half of the 46% who had a poor response had a marked subjective improvement in general well-being. Statistical evaluation of the six variables (age, sex, result, trance depth, psychological factors and severity of the asthma) confirmed the clinical impression that the ability to go into a deep trance (closely associated with the youthfulness of the subject) gives the best possibility of improvement, especially if there are significant aetiological psychological factors present and the asthma is not severe. Subjective improvement in well-being and outlood is a potential outcome at all age levels, independent of severity of the illness or entranceability of the patient.


Management of the hypercalcaemia of malignancy by peritoneal dialysis.

A case is reported which illustrates the use of peritoneal dialysis in the treatment of hypercalcaemia due to metastatic carcinoma of the breast. Control of hypercalcaemia was rapid and sustained. Removal of calcium did not completely explain the results observed. The possibility is discussed that treatment temporarily suppressed tumour growth or removed some dialysable hypercalcaemic or tumour growth factor.


The role of the clinical pharmacologist in the teaching hospital.

Clinical pharmacology is the scientific basis of rational drug therapy. The functions of the clinical pharmacologist comprise education, clinical practice, research and administrative duties. The functions of the department of clinical pharmacology in the modern teaching hospital have been outlined.


Sodium restriction and thiazide diuretics in the treatment of hypertension.

In a group of hypertensive patients it has been shown that moderate sodium chloride restriction has a hypotensive effect that is similar to that produced by thiazide diuretics. Blood pressure changed in relation to body weight in individual patients, and appeared to correlate with their sodium balance. The more a patient was depleted of sodium, the lower was the blood pressure. The serum potassium level fell with the use of thiazide diuretics, but in this group of patients there was little change in total body potassium content. The fall in serum potassium level appeared to relate to a shift into the cells due to the accompanying alkalosis. Potassium supplementation appeared to have had little effect and was unnecessary for most patients who were given diuretics for hypertension. Amiloride corrected the alkalosis and restored the serum potassium level to normal.


Tuberose sclerosis with malignant astrocytoma.

A case is described of a recurrent malignant gemistocytic astrocytoma in which a diagnosis of tuberose sclerosis was made at post-mortem examination, when "rhabdomyomata" were found in the cardiac muscle and tubers in the cerebral hemispheres. Malignant degeneration of a cerebral lesion has not been described in association with tuberose sclerosis.


Somatomedins.

An intact pituitary gland capable of secreting growth hormone has long been considered the prime requirement for the achievement of skeletal growth potential in man. Recent studies have revealed that the growth-promoting action of growth hormone is an in-vivo phenomenon which cannot be mimicked by the addition of the hormone to skeletal tissue in vitro. The humoral agent responsible for skeletal growth has now been identified as somatomedin, a peptide produced in the liver under the stimulus of pituitary growth hormone. Serum levels of somatomedin are measured in a bioassay system by monitoring the stimulation of uptake of labelled sulphate by cartilage. Low levels of somatomedin activity are detected in the serum of children with growth hormone deficiency and short stature; the levels are high in acromegalics and low in patients with cirrhosis of the liver or chronic renal failure. Undernourished children also have low levels despite reaised serum levels of growth hormone; this suggests the presence of an inhibitor which lowers the growth-promoting activity of the somatomedin molecule. Adequate nutrition in these children results in the restoration of serum somatomedin levels to normal. Attempts to isolate and purify somatomedin have led to the identification of a group of substances sharing similar actions on skeletal tissue. Insulin has also been demonstrated to share some of these growth-promoting activities but varies in its organ specificity. Nerve growth factor, epidermal growth factor and proinsulin are other molecules which form a large group of growth promoting peptides which may all be related to the somatomedins.


The incidence of unwanted pregnancy in Australia.

A great number of unwanted pregnancies occurs annually in Australia, but more sociological data are needed to explore this current problem. If one defines unwanted pregnancy as one which was unwanted by either partner weeks before the conception, it can be estimated that approximately two in three pregnancies are unplanned and one in two is unwanted.


Factors influencing conception in women seeking termination of pregnancy. A pilot study of 100 women.

An urgent social, medical and psychological problem is that of unwanted pregnancy. It is only comparatively recently that full responsibility for termination of an unwanted pregnancy has fallen fully on the medical profession and has been accepted by doctors with varying degrees of willingness and reluctance. Doctors are puzzled because in this permissive society, in which there appears to be good access to contraceptive advice and easy accessibility to the pill, women still have unwanted pregnancies; some doctors feel this is on the increase. In this study some factors have been examined which appear to have contributed to the conception of an unwanted child, in particular the women's attempts at preventing this unwanted conception, in an effort to identify groups of volnerable women by their attitudes to contraception.


Follow-up studies of aboriginal children with ear disease and hearing loss at Cherbourg (Queensland).

A random sample of 100 Aboriginal primary school children originally examined in February, 1970, was followed up in February, 1971, and February, 1972.  Over this period, the incidence of hearing loss dropped from 41% to 23%.  Most of the improvement occurred in the younger children, and, while this could be attributed to treatment in a few cases, the majority of children appeared to improve spontaneously.  A complete school grade of 37 children aged six years in 1970 was retested six times over a period of three years.  Again, there was a general improvement, from 60% incidence of hearing loss in 1970 to 22% in 1972.  Most of this improvement was spontaneous.  During the three years of observation (1970, 1971, 1972), 30 Aboriginal children from Cherbourg underwent surgery including myringotomy, myringoplasty and mastoidectomy.  Operative successes and failures in these children are discussed.


Factors leading to chronic middle ear disease.

In an Australian Aboriginal community, 65% of all people examined had clinical evidence of pathology in the ear drum or middle ear, but active ear disease was found mainly in children.  In most people, both ears showed similar clinical changes.  Clinical nutritional status and hygienic factors did not correlate with the presence of ear disease.  Some families had significantly more ear disease than did others, suggesting that there is some as yet unidentified familial factor.


Ear disease and hearing in aboriginal and white children in two schools in rural New South Wales.

A survey of 212 Aboriginal and 382 European children attending two primary schools in western New South Wales revealed 60.4% of Aboriginal children's ears and 16.1% of European children's ears to be abnormal.  Perforated eardrums were found in 13.9% of Aboriginal and in 0.3% of European children's ears, and this abnormality was strongly associated with low weight and height status.  Some degree of deafness in at least one ear was found in 34.8% of Aboriginal children and in 4% of European children. Hearing loss of greater than 25 dB in the better ear was found in 11.6% of Aborigines and in 0.7% of European students in the second to the sixth classes (that is, children aged seven to 13 years).  "Running" ears also contributed to prejudice against Aboriginal children.  Suggestions are made about a possible medical approach to alleviate ear disease in Aboriginal people.


[Results of therapy in acute leukemia in adults. Comparison of different combinations of cytotoxic drugs].

In 67 patients with acute leukemia 76 treatment-series were performed which were analyzed to evaluate whether chemotherapy has brought some progress during the past years. With 67 sufficient treatments a total of 26 remissions were achieved. VIDaP-scheme with 43 p.c. and cytosinarabinosid with 46 p.c. were significantly superior to the older scheme methotrexat-purinethol-prednisone with only 29 p.c. remissions. A remarkable deterioration of prognosis with increasing age rises the question whether treatment with cytotoxic drugs should be tried in patients more than 60 years old. Remission rate in patients below 20 was especially high with 71 p.c. so that the well-known good prognosis of juvenile leukemia can be extended with some limitations until age 20.


[Endoscopic transpapillary cholangiography (author's transl)].

Endoscopic transpapillary Cholangiography is able to give valuable informations for indication and operative procedure in biliary diseases especially in obstructive jaundice. Indication for "blind" explorative laparotomy seems to become more rare as well as necessity for clearing situations of biliary tract by surgical preparation or X-ray-examinations as usually performed. If one is well trained in technical procedures and in interpretation of radiologic findings, very helpful diagnostic hints can be presented. In opposition to retrograde pancreaticography, endoscopic examination of the biliary tract can be propagated with more enthusism.


[Septate gallbladder (author's transl)].

In 3,8% of 2,437 in-side patients, examined by x-rays, septs of the gallbladder, supposed to be congenital form variations, were found. There were no differences in sex distribution of the segmented organs and no recognizable correlation to increasing age. Usually, septations were found by accident without clinical relevance. In the proximal parts of the gallbladder located septs occasionally cause symptoms not to be differentiated from those of cholelithiasis. In these cases ectomize is indicated. Calculi are found to be more frequent in septate gallbladders than in unsegmented ones. Sex differences between concrement-bearing, septate gallbladders and unsegmented organs containing stones, were not observed. Likewise, there was no correlation of gallbladder-septs to other diseases, particularly to hepatitis.


[The lithiasis of the gall bladder, a stepchild of the diagnosis of the epigastrium? (author's transl)].

An anamnestic questionnaire project at a hospital for gastroenterological diseases has proved, that in 100 patients cholelithiasis after a cholecystectomy was not diagnosed at first. In more than two thirds of the preliminary diagnoses (69.8 p.c.) stomach was concerned. The therapy required in these cases took 7.9 years on an average. Generally it took 12.6 years of complaints from the first symptom until cholecystectomy was performed. Even when cholelithiasis was diagnosed, the operation was not decided upon until 6.8 years had passed on an average. For the most part the patient himself delayed the operation. According to the patients questioned, chronic pancreatitis was the disease most frequent following cholecystectomy. Reasons for errors in diagnosis of epigastric pain are discussed. The undoubted value of early cholecystectomy is emphasized.


[Acute respiratory insufficiency caused by plunging goiter (author's transl)].

Acute respiratory insufficiency and unconsciousness are symptoms which may lead to misinterpretation. In cases of unclear acute respiratory insufficiency one should think of the rare plunging goiter with acute tracheostenosist, especially in female patients over 40 years. Diagnosis can easily be found if the patient is thoroughly observed. Resection of the retrosternal struma is the only possible therapy. One case of plunging goiter is described here.


[Behavior of serum IgE in patients with atopic extrinisic asthma. Studies with a modified radioimmunologic sorbent technic, Phadebas-IgEtest].

Serum IgE levels were measured by radioimmunosorbent techniqueera from patients with atopic extrinsic asthma, from patients with chronic bronchitis and from healthy adults. 51 of 65 patients with atopic extrinsic asthma had IgE values above the mean normal. Patients who were hypersensitive to different allergens commonly showed higher IgE concentrations than those who were hypersensitive to a single allergen only. Compared with IgE values found in patients with chronic bronchitis the differences were statistically highly significant. However the measurement of serum IgE may be a valuable diagnostic tool but only in supplement to other clinical investigations.


[Dose-effect study on the bronchospasmolytic drug ipratropium bromide in relation to blood gases and hemodynamics].

In 9 patients with chronic bronchitis and cor puomonale and in one patient with vascularly pulmonary hypertension the efficiency of 0,04 mug and 0,16 mug Sch 1000 (isopropylatropin,), applicated with metered dose inhaler referring to blood gases and hemodynamics was examined. Inhalation of drug was not followed by any variations either referring to hemodynamic parameters (pulmonary pressure, systemic blood pressure, cardiac output, peripheral resistance) nor to the blood gases. After a dosage as high as eigth time as normal side effects were not found.


[Functional studies on the differential diagnosis of so-called cardiospasm and esophageal achalasia. Simultaneous electromanometric and serial radiographic studies].

The characteristic esophageal pressure tracings and radiological appearances of diffuse spasm and achalasia are reported. In two patients of the series spastic activity involves the gastroesophageal junction. The findings indicate that differentiation of so-called cardiospasm and achalasia can only be obtained by simultaneous electromanometric pressure measurement and serial film technique. The resulting surgical methods are briefly reviewed.


9-Aminoacridine mutagenesis of bacteriophage T4 intracellular DNA.

Most of the intracellular T4 DNA made in the presence of 9-aminoacridine is of lower molecular weight than mature T4 DNA and does not get packaged into phage particles.  Using a T4 DNA transformation assay, we have examined this intracellular T4 DNA for its content of 9-aminoacridine-induced revertants of certain rII gene frameshift mutations.  The proportion of acridine-induced revertants in the intracellular DNA population is close to that found in the phage progency made in the presence of 9-aminoacridine.  Thus, the generation of low molecular weight T4 DNA in the presence of 9-aminoacridine is not, in itself, also a mutagenic process.


Agrocin 84 sensitivity: a plasmid determined property in Agrobacterium tumefaciens.

It was shown for some oncogenic Agrobacterium tumefaciens strains that agrocin 84 sensitivity is determined by the presence of a large closed circular DNA plasmid, called the Ti-plasmid.  Whereas wild-type strain C58 is agrocin 84 sensitive, all Ti-plasmid cured derivatives were found to be fully resistant.  Moreover all independently isolated agrocin 84 resistant colonies were stably non-oncogenic and plasmid negative.  In a growth experiment carried out at 37 degrees C it was shown that the kinetics of appearance of non-oncogenic cells on the one hand and of agrocin 84 resistant cells on the other were identical.  The fact that not all oncogenic, plasmid harbouring, Agrobacterium tumefaciens strains are sensitive to agrocin 84, points to the possibility that the genes determining agrocin 84 sensitivity are not essential for tumor-inducing ability.


[On the importance of B-scan-ultrasound for the diagnosis of nephrological and urological diseases in childhood (author's transl)].

Kidneys of 118 children of all age groups, and of 2 adults were investigated by means of senography.  Normal kidneys could be identified on account of a typical echo-pattern.  Deviations from this pattern were interpreted as evidence for pathological changes in the kidneys; they were correlated to the radiological and in some cases to the pathologic-anatomical findings.  Typical deviations of the echo-pattern were found in cases of hydronephrosis, duplex kidneys, duplex kidneys in combination with hydronephrosis, polycystic renal diseases and other renal diseases.  It was even possible to demonstrate decrease and increase of hydronephrosis by means of sonography.  Indications for the application of this method are pointed out.  In addition its accuracy and importance in relation to other diagnostics methods are discussed.


The genetic control of the antibody response in inbred rats.

The antibody response of genetically inbred rats to poly(Glu52Lys33Tyr15) is controlled by a complex polygenic system which includes at least two autosomal genes and a sex influence, which may also be genetically determined. The genetic control of the quantity, binding constants, and specificity of the antibody formed linked to the major histocompatibility locus. Factors other than the major genetic ones and the sex influence also affect the quantity of antibody formed, since animals of the same genotype can make significantly different amounts of antibody, depending upon the crosses by which they acquire the major histocompatibility alleles. After immunization with poly(Glu52Lys33Tyr15) the low responders make fewer antibody-producing cells, are not capable of mounting a delayed hypersensitivity reaction to the polypeptide and appear to be deficient in their ability to produce the specific IgM antibody. Immunization of the low responders with antigen aggregated with methylated bovine serum albumin enhances the quantity of antibody formed, increases the binding constants and crossreactivity of the antibody and enhances the delayed hypersensitivity response. In contrast to the findings with the L-amino acid polypeptide, there does not appear to be any genetic control over the antibody response to the D-amino acid enantiomorph poly(DGlu52DLys33DTyr15), which is minimal in all strains.


[D(--)alpha-aminobenzylpenicilline and amino acid pattern in urine (author's transl)].

Three cases of patients with D(--)alpha-aminobenzylpenicillinuria are reported.  On the quantitative, urinary amino acid chromatogram we found a high ninhydrinpostitive peak between the xi-aminocaproic acid and the arginine peak.  Column chromatographic and thin-layer chromatographic studies with test substances permitted to identify the unknown peak as D(--)alpha-aminobenzylpenicillin.


[Diaper thrush. Clinical picture, mycology, histology, therapy (author's transl)].

During the last 7 years a well defined, characteristic disease has been observed in babies of the department of dermatology of the university clinic of Innsbruck.  Because of the localisation and probable pathogenesis we have coined the term "Windelsoor" (diaper thrush) for it.  Clinical picture, mycological and histological findings, therapeutical experience with therapy and follow-up results are reported.  With reference to the anglo-american literature on this subject the pathogenesis of this disease is discussed.


[The distribution of ampicillin between blood and cerebrospinal fluid in patients with and without serous meningitis (author's transl)].

1. With a constant plasma concentration of Ampicillin the ratio of concentration in the cerebrospinal fluid to concentration in the plasma reaches a constant value after 2 hrs in patients with and without serous meningitis. 2. Patients without serous meningitis have a value of 0.025, patients with serous meningitis a value of 0.061. 3. From this it can be calculated that Ampicillin passes two and a half times faster through inflamed meningeal membranes than unaffected membranes.


Reversion of the 8-azaguanine resistant phenotype of variant Chinese hamster cells treated with alkylating agents and 5-brono-2'-deoxyuridine.

From cultures of V79 Chinese hamster cells, 10 independent clones of 8-azaguanine resistant cells were isolated and subcultured. Cells from all ten clones were resistant to 1 mg/ml levels of 8-azaguanine (8-AzG), contained less than 3% of the wild type levels of the enzyme, hypoxanthine guanine phosphoribosyl transferase (HGPRT), and were unable to grow in HAT medium. The ten clones were classified according to the conditions under which they reverted to the wild type phenotype. Clones in classes I and II reverted spontaneously with frequencies of 40-10(-5) and about 3-10(-5) respectively, and the reversion frequency was independent of the density of cells of all but one of the clones in the culture medium used. Class II clones evinced increased reversion frequencies with ethyl methanesulfonate (EMS) and N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), and to a lesser extent with 5-bromo-2'-deoxyuridine (budR), suggesting that these clones contained point mutations in a locus which controls HGPRT activity. The processes of reversion and toxicity appeared to be associated. Class III clones did not revert spontaneously or with BUdR and MNNG, but did revert with EMS. The reversion frequency of class I clones was not increased after treatment with EMS, MNNG or BUdR.


The excision of pyrimidine dimers from the DNA of mutant and wild-type strains of Ustilago.

UV-induced pyrimidine dimers were excised from the DNA of wild-type and four mutant strains of Ustilago maydis. Excision was partially dose dependent. The kinetics of excision differed in recombination deficient strains (rec 1 and rec 2) from those found in a recombination proficient radiation-sensitive strain (uvs 3). At fluences above 100 J-m-2 excision was saturated in uvs 3 but not in rec 1 or rec 2. Fluences above 300 J-m-2 started to saturate excision in wild-type. pol1-1, a temperature-sensitive DNA polymerase mutant, was excision proficient at both the permissive (22 degree) and restrictive (32 degree) temperatures. Wild-type cells were observed to excise CC before CT or TT in high dose experiments.


Spinal epidural abscess.

Thirty-nine patients with spinal epidural abscess were evaluated at the Massachusetts General Hospital between 1947 and 1974. Twenty had acute symptoms, and purulent epidural collections were present; 19 had prolonged courses, and epidural granulation tissue was observed at operation. Staphylococcus aureus was the most common etiologic agent (57 per cent), followed by streptococci (18 per cent) and gram-negative bacilli (13 per cent). The source of infection was osteomyelitis in 38 per cent of cases and bacteremia in 26 per cent. In 16 per cent epidural abscess was due to postoperative infection. The progression from spinal ache to root pain to weakness followed by paralysis continues to be characteristic of spinal epidural abscess. Although the disease is uncommon, the complications are so serious that prompt diagnosis and treatment are of paramount importance. The combination of back pain with fewer and local tenderness is an indication for cerebrospinal-fluid examination and, depending on the results, immediate performance of myelography.


Effects of somatostatin on hemostasis in baboons.

Because some baboons repeatedly infused with somatostatin died we reviewed available autopsy material. All six animals chronically treated with somatostatin displayed gross or microscopical pulmonary hemorrhage and increased hemosiderin in lung and liver whereas only one of six untreated animals had a similar abnormality. We therefore examined the hemostatic system in living baboons. Thrombocytopenia (mean platelet count of 84,000 per microliter) was noted in six of seven baboons chronically treated with somatostatin; platelet survival was normal. Clotting factors were unaffected. Fibrinogen concentration and survival were unchanged. The acute effects of intravenous somatostatin (0.8 micrograms per kilogram per minute for two hours) in previously untreated animals transiently decreased platelet count, reduced retention of platelets on glass-bead columns and inhibited aggregation induced by ADP, collagen and epinephrine. Bleeding times were not prolonged. Somatostatin added to platelet-rich plasma in vitro was without effect. These data suggest that prolonged administration of somatostatin should be undertaken with caution.


The effect of somatostatin on coagulation and platelet function in man.

Preliminary evidence has suggested that somatostatin might interfere with platelet function in the baboon. Because this agent is currently being administered experimentally to human beings, we studied its effect on coagulation and platelet function in man. In five subjects, a four-hour infusion of somatostatin (500 micrograms  per hour) had no definite effect on platelet count, leukocyte count, hematocrit, platelet adhesiveness and aggregation, bleeding time, partial thromboplastin time, prothrombin time, and fibrinogen levels. A similar infusion for 18 hours in three subjects was likewise without effect. These studies indicate that somatostatin does not affect coagulation and platelet function in man and that its prolonged administration lacks ostensible toxicity.


Lack of clinical usefulness of the limulus test in the diagnosis of endotoxemia.

Studies of the clinical value of the limulus amebocyte lysate test for the detection of endotoxemia are inconsistent. In an attempt to define the value of this test, a total of 237 plasma samples from 111 patients were tested for endotoxin with seven different lysate preparations. A total of 48 plasma samples yielded a positive test with one or more of the seven preparations. Two of eight samples positive with all seven preparations were from ambulatory patients. A significant positive correlation of the test with bacteremia, neutrophilia and elevated serum alkaline phosphatase was found. Only three of the 48 positive tests occurred by four hours of incubation, and only 12 were associated with positive blood cultures (eight contained gram-negative bacteria). The test now available has no clinical usefulness in the detection of endotoxemia or gram-negative septicemia.


The role of intestinal gas in functional abdominal pain.

A washout technic with intestinal infusion of an inert gas mixture was used to study the relation of gas to functional abdominal symptoms. The volume of gas in the intestinal tract (176 plus or minus 28 ml S.E.M.) of 12 fasting patients with chronic complaints of excess gas did not differ significantly (P greater than 0.10) from that of 10 controls (199 plus or minus 31 ml). Similarly, there was no difference in the composition or accumulation rate of intestinal gas. However, more gas tended to reflux back into the stomach in patients who complained of abdominal pain during infusion of volumes of gas well tolerated by controls. Six patients with severe pain during the study had intestinal transit times of gas (40 plus or minus 6 minutes S.E.M.) that were significantly (P less than 0.05) longer than those of the control group (22 plus or minus 3 minutes). Thus, complaints of bloating, pain and gas may result from disordered intestinal motility in combination with an abnormal pain response to gut distention rather than from increased volumes of gas.


Spontaneous abortion and aging of human ova and spermatozoa.

To test the hypothesis that aging of human gametes within the genital tract increases the chance of abortion, we measured the probabilities of abortion after insemination on a given day of the menstrual cycle in relation to the day of the shift in the basal body temperature in 965 patients. Cases came from family-planning and sterility clinics where basal body temperature and coital records are kept routinely. The probability of abortion diminished significantly (P less than 0.001) as the shift in temperature was approached and the increased to its highest point (24 per cent) three days later. Animal experiments have shown that aging of both spermatozoa and ova before fertilization is accompanied by higher probabilities of abortion. Present evidence indicates that this higher prevalence is also true for human beings.


Re-examination of histocompatibility antigens found in patients with juvenile rheumatoid arthritis.

One hundred and twenty-three patients with juvenile rheumatoid arthritis and a similar number of controls were tissue typed for 30 HL-A antigens to determine if there were any associations between particular HL-A antigens and the disease. None were found. However, HL-A7 was found more frequently in patients with juvenile rheumatoid arthritis demonstrating tenosynovitis than in the population with juvenile rheumatoid arthritis as a whole. These observations fail to support the contention of others that HL-A-W27 is found more frequently than expected in such patients.


Lymphocyte stimulation in hepatitis B infections.

Cell-mediated responses in patients with acute and chronic forms of Type B hepatitis were tested by lymphocyte transformation to purified hepatitis surface antigen (HBS Ag) and to phytohemagglutinin, by dinitrochlorobenzene sensitization and by response to skin-test antigens.  Although absent during acute Type B hepatitis, lymphocyte transformation by HBS Ag appeared during early convalescence and remained detectable for six years after recovery.  Patients with Type B chronic active hepatitis with increased serum transaminase levels showed a partial lymphocyte transformation with HBS Ag, whereas those with normal transaminase values demonstrated no transformation.  Patients with Type B chronic persistent hepatitis and carriers of HBS Ag did not have lymphocyte transformation.  Normal responses to dinitrochlorobenzene, intradermal skin tests and phytohemmaglutinin were found in all patients with acute, chronic active or chronic persistent hepatitis and carriers.  These results indicate that recovery from Type B hepatitis is associated with the ability to elicit a specific lymphocyte response to HBS Ag.


Internal medicine and family practice. Controversies, conflict and compromise.

Internal medicine and family practice have come into conflict because both specialties consider primary care to be part of their "turf". Moreover, in academic medical centers there is competition for scarce resources, including patients and support for residents. Analysis of the number of physicians in practice as well as in training shows clearly that both internists and family physicians, as well as pediatricians and obstetricians, must participate in rendering primary care if the needs for this type of physician are to be met.  Internal medicine also has to achieve a better balance between generalists and subspecialists, and family practice must define its limitations, monitor its rapid growth and assure the quality of its training programs.  Most of these problems are internal to each speciality rather than between two specialties, and, where there is conflict, compromise is clearly possible.


Chenodeoxycholic acid treatment of gallstones. A follow-up report and analysis of factors influencing response to therapy.

We treated 70 patients with gallstones with chenodeoxycholic acid over 3 1/2 years and analyzed the factors influencing the outcome of therapy. This treatment was unsuccessful in 11 patients with radiopaque gallstones and in seven with nonfunctioning gallbladders, but 64 per cent with radiolucent gallstones treated for six months or more showed partial or complete gallstone dissolution, and of those whose bile became unsaturated with cholesterol, 100 per cent had evidence of dissolution. In patients with partial or complete gallstone dissolution, the mean post-treatment biliary cholesterol saturation index--0.78 +/- 0.04 (S.E.M.)--was significantly less (P less than 0.001), and the dose of chenodeoxycholic acid (14.4 +/- 1.0 mg per kilogram of body weight per day) significantly more (P less than 0.025) than in those whose gallstones did not change (1.15 +/- 0.04 and 10.6 +/- 1.2 respectively). In patients with radiolucent gallstones, the dose of chenodeoxycholic acid should be based on body weight; 14 to 15 mg per kilogram of body weight per day effectively lowers the saturation index and dissolves gallstones.


The occupation of fishing as a risk factor in cancer of the lip.

To study the role of commercial fishing and related factors in the development of lip cancer, a project that included a case-control study and a cohort analysis was undertaken in Newfoundland. Household survey data were linked with cancer-registry and census data. In comparison with other males, fishermen had a probability of development of lip cancer that was 1.5 times higher (by the case-control method, P less than 0.05) or 4.4 times higher (by cohort analysis, P less than 0.001). Despite the effect of pipe smoking, "outdoorness" and age on the development of lip cancer in general, the occupation of fishing was an additional, independent contribution to the risk. Unexpectedly, using the mouth as a third hand to handle tar-coated nets seemed to protect fishermen from the disease. It was not possible to attribute the higher risk to a particular work activity, nor was a specific responsible carcinogen identified.


Electromagnetic bougienage to lengthen esophageal segments in congenital esophageal atresia.

Some cases of esophageal atresia, either with or without tracheoesophageal fistula, are not suited for primary anastomosis. To avert the need for colon interposition in two such infants, intermittent electromagnetic force was used to pull together "bullets" placed in the esophageal ends. This method elongated and enlarged the esophageal segments enough to accomplish their anastomosis later. This approach appears feasible to use for infants whose esophageal malformation does not permit primary repair. It may also be applicable to cases of imperforate anus with a hight pouch.


[Cryptococcosis in Venezuela. Comments on a clinical case with unusual location].

A tumor like case of Cryptococcosis with a rare location in the abdomen of a young healthy woman is commented. It gave the opportunity to refer to the pathogeny of the disease, making in that way a brief review of the cases known in Venezuela and some not still published from which we got information. That review showed that generally doctors found more frequently organic lesions within the fields they are specially working for. It is obvious that mycosis must be considered in the diagnosis of nearly every patient in many countries and that laboratories must get appropriate equipment and personnel to help in that diagnosis.


Growth responses of two phytopathogenic fungi to fernasan in culture media.

The toxic effect of fernasan (containing 25% thiram) was tested on Rhizoctonia solani and Fusarium solani in liquid and agar media. The fungicide was more effective in liquid (at 100 p.p.m.) than in solid media, where 400 p.p.m. checked the growth of R. solani, but was ineffective against F. solani. Both fungi exhibited a zone of inversion growth in liquid culture whereby certain intermediate concentrations were less inhibitory than lower or subsequently higher doses. Similar reaction was recorded for F. solani alone in fungicide-containing agar media. Sclerotium formation by R. solani was highly significant, in relation to controls, at 40 p.p.m. The abundance of chlamydospores of F. solani was coupled with cessation of conidium formation increasing fernasan doses.


Penetration of Trichophyton terrestre in human hair.

The systematic human hair degradation by Trichophyton terrestre was examined by electron and light microscopy. The cuticular and hair shaft regions were readily decomposed by the wild type or parent strain selected for phenotype studies after exposure to spaceflight parameters.


[Microflora of the atmosphere in the city of Trujillo (Peru). III. Genera isolated during the year 1971].

There were 1762 fungi isolated from the atmosphere of Trujillo city (Peru) during the year 1971. These isolants belonged to 23 genera of fungi. The most frequently isolated were: Cladosporium, Penicillium, Fusarium, Stemphylium, Alternaria, Helminthosporium, Aspergillus and Tilachlidium. Nine genera are reported for first time from the air of the city (Tilachlidium, Cephalosporium, Mucor, Aureobasidium, Hormiscium, Trichoderma, Stachybotrys, Paecilomyces and Fisidium). Six genera may be alergenic for asthmatic patients of Trujillo city.


Paracoccidioidomycosis with palpebral and conjunctival involvement.

A case of pulmonary and lymphatic paracoccidioidomycosis followed by conjunctivo-palpebral involvement is studied in Sao Paulo (Brazil). The Brazilian literature is reviewed. The most frequent clinic forms of ocular lesions in natural infection are described. The small number of human cases observed is discussed. The severity and frequency of ocular lesions in experimental animals, intracardiacally inoculated with P. brasilensis cultures suggest haematogenic ocular dissemination of the fungus, which may occur in the septicemic stage of the human paracoccidioidomycosis.


[Study on a Trichophyton quinckeanum species with a distinctly marked fluorescence of the scutulum in animal experiments].

A vesicular skin lesion which existed since 1 week in the lower part of the leg of a 45-year-old woman appeared to be caused by fungus which was identified as Trichophyton quinckeanum (Zopf) MacLeod & Muende. The patient could not state to have had contact with animals. Peroral administration of griseofulvin and local application of 2% salicyl--5% sulfur--vaseline alternate with tonoftal cream healed the lesion completely. The fast growing fungus produced white, convoluted colonies with a brown, lat er wine-red reverse. Globose and club-shaped, one- and two-celled microconidia were formed especially 'en thrse'. The majority of the thin-walled macroconidia had rounded apices but a fusiform type of spore was also seen. Germination of the macroconidia was frequently observed. Experimental infection into the dorsal skin of white laboratory mouse produced a scutulum with a bright yellow later green fluorescence in Wood's light. The taxonomy of Trichophyton quinckeanum is briefly discussed.


[Toxin production by Fusarium species and occurrence of the toxins in agricultural products].

In rainy autumnal weather and unfavourable storage conditions, certain agricultural products may be severely infested with Fusarium species also in Hungary. Since 1970 the authors have detected more than 200 Fusarium infestations in maize, wheat and mixed fodder. The Fusarium toxins were detected thin-layer chromatographically after extraction with chloroform and purification by means of solumn chromatography. Apart from F-2 (zearalenone) which is the most frequent toxin, other ultraviolet active toxic compounds were disclosed. Of the latter, the compounds F-3 and F-4 were isolated; their infra-red spectra were determined. From the results obtained, it may be concluded that these compounds have structures which resemble that of zearalenone and that they produce toxic effects.


[Isothiocyanate and vinyl thio-oxazolidone contents of rape seeds and rape seed oil].

Comparative studies on the isothiocyanate content of rape-seeds and rape-seed oil show that, apart from nearly 300 mg/100 g of vinyl thio-oxazolidone, rape-seeds contain almost 200--300 mg/100 g of isothiocyanates of which 3-butenyl isothiocyanate and 4-pentenyl isothiocyanate (ratio of 4:1) are the main components as evidenced thin-layer and gaschromatographically. Only about 1 mg/100 g of isothiocyanates are found in pressed rape-seed oil; and but circa 10 mg/100 g, in extracted rape-seed oil. 3-Butenyl isothiocyanate and 4-pentenyl isothiocyanate (ratio of 4:1) are once more the main components. Thioglycerides are not detected in the oil. Vinyl thio-oxazolidone is found only in extracted rape-seed oil (about 2 mg/100 g).


[Behavior of fat constitutents during refining. 8. Determination of polymeric fatty acids in rape seed oil and their behavior during refining].

1. Studies on rape-seed oil have shown that the determination of oxypolymers by means of the method according to Rost (determination of fatty acids insoluble in petroleum ether) yields unsatisfactory results. By way of contrast, the gravimetric determination (after isolation of the polymers via the non-urea adduct fatty acid methyl esters and thin-layer chromatographic separation), as proposed by the authors, permits to obtain results of good reproducibility and to determine thermopolymers and oxypolymers separately. 2. During the refining of rape-seed oil, it was observed that its polymer content decreased considerably on bleaching, and increased on deodorizing.


Principles of protein-protein recognition.

The formation of the protein-protein interface by the insulin dimer, the trypsin-PTI complex and the alphabeta oxyhaemoglobin dimer removes 1,130-1,720 A2 of accessible surface from contact with water. The residues forming the interface are close packed: each occupies the same volume as it does in crystals of amino acids. These results indicate that hydrophobicity is the major factor stabilising protein-protein association, while complementarily plays a selective role in deciding which proteins may associate.


Chloroplast DNA from higher plants replicates by both the Cairns and the rolling circle mechanism.

The chloroplast DNA (ctDNA) from pea and corn plants contains both Cairns type and rolling circle replicative intermediates. Denaturation mapping studies with pea ctDNA molecules have shown that the rolling circles initiate replication at or near the site where the Cairns replicative intermediates terminate replication. These results suggest that the rolling circles are initiated by a Cairns round of replication. A model for the replication of the chloroplast DNA is based on these results.


Prejunctional effects of a purified toxin from the scorpion Tityus serrulatus: release of 3H-noradrenaline and enhancement of transmitter overflow elicited by nerve stimulation.

The effects of a purified fraction of the venom of the Brazilian scorpion, Tityus serrulatus, were studied in isolated guinea-pig atria previously labelled with 3H-noradrenaline. Exposure to 0.3 and 1.0 mug/ml of the scorpion toxin resulted in a long lasting positive chronotropic effect which was concentration-dependent. The increase in atrial rate coincided with an enhancement in spontaneous outflow of radioactivity. The increase in outflow of radioactive products elicited by exposure to 1.0 mug/ml of the scorpion toxin was approximately 3-fold. 3H-noradrenaline accounted for 60% of the total increase in outflow of radioactivity elicited by the scorpion toxin and the 3H-deaminated glycol (3,4-dihydroxyphenyl-glycol) represented the main metabolite formed, accounting for approximately 35% of the total release. 20 min after exposure to 1.0 mug/ml of the scorpion toxin the overflow of the labelled transmitter elicited by accelerans nerve stimulation (4 Hz, during 60 sec. supramaximal voltage) was increased 8-fold. This effect of the scorpion toxin appears to be unrelated to inhibition of neuronal uptake, block of alpha-adrenoceptors or stimulation of beta-adrenoceptors. Consequently, in addition to releasing noradrenaline, the scorpion toxin enhances transmitter overflow elicited by nerve stimulation through a prejunctional effect which appears to reflect a nove mechanism of action.


Selective inhibition by hydrocortisone of 3H-normetanephrine formation during 3H-transmitter release elicited by nerve stimulation in the isolated nerve-muscle preparation of the cat nictitating membrane.

The metabolism of 3H-noradrenaline released by nerve stimulation in the isolated nerve-muscle preparation of the cat nictitating membrane was determined under control conditions and in the presence of hydrocortisone, 28 muM, a concentration which inhibits the high affinity extraneuronal uptake of noradrenaline in this tissue. In the controls the main fraction in the overflow elicited by stimulation at 10 Hz during 2 min was the deaminated glycol, 3H-DOPEG (3,4-dihydroxyphenylglycol), which accounted for 45.2 +/- 2.96% of the total radioactivity. Under these conditions, 3H-noradrenaline represented 30.8 +/- 1.92%, while 3H-normetanephrine accounted for 14.5 +/- 0.94% of the total overflow of radioactivity. During exposure to hydrocortisone there was a selective inhibition in 3H-normetanephrine formation from 3H-noradrenaline released by stimulation while the other fractions were not affected significantly. In contrast to these results, there were no changes in the spontaneous outflow of 3H-normetanephrine during exposure to hydrocortisone. The results obtained support the view that 3H-normetanephrine in spontaneous release originates from the activity of prejunctional catechol-O-methyltransferase. On the other hand, 3H-normetanephrine formed during transmitter release elicited by nerve stimulation is due to the activity of extraneuronal catechol-O-methyltransferase. Access of 3H-noradrenaline released by nerve stimulation to extraneuronal catechol-O-methyltransferase is mediated through the high-affinity, hydrocortisone-sensitive extraneuronal uptake mechanism.


Inhibition of gluconeogenesis in rat renal cortex slices by metabolites of L-tryptophan in vitro.

The inhibitory effects of metabolites of L-tryptophan on gluconeo-genesis in rat renal cortex has been established. 1. Glucose production was inhibitied by quinolinate in vitro. The inhibition is due to the decreased phosphoenolpyruvate carboxykinase activity. As suggested for purified enzyme systems, quinolinate seems to exert its action in tissue slices by chelating divalent metal ions. The minimum effective extracellular concentration of the inhibitor was 5 X 10(-5) M with pyruvate as a precursor for gluconeo-genesis. 2. The effect of 3-hydroxyanthranilate is stronger (minimal effective concentration 10(-5) M) than that of quinolinate. 3-Hydroxyanthranilate may be effective in its original form and/or as a dimer degrandation product. The compound(s) exert a second effect in addition to blocking the phosphoenolpyruvate carboxykinase. This block is attained by conversion of 3-hydroxyanthranilate to quinolinate. The non-quinolinate mediated effect may be due to a reduced ATP regeneration. 3. It is suggested that kidney cortex responds sensitively to disturbances in ATP metabolism by reduction of glucose synthesis, when it is not the result of blocked formation of phosphoenolpyruvate.


A solid phase radioimmunoassay for digoxin and its acylated derivatives.

A solid phase radioimmunoassay (RIA) is presented for the determination of digoxin and its acylated derivatives. In the procedure the antiserum is covalently bound to bromacetylcellulose. Therefore the free and the immunologically bound digoxin fractions can easily be separated by centrifuging. The radioactivity in the supernatant representing the unbound digoxin is proportional to the digoxin concentration in the sample. This modification of the RIA for digoxin is far more time saving than the separation procedure using dextran-coated charcoal as an absorbent; nevertheless both methods are equally sensitive, specific and reliable. The use of the solid phase assay is demonstrated comparing the bioavailability of various digoxin derivatives.


[Labyrinthine and extralabryinethine influences on the background activity of the spinal interneurons of cats during swaying].

Interneuronal activity in the spinal cord of cats was recorded extracellularly at the lumbosacral level during vestibular stimulation by rocking in the vertical plane. Cats with normal and destroyed labyrinths were used. Four types of interneuronal responses were observed during stimulation. Interneuronal responses to stimulations by rocking in animals with destroyed labyrinths were similar to those in intact animals, but far less pronounced. The results show that responses of spinal cord interneurons to acceleration are under great extralabyrinthine influences


[Characteristics of the reactions of the cochlear nuclei of bats to single and paired ultrasound stimuli].

Some discharge characteristics were investigated for response of certain neurons of the cochlear nuclei in Rhinolophus ferrum equinum to ultrasonic stimuli filling frequency within aecholocating range. Most neurons were found to have three spearated response areas, one in the 80-90 kHz frequency band (basic characteristic frequency) and two others-1/2 and 1/3 of the first one. The response areas included the inhibitory band, one of which was located higher than the basic characteristic frequency. Two other inhibitory bands overlapped with the complementary response areas. The sensitivity of neurons to the frequency of the stimulus increased when the characteristic frequency was changed from 90 to 80 kHz with maximal sensitivity at 80-80.5 kHz.


[Reflex mechanisms of interlimb interrelationships displayed in lumbar flexor centers of the cat spinal cord].

Interaction of segmental, propriospinal and spino-bulbo-spinal components of the lumbar flexor reflexes evoked by activation of the hind-and forelimb afferents with paired stimuli was studied in anesthetized cats. Coincidence in time of a reflex discharge evoked by stimulation of the forelimb afferent nerves with monosynaptic hindlimb flexor reflex causes considerable facilitation of the latter. The monosynaptic reflex increases for 40-50 ms. tthe polysynaptic flexor reflexes of segmental, propriospinal and spino-bulbo-spinal origin act upon each other in both a facilitatory and an inhibitory manner. Facilitation takes place only during the period of coincidence of the responses, inhibition when the responses are separated in time. Three types of inhibition with duration of 7-15, 40-150, 300-500 ms were observed. Possible neuronal mechanisms of interaction of the above-mentioned responses and their role in the inter limb interrelations are discussed


[Afferent impulse of fibers of the vagus nerve of cats using the method of coincidence of outgoing action potentials].

Tonic electrical activity of afferent fibres of intact vagus nerve was studied in cats using the method of coincidence of recorded action potentials. It was found that tonically active afferent fibres of the intact vagus nerve of the cat had conduction velocity 8-65 m/s. Two groups of fibres conducting the most intensive impulsation from the pulmonary stretch receptors were found. At the maximum frequency of the coincident oscillations the average conduction velocities in these two groups was 29.4 plus or minus 1.4 and 41.0 plus or minus 2.5 m/s. The frequency of oscillations was modulated by respiration.


[Conduction velocity and excitability of A and C fibers of the mesenteric nerve in the cat].

Conduction velocity and electrical excitability of mesenteric nerve fibres were studied in experiments on cats. These nerves were shown to consist of: 1) fibres with an excitation threshold of 0.06-0.10 V (stimuli duration being 0.1 ms) and with maximum conduction velocity of 48-85 m/s; 2) fibres with a threshold of 0.3-0.7 V and with conduction velocity from 8-10 to 33-39 7/s; 3) fibres with a threshold above 1 V and with conduction velocity from 1.8 to 7 m/s; 4) fibres with a threshold 6-8 V and conduction velocity below 1.8 m/s. The fibres of the first three groups are the afferent A-fibres. According to conduction velocity and wave amplitude in the compound action potential the fibres of the last group are divided into three subgroups. The first and third subgroups are shown to consist of afferent C-fibres; the second subgroup - of both afferent and postganglionic sympathetic C-fibres.


[Functional characteristics of electroreceptors (small pitted organs) of the dwarf catfish].

The response characteristics of the small pit organs in the catfish Ictalurus nebulosus to electrical stimuli of various polarities, intensities and durations were investigated using the recording of electrical activity from single nerve fibres of the lateral nerve. The fibres showed background activity either rhythmical (35-45 imp/s) or modulated by fish swimming movements. The current density thresholds were in a range of 10 minus 10 -10 minus 11 /mm-2. Electrical stimulation evoked a phasic-tonic response in the electroreceptor fibres. The latencies varied from 10 to 50 ms for on-responses and from 10 to 200 ms for off-responses. Certain units responded with excitation to strong cathodal stimulation, and with excitatory response to anodal stimulus of weak or moderate intensity. The properties of small pit organs and other electroreceptors are compared.


[Changes in the amplitude of evoked potentials of the cerebral cortex and characteristics of the associated fast oscillations].

A permanent decrease of the primary response in the external layers of the rat somatosensory cortex was observed to be connected with a considerable increase of the response in deeper cortical layers (0.5 mm and more). Fast oscillations were recorded only in the upper cortical layers. They varied independently of the primary response and were absent under nembutal anesthesia. Fast  oscillations were more stable to the surface application  of potassium choride. A separate source of such oscillations is suggested


[Influence of the hypothalamic nuclei on the electrical activity of neurons of the visual cortex].

Background and light-evoked activity of single neurons in the rabbit optic cortex was investigated before and after electrical stimulation of the anterior and posterior hypothalamic nuclei. No distinct reciprocity between the effect of the anterior and posterior hypothalamic areas on the optic cortex neurons was found. Long cyclic changes in the background rhythmic activity of the neurons were observed after stimulation of different hypothalamic nucleima modulating effect of these nuclei on the activity of the optic cortex neurons was also detected under conditions of retinal stimulation by repetitive light.


[Effect of thermal stimulation of the skin on the activity of the cat cutaneous nerve].

Impulse activity of single postganglionic fibres in the sural nerve induced by thermal stimulation of skin of the contralateral hind limb was studied in the cat. The frequency of the impulse activity of these fibres increased in response to cooling and increased or decreased in response to heating= It is supposed that the sural nerve contains not only vasoconstrictive but also vasodilatative fibres


[Selective reduction of the amplitude of the action potentials of neurons in the process of habituation].

Spike discharges of single neurons in the forebrain general cortex of the turtle were recorded extracellularly during habituation to light flashesmthe amplitude of spontaneous spikes, short-latent evoked spikes and spikes after the inhibitory pause was measuredmthe amplitude of short-latent evoked spikes significantly decreased during habtiuation while the background and postinhibitory spikes remained unchanged. It is supposed that the pattern of synapses activated by a definite stimulus may change the state of the elcetrically excitable neuronal membrane during habituation


[Intracellular perfusion of the giant neurons of snails].

The method is developed to perform intracellular perfusion of isolated Helix pomatia neurons. The cell is put under hydrostatic pressure into a pore in the plastic film separting the experimental chamber in two compartmentsmthe lower compartment is perfused with high-potassium solution that destroys the barrier properties of the lower part of the cell membrane. The upper compartment is oerfused with normal Ringer solution and the part of the membrane in contact with it demonstrates usual excitability; Replacement of the high-potassium solution in the lower compartment by a potassium-free one abolished the delayed outward current through the working part of the membrane indicating a free acess of ions to and from its inner surfacemthe investigated membrane maintains its excitability for several hours beeing perfused with the F- and PO4--salts of K+ and Tris


The primary cultures of animal ascites tumor cells growth in tubes in suspension as a model in the screening of antitumor agents.

By alternating in vivo-in vitro passage of NK/Ly ascitic tumor cells, a line of tumor cells was achieved which can be used for primary in vitro screening of antitumor compounds. Example is given from testing various known and new compounds.


Effect of D-glucosamine and D-galactosamine on the uridine nucleotide concentration in mouse myeloid tumor (Graffi) and myeloma MOPC-21.

The effect of D-glucosamine and D-galactosamine on the content of uridine nucleotides in myeloid tumor (Graffi) and myeloma MOPC-21 of mice was investigated in vivo. After treatment with aminosugars a marked decrease in UTP and UDP-glucose quantity was found. The trapping of uridine phosphates by formation of UDP-sugar derivatives was different in the two tumors and depended on the aminosugar employed. D-glucosamine provoked an increase in the UDP-N-acetylglucosamine pool size in myeloid tumor (Graffi) and myeloma MOPC-21. D-galactosamine administration led to formation of UDP-galactosamine and UDP-N-acetylglucosamine in myeloma MOPC-21, while in myeloid tumor (Graffi) an increase in the content of UDP-N-acetylglucosamine was obtained only.


Macromolecular antitumor agents from Chamaenerium angustifolium.

The antineoplastic substances isolated from Chamaenerium angustifolium, Chanerol, a macromolecular polyphenol, and its complex with polysaccharide, Chanerozan, have been studied in vitro in tests of haemagglutination, tumor cell agglutination, leucoagglutination and some others. The results obtained show Chanerol as a new phytohaemagglutinin (lectin) which has no group specificity for human erythrocytes (ABO system). As distinct from other lectins (proteins) Chanerol belongs to another chemical class (macromolecular polyphenols) and has no effect on lymphocytes in leukoagglutination and blast transformation tests. Both preparations have been shown capable of agglutinating tumor cells in vitro and revealed antitumor activity in the intravenous and intraperitoneal administration to mice with transplanted tumors. The toxicity of Chanerozan and its titre of human and mouse erythrocyte agglutination are considerably lower than those of Chanerol. Thus, judging by haemagglutination test Chanerozan behaves as a typical complex of agglutinin with concurrent sugar.


Antiproliferative effect of thymosterin on KB tumor cells in vitro and h 18 R tumor development in the new-born rat.

The authors report on preliminary data concerning the antiproliferative activity of thymosterin upon the growth of the KB tumor cells in vitro and in vivo. The experiments in vitro showed an intense antiblastic action of thymosterin, which was proportional to the administered dose. The preliminary results of the in vivo experiments suggest that inhibitory effect of thymosterin on the h 18 R tumor growth in newborn rats.


Antileukemic effect of L-aspartyl-hydrazine.

Beta-L-aspartyl-hydrazine can significantly prolong survival of the A mouse strain infected with a lymphatic leukemia sensitive to L-asparaginase. By combining the above substance with L-asparaginase even better results can be obtained.


Morphology of metastatic cancer of the fallopian tube in uterine cervix carcinoma.

Morphological examination of 452 Fallopian tubes removed together with the uterus for uterine cervix cancer revealed in 221 patients at the time of operation and in 5 dead on autopsy, metastatic cancer in 8 females (3.5%) in 12 tubes (right-side involvement 2 cases, left-side 2 cases, ambi-lateral 4 instances). In 37 patients there were metastases in inner organs; of these diseased 21.6% were affected by metastatic cancer of the Fallopian tube. Macroscopically, metastatic tumors were of different form in 4 cases; in the remaining instances they were only discovered on microscopical examination. In two cases the tubes were affected in their whole length, in the other case the tumor was located in the ampullary portion. The cyto- and histological structures of the metastatic cancer were the same as those of the primary uterine cervix tumor. The predominating route of tumor dissemination has proved to be lymphogenic propagation (5 cases). In two cases lymphohematogenic dissemination, in one case propagation by implantation were observed.


Value of lymphangiography in the diagnosis and treatment of lymphangioma.

On the basis of the author's own results and literary data emphasis is laid on the significance of lymphography for confirming or establishing a diagnosis, for determining the extent of a lesion and for proper considerations on indications for surgical treatment. Relymphography following a surgical intervention is capable of showing whether the latter had been successful and of revealing foci of recurrence. The case history bears on two histologically verified lymphangioma -- in the first case of the soft parts of the right leg, in the second of the soft part of the left thoracic wall, the armpit and the mediastinum. In both cases, relapse after repeated surgical interventions was verified by direct lymphography from superficial lymph vessels of the foot and the cubital fossa.


Iliac lymph nodes as a primary lymph center draining the testicles.

The visceral radioisotopic lymphography, as a new technic, reveals new possibilities to investigate the lymph system of the testicle. The testicular lymph center is regularly visualized at the level of the para-aortic lymph nodes. But in 16.9% of the patients, respectively in 10.8% of the examined testes, iliac lymph nodes are demonstrated as a primary lymph center, draining the testicle. A preoperative scintigraphic search can be made for every patient with testicular neoplasma in the intention to obtain a more correct determination of the stage, the prognosis and the proper treatment planning.


Dietary management of patients in chronic renal failure.

A new oral amino acid preparation was given to two groups of patients: group 1, five patients on hemodialysis; and group 2, five patients with chronic renal failure (CRF). In group 1 significant pre- and postdiet changes were: BUN 93-37 mg% (p smaller than 0.01); creatinine 13.0-9.7 mg% (p smaller than 0.001); phosphorus 6.6-4.2 mg% (p smaller than 0.05); uric acid 8.7-6.0 mg% (p smaller than 0.01); CO2 16.3-21.3 mEq/I (p smaller than 0.01); hematocrit 18.0-20.8% (p smaller than 0.05). In group 2: BUN 93-66 mg% (p smaller than 0.05); phosphorus 5.6-3.8 mg% (p smaller than 0.05); hematocrit 27.3-30.7% (p smaller than 0.05). Nitrogen balance was positive in all patients. It is concluded that this oral amino acid mixture is well-tolerated and can be utilized in CRF to attain protein anabolism.


Content and distribution of water and electrolytes in maitenance hemodialysis.

A group of patients whose dietary potassium was unrestricted and who received 12-18 h of Kiil dialysis twice weekly against a bath containing no potassium, had body potassium concentrations (total body potassium/intracellular volume) of 7.6% lower than normal. Despite marked hypokalemia at the end of dialysis, suprisingly few electrocardiographic changes were seen. Another group of subjects, dialyzed fro 5-6 h thrice weekly against a bath containing 1 mEq/liter of potassium in a Dow dialyzer, showed more marked electrocardiographic abnormalities despite smaller alterations in transmembrane potassium gradients. Rapidity of establishment of potassium gradients is important as well as magnitude. The following changes occur in a single dialysis: 100 mEq of cell potassium and 20 mEq of extracellular potassium leave the body; 100 mEq of extracellular sodium enter the cells and 415 mEq of extracellular sodium leave the body; 3.5 liters of water leave the extracellular fluid, 2.5 liters into the bath and 1 liter into the cells.


Protection against the impairment of renal function after intravascular coagulation in the rat kidney by increased ingestion of sodium chloride.

Rats were kept for 4 weeks on a dietary regimen with a low or high sodium intake to increase or reduce, respectively, the renin activity of the kidneys and plasma. Fibrinolysis was inhibited by intravenous injection of AMCA and thrombin was infused into the jugular vein, giving rise to heavy intravascular fibrin deposition in the kidneys. Shortly after the thrombin infusion the glomerular filtration rate (GFR) decreased equally in saline-loaded and normal rats. 48 h after the thrombin infusion the GFR was still markedly reduced in saline-deprived and normal rats but had returned to preinfusion values in the saline-loaded rats. The results might indicate that the renin-angiotensin system is involved in the presistence of the renal functional impairment after intravascular coagulation in the rat kidney.


The influence of ouabain on in vitro renin secretion and intracellular sodium.

Renin secretion has been hypothesized to be inversely related to the tubular sodium concentration or load. Using rat kidney cortex slices, in vitro renin secretion was measured as a function of sodium concentration of the medium. We found, as have many others, that renin secretion increases with increasing medium sodium concentration. However, in the presence of 10(-3) M ouabain, renin secretion decreased with increasing medium sodium concentration. We also found that intracellular sodium concentration varied directly with medium sodium both in the presence and absence of ouabain. Furosemide, a known renin stimulator in vivo, had no effect on renin secretion from tissue slices. Although obvious differences exist between in vitro and in vivo results, no simple relationship may exist between intracellular sodium concentration and renin secretion.