[Therapeutic action of S-adenosylmethionine in some chronic hepatopathies].

Albuminopoyesis, prothrombin activity, BSF clearance, bioptic and sometimes also laparoscopic pictures have been examined in order to test the hepatic activity of SAMe. This study has been carried out in patients suffering from liver cirrhosis and other chronic hepatites. The above-mentioned parameters proved to be significantly improved in almost all the 25 patients studied and checked after 30 and 60 days' treatment with 30-45 mg SAMe administered by slow intravenous route.


[On the therapeutic combination of S-adenosylmethionine with D-penicillamine in Wilson's disease].

After some general preliminary remarks concerning aetiopathogenetic hypoteses and therapeutic possibilities for Wilson's disease, the Authors report the data obtained from a long-term study carried out on a family of nine brothers. These subjects were all affected with Wilson's syndrome and kept under a D-penicillamine treatment. The addition of 4-5 oral adminstrations a day of 30 mg SAMe resulted in highly significant favourable modifications of all the laboratory data considered to test liver function. The progressive worsening of the same data observed after 60, 90 and 120 days from SAMe withdrawal, seems to prove the actual activity of this molecule on liver function. During SAMe therapy no clinical and laboratory side-effects (macular and papular eruption, pruritus, neutropenia, thrombocytopenia, etc.) were observed while they were detectable in some patients treated with D-penicillamine alone.


[Technical modification of the endocardiac electrode catheter of the pacemaker for easy removal after long-term use].

In treating a.v. block by endocardial pacemaker, it is often necessary to remove the catheter electrode after a time. Usually this is tenaciously clamped to the endocardium. A simple modification has been made to the electrode to enable it to be removed easily, safely and completely.


[Histopathology of the liver in patients with severe burns. Preliminary biopsy study].

Liver histobiopsy was carried out in 21 patients with burns of from 25 to 75 percent, between the 2nd and 125th day following trauma. The most frequent type of lesion encountered was albuminoid degeneration and hydropic ballooning of the cytoplasm to the point that the parenchyma assumed a "vegetable" appearance. No steatosis intervenes until the 6th-8th day after the burn and where it was not present previously, is a sign that the patient's condition is worsening. Total, or nearly total, disappearance of glycogen from the sections is an indication that the patient is worsening; in effect in patients who died, biopsy carried out shortly beforehand revealed the extreme paucity of PAS-positive material in the hepatocytes.


[Contribution of gastroscopy with aimed biopsy to the diagnosis of early gastric cancer].

Gastroscopy was carried out in 320 patients with gastric cancer. In 35 instances, the tumour was located in the mucosa or barely extended into the submucosa. Diagnostic corroboration was obtained by means of biopsies conducted during the examination. Gastric fibroscopy can now offer early diagnosis of carcinoma of the stomach. A barium meal often fails to reveal these lesions, especially in the initial stages, nor can it indicate whether an ulcer is benign or a tumour. The fact that biopsy can be performed at the same time is of fundamental importance in determing whether medical or surgical management should be chosen.


The fever index: A technic for evaluating the clinical response to bacteremia.

The fever index, quantitative measure of the total amount of fever in degree hours, was determined in obstetric-gynecologic patients with bacteremia. Comparison of the mean fever index between those women with hospital-or community-acquired infections, those patients monitored or not monitored during labor, or by grouping of single organisms recovered by culture revealed  no significant differences. Bacteremia patients over the age of 40 had significantly more fever than those under the age of 40. Patients with postpartum with postpartum bacteremia following cesarean section had a mean fever index significantly greater than women who had vaginal delivery. The implications of these findings are discussed.


Death from pseudomembranous enterocolitis.

During the past 2 years at the Los Angeles County-University of Southern California Medical Center (LAC-USC), there have been 2 deaths from pseudomembranous enterocolitis. Each of these deaths occurred postoperatively in previously healthy women who received pronlonged antibiotic prophylasix. The implications of these poor therapeutic results are discussed. The distinctive clinical symptology of a patient with pseudomembranous enterocolitis is described, and current treatment recommendiations are presented.


Features of Turner's syndrome in women with polycystic ovaries.

Four women with phenotypic features of Turner's syndrome and with poly  cystic ovaries (PCO) are describe. In addition to  the phenotypic features, Case 1 had primary amenorrhea and small PCO, Case 2  had a 46, XX/45, X karyotype (lumphocytes), Case 3 had enlarged PCO  which contained a  decreased number of oocytes, and Case 4 had enlarged PCO and was short in statute. These cases support the concept of a relation between PCO and the X chromosome. Some PCO may represent an intermediate condition in a spectrum that extends from the streak gonad of Turners syndrome to the normal ovary. Evidience for X chromosome involvement in PCO is summarized. The concept is advanced that at least some cases of OCO may be due to X chromosomal factors causing an abnormal follicular appartus.


Influence of prostaglandins F2alpha and E1 on vaginal contractility.

Sixty strips of vaginal wall obtained from 20 nonpregnant women (12 in the proliferative phase and 8 in the secretory phase of the menstrual cycle) were studied in vitro. Described and illustrated are 1) their spontaneous contractility, 2) enhancement of this by prostaglandin F2alpha, epinephrine, and  norepinephrine, and 3) de novo induction of contractions by these agents. Contractility was inhibited and suppressed by prostaglandin E1, and after such suppression of norepinephrine-induced contractions they could not thereafter be reestablished by norepinephrine. The physiologic implications of these findings for the processes of reproduction are discussed.


Cysts of the  vagina: Classification and clinical correlations.

The clinical and morphologic features, as well as the classification, of surgically excised cysts of the vagina were reviewed. Sixty-four cysts were available for study. Classification was principally along developmental grounds, based on histologic and histochemical features of cyst epithelium. Detection of epithelial mucus production reduced significantly the incidence of Gartner's duct (mesonephric) cysts, indicating that this is an uncommon lesion. Cysts of mullerian origin, lined mainly by endocervical and occasionally by fallopian tubal epithelium, comprised one-third of the cases. Inclusion  cysts of surface mucosa constituted the most common, but usually a clinically insignificant, type of vaginal cyst. Dilation of paraurethral glands and ducts could not adequately explain all the several cysts lined by urothelium. These lesions were difficult to distinguish on clinical grounds, alone, although mullerian cysts were nor symptomatic, due to their greater size.


Malignant melanoma of the vulva: A report of 44 cases.

Forty-four cases of melanoma of the vulva are reviewed. A leveling system comparable to that of Clark's (in cutaneous melanoma of nongenital origin), is described. Survival appears to be directly related to depth of invasion, with no patient with a Level II lesion succumbing to disease. Minimal therapy recommended is radical vulvectomy with bilateral inguinal-femoral node dissection.


Relevance of microinvasion in carcinoma of the vulva.

Retrospective analysis of 22 cases of Stage I invasive carcinoma of the vulva showed 11 cases in which the depth of tumor invasion was 5 mm or less. All of these patients were treated with radical vulvectomy and lymphadenectomy. In 3 cases positive groin node metastases were discovered. A fourth patient with minimal stromal invasion (less than 5 mm) was prospectively managed with vulvectomy alone and subsequently developed groin node metastasis leading to death from disseminated tumor. Depth of the invasion alone, therefore, is not a reliable indicator of the likelihood of groin node involvement, and lymphadenectomy should continue to be considered for all patients with invasive squamous cell carcinoma of the vulva.


Carcinoma of the cervix: A third treatment.

A selected group of 136 patients with Stage I squamous cell carcinoma of the cervix was treated in six naval hospitals during the period 1957-1965 using a three-stage combined radiation therapy and surgery protocol. Treatment consisted of two radium applications to the cervix, followed in 6 weeks by extraperitoneal lymphadenectomy. If the lymph nodes were tumor-negative, simple hysterectomy in 6 to 6 months completed the protocol. If the nodes were tumor-postive, a course of external pelvic irradiation  was given with midline shielding. The incidence of positive nodes was 9.6 per cent. Actuarial survival for all patients was 89.4 per cent, comparabale to the rate obtained by radical surgery or radiation alone. Postoperative and postradiation complications were minimal, with nourinary or bowel fistulas. There was no  operative mortality.


Lymphocytes in patients with ovarian cancer.

Studies  to determine the total number of circulating lymphocytes and their morphologic transformation in the presence of phytohemagglutinin and pokeweed mitogen were carried out in 156 women: 81 who currently had an ovarian cancer or who had had it in the past; 54 normal women; and 21 patients with malignant diseases. The latter two groups served as controls. The total number of circulating lymphocytes is an important cosideration, as there is a significant decrease of lymphocytes in patients with ovarian cancer, a factor with great bearing on prognosis. The lymphoblastic transformation test in the presence of phytohemagglutinin and pokeweed mitogen showed not only significant changes in patients with ovarian cancer but also a correlation with survival at 6 months.


Obesity: a maternal high-risk factor.

In reviewing maternal mortality in Minnesota over the last 10-year period, obesity proved to be a major high-risk factor to the parturient. In the following report 12 per cent of the study group weighed over 200 lb in the nonpregnant state. Pulmonary embolism was the leading cause of death in obese group. Obstetricians are encourged to recognize the possible complications that obesity poses in the pregnancy period.


Sclerosing stromal tumor of the ovary: A hormonal  and ultrastructural analysis.

Report on a case of sclerosing stromal tumor of the ovary with detailed pre- and postoperative hormonal analysis and an electron microscopic study of the tumors. The tumor was secreting both estrogenic and androgenic hormones. Ultrastructural studies have corroborated previous light microscopic findings on the variegated appearance of the tumor and the abundance of collagen among the cells and indicated that the tumor is functionally active and of ovarian stromal origin.


Adenoid cystic carcinoma of uterine cervix.

A 68-year-old postmenopausal patient with adenoid cystic carcinoma of the cervic is described. Thirty-two other cases were collected from the literature, and a clinicopathologic analysis for the whole group is presented. The study indicates that a) adenoid cystic carcinoma usually occurs in postmenopausal patients in the commonest presenting problems; c) vaginal cytology was abnormal in most cases in which it was reported; d) the lesion usually forms a mass and infiltrates parametrial and paracervical tissues; e) the tumor is frequently associated with squamous cell carcinoma (in situ or invasive) or other types of cancer; f) local recurrence after radical  surgery and /or irradiation, as well as pelvic and widespread metastases, can occur; and g) the histogenesis of this type of tumor is unclear. The various possibilities are discussed.


Effect of adrenal suppression  in gonadal gysgenesis.

Plasma steroids, estrogen, progesterone, and testosterone, and plasma gonadotropins FSH and LH were determined before and after adrenal suppression in an 18-year-old patient with gonadal dysgenesis (XX/XO). Total plasma estrogen was initially low (9.2 plus or minus 2.4 pg/ml) and did not change  after adrenal suppression. Plasma progesterone (380 plus or minus 18 pg/ml) and testosterone (236 plus or minus pg/ml) were in the range found in the normal follicular phase and fell to 50 plus or minus 17 pg/ml and 112 plus or minus pg/ml, respectively, after adrenal suppression. Mean levels of FSH and LH were unchanged after adrenal suppression. These results suggest that the adrenal may make a significant contribution to plasma levels of progesterone and testosterone in patients with gonadal dysgenesis and may also contribute to the plasma levels of these steroids during the follicular phase of the mensturual cycle.


Iliac artery aneurysm presenting as a complication of hysterectomy.

Aneurysms rarely presenta as a complication of hysterectomy. A case is reported of a left common iliac artery aneurysm causing readmission 2 weeks after total abdominal hysterectomy. The aneurysm remained undiagnosed prior to percutaneous rupture and subsequent laparotomy. The aneurysm was ligated and resected. No graft or arterial repair was attempted because of the infection that was  present. Twenty-three days after hysterectomy, the patient underwent above-the-knee amputation. A review of the literatureis undertaken and possible etiolgic mechanisms discussed.


Prepapillary metastatic abscess in a case of subacute bacterial endocarditis.

The case of a 49-year-old woman is described in which the presenting symptom of subacute bacterial endocarditis was the rare condition of a prepapillary abscess. There was a rapid decrease in visual acuity in the patient's left eye 10 days after the onset of an influenza-like episode, and ophthalmological examination revealed a pus-containing formation covering the optic disc, star-figure exudates in the macula, and some retinal hemorrhages with white centers. These findings in a patient known to have old valvular stenosis indicated a diagnosis of subacute bacterial endocarditis which was confirmed by further investigation. Both forms of endogenous primary retinitis were present in the same eye, i.e. (1) acute suppurative metastatic retinitis in the form of a prepapillary abscess and (2) subacute focal retinitis with the characteristic Roth's spots. Intensive antibiotic treatment was instituted, and within one month the prepapillary abscess was resorbed, with a parallel improvement in the general condition of the patient.


Relationship between monocular and binocular depth acuity.

Estimates of monocular and binocular depth acuity were obtained on two samples of subjects with adequate visual acuity and capacity for stereopsis. Both a method of average error and a modified method of limits were employed to secure the estimates. Eight ratios of binocular to monocular depth acuity ranged from 2.4:1 to 4.2:1 at a distance of 15 ft. The results contradict the familiar generalization that binocular depth perception is about 20 times as acute as monocular depth perception.


[Clinical use and action mechanism of propranolol].

Propranololum reduces the intraocular tension by inhibiting the production of aqueous humour. In about 50% of all cases the medicament, given as 1% drops, proves an effective anti-glaucomatous agent. Combined with adrenaline it is particularly effective and well tolerated.


A new indirect ophthalmoscope.

A hand-instrument is described, which serves the purpose of direct and indirect ophthalmoscopy. One part of the instrument, which may be used alone, is a direct ophthalmoscope; it comprises as a distinctive feature a mirror which is vertically movable. The other part is an attachment comprising magnifying lenses, a system for viewing the fundus periphery, a movable fixation target, a system for seeing the patient's eye, and a demonstration mirror. Both parts together form a light, easy-to-handle unit for monocular indirect ophthalmoscopy.


Scanning microscope observations of alcali-burned rabbit cornea treated with embryonic corneal homogenisates.

The process of epithelial regeneration of alcali-burned rabbit cornea was observed in control animals and in animals treated with bovine embryonic corneal homogenates using scanning electron microscopy. It was found that regeneration is more rapid when homogenate treatment is applied, but follows the same stages as observed in the control animals.


[Histological findings following experimental resection of the small intestine].

The small intestine remaining after resection of up to 50% of the small intestine in young rats was studied continuously in serial sections. Morphological changes in the area of the serous surface, the strength of the musculature, the number and length of villi per section and the surface index were scrutinized. Statistical evaluation and the discussion (with the results of authors who have been concerned with the same problem) showed that a true hyperplasia of the mucosa and of the whole gut wall with an increase in the number of villi occurs in animals with a resectioned small intestine. Thus it could be demonstrated that functional integrity is restored by morphological changes in the residual gut which are based on hyperplasia and hypertrophy.


[Problems of extensive resection of small intestine in newborn infants and infants].

Massive resection of the small intestine in neonates and infants is mostly necessitated as a result of atresias, stenosis or circulatory disorders. At this period of life, the term "sub-total resection of the small intestine" is not applied in a standard way. Most authors use it when the residual small intestine is 75 cm or less in lenght. The survival prospects after sub-total resection of the small intestine are determined not only by the absolute length of the remaining small intestine; it is important which part can be preserved. Distal resections lead to a particularly serious malabsorption syndrome. In ileal resections, lipid absorption is disturbed owing to the lack of absorption of bile acids. A chologenous diarrhea results. The absorption functions (which are largely eliminated directly after the operation) recover in a regular pattern. The more orally localized functions (carbohydrate) recover more quickly than the more distally localized (lipid absorption). Surgical measures to slow the passage of intestinal contents have been applied with varying success in animal experiments. Clinical experience is largely lacking (only five cases). Various mechanisms for compensation after extensive resection of the small intestine in neonates (increase in length of the intestine, mucosal hypertrophy or greater cell density) are being discussed. These are only occasionally observed and the factors on which they depend are mostly obscure.


[Surgical methods for adaptation of impaired absorption in cases of extensive resection of the small intestine in childhood].

Many surgical methods are available for slowing down the passage of food through the bowel to achieve better absorption in patients with extensive resections of the small intestine. Reversal of an intestinal segment seems to be the best procedure and has resulted in substantial experimental and clinical experiences. The author reviews the present state of knowledge with respect to surgical improvement of absorption. He also reports on his own experimental studies in which reversed segments of small intestine produced active slowing of passage with good mixture of chyme. For a prolonged period of time the short segments transport the chyme mixture upwards into the oral section of the bowel under low frequency, increased pressure and uniform muscle hypertrophy. To date 37 clinical cases have been published. The follow-up shows that the patients gained weight, their general condition improved and the time of passage increased. However, only five pediatric cases are reported in the world literature: of which 3 patients had a small intestine segment and two children a colon segment to achieve antiperistalsis. With one exception all children died in the postoperative phase. Death was not due to the surgical intervention. The use of an antiperistaltic segment is only indicated when the presently available means of parenteral feeding have failed or are inadequate. Segment reversal should never be used as primary treatment; segment length should not exceed 5 to 10 cm.


[Histological findings following experimental implantation of an antiperistaltic segment into the small intestine].

Implantation of a small-intestine segment turned 180 degrees has proved good for improving utilization of remaining residues of small intestine. We studied the histological changes after rotation of such a segment in young dogs and young rats. We found an increase in the diameter of the gut in the region of the rotated segment. The height of villi, the number of villi per section and the thickness of the tunica muscularis were substantially increased. Overall, the absorptive surface in the area of the rotated segment had significantly increased at the front and the back.


[Present-day situation with regard to the transplantation of the small intestine].

At the time of writing, seven transplantations of intestine in man have been carried out, three of these being in children. All the patients eventually died. The longest survival time was 75 days. The animal experiments on the various problems of small-intestine transplantation, tolerance of ischemia, preservation of transplants, section of lymph vessels and nerves and the problem of rejection are summarized with reference to the literature and the Author's own investigations. Transplantation of the small intestine is only justified if all the other possibilities have been exhausted. The Author attempted to lay down provisional guidelines on the indications for transplantation of the intestine. With the necessarily strict indications, the patients coming into question are likely to be rare and must be concentrated in a small number of specielized centers.


The lysosomal enzyme N-acetyl-beta-glucosaminidase in rabbit muscle following a period of ischaemia.

N-acetyl-beta-glucosaminidase activity increased in injured plantar muscle during the interval of 1 to 7 days after a period of 6 hours ischaemia of the rabbit hindpaw. Histochemical visualization demonstrated that this increased activity was not only associated with infiltrating inflammatory cells but also with the appearance of discrete lysosomal-like granules within damaged muscle fibres. Seven days after injury, the enzyme activity had reached a maximum with levels in the injured muscle 11 times higher than in normal muscle. The activity at this time was visualized in granules longitudinally arranged along regenerating muscle fibres, seemingly implicating the longitudinal sarcotubular system in their origin. Residual histochemical activity was evident at 14 and 28 days after injury. It is suggested that, in addition to its hydrolytic activity, N-acetyl-beta-glucosaminidase may have a role in the formation of mucopolysaccharides in the regenerative processes of muscle.


Small intestinal malabsorption of vitamin B(12) in iron-deficient rats.

Rats were rendered iron deficient by a combination of diet and bleeding to study its effects on vitamin B(12) absorption. Small intestinal loops were isolated in vivo and the absorption of -57Co-vitamin B(12) bound to a known quantity of intrinsic factor was measured. Iron deficiency resulted in the impairment of both uptake and transport of B(12). This malabsorption was corrected within 5 days by parenteral iron repletion. The findings were not due to a non-specific effect of anaemia since no correlation existed between haemoglobin levels and B(12) absorption in rats anaemic as a result of acute blood loss. No evidence was found for an altered small-intestinal microflora, bacterial counts being similar in iron-deficient and control rats. It is concluded that iron deficiency in the rat results in impaired absorption of B(12) by the small intestine, probably as a result of some defect produced in the enterocyte.


[A first description of the larva and additional information on the systematics of Eusimilium schogakii Rubz. (Diptera, Simuliidae)].

Eusimulium schogakii Rubz. was recorded from the USSR for the first time. The description of its larvae and some additional data on the taxonomy of males, females and pupae are given. The hatching sites, distribution areas and the pupation periods are indicated.


[The systematic position of mites of the genus Larinyssus Strandtmann (Gamasoidea, Rhinonyssidae), parasitizing gulls].

A study was carried out of the variability of mited colledted from 6 species of birds as follows: Larus argentatus Pontopp., L. minutus Pall., Gelochelidon nilotica Gm., Chlidonias leucoptera (Temm.), Ch. nigra (L.) and Sterna hirundo L. Structural peculiarities characteristic of the parasites of the above species have been revealed. The mites from St. hirundo were isolated into a distinct species, Larinyssus substerna sp. n., which is most close to L. sterna Fain, 1972. The new species differs from L. sterna in a smaller size of gnathosoma and chelicerae, lesser number of hypostomal setae and the presence of pigidial shields.


[Attacks of bloodsucking biting midges on birds in the forests of Prikam'ia].

63 nests of 11 species of birds were examined in the mid-taiga forests of Prikamje from 1971 to 1973. 710 specimens of midges were caught within this period. 8 species of midges attacked birds. Of them the most abundant was Culicoides cubitalis Edw. (62.8%). Rather numerous were C. sajanicus Mirz. (14.9%) and C. reconditus C. et P.-C (11.9%). The other species were few in number or rare. In closed nests C. reconditus C. et P.-C. (42.1%) prevailed. One fourth of caught females were with blood (26.9%). The highest per cent of engorged females was found in C. sajanicus Mirz. (58.3%).


Hypoxanthine as a measurement of hypoxia.

The hypoxanthine concentration in plasma was found to be a sensitive parameter of hypoxia of the fetus and the newborn infant. The plasma level of hypoxanthine in the umbilical cord in 29 newborn infants with normal delivery varied between 0 and 11.0 mumol/liter with a mean of 5.8 mumol/liter, SD 3.0 mumol/liter. Compared with this reference group the hypoxanthine concentration in plasma of the umbilical cord in 10 newborn infants with clinical signs of intrauterine hypoxia during labor was found to be significantly higher, with a range of 11.0-61.5 mumol/liter, with a mean of 25.0 mumol/liter, SD 18.0 mumol/liter. The plasma level of hypoxanthine in two premature babies developing an idiopathic respiratory distress syndrome was monitored. The metabolite was found to be considerably increased, in one of them more than 24 hr after a period of hypoxia necessitating artificial ventilation. The hypoxanthine level in plasma of umbilical arterial blood was followed about 2 hr postpartum in three newborn infants with clinical signs of intrauterine hypoxia. The decrease of the plasma concentration of the metabolite seemed to be with a constant velocity, as it was about 10 mumol/liter/hr in these cases. A new method was used for the determination of hypoxanthine in plasma, based on the principle that PO2 decreased when hypoxanthine is oxidized to uric acid.


The significance of circulating glycerol as a precursor of pulmonary phosphatidylcholine in the developing mammalian lung.

There is scant information regarding the contribution made by circulating precursors to pulmonary phosphatidylcholine synthesis in the developing mammalian lung. In situ pulmonary artery perfusions were performed in term New Zealand newborn rabbits with physiologic buffer containing either 3.6 mM or 10.8 mM glycerol. There was a twofold increase in nanomoles of glycerol-phosphatidylcholine synthesized at 30 min when the higher concentration of glycerol was used. Continuing with the higher concentration, a near three-fold increase was observed between the 30-min and 60-min perfusions. This data indicates that the de novo synthesis of pulmonary phosphatidylcholine is influenced by the concentration of glycerol in the perfusate as well as the duration of perfusion.


Sex differential of survival during perinatal period: an immunologic phenomenon?

The sex-differential early neonatal mortality experienced by a population of 27,243 neonates has been analyzed in relation to sex-related reproductive antecedents of their mothers. An association between the risk of dying of a neonate and the sex of previous pregnancies of its mother has been found: the risk decreases with a previous pregnancy of the same sex as the neonate, and increases with one of the opposite sex. Repeated pregnancies of same sex increase the phenomenon. An immunologic hypothesis has been formulated from these results: sex-differential survival of conceptuses during the perinatal period would be due to sex-differential conceptomaternal immunologic interactions. An advantage in survival of the female fetus results from these interactions in primiparous mothers. However, immunologic behavior of the mother is altered by previous contact with fetal antigens. Consequently sex-differential survival varies with sex-related antecedents of the gravida. Previous sensitization of the gravida by male pregnancy provides an advantage in survival for a subsequent male conceptus, and previous sensitization by female pregnancy provides an advantage in survival for a subsequent female conceptus.


Metabolic studies of transient tyrosinemia in premature infants.

The recently developed technique of gas chromatography-mass spectrometry supported by computer has considerably improved the analysis of physiologic fluids. This study attempted to demonstrate the value of this system in the investigation of metabolite patterns in urine in two metabolic problems of prematurity, transient tyrosinemia and late metabolic acidosis. Serial 24-hr urine specimens were analyzed in 9 infants. Transient tyrosinemia, characterized by 5-10-fold increases over basal excretion of tyrosine, p-hydroxyphenyllactate, and p-hydroxyphenylpyruvate in urine, was noted in five of the infants. Several infants had fluctuating levels of tyrosine metabolites in urine although dietary protein intake remained constant at 3-4 g/kg/24 hr and ascorbic acid at 50 mg/24 hr. Late metabolic acidosis was seen in four infants, but bore no relation to transient tyrosinemia. The ratio of net acid to urea excretion in urine increased with increasing base deficit, implying a nonprotein origin of the metabolic acid. No unique metabolic patterns were characteristic of late metabolic acidosis.


The effect of phenobarbital on asphyxia in the newborn monkey.

This study characterizes the circulatory changes associated with asphyxia in the newborn monkey and examines the effect of phenobarbital on asphyxia. The time to last gasp and duration of total asphyxia as well as heart rate at the start of resuscitation were the same in the phenobarbital-treated and untreated infants. Initial cardiac output was the same in both groups; there was a profound drop in cardiac output with asphyxia which was the same in both groups. Organs which preferentially receive a greater percentage of cardiac output during asphyxia are heart, total brain, and adrenal glands. Organs receiving a decreased percentage of cardiac output during asphyxia are kidneys, liver, and gastrointestinal tract. Cerebral hemisphere flow as a percentage of cardiac output is maintained during asphyxia, whereas paleoencephalon flow as a percentage of cardiac output increases significantly. These data confirm the circulatory redistribution of cardiac output in response to asphyxia described previously in the monkey fetus. The treated infants did not show the prolongation of time to last gasp reported in the monkey fetus; the dose of phenobarbital we used, although adequate to produce sedation, may have been too low to demonstrate the protective effect.


What constitutes adequate well-baby care?

Two hundred forty-six full-term, first-born well infants were randomly assigned to receive well-baby care during their first year in one of four ways: six visits by a physician; three visits by a physician; six visits by a pediatric nurse practitioner (PNP); or three visits by a PNP. One hundred sixteen of the study babies received care in a clinic setting and 130 in a private-practice setting. The adequacy of care rendered was assessed by measurement of gain in maternal knowledge important for competence in child-rearing, level of maternal satisfaction, degree of maternal compliance, and attainment of the health supervision planned. These endpoints were subjected to two-way and three-way analyses of variance to determine if there were differences across the setting, provider, or schedule variables. Essentially no differences were observed in the endpoints measured within settings between providers of care, between visit schedules, or between any of the provider and visit schedule combinations. These results indicate that well-baby care during the first year delivered by PNPs is as adequate as that delivered by physicians and the use of abbreviated visit schedules by either professional does not reduce the adequacy of care.


Respiratory infections due to Mycoplasma pneumoniae in infants and children.

Systematic monitoring of infants and children in a day-care center revealed infection with Mycoplasma pneumoniae to be more common than expected. Most of these infections were asymptomatic (74%) or associated with mild, nonspecific coryza and cough. Infected children ranged in age from 2 months to 8 years. Complement-fixing and growth-inhibiting antibodies in serum tended to wane rapidly and reinfection was detected in five children after one and one-half to 3 years. In vitro lymphocyte studies revealed antigen-reactive cells were detectable in few of the children under age 4, but thereafter lymphocyte reactivity was found in 53%. These findings suggest that recurrent, unsuspected M. pneumoniae infections occur during infancy and early childhood and that pneumonic disease, common above age 10 years, is an expression of increasing host immune response to the organism.


Fatal "iron heart" in an adolescent: biochemical and ultrastructural aspects of the heart.

Histochemical and ultrastructural aspects of the heart were investigated in an adolescent with fatal congestive heart failure resulting from exogenous hemochromatosis. Extensive iron deposits were found in all four chambers, papillary muscles, and the conduction system. These deposits were most prominent over the outer third of the left ventricular myocardium, with no significant difference between deposits in the middle and inner thirds. Quantitative analysis of iron from different chambers and all zones of the left ventricular myocardium confirmed the aforementioned pattern of iron distribution. Iron deposits in sinoauricular and atrioventricular nodes were similar to those in the right atrial myocardium. Degenerative changes and fibrosis were minimal. Ultrastructural studies showed that intracytoplasmic iron deposition followed a perinuclear, paranuclear, or diffuse pattern. In addition, some iron was consistently present in the nucleus and mitochondria. It is postulated that the presence of iron in the mitochondria may adversely affect the cellular enzyme system; this could provide a biochemical basis for myocardial dysfunction in patients with acquired iron-storage disease.


Reduction of gastroenteritis morbidity in high-risk infants.

A method of predicting infants at high risk for developing gastroenteritis was validated in a prospective study. The ability to predict a high-risk subset of the population is particularly important if risk can be reduced with preventive measures. Performance of a preventive educational task in the field by community health workers was associated with a significantly lower rate of morbidity from gastroenteritis among high-risk infants, while achieving no significant reduction among the average-risk group.


Acute necrotizing enterocolitis in infancy: a review of 64 cases.

Sixty-four cases of necrotizing enterocolitis are reviewed. The diagnosis was based on tissue examination in 57 and on the clinical syndrome, including pneumatosis, in 7. Three factors are important in the development of the disease: injury to the intestinal mucosa, bacteria, and feedings. The indications for surgical intervention are pneumoperitoneum, signs of peritonitis, and intestinal obstruction. The importance of stress in the etiology of the disease is confirmed by the high incidence of perinatal complications, particularly hypoxia. The mortality was high, but results are improving with the institution of early aggressive treatment.


Tine test compliance in a clinic setting.

Parental compliance in keeping a return appointment for the purpose of having their child's Tuberculin Tine test read was studied in the setting of a large urban pediatric clinic. This compliance rate was found to be 72%. Various factors which could potentially affect compliance with this procedure were examined, and the only factor which correlated significantly was family size. A modified system whereby parents read their child's Tine test in the home setting and reported the test results to the clinic by mail (a method used today in many pediatric outpatient departments) was implemented and evaluated. With this new system, the compliance rate increased to 90%.


The timing of tuberculin tests in relation to immunization with live viral vaccines.

The validity of the recommendation that routine screening for tuberculosis precede the administration of live viral vaccines was tested in a field study. One hundred and ten children already known to be tuberculin-positive, mostly on the basis of prior vaccination with BCG, were immunized with live viral vaccine and retested with tuberculin at the same time. Reversion to a negative tine test occurred in 3% of children given measles, mumps, or rubella vaccine, and 3.6% of controls who received no vaccine but had the tuberculin test repeated at the same interval. Very few Mantoux reactions (two of 68) reverted to negative in children given one of the three vaccines, singly or in combination; some became smaller, but there was no significant difference in the changes in the size of the Mantoux reaction between the vaccinated group and the control group, with the exception of an unexplained increase in the size of the reaction in many of those who received rubella vaccine. Screening for tuberculosis by tine or Mantoux test is not invalidated by simultaneous administration of vaccines against measles, mumps, or rubella, given singly or in combination, as part of preventive care programs.


A comparison of pediatric interviewing skills using real and simulated mothers.

In order to allay concerns about using simulators as opposed to real mothers for teaching and evaluating interviewing skills, a study was designed to test for differences in students' approaches when interviewing simulated and real mothers. Three mothers were trained to give their own children's histories consistently and two mothers trained to simulate a history. Thirty third-year medical students conducted two interviews which were audiotaped. Students were told the nature of the study and whether the mother was real or simulated. One half of the time the mothers were presented as simulators and one half of the time the simulators were presented as mothers. The variable of order was controlled. An objective checklist containing 70 to 80 bits of organic and personal data per case and an interaction analysis (with an average of 285 interactions per interview) were utilized to measure the content material gathered and the approach used by the students. The data were analyzed using an analysis of variance (ANOVA) technique. All but 1 of the 55 null hypotheses were accepted, i.e., no significant differences were found. The Use of Simulation for Teaching and Evaluating Interviewing Skills Provides a Valid Experience.


Aspects of communication between patients and doctors: an analysis of the discourse in medical interviews.

The transcripts of tape-recorded interviews of pediatric endocrinologists and patients with Turner's syndrome and their parents were reviewed in consultation with child psychoanalysts in order to evaluate certain aspects of communication between patients and doctors. The transcripts showed that the doctors often talked at cross purposes with the parents and their patients, evading emotional issues in favor of quasi-scientific explanations which the patients and parents did not understand. Parts of the discourse, at times unconscious, have been shown to be of great importance as means of communication. Reviewing the transcripts of the doctor-patients discourse is an excellent way of improving one's therapeutic communication with the patient. The same material can be used for teaching purposes.


Recurrence of skin disease in a nursery: ineffectuality of hexachlorophene bathing.

An outbreak of streptococcal and staphylococcal skin disease was discovered in a full-term nursery after the discontinuation of bathing infants with hexachlorophene. The epidemic was only temporarily controlled by conventional means and recurred despite reinstitution of hexachlorophene bathing. Measures that decreased infants' exposure to visitors and hospital personnel and enforced aseptic techniques in the nursery were more important than use of hexachlorophene soap in achieving and maintaining control.


Coarctation of the aorta in male cousins with similar maternal environmental exposure to insect repellent and insecticides.

Two male infants, whose mothers are sisters and whose fathers are unrelated, were born within two weeks of each other. Both infants had coarctation of the aorta. Since both mothers were exposed to an insecticide while on a camping trip in the first trimester of pregnancy, it is unknown whether genetic or environmental factors caused the anomalies. Observations should be made on other patients with congenital heart defects to clarify the etiologic factors.


Normal values for intercanthal distances of 5- to 11-year-old American blacks.

From measurement of the distances between the medial canthi, lateral canthi, and the pupils of 580 black boys and 639 black girls, we present values for these dimensions for 5- to 11-year-old normal subjects. With use of the cranial circumference, we also give normal values for two clinically used indices, the canthal and the circumference-interorbital. Compared with previously published standards, the intercanthal and interpupillary values for black boys significantly exceed those of white boys with only three exceptions involving interpupillary distance, and the values for black girls exceed those of white girls with just two exceptions, one each of the lateral canthal and interpupillary distances. Thus, we suggest that the measurements of a patient be compared with normal standards specific for race as well as age and sex. In contrast, values for neither the canthal nor the circumference-interorbital index of the blacks differed from values available for whites. Consideration of the position of eyes is relevant to the diagnosis of a large number of syndromes.


The effect of pyridoxine hydrochloride on blood serotonin and pyridoxal phosphate contents in hyperactive children.

The contents of serotonin (hydroxytryptamine) and pyridoxal phosphate (PLP) in the blood of 11 hyperactive children and 11 controls were determined on an outpatient basis. A significant decrease in serotonin content was found in blood samples from hyperactive patients as compared with controls. There were no differences in PLP content of blood between the two groups. Four children were selected for a study of the effects of pyridoxine hydrochloride (vitamin B6) on low serotonin levels. Oral doses of pyridoxine resulted in an appreciable increase in the serotonin content and a very large increase in the PLP content of blood in these hyperactive patients.


Plasma protein alterations in cattle suffering from acute peritonitis.

Modification of the normal plasma protein picture has been studied in plasma samples from cows suffering from spontaneously arisen (17 cases) or experimentally induced acute peritonitis (5 cases) using polyacrylamide electrophoresis. Considerable differences were found in the postalbumin region during peritonitis. One protein component increased in size, while another disappeared. Two weak components in normal samples were replaced by four discrete protein bands. These modifications were not detected in any of 10 plasma samples from cows suffering from other diseases than peritonitis or in any of 35 samples from clinically healthy animals. The modifications were visible 12-16 h after injection of the provoking agent and were remarkably alike from one case to the next.


[Hemagglutinating encephalomyelitis virus (HEV) infections in swine. Serologic indication for infectional occurrence in Denmark].

In 1956 a disease of nursing pigs previously unreported in Denmark, was observed in several swine herds. The disease syndrome appeared identical with that later described by Roe and Alexander in 1958 and by S. F. Cartwright and M. Lucas in 1968. Since 1956 there have been no reports of such outbreaks in Danish herds. To investigate whether the virus is still present, a survey was carried out to detect neutralizing antibodies in sera from a number of boars using a micro technique. In 144 sera from Jutland 12% had titers ranging from 10 to 32 ND-50, 22% from 32 to 90, 37% from 90 to 256, 14% from 256 to 724 and 3% above 724 ND-50 with a total of 86% positive. Of 174 sera from the rest of the country 16% had titers ranging from 10 to 32 ND-50, 18% from 32 to 90, 28% from 90 to 256, 13% from 256 to 724 and 3% exceeding 724 ND-50 with a total of 79% positive.


[Low milk fat syndrome in dairy cows. Field trial with potential fat content increasing substances (author's transl)].

In cases of low milk fat syndrome in dairy cows, in which no cause-factor could be found, a mixture of different potential fat content increasing substances was added to the feed, one group was fed 50 g NaHCO-3, 50 g MgO, 50 g urea and 100 g sodium bentonite mixed into 250 g of carrier per cow per day, while another group was fed the same mixture with sodium bentonite excluded. A third group was used as an untreated control. Fat content and milk yield were not positively influenced by these additives. The inclusion of sodium bentonite even seemed to result in a certain decrease of milk yield. In another similar trial, 150 g NaHCO-3 and 100 g MgO were fed, mixed into 250 g of carrier per cow per day. This improved the milk fat content when compared to an untreated control group. The increase was not significant. The milk yield, however, was significantly influenced by the addition. The yield increase in this trial was calculated to be approx. 2.0 kilos FCM per cow per day.


[A bacteriological investigation of Norwegian cod liver oil (author's transl)].

Samples of medicinal cod liver oil collected from four of the main producers in Norway have been investigated for content of microorganism. Viable counts for bacteria and fungi were found to be low. No coliform bacteria, coagulase positive Staphylococcus or Pseudomonas could be detected. The findings suggest that the main part of the flora found in cod liver oil belongs to the family Micrococcaceae. Several of the isolated colonies showed lipolytic activity.


[The effect of flame treatment on microflora and storage quality of chicken carcasses (author's transl)].

In the present investigation the effect of flame treatment on the microflora, storage time and organoleptic quality of chickens carcasses has been studied. The flame treatment had an immediate decimating effect on the surface microflora. This positive effect was observed throughout the storage period on chicken carcasses flame treated after exvisceration. The total bacterial count in this group was significantly lower both initially and in the end of the storage period compared to the bacterial counts in non treated chickens and chickens flame treated after exvisceration (F = 7.62, respectively, 7.67; df = 16). However, by organoleptic testing at the end of the storage period no significant difference could be observed between the groups.


[New data about oligoblastic leukemias. Apropos of an analysis of 120 cases].

We studied 120 aptients within the following condition: moderate bone marrow myeloblastosis (blast cells + promyelocytes less than or equal to 50 p. cent); quantitative and/or qualitative medullary insufficiency; preservation of maturation of the granulocytic line without a gap; WBC count less than 20 000/mm-3. Computer analysis pointed out the following results: 1. This group may be differenciated from the group of acute myeloblastic leukemias by: a) a predilection for subjects older than 60 in 73 p. cent of cases; b) male dominance in 70 p. cent of cases; c) a sharply defined improved prognosis with a median of survival of 15 months and with more than 30 p. cent of survivors for more than two years; d) death in 63 p. cent of teh cases is directly due to a complication of bone marrow insufficiency, and only in 14 p. cent of the cases is related to blastic invasion; e) a complete absence of favourable response to intensive chemotherapy. 2. There are five initial prognostic parameters which are of statistical significance: a) the hemoglobin level; b) the sedimentation rate; c) the platelet count, the level of bone marrow cellularity, and age. 3. Multidimensional analysis makes it appear that the whole population obeys a unidimensional phenomenon and depends on a common "biological axis" constituted by the five prognostic factors which are inter-related. 4. The disease nevertheless may be subdivided into three subgroups; a) High inflammatory hypoplastic forms are a very high risk group; b) The group of slowly invasive acute leukemias in young subjects is a bad or moderately poor risk group; c) The forms with a purely qualitative disorder of myelopoiesis with very low evolutive potential. These observations point to: a) The concept of OBL as an entity of a distinctive type including the preleukemic syndrome, the myelo-monocytic leukemias, and the smoldering leukemias; b) The concept of a unique and basic bone marrow disorder which embraces the OBL and the common acute myeloblastic leukemia.


[Value of retropneumoperitoneum in the exploration of Cushing's syndrome. 155 cases].

The study is based upon 155 cases of Cushing's syndrome and shows the diagnostic value ognosis of the suprarenal lesion responsible was possible. Bilateral suprarenal hyperplasia was always recognised with accuracy. Pneumoretroperituneum is the technique of choice for the surveillance of the therapeutic effects of synthetic anti-cortisols (especially O.P.'D.D.D.).


[Isotope-angiographic measurement of aortic flow velocity for differential diagnosis of aortic sclerosis].

The speed of flow between aortic arch and abdominal aorta was determined from the corresponding minimal transit time (MTT) measured with 113m-In-DTPA and the Fucks-Knipping gamma camera. A total of 144 individuals was examined: 62 normal persons, 34 patients with cardiac insufficiency; 31 patients with hyperkinetic syndrome (effort syndrome and hyperthyroidism) and 17 patients with isolated aortic sclerosis without impairment of cardiac function. In all individual groups there was a highly significant correlation between speed of flow and heart rate. For a given heart rate speed of flow was diminished in cases of cardiac insufficiency and aortic sclerosis; it was accelerated in patients with hyperkinetic syndrome. By plotting the speed of flow through the aorta, normalized to an arbitary heart rate, against the corresponding MTT, also normalized to the same heart rate, the presence of aortic sclerosis could be differentially recognized in 14 of the 17 patients with this disease.


[Minimal cardiac transit time in thyroid disorders and in the effort syndrome].

Minimal transit times (MTTs) were determined with the Fucks-Knipping gamma camera from differences between arrival times in consecutive cardiac compartments of blood radioactively labelled with 113m-In-DTPA Measurements were made on 50 patients with effort syndrome, 59 patients with hyperthyroidism before and after thyroid suppression therapy partly suffering from associated heart disease, and 25 patients with hypothyroidism before and after therapy with thyroid hormone. In patients with effort syndrome and hyperthyroidism, MTTs were often, but not always shortened below the control values; consequently, in case of associated heart disease, MTT-prolongation may be masked in such instances where hyperthyroidism causes MTT shortening. Hypothyroidism caused MTTs to be prolonged. The prolonged MTTs reverted to normal values upon adequate therapy with thyroid hormone.


Some aspects of the radiopharmaceutics of 99m-Tc-phytate.

This paper outlines the method of preparation of 99m-Tc-phytate and its use for scanning the reticuloendothelial system. The tissue distribution studies in mice and rats indicate that 99m-Tc-phytate is a safe and effective liver imaging agent. This was confirmed by preliminary studies in human subjects. The stability of the aqueous tin-phytate complex is remarkably good, and it could be successfully used for more than two months to prepare the labelled product.


[Proposal for an improved determination of liver size based on scintigraphy].

Using an own formula (VI) or the formula (VII) of Karran et al. for the determination of liver size from scintigrams, a good correlation was demonstrated to the measured weight in rats. Also the liver size of 44 healthy subjects estimated by the same method (VI) was compared to the ideal liver weight derived from the "Geigy Tables" and showed good correlation. This demonstrates the value of the proposed empirical formula: G equals 0.141 g/cm-3 D1 D2 D3 + 950 g for the calculation of liver weight using scintigraphy.


Evaluation of carbon-11 labelled phenylglycine and phenylalanine for pancreas scintigraphy.

Carbon-11 (t1/2 equals 20.4 min, beta-+) labelled DL-alpha-phenylalanine and DL-alpha-phenylglycine were administered intravenously to rats and the distribution of the radioactive amino acids over pancreas, liver, spleen, kidneys and blood was measured after several time intervals. From these results the ratios of the concentration in pancreas and liver were calculated and compared with the corresponding ratios from the literature for some 18-F-labelled aromatic amino acids and L-selenomethionine-75-Se. On the basis of this study it appears that DL-alpha-phenylglycine-1-11-C, in spite of a small percentage of the administered dose reaching the pancreas, and DL-alpha-phenylalanine-1-11-C are better suited to pancreas scintigraphy than L-selenomethionine-75-Se.


[Incorporation of a 131-iodine-deoxycytidine monophosphate protamine complex into the DNA of tumor-bearing rats following partial synchronization with hydroxyurea].

The incorporation of 131-Iodo-deoxyuridine in rat tumours can be increased by partial synchronisation with hydroxyurea. The reported investigation was carried out to determine whether the incorporation could be further increased by using a basic 131-Iodo-deoxycytidine-monophosphate-protamine complex as a depot of Iodo-deoxyuridine. It was shown that the incorporation observed after synchronisation could be increased by using this complex (non-synchronized tumours 1,46% retention, synchronized tumours 2,28% retention; measured 4 hour after the final injection of hydroxyurea) whereas in a control group injected with 131-Iodo-deoxycytidine-monophosphate alone, only a small increase was observed. The large increase in activity in the liver and in the spleen (liver: non-synchronized 2,76%, synchronized 2,79% retention; spleen: non-synchronized 3,00, synchronized 3,80% retention; measured 4 hours after final injection of hydroxyurea) which is observed after injection of the 131-Iodo-deoxycytidine-monophosphate-protamine complex renders it unsuitable for use in the scintigraphic detection of tumours. 131-Iodo-deoxyuridine is shown to be more suitable for this purpose.


The base-pairing specificity of cellulose-pdT9.

The stability of the interaction of oligoadenylates, containing single nucleotide substitutions, with cellulose-pdT9 has been studied by thermal elution. In the case of oligodeoxyriboadenylates, the replacement of an internal dA by dC, dG or dT caused destabilization. In the case of oligoriboadenylates, replacement of an internal A residue by C or U resulted in a significantly lesser destabilization. The results indicate that caution should be exercised in extrapolation of data on the specificity of deoxyribonpolynucleotide-deoxyribopolynucleotide hybridization to structure of the type deoxyribopolynucleotide-ribopolynucleotide.


Isolation and characterization of collagen messenger RNA*.

Chick embryo collagen-synthesizing polysomes were isolated by differential centrifugation. RNA  extracted from these particles was chromatographed in oligo(dT)-cellulose solumns and the mRNA thus obtained characterized as collagen mRNA by its electrophoetical mobility in acrylamide gels (equivalent to 1.05 x 10-6 daltons) and its effect upon a cell-free system derived from Krebs ascites tumor cells. The incorporation of 3H-proline was markedly dependent upon rabbit reticulocyte initiation factors and inhibited by initiation inhibitors such as aurintricaboxilate and pyrocatechol violet. The incorporation product was characterized as collagen by its lack of tryptophan, digestibility by purified bacterial collagenase, and by its co-chromatography with unlabled chick collagen in Sephadex G-200 and CM-cellulose columns.


Isolation and characterization of the DNA fraction of rat liver chromatin which binds polylysine.

The structure of eukaryotic chromatin has been investigated by isolating and analyzing the "accessible" DNA fraction of rat liver chromatin. This DNA fraction has been isolated by titrating the chromatin with the protese-resistant D isomer of polylysine to bind the "accessible" DNA sites. After removal of chromosomal proteins by digestion with pronase, all DNA not protected from attack by bound polylysine was removed by digestion with DNase. Even after exhaustive treatment with pronase and DNase approximately 30% of the chromatin DNA remains resistant to nuclease attack. Analysis of the isolated DNA shows it to be mainly double-stranded with an average size of 200-250 base pairs. The DNA is slightly A-T rich and contains both repetitive and "single-copy" nuleotide sequences. The results suggest that there are extensive regions in chromatin where the DNA is not tightly complexed with protein. Furthermore, the DNA of these regions is similar in gross properties to the DNA of the total genome.


Synthetic analogues of polynucleotides. (Part) XIV. The synthesis of poly (3'-0-carboxymethyl-2'-deoxycytidine) and its interaction with polyinosinic acid.

Poly (3'-O-carboxymethyl-2'-deoxyctidine) (VII) has been synthesised by the polymerisation of 3'-O-carboxymethyl-4-N-phenoxyacety-2'-deoxycytidine (V) and removal of the phenoxyacetyl groups under acidic conditions. V was obtained by the action of 2,4-dinitrophenyl phenylacetate on 3'-O-carboxymethyl-5'-O-triphenylmethyl-2'-deoxycytidine (III) followed by removal of the triphenylmethyl group under carefully controlled acidic conditions. The polymer, VII gave a hypochromic effect of about 20% at 250nm when mixed with poly (1) in 0.2Macetate, pH 5.0. It appeared, therefore, that a complex was formed. Upon heating a solution of this complex there was an initial decrease in optical density followed by a much larger increase to give a Tm of about 60 degrees. Attempts to form the 3'-O-carboxymethyl derivative of 4-N-phenoxyacetyl-5'-O-'triphenylmethyl-2'-deoxycytidine to give a shorter synthetic route to VII were not successful. 3'-O-Carboxymethyl-2'-deoxycytidine was obtained by removal of thetriphenylmethyl group from III. Attempts to polymerise this compound in concentrated aqueous solution with a water-soluble carbodiimide were not successful.


Isolation and characterization of casein mRNAs from lactating ewe mammary glands.

RNA from bound polysomers of lactating ewe's mammary gland directs the synthesis of the three major milk proteins (alphas, beta and kappa-caseins) in a cell-free system derived from rabbit reticuyocytes. The "in vitro" product was identified by immunoprecipitation with specific antibodies and by electrophoresis in SDS polyacrylamide gel. Each of these messengers was purified from 20 to 25 fold from total membrane-bound polysomal RNA using poly U-Sepharose chromatography. This purified fraction assayed in a reticulocyte cell-free system is able to direct also the synthesis of 2 minor secretory proteins (beta-lactoglobulin and alpha-lactalbumin). The messenger RNAs purified by hybridization to poly U-Sepharose have a sedimentation coefficient of about 12 S and an apparent molecular weight of approximatively 3.5 s 10-5 daltons was observed by polyacrylamide gel electrophoresis under denaturing contitions. This value which correspond to about 900 nucleotides is significantly greater than the number expected for coding milk proteins.


Stimulation of transcription of mouse kidney chromatin by sulfated polysaccharides.

The sulfated polysaccharides polydextran sulfate (PDS) and heparin stimulate in vitro transcription of mouse kidney chromatin by E. coli RNA polymerase by about 100 and 40 fold respectively. Heparin which has been N-desulfated and N-acetylated stimulates only 13 fold. Chondroitin sulfate B and heparitin sulfate do not stimulate transcription under similar conditions. PDS inhibits transcription of deproteinized chromatin. Therefore, the stimulation with chromatin is due to interaction with the chromatin and not the polymerase. Polydextran sulfate has no effect on the size of the RNA that is made either under conditions in which the enzyme can reinitiate or under conditions in which reinitiation is blocked. If reinitiation of the enzyme is blocked, the time required to complete the synthesis of the RNA is the same whether or not the enzyme is stimulated by PDS. These observations indicate that sulfated polysaccharides stimulate transcription by making available new RNA polymerase binding sites on the chromatin.


Ribosome-dependent conversion of polyA-containing heterogenous nuclear RNA into smaller RNA molecules.

The polyA-containing heterogenous nuclear RNA fraction separated from total rat liver nRNA by gel filtration on Sepharose 4B followed by affinity chromatography on polyU-Sepharose and containing predominantly the 45S components becomes enzymatically bound to homologous 80S ribosomes and polyribosomes at 0 degree C. If 80S ribosomes or polyribosomes with bound poly-a-containing HnRNA are subjected to a further incubation at 37 degree C, the original 45S RNA is gradually converted into smaller RNA species of 10- 35S which remain bound to the particle. This ribosome-dependent cleavage of larger HnRNA species into smaller RNA molecules may represent the ultimate step of mRNA maturation.


Isolation of endonuclease from mammalian cells by DNA - cellulose chromatography.

By means of DNA-cellulose chromatography an enzyme with endonucleolytic activity has been isolated from nuclear acidic protein fraction of mammalian cells. The main active fraction, eluted at 0.7 M NaCl, effects the velocity sedimentation of UV-irradiated and alkylated DNA, resulting in a decrease of the molecular weight. The fraction is completely inactive using native as well as heat-denatured DNA.


Conversion of covalently mercurated nucleic acids to tritiated and halogenated derivatives.

Mercurated nucleic acids are converted to the corresponding tritiated, brominated, and iodinated derivatives by treatment with sodium borotritiide, N-bromosuccinimide, and elemental iodine, respectively. All three reactions occur under mild conditions in neutral aqueous solutions. Mercury-halogen conversions are essentially quantitative at both the mono- and polynucleotide  levels. Tritiation reactions also proceed efficiently with mononucleotides, although polymers undergo incomplete demercuration. In spite of the latter limitation , these reactions provide novel and efficient synthetic routes to radiolabeled nucleic acid derivatives.


Peptidyl - tRNA hydrolase and RNase activities in cell fractions of rat liver used in in vitro reconstitution of rough membrane.

Peptidyl-tRNA hydrolase and RNase activities have been studied in those fractions of rat liver, which are used in in vitro reconstitution of rough membrane, because these enzymes may interfere with the in vitro reconstitution. It was found that smooth membrane has an active peptidyl-tRNA hydrolase, while the other fractions tested, polyribosomes, rough membrane, stripped rough membrane and the post-microsomal supernatant had no, or very low, peptidyl-tRNA hydrolase activity. Polyribosomes, rough and stripped rough membrane have RNase activity; this activity could be completely inhibited by rat liver RNase inhibitor. It is shown that RNase inhibitor is an obligatory component in in vitro experiments, in which rough membrane is reconstituted from stripped rough membrane, ribosomes and mRNA.


Metal ion-mediated specific interactions between nucleic acid bases of polynucleotides and amino acid side chains of polypeptides.

Interactions between copolypeptides containing Glu and Tyr residues and polynucleotides can be mediated through divalent metal ions such as Zn-2+ and Ci-2+. Circular dichroism studies show that the binding of metal ion - polypeptide complexes to poly(A) induces an unstacking of adenine bases. Fluorescence investigations demonstrate that Tyrosine - Adenine interactions result from the formation of ternary complexes polypeptide-Zn-2 plus-polynucleotide.


Physico-chemical study of the complexes of "33258 Hoechst" with DNA and nucleohistone.

The degree of binding of "33258 Hoechst" to DNA and nucleohistone has been determined by equilibrium dialysis and the properties of the complexes have been followed by different optical and electro-optical methods, after determining the orientation of the main transition moments within the dye molecule. The binding isotherm was found composed of a Langmuir-type and of a strongly cooperative component. The existence of two bound species yielded a continuous variation of most of the properties of the complexes studied as the amount of binding increased, while the hydrodynamic properties of the macromolecules were not affected. At low binding, the strongly bound dye molecules appeared to bind to highly fluorescent sites with their long axis oriented at 45 degree to the helix axis. As the binding proceeds, less fluorescent sites are cooperatively occupied and the inclination of these ligand molecules becomes closer to that of the base planes. These results are compatible with the formation of two external complexes with the double helical structure.


Studies on indomethacin acute toxicity and absorption.

Indomethacin can be found in several crystalline forms, of which only gamma is allowed in therapy. To determine the possible correlation between indomethacin crystalline form and its absorption as well as acute toxicity, a cycle of experiments was undertaken on mice and rats. Significant differences in toxic activity of alpha and gamma forms were stated in mice. In rats, however, no influence of the crystalline form on toxicity or absorption was observed.


The analysis of the hypotensive action of new piperazine derivatives in the experimental hypertension in rats.

The correlation of hypotensive action and chemical structure of some new piperazine derivatives was studied in normotensive rats and those with experimental hypertension. In the latter, all the tested derivatives, administered both once and repeatedly, appeared to have hypotensive action of various degree. In normotensive animals, there was no evidence of such action.


Inflammation and writhing syndrome inducing effect of PGE1, PGE2 and the inhibition of these actions.

The inflammatory and nociception inducing effect of PGE1 and PGE2, and the inhibition of these actions were studied. The inflammatory effect was produced in rat paw by intradermal injection of PG. Both PGE1 and PGE2 in doses of 500 ng produced maximal inflammatory and vascular permeability increasing effects. With higher doses these responses decreased. Antiserotonin, antihistamine drugs partly antagonized the above mentioned effects of PG.


Catecholamines concentration in brain and heart tissue of rats and its blood pressure during chronic treatment with a new tricyclic antidepressant 10-(3-dimethylaminopropyl)-7-chlorobenzo-(b), (1,8)-naphthyridone-5 monohydrochloride (IF-C-45).

DA concentration in brain tissue decreased statisticaly after 3, 6 and 9 weeks, NA concentration also statisticaly decreased but after 3 weeks only. The NA concentration in heart tissue decreased statisticaly significant in all investigated animals. There were no statisticaly significant changes in blood pressure.


New amidine derivatives of indole.

A series of new derivatives of indole of expected biological activity was prepared. Amidines 7 and 8 were obtained from the corresponding nitriles 3 and 4 and iminoethers 6.


Synthesis and properties of 7-hydroxyalkyl-8-benzylaminotheophyllines.

The synthetic routes leading to 7-beta-hydroxyethyl- (I) and 7-beta-hydroxypropyl-8-benzylaminotheophylline (II) were described. Particularly the opening of oxazolidine ring in easy available oxazolidine-(2,3-f)-theophyllines with benzylamine was investigated. The structure of I, II and acetyl derivatives Ia, Ib, IIa and IIb was also confirmed by UV spectra.


Piperazine derivatives of dimethylxanthines. III. 1-Piperazinoethyltheobromines.

1-Beta-Chloroethyltheobromine (CETb) heated with piperazine in the medium of 2-methoxyethanol yields N,N'-bis-(theobrominyl-1-ethyl)-piperazine dihydrochloride (IIb) or 1-piperazinoethyltheobromine (I). The use of N-methyl, N-beta-hydroxyethyl, N-ethoxycarbonyl and N-phenylpiperazine for exchange of chlorine in CETb lead to corresponding 1-N-alkyl or N-arylpiperazinoethyltheobromines (III--VIa) isolated in the form of salts. The preliminary investigations for diuretic and cardiovascular activity of the obtained compounds were performed.


Application of pyridinium salts derived of barbituric acid in Kröhnke's reaction.

A series of pyridinium salts derived of barbituric acid (BAC) was obtained, as starting substances in Kröhnke's reaction. On the example of 3-(1',3'-dimethyl-5'-isopropylbarbituryl-5')-1-acetonylene-N-pyrifinium bromide it was stated that the corresponding nitron can be formed only when in positions 1 and 3 of barbituric ring are no hydrogen atoms able to enolization. 3-(1',3'-Dimethyl-5'-isopropylbarbituryl-5')-pyruvic aldehyde (XIII) was obtained by decomposition of nitron XII.


The components of ethereal and methanolic extracts from the fruits of Celastrus tatarinovii (Rupr.).

The ethereal extract contains the glycerides of saturated: hexadecanoic, octadecanoic, tetradecanoic, dodecanoic and eicosanoic, and of unsaturated: octadecaenoic, octadecadienoic, octadecatrienoic acids. From the neutral fraction n-nonacosane was isolated beside to beta- and gamma-sitosteroles, a triterpene compound, crystalline mixture of unidentified compounds and amorphous substance with haemolytic properties. From methanolic extract five heterosides derivatives of kaempferol and quercetin were obtained.


Kinetics of drug decomposition. Part XXXVI. Stability of 10-(1'-methyl-4'-piperazinylpropyl)-phenothiazine derivatives on the grounds of kinetics of thermal degradation and Hammett equation.

Thermal degradation of aqueous and buffered solutions of perazine, prochlorperazine, trifluoperazine, thioproperazine, thiethylperazine and butaperazine salts was examined by kinetic method using an accelerated testing of pharmaceutical preparations. The order, rate constants and activation parameters (Q100, E, delta H not equal to, delta S not equal to, delta G not equal to ) of the reaction given were discussed. The predicted stability of the examined derivatives was compared on the grounds of a calculated time t10% and K293 kappa. A dependence between the stability and kind of substituent in the C2 positions was discussed in terms of the Hammett equation.


Flavonoids in the herb of yellow loosestrife (Lysimachia vulgaris L.).

Nine heterosides, derivatives of kaempferol, quercetin and myricetin from the drug were isolated. Six glycosides were identified, and the structure of the three compounds was established partially, one of these is triglycoside of quercetin, the other two are the higher-molecular glycosides of quercetin and myricetin.


Antimitotic activity of saponin fractions and extracts from RX. primulae, RX. saponariae and Sem. Hippocastani.

The strongest biological activity in the Allium test was shown by Rx. Primulae. The inhibition of the linear growth of the onion roots affected with the extract from 0-2 g of Rx Primulae in 100 ml of water (W0-2) and with the 0-05% solution (S0-05) of the saponin fraction after 24 hrs was about 70% of the blanc halves. The inhibition of mitose affected with W0-2 and S0-05 was 90% and 80% respectively.


Phytochemical examination of Vernonia flexuosa Sims. Part I. Isolation of 5,4'-dihydroxy-7,3'-dimethoxyflavone.

The isolation of the title compound (velutin) from Vernonia flexuosa Sims, and the elucidation of its structure are described.


Practical use of sex-maturity rating in adolescents.

We believe that the use of sex-maturity ratings as a routine part of physical examinations for adolescents is of value to all physicians caring for adolescents. The information is useful not only in following the growth of an individual patient but in detecting early abnormal patterns of adolescent development and also as a means of comparison with other adolescents. Because anaemia or a low haemoglobin-haematocrit value is a major concern during growth, we believe norms related to the sex, race, and maturity rating of an adolescent patient are of significant value. Caloric intake as well as dietary iron intake and percentage of transferrin saturation tend to increase with increasing maturity ratings and provide an indication for further evaluation if they are below the mean and standard deviation for the rating of maturity.


Comparison of injection techniques for soluble and protamine zinc insulins in diabetes mellitus.

Soluble and protamine zinc insulins were given to six insulin-dependent diabetic patients using three different techniques of administration to determine whether the recommended single injection of the insulins, from separate syringes with the needle redirected, compared more closely with separate injections or with a single injection from the same syringe. It was shown that the mixture of the two insulins in the same syringe resulted in both a significant loss of the initial rapid effect of soluble insulin and an increased protamine zinc action with the risk of late night-time hypoglycaemia. A single injection of the insulins, using separate syringes and redirecting needle, gave at least as satisfactory control of the 24-hour blood glucose profile as when they were given by separate injections.


Remission of active chronic hepatitis after treatment with cyclophosphamide and prednisolone. Report of four cases.

A description is given of four patients with active chronic hepatitis, all of whom were treated with prednisolone and cyclophosphamide. In all the patients diagnosis was established by the finding of a clinical picture of hepatic dysfunction associated with abnormal results of biochemical tests of liver function, evidence of disturbed immunity mechanisms and liver biopsy. After treatment  all four patients made a clinical recovery. Three eventually had normal serum tests for liver function, normal bromsulphthalein excretion tests and normal histology in their needle liver biopsies. The fourth patient has shown considerable improvement in her serum tests of liver function, but she has been treated for a much shorter period than the others. Her test results are still improving. It is concluded that the combination of prednisolone and cyclophosphamide therapy is a satisfactory one for active chronic hepatitis, and probably superior to other therapeutic measures based upon the suppression of autoimmune mechanisms.


The investigation and treatment of hyperlipidaemia in general practice.

An investigation was made into the incidence of type IIa hyperlipidaemia in two generations of a family in which there was a tendency to develop premature ischaemic heart disease. Forty-three per cent of those tested showed a lipoprotein abnormality characteristic type IIa hyperlipidaemia. Treatment of this condition, by dietary and drug therapy, was uniformaly successful. The importance of early detection of this condition by the general practitioner is emphasized, in view of the high incidence of premature ischaemic heart disease in such patients.


Common gastroenterological problems. III. Chronic benign gastric ulcer.

A gastric ulcer is a lesion which needs to be treated with respect and should be followed to a satisfactory conclusion. The barium meal is still the mainstay of diagnosis but the accuracy of this examination is considerably improved when a double-contrast technique is used. Endoscopy is of value both to check the radiological findings and in particular to obtain biopsy material for histological examination. When the diagnosis has been established surgical intervention may be indicated, but if a course of medical treatment is thought to be justifiable the patient's progress must be closely followed radiologically and surgery reconsidered if there is no convincing evidence of ulcer healing.


Common gastroenterological problems. IV.--Duodenal ulcer.

Duodenal ulcer is a common cause of dyspepsia. The clinical features are non-specific, and suspicion of this lesion requires confirmation with a barium meal, perferably using a double-contrast technique. Duodenoscopy and gastric-acid-secretion studies are helpful in selected cases. Medical treatment is essentially symptomatic but nevertheless remains perfectly acceptable to many ulcer suffers. Surgical intervention is usually necessary in the presence of ulcer complications, but careful assessment is required before recommending operation for a patient with an uncomplicated duodenal ulcer. This decision should be based predominantly on the severity and duration of symptoms.


The family doctor and the social worker.

Through cooperation with a social worker attached to his practice, a family doctor can obtain valuable help in coping with patients who present problems of marriage, parenthood, old age, bereavement, physical disability and psychiatric illness. This help does not replace that already available from existing services, need not interfere in the doctor-patient relationship, and increases the doctor's effectiveness.


Common gastroenterological problems. V.-Ulcerative colitis.

Symptoms such as diarrhoea and rectal bleeding are suggestive of ulcerative colitis but this diagnosis should never be made without confirmation by sigmoidoscopy and rectal biopsy and the possibility of infection excluded by stool culture and microscopy. A barium-enema is usually essential to assess the extent of the disease process. Treatment of the initial attack or subsequent relapses should be started as soon as possible and early referral to hospital is indicated, both for diagnostic confirmation and for therapeutic advice. The relapsing nature of the disease necessitates adequate follow-up and it should be possible for the patient to be seen at hospital with the minimum of delay. Most patients with colitis can be managed successfully by medical treatment, but occasionally emergency or elective proctocolectomy is indicated.


A survey of pelvic x-rays in the elderly.

Pelvic x-rays taken as a routine in 150 patients in a geriatric hospital revealed a considerable number of pathological conditions, many of which were unexpected. These included pathollgical fractures of the pelvic bones and femoral necks, calcification of the walls of the iliac and femoral vessels, calcified fibroids of the uterus, urinary stones, arthritis of the hip joints, metastases, osteomalacia, Paget's disease of pelvic bones and lumbar vertebrae, and degenerative arthritic chcnages in the lumbar spine. Routine x-ray of the pelvis is indicated in elderly patients admitted to geriatric hospitals.


Common gastroenterological problems. The irritable bowel syndrome.

The irritable bowel syndrome is one of the commonest conditions seen in gastroenterology clinics. The diagnosis is suggested by the presence of longstanding colonic symptoms without any deterioration in the patient's general condition but depends essentially on the exclusion of any underlying organic disease. Particular care is required before attaching this label to middle-aged and elderly patients presenting with bowel symptoms for the first time. The most important aspects of treatment are firm reassurance, a simple explanation of symptom production and sympathetic follow-up. Drug therapy plays a comparatively minor role although a variety of preparations are helpful in individual cases. Reinvestigation is rarely indicated unless the symptom complex changes or the patient loses weight.


Intranasal immunization with inactivated influenza virus vaccine in a boys' boarding school.

An influenza B epidemic which occurred in a boys' boarding school during the early part of 1974 is described; 41 per cent of the boys, 30 per cent of the masters and 38 per cent of the house masters developed influenza. The incidence of influenza was similar in all blocks in the school but variable in the boys' houses. The four-day half-term holiday which took place in the middle of the epidemic was of undoubted value in curtailing the spread of infection. Intranasal vaccination with a vaccine which did not contain specific protection against the subsequent epidemic was of slight benefit.


The efficacy of influenza vaccination in a boys' boarding school.

Vaccination against influenza of boys resident in a public school (Winchester College) was followed some months later by an outbreak of the disease at the school. Analysis of the sickness records of all the boys shows that vaccination prevented disease in a large number of the pupils, reduced peak temperatures in those who nevertheless contracted the disease, and led to a shorter illness than in the unvaccinated.


[Atypical Mycobacterias in Mexico. Incidence and epidemiology in a general hospital].

All the cultures for mycobacteriae taken from 1967 to 1973 at the Hospital General del Centro Médico Nacional del Instituto Mexicano del Seguro Social were reviewed. From 802 positive cultures, 361 (44.2 per cent) were atypical mycobacteriae. 89 per cent of them were scotochromogen, 10.3 per cent of rapid growth, one non-chromogen, and none were photochromogen. These data are in contrast with those observed in other countries. Isolation sources varied also from other reports, in this series the most common isolation were from urine specimens, sputum, feces and bone marrow. A possible explanation for that in this hospital there are very few pulmonary patients. The percentage of atypical mycobacteriae was greatest in the last two years. In bacterioscopic examination atypical micobacteriae were detected less frequently than M. tuberculosis.


[Retrospective analysis of 44 cases of amyloidosis].

To know the natural history and the several clinical manifestations of amyloidosis, were reviewed retrospectively 44 cases at the Hospital General, Centro Médico Nacional, I.M.S.S. We found the secondary type in 79 per cent, primary shape in 9 per cent and 2 per cent associated with multiple myeloma. The frequency was similar in both sexes and was greater between the fifth and sixth decade of life; 34 per cent of the patients were diabetic; the symptomatology corresponded in 90 per cent of the cases to the main pathology, and only 9.9 per cent of the cases it was secondary to the amyloidosis itself; the alterations of laboratory test were not specific. The organs involved in the cases of primary amyloidosis were: spleen (100 per cent), kidney (80 per cent), heart (80 per cent), digestive tract (60 per cent), and lung (60 per cent). In the secondary shape: spleen (56 per cent), liver (41 per cent), adrenals (23 per cent) and kidney (11 per cent). Death could generally be adscribed to intercurrent pathology.


[Elemental diet and external fistulae of, the digestive system].

An elemental diet is a food which provides the basic needs in calories, proteins, vitamins and minerals with two advantages: it is predigested and leaves minimal or no residue to provide bulk. The care of 20 patients, with an elemental diet, presenting 20 external fistulas (75 per cent with low output and 25 per cent with high output) succeeded to obtain a spontaneous healing in 75 per cent of the cases, and an improvement of the general conditions of 15 per cent of the patients who were operated on because of fistula persistency. The death rate was 10 per cent. We think that the elemental diet is a useful tool in the treatment of external fistulas of patients who have preserved their bowel movements and an output smaller than 500 ml. in 24 hrs.


[IgA multiple myeloma with osseous lesions (laryngeal plasmocytom)].

One case of myeloma IgA is presented. It was associated with laringeal plasmocytoma and other lesions that afected superior airways The association hypergammaglobuinemia IgA and extraosseus lesions are under discussion. The extraosseus plasmcytomas can be seen in the presence of osteolytic lesions of multiple myeloma, or can appear independently. The prognosis can be better in the presence of disseminated skeletical lesions with few manifestations of tisular infiltrate, as in the present case. Despite the fact that extramedular plasmocytomas are rare, they must be considered in the differential diagnosis of laringeal tumors.


Improved isolation procedures for the purple membrane of Halobacterium halobium.

Techniques for purifying teh purple membrane of Halobacterium halobium are given. This purple membrane contains a chromoprotein with a retinal prosthetic group similar to rhodopsin, the chromprotein found in the visual systems of higher invertebrates and vertebrates. The described purple membrane isolation procedures yield a highly purified preparation as determined by transmitting electron microscopy and gel electrophoresis. Critical analysis of the absorption spectra of the purple membrane was also employed to establish criteria of purity for the preparation. The visible absorption spectra of the purified purple membrane preparation in buffer was found to have a maximum at 559 nm which shifted to 567 nm on light exposure. No indication of any spectral perturbation arising from bacterioruberin-containing membrane, the major contaminant in purple membrane preparations, was found. Furthermore, the ratio of protein aromatic amino acid absorbance at 280 nm to chromophore absorbance at 567 nm was found to be 1.5 in light-exposed preparations compared to the previously reported ratio of 2.3.-3 The decrease in the value of this ratio is also indicative of an increase in the purity of the purple membrane preparation.


Leukocyte isolation by sedimentation: the effect of rouleau-promoting agents on leukocyte differential count.

The rouleau-promoting agents dextran and polyvinylpyrrolidone (PVP) were used to accelerate erythrocyte sedimentation in order to harvest the leukocyte rich plasma (LRP). The objective of the work was to determine if agent concentration or blood: agent ratio had any effect on the leukocyte differential count and if so at what agent concentration and agent:blood ratio did the LRP leukocyte differential count most closely match the whole blood leukocyte differential count. With both sedimentation agents the data clearly indicate that both parameters effect LRP differential counts and that low concentrations of sedimentation agents are most important in obtaining LRP differential counts which most closely match the whole blood differential counts.


[State of the cerebral circulation according to radiocirculographic data in patients with diabetes mellitus].

Cerebral circulation velocity was studied by the method of radiociruclography in patients (101) with various forms of diabetes mellitus.  There was revealed a decrease in this velocity in the majority (2/3) of these patients.  Early preclinical forms of affections of the vessels of the brain were revealed, and the degree of these changes was established.  This method permitted to detect an association between a disturbed cerebral circulation and the most frequent complication occurring in patients with diabetes mellitus (atherosclerosis and microangiopathies).


[Changes in the sensitivity of lipoatrophic tissues to insulin under the effects of novocaine].

A study was made of the isolated adipose tissue of 9 healthy women and the adipose tissue from the zone of lipoatrophy obtained from 7 women suffering from diabetes mellitus treated with insulin.  In difference to the adipose tissue of healthy persons, in the lipoatrophic adipose tissue there occurred under the effect of insulin-novocain mixture a marked increase in the incorporation of C-14-labeled glucose into the total lipids of the adipose tissue.  The data obtained served as an argument in favour of the neurotrophic genesis of the postinjection insulin lipoatrophies and proved the neuro-trophic mechanism of the therapeutic effect of the insulin-novocain mixture.


[Contractile function of the myocardium of the right ventricle in thyrotoxicosis].

The functional condition of the myocardium of the right ventricle was studied in 98 patients suffering from thyrotoxicosis and in 28 healthy persons.  The pressure in the pulmonary artery, the tension index of the myocardium and the frequency of cardiac contractions proved to increase against the background of an excess of thyroid hormones in the organism.  The contractility index of the myocardium, the volume velocity of the ejection, the rate of displacement of the wall of the ventricle during blood expulsion increased at the early stages of the disease, and later became lowered.  Under experimental conditions the initial period of thyoidin intoxication was characterized by increased work of the right ventricle.  The electron microscopic picture corresponding to this phase of the process pointed to the injurious action of the thyroid gland hormones on the mitochondria.  The greatest increase in the functional intensity of the myocardium of the right ventricle was reached on the 14th day of the experimental thyroidin intoxication.  The ultrastructural changes recorded at this period reflected the growing hyperfunction of the mitochondria and the development of destructive changes in the contractile aparatus of the myocytes.


[Cholesterol level in the blood serum and some indices of protein metabolism in patients with endemic hyperplasia of the thyroid gland of stages I and II in the presence of chronic foci of infection].

Chronic foci of infection, and primarily an inflammatory affection of the biliary system revealed in 58.3 per cent of persons with endemic hyperplasia of the thyroid gland of the I and II degree promoted an increase in cholesterolemia and caused a more pronounced (than in the absence of focal infection) reduction in the albumin level and increase in the blood serum globulin fractions.  Chronic foci of infection can be regarded as one of the causes of a change of endemic hyperplasia of the thyroid gland into endemic goiter and of the euthyroid state--into hyperthyroid.


[Effect of prednisolone on the vascular tonicity of patients with thyrotoxicosis].

In 118 patients suffering from thyrotoxicosis before and after the operation by the method of rheography a study was made of the effect of prednisolone on the stroke and minute volume of the heart, hydraulic resistance of peripheral vessels and the tone of the vessels of extremities.  Brief courses of prednisolone treatment (medium doses) before the operation and also after it promoted a more rapid normalization of the mentioned indices.  High doses of glucocorticoids prescribed under conditions of a thyrotoxic crisis also influenced the state of the systemic circulation favourably.  The data obtained showed that it was expedient to include short courses of low and medium doses of prednisolone into the complex treatment of patients with thyrotoxicosis and in case of developed thyrotoxic crises, to carry out massive hormonal therapy.


[Excretion of aldosterone in the urine, renin activity in the plasma and some indices of the metabolism of potassium and sodium in patients with the iodiopathic edema syndrome].

It appeared that urinary aldosterone excretion was increased in 23 of 35 patients with a syndrome of idiopathic edema.  The plasma renin activity failed to differ from the norm; consequently it can be supposed that the renin-angiotensin system played no significant role in the mechanism of hyperaldosteronism development in this form of pathology.  A negative sodium balance was revealed in some of the patients with an edema syndrome and hyperaldosteronism.


[Histochemical study of tanycytes in connection with the adrenocorticotropic function of the hypophysis].

Chronic experiments were conducted on sexually mature rats; histochemical study of the activity of some redox enzymes (glutamic dehydrogenase, lactic dehydrogenase, glucoso-6-phosphoric dehydrogenase, glycerophosphoric dehydrogenase, and succinic dehydrogenase) was carried out in the ependymal cells of the floor of the third cerebral ventricle, the so called tanycytes, in case of an increased adrenocorticotrophic function of the hypophysis attained by bilaterial adrenalectomy, and in depression of this function as a result of chronic dexametasone administration. The activity of the enzymes under study decreased 2, 3 and 4 weeks after bilateral adrenalectomy. The activity of lactic dehydrogenase, glucerophosphoric dehydrogenase and succinic dehydrogenase increased in the tanycytes during administration of 5 gamma of dexametasone. Chronic administration of 100 gamma of dexametasone was accompanied by a toxic action of the preparation (a marked reduction in the weight of the adrenal glands, a negative body weight gain, and an aggravation of the animal's general condition). The results obtained pointed to the existence of a reverse correlation between the metabolic activity of tanicytes and the adrenocorticotrophic function of the hypophysis.


[Incidence of diseases of the cardiovascular system in patients with diabetes during various types of therapy].

A study was made of the effect of the character of the sugar-reducing therapy on the incidence and the severity of diabetic angiopathies in 1365 patients treated at the clinics of Kiev and Kharkov Institutes of Endocrinology.  The character of the sugar-reducing therapy did not produce any significant effect on the indicence and the severity of the vascular affections in diabetes mellitus on condition of its compensation and with the consideration to the patient's age.


[Effect of prolonged feeding of glucose to rats on the levels of sugar and insulin in the blood and the activity of key glycolysis enzymes in the liver].

A study was made of the effect of food with a high glucose content given to albino rats for a long time on blood sugar and insulin.  Changes in the activity of hexokinase and pyruvickinase in the liver were also investigated.  Food with a high glucose content given to rats for 90--100 days led to an increase in the blood sugar and insulin level.  The activity of hexokinase and pyruvickinase rose markedly by the 40th--60th day of feeding, and fell to the initial level by the 80th--90th day.  Thus, in case of a prolonged action of insulin on the organism as a result of prolonged stimulation of the insular apparatus of the pancreas by glucose there developed signs of peculiar insulin-resistance.


[Experimental thyrotoxicosis under conditions preventin hyperlipacidemia].

Prolonged administration to rabbits of nicotinic acid was accompanied by a fall in glucogen level in the liver and hyperglycemia.  Consumption of O2 by the animals, their weight, and also the volume circulation along the main vessels and the pulse frequency remained unchanged.  Thyroidin administration to rabbits led to increase in the content of free fatty acids (FFA) in the plasma, reduction in the glycogen level in the liver and the myocardium a sharp fall in body weight of the animals, an increase of O2 consumption by them, tachycardia and an increase in the volume circulation.  A simultaneous administration of thyroidin and nicotinic acid blocked an increase in the FFA level in the plasma and led to a greater fall in the glycogen content in the liver, but failed to alter any other manifestations of thyrotoxicosis.  The authors concluded that the thyrotoxic hypermetabolism was independent of increase in the blood FFA level and their tissue oxidation.  Various mechanisms of the calorigenic effects of catecholamines and of the thyroid hormones are analyzed; it is supposed that hypermetabolism of any genesis had an increase of free thyroid hormones in the blood as the common final link of its development.


[Pathomorphological changes in the kidneys in experimental hypothyroidism].

Morphohistochemical changes were studied in the kidneys of rats in experimental hypothyroidism. The latter was induced by subtotal thyroidectomy (observation periods--60 days), feeding of 6-methylthiouracil (observation periods--100 days), feeding of 6-methylthiouracil to thyroidectomized animals (observation periods--7 to 60 days). Animals of all the three groups displayed morphohistochemical signs of disturbance of acid and neutral polysaccharide metabolism in the vaso-stromal structures of the kidneys and also in the glomeruli. The degree of these changes depended directly on the extent and the duration of a hypothyroid condition. The changes described led to development of sclerosis. Among these changes attention was attracted to deposition of calcium salts in the epithelium, chiefly of the distal tubules.